bluuebunny/crossref_metadata_2025 huggingface dataset:
Combination Antibiotic Treatment of Chemotherapy-Induced Neutropenia in Non-Leukemic Patients
Authors: Gasparini Giampietro , Turnolo Salvatore , Toffoli Giuseppe , Talamini Renato , Vaglia Alberto , Benedetti Marco
Published: April 2018

The use of more aggressive chemotherapies in the treatment of patients with some tumors has caused a higher frequency of neutropenia and subsequent serious infections. To verify the role in these patients of a combination therapy of amikacin (300 mg/m2 i.v. every 12 hours) plus ceftazidime (2 g/m2 i.v. every 8 hours) adminsitered as initial empiric treatment, followed in non-responsive cases by a second-line therapy with clindamycin (300 mg/m2 i.v. every 8 hours), we conducted a prospective study in 45 febrile episodes (temperature ≥38.5 °C) in neutropenic patients (neutrophils ≤500/ml). The patients' median age was 58 (range, 19-80); 29 were women and 16 were men. The median performance status was 50 (range, 30-90), and 71 % of the patients had progressive tumoral disease. Before antibiotic therapy the median duration of fever was 12 hours (range, 4-48 hours). The median granulocyte count was 350/ml (range, 100-500 cells/ml), and the median peak temperature was 38.8 °C (range, 38.5-41 °C). The median time for neutrophils to rise towards 1000/ml was 4 days (range, 2-12), and the median duration of therapy was 8 days (range, 3-12). Documented bacterial infections were present in 28 patients whereas 17 had clinically possible infections or fever of unknown origin. The infection sites in microbiologically documented infections were: septicemia (12), multiple sites (4), tonsillitis (4), urinary tract (4), pneumonia (2) and fistula (2). Complete response to first-line therapy was obtained in 36 out of 45 episodes (80 %; 95 % confidence limits from 65 % to 90 %). Five out of 8 cases responded to second-line therapy with clindamycin for an overall recovery rate of 91 %. The amikacin-ceftazidime combination followed by clindamycin in non-responsive cases is effective, with moderate toxicity in non-leukemic febrile neutropenic patients.
The Use of High Resolution Ultrasound in Preoperative Evaluation of Cutaneous Malignant Melanoma Thickness
Authors: Reali Umberto Maria , Santucci Marco , Paoli Giovanni , Chiarugi Cristina
Published: April 2018

High resolution ultrasound (HRUS) was tested in 58 cutaneous malignant melanomas to check its validity in evaluating tumor thickness in vivo before surgery. The values obtained with this method were compared with histologic values (measured according to Breslow); a highly significant correlation was found (r = 0.895, p < 0.001). The accuracy of HRUS in distinguishing between low- and high-risk cutaneous malignant melanoma was also found to be quite high. Our data therefore justify the use of such a technique in the preoperative staging procedure.
Cytogenetic Analysis in 28 Radically Operated Non-Small-Cell Lung Cancer: Preliminary Considerations
Authors: Clerici Maurizia , Lavezzi Anna Maria , Vergani Claudio , Pezzuoli Giuseppe , Luporini Gino , Matturri Luigi
Published: April 2018

Twenty-eight radically operated non-small-cell lung cancer patients were analyzed with regard to chromosomal assessment and DNA content: in 13 cases, different quantitative/ qualitative chromosome alterations were found. In particular, in 12 cases marker chromosomes and cytogenetic abnormalities in euploid cells were demonstrated. The prognostic value of these findings will be aim of further studies.
Tumor Markers in Serum of Patients with Primary Squamous Cell Carcinoma of the Esophagus
Authors: Gion Massimo , Tremolada Carlo , Mione Riccardo , della Palma Paolo , Dittadi Ruggero , Zari Claudio , Nosadini Attilio , Castoro Carlo , Ruol Alberto , Peracchia Alberto , Bruscagnin Giuliano
Published: April 2018

Serum levels of several tumor markers were studied in 96 patients with untreated primary squamous cell carcinoma of the esophagus. Three markers specific for digestive tract malignancies - CEA, CA19.9 and CA50 - and two non organ specific indicators of malignancy - ferritin and TPA - were evaluated. Positivity rates of CAI9.9 and CA50 were very low (4.4 % and 8.6 % respectively); the markers were therefore considered ineffective in the disease. CEA, TPA and ferritin showed a fair positivity rate (27.1 %, 28.1 %, 33.7% respectively); CEA and TPA were directly related to clinical stage, CEA levels being significantly higher in stage IV than in stage III cases (p = 0.016). TPA preoperatory levels were also directly related to a lower survival probability (p = 0.004). CEA showed significantly lower levels in tumors of lower than in those of middle (p = 0.03) and upper esophagus (p = 0.004). TPA showed a similar behaviour with lower levels in tumors of lower than of middle esophagus (p = 0.03). These findings could be due to a bulky metabolism of tumor markers drained via portail vein in the liver. From our data the following conclusions may be drawn: 1) CEA and TPA may be useful in the staging of esophageal cancer as an ancillary tool to assess the extent of the disease; 2) tumor location is an important variable when evaluating blood levels of tumor markers in patients with esophageal cancer.
Immunohistochemical Reactivity of a Monoclonal Antibody Prepared against Human Ovarian Carcinoma on Normal and Pathological Female Genital Tissues
Authors: Veggian Rosalia , Fasolato Silvano , Ménard Sylvie , Minucci Daria , Pizzetti Paolo , Regazzoni Mario , Tagliabue Elda , Colnaghi Maria Ines
Published: April 2018

The reactivity profile of the monoclonal antibody (MAb) MOv18, raised against a poorly differentiated ovarian carcinoma specimen, was studied on normal tissues and tumors from the female reproductive system and on the kidney, which like the oviducts, vagina and uterus, also derives from the intermediate mesoderm. The obtained results indicate that MOv18 recognizes an epitope present on the normal epithelium of the oviducts, on 14-week old fetal kidney and, focally, on proximal and distal tubules of normal adult kidney. A strong reactivity was found on ovarian carcinomas, on invasive squamous carcinomas of the cervix and on endometrial carcinomas and hyperplasias. The antigen recognized by MOv18 (CaMOv18) therefore seems to be an epithelial cell marker associated with intermediate mesoderm differentiation, which can be derepressed during the neoplastic transformation of the ovary and the uterus.
In Situ and Microinvasive Carcinoma with Squamoid Differentiation Arising in a Phyllodes Tumor: Report of a Case
Authors: de Rosa Gaetano , Ferrara Gerardo , Goglia Pasquale , Ghicas Christos , Zeppa Pio
Published: April 2018

A case of in situ and invasive ductal carcinoma with areas of squamoid differentiation arising in a phyllodes tumor is reported. This last aspect has never been described before and is discussed reviewing the previously reported cases in the literature.
Clinically Useful Measures to Assess the Effectiveness of Treatments: Hints for a Proper Choice with Special Emphasis on Cancer Research
Authors: Boracchi Patrizia , Mezzanotte Guerrino , Mariani Luigi , Valagussa Pinuccia , Marubini Ettore
Published: April 2018

Several absolute and relative measures useful to assess the consequences of treatments in cancer research are presented together with statistical methods suitable for computing the pertinent confidence intervals. The relationship of these measures with the parameters of the regression models commonly used in the analysis of survival data is elaborated upon. Three examples are elaborated, and conditions of interchangeability of the measures are discussed in detail. Finally, suggestions for the choice of the measure most appropriate for a specified data set are given.
MOv18 Monoclonal Antibody in Diagnostic Applications: Capability to Recognize the Histotype of the Original Tumor
Authors: Belloni Carlo , Bianchi Marco Claudio , Colombo Gabriella , Frigerio Ambrogio , Luchini Stefania , Ménard Sylvie , Pizzetti Paolo , Taccagni Gian Luca , Tagliabue Elda , Colnaghi Maria Ines
Published: April 2018

Cells from 52 ascitic fluids and 28 abdominopelvic cavity washings, obtained from 46 ovarian cancer patients, 17 patients bearing malignancies of non ovarian sites and 17 patients with non-malignant ovarian diseases, were tested using 2 methods: traditional cytology and monoclonal antibody immunofluorescence. The immunologic test using the MOv18 MAb, raised against ovarian carcinoma, revealed immunoreactive cells in 83 % of the 36 cytologically positive fluids and in one of the 8 negative fluids from ovarian carcinoma patients and in 18% of the 17 fluids from patients with non-malignant ovarian disease. Forty six cytologically positive ascitic fluids from malignant patients were analyzed in order to evaluate the ability of this MAb to identify the histotype of metastatic cells. Ninety-three percent (26/28) of the effusions from non-mucinous ovarian carcinomas contained MOv18-positive cells, whereas no reactive cells were found in cytologically malignant fluids from patients with ovarian tumors of other oncotypes or with carcinomas of non-ovarian origin. The MOv18 reagent, used as an adjuvant in cytological analysis, can help in the identification of the histotype of metastatic cells of unknown origin.
Sensitization of Chronic Myeloid Leukemia Cells to Adriamycin Cytotoxicity by Clofibrate
Authors: Parekh Hemant , Satyamoorthy K. , Advani Suresh , Chitnis Manik
Published: April 2018

Clofibrate (CPIB), an antihyperlipidemic agent, was employed as a drug response modulator in this study to evaluate its action, if any, on adriamycin (ADR) cytotoxicity in adriamycin insensitive chronic myeloid leukemia (CML) cells in vitro. Inhibition of (3H)-thymidine incorporation was used as a measure of DNA biosynthesis inhibition. A marginally toxic concentration of CPIB [0.001 % (v/v)] was utilized to evaluate the cytotoxicity in CML cells exposed to ADR 5 and 10 μg/ml. A heterogeneous response was observed in 16 different CML blood samples, 9 samples displaying a synergistic, 3 an additive and 4 a less than additive inhibition of DNA biosynthesis when exposed to the combination of ADR and CPIB. The cytotoxic effect induced by ADR alone and in combination with CPIB was found to be irreversible. The data suggest that the cell membrane modulating drug CPIB is effective as an adjuvant to enhance the antiproliferative action of ADR.
Hormones in Male Breast Cancer
Authors: Ballerini Paola , Recchione Camilla , Cavalieri Adalberto , Moneta Rolando , Saccozzi Roberto , Secreto Giorgio
Published: April 2018

Urinary levels of testosterone, 5α-androstanediol, 17-hydroxycorticosteroids, pregnanediol, and circulating levels of testosterone, 17β-estradiol, dehydroepiandrosterone-sulfate, prolactin, luteinizing hormone, follicle-stimulating hormone and sex hormone-binding globulin, were measured in 10 male patients with breast cancer and in a suitable group of healthy controls. No difference, either in blood or in urine, was observed between the two groups in the hormonal levels. The lack of abnormalities in peripherally detectable hormones suggests that the well recognized hormone dependency of male breast cancer may be due to some endocrine imbalance in the central (diencephalic) regulation of the sex steroids pathway. Alternatively, abnormal response of breast tissue to normal hormonal stimuli might be hypothesized in these patients.
Observer Variation in Mammary Thermography: Results of a Teaching File Test Carried Out in four Different Centers
Authors: Mustacchi Giorgio , Milani Silvia , Ciatto Stefano , Del Turco Marco Rosselli , Luzzati Guido , Lattanzio Vincenzo , Pietri Piero
Published: April 2018

To evaluate observer variation in mammary thermography, a teaching file test of 159 thermographies was worked out by 4 senology centers. The evaluation of accuracy and the K index of variability demonstrated a significant variability among centers. The reliability of thermography in senology seems to be too poor for it to be able to direct any therapeutic decision, either diagnostic or prognostic.
Phase II Trial of Cytarabine, Cisplatin and Vindesine for Advanced Non-Small Cell Lung Cancer
Authors: Bianco Adrian , Perez Juan E. , Machiavelli Mario , Leone Bernardo A. , Romero Alberto , Rabinovich Mario G. , Vallejo Carlos T. , Rodriguez Ricardo , Cuevas Maria A. , Alvarez Luis A.
Published: April 2018

Thirty-two patients with advanced non-small cell lung cancer (NSCLC) were entered in this study to evaluate the efficacy and toxicity of a chemotherapy schedule including cisplatin (C) 40 mg/m2 intravenously (i.v.) on days 1–3; vindesine (V) 3 mg/m2 i.v. on day 1, and cytarabine (ara-C) 15 mg/m2 subcutaneously every 12 hours on days 1–3 (total dose: 90 mg/m2). Cisplatin was administered simultaneously with one dose of ara-C. Cycles were repeated every 28 days. Five patients out of 28 (18 %) fully evaluable for response presented partial remissions. No complete response was observed. Median survival was 8 months and median duration of response was 4 months. Hematologic toxicity was severe in 3 patients. There were no toxicity-related deaths. Other adverse reactions included nausea and vomiting, alopecia and peripheral neuropathy. We conclude that this chemotherapy combination is marginally effective against NSCLC showing in this group of patients a low number of responses of short duration without a significant impact on survival.
Results of Conservative Surgery for Stage I Lung Cancer
Authors: Pastorino Ugo , Valente Maurizio , Bedini Vittorio , Infante Maurizio , Tavecchio Luca , Ravasi Gianluigi
Published: April 2018

This paper reports our results with sublobar resections for stage I non small cell lung cancer. Sixty-one cases of wedge or segmental resection were compared with 517 standard resections (411 lobectomies and 106 pneumonectomies), performed during the years 1971–88. Operative mortality was 0% in the limited resection group and 4 % (19/517) in the standard resection group; cancer recurrence was detected in 36 % of both groups; actuarial survival at 5 years was 55% versus 48% overall. In 28 patients with pre-existing cardiac or pulmonary co-morbidity, limited resection yielded a similar 5-year survival than standard resection (53 % vs 49 %) with no perioperative deaths (0 vs 6 %). Our data support the experience of other authors on conservative management of stage I lung cancer. Particularly in patients with concomitant cardiopulmonary disease, previous cancer or small peripheral tumors, limited resection combined with adequate nodal staging may be as effective as standard lobar resection with respect to long term survival.
Liver Glutathione Contents in Patients with Gastric Adenocarinomas
Authors: Engin Afilla , Ferahköse Zafer
Published: April 2018

Many antineoplastic agents alter the reduced glutathione (GSH) status of liver and tumor tissue by inhibiting cellular GSH-linked enzymes. Thus, intracellular GSH plays an important role in a wide variety of antineoplastic interventions regarding therapeutic efficacy and toxicity. Mean GSH values were 0.791 ± 0.072 mg/m wet weight (ww) and 0.719 ± 0.047 mg/g ww in gastric cancer tissue and nontumorous glandular mucosa, respectively. Whereas, the average GSH level of normal gastric mucosa was 1.709 ± 0.135 mg/g, the mean GSH level of normal liver biopsies was 2.378 ± 0.260 mg/g. The GSH values of normal liver tissue were higher than the hepatocellular GSH concentrations of patients with gastric adenocarcinoma and of another group of tumor-bearing patients who had received chemotherapy preoperatively. These results suggest that the GSH levels of tumor and liver may influence the efficacy and/or toxicity of chemotherapeutic agents.
Thermal Lesions Induced by 480 KHz Localized Current Field in Guinea Pig and Pig Liver
Authors: Rossi Sandro , Fornati Fabio , Pathies Carlo , Buscarini Luigi
Published: April 2018

We evaluated the type, dimension and histopathological evolution of thermal lesions induced in guinea pig and pig liver by radiofrequency electrode needles at various temperatures for different exposure times. The greatest useful necrosis volume was induced by a needle of 1.1 mm diameter and exposed tip 10 mm long at 90 °C and 120 seconds exposure time. It was an ellipsoid with the biggest diameter of about 14 mm diameter and length of about 18 mm. It seems possible that liver tumors of not more than 20 mm diameter in patients without surgical prospects could be destroyed, ultrasonography guiding the needle into the tumor and using the temperature and exposure time mentioned above.
A Study of the Pineal Hormone Melatonin as a Second Line Therapy in Metastatic Colorectal Cancer Resistant to Fluorouracil plus Folates
Authors: Barrii Sandro , Lissoni Paolo , Paolorossi Franco , Crispino Sergio , Archili Caterina , Tancini Gabriele
Published: April 2018

Since there is no effective second line chemotherapy in colorectal cancer resistant to fluorouracil, this study was carried out to evaluate the therapeutic activity of the pineal hormone melatonin, which has appeared to have antineoplastic activity in some experimental conditions, in patients with metastatic colorectal carcinoma who did not respond to fluorouracil. The study included 14 patients (8 men, 6 women; mean age 58 years). Melatonin was given intramuscularly at a daily dose of 20 mg at 3.00 p.m. for 2 months; after that, melatonin therapy was continued at 10 mg/day orally in responder patients, in those with stable disease and/or an evident improvement in PS. One patient had a minor response; 3 other patients had a stable disease, wehereas the other 10 cases progressed. An evident improvement in PS was seen in 5/14 (36 %) patients. These preliminary results show that melatonin does not have important antitumor activity in metastatic colorectal cancer patients resistant to fluorouracil. However, the pineal hormone could be usefully employed as supportive care to improve the quality of life in these patients for whom no standard treatment is yet available.
Histochemical Study of Mucinous Ovarian Cystomas of Intestinal and Mixed Types: O-Acetylated Sialomucin Content in Relation to Biologic Behavior
Authors: Fulcheri Ezio , Baracchini Patrizia , Foglia Giovanni , Lapertosa Gabriella , Siciliano Beatrice , Ragni Nicola
Published: April 2018

The subgroup of mucinous ovarian cystomas of intestinal type containing site 8 O-acetylated sialomucins and its relation to malignant behavior were studied. Of 75 mucinous cystomas of the ovary from the files of the Institute of Pathological Anatomy and Histology (University of Genoa), 54 were endocervical, 19 were mixed, and 2 were intestinal. As regards their histologic pattern, the 54 mucinous endocervical cystomas were benign, whereas the 19 mixed type group included 8 benign, 5 borderline and 6 malignant; the 2 intestinal type tumors were borderline. According to histochemical investigations, the frequency of tumors with goblet cells containing site 8 O-acetylated sialomucins (positive to PB/KOH/PAS) was 47% In the mixed type cystomas and 100% in the intestinal type cystomas. Twenty-five percent of benign mixed cystomas, 60 % of borderline mixed cystomas, and 67 % of mixed cystadenocarcinomas were positive to PB/KOH/PAS. One hundred percent of the borderline cystomas of intestinal type were positive. Our results confirm that among mucinous ovarian cystomas, those containing intestinal type epithelium are the most likely to fall within the borderline or malignant categories. Moreover, of all ovarian cystomas of intestinal type, those characterized by site 8 O-acetylated sialomucins seem to be more aggressive and, in general, to have a more malignant behavior than the mucinous cystic tumors of müllerian or endocervical type.
Alveolar Soft Part Sarcoma of the Vagina
Authors: Cannelli Silvestro Giuliano , Giudici Maria Natalina , Brioschi Diana , Cefis Francesco
Published: April 2018

We describe a case of primary alveolar soft part sarcoma presenting as a vaginal mass in a 27 year old woman and also review the literature on this type of tumor arising in the lower female genital tract. Histologically, most of the tumor exhibited poorly developed alveolar architecture, but anaplasia was absent. Although the mass was well circumscribed, a few tumor cells were seen focally within the peritumoral tissue. Treatment consisted of wide local excision followed by external radiation therapy. The patient is alive without evidence of disease 17 years after operation.
Descriptive Epidemiology of Adenocarcinomas of the Cardia and Distal Stomach in the Swiss Canton of Vaud
Authors: Levi Fabio , La Vecchia Carlo , Te Van-Cong
Published: April 2018

Incidence registration and survival data from various anatomical subsites of gastric cancer have been abstracted from the population-based Cancer Registry of the Swiss Canton of Vaud for the period 1976-87. Overall age-standardized (Vaud population in 1980) incidence rates for all gastric adenocarcinomas were 22.2/100,000 males and 8.3/100,000 females, with a sex ratio of 2.7. The male preponderance was appreciably greater for cardia (5.9 vs 0.9, sex ratio = 6.5) than for distal stomach (10.2 vs 5.0, sex ratio = 2.0). Adenocarcinomas of unspecified origin had an intermediate sex ratio (2.6). The sex ratio for all gastric adenocarcinomas was lower in the third and fourth decades of age (1.3) than at older ages. In relation to calendar period of diagnosis, no appreciable trend with time was observed for adenocarcinomas of the cardia, and only some modest decline was observed for distal stomach, in the presence of stable sex ratios. A marked fall was observed for « other and unspecified » subsites. Thus, the overall decline in the incidence of gastric adenocarcinomas over the calendar period considered was about 20% for males and 30% for females. Five-year survival was significantly higher for cancers arising in the distal stomach (30%) than for cardiac carcinomas (11%), and intermediate for « other and unspecified sites » (19%). These results indicate that adenocarcinomas arising from the cardia and those arising from the distal stomach are considerably heterogeneous in relation to descriptive epidemiology and prognosis. This may have relevant etiological correlates, particularly since carcinoma of the cardia appears to share important epidemiologic features with esophageal cancer.
Follicular Non Hodgkin's Lymphoma in Adenolymphoma: Report of a Case
Authors: Giardini Roberto , Mastore Marinella
Published: April 2018

A case of centroblastic centrocytic follicular lymphoma arising within a bilateral adenolymphoma of the parotid glands with Involvement of the adjacent lymph nodes is reported. The patient was treated with combination chemotherapy and three years after the first cycle of therapy there was no evidence of disease. The occurrence of primary malignant lymphomas in the lymphoid stroma of an adenolymphoma has seldom been discussed in literature. All cases reported of follicular centre cell type were characterized by an indolent clinical course.
Some Further Consideration on the Role of Oral Contraceptives in Breast Carcinogenesis
Authors: La Vecchia Carlo , Bruzzi Paolo , Boyle Peter
Published: April 2018

Available evidence concerning oral contraceptives and their potential interaction with reproductive history on breast cancer risk Is reviewed. The relative risks in 15 out of 15 studies were above unity among younger women (i.e., below age 35 and perhaps up to 45) for long-term oral contraceptive use, although apparent heterogeneities emerged in the risk estimates. The overall evidence is reassuring in subsequent age groups, whereas the modifying effects or interactions between oral contraceptives, reproductive factors and breast cancer risk are still largely undefined. Thus we suggest that, besides chance and bias, the apparent discrepancies between various studies should be considered within the framework of the complex time- and age-effects of hormone-related risk factors on breast carcinogenesis.
The Role of Fine Needle Aspiration Cytology in the Differential Diagnosis of Suspected Breast Cancer Local Recurrences
Authors: Ciatto Stefano , Bravetti Patrizia , Cecchini Silvia , Grazzini Grazia , Iossa Anna , Cariaggi Paola , Bulgaresi Paolo , Confortini Massimo , Pacini Paolo
Published: April 2018

The authors report on 228 cases of suspected breast cancer local recurrences studied by fine needle aspiration cytology (FNAC). The nature (malignant = 133, benign = 95) of suspected lesions was assessed on histology (no. = 46) or according to unequivocal follow-up (no. = 182). Inadequacy rate was 0.20, 0.09 or 0.35 in total, cancer or benign cases, respectively, and was particularly high (0.50) for benign chest wall lesions. Accuracy was determined on adequate smears; dubious reports were assumed as positive. Sensitivity and specificity were 0.96 and 0.97, respectively. The routine use of FNAC is recommended since it helps in the differential diagnosis of suspicious cases and may bypass surgical biopsy of positive cases not eligible for surgical treatment.
External Radiotherapy in the Treatment of Tonsillar Carcinomas. Analysis of 183 Cases
Authors: Di Marco Adriano , Rizzotti Aldo , Grandinetti Antonio , Campostrini Franco , Palazzi Mario , Garusi Gianfranco
Published: April 2018

A retrospective analysis of 183 consecutive patients with tonsillar carcinoma obserevd from 1970 through 1984 and treated by external radiotherapy was carried out. The data were analyzed retrospectively to determine the factors affecting prognosis. Tumor size (T) and lymph node involvement (N) were found to be predominant prognostic factors. The difference in 5 year survival rate between T2 and T3 tumors was significant, and that between N1 and N3 was highly significant, whereas difference in survival could be found between N0 and N1 groups. The primary tumor was controlled by radiotherapy alone in 90% of cases of T1 lesions, 58% of T2, 37% of T3 and 11% of T4, and lymph node metastases was controlled in 70% of N1 cases, 0 of N2 and 15.5% of N3. Twenty-three patients underwent salvage surgery after radiotherapy had failed and the actuarial 5 year survival rate was 75% for stage I, 40% for stage II, 30% for stage III and 13% for stage IV.
High Prevalence of Occult Papillary Thyroid Carcinoma in a Surgical Series for Benign Thyroid Disease
Authors: Pelizzo Maria Rosa , Piotto Andrea , Rubello Domenico , Casara Dario , Fassina Ambrogio , Busnardo Benedetto
Published: April 2018

In a surgical series of 277 consecutive patients operated on the thyroid for benign diseases, a high prevalence rate (10.5%) of occult papillary carcinoma was found by means of an accurate histologic examination. Indications for surgery were euthyroid multinodular goiter in 25 patients, autonomously hyperfunctioning adenoma in 2 and Graves’ disease in 2 patients. Neoplastic foci were unilaterally found in 25 cases but multifocally in 6 and bilaterally in 4 cases: the diameters ranged from 2-10 mm. After operation (14 subtotal and 15 total thyroidectomies), all patients received TSH-suppressive doses of T4. At a mean follow-up of 5.6 years, neither local recurrences nor lymph node or distant metastases had occurred; no patient died of the tumor. In keeping with other surgical and autopsy series, the prevalence of occult thyroid carcinoma in a normal population is calculated to be about 5-10%, whereas it is known that the prevalence of clinically evident thyroid cancer is only 0.05%. This means that only 1-2% of occult carcinomas may evolve in an overt tumor during life. In view of such an epidemiologic difference and the favorable course of our patients, although the mean follow-up is rather short, we suggest that lobectomy plus T4 treatment may be considered an adequate therapeutic approach in patients with occult papillary thyroid carcinoma.
Extra-Adrenal Non-Functioning Paraganglioma
Authors: Kulkarni Jagdeesh N. , Tongaonkar Hemant B. , Kamat Murali R. , Krishnamurthy Shanta C.
Published: April 2018

Extraadrenal non-functioning retroperitoneal paragangliomas are rare tumors. We herein report a case of retroperitoneal tumor which posed a diagnostic and management problem. Review of the literature shows only 16 previously reported cases of extraadrenal paraganglioma which underwent complete surgical excision.
Quality of Care of Colorectal Cancer Patients in General Hospitals: Diffusion and Impact of Management Guidelines
Authors: Apolone Giovanni , Grilli Roberto , Alexanian Alexan A. , Confalonieri Carlo , Labianca Roberto , Liati Paola , Marsoni Silvia , Martignoni Giancarlo , Mosconi Paola , Nicolucci Antonio , Pancera Gian Franco , Taiana Anna , Torri Walter , Zaniboni Alberto , Liberati Alessandro
Published: April 2018

Over the last ten years the Italian National Research Council (C.N.R.) has launched an educational program aimed at favoring the delivery of the most up to date care for cancer patients in community hospitals. Among various tumors for which this effort was undertaken, management guidelines for colorectal cancer were developed in 1978 by a multidisciplinary team of national experts and reported in booklets distributed nationwide under the aegis of the Colorectal Cancer Task Force. In 1988, the C.N.R. funded an evaluation to learn whether: a) the guidelines were widely diffused in the target physician populations; b) their content was accepted by those who received them and, c) practice patterns were consistent with the recommendations in the guidelines. Overall results indicate only a limited effect. Despite clear evidence of a positive self-selection in the physicians’ survey, guidelines were familiar to only 47% of responders. Although acceptance of at least some specific recommendations was good among doctors aware of the guidelines (≥ 60% responders), this finding loses relevance since a not negligible proportion of those not aware of them had the same convictions. Finally, analysis of practice patterns showed serious deficiencies (mostly in terms of thoroughness of operative staging) even in centers where more widespread knowledge of the guidelines should have led to better quality of care. The paper also discusses the comparability of our findings to results of a similar evaluation carried out in the U.S.A. Our results underscore the importance of analyzing the process of diffusion in any assessment of interventions based on knowledge dissemination.
Role of Immunoscintigraphy in Clinical Assessment of Gastrointestinal Tumors
Authors: Barone Carlo , Ricevuto Enrico , Garufi Carlo , Cassano Alessandra , Astone Antonio , Grieco Antonio , Albanese Carla , Giordano Alessandro , Troncone Luigi
Published: April 2018

From June 1986 until April 1989 31 patients with gastrointestinal tumors were studied at follow-up for recurrences by Immunoscintigraphy (IS) using F(ab)2 fragments of monoclonal antibodies anti CEA and anti CA 19-9. IS was employed to confirm the presence of metastases already found (group A) and to verify metastases suspected following physical and Instrumental examinations and/or increases in CEA and/or CA 19-9 (group B). Thirty-four IS findings have been evaluated to date: 19 in group A, with 18 true positive and 1 false negative results; 15 in group B. In these patients there were 12 cases of pathologic high fixation: 6 were confirmed using standard examinations after a median follow-up of 1 month (range 1-12); 6 cases had no metastatic evolution at the suspected site after a follow-up of 5-28 months. In 3 cases IS was negative, these patients are disease free at 13, 14 and 24 months. In group B, 5 of 8 abdominal intense fixations were early diagnoses of local or peritoneal recurrences. The overall accuracy was 79.4% and it was not affected by circulating CEA levels; sensitivity was 96%. IS can be considered useful as a primary diagnostic examination in the follow-up of patients with suspected abdominal metastases.
Prognostic Factors in Stage IV Ovarian Carcinoma Treated with Platinum-Based Regimens
Authors: Repetto Lazzaro , Chiara Silvana , Pace Maurizio , Guido Tiziana , Bruzzone Milena , Oliva Cristina , Muralo Carmelina , Conte Pier Franco , Rosso Riccardo
Published: April 2018

Eight factors were analyzed for prognostic significance in univariate analyses in a series of 76 women with stage IV ovarian carcinoma treated with combination chemotherapies including cisplatin or carboplatin. The clinical objective and pathologic complete response rates were 51.2% and 27.3%, respectively. Median overall survival and progression-free survival were 15 and 7 months, respectively. No variables reached statistical significance. Trends toward better survival were noted for grades 1 and 2 for the adriamycin-containing regimen. Using progression-free survival as an end point, significant prognostic factors included complete clinical or pathologic response. Our data confirm that the standard approach is unlikely to modify the clinical outcome of stage IV ovarian cancer. New treatment modalities including high-dose-intensity regimens and neo-adjuvant chemotherapy delivered before surgery could improve clinical results. Moreover, biologic characterization of ovarian tumors may provide information to design specifically targeted treatment.
Partial Response to Lonidamine of Advanced Bladder Carcinoma: A Case Report
Authors: Re Giovanni Lo , Veronesi Andrea , Tumolo Salvatore , Morassut Sandro , Belmonte Pietro , Francini Marcello , Monfardini Silvio
Published: April 2018

A 76 year old woman presented with locally advanced papillary transitional cell carcinoma. The patient had elsewhere had trans-urethral resection and radiotherapy and declined salvage cystectomy. She was treated with Lonidamine (150 mg × 3/day p.o. Repeat CT scan after 8 months showed partial remission. This response was unchanged after 28 months Lonidamine therapy.
Projections to the end of the Century of Mortality from Major Cancer Sites in Italy
Authors: Negri Eva , La Vecchia Carlo , Decarli Adriano , Boyle Peter
Published: April 2018

We used an age-period-cohort model with arbitrary constraints on the parameters, fitted to the mortality data for the period 1955-84, to project rates in mortality from all cancers and 11 major cancer sites in Italy for the period 1985-1999. For all neoplasms considered, using estimated age and cohort values, two models were fitted, one based on constant period effects, and one on a linear regression on the logarithm of the six calendar periods. Furthermore, « a priori » defined coefficients based on epidemiologic inferences were given to period values for tobacco-related neoplasms (below unity for males, above unity for females, on the basis of recent trends in tobacco prevalence in the two sexes), for breast and ovarian cancer (in relation to the potentially different effect of oral contraceptives, other female hormones, reproductive factors and treatment on these neoplasms), and for total cancer mortality. This produced a range of potential estimates, which were reasonably similar for neoplasms (such as stomach, intestines, breast, ovary or prostate) for which no major change in slope of the cohort effects was evident, but wider (i.e., between 188 and 264/100,000 males aged 40 to 79 in 1995-99) for lung or other tobacco-related cancers. Although this range of variation is far from negligible, the estimated values indicate that lung cancer among Italian males aged 40 to 79, even under the more optimistic assumption, will probably be higher at the end of the century than in the early 1980′s, and that lung cancer alone will account for 35 to 42% of all cancer deaths in males between 40 and 79 years. Though any prediction has, by definition, inherent difficulties and uncertainties, cancer mortality in the near future will be strongly influenced by age and cohort effects already known, and hence its projections may offer some indication of public health relevance.
Enhancement of Adriamycin Cytotoxicity in Sensitive and Resistant Sublines of Human Tumor Cells by Calcium Antagonists
Authors: Mircheva Jordanka , Tsuruo Takashi
Published: April 2018

The effect of the calcium antagonists cepharanthine and verapamil on adriamycin-induced cytotoxicity against sensitive (K 562 and Ov 2780) and resistant (K 562/ADM and AD 10) sublines of human tumor cells was evaluated. Nontoxic concentrations of cepharanthine moderately enhanced adriamycin cytotoxicity against sensitive sublines (2.1-2.5 fold). A significant enhancement (13-26 fold) of drug cytotoxicity was observed when resistant cells were treated with a combination of cepharanthine and adriamycin. The calcium influx blocker verapamil (used for comparison) also enhanced adriamycin cytotoxicity, although to a lesser extent. The fact that enhancement was 6-10 fold greater in resistant then in sensitive cells, as well as the loss of biphasic properties of adriamycin on dose-response curves after combined treatment, indicate that cepharanthine may play a role in overcoming drug resistance in some tumor cells.
Therapeutic Possibilities of 131I-Mibg in Metastatic Carcinoid Tumors - Preliminary Report
Authors: Guerra Paolo , Colombo Luigia , Maira Giovanni , Pagliaini Roberto , Terzi Arturo , Pizzocaro Claudio , Dottorini Massimo E. , Lomuscio Giuseppe , Bestagno Maurizio
Published: April 2018

The poor results of traditional therapy in advanced carcinoid tumors and the well-proven uptake of 131I-MIBG shown by some of these tumors induced us to attempt a radiometabolic approach. We selected for the treatment 5 patients (3 men and 2 women) who showed progression of disease, a fairly good uptake of 131l-MIBG with severe related symptoms, and a poor response to traditional therapy. A cumulative radioactivity of 5.5-29.6 GBq was given. Acute side effects after 131l-MIBG ad ministration or late radiation-induced damages were not observed. Symptoms increased during the first 2-4 weeks in 2 patients: in one of these relief was achieved with drugs. Results concerning objective remission of the disease were unsatisfactory. In contrast, definite improvement of symptoms was shown in 2 of 5 patients, resulting in a better quality of life.
Phase II Study with High Doses of Epirubicin in Patients with Advanced Rectal Cancer
Authors: Alberala Vicente , Conde Javier Garcia , Jimeno José , Martos Carlos Fernandez , Herranz Constantino , Macheng Ignacio , Centelles Margarita , Sánchez Javier
Published: April 2018

We tested the possible role of epirubicin, 100 to 130 mg/m2 administered i.v. every 3 weeks, in patients with advanced adenocarcinoma of the rectum untreated with chemotherapy. Sixteen of 17 entered cases were evaluable. No complete or partial responses were observed. The median time to progression was 6 weeks, and the median survival was 36 weeks. Reversible leukopenia was the major toxic side effect. The median epirubicin cumulative dose was 330 mg/m2; no patient had clinical cardiac toxicity. With no responses recorded in 16 evaluable patients, the activity of epirubicin in rectal cancer ranged between 0 and 18%, with 95% probability. Further studies with epirubicin in this tumor are not indicated.
Reactivity of Polyclonal and Two Monoclonal Antibodies with Cell Subsets Isolated from Cystic Fluids of Ovarian Serous Neoplasms
Authors: Hartozińska Antonina , Bar Julia K. , Rabczyński Jerzy , Bast Robert C. , Richter Roman , Cisto Mieczystaw
Published: April 2018

The distribution of antigenic determinants on a cellular level in serous ovarian neoplasms was evaluated using polyclonal and two monoclonal antibodies (OC 125 and 10B). The expression of antigens was estimated by an immunofluorescence test on each cell fraction isolated by density centrifugation from cystic fluids of individual malignant and benign ovarian tumors, taking into account the density and cytomorphologic features of cell subpopulations. It was found that the studied antibodies recognized different antigenic determinants. Significant immunologic heterogeneity of cells among and within individual tumors was shown. Our studies show the value of isolated cell subpopulations for comparing the reactivity of different antibodies and estimating their immunodiagnostic potency.
Thrombocytopenia following Treatment with Low Doses of Aminoglutethimide
Authors: Di Costanzo Francesco , Brugia Mauro , Parriani Damiano , Bartolucci Roberta
Published: April 2018

The authors report a case of severe thrombocytopenia during treatment with low doses of aminoglutethimide in a woman with advanced breast cancer. Hematologic toxicity secondary to aminoglutethimide did not seem to be dose-related, and an immunologic mechanism may be postulated. Although the incidence of the side effect is probably low, monitoring of blood counts during the first months of therapy is necessary.
Expression of Two Antigens Defined by Monoclonal Antibodies in Normal, Benign and Malignant Human Mammary Tissues
Authors: Perrone Francesco , Ménard Sylvie , Da Dalt Maria Grazia , Leoni Flavio , Di Palma Silvana , Patriarca Carlo , Rilke Franco , Colnaghi Maria Ines
Published: April 2018

We examined the reactivity of two monoclonal antibodies (MAbs), MBrl and MBr8, on sections from normal breast tissues, benign lesions, primary infiltrating carcinomas and distant breast cancer metastases and compared the expression of the recognized antigens (CaMBr1 and CaMBr8 respectively) in these different normal and pathologic conditions. The expression of both antigens was found to significantly decrease in the neoplastic tissues, in comparison to normal breast tissue (34% vs 61% for MBr1 and 52% vs 86% for MBr8; p < 0.001 for both). Atypical epithelial hyperplasia was found to be reactive on the same level (31%) of the tumors when tested with MBr1, whereas its reactivity was similar to that of normal tissues (78%) when MBr8 was used. Non-atypical epithelial hyperplasia showed the same reactivity with both MAbs (positive staining on about 50% of the cells). 65% of the « in situ » ductal carcinoma cases was MBr1-positive, whereas 50% was MBr8-positive; these values, when compared with the reactivity on normal glands, were significantly lower for MBr8, but not for MBr1. When testing sections from premenopausal women who had biopsies performed on different days during their menstrual cycle a correlation was found between the expression of CaMBr1 in normal breast epithelial cells and the stimulatory phase of the cycle. These findings suggest that both antigens are typical of normal breast and their expression could possibly decrease in pathologic tissues.
Mononuclear Cell Infiltrate and Hla-Dr Expression in 28 Pituitary Adenomas
Authors: Rossi Marco L. , Jones Nigel R. , Esiri Margaret M. , Havas Lazio , Izzi Moutaiz Al. , Coakham Hugh B.
Published: April 2018

Frozen sections from 28 pituitary adenomas were reacted with a panel of monoclonal antibodies to macrophages, lymphocytes and HLA-Dr invariant chain. A low number of macrophages were demonstrated in all tumors, mainly perivascular. CD8 and CD4 lymphocytes were detected in even smaller numbers in 80% and 14% of tumors respectively. B lymphocytes were present in only 1 case. An occasional NK cell was present in 1/13 cases studied. HLA-Dr antigen was expressed by macrophages in all cases and by tumor cells in 2 growth hormone-producing adenomas/19 adenomas. These findings may represent evidence for a low degree of cellular immune response to pituitary adenomas.
Intraductal Breast Carcinoma. Review of a Multicenter Series of 350 Cases
Authors: Ciatto Stefano , Bonardi Rita , Cataliotti Luigi , Cardona Gaetano ,   Coordinating Center and Writing Committee of FONCAM (National Task Force for Breast Cancer), Italy, Grosso P. , Tagliati T. , De Leo G. , Punzo C. , Monasterolo F. , Del Turco M. Rosselli , Bravetti P. , Bianchi S. , Schincaglia P. , Del Rio S. , Danese S. , Fessia L. , Giardina G. , Priolo A. , Torretta G. , Mansutti M. , Sandri P. , Modena S. , Massocco A. , Molino A.M. , Nortilli R.
Published: April 2018

A multicentrer series of 350 intraductal breast cancers (DCIS) is reported. Mammography was the most sensitive test but suspicion arose only at palpation in 13% of cases whereas in 10% of cases biopsy was recommended for a benign lesion and DCIS was an unexpected finding. Mammography, physical examination and cytology must be combined to achieve optimal sensitivity. Systematic biopsy of apparently benign masses would increase DCIS detection rates but the cost-effectiveness of such a policy is questionable. A trend of conservative surgery was evident over time (from 1968-79, 28%; 1985-1989, 50%) but breast irradiation followed only in one fourth of the cases. The local recurrence rate was significantly higher in cases of limited surgery (with or without irradiation) with respect to mastectomy (1.2 vs 0.2 × 100 patient-years at risk). Most recurrences (7 of 8) in the conserved breast were infiltrating, but no recurrence was seen in subclinical DCIS cases. Three patients died of breast cancer after local recurrence in the conserved breast (2 cases) or mastectomy scar (1 case). Eligibility for conservative surgery of DCIS needs to be carefully discussed to avoid under-treatment. Contralateral breast cancer was recorded in 44 cases and the incidence of further metachronous cancer to the other breast was ten times higher than expected in normal breasts. Four patients died of contralateral breast cancer, free of ipsilateral recurrence. A careful follow-up of the contralateral breast in DCIS cases looks as important as surveillance of the conserved breast.
Radiotherapeutic Treatment for Breast Cancer Choroidal Metastases
Authors: Panizzoni Gino Antonio , Gasparini Giampietro , Fior Sandro Dal , Pinna Vittore , Marchetti Cristina , Pozza Franco
Published: April 2018

A series of 14 eyes (11 patients) with choroidal metastases from breast cancer were reported. The lesions were classified into three grades according to the severity and extent of involvement. Eleven eyes (9 patients) were treated by radiotherapy with two opposed lateral fields using a 4 MeV linear accelerator. The contralateral eye received a prophylactic irradiation. An average dose of 42 Gy was delivered (range, 30-50). Results of radiotherapy were the following: 5 CR and 2 PR in grade II (9 eyes) and 2 PR in grade III (2 eyes). We conclude that radiotherapy is useful to control choroidal metastases of breast cancer. No contralateral metachronous involvement was found. Quality of life of responders showed a marked improvement. Radiation-induced injury was not seen.
Lung Cancer with a Single Brain Metastasis: Therapeutic Options
Authors: Rizzi Adriano , Tondini Maurizio , Rocco Gaetano , Rossi Gerolamo , Robustellini Mario , Radaelli Francesco , Pona Claudio Della
Published: April 2018

Between January 1983 and December 1988 67 patients presenting with solitary cerebral recurrence from lung cancer were observed in our Institution. Resection was possible in 21 cases (31%). The surgical treatment included craniotomy with radical thoracotomy in 10 patients, craniotomy alone (with thoracotomy not including radical lung resection) in 5 patients and craniotomy performed within months of the initial elective thoracic surgery in 6 patients. In our series routine brain CT was carried out as a part of the staging procedure for lung cancer. Based on our results, we recommend an aggressive surgical approach to both cerebral recurrence and lung primary (scheduling craniotomy before thoracotomy), followed by whole brain RT, in order to prolong survival and improve the quality of life.