bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stromal Tumors of the Stomach: A Clinicopathological Study of 15 Cases and Review of the Literature
Authors: Galateros George , Simatos George , Lakiotis Gregorios , Stathaki Martha , Volteas Spyros , Kafiri Georgia , Theologi Varvara 
Published: February 2018

Aims and Background Gastrointestinal stromal tumors are the most common mesenchymal tumors of the digestive tract, although their incidence is low. These tumors make up a unique entity based on their molecular pathogenesis, immunohistochemical staining and responsiveness to targeted therapy. Gastrointestinal stromal tumors vary in malignant potential ranging from small incidentally detected tumors with an excellent outcome to aggressive sarcomas. Their optimal diagnostic approach and treatment remain a matter of debate. We present our experience in this rapidly moving field. Methods We present our experience on 15 patients presented during a 5-year period (June 2000-September 2005) with gastrointestinal stromal tumors located in the stomach. Results Upper gastrointestinal endoscopy and CT scan revealed the tumors in all cases. All patients underwent curative surgery. A definitive diagnosis was established after surgery. Conclusions Although an inverse correlation between level of risk and survival of patients with gastrointestinal stromal tumors has been observed, 6 of our patients with an intermediate risk of recurrence had a favorable outcome.
RNA Interference-Mediated Silencing of the Hsp70 Gene Inhibits Human Gastric Cancer Cell Growth and Induces Apoptosis in Vitro and in Vivo
Authors: Xiang Ting-Xiu , Li Yan , Jiang Zheng , Huang Ai-Long , Luo Cong , Zhan Bin , Wang Pi-Long , Tao Xiao-Hong 
Published: February 2018

Aims and Background The role of heat shock protein (HSP) 70 in gastric cancer has been extensively examined in many studies for the past decade. It has been demonstrated that over-expression of Hsp70 might play important role in malignant transformation and maintenance of malignant phenotypes. Therefore, silencing the Hsp70 gene could be applicable in molecular therapies of human gastric cancer. Herein, we designed a small interfering RNA targeting Hsp70 to knock down its expression and investigated its effect on cell proliferation and apoptosis in a gastric cancer cell line. Methods Two plasmids (phsp1-siRNA, phsp2-siRNA), along with a negative control (phsp3-siRNA), were created using a genic recombination technique. BGC823 cell lines were used to perform experiments. Western blotting and RT-PCR were used to detect Hsp70 expression in vitro and in vivo. Cell morphology was observed under light microscope. Cell cycle and apoptosis were analyzed by flow cytometry and acridine orange/ethidium bromide double stain, and cell proliferative activity was measured by alamarblue assay. In all experiments, a negative control served as a baseline measure. Results We successfully constructed phsps-siRNA plasmids and transfected them into BGC823 cells. RT-PCR and western blotting revealed that the expression of Hsp70 was down-regulated in transfection groups compared with the control group. Flow cytometric analysis indicated that less S-phase fraction accumulated in small interfering RNA transfected cells than in parental cells and the cells transfected with empty vector. Conclusions Our results demonstrated that RNAi against Hsp70 could effectively knock down gene expression, inhibit growth of cancer cells, induce cell cycle arrest and increase cell apoptosis in vitro and in vivo. Hsp70 might serve as a therapeutic target for human gastric cancer.
5-HTTLPR Polymorphism of Serotonin Transporter and Effects of Sertraline in Terminally Ill Cancer Patients: Report of Eleven Cases
Authors: Schillani Giulia , Capozzo Maria Anna , Aguglia Eugenio , De Vanna Maurizio , Grassi Luigi , Conte Maria Anna , Giraldi Tullio 
Published: February 2018

Depression is difficult to detect in cancer patients, though its determination offers an opportunity to relieve patients’ suffering in palliative care. Selective serotonin reuptake inhibitors (SSRIs) are the treatment of choice for mood disorders, but they show a highly variable response. The short allelic variants “s/s” and “s/l” of the 5-HTTLPR polymorphism in the promoter region of the serotonin transporter gene has been consistently associated with a poorer response to SSRIs. The aim of this study has therefore been to examine depression, anxiety and mental adaptation to cancer in terminally ill and depressed cancer patients, in relation to treatment with sertraline and to the 5-HTTLPR genetic polymorphism. Eleven consecutive depressed patients with different forms of advanced cancer who were admitted to the Hospice of the Casa di Cura “Pineta del Carso” (Trieste, Italy) were treated with sertraline for two weeks and their response was determined and related to 5-HTTLPR. Sertraline significantly reduced the average depression and anxiety subscale scores of HADS, as well as the scores of the subscales of Mini-MAC. When the effects of sertraline were analyzed in relation to the 5-HTTLPR polymorphism, only patients with the “l/l” allelic variant had significantly lower scores of HADS anxiety, Mini-MAC hopelessness-helplessness and anxious preoccupation, and a higher score for the fighting spirit of Mini-MAC; the depression score was significantly reduced in patients with both allelic variants. These data indicate that sertraline is effective after two weeks of treatment in terminally ill cancer patients, acting not only on depression but also on anxiety and mental adaptation to cancer. Moreover, the effect of sertraline significantly depended on the genetic polymorphism of the serotonin transporter, being more pronounced in patients carrying the “l/l” genetic variant; these findings seem to encourage the examination of a larger sample of patients.
Hepatogastric Inflammatory Pseudotumor Presumably Deriving from Prior Amebic Infection
Authors: Alfieri Rita , Alaggio Rita , Ruol Alberto , Castoro Carlo , Cagol Matteo , Michieletto Silvia , Pomerri Fabio , Acquaviva Antonio , Ancona Ermanno 
Published: February 2018

Introduction Inflammatory pseudotumor is a rare entity with a clinical and radiographic presentation that is difficult to differentiate from malignancy. This is a case report of a large hepatogastric inflammatory pseudotumor that presumably developed from a prior amebic pseudocyst. Case Report A 14-year-old boy presented with increasing vomiting, epigastric pain, dysphagia, asthenia and weight loss. The clinical history included an amebic infection at the age of 2 months. Instrumental investigations revealed an 8 x 6 cm left subdiaphragmatic mass inseparable from the gastric fundus, which appeared to infiltrate the left hepatic lobe. Surgery disclosed a bulky mass adhering to the gastric fundus and left hepatic lobe that prompted total gastrectomy, resection of the second and third hepatic segments, and Roux-en-Y esophagojejunal loop anastomosis. Histology subsequently confirmed that this was a pseudocyst with a large calcified nucleus surrounded by myofibroblastic proliferation associated with a diffuse lymphoplasmacytic infiltrate affecting the gastric wall and hepatic parenchyma, hence the final diagnosis of inflammatory pseudotumor, presumably in response to a prior amebic pseudocyst. Conclusions Inflammatory pseudotumor is a rare entity that is seldom found in the stomach. The particular interest of the present case lies in the fact that it developed in the stomach and liver, presumably deriving from a previous amebic pseudocyst.
Carboplatin and oral cyclophosphamide combination after temozolomide failure in malignant gliomas
Authors:   Mustafa Benekli for the Anatolian Society of Medical Oncology (ASMO), Yaman Emel , Buyukberber Suleyman , Uner Aytug , Coskun Ugur , Yamac Deniz , Ozturk Banu , Kaya Ali Osman , Yildiz Ramazan 
Published: February 2018

Background Temozolomide is a novel cytotoxic agent for malignant gliomas. However, treatment failure occurs approximately in half of patients, and the optimal regimen in this setting has yet to be defined. In the present study, we assessed retrospectively the efficacy and toxicity of the combination of carboplatin and oral cyclophosphamide in temozolomide-resistant patients. Methods We evaluated the medical records of 30 patients with malignant gliomas. After failure of temozolomide therapy, patients were treated with a combination of carboplatin and oral cyclophosphamide. Treatment consisted of intravenous carboplatin AUC 6 (based on the Calvert Formula) on day 1 and oral cyclophosphamide 75 mg/m2 daily on days 1 to 14, followed by 14 days of rest, with the treatment repeated every 4 weeks. Results All patients were evaluated for response and toxicity. The objective response rate was 30%, including 9 partial responses. Median time to disease progression and median overall survival was 7 months and 8 months, respectively. Clinically responsive patients had statistically significant longer progression-free survival and overall survival than unresponsive patients. Hematological side effects were commonly observed toxicities, with neutropenia the most frequent. Conclusions Our data suggest that carboplatin and oral cyclophosphamide therapy is a convenient regimen after failure of temozolomide therapy in patients with malignant gliomas because of its activity, feasibility and tolerability. Further prospective studies are needed in this setting.
Disease Presentation and Outcome in Very Young Patients with Brain Metastases from Breast Cancer
Authors: Nieder Carsten , Astner Sabrina T , Andratschke Nicolaus H , Adam Markus 
Published: February 2018

Aims and background Little information is available on disease presentation and treatment outcome in very young patients with brain metastases from breast cancer. Therefore, we evaluated our results in this group. Methods In our database, 7/74 breast cancer patients treated for brain metastases were <40 years old. All received whole-brain radiation therapy plus individual local or systemic measures. Results In patients with information available, tumors were poorly differentiated and metastatic to the axillary lymph nodes at primary diagnosis. All patients had extracranial metastases. Two died from their brain disease within 5 months. Five patients died from extracranial progression after 3–84 months (2 long-term survivors beyond 2 years, characterized by single brain lesions and high performance status). Conclusions Very young patients did not achieve a better outcome than intermediate age groups. Whole-brain radiation therapy plus surgery or radiosurgery provided durable CNS control in most of the patients. Improved systemic therapy appears to represent the key to a better outcome.
The Porta Hepatis as a Site of Recurrence of Mucinous Appendiceal Neoplasms Treated by Cytoreductive Surgery and Perioperative Intraperitoneal Chemotherapy
Authors: Sugarbaker Paul H , Bijelic Lana 
Published: February 2018

Background A successful new treatment for a particular disease may change the natural history of that disease as patients go on to longer survival. The goal of this study was to investigate the porta hepatis as a site of recurrence of appendiceal mucinous neoplasms. Methods A prospective database on patients with peritoneal dissemination of mucinous appendiceal neoplasms has been maintained for 21 years. In patients with complete cytoreduction, disease progression/recurrence in and around the porta hepatis has been noted as a new manifestation of this disease. Results In 710 patients treated for mucinous appendiceal cancer with a complete cytoreduction, 140 developed recurrent disease. Seven patients (5%) had disease recurrence in and around the porta hepatis. Four of the seven had biliary obstruction and three had masses within the liver hilum not causing bile duct obstruction. Four of the seven patients were successfully palliated by surgical procedures within the liver and biliary tree. Two patients were successfully palliated using a biliary stent and one patient was not treated. Conclusions Progression of mucinous neoplasms within the porta hepatis may be related to imperfect cytoreduction technique. Reoperative surgical treatment and biliary stents were beneficial in some of these patients.
Effect of Treatment on Mononuclear Cell Migration in Cervical Cancer Patients
Authors: Garcia Cristiana Bernadelli , Fernandes Paulo Cesar , Micheli Douglas Côbo , Pereira Ana Helena Macedo , Murta Eddie Fernando Candido , Tavares-Murta Beatriz Martins 
Published: February 2018

Aims and background Our aim was to evaluate the effect of treatment on the in vitro migration of circulating mononuclear cells in cervical cancer patients at different stages. Methods We prospectively investigated 24 patients with cervical neoplasia, without prior treatment, submitted to surgery or chemotherapy as therapeutic conduct. Controls were healthy volunteer women (n = 23). Mononuclear cells were isolated from peripheral venous blood before and after treatment, and their migration capacity was evaluated in a microchemotaxis chamber assay towards the chemotactic stimuli fMLP, MCP-1 and RANTES, compared to basal migration. Serum levels of nitric oxide metabolites were assayed by the Griess reaction. Results Increased mononuclear cell migration in response to the chemotactic stimuli, compared to basal migration, was observed in controls and patients, without differences between them. After treatment (n = 14), mononuclear cell migration in response to MCP-1 and RANTES was increased compared to pre-treatment. Serum levels of nitric oxide metabolites were more elevated in patients (n = 19) than in controls (n = 17), but decreased after treatment (n = 15). Conclusions The results suggest that the production of soluble circulating factors by tumor cells could interfere with the functional activity of blood mononuclear cells.
Primary Duodenal Adenocarcinoma
Authors: Solej Mario , D'Amico Silvia , Brondino Gabriele , Ferronato Marco , Nano Mario 
Published: February 2018

Aims and Background Primary duodenal adenocarcinoma is a rare tumor with a poorly defined natural history and prognostic factors. It presents with nonspecific symptoms, and for this reason the diagnosis is often delayed. It is a serious problem for the surgeon because of the difficulty in obtaining an early diagnosis and standardizing basic tenets for an appropriate surgical approach. The aim of this work was to conduct a review of the literature analyzing the points most frequently debated about this pathology. Methods and Study Design A bibliographic search was carried out on the main search engines to find studies regarding duodenal adenocarcinoma, published in English, from January 1992 to January 2007. Results A total of 19 articles was selected. Results concerning symptoms, location of the tumor, diagnostic examinations, surgical treatment, histopathology of the tumor, survival and follow-up were obtained and discussed. Conclusions All patients who are medically fit to undergo surgery should be given the option of aggressive resection regardless of tumor size, tumor invasion or appearance of positive lymph nodes. Hopefully, an early diagnosis will correlate with improved long-term survival.
Videoconferencing to Enhance the Integration between Clinical Medicine and Teaching: A Feasibility Study
Authors: Morganti Alessio G , Pasquarelli Lino , Deodato Francesco , Digesù Cinzia , Di Falco Carlo , Dinapoli Nicola , Macchia Gabriella , Picardi Vincenzo , Tagliaferri Luca , Valentini Vincenzo , Cellini Numa 
Published: February 2018

Aims and Background The aim of the study was to analyze the feasibility of a setting up of a radiotherapy department using videoconferencing technology. Material and Methods A videoconferencing network was started to link an academic center of radiotherapy to a peripheral center of research at the start of its activity. Two years of data of involved professionals, subjects of links, audio, video link problems and running costs were recorded. Results A total of 418 links was established for an overall duration of 458 hours. The participants included all departmental staff. Videoconferencing involved teaching, ward organization, medical care and scientific subjects. In the second year of experience, the number of videoconferencing links was higher than the first (232 vs 186). Link times were reasonable for both skilled and unskilled operators. Overall, the cost per minute of link was 0.2 Euro, and the mean cost per link was 13 Euros. Videoconferencing was integrated with fax and computer networks to enhance sharing paper and electronic documents. Audio-video technical problems progressively decreased: the link was definitively interrupted or its activation unfeasible in only 1.0% of cases. Conclusions Our experience suggests that the establishment of a link between radiotherapy departments addressed to these aims is feasible by a videoconferencing network.
Uterine Leiomyosarcoma Metastatic to the Brain: Case Report
Authors: Melone Graziella Angelina , D'Elia Alessandro , Brogna Christian , Salvati Maurizio 
Published: February 2018

Background We report a leiomyosarcoma of the uterus, an uncommon tumor with a very aggressive course and poor prognosis due to the fact that, despite complete resection, it recurs with micrometastases. The most common metastatic sites are the lung, intraperitoneal, pelvic and paraaortic lymph nodes, and liver. Brain and skull metastases are very rare. Case A 57-year-old woman underwent a hysterectomy and bilateral salpingo-oophorectomy for a grade T2N0M0 uterine leiomyosarcoma. There was no evidence of other lesions. Three months later a total-body PET scan demonstrated the presence of metastases in both lungs, and the patient was started on chemotherapy. One year later a cranial MRI demonstrated a brain metastasis to the temporal lobe. Emergency complete resection of the recurrence was performed, followed by whole-brain radiation and adjuvant chemotherapy. Conclusions Given the limited treatment options, the gold standard for uterine leiomyosarcoma brain metastasis is total surgical removal. Chemotherapy and radiation therapy may provide only palliative benefit.
Estimates of the Incidence and Prevalence of Renal Cell Carcinoma in Italy in 2002 and Projections for the Years 2007 and 2012
Authors: Bosetti Cristina , Bianchi Cosetta , Negri Eva , La Vecchia Carlo 
Published: February 2018

Aims and background Data on kidney cancer incidence and prevalence are not available on a national and regional level. We provided estimates of the number of incident and prevalent cases of kidney and renal cell cancer in Italy overall and in various regions in 2002 and gave projections for the years 2007 and 2012. Methods We derived annual numbers of incident cases combining mortality data provided by the World Health Organization and information on relative survival from kidney cancer and we subsequently derived 5-year prevalence by combining incidence with information on survival. We provided different projection estimates for the years 2007 and 2012 for incidence and prevalence, on the basis of various hypothetical scenarios, i.e., stable rates over time or steady falls by 1% per year. Results In 2002, there were about 8000 incident cases and 26,800 prevalent cases of kidney cancer in Italy. Of these, approximately 6800 and 22,750 were incident and prevalent cases of renal cell cancer, respectively. The most reliable estimate of incident kidney cancer cases in Italy over the period 2007–2012 is likely to range between 7000 and 9000. Of these, between 6000 and 8000 are renal cell cancer cases. The best estimate of prevalence of kidney cancer is between 20,000 and 34,000 cases and that of renal cell cancer between 17,000 and 29,000 cases. Conclusions Incidence and prevalence of renal cell cancer are likely to remain approximately stable between 2002 and 2007. Increased diagnostic attention due to widespread use of echography and other diagnostic techniques may, however, lead to earlier detection of kidney neoplasms and consequently to an apparent increase in the incidence of renal cell cancer.
Conformal Radiotherapy of Clinically Localized Prostate Cancer: Analysis of Rectal and Urinary Toxicity and Correlation with Dose-Volume Parameters
Authors: Ballare Andrea , Di Salvo Maurizio , Loi Gianfranco , Ferrari Gianmarco , Beldì Debora , Krengli Marco 
Published: February 2018

Aims and background Rectal and urinary toxicities are the principal limiting factors in delivering a high target dose to patients affected by prostate cancer. The verification of such toxicity is an important step before starting a dose-escalation program. The present observational study reports on the acute and late rectal and urinary toxicity in relation with dose-volume parameters in 104 patients with localized prostate cancer treated with 3-dimensional conformal radiation therapy. Methods and study design One hundred and four patients with stage T1b-T3b prostate cancer were treated with three-dimensional conformal radiation therapy to a total dose of 74 Gy, 2 Gy per fraction. Rigid dose constraints were applied for rectum and bladder. Acute and late rectal and urinary toxicities were analyzed also in relation to dose-volume histograms. Biochemical relapse-free survival was defined according to the American Society of Therapeutic Radiation Oncology (ASTRO) criteria and to the RTOG-ASTRO Phoenix Consensus Conference Recommendations using the Kaplan-Meier method. Results No grade 3 toxicity was observed. Acute and late grade 2 toxicity rates were 5.8% and 9.0% for rectum and 12.5% and 2.0% for bladder, respectively. Rectal V70 influenced the occurrence of late grade 2 toxicity. A relationship between acute and late urinary toxicity was also found. After a median follow-up of 30 months (range, 20–50), the actuarial overall and biochemical relapse-free survival rates were 84% and 77%, respectively, with a significant difference between low-intermediate and high-risk patients. Conclusions Conformal radiotherapy to the dose of 74 Gy was administered with good compliance. The incidence of acute and late toxicity was relatively low in accord with our dose constraints. Rectal V70 proved to be a reliable prognosticator of late toxicity. Overall survival and biochemical relapse-free survival rates were more favorable for low and intermediate-risk and significantly less favorable for high-risk patients.
Molecularly Targeted Therapy and Radiotherapy in the Management of Localized Gastrointestinal Stromal Tumor (GIST) of the Rectum: A Case Report
Authors: Ciresa Marzia , D'Angelillo Rolando Maria , Ramella Sara , Cellini Francesco , Gaudino Diego , Stimato Gerardina , Fiore Michele , Greco Carlo , Nudo Raffaele , Trodella Lucio 
Published: February 2018

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the gastrointestinal tract. The main treatment for localized gastrointestinal stromal tumors is surgical resection. These tumors respond poorly to conventional cytotoxic chemotherapy agents and to radiotherapy. Imatinib mesylate, a small-molecule kinase inhibitor, has proved useful in the treatment of recurrent or metastatic GISTs and is now being tested in the adjuvant and neoadjuvant setting. The role of radiotherapy in the management of patients with GIST is currently restricted to symptomatic palliation. We present the case of a 54-year-old man affected by rectal GIST extending to the anal canal, with constipation, hematochezia, and anal pain. He received imatinib, 400 mg orally per day, for a week before and during radiation therapy. Irradiation was delivered to the gross tumor volume by 3D conformal therapy. The planned total dose was 50.4 Gy in fractions of 1.8 Gy daily. We observed a partial clinical response 3 weeks after the end of combination treatment. The patient then underwent a sphincter-saving surgical procedure. There was no perioperative morbidity and a complete pathological response was obtained. At the present time, the role of radiotherapy in the management of patients with GIST is restricted to symptomatic palliation. The introduction of molecularly targeted therapy combined with radiation therapy could improve the outcomes for patients diagnosed with GIST.