bluuebunny/crossref_metadata_2025_split huggingface dataset:
Peritoneal Carcinomatosis from an Unknown Primary Site. Management of 15 Patients
Authors: Sebbag Gilbert , Shmookler Barry M , Chang David , Sugarbaker Paul H 
Published: April 2018

Aims and background Peritoneal carcinomatosis from an unknown primary site is a rare and ill-defined entity. This work attempts to identify clinical and pathological features of patients with this disease and report the results of an aggressive combined treatment modality. Methods Retrospective analysis was performed of medical records of 15 patients with peritoneal carcinomatosis with no primary site identified at a single institution between 1989 and 2000. A primary gastrointestinal cancer was ruled out after a thorough endoscopic and radiologic work-up and complete exploratory surgery. Results Four women and 11 men were identified; the average age was 49 years. All patients had cytoreductive surgery with peritonectomies; 4 patients underwent a second-look operation. Perioperative intraperitoneal chemotherapy was given to 10 of the 15 patients, and 9 patients received post-cytoreduction chemotherapy given intraperitoneally (1), systemically (7) or both intraperitoneally and systemically (1). Overall median survival from diagnosis was 19.0 months; 1 patient is alive with disease at 21 months; and 3 patients are disease-free at 17, 38, and 60 months from diagnosis. Significant positive predictive factors for survival were a small volume of ascites (P = 0.02), a large number of peritonectomies performed (P = 0.001), second-look cytoreduction (P = 0.003), perioperative intraperitoneal chemotherapy (P = 0.008) and postoperative chemotherapy (P = 0.01), either intraperitoneal or systemic. Conclusions Peritoneal carcinomatosis from an unknown primary site is a rare subset of primary peritoneal malignancy. Aggressive treatment may provide prolonged palliation with occasional long-term survival.
Role of Double-contrast Barium Enema in Colorectal Cancer Screening Based on Fecal Occult Blood
Authors: Ciatto Stefano , Castiglione Guido 
Published: April 2018

Aims and Background Screening for colorectal cancer by fecal occult-blood testing has been shown to be effective in reducing colorectal cancer mortality. Total colonoscopy is the test of choice for the assessment of fecal occult blood-positive subjects. Double-contrast barium enema is commonly employed to study the rest of the colon when colonoscopy is incomplete. The present study evaluated the contribution of double-contrast barium enema in detecting neoplastic lesions of the colon in fecal occult-blood-positive subjects with incomplete colonoscopy. Methods In the frame of a screening program for colorectal cancer in the Florence District, a new immunochemical fecal occult-blood test replaced the classic guaiac fecal occult-blood test in 1993. Subjects with a positive fecal occult-blood test were invited to undergo total colonoscopy. Incomplete colonoscopy prompted double-contrast barium enema. Type and rate of neoplastic lesions detected by endoscopy or double-contrast barium enema as single methods or combined were evaluated. Results A total of 38,829 subjects underwent fecal occult-blood testing in the period 1993-2000. Overall, 1,542 were positive. Assessment was refused by 235 subjects. Out of 1,307 subjects accepting assessment, total colonoscopy was attempted in 1,294: of these, it was not possible in 343 cases, and double-contrast barium enema was advised and performed in 261 subjects. Colorectal cancer was detected in 115 subjects, single or multiple adenomas in 323, hyperplastic polyps in 58, inflammatory, hamartomatous or not histologically confirmed polyps in 38, and other benign non-polypoid findings or no abnormality in 773. There were significant differences between the rates of detected colorectal cancers or adenomas of total and incomplete colonoscopy. There were also significant differences between incomplete colonoscopy and the combination of incomplete colonoscopy and double-contrast barium enema as regards rates of detected colorectal cancer, and between total colonoscopy and the combination of incomplete colonoscopy with double-contrast barium enema as regards rates of detected adenomas. Double-contrast barium enema associated to incomplete colonoscopy was responsible for an increase in detection rates of cancer or adenoma of 2.3‰ or 3.8‰, respectively. Conclusions Double-contrast barium enema was useful in detecting colorectal cancer beyond the range reached by incomplete colonoscopy, whereas our data confirmed a lower sensitivity of double-contrast barium enema for polyps. The diagnostic contribution observed in the present survey confirms the opportunity of performing double-contrast barium enema as a routine adjunct to incomplete colonoscopy. Nevertheless, in order to maximize the detection rate of adenomas, the rate of total colonoscopy should be kept as high as possible.
Levels of Ve-Cadherin Increase Independently of Vegf in Preoperative Sera of Patients with Colorectal Cancer
Authors: Sulkowska Mariola , Famulski Waldemar , Wincewicz Andrzej , Moniuszko Tadeusz , Kȩdra Bogusłtaw , Koda Mariusz , Zalewski Bogdan , Baltaziak Marek , Sulkowski Stanislaw 
Published: April 2018

Aims and Background Vascular endothelial cadherin (VE-cad-herin) preserves the tightness of the mature vascular network as a component of endothelial adherens junctions. Vascular endothelial growth factor (VEGF) makes VE-cadherin dissociate from complexes with β-catenin, so that endothelial cells can loosely proliferate and migrate. We searched for relationships between VEGF and VE-cadherin levels in preoperative sera of patients with colorectal cancer (CRC). We also compared VE-cadherin levels of control and preoperative CRC sera in relation to clinicopathological features. Methods We measured with an ELISA kit the serum levels of the proteins in preoperative samples from 125 CRC patients and in samples from 16 healthy volunteers. Results Serum VE-cadherin was about fourfold higher in CRC patients than in controls (P <0.00001), with similar results being found in subgroups with different clinicopathological features versus controls. VE-cadherin was not correlated with VEGF in the entire group of CRC patients nor in the subgroups of node-positive and node-negative patients, different grades of histological differentiation (G2 or G3), extent of tumor growth (pT1+pT2 or pT3+pT4), histopathological type (adenocarcinoma or mucinous carcinoma), sex, age, and tumor site (colon or rectum). However, the serum levels of VE-cadherin and VEGF in CRC patients, which were higher than the mean values of controls, tended towards a negative correlation in node-positive patients (P = 0.078, r = -0.279). Conclusions VEGF and VE-cadherin seem to be independent markers of angiogenesis in CRC with no significant correlation between their serum levels.
Ileal Carcinoid with Liver Metastasis Presenting after Ten Years with Abdominal Mass and Right Heart Failure: Report of a Case
Authors: Stella Mattia , Decian Franco , Mithieux François , Meeus Pierre , Rivoire Michel 
Published: April 2018

A case of ileal carcinoid metastatic to the liver is reported. The diagnosis was made and treatment given ten years after the detection of a left hypervascular liver mass, which was first confounded with a hemangioma. The onset of right heart failure led to surgical replacement of the tricuspid and pulmonary valves. After cardiac surgery the patient underwent an ileal resection and left hepatectomy for a cystic left liver metastasis. Isolated right heart failure and cystic degeneration of a liver metastasis are uncommon features of metastatic carcinoid tumors; only a few cases have been described in the literature. Cardiac surgery is recommended before liver surgery to reduce venous pressure and consequent bleeding during hepatectomy. Surgical treatment of liver metastases may relieve endocrine symptoms and result in an overall five-year survival rate of 47%.
Considerazioni Sul Problema Dei Mioepiteli Nella Genesi Di Talune Neoplasie
Authors: Pignataro O. 
Published: April 2018

Basing on Cotchin's identification of the so-called «interposed cells » of mammary tumours with myoepithelia, a careful analysis of the literature concerned with the nature of these elements was carried out. Data supporting the hypothesis that these cells, under hormonal unrestrained influence, may be able to acquire in part characters of embrional plasticity, and to become pluripotential giving origin to some benign or malignant neoplasms (especially of the breast) are compared, and the peculiar histological and histochemical characters allowing the identification between interposed cells and myoepithelia are considered. Results seem to be rather probative. Among the benign tumours of the breast, the « fibrosing adenosis » is of particular interest, both for the close relations of its evolution to the hormonal metabolism and for the role that the myoepithelia play in its evolution. The personal observation of over 60 cases of fibrosing adenosis permitted to check the observations related to other neoplasms as concerns the argyrophilia and histochemistry of these elements. Results are tabulated. The present research is preliminary to a more specific investigation on the role of myoepithelia in the genesis of mixed tumours of the parotis which, according to some authors, would be a hormone target organ.
Le Auxine in Biologia Animale: Parte II - Azione Dell'acido Indolacetico e Della Kinetina in Vitro Su Tessuti Normali e Tumorali
Authors: Volpe R. Della , Albertini E. , Necco A. 
Published: April 2018

The present paper is concerned with mitokinetic and cytokinetic action of two auxins — Kinetin and indolacetic acid — on «in vitro » cultures of normal animal cells (heart fibroblasts of chick embryo), and of neoplastic cells (from ascites Walker adenocarcinoma of the rat). The «in vitro » cultures were kept into contact with Kinetin doses ranging between 0.0005 and 0.001 γ/ml for normal tissues, and between 0.001 and 1 γ/ml for neoplastic cells. Indolacetic acid was used in doses ranging between 0.00005 and 0.0005 γ/ml for normal cells, and between 0.0005 and 0.05 γ/ml for neoplastic cells. Consideration has been given to the growth properties of the cultures, to the frequency of mitoses, and to the content in nucleic acids determined by the histochemical method and by the orange-acridin in U.V. light method. It has been demonstrated that Kinetin, even at low doses, exerts an inhibitory action on the heart fibroblasts growth, with considerable cytitoxic action and partial inhibition of the mitotic activity. Indolacetic acid did not show any cytotoxic action, and failed to demonstrate any cyto- and mitokinetic activity. Experiments carried out with the association of both auxins in suitable dosage showed a prevailing cytotoxic action of Kinetin, and were not able to demonstrate a mitotic activity. In addition, the single or associate administration of the two auxins did not influence the DNA synthesis in normal cells. In «in vitro» cultures of cells from ascites Walker adenocarcinoma an early and constant mitokinetic activity has been demonstrated by Kinetin and indolacetic acid as well. Cytotoxic activity was absent, even at high concentrations. No synergic action was shown by the two auxins.
Characterization of a Herpes Simplex Virus Isolated from a Lip Tumor Developing after Recurrent Herpes.
Authors: Cassai Enzo N. , Terni Maurizio , Califano Adalberto 
Published: April 2018

A spindle-cell carcinoma developed on the lower lip of 53-year-old patient who had suffered from recurrent local herpes. From a tumor biopsy a human herpesvirus 1 (Type 1 Herpes Simplex Virus) was isolated (strain n. 466). Infected cells contain eosinophilic intranuclear inclusions (fig. 3); the agent's cpe is abolished by anti-HSV antiserum and by chloroform; the agent produces typical plaques (fig. 4), grows at 38 °C, and its DNA has a density of approximately 1.726 g per cm3, equal to that of DNA of « F » prototype of human herpesvirus 1 (text-fig. 1). However, its immunological structure (text-fig. 2) and its protein electrophoretic pattern (fig. 5) slightly differentiate this virus from homotypic strains including some local isolates. At the time the virus was isolated from the tumor no HSV was recovered from the surrounding skin of the patient. After surgical removal of the tumor, the patient suffered no more of herpetic recurrences. As far as the significance of the isolation is concerned, UV-inactivated strains possess a transforming activity in vitro and human herpesvirus 2 is known to be associated to cervical carcinoma in some human populations, but no direct oncogenicity has been shown in HSV. In our case, HSV may have been implicated through the association of the irritant effect of repeated recurrences and a possible abortive type of infection with cigarette smoking.
Studying Survival of Cancer Patients in Different Populations: Its Potential and Role
Authors: Micheli Andrea , Gatta Gemma , Verdecchia Arduino 
Published: April 2018

Rationale Survival figures from a population-based study incorporate the overall practice in diagnosis, cure and clinical follow-up for a specific disease within a given health care system. Being the outcome of a number of individual, social and economical aspects, population-based survival may be thought as index for measuring the level of a country's development. Data The EUROCARE project, a European Cancer Registries (CR) concerted action, provided reliable information on survival for more than 800,000 cancer patients from 11 European countries. A great deal of epidemiologic information has derived from EUROCARE. Women had a longer survival than men for all studied tumour sites, except for the colon. European survival variability was fairly high for several cancers, but it was lower for cancers with a relatively good prognosis and those sensitive to treatment. The ranking of populations of cancer survival tended to be fairly stable for many cancers: CR of Switzerland and Finland ranked high and Polish CR low. Denmark, Italian and France CR did not substantially differ from the European survival average. For most cancers, prognosis improved during the studied period (years of diagnosis: 1978–1985). Survival figures for colon (r = 0.74, males; r = 0.73, women) and female breast cancer (r = 0.57) well correlated with the national health expenditure of different participating countries. The ITACARE study, a new Italian Cancer Registries collaborative project involving more than 100,000 cancer patients, was set up to study survival differences within the country. Survival of cancer patients was not homogeneous in 7 studied Italian regions (the estimated 5-year relative survival for all malignant neoplasms combined ranked from 37.8% in CR of Sicily to 42.1% in those of Emilia-Romagna). The lowest levels of regional health expenditures were accompanied by the lowest levels of prognosis for overall cancers. However, a relatively low correlation among patient cancer survival and the regional health expenditure (r = 0.21) was found, suggesting that other factors such as different efficiency in managing cancer may play a role in explaining the intracountry differences. Conclusions Population-based survival figures may be used to study epidemiologic aspects, comparing different health systems, and may be interpreted as indexes for discussing inequalities in health in different populations.
Does Concomitant Chemoradiotherapy Influence Cosmetic Outcome in Conservative Treatment of Breast Cancer?
Authors: Moro Gregorio , Stasi Michele , Borca Valeria Casanova 
Published: April 2018

Purpose To evaluate retrospectively factors influencing the cosmetic outcome after conservative treatment for breast cancer. Material and methods From 1988 until 1992, 164 patients were treated with conservative surgery (quadrantectomy) and radiotherapy with 60Co (50 Gy on the whole breast) plus 10 Gy on the surgical bed (300 kV photons) for T1–T2 breast cancers; 46 patients (28%) received concomitant adjuvant chemotherapy (CMF schedule). Cosmesis evaluation was carried out after 24 to 108 months (median, 38 months). A logistic regression analysis was performed to identify independent variables influencing the aesthetic outcome. P values of 0.05 or less were considered significant. Results Univariate analysis showed that T2 versus T1 (P = 0.0102), lower quadrants site (P = 0.0002) and concomitant adjuvant chemotherapy (P = 0.0009) produced a worse aesthetic outcome. Multivariate analysis confirmed the same factors: tumor size (P = 0.0020), tumor site (P = 0.0150) and concomitant chemotherapy (P = 0.0024). Conclusions The significant negative influence on the cosmetic outcome of concomitant adjuvant chemotherapy implies questions about the timing of radiotherapy and chemotherapy in breast cancer conservative treatment.
The Influence of Blood Glucose Levels on [18F]Fluorodeoxyglucose (Fdg) Uptake in Cancer: A Pet Study in Liver Metastases from Colorectal Carcinomas
Authors: Crippa Flavio , Gavazzi Cecilia , Bozzetti Federico , Chiesa Carlo , Pascali Claudio , Bogni Anna , De Sanctis Vinicio , Decise Donatella , Schiavini Mauro , Cucchetti Gianenrico , Bombardieri Emilio 
Published: April 2018

Aims and background To study the influence of blood glucose levels on the clinical reliability of positron emission tomography (PET) with [18F]-2-fluoro-2-deoxy-D-glucose (FDG) in the detection of liver metastases from colorectal carcinomas and in the analysis of tumor uptake of FDG. Methods After having given their informed consent, 8 patients with 20 liver metastases (mean size, 31.5 mm; range, 10–75 mm) detected by means of CT were submitted to a first FDG-PET examination under fasting conditions and, 2 days later, to a second FDG-PET examination performed after iv infusion of a glucose solution (4 mg/kg/min for 2 hrs). The results of the two studies were compared in each patient, considering both the localization of the metastases and the FDG uptake in the lesions. A non-kinetic method was used, calculating the Standardized Uptake Value (SUV). Results All 20 metastases were clearly visible on FDG-PET under fasting conditions. Moreover, in 2 patients FDG-PET detected a number of unknown liver metastases. The blood glucose levels after glucose infusion were significantly higher than the levels under fasting conditions, 158 ± 13.8 mg/100 ml (mean ± sd) and 92.4 ± 10.2, respectively (P « 0.001), and the quality of the FDG-PET images showed a marked deterioration. FDG-PET was unable to detect 6 of the 20 lesions and another 10 lesions were localized less clearly. Moreover, 80% of the unknown liver metastases were not detected after glucose loading. The SUVs of metastases decreased from 9.4 ± 5.7 (mean ± sd) under fasting conditions to 4.3 ± 8.3 after glucose loading (P « 0.001). Conclusions FDG-PET studies may be particularly unreliable under conditions of high levels of blood glucose. Therefore, patients entering FDG-PET studies should fast, and blood glucose concentration needs to be taken into account when evaluating FDG uptakes in follow-up studies.
Colposcopy as a Primary Screening test for Cervical Cancer
Authors: Cecchini Silvia , Bonardi Rita , lossa Anna , Zappa Marco , Ciatto Stefano 
Published: April 2018

Aim and background To evaluate the cost effectiveness of screening by colposcopy compared to conventional cytology. Methods A prospective study was performed in the Florence District screening center on 3,000 consecutive women, self referring, who were examined by cytology and colposcopy in a blind fashion. Further assessment was based on cytologic report or on colposcopy-directed punch biopsy. Actual costs of the whole screening process were known. The cost effectiveness of different possible simulated screening scenarios was then determined. Results Overall, 18 high-grade lesions (CIN3 = 9, CIN2 = 9) were detected. Four different screening scenarios were compared, namely a) cytology alone, b) cytology + repeat smear for ASCUS (atypical squamous cells of undeterminate significance) cases, c) colposcopy + cytology for cases of condyloma at punch biopsy, and d) colposcopy alone. Although they had a higher cost per examined woman (a) = 17.98, b) = 19.40, c) = 23.86, d)= 22.10 US$), scenarios c) and d) had a higher relative sensitivity (a = 44.4, b = 61.1, c = 100, d = 88.8%) and a lower cost per high-grade lesion detected (a = 6,743, b = 5,291, c = 3,977, d = 4,144 US$). Conclusions Screening by colposcopy is a feasible procedure which is more sensitive and more cost effective than conventional cytologic screening. At least in those settings where access to cytopathology may be difficult, screening by colposcopy should be considered as a possible alternative.
Lymph Node Merkel Cell Carcinoma with No Evidence of Cutaneous Tumor - Report of Two Cases
Authors: Ferrara Gerardo , lannielio Giovanni Pietro , Di Vizio Dolores , Nappi Oscar 
Published: April 2018

We report two cases of Merkel cell carcinoma within inguinal and axillary lymph nodes, respectively, showing no clinicopathologic evidence of a primary (extranodal) tumor; one of our patients was alive with no evidence of disease five years and ten months after the surgical excision of the neoplasm with no postoperative chemotherapy. The diagnosis of nodal Merkel cell carcinoma needs to be supported by a careful immunohistochemical study: in fact, cytokeratin- and neurofilament-positive paranuclear “dots”, as well as epithelial antigens and neuroendocrine markers may be variably expressed in tumor cells, thus requiring the application of a complete antibody panel. In the presence of a nodal Merkel cell tumor, an exhaustive clinico-radiologic search for a primary tumor must be carried out. After the exclusion of any reasonable starting point of the neoplasm, a provisional diagnosis of “primary” nodal Merkel cell carcinoma may be acceptable; since a primary extracutaneous tumor is expected to follow a less aggressive course than a metastatic one, follow-up data may provide indications as to the truly extracutaneous origin of Merkel cell carcinoma.
Brachytherapy for Squamous Cell Carcinoma of the LIP. The Experience of the Institute of Radiology of the University of Rome “La Sapienza”
Authors: Tombolini Vincenzo , Bonanni Alessio , Valeriani Maurizio , Zurlo Alfredo , Vitturini Alessandro 
Published: April 2018

Aims and background Cancer of the lip is the most common malignancy occurring in the oral cavity. The aim of our retrospective study was to review the results of patients with lower lip squamous cell carcinoma who were treated with radiotherapy. Methods & study design From 1970 to 1992, 57 patients with squamous cell carcinoma of the lower lip were treated at the Institute of Radiology of the University of Rome “La Sapienza” with low-dose rate interstitial brachytherapy. According to the UICC 1992 TNM classification, the disease stage was T1 in 27 (47%) cases, T2 in 20 (35%) and T3 in 10 (18%); 8 patients (14%) were cN+. The median tumor dose was 62 Gy (range, 44-96): 10 patients (18%) received a total dose < 50 Gy, 28 (49%) between 50 and 70 Gy, and 19 (33%) > 70 Gy. The cN+ cases were irradiated to total doses of 65-70 Gy on the involved station. Ail patients obtained complete remission. Results The actuarial overall survival rates at 3, 5 and 10 years were 95%, 76% and 53%; actuarial disease-free survival at 3, 5 and 10 years was 84%, 81%, and 81%, respectively. Actuarial cause-specific survival was 98%, 88% and 84% at 3, 5 and 10 years, respectively. Actuarial local control rate was 90% at 3 and 5 years, rising to 94% with salvage surgery. Local-regional control was obtained in 90% and 86% of patients at 3 and 5 years, and in 93% and 89% of cases, respectively, following surgery. Five of 11 deaths were due to local-regional or distant disease recurrence. Conclusions Tumor stage and positivity of regional nodes were the only predictive factors of survival and disease control. Radiation-induced morbidity was very low, and all patients considered their cosmetic outcome at least satisfactory.