bluuebunny/crossref_metadata_2025 huggingface dataset:
Small Cell Carcinoma of the Urinary Bladder. Report of two Cases and Review of the Literature
Authors: Amichetti Maurizio , Boi Sebastiana , Fellin Gianni , Maluta Sergio , Palma Paolo Dalla , Luciani Lucio
Published: April 2018

Undifferentiated small cell carcinoma of the bladder is a rare but aggressive subset of urinary tract neoplasms. Analogous to small-cell carcinoma of the lung, this tumor frequently exhibits neuroendocrine differentiation. We report the 92nd and 93rd case of small cell carcinoma of the bladder reported in the literature with characteristic cytologic, histologic, histochemical, and ultrastructural features. The patients were treated initially with chemotherapy, but after a brief clinical course died for progression of disease and for myocardial infarction, respectively. The pathologic and clinical features and therapeutic options of the cases described in the literature are reviewed.
Epidemiology of Hepatocellular Carcinoma in a Province of Northern Italy: Prevalence of the Risk Factors and Incidence in the Population
Authors: Mels Guido Colloredo , Leandro Gioacchino , Scorpiniti Anna , Cristini Piero , Moretti Giovanni Battista , Di Nolfo Anna Maria , Angeli Giovanni
Published: April 2018

Aims

Epidemiologic studies on hepatocellular carcinoma (HCC) in limited geographic areas of Italy are rare, and most of them derive from autopsies. We retrospectively analyzed the prevalence of risk factors (sex, age, HBsAg, alcoholism, cirrhosis) in 137 HCC diagnosed between 1980 and 1989 in a single centre of northern Italy (Bergamo).

Results and conclusions

One hundred and nine of the HCC (79.6%) occurred in men (M:F = 3.9:1); 35.8% were HBsAg+ and 41.4% had histories of alcoholism. There were significant differences between men and women as regards prevalence of HBsAg+ (40.4% vs 17.9%; p = 0.046) and alcoholism (47.6% vs 17.9%, p = 0.008). The mean age of the patients was 63.6 years (range, 40-82), with significant differences between men and women (62.4 ± 08 vs 68.2 ± 1.4, p = 0.001), between HCC/HBsAg + and HCC/HBsAg– (59.1 ± 1.1 vs 66.1 ± 0.8, p = 0.00001) and between alcoholics and nonalcoholics (61.6 ± 1.1 vs 64.8 ± 0.9; p = 0.03). Liver cirrhosis was associated with HCC in 104/122 cases (data not available for 15 patients) without differences in distribution of sex, age, HBsAg+ or alcoholism between HCC with cirrhosis and HCC without cirrhosis. Incidence was calculated for the surrounding territory of the hospital center (10 towns, districts 5 and 6, USSL 30). Fifty-four cases of HCC were found in this area over the 10-year period, In according with a mean standardized incidence rate (Lombardy population 1971) of 11.7/100,000 inhabitants/year (c.i. 95%, 1.49-21.86).
Reduction of Leukopenia in Mice by « Viscum Album » Administration during Radiation and Chemotherapy
Authors: Kuttan Girija , Kuttan Ramadasan
Published: April 2018

« Viscum album » extract, iscador, was found to reduce the lekocytopenia produced by radiation and cyclophosphamide treatment in animals. Weight loss due to radiation was considerably reduced by « Viscum album » extract whereas weight loss due to cyclophosphamide was not altered. Hemoglobin levels also were not affected by « Viscum album » extract administration. The results indicated that treatment with « Viscum album » extract reduces lymphocytopenia and hence could be used along with chemotherapy and radiation therapy.
Study of the HLA-DPβ1 Locus by the Polymerase Chain Reaction Technique in Patients with Hodgkin's Disease
Authors: Pellegris Guseppe , Lombardo Claudia , Cantoni Annelisa , Devizzi Liliana , Balzarotti Monica
Published: April 2018

Background

A number of reports have studied associations between Hodgkin's disease and HLA. Some of them established correlation between several antigens and Hodgkin's disease, and others found no correlations.

Methods

The HLA DP locus was determined by the polymerase chain reaction method in 31 Hodgkin's disease patients and 58 healthy controls.

Results

No significant difference between patients and controls was noted.

Conclusions

Further investigations are needed to confirm the hypothesis of a possible role of the HLA complex as one of the factors involved in Hodgkin's disease.
Kasabach-Merritt Syndrome Associated to Angiosarcoma of the Breast. A Case Report and Review of the Literature
Authors: Mazzocchi Alessandro , Foschini Maria P. , Marconi Franco , Eusebi Vincenzo
Published: April 2018

Introduction

Kasabach-Merritt syndrome is characterized by the association of a consumptive thrombohemorrhagic disorder and angioma occurring usually in children. In the present study, a case of Kasabach-Merritt syndrome associated to an angiosarcoma of the breast is reported.

Clinical History

The tumor together with the thrombohemorrhagic disorder manifested in a 28-year-old woman. The patient underwent mastectomy. The tumor recurred in the same site 2 years later. The patient died of severe anemia 8 years after the first appearance of the angiosarcoma.

Material and Methods

Tissues were formalin fixed and paraffin embedded; in addition, selected sections were immunohistochemically stained.

Results and Conclusions

A well-differentiated angiosarcoma was visible throughout the removed organ. A review of the literature showed that only 6 cases of Kasabach-Merritt syndrome associated to malignant vascular tumors have been previously reported. All these 6 cases occurred in adult patients. On the contrary, Kasabach-Merritt syndrome associated to benign vascular tumors affects children. This is the first case occurring in the breast.
Use of a Pool of Monoclonal Antibodies in Diagnosing Cells from Serous Cavities
Authors: Cappellari Antonio , Bagarella Mariangela , Ménard Sylvie , Calabrese Marcella , Colnaghi Maria Ines
Published: April 2018

Aims and Background

The usefulness of monoclonal antibodies that recognize markers of neoplastic lesions in complementing conventional cytology was evaluated by the avidin-biotin-peroxidase complex, indirect immunoperoxidase technique.

Methods

In order to enhance the sensitivity of the traditional method, a pool of seven combined monoclonal antibodies (Pool C7), which reacts specifically with cells of epithelial origin and is able to distinguish between mesothelial and malignant cells, was tested on cytologic smears of 262 serous effusions. The effusions were benign or neoplastic, mainly from breast, ovary and lung cancers.

Results

Immunocytochemical method showed an 100 % specificity and 100 % of predictivity whereas the sensitivity was 98 %, 96 % and 95 % for breast ovarian and lung carcinomas, respectively.

Conclusions

The results demonstrated that the pool when used together with conventional methods, is useful in analysis of serous effusions in diagnostic investigations.
PCNA/Cyclin and P-Glycoprotein as Prognostic Factors in Locally Advanced Breast Cancer. An Immunohistochemical, Retrospective Study
Authors: Botti Gerardo , Chiappetta Gennaro , D'Aiuto Giuseppe , de Angelis Ernesto , De Matteis Andrea , Montella Maurizio , Picone Alessandro , Cascione Francesco
Published: April 2018

Aims and Background

The aim of the present study was to determine, retrospectively, whether the immunohistochemical expression of two biologic markers of aggressivity, P-glycoprotein (P-gp) and PCNA/cyclin (PCNA), could be related to response to chemotherapy and prognosis in locally advanced breast cancer.

Methods

PC 10 Mab was used to determine the proliferation index (PCNA) and C-219 Mab to determine P-gp in 25 locally advanced breast carcinomas subjected to preoperative chemotherapy with MDR-related drugs.

Results

P-gp and PCNA were expressed in 76 % and 100 % of the tumors, respectively. No case of high P-gp expression was associated with good chemosensitivity, and all P-gp-negative cases showed the best chemotherapeutic response. P-gp and PCNA were both highly expressed in patients who developed local-regional or distant metastases. No recurrence was associated with a negative or low P-gp score.

Conclusions

Statistical analysis showed that high P-gp expression was related to a poor response to chemotherapy and a short disease-free survival. A high PCNA score was not found to be significant for predicting chemosensitivity or survival.
Childhood. Leukemia in Southwest Sardinia (Italy)
Authors: Cocco Pierluigi , Bernardinelli Luisa , Biddau Pierfranco , Montomoli Cristina , Murgia Giulio , Rapallo Maurizio , Targhetta Roberto
Published: April 2018

Aim and background

Public concern on an increased incidence of childhood leukemia in SW Sardinia prompted the authors to an epidemiological investigation.

Methods

Incident childhood neoplasms observed in the Cagliari province (Sardinia - Italy) in 1974-1989 were registered. Expected cases of the most frequent childhood cancers were calculated for each town, based on the sex-and age-specific incidence rates in the province.

Results

An excess risk of childhood acute lymphoblastic leukemia (ALL) was observed in Carbonia, a town located in the SW part of the province. The risk was highest in 1983-85, when 7 cases occurred versus 0.8 expected (RR = 8.7; 95 % C.I. = 4.6, 16.3). No spatial clustering of ALL cases was observed within the town.

Conclusions

A significantly higher than expected incidence of childhood ALL was observed in the town of Carbonia in 1983-85. In alternative to chance, possible exposure to environmental pollutants from a near industrial settlement is discussed as the cause of the observed excess, but it is far to be proven. Other hypotheses, including a viral infection in a population with increased susceptibility, as suggested for new urban settlements, cannot be discarded.
A Phase III Study of Oral Doxifluridine plus Radiotherapy in Radiosensitive Tumors of the Pelvic Region
Authors: Spagnesi Stefano , Ducci Francesco , Laddaga Michele , Falcone Alfredo , Conte Pier Franco , Pandolfi Alessandra , Stampino Corrado Gallo
Published: April 2018

Aims and backround

Fluoropyrimidines have shown synergic effects in combination with radiotherapy in several tumor types. Doxifluridine is a novel 5-fluorouracil (5-FU) prodrug which is transformed into 5-FU in neoplastic tissue. This would imply enhancement of radiotherapy by 5-FU in neoplastic tissue, where the drug is concentrated higher than in surrounding healthy tissues.

Methods

A phase I-II study was carried out on 10 patients with radiosensitive tumors of the pelvic area (4 uterine carcinomas). Escalating doses of oral doxifluridine were administered in combination with standard radiotherapy to assess the efficacy and toxicity profile of the combined treatment. The 9 evaluable patients (3 groups of 3 patients each) received oral doxifluridine, at daily doses of 500, 750, or 1000 mg, for 6 consecutive weeks in combination with a standard (1.8-2.0 Gy) dose of radiotherapy. Assessment of physical and laboratory parameters was made at baseline, then weekly up to the end of the treatment and at follow-up.

Results

At the final evaluation, one patient with a diagnosis of uterine carcinoma showed a complete response that lasted 10 weeks. One patient had a partial response, and 7 patients had no change. The most frequent adverse events were gastrointestinal: 27 episodes of mild to moderate nausea/vomiting and diarrhea. Three patients complained of severe diarrhea of 5-7 days duration: all patients spontaneously recovered. There were no significant changes in laboratory or clinical parameters, and no serious toxicity requiring reduction or interruption of the radiotherapy.

Conclusions

The maximum tolerated dose of oral doxifluridine in combination with standard radiotherapy was assessed at 1000 mg/patient/day (equivalent to 36-38 g monthly, previously reported as mTD in phase I studies).
Color-Doppler Ultrasound in Ovarian Masses: Anatomo-Pathologic Correlation
Authors: Spreafico Carlo , Frigerio Laura , Lanocita Rodolfo , Spatti G. Battista , Marchianò Alfonso , Milella Marco , Garbagnati Francesco , Böhm Silvia , Damasceni Bruno
Published: April 2018

Background and aims

In the radiologic assessment of ovarian masses, the major difficulty consists in the late recognition and lack of parameters for a differential diagnosis between benign and malignant lesions, especially in the post-menopause when the incidence of cancer is higher. The use of a transvaginal probe and the color-Doppler examination have recently improved the study of the female pelvis. This study is aimed to verify the possibility of the color-Doppler imaging to differentiate between malignant and benign ovarian lesions during transvaginal echographies, on the basis of the qualitative and quantitative characteristics of the vascular pattern of the ovarian lesions.

Results

Twenty-six expansive ovarian lesions were studied: 8/26 showed no vascular signals and were considered benign as confirmed at histology. In the remaining lesions with some vascularization, the resistance index (RI) was evaluated: those with RI > 0.40 were considered benign, those with RI < 0.40 malignant. In 8/9 benign lesions and in 7/9 malignant neoplasms, the results of color-Doppler were coherent with histology. The results showed a sensibility of 87.5 % and a specificity of 88.8 % for the transvaginal examination.

Conclusions

The main advantages of the color-Doppler transvaginal examination are: the high frequency of visualization of the ovaries, even in postmenopausal patients; the definition of small lesions; the visualization of small parenchymal vessels, both physiologic and pathologic, and their quantitative analysis. The importance of the RI cutoff was critical for the differential diagnosis between benign and malignant lesions: we think that a cutoff of 0.50, instead of 0.40 proposed by other authors, would be far more appropriate.
Multiple Primary Tumors and Familial Cancers. A Case Report
Authors: Provencio Mariano , Bonilla Felix , Lopez-Vega José M. , Lacasta Adelaida , España Pilar
Published: April 2018

We herein report the case of a patient who had 4 primary tumors, 3 of which were malignant. His family had a high rate (26 %) of cancer. The possible genetic factors that can produce these events are briefly discussed.
Spontaneous Perforation of the Rectum by Carcinoma of the Prostate. Case Report
Authors: Cormio Luigi , Perttilä Ilkka , Saarinen Osmo , Tierala Esko , Nordling Stig , Ruutu Mirja
Published: April 2018

A case of spontaneous perforation of the rectum by a locally advanced prostatic carcinoma is described. The mechanisms of rectal involvement by prostatic carcinoma are discussed, focusing attention on the difficulties in differential diagnosis with primary carcinoma of the rectum.
Screening History of Incident Cases of Invasive Carcinoma of the Cervix. Florence District 1988-1989
Authors: Ciatto Stefano , Grazzini Grazia , Cecchini Silvia , Iossa Anna
Published: April 2018

Background

Incident cases of carcinoma of the cervix may be assumed as failures of a population-based cytologic screening program. Monitoring such cases would provide an estimate of screening effectiveness, and evaluating the causes of the failures would improve screening performance.

Study design

All incident cases of cervicocarcinoma registered in 1988 and 1989 in the Tuscany Tumor Registry were eligible for the study and were reviewed.

Results

Sixty-nine eligible cases were considered. Non- or irregular attendance (negative smear-to-diagnosis interval > 5 years) for the Pap smear was recorded in 53 subjects. A false-negative smear (smear-to-diagnosis interval < 5 years) and refused or inadequate assessment/treatment at private practices or local hospitals were recorded in 12 cases. False-negative smears by the local screening program were recorded in 4 cases only.

Conclusions

Non- or irregular attendance was the major cause of screening failures. Since cytologic screening or diagnostic assessment outside the screening program may be inadequate, central screening and follow-up is recommended. Non-attenders showed a strong negative attitude towards screening, and general practitioners and gynecologists need to be further stimulated for systematic screening promotion. Immediate evaluation of the screening history of incident cases of cervicocarcinoma should be mandatory in any screening program.
A Phase I Safety Study of Doxifluridine and Interferon-α-2a in Patients with Advanced Neoplastic Disease
Authors: Antimi Mauro , Majoli Laura , Minelli Mauro , Stampino Corrado Gallo , Pandolfi Alessandra , Papa Giuseppe
Published: April 2018

Aims and Background

Doxifluridine (RO 21-9738, 5′-dFUR) is a fluoropyrimidine derivative with proven antitumor activity in different experimental models. On the basis of experimental evidence, several clinical trials have been carried out to define the optimal 5′-dFUR dose and route of administration. In general, the maximum monthly dose of 5′-dFUR was 36-38 g. According to these clinical data, we explored the feasibility of a combination of 5′-dFUR and interferon-alpha-2a (IFN-alpha-2a). The aim of the protocol was to confirm the maximum tolerated dose (MTD) of the drug in combination with a settled dose of IFNα2a.

Methods

An open-label phase I study with intravenous 5′-dFUR was carried out in 12 patients with a histologically proven diagnosis of advanced gastrointestinal or breast cancer refractory to previous conventional hormone-chemotherapy. Escalating doses of 5′-dFUR were administered as a 2-h intravenous infusion, once a week for at least 4 weeks in groups of 3 patients. IFN-alpha-2a was administered as an intramuscular injection of 3 MU 3 times a week for 4 consecutive weeks. Physical and laboratory parameters were assessed at baseline and then weekly until the end of treatment.

Results

The treatment with 5′-dFUR was stopped at 5 g/m2, since this level corresponded to the maximum monthly dosage reported in the literature (36-38 g). No severe toxicity was recorded up to this drug level.

Conclusions

The combination of 5′-dFUR plus IFN-alpha-2a was well tolerated at the level of 5 g/m2. Although the MTD was not reached, it can be stated that the dosage administered in this study could be explored in a larger trial.
Disodium Pamidronate in the Treatment of Bone Metastases from Breast Cancer
Authors: Coileoni Marco , Bochicchio Anna Maria , Nolè Franco , Bajetta Emilio
Published: April 2018

Aims and Background

Symptomatic relief of bone metastases with biphosphonates has been previously reported, but limited data are available on the possibility of the induction of sclerosis in osteolytic lesions.

Methods

We therefore initiated an open study with disodium pamidronate (45 mg infused over 1 h and repeated every 21 days) in patients with bone metastases from breast cancer pretreated with chemotherapy and/or hormonetherapy. Fourteen patients wiht measurable lytic or mixed bone disease entereted the study. No other systemic therapy for breast cancer was allowed after their Inclusion in the study.

Results

No radiologic evidence of bone sclerosis of lytic disease was seen. After 2 months of therapy, 9 patients had progressed and 5 had stable disease. The median time to progression of bone disease was 1.6 months (range, 1-9). No significant improvement in terms of symptomatic status or analgesic consumption was recorded. The treatment was well tolerated, and no significant local or systemic toxicity was observed.

Conclusions

Disodium pamidronate at a dose of 45 mg every 3 weeks is not capable of inducing sclerosis of lytic lesions from pretreated breast cancer. Further trials concentrating on higher dosages of disodium pamidronate are warranted.
Prolonged Stabilization of Multiple and Single Brain Metastases from Breast Cancer with Tamoxifen. Report of Three Cases
Authors: Salvati Maurizio , Cervoni Luigi , Innocenzi Gualtiero , Bardella Lia
Published: April 2018

Cancer frequently metastasizes to the brain, and such lesions, whether multiple or solitary, have a poor prognosis, despite all efforts to treat them. There have been recent sporadic reports of brain metastases from breast cancer responding for some years to antiestrogens (particularly tamoxifen) or bromocryptine. We report three cases of brain metastasis from cancer – two multiple and one a solitary lesion. The long survival of the patients – two for 5 years and one for 6 years, with more than an acceptable quality of life – should prompt therapeutic trials to test tamoxifen and designed to assess its effects on a sizable number of patients.
Pathological Stage I Endometrial Carcinoma: The Role for Adjuvant Radiotherapy
Authors: Barhum Massad , Stein Moshe , Ronsenblatt Eduardo , Dale Janet , Kuten Abraham
Published: April 2018

Background

In order to assess the efficacy of adjuvant radiotherapy in the treatment of pathological stage I endometrial carcinoma, we performed a retrospective analysis of 158 patients with this diagnosis who after surgery were either treated with radiation therapy or only followed from January 1980 through December 1987.

Methods

Patients were divided into two prognostic categories, high and low risk, on the basis of three known predictors of survival: histology, differentiation, and depth of myometrial invasion. All patients underwent total abdominal hysterectomy and bilateral salpingooophorectomy but only the high risk group received radiotherapy as well.

Results

After a median follow up time of 59 months the survival rates of the two groups were similar. The 5-year disease-free survival of the surgery alone group was 92 % compared to 89 % for the postoperative radiotherapy group. Side effects of treatment were minimal.

Conclusions

Postoperative radiation therapy for high risk pathological stage I endometrial carcinoma is an effective adjuvant therapy and confers an excellent prognosis.
Mammography and Morphobiologic Characteristics of Human Breast Cancer
Authors: Paradiso Angelo , Mangia Annita , Barletta Anna , Marzullo Francesco , Ventrella Vincenzo , Racanelli Angela , Schittulli Francesco , De Lena Mario
Published: April 2018

Aims

A comparative analysis was performed to verify a possible correlation between mammographic features and morphobiologic characteristics of the tumor in a series of 176 invasive primary breast cancer patients.

Methods

Breast cancers were grouped according to mammographic features as follows: tumor mass with spiculated borders; tumor mass with well-circumscribed borders; tumor with density alteration of parenchyma with no clear borders; a cluster of micro-calcifications as the only sign of tumor presence; tumor without mammographic abnormality. The tumor tissue biologic characteristics investigated were: hormone receptor content, tumor proliferative activity, DNA content and cytohlstologic tumor-grade differentiation.

Results

Spiculated tumors showed a significantly higher percentage of estrogen-receptorpositive cases with respect to circumscribed tumors, independently of the patient's menopausal status. Tumors with only microcalcifications were all from premenopausal patients and showed a significantly higher percentage of progesterone-receptor-positive cases (83 %). Tumor proliferative activity did not significantly differ in the 5 mammographic breast cancer groups; aneuploidy was less frequent in tumors with spiculated borders than in mammographic types (39 % vs 57 %; p = 0.05); percentages of G1-G2-G3 tumors did not differ significantly among the mammographic groups considered.

Conclusions

Certain relationships between mammographic features and biologic characteristics could be of potential clinical interest and stimulate more detailed studies on this issue.
Immunohistochemical Distribution of Basement Membrane Type IV Collagen and Laminin in Synovial Sarcoma
Authors: Guarino Marcello
Published: April 2018

Aims

To investigate the distribution of basement membrane components type IV collagen and laminin in synovial sarcomas.

Methods

Paraffin sections from four synovial sarcomas were studied by the peroxidase-antiperoxldase procedure using specific antibodies to type IV collagen and laminin.

Results

Type IV collagen and laminin immunoreactivity was confined around epithelial areas in biphasic tumors. Several interruptions and discontinuities of the linear basement membrane profile were seen in sites of transition between mesenchymal and epithelial tissue. Moreover, a spot-like immunoreactivity was often observed in the spindle cell component of biphasic tumors. Monophasic tumors were either negative or showed a pericellular staining for both type IV collagen and laminin.

Conclusions

The distribution of basement membrane components is clearly related to the formation of epithelial elements in biphasic synovial sarcoma. The spot-like immunoreactivity of the spindle cell component, and the basement membrane interruptions at the boundary between mesenchymal and epithelial tissue, are both consistent with early basement membrane formation by developing epithelium. These findings support the concept that synovial sarcomas are basically soft tissue carcinosarcomas and that the epithelial component of the tumors develops by conversion of mesenchyme to epithelium.
Medical Management of Colorectal Carcinomas
Authors: Verschraegen Claire F. , Pazdur Richard
Published: April 2018

Current information on the medical treatment of colorectal cancer was reviewed after a search of the literature through Medline. Publications from 1984 to present were surveyed. Appropriate adjuvant therapy increases overall survival and disease-free intervals. The treatment modalities of unresectable or metastatic tumors are disappointing, with at best 40% of patients experiencing short-lasting responses. Whenever possible, patients with advanced colorectal cancer should be enrolled in clinical trials.
Cancer Mortality in Italian Migrants to Canada
Authors: Geddes Marco , Balzi Daniela , Buiatti Eva , Brancker Anna , Parkin Donald Max
Published: April 2018

The present study reports on the analysis of cancer mortality in Italian first-generation migrants resident in Canada, deceased in the period between 1964-1985 (5,801 males: 3,267 females). Mortality in migrants is compared to that of the host population as well as to that in the migrants’ country of origin. This is carried out both on a national level (Italy), and on a regional level with those regions that have made the greatest contribution to the Italian migratory flow (Southern Italy). Compared with the Canada-born population, significantly higher risks were evident for nasopharynx, stomach, liver and gallbladder tumors in migrants. Lower risks were observed for the oral cavity, esophagus, colon, rectum, pancreas (females), larynx, lung, melanoma, breast, ovary, prostate, bladder (females), and non-Hodgkin's lymphoma in migrants. This is consistent with that evidenced in the comparison between Italy and Canada. The data are discussed in relation to the results of other studies on Italian migrants and the prevalence of main risk factors.
Relation between Ovarian Carcinoma-Associated Antigens in Tumor Tissue and Detached Cyst Fluid Cells of Patients with Ovarian Neoplasms
Authors: Bar Julia K. , Harłtozińska Antonina , Sobańska Ewa , Cislo Mieczysłtaw
Published: April 2018

Aims

The expression and potential diagnostic value of ovarian carcinoma-associated antigens were estimated in different types of epithelial ovarian neoplasms. The comparison of antigenic expression was performed on solid tumor tissues and loose cyst fluid cells in individual cases of malignant and benign ovarian neoplasms.

Methods

All studies were performed using monoclonal antibodies (mAbs) against ovarian carcinoma-associated antigens (OC125, OV-TL3, OV632, 10B, 8C) by 3-step peroxidase-antiperoxidase test.

Results

All ovarian carcinoma-associated antigens were detected in most serous and endometrioid carcinomas. In mucinous carcinomas as well as in benign ovarian neoplasms these antigens were present only in some cases. Significant inter- and intratumoral immunological heterogeneity was evident; however, the antigens detectable in tissue sections were also found in detached cyst fluid cells.

Conclusions

Our results show that mAb show OV-TL3 is the best marker for endometrioid carcinomas and confirmed that mAbs OV632, OC125 and OV-TL3 could be good complementary markers for differentiating malignant and benign lesions in the ovary. The percentage content of all ovarian carcinoma-associated antigens in solid tumors and respective cyst fluid cells was comparable.
Ossifying Fibroma of the Skull: Clinical and Therapeutic Study
Authors: Artico Marco , Cervoni Luigi , Salvati Maurizio , Raco Antonino , Ciappetta Pasquale
Published: April 2018

Aims and Backround

Ossifying fibroma is a tumor with benign course that rarely affects the cranial bones.

Methods

The authors report 5 cases of ossifying fibroma of the skull and analyze the clinical course and treatment of this lesione.

Results

3 patients were females and 2 males. The mean clinical history was 3.2 years. 4 patients underwent total removal and 1 partial. At mean follow-up of 19 years, all patients who underwent total removal showed improvement of neurological deficit, whereas the patient who underwent partial removal had clinical regrowth.

Conclusion

The authors conclude that total removal of fibroma should be extended to normal bone and in cases in which total removal is not possible the residue should be checked for regrowth by serial MRI.
Mitomycin C Etoposide and Vinorelbine (MEV II) in the Treatment of Metastatic Stage IV Non Small Cell Lung Cancer
Authors: Gridelli Cesare , Rossi Antonio , Palazzolo Giovanni , Pepe Rosario , Airoma Giuseppe , Incoronato Pasquale , Bianco Angelo Raffaele
Published: April 2018

Aims and Background

In a prior study with a new non-cisplatin-based regimen including mytomycin C, etoposide and vindesine (MEV I) we observed a 37% response rate and very low toxicity in stage IV non small cell lung cancer. In an attempt to improve the activity of MEV I we evaluated a new regimen, MEV II, a modification of MEV I in which vinorelbine replaced vindesine.

Methods

21 Patients with metastatic stage IV non small cell lung cancer entered the phase II trial and were treated with the MEV II regimen (mitomycin C 8 mg/m2, i.v., d 1, etoposide 100 mg/m2, i.v., d 1-3, vinorelbine 30 mg/m2, i.v., d 1, every 4 weeks.

Results

We observed a partial response rate of 30% (95% confidence limits 10-50) with a median survival of 6 months. The worst reported toxicity was leukopenia grade 4 in 10% of patients including one who died of sepsis and grade 3 in 20%.

Conclusions

The MEV II regimen showed a similar activity but greater toxicity than MEV I.
Intralesional Beta-Interferon Treatment of Cervical Intraepithelial Neoplasia Associated with Human Papillomavirus Infection
Authors: Penna Carlo , Fallani Maria Grazia , Gordigiani Rodolfo , Sonni Lorella , Taddei Gian Luigi , Marchionni Mauro
Published: April 2018

Aims and backround

Interferons (IFN) have offered considerable advances in the therapy of genital warts even those associated with cervical intraepithelial neoplasia (CIN); intralesional therapy either alone or in combination with other modalities such as cryosurgery and laser surgery provides improved clearing and cure of these often recalcitrant lesions. The purpose of this study was to evaluate the effectiveness of intralesional IFN therapy in patients with CIN associated with human papillomavirus (HPV) infection.

Methods

Beta-IFN was injected intra-perilesionally into the cervix in 41 patients with CIN associated with HPV infection.

Results

The regimen of 3 million international units (IU) injected intralesionally daily in the 1st week and 3 times a week in the 2nd and 3rd weeks for a total of 11 injections and a total dosage of 33 million IU yielded an 80 percent cure rate and may be more advantageous than other treatment options in certain instances. Cytocolposcopic and histologic examination was carried out before and after treatment and 24 lesions were also analyzed for type-specific papillomaviruses using in situ DNA hybridization. CIN disappeared in 33 patients 6 months after the end of therapy. Side effects of intralesional IFN therapy are dose related and for the most part readily tolerated.

Conclusions

Intralesional IFN proved to be effective treatment for CIN associated with HPV infection (cure rate: 80%) and well accepted because hospitalization is not required and no important side effects occur.
Sarcomas Involving the Head and Neck, Trunk and Breast
Authors: Fernández-Trigo Vincente , Sugarbaker Paul H.
Published: April 2018

Sarcomas of the head, neck, trunk and breast are biologically similar to and behave like the soft tissue tumors found in other anatomic areas. In the past and still today, radical surgical resection with negative margins is the only reliable treatment for these sarcomas. The opportunity to use chemotherapy, surgery, and radiation therapy in selected patients as a multi-modality approach may improve the likelihood of long-term, disease-free survival. Added experience with radiologic evaluation of patients to accurately define the anatomic location of the tumor, more definitive pathology to assess the biologic aggressiveness of the lesion, and more conservative wide excisions have allowed patients to retain function and cosmesis. In addition, the development of new surgical techniques has made it feasible to reconstruct large surgical defects.
Smoking in Italy, 1990-1991
Authors: La Vecchia Carlo , Pagano Romano , Decerli Adriano , Ferraroni Monica
Published: April 2018

Smoking prevalence and patterns in Italy were analyzed using data from the 1990-1991 Italian National Health Survey, based on a sample of 27, 135 males and 28,854 females aged 15 years or over, randomly selected within strata of geographic area and size of the place of residence and of the household, in order to be representative of the general Italian population. Overall, 26.9% of the Italians aged 15 years or over described themselves as current smokers (37.2% males, 17.4% females), and 14.0% as ex-smokers (22.2% males, 6.4% females). The difference in smoking prevalence between males and females was 65% below age 45, but increased substantially with increasing age up to 5-fold above age 65. Moderate smokers (< 15 cigarettes per day) were 12.6% of males and 10.4% of females, intermediate smokers (15 to 24 cigarettes per day) 17.7% of males and 5.5% of females, and heavy smokers (> 25 cigarettes per day) 6.3% of males and 1.5% of females. Pipe or cigar smokers were 0.6% of males. The averange number of cigarettes per smoker per day was 16.6 (17.9 for males, 14.0 for females). The overall smoking prevalence of 26.9% was the lowest registered since 1949, thus confirming the long-term steady decline of smoking, particularly among males. Smoking prevalence, however, has remained constant over the last 15 years among females, after substantial rises in previous calendar years. These falls in overall self-reported smoking prevalence were reflected in declines of legal sale figures (-15% between 1986 and 1991), although it is difficult to quantify the impact of smuggling on total tobacco consumption. Thus, at least part of the falls in self-reported tobacco consumption is attributable to increased underreporting. In males, but not in females, smoking was less frequent in northern (and wealthier) areas of the country, and in more educated individuals. The opposite pattern was observed in females, indicating that even more educated Italian women have not yet recognized the accumulated evidence on the health consequences of smoking. These patterns in smoking are reflected by recent trends in lung cancer, which show some decline in males but persistent upward trends in females, although still on much lower absolute values.
High-Dose Intra-Arterial plus Intraperitoneal Chemotherapy Combined with Hemofiltration in Liver Metastases from Colorectal Cancer
Authors: Dazzi Claudio , Fiorentini Giammaria , Davitti Bruno , Priori Tarcisio , Cantore Maurizio , Poddie Domenico , Cerosi Vittorio , Marangolo Maurizio , Albizi Sergio Degli , Cruciani Giorgio
Published: April 2018

Aims

Twenty-three patients with liver metastases from colorectal cancer were entered into a prospective, phase II pilot study to evaluate the efficacy and feasibility of intra-arterial high-dose chemoterapy (IAHC) + intraperitoneal chemotherapy (IPC) combined with hemofiltration.

Methods

All patients had abdominal laparotomy to position a hepatic artery infusion port and in 15 cases an implantable system for IPC. A double-lumen filtration catheter was placed in the vena cava via the saphenous or femoral vien and connected to a modified hemofiltration unit. The treatment schedule consisted of mitomycin (30-50 mg/m2) and epirubicin (60-90) mg/m2) as IAHC combined with cisplatin (60 mg/m2) given in a 2000 ml saline solution by IPC. The high-dose IAHC-IPC was followed by 4 cycles of intra-arterial standard dose chemotherapy through the arterial port-a-cath (6 mg/m2 mitomycin and 20 mg/m2 epirubicin) and if possible by another cycle of high dose IAHC-IPC.

Results

We delivered a toal of 31 cycles of IAHC, 21 of which were combined with IPC. Ten cycles of IAHC were administered without concurrent IPC because of painful adhesions, clinical contraindications or patient refusal. Seven of 23 patients (30%) were pretreated and with progressive disease after systemic chemotherapy. Among 22 evaluable patients, we obtained 2 complete remissions (9%) and 11 partial remissions (50%); moreover, 4 of 7 pretreated patients obtained a response to treatment. As a result, an objective tumor response was observed in 59% of patients (13/22). Therefore, a dose-response behavior was demonstrated also in tumors with a low chemosensitivity. The median duration of response and survival was 10 and 14 months, respectively. Toxicity was usually mild, but we reported one toxic death due to treatment complications.

Conclusions

Further prospective randomized studies are needed to confirm the results of our study.
Ondansetron Does not Stimulate Prolactin Release in Breast Cancer Patients
Authors: Lissoni Paolo , Cazzaniga Marina , Rovelli Franco , Mainini Edoardo , Tancini Gabriele , Barni Sandro
Published: April 2018

Aims and background

Prolactin (PRL) may be a tumor growth factor, mainly for breast cancer. The antidopaminergic drugs commonly used in the treatment of chemotherapy-induced vomiting stimulate PRL release, and this finding could represent a potentially negative biologic event for cancer patients. This study was performed to analyze PRL response to the serotonin-type 3 receptor antagonist ondansetron, a new active drug in the treatment of vomiting due to chemotherapy, in cancer patients.

Methods

The study included 8 premenopausal breast cancer patients undergoing adjuvant chemoterhapy. Ondansetron was given intravenously at a dose of 8 mg, and venous blood samples were drawn at 0, 20, 60 and 120 min. The result were compared to those seen in 10 breast cancer patients treated with metoclopramide (10 mg. i.v.).

Results

PRL mean levels significantly increased in response to metoclopramide. In contrast, no significant changes in PRL mean values occurred after ondansetron injection.

Conclusions

The study showed that ondansetron, whose efficacy in the treatment of chemotherapy-induced vomiting is well known, does not stimulate the tumor growth factor PRL in cancer patients, in contrast the the action of the most commonly used antidopaminergic drugs.
Serum Levels of Insulin-Like Growth Factor-I in Operable Breast Cancer in Relation to the Main Prognostic Variables and their Perioperative Changes in Relation to those of Prolactin
Authors: Barni Sandro , Lissoni Paolo , Brivio Fernando , Fumagalli Luca , Merlini Desiré , Cataldo Michele , Rovelli Franco , Tancini Gabriele
Published: April 2018

Aims and background

In addition to estrogens, prolactin (PRL) and IGF-I have also appeared to stimulate breast cancer growth. The present study was performed to evaluate IGF-I blood levels in operable breast cancer in relation to PRL values and the main prognostic variables.

Methods

The study included 40 patients, clinical stage T1-3NO-2MO. Venous blood samples were collected before and 7 days after surgery. PRL and IGF-I were measured by radioimmunoassay. The control group consisted of 50 healthy women.

Results

Mean serum levels of IGF-I were significantly higher in patients than in controls, without any apparent relation to the main prognostic variables, including estrogen receptor and node status. Surgery-induced hyperprolactinemia occurred in 22/40 patients. IGF-I mean concentrations observed in the postoperative period in patients with surgery-induced hyperprolactinemia were significantly lower than those seen in patients showing no postoperative PRL rise.

Conclusions

The study showed that operable breast cancer may be associated with abnormally high levels of tumor growth factor IGF-I, and that surgery was followed by an IGF-I decline only in patients who showed surgery-induced hyperprolactinemia. Our previous studies have shown that postoperative hyperprolactinemia is a favorable prognostic factors for operable breast cancer. The present study, by showing that a postoperative PRL rise is associated with a fall in IGF-I, would suggest that surgery-induced hyperprolactinemia may determine a lower tumor relapse rate by determining a diminished secretion of breast tumor growth factor IGF-I.
Age Related Natural Killer Activity of Peripheral Blood Lymphocytes from Healthy Subjects and Cancer Patients. A Comparative in Vitro Study with Interleukin-2
Authors: Chakraborty Abalokita , Chakraborty Nitya G. , Chattopadhyay Utpala
Published: April 2018

Aims and Beckground

Natural killer (NK) cell activity is known to be depressed in neoplastic diseases, and ageing influences the cytotoxicity of NK cells. However, very little information is available on the responsiveness of NK cells of cancer patients to the stimulating effects of interleukin-2 (IL-2) as a function of age.

Methods

We assessed in vitro IL-2 induced modulation of NK activity in peripheral blood lymphocytes (PBL) from 7 young (30-50 years) and 9 elderly (55-78 years) male patients with carcinoma of the oral cavity. In these patients generation of lyphokine activated killer (LAK) activity was also studied. NK and LAK activity of PBL were measured in 14 age and sex matched healthy volunteers as who served as conrols. Cytotoxicity of the NK and LAK cells was assayed against NK sensitive K562 and NK resistant Daudi cells in 4-h 51 Cr-release assays.

Results

NK activity in the cancer patients was significantly lower than that in healthy volunteers. In both groups the younger subjects had higher NK activity than the elderly ones. NK cells of both young and elderly healthy controls responded similarly to 24-hour in vitro exposure to human recombinant IL-2 (rIL-2, 100 u/ml) with highly increased cytotoxicity. Though there was significant enhancement of NK activity with rIL-2 in both young and elderly cancer patients, the rIL-2 induced NK cytotoxicity in the elderly patients was much lower than the basal level of NK activity of the age matched controls. Interestingly, LAK activity, generated by 3-7 days of in vitro exposure of PBL to rlL-2 was comparable in the cancer patients and healthy volunteers

Conclusion

The data suggest serious impairment of NK function in elderly patients with oral carcinoma. Generation of LAK activity with exogenous IL-2 could be an important modality of treatment in these patients.
Pilomatrix Carcinoma. A Case Report with Immunohistochemical Findings, Flow Cytometric Comparison with Benign Pilomatrixoma and Review of the Literature
Authors: Panico Luigi , Manivel J. Carlos , Pettinato Guido , De Rosa Nicolina , Ruggiero Angela , De Rosa Gaetano
Published: April 2018

We report a case of pilomatrix carcinoma in a 42 year old woman. The patient presented a rapidly growing 4-cm subcutaneous mass in the right preauricular area. She was free of recurrence 24 months after surgery. Immunoreactivity was studied for cytokeratins, epithelial membrane antigen, S-100 protein, blood group antigens, Leu-M1, β-2-microglobulin, vimentin, neuron-specific-enolase and cellular binding for peanut agglutinin. Squamous cells were reactive for cytokeratin AE1/3, epithelial membrane antigen, blood group antigens B and H, and peanut agglutinin. Basaloid cells were focally reactive for cytokeratin AE1/3 and epithelial membrane antigen. Flow cytometry revealed a euploid DNA content and a high proliferative rate of the pilomatrix carcinoma and in benign pilomatrixoma studied for comparison. The pathological diagnosis must be based on histomorphological criteria.
Preoperative Intra-Arterial Mitomycin-C in the Management of Sigmoid Adenocarcinoma: Long-Term Results of a Pilot Study
Authors: Secco Giovanni Battista , Fardelli Roberto , Campora Elisabetta , Sertoli Mario Roberto , De Caro Giovanni , Cariati Andrea , Zoli Simona , Gianquinto Daniela
Published: April 2018

Aims and background

In patients undergoing potentially curative surgery for colorectal adenocarcinoma, the presence of occult disease is thought to be responsible for distant metastases, particularly of the liver. During the 1980's preoperative intra-arterial chemotherapy was used in patients with adenocarcinoma of the sigmoid colon since it was thought that the biological effects induced by radiation in rectal lesions could be induced by cytotoxic agents in sigmoid cancer which was found to be less sensitive to radiation. The aim of the present paper is to report long-term results of an early pilot study on 20 patients with sigmoid colon adenocarcinoma treated with a 6 preoperative intra-arterial infusion of mitomycin-C followed by curative surgery.

Methods

From January 1980 to December 1986, 20 patients with adenocarcinoma of the sigmoid colon were treated with a 6 hours preoperative intra-arterial infusion of mitomycin-C followed by potentially curative surgery (Group A). Eighteen hours prior to surgery the patients underwent selective arteriography of the inferior mesenteric artery through puncture of the femoral artery at the inguinal fold. The Seldinger technique was applied and Cook BP6 catheter was used. At the end of the examination, the catheter was positioned in the inferior mesenteric artery and mitomycin-C, 10 mg/m2, was infused in 500 mi of normal saline over a 6 hours period after which the catheter was definitively removed. Within 18 hours following intra-arterial mitomycin-C infusion all 20 patients underwent potentially curative surgery of their sigmoid adenocarcinoma. During the same period, 48 comparable sigmoid colon cancer patients underwent potentially curative resection alone (Group B).

Results

At 5 years overall recurrence rate was 30% and 39.6% in Group A and B patients, respectively (P = n.s.). In patients with Stage C disease, recurrence was less frequently observed in Group A (44.4%) than in Group B (77.7%) (P = n.s.). Overall survival at 5 years was comparable in the two groups of patients (70% and 64% for Group A and B, respectively) and median survival was >60 months in both groups. In patients with Stage C lesions, there was a trend for improved survival at 5 years in Group A patients (55%; median >60 months) compared to Group B (22%; median 27 months) patients (P = n.s.).

Conclusions

Although the difference indicating decreased recurrences and improved survival for Stage C patients treated with preoperative intra-arterial mitomycin-C were not statistically significant, the long term results of this small pilot study are encouraging.