bluuebunny/crossref_metadata_2025 huggingface dataset:
Characteristics of Women Reporting Cervical Screening
Authors: Parazzini Fabio , Negri Eva , La Vecchia Carlo
Published: April 2018

The characteristics of women reporting cervical cytology screening has been evaluated using data from control subjects collected in the framework of a case-control study on invasive cervical cancer conducted since 1981 in the greater Milan area. A total of 515 women admitted for nonneoplastic, non-gynecologic, nonendocrine-related acute conditions to a network of general and university hospitals were interviewed. The frequency of cervical screening utilization decreased with age: regular screening (≥ 3 lifetime Pap smears) was reported by 46% of women aged 44 years or less, but only 11% of those aged 65 or more. Married women reported about 50% more frequently occasional (1 or 2) and about three times regular (≥ 3) cervical screening than unmarried ones. Parous women were more frequently screened, but no trend emerged with number of births. Similarly number of medical consultations in the year before the interview was associated with an increased number of Pap smears. There was no consistent association between number or recency of Pap smears and smoking, sexual habits or education, but women in low social classes tended to be less frequently screened. Ever contraceptive users (oral contraceptives or barrier methods) reported an increased probability to be screened regularly and within two years before the interview.
A Feasibility Study of High-Dose Cisplatin and 5-Fluorouracil with Glutathione Protection in the Treatment of Advanced Colorectal Cancer
Authors: Cozzaglio Luca , Doci Roberto , Colla Giovanni , Zunino Franco , Casciarri Gino , Gennari Leandro
Published: April 2018

On the basis of previous studies supporting that glutathione (GSH) reduced cisplatin nephrotoxicity we have designed a new regimen in the treatment of advanced colorectal cancer, which included GSH as a modulator of cisplatin-induced toxicity. Eleven untreated patients with measurable metastatic colorectal cancer received 5-fluorouracil (750 mg/m2, daily continuous infusion for days 1-5) and cisplatin (40 mg/m2 1 hour-infusion for days 6-8) given every 4 weeks. Reduced glutathione (2.5 g) was delivered i.v. prior to each cisplatin infusion. Toxicity was minimal and reversible and included nausea/vomiting (11 cases), mild neurotoxicity (4 cases) and leukopenia (2 cases); only 2 patients showed moderate and transient increases of serum creatinine « 2 mg/dl) and BUN. Renal function impairment was also monitored by magnesemia levels and urinary marker enzymes indicating minimal cumulative nephrotoxicity. Out of 10 evaluable patients, only 2 partial responses were observed. The median survival was 9 months (range 5-26). The study was closed, since the preliminary results do not suggest any therapeutic advantage in adding cisplatin to 5-fluorouracil in the present schedule, even using an intensive regimen. Indirect evidence suggests that these disappointing results are not the consequence of interference of GSH on the cytotoxic efficacy of cisplatin. The lack of incidence of severe toxicity of this regimen supports the role of reduced glutathione as a potential protective against cisplatin nephrotoxicity. Although these preliminary results suggest that further studies with the present regimen in this disease are not warranted, in view of its safety this program deserves evaluation in the treatment of neoplastic diseases responsive to 5-fluorouracil/cisplatin.
Prevention of Nausea and Vomiting in Cisplatin-Treated Patients by a Selective 5-Hydroxytryptamine (5-HT3) Receptor Antagonist, ICS 205-930
Authors: Dogliotti Luigi , Faggiuolo Roberto , Berruti Alfredo , Antonacci Rosa Anna , Ortega Cinzia , Lancranjan loanna
Published: April 2018

The results of an open study designed to evaluate the prevention of cisplatin-induced emesis by the specific 5-HT3 receptor antagonist ICS 205-930 are reported. Fifty-four cancer patients, treated with diverse chemotherapy regimens, all including cisplatin (> = 50 mg/m2), received ICS 205-930 for a total of 165 courses. ICS 205-930 (10 mg) was given i.v. immediately before the cisplatin infusion and a second 10-mg dose was given immediately after. In 109 courses (66%) the patients did not have any vomiting episodes. Nausea was absent in 44.8% of courses. More than 3 vomiting episodes occurred only in 17 (10.4%) courses, and severe nausea only in 11 (6.6%). ICS 205-930 was extremely well tolerated. Mild headache occurred during 7 courses (4.2%) in 4 patients, hypotension during 5 courses (3%) in 3 patients and lipothymia in 2 courses (1.2%) in 2 patients. These results suggest that ICS 205-930 is an effective and well tolerated antiemetic drug in patients receiving cisplatin chemotherapy.
In Vitro Chemosensitivity of Newly Diagnosed and Relapsing Acute Non-Lymphoid Leukemia Patients
Authors: Lepri Enrica , Liberati Marina , Portuese Maria Giovanna , Menconi Emma , Santucci Antonella , Barzi Anna
Published: April 2018

We evaluated the in vitro sensitivity of circulating blasts from 25 newly diagnosed and 7 relapsing ANLL patients to drugs employed in vivo for inducing remission. Ten of the 14 newly diagnosed complete responders were in vitro sensitive to cytosine arabinoside and daunorubicin, whereas 10/11 non-responders were resistant to both agents. Although cells from all 7 relapsing patients were in vitro sensitive to the remission inducing agents, only 4 entered complete remission. Even if only indicative, these findings suggest that the poor prognosis of relapsing patients may be due, at least in part, to factors other than drug resistance. Moreover, the chemo-sensitivity test adopted is a better predictor in newly diagnosed than relapsing patients, as indicated by the concordance between in vitro and in vivo results.
The Risk of Breast Cancer Subsequent to Histologic Diagnosis of Benign Intraductal Papilloma Follow-Up Study of 339 Cases
Authors: Ciatto Stefano , Andreoli Claudio , Cirillo Anna , Bonardi Rita , Bianchi Simonetta , Santoro Giuseppe , Farante Gabriel , Magni Andrea , Campa Tiziana , Costa Alberto , Berrino Franco
Published: April 2018

The risk of developing breast cancer was investigated in 339 patients in whom histologically confirmed intraductal papilloma had been surgically removed. Follow-up ranged from 2 to 14 years, (average, 6.62 years). Ten breast cancers were observed, whereas 3 were expected on the basis of age-specific incidence rates drawn from local cancer registries (relative risk = 3.33, 95% confidence interval = 1.60-6.13). No significant difference in the relative risk was observed as far as papilloma type (single or multiple) was concerned. All breast cancers observed occurred in the same breast as the papilloma. Women in whom a benign intraductal papilloma has been excised should be carefully followed since they at are higher risk for ipsilateral breast cancer.
Endocrine Status in 29 Patients Treated by Curative Radiation Therapy for Nasopharyngeal Carcinoma
Authors: Zamboni Carla , Olmi Patrizia , Cellai Enrico , Forti Gianni
Published: April 2018

The basal endocrine status of 29 patients treated with curative radiation therapy for nasopharyngeal carcinoma was assessed; they were disease-free for a minimum of 4 years from the end of treatment. None showed clinical evidence of endocrine disease, and most of them had a substantially normal hormonal blood pattern. A slightly elevated TSH value, suggesting subclinical primary hypothyroidism, was found only in two male patients, which could be ascribed to the radiotherapeutic treatment of the neck. Although we cannot exclude more subtle alterations of hypothalamic-pituitary function, the percentage incidence of endocrine impairment in our patients seems lower than previously reported by other authors.
Establishment and Characterization of a Human Prostatic Carcinoma Cell Strain Obtained from Exfoliated Tumor Cells after Prostatic Massage
Authors: Bologna Mauro , Festuccia Claudio , Vicentini Carlo , Muzi Paola , Biordi Leda , De Nicola Giuliano , Ventura Terenzio
Published: April 2018

During a control campaign connected to our main program on early diagnosis of prostatic carcinoma through tissue culture of prostatic fluid samples obtained after prostatic massage (M. Bologna et al., Eur. Urol., 14, 474-476, 1988), we isolated and characterized a human prostatic carcinoma cell strain from a 58-year-old patient with a grade III prostatic carcinoma. The epithelial cell strain, named PMU-23, has been passaged In vitro for 31 subculture cycles during a period of approximately 8 months, after which cell proliferation slowed down irreversibly. The isolation of this cell strain constitutes a renewed confirmation of the validity of our method for the early diagnosis of prostatic carcinoma and demonstrates some intermediate features in the progression of prostatic tumors. In addition, the study of limited-lifespan tumor cell strains in culture may extend the knowledge on prostatic cell biology, particularly toward the Identification of intermediate steps of tumor progression, for a better approach of tumor therapy and prevention of metastatic spread.
N-MYC and C-MYC Oncogenes Amplification in Medulloblastomas. Evidence of Particularly Aggressive Behavior of a Tumor with C-MYC Amplification
Authors: Badiali Manuela , Pession Annalisa , Basso Giuseppe , Andreini Luana , Rigobello Luca , Galassi Ercole , Giangaspero Felice
Published: April 2018

N-myc and c-myc amplification was investigated in 27 medulloblastomas. DNA was extracted from 19 formalin fixed and paraffin embedded tumors and from fresh frozen tumor tissue in 8 other cases. The results showed no evidence of amplification of N-myc oncogene and only 1 case had a 27 fold amplification of c-myc. Cytogenetically, this neoplasm presented numerous double minute chromosomes (DMs). Moreover, it had an unusual rapidly aggressive course with massive cerebrospinal fluid dissemination unresponsive to intrathecal chemotherapy. Our results indicate a low incidence of N-myc and c-myc gene amplification in medulloblastomas, suggesting that the oncogenic mechanism in these neoplasms is not closely related to DNA gene amplification. C-myc amplification, although not frequently observed, may however provide a growth advantage for medulloblastoma cells in vivo, favoring their rapid dissemination. Medulloblastomas with c-myc activation may represent a subgroup of tumors with a more aggressive behavior.
HLA-Dr Expression by Tumor Cells Compared with Survival in High Grade Astrocytomas
Authors: Rossi Marco L. , Jones Nigel R. , Karr George F. , Esiri Margaret M. , Havas Laszlo , Coakham Hugh B.
Published: April 2018

Frozen samples from 78 high grade astrocytomas were reacted with a monoclonal antibody directed against HLA-Dr invariant chain. Survival data was obtained for all 78 cases. HLA-Dr was expressed by a proportion of tumor cells in 65/78 (83 %). Comparison of the survival of positive and negative cases showed that the difference was not statistically significant (p = 0.4). The relevance of the finding is discussed in the context of the immunoreaction to brain tumors.
Treatment Patterns in Elderly Patients (≥70 YEARS) with Breast Carcinoma. A Retrospective Study of the Gruppo Oncologico Clinico Cooperativo del Nord-est (Goccne)
Authors: Crivellali Diana , Galligioni Enzo , Foladore Silva , Errante Domenico , Conte Giovanni , Nascimben Ottorino , Amichetti Maurizio , Spagnolli Paolo , Recaldin Enrico , Grandinetti Antonio , Palazzi Mario , Azzoni Paolo , Tirelli Umberto , Monfardini Silvio
Published: April 2018

The pattern of treatment used in elderly women affected by breast carcinoma was evaluated in a retrospective study by the North-East Clinical Cooperative Group in Italy (GOCCNE). Six divisions were involved in the study. The medical records of 115 elderly women were reviewed; the women's median age was 75 years (range, 70-93). Surgery was used in 70/72 operable patients (97 %), although limited surgery plus radiotherapy was used in only 7.5 %. Most stage II patients were treated with adjuvant tamoxifen, as were younger postmenopausal patients, according to the guidelines of the Bethesda Consensus Meeting. Comorbid conditions are of particular concern in therapy planning, considering that more stage III patients died of competing causes than for disease progression. The role of chemotherapy was very marginal.
Medical Castration with Zoladex: A Conservative Approach to Premenopausal Breast Cancer
Authors: Brambilla Cristina , Escobedo Agustin , Artioli Rossana , Lechuga Maria José , Motta Marcella , Bonadonna Gianni
Published: April 2018

For almost a century surgical castration represented the initial standard therapy for metastatic breast cancer in premenopausal women with hormone dependent tumors. Today the suppression of ovarian function can also be obtained by the administration of supraphysiologic doses of luteinizing hormone releasing hormone (LHRH) agonists. From April 1987 to February 1989, 23 premenopausal patients with advanced breast cancer (median age 39 years, range 28-52, ER positive 20, unknown 3; prior chemotherapy 17) were treated with the LHRH agonist goserelin depot (Zoladex) at the dose of 3.6 mg. every 4 weeks. Twenty-two patients were evaluable. Serum levels of 17 β estradiol, progesterone, FSH and LH were suppressed by goserelin and fell to postmenopausal values within 8 weeks of therapy in 77 % of cases. Complete response (CR) plus partial response (PR) was documented in 7 of 22 (32 %) and occurred in all major sites of disease. Five patients achieved CR (soft tissue 3, viscera 2). Response rate was higher in patients not previously treated with chemotherapy (4/6). In the present series, all responses were seen in women > 35 years old, regularly menstruating at the start of treatment. Time to progression for the entire case series was 22 weeks and for responders 64 weeks. Oophorectomy was performed after disease progression in four patients without success. Goserelin was well tolerated. Local cutaneous dyschromia occurred in 45 % and hot flushes in 82 %. Treatment efficacy of goserelin is comparable to that of oophorectomy, without the psychological trauma and the morbidity related to surgical castration.
Chinese Flap in Head and Neck Surgery
Authors: Ahumada Juán Carlos , Rancati Alberto , Mezzadri Norberto , Falco Jorge , Montesinos Manuel , Montoreano Isidoro , Sarra Luis Domingo , Curutchet Pablo
Published: April 2018

Twenty patients underwent resections for head and neck cancer. The reconstructive procedure used was the free forearm flap with microsurgical technique on 22 occasions. The free forearm flap was used in its simple or composite form, with double or manifold islands, with a segment of the radius for mandible reconstruction or with two islands Joined solely by the vascular pedicle, constituting what the authors call « tandem flap », with excellent results. The procedure does not replace conventional ones, but the authors believe it should be regarded as one of the choice flaps by surgeons dedicated to this special field.
Karyotype Studies of Patients with Gonadal Tumors
Authors: De Madhusnata , Talukder Geeta , Sharma Archana , Roy Samir , De Subhash
Published: April 2018

Chromosomes from the peripheral blood of 10 patients with gonadal tumors were studied to detect any inherent chromosomal defect. Aneuploidy, breakages and loss of chromosome X were observed. In all cases the karyotype was compatible with the phenotype.
Long Term Survival in Metastatic Nephroblastoma. A Case Report
Authors: Angulo Javier C. , Lopez José I. , Indiano José M. , Flores Nicolas
Published: April 2018

We describe a case of metastatic nephroblastoma presenting as renal rupture. Histology was « favorable ». Lung metastases were discovered early during follow-up. Radiotherapy and surgical excision were therefore combined with intensive chemotherapy. Ten years later, the patient is symptom-free.
Randomized Trial of Primary School Education against Smoking
Authors: Gatta Gemma , Malvezzi Illaria , Sant Milena , Micheli Andrea , Panico Salvatore , Ravasi Gianni , Berrino Franco
Published: April 2018

Sirice 1974 an anti-smoking campaign consisting of a one-day educational intervention has been carried out in primary schools in Milan by the Italian League against Cancer (Milan Division). All but two of the 165 schools were randomized to evaluate the intervention effect. A total of 8549 children aged 9-10 were allocated to the intervention group and 8897 to the control group. Four years later a self-administered questionnaire was distributed in order to investigate the children's smoking habits. The proportion of smokers was 8.05 % and 8.72 % (p = 0.23) respectively for the intervention and control groups. It was concluded that sporadic educational Intervention carried out during primary school years has little or no impact in preventing cigarette smoking in teenagers.
Daily Low-dose Carboplatin and Standard Radiotherapy in Unresectable Head and Neck and Lung Cancers: A Pilot Study
Authors: Orecchia Roberto , Urgesi Alessandro , Sacco Marilena , Gabriele Pietro , Vasario Ezio , Ricardi Umberto , Gribaudo Sergio , Sola Barbara , Sannazzari Gian Luca
Published: April 2018

A total of 14 patients with locally advanced and unresectable head and neck (SCCHN) or non small cell lung cancer were treated with a definitive course of radiation therapy with conventional fractionation and 30 mg/m2 carboplatin (CBDCA) given daily as an i.v. infusion during the 1st, 3rd, 5th and 7th weeks of the combined treatment. The planned tumor dose of at least 7000 cGy was reached in all SCCHN patients except 1 (6600 cGy). The 2 NSCLC patients received 6320 and 5980 cGy, respectively. The planned total CBDCA-dose of 600 mg/m2 was administered in all patients. No treatment delays were required in 10 patients. Interruptions for severe mucositis or myelosuppression occurred in 4 patients (28.6 %), but in no case did the delay exceed 1 week. Complete response was obtained in 8 patients (57.1 %); 7 of the 12 with SCCHN and 1 of the 2 with NSCLC. The other 6 patients achieved a partial response. Granulocytopenia of WHO grade 3 occurred in 1 patient; apart from vomiting and mucositis, toxicities above grade 2 were not observed.
Liposarcoma in a Child: A Case Report
Authors: Guarino Marcello , Tricomi Paolo , Cristofori Enrico , Colpani Lorenzo , Squillaci Salvatore , Micoli Giorgio
Published: April 2018

Liposarcoma is a soft tissue tumor usually observed in adults. Although occasional cases have been reported in childhood, it is virtually unknown in infants and small children. Our experience documents a case of liposarcoma in a 6-year-old girl, an extremely rare occurrence in this age-group. The patient underwent wide local excision followed by chemotherapy. Histologically, the tumor was a myxoid type. Differential diagnosis and problems concerning prognosis and therapy of this tumor in children are discussed.
Malignant Melanoma of the Nipple: A Case Studied with Radiolabeled Monoclonal Antibody
Authors: D'Aiuto Giuseppe , Del Vecchio Silvana , Mansi Luigi , D'Aprile Modesto , Botti Gerardo , Salvatore Marco
Published: April 2018

We describe a case of histologically confirmed malignant melanoma of the nipple. The rare occurrence of these lesions accounts for the relative lack of criteria for standard surgical treatment. After a conventional workup including mammography, chest X ray, bone scan, liver ultrasonography and cytologic smear of the lesion, we used specific radiolabeled monoclonal antibody and external photoscanning to differentiate melanoma from Paget's disease. The patient underwent wide local excision of the lesion and axillary node dissection, and tumor control is optimal since she has no evidence of disease after 5 years of follow-up.
Breast Cancer Estrogen and Progesterone Receptors: Associations with Patients' Clinical and Epidemiologic Characteristics
Authors:   G.I.V.I.O. (Interdisciplinary Group for Cancer Care Evaluation), Italy, Fossati R. , Alexanian A.A. , Liberati A. , Marsoni S. , Monferroni N. , Nicolucci A. , Parazzini F. , Giganti M. , Piffanelli A. , Ghezzi P. , Magnanini S. , Rinaldini M. , Berardi F. , Di Biagio G. , Testore F. , Tavoni N. , Palmieri D. , Schittulli F. , Pedicini T. , Fumagalli M. , Gritti G. , Braga M. , Marini G. , Zamboni A. , Cosentino D. , Epifani C. , Scognamiglio G. , Perroni D. , Peradotto F. , Saba V. , Indelli M. , Santini A. , Isa L. , Scapaticci R. , Aitini E. , Gavazzini G. , Smerieri F. , Lomonaco I. , Nascimben O. , Locatelli E. , Monti M. , Ghislandi E. , Gottardi O. , Majno M. , Poma C. , Pluchinotta A. , Armaroli L. , Confalonieri C. , Viola P. , Sisto R. , Buda F. , Plaino R. , Galletto L. , Trolli B. , Biasio M. , Rolfo A. , Vaudano G. , Giolito M.R. , Scoletta G. , Ambrosini G. , Busana L. , Molteni M. , Richetti A.
Published: April 2018

A total of 1095 patients with operable breast cancer and en-rolled in a randomized clinical trial were analysed for estrogen (ER) and progesterone (PgR) receptor content of their primary tumor, and the relationships between steroid receptor status and several epidemiologic characteristics were studied. The proportion of ER+ and median ER levels increased with age: compared to women younger than 40, those aged 66 or more were approximately three times more likely to have an ER+ tumor (OR = 3.0, 95% C.I. = 1.6–5.7). This difference tended to be more marked after comparison between patients with ER > 100 fmol/mg protein and ER- within the same age groups: OR = 7.04, 95 % C.I. = 2.89–17.12. No association emerged between age and PgR. ER status and concentrations were independent of menopausal status after adjustment for age, whereas the proportion of PgR+ and PgR levels were significantly lower in postmenopausal patients of the same age. The distribution of ER and PgR profiles was similar in relation to family history of breast cancer, reproductive events and other selected epidemiologic characteristics of the patients.
A Pilot Study of Mitomycin, Ifosfamide and Cisplatin as Outpatient Combination Chemotherapy for Advanced Non-Small Cell Lung Cancer
Authors: Mariani Gabriella Lucia , Pennucci Maria Cristina , Addamo Gianfranco , Venturini Marco , Ardizzoni Andrea , Rosso Riccardo
Published: April 2018

Twenty-one patients with advanced stage, non-small-cell lung carcinoma were treated with a chemotherapy regimen including: mitomycin (6 mg/m2), ifosfamide (3 g/m2), cisplatin (80 mg/m2). The regimen was administered on an outpatient basis. Two patients were lost to follow-up. Among the 29 patients evaluable for response we registered a response rate of 36.8 %; 36.8% of patients had stable disease, and 15.7 % progressed during treatment. Median duration was 8.7 months and median survival was 11 months. Toxicity was low and easily manageable on an outpatient basis.
Multicentric Gliomas. Report of Seven Cases
Authors: Salvati Maurizio , Oppido Piero Andrea , Artizzu Spartaco , Fiorenza Fabio , Puzzilli Fabrizio , Orlando Epimenio Ramundo
Published: April 2018

Multifocal gliomas fall into four main categories: diffuse, multiple, multicentric and multiple-organ. Multicentric gliomas are uncommon lesions of the central nervous system. Even more so are multicentric gliomas lying both above and below the tentorium (16 cases to date, as far we know). We report a clinical series of 7 cases, including 3 supra-Infratentorial tumors. The distinctive features of multicentric gliomas are mainly the absence of gross or microscopic connections and absence of seeding along easily accessible routes like the cerebrospinal fluid pathways or the median commissures. We consider the pathogenetic hypotheses and problems of diagnosis, especially differential from other multifocal diseases of the central nervous system.
A Case of T-Cell Lymphoma Accompanying Marked Eosinophilia, Chronic Eosinophilic Pneumonia and Eosinophilic Pleural Effusion. A Case Report
Authors: Kawasaki Akira , Mizushima Yutaka , Matsui Shoko , Hoshino Kiyoshi , Yano Saburo , Kitagawa Masanobu
Published: April 2018

A 57-year-old woman was admitted to our hospital for lumbago, weight loss and weakness of her right lower extremity. Leukocytosis was evident with marked eosinophilia (65.5 % = 46,000/mm3), and the chest roentgenogram showed diffuse reticular shadows throughout both lung fields and a left pleural effusion. The pleural effusion contained 22.4 % eosinophils with no immature cells. Biopsy of a thumb-sized mass on the chest wall revealed a T-cell lymphoma of pleomorphic type. The diffuse pulmonary shadow was diagnosed as chronic eosinophilic pneumonia by autopsy. This was a relatively rare case of T-cell lymphoma, in which an eosinophilic pneumonia and eosinophilic pleural effusion were observed.
The First Breast Cancer Screening Program in Southern Italy: Preliminary Results from Three Municipalities of the Naples Province
Authors: De Placido Sabino , Nuzzo Francesco , Perrone Francesco , Carlomagno Chiara , Noviello Arturo , Delrio Paolo , Di Palma Ester , Pini Maria Teresa , Cerato Pier Luigi , Bianco Cataldo , Rivellini Maria , Petrella Giuseppe , Gallo Ciro , Sodano Antonio , Bianco Angelo Raffaele
Published: April 2018

Aims and Background

It has been demonstrated that breast cancer screening induces a 30% reduction of specific mortality. In May 1990, we started a pilot screening program to assess the feasibility of carrying out such a program in Campania (southern Italy). Herein we report the results of the first round of the program from three municipalities (Giugliano, Mugnano and Qualiano) that lie within the local health district no. 23, close to the city of Naples.

Methods

Women between the ages of 50 and 69 years were sent a personalized letter inviting them to attend the screening test; those not responding were sent a second invitation. The screening test consisted of clinical examination followed by two-view mammography. Second–level diagnostic tools were sonography, fine needle aspiration (manual, echo-guided and stereotaxic) and surgical biopsy.

Results

Out of 5,732 women invited for the first round, 1,813 (31.6%) attended the screening. Attendance rate was higher among younger women. Ninety-one women were positive at the screening test and underwent further examination (recall rate, 5.0%). Among them, 19 had surgical biopsy (biopsy rate, 1.0%) that led to breast cancer diagnosis in 11 cases. The benign/malignant biopsy rate was 0.73. Detection rate was 6.07 × 1,000 screened women and varied among age categories, increasing within the 60–69 subgroup; detection rate/expected incidence ratio in the overall group was 4.5 and also increased within the older age category. Seven out of 11 cancers were at UICC stage 0-I. Among 327 self-referring women, 38 were positive (recall rate, 11.6%), and 14 underwent biopsy (biopsy rate, 4.3%), which showed cancer in 7 cases (benign/malignant biopsy rate, 1.0). In addition, 2 inflammatory cancers were diagnosed without surgical biopsy. Thus 9 cancer cases were detected in this group. Self-referring women differed from responding women in that they had a higher frequency of symptoms or familiar history of cancer, and a higher educational level and awareness of preventive medicine. Clinical examination added no diagnostic advantage in the responding group but did not significantly worsen the recall rate. In the self-referring group, one case of inflammatory cancer was missed by mammography and diagnosed by clinical examination.

Conclusion

The early results (recall rate = 5%, detection rate/expected incidence ratio = 4.5, benign/malignant biopsy rate = 0.73, advanced cancers = 36.4%) are encouraging and indicate the validity of the program. Strategies to improve attendance rate are planned.
Third-Line Chemotherapy with Mitomycin C and Lonidamine in Advanced Bladder Cancer. Partial Response in a Patient with Skin and Lung Metastases
Authors: Berruti Alfredo , Gerbino Alex , Faggiuolo Roberto , Rovero Enrica , Dogliotti Luigi
Published: April 2018

Skin metastases from transitional cell carcinoma are quite rare. The present case report describes the results of a combination of mitomycin C and lonidamine administered as third-line chemotherapy in a patient with pulmonary and skin involvement from bladder cancer. The partial response obtained suggests that further testing should be carried out on the activity of this association in a second-line approach.
Carbon Dioxide Digital Subtraction Angiography in Oncological-Interventional Radiology
Authors: Garbagnati Francesco , Spreafico Carlo , Marchianò Alfonso , Frigerio Laura Francesca , Patelli Gianluigi , Gervasoni Maria , Giovannardi Giulia , Damascelli Bruno
Published: April 2018

Aims and background

The aim of this work is to demonstrate the usefulness of carbon dioxide, used as contrast agent, in special indications in vascular interventional oncological procedures.

Methods

We studied 40 patients with digital subtraction angiography enhanced with CO2 as a contrast agent. At the same time we utilized also, in all cases, jodinated contrast agent to evaluate the different opacification gradient, the different viscosity range and the different perfusion.

Results

The low viscosity of CO2 allows demonstration of the presence of even minimal blood losses in gastrointestinal tumors and enhances arteriovenous shunts in hepatocellular carcinoma. Carbon dioxide can also be employed to assess the patency of small-sized catheters for chemotherapy infusion which do not allow easy injection of the traditional iodinated contrast agents characterized by high viscosity.

Conclusion

Carboangiographic study combined to digital subtraction angiography can clear some diagnostic problems and is further method to assess the outcome of angiographic interventional procedures in oncology.
Adjuvant Hormone Therapy after Radical Prostatectomy: Indications and Results
Authors: Ditonno Pasquale , Battaglia Michele , Selvaggi Francesco Paolo
Published: April 2018

Despite recent advances in staging modalities, nearly 30–40% of patients undergoing radical prostatectomy for clinically localized prostate cancer have residual disease. In these cases, one or more of the following conditions may be present: extracapsular disease, positive margins, invasion of the seminal vesicles, lymph node metastases or the postoperative persistence of PSA values above the biological threshold. The optimal management for residual prostate cancer remains controversial and in this setting adjuvant therapy could be appropriate. In the present review we examine the conditions in which hormonal adjuvant therapy can be indicated and the results available from retrospective or non-randomized studies. From the data in the literature and in the absence of randomized prospective studies, prudent conclusions could be drawn on the efficacy of adjuvant hormonal therapy. In cases of small volume, low grade (Gleason score «7) prostate cancer in stage C or D1, radical surgery coupled with adjuvant hormonal therapy leads to survival rates in stage C similar to those in the intraprostatic stage, and in stage D1 with minimal lymph involvement, seems to delay clinical development of metastases. Finally, the quality of life associated with adjuvant therapy and the drug regimens available for this therapy are reviewed.
The Potential Role of Tomudex in the Treatment of Advanced Colorectal Cancer
Authors: Sobrero Alberto F.
Published: April 2018

Aims and Background

The quinazoline folate analog thymidylate synthase inhibitor, Tomudex, is about to enter the Italian pharmaceutical market. Its place among the therapeutic options for advanced colorectal cancer is discussed.

Methods

The pros and cons of currently available chemotherapeutic regimens are briefly described with special attention to patient's and tumor's determinants of treatment outcome. The mechanism of action and the results of phase I, II and III studies of Tomudex are reviewed.

Results

Not all patients need to be treated. Guidelines are given in this respect. Tomudex at the dose of 3 mg/m2 given i.v. every three weeks has antitumor activity similar to that of currently available regimens, with a favorable toxicity profile.

Conclusions

Current research approaches are unlikely to dramatically improve the treatment outcome of this disease in the near future. What can reasonably be expected is less toxicity and more convenient routes and schedules of drug administration that may translate into better quality of life for our patients. Tomudex has been devised along these lines.
Unusual Breast Lumps
Authors: Bartoli Cesare , Bono Aldo , Di Palma Silvana , Pilotti Silvana , Pampiglione Silvio
Published: April 2018

Two new Italian cases of breast infection by Dirofilaria Repens are presented. In one case the correct diagnosis was clinically achieved through needle aspiration. This case is documented by a surprising macrophotography.
Frequency of Thyroid Carcinoma in a Recent Series of 539 Consecutive Thyroidectomies for Multinodular Goiter
Authors: Pelizzo Maria Rosa , Bernante Paolo , Toniato Antonio , Fassina Ambrogio
Published: April 2018

Aims and background

The aim of the study was to analyze the frequency of thyroid carcinoma in a consecutive series of 539 thyroidectomies for multinodular goiter (MNG) and to assess the influence of sex and age as cancer risk factors.

Methods

In a 2-year period, 539 patients underwent subtotal or total thyroidectomy for MNG at the Institute of General Surgery, University of Padova, Padova, Italy: 455 were females and 84 males (F/M = 5.5/1); mean age was 46 years (min. 17, max 78). Only 17 patients (3.1%) (16 females and 1 male) were aged 21 years or less.

Results

A malignancy was found in 41 patients: 38 females and 3 males; 39 older and 2 younger than 21 years. The frequency of cancer in MNG was 7.6%: 8.3% in females and 3.6% in males; 7.5% in patients older than 21 and 11.7% under 21 years.

Conclusions

The combination of MNG and carcinoma should always be carefully considered but not overemphasized, and the policy of surgically treating all patients with MNG is not justified. Sex and age cannot be considered as factors of a higher risk of cancer.
Lack of Prognostic Value of p53 Protein Expression in Node-Negative Breast Cancer
Authors: Bianchi Simonetta , Calzolari Anna , Vezzosi Vania , Zampi Giancarlo , Cardona Gaetano , Cataliotti Luigi , Bonardi Rita , Ciatto Stefano
Published: April 2018

Aims and background

The association of p53 protein accumulation and prognosis in node-negative breast cancer patients has been alternately demonstrated and denied in literature reports, and opinions on the use of p53 expression as an indicator of high risk of recurrence and as a guide for adjuvant therapy are controversial.

Study design

The association of p53 protein accumulation with prognosis was retrospectively evaluated in a series of 221 node-negative breast cancer patients treated with surgery alone and followed up for a minimum of 10 years. p53 accumulation was determined by immunohistochemistry on archive material, and classified into four grades of increasing immunostaining.

Results

No association was observed between p53 and age or pT category, whereas a significant association with nuclear grade was found (P = 0.0014). Univariate and multivariate analysis of 10-yr disease-free and overall survival showed a significant and independent prognostic association for tumor size (pT category) and nuclear grading but not for p53 expression, whatever grade grouping was used.

Conclusions

We did not find any evidence supporting the use of p53 immunostaining in current practice as an independent prognostic indicator or as a discriminant factor for adjuvant treatment of node-negative breast cancer patients.
The Use of Mab 1977 Monoclonal Antibody for the Immunohistochemical Localization of β1 Integrins in Paraffin-Embedded Human Kidney
Authors: Bernardini Nunzia , Bianchi Francesco , Lupetti Mario , Dolfi Amelio
Published: April 2018

Aims and background

Integrins are widely known cell membrane receptors for extracellular matrix molecules. The β1 integrin subgroup is mainly expressed by kidney cells; immunolocalization of these molecules is usually carried out on cryostatic sections. A commercial monoclonal antibody directed against the human β1 integrin was tested in order to design a method for the detection of this antigen in formalin-fixed, paraffin-embedded human kidney tissue.

Methods

Specimens obtained from nephrectomies were fixed with 10% formalin and embedded in paraffin. Three different detection protocols were applied after incubation with the anti-human β1 integrin monoclonal antibody (MAB 1977): 1) immunoperoxidase with labeled streptavidin biotin (LSAB), using biotinylated secondary antibodies, peroxidase-labeled biotin-streptavidin, and 3, 3′-diaminobenzidine tetra-hydrochloride (DAB) as the revealing system; 2) immunoperoxidase with tyramide signal amplification (TSA), using biotinylated secondary antibodies, streptavidin-peroxidase, tyramide, streptavidin-peroxidase again and DAB; 3) indirect immunofluorescence with fluorescein-labeled anti-mouse immunoglobulins.

Results

The best results were obtained with the LSAB detection protocol preceded by a predetection step with proteinase k. Proteinase k pretreatment did not significantly damage the tissue morphology and successfully unmasked 31 integrin antigens. Nonspecific background staining was reduced by a blocking step with swine serum. Similar results were obtained with the TSA detection method; however, although lower concentrations of anti-β1 integrin immunoglobulins and of secondary biotinylated antibody were employed, there was more undesired background staining than with the LSAB protocol.

Conclusions

The method reported and discussed here may represent a valid tool for research and diagnostic applications based upon detection of β1 integrin in paraffin-embedded human tissues.
Endoductal Tissue Sampling of Biliary Strictures through Endoscopic Retrograde Cholangiopan Creatography (ERCP)
Authors: Pugliese Vittorio , Antonelli Giovanna , Vincenti Maura , Gatteschi Beatrice
Published: April 2018

Aim and background

Pathological proof of malignant in biliary strictures is useful in the preoperative setting as it helps define therapeutic planning and prognosis, and reduces the length of the subsequent surgical intervention. However, it is difficult to obtain. The aim of this study was to evaluate the yield of histological and cytological examination of endobiliary samples obtained during endoscopic retrograde cholangiopancreatography (ERCP).

Methods

Endobiliary forceps biopsy and brush cytology were performed during ERCP examination in 52 consecutive patients, 36 with malignant and 16 with benign strictures.

Results

Histology and cytology turned out to have the same sensitivity (53%). The gain in sensitivity achieved by combining the two techniques was limited, reaching a value of 61%. The specificity, however, was 100% for both methods. Most of the few complications observed were due to sphincterotomy and subsided spontaneously or with medical treatment. However, one patient experienced a serious complication and chose to be treated by surgical intervention. The complication was caused by forceps biopsy.

Conclusions

This study shows that 1) sampling of biliary strictures during ERCP is the primary approach to tissue diagnosis; 2) brush cytology alone is sufficient in clinical practice; 3) forceps biopsy must always be used to sample intra-ampullary strictures but should be considered as a secondary step to sample strictures located more proximally, in the bile ducts, if previous cytology was negative.
Antineuronal Antibody in a Patient with Neuroblastoma and Opsoclonus-Myoclonus-Ataxia: A Case Report
Authors: Salmaggi Andrea , Nemni Raffaello , Pozzi Annalisa , Silvani Antonio , Forno Maria Grazia , Luksch Roberto , Confalonieri Paolo , Boiardi Amerigo
Published: April 2018

We describe the case of a patient with neuroblastoma and opsoclonus-myoclonus-ataxia displaying serum and CSF anti-Hu antibodies that were able to recognize antigens of the patient's own tumor.
Multiple Tumor Case: Report and Analysis of an Autopsy Case
Authors: Tornóczky Tamás , Szuhai Károly
Published: April 2018

An interesting multiple tumor case is described in which 4 different kinds of tumors were diagnosed in the same patient at autopsy and histopathologic examination. The tumors were the following: 1) prolactinoma of the anterior pituitary lobe; 2) basal cell carcinoma of the nose; 3) adenocarcinoma of the colon sigmoideum; 4) multiple oncocytomas (oncocytomatosis) in the kidneys. Immunohistochemical investigation for p53 revealed a strong intranuclear positivity in the colonic carcinoma cells as a result of the overexpression of a possible mutant type of the protein. The other 3 tumors were negative with the p53-specific DO-7 antibody, therefore, no point mutation was thought to be present in the p53 gene of the tumor cells. The immunohistochemical and anamnestic data suggested that this is not a hereditary syndrome, and there is no common pathogenesis of these tumors. Its rarity is interesting in our case because of the coincidence of 4 different unrelated tumors and the absence of anamnestic data for familial accumulation or predisposition for multiple tumors.
Radiation-Induced Sarcoma following Curative Radiotherapy for Testicular Seminoma: Case Report and Brief Review of the Literature
Authors: Stein Moshe E. , Leviov Michelle , Drumea Keren , Goralnik Ludmilla , Miselevich Innes , Kuten Abraham
Published: April 2018

We report a case of radiation-induced retroperitoneal leiomyosarcoma which developed 37 years after the patient received radiation therapy for testicular seminoma. The sarcoma originated within the para-aortic field, extensively involving neighboring organs, soft tissue and muscle tissues, and could be only partially resected. The absolute number of these secondary sarcomas is low, but the risk of developing such neoplasms calls for awareness in the long-term follow-up of cured seminoma patients.
Amianthoid Myofibroblastoma of the Soft Tissues
Authors: Corsi Alessandro , Camassei Francesca Diomedi , Bosman Cesare
Published: April 2018

Myofibroblastoma (MF) is an uncommon, usually benign, mesenchymal tumor infrequently described in soft tissues. We report here on the clinicopathologic findings of a soft tissue MF (STMF) presenting in the neck of a 90-year-old man as a slowly growing and non-painful nodule, 4 cm in greatest diameter. Histology revealed a circumscribed lesion constituted of monomorphous bipolar spindle cells arranged in swirling fascicles with intervening broad bands of hyalinized collagen and well formed “amianthoid” fibers. Immunohistochemistry showed the spindle cells to be immunoreactive for vimentin, smooth muscle actin and muscle specific actin and, focally, for desmin; im-munostaining for cytokeratin, epithelial membrane antigen, S-100 protein, factor VIII-related antigen, and CD34 was negative. Based on the present case and on those previously reported in the literature, STMF is characterized by: 1) exclusive incidence in the male sex; 2) variable immunoreactivity of the neoplastic cells for desmin, probably reflecting an origin from a peculiar subset of myofibroblasts, or, alternatively, a further myoid differentiation; 3) variable abundance of (hyalinized) collagen; 4) presence of amianthoid fibers. The combination of desmin immunoreactivity, frequently observed in MF of the breast, and amianthoid fibers, the main feature of MF of the lymph nodes, has never been observed in soft tissue MF. It is important to recognize STMF as a specific clinicopathologic entity to avoid confusion with other types of spindle cell proliferation and to differentiate it from other types of myofibromatosis.
Percutaneous Intraductal Sampling for Cyto-histologic Diagnosis of Biliary Duct Strictures
Authors: Cozzi Guido , Alasio Loredana , Civelli Enrico , Colnago Maria Fides , Salvetti Monica , Pilotti Silvana , Rilke Franco , Severini Aldo
Published: April 2018

Background

Percutaneous transhepatic biliary drainage (PTBD) allows ductal material to be collected for cyto-histologic examination. We evaluated the data from a large series of patients with a PTBD in whom endobiliary cyto-histologic sampling techniques were employed in order to define a strategy for their use in the diagnostic work-up.

Patients and Methods

Ductal samples for cyto-histologic examination were obtained from 409 consecutive patients with a PTBD for stenosing lesions of the biliary tree. Bile aspirate cytology was performed for all patients and ductal biopsy specimens were obtained, generally after negative cytology, from 49 of them (11.9%), all candidates for a therapeutic procedure. The cyto-histologic results of intraductal sampling were compared with pathologic surgical data in 210 patients and with clinical-radiologic follow-up in 199.

Results

Overall, 22 out of the 409 patients had a final diagnosis of benign stenosis and 177 had samples positive for neoplastic disease. The sensitivity of bile cytology was 43.8% while ductal biopsies showed a sensitivity of 60.4%. The combination of the two sampling techniques achieved a sensitivity of 65.1%. For both sampling methods the specificity was 100%. Hilar metastases from neoplastic lesions of the GI tract and primary lesions of the biliary ducts showed the highest sensitivity.

Conclusion

Cyto-histologic assessment of stenosing lesions of the biliary ducts is mandatory when highly sophisticated interventions (e.g. wide hepatic resection or liver transplantation) or non-surgical treatments are envisaged. The collection of cyto-histologic samples from bile ducts, in patients with a percutaneous bile drainage, is an easy, safe and valuable method to obtain the diagnosis. In view of the absence of false positive results in our series and in others, intraductal biopsy serves no purpose when positive exfoliative cytology is positive for malignancy. In the presence of negative cytology it is felt that an intraductal biopsy should be mandatory when the choice of a therapeutic program depends on the result of the cyto-histologic diagnosis.
Risk of Colorectal Cancer following Colonoscopic Polypectomy
Authors: Bertario Lucio , Russo Antonio , Sala Paola , Pizzetti Paolo , Ballardini Giovanni , Andreola Salvatore , Spinelli Pasquale
Published: April 2018

Aims and Background

To follow a cohort of patients who had undergone polypectomies in order to assess the overall risk of subsequent colorectal cancer in relation with various adenomas characteristics.

Methods

A total of 1,063 patients with adenomatous polyps of the large intestine were treated between 1979 and 1996 at the National Cancer Institute of Milan, during a screening program for colorectal carcinoma. Data on patients who had undergone colonoscopies were collected prospectively. The relation between colorectal cancer and adenomas characteristics was assessed by computing the hazard ratio (HR) values and corresponding confidence intervals (95% CI), according to Cox.

Results

Of the 1,063 patients who met the eligibility requirements, 672 had single adenomas (63.2%) and 391 had multiple adenomas (36.8%). Histological examination revealed 743 cases of tubular adenoma, 196 cases of tubulo-villous adenoma, and 96 cases of villous adenoma. High-grade dysplasia was found in 3.1% of the cases. During the 8,906 persons/year of follow-up, adenocarcinomas of the large bowel developed in 11 patients. Several adenomas’ characteristics at index polypectomy were significant predictors of colorectal cancer occurrence. In univariate analysis the risk of colon cancer was significantly related with multiple adenomas (HR 4.2, 95% CI 1.1-6.5), high-grade dysplasia adenomas (HR 10.0, 95% CI 2.6-38.1) and with adenomas larger than 2 cm (HR 5.0, 95% CI 1.2-20.4). A multivariate stepwise procedure confirmed that the presence of multiple adenomas and presence of high-grade dysplasia are the most important predictors of carcinomas. Hazard ratios for colorectal cancer occurrence, from multivariate Cox's model, were 5.1 (95% CI 1.2-19.9) for multiple compared to single adenomas, and 13.0 (95% CI 3.6-50.7) for adenomas with high-grade dysplasia compared to those with low-grade dysplasia.

Conclusions

High-grade dysplasia, number and size of adenomas were confirmed as the major cancer predictors. Based on this conclusion, a subgroup of patients, who may benefit from intensive surveillance colonoscopy, can be identifiable.