bluuebunny/crossref_metadata_2025 huggingface dataset:
Trends in the Prevalence of Cervical Intraepithelial Neoplasia Grade 3 in the District of Florence, Italy
Authors: Cecchini Silvia , Ciatto Stefano , Zappa Marco , Biggeri Annibale
Published: April 2018

Aims and background

The objective of this study was to investigate the detection rate of cervical intraepithelial neoplasia grade III (CIN 3) in previously unscreened women, in order to reveal trends over time in the prevalence of CIN 3 in the District of Florence, where a population-based screening for cervical cancer has been going on since 1973.

Study design

We considered the women, recorded in the computerized archives of CSPO, who had had no pap test for at least 10 years. Trends of CIN 3 (histologically proven) were analyzed within age groups; the effect of age, cohort and period were considered by means of a Poisson regression model.

Results

A total of 648 cases of histologically proven CIN 3 were detected in the study period. The detection rates of CIN 3 increased steadly within age groups over birth cohort and calendar period simultaneously. The Poisson regression analysis showed that only the model with age + time trend was statistically significant.

Conclusions

Although several biases should be taken into account, the analysis seemed to indicate a real increase in CIN 3 prevalence. An increase in frequency of precancerous lesions for cervical cancer in more recent birth cohorts supports the need to keep screening coverage and efficiency as high as possible.
A Feasibility Study of Screening for Endometrial Carcinoma in Postmenopausal Women by Ultrasonography
Authors: Ciatto Stefano , Cecchini Silvia , Bonardi Rita , Grazzini Grazia , Mazzotta Antonia , Zappa Marco
Published: April 2018

Background

Abnormal endometrial thickness assessed by ultrasonography has been reported as a reliable indicator for early asymptomatic endometrial carcinoma.

Study design

We evaluated the feasibility and the performance of screening by ultrasonography in a consecutive series of postmenopausal volunteers.

Results

A total of 2,025 women were screened, and 117 (5.8%) showed abnormal endometrial thickness. Ninety-eight subjects consented to be assessed by outpatient endometrial biopsy, which was not possible in 32 for cervical stenosis. Three cancers were detected among 66 assessed subjects, 34 not-assessed subjects were controlled by repeat sonography (no change), and 17 were lost to follow-up. No other cancer was recorded by the local Cancer Registry among screened subjects. The prevalence/incidence ratio was 2.65:1, and the cost per screen-detected cancer was 18,571,000 Italian lire.

Conclusions

Screening by endometrial sonography is feasible on a practical basis, but its efficacy needs to be proven by prospective controlled studies which would enroll large populations to ensure sufficient statistical power, considering the low incidence and the low lethality of the disease. Studies of screening for other carcinomas may be considered of higher priority.
Information Oncologic Tools Produced by the U.S. National Cancer Institute: How Much are They Known and Used? Results of an Enquiry in Italy
Authors: Cognetti Gaetana , Paradiso Biagio , Truccolo Ivana , Ugolini Donatella , Santi Leonardo
Published: April 2018

A survey was conducted among specialized users in order to establish the level of knowledge and diffusion of four informative tools: Cancerlit, PDQ, Clinprot, Cancergram. A questionnaire was distributed to 975 graduate researchers working in four national cancer research institutes in the north (2), center (1) and south (1) of Italy, as well as to the students of the Postgraduate School of Oncology (Oncology 2nd) of the “La Sapienza” University of Rome. Respondents were 486 (49.8%): only 167 (34.4%) declared to know Cancerlit, 56 (11.5%) PDQ, 10 (2%) Clinprot and 39 (8%) Cancergrams. Moreover, there is a time gap of nearly 6 years between the availability on-line of these tools and the information of its existence by the users. Most of the respondents were in favor of inserting courses on the use of information tools into the University curriculum and of training in the use of the tools.
5,20-BIS(4-Sulphophenyl)-10,15-Bis(2-Methoxy-4-Sulphophenyl)-21-Thiaporphyrin as a new Potent Sensitizer in Photodynamic Therapy
Authors: Ziółkowski Piotr , Milach Jerzy , Symonowicz Krzysztof , Chmielewski Piotr , Latos-Grażyński Lechosław , Marcinkowska Ewa
Published: April 2018

The main purpose of the study was to investigate the effectiveness of a new photosensitizer for photodynamic therapy. 5,20-bis(4-sulphophenyl)-10,15-bis(2-methoxy-4-sulphophenyl)-21-thiaporphyrin (21-thiaporphyrin) was compared to chlorin e6 and tetra(m-hydroxyphenyl)porphyrin (m-THPP) for its ability to sensitize tumors and skin to light. Chlorin e6 and m-THPP induced a strong tumor and skin photosensitization. In contrast, the same doses of 21-thiaporphyrin produced no skin sensitization and gave approximately 10 mm tumor necrosis after light exposure, in comparison to the 5-6 mm necrosis induced by chlorin e6 or m-THPP under identical conditions. 21-Thiaporphyrin, tested as a potential photosensitizer, induced no skin sensitization even at doses as high as 7.5 mg/kg body weight. 21-Thiaporphyrin presents a high potency in tumor sensitizing, i.e. a feature required for an efficient photosensitizer in photodynamic therapy applications.
Lymphangiosarcoma in a Chronic Lymphedematous Limb: A Case Report
Authors: Lasa Maria Victoria , Mateo Pedro , Bascón Natividad , Baquedano José , Fuertes Fernando , López Paloma , Escó Ricardo
Published: April 2018

A 69-year-old-woman developed a lymphangiosarcoma of the limb on chronic lymphedema after radical mastectomy and radiotherapy for primary breast cancer 12 years before. Since 1948, when Stewart and Treves described this entity, 200 cases have been described. We report this case because of its extremely rare frequency. Concepts of etiology, treatment and prognosis are reviewed.
Differences in Cancer Mortality Trends between Four Neighboring North-Eastern Areas and Italy, 1970-1990
Authors: Bidoli Ettore , Franceschi Silvia , Simonato Lorenzo , Piffer Silvano , Tognazzo Sandro , Vian Paolo , Prati Sabrina , Fascioli Silvia , Cristofolini Mario ,   The Gruppo Epidemiologico del Nord-Est, Simonato L. , Zambon P. , Giorio M.P. , Rodella S. , Franceschi S. , Talamini R. , Bidoli E. , Barbone F. , Stanta G. , Cuttini M. , Bovenzi M. , Piffer S.
Published: April 2018

Aims and background

The present report combines descriptive statistics (partly never published) on four neighboring areas of north-eastern (NE) Italy [Friuli-Venezia Giulia (1970-89) and Veneto (1970-87) regions and the provinces of Trento (1970-89) and Bolzano (1971-90)], and all Italy (1970-89). The aim was to highlight potential differences in mortality trends and promote a more systematic sharing of data and methodologies.

Methods

Death certificates stratified by cause, sex, age and residence were obtained from official publications of the Italian Central Institute of Statistics. Absolute numbers of deaths from different causes, age-standardized rates (on the basis of the European standard population) and percentage of change over the examined period for both sexes were computed for each geographic area.

Results

Unfavorable trends were seen for neoplasms of the upper aerodigestive tract, lung, breast, colorectum, bladder, kidney and pancreas and cutaneous malignant melanoma. Increases in most of these neoplasms were more marked in the 4 NE areas than in Italy, especially with respect to cancers of the upper aerodigestive tract in both sexes and cancer of the lung and ovary in women. In Bolzano, rates of neoplasms associated with tobacco and alcohol consumption were lower and less steeply increasing than in the other NE areas, most notably Trento, therefore, contributing to produce the lowest overall cancer mortality rates of NE areas. Cancers of the stomach, uterus, and testis and Hodgkin's disease presented consistent downward trends in all examined areas.

Conclusions

The analysis of mortality trends across areas is consistent with elevated and still increasing cancer rates in the 4 NE areas considered, especially for tobacco and alcohol-related neoplasms and skin melanoma. Preventive strategies, based on epidemiologic knowledge, especially against tobacco and heavy alcohol consumption, and intense intermittent sun exposure, seem to be priorities and may benefit from systematic sharing of information, expertise and intervention tools in NE Italy. At least part of the lack of cancer deaths in Bolzano must be attributable to the deaths of Bolzano residents abroad (especially in Austria) and/or to differences in coding practices. This should be elucidated in future studies.
Effectiveness of Early Chemotherapy Treatment in Anaplastic Astrocytoma Patients
Authors: Silvani Antonio , Salmaggi Andrea , Pozzi Annalisa , Fariselli Laura , Franzini Angelo , Boiardi Amerigo
Published: April 2018

There are limited data in the literature concerning chemotherapy trials for the treatment of anaplastic astrocytomas. Forty-one anaplastic astrocytoma patients, operated on during the period 1988 to 1993 at the Neurological Institute of Milan, received 4-5 cycles of chemotherapy (BCNU + cisplatin), subsequently radiotherapy (median dose 56.5 Gy), and finally a second-line chemotherapy protocol at recurrence (procarbazine, vincristine, lomustine). The aim of the study was to evaluate the effectiveness of the planned protocol, considering the time to tumor progression and the survival time. The group of anaplastic astrocytoma patients was compared with a homogeneous group of 39 anaplastic astrocytoma patients treated only with radiotherapy after surgery. The median time to tumor progression of patients on the protocol was 24.5 months. The median survival time for anaplastic astrocytoma patients treated with our scheduled protocol or only with radiotherapy was 38.8 and 21 months, respectively. However, our data need to be confirmed by large randomized clinical studies.
Mitomycin-C and Lonidamine as Second-Line Therapy for Colorectal Cancer: A Phase II Study
Authors: Zaniboni Alberto , Meriggi Fausto , Alghisi Alberto , Mutti Stefano , Distefano Luciana , Rizzi Anna , Bettini Lamberto , Simoncini Edda , Marpicati Patrizia , Montini Elisabetta , Marini Giovanni
Published: April 2018

Aims and background

Recent preclinical data have suggested that lonidamine may potentiate the activity of mitomycin C in human colon cancer cell lines LoVo and HT29.

Study design

A phase II study was carried out in 14 patients with advanced colorectal cancer pretreated with fluorouracil and folinic acid. Treatment consisted of lonidamine, 600 mg po, followed after 2 h by mitomycin, 20 mg/m2 by iv bolus, followed by lonidamine, 150 mg tid for 5 days; the cycle was repeated every 6 weeks.

Results

No objective response was seen. Three patients had stable disease; the median survival for the whole group was 4 months. Although hematologic toxicity was negligible, lonidamine-related side effects were moderate to severe in most patients and mainly represented by myalgia and gastric pain.

Discussion

Despite a sound preclinical rationale, this schedule of lonidamine and mitomycin C was ineffective and toxic in patients with advanced colorectal cancer. More experimental data about lonidamine are needed in order to design more effective regimens based on the combination of this interesting drug with other anticancer agents.
Liver Metastases from Gastric Carcinoma: Report of a Patient Treated with Adoptive Immunotherapy (Tumor-Infiltrating Lymphocytes plus Interleukin-2 and Subsequently Local-Regional Lymphokine-Activated Killer Cells plus inTerleukin-2)
Authors: Fabbri Laura , Ridolfi Ruggero , Riccobon Angela , Maltoni Roberta , Flamini Emanuela , Fedriga Roberta , Flamigni Alberto , Migliori Giuseppe , Ortolani Franco , Calzolari Filippo , Amadori Dino
Published: April 2018

A 37-year-old patient with liver metastases from gastric cancer was treated with a double adoptive immunotherapy regimen comprising tumor-infiltrating lymphocytes plus interleukin-2 and subsequently local-regional lymphokine-activated killer cells plus interleukin-2 because of an extremely high in vitro cytotoxic specific activity on established gastric cancer cell lines. The necrosis verified in the center of the hepatic metastasis would appear to demonstrate treatment efficacy, but no clinical response was seen. In vitro cytotoxicity data alone are insufficient to predict the clinical efficacy of adoptive immunotherapy.
Renal Angiomyolipoma: Report of three cases with Regional Lymph Node Involvement and/or with Renal Cell Carcinoma
Authors: Csanaky György , Szereday Zoltán , Magyarlaki Tamás , Méhes Gábor , Herbert Tamás , Buzogány István
Published: April 2018

Aims and background

Angiomyolipomas (AMLs) are benign hamartoid tumors which frequently occur in tuberous sclerosis (TS). They may be manifest at different organ sites such as kidneys, lymph nodes, liver and lung and may be associated with renal cell carcinoma (RCC). The nature of multiple organ involvement in AML (metastasis versus multicentric synchronous tumors), the malignant transformation and the relation of AML to RCC have not been sufficiently clarified.

Study design

Three cases of renal AMLs in patients with tuberous sclerosis associated with lymphangioleiomyomatosis of the paraaortic lymph nodes and/or with RCC are reported. The concise clinical history of the patients as well as the findings of histology, immunohistochemistry and quantitative DNA analysis are presented.

Results

The multicentric form of AML and coincidence of renal AML and RCC were observed in 2 patients. AML and RCC were found within the same focus in one of the cases. RCCs were either aneuploid or “near diploid”, whereas one of the multicentric AMLs showed a discordant DNA ploidy pattern, namely aneuploidy in the kidney and diploidy in the lymph nodes.

Conclusions

The presented cases (all of them underwent periaortic lymphadenectomy) suggest that lymph node involvement in renal AML may be more frequent than expected (1-2% of all AMLs) on the basis of the few reported cases. The discordant DNA ploidy (renal versus lymph node lesions) observed in one of the cases with multicentric AML implies synchronous tumor growth at different sites rather than metastatic disease. The intimate coexistance of RCC and AML (RCC revealed by immunohistochemistry within a larger mass of renal AML) may indicate that malignant transformation of an AML should only be accepted, if such a coincidence is unequivocally excluded.
Hodgkin's Disease Stage I and II with Exclusive Subdiaphragmatic Presentation. The Experience of the Departments of Radiation Oncology and Hematology, University “La Sapienza” of Rome
Authors: Enrici Riccardo Maurizi , Osti Mattia Falchetto , Anselmo Anna Paola , Banelli Enzo , Cartoni Claudio , Sbarbati Stefano , Padovan Fabio Scattoni , Zurlo Alfredo , Biagini Carissimo
Published: April 2018

During the period 1978 to 1994, 1054 patients with Hodgkin's disease were evaluated and treated at the Departments of Radiation Oncology and Hematology, University “La Sapienza”, Rome. A total of 549 patients presented with clinical or pathological stage I and II; 37 of these had Hodgkin's disease below the diaphragm (BDHD), and 512 above the diaphragm (ADHD). A comparison of patients with BDHD versus those with ADHD showed that the first group had a higher male to female ratio. A comparison of cases with stage II BDHD versus those with stage II ADHD showed that patients with BDHD were older (48 years vs 28 years), had different histologic features and a higher incidence of systemic symptoms (67% vs 33%). Stage II BDHD patients had a worse prognosis; in fact, there were significant differences in the overall survival and relapse-free-survival rates for cases with stage II BDHD versus those with stage II ADHD (overall survival, 46% vs 80%, P<0.001; relapse-free survival, 44% vs 69%, P<0.005). Stage was found to be the most important prognostic factor for BDHD cases without systemic symptoms treated with radiation therapy alone. The type of infradiaphragmatic presentation (intra-abdominal vs peripheral disease) did not influence outcome, probably due to the more aggressive therapy received by the intra-adbominal group. Treatment recommendations for BDHD cases should be tailored to the stage and the presence or absence of intra-abdominal localization. For patients with stage IA extended fields, irradiation (inverted Y) is sufficent. However, combined modality therapy should be the treatment of choice for stage II cases, particularly in the presence of intra-abdominal disease. Patients with systemic symptoms also require combined modalities.
A Phase II Study of Mitomycin C, Vindesine and Cisplatin Combined with Alpha Interferon in Advanced Non-Small Cell Lung Cancer
Authors: Silva Rosa Rita , Bascioni Romeo , Rossini Simonetta , Zuccatosta Lina , Mattioli Rodolfo , Pilone Alberta , Delprete Stefano , Battelli Nicola , Gasparini Stefano , Battelli Tullio
Published: April 2018

Aims and background

MVP chemotherapy (mitomycin C, vindesine or vinblastine, cisplatin) is one of the most commonly used regimens for advanced non-small cell lung cancer (NSCLC). Experimental data suggest a synergistic cytotoxic activity of alpha-interferon (α-IFN) when combined with cisplatin, mitomycin C, and vinca alkaloids. In an effort to improve MVP chemotherapy activity, we have combined this regimen with α-IFN.

Patients and methods

Thirty-five patients with advanced NSCLC (19 stage IV) were treated with the MVP regimen (mitomycin C, 8 mg/m2; vindesine, 3 mg/m2; cisplatin, 75 mg/m2, all on day 1) plus α-2a-IFN, 3×106 U im from day 1 to 7. The cycles were repeated every 28 days.

Results

There were no complete responses and 18 partial responses, for an overall response rate of 51%. Median time to treatment failure was 6 months (range, 1-18), and median survival was 9.5 months (range, 1-32). WHO grade 3 toxicity was recorded in up to 8% of patients, flu-like syndrome was a common complaint; one toxic death occurred.

Conclusions

The combination yielded a level of response comparable to that of other cisplatin-based regimens. Larger randomized trials are needed to assess the role of α-IFN combined with chemotherapy in advanced NSCLC.
Characterization of Cancer-Related Disseminated Intravascular Coagulation in Relation to Tumor Necrosis Factor-Alpha Blood Concentrations: Possible Therapeutic Role of Pentoxifylline
Authors: Lissoni Paolo , Ardizzoia Antonio , Barni Sandro , Pittalis Salvatore , Rossini Fausto , Porta Alvaro , Tancini Gabriele
Published: April 2018

Aims and background

Preliminary experimental data suggest the involvement of tumor necrosis factor (TNF) in determining endothelial damage related to disseminated intravascular coagulation (DIC). The present study was performed to investigate TNF secretion in DIC occurring in metastatic solid tumor patients and to evaluate the possible therapeutic role of pentoxifylline, which has been proven to have a TNF-lowering activity.

Methods

The study included 20 metastatic solid tumor patients who showed clinical and laboratory signs of DIC. Pentoxifylline was given orally at a dose of 1200 mg/day for 28 days.

Results

Abnormally high levels of TNF were found in 13/20 patients, and mean TNF serum levels observed in patients were significantly higher than those seen in a control group of 50 healthy subjects. Fibrinogen plasma concentrations were low in 11 cases. Patients with low fibrinogen values showed significantly higher mean TNF levels than those with normal or elevated concentrations. Pentoxifylline therapy induced a significant decrease in mean TNF concentrations and a significant increase in mean platelet number, which returned to within the normal range in 11/20 patients. An increase in platelets in response to pentoxifylline was more evident in patients with elevated pretreatment TNF values.

Conclusions

Our results suggest the existence of abnormally high blood levels of TNF in cancer-related DIC, mainly in the presence of low fibrinogen values. Moreover, they indicate that pentoxifylline therapy may determine a decrease in TNF levels in DIC patients, an event associated with an increase in platelet number.
Molecular Genetics of Hereditary Non-Polyposis Colorectal Cancer (HNPCC)
Authors: Cama Alessandro , Genuardi Maurizio , Guanti Ginevra , Radice Paolo , Varesco Liliana
Published: April 2018

The story of the molecular genetics of HNPCC is one of astonishingly rapid achievements. In just 16 months, from May 1993 to September 1994, four different genes, namely hMSH2, hMLH1, hPMS1 and hPMS2 have been identified and demonstrated to be associated with the disease. Their cloning was facilitated by the finding that tumor cells in HNPCC patients display a hypermutability of DNA short tandem repeats (microsatellite instability). In fact, HNPCC associated genes are the human counterparts of genetic elements known to control the fidelity of DNA replication in lower organisms. So far, more than 50 germline mutations of hMSH2 and hMLH1 genes have been reported in HNPCC kindreds. In addition, somatic mutations have been documented in hereditary as well as sporadic cancers. Unfortunately, the molecular diagnosis of HNPCC is hampered by the lack of mutational “hot spots” and of clearly defined genotype-phenotype correlations and different screening methods are to be employed for the analysis of affected and at-risk individuals.
Smoking in Italy, 1994
Authors: Pagano Romano , La Vecchia Carlo , Decarli Adriano
Published: April 2018

The prevalence of smoking in Italian males and females has been investigated using data from the National Health Survey (first cycle), collected between January and March 1994, and based on a total sample of 13,048 individuals (6,307 males and 6,741 females) representative of the general Italian population. Overall, 24.2% of Italians aged 15 years or over described themselves as current smokers (32.6% of males and 16.3% of females). Ex-smokers were 14.2%, including 22.3% of males and 6.6% of females; never smokers were 61.6% (45.1% of males, 77.1% of females). In both sexes, the highest proportions of smokers were young to middle-aged (35-44 years), and there was a substantial decline in smoking rates in the youngest age group (15-24 years), to reach 19.8% of males and 9.9% of females. A steady and substantial decline in reported smoking prevalence over time was observed in males (from 54.2% in 1980 to 32.6% in 1994), whereas smoking prevalence remained approximately stable around 17% in females. This was due to some increase in smoking prevalence among women over 35 years of age, following a cohort effect, and the low quit rate among females. The average number of cigarettes per smoker per day was slightly up, to reach 18.3 in males and 13.4 in females in 1994. The fall in reported cigarette consumption was only partly reflected in legal sale data, which showed for 1993 a consumption of 1.86 kg per adult per year, corresponding to 5.1 cigarettes per day. Taking into account also smuggling, this indicates that interview-based figures were underestimated by at least 25%. In males, but not in females, smoking was less frequent in northern and more developed areas of the country and among more educated individuals. Among Italians with a university degree, smoking rates were for the first time higher in females (31.5%) than in males (23.7%). Thus, the data from the 1994 National Health Survey confirm the long-term decline in smoking prevalence among Italian males, in the absence however of appreciable changes in females.
Indications, Results and Techniques of Radiotherapy in the Treatment of Small-Cell Lung Cancer
Authors: Palazzi Mauro , Villa Sergio , Leonardi Maria Cristina , Milani Franco
Published: April 2018

Aims and background

To define the role of radiotherapy in the treatment of small-cell lung cancer (SCLC) on the basis of clinical data reported in the medical literature.

Methods

Published reports are critically reviewed, with particular attention to randomized trials.

Results

Thoracic radiotherapy has an important role in improving local control and 3-year survival in limited-stage SCLC; radiation should be delivered early in the course of the chemotherapy program, avoiding large volumes and total doses exceeding 40-50 Gy. Thoracic radiotherapy probably has no role in resected patients treated with adjuvant chemotherapy and may even be detrimental in patients with extensive SCLC. Prophylactic cranial irradiation has been shown to reduce the risk of brain relapse, but it is not associated with a consistent increase in survival or cure rate: its use in clinical practice is therefore not advised.

Conclusions

Survival rates approaching 50% at 2 years are now possible in limited SCLC with the integrated effort of the surgeon, the medical oncologist and the radiation oncologist; their strict cooperation appears to be of the utmost importance in the earliest phase of treatment planning.
Molecular Characterization of Cellular Proteins from Colorectal Tumors
Authors: Szymczyk Piotr , Krajewska Wanda M. , Jakubik Jaroslaw , Berner Andrzej , Janczukowicz Janusz , Mikulska Urszula , Berner Jan , Kiliańska Zofia M.
Published: April 2018

Aims and background

Recent evidence has suggested that progressive stages of colorectal tumorigenesis can be defined by a sequence of genetic events characterized by altered expression of certain genes and the appearance of cancer-specific proteins. Although the significance of these events is still not clear, expression of cancer-specific protein components may be directly involved in the neoplastic transformation. The purpose of the present study was to compare molecular characteristics of cellular proteins from human colorectal tumors and normal colonic mucosa.

Methods

Normal mucosa and colorectal tumors from 18 patients were fractionated by a differential centrifugation scheme into four cellular fractions, i.e., nuclear, mitochondrial (10P), microsomal (100P) and cytosolic (100S). The proteins of these fractions from normal and tumorigenic mucosa were analyzed by one-dimensional polyacrylamide gel electrophoresis followed by Coomassie brilliant blue R-250 and silver nitrate staining. Nuclear proteins from normal and neoplastic tissues which had revealed the most significant diversities were further characterized by two-dimensional gel electrophoresis. Electrophoretically cancer-specific nuclear proteins in the molecular mass zone 35-40 kDa were used as immunogen to produce rabbit polyclonal antibodies.

Results

Electrophoretic analysis by one-dimensional gel electrophoresis showed clear differences in molecular characteristics of cellular proteins between normal and tumorigenic mucosa, especially among nuclear fractions. The latter were also confirmed by their two-dimensional electrophoresis results. Rabbit antibodies raised against electrophoretically specific nuclear proteins characterized by molecular mass of 35-40 kDa cross-reacted with 36 kDa polypeptide in 15 of 18 (83.3%) studied nuclear fractions of colorectal tumors but not with any normal mucosa. In some cases, nuclear cancer-associated components of 38 and 40 kDa were also recognized by these antibodies.

Conclusions

During colorectal carcinogenesis, specific expression of several nuclear proteins takes place. One of them, the polypeptide of 36 kDa not found in normal colonic epithelium, was shared by over 83% of the studied carcinomas despite variations in detailed cancer properties. This particular nuclear protein may be considered as a potential marker for the colon malignancy.
Attitudes of Non-Oncology Physicians Dealing with Cancer Patients. A Survey Based on Clinical Scenarios in Ancona Province, Central Italy
Authors: Piga Andrea , Graziano Francesco , Zahra Georges , Cellerino Riccardo
Published: April 2018

Aims and Background

With this study we attempted to determine to what extent recent acquisitions in clinical oncology had reached categories of physicians involved in the management of patients with cancer, namely general surgeons, internists and family doctors.

Methods

A questionnaire was prepared with scenarios based on the following clinical situations: Scenario A, Adjuvant therapy in colon cancer; Scenario B, Treatment of small-cell lung cancer; Scenario C, Adjuvant therapy in high-risk, node-negative breast cancer; Scenario D, Treatment of early stage breast cancer; Scenario E, Asymptomatic transient myelosuppression during chemotherapy. Questionnaires were mailed to 365 family doctors, 54 general surgeons and 61 internists of the Province of Ancona in central Italy.

Results

A total of 198 completed questionnaires were returned (41%). Respondents were 36.7% of family doctors, 54.1% of internists and 57.4% of surgeons. Less than half of respondents selected an adequate approach such as adjuvant chemotherapy for colon cancer and high-risk, node-negative breast cancer or chemotherapy as first-line treatment for small-cell lung cancer. Conservative surgery plus radiotherapy (QUART) for early stage breast cancer was indicated by 69% of respondents. Over three quarters of physicians would give treatment for asymptomatic transient chemotherapy-induced leukopenia. In most of the scenarios, significant differences were detected in the distribution of preferences according to category of physicians. Family doctors and young physicians (<40 years) generally performed worse than hospital-based physicians (general surgeons and internists) and older physicians.

Conclusions

Non-oncology physicians showed insufficient awareness of currently available knowledge in cancer treatment. Basic concepts in cancer management should be part of the professional knowledge of all medical doctors, and key advances in clinical oncology should spread outside the oncologic environment more promptly, with a wide circulation among all physicians who care for cancer patients.
Results. of a Mammographic and Clinical Screening in a Health District (USSL) of Brescia, Italy
Authors: Filippini Luigi , Braga Marco , Perna Egidio , Bianchi Anna Maria , Bettoni Carlo , Lucini Laura , Pezzola Diego , Pinelli Domenico , Tonini Gabriele , Tonini Gerolamo , Callea Francesco
Published: April 2018

Aims and Background

Screening by mammography has been shown to be effective in reducing breast cancer mortality. We present the results of a mammographic and clinical screening program carried out in an Italian health district.

Methods

The first screening round started in June 1987 and ended in July 1990, and 25,100 women between the age of 50 and 60 years were invited. The second screening round invited 34,332 women between the age of 50 and 64 years and was carried out from September 1990 to September 1993. Women with positive or equivocal results at palpation or mammography were referred for immediate diagnostic assessment followed by surgery, when required.

Results

The attendance rate was 67.3% at the first and 62.1% at the repeat screening. At the first screening, 206 biopsies were advised and 197 were performed; 129 of the 197 were found to be malignant. At repeat screening, 248 biopsies were recommended, 208 were performed, and 125 were found to be malignant. The cancer detection rate was 7.7 per thousand at the first and 5.9 per thousand at repeat screening. Of 129 cancers, 107 (83.0%) were T1 at first screening; 6.2% were in situ carcinomas. Axillary lymph nodes were histologically positive in 24% of cases. At repeat screening, 77.6% (97/125) of cancers were T1; 11.2% were in situ carcinomas. Positive axillary lymph nodes were found in 16.8% of cases.

Conclusions

The attendance to screening was satisfactory. A higher frequency of small tumors (83.0%) was found at first screening than before the introduction of screening (56.6%). A marked difference in lymph node positivity (24.0% vs 40.6% in the pre-screening era) was also observed. Such a difference was even more evident at repeat screening. Quality standards of the screening in our study proved to be higher than those currently recommended. The reported results are encouraging, also considering the greater chance for conservative treatment.
Ten-Year Survival and Age at Diagnosis of Women with Breast Cancer from a Population-Based Study in Umbria, Italy
Authors: La Rosa Francesco , Patavino Vincenzo Michele , Epifani Anna Cristina , Petrinelli Anna Maria , Minelli Liliana , Mastrandrea Vito
Published: April 2018

We analyzed the 10-year survival of 1,512 women with breast cancer in relation to age at diagnosis. The incident cases were from an ad hoc investigation in Umbria, a region of central Italy, for the period 1978-1982. The follow-up was carried out by an automatic link with the RENCAM (Nominative register of causes of death) and verified at the Registrar's Offices of the various towns of the region. Observed survival at 1 year was 0.89, at 3 years 0.75, at 5 years 0.64 and at 10 years 0.47. Median survival was 9.0 years. Relative survival at 1, 3, 5, 10 years was respectively 0.91, 0.79, 0.71 and 0.59. Women <35 years of age had a better prognosis both at 5 (0.83) and 10 years (0.69) from diagnosis. Thereafter, survival decreased with increasing age. The exception to this trend was women in the 45-49 and 60-64 year age ranges, for which survival was greater than the previous age range classes by 6% and 13%, respectively, at 5 years from diagnosis and 6% and 14% at 10 years. Comparison of data from Umbria and Italian and European Registries shows that the prognosis for Umbrian women with breast cancer is quite good.
Association of Breast Carcinoma and Meningioma: Report of Nine New Cases and Review of the Literature
Authors: Salvati Maurizio , Cervoni Luigi
Published: April 2018

Nine patients with diagnosed breast cancer who developed meningiomas are reported. Articles suggesting that an association of these two tumors is possible. Some authors have noted hormonal sensivity and the presence of hormonal receptors in some meningiomas. Since breast cancer is the most common tumor in women, an association between it and meningiomas might be fortuitous. However, it is important to fully investigate brain lesions in patients with breast cancer so that potentially curable meningiomas are not considered as metastases.
Agreement Estimate among three Italian Cancer Registries in the Coding of Multiple Primary Cancers
Authors: Buiatti Eva , Crocetti Emanuele , Gafà Lorenzo , Falcini Fabio , Amorosi Andrea , Milandri Carlo , La Rosa Maria
Published: April 2018

Aims

The aim of the study was to compare agreement on the coding of multiple primary cancers (MPs) between three Italian cancer registries, the Ragusa Cancer Registry (RCR), the Cancer Registry of Romagna (RTRo), and the Tuscany Tumor Registry (RTT), that adhere to different rules for accepting MPs and to study whether coding according to common international rules (IARC-IACR) increased comparability.

Methods

One hundred cases were randomly extracted from the archives of each registry from those recorded as having more than one cancer. For each of the 300 patients, the number of independent cancers was attributed independently by one coder from each registry. The coders coded the series twice: once following the local registry rules and once according to the IARC-IACR rules. The agreement was estimated by couples of coders by means of Cohen's kappa statistics.

Results

The agreement on MP status between coders using local rules and definitions was good between the RTT and RCR (kappa = 0.77) and very good between the RTRo and RCR (kappa = 0.81) and the RTT and RTRo (kappa = 0.96). Exclusion of 23 expected discordant cases increased the agreement. The agreement reached with the use of the IARC-IACR rules was very good (RTRo vs RCR, 0.95; RTT vs RTR, 0.94; RTT vs RTRo, 0.95).

Conclusions

The comparison among the RTT, RTRo and RCR confirmed that the number of tumors considered MPs may be modified depending on the rules adopted. There were minor differences between the RTT and the RTRo since their rules were very similar. Most differences in agreement were with the RCR since its classification was conceptually different from the other two. The result on agreement with IARC-IACR rules is encouraging from the point of view of conducting a cooperative study among different registries on the incidence of MPs.
New Scm (Structuredness of the Cytoplasmatic Matrix)-Based Approach in Breast Cancer Detection
Authors: Birindelli Sarah , Colnaghi Maria Ines , Pilotti Silvana
Published: April 2018

Aims and Background

We evaluate the possibility to use a combination of techniques such as lymphocyte stimulation and the Cell Scan instrument for early detection of breast cancer. This method can detect differences in lymphocytes activation in the presence or absence of cancer.

Methods

The Cell Scan is a static cytometer system able to examine cellular membrane polarization. We screened 88 women with benign breast lesions, 207 women with mammary carcinoma and 325 healthy blood donors. After lymphocytes separation, each blood sample was incubated with encephalitogenic factor (EF), phytohaemagglutinin (PHA) and Breast Antigen (BrAg) then SCM test was performed.

Results

Positivity was 50% among breast cancer patients, 34% among women affected by benign disease and 27% and 22% respectively among healthy female and male controls with an increase of the specific predictivity of the test during the period of ovulation. A significant difference ( P <0.0001) was observed between healthy donors and breast cancer patients.

Conclusions

This results suggest that the Cell Scan test could be useful to investigate patient's immunogenicity to molecules known to be involved in tumor development and progression, such as oncogene or suppressor gene products, which could be appropriate targets for immune-derived therapeutic approaches.
Treatment of Recurrent Sarcoma of the Extremities by Isolated Limb Perfusion Using Tumor Necrosis Factor Alpha and Melphalan
Authors: Santinami Mario , Deraco Marcello , Azzarelli Alberto , Cascinelli Federico , Chiti Arturo , Costagli Valerio , Inglese Maria Grazia , Manzi Renato , Quagliolo Vittorio , Rebuffoni Giacomo , Santoro Nicola , Vaglini Maurizio
Published: April 2018

Background

24-60% of patients with soft tissue sarcoma shows local recurrences after treatment of the primary tumor. The event is associated with a high incidence of macroscopic or microscopic metastases and a poor survival. Our goal is to preserve a patient's functional limb by treating such cases with isolated limb perfusion (ILP) with recombinant human tumor necrosis factor alpha (rHu TNF-α) and melphalan, which have demonstrated a potent antitumor activity in vivo and in vitro studies.

Methods

During the period November 1991 to November 1995, 10 patients with unresectable recurrent soft tissue sarcoma of the limb were treated by ILP at intermediate hyperthermia (40-40.5 °C) with rHu TNF-α and melphalan. Two patients also received recombinant interferon gamma (rIFN-γ) before and during ILP. We used a range of 2-4 mg for rHu TNF-α and 50-100 mg of melphalan. rIFN-γ was administered on days -2 and -1 (15x106 IU) subcutaneously and the same dose was injected in the arterial line during ILP.

Results

No perioperative surgical complication was observed. Local toxicity was moderate (grade I or II); general toxicity was observed in 6 patients (2 grade I and 4 grade III). Complete response was obtained in 7 cases; 2 patients had a partial response and finally 1 was a nonresponder and showed local progression, which required surgical amputation. Tumor necrosis (observed in 5 cases) was maximal in 4 patients (80-100%) and absent in the patient who had local progression.

Conclusions

The results we obtained with the treatment of soft tissue sarcoma confirm the efficacy of ILP as a limb-sparing methodology for unresectable recurrences. Furthermore, rHu TNF-α and melphalan confirmed their antitumor activity when associated with hyperthermia. Amputation or disarticulation may be reliable as a second-choice treatment for these patients.
Serum Neurotensin in Human Pancreatic Cancer
Authors: Meggiato Tamara , Ferrara Chiara , Tessari Giovanna , Plebani Mario , De Paoli Massimo , Del Favero Giuseppe , Naccarato Remo
Published: April 2018

The role of neurotensin as a physiologic regulator of exocrine pancreatic secretion is known, but the hormone has only recently been recognized as important mitogen in vitro for human cancer cells. The aim of this study was to evaluate the variations of serum levels of neurotensin in pancreatic cancer. We studied 58 patients: 13 control subjects, 20 pancreatic cancer patients, 11 chronic pancreatitis patients, and 14 cases of extrapancreatic disease. No differences were found between serum values of neurotensin in pancreatic cancer and control subjects or extrapancreatic disease. Significantly higher values were detected in chronic pancreatitis than in pancreatic cancer patients ( P <0.04). In chronic pancreatitis patients, the serum levels of neurotensin were correlated with serum amylase ( r = 0.95, P <0.01). Lower levels of neurotensin were found in stage IV pancreatic cancer than in stages I-II ( t = 1.82, P <0.04) and in grade II than in grade I ( t = 2.21, P <0.02). Significant correlations were found between serum levels of neurotensin and two indices of nutrition: albumin ( r = 0.60, P <0.05) and the percentage reduction in body weight (Z = 2.20, P <0.02). No correlations were found between serum levels of the hormone and size of the neoplasm or the survival of patients. We can conclude that the serum variations of neurotensin do not seem to be related to the progression of human pancreatic cancer. The variation of serum levels of the hormone may be linked to a poor nutritional status of the patient.
Analysis of False-Negative and Underreported Smears in the Florence District Screening Program for Cervical Carcinoma
Authors: Confortini Massimo , Ciatto Stefano , Bonardi Lucia , Bulgaresi Paolo , Cariaggi Maria Paola , Carozzi Francesca , Cipparrone Gioia , Minuti Paola Anna , Rubeca Tiziana , Biggeri Annibale
Published: April 2018

Aims and background

To review false-negative or underreported (reactive changes, squamous or glandular atypia) smears performed in women developing histologically proven CIN2 or more severe lesions within 24 months and evaluate error causes. The study setting was the Florence District cervical cancer population-based screening: about 60,000 women age 25–60 years screened per year.

Methods

118 false-negative or underreported cases were identified at screening files-cancer Registry matching, and the original smears were reviewed by six independent readers to judge smear adequacy and error type.

Results

Sampling errors (reported as inadequate, negative or less severe than CIN1 at review) accounted for 74% and screening/interpretation errors (reported as CIN1 or more severe at review) accounted for 26% of studied cases. Screening/interpretation errors were more likely ascribed to misinterpretation and underreporting than to mis-perception of cellular abnormalities.

Conclusions

Quality control should above all address the problem of sampling adequacy. Due to the rarity of misperceived abnormalities (true screening errors), manual or automated rescreening of negative smears would not be an effective procedure for quality control.
Postsurgical Policy in Stage I Testicular Seminoma: Cost and Benefit of Prophylactic Irradiation in a Long-term Experience
Authors: Tana Silvia , Cerrotta Annamaria , Gardani Gianstefano , Palazzi Mauro , Pizzocaro Giorgio
Published: April 2018

The definitive cure rate for clinical stage I testicular seminoma is very close to 100%, and prophylactic irradiation of the regional lymph nodes is associated with a low morbidity. Nevertheless, in recent years a “wait-and-see” policy has been proposed by some researchers. We analysed the cost/benefit ratio of radiotherapy (RT) by review of the case histories of 299 patients treated at the Department of Radiotherapy of the Istituto Nazionale per lo Studio e la Cura dei Tumori in Milan from January 1968 to December 1989. The 5-year overall survival was 99% (97.5% at 10 years), while the 10-year disease-free survival was 96%. The recurrence rate was 2.3%, but no patient relapsed in the irradiated areas. Acute toxicity was very moderate with only 4 (1.3%) serious radiation sequelae occurring 6 to 27 years after treatment. However, 9 second malignancies (3%) were observed. Lastly, we have calculated the costs for our National Health Service comparing surveillance policy and prophylactic irradiation.
Agnor Counts and their Combination with flow Cytometric Analyses and Clinical Parameters as a Prognostic Indicator in Breast Carcinoma
Authors: Rzymowska J.
Published: April 2018

Silver binding nucleolar organizer regions (AgNORs) were counted in tissue sections and were shown to assist in the distinction between benign and malignant breast lesions. The mean AgNOR counts in fibroadenomas were 1.05 ± 0.85 (n=18), in lobular carcinoma 3.55 ± 0.56 (n=35), and in intraductal carcinoma 4.83 ± 1.20 (n=45). AgNOR counting may provide information on breast cancer prognosis supplementary to that obtained with other methods such as flow cytometric analysis. The AgNOR values in carcinomas were also compared with ploidy and S-phase fractions (S) by flow cytometry. More than 75% of the total cancers with counts above 3 dots per nuclear profile contained aneuploid cells, whereas 20% with counts below 3 contained diploid cells (P < 0.05). Similar trends were noticed with regard to S-phase fractions, which were 45% ± 12.5 and 14% ± 4.5, respectively, for the two groups (P < 0.05). AgNOR counting, flow cytometry and clinical parameters may provide complementary information on breast cancer prognosis.
Sentinel Node Biopsy and Selective Dissection for Melanoma Nodal Metastases
Authors: Belli Filiberto , Lenisa Leonardo , Clemente Claudio , Tragni Gabrina , Mascheroni Luigi , Gallino Gianfrancesco , Cascinelli Natale
Published: April 2018

Background

Early detection of nodal metastases still represents an important goal in the management of melanoma patients. A sentinel node is defined as the first colored node in the regional lymphatic basin following injection of blue dye in the site of the primary melanoma. Sentinel node biopsy may represent a feasible technique for early identification of occult disease. A therapeutic dissection is then performed only in patients with proven nodal disease, thus introducing the concept of selective dissection.

Methods

At the National Cancer Institute of Milan from February 1994 to October 1996, 74 patients with a melanoma of the trunk or limbs and without clinically detectable node metastases were submitted to sentinel node biopsy and eventual selective dissection.

Results

The sentinel node was identified in 67 patients (90%). Nodal metastases were detected in 11 patients (16%); 5 of these were identified by an intraoperative frozen section examination. In all but one case, only the sentinel node was affected at radical dissection. Incidence of positive sentinel nodes was correlated with depth of infiltration of the primary lesion. Mapped nodal basin failures were observed in 3 patients with negative sentinel node biopsy. All patients but one, presenting distant metastases, are alive at this writing and free of disease with a follow-up ranging from 2 to 34 months.

Conclusions

Our study adds to accumulating evidence supporting the efficacy of sentinel node biopsy in detecting occult localizations and the potential of the technique to better select the group of patients that may benefit from nodal dissection.