bluuebunny/crossref_metadata_2025 huggingface dataset:
Alexithymia and Cancer-Related Fatigue: A Controlled Cross-Sectional Study
Authors: Gritti Paolo , Lombardi Salvatore , Nobile Barbara , Trappoliere Paola , Gambardella Antonio , Di Caprio Ester Livia , Resicato Gianluca
Published: February 2018

Aims and background

The study aims to investigate the alexithymia construct in patients with a recent or longtime diagnosis of cancer as well as in healthy people, and whether alexithymia and fatigue are linked in the mentioned groups.

Methods

A first group, diagnosed less than 3 months previously (n = 63), and a second group whose cancer diagnosis dated back more than 30 months (n = 53), matched for sex, age, educational level and cancer site were assessed. Matched healthy controls (n = 50) were also evaluated. Alexithymia was assessed with the Toronto Alexithymia Scale-20, while fatigue was assessed with the Brief Fatigue Inventory.

Results

Alexithymia scores were higher in the recently diagnosed group than in the group with a longtime cancer diagnosis (t = 2.18, P <0.05). Both groups had higher scores than controls (t = 4.3, P <0.001; t = 2.01, P <0.05). Alexithymic subjects were 45.6% in the recently diagnosed and 21.4% in the longtime diagnosed group (χ2 = 6.3, P <0.05) and 18% in controls. Fatigue was more severe in patients with a longtime diagnosis compared with recently diagnosed patients (t = 7.079, P = 0.000). A weak but significant association between fatigue and alexithymia was found in recently diagnosed patients (r = 0.27.2; P <0.05).

Conclusions

Our study confirms that alexithymia scores are higher in cancer patients than in controls. The study suggests that alexithymia could be considered a dynamic reaction to illness in recently diagnosed patients, declining during subsequent phases. High fatigue rates in patients with a longtime diagnosis of cancer underline the role of the long course of illness in the perception of fatigue. The association between fatigue and alexithymia was weak in the recently diagnosed group and not significant in patients with a longtime diagnosis, in whom fatigue was an important complaint.
Two Cases of Pediatric High-Grade Astroblastoma with Different Clinical Behavior
Authors: Mastrangelo Stefano , Lauriola Libero , Coccia Paola , Puma Nadia , Massimi Luca , Riccardi Riccardo
Published: February 2018

Astroblastoma is a rare glial tumor occurring in older children and defined by histological criteria as low or high-grade. We describe two children with high-grade astroblastoma. The first patient, with multiple recurrences of a frontoparietal tumor, died 10 years from diagnosis after progression of the disease despite surgery, radiotherapy and chemotherapy. The second patient underwent subtotal resection of a temporal mass; the residual tumor progressed five months after radiotherapy, but after a subsequent gross total resection the patient is now in complete remission 54 months from diagnosis. Although both patients had high-grade astroblastomas, there were histological differences between the two tumors, in particular regarding the proliferative index, which was 30% and 5–10%, respectively.

High-grade astroblastoma is usually treated with surgery and radiotherapy, but may have an unpredictable behavior even when tumor excision is deemed complete. The two cases reported here illustrate the variable clinical course of this rare tumor. The proliferative index may be a useful tool to better define prognosis.
Cancer Mortality in Córdoba, Argentina, 1986–2006: An Age-Period-Cohort Analysis
Authors: Pou Sonia Alejandra , Osella Alberto Rubén , Eynard Aldo Renato , Del Pilar Diaz María
Published: February 2018

Aims and background

Cancer is the second main cause of death in Argentina, surpassed only by cardiovascular disease. However, analytical approaches isolating some of the known effects, such as age at death, period of death and birth cohort, have never been performed in cancer mortality studies in Argentina. The aim of this study was to analyze cancer mortality trends in a representative region of the country, the Córdoba province (1986–2006).

Methods and study design

Overall age-standardized (world population) mortality rates for cancer (all sites) were computed by a direct method. Joinpoint regression was fitted to the age-standardized mortality rates for both sexes to provide estimated and 95% confidence intervals of the annual percentage changes. The effects of age (15 age groups), period of death (1986–90, 1991–95, 1996–00 or 2001–06), and birth cohort (18 overlapping 10-year birth cohorts) covariates on mortality rates were estimated using a sequentially fitted Poisson regression model.

Results

During the study period, 102,737 people died of cancer in Córdoba, with the age-standardized mortality rates decreasing from 139.3 to 118.7/100,000 person-years. Although this reduction was more noticeable in men, the joinpoint regression model showed a significant change of the age-standardized mortality rates after 1996 in both sexes. Age-period-cohort analysis suggested that the cancer mortality trends may be linked with a strong age effect and a moderate or mild period and cohort effect, related to sex and place of residence.

Conclusions

Based on the observed cohort effect, it maybe argued that there has been a lower exposure level to some risk factors, such as diet and other environmental factors, in Cordoba over the last decades.
Comparison of Radiotherapeutic Management of Operated Breast Cancer in 1999 and in 2006: A Sampling Survey on the Southeast Coast of China
Authors: Tian Ye , Li Xian-Ming , Liu Jing-Jie , Ji Yong-Ling , Wang Ber , Yu De , Zhu Ya-Qun
Published: February 2018

Aims

To obtain a better understanding of the changes in radiotherapeutic management of breast cancer patients in the more developed areas of China over the past decade.

Methods

Four academic radiation therapy departments located on the Southeast Coast of China were selected for the study. The survey was conducted on female breast cancer patients who received radiotherapy in 1999 and 2006. The questionnaires were designed to determine the purposes of radiotherapy and to address the postoperative radiotherapy techniques used. The data for these two years were analyzed and compared.

Results

The percentage of breast-conserving treatment increased from 3% in 1999 to 13% in 2006, but the percentage of patients treated with postmastectomy radiotherapy dropped from 69% in 1999 to 66% in 2006 (P <0.05). As regards the changes in techniques from 1999 to 2006, the use of special immobilization devices, treatment planning systems, and CT simulations increased from 46% to 80%, 23% to 70%, and 0% to 14%, respectively (P <0.01). From 1999 to 2006, irradiation of the chest wall following mastectomy increased from 67% to 90%, but for internal mammary irradiation it decreased from 76% to 30% and for the axilla, from 69% to 37% (P <0.01). There were no obvious differences between 1999 and 2006 on the field design, boost treatment on the tumor bed, or dose prescription.

Conclusions

Breast-conserving treatment was performed more frequently in China in 2006 than in 1999, but postmastectomy radiotherapy did not change a great deal and it was still an essential option. Although the international treatment guidelines have been accepted and implemented by physicians in recent years, prompt improvement in the quality of breast cancer radiotherapy is needed.
The Effectiveness of a Scalp Cooling Cap in Preventing Chemotherapy-Induced Alopecia
Authors: Auvinen Päivi Kaarina , Mähönen Ulla Annikki , Soininen Kirsi Marika , Paananen Päivi Kaarina , Ranta-Koponen Päivi Helena , Saavalainen Irma Esteri , Johansson Risto Tapio
Published: February 2018

Aims and background

Hair loss is one of the most unpleasant side effects associated with chemotherapy treatments. It causes emotional disturbances and constantly reminds the patient of the disease. This study analyzed the effectiveness of scalp cooling caps in preventing alopecia among 64 patients.

Methods

The patients were given one of the following chemotherapeutic treatments: doxorubicin 60 mg/m2, docetaxel 80 mg/m2, FEC (5-fluorouracil 600 mg/m2, epirubicin 60 mg/m2, cyclophosphamide 600 mg/m2) or the combination of three cycles of docetaxel (80 mg/m2) followed by three cycles of FEC (5-fluorouracil 600 mg/m2, epirubicin 60 mg/m2, cyclophosphamide 600 mg/m2). All the chemotherapy treatments were given in a three-weekly schedule. Patients with early stage disease were given six adjuvant chemotherapy cycles, while patients with metastatic disease were given nine chemotherapy cycles. The patients were provided with detailed instructions on how to treat the hair at home for one to three days after the chemotherapy treatment. Hair loss was evaluated after the third, sixth and final treatments.

Results

In the final results, major hair loss was avoided in all patients given doxorubicin treatment, in 83.3% of patients given docetaxel treatment, in 76.5% of patients given FEC treatment, and in 78% of patients given docetaxel followed by FEC. In the final evaluation, 87.5% of the patients considered the avoidance of hair loss to be important. Only 20.3% of the patients needed to use a wig.

Conclusions

This study shows that all the patient groups studied gained some benefit by using scalp cooling caps.
The Revised Piper Fatigue Scale (PFS-R) for Italian Cancer Patients: A Validation Study
Authors: Annunziata Maria Antonietta , Muzzatti Barbara , Mella Sara , Narciso Daniela , Giacalone Annalisa , Fratino Lucia , Tirelli Umberto
Published: February 2018

Background and aim

Fatigue is one of the most frequently reported symptoms by cancer patients. In recent years, much effort has been directed to designing fatigue measures which are psychometrically appropriate as well as easily administered. Among these, the Revised Piper Fatigue Scale (PFS-R) is widely used in assessing fatigue in cancer patients and other populations. Despite its large utilization in different national contexts and with different populations, its structure appears to vary across cultures, suggesting the need for its validation before use. The main aim of the present work was to verify the validity (i.e., dimensional structure and construct validity) and reliability (i.e., internal consistency) of an Italian translation of the PFS-R to reassure Italian oncology practitioners about its appropriate usage in practice and research.

Methods and study design

One-hundred ten Italian oncological inpatients were administered an Italian translation of the PFS-R together with a form for the collection of personal identification and clinical data and other fatigue and quality of life measures (POMS and EORTC QLQ-C30) already validated for Italy.

Results

Principal component exploratory factor analysis revealed a four-factor structure quite similar to (although not overlapping) the original described by Piper and colleagues; all four factors proved to be reliable and to correlate with one another and with previous validated measures of fatigue and quality of life. Preliminary descriptive statistics were also provided for data comparisons.

Conclusions

Despite the discussed limitations, PFS-R seems a valid and reliable multidimensional fatigue measure also adequate in Italian oncological settings.
Expression Analysis of Wnt-5a in Renal Epithelial Neoplasms: Distinguishing Renal Oncocytoma from a Wide Spectrum of Renal Cell Carcinomas
Authors: Rao Qiu , Liu Xiao-hong , Zhou Hang-bo , Ma Heng-hui , Lu Zhen-feng , Zhou Xiao-jun
Published: February 2018

Objective

To study the expression of a novel marker, Wnt-5a, in renal epithelial neoplasms and determine its clinicopathological significance.

Methods

Immunohistochemical analysis of Wnt-5a was carried out in normal human kidney samples as well as in 123 primary renal epithelial neoplasms including 37 clear cell renal cell carcinomas (RCCs), 24 papillary RCCs (15 type 1 and 9 type 2), 25 chromophobe RCCs, 11 Xp11 translocation carcinomas, 6 mucinous tubular and spindle cell carcinomas, and 20 oncocytomas.

Results

Wnt-5a was expressed in 18.9% (7/37) of clear cell RCCs, 12.5% (3/24) of papillary RCCs, 16% (4/25) of chromophobe RCCs, 18.2% (2/11) of Xp11 translocation carcinomas, 0% (0/6) of mucinous tubular and spindle cell carcinomas, and 100% (20/20) of oncocytomas. There was a significant difference in Wnt-5a immunohistochemistry between renal oncocytoma and the other subtypes of RCC (P <0.01).

Conclusions

Our results indicate that Wnt-5a is a potentially useful immunohistochemical marker for the complex differential diagnosis between oncocytoma and other subtypes of RCC and also suggest that Wnt-5a may be a tumor suppressor gene in RCC.
Cytoreductive Surgery and Perioperative Intraperitoneal Chemotherapy in Recurrent Ovarian Cancer
Authors: Tentes Antonios-Apostolos K , Korakianitis Odysseas S , Kakolyris Stylianos , Kyziridis Dimitrios , Veliovits Dousan , Karagiozoglou Chrysa , Sgouridou Evanthia , Moustakas Konstantinos
Published: February 2018

Background and aims

Cytoreductive surgery with perioperative intraperitoneal chemotherapy is another approach for recurrent ovarian cancer. The purpose of the study was to assess the feasibility and the effect of cytoreduction and perioperative intraperitoneal chemotherapy in recurrent ovarian cancer.

Patients and methods

Twenty-nine women with recurrent ovarian cancer underwent cytoreductive surgery. Clinical variables were correlated to morbidity, hospital mortality, recurrences, and survival.

Results

Complete cytoreduction was possible in 58.6%. Extensive seeding of the small bowel and distant metastases excluded the possibility of performing complete cytoreduction. Perioperative intraperitoneal chemotherapy was given in 75.9%. Morbidity and hospital mortality rates were subsequently 24.1% and 3.4%. Recurrence was recorded in 48.3%. The extent of peritoneal dissemination was an independent variable of recurrence (P = 0.014). The 5-year survival rate was 30%. The extent of peritoneal dissemination and the completeness of cytoreduction were related to survival (P <05). The completeness of cytoreduction independently influenced survival (P = 0.013).

Conclusions

Secondary cytoreduction with intraperitoneal chemotherapy is feasible in most women with recurrent ovarian cancer with acceptable morbidity and mortality. Complete cytoreduction is not possible if distant and unresectable metastases are present or if the small bowel is extensively seeded. Long-term survivors are patients with limited peritoneal dissemination who may undergo complete cytoreduction.
Pharmacoeconomic Aspects of FOLFIRI or FOLFOX Regimens Administered with a Fully Ambulatory Pump Compared to the Day Hospital Setting
Authors: Tampellini Marco
Published: February 2018

Aims and background

The social cost of management of patients suffering from colorectal cancer has been growing dramatically in the last decade due to the high number of active antitumor agents and to the increased incidence of the tumor in western countries. The aim of the study was to explore from a pharmacoeconomic point of view a different way to administer the two most common regimens in this patient setting.

Study design

This was a cost-minimization study. Data were extracted from hospital registries and dedicated offices. The traditional setting (day hospital inpatient setting) and a fully ambulatory setting (CIP™ pump) were considered and compared.

Results

The CIP™ system resulted in higher direct costs than the day hospital setting (444.70 vs 159.00 euro/cycle). However, traditional infusion resulted in longer nursing care, with an increase in nursing costs of more than 100.00 euro/cycle. Moreover, the inpatient setting obliged patients to stay in the hospital as much as ten times longer than with the CIP™ system. This meant that with the same time span and the same resources, the CIP™ pump permitted treatment of at least five times more patients than the traditional setting. Thus, a threshold of 52.00 euro per patient for general hospital costs (ordinary and extraordinary maintenance of buildings, power supply, and housekeeping) was identified to discriminate whether the CIP™ pump is cost-saving or not.

Conclusions

Administration of the FOLFIRI or FOLFOX regimen in a traditional day hospital setting was less costly when considering the direct costs. However, a fully ambulatory pump permitted to better employ hospital resources and could permit cost-saving in those units in which more than five patients per day are treated and global costs are higher than 52.00 euro per patient.
Protective Effect of Tetrandrine on Doxorubicin-Induced Cardiotoxicity in Rats
Authors: Xu Meng , Sheng Lianghe , Zhu Xinhai , Zeng Shibin , Chi Dexiang , Zhang Guo-jun
Published: February 2018

Aims and background

Doxorubicin (Dox) is effective in curative and adjuvant chemotherapy of malignant tumors. Cardiotoxicity is the chief toxic effect that limits the clinical use of Dox. We studied the effects of tetrandrine (Tet) on doxorubicin-induced cardiotoxicity in rats and its protective activity.

Materials and methods

Sprague-Dawley rats were randomly divided into the following 4 groups: a control group (received only saline), Dox group (received only Dox), Tet/Dox group (received Tet plus Dox), and Tet group (received only Tet). Rats were injected intravenously with 2 mg/kg Dox once a week for 7 weeks and 50 mg/kg Tet was administered intraperitoneally weekly for 7 weeks. Measurements of cardiac contractile parameters including LSVP, +dP/dt max and -dP/dt max, and assessment of electrocardiograms were carried out. Mitochondrial oxidation and phosphorylation state 3 (S3) and state 4 (S4) respiration were measured. Respiration control rate (RCR) and the ADP/O ratio were calculated. Cardiac ultrastructure was examined by electron microscopy.

Results

Dox induced significant cardiotoxicity in this rat model. The values of LSVP, +dP/dt max, and -dP/dt max in the Tet/Dox group increased as compared to the Dox group (P <0.05). The cardiac contraction and relaxation improved on Tet administration. Tet inhibited the prolonged QT interval on the electrocardiogram in Dox-treated rats. Compared to the Dox group, the values of S3, RCR, and ADP/O increased by more than 28%, 48%, and 27%, respectively, in the Tet/Dox group. Significant cardiac morphological protection was observed in the Tet/Dox-treated rats.

Conclusion

Tet can improve the reduced cardiac function caused by Dox treatment and prevent Dox-induced mitochondrial impairment in rat cardiotoxicity.
Trends in Cervical Cancer Incidence and Mortality in Bulgaria, Estonia, Latvia, Lithuania and Romania
Authors: Arbyn Marc , Antoine Jerome , Valerianova Zdravka , Mägi Margit , Stengrevics Aivars , Smailyte Giedre , Suteu Ofelia , Micheli Andrea
Published: February 2018

Objective

The burden of cervical cancer varies considerably in the European Union. In this paper, we describe trends in incidence of and mortality from this cancer in the five most affected member states.

Methods

Data on number of deaths from uterine cancers and the size of the female population of Estonia, Latvia, Lithuania, Bulgaria and Romania were extracted from the WHO mortality database. Mortality rates were corrected for inaccuracies in the death certification of not otherwise specified uterine cancer. Incidence data were obtained from the national cancer registries. Joinpoint regression was used to study the annual variation of corrected and standardized incidence and mortality rates. Changes by birth cohort were assessed for specific age groups and subsequently synthesized by computing standardized cohort incidence/mortality ratios.

Results

Joinpoint regression revealed rising trends of incidence (in Lithuania, Bulgaria and Romania) and of mortality (in Latvia, Lithuania, Bulgaria and Romania). In Estonia, rates were rather stable. Women born between 1940 and 1960 were at continuously increasing risk of both incidence of and mortality from cervical cancer.

Conclusions

Rising trends of cervical cancer in the most affected EU member states reveal a worrying pattern that warrants urgent introduction of effective preventive actions as described in the European guidelines.
Impact of Implementing a Nationwide Cervical Cancer Screening Program on Female Population Coverage by Pap-Tests in Estonia
Authors:   on behalf of the EUROCHIP Working Group, Veerus Piret , Arbyn Marc , Amati Camilla , Baili Paolo
Published: February 2018

Background

The objective of the EUROCHIP project in Estonia was to describe the organized cervical cancer screening program started in 2006 (after pilot studies in 2003–2005), to compare its performance with opportunistic screening, and to define priorities for improvement of the program.

Methods

Population data was retrieved from Statistics Estonia, data about performed Pap-smear tests within the screening program from the Estonian Cancer Society and from clinics and labs participating in the program, data about Pap-smear tests outside the screening program from the Estonian Health Insurance Fund, and data about cancer incidence and mortality from the Estonian Cancer Registry database.

Results

During the first year after implementing the nationwide cervical cancer screening program in Estonia, the number of tests outside the organized program remained high. Within the organized program, the number of Pap-tests in different age groups increased with age except for the oldest age group while population coverage with Pap-tests outside the organized screening program decreased with age. The number of cervical cancer cases at early stages increased after implementation of organized screening. The time-frame does not permit to draw any definitive conclusions.

Conclusions

Implementation of organized cervical cancer screening did not decrease the volume of opportunistic screening. The factors influencing attendance in the organized cervical cancer screening program in different age groups should be studied further. Moreover, a central cancer screening registry without restrictive data protection legislation would improve data collection and enable to evaluate performance of the program on a regular basis.
Modern Computer Technologies Facilitate Communication with a Young Cancer Patient
Authors: Ripamonti Carla Ida , Piccinelli Claudia , Pessi Maria Adelaide , Clerici Carlo Alfredo
Published: February 2018

Aim

The aim of this paper is to show how new technologies may help the communication process in clinical practice in a department providing supportive care to patients undergoing cancer treatment.

Method

Communication via Internet chat between the psychologist and a young man who sees chatting on the Internet as a natural and familiar mode of expression was shown to be useful.

Results

The Internet link enabled us to open a communication channel with the patient and to have a conversation that would otherwise have been impossible.

Conclusions

Although verbal communication is the most important way to communicate among people, Internet communications are certainly an opportunity worth exploring, because they may open up new channels for cancer patients whose ability to speak is restricted. We might imagine using this approach in pediatric oncology, with adolescents and preadolescents, and with young adults like the patient discussed here. The case discussed highlights the enormous difference between the mere transfer of information and genuine communication, the latter involving an encounter with the patient.
Molecular Characterization and Response to Cetuximab in a Patient with Refractory Squamous Cell Anal Carcinoma
Authors: De Dosso Sara , Martin Vittoria , Zanellato Elena , Frattini Milo , Saletti Piercarlo
Published: February 2018

There are no standard chemotherapeutic options for patients with squamous cell anal carcinoma, relapsing and progressing on palliative cisplatin-based regimens. Similarly to other malignant conditions, monoclonal antibodies directed against the epidermal growth factor receptor may represent an attractive therapeutic strategy. Here we describe a patient who, based on molecular profile, benefited from the combination of irinotecan and cetuximab.
Primary Cardiac Chondrosarcoma with Rapid MFH-like Recurrence: Case Report and Review of Tumor Type
Authors: Sawaed Shtiwi , Adler Adam C , Vlodavsky Eugene , Bar-Sela Gil
Published: February 2018

We present a case report of a patient with a rare primary cardiac tumor, chondrosarcoma. After initial excision, a locally advanced recurrence appeared within six weeks at a different site in the heart with the histological features of a high-grade sarcoma. We discuss the background, management and prognosis of these rare tumors.
Molecular Oncogenesis of Prostate Adenocarcinoma: Role of the Human Epidermal Growth Factor Receptor 2 (HER-2/neu)
Authors: Neto Ary Serpa , Tobias-Machado Marcos , Wroclawski Marcelo Langer , Fonseca Fernando Luiz Affonso , Pompeo Antonio Carlos Lima , Del Giglio Auro
Published: February 2018

The potential mechanisms involving the genesis and growth of androgen-independent prostate cancer include super-expression of the androgen receptor (AR), in an attempt to compensate for the low androgenic plasma levels and mutations of this specific receptor, which could determine resistance to anti-androgenic therapy. However, most advanced prostate tumors have no mutations or amplifications of the AR, suggesting a potential role of non-androgenic growth factors, including epidermal growth factor (EGF), transforming growth factor α, insulin-like growth factor (IGF-1) and fibroblast growth factor. More specifically, these factors, and their receptors like EGFR (HER-1) and HER-2/neu, through paracrine and autocrine mechanisms, may contribute to the proliferation and growth of prostate cancer. Free full text available at www.tumorionline.it
Treatment of Glioblastoma in Elderly Patients: An Overview of Current Treatments and Future Perspective
Authors: Lanzetta Gaetano , Minniti Giuseppe
Published: February 2018

Current treatment of glioblastoma in the elderly includes surgery, radiotherapy and chemotherapy, but the prognosis remains extremely poor, and its optimal management is still debated. Longer survival after extensive resection compared with biopsy only has been reported, although the survival advantage remains modest. Radiation in the form of standard (60 Gy in 30 fractions over 6 weeks) and abbreviated courses of radiotherapy (30–50 Gy in 6–20 fractions over 2–4 weeks) has been employed in elderly patients with glioblastoma, showing survival benefits compared with supportive care alone. Temozolomide is an alkylating agent recently employed in older patients with newly diagnosed glioblastoma. The addition of concomitant and/or adjuvant chemotherapy with temozolomide to radiotherapy, which is currently the standard treatment in adults with glioblastoma, is emerging as an effective therapeutic option for older patients with favorable prognostic factors. The potential benefits on survival, improvement in quality of life and toxicity of different schedules of radiotherapy plus temozolomide need to be addressed in future randomized studies. Free full text available at www.tumorionline.it
Characteristics of Upper Urothelial Carcinoma in an Area of Balkan Endemic Nephropathy in South Serbia. A fifty-year Retrospective Study
Authors: Cukuranovic Rade , Ignjatovic Ivan , Visnjic Milan , Velickovic Ljubinka Jankovic , Petrovic Branislav , Potic Milan , Stefanovic Vladisav
Published: February 2018

Aims and background

Upper urinary tract transitional cell carcinoma, a relatively rare tumor, is up to 100 times more frequent in regions with Balkan endemic nephropathy. Characteristics of transitional cell carcinoma in the endemic South Morava Region in Serbia in the previous 50 years were evaluated.

Patients

We analyzed 477 cases with pathologically confirmed transitional cell carcinoma who underwent surgery from 1957 to 2006: 91 from endemic, 106 from adjacent and 280 from control settlements. Cases in the study came from 10 endemic villages, 46 adjacent villages, 51 control villages and the city of Nis.

Results

The increase in number of transitional cell carcinoma from 1957 was followed by a peak between 1967 and 1978 (yearly incidence 21.9 per 100,000) and a slow decrease thereafter to 7.4 (1997–2006). In the control settlements, the increase was steady. Reduced kidney function at surgery was found in 58% of patients from endemic and in 20% from control settlements. Age at surgery has significantly increased from 52.3 and 51.5 (1957–1966) to 70.9 and 66.1 (1997–2006) for endemic and control settlements, respectively. The female sex was predominant in endemic and adjacent settlements and the male sex in control settlements. Transitional cell carcinoma from endemic settlements was of a lower grade in the period from 1957–1986, but in the period from 1987–2006 they were predominantly high grade. Low tumor stage (pTa-pT1) predominated in transitional cell carcinoma from the endemic and adjacent but not the control settlements in the period from 1957 to 1986. However, in the last 20 years, upper urinary tract transitional cell carcinoma stage increased, the highest in the period from 1997 to 2006 in all settlements studied. Conservative surgery was advocated for transitional cell carcinoma in Balkan endemic nephropathy areas up to 1996. Transitional cell carcinoma are now more malignant and more advanced than before, and a less aggressive approach is used only for absolute indications.

Conclusions

An increased number of transitional cell carcinoma in endemic settlements was observed, markedly decreasing in the last decade. An increasing age and a shorter survival were recorded in patients both from Balkan endemic nephropathy and control settlements. Sporadic cases upper urinary tract transitional cell carcinoma in settlements adjacent to endemic settlements were demonstrated. Free full text available at www.tumorionline.it
Central Venous Catheter-Associated Thrombosis in the Perioperative Period: A Frequent Complication in Cancer Patients that can be Detected Early with Doppler Examination
Authors: Yilmaz Kerim Bora , Akinci Melih , Dogan Lutfi , Yologlu Zeynel , Atalay Can , Kulacoglu Hakan
Published: February 2018

Aims and background

The aim of the study was to determine the incidence of venous thrombosis in cancer patients with central venous catheters inserted perioperatively.

Methods and study design

A prospective analysis was performed with 68 patients in whom central venous catheters were placed perioperatively. Cancer patients with planned central venous catheters had prophylaxis with low-molecular-weight heparin. Patient characteristics, procedure-related complications and venous thrombosis related to central venous catheters were recorded. In order to detect the venous thrombosis, color Doppler sonography was used after removal of the central venous catheter.

Results

The median age of the 68 patients was 55 years (range, 24–83). The median duration of catheter placement in patients was 9 days (range, 1–24). Venous thrombosis was detected in 45 (66.2%) patients: at the superficial veins (jugular and subclavian veins) in 27 patients, stretching from superficial veins into the vena cava in 8 cases, in the vena cava in 2 cases, in the right atrium in 2 cases, and at more then one place in 6 patients. Total thrombosis was detected only in 3 patients.

Conclusions

Cancer patients have a high central venous catheter-related thrombosis risk perioperatively despite prophylactic anticoagulation. Color Doppler sonography is a rapid and noninvasive technique and it is accurate in the diagnosis of venous thrombosis. Early detection of venous thrombosis is important to prevent the systemic and fatal complication of the thrombosis. Free full text available at www.tumorionline.it
Laparoscopic Resection of Colorectal Cancer in Elderly Patients
Authors: Fiscon Valentino , Portale Giuseppe , Migliorini Giovanni , Frigo Flavio
Published: February 2018

Aims and background

Aging of the population and a longer life expectancy have led to an increased number of elderly patients presenting with colorectal cancer and searching for treatment. The aim of the study was to assess the effects of age on the outcome of laparoscopic colorectal surgery for cancer at a single department.

Methods

Perioperative outcome of patients ≥75 years old undergoing laparoscopic colorectal surgery between June 2005 and January 2009 for colorectal cancer were compared with findings in younger patients.

Results

The analysis considered 134 patients <75 years and 82 patients ≥75 years of age. There was a significant difference in perioperative risk factors, as reflected by different ASA scores and a significantly higher postoperative ‘medical’ morbidity, but ‘surgical’ morbidity was similar in the two groups and remained low.

Discussion

Surgical morbidity rate was not affected by age. Cardiovascular and pulmonary comorbid conditions were mainly responsible for the higher morbidity rate reported in the elderly patients, although advanced age, per se, should not be considered a contraindication to laparoscopic colorectal surgery for cancer. Free full text available at www.tumorionline.it
Caveolin-1 and VEGF-C promote Lymph Node Metastasis in the Absence of Intratumoral Lymphangiogenesis in Non-small Cell Lung Cancer
Authors: Li Minhua , Chen Honglei , Diao Luming , Zhang Yuxia , Xia Cong , Yang Fei
Published: February 2018

Aims and background

Caveolin-1 is a key component of membrane caveolae which plays an important role in cell transformation, cell migration, metastasis and angiogenesis. The mechanism of caveolin-1 and VEGF-C in lymphatic metastasis of non-small cell lung cancer (NSCLC) is still unclear. This study aimed to define the caveolin-1 and VEGF-C expression and lymph vessel density in NSCLC and look for correlations with clinicopathological features in NSCLC.

Methods

Caveolin-1, VEGF-C, and D2–40 protein expression were assessed by immunohistochemistry in a tissue microarray constructed from 70 NSCLCs and 12 normal lungs.

Results

Caveolin-1 expression was detected in 31 of 70 (44.3%) NSCLCs, which was significantly lower than its expression in normal lungs (9 of 12, 75%; P = 0.049). Expression of VEGF-C was detected in 49 of 70 (70%) NSCLCs and 4 of 12 (33.3%) normal lungs (P = 0.022). Both caveolin-1 and VEGF-C expression were correlated with lymph node metastasis of NSCLC (P = 0.001; P = 0.028). Moreover, caveolin-1 expression was correlated with tumor stage, histological type, and differentiation grade (P = 0.012; P = 0.038; P = 0.002). VEGF-C expression was correlated only with histological type (P = 0.020). There was no correlation between intratumoral lymph vessel density and any clinicopathological parameters including lymph node status. Furthermore, there was no correlation between caveolin-1 expression, VEGF-C expression, and lymph vessel density.

Conclusions

These findings indicated a reduction of caveolin-1 expression in NSCLC and suggested that caveolin-1 as well as VEGF-C might be involved in lymph node metastasis of NSCLC. The role of caveolin-1 in lymphatic metastasis and intratumoral lymphangiogenesis in NSCLC needs further study. Free full text available at www.tumorionline.it
Suppression of TSPAN1 by RNA Interference Inhibits Proliferation and Invasion of Colon Cancer Cells in Vitro
Authors: Chen Li , Yuan Daiyue , Zhao Ren , Li Hui , Zhu Jianwei
Published: February 2018

Aims and background

To investigate effect of TSPAN1 downregulation by RNA interference (RNAi) on proliferation and invasion of human colon cancer cells in vitro.

Methods and study design

RNAi was performed using the vector (pU6H1-GFP)-based small-interfering RNA (siRNA) plasmid gene silencing system to specifically knock down TSPAN1 expression in a colon cancer cell line, HCT-8. The expression of TSPAN1 mRNA was detected by reverse-transcription polymerase chain reaction. TSPAN1 protein expression was observed using Western blots and immunofluorescent microscopy. Cell proliferation and cell cycle assay were measured using methyl thiazolyl tetrazolium (MTT) and flow cytometry, respectively. The invasive ability of HCT-8 cells was examined using a duel culture chamber separated by polycarbonate membranes coated with Matrigel (8.0-μm pore size).

Results

After transfection with the TSPAN1 siRNA plasmid, TSPAN1 mRNA and protein expression was significantly decreased. The decrease in mRNA and protein was associated with a significant decrease in TSPAN1 fluorescent staining and a decrease in cell proliferation due to cell cycle arrest in the G1/G0 phase. A significant decrease in the number of invading HCT-8 cells was associated with these changes.

Conclusion

RNAi-mediated downregulation of TSPAN1 expression significantly inhibits the proliferation and invasion of colon cancer cells in vitro. This finding suggests that TSPAN1 plays an important role in colon cancer progression, and RNAi targeting of TSPAN1 may be a potential therapeutic strategy for the treatment of colon cancer. Free full text available at www.tumorionline.it
Small Cell/Neuroendocrine Tumors of the Esophagus: Presentation of Two Cases and Review of the Literature
Authors: Gollard Russell , Ellis Carla , VanderHarten Carol
Published: February 2018

Small cell cancers of the gastrointestinal tract are part of a family of extrapulmonary small cell carcinomas. These tumors can occur anywhere in the body and generally carry a poor prognosis. Treatment usually consists of a combination of chemotherapy and radiation therapy. We present two cases illustrating diagnostic and treatment issues and review the literature on the treatment of this uncommon but aggressive family of tumors. Free full text available at www.tumorionline.it
Lung Cancer Risk and Residence in the Neighborhood of a Sewage Plant in Italy. A Case-Control Study
Authors: Pizzo Anna Maria , Chellini Elisabetta , Costantini Adele Seniori
Published: February 2018

Aims and background

Environmental pollution originating in sewage and industrial plants can be associated with lung cancer risk, as ecological and case-control studies have indicated. In the present study, the association between lung cancer occurrence and residence near a sewage plant in Prato (Italy) was investigated. A previous geographic study in the same area had shown an increasing trend of lung cancer mortality and incidence with propinquity to the plant.

Methods

A case-control study was carried out in the male population of Prato. Incident cases in the period 1987–1997 were identified from the Tuscan Cancer Registry (no. 918). Controls were randomly extracted from the Registry Office of the Municipality of Prato (no. 1852). For all subjects, the residential history was reconstructed. A weighted average distance from the plant was computed and used as a proxy variable of exposure. Two analyses were performed: on the whole data set and on a subset of subjects for whom information on tobacco exposure and education was obtained through a postal questionnaire (response rate, 41.1%). Logistic regression models were applied to estimate odds ratios and 95% CI.

Results

Both analyses showed a significantly elevated lung cancer risk for subjects living within 1.5 km (ORwhole = 1.56, 1.06–2.28; ORsubset = 2.28, 1.06–4.86) and suggested a risk increase with a decrease of weighted average distance from the plant.

Conclusions

The findings highlight a possible role, in lung cancer occurrence, for environmental pollution spread from the plant. Due to drawbacks of the study, further analyses are needed to evidence a noncontroversial etiological conclusion. When environmental data are not available, results of epidemiological studies using residential histories may be useful in preventive policies regarding point source emissions. Free full text available at www.tumorionline.it
Is Cancer Overtaking Cardiovascular Diseases as the Killer Number one in Men in Tuscany?
Authors: Giovannetti Lucia , Gorini Giuseppe , Martini Andrea , Chellini Elisabetta , Fornai Maria Grazia , Sorso Brunella , Seniori-Costantini Adele
Published: February 2018

Aims and background

For the first time in 2006, cancer became the main cause of death in men in Italy, exceeding cardiovascular disease. The aim of the study was to verify whether the overtaking of cancer male mortality occurred also in Tuscany or in some of its 12 subregional areas and whether there was a geographical trend.

Methods

Age-standardized mortality rates from the Tuscan Regional Mortality Registry, 1987–2008, were calculated for neoplasms, cardiovascular diseases, and respiratory diseases, considering the whole region and its 12 areas. Joinpoint analyses were carried out to study temporal trend.

Results

Up to 2008, the number of male deaths for neoplasms (6,786) in Tuscany did not exceed deaths from cardiovascular disease (7,065). Instead, overtaking occurred in some subregional areas from 2004 onwards. When we compared age-standardized mortality rates, cancer became the first cause of death in Tuscany from 2004 onwards (age-standardized mortality rates for cancer 236.5 per 100,000; for cardiovascular disease 227.8 per 100,000). Age-standardized mortality rates for cardiovascular disease recorded an annual 2.4% decrease until 1998, then a 3.5% decrease. Age- standardized mortality rates for all cancers recorded an annual 1.6% decrease in the whole period.

Conclusions

Our study confirmed a geographical trend in cancer overtaking as the main cause of death in males: from the more urbanized areas in northern Tuscany, where the phenomenon occurred earlier, to the southern part. Free full text available at www.tumorionline.it
Targeted Therapy in Head and Neck Cancer
Authors: Bianchini Chiara , Ciorba Andrea , Pelucchi Stefano , Piva Roberta , Pastore Antonio
Published: February 2018

Aims and background

This review focuses on recent advances in understanding the molecular mechanisms at the basis of cancer initiation and progression in the head and neck and also discusses the possible development of targeted cellular strategies. Intrinsic and acquired resistance of cancer cells to current conventional treatments, as well as recurrence, represent a major challenge in treating and curing the most aggressive and metastatic tumors also in the head and neck. Even though in some hematologic malignancies (i.e., non-Hodgkin's lymphomas) antibodies specifically designed to target tumor-specific cells have already been introduced, in solid tumors molecular targeted therapy is now entering clinical practice.

Methods

A Pub Med database systematic review.

Results and conclusions

Molecular targeting could achieve specific damage to cancer cells, at the same time preserving functionally important tissues. This could offer new prospectives in primary and adjuvant treatment also of head and neck tumors.
Do Pre-Diagnostic Drinking Habits Influence Breast Cancer Survival?
Authors: Allemani Claudia , Berrino Franco , Krogh Vittorio , Sieri Sabina , Pupa Serenella M , Tagliabue Elda , Tagliabue Giovanna , Sant Milena
Published: February 2018

Aims and background

Alcohol consumption increases the risk of developing breast cancer and may also be associated with late diagnosis, recurrence, distant metastases and death. Many studies have examined the role of alcohol as a risk factor for the development of breast cancer, but very few studies have addressed the role of alcohol as a prognostic factor for survival among women diagnosed with breast cancer. The aim of this study was to investigate the survival of women with breast cancer in relation to pre-diagnostic alcohol intake and other factors known to influence prognosis.

Methods

We analyzed data for 264 women in the EUROCARE and ORDET studies who were diagnosed with breast cancer from 1987 up to 31 December 2001 and for whom information was available on follow-up, stage at diagnosis, HER-2 and hormone receptor status, and pre-diagnostic dietary alcohol intake, categorized as zero (0 g/day, non-drinkers), moderate (up to 13 g/day, about 1 serving) and high (>13 g/day). Ten-year relative survival was estimated using the maximum-likelihood approach. The excess risk of death within 10 years of diagnosis was modeled by level of alcohol intake, adjusting separately for age, stage, body mass index and tumor subtype.

Results

Ten-year relative survival was lowerin women who drank more than 13g/day (65%; 95% CI, 47–78) than in non-drinkers (88%; 95% CI, 75–95). The excess risk of death within 10 years was significantly higher in women who drank more than 13 g/day than non-drinkers (relative excess risk, 4.13; 95% CI, 1.69–10.10) and was not altered by adjustment for other prognostic factors. The excess risk within 10 years was higher for women with a body mass index of 25 kg/m2 or higher (relative excess risk, 2.20; 95% CI, 1.01–4.70) and higher for those with more advanced disease.

Conclusions

Women who drank more than 13 g alcohol per day had lower survival than non-drinkers. The excess risk of death within 10 years of diagnosis was unaffected by other known risk factors. High alcohol consumption may be an adverse prognostic factor for breast cancer.
Malignant Mesothelioma of the Pleura in Nonagenarian Patients
Authors: Bianchi Claudio , Bianchi Tommaso , Bucconi Sergio
Published: February 2018

Aims and background

Malignant mesothelioma developing at very old ages is a rare event. The reasons for such late development were investigated.

Methods

A series of 811 malignant mesothelioma of the pleura, diagnosed at the Trieste and Monfalcone Hospitals, in northeastern Italy, in the period 1968–2008 were reviewed. Eight cases regarding patients aged 90 years or more were selected. In such cases, occupational histories were re-examined, and additional data could be obtained from the patients' relatives. Routine lung sections obtained at necropsy were examined for asbestos bodies. In 2 cases, asbestos bodies had been isolated after chemical digestion of lung tissue.

Results

The group included 7 men and one woman, aged between 90 and 93 years. All 8 patients had long-term histories of occupational exposure to asbestos, mostly in shipyards. Latency periods, elapsed between first exposure to asbestos and tumor manifestation, ranged between 64 and 75 years. Asbestos bodies were found on routine lung sections in 6 cases. Isolation of lung asbestos bodies showed 72, 000 bodies per gram of dried tissue in a90-year-old man, who had worked in the shipyards for 34 years, and 150 bodies per gram in a 93-year-old woman, who had worked in the shipyards for 23 years.

Conclusions

In this group of cases, the late development of mesothelioma can not be attributed to mild exposure to asbestos or to unusually late exposures. Very long latency periods even in people heavily exposed suggest an individual resistance to the oncogenic effects of asbestos.