bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors Related to Recurrence after Pathological Complete Response to Postoperative Chemotherapy in Patients with Epithelial Ovarian Cancer
Authors: Karagol Hakan , Saip Pinar , Eralp Yesim , Topuz Samet , Berkman Sinan , Ilhan Ridvan , Topuz Erkan 
Published: February 2018

Aims and background It has been appreciated for some time that the lack of detection of ovarian cancer at clinical and pathological (second-look laparotomy) evaluation is not synonymous with cure. The goal of this study was to define clinical risk factors for recurrence after complete pathological response to postoperative chemotherapy in patients with epithelial ovarian cancer. Methods Fifty-seven patients who met the inclusion criteria of our study were evaluated. The characteristics (age, menopausal status, histological subtype, tumor grade, presence of ascites at diagnosis, type of omentectomy, FIGO stage, and residual tumor volume after primary surgery) of patients with and those without tumor recurrence were compared. Results The median follow-up was 52 months (range, 15–142 months). The overall survival rates of the patients were 100%, 96%, and 87% at 1, 3 and 5 years, respectively. At the time of the study analysis, 21 of 57 (37%) patients had recurrent disease. The median time to recurrence was 16 months. Recurrences were most frequent in the pelvis and abdominal cavity (38%). Age, menopausal status, stage at diagnosis, and residual tumor volume after initial surgery were significantly related to the risk of recurrence in univariate analysis (P = 0.039, 0.038, 0.004, and 0.000, respectively). Residual tumor volume after initial surgery was found to be the only significant independent prognostic factor (P = 0.049, HR: 0.16, 95% CI: 0.02–0.99). Conclusion We believe it is necessary to conduct randomized studies on this issue because insight into predictors of recurrence after pathological complete response to postoperative chemotherapy could be used to select patients for trials of consolidation therapy.
Tobacco Sales to Minors in Italy
Authors: Gallus Silvano , Tramacere Irene , Zuccaro Piergiorgio , Colombo Paolo , La Vecchia Carlo 
Published: February 2018

Aims and background One of the strategies to control tobacco is to limit purchase of cigarettes to minors. To understand the attitudes of Italian adults towards regulations to prevent minors from purchasing tobacco products, we added specific questions to the annual survey on smoking in Italy. Methods During March-April 2007, we conducted a survey on smoking on 3,057 subjects representative of the Italian population aged ≥15 years. Two specific questions were included, one investigating the attitudes towards the proposed legislation prohibiting purchase of tobacco to individuals under 18 years of age (instead of 16 years) as a policy to reduce smoking prevalence and consumption. The second question asked whether the current tobacco sales-to-minors law was observed. Results Overall, 78% of Italians believed that a restriction of the current tobacco sales-to-minors law could be moderately to extremely effective as a strategy to decrease smoking prevalence and consumption. More than 90% of Italians reported that they had never seen in their lifetime a retailer refusing to sell cigarettes to an adolescent or requesting the minor's identification or age. Conclusions A restriction of the legislation, increasing to 18 years the minimum age for purchasing tobacco, would limit access to tobacco products by minors, only if adopted together with systematic and effective enforcement measures.
Prognosis of Acute Myeloid Leukemia in the General Population: Data from Southern Switzerland
Authors: Lerch Erika , Espeli Vittoria , Zucca Emanuele , Leoncini Leda , Scali Giancarlo , Mora Oreste , Bordoni Andrea , Cavalli Franco , Ghielmini Michele 
Published: February 2018

Aims and background To evaluate the outcome of adult patients with de novo acute myeloid leukemia in the Italian-speaking part of Switzerland and to identify prognostic factors, time to progression and overall survival. Methods and study design Data of all adult patients diagnosed with acute myeloid leukemia from January 1984 to December 2003 were collected retrospectively. Univariate and multivariate analysis for time to progression and overall survival were performed. Results The incidence of acute myeloid leukemia in the adult population in southern Switzerland is 2.6/100,000 per year. Complete clinical and pathological data and follow-up information were available for 128 patients. The median age was 67 years (range, 18 to 94). The median follow-up was 97 months. Median overall survival was 6 months, with a 2-year overall survival of 16%. Median time to progression was 3 months. Thirty-five patients (median age, 80 years) were given best supportive care and/or palliative chemotherapy. The median survival in this subset was 2 months. Of the 93 patients treated with a curative intent, 48 were older than 60 years. The complete remission rate after induction chemotherapy was 80% for patients younger than 60 years and 31% for those older than 60 years (P <0.0001). Overall survival at 2 years was 40% and 12%, respectively (P <0.0005). The relapse rate was 61%, and only 28% of the patients who were given reinduction chemotherapy reached a second complete remission. Of the patients treated with curative intent, 52% were treated in a clinical trial. Their median age was significantly lower than those not included in a trial: 57 vs 66 years (P <00001). Patients treated in a trial had a significantly better prognosis than those not so treated (median survival, 12 vs 6 months). Patients treated with high-dose cytarabine as first-line therapy (given to 25 of 93 patients treated with a curative intent) had a better survival than those given standard cytarabine doses (P <0.0005). The outcome of the patients treated after 1993 was significantly better (P = 0.026) than that of the previously treated cohort. In multivariate analysis (not including cytogenetic data), only age (P = 0.005), performance status >1 (P = 0.001) and treatment given before/after 1993 (P = 0.044) were found to be independent prognostic factors for both overall survival and time to progression. Conclusions Most patients with acute myeloid leukemia are older than 60 years, and their outcome is still disappointing. For younger patients, the prognosis is better if they receive high-dose cytarabine as post-remission therapy and if they are treated in the setting of a clinical trial.
The Challenge of Culturing Human Colorectal Tumor Cells: Establishment of a Cell Culture Model by the Comparison of Different Methodological Approaches
Authors: Failli Alessandra , Consolini Rita , Legitimo Annalisa , Spisni Roberto , Castagna Maura , Romanini Antonella , Crimaldi Gaetano , Miccoli Paolo 
Published: February 2018

Background Because colorectal cancer is a significant cause of morbidity and mortality in the Western population, knowledge of the molecular and biological alterations associated with its development is important. Since primary human colon cancer cultures from fresh tumor tissue are technically difficult to obtain, experiments in most laboratories are performed on colon epithelial cell lines, but these represent just one stage of tumor progression. Only primary cultures of neoplastic colonocytes may reflect the actual responsiveness of tumors at certain developmental stages to antitumor agents. Methods This paper analyzes several critical points concerning primary cultures, ranging from cell isolation to culture conditions, and compares different methodological approaches to isolate and cultivate a pure fraction of viable tumor cells. Samples of resected colorectal cancers were collected from 20 patients (stage T3 or T4). We compared in vitro several approaches of tissue disaggregation including mechanical disaggregation and enzymatic dissociation with trypsin or collagenase. Isolated cells were maintained in a short-term serum-free culture system. Evaluation of the purity and tumoral nature of isolated cells was performed by immunochemistry. Results We established the antibiotic concentration necessary during transport and washing of the specimens to prevent microbial overgrowth. We demonstrated that the number of viable cells was dependent on the dissociation method used. Mechanical disaggregation is not a valid dissociation method because of the high mortality of cells and might be used only in samples for molecular analysis. Comparison of the enzymatic digestion procedures showed that digestion with trypsin allowed the highest recovery of viable cells. Conclusion In this paper we analyzed several critical aspects of cell culture procedures and designed a methodological approach suitable for functional studies of colorectal cancer.
Surgery and Radiotherapy in the Treatment of Malignant Parotid Tumors: A Retrospective Multicenter Study
Authors: Nagliati Michele , Bolner Andrea , Vanoni Valentina , Tomio Luigi , Lay Giancarlo , Murtas Rita , Deidda Maria Assunta , Madeddu Angela , Delmastro Elena , Verna Roberta , Gabriele Pietro , Amichetti Maurizio 
Published: February 2018

Aims and background Major salivary gland cancers are rare, with many histologic types and subtypes. The low incidence and heterogeneity of primary parotid carcinomas makes their outcome difficult to evaluate. Treatment remains primarily surgical, but optimal therapeutic regimens have yet to be fully realized. The present study reviews the experience of three Italian institutions in the treatment of primary parotid carcinomas in order to describe the clinicopathological presentation and treatment options with emphasis on radiotherapy and to analyze the factors influencing survival. Methods and study design The records of 110 patients with primary parotid neoplastic lesions treated at three Italian institutions from 1993 to 2004 were retrospectively reviewed. Six patients were excluded from the study: 3 received surgery alone and 3 were not assessable, for a total of 104 assessable patients. Acute and late toxicity of radiotherapy was quantified following the recommendations of the RTOG/EORTC. Survival was analyzed by the actuarial Kaplan-Meier product-limit method. The influence of selected factors on 10-year disease-specific survival was analyzed. Results The 104 assessable patients were treated as follows: 11 patients received radiotherapy as their only treatment (3 with a palliative purpose) and 93 had postoperative radiotherapy. Thirty-two patients underwent neck dissection: neck lymph node metastases were found in all them. Their mean age was 60 years (range, 14–92). According to the UICC/2002 TNM Classification, 8 patients were stage I, 19 stage II, 34 stage III, 25 stage IVA, 5 stage IVB, 3 recurrent and 10 not assessable (Tx). The most frequent histologies were adenoid cystic carcinoma (n = 16), mucoepidermoid carcinoma (n = 15), and acinic cell carcinoma (n = 15). Twenty-three patients had recurrences: 10 had local recurrences, 3 neck recurrences, 9 distant metastases, and 1 patient had both local recurrence and distant metastases. No factors were observed that would negatively influence the prognosis. Actuarial 10-year disease-specific survival was 71% and actuarial 10-year local control 82%. Conclusions The treatment of salivary gland malignancies remains primarily surgical. Our study confirms the results of the literature with surgery and adjunctive radiotherapy in patients with advanced-stage disease. No variables were observed to influence the prognosis.
Three-Fraction Stereotactic Body Radiation Therapy for Isolated Liver Recurrence from Colorectal Cancer
Authors: Kim Mi-Sook , Kang Jin-Kyu , Cho Chul Koo , Choi Chul Won , Seo Young Seok , Hwang Dae Yong , Moon Sun Mi , Kang Hae Jin , Kim Young Han , Kim Min Suk , Oh Nahmgun 
Published: February 2018

Aims To determine the feasibility and efficacy of 3-fraction stereotactic body radiation therapy for isolated colorectal cancer liver metastases. Materials and methods Ten patients with isolated inoperable liver metastasis from colorectal cancer with progression after salvage chemotherapy underwent stereotactic body radiation therapy. Follow-up was 7–49 months (median, 12). Six patients had a solitary lesion and 4 patients had 2 lesions. Internal target volumes of metastatic liver tumors ranged from 3.4 to 271 ml. Stereotactic body radiation therapy doses ranged from 36 to 51 Gy and were administered in three fractions. All patients demonstrated disease progression despite chemotherapy prior to stereotactic body radiation therapy. Results Three-year overall survival and local control rates were 40% and 60%, respectively. Tumors with an internal target volume <100 ml showed better local control rate than larger tumors. No severe complication was attributed to the therapy. Conclusion Our study suggests the potential feasibility of stereotactic body radiation therapy for selected patients with colorectal cancer liver metastasis and no treatment option. The study showed that excellent local control was achieved in patients with a total tumor volume of <100 ml but failed to clarify the role of stereotactic body radiation therapy for larger tumors. Further large scale studies are needed to define the indications of such therapy.
Serotonin Transporter 5-HTTLPR Polymorphism and Response to Citalopram in Terminally ill Cancer Patients: Report of Twenty-One Cases
Authors: Capozzo Maria Anna , Schillani Giulia , Aguglia Eugenio , De Vanna Maurizio , Grassi Luigi , Conte Maria Anna , Giraldi Tullio 
Published: February 2018

The aim of this study was to examine the effects of the SSRI antidepressant drug citalopram on anxiety, depression and mental adjustment to cancer in terminally ill cancer patients, considering also the 5-HTTLPR genetic polymorphism. A group of twenty-one consecutive patients admitted to the hospice of the Casa di Cura Pineta del Carso (Trieste, Italy) with different types of advanced cancer, who were clinically judged to require treatment with an antidepressive drug, was treated with citalopram for two weeks. The response was determined and related to 5-HTTLPR. Citalopram significantly reduced the scores on the depression and anxiety subscales of the Hospital Anxiety and Depression Scale (HADS). When the effects of citalopram were analyzed in relation to the 5-HTTLPR polymorphism, the HADS depression score was significantly decreased only in patients with the “l/l” allelic variant of the serotonin transporter conferring high functional activity, while the score of the Mini-MAC fatalism scale was significantly increased in patients carrying at least one “s” allele. These preliminary findings seem to indicate that two weeks of treatment with citalopram are effective in reducing depressive symptoms in terminally ill cancer patients. Moreover, the effects of citalopram on fatalism as a strategy of mental adaptation to cancer, and on depressive symptoms depend on the allelic variants of the 5-HTTLPR genotype of the patients. These results seem to encourage the examination of a larger patient sample and of different treatment schedules, as well as a more thorough characterization of fatalism as a coping strategy in cancer patients.
Loss of Heterozygosity Combined with Promoter Hypermethylation, the Main Mechanism of Human MutL Homolog (hMLH1) Gene Inactivation in Non-Small Cell Lung Cancer in a Chinese Population
Authors: Geng Xin , Wang Fei , Zhang Liang , Zhang Wei Ming 
Published: February 2018

Aims and background The mechanism of human MutL Homolog (hMLH1) gene transcriptional inactivation in non-small cell lung cancer (NSCLC) is still unclear. The aim of this study is to further investigate the main mechanism of hMLH1 gene inactivation in NSCLC samples of Chinese patients. Methods and study design This study was performed in surgically resected primary tumor and matched normal tissues from 116 NSCLC cases. The hMLH1 gene alterations examined included loss of heterozygosity (LOH) by D3S1612 locus PCR-electrophoresis-silver staining and promoter methylation by HpaII/ MspI-based PCR analysis. Loss of hMLH1 mRNA expression was analyzed by reverse transcription-polymerase chain reaction (RT-PCR) and loss of hMLH1 protein expression was studied by immunohistochemistry and Western blot. Results The frequencies of LOH and promoter hypermethylation of the hMLH1 gene were 68.1% (79/116) and 72.4% (84/116), respectively. Among the 79 hMLH1 LOH (+) cases, 68 (86.1%) showed hypermethylation, which was significantly higher than in the LOH (–) group. The frequencies of loss of hMLH1 mRNA expression and protein expression in NSCLC were 79.3% (92/116) and 76.7% (89/116), respectively. The frequency of 2-hit inactivation of hMLH1, 75.3% (67/89), by LOH combined with promoter hypermethylation was related to the loss of protein expression. Conclusions Biallelic inactivation of the hMLH1 gene by LOH combined with promoter hypermethylation is likely to cause inactivation of hMLH1 protein and to play an important role in the development of NSCLC in the Chinese population.
Pitfalls in the Diagnosis of Neuroendocrine Tumors: Atypical Clinical and Radiological Findings as Cause of Medical Mistakes
Authors: Bajetta Emilio , Catena Laura , Ducceschi Monika , Pusceddu Sara , Milione Massimo , Maccauro Marco , Bajetta Roberto , Procopio Giuseppe , Buzzoni Roberto , Formisano Barbara , Di Guardo Lorenza , Platania Marco 
Published: February 2018

Aims and background Carcinoids are infrequent neoplasms arising from neuroendocrine cells. Due to blurred symptoms and the presence of equivocal diagnostic findings, these tumors are sometimes misdiagnosed. Therefore, increased rates of false neuroendocrine tumors represent an emerging problem in clinical practice. Our aim is to alert clinicians on this matter by supplying them with useful warnings. Methods In the specialized neuroendocrine tumor study Center Centro di Riferimento per lo Studio e la Cura dei Carcinoidi e dei Tumori Neuroendocrini (Ce.Ri.Ca), some patients highly suspected to have a neuroendocrine tumor have been recognized as having false neuroendocrine tumors. The related clinical and instrumental findings leading to a previous wrong neuroendocrine tumor diagnosis are reported. Results From July 2006 to December 2008, 88 consecutive cases of neuroendocrine tumors (Nets) were referred at Ce.Ri.Ca. In the former group, 8 cases of false Nets were discovered while in the remaining 80 cases a correct Net diagnosis was carried out. Watchful differential diagnoses and skill appraisal of laboratory investigations resulted in: chronic atrophic gastritis with enterochromaffin-like cell hyperplasia (4 cases), estrogen-deprivation syndrome (1), hypochondriac disorder (1), metabolic syndrome (1), and sarcoidosis (1). Conclusions Neuroendocrine tumors are still relatively known clinical entities. To discriminate false neuroendocrine tumors from neuroendocrine tumors requires a good expertise and a large daily practice with the disease. Good knowledge and skillfulness in identifying biochemical alterations and false radiological positive results could avoid both patient inconvenience and very expensive workup. The importance of a multidisciplinary approach in specialized centers is emphasized.
Perianal Granular Cell Tumor: Report of a Case and Review of the Literature
Authors: Mistrangelo Massimiliano , Cassoni Paola , Scozzari Gitana , Castellano Isabella , Gavello Giorgia , Corno Franco , Morino Mario 
Published: February 2018

Introduction Granular cell tumor was first described by Abrikossoff in 1926. Over the years several cases of this neoplasm have been reported, with a variety of localizations. We here report a case of perianal granular cell tumor and discuss its histogenesis and its relevance to clinical practice. Methods The clinical course and histopathology of the case are reviewed, and a literature search for other reported cases has been performed. Results A 46-year-old woman presented with a perianal nodular lesion. Pathological examination revealed a granular cell tumor. A literature search produced only 25 other cases of anal and perianal granular cell tumors. Conclusions Granular cell tumors are rarely observed in the perianal region. Their existence must always be borne in mind in the differential diagnosis of perianal neoplasms. In most cases surgical excision is curative, but potential malignant transformation must be considered during therapeutic procedures and follow-up.
Adaptive Radiation Therapy in a Patient with a Massive Nodal Breast Cancer Recurrence
Authors: Trovò Marco , Drigo Annalisa , Dassie Andrea , Rumeileh Imad Abu 
Published: February 2018

Adaptive radiation therapy (ART) is the next improvement in image-guided radiation therapy (IGRT). ART consists in changing treatment delivery to compensate for changes in patient anatomy or tumor volume. The treatment planning is therefore adapted to the new target volume. By daily imaging, the tumor volume can be assessed and compared with the initial volume. In case of tumor progression or tumor response, a new plan can be obtained to adequately treat the new volume. We report the use of ART with the Plan Adaptive software of TomoTherapy Inc. in a patient with massive breast cancer recurrence in the axilla. Between the CT simulation and the first day of radiotherapy the axillary lesion progressed. Megavolt CT performed to image-guide the treatment showed impressive growth of the lesion, which went out of the treatment field. By studying the dose distribution on the new anatomy, we found that the planning target volume was substantially undercovered by the prescription dose. Adaptive planning was performed using the anatomical information acquired by the megavolt CT.
Comprehensive cancer control-research & development: knowing what we do and doing what we know
Authors: Kerner Jon F , Cazap Eduardo , Yach Derek , Pierotti Marco A , Daidone Maria Grazia , de Blasio Pasquale , Geary Peter , Schacter Brent , Sant Milena , Habbema J Dik F , Sankaranarayanan Rengaswamy , Sutcliffe Catherine , Sutcliffe Simon ,   ICCC-3 Session D group
Published: February 2018

Comprehensive cancer control is defined as an integrated and coordinated approach to reducing cancer incidence, morbidity, and mortality across the cancer control continuum from primary prevention to end-of-life care. This approach assumes that when the public sector, non-governmental organizations, academia, and the private sector share with each other their skills, knowledge, and resources, a country can take advantage of all its talents and resources to more quickly reduce the burden of cancer for all its population. One critical issue for comprehensive cancer control is the extent to which the private sector can contribute to cancer prevention and control programs and policies that have historically been lead by the public health sector, and similarly how can the public sector increase its investment and involvement in clinical research and practice issues that are largely driven by the private sector worldwide? In addition, building capacity to integrate research that is appropriate to the culture and context of the population will be important in different settings, in particular research related to cancer control interventions that have the capacity to influence outcomes. To whatever extent cancer control research is ultimately funded through the private and public sectors, if investments in research discoveries are ultimately to benefit the populations that bear the greatest burden of disease, then new approaches to integrating the lessons learned from science with the lessons learned from service (public health, clinical, and public policy) must be found to close the gap between what we know and what we do. Communities of practice for international cancer control, like the ones fostered by the first three International Cancer Control Congresses, represent an important forum for knowledge exchange opportunities to accelerate the translation of new knowledge into action to reduce the burden of cancer worldwide.