bluuebunny/crossref_metadata_2025 huggingface dataset:
Phase II Study with Ifosfamide in Advanced Malignant Melanoma
Authors: Negretti Elena , Ferrari Laura , Bonfante Valeria , Bajetta Emilio
Published: April 2018

Ifosfamide was tested in a phase II study in 12 evaluable patients with advanced malignant melanoma. The drug was administered at the dose of 3 g/m2 on days one and two every 3-weeks. Seven patients were not previously treated and 5 received only minimal prior chemotherapy. Visceral involvement was present in 9 patients, and the remaining 3 had only soft tissue lesions. No patient showed objective tumor response. Mild vomiting was observed in 75% of patients; alopecia occurred in all of them. No other major side effects were observed, in particular, myelotoxicity and urotoxicity. Lack of response advised us to discontinue patient accrual. Our data do not support a therapeutic role of ifosfamide at the given dose schedule in the treatment of metastatic malignant melanoma.
Clinical Significance of Serum Spermine in Breast Cancer
Authors: Inamdar Nitin A. , Redkar Suhas L. , Mittra I. , Damle Shrikrishna R.
Published: April 2018

The diagnostic significance of three polyamines (putrescine, spermidine and spermine), of carcinoembryonic antigen and of phosphoglucose isomerase have been compared in sera of patients with breast cancer or benign breast disease and normal age matched controls. The results of the study indicate that the performance of spermine was more striking than that of any of the other markers. The estimation of spermine may prove to be a valuable parameter not only in detection but also in prediction of recurrence of the disease.
The Role of Galactography in the Detection of Breast Cancer
Authors: Ciatto Stefano , Bravetti Patrizia , Berni Daniela , Catarzi Sandra , Bianchi Simonetta
Published: April 2018

The authors report on a series of 529 consecutive patients examined on physical examination, mammography, nipple discharge cytology and galactography. The criterion for galactography was essentially bloody nipple discharge (73% of cases). Serous nipple discharge was not considered worthy of routine galactography since it is associated with an extremely low incidence of breast cancer. Surgical excision and histologic examination of the discharging duct was performed in 200 cases. Eighteen cases of breast cancer were detected (10 infiltrating, 8 intraductal) of which 9, 6, 7 or 7 were suspected on physical examination, mammography, cytology or galactography, respectively. All combined tests suspected 13 of 18 breast cancers; 3 intraductal breast cancers were biopsied because of evidence of multiple papillomas on galactography, and 2 infiltrating breast cancers were operated because of persistent bloody nipple discharge in the absence of any other sign. No breast cancer was suspected on galactography alone. Galactography is indicated in the presence of bloody nipple discharge, and a biopsy should be performed when breast cancer or multiple papillomas are suspected. The diagnosis and excision of a single papilloma (breast cancer was never misdiagnosed as a single papilloma on galactography) is not worthwhile since a single papilloma is a benign lesion, and the benefit of its excision is still unclear.
Cisplatin and Etoposide in Chemotherapy-Refractory Advanced Breast Cancer
Authors: Giaccone Giuseppe , Donadio Michela , Ferrati Patrizia , Calciati Alessandro
Published: April 2018

Fourteen evaluable advanced breast cancer patients, extensively pretreated by chemotherapy, received a combination of cisplatin (DDP) and etoposide (VP 16). DDP was given at 60 or 100 mg/m2 on day 1, and VP 16 at 120 mg/m2 on days 1, 2 and 3; cycles were repeated every 4 weeks. Major responses were never obtained; a minor response in 1 patient, no change in 7 patients, and progression in 6 patients were observed. Main side effects were nausea and vomiting (62% severe), and leukopenia (31% leukocytes < 2,000/mm3). Two patients refused further treatment due to intense nausea and vomiting. DDP-VP 16 combination chemotherapy is ineffective and poorly tolerated in heavily pretreated breast cancer patients.
Transposition of Myocutaneous Flaps in Breast Reconstruction following Radical Mastectomy: Latissimus Dorsi Vs. Rectus Abdominis Flap
Authors: Galli Angelo , Berrino Pietro , Rainero Maria Luisa , Santi Pierluigi
Published: April 2018

We evaluated two homogeneous groups of patients (20 each) who had undergone radical mastectomy and who underwent breast reconstruction in our department by transposition of a latissimus dorsi or of a rectus abdominis myocutaneous flap. The results achieved were very similar (in terms of postoperative hospitalization, complication rate, thoracic symmetry). We therefore believe that both these techniques should be considered as first choice in breast reconstruction following radical mastectomy. However, from the aesthetic viewpoint, the use of the latissimus dorsi is best suited to tall, slim patients, whereas the rectus abdominis allows us to obtain better results in patients of sturdy build, with a voluminous residual breast.
Modified Schoemacher Resection for Distal Gastric Cancer
Authors: Valente Maurizio , Alloisio Marco , Pastorino Ugo , Tavecchio Luca , Cataldo Ignazio , Bedini Amedeo Vittorio , Muscolino Giuseppe , Ongari Mauro , Ravasi Gianni
Published: April 2018

Between October 1979 and February 1987, 30 consecutive patients with cancer of the lower stomach underwent B1-Schoemacher resection with a tubular gastric pouch. Operative mortality was 0% and operative morbidity 10% (leak 3%, anastomotic stricture 3% and abscess 3%). After a mean follow-up of 30 months, the expected 5-year survival was 32%. The causes of death were: 7 distant relapses, 2 noncancer diseases and 1 new primary cancer. The overall incidence of postgastrectomy symptoms was 23% for the whole series and 35% for the patients harboring small tumors. Mild dyspepsia occurred in 71%. The declining concept of total gastrectomy as an essential requirement for curative resection and the recent evidence that B2 for gastric lesions is a carcinogenic operation necessitate alternative procedures. The data show that modified Schoemacher resection can be consider a valid challenge to B2.
Clinical and Neurophysiologic Features in Paraneoplastic Polyneuropathy
Authors: Valli Giorgio , Strada Ornella , Pirovano Carlo
Published: April 2018

Three of 8,954 in- patients have been selected as affected by paraneoplastic polyneuropathy. In all of them the polyneuropathy had a steadily progressive course, with symptoms beginning in the lower limbs and spreading to the upper limbs in a few months. An increase in protein content of the cerebrospinal fluid was evident in each case. No other possible causes of polyneuropathy were found, and the association with malignancy was histologically proved in all 3 cases. A bronchogenic (« oat cell ») carcinoma was present in the first patient, who had an almost exclusively motor neuropathy. An osteosarcoma was diagnosed in the second case, and its association with a polyneuropathy seems to be exceptional. A sigmoid adenocarcinoma was discovered in the third patient. Neurophysiologic investigations were indicative of a polyneuropathy with predominant axonic involvement in all 3 cases.
Metastatic Patterns in Osteosarcoma
Authors: Bacci Gaetano , Avella Maddalena , Picci Piero , Briccoli Antonio , Dallari Dante , Campanacci Mario
Published: April 2018

The clinical courses of 193 patients with high-grade, non-metastatic osteosarcoma were reviewed to ascertain the evolution of the natural history of the disease. All patients had the primary lesion in the extremities and were treated at the Rizzoli Orthopaedic Institute between 1976 and 1982 with surgery alone (30 cases) or surgery plus adjuvant chemotherapy (163 cases). All patients were regularly followed at our Institute. One hundred and fourteen patients, of which 27 were treated with surgery alone and 87 treated with adjuvant chemotherapy, developed overt metastatic disease. No differences were found concerning the sites of the first relapse which, for approximately 90 % of cases, were lungs in both groups. However, in the group of patients treated with adjuvant chemotherapy the development of overt metastatic disease, as compared to non-adjuvant patients, was delayed with time (13 vs 8 months) and the number of metastatic nodules in the lung at first relapse was reduced. This alteration in metastatic pattern due to adjuvant chemotherapy is important because it allows surgical resection of pulmonary metastases in a larger number of patients (51 % vs 29 %).
Intraarterial Chemotherapy for Advanced Bladder Cancer
Authors: Tsyb Anatoly F. , Dunchik Vasily N. , Karyakin Oleg B. , Grishin Gennady N. , Sakharova Olga V. , Dergachev Anatoly I.
Published: April 2018

The results of prolonged intra-arterial chemotherapy in 61 patients with locally advanced bladder cancer (T3–T4) are discussed. Regional internal iliac artery infusion of chemotherapeutic agents was done daily for 5 or 7 days at a rate of 1 to 3 ml/h over an 18-20-h period. The total dosages of each course were 60–120 mg/m5 adriamycin, 2.5–3.5 g/m2 5-fluorouracil (5-FU), 20–40 mg/m2 methotrexate or 30–50 mg/m2 cisplatin. At 3 to 4 weeks after the completion of infusional chemotherapy the results were evaluated, based on data from control cystoscopy and sonography. One patient (1.6 %) was free of tumor; an objective response of greater than 50 % reduction in tumor size occurred in 26 (42.7 %) patients; 34 (55.7 %) demonstrated objective responses of less than 50 %. No further increase in tumor size during the management was detected. Hematuria, dysuria and urine infection were controlled and pain was relieved. The use of cytostatics and prolonged iliac artery catheterization did not incur any serious complications.
Sacral Chordoma and Rehabilitative Treatment of Urinary Disorders
Authors: Torelli Tullio , Campo Biagio , Ordesi Giorgio , Pirovano Carlo , Azzarelli Alberto , Zanolla Rita
Published: April 2018

Sacral chordoma is one of the rarest tumors of the central nervous system (less than 1 % of the entire group). Mictional disorders are among the most frequent symptoms and are caused by the extrinsic compression brought to bear on the cauda equina and by surgical demolition of the sacrum. Seven patients who had undergone sacral resection for chordoma, starting from S2, were followed for at least one year. It was observed that mictional disorders were often early symptoms signalling the presence of chordoma. Several patients were affected by a complete bladder denervation (infrasacral lesion) after surgery. Early rehabilitative treatment given after surgery for one year restored normal bladder functions in all the patients whose bladder denervation seemed to be not total (negative Lapides’ test). Even when a complete infrasacral lesion of the bladder has been ascertained, early rehabilitative treatment may well prevent serious renal damage.
Giant Cell Lesion of the Jaw. Case Report
Authors: Bondi Roberto , Urso Carmelo , Santucci Beatrice , Santucci Marco , Marchesi Alessandro , Panzoni Enrico
Published: April 2018

A case is presented of a male patient affected by a giant cell lesion of the jaw, which had two recurrences in 8 years. Histologically, the lesion appeared to be composed of giant cells and mononuclear cells. Histoenzymatic study demonstrated acid phosphatase in both types of cells, and beta-glucuronidase in giant cells only. In some nuclei of giant cells, ultrastructural investigation showed filaments or microtubular structures of variable length, with irregular transverse periodicity, in addition to other expected findings. These characteristic features, found in giant cells of some giant cell tumors of the long bones, have never before been reported in a giant cell lesion of the jaw. The results are considered in order to assess the diagnosis, and the pathologic profiles of giant cell reparative granuloma, and of giant cell tumor are critically discussed.
Radio-Hyperthermia for Subcutaneous Metastasis of Hemangiopericytoma of the Mediastinum: Case Report
Authors: Puleo Stefano , Di Cataldo Antonio , Li Destri Giovanni , La Greca Gaetano , Castobello Claudio , Bartoloni Giovanni , Privitera Giuseppe , Scandurra Giuseppina , Latteri Ferdinando , Rodolico Gaspare
Published: April 2018

Hemangiopericytoma is a rare type of neoplasia originating from the Zimmermann pericytes and can arise in numerous sites. As it is difficult to correlate the histologic aspect with the prognosis, it was considered advisable to take account of other factors such as age and tumoral site. Aggressive surgery followed by irradiation therapy is suggested as the most suitable management. Hyperthermia also was adopted in treating subcutaneous metastasis, but its role has yet to be fully defined.
Leiomyoma of the Kidney
Authors: Di Palma Silvana , Giardini Roberto
Published: April 2018

This is the report of a 27-year old woman with a symptomatic leiomyoma of the left kidney. Symptoms consisted of a mild discomfort at the left flank and a walking difficulty. A left radical nephrectomy was performed. The tumor measured 15 cm in its largest diameter and was composed of elongated cells which demonstrated positive reactivity with anti-desmin and anti-actin antisera and negative reactivity for S-100 protein and cytokeratins. Histologic differential diagnosis is with other spindle cell renal tumors such as leiomyosarcoma, mesoblastic nephroma, angiomyolipoma, fibroma, schwannoma and sarcomatoid renal cell carcinoma.
Activation by Point Mutation of Ki-ras Gene Occurring in Transfected Human Normal dna
Authors: Viel Alessandra , Maestro Roberta , Pistello Mauro , Dolcetti Riccardo , De Re Valli , Boiocchi Mauro
Published: April 2018

A mutation-activated human Ki-ras gene was detected in NIH 3T3 cells transfected with high molecular weight DNA extracted from peripheral blood leukocytes of a healthy blood donor. A deoxyguanosine at position 35 of the first exon was substituted by deoxythymidine. Nevertheless, cloning and sequencing of seven independent Ki-ras first exons, isolated from the same human genomic DNA used to transfect NIH 3T3 cells, failed to reveal the expected point mutation. Since transfected DNA is susceptible to mutagenesis in mammalian cells, we hypothesize that a base substitution occurred during the transfection assay.
Enhancement of Methotrexate Cytotoxicity by Modulation of Proliferative Activity in Normal and Neoplastic t Lymphocytes and in a Myeloid Leukemia Cell Line
Authors: Ciaiolo Carlo , Ferrero Dario , Pugliese Agostino , Biglino Alberto , Marletto Giuseppe , Tonello Mauro , Colzani Gabriele , Marietti Giorgio
Published: April 2018

Recent advances in the modulation of cell kinetics with growth factors suggest that the effect of cyclespecific cytostatic drugs can be enhanced by combination with such factors. The truth of this hypothesis was investigated by studying the effect of phytohemoagglutinin and/or interlenkin 2 on the sensitivity to methotrexate (MTX) of normal T lymphocytes and of lymphoblastis of a patient with acute T-cell lymphoid leukemia. In both cases, inhibition of proliferation by MTX was increased from less than 30% in resting cells or those sub-optimally stimulated, in the case of leukemic blasts, to 68-83% in maximally stimulated cells. Similar results were observed when the AML 193 human myeloid leukemia line was stimulated with human recombinant granulocyte macrophage colony stimulation factor (GM-CSF). Under basal proliferation conditions, the addition of 1 μg/ml and 10 (μ/ml MTX was followed by 48% and 72% inhibition respectively. When 1 ng/ml GM-CSF (40 I.U./ml) was present, these figures rose to 89% and 91%. It is thus clear that growth factor-induced cell proliferation increases sensitivity to cyclespecific cytostatic agents. There is thus a biological premise for new perspectives in antineoplastic therapy.
T(1;7) in Acute Myeloblastic Leukemia following Myelodysplastic Syndrome (RAEB-T)
Authors: Defferrari Raffaella , Sessarego Mario , Santini Gino , Ajmar Franco
Published: April 2018

A case is described of myelodysplastic syndrome (MDS) refractory anemia type with an excess of blasts in transformation with early leukemic evolution (AML-M1). All bone marrow cells examined showed an unbalanced translocation t(1;7). The karyotype was 45, xy, –21, –7, + der dic t(1;7) (q12;q21). There are reports in the literature of the translocation t(l;7) (pll;pll), which leads to trisomy of the long arms of chromosome # 1 and monosomy of the long arms of chromosome # 7. In the case here described the breakpoints of the chromosomes involved in the translocation differ from the classic ones: in this case there is trisomy of the region 1q12→1qter and monosomy of the region 7q21→7qter. Some clinical and cytogenetic considerations are suggested.
Timing of Surgery and the Role of Cytoreductive Chemotherapy in Patients with Advanced Ovarian Carcinoma
Authors: Negretti Elena , Zambetti Milvia , Luciani Luciano , Gianni Luca
Published: April 2018

We retrospectively selected 27 consecutive patients with advanced ovarian carcinoma (15 stage III, 11 stage IV and 1 relapse) who had an unresectable intraabdominal tumor at presentation and prospectively evaluated the overall treatment outcome. Patients were initially treated with chemotherapy consisting of cisplatin-containing regimens in 20 cases, adriamycin and cyclophosphamide in 5, and melphalan in 2. Treatment was continued until maximal tumor response or progression. Following a median of 6 cycles of chemotherapy, all patients underwent debulking surgery. Six women were without evidence of disease and 13 had minimal residual disease after surgery, for an overall 70% rate of optimal debulking. Patients with evidence of disease at laparotomy were treated with 5 additional cycles of chemotherapy, and response was then assessed at laparotomy except for patients with progressive disease. Nine (33%) patients were pathologic complete responders at the end of the entire treatment program. Overall median survival time was 26 months, with a median relapse-free survival of 33 months. Tumor responses were not associated with any particular chemotherapy regimen. The results achieved in this series of patients together with the data from the literature suggests that use of a cytoreductive chemotherapy of short duration has the potential of increasing the rate of optimal debulking surgery. Furthermore, it may contribute to a better disease control in women with bulky ovarian carcinoma compared to the present strategy, which consists of surgery followed by chemotherapy.
Contemporary Chemotherapy and Radiotherapy for Inguinal Metastases of Carcinoma of the Penis: A Case Report
Authors: Palmieri Giovannella , Gridelli Cesare , Vitale Alberto , Bianco Angelo Raffaele
Published: April 2018

A case is reported of a 76 year old patient with inoperable lymph node metastases from cancer of the penis. Methotrexate and bleomycin chemotherapy and concurrent irradiation were administered. The patient achieved a complete remission and is disease-free 30 months after therapy. The treatment was well tolerated.
Langerhans Histiocytosis of the Choledochus in an Adult Patient with a History of Disseminated Disease
Authors: Di Palo Saverio , Faravelli Agostino , Beretta Edoardo , Taccagni Gian Luca
Published: April 2018

A 43 year-old man with a 15-year history of disseminated Langerhans histiocytosis (LH) in complete clinical remission was admitted with jaundice and abdominal pain. Pathological examination demonstrated LH in the choledochus associated with sclerosing cholangitis in the liver. Immunohistochemistry for S-100 protein and electron microscopy of the choledochus tissue showed Langerhans cell-like elements in the infiltrate. Our findings suggest that, in patients with disseminated Langerhans histiocytosis, liver function should be monitored, particularly, for signs of biliary obstruction, and demonstrate that such a finding is possible in adults.
Hypophosphatemic Oncogenic Osteomalacia: Report of Three new Cases
Authors: Papotti Mauro , Foschini Maria Pia , Isaia Giancarlo , Rizzi Guido , Betts Christine M. , Eusebi Vincenzo
Published: April 2018

Three cases of connective tissue tumors causing hypophosphatemic osteomalacia are reported and the literature is reviewed. In two of our patients the tumors were completely excised with total disappearance of the symptoms. In one case a total excision was not possible and the symptoms of this patient have not completely disappeared. The substance responsible for the syndrome has not been identified yet, but probably interferes with vitamin D renal hy-droxylation, thus causing osteomalacia. As more than 30 per cent of cases of this condition have been reported in the last 5 years, it is suggested that these tumors are more frequent than previously believed.
Multiple Marker Studies on a Malignant Fibrous Histiocytoma with Primary Cutaneous Localization
Authors: Moretti Silvia , Santucci Marco , Brogelli Laura , Palermo Alessandro , Reali Umberto Maria , Pimpinelli Nicola , Fattorossi Andrea
Published: April 2018

Continuing controversy exists concerning a possible relation between neoplastic cells of malignant fibrous histiocytoma (MFH) and the mononuclear phagocyte system. The aim of this study was to investigate the membrane and cytoenzymatic phenotype of a primary cutaneous MFH, storiform pleomorphic type, and to compare these data with ultrastructural observations. Cytoplasmic proteins (acid phosphatase, non specific esterase, alpha-1 antitrypsin, and lysozyme) suggestive of a mononuclear phagocyte origin were demonstrated in varying amounts in neoplastic cells infiltrating the dermis. Consistent with these data, two (LeuM3 and OKM5) out of four (OKM1 and LeuM1) monoclonal antibodies directed against mononuclear phagocyte antigens stained most of the neoplastic cells. Class II MCH antigens (DR and DQ) were variably expressed on distinct groups of neoplastic cells, suggesting different activation/differentiation states. The results favor the view that the present case of primary cutaneous MFH was of mononuclear phagocyte origin. However, the observed phenotypic profile was expressed on neoplastic cells irrespective of their ultrastructural morphology (histiocytic or fibroblastic). Together with previous data in the literature, the latter finding corroborates the view that distinction between these two cell types in MFH is likely to reflect divergent growth and differentiation patterns rather than histogenesis.
Dietary Habits in Spain: An Approximation
Authors: Gonzalez Carlos A. , Torrent Matias , Agudo Antonio
Published: April 2018

The dietary pattern of a population sample of males selected as a control group for a case-control study on bladder cancer carried out in four different regions of Spain is presented. Out of 807 population controls initially selected, 530 were interviewed, 465 males and 65 females. The method of selection of the study subjects and the diet assessment method are described. Our results confirm the Mediterranean pattern of the Spanish diet, with an important consumption of fresh fish, fruits and vegetables, and the use of vegetable oils, specially olive oil, for cooking and seasoning, accompanied with a high polyunsaturated/saturated ratio (0.7). The consumption of butter, cheese and other dairy products, on the other hand, is very low. Estimated total caloric intake is relatively low if compared with international figures, although questionnaire base assessment may seriously underestimate caloric intake, as it is the absolute amount of intake of lipids and carbohydrates. In relative terms, however, lipids provide the highest percentage of calories.
Diet and Epithelial Cancer of the Thyroid Gland
Authors: Franceschi Silvia , Talamini Renato , Fassina Ambrogio , Bidoli Ettore
Published: April 2018

Enhanced secretion of thyroid stimulating hormone (TSH) has been linked with increased risk of thyroid carcinoma. Diet can increase TSH secretion in various ways: 1) low iodine intake, 2) high goitrogen intake, especially in subjects living in iodine-deficiency areas and 3) direct stimulation of anterior pituitary gland. Excessive iodine intake, however, has also been shown to increase risk of goitre and, perhaps, also thyroid carcinoma. Epidemiological evidence on the role of diet in the etiology of thyroid carcinoma is reviewed here. Ad hoc studies in affluent countries are few and often conflicting. A case-control study conducted in the North of Italy suggests that perhaps dietary aspects other than iodine or goitrogens (i.e. fresh fruit and vegetables and animal fat) may be involved.
In Vivo and in Vitro Interaction of 1,2-Dichlorobenzene with Nucleic Acids and Proteins of Mice and Rats
Authors: Colacci Annamaria , Bartoli Silvana , Bonora Bruna , Niero Alessandra , Silingardi Paola , Grilli Sandro
Published: April 2018

Twenty-two hours after i.p. injection into male Wistar rats and BALB/c mice, 1,2-dichlorobenzene (1,2-DCB) was covalently bound to DNA, RNA, and proteins of liver, kidney, lung and stomach. The covalent binding index to liver DNA was typical of carcinogens classified as weak initiators. The enzyme-mediated in vitro interaction of 1,2-DCB with calf thymus DNA or synthetic polyribonucleotides was carried out by a microsomal mixed-function oxidase system and microsomal GSH-transferases, which seemed to be effective only in liver and lung of rat and mouse. Cytosolic GSH-transferases played a minor role in 1-2-DCB bioactivation. The latter finding provides the first evidence of 1,2-DCB genotoxicity in mammalian cells. The type of halide, the number of halosubsti-tuents and their spatial dispostion on the benzene ring are the major determinants of halobenzenes activability to intermediate(s) capable of interacting covalently with DNA and other macromolecules in biologic systems.
Characterization of a New Murine Tumor Variant with Different in Vivo Behavior Selected by Its Adhesive Properties
Authors: Puricelli Lydia , Colombo Lucas L. , Gomez Daniel E. , Vidal María del Carmen C. , de Kier Joffé Elisa Bal
Published: April 2018

The purpose of the study was to determine whether the selection by adhesion to fibronectin (FN) also selects for cells with different tumorigenic and metastatic abilities. M3 murine mammary adenocarcinoma cells with moderate metastatic potential were seeded on FN-coated plastic substrates. Non-adherent cells were removed at 30 min, and the adherent ones were expanded in monolayer culture. Selected tumor cells were then harvested and inoculated sc into syngeneic mice. The selection procedure was repeated three times. After the third cycle, tumors were further maintained by sc trocar transplantation, and the variant obtained was called M3Ad. Although the in vitro selection was adhesion to FN substrate, the in vitro adhesion behavior of the variant M3Ad was identical to that of the parental tumor M3. However, the cytogenetic profile and the in vivo behavior indicated that M3Ad differed from M3. The distribution of the chromosome number of M3Ad cells revealed a lower mode and mean than of M3 cells. Moreover, the M3Ad variant exhibited a shorter latency, a higher growth rate and a lower incidence of spontaneous lung metastases. However, it produced significantly more and larger lung colonies than M3 after iv injection.
Clinical Relevance of Immunocytochemical Detection of Multidrug-Resistance-Associated P-Glycoprotein in Hematologic Malignancies
Authors: Musto Pellegrino , Cascavilla Nicola , Di Renzo Nicola , Ladogana Saverio , La Sala Antonio , Melillo Lorella , Nobile Michele , Matera Rosella , Lombardi Gina , Carotenuto Mario
Published: April 2018

P-glycoprotein (P-170) is the phenotypic marker of tumoral cells that show the phenomenon of multidrug resistance (MDR). Using an immunocytochemical approach, we employed the monoclonal antibody C219 (which recognizes an epitope of such a glycoprotein) to evaluate in cytologic samples the expression of P-170 on neoplastic cells from 52 patients affected by different hematologic malignancies and its eventual correlation to clinical outcome. Longitudinal studies were also performed in 14 patients. Results obtained demonstrated that a) the so-called « MDR phenotype » may be heterogeneously represented (from « 1 to 100% of positive cells) in hemopoietic tumors at diagnosis (without exposure to pharmacologic agents), as well as during the course of the disease, although a more substantial presence of P-170 occurred in treated patients. There was no correlation between neoplastic kinetic activity (such as expression of Ki 67 recognized nuclear proliferation-associated antigen) and P-170-positive cells. b) Percentage of positive cells as well as intensity of staining seemed to be important in determining MDR; in general, there was a strong correlation between expression of P-170 in more than 20% of neoplastic cells and a lack of response to chemotherapy. However, some false-positive and false-negative cases were observed. c) The detection of scattered P-170-positive cells may predict a pharmacologic selection of intrinsic or mutant-resistant clones.
Is Tissue Polypeptide Antigen Still a Useful Tumor Marker in Breast Carcinoma? Comparison with Ca15.3 and Mca
Authors: Gion Massimo , Mione Riccardo , Gatti Carlo , Dittadi Ruggero , Leon Antonette , Nascimben Ottorino , Pizzorno Beatrice , Bruscagnin Giuliano
Published: April 2018

Serum levels of tissue polypeptide antigen (TPA) are related to the proliferative activity and to the mass of the malignancy, differently from any other available tumor marker. We therefore evaluated TPA in comparison with CA15.3 and MCA (mucinous-like carcinoma-associated antigen) in patients with primary breast cancer. TPA was measured in tumor cytosol and in serum. Cytosol and serum TPA levels were not significantly correlated. Serum TPA was higher in patients with locally more advanced disease and in receptor-negative cases. The relation between TPA and disease spread was not directly dependent on tumor bulk, whereas CA15.3 and MCA were highly correlated to the number of positive lymph nodes and tumor size. No correlations were found between TPA and CA15.3 or MCA, and the positivity concordance rate between TPA and CA15.3 or MCA was very low. Patients with higher TPA serum levels showed a worse prognosis in cases with and in those without axillary metastases. From our data we conclude that TPA provides information different from that obtained with breast-specific tumor markers and could therefore be useful in association with CA15.3 and/or MCA In the management of patients with breast cancer.
Histopathologic and Immunohistochemical Features of Neuroblastoma: A Tool for Evaluating Prognosis
Authors: Bigotti Giulio , Coli Antonella
Published: April 2018

To investigate the relationship of morphologic appearance with other parameters such as age at diagnosis, primary site and clinical stage in regard to the prognosis, we examined a total of 20 neuroblastomas of various sites from children undergoing treatment at the Catholic University of Rome and Regina Elena Cancer Institute of Rome. We used a histopathologic classification, developed by Shimada et al. (JNCI, 1984), based on the presence of Schwann cells and ganglio-neuromatous component, neuroblastic maturation and transition to ganglionic forms, and number of mitotic and karyor-rhetic nuclei. We observed a 100% 2-year survival for patients in the favorable groups (13 patients) and 0% 2-year survival for children (7 patients) in the group with unfavorable histology. Furthermore, immunohistochemical evaluation of neural markers such as NSE, S-100 protein and neurofilaments offered additional important information. Our results confirm that the combination of pathologic, immunohistochemical and clinical criteria can be usefully employed to predict the outcome of neuroblastomas.
Alpha-2 Interferon and 5-Fluorouracil in Advanced Colorectal Cancer
Authors: Fornasiero Adriano , Daniele Otello , Ghiotto Cristina , Aversa Savina M.L. , Morandi Paolo , Fiorentino Mario V.
Published: April 2018

A total of 21 untreated patients (5 males, 16 females; median age, 55 years; range, 28-72) with advanced measurable colorectal carcinoma were treated with an association of 5-fluoro-uracil (1000 mg/weekly) and alpha-2 interferon (three times a week s.c.: 6×106 U in the 1st month, 9×106 U in the 2nd month, 12×106 U in the 3rd month and then 18×106 U) until maximum response or progression of disease. Sites of disease involved liver in 10 patients, lung in 6, supraclavicular lymph nodes in 3, skin in 1, abdomen in 4, and vagina in 1 patient. Nine responses (42.8%) were documented (4 complete and 5 partial) with metastases confined to the liver, lung, nodes and skin. Median duration of response was 11 months (range, 4-17+) and median survival was 10 months (range, 2-17+). Side effects (fever, flu-like syndrome and leukopenia) required a dose reduction of 5-fluorouracil In 8 patients and interferon in 2 patients.
Severe Hypotension in Disseminated Colon Cancer Due to a Possible Decreased Dopamine Brain Content: A Case Report
Authors: Lissoni Paolo , Barni Sandro , Meregalli Sofia , Cattaneo Giulio , Archili Caterina , Tancini Gabriele
Published: April 2018

The case of a patient with advanced colon carcinoma is reported. She was hospitalized for severe hypotension, which was probably due to systemic vasodilatation. The patient was responsive only to continuous intravenous infusion of dopamine and was then successfully treated with an oral combination, consisting of L-dopa plus benserazide. Since benserazide blocks the peripheral production of dopamine, the effectiveness of this schedule in the treatment of severe hypotension would suggest the existence of a dopaminergic deficiency of the central nervous system rather than the peripheral vascular system. The present case report might represent a useful model to better understand the biochemical basis of hemodynamic dysfunction, which may occur in disseminated neoplasms or during immunotherapy of cancer with cytokines.
Cutaneous Presentation of Acute Myeloid Leukemia in a « Classical » Kaposi's Sarcoma Patient
Authors: Bisceglia Michele , Zenarola Patrizia , Melillo Lorella , Parisi Salvatore , Di Candia Leonarda , Carotenuto Mario
Published: April 2018

A case of early cutaneous involvement by an acute myeloid leukemia in a Caucasian man, previously affected by a « classical » Kaposi's sarcoma is reported. The diagnoses were based upon histologic examinations and appropriate hematologic investigations. After reviewing extensively the literature about the association of lymphoreticular system malignancies and Kaposi's sarcoma, possible implications and hypothetical etiopathogenetic mechanisms are discussed.
Primary Laryngeal Malignant Fibrous Histiocytoma: A Case Report
Authors: De Rosa Gaetano , Palombini Lucio , Terracciano Luigi Maria , D'Angelo Luigi
Published: April 2018

Malignant fibrous histiocytoma (MFH) of the upper respiratory tract is rare. We report a case of laryngeal MFH in a 78-year-old man. The patient died 8 months after the first surgical treatment. The clinicopathologic features are described, and the importance of electron microscopy and immunohisto-chemical techniques in the differential diagnosis with so-called « sarcomatoid carcinoma » is stressed. The tumor has an aggressive biological behavior and tends to recur and metastasize.
Comparative Studies of Steroidogenesis Inhibitors (Econazole, Ketoconazole) on Human Breast Cancer MCF-7 Cell Proliferation by Growth Experiments, Thymidine Incorporation and Flow Cytometric DNA Analysis
Authors: Najid Abderrahim , Ratinaud Marle-Hélène
Published: April 2018

The effects of aminoglutethlmide, econazole and ketoconazole on human breast cancer cells In culture were compared with those of tamoxifen using four methods (growth experiments, thymidine incorporation, monoparameter and bivariate DNA content flow cytometry analysis). Aminoglutethlmide (1 nM-10 μM) had no effect on cell proliferation after 8 days of treatment and did not decrease thymidine tritiated incorporation during logarithmic phase. Even at 20 μM, similar results were obtained with flow cytometry. Econazole and ketoconazole (1 nM-1 μM) decreased MCF-7 cell proliferation in a time- and dose- dependent fashion. They also decreased tritiated thymidine incorporation. By using flow cytometry and a monoclonal antibody against bromodeoxyuridine, we showed an accumulation of MCF-7 cells treated by imidazoles derivatives In G0-G1 phase of the cell cycle.
Differential Response of Retinoic Acid Pretreated Human Synovial Sarcoma Cell Line to Anticancer Drugs
Authors: Adwankar Manohar , Banerji Ashutosh , Ghosh Soumendranath
Published: April 2018

The response of tumorigenic human synovial sarcoma (HSS) cell line to 10–5M optimum concentration of retinoic acid (RA) included changes in morphology, growth rate, suppression of anchorage-independent growth, induction of high alkaline phosphatase activity and excessive secretion of a 68 kDA glycoprotein of unknown function. HSS cells pretreated with 10–5M RA exhibited differential response to 3 potent anticancer drugs, namely cisplatin, vincristine and adriamycin. Sensitivity of the cells to cisplatin was found to be considerably enhanced after exposure to retinoic acid.
Ploidy and Proliferation Evaluated by Flow Cytometry. An Overview of Techniques and Impact in Oncology
Authors: Giaretti Walter
Published: April 2018

Flow cytometric methods for the assessment of nuclear and chromosomal DNA content and of cell proliferation (including methods based on pulse-chase of bromodeuxyuridine and on monoclonal antibodies against nuclear oncoproteins and proliferation-associated antigens) are illustrated by examples and analyzed critically. The impact of most of these techniques for the study of human solid tumors, with exception of nuclear DNA content evaluation, appears still limited. In particular, new studies of cell lines and clinical material from human tumors using new proliferation markers and multiparameter flow cytometry are necessary to solve a considerable number of methodologic and scientific problems.
The Itacare Study
Authors: Sant Milena , Gatta Gemma , Valente Fulvia , Barchielli Alessandro , Ramazzotti Valerio , Serventi Lidia , Rosso Stefano
Published: April 2018

ITACARE is a collaborative study on the survival of Italian cancer patients diagnosed in the period 1978–1989. The study involves 11 Italian population-based cancer registries (CRs) (Firenze, Forlì-Ravenna, Genova, Latina, Modena, Parma, Ragusa, Torino, Varese, the childhood CR of Piedmont and the colorectal CR of Modena), and its principal aim is to identify and analyze possible differences between the areas covered by the CRs. This article describes the ITACARE database. Ten percent of the Italian population is covered by the participating CRs, most of which are located in the northern part of the country. All malignant cancer sites (classified by ICD-9) except skin cancers were included. For bladder cancers, papillomas and transitional cell tumours grade 1 and 2 were also included. Survival data on over 100,000 cases were collected. The principal information variables were sex, date of birth, diagnosis and end of follow-up, life status, ICD-9 code for tumour site, diagnosis modality (clinical, cytologic confirmation, histologic confirmation), ICD-0 morphology code, and tumour stage (grouped into broad categories). Follow-up is active in all registries. All cases were checked systematically for errors and inconsistencies, following which about 0.2% of cases were excluded from the analyses. The percentage of cases microscopically verified, which is an indicator of diagnostic accuracy and data reliability, was higher among patients under 65 years of age (90%), breast cancer patients (92%) and cases covered by the Varese, Torino and Forlì-Ravenna CRs (more than 82%). The percentage of cases known by death certificate only (an indicator of the completeness and quality of registration) was about 3% of total cases and was higher among older patients (4%). Province-specific mortality, used to compute relative survival from cancer (i.e., survival adjusted for competing causes of death), varied according to period of diagnosis, sex and area: the highest mortality was among women of the Ragusa CR (Sicily) and men in northern CRs. Overall mortality decreased during the period, more markedly in the north and among women.
Survival of Childhood Cancer Patients in Italy, 1978–1989
Authors: Magnani Corrado , Pastore Guido ,   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 , Luisa Mosso Maria , Vercelli Marina , Casella Claudia , Parodi Stefano , De Lisi Vincenzo , Serventi Lidia , Barchielli Alessandro , Buiatti Eva , Balzi Daniela , Crocetti Emanuele , Falcini Fabio , Nanni Oriana , Ponz de Leon Maurizio , Roncucci Luca , Federico Massimo , Mangone Lucia , Conti Ettore , Ramazzotti Valerio , Gafà Lorenzo , La Rosa Maria
Published: April 2018

In the framework of the ITACARE project, a cooperative investigation conducted on the data from the Italian population-based cancer registries, survival of patients with childhood malignant neoplasms was studied. The study included 1,768 cases diagnosed at age 0–14 plus 29 osteosarcoma cases diagnosed at age 15–19. Cases were collected over the period 1978–1989, or more limited periods for some participating registries. A total of 1,138 cases were from the Childhood Cancer Registry of Piedmont and 659 from the registries operating in the provinces of Varese, Parma, Modena, Forlì and Ravenna, Florence, Latina, Ragusa and in the cities of Genova and Torino (the last contributed only for bone neoplasm diagnosed at age 15–19). Overall 5-year survival was 54% for malignancies diagnosed in 1978–1981, 60% for the period 1982–1985, and 69% for the period 1986–1989. The range among registries of 5-year survival for cases diagnosed in 1986–1989 was 55–78%. Most diagnostic categories presented an improved prognosis for the cases diagnosed more recently. For cases diagnosed in 1986–1989, 5-year survival was: 74% for acute lymphatic leukaemia, 40% for acute non-lymphatic leukaemia, 65% for central nervous system neoplasms (76% for astrocytoma, 75% for ependymoma and 85% for medulloblastoma), 66% for osteosarcoma, 55% for Ewing's sarcoma, 87% for Hodgkin's disease, 64% for non-Hodgkin's lymphoma, 74% for rhabdomyosarcoma, 64% for neuroblastoma, 78% for nephroblastoma and 100% for retinoblastoma. Italian survival was similar to that observed in other population-based surveys in the UK and USA.
Attitudes of Italian General Practitioners in the Treatment of Cancer Pain
Authors: Minotti Vincenzo , Betti Maura
Published: April 2018

The attitude of Italian general practitioners in prescribing practices for patients with cancer pain was assessed by means of a questionnaire. The results indicated that among most of the doctors who completed the questionnaire the basic principles of pain treatment in cancer patients are largely understood. Oral morphine emerged as the most commonly used opioid (60%) and controlled-release morphine as the preferred preparation. Non-steroidal anti-inflammatory drugs were the most commonly used minor analgesics. Fear of side effects and restrictive prescribing regulations emerged as the most important barrier against adequate pain management. The survey emphasised the need for continued efforts in implementing specific educational programming for improvement in cancer pain management.
Comparing two Modalities of Management of Women with Cytologic Evidence of Squamous Or Glandular Atypia: Early Repeat Cytology or Colposcopy
Authors: Cecchini Silvia , lossa Anna , Bonardi Rita , Ciatto Stefano , Cariaggi Paola
Published: April 2018

Early repeat cytology is recommended in most screening programs for cervical cancer in subjects with squamous or glandular abnormalities not amounting to neoplasia (atypical squamous cells of undetermined significance, ASCUS), but immediate colposcopy is also recommended in some countries, especially those where there is easy access to colposcopic facilities. We evaluated the cost-effectiveness of the two procedures in a prospective study of women with cytologic ASCUS, invited to cytocolposcopic assessment after 6 months. Colposcopy-directed biopsy was assumed as the gold standard, and the accuracy of colposcopy at 6 months was assumed to be equal to that of immediate colposcopy. Out of 874 compilers, punch biopsy was performed in 303 cases (34.7%), and 19 CIN2+ lesions were detected (CIN2 = 12, CIN3 = 6, microinvasive carcinoma = 1). Detecting 13 CIN2+ lesions at colposcopy required 874 colposcopies and 303 directed biopsies: the cost per CIN2+ lesion detected with the procedure was 2,749 US$. Detecting 15 CIN2+ lesions at repeat cytology required 874 cytologic examinations, 137 colposcopies, 64 directed biopsies, and 6 diagnostic large-loop resections, the latter being performed in subjects with high-grade squamous intraepithelial lesion and less severe lesions at punch biopsy: the cost per CIN2+ lesion detected with the procedure was 1,961 US$. The policy of repeat smear was more cost-effective than immediate colposcopy. According to such results, the protocol of the Florence screening program has been modified since October 1996.
Adenocarcinoma of the Body and Tail of the Pancreas: Is There Room for Adjuvant Radiotherapy?
Authors: Coquard Régis , Ayzac Louis , Romestaing Pascale , Ardiet Jean-Michel , Sentenac Irénée , Gilly François-Noël , Braillon Georges , Gérard Jean-Pierre
Published: April 2018

Aims and background

Adenocarcinoma of the body and tail of the pancreas is a rare malignancy with a poor prognosis. Few long-term survivors have been reported in the literature. The role of adjuvant treatment after curative resection has not yet been assessed. This retrospective study aims to describe the patterns of failure and the survival of 10 patients treated with resection and adjuvant radiotherapy.

Materials and methods

from 1982 to June 1994, 10 patients with adenocarcinoma of the body and tail of the pancreas received adjuvant radiotherapy in our department. There were 4 females and 6 males, with a median age of 63 years (range, 45–77). The pT distribution was 2 pT1, 4 pT2, 4 pT3 and for pN it was 7 pN0 and 3 pN1. Four patients had stage I, 3 stage II and 3 stage III disease. All the patients underwent a resection: distal pancreatectomy in 7, partial resection of the body in 1, and total pancreatectomy in 2. Gross residual disease was present in 2 cases. Three patients received intraoperative radiotherapy up to a dose of 12–15 Gy. Postoperative radiotherapy was given in 9 patients with a dose ranging from 40 to 50 Gy (median, 45). One patient who received intraoperative radiotherapy had no postoperative radiotherapy. In 4 patients, chemotherapy with 5-fluorouracil was given during the first week of irradiation.

Results

Six patients experienced a local-regional relapse and 3 developed metastases. The median survival was 21 months. The 5-year overall survival was 15%. Eight patients died of progressive disease. One patient who presented with stage I disease was alive and free of disease at 24 months from diagnosis and, interestingly, one with stage III disease was alive at 111 months. No severe treatment-related complications were observed.

Conclusions

As in carcinoma of the head of the pancreas, adjuvant radiotherapy should be considered as an adjuvant treatment of resected adenocarcinoma of the body and tail of the pancreas. Further evaluation is necessary to assess the role of intraoperative radiotherapy.
Bilateral Synchronous Testicular Involvement in Multiple Myeloma. Case Report and Review of the Literature
Authors: Castagna Maura , Gaeta Patrizia , Cecchi Massimo , Pagni Gino Luca , Pingitore Raffaele
Published: April 2018

The authors describe a case of synchronous bilateral involvement of the testes in a 70-year-old patient seven years after the onset of an IgG k IIIA multiple myeloma. Ultrasonographic and postoperative immunohistochemical studies were performed. A complete review of the literature shows the rarity of testicular plasmacytoma. The present one is the second reported case of syncronous involvement of the testes.