bluuebunny/crossref_metadata_2025 huggingface dataset:
Vindesine in Plasma Cell Tumors
Authors: Salvagno Luigi , Paccagnella Adriano , Sileni Vanna Chiarion , De Besi Pietro , Frizzarin Michela , Casara Dario , Fiorentino Mario V.
Published: April 2018

Twenty-one patients with plasma cell tumors received vindesine (VDS) at the dose of 3 mg/m2 i.v. on day 1 plus prednisone at the dose of 100 mg p.o. from day 1 to 5, recycling every 8 days 3 times and then every 10-12 days. In 3 patients with gastric or duodenal ulcer prednisone was not administered. All but one patient were heavily pretreated and resistant to M-2 regimen. Overall there were 4 objective responses (19 %): 2 among 15 patients (13 %) with multiple myeloma and 2 among 6 patients (33 %) with extramedullary plasmacytoma (EMP). The responses lasted for 2, 12, 15 and 48+ months. One previously untreated EMP patient received VDS without prednisone and obtained a complete long-lasting remission. The association of VDS with high-dose prednisone seems to have some activity in plasma cell tumors; probably in multiple myeloma the objective responses are due to the high dose of cortisone rather than to VDS. On the contrary, in EMP patients, VDS may be an active agent, even if administered without cortisone.
Immunological Reactivity of Serum Ferritin in Patients with Malignancy
Authors: Cazzola Mario , Arosio Paolo , Belletti Vittorio , Bergamaschi Gaetano , Dezza Laura , Iacobello Carmelo , Ruggeri Giuseppina , Zappone Elisabetta , Albertini Alberto , Ascari Edoardo
Published: April 2018

Serum ferritin has been suggested as a tumor marker in the diagnosis of certain malignancies and for following the activity or dissemination of the malignant process. Since neoplastic tissues generally contain more acidic isoferritins than their normal tissue counterparts, it has also been suggested that the specific assay of such isoferritins in serum may be of particular value in the diagnosis of malignancy. In this work, we have evaluated ferritin concentration in the serum of normal subjects and patients with acute nonlymphocytic leukemia, Hodgkin's disease, breast cancer and lung cancer by simultaneously using three different immunoassays: (a) an immunoradiometric assay based on polyclonal antibodies against human liver (basic, L-subunit rich) ferritin, (b) a radioimmunoassay based on polyclonad antibodies against HeLa cell (acidic, H-subunit rich) ferritin, and (c) an immunoradiometric assay based on the monoclonal antibody 2A4 raised against human heart (acidic, H-subunit rich) ferritin. Most of the patients studied had increased values for liver-type ferritin in the absence of increased iron stores. Binding of serum ferritin to concanavalin A did not prove to be useful in distinguishing a tumor-specific basic isoferritin. The HeLa ferritin assay was found to be less specific than the heart ferritin assay in the detection of acidic isoferritins, and did not provide any advantage over the liver assay in detecting the increased levels of serum ferritin associated with malignant disease. Heart-type ferritin was found in one-fifth of normal sera and 64 % of sera from patients with malignancy. Values were very low compared with those for basic ferritin, ranging from less than 0.1 to 17 % of total serum ferritin (geometric mean value 1.3 %) in patients with malignancy. These findings indicate that at present there is little application for serum ferritin immunoassays based on antibodies to HeLa cell or heart ferritin in the diagnosis or monitoring of malignant disease. This seems to be due to the presence in human serum of biding factors which are responsible for the rapid clearance of acidic isoferritins from the circulation. The serum concentration of basic ferritin, however, can be useful in the diagnosis and management of some malignancies, and it is possible that studies on cell isoferritins can be important in biologic monitoring of neoplastic disorders. It should also be noted that the increased levels of serum ferritin found in patients with malignancy can exert adverse effects on the host immune response and perhaps an inhibitory effect on hematopoiesis.
Prognosis for Localized Cutaneous Melanoma Treated with Wide Excision Only, with Special Reference to Development of Regional Node Metastases
Authors: Eldh Jan , Suurkula Mart , Holmström Hans
Published: April 2018

A consecutive series of 564 patients with localized (Stage I) melanoma treated by wide excision only were followed for at least 5 years. The median tumor thickness was 1.50 mm, and 30 % were ulcerated. The female/male ratio was 54/46. The overall survival rates were 80 % at 5 years and 73 % at 10 years. The survival rates were statistically significantly better for females, even when tumor thickness and ulceration were taken into consideration. Twenty percent developed regional node metastases after an average remission period of 13 months. The actuarial survival rates after node dissection were 32 % at 5 years and 27 % at 10 years. A subgroup with an exceptionally poor prognosis and a high rate of regional node dissemination was looked for. Only 26 % of the intermediate thickness group (1.50–3.99 mm, Breslow) developed nodal metastasis, whereas patients with thick lesions (> 4 mm) had a metastasis rate of 43 %. Patients with thick lesions may therefore benefit more from elective node dissection than patients with lesions of intermediate thickness. Patient characteristics, e.g., sex and tumor characteristics (ulceration), may prove to be of importance in a prospective trial on elective node dissection.
Hemothorax in Congenital Neuroblastoma
Authors: Minola Ernesto , Gambacorta Marcello
Published: April 2018

The authors report a case of massive left hemothorax in a 15-day-old baby girl, caused by the rupture of a thoracic neuroblastoma.
Current Results of Esophageal Cancer Surgery. Time Trends in Operative Mortality and Long Term Survival
Authors: Pastorino Ugo , Valente Maurizio , Alloisio Marco , Bedini Vittorio , Cataldo Ignazio , Muscolino Giuseppe , Ongari Mauro , Preda Ferdinando , Ravasi Gianni
Published: April 2018

This paper represents a historical analysis of the results achieved by esophageal cancer surgery over the last three decades, as they appear in the literature of the years 1954–1985, and in our own experience between 1965 and 1985, with the aim of assessing the evolution of operative mortality and long-term survival. In a review of 4930 resections reported in western literature, mean values of perioperative mortality went down from 30 % to 9 %, while the five-year survival increased from 8 % to 19 %. Similar changes were evident in Japanese and Chinese literature where the survival rose from 9 % to 23 % in unscreened populations and up to 90 % in early cancers. In our experience, dividing the series in two decades (1965–74 and 1975–85), the overall perioperative mortality changed from 28 % to 13 %. The actuarial survival for the two periods was 8 % vs 18 % at 5 years, with a median survival of 9 and 18 months. A greater difference was evident for NO patients where the survival rose from 15 % to 35 % at 5 years, with a median survival of 15 vs 38 months.
Adjuvant Treatment with Melphalan in Ovarian Carcinoma with no Residual Disease following Surgery
Authors: Spatti Gianbattista , Regazzoni Mario , Koronel Remi , Zecchini Anna Maria , De Palo Giuseppe
Published: April 2018

Forty-nine patients classified after surgery and complete non-surgical restaging as « no residual disease » were treated with adjuvant chemotherapy. Thirty-nine patients had ovarian carcinoma and 10 borderline tumors. All patients had geographic inaccessibility. Domiciliary treatment with melphalan at the dose of 10 mg/day p.o. for 5 consecutive days every 4 weeks for 12 cycles was used. Within 6 months from the end of adjuvant treatment a second restaging with peritoneoscopy and peritoneal cytology was performed. The median administered dose of melphalan was 575 mg. No patient with a borderline tumor relapsed. Nine patients with ovarian carcinoma relapsed (23 %): 4/10 at stage II-III and 5/29 (17 %) at stage I. The relapse-free survival at 96 months was 77 % for stage I patients and 73 % for all patients. The overall survival was 87 % for stage I patients and 81 % for all patients. Mild myelodepression was evident in 65 % of patients. No case of acute nonlymphocytic leukemia was observed.
Epithelial Neoplasia of the Endometrium in Pregnancy. A Case Report
Authors: Carinelli Silvestro Giuliano , Cefis Francesco , Merlo Daniela
Published: April 2018

A case of focal severe atypical hyperplasia-carcinoma in situ discovered during voluntary abortion is described. The patient did not undergo hysterectomy; after abortion, menses were regular and the endometrium was histologically normal at a control. Ten cases of endometrial epithelial neoplasia in pregnancy (9 cases) or in puerperium (1 case) found in the literature were reviewed. Although in some of them stromal invasion, which actually is the main prognostic indicator of endometrial neoplasia, was absent or not documented, all lesions were designated as adenocarcinoma. There is evidence that young women with a noninvasive neoplasm and desiring children or preservation of the uterus may be treated conservatively even if the lesion is detected in pregnancy or puerperium.
Acute Effects of Various Chemotherapeutic Combinations on Hypophyseal and Pineal Hormone Secretions in Cancer Patients
Authors: Barni Sandro , Lissoni Paolo , Tancini Gabriele , Crispino Sergio , Paolorossi Franco , Rovelli Franco , Fumagalli Gabriele , Ferri Luigi , Esposti Daniele , Esposti Germana , Fraschini Franco
Published: April 2018

It is known that prolonged therapy with cytotoxic drugs may affect the endocrine system. The present study was carried out to establish whether administration of chemotherapeutic drugs acutely influences hypophyseal and pineal activities. Nineteen patients affected by solid tumors were included in the study, 5 of whom were treated with CMF, 4 with FEC, 4 with CEV, and 6 with CDDP. Cytotoxic drugs were intravenously administered. Venous blood samples were collected at zero time and at 30, 60, 120 and 180 min after drug administration. On a separate occasion, venous blood samples were drawn during a saline infusion only. In each sample FSH, LH, GH, PRL, TSH, Cortisol, melatonin and β-endorphin were determined by the RIA method. The only significant changes observed in this study were a rise in PRL and a decrease in β-endorphin after CDDP administration. Melatonin was enhanced after CDDP and CMF, and Cortisol decreased after CMF and FEC, but their variations were not statistically significant with respect to those seen during saline infusion.
Spontaneous Massive Necrosis of a Hepatocellular Carcinoma
Authors: Andreola Salvatore , Audisio Riccardo A. , Mazzaferro Vincenzo , Doci Roberto , Milella Marco
Published: April 2018

A case of hepatocellular carcinoma that underwent total necrosis without previous chemotherapy is described. Histologic examination of the neoplasm revealed massive thrombosis of numerous peritumoral venous vessels in the adjacent normal liver. Although the importance of a newly formed arterial blood supply for the maintenance of the viability of hepatocellular carcinoma is unquestionable, this case suggests a similar importance of the venous drainage of the surrounding liver.
Morphologic Heterogeneity of Cell Populations Isolated by Density Gradient Centrifugation from Serous Fluids of Ovarian Tumors
Authors: Rabczynski Jerzy , Bar Julia K. , Noworolska Anna , Cislo Mieczyslaw , Richer Roman , Harlozinska Antonina
Published: April 2018

The cells of tumor fluid from patients with malignant and benign serous ovarian neoplasms were fractionated using Ficoll-Uropoline density gradient centrifugation. Density distribution and morphologic characteristics of cell fractions were analyzed. It was found that serous ovarian adenocarcinomas contained three to four types of morphologically malignant cells focused in low density layers. Borderline ovarian neoplasms showed the presence of one subpopulation of cells with some features of malignancy and cells with some atypical but non-malignant features. The fluids of serous cysts contained mainly normal epithelial cells representing different stages of morphological maturity and were focused in denser layers. The results allowed us to catalogue ovarian tumor cell subpopulations present in each density fraction of individual patients and confirmed that ovarian tumors could be diagnosed by morphologic identification of cells from tumor fluids.
Constitutive and Induced Synthesis of Heat Shock Proteins in Transplantable Hepatomas
Authors: Schiaffonati Luisa , Bardella Lidia , Cairo Gaetano , Rappocciolo Emilia , Tacchini Lorenza , Bernelli-Zazzera Aldo
Published: April 2018

The synthesis of heat shock proteins (HSP) was studied in rat liver and in a series of transplantable Morris hepatomas with different growth rates, subjected to heat shock in vivo and in vitro. Different from the liver, hepatomas synthesized HSP constitutively, i.e., also before exposure to heat. This constitutive synthesis was low and limited to one HSP in the slowest-growing tumor, more marked and involving other HSP in the intermediate- and fast-growing hepatomas. In tumor that synthesized HSP constitutively, the induction of HSP in response to heat was proportionately reduced. These patterns of reaction were essentially similar in vivo ad in vitro. The amount of HSP 68 was well correlated to the levels of its mRNA in liver and in all hepatomas, whereas the increase in HSP 89 was accompanied by a corresponding increase in the related mRNA in liver and in slow-growing hepatoma, not in the other tumors, thus suggesting a different mechanism of control of HSP 89 synthesis in the more malignant hepatomas.
Non-Hodgkin's Lymphoma Primarily Involving the Bronchial Tree
Authors: Verdiani Paolo , Di Carlo Stefania , Sforza Vincenzo , Santopietro Rosa
Published: April 2018

Among extranodal localizations, the bronchial one is very unusual, especially as primary involvement. The authors present 2 cases of non-Hodgkin's lymphoma (NHL) admitted to the hospital because of thoracic abnormalities. Chest x-ray revealed lobar atelectasis. Fiberoptic bronchoscopic findings agreed with the diagnosis of unresectable bronchogenic tumor in both cases. Histologic examination of biopsy specimens was nonrevealing in the first patient, and suggested small cell lung cancer in the second one. Further histologic and immunohistochemical examinations excluded bronchial tumors (particularly small cell bronchogenic carcinoma) and led to the diagnosis of lymphocytic lymphoma in one case and centroblastic lymphoma in the other. In the differential diagnosis of bronchogenic tumors, it is necessary to keep in mind the hypothesis of lymphomatous involvement of the bronchial wall, although it rarely occurs.
Light Microscopic, Immunocytochemical and Ultrastructural Study of a Case of Sertoli Cell Tumor of the Testis
Authors: Ventura Terenzio , Discepoli Stefania , Coletti Gino , Leocata Pietro , Francavilla Sandro , Properzi Giuliana , Santiemma Vittorio , Martini Ettore
Published: April 2018

A case of testicular specialized gonadal stroma tumor was evaluated by histologic, ultrastructural and immunohistochemical techniques in a young adult male patient. The neoplastic cells were organized in cords or tubular structures delimited by a basement membrane. The ultrastructural findings suggested a diagnosis of a partially differentiated Sertoli cell tumor. This was also supported by the presence of a vimentin rich cytoskeleton, which is normally present in Sertoli and Leydig cells. The tumor cells did not secrete steroid hormones, as suggested by clinical findings, as well as by hormonal, immunohistochemical, and ultrastructural observations.
High Chemotactic Motility and Growth in Hard Agar of a Variant of RSV-Transformed Fibroblasts are Lost in Late Passages
Authors: Allavena Gabriella , Melchiori Antonella , Carlone Sebastiano , Di Renzo Maria Flavia , Comoglio Paolo , Parodi Silvio , Santi Leonardo , Albini Adriana
Published: April 2018

Cloning efficiency in hard agar (0.6%) and high chemotactic migration toward fibroblast conditioned medium have been shown to characterize metastatic tumor cells. We studied growth in 0.6% agar and chemotaxis of two lines of Rous Sarcoma virus-transformed Balb/ c3T3 cells, B77/3T3 (low metastatic) and AA12 (high metastatic), and compared them to their non-transformed counterpart, in order to verify whether these properties were maintained during several subcultivations. Cells were cryopreserved at early passages and thawed for experiments. Both assays were performed on freshly thawed cells (4-6 weeks in culture) and on cells which had been cultured 15-20 weeks after thawing. B77/3T3, which are tumorigenic but low metastatic and which have a very low cloning efficiency in hard agar (0.1-1%), showed a chemotactic response to Balb/c3T3 conditioned medium about two-fold higher than control Balb/c3T3. This response did not change with time in culture. AA12 cells, a genetic unstable variant of B77/3T3 selected for its growth in hard agar (0.6%), had a high cloning efficiency in hard agar and showed a high chemotactic motility (three-fold the controls). High growth in 0.6 % agar and high chemotaxis of AA12 were lost in late passages, where cells behaved as the controls. It seems that besides the already reported variation in anchorage-independent growth, genetically unstable tumor cells can also have important variations in chemotactic motility during subcultivations.
4-Demethoxydaunorubicin Administered Orally in Advanced Breast Cancer
Authors: De Lena Mario , Brandi Mario , Bozzi Domenica , Calabrese Pietro , Romito Sante
Published: April 2018

Twenty-five patients with advanced breast cancer were treated with 4-demethoxydaunorubicin (4-DMDR), a new antitumor analogue of daunorubicin, at the dose of 15-20 mg/m2/day X 3 days by oral route every 3-4 weeks. All patients were previously treated with chemotherapy and/or hormone therapy but none with anfhracyclines. Of 23 evaluable patients, 1 complete and 5 partial remissions (26%) were observed for a median duration of 4+ months. Leukopenia and nausea occurred in 61% of the patients, vomiting in 30%, diarrhea in 17% and alopecia in 43%. There were 2 cases with minimal and transient EKG variations. 4-DMDR, administered orally in advanced breast cancer, was found to be generally well tolerated. Nevertheless, randomized trials with adriamycin or epirubicin are necessary to compare and to define the therapeutic activity and the toxicity of 4-DMDR.
Phase II Study of a 5-Fluorouracil, Teniposide and Mitomycin-C Combination Chemotherapy in Advanced Colorectal Carcinomas
Authors: Becouarn Yves , Calabet Jean , Brunet René
Published: April 2018

Fifteen patients (median age 62, with a mean Karnofsky performance status of 70%) presenting with advanced colorectal carcinoma were included in the study. The treatment combination consisted of 5-fluorouracil (800 mg/m2 in a 30 min infusion, days 1 and 8), teniposide (80 mg/m2 in i.v. push, day 1), and mitomycin-C (10 mg/m2 in i.v. push, day 1); therapy was resumed every 29 days. A partial objective response (for 4 months) was noted in one patient who had received no prior chemotherapy; the overall median survival of the 15 patients was 5 months. Toxicity was acceptable, with leukopenia (1 case), mucositis (1 case) and diarrhea (1 case), leading to drug dose reduction. Chemotherapy was stopped once owing to severe hematologic toxicity. With the doses and schedule used, the drug combination appears to have minimal activity in advanced colorectal cancer.
Thymoma: A Clinico-Pathologic Study Based on Newly Developed Morphologic Criteria
Authors: Rendina Erino A. , Pescarmona Edoardo O. , Venuta Federico , Nardi Stefano , De Rosa Giovanni , Martelli Massimo , Ricci Costante
Published: April 2018

A retrospective study of 28 cases of thymoma classified according to Marino and Müller-Hermelink (cortical, medullary, mixed common, mixed with cortical predominance, mixed with medullary predominance thymoma) was undertaken to determine the existence of correlations between histology and clinical behavior. Cortical thymoma was observed in 11 cases (39.2%), mixed common thymoma in 9 (32.1%), mixed with cortical predominance in 5 (18%), and medullary thymoma in 3 (10.7%). In patients with cortical thymoma the tumor was always invasive (stages II and III according to Bergh), whereas medullary thymomas were noninvasive in 2 cases (stage I) and slightly invasive with a moderate infiltration of the capsule in the remaining case (stage II). Mixed common and mixed with cortical predominance thymomas displayed intermediate behavior. Twelve patients were affected by myasthenia gravis: 1 had medullary thymoma, 6 had mixed common thymoma, 3 had mixed thymoma with cortical predominance, and 2 had cortical thymoma. One patient with cortical thymoma had superior vena cava syndrome and 1 had erythroid hypoplasia; mixed common thymoma was associated with Cushing's syndrome in 1 patient. These data confirm previously reported observations (16) showing a higher degree of malignancy in patients with cortical thymoma.
Cell Kinetics Aspects of Human Malignant Neuroepithelial Tumors: A Follow-Up Study
Authors: Gaetani Paolo , Danova Marco , Butti Giorgio , Silvani Vittorio , Brugnatelli Silvia , Buttini Roberto , Knerich Roberto , Riccardi Alberto
Published: April 2018

The prognostic value of proliferative activity and DNA distribution (ploidy), determined by flow cytometry (FCM), was evaluated in 38 cases of human malignant neuroepithelial tumors. No statistically significant correlation was found between flow cytometric data and clinical outcome. In particular, there was no significant difference between mean survival in cases with percentage of cells in S-phase lower and higher than 5%, respectively. In 21 cases with unimodal DNA distribution, the mean survival was 11.7 months; in 17 cases with bimodal DNA distribution, the mean survival was 12.5 months. The difference was not statistically significant. In our experience, proliferative activity and ploidy do not correlate well with the clinical course and survival of patients with malignant neuroepithelial tumors. However, application of FCM may provide, aside from histopathologic examination, additional biologic information that may be valuable in understanding the variation observed in the course of individual patients.
Lung Resection as Salvage Treatment for Metastatic Osteosarcoma
Authors: Pastorino Ugo , Valente Maurizio , Gasparini Marco , Azzarelli Alberto , Santoro Armando , Tavecchio Luca , Alloisio Marco , Ongari Mauro , Ravasi Gianni
Published: April 2018

Resection of pulmonary metastases has achieved a central role in the overall management of osteosarcoma, since a number of studies have demonstrated that salvage surgery is able to cure 20 to 40% of all relapsing patients. This paper presents the results of surgical management of 27 consecutive cases of pulmonary metastases from osteosarcoma, who underwent complete resection at the Istituto Nazionale Tumori of Milan between 1975 and 1986. In the present series, overall actuarial survival at 3 years from the first thoracotomy was 47%, with a median survival of 28 months and no operative mortality. Better results were observed in patients with single lesions (68% survival) or when the interval to lung metastases exceeded 12 months (60% survival). These data support the concept of pulmonary metastasectomy as effective salvage therapy for metastatic osteosarcomas whose distant spread is confined in the lungs.
Prognostic Value of Squamous Cell Carcinoma Antigen in Patients with Uterine Cervical Carcinoma
Authors: Bhatavdekar Jyotsna M. , Ghosh Nandita , Shukla Minakshi K. , Balar Damodar B. , Bhaduri Anita , Karelia Neelkamal H. , Shah Neelam G. , Trivedi Sunil N.
Published: April 2018

Squamous cell carcinoma antigen (SCC Ag) was estimated in 30 controls, in 16 patients with benign lesions of the uterine cervix, and in 51 patients with uterine cervical carcinoma. The rate of positivity of the antigen among the cancer patients was 87% (N = 49). SCC Ag estimations were of no diagnostic value, since 37% of patients with bening lesions had elevated levels compared to controls. SCC Ag was highly correlated to histologic subtype. The highest values were obtained in keratinizing tumors, followed by large cell nonkeratinizing and small cell nonkeratinizing types. Moreover, elevation of SCC Ag was statistically significant (p < 0.001) among all the three histologic subtypes compared to controls. However, SCC Ag levels were not consistently correlated to the stage of the disease. Patients with pretherapeutic SCC Ag levels above 30 ng/ml had a faster recurrence rate and shorter survival than those who exhibited antigen values below 2.0 ng/ml. From our results, it is suggested that SCC Ag has limited use as a parameter for early diagnosis of cervical carcinoma, but it seems to reflect advancement of the disease. These findings indicate that SCC Ag elevation may prove to be a valuable marker in predicting subclinical disease.
Osteosarcoma of the Myometrium Synchronous with Bilateral Papillary Cystadenocarcinoma of the Ovary and Papillary Adenocarcinoma of the Cervix
Authors: Basolo Fulvio , Pingitore Raffaele , Gadducci Angelo
Published: April 2018

We report an extremely rare case of a 60-year-old woman with myometrial osteosarcoma associated with bilateral papillary cystadenocarcinoma of the ovary and papillary adenocarcinoma of the cervix. The uterine osteosarcoma is the seventh case reported in the world, while it is the second case of syncronous triple primary tumors of the upper female genital tract. Clinical and pathological features of previously reported cases of uterine osteosarcoma and triple primary neoplasias of the upper female genital tract are critically reviewed.
The Role of Partial Cystectomy in the Management of Transitional Bladder Cancer
Authors: Torelli Tullio , Leidi Gian Lorenzo , Corrada Piero , Bacchioni Antonio M. , Ordesi Giorgio , Zanitzer Livio , Campo Biagio
Published: April 2018

A study on 81 patients who underwent partail cystectomy for bladder cancer is presented. The low postoperative mortality (2.46%) and the high 5-year survival (72%) show that this type of surgery is effective and without major complications. Thirty-eight patients were treated with endovesical thiotepa (OTT); the remaining 41 patients were untreated after surgery. Results showed that survival and number of relapses were similar in the two groups. This fact seems to prove that chemotherapy with OTT is not essential after segmental cystectomy. To explain this assertion, several hypotheses are presented.
Induction of New Antigenic Properties on Dtic-Treated L1210 Clones
Authors: Marelli Ornella , Franco Paola , Canti Gianfranco , Prandoni Nancy , Ricci Laura
Published: April 2018

In vivo treatment of mouse leukemia L1210 with DTIC can induce new antigens on tumor cells that are not detectable on parental cells and that are transmissible as a genetic character. Moreover, L1210/DTIC is rejected by syngeneic hosts. The aim of this study was to investigate whether DTIC selects pre-existing immunogenic clones rather than inducing ex novo new antigenic determinants and to verify the number of induced antigens. L1210 leukemia was cloned in vitro and 4 clones were treated in vivo with DTIC. All the treated clones displayed antigenic properties since they were rejected by syngeneic hosts. Cytotoxic T lymphocytes (CTL) activated against one DTIC clone could recognize and lyse the relevant target. One of these DTIC-modified clones (L4/DTIC) was recloned and the subclones were tested in vivo and in vitro. Two out of six subclones were rejected by syngeneic hosts. CTL specific against these two clones were able to recognize and lyse all the other clones to different degrees. The degree of suscptibility to lysis did not correlate with the capability to evoke an immune response in vivo. Based on these findings we conclude that DTIC does not select pre-existing clones but modifies the tumor cells antigenically, and that the antigenicity induced by DTIC in a cloned tumor line is due to the presence of common antigens shared to different degrees with treated cells.
Benign Lipoblastoma: First Case Report of a Mesenteric Origin
Authors: Zanetti Gianfranco
Published: April 2018

A case of benign lipoblastoma of the mesentery, surgically resected in a 4-year-old boy, is reported, with data on its gross and histologic features. Both diffuse lipoblastomatosis and single benign lipoblastoma have been observed in different anatomical sites, mostly involving the subcutaneous tissue, and only sporadic cases of mediastinal or retroperitoneal lipo-blastomas have been reported. The present case therefore appears to be the first description of a lipoblastoma arising from mesentery. The main tumoral lesions with which lipoblastoma can be confused are briefly discussed.
Electron Microscopy in an Oncologic Institution. Diagnostic Usefulness in Surgical Pathology
Authors: Lombardi Luciano , Orazi Attilio
Published: April 2018

A retrospective survey of all electron microscopic (EM) examinations of surgical pathology specimens obtained at the Istituto Nazionale Tumori of Milan over a 5-year period (1981-1985) was carried out. During this time a total of 259 cases were examined: for 97 (38%) electron microscopy provided a substantial diagnostic contribution, whereas in 151 (58%) it confirmed the previous light microscopic diagnosis. In our experience, EM was most useful for diagnosing selected cases of cutaneous malignant melanoma predominantly metastatic, rhabdomyosarcoma, neuroblastoma and poorly differentiated neuroepithelial tumors and less helpful in the further analysis of cases of malignant mesothelioma, Ewing's sarcoma, leiomyosarcoma and fibrohistiocytic malignancies. In cases of well-differentiated neuroepithelial tumors, such as carcinoids, EM data was essentially confirmatory of (immuno)-histochemical findings.
Lung Cancer in Acute Myelomonocytic Leukemia: A Report of two Cases
Authors: Marra Roberto , Pagano Livio , Storti Sergio , Nicoletti Giovanni , Teofili Luciana , Rabitti Carla , Leone Giuseppe
Published: April 2018

The authors describe two cases of acute nonlymphoblastic leukemia, FAB subtype M4, who developed a lung cancer while in complete remission of the leukemia. The possible interrelations between the two diseases are discussed.
Cisplatin (P) versus Cyclophosphamide, Adriamycin and Cisplatin (CAP) for Stage III-IV Epithelial Ovarian Carcinoma: A Prospective Randomized Trial
Authors: Tomirotti Maurizio , Perrone Silvia , Giè Paolo , Canaletti Rodolfo , Carpi Amalia , Biasoli Roberto , Lombardi Franco , Giovanninetti Anita , Mensi Fabio , Villa Silvia , Scanni Alberto
Published: April 2018

In 1982 a randomized trial was started to compare a cisplatin-containing polychemotherapy (CAP: cyclophosphamide - CPA 750 mg/m2, adriamycin - ADM 50 mg/m2, cisplatin - P 50 mg/m2 on day 1 every 21 days) with full-dose cisplatin as single agent (P 60 mg/m2/day on days 1 and 2 every 28 days) in 44 patients undergoing exploratory laparotomy or debulking sugery for stage III-IV epithelial ovarian carcinoma with residual disease > 5 cm. The response was evaluated at second-look surgery with random biopsies and peritoneal washing. On the basis of the final results the authors underline some data which, although merely indicative (because of the small number of patients) appear to be worth considering since they are in accordance with the latest reports: a) similar response rate (CR+PR=47%) to first-line treatment in the two groups; b) the CAP treatment may achieve a longer median duration of CRs than the P treatment (20 versus 11 months); c) overall survival seems similar in the two groups of patients (19 versus 18 months), whereas the survival of CRs seems longer in the CAP treated patients (> 32 versus 25 months). The authors also discuss some observations on a possible salvage therapy.
Bilateral Primary Malignant Lymphoma of the Breast. A Case Report
Authors: Bucciarelli Emilio , Cavaliere Antonio , Sidoni Angelo , Alberti Paolo F. , Sfondalmondo Stefano
Published: April 2018

A case of bilateral primary malignant lymphoma of the breast in a 30 year old woman is described. The tumors were first discovered during a self-examination of the breast at the 7th month of pregnancy. Thereafter they rapidly increased in size. The patient underwent simple bilateral mastectomy, and histological examination revealed a centroblastic/centro-cytic lymphoma. The patient is alive and well 9 months after mastectomy.
Diet and Cancer Risk in Northern Italy: An Overview from Various Case-Control Studies
Authors: La Vecchia Carlo , Negri Eva , Parazzini Fabio , Marubini Ettore , Trichopolous Dimetrios
Published: April 2018

A critical overview is presented of selected findings from a series of case-control studies conducted in the greater Milan area on cancers of the digestive tract, breast, female genital tract, prostate and bladder. Even using very simple data collection instruments (based on the frequency of use of a restricted number of food items), a number of consistent and strong associations emerged. In particular, frequent green vegetable consumption appeared to exert substantial protection against most of the cancer sites considered, which could not be explained in terms of information, selection or confounding bias. Other interesting clues, such as a moderately positive relation between fats and breast cancer, and a positive association between maize and esophageal or gastric cancer are discussed in order to illustrate the potential scope of studies of diet and cancer risk based on populations with considerable heterogeneity and modifications in dietary patterns, and recent changes in mortality from various common cancers.
Cytogenetics and Occupational Exposure to Solvents: A Pilot Study on Leukemias and Myelodysplastic Disorders
Authors: Vineis Paolo , Avanzi Gian Carlo , Giovinazzo Bruna , Ponzio Giorgio , Cambrin Giovanna Rege , Ciccone Giovannino
Published: April 2018

In a pilot study, 57 patients affected by leukemias or myelodysplastic syndromes were interviewed to identify potential exposure to organic solvents. Cytogenetic analyses were performed in 40 of the 57 patients. Unlike previous investigations, no association was found between the occurrence of chromosomal abnormalities and exposure to organic solvents. An original finding was a strong association between solvent exposure and myelodysplastic disorders (4 certainly exposed and 1 possibly exposed out of 11 patients). Such an observation warrants confirmation from case-control studies.
Evaluation of the Circulating Glycoprotein CA549 in Mammary Cancer and Other Malignancies
Authors: Clocchiatti Luigi , De Biasi Flora , Cartei Giuseppe , Sibau Angela , Vigevani Enrico , Signor Marco , Giovannoni Mariella , Ceschia Valentina , Di Chiara Francesco , Grandis Stefano , Taimassons Giovanni , Praturlon Silvio
Published: April 2018

A prospective study was carried out on a recent marker for breast cancer, CA549, a mucine-like acid glycoprotein present in the fat membranes of human milk. Fifty healthy control subjects and 91 with benign conditions, 103 mammary cancer patients and 256 patients with other types of malignancy were studied. For comparison, CEA and CA15-3 were also investigated. The CA549 cutoff was 11 U/ml. In breast cancer the marker was below the cutoff in 9 cases (92.8 %); in malignancies other than breast cancer it was above the cutoff in 5 to 50 % of patients. In breast cancer it was raised in 83.3 % of cases (CA15-3 showed 82.9% and CEA 50 %). In breast cancer after radical surgery, CA549 was normal in patients who were in TNM stage I but above the cutoff in 57.1 % of those at more advanced stages. The follow-up study is ongoing among these patients. In all the study conditions, CA549 favorably compared to CA15-3 values, with sensitivity and specificity greater than CEA.
Comparability Issues within the Itacare Data Base
Authors: Buiatti Eva , Crocetti Emanuele , Conti Ettore , Falcini Fabio , Gafà Lorenzo
Published: April 2018

Aims and background

The aim of the study was to describe the extent of variability among Italian cancer registries in data managing practices that may affect differences in incidence and possibly in survival estimates.

Methods

a self-administered questionnaire was sent to each participating registry. The definitions of the disease, of the start point and of the end point of survival computation were investigated. Moreover, information on the proportion of histologic confirmation, of ill-defined sites and of DCO (death certificate only) was also considered.

Results

There were some differences in cancer registration techniques among Italian cancer registries. As regards disease definition, the most relevant problems arose for urinary bladder. Skin melanoma should also be considered with some caution, due to variability among registries in coding in situ cases. For the CNS and meninges, the proportion of cases that could be differently considered was so limited that no effect on survival is expected. For female breast, colorectum and cervix uteri, the effect of early diagnosis services (which are active only in some areas) may lead to better survival estimates. The variability in incidence date definition was high among registries and sites, but its effect on survival was very limited. There was a wide variability in the proportion of DCOs and of DCIs (initially known from death certificate), which should be considered in survival comparisons. All the registries stated that they carried out an active follow-up of their patients.

Conclusions

In general, quality standards of the registries are good and allow comparability of survival data. The variability of rules adopted by Italian registries may affect geographic survival differences only in a limited number of cancer sites, so that results should be interpreted with caution.
Survival in Adult Italian Cancer Patients, 1978–1989
Authors: Verdecchia Arduino ,   The ITACARE Working Group, Verdecchia Arduino , Capocaccia Riccardo , De Angelis Roberta , Valente Fulvia , Chessa Egidio , Sant Milena , Gatta Gemma , Micheli Andrea , Berrino Franco , Zanetti Roberto , Rosso Stefano , Magnani Corrado , Terracini Benedetto , Vercelli Marina , Casella Claudia , Parodi Stefano , De Lisi Vincenzo , Serventi Lidia , Barchielli Alessandro , Buiatti Eva , Balzi Daniela , Crocetti Emanuele , Falcini Fabio , Nanni Oriana , de Leon Maurizio Ponz , Roncucci Luca , Federico Massimo , Mangone Lucìa , Conti Ettore , Ramazzotti Valerio , Gafà Lorenzo , La Rosa Maria
Published: April 2018

Aims

To present a systematic analysis of population-based cancer patient survival in Italy.

Methods

Population-based survival data have been made available from 10 Italian cancer registries within the ITACARE project. Data, collected and validated using a common protocol, included over 100,000 patients with cancer diagnosed between 1978 and 1989. Multivariate weighted analysis was used to provide relative survival estimates attributable to Italy at national level.

Results

Results are presented, according to a systematic frame, as the main object of the ITACARE study, involving crude and relative survival figures for adult Italian cancer patients, by age, sex, period of diagnosis and registry area. An estimate with reference to Italy as a whole is also presented by cancer site and for all malignant neoplasms combined. Age-standardized relative survival figures are presented to allow comparisons between Italian registries and also to give a basis for international comparisons with countries involved in the EUROCARE study.

Conclusions

For the fist time, population-based survival of cancer patients is made available in Italy on a large scale analysis of data from all the Italian cancer registries in a combined action. Estimates of cancer patient survival at a national level in Italy allow proper international comparisons with European countries and give elements of evaluation and discussion on the performance of the Italian health care system.
Clinical Pathway for Peritoneal Carcinomatosis from Colon and Rectal Cancer: Guidelines for Current Practice
Authors: Portilla Alberto Gomez , Deraco Marcello , Sugarbaker Paul H.
Published: April 2018

Peritoneal carcinomatosis from colon and rectal cancer was in the past a terminal condition without curative treatment options. Recently, an aggressive treatment strategy has resulted in long-term survival in a select group of patients with this condition. The sequence of diagnostic tests and treatments for these patients are presented in a chronological order as a clinical pathway. This exposition is to provide a standardized management plan that will allow critical evaluation of the morbidity, mortality, outcomes and cost of this protracted plan of patient care. The discipline that the clinical pathway process demands may facilitate the continued optimization of this treatment strategy.
Accelerated Bifractionated Radiation with Concurrent Cisplatin Administration in Locally Advanced Head and Neck Cancer: A Feasibility Study
Authors: Fountzilas George , Athanassiadis Athanassios , Nikolaou Angelos , Kalogera-Fountzila Anna , Tzitzikas John , Samantas Epaminontas , Skarlos Dimosthenis , Zamboglou Nicolaos , Daniilidis John
Published: April 2018

Aims and Background

To test the feasibility of accelerated interrupted twice-daily radiation and concurrent cisplatin administration in patients with locally advanced head and neck cancer.

Patients and Methods

Nineteen patients with locally advanced head and neck cancer were treated with accelerated bifractionated radiation with concurrent administration of cisplatin. There were 18 men and 1 female with a median age of 60 years (range, 17–71) and median performance status of 90 (-range, 80–100). Sixteen patients (85%) presented with stage IV disease. Primary site included the nasopharynx (n = 7), oropharynx (n = 5), hypopharynx (n = 1) and larynx (n = 6). Radiation consisted of two fractions of 1.6 Gy each daily, five times weekly to a total dose of 64 Gy. Cisplatin was administered at a dose of 100 mg/m2 on days 2 and 28 of the treatment period.

Results

Nine patients achieved a complete response (47%; 95% CI, 25%–70%) and 5 a partial response (26%; 95% CI, 7%–46%). Grade III–IV toxicity included leukopenia (16%), mucositis (26%), dry mouth (5%), weight loss (16%) and infection (5%). After a median follow-up of 27.11 months (range, 1–33+), 9 patients have died. Median time to progression was 11 months (range, 1–32+) and median survival 25 months (range, 1–32+).

Conclusions

Accelerated twice-daily radiation with concurrent cisplatin is effective in locally advanced head and neck cancer and can be safely given with manageable toxicity.
Immunophenotypes and Cytotoxic Functions of Lymphocytes in Patients with Hepatocellular Carcinoma
Authors: Chavan Sangeeta S. , Chiplunkar Shubhada V.
Published: April 2018

Aims and background

Hepatocellular carcinoma (HCC) is one of the most common cancers in Asia. Immunological mechanisms are thought to play an important role in the control of tumor progression. The immune responses in HCC patients are poorly understood. In the present study, the proliferation and cytotoxic functions of lymphocytes from tumor tissues and peripheral blood of HCC patients were analysed. Simultaneously, the microcultures were phenotyped in order to determine the involvement of different lymphocyte subsets in mediating the cytotoxic function.

Methods

The frequencies of proliferating and cytotoxic lymphocytes from three tumor tissues and peripheral blood from ten HCC patients and nine healthy individuals were assessed by limiting dilution microculture analysis. These microcultures were phenotyped by single and dual color flow cytometry using monoclonal antibodies specific for CD4, CD8, CD56 and HLA-DR markers.

Results

The precursor frequencies of both proliferating and cytotoxic lymphocytes were found to be comparable in the peripheral blood of HCC patients and healthy individuals. Compared to peripheral blood, a marked reduction in the precursor frequencies of proliferating and cytotoxic lymphocytes was observed in the tumor tissues of HCC patients. In the tumor tissues, a significantly higher frequency of cytotoxic T cells compared to natural killer cells was observed. Dual color flow cytometric analysis revealed increased percentages of CD8+ HLA-DR+ lymphocytes compared to CD4+ HLA-DR+ cells in the tumor tissues.

Conclusions

Our results suggest that depressed immune responses at the tumor site might be responsible for the escape of tumor cells from the immune surveillance of the host.
Radiation Therapy for Local-Regional Recurrences of Rectal Carcinoma following Primary Surgery
Authors: Osti Mattia F. , Bonanni Alessio , Zurlo Alfredo , Enrici Riccardo Maurizi , Biagini Carissimo
Published: April 2018

Aims and background

Several studies have emphasized the role of radiation therapy for patients with pelvic recurrences of rectal carcinoma following primary surgery. The occurrence of local-regional relapse usually means a poor prognosis and often a poor quality of life, so that different authors consider the prognosis of patients relapsing after surgery worse than those with primary inoperable tumors or those with residual disease after resection.

Methods

Between January 1988 and January 1995, 43 patients with local recurrence of rectal carcinoma were treated at our Institution. Twenty-three had previously been operated by abdominoperineal resection and 20 by anterior resection. Thirteen cases also received adjuvant chemotherapy. All patients underwent irradiation with a 6-15 MeV linear accelerator; 8 (19%) received a total dose of up to 45 Gy on the pelvis and 35 (81%) higher than 45 Gy. Eighteen cases (42%) underwent 3-6 courses of chemotherapy with 5-fluorouracil and folates during radiation.

Results

Treatment tolerance was satisfactory. All cases underwent restaging at 45 days from completion of treatment. Sixteen cases (37%) showed a radiologic response >50%. Median overall survival after relapse was 18.8 months. There were no statistical significant differences in survival between patients treated exclusively with radiation and those treated with chemo-radiothera-py (17 vs 22 months). The results of patients who received doses higher than 45 Gy were statically better (P < 0.05) than those irradiated up to 45 Gy. A slight increase in survival was demonstrated in cases submitted to radical surgery after combined treatment (25 months). Twenty-seven cases (63%) obtained pain control after radiation therapy (median pain remission, 11 months).

Conclusions

Our results seem to encourage radiation therapists, surgeons and oncologists to have a more curative attitude in the treatment of selected patients with local-regional recurrences of rectal cancers by using multi-modality therapy.