bluuebunny/crossref_metadata_2025 huggingface dataset:
Inflammatory Pseudotumor of the Liver: Report of Two Cases
Authors: Andreola Salvatore , Cattoretti Giorgio , Lombardi Luciano , Audisio Riccardo A. , Regalia Enrico , Bosch Juan P. , Mazzaferro Vincenzo , Doci Roberto
Published: April 2018

Inflammatory pseudotumor of the liver is a very rare lesion. Herein we describe two cases of this entity which occurred in two women aged 22 and 49 years, respectively. Both cases were considered to be clinically malignant and only the histopathologic examination revealed the non-neoplastic nature of the disease. Ultrastructural and immunohistochemical studies further supported the evidence of a reactive disease.
In Situ Hpa II Endonuclease Digestion on Fixed Chromatin of Solid Tumor Cells
Authors: Stuppia Liborio , Franchi Paolo Guanciali , Parruti Giustino , Calabrese Giuseppe , Bianchi Umberto , Palka Giandomenico
Published: April 2018

Neoplastic cells from different tumors (lung, colon, rectal, and pancreatic carcinoma, synovial sarcoma, and Wilm's tumor) were fixed on slides and in situ digested with Hpa II and Msp I restriction enzymes. Staining of samples with the DNA specific fluorochrome ethidium bromide showed a clearcut decreased fluorescence after Hpa II digestion in neoplastic cells as compared to normal controls, whereas Msp I digestion produced the same pattern in neoplastic and in normal cells. The authors hypothesize that the altered state of methylation in neoplastic cells could affect the Hpa II activity on fixed chromatin.
Ceop Regimen in the Treatment of Advanced Low-Grade Non-Hodgkin's Lymphomas: Preliminary Report
Authors: Zinzani Pier Luigi , Mazza Patrizio , Gherlinzoni Filippo , Zanchini Roberto , Bocchia Monica , Aitini Enrico , Cavazzini Giovanna , Amurri Barbara , Gobbi Marco , Tura Sante
Published: April 2018

Between March 1987 and December 1988, 30 previously untreated patients with low-grade non-Hodgkin's lymphomas (NHL), according to the Kiel classification, were treated by a combination of therapy including cyclophosphamide, epirubicin, vincristine, and prednisone (CEOP). Eighteen patients (60%) achieved a complete pathologic remission, and 8 patients (26.6%) had a partial response with a reduction of more than 50% of tumor-related manifestations. Four patients (13.4%) were primary resistant to CEOP. The overall survival was 96.6% with a median follow-up of 25 months from the diagnosis; none of the patients who achieved complete response relapsed at a median follow-up of 21 months from the completion of treatment. Clinical and hematologic toxicities were irrelevant. This regimen was effective in inducing a good remission rate of low-grade NHL, but a longer follow-up for definitive conclusions is warranted.
Primary Chemotherapy and Delayed Surgery for Malignant Fibrous Histiocytoma of Bone in the Extremity
Authors: Bacci Gaetano , Avella Maddalena , Picci Piero , Dallari Dante , Malaguti Cristina , Biagini Roberto , Ruggieri Pietro , Bailadelli Alba , Ferrari Stefano , Caldora Patrizio , Campanacci Mario
Published: April 2018

Between March 1983 and September 1988, 22 patients with non-metastatic malignant fibrous histiocytoma MFH of bone of the extremities were treated with two regimens of neoadjuvant chemotherapy successively activated. Preoperatively, the patients received moderate doses of methotrexate and cisplatinum-Regimen 1- or high dose methotrexate, cisplatinum and adriamycin-Regimen 2. Cisplatinum was delivered intra-arteriously, the other drugs intravenously. Limb salvage surgery was performed in 20 patients, and 2 patients were amputated. The surgical margins were adequate (radical or wide) in 18 cases and inadequate (marginal) in 4. The histologic response to chemotherapy was good (90% or more tumor necrosis) in 8 patients. In both regimens postoperative chemotherapy was tailored according to the grade of necrosis determined by preoperative treatment on the primary tumor. At an average follow-up of 40 months (15-70), 15 patients (68%) remained continuously disease-free and 7 relapsed with metastases. No local recurrences were observed. Regimen 2 was slightly more effective than Regimen 1 in terms of good histologic response (5/10 vs 1/12) and continuous disease-free survival (8/10 vs 7/127). The results demonstrate that, as in osteosarcoma, in non-metastatic malignant fibrous histiocytoma of bone in the extremities a high percentage of patients can be cured with neoadjuvant chemotherapy and that in most of them limb sparing surgery is possible and safe.
Metastatic Disease of the Cavernous Sinus: Contribution of Computed Tomography and Magnetic Resonance Imaging to Diagnosis
Authors: Merimsky Ofer , Reider Irith , Inbar Moshe , Kovner Felix , Chaitchik Samario
Published: April 2018

The clinical presentation of metastatic disease to the cavernous sinus includes ophthalmoplegia, pain and sensory deficit along the optic or maxillary branches of the trigeminal nerve. The role of a CT scan and magnetic resonance imaging in the diagnosis is discussed. It was found that magnetic resonance imaging is superior to CT scan in demonstrating the cavernous sinus and pontine borders, especially in lymphomatous involvement of these structures.
Survival of Patients with Cancer of the Stomach, Colon and Rectum, Lung and Breast in Ragusa, Sicily
Authors: Gafà Lorenzo , Amendola Pasquale , Dardanoni Gabriella , Dardanoni Luigi
Published: April 2018

Survival of 1747 patients with cancer of the stomach, colon/rectum, lung and female breast was investigated on incident cases registered by the Ragusa Cancer Registry, covering the Province of Ragusa (275,000 inhabitants) between 1981 and 1986. Cases known from the death certificate only were excluded. Date of death was obtained by a linkage with death certificates issued for Ragusa residents. Living status was assessed directly at the Registrar's Office. Analysis was performed also by sex, age group and presence of histologic verification. Relative survival at 5 years of Ragusa cancer cases was of the same order of magnitude as that observed in the U.S.A. (1980) and in Switzerland (1970-1980). However, the slight differences observed were mostly in favor of the Swiss and American patients. Sex did not significantly influence survival, but younger patients survived longer than older ones. Lack of histologic verification was associated with poor survival.
Glucose-6-Phosphate Dehydrogenase Deficiency and Lung Cancer: A Hospital Based Case-Control Study
Authors: Pisano Mario , Cocco Pierluigi , Cherchi Roberto , Onnis Roberto , Cherchi Pierpaolo
Published: April 2018

A hospital based case-control study was conducted to test the hypothesis of a lower lung cancer risk in G6PD-deficient subjects. Cases were 156 male patients with lung cancer, admitted to « Binaghi » Hospital, Local Health Unit (USL) 20, Cagliari (Italy), between January 1984 and November 1986. Controls were 235 male patients, admitted to the same hospital In the same time period, for diseases other than cancer (all types) and hemolytic anemia. No decrease of the lung cancer risk was found in G6PD-deficient subjects. This result, in line with recent reports in the literature, suggests that the genetic condition of G6PD deficiency does not provide significant protection against the development of lung cancer in humans.
Primary Lymphoma of the Central Nervous System
Authors: Amadori Marinella , Maltoni Marco , Ravaioli Alberto , Rosti Giovanni , Pasquini Enzo , Leoni Maurizio , Amadori Dino
Published: April 2018

Primary lymphoma of the central nervous system (CNS) represents a pathology that is no longer considered rare, also in the light of its high correlation with the human immunodeficiency virus (HIV) syndrome reported recently. Often the correct diagnosis of the disease is difficult to reach, owing to the wide spectrum of non-lymphoma pathologies from which it should be differentiated and the invasiveness of some diagnostic techniques. The biologic aggressiveness of the neoplasm often makes a combined radio-chemotherapeutic approach necessary. In contrast, surgical resection does not seem to provide any significant benefit. The clinical experience reported here, together with a review of the most recent literature, lead the authors to suggest the opportunity of treating primary lymphoma of the CNS with the most active and modern chemotherapeutic protocols in association with traditional treatments to obtain an improvement in overall survival.
Epirubicin in the Treatment of Malignant Mesothelioma: A Phase II Cooperative Study
Authors: Magri Maria Donatella , Veronesi Andrea , Foladore Silva , De Giovanni Daniela , Serra Corrado , Crismancich Franco , Tuveri Guido , Nicotra Mario , Tommasi Mauro , Morassut Sandro , Carbone Antonino , Grandi Giorgio , Monfardini Silvio , Bianchi Claudio ,   Within the framework of the North-Eastern Italian Oncology Group (GOCCNE) - Mesothelioma Committee
Published: April 2018

From September 1986 to April 1988, all consecutive patients with histologically proven (pathologic review mandatory) malignant mesothelioma, measurable disease, age less than 75 years, Karnofsky performance status equal to or greater than 40, and no previous chemotherapy were treated with epiru-blcin at the dosage of 75 mg/m2 i.v. every 3 weeks. Of the 23 patients who entered the study, 2 were retrospectively found not to have malignant mesothelioma. In the 21 eligible patients (all evaluable), no complete remission, 1 partial remission, 11 stable diseases and 9 progressions were noted. Toxicity was very mild. Median survival was 7.5 months. At the dosage used, epirubicin proved to be of little value in the management of these patients. Whether higher doses are more effective, as has been noted in other tumors, remains to be ascertained.
Comparison of Two Newly Identified Tumor Markers (CAR-3 AND DU-PAN-2) with CA 19-9 in Patients with Pancreatic Cancer
Authors: Ferrara Chiara , Basso Daniela , Fabris Carlo , Malesci Alberto , Fogar Paola , Meggiato Tamara , Panozzo Maria P. , Scalon Paola , Del Favero Giuseppe , Plebani Mario , Burlina Angelo , Di Mario Francesco , Naccarato Remo
Published: April 2018

We compared the diagnostic utility of DU-PAN-2 and CAR-3 with that of CA 19-9 in differentiating pancreatic cancer (23 patients) from chronic pancreatitis (16 patients) and various extra-pancreatic diseases (28 patients) mainly of the upper gastrointestinal and biliary tract. The influence of some pathophysiologic variables on the three markers was also assessed. The sensitivities of the three markers in detecting pancreatic cancer were: CA 19-9, 83%; DU-PAN-2, 56%; and CAR-3, 39%. In patients with chronic pancreatitis and extra-pancreatic diseases, CA 19-9 gave the highest number of false positives. Receiver-operating characteristic curves showed that the ability of CAR-3 to discriminate between pancreatic cancer and other diseases was similar to that of CA 19-9, whereas DU-PAN-2 was a less reliable discriminator. Correlations were found between the behavior of all three markers and that of the cholestasis indices (ALP and GGT). Our findings indicate that DU-PAN-2 and CAR-3 serum determinations do not provide any more information than does CA 19-9 alone. The latter remains the marker of choice in the differential diagnosis of pancreatic cancer, even though it cannot be considered a definitive aid. Serum levels of all three markers increase in the presence of extrahepatic cholestasis, possibly due to interference with the hepatic clearance of glycoproteins and destruction of ductal biliary epithelium.
Primary Radiotherapy versus Surgery and Radiotherapy in the Management of Postmenopausal Locally Advanced Breast Cancer
Authors: Micheletti Enrico , Plebani Franco , Testolin Alessandro , Bignardi Mario
Published: April 2018

From 1978 through 1984, 103 postmenopausal patients with locally advanced breast cancer (T4 N1-2-3 MO) were treated by definitive radiotherapy (XRT, 35 patients) or mastectomy and postoperative radiotherapy (RM+XRT, 68 patients). A control group of 35 of the 68 RM+XRT patients was selected by matching several prognostic variables with the XRT group. Patients were followed for 4 to 10 years. At 5 years the probabilities of overall survival and relapse-free survival were 49.9% and 33.2% for XRT patients and 49.2% and 42.8% for RM+XRT patients, respectively (with no significant difference). The probability to remain free of local-regional progression at 5 years, with censoring of deaths, was 71.9% in the XRT group and 79.8% in the RM+XRT group. Of the patients treated with definitive radiotherapy, those who received 60 Gy or more to the primary tumor had a significantly better 5-year rate of local control: 88.0 % vs. 68.0 %, p < 0.05. Our results suggest that adequate doses of radiotherapy can provide long-term local-regional control in a large proportion of survivors and can spare mastectomy in most patients, without however achieving substantial improvements in the poor survival results.
Apparent Isolated Skin Relapse in Acute Monocytic Leukemia. A Case Report
Authors: Pagano Livio , Larocca Luigi Maria , Zollino Marcella , Sica Simona , Storti Sergio , Rotoli Maurizio , Marra Roberto , Leone Giuseppe
Published: April 2018

A case of acute monocytic leukemia with an apparent isolated skin relapse is reported. The cutaneous involvement was associated with a morphological bone marrow remission but a cytogenetic relapse was present. Regression of the skin lesions was obtained with a protocol including daunoblastine, aracytin and thioguanine, but the patient relapsed and died a few months later without achieving another remission. The relation between cutaneous and medullary disease is discussed.
Intensive Alternating Combination Chemotherapy and High Dose Chest Radiotherapy in Small Cell Lung Cancer
Authors: Bianco Angelo Raffaele , Stefani Stefano , Gridelli Cesare , Gentile Maria , Contegiacomo Alma , Giampaglia Francesco , Lauria Rossella , Conte Augusto , Ferrante Giovanni
Published: April 2018

Sixty-nine patients, 32 with limited and 37 with extensive small cell lung cancer (SCLC), were admitted to the present study. Patients with limited disease underwent alternating combination chemotherapy consisting of CAV (cyclophosphamide, adriamycin, vincristine) and PE (cisplatin and etoposide) regimens and concurrent high dose thoracic radiotherapy (6,000 cGy); prophylactic brain irradiation (3,000 cGy) was administered to complete responders. Patients with extensive disease received the same alternating chemotherapy but not radiotherapy. In the 25 evaluable patients with limited disease we obtained an objective response (OR) in 80% with a complete response (CR) in 54% and partial response (PR) in 24%, stable disease (SD) in 4 % and progressive disease (PD) in 16%. Median duration of response was 9.5 months for CR and 8.5 months for PR. Median survival was 14 months for all patients with 12% long-term survivors. Toxicity was acceptable. In the 32 evaluable patients with extensive disease we observed 65.6% OR with 18.7% CR and 46.8% PR, 9.3% minimal response and 25 % PD. Median duration of response was 7 months for CR and 8 months for PR. Median survival was 10 months for all patients. The treatment was well tolerated. Our study did not show a therapeutic advantage for alternating combination chemotherapy in SCLC and failed to show the use of high dose chest radiotherapy in combined modality for limited disease.
Doppler Flowmetry and the Diagnosis of Breast Lumps
Authors: Gallo Enrico , Galante Emanuele , Martelli Gabriele , Stanzani Marco , Landi Grazia , Cerrotta Annamaria , Motta Alberto , Attili Angelo
Published: April 2018

The aim of the study was to ascertain the reliability of a Doppler signal in the diagnosis of breast cancer. Computerized blood flow analysis was performed on 117 patients who presented with a breast lump at the Division of Diagnostic Oncology of the Istituto Nazionale Tumori of Milan. The values of systolic peak and diastolic frequency were evaluated in relation to the histologic diagnosis. Ten patients had a spontaneous regression of the lump and were excluded from the study. The number of evaluable cases with histologic confirmation was 107: 69 carcinomas and 38 benign lesions. Systolic peak values for the 69 carcinomas ranged from 1500 to 7400 Hz, with a mean value of 3243.4 Hz; diastolic frequency ranged from 200 to 3700 Hz, with mean value of 1413.9 Hz. No diagnostic signals were found in 4 breast cancers (false negatives). Twenty-three of 38 benign lesions (60.5 %) and 65 of 69 malignant nodes (94.2 %) were correctly diagnosed. The Doppler signal with computerized spectral analysis in addition to more specific ultrasonographic parameters could be considered a useful tool in the diagnosis of breast cancer.
Antiproliferative Effects of Mitoxantrone in Adr-Sensitive and Adr-Resistant P388 Leukemia Cells Enhanced by Vitamin K3
Authors: Parekh Hemant , Chavan Surendra , Chitnis Manik
Published: April 2018

Vitamin K3 was employed as a resistance-modifying agent to Investigate its activity in enhancing mitoxantrone (MITO)-induced cytotoxicity in parental (P388/S) and multidrug resistant (P388/ADR) P388 leukemia cells. Vitamin K3 potentiated the antitumor effects of MITO in P388/S and P388/ ADR tumor cells as monitored by inhibition of tumor cell survival (MTT assay). MITO and vitamin K3 in combination effected an enhanced inhibition of [3H]thymidine (DNA synthesis) and [3H]uridine (RNA synthesis) and also Increased the life span of the sensitive and resistant tumor-bearing animals. The effect of vitamin K3 on the induction of DNA strand breaks by MITO was also examined. Increased fragmentation of DNA was illustrated in the sensitive and resistant P388 leukemia cells exposed to the combination. Observations indicate the restoration of sensitivity in P388/ADR cells to MITO by vitamin K3 that may be due to its ability to increase the MITO-induced DNA strand breaks.
Effect of Prolonged Subcutaneous Administration of Interleukin-2 on the Orcadian Rhythms of Cortisol and Beta-Endorphin in Advanced Small Cell Lung Cancer Patients
Authors: Spinazzé Silvia , Viviani Simonetta , Bidoli Paolo , Rovelli Franco , Palmer Peter , Franks Christopher R. , Arienti Flavio , Rivoltini Licia , Parmiani Giorgio
Published: April 2018

Interleukin-2 has been shown to stimulate Cortisol secretion in man. Owing to its Immunosuppressive properties, an increase in Cortisol levels during interleukin-2 cancer immunotherapy could potentially counteract induced activation of the antitumor immune response. Few data are available about Cortisol secretion secondary to prolonged interleukin-2 administration. To Investigate the problem, we evaluated Cortisol circadian rhythms in 7 consecutive metastatic small cell lung cancer patients who received interleukin-2 subcutaneously for 4 weeks (daily dose: 6 × 106 × IU/m2). Venous blood samples were drawn at 8.00 a.m., 4.00 p.m. and 12.00 p.m., before Interleukin-2, and after each week until the end of the cycle. Beta-endorphin levels were also measured on the same samples. Four patients were evaluated during a second interleukin-2 cycle. Mean Cortisol levels increased during Interleukin-2 therapy, but were significantly higher than those seen in basal conditions after the first week of treatment. Moreover, Cortisol peaks observed during the second cycle of therapy were not significantly different from those seen during the first cycle. Mean beta-endorphin levels increased in response to interleukin-2 administration, but the increase did not reach statistical significance. The early Cortisol rise progressively decreased as treatment continued. This suggests that the interleukin-2-induced Cortisol rise has no relevant clinical importance in antagonizing the activation of an effective antitumor immune response during cancer immunotherapy with interleukin-2.
Leukocyte Adherence Inhibition Test: Cell-Mediated Reactivity to Tumor Antigens in Colorectal and Lung Tumor Long Survivors
Authors: Fazio Massimo , Calabrese Felice , Camandona Michele , Correggia Franco , Giacomasso Sara , Meina Giovanna , Negri Luciano , Mastromatteo Vincenzo
Published: April 2018

Cell-mediated Immunity versus tumor antigens (cytosols) of the same histotype and site was evaluated by means of the leukocyte adherence Inhibition (LAI) test in 44 colorectal adenocarcinoma and 17 lung squamous-cell carcinoma patients 3–10 years after surgical resection. LAI-positivity was observed in 17/44 (38.6 %) and 13/17 (76.5 %) patients, respectively, together with serum blocking factors in 7/17 (41.2%) compared to 0/13. These results indicate that a high percentage of long survivors retain an immunologic memory of the tumor antigen to which they have been exposed. The prognostic significance of serum blocking factors is less clear.
Pleomorphic Carcinoma of the Gallbladder: Report of a Case
Authors: Caruso Rosario A. , Familiari Ciro , Giuffré Giuseppe , Mazzeo Giovanni
Published: April 2018

The authors report a rare case of primary pleomorphic carcinoma of the gallbladder in a 70-year-old woman. A polypoid tumor protruded into the lumen from the fundus of the gallbladder. Characteristic histologic findings Included a general lack of architectural cohesiveness, marked pleomorphism, presence of mononucleated and multinucleated giant cells, extensive necrosis, leukocyte-tumor cell phagocytosis or cannibalism. Immunoreactivity for cytokeratin, carclnoembryonic antigen and epithelial membrane antigen as well as histochemical positivity for mucins demonstrated the epithelial nature of the tumor. The neoplasm behaved aggressively; the patient died of metastases 9 months after the operation.
Performance of Fine-Needle Aspiration Cytology. of the Breast-Multicenter Study of 23,063 Aspirates in ten Italian Laboratories
Authors: Ciatto Stefano , Bonardi Rita , Cariaggi Maria Paola
Published: April 2018

Aims and background

The aim of this study was to assess the performance of routine breast cytology in a group of Italian laboratories, as a basis for interlaboratory quality control.

Methods

A multicenter retrospective consecutive series of 23,063 aspirates from breast lesions (5,130 invasive carcinoma, 247 intraductal carcinoma, 2,386 benign lesions [histological], 13,144 benign lesions [follow-up], 2,156 other [no follow–up]) was reviewed. Standard accuracy measurements (inadequacy rate, sensitivity, specificity, predictive value) were determined, as well as the contribution of diagnostic tests such as physical examination and instrumental diagnostic procedures (mammography, sonography).

Results

Overall, inadequacy rate was 6.5% for malignant and 23.2% for benign lesions. Sensitivity was 92.2%, specificity was 95.3%, and the positive predictive value of an equivocal or malignant report was 53.4% or 96.9%, respectively. Sensitivity was associated with histological type (intraductal vs invasive: 77.0% vs 92.9%, p < 0.000001; lobular vs other invasive: 85.5% vs 94%, p = 0.0025) as well as with tumor size (pT1 = 91.6%, pT2 = 94.3%, pT3–4 = 96.0%, p < 0.000001). Observed differences in performance indicators between centers may be explained by variability in sampling or reading accuracy, and warrant the need for some adjustment in single centers, especially, as far as the criteria to report an equivocal smear are concerned. Cytology contributed to detect otherwise unsuspected carcinomas, although in some centers this benefit was poor and not cost-effective because a large number of unnecessary biopsies were caused by false equivocal/positive reports.

Conclusions

Although centers scored, on average, well within standards recommended by national authorities, this study suggests the opportunity of interlaboratory quality control to achieve more homogeneous criteria.
Second-Line Therapy with Interferon-Alpha plus Vinblastine in Metastatic Renal Cell Cancer Patients Progressed under Interleukin-2 Subcutaneous Immunotherapy
Authors: Paolorossi Franco , Villa Silvia , Barni Sandro , Tancini Gabriele , Andres Marco , Lissoni Paolo
Published: April 2018

Aims and background

Interferon (IFN) ± vinblastine (VNB) has appeared to be effective as first–line therapy of metastatic renal cell cancer. This study was performed to establish the efficacy of IFN plus VNB in metastatic RCC previously treated with interleukin-2 (IL-2).

Methods

The study included 14 metastatic renal cell cancer patients who did not respond to IL-2 subcutaneous therapy or who relapsed after initial response or stable disease. IFN-alpha 2a was given subcutaneously at 3 million U thrice a week in association with VNB (0.1 mg/kg i.v. every 21 days) until progression or toxicity. Patients were considered as evaluable when they were treated for at least 1 month.

Results

Evaluable patients were 13/14. No patient had a complete response. Partial response was achieved in 2/13 (15%) patients. Stable disease was seen in 5/13 patients, and the last 6 progressed.

Conclusions

This study, by showing a tumor response rate comparable to that reported with first-line therapy, suggests that previous IL-2 immunotherapy does not influence negatively the efficacy of IFN + VNB in metastatic renal cell cancer.
Latissimus Dorsi Pedicled Flap Applications in Shoulder and Chest Wall Reconstructions after Extracompartimental Sarcoma Resections
Authors: Capanna Rodolfo , Manfrini Marco , Briccoli Antonio , Gherlinzoni Franco , Lauri Giulio , Caldora Patrizio
Published: April 2018

Aims and background

In sarcomas of shoulder and of chest wall, latissimus dorsi muscle gives the opportunity to solve any plastic problem without recourse to free flaps. The authors report their experience in the use of latissimus dorsi pedicled flap as adjuvant procedure in the surgery of bone and soft tissue sarcoma.

Methods

The latissimus dorsi pedicled flap was used in seventeen patients to reconstruct composite tissue defects after sarcoma resection of the shoulder or of the chest wall. Three groups were recognized. The eight patients of Group I received the flap to close the chest cavity after a multiple rib resection performed to remove a tumor of the chest wall. In Group II four patients had the latissimus dorsi transported to reconstruct the soft tissue coverage over a proximal humerus prosthesis previously appiled after bone tumor resection. The five patients of Group III had the flap performed at the same time of the resection of a tumor arising in the shoulder area (1 bone and 4 soft tissue sarcoma).

Results

Two patients of the Group II presented a recurrent skin failure. A satisfactory coverage without any flap complication was provided in all the other 15 patients (88%).

Conclusions

Latissimus dorsi pedicled flap represents a reliable and effective technique to reconstruct large chest wall or shoulder soft tissue defects.
Gastric Cancer with Bone Marrow Invasion at Presentation: Case-Report and Review of the Literature
Authors: Crivellari Diana , Carbone Antonino , Sigon Roberto , Buonadonna Angela , Cannizzaro Renato , Sorio Roberto , Rossi Carlo , Monfardini Silvio
Published: April 2018

A case of extensive bone marrow infiltration due to gastric cancer is reported. A 65-year old man with an acute episode of anemia (Hb 4.1 mg/dl) and dyspnea was admitted to the Medical Department of a general hospital. Bone marrow biopsy showed extensive paratrabecular infiltration of a poorly differentiated adenocarcinoma of gastric origin. The primary tumor in the stomach was confirmed, and the patient was referred to our Institute and treated with combination chemotherapy (FAMTX) for 6 cycles. Due to the disappearance of bone marrow infiltration, the patient was considered for curative resection of the primary gastric cancer. After 27 months the patient is alive and in clinical complete remission.
Ifosfamide and Etoposide in Previously Treated Patients with Advanced Breast Cancer
Authors: Kiraz Sedat , Baltalı Esomen , Güler Nilüfer , Barisota İbrahim , Benekli Mustafa , Çelik İsmail , Güllü İbrahim H. , Kars Aysoe , Tekuzman Gülten , Firat Dinrçer
Published: April 2018

Aims and background

Ifosfamide is an active alkylating agent in the treatment of breast cancer, as a first-line therapy and in advanced disease. Since the combination of etoposide with an alkylating agent produces a synergistic and tolerable activity in various malignancies, in the present study, ifosfamide and etoposide were administered to patients with advanced breast cancer to evaluate the response characteristics and the toxicity profile.

Study design

The combination of ifosfamide, mesna and etoposide was prospectively administered to 41 previously treated patients with stage IV breast carcinoma. The treatment schedule consisted of ifosfamide, 1500 mg/m2, infused over 24 hrs with 1500 mg/m2 mesna on days 1 to 5 and 120 mg/m2 etoposide, infused over 1 hr on days 1 to 3, to be repeated every 4th week.

Results

After a median follow-up of 10 months, an objective response rate of 23% (overall 2.5% complete remission and 20.5% partial remission) and a median response duration of 5.3 months were obtained in 39 assessable patients. The non-responder group consisted of 28.3% stable disease and 48.7% progressive disease. The prior status of chemotherapy was the only significant prognostic factor with an impact on the response rate. The overall toxicity was generally mild, with grade 3 myelotoxicity encountered in 25.7% of patients.

Conclusions

The tolerable side effect profile of the ifosfamide and etoposide combination might be advantageous as regards the quality of life. To improve the rate and/or the duration of response and to clarify the precise role of the ifosfamide-etoposide combination in previously treated advanced breast cancer, further trials are warranted.
Flow Cytometric and Immunohistochemical Correlations in High Incidence Human Solid Tumors
Authors: Danesi Donatella Tirindelli , Spanò Marcello , Antonini Fabiana , AltaVista Pierluigi , Catalano Piera , Cordelli Eugenia , Pasqualetti Patrizio , Santacroce Criselda , Toscano Maria Gabriella , Mecozzi Antonella , Fabiano Alfredo
Published: April 2018

475 patients with carcinoma at different sites (141 colon-rectum; 102 breast; 50 stomach; 48 kidney; 46 head and neck; 41 bladder; 47 other sites) submitted to surgery have been analyzed after histopathological staging and grading, by flow cytometry (monoparametric DNA content analysis) and immunohistochemistry (p53, c-erbB-2, and PCNA expression). In breast cancer patients the presence of receptors for estrogen (ER) and progesterone (PGR) has also been determined. Flow cytometry-derived parameters were DNA ploidy, fraction of cells in S-phase (SPF), and DNA content heterogeneity (multiclonal stem cell lines with different DNA index and/or more than one subpopulations with different ploidy levels in different samples from the same tumor). Correlations of the results obtained by the different techniques have been attempted by the non-parametric Spearman's rank correlation approach. Significant associations (P «0.05) were found between the histopathological, immunohistochemical and flow cytometric parameters considered in some anatomical regions, such as stomach (p53 vs DNA content aneuploidy and vs heterogeneity), colon-rectum (TNM vs p53 and vs heterogeneity), bladder (grading vs DNA content aneuploidy and vs heterogeneity). Tumor heterogeneity proved to be dependent on the number of tumor samples taken. The results of this preliminary assessment will subsequently be compared with the data obtained from a currently ongoing follow-up survey.
Temporomandibular Joint Metastasis from Rectal Carcinoma: Ct Findings before and after Radiotherapy. A Case Report
Authors: Balestreri Luca , Canzonieri Vincenzo , Innocente Roberto , Cattelan Alessandro , Perin Tiziana
Published: April 2018

Metastatic disease to the masticator space and to the jaws is a rare event. About a dozen cases are reported in the current literature. We describe the imaging findings of a rectal adenocarcinoma metastatic to the temporomandibular joint before and after radiotherapy.
Total Parenteral Nutrition and Tumor Growth in Malnourished Patients with Gastric Cancer
Authors: Bozzetti Federico , Gavazzi Cecilia , Cozzaglio Luca , Costa Aurora , Spinelli Pasquale , Viola Giovanna
Published: April 2018

Aims and Background

Evidence that total parenteral nutrition (TPN) can stimulate tumor growth in humans is scanty and contradictory. The purpose of this study was to evaluate the impact of TPN on tumor cell proliferation in malnourished patients receiving preoperative TPN.

Methods

We evaluated variations in the S-phase cell fraction, defined as 3H-thymidine labeling index (TLI), before and after 10 days of TPN or non-administration of nutritional support in 19 malnourished patients (weight loss, ≥ 10%) with gastric cancer. TLI was determined on endoscopic biopsies at the time of diagnosis, and subsequently on the operative specimen or through intraoperative sampling.

Results

At diagnosis, a higher median TLI value was observed in the control than in the TPN group. Administration of TPN enhanced tumor cell proliferation in 50% of patients; however, at surgery there was no difference in the median TLI value of the two groups.

Conclusions

The TPN regimen seems to be associated with increased tumor cell proliferation, even though this stimulating effect was moderate and at surgery the TLIS of TPN patients and controls were not different. Although the potential stimulation probably has little consequence for patients receiving short-term preoperative nutrition, it may call for further investigation in cancer patients undergoing long-term home TPN.
The Role of Vindesine and Lonidamine in the Treatment of Elderly Patients with Advanced Non-small Cell Lung Cancer: A Phase III Randomized Fonicap Trial
Authors: De Marinis Filippo , Rinaldi Massimo , Ardizzoni Andrea , Bruzzi Paolo , Pennucci Maria Cristina , Portalone Luigi , D'Aprile Modesto , Ripanti Paola , Romano Francesco , Belli Massimo , Altavilla Giuseppe , Migliorino Maria Rita , Rosso Riccardo ,   Franco Salvati for the Italian Lung Cancer Task Force
Published: April 2018

Aims

To evaluate the efficacy and treatment compliance in elderly patients with advanced non-small cell lung cancer (NSCLC) of two chemotherapeutic agents with mild toxicity, 153 previously untreated patients aged over 70 years were randomized to receive lonidamine (450 mg daily p.o. until progression), vindesine (3 mg/m2/daily i.v. weekly for 4 weeks and then every 2 weeks until progression), the combination of the two drugs at the same dose and schedule, or supportive therapy only in a four-arm factorial randomized trial.

Methods

126 patients were included in the final analysis. Their median age was 75 years. Forty percent had stage IV disease and 60% stage III. Most patients were males (85%) and the majority had squamous histology (68%).

Results

Among 104 patients evaluable for response there were only 3 PRs (1/30 in the lonidamine arm and 2/33 in the lonidamine + vindesine arm). Overall, 8.7% and 9.5% of the patients, respectively, progressed or died early, before response evaluation; another 9.4% refused treatment continuation because of poor compliance with the study protocol. Eighty-five patients were fully evaluable for toxicity, which was generally mild. Leukopenia grade 1-3 was found in less than 30% of patients treated with vindesine or vindesine + lonidamine. The most common complaints associated with lonidamine treatment were myalgia (70% of patients), fatigue (55% and 83% of patients treated with lonidamine or lonidamine + vindesine, respectively) and testicular pain in nearly 40% of cases. The overall median survival was 170 days, with no significant impact on survival of either lonidamine or vindesine.

Conclusions

The low response rate and survival together with the poor treatment compliance, even in the presence of mild toxicity, do not support the usefulness of these “gentle” chemotherapies in elderly NSCLC patients. The standard management of advanced NSCLC in elderly patients remains to be defined. Specifically designed studies to address this issue are warranted.
Hyperthyroidism and Concurrent Thyroid Cancer
Authors: Vaiana Roberto , Cappelli Carlo , Perini Paola , Pinelli Domenico , Camoni Giuseppe , Farfaglia Roberto , Balzano Rino , Braga Marco
Published: April 2018

Aims and Background

The aim of this study was to analyze the frequency of coexisting hyperthyroidism and thyroid malignancy in endemic goiter areas and review the current literature on the subject.

Methods

During the period January 1984 to June 1998, 1853 patients were examined for hyperthyroidism at the Spedali Civili Hospital of Brescia, Italy; 512 (27.6%) subjects underwent surgery. Of these patients 108 (21%) had Graves’ disease, 251 (49%) multinodular toxic goiter (MTG) and 153 (30%) uninodular toxic goiter (UTG).

Results

Malignancy was found in 24 (4.7%) patients: 19 females and 5 males with a mean age of 52.2 years (range, 21-76 years). The frequency of cancer in Graves’ disease was 6.4%, 5 females and 2 males; in MTG 3.9%, 2 females and 8 males, and in UTG 4.4%, 7 females and 1 male.

Conclusions

Our data confirm previous reports on the frequency of thyroid cancer in hyperthyroidism. This association is more relevant than previously suspected. The frequent coexistence of hyperthyroidism and neoplasia, demonstrated by our study and the most recent literature, underlines the importance of studying and excluding the possibility of neoplastic degeneration by means of a systematic approach.
Clinical Relevance of Tumor Ploidy and Micronucleus Formation for Oral Cavity Cancer
Authors: Kolotas Christos , Tonus Carolin , Baltas Dimos , Cernea Marianne , Vogt Hans-Georg , Martin Thomas , Strassmann Gerd , Zamboglou Nikolaos
Published: April 2018

Aims and Background

To study the clinical relevance of tumor ploidy and micronucleus formation as prognostic factors.

Methods and Study Design

Twenty-eight patients with squamous cell carcinoma of the oral cavity were treated with primary radiochemotherapy consisting of irradiation up to 70 Gy in combination with cisplatin. Cell cycle distribution, micronucleus formation and ploidy were evaluated by flow cytometry of biopsies taken before treatment and after irradiation to 10 Gy (5 × 2 Gy). Sexteen out of 28 patients relapsed after a minimum follow-up period of two years.

Results

Flow cytometry of the recurrence biopsy showed hyperpentaploid (5c exceeding) cells in 13/16 (81%) of the relapsed patients. In 7 patients the hyperploid clone was not present in the flow cytometry of the primary tumors. Ploidy could retrospectively be determined also by image cytometry in archival tumor material of the pretreatment specimens. Patients with a level below 100 5c cells per 10,000 cell nuclei were shown to have a significantly better prognosis than patients with more than 100 hyperpentaploid tumor cells. The micronucleus formation was 2-5 times higher in tumors showing a good response to treatment than in carcinomas relapsing within two years.

Conclusions

The 5c-exceeding ratio measured by image cytometry and micronucleus formation proved to be good prognostic parameters for the clinical outcome of patients with locally advanced head and neck carcinomas.
Endoscopic Treatment of Carpet-Like Adenomas of the Rectum
Authors: Spinelli Pasquale , Calarco Giuseppe , Gallo Cirino , Rigante Antonella , Schicchi Angelo Aldo
Published: April 2018

Background

Transanal microsurgery, endoscopic laser photocoagulation and snare resection have all been used to treat large sessile adenomas of the rectum alternatively to a surgical approach. However, such modalities are often defective due to the carpet-like shape and the frequently large extension of the lesions.

Methods

Ten patients with carpet-like adenoma were submitted to transanal endoscopic resection by urological resectoscope.

Results

Complete eradication was obtained in all lesions. The mean number of treatment sessions was 3 (range, 1-5). The mean time between the first treatment and the complete eradication was 6 months (range, 1-18). The only complications were an intraoperative and an early postoperative bleeding. There was no early or late mortality related to the procedure.

Conclusions

Transanal endoscopic resection by urological resectoscope appears to be a suitable therapeutic approach for sessile and carpet-like adenomas of the rectum or for pTI cancer in patients who refuse major surgery.
A Case of Primary Small Cell Carcinoma of the Cervical Esophagus with Long-term Survival following Concurrent Chemoradiotherapy: Case Report and Review of the Literature
Authors: Hama Yukihiro , Uematsu Minoru , Ichikura Takashi , Tamura Etsuyo , Aida Shinsuke , Kohno Masashi , Kusano Shoichi
Published: April 2018

The authors describe a case of small cell carcinoma of the esophagus that was treated by concurrent chemoradiotherapy. Both the esophageal tumor and the regional lymph node metastases disappeared after this treatment. The patient is alive and disease free after more than five years.

Primary small cell carcinoma of the esophagus is a rare and aggressive neoplasm with a very poor prognosis, and the treatment modality is controversial. This case illustrates the possibility of treating this tumor type with concurrent chemoradiotherapy.
Cancer Prevalence in Italian Cancer Registry Areas: The Itapreval Study
Authors: Micheli Andrea , Francisci Silvia , Krogh Vittorio , Rossi Annia Giorgi , Crosignani Paolo ,   The ITAPREVAL WORKING GROUP: Project Co-ordination, Data Management and Analysis: A Micheli (Project Leader), Gatta G , Sant M , Rossi A Giorgi , Francisci S , Saltarelli S , Dell'Era L , Gasparre N , Verdecchia A , Capocaccia R , Mariotto A , Dally L , Corazziari I ,   Composition of group, Conti E , Ramazzotti V , Caperle M , Vercelli M , Caselli C , Parodi S , Crosignani P , Tagliabue G , Berrino F , Federico M , Mangone L , Santacroce M , de Leon M Ponz , Roncucci L , Benatti P , Zanetti R , Rosso S , Patriarca S , Falchi F , Milandri C , Vattiato R , De Lisi V , Serventi L , Barili A , Gafà L , Tumino R , La Rosa E , Barchielli A , Balzi D , Crocetti E , Paci E , Guzzinati S , Simonato L , Bovo E
Published: April 2018

Aim

To present data on cancer prevalence for the areas covered by Italian cancer registries, by using a standardized set of data collection and elaboration criteria, and a single method of data analysis.

Subjects and Methods

Data on over 250,000 patients with cancer, diagnosed between 1978 and 1992, from 11 Italian cancer registries covering about 12% of the Italian population were collected, validated and analyzed according to the unified protocol of the ITAPREVAL project. The method implemented in the PREVAL computer program was used to provide prevalence estimates for the period covered by cancer registration. The total prevalence for each registry and for the pool of all registries was then estimated by correcting for incomplete observations due to the period in which the registration was not yet activated. All prevalence estimates were for 1992.

Results

Prevalence figures are presented by cancer site, age, sex, years from diagnosis and registry area. For all malignancies combined, total prevalence ranged from 1,350 per 100,000 inhabitants in Ragusa to 3,650 per 100,000 inhabitants in Romagna, the ratio between these two extremes being 2.7. For the pool of the areas covered by registration cancer prevalence was 3,100 per 100,000 females and 2,250 per 100,000 males. About a third of the total female cases and about half the male cases were diagnosed in the previous five years. Among those aged over 75 years, total prevalence was higher for males than for females: 11,300 versus 8,900 per 100,000 respectively.

Conclusions

This is the first large-scale estimate of the burden of cancer in Italy. It is also one of the first studies in the world which was aimed to study cancer prevalence in detail. These data are necessary for predicting health service needs and help in the evaluation of differences in health service demand by sex, age and Italian regions.
The Prevalence of Colorectal Cancer in Italy
Authors: Gatta Gemma , Francisci Silvia , De Leon Maurizio Ponz
Published: April 2018

Aims

To analyze the prevalence of colorectal cancer (CRC) in different areas of Italy by age, interval since diagnosis and disease stage at diagnosis, and to estimate the prevalence of CRC. These data provide estimates of patient demand on health resources.

Patients and Methods

Eleven Italian cancer registries (CRs) provided data on 33,740 patients observed for up to 15 years. For the 1,829 cases from the specialized colorectal cancer registry of Modena we analyzed prevalence by Dukes’ stage and family history. PREVAL software produced observed prevalence figures by time from diagnosis; to determine the total prevalence, correction factors were applied to the observed data.

Results

At the end of 1992, five-year CRC prevalence was high (close to 200 per 100,000) in Genova, Parma, Romagna and Firenze, and low (around 75 per 100,000) in the southern areas of Latina and Ragusa. For all CRs, 86 patients per 100,000 population were alive up to 2 years from diagnosis and 77 per 100,000 between 2 and 5 years from diagnosis. The 5-year prevalence of patients diagnosed with Dukes’ B or C (high risk of recurrence and requiring postoperative surveillance) was 152 per 100,000; that of Dukes’ A patients 36 per 100,000 (considered cured after surgery and not requiring intensive follow-up or care); that of unstaged patients plus those with distant metastasis at diagnosis was 28 per 100,000 at 5 years (requiring palliative care but not follow-up). The 12-year prevalence of HNPCC was 23 per 100,000, or about 7% of the total; for such patients knowledge of the long-term prevalence is important because they are diagnosed young and are at high risk of multiple tumor development.

Conclusions

70% of the prevalent patients diagnosed within 5 years prior to the prevalence date were likely to require care for cancer recurrence, while 13% of the prevalent cases required care for distant metastases.