bluuebunny/crossref_metadata_2025 huggingface dataset:
Gastric Cancer Mortality Trends in Tuscany, Italy, 1971–2004
Authors: Gorini Giuseppe , Giovannetti Lucia , Masala Giovanna , Chellini Elisabetta , Martini Andrea , Mallone Sandra , Costantini Adele Seniori
Published: February 2018

Aims, Background, and Methods

In Tuscany, Italy, gastric cancer mortality has been decreasing since 1950, although with relevant geographical variability across the region. In Eastern Tuscan areas close to the mountains (high risk areas), gastric cancer mortality has been and is still significantly higher than that recorded in Western coastal areas and in the city of Florence (low risk areas). High-risk areas also showed higher Helicobacter pylori seroprevalence. Aim of this paper is to study gastric cancer mortality trends in high and low-risk areas, during the period 1971–2004, using age-period-cohort models.

Results

In high-risk areas, gastric cancer mortality rates declined from 61.4 per 100,000 in 1971–74 to 19.8 in 2000–2004 and in low-risk areas from 34.9 to 9.8. Mortality decline in high-risk areas was mainly attributable to a birth cohort effect, whereas in low-risk areas it was due either to a birth cohort effect or a period effect. In low- and high-risk areas, birth-cohort risks of dying decreased over subsequent generations, except for the birth cohorts born around the second world war.

Conclusions

Gastric cancer mortality in areas with higher H. pylori seroprevalence in Tuscany (high-risk areas) showed a predominant decline by birth cohort, in particular for younger generations, possibly due to the decrease of the infection for improvement of living conditions.
Dermatofibrosarcoma Protuberans of the Breast
Authors: Lin Jong-Yueh , Sheen-Chen Shyr-Ming , Hsu Wayne , Huang Chao-Cheng , Ko Sheung-Fat , Eng Hock-Liew
Published: February 2018

Background

Dermatofibrosarcoma protuberans is an uncommon, locally aggressive but rarely metastasizing tumor of the deep dermis and subcutaneous tissue. It may occur at almost any site but is most common in the trunk and extremities. Dermatofibrosarcoma protuberans of the breast has been rarely reported.

Case Presentation

A 49-year-old woman without a significant medical history presented with a right breast mass that had been present for more than 10 years. Recently, progressive enlargement of the mass was noted. Physical examination showed a firm, well-defined, non-tender, mobile, erythematous 2 × 2 cm mass in the upper outer part of the right breast. Breast sonography showed a 2.3 × 1 cm slightly heteroechoic nodule with uneven anterior contours located in the dermal layer, highly suggestive of a dermal lesion. Wide excision of the mass was performed. Microscopically, the hypercellular tumor was composed of relatively monomorphic spindle cells forming a storiform pattern around the sweat glands of the deep dermis and the subcutaneous fat vacuoles. The tumor cells showed strong immunoreactivity for CD34. The final histological diagnosis was dermatofibrosarcoma protuberans.

Conclusions

Dermatofibrosarcoma protuberans of the breast, though uncommon, does exist. With the awareness of this entity can a prompt diagnosis be made and the disease be properly managed.
Progress in the use of Immunotherapy to Treat Uterine Cervical Cancer
Authors: Helena De Lorenzo Beatriz , De Carvalho Ramos Marisa , Antoniazi Michelin Márcia , Candido Murta Eddie Fernando
Published: February 2018

Cervical intraepithelial neoplasia has a high incidence in many of the world's populations, and it has been hypothesized to be a precursor of uterine cervical cancer. Cervical intraepithelial neoplasia also shares similar pathological traits with human papillomavirus infections. Various surgical treatments have been proposed over the years for the treatment of cervical intraepithelial neoplasia, including conization, hysterectomy and, more recently, a loop electrosurgical excisional procedure. However, a higher recurrence rate of the disease has been observed after these procedures. Therefore, immunotherapy has been proposed as a potential treatment to be used in conjunction with surgery, or independently, as treatment for cervical intraepithelial neoplasia. Currently, immunotherapy includes the application of recombinant viral proteins, vaccines, or antibody- and dendritic cell-based therapies. In this review, we summarize the development and testing of these immunotherapy approaches, particularly in regard to their application for the treatment of cervical intraepithelial neoplasia.
Role of Osteopontin in Breast Cancer Patients
Authors: Macrì Antonio , Versaci Antonino , Lupo Giuseppe , Trimarchi Giuseppe , Tomasello Chiara , Loddo Saverio , Sfuncia Giuseppe , Caminiti Rocco , Teti Diana , Famulari Ciro
Published: February 2018

Aim and background

In breast cancer, as in almost all neoplastic diseases, the prognosis is strictly related to the invasive capacity, local and distant, that characterizes the growth of all tumors. Since the mechanisms that regulate replication of the neoplastic cells, with consequent capacity to metastasize, are not completely known, identification of new markers represents the gold standard of research in the stratification of patients with such a pathology. Osteopontin, a specific phosphoglycoprotein isolated from extracellular bone matrix and actively involved in mechanisms of bone reabsorption, appears to play a key role in osteoclastogenesis at the level of the skeleton in some pathologic situations. It has been found that patients with metastatic bone lesions from breast or prostate cancer present, with respect to subjects without repetitive bone lesions, elevated serum levels of the protein, indicating that osteopontin could play an important role in the development and progression of the neoplastic disease at the bone level.

Methods and study design

The authors studied 26 patients with breast cancer, evaluating as a marker also serum osteopontin levels.

Results and conclusions

The results, although obtained on a small number of patients, showed that osteopontin evaluation in breast cancer patients can be a particularly interesting method of research in staging of the disease as well as in the prognosis, thereby attributing a role of a biotumoral marker also in the follow-up of the therapy.
Mutation in CNR1 Gene and VEGF Expression in Esophageal Cancer
Authors: Bedoya Fernando , Meneu Juan C , Macías María Isabel , Moreno Almudena , Enríquez-de-Salamanca Rafael , Gonzalez Enrique Moreno , Vegh Irene
Published: February 2018

Aims and background

Cannabinoid receptors have an impact on gastrointestinal function, but it remains unknown whether mutations may affect tumor susceptibility in patients with esophageal carcinoma. The aim of this study was to determine mutation in the cannabinoid receptor-1 (CNR1) gene and its relation to vascular endothelial growth factor (VEGF) expression as an angiogenic and poor prognostic factor.

Methods

179 esophageal tissue samples from 69 patients (29 with esophageal cancer and 40 controls) were studied. CNR1 gene mutation (1359 G → A in codon 453) was detected with PCR, using the MspI restriction enzyme. VEGF was determined by immunoassay.

Results

Genotyping in control patients’ samples revealed that 24/40 were G/G wild type and 16/40 were G/A; no samples were A/A. Of the 139 tissue samples from the 29 esophageal cancer patients, 15 were G/G homozygous, 85 G/A heterozygous, 11 had an A/A genotype and 28 were without amplification. In the normal tissue adjacent to tumor, some mutations were observed. The overall survival time was reduced in patients with the A/A type in all their 5 samples, in comparison to G/G type (P = 0.04, chi-square: 4.26). VEGF expression was higher in tumor than nontumor areas (P <0.025). VEGF expression was not correlated with survival time.

Conclusions

Our preliminary findings in esophageal tissue showed a high frequency of G → A mutation in the CNR1 gene. No correlation between VEGF expression and gene receptor mutation was found. Patients with mutation in all their samples had a reduced survival time.
Nodal and Extranodal Soft Tissue Polymorphous Hemangioendothelioma: A Case Report and Review of the Literature
Authors: Falleti Jessica , Siano Maria , De Cecio Rossella , Somma Anna , Pettinato Guido , Insabato Luigi
Published: February 2018

Background

Polymorphous hemangioendothelioma is a rare vascular tumor of borderline malignant potential and only 10 cases have been described in the literature so far.

Methods and Results

We report a case of nodal and extranodal polymorphous hemangioendothelioma and review the literature. A 66-year-old man with an unremarkable past medical history was admitted for a left submandibular mass. The main nodule was composed of angiosarcoma-like areas mixed with angiomatous features; some vascular spaces with hobnail endothelium were seen. The tumor involved two adjacent lymph nodes. Immunohistochemically, the neoplastic cells were strongly positive for CD31 and vimentin. After a few months the tumor recurred and the patient was treated with radiation therapy.

Conclusions

Polymorphous hemangioendothelioma is a distinct entity in the hemangioendothelioma group with its own clinical and histological features.
Primary Pancreatic Lymphoma
Authors: Luo Guopei , Jin Chen , Fu Deliang , Long Jiang , Yang Feng , Ni Quanxing
Published: February 2018

Aims and backgrounds

Primary pancreatic lymphoma is non-Hodgkin lymphoma primarily involving the pancreas, which is rare in pancreatic diseases. The aim of this work is to summarize the diagnostic and therapeutic experience of primary pancreatic lymphoma.

Methods

We retrospectively reviewed the clinical data of 7 cases of primary pancreatic lymphoma admitted to Huashan Hospital in the past 3 years. Available English literature was also reviewed using the following terms: primary pancreatic lymphoma and pancreatic lymphoma.

Results

The literature review identified 157 additional cases, and a total of 164 cases had been analyzed. In this series, only 30% had a successful non-operative diagnosis. The curative rate of the surgery-adjuvant chemotherapy group was higher than that of the chemotherapy alone group.

Conclusions

Obtaining specimens through surgery is an effective diagnostic tool. Surgical resection in combination with postoperative chemotherapy plays a therapeutic role.
The National Center for Oncological Hadron Therapy: Status of the Project and Future Clinical use of the Facility
Authors: Orecchia Roberto , Fossati Piero , Rossi Sandro
Published: February 2018

Aims and background

Hadron therapy is an advanced radiotherapy technique that employs charged particle beams. Several particles (pions, oxygen, neon and helium ions) have been investigated in the past, but at present only protons and carbon ions are used in clinical practice. Hadron therapy has been used for more than 50 years, more than 50,000 patients have been treated worldwide, and many new facilities are being built. Indications are still a matter of debate. The Italian National Center for Oncological Hadron Therapy (CNAO) is under construction in Pavia and will begin to treat patients in the near future.

Methods

The CNAO will be a center capable of using both protons and carbon ions. In the first phase, three rooms with vertical and horizontal fixed beams will be available, subsequently the center will be upgraded with two more rooms equipped with a rotating gantry. The facility will use active scanning delivery systems and state-of-the-art immobilization and setup verification devices. One additional room will be devoted to physical and radiobiological research. The CNAO will be a high-patient-throughput facility capable of treating more than 3,000 patients per year. Seven areas of interest have been identified: lung cancer, liver cancer, head and neck malignancies, pediatric solid cancers, eye tumors, sarcoma and central nervous system cancers. A disease-specific working group has been created for each area and has defined selection criteria and protocols to be used at the CNAO. Two more working groups are being set up on gynecological and digestive (pancreas, biliary tract and rectum) tumors. All the patients will participate in clinical trials to establish with sound evidence the real indications for hadron therapy. National and international cooperation networks are being set up to facilitate patient referral and follow-up. A medical service is already operative to assist patients and in selected case to refer them abroad.

Conclusions

The CNAO will be the only carbon ion facility in Italy and will have an international basin. Close cooperation with existing oncological centers is of paramount importance to fully exploit its potential.
Changes in Glucose Metabolism during and after Radiotherapy in Non-Small Cell Lung Cancer
Authors: Giovacchini Giampiero , Picchio Maria , Schipani Stefano , Landoni Claudio , Gianolli Luigi , Bettinardi Valentino , Di Muzio Nadia , Gilardi Maria Carla , Fazio Ferruccio , Messa Cristina
Published: February 2018

Aims and background

Evaluation of the metabolic response to radiotherapy in non-small cell lung cancer patients is commonly performed about three months after the end of radiotherapy. The aim of the present study was to assess with positron emission tomography/computed tomography (PET/CT) and [18F]fluorodeoxyglucose changes in glucose metabolism during and after radiotherapy in non-small cell lung cancer patients.

Methods and study design

In 6 patients, PET/CT scans with [18F]fluorodeoxyglucose were performed before (PET0), during (PET1; at a median of 14 days before the end of radiotherapy) and after the end of radiotherapy (PET2 and PET3, at a median of 28 and 93 days, respectively). The metabolic response was scored according to visual and semiquantitative criteria.

Results

Standardize maximum uptake at PET1 (7.9 ± 4.8), PET2 (5.1 ± 4.1) and PET3 (2.7 ± 3.1) were all significantly (P <0.05; ANOVA repeated measures) lower than at PET0 (16.1 ± 10.1). Standardized maximum uptake at PET1 was significantly higher than at both PET2 and PET3. There were no significant differences in SUVmax between PET2 and PET3. PET3 identified 4 complete and 2 partial metabolic responses, whereas PET1 identified 6 partial metabolic responses. Radiotherapy-induced increased [18F]fluorodeoxyglucose uptake could be visually distinguished from tumor uptake based on PET/CT integration and was less frequent at PET1 (n = 2) than at PET3 (n = 6).

Conclusions

In non-small cell lung cancer, radiotherapy induces a progressive decrease in glucose metabolism that is greater 3 months after the end of treatment but can be detected during the treatment itself. Glucose avid, radiotherapy-induced inflammation is more evident after the end of radiotherapy than during radiotherapy and does not preclude the interpretation of [18F]fluorodeoxyglucose images, particularly when using PET/CT.
Radiotherapy after Partial Laryngectomy: An Analysis of 36 Cases and a Proposal to Optimize Radiotherapy
Authors: Garibaldi Elisabetta , Bresciani Sara , Airaldi Claudia , Panaia Rocco , Ferrara Teresa , Delmastro Elena , Baiotto Barbara , Gabriele Pietro
Published: February 2018

Aims and background

Laryngeal cancer treatment options include radical surgery, “organ preservation surgery”, radiotherapy and chemotherapy. There is no proven evidence of a significant increase in late toxicity with adjuvant radiotherapy after conservative surgery. The aim of this retrospective study was to evaluate the toxicity, local-regional control and overall survival of adjuvant radiotherapy after conservative surgery.

Methods

A total of 36 patients was treated with radiotherapy after partial laryngectomy at the Radiotherapy Department of the Institute for Cancer Treatment and Research (IRCC) of Candiolo and of the Mauriziano Hospital in Turin, between 1994 and 2007. The postoperative treatment doses ranged from 45 to 70.2 Gy with conventional fractionation. The Kaplan-Meier method was applied for statistical analysis. The RTOG-EORTC scale was used to evaluate late and acute toxicity.

Results

Overall 5- and 10-year survival was 93% and 47%, respectively. Local control was 93.5% at 5 and was unchanged at 10 years. Grade 2 acute cutaneous and mucous toxicity was 41% and 62%, and grade 3, 6.9% and 3.5%, respectively. Only one patient required percutaneous endoscopic gastrostomy due to severe dysphagia and one patient required temporary tracheostomy for severe acute laryngeal edema (grade 3). Two patients experienced late toxicity greater than grade 3. The median dose to the residual larynx was 59.5 Gy (range, 45–70.2), and the median dose to the neck was 50.4 Gy (range, 39.6 −55.8).

Conclusions

The results of our study showed a dose-dependent increase in the late toxicity trend at doses over and above 60 Gy, which is higher than the cutoff dose reported in the literature. There was no indication from our data that adjuvant postoperative radiotherapy means additional toxicity. The use of highly conformal techniques can further reduce toxicity of the radiotherapy.
Psychosexual and Body Image Aspects of Quality of Life in Turkish Breast Cancer Patients: A Comparison of Breast Conserving Treatment and Mastectomy
Authors: Alicikus Zumre Arican , Gorken Ilknur Bilkay , Sen Rachel Cooper , Kentli Suleyman , Kinay Munir , Alanyali Hilmi , Harmancioglu Omer
Published: February 2018

Aims and background

Assessing psychosexual and body image aspects of quality of life in Turkish breast cancer patients treated by either mastectomy or breast conserving treatment (BCT).

Methods

The study group consisted of 112 patients who had undergone all treatment at a single institution under the care of a multidisciplinary breast team. Following surgery all patients underwent adjuvant radiotherapy with or without chemotherapy and hormone therapy. At the time of this study all patients were disease free with at least 2 years' follow-up. Twenty percent of the patients were premenopausal and 80% postmenopausal. The patients completed a questionnaire consisting of 42 questions related to their sexual relations and body image.

Results

Forty-one percent of sexually active patients had experienced a deterioration of sexual functioning after treatment. This was mainly due to loss of libido (80%), loss of interest in partner (54%), and sexual dissatisfaction (59%). Problems tended to develop early in the course of treatment. Decreased sexual desire was significantly more frequent in patients undergoing mastectomy versus BCT (80% vs 61%; P = 0.043) and in premenopausal versus postmenopausal patients (P= 0.024). Although 80% of patients were satisfied with their apperance as a whole, only 54% liked their naked bodies. There was no significant difference in body image scores between patients undergoing mastectomy or BCT apart from a general feeling of physical unattractive-ness in mastectomy patients (3.4 vs 2.8; P = 0.03).

Conclusions

Significant, similar psychosexual and body image problems occur in patients treated for breast cancer with either mastectomy or BCT. Problems arise early in the course of the disease and therefore detection and treatment of these problems should be addressed during the patients' initial assessment and at the start of treatment. These findings are similar to those reported on similar groups of treated women in American and European populations.
Increased Transglutaminase 2 and GLUT-1 Expression in Breast Tumors not Susceptible to Chemoprevention with Antioxidants
Authors: Martins Filipe C , Teixeira Filipa , Reis Ines , Geraldes Nuno , Cabrita AM Silvério , Dias Margarida F
Published: February 2018

Goals

Expression of GLUT-1 and transglutaminase 2 is increased in aggressive breast cancer, whereas claudin-1, which is expressed in normal tissues, is absent in such tumors. This experimental study was undertaken to establish the aggressiveness and prognosis of DMBA-induced mammary tumors in female Wistar rats based on the assessment of these markers.

Materials and methods

The rats were divided into two groups, a control group (n = 70) and a chemoprevention group (n = 70). Breast tumors were induced in both groups by administration of 7,12-dimethylbenz[a]anthracene (DMBA). The chemoprevention group also received alpha-tocopherol and a solution of micronutrients containing ascorbic acid and selenium. Neoplastic lesions of both groups were randomly selected for immunohistochemical assessment of the expression of GLUT-1, transglutaminase 2 and claudin-1.

Results

A higher proportion of mammary tumors expressed GLUT-1 and transglutaminase 2 in the chemoprevention group. Claudin-1 expression was absent in all tumors of both groups.

Conclusions

These results are suggestive of increased aggressiveness of tumors not susceptible to chemoprevention by the agents used in this study.
Bone Metastases from Primary Cardiac Sarcoma: Case Report
Authors: Strina Carla , Zannoni Marina , Parolin Veronica , Cetto Gian Luigi , Zuliani Serena
Published: February 2018

Tumor spread from primary cardiac sarcoma to the bone is very rare and has a poor prognosis. Only six cases have been reported in the literature. We present a 32-year-old female patient with bone metastases from primary cardiac sarcoma.
Supraclavicular Metastases from a Sex Cord Stromal Tumor of the Ovary
Authors: Ismi Onur , Vayisoglu Yusuf , Karabacak Tuba , Ünal Murat
Published: February 2018

Metastases to the supraclavicular fossa usually originate from head and neck or infraclavicular tumors. Ovarian primaries of supraclavicular metastases are very rare. Sex cord stromal tumors of the ovary account for 5–8% of all ovarian malignancies and there have been only a few case reports on distant metastases from these tumors. A 46-year-old woman presented to us with a left supraclavicular mass. She had had a sex cord stromal tumor in the right ovary four years before. Comprehensive clinical investigation and fine-needle aspiration cytology were performed. The lesion had the characteristics of a sex cord stromal tumor. To our knowledge, this is the first report of such a case in the English literature. We discuss its pathological and clinical features in the light of the current knowledge.
Spontaneous Regression of Two Giant Basal Cell Carcinomas in a Single Patient after Incomplete Excision
Authors: Rieger Ulrich M , Schlecker Christina , Pierer Gerhard , Haug Martin
Published: February 2018

Background

Spontaneous regression of small basal cell carcinoma has been reported. For giant basal cell carcinoma, however, no spontaneous regression has been described to date.

Case report

We present a patient with two independent giant basal cell carcinomas over the left clavicle and the lower back, measuring 7 × 12 cm and 18 × 20 cm, respectively. Both tumors were excised incompletely (R2) and the patient refused follow-up resections. After 52 and 16 months, respectively, no signs of recurrence were observed.

Conclusion

Incompletely excised giant basal cell carcinomas can regress spontaneously. A watch-and-wait approach after incomplete resection may be pragmatic to avoid mutilating follow-up resections in patients refusing further surgery.
Clinical Relevance of Sentinel Lymph Node Status Examined with Conventional Histology and Molecular Biology
Authors: Micciolo Rocco , Boi Sebastiana , Paoli Loredana , Cristofolini Paolo , Girlando Salvatore , Palma Paolo Dalla , Cristofolini Mario
Published: February 2018

Aims and background

The presence of nodal metastases in patients with primary cutaneous melanoma adversely affects the biological behavior and is related to a poor prognosis. The role of sentinel lymph node biopsy is still debated. The aim of this study was to evaluate the prognostic role of sentinel lymph node biopsy with respect to disease-free period and overall survival.

Patients and methods

Patients with invasive cutaneous melanoma who underwent sentinel lymph node biopsy in the Santa Chiara Hospital of Trento between October 1997 and December 2002 were evaluated. The lymph nodes were examined with conventional histology, S100 and tyrosinase in immunohistochemistry, and tyrosinase in molecular biology.

Results

There were 144 patients with 198 sentinel lymph nodes. A significant association was found in conventional histology with Clark level and Breslow thickness. The prognostic role of sentinel lymph node status was independent of the other considered variables. However, no significant association was found with the molecular biology test. A significant excess of positive results at molecular biology was found.

Conclusions

Sentinel lymph node biopsy is an important independent prognostic factor for invasive cutaneous melanoma, but only when evaluated with conventional histology. As a result of this study, we stopped performing the tyrosinase test in molecular biology.
Prognostic Implication of Immunohistochemical Runx2 Expression in Osteosarcoma
Authors: Won Kyu Yeoun , Park Hye-Rim , Park Yong-Koo
Published: February 2018

Aims and background

Osteosarcoma is the most common primary bone malignancy. Many genetic markers have proven prognostic value in osteosarcoma and studies are under way to determine their potential application as specific therapeutic targets. Runx2, Indian hedgehog (IHH), and Sox9 are proteins that play major roles in bone formation and tumorigenesis. We studied the protein expression of Runx2, IHH, and Sox9 in osteosarcoma and correlated their expression with clinicopathological variables. We also studied the prognostic value of the expression of these three genes in osteosarcoma.

Methods and study design

We produced 48 formalin-fixed, paraffin-embedded tissue microarrays containing osteosarcoma tissue cores for immunohistochemical staining of Runx2, IHH and Sox9. We evaluated the expression of each gene by immunohistochemical staining and analyzed the relationship between expression and clinicopathological parameters.

Results

High expression of Runx2 was significantly related to metastasis (P = 0.015). High expression of Runx2 indicated a trend toward a poor survival rate (P = 0.056). High expression of IHH and Sox9 were not related to any clinicopathological parameters.

Conclusions

High expression of Runx2 was significantly related to tumor metastasis in osteosarcoma. Our results suggest that overexpression of Runx2 might be a useful prognostic marker in osteosarcoma cases.
DNA Binding and Cleavage Properties of Ponicidin
Authors: Xu Xia , Ke Yu , Zhang Qi , Qi Xiaoyu , Liu Hongmin
Published: February 2018

Aims and background

Ponicidin, an effective component isolated from Isodon rubescens, possesses anticancer properties. In the present study, we proved its ability to bind to and cleave DNA. DNA binding and cleavage properties are important for designing the rational construction of new and more efficient drugs targeted to DNA, because DNA is the biological target with which many anti-tumor drugs and potential antineoplastic agents interact. The characterization of interaction of ponicidin not only provides insights into its biology, but also gives the opportunity for developing effective therapeutic agents for control of gene expression.

Methods

The interaction of ponicidin with DNA has been explored by using absorption spectroscopy, fluorescence spectroscopy, viscosity measurement, thermal denaturation and electrophoresis measurement.

Results

Firstly, adding ponicidin to a DNA solution could shift the absorption spectra to red. Secondly, ponicidin also raised the melting temperature and viscosity of DNA. Moreover, fluorescence of DNA binding with ethidium bromide was quenched by ponicidin. Finally, ponicidin showed nuclease activity.

Conclusions

We propose that the DNA binding and cleavage properties of ponicidin may underlie the mechanism of its cell toxic effects.
Response to Oxaliplatin with Cetuximab in Minor Salivary Gland Adenoid Cystic Carcinoma
Authors: De Dosso Sara , Mazzucchelli Luca , Ghielmini Michele , Saletti Piercarlo
Published: February 2018

Esophageal localization of adenoid cystic carcinoma of minor salivary glands is rare; it may occur in the early to mid-sixties' age group and is more frequently encountered in men than women. In the majority of cases, it arises from subepithelial glands of the middle to lower third of the esophagus, a similar distribution as squamous cell carcinoma. Prognosis depends mostly on tumor staging and resectability, which represents the only chance of cure. Due to the extreme rarity of this condition, there is limited experience with systemic therapy for advanced disease. We report a case of a patient with metastatic primary esophageal adenoid cystic carcinoma progressing on platinum- and irinotecan-based regimens, who achieved an objective response with oxaliplatin-based chemotherapy in combination with cetuximab.
Intramedullary Melanocytoma: Case Report and Review of Literature
Authors: Caruso Riccardo , Marrocco Luigi , Wierzbicki Venceslao , Salvati Maurizio
Published: February 2018

We report on a very rare case of dorsal intramedullary melanocytoma in a 62-year-old man. The tumor was resected and gross total removal was achieved. During a 2-year follow-up period in which no radiotherapy was given, the tumor did not recur. We review the literature on these tumors and present disease criteria to distinguish melanocytoma from primary malignant melanoma. Patients and investigators should be cautioned that an intramedullary melanocytoma may recur and give rise to metastatic spread via the cerebrospinal fluid.
Limb Sparing Treatment of Bleeding Melanoma Recurrence by Electrochemotherapy
Authors: Snoj Marko , Cemazar Maja , Srnovrsnik Tinkara , Kosir Snezna Paulin , Sersa Gregor
Published: February 2018

Aims and background

Electrochemotherapy is an effective local treatment for tumors that combines administration of a chemotherapeutic drug with the subsequent application of electric pulses to the tumor. In addition, it was also found to have a vascular-disrupting effect. We report a case of limb-sparing treatment of bleeding melanoma recurrence by electrochemotherapy.

Methods

After intravenous application of bleomycin (15,000 IU/m2), 15 runs of electric pulses were applied by hexagonal needle electrodes (1.7 cm in diameter) in the center of the bleeding melanoma recurrence, and an additional 10 runs of electric pulses were delivered via plate electrodes (8 mm) on the rim of the tumor.

Results

Immediately after the administration of electric pulses, the bleeding stopped and did not recur. Crust formation was observed and the lesion decreased in size in a matter of weeks.

Conclusions

We conclude that electrochemotherapy should be considered as a treatment option when dealing with bleeding melanoma recurrences as well as a limb-preserving treatment.
MRI Features of Cotyledonoid Dissecting Leiomyoma of the Uterus
Authors: Preda Lorenzo , Rizzo Stefania , Gorone Maria Sole Prevedoni , Fasani Roberta , Maggioni Angelo , Bellomi Massimo
Published: February 2018

Imaging evaluation of uterine masses is important to assess the type of lesion and to target surgery, if surgical excision is necessary. This can be decisive in fertile women with benign masses resembling malignancies, in order to avoid overtreatment. In this study, the magnetic resonance imaging (MRI) appearance of cotyledonoid dissecting leiomyoma of the uterus, a rare benign variant of leiomyoma mimicking malignancy, is presented.
Use of Sorafenib in Two Metastatic Renal Cell Cancer Patients with End-Stage Renal Impairment Undergoing Replacement Hemodialysis
Authors: Ferraris Elisa , Di Cesare Pamela , Lasagna Angioletta , Paglino Chiara , Imarisio Ilaria , Porta Camillo
Published: February 2018

Patients with renal cell carcinoma (RCC) may exhibit renal impairment as a more or less direct consequence of their primary disease. Renal impairment may become a severe complication and alter the normal pharmacokinetic and pharmacodynamic behavior of treatment drugs, thus increasing the risk of side effects. We will discuss the cases of two advanced RCC patients with end-stage renal impairment submitted to dialysis who were treated with sorafenib tosylate in our center.

Our experience confirms the scarce literature data available so far that indicate that sorafenib can be used in patients undergoing dialysis. Dialysis cannot be considered per se a contraindication to sorafenib therapy, which can be effective. However, patients must be carefully selected and monitored, since sorafenib administration unquestionably increases the risk of side effects in patients affected by several conditions.
Ifosfamide Encephalopathy and Use of Methylene Blue. A Case Report of Different Sequential Neurotoxicity
Authors: Giovanis Petros , Garna Antonella , Marcante Marilisa , Nardi Katiuscia , Giusto Mauro
Published: February 2018

Neurotoxicity is a clinically relevant adverse event observed with the use of ifosfamide. It is usually mild, occasionally severe and seldom fatal. Ifosfamide-induced encephalopathy requires interruption of chemotherapy, intravenous hydration and administration of methylene blue. Less is known about the efficacy of methylene blue in avoiding a second episode of ifosfamide-induced encephalopathy while maintaining chemotherapy with ifosfamide. We report a case of a different clinical manifestation of ifosfamide-induced encephalopathy after continued ifosfamide use and despite methylene blue in a patient with retroperitoneal sarcoma.
Salvage High Dose Rate Brachytherapy after Primary External Beam Irradiation in Localized Prostate Cancer: A Case Report
Authors: De Cicco Luigi , Vavassori Andrea , Cattani Federica , Jereczek-Fossa Barbara A , Orecchia Roberto
Published: February 2018

No standard treatment exists for locally relapsed prostate cancer after primary external beam radiotherapy with no evidence of distant metastases. Radical prostatectomy, brachytherapy, cryotherapy and high-intensity focused ultrasound are currently used as local salvage treatments. Data on the safety and effectiveness of high dose rate (HDR) brachytherapy in this scenario are limited. We report on a patient who has no evidence of disease and no late urinary or gastrointestinal toxicity 33 months after receiving HDR treatment for recurrent prostate cancer.
Cancer control-planning and monitoring population-based systems
Authors: Harford Joe B , Edwards Brenda K , Nandakumar Ambakumar , Ndom Paul , Capocaccia Riccardo , Coleman Michel P ,   ICCC-3 Session A Group
Published: February 2018

Cancer is a growing global health issue, and many countries are ill-prepared to deal with their current cancer burden let alone the increased burden looming on the horizon. Growing and aging populations are projected to result in dramatic increases in cancer cases and cancer deaths particularly in low- and middle-income countries. It is imperative that planning begin now to deal not only with those cancers already occurring but also with the larger numbers expected in the future. Unfortunately, such planning is hampered, because the magnitude of the burden of cancer in many countries is poorly understood owing to lack of surveillance and monitoring systems for cancer risk factors and for the documentation of cancer incidence, survival and mortality. Moreover, the human resources needed to fight cancer effectively are often limited or lacking. Cancer diagnosis and cancer care services are also inadequate in low-and middle-income countries. Late-stage presentation of cancers is very common in these settings resulting in less potential for cure and more need for symptom management. Palliative care services are grossly inadequate in low- and middle-income countries, and many cancer patients die unnecessarily painful deaths. Many of the challenges faced by low- and middle-income countries have been at least partially addressed by higher income countries. Experiences from around the world are reviewed to highlight the issues and showcase some possible solutions.
Off-Label Prescription of Antineoplastic Drugs: An Italian Prospective, Observational, Multicenter Survey
Authors: Roila Fausto , Ballatori Enzo , Labianca Roberto , De Braud Filippo , Borgonovo Karen , Martelli Olga , Gallo Ciro , Tinazzi Angelo , Perrone Francesco
Published: February 2018

Aims and Background

An appropriate use of drugs should follow the registered indications. Different reasons can induce oncologists to prescribe drugs off-label. The aim of this study was to describe incidence and characteristics of these prescriptions in Italy.

Methods

Patients submitted to chemotherapy in 15 Italian oncology centers were evaluated for two randomized non-consecutive days of two weeks in May 2006.

Results

The study enrolled 644 patients receiving 1,053 drugs. Overall, 199 of 1053 (18.9%) prescriptions were off-label. In 92 of 199 cases (46.2%), the drugs were used for a neoplasm for which they were not approved, but there was scientific evidence (one or more randomized clinical trials or more phase II studies published in a major oncology journal) justifying the prescription. In 27 cases (13.6%), the drugs were prescribed for a rare neoplasm (cisplatin and gemcitabine in mesothelioma). In 20/21 cases (10.1%/10.5%), drugs were used in association/alone in contrast with the approved use (capecitabine in association in colorectal cancer). In 28/11 cases (14.0%/5.6%), the drugs were used in lines of chemotherapy subsequent/previous to that approved.

Conclusions

Off-label use of antineoplastic drugs, in this observational survey, represents less than 20% of the prescriptions, and most of them are based on scientific evidence of efficacy.
Trends in Cancer Mortality in Spain: 1975-2004
Authors: Bernal Milagros , Gómez Franchesco J , Gómez German
Published: February 2018

Aims and Background

Total cancer mortality rates in the European Union have declined by about 7% over the period 1982-2002. The aim of the present study was to investigate similar trends in Spain over the period 1975 to 2004 by age, sex, and cancer site.

Patients and Methods

Trends in Spanish mortality rates (standardized to the world standard population) for all cancers and for 14 major cancer sites for the years 1975 to 2004 are analyzed. Join point regression analysis was used to identify points where a significant change in trend occurred.

Results

The overall cancer mortality rate in Spain in men and women declined by about 1% a year between 1995 and 2004. For the period 1975 to 2004, declines were observed for several neoplasms: lip, −3.62% in men and −3.39% in women; esophagus, −0.28% in men and −2.73% in women; stomach, −2.99% in men and −3.66% in women; liver, −0.52% in men and −3.77% in women. There was a substantial rise in: colon cancer, 3.72% in men and 1.79% in women; pancreas, 2.21% in men and 2.25% in women; lung cancer rose 1.18% in men and 0.97% in women, and between 1999-2004 it rose 5.23% in women. Most of these are tobacco-related neoplasms.

Conclusions

Cancer mortality in Spain is mainly a tobacco-related problem. More attention needs to be focused on campaigns to decrease and prevent smoking, especially in the young, where smoking rates are higher than in the general population.
Incidence of Palmar-Plantar Erythrodysesthesia in Pretreated and Unpretreated Patients Receiving Pegylated Liposomal Doxorubicin
Authors: Miolo GianMaria , Baldo Paolo , Bidoli Ettore , Lombardi Davide , Scalone Simona , Sorio Roberto , Veronesi Andrea
Published: February 2018

Aims and Background

Association between pegylated liposomal doxorubicin-based regimens and palmar-plantar erythrodysesthesia have just been emphasized, whereas the relationship between previous treatment and palmar-plantar erythrodysesthesia is still a matter of discussion. We evaluate the relationship between previous chemotherapy treatments and the development of palmar-plantar erythrodysesthesia in patients receiving pegylated liposomal doxorubicin-based regimens.

Methods

Between January 2005 and November 2006, 92 patients received regimens including pegylated liposomal doxorubicin. Patients were divided into three groups based on pegylated liposomal doxorubicin dosing interval length, different dose chosen, and previous chemotherapy.

Results

Among pretreated patients receiving regimens including 30 mg/m2 of pegylated liposomal doxorubicin repeated every three weeks, the incidence of palmar-plantar erythrodysesthesia was not significantly higher than in unpretreated patients receiving the same weekly schedule ( P = 0.4). There was no difference in the incidence of palmar-plantar erythrodysesthesia between pretreated patients with regimens including 30 mg/m2 of pegylated liposomal doxorubicin every three weeks and pretreated patients receiving 20 mg/m2 of pegylated liposomal doxorubicin every two weeks ( P = 0.8). The prevalence of palmar-plantar erythrodysesthesia observed in the unpretreated group exposed to 30 mg/m2 every three weeks was comparable to that of the pretreated group receiving 20 mg/m2 biweekly ( P = 0.3). However, excluding all the patients who developed grade 1 palmar-plantar erythrodysesthesia, the incidence of grade 2 and 3 palmar-plantar erythrodysesthesia observed in pretreated patients receiving regimens including 20 mg/m2 of pegylated liposomal doxorubicin biweekly was significantly higher than in unpretreated patients receiving 30 mg/m2 of pegylated liposomal doxorubicin every three weeks ( P = 0.001).

Conclusions

Our findings indicate that the pretreatment is not involved in the increased incidence of any grade palmar-plantar erythrodysesthesia. On the contrary, the study could suggest that the type of previous treatment may be an important factor in the development of more severe forms of palmar-plantar erythrodysesthesia.
Paclitaxel-Dependent Prolonged and Persistent Complete Remission Four Years from First Recurrence of Secondary Breast Angiosarcoma
Authors: Gambini Donatella , Visintin Roberto , Locatelli Elisa , Galassi Barbara , Bareggi Claudia , Runza Letterio , Onida Francesco , Tomirotti Maurizio
Published: February 2018

Among angiosarcomas, radiation-induced breast sarcomas (RIBS) represent a well-known entity generally characterized by a poor outcome, especially in patients with advanced disease. Despite the unfavorable prognosis, some chemotherapeutic agents have been used to treat these malignancies, occasionally with success. Treatments with demonstrated activity against sarcomas include ifosfamide-based regimens and, more recently, taxane derivatives.

We report a case of a patient having a secondary breast angiosarcoma recurring early after surgery, who achieved complete remission following treatment with weekly paclitaxel. After 4 years of maintenance therapy, with an interval between consecutive administrations of no longer than 3 weeks, the patient is still in complete remission. A locoregional recurrence was documented twice during this period, the first as a consequence of a brief treatment interruption and the second because of a treatment delay. Nonetheless, in both instances a new complete remission was rapidly achieved with the resumption of the same treatment, without evidence of any significant adverse effects. We discuss the highly unusual behavior of this malignancy and the possible role of the two different mechanisms of action of paclitaxel-antiangiogenic versus cytotoxic-depending on the schedule of administration, with evidence of “false” drug-resistance.
Beta-Catenin Mutations are not Observed in Chronic Myeloid Leukemia
Authors: Sercan Zeynep , Pehlivan Melek , Gokturk Dilek , Sercan Hakki Ogun
Published: February 2018

Aims and Background

Studies reporting activated Wnt signaling in all stages of chronic myeloid leukemia (CML) have demonstrated that deregulation of the pathway plays a role in the pathogenesis of this disease. Several reports have suggested mechanisms for the deregulated Wnt signaling and beta-catenin stabilization observed in CML. One possible mechanism for beta-catenin stabilization could be the acquisition of mutations at its N-terminal domain, especially in the third exon where it is marked via phosphorylation for degradation. We sought to determine whether mutations in the third exon of the beta-catenin gene are responsible for the observed Wnt activation in CML

Material and Methods

We screened bone marrow specimens from 33 patients with CML in the chronic phase and also examined the K562 cell line for beta-catenin mutations.

Results

None of the patients nor the K562 cell line were found to carry mutations.

Conclusion

Beta-catenin amino-terminal mutations are not observed or very rare and therefore are not the underlying mechanism of activated Wnt signaling in CML.
Expression of the Transcription Factor HEY1 in Glioblastoma: A Preliminary Clinical Study
Authors: Gaetani Paolo , Hulleman Esther , Levi Daniel , Quarto Micaela , Scorsetti Marta , Helin Kristian , Simonelli Matteo , Colombo Piergiuseppe , Baena Riccardo Rodriguez y
Published: February 2018

Aims and background

The hairy/enhancer of split (E(spl))-related family of transcription factors (HES and HEY) are established targets of the notch signaling pathway, which has been implicated in different developmental processes, tumor formation and the self-renewal of neural stem cells. We determined the expression of HEY1 in human malignant gliomas to investigate whether its expression might be related to prognosis.

Methods

The expression of HEY1 was studied by in situ hybridization on 62 cases of glioblastoma. Patients were treated with surgery followed by chemotherapy and radiotherapy. We considered as end points of the study the overall survival time and progression-free interval. Correlations between HEY1 expression and tumor grade/patient overall survival and free interval before recurrence were analyzed using univariate analysis.

Results

Based on the in situ hybridization results, HEY1 expression rate was reported as negative staining in 13 cases (20.6%), as weak staining in 11 cases (17.3%), as moderate staining in 21 cases (33.3%), and as strong staining in 17 cases. We considered in the analysis the cumulative expression of HEY1 at in situ hybridization (Hey Index) as negative in 13 cases and positive in 49 cases (77.78%). The overall survival (P = 0.002) and the free-interval (P = 0.012) were significantly longer in patients who were negative for HEY1 expression.

Conclusions

Our data suggest that expression of HEY1 might be used as a marker to distinguish glioblastoma patients with a relatively good prognosis from those at high-risk, and that, in the future, HEY1 might represent a therapeutic target.