bluuebunny/crossref_metadata_2025 huggingface dataset:
BCL2 Expression and its Correlation with Neuroendocrine Differentiation in Colon Carcinomas
Authors: Atasoy Pınar , Bozdoğan Önder , Öztürk Sibel , Ensari Arzu
Published: April 2018

Aims and background

In this study we investigated the association between BCL2 expression and neuroendocrine differentiation in tubular adenomas and colon carcinomas. We also evaluated the prognostic significance of BCL2 expression and neuroendocrine differentiation in the carcinoma group.

Methods

Forty-eight colon carcinomas and twelve tubular adenomas were stained immunohistochemically with BCL2 and chromogranin A (CgA). Staining patterns were scored semiquantitatively and correlated with tumor type, tumor grade, Dukes stage, and survival time.

Results

BCL2 expression was detected in 7 of 12 (58.3%) adenomas and 37 of 48 (77.0%) carcinomas. In normal mucosa we observed positive staining only in the basal portions of the crypts. However, diffuse positivity was observed in the adenomas and carcinomas. Carcinomas had significantly higher BCL2 scores than the normal group, but we did not observe any significant differences either between the adenoma and carcinoma group or between the adenoma and normal group. BCL2 scores were higher in stage B than in stage C tumors, and in adenocarcinomas than in mucinous carcinomas. CgA positivity was observed in 24 of 48 (50%) carcinomas. It was not detected in adenomas. We did not find a significant correlation between CgA expression and any of the clinicopathological parameters.

Conclusion

On consecutive sections BCL2 and CgA positivity closely paralleled each other and a significant positive correlation was observed between CgA and BCL2 expression. These findings suggest a close association between BCL2 expression and neuroendocrine differentiation and indicate that BCL2 may be involved in neuroendocrine differentiation in addition to its role in protecting cells from apoptosis.
Low Expression of P63 and P73 in Osteosarcoma
Authors: Park Hye-Rim , Kim Youn-Wha , Park Jae-Hoon , Maeng Young-Hee , Nojima Takayuki , Hashimoto Hiroshi , Park Yong-Koo
Published: April 2018

Background

The recent discovery of two p53-related genes, p63 and p73, has revealed an additional level of complexity to the study of p53 function. Both genes encode multiple proteins arising from alternative promoter usage and splicing, with transactivation, DNA-binding, and tetramerization domains. Recent data support a role for p63 in squamous and transitional cell carcinomas, as well as in certain lymphomas and thymomas.

Methods

To characterize the involvement of p63 and p73 in the development of osteosarcoma, we analyzed the expression and mutation of TAp63 and TAp73 in six osteosarcoma cell lines and twelve osteosarcoma specimens.

Results

Semiquantitative DNA/PCR analysis revealed that eight (67%) and six (50%) out of twelve osteosarcoma specimens showed significantly reduced levels of p63 and p73 transcription, respectively. Direct sequencing of the entire coding region detected no mutations in cell lines or osteosarcoma specimens.

Conclusions

Our data suggest that low expression of p63 and p73 is relatively common in osteosarcomas and might contribute to their molecular pathogenesis.
Decrease in Length of Hospitalization before Death of Cancer Patients in the Italian Province of Imperia
Authors: Campora Elisabetta , Colloca Giuseppe , Addamo Gianfranco , Venturino Antonella , Guarneri Domenico
Published: April 2018

Although the overall cure rates for cancer in Italy are comparable to those of other developed countries, these results are the product of very heterogeneous facilities. In order to assess the possible impact of improved acute cancer care services on the last phase of life, a retrospective study was carried out which included 4238 patients registered at the Division of Medical Oncology of Imperia Province from January 1995 to December 2002. In 1998 the Province of Imperia, with a population of 217,000, had only two doctors and five day-hospital beds. During 1999 and 2000, resources increased to include five oncology specialists and 10 day-hospital beds. Compared to 1998, in 2002 the number of new patients registering at the Division of Medical Oncology and the number of day-hospital treatments increased by 76% and 67%, respectively.

Since end-of-life care for advanced cancer patients is expensive, the length of hospitalization of cancer patients dying in acute hospital settings was analyzed for the years 1995-2002. Of the 4238 patients registered during the eight-year period, 1433 (33.8%) died before 31 December 2002. Among these 1433 patients, the records relative to hospitalization and death were available for 571 cancer patients, 324 males (56.7%) and 247 females (43.3%) with a median age of 70 years (range, 21-91). The average number of days of hospitalization declined from 14.6 (range, 1-76) in 1998 to 8.2 (range, 1-29) in 2002, a decrease of approximately 44%.

The length of hospitalization prior to death has declined considerably for cancer patients in the Imperia Province and the costs of acute hospital facilities for end-of-life care in cancer patients have decreased. In addition, fewer days in hospital before death may have had an important impact on the quality of life of these cancer patients.
Recurrent Intracranial Hemangiopericytoma with Extracranial and Unusual Multiple Metastases: Case Report and Review of the Literature
Authors: Spatola Corrado , Privitera Giuseppe
Published: April 2018

Hemangiopericytoma is a rare tumor with uncommon location in the central nervous system. It has only recently been included (WHO classification 1993) in a specific group of CNS tumors and subsequently (WHO classification 1997 and 2000) as a group by itself, while before it was confused with meningeal tumors. We report on a case of a 48-year-old woman affected by this tumor. The neoplasm was located in the posterior fossa. The patient underwent primary surgery in 1990, not followed by any adjuvant therapy because of the histopathological diagnosis of meningioma. After being free from disease for eight years she developed a local recurrence in 1998. Subtotal excision of the tumor, which was finally identified as a hemangiopericytoma, was carried out, followed by adjuvant radiotherapy (64 Gy). After six months multiple metastases were found in the liver and right kidney. A radical metastasectomy was performed, followed by systemic chemotherapy. One year later (2001) the tumor recurred again intracranially and a metastases was detected in the right breast, so the patient again underwent cranial irradiation (40 Gy) and second-line chemotherapy. She died in September 2002, 12 years after the diagnosis. We may conclude that, despite the tumor's natural tendency to recur several times and the ability of intracranial hemangiopericytoma to spread outside the CNS, it is possible to ensure a long survival time.
Primary Cerebral Lymphoma: A Retrospective Study in 22 Immunocompetent Patients
Authors: Caroli Emanuela , Acqui Michele , Ferrante Luigi
Published: April 2018

Aims and background

Primary CNS lymphomas are uncommon tumors in immunocompetent patients. We describe the radiological features that should orient towards performing a biopsy and analyze the results in our series of patients.

Methods

We reviewed 22 immunocompetent patients with primary central nervous system lymphoma admitted in our Institute between 1977 and 1997. The follow-up period ranged from 2 months (patient deceased) to 69 months. Fourteen patients underwent surgical removal of the tumor and the remainder a biopsy. All patients received radiotherapy and 8 patients radiotherapy plus chemotherapy.

Results

Two of the 14 patients treated by surgical removal of the tumor died. There was no mortality related to biopsy procedures. Patients treated with radiotherapy had 1-year, 2-year and 5-year survival rates of 66%, 41.6% and 16.6%, compared to 87.5%, 62.5% and 50%, respectively, for patients who received radiotherapy and chemotherapy.

Conclusions

At present, there is no definite treatment for these highly malignant brain tumors. The most favorable results seem related to biopsy followed by radiotherapy plus chemotherapy versus surgical removal, which is related to a high risk of severe postoperative deficit for both the deep location and infiltrating nature of these lesions.
Extremely Delayed Cerebral Metastasis from Renal Carcinoma Report of Four Cases and Critical Analysis of the Literature
Authors: Cimatti Marco , Salvati Maurizio , Caroli Emanuela , Frati Alessandro , Brogna Christian , Gagliardi Franco Maria
Published: April 2018

Brain metastases from renal carcinoma may appear even a long time after surgical treatment of the primary tumor. The authors present 2 series of patients, one of which has already been published and the other new, for a total of 4 cases of brain metastasis from renal carcinoma with late onset, which occurred 13, 17, 26 and 12 years after primary surgical treatment. The other cases described in the literature were also critically reviewed.
Massive Bone Marrow Crystal-Storing Histiocytosis in a Patient with Iga-Lambda Multiple Myeloma and Extensive Extramedullary Disease. A Case Report
Authors: Zioni Franco , Giovanardi Paolo , Bozzoli Mara , Artusi Tullio , Bonacorsi Goretta , Sighinolfi Pamela
Published: April 2018

We report a case of multiple myeloma (MM) displaying an unusual course, with metastatic spread in uncommon sites (gastroduodenal and upper respiratory tract, breast, skin and liver) and with a fatal outcome. In our patient this plasma cell neoplasm was associated with a rare condition named crystal-storing histiocytosis (CSH), resulting from the storage in reactive histiocytes of crystalline immunoglobulin inclusions. These crystal-forming paraprotein components are secreted by the neoplastic plasma cells and give rise to the crystalline material of the histiocytes only after their ingestion and degradation by the same histiocytes. In this disorder crystal-storing cells may be present in various tissues (in our case mainly in bone marrow), often with functional alterations of the involved organs. In our opinion the association of this “atypical” MM with CSH is to be considered an uncommon event.
Atypical Lymphoproliferative Disorders: Castleman's Disease Case Report and Review of the Literature
Authors: Martino Giovanni , Cariati Sonia , Tintisona Orlando , Veneroso Stefano , De Villa Fabio , Vergine Massimo , Monti Massimo
Published: April 2018

Castleman's disease (CD) is a rare atypical lymphoproliferative disorder characterized by enlarged hyperplastic lymph nodes with striking vascular proliferations. CD is categorized as being either localized or disseminated and further subdivided into hyaline-vascular, plasma cell, or mixed histopathological patterns. Here we report a case of CD in a 15-year-old girl who presented with a solitary asymptomatic hyaline-vascular mass in the right supraclavicular space. In addition, we discuss the pathogenesis, clinical features and reported comorbidities of unicentric and multicentric CD and evaluate effective treatment strategies based on the results of lymph node biopsy and careful staging. Surgical excision is curative for the localized variants of CD, either hyaline-vascular or plasma cell type. If complete resection is not possible, partial resection or radiotherapy may be useful to control possible systemic manifestations. Multicentric CD, regardless of the histological subtype, is a more aggressive clinical entity, commonly with a chronic or rapidly fatal course. Patients with multicentric CD do not benefit from surgical treatment and should be candidates for systemic therapy (steroids, combination chemotherapy, novel therapies), although this is still in a fairly experimental phase.
Neoadjuvant Therapy of Rectal Cancer New Treatment Perspectives
Authors: De Paoli Antonino , Innocente Roberto , Buonadonna Angela , Boz Giovanni , Sigon Roberto , Canzonieri Vincenzo , Frustaci Sergio
Published: April 2018

During the past two decades, significant advances have been made in the management of patients with rectal cancer. A number of clinical studies have demonstrated the efficacy of preoperative chemoradiation therapy with 5-fluorouracil (5-FU)-based regimens in decreasing local recurrences and improving survival and the likelihood of sphincter preservation. Although 5-FU has been the standard drug used in combination with radiation therapy for many years, new effective drugs including capecitabine, raltitrexed, irinotecan and oxaliplatin have been recently investigated in combination with radiation therapy in the preoperative setting. In addition, novel targeted biological agents including epidermal growth factor receptor inhibitors and vascular endothelial growth factor inhibitors have been shown to enhance the antitumor effect of both radiation and chemotherapy and are currently being explored in initial clinical trials. In the present review we summarize the results of adjuvant therapy. In addition, we will discuss the recently reported phase I-II trials with new drug plus radiation combinations in the preoperative treatment of patients with rectal cancer.
Post-Traumatic Glioma. Report of Four Cases and Review of the Literature
Authors: Salvati Maurizio , Caroli Emanuela , Rocchi Giovanni , Frati Alessandro , Brogna Christian , Orlando Epimenio Ramundo
Published: April 2018

Aims and background

To add a further contribution to the literature supporting the relationship between previous head trauma and development of glioma.

Methods

We report on four patients who developed brain gliomas in the scar of an old brain injury.

Results

All cases fulfilled the widely established criteria for brain tumors of traumatic origin. In all of our cases there was radiological evidence of absence of tumor at the time of the injury.

Conclusions

We believe that in specific cases it is reasonable to acknowledge an etiological association between a severe head trauma and the development of a glioma. This assumption is further sustained if there is radiological and surgical documentation of the absence of neoplasia at the moment of the trauma.
Presentation of Malignant Pleural Mesothelioma with Symptomatic Brain Metastasis: Report of a Case
Authors: Huncharek Michael , Bseiso Ali , Hutchins Lawrence , Warner John
Published: April 2018

Central nervous system metastases from diffuse malignant pleural mesothelioma are rare. Here we describe a patient without known asbestos exposure who presented with chest pain, increasing shortness of breath and persistent headache. Evaluation found biphasic malignant mesothelioma of the right hemithorax and a single brain metastasis confirmed by computed tomography. This represents only the second case of a patient with pleural mesothelioma presenting with symptomatic central nervous system metastases.
Hepatic Arterial Infusion Chemotherapy in Gastric Cancer: A Report of Four Cases and Analysis of the Literature
Authors: Melichar Bohuslav , Vobošil Zbyněk , Cerman Jaroslav , Melicharová Karolina , Nožička Jan , Mergancová Jindšiška , Vobošil René , Jandík Pavel
Published: April 2018

Aims and background

Gastric cancer is associated with high mortality. Although the liver is a common site of metastases in this tumor, the experience with liver-directed therapies is limited.

Methods

We report a single-center experience involving four patients with liver metastases from gastric cancer treated by hepatic arterial infusion (HAI). In addition, we performed a search for reports on HAI in gastric cancer metastatic to the liver and used the studies with data on survival of individual patients for a pooled analysis.

Results

Among three valuable patients, one had a complete response, one had stable disease and one had progressive disease. The patient with complete response is still alive 41 months after the diagnosis of liver metastases, while the other patients died 6, 22 and 31 months after the diagnosis. Objective responses were observed in 48% of the 25 patients in the pooled analysis. Objective response and limited hepatic involvement were independent predictors of survival in these patients.

Conclusions

Although isolated liver involvement in metastatic gastric cancer is rare, HAI seems to be similarly effective in these patients as in patients with liver metastases from colorectal cancer. The prognosis is significantly better in gastric cancer patients who have limited hepatic involvement and attain an objective response after HAI.
Analysis of the Reasons for Accepting or Declining Participation in Genetic Research for Breast Cancer: A Hospital-Based Population Study
Authors: Paradiso Angelo , Bruno Michele , Cicoria Onofrio , Digennaro Maria , Longo Salvatore , Rinaldi Michele , Schittulli Francesco
Published: April 2018

The majority of a hospital-based population accepted to participate in a molecular screening project for familial breast cancer, giving their informed consent to blood sampling. Only 9.5% of patients declined to sign the consent form. Here we report the reasons for refusal and we critically review our methodological approach to obtain consent for a blood test for genetic research in a clinical setting.
Concurrent 5-Fluorouracil, Mitomycin C and Radiation, with or without Brachytherapy, in Recurrent Endometrial Cancer: A Scoring System to Predict Clinical Response and Outcome
Authors: Smaniotto Daniela , D'Agostino Giuseppe , Luzi Stefano , Valentini Vincenzo , Macchia Gabriella , Mangiacotti Maria Grazia , Margariti Pasquale Alessandro , Ferrandina Gabriella , Scambia Giovanni
Published: April 2018

Aims and background

This prospective, phase II study aimed to test the efficacy of concurrent 5-fluorouracil, mitomycin C and radiation, with or without brachytherapy, on the clinical outcome of a series of recurrent endometrial cancer patients and to determine the prognostic impact of a subset of factors.

Methods

Thirty patients with locally recurrent, nonmetastatic endometrial cancer received external beam radiation (4-week split course: 23.4 + 23.4 Gy) plus two courses of concomitant chemotherapy (5-fluorouracil, 96-h continous infusion, days 1-4; 1 g/m2/day; mitomycin C, 10 mg/m2, bolus iv, day 1). Nineteen patients (63.3%) underwent endocavitary, low-dose brachytherapy boost (20-25 Gy); eight patients (26.7%) received external beam radiation boost (14-20 Gy).

Results

Eleven complete responses (36.7%), 11 partial responses (36.7%), 6 disease stabilizations (20.0%) and 2 progressions (6.6%) were observed. After a median follow-up of 27 months (range, 1-108), overall actuarial 3-year survival, progression-free survival and local progression-free survival were 46.8%, 35.2% and 41.2%, respectively. Two patients (6.7%) experienced hematological grade 3 toxicity. Two patients (6.7%) had grade 3 intestinal toxicity. Severe late toxicity was infrequent, only 3 patients showing severe vaginal stenosis (10.0%). A clinical score of 0 to 1 was assigned to each patient on the basis of the absence (score = 0) or presence (score = 1) of any of the following prognostic factors: time between surgery and recurrence shorter than 12 months, pelvic wall site of recurrence, positive lymph nodes, hemoglobin <11 g/dL. With this device, it was clear that patients with a low score had a significantly better outcome (clinical remission: 77.2% of patients with a score <2 vs 25.0% of patients with a score ≥2, P = 0.009), better local control of the disease (50.2% vs. 0 at 3 years, P = 0.014,) and better overall survival (65.8% vs 0 at 3 years, P = 0.003).

Conclusions

Our data suggest that this combined modality therapy was relatively well tolerated and resulted in reasonable local control and survival. The scoring system proved to be helpful in identifying patients with the best chance of benefiting from the treatment.
A Modified Prognostic Score for Patients with Curatively Resected Gastric Cancer
Authors: Mariani Luigi , Miceli Rosalba , Lusa Lara , Di Bartolomeo Maria , Bozzetti Federico
Published: April 2018

Aims and background

Gastric cancer is the second leading cause of cancer death worldwide; the risk of dying depends on several patient and disease characteristics. An existing prognostic score predicts survival in gastric cancer patients undergoing curative resection based on patient age, tumor site, extent of wall invasion and nodal status, categorized as simply as negative or positive.

Methods

Our aim was to modify the original prognostic score by incorporating information on nodal stage according to the latest TNM classification (number of involved nodes), based on a retrospective series of 610 chemotherapy-naïve gastric cancer patients recruited to a surgical clinical trial. We then tested the modified score on an independent series of 136 gastric cancer patients.

Results

Nodal stage added significant prognostic information to the nodal status classification (P <0.001), and was therefore included in the modified score. With the latter, we were able to identify three risk groups with overall five-year survival varying from more than 70% to less than 30%. The prognostic performance of the modified score was better than that achieved with the AJCC-UICC TNM staging.

Conclusions

The modified score, based on established prognostic factors, is proposed as a simple tool for prognostic grouping of gastric cancer patients undergoing curative surgery.
An Unusual Case of Three Synchronous Tumors in a Young Woman
Authors: Longo Raffaele , Carillio Guido , Torrisi Antonietta , Tocco Maria Pia , Grassi Giovanni Battista , Marrese Renato , Fanasca Angelo , Balistreri Paolo , Gasparini Giampietro
Published: April 2018

The occurrence in the same young patient of three synchronous tumors deriving from different embryogenic tissues and without a clear correlation with a common etiopathogenic factor is very unusual. We report a case of a Caucasian woman submitted to wide resection of a large retroperitoneal liposarcoma and right radical nephrectomy for suspected tumor infiltration. Histological examination of the right ureter and renal pelvis showed the presence of a multifocal urothelial carcinoma that was clinically asymptomatic. Two months later, during follow-up, chest X-ray and computed tomography documented a coin lesion of the upper left lung, confirmed by positron emission tomography. This nodule was surgically removed and examined histologically, resulting in a diagnosis of sclerosing hemangioma. The patient is alive without evidence of recurrent disease.
Late Brain Metastases from Colorectal Cancer a Case Report and Review of the Literature
Authors: Cante Domenico , Girelli Giuseppe , La Porta Maria Rosa , Sciacero Piera , La Sala Simona , Ozzello Franca
Published: April 2018

Metastatic brain tumors from colorectal cancer are relatively rare. In previous reports the incidence ranged from 1.9 to 3.5 percent of all metastatic brain tumors. In another recent article the cumulative incidence of brain metastasis was estimated at 1.2%. The prognosis for patients with even a single resectable brain metastasis is poor. This paper presents the case report of a 72-year-old woman with a solitary brain metastasis 16 years after a diagnosis of colorectal cancer. She remained asymptomatic for 16 years. The first sign of a secondary tumor was diplopia. Brain scan demonstrated a space-occupying lesion in the occipital area. A solitary tumor was removed by craniotomy. Histological examination showed that it was a metastasis from the intestinal primary tumor. The patient subsequently underwent whole brain radiotherapy for a total dose of 30 Gy in 10 fractions.
Synchronous Bilateral Retinal Metastases from Lung Adenocarcinoma
Authors: Rossi Antonio , Manto Andrea , Maione Paolo , Gridelli Cesare
Published: April 2018

Hematogenous retinal metastases from non-small cell lung cancer are rare, and are even more uncommonly observed bilaterally. Non-small cell lung cancer usually metastasizes to the liver, adrenal glands, lung, bone, central nervous system, and kidney. We report the case of a 41-year-old male patient with advanced lung adenocarcinoma heavily pretreated with polychemotherapy and palliative radiotherapy up to June 2003, when synchronous bilateral retinal metastases were diagnosed. The patient's prognosis was worsened by the onset of the retinal metastases and he died three months later.
Multiple-target Chemotherapy (Lv-modulated 5-FU Bolus and Continuous Infusion, Oxaliplatin, CPT-11) in Advanced 5-Fu-refractory Colorectal Cancer: Mtd Definition and Efficacy Evaluation. A Phase I-II Study
Authors: Bonetti Andrea , Zaninelli Marta , Durante Emilia , Fraccon Anna Paola , Franceschi Tiziano , Pasini Felice , Zustovich Fable , Brienza Silvano
Published: April 2018

Aims and Background

To identify the maximum tolerated doses and to define the activity of a regimen incorporating leucovorin (LV)-modulated 5-fluorouracil (5-FU) bolus and continuous infusion, oxaliplatin (I-OHP) and irinotecan (CPT-11) in patients with advanced, 5-FU-refractory colorectal cancer (CRC).

Patients and Methods

Starting doses: LV 100 mg/m2 as a 2-hour infusion followed by 5-FU 300 mg/m2 bolus administration followed by 5-FU 500 mg/m2 as a 22-hour infusion on days 1 and 2; I-OHP 65 mg/m2 as a 2-hour infusion concomitantly with LV on day 1; CPT-11 90 mg/m2 concomitantly with LV on day 2. Planned cycle interval: 2 weeks.

Results

Two hundred twenty-six cycles were administered to 27 patients. Recommended doses were 5-FU bolus 300 mg/m2, 5-FU protracted infusion 500 mg/m2, l-OHP 75 mg/m2, and CPT-11 150 mg/m2. Among 25 patients evaluable for response we observed 13 disease stabilizations (52%; 95% CI: 33-71%), 6 instances of disease progression and 6 responses (24%; 95% CI: 7-41%). Median time to progression and overall survival were 24 and 60 weeks, respectively. A cycle delay >3 days was observed in 134/199 cycles (67%).

Conclusions

This study confirms the feasibility of triplet chemotherapy in patients with advanced 5-FU-refractory CRC.
Selected Hypoxic Stop-flow Perfusions: Indication and Limits
Authors: Guadagni Stefano , Kanavos Evangelos , Schietroma Mario , Fiorentini Giammaria , Amicucci Gianfranco
Published: April 2018

Aims and Background

The treatment of unresectable cancers is still one of the main medical challenges. Stop-flow perfusion has been used as locoregional chemotherapy based on blood supply blockage of the tumor-bearing area. The aim of the present paper is to report our personal experience in the clinical use of hypoxic stop-flow perfusion and discuss future prospects for research.

Methods and Study Design

Since December 1997 more than 500 stop-flow perfusions have been performed at the University of L'Aquila. Hypoxic perfusion was adopted for the following indications: recurrent rectal cancer, advanced pancreatic cancer, recurrent pelvic and limb melanoma, and recurrent limb melanoma.

Results

For recurrent rectal cancer median survival was 12.2 months, for advanced pancreatic cancer 9.6 months, for recurrent pelvic and limb melanoma 34.4 months, and for recurrent limb melanoma 23.8 months.

Conclusions

Based on these encouraging results, stop-flow perfusion should be considered an effective treatment. Future fields of research include tailored chemotherapy and hyperthermia.
Factors Influencing Axillary Node Metastasis in Breast Cancer
Authors: Çetintaş Sibel Kahraman , Kurt Meral , Özkan Lütfi , Engin Kayihan , Gökgöz Şehsuvar , Taşdelen İsmet
Published: April 2018

Aims and Background

The status of the axillary lymph nodes at the time of diagnosis has been accepted as one of the most important prognostic factors for the overall and disease-free survival of patients with breast cancer. The aim of our study was to determine which factors influence axillary node involvement in invasive breast cancer.

Methods

The data presented here were obtained from 344 patients who were treated for invasive breast cancer at the Department of Radiation Oncology, Uludag University Medical College, Bursa, Turkey. Possible prognostic factors were categorized as patient related and tumor related. The Mann-Whitney U test was used for univariate analysis and logistic regression was used for multivariate analysis.

Results

In univariate analysis, a familial cancer history (P = 0.0042), age <40 years (P = 0.0276), higher T stage (P <0.0000), nipple involvement (P = 0.0345), skin involvement (P = 0.0270), perineural invasion (P = 0.0231), and lymphatic vessel invasion (P <0.0000) were correlated with increased axillary node involvement. A higher incidence of ≥4 involved lymph nodes was associated with higher T stage (P = 0.0004), nipple involvement (P = 0.0292), presence of an extensive intraductal component (P = 0.0023), skin involvement (P = 0.0008), perineural invasion (P = 0.0523), and lymphatic vessel invasion (P <0.0000) in univariate analysis. In multivariate analysis, age <40 years (P = 0.0454), cancer history within the family (P = 0.0024), higher T stage (P = 0.0339), lymphatic vessel invasion (P = 0.0003), and perineural invasion (P = 0.0408) were found to be independent factors for axillary lymph node positivity. Age <40 years (P = 0.0221), perineural invasion (P = 0.0408), and an extensive intraductal component (P = 0.0132) were associated with an increased incidence of ≥4 involved nodes in the logistic regression analysis. In patients with breast cancer, the incidence of axillary lymph node involvement was independently influenced by age <40 years, presence of cancer history within the family, higher T stage, lymphatic vessel invasion, and perineural invasion.

Conclusions

In conclusion, absence of familial cancer history, presence of lymphatic vessel invasion, higher T stage, and age below 40 years independently increased the risk of axillary node involvement. Presence of perineural invasion and lymphatic vessel invasion, age below 40, and an extensive intraductal component of more than 25% independently affected the risk of having ≥4 nodes involved. Patients characterized by these factors may be classified into a higher risk group for nodal involvement, but more data are needed to define factors that can help in the decision-making regarding the omission of axillary treatment.
Superior Mediastinal Syndrome in an Infant Caused by Mediastinal Teratoma: Case Report
Authors: Roganovic Jelena
Published: April 2018

A 3-month-old male infant presented with superior mediastinal syndrome due to a large mediastinal teratoma. The child suffered from severe cardiorespiratory compromise that required emergency treatment. Mediastinal teratomas are potentially lifethreatening in infancy. Close cooperation among pediatric oncologists, surgeons, anesthesiologists, intensivists, and radiologists is crucial in the management of these rare tumors
In Tema di Difficolta’ della Diagnostica Ossea: Osteomielite Pseudocondromatosa
Authors: Sirtori Carlo , Calvi Nardo , Maiocchi Antonio Bianchi
Published: April 2018

Two cases of chronic osteomyelitis in young patients are described. There is slight sclerotic reaction and absence of sequestra; very strong proliferation of unripe chondral tissue (as a conseguence of a reactive stimulation of epithelial cartilages and of eterotopic cartilage nodules). Neoplastic appearences were produced involving possibility of diagnostic errors.
Sul Trattamento Radioterapico delle Metastasi Craniche da Carcinoma del Collo Uterino
Authors: Pisani Giovanni
Published: April 2018

Two cases of cranial metastases from a uterine carcinoma are described. In one case there was a large and very precocious metastatic diffusion to the skeleton, in the other case the bone metastases appeared after 5 years since the clinical recovery of the primary lesion. The X-rays treatment exerted a prolonged delay in the further metastic diffusion.
Le Metastasi Linfoghiandolari Periferiche Come Primo Sintomo dei Tumori Maligni
Authors: Catania V. C.
Published: April 2018

The peripheral metastatic adenopathy, clinically easy to evidentiate, may be a guide to the detection of the primary focus. The anatomical, topographical and clinical picture of the most important peripheral lymph nodes (cervical, supraclavicular, axillary, inguinal) and of their tributary organs and regions is exposed.
CONTRIBUTO CASISTICO E CRITICO ALLA CONOSCENZA DEGLI ADENOLINFOMI, CON PARTICOLARE RIGUARDO ALLA LORO ISTOGENESI E ALLE VARIANTI ISTOLOGICHE
Authors: Vitagliano Giovanni
Published: April 2018

The histological picture of 12 adenolymphoma has been studied. The following conclusions are drawn: 1. The adenolymphoma may be considered as a real benign tumour arising from metaplastic epithelium of salivary glands. The lymphoid structure of this tumour may be compared with that observed in many inflammatory and tumour processes of the most different sites. 2. Besides the classical well-known histological picture, the adenolymphoma present a cystic degenerative, lobular, fibrocystic, papilliferous and squamous metaplastic aspect.
Studio Sulle Mitosi nel Tumore Ascite del Ratto per Somministrazione di Estere Metilico Dell'Acido Trimetilcolchicinico da solo Od Associato a Florizzina
Authors: Resegotti Luigi , von Euler Hans
Published: April 2018

The mitoses blocking in rat ascite tumours has been studied after administration of different doses of d-tartrate of trimethylcolchicinic acid methyl ester (NCI 1136). The number of mitoses gradually increases until the 7th hour. Then a diminution is observed for the smallest doses, while it is unmodified for the mean doses and increases again for the large and small doses repeated.

The association of Florizine prolonges and enhances the mitotic blocking. The modifications induced by NCI 1136 are repaired between the 24th and 72nd hour after injection: the smallest the dose administered, the most precocious the reparation.

The capacity of NCI 1136 to prolonge the life of the tumour bearing animal is discussed and its action on mitoses is compared to that obtained with colchicine.
Azione Antimitotica del Tem e di Due Nuove Idrazine sul Test Allium Cepa
Authors: Bianco R. , Talamazzi F.
Published: April 2018

A high antimitotic action of a hydrazine derivative (1-phenyl-1-benzyl-hydrazine) has been demonstrated on vegetal cells (Allium Cepa). The substance at 1:500.000 concentration causes a prophasic blocking. On the contrary, another hydrazine derivative, the hydrazobenzothiazolhydrazine, was found to be inactive. TEM action is not enhanced by addition of hydrazine derivatives.
Comportamento Dell'Attivita’ Deidrogenasica in Seguito alla Irradiazione nel Sarcoma 180 del Topo e Nell'Adenocarcinoma di Walker del Ratto
Authors: Ferri L. , Palazzi D.
Published: April 2018

In mice and rats bearing Sarcoma 180 and Walker adenocarcinoma (respectively radiosensitive and radioresistant according to earlier experiments) the dehydrogenasic activity has been determined « in vitro » after irradiation of the neoplasms. No variation of the dehydrogenasic activity was observed after irradiation in Walker adenocarcinoma; while a moderate but evident dehydrogenase diminution is observed in sarcoma 180. On the basis of the obtained results some considerations are exsposed on the different biochemical behaviour between radiosensitive and radioresistant biological substrates.
Il Granuloma Lipofagico della Mammella Maschile
Authors: Vitagliano Giovanni
Published: April 2018

A histological study of nine « lipophagic granuloma » of the male mammary gland is exposed.

All inflammatory cells were present, and the trauma is pointed out as responsible for that particular disease.

In two out of nine cases, the anti-typhoid fever injection had been carried out many years previously.
Ibernoma: (Lipocitoblastoma Bruno Adenomorfo)
Authors: Genesi Mario
Published: April 2018

A description is given of a human tumour of the vestigial brown fat tissue, capsulated, with a lobulated microscopical structure. Histologically it is characterized by a rich capillary network conveying the blood to solid lobules composed of cells with cytoplasms partly fatty and vacuolar, partly compact and granular, stainable with hematoxylin. Such tumour developed in the axillary-subclavian region of a 18 years old woman and was identified as « hibernoma »; it is the 18th case reported in the literature.

The histological and cytochemical features are exposed in detail. The literature on the subject is surveyed and completed. In accordance to morphological and histogenetic criteria, such tumour is suggested to be named « adenomorphous brown lipocytoblastoma » instead of « hibernoma ».
Studio Dell'azione Anticatalasica « in Vitro » di Estratti di Tumori E di Organi Normali
Authors: Ceriotti G. , Spandrio L.
Published: April 2018

The question of the « in vivo » inhibition of catalase by tumor extracts (Kochsaft), has been examined.

Two experimental tumors, Sarcoma 180 and a spontaneous mammary adenocarcinoma of mouse, several organs of normal and tumor-bearing mice, several human tumors, namely gastric carcinoma and their corresponding mucosa, gastric mucosa of patients with ulcer, were investigated.

A comparison between the simple « Kochsaft » and the extracts purified by alcoholic precipitation has also been performed, but showed no essential differences.

The inhibition curves given by increasing amounts of tumor extracts lead us to suggest the presence of an activator beside the catalase inhibitor.
Contributo Alla Conoscenza Dei Tumori Del Glomo Carotideo
Authors: Baldoni Giuseppe , Pandolfini Angiolo
Published: April 2018

On the basis of two personal cases, the anatomopathological and clinical peculiarities of the tumours of glomus caroticum are illustrated. The embryogenesis and the therapeutical criteria are discussed.
Ricerche Sperimentali Sull'azione Cocarcinogena Della Follicolina in Associazione Con Olio di Croton
Authors: Picco Augusto , Somaglino Walter
Published: April 2018

Female rats have been treated with follicular hormone in association with croton oil. In one case only a malignant ovarian tumour was observed. The hypothesis is suggested that oestrogens may promote the carcinogenesis.
Su Un Caso di Cosidetto Seminoma Del Testicolo
Authors: Piana Carlo
Published: April 2018

A seminoma of the left testis was observed in a 46-years-old man, who had been operated from right orchiopexy in early age. The factors favouring the occurrence of such tumor are considered.
Modificazioni Epiteliali Secondarie Ad Avitaminosi a Nell'Oncogenesi Sperimentale Del Ratto
Authors: Carminati V. , Baglioni T.
Published: April 2018

The present researches are derived from the frequent observation of epidermal hyperplastic-dysplastic processes during subcutaneous carcinogenesis. Aim of this paper is to investigate the possible enhancement of such processes through experimental summation conditions. The results obtained on rats bearing benzpyrene sarcoma and kept in vitamine A deficiency are referred. In opposition to what expected, a hyperdifferentiating action due to vitamine deficiency (hypotrophy, sclerosis, hyperkeratosis) and a reduction or disappearence of the hyperplastic processes were observed.
La Diagnosi Clinica E La Terapia Della Endometriosi (Evoluzione maligna dell'Endometriosi)
Authors: Grattarola Renzo
Published: April 2018

43 cases of endometriosis, hystologically confirmed have been studied. Locations and symptoms of end.osis are here examined. It is observed the frequency of irregulary of bloody spotting in interna end.osis (adenomiosis). The use of androgen-therapy is advised to confirm the diagnosis and frequently to cure the end.osis.

The urinary 17-ketosteroids were followed during androgen-therapy and it was observed that their values are descreasing notwithstanding the continued hormonal supplying. Surgical problem of endometriosis are reviewed. One case of malignancy (carcinosarcoma developed on adenomiosis) is presented.
La Posizione Di Un Derivato Colchicinico (Citostal) Fra I Vari Farmaci Antineoplastici
Authors: Di Pietro Sergio
Published: April 2018

The clinical results obtained with a colchicine derivative, the trimethylcolchicinic acid methyl ether, are refrerred. 20 cases were treated, and respectively 14 Hodgkin's diseases, 3 reticulosarcomas, 3 carcinomas. The compound showed a considerable antitumoral activity and a scarce toxicity in general and on the hemopoietic function in particular. It may be considered as possessing the most important requisite for a cytostatic drug actually, that is the possibility of a prolonged and efficient administration without secondary toxical phaenomena. The association of trimethylcolchicinic acid methyl ether with other chemotherapeutical and radiotherapeutical means seem to be of interest and worth of further development.
Il Contenuto in Amminoactdi Di Alcuni Tessuti Di Ratti Normali E Portatori Di Tumori Trapiantati
Authors: Mor M. A.
Published: April 2018

In rats bearing sarcoma Galliera the aminoacids content for N g was found to be lower than in the corresponding normal tissues.
« Influenza Degli Ormoni Sessuali Sulla Crescita Dell'Adenocarcinoma Mammario Spontaneo Del Topo in Vitro »
Authors: Monesi Valerio
Published: April 2018

Explants from spontaneous mammary adenocarcinoma of C 3 H and IV B mice were treated « in vitro » with oestrone, progesterone and testosterone. The « roller-tubes » technique was used for the observation of the migration area, the « roller-slides » technique for histological preparations and mitotic index calculations, the Carrel flasks for phase contrast microscopical observations. Growth determination was carried out in 15 days old cultures by planimetric measurements of the migration area and calculations of the mitotic index.

1) Cultured tumor cells show a tendency to convert from round into fusiform shape, increasing considerably in size and assuming a more differentiated aspect (Caspersson's « B » cells). The tendency to cytological differentiation is accompanied with a gradual reduction of the proliferation.

2) Oestrone administration enhances considerably the growth (increase of the migration area to more than the 400 per cent) and the tendency to the cyto-histological differentiation of the tumor. The stimulating effect of oestone is exerted only on epithelial elements.

3) Progesterone administration brings about a lower increase of the growth (augment of the migration area of the 308 per cent at a dilution of gr. 1.100-5/cc. and of the 39 per cent at a dilution of gr. 5.10-5/cc.) and of the tendency to cyto-histological differentiation of the tumour. In contrast with what observed for oestrone, the stimulating effect would be manifest also on the stroma.

4) Testosterone administration inhibits strongly the tumour growth of the 66 per cent at a dilution of gr. 1.10-5/cc and of the 29 per cent at a dilution of gr. 5.10-5/cc.) without influencing its differentiation. The stroma seems to be scarcely influenced by hormonal treatment. The inhibiting action of testosterone is accompanied by regressive phenomena of the tumour elements.

Results show that the spontaneous adenocarcinoma of mouse maintains « in vitro » the hormono-dependency properties which are characteristic of the normal mammary cell.
« Le Recidive Dei Carcinomi Delle Mucose Del Cavo Orale Dopo Radioterapia »: I. - Le Labbra
Authors: Pompili G.
Published: April 2018

509 cases of carcinoma of the lips were radiologically treated in the Cancer Institute of Milano from 1928 to 1950. 47 cases of recurrences followed to such treatment are considered.
Azione Inibente di Alcuni Tioanaloghi Pirimidinici Sulla Moltipicazione di Fibroblasti in Cultura
Authors: Di Marco A. , Necco A.
Published: April 2018

The behaviour of some pyrimidine thioanalogs has been studied on in vitro fibroblasts from chick embryo heart. 4 out of the 7 tested substances showed a typical inhibiting action on cytodieresis, and namely:

2-thio-5-methyl-cytosine, 2-thio-4-methyl-aminopyrimidine, 2-methyl-thio-5-bromo-cytosine and 2-6-dithio-thymine. Three of them proved to be aspecifically toxic: 2-thiocytosine, 2-thio-4-oxycytosine and 2-6-dithio-uracil.

Cytodieresis is inhibited by intermediate concentrations, higher concentrations blocking mitosis of the interkinetic nuclei. This action results in the formation of multinuclear elements with syncytial aspect. Low concentrations induce chromosomal alterations with atypical mitotic pictures (picnosis, fragmentation, stickiness) and alterations of nucleoli which are enlarged and show morphological abnormalities.

In the search of possible correlations between mitotic and biochemical alterations during the interkinetic phase, a study has been carried out in order to prove the microbiologic finding of an antagonism from folic acid and thymine. Folic acid was found to be unable to antagonize effectively the action of all the tested inhibitors.

Thymine, which at high concentrations behaves as cytodieresis inhibitor, allows the growth recover with increasing number of mitoses; the picture of cytodieresis inhibition is unmodified.
Le Recidive da Radioterapia Dei Carcinomi Delle Mucose Del Cavo Orale
Authors: Pompili Giuseppe
Published: April 2018

A study of 586 cases of carcinoma of the cheek and the gingivogenian fornices radiologically treated from 1928 to 1950 in the Cancer Institute and Radiological Department of the Milan University. Particular consideration is given to 131 recurreces following such treatment.
Suggestiva Carcinoresistenz a Della Prima Porzione del Duodeno
Authors: Cavani Attilio
Published: April 2018

After an evposition of elements suggesting a carcinoresistance of the first duodenal portion, the hypothesis is advanced that the phenomenon rests on functional rather than on anatomical grounds, with a prevalence of the hormonal function of the duodenum. It is suggested that the antitumoral principle could be represented in the duodenum either by a still unknown incretion or a still uncompletely known hormonal complex. A trial of cancer therapy with large doses of extracts from the mucous membrane of the first duodenal portion is therefore advised.
Considerazioni Sopra un Angioma Costale Roentgen Trattato
Authors: Carimati Angelo
Published: April 2018

Serial roentgenographic controls of a costal angioma treated by a single cycle of high roentgen doses are presented. They show the modifications induced by the ionizing radiations in a seven year period. The evidence for recovery is given by disappearance of clinical symptoms with reduction of the involved soft parts rather than by return to normality of the costal radiographic picture.
IL Problema Dell'ereditarieta’ Neoplastica Nell'uomo 3° - IL Cancro Dell'utero
Authors: Bucalossi Pietro , Veronesi Umberto , Pandolfi Anna
Published: April 2018

A statistical study on tumour heredity has been carried out on 251 women (probands) bearing uterus carcinoma (185 cervical carcinomas and 66 corpus carcinomas) and on 251 healthy subjects (controls). 3575 relatives of the probands and 3578 of the controls were examined (parents, grandparents, uncles and aunts, collaterals, sons).

219 relatives of the probands (6,12 per cent) and 131 (3,66 per cent) of the controls were found to be or to have been affected by malignant tumours.

Among the female relatives of the probands the 2,49 per cent resulted to be affected by uterus carcinoma, among those of the controls only the 1,17 per cent.

As for tumour incidence, no significant differences have been observed between relatives of probands with cervical carcinoma and with uterus carcinoma. The neoplastic incidence in all sites was found to be moderately higher in relatives of probands bearing corpus carcinoma (6,57 per cent) than in those of probands bearing cervix carcinoma (5,94 per cent). Among the relatives of these two groups of probands (with cervix and uterus carcinomas) no remarkable differences weer observed as concerns tumour incidence.

A three-times higher neoplastic incidence of genital organs and prostata was observed among male relatives of the probands in comparison with male relatives of the controls.
Tumore Eterologo Dell'utero Con I Caratteri del Tecoma e Con Aree a Tipo Rete Ovarii e Tipo Cordoni Gonadali Embrionali
Authors: Sirtori Carlo
Published: April 2018

A 38 years old woman suffering from metrorrhagia and with a uterine growth proved by hysterosalpingography, was submitted to hysterectomy and adnexectomy. A submucous neoformation 2 cm in diameter, with myometrium infiltration, was observed in the uterus. The histological examination of the growth showed areas with aspects of thecoma, rete ovarii and embrionary gonadal strands. No similar cases have been found in the literature. The patient is well, two years after the operation.