bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychological Distress Screening in Cancer Patients: Psychometric Properties of Tools Available in Italy
Authors: Muzzatti Barbara , Annunziata Maria Antonietta 
Published: February 2018

Aims and background The main national and international organisms recommend continuous monitoring of psychological distress in cancer patients throughout the disease trajectory. The reasons for this concern are the high prevalence of psychological distress in cancer patients and its association with a worse quality of life, poor adherence to treatment, and stronger assistance needs. Most screening tools for psychological distress were developed in English-speaking countries. To be fit for use in different cultural contexts (like the Italian), they need to undergo accurate translation and specific validation. In the present work we summarized the validation studies for psychological distress screening tools available in Italian that are most widely employed internationally, with the aim of helping clinicians choose the adequate instrument. With knowledge of the properties of the corresponding Italian versions, researchers would be better able to identify the instruments that deserve further investigation. Methods We carried out a systematic review of the literature. Results Twenty-nine studies of eight different instruments (five relating to psychological distress, three to its depressive component) were identified. Ten of these studies involved cancer patients and 19 referred to the general population or to non-cancer, non-psychiatric subjects. For seven of the eight tools, data on concurrent and discriminant validity were available. For five instruments data on criterion validity were available, for four there were data on construct validity, and for one tool divergent and cross-cultural validity data were provided. For six of the eight tools the literature provided data on reliability (mostly about internal consistency). Conclusions Since none of the eight instruments for which we found validation studies relative to the Italian context had undergone a complete and organic validation process, their use in the clinical context must be cautious. Italian researchers should be proactive and make a valid and reliable screening tool for Italian patients available.
Heterogeneity of COX-2 and Multidrug Resistance between Primary Tumors and Regional Lymph Node Metastases of Gastric Cancer
Authors: Li Yong , Tan Bi-bo , Fan Li-qiao , Zhao Qun , Liu Yü , Wang Dong 
Published: February 2018

Aims and background Cyclooxygenase-2 (COX-2) is involved in the progression of gastric cancer; however, the role of COX-2 in multidrug resistance (MDR) is still unclear. This study aimed to elucidate the relationship between COX-2 and MDR so as to show the heterogeneity of gastric primary tumors and regional lymph node metastases. Methods Between 2008 and 2009, 56 primary tumor samples and paired metastatic lymph node tissues from gastric cancer patients confirmed by surgery and pathological examination in our hospital were collected. The expression levels of COX-2 and MDR-associated factors such as P-glycoprotein (P-gp), glutathione S-transferase pi (GST-π) and topoisomerase II alpha (Topo-II-α) were determined by immunohistochemical staining. Tumor cells from these tissues were cultured and the cell chemosensitivities for 11 chemotherapeutic agents were measured by sulforhodamine B assay. Results The expression levels of COX-2, P-gp and GST-π were significantly higher in metastatic lymph node tissues than in primary tumors, while the expression level of Topo-II-α was lower in metastatic lymph node tissues than in primary tumors (all P <0.05). In primary tumors, COX-2 and GST-π were positively correlated and COX-2 and Topo-II-α were negatively correlated; in metastatic lymph node tissues, a positive correlation was found between COX-2 and P-gp (all P <0.05). The inhibition rates of eADM, VP-16, THP and MMC on cells from primary tumors were significantly lower than those on cells from metastatic lymph nodes, while the inhibition rates of HCPT, L-OHP and VCR on cells from metastatic lymph nodes were lower than those on cells from primary tumors. Conclusion The expression of COX-2 and MDR-associated factors as well as cell chemosensitivities are different in primary tumors and regional lymph node metastases of gastric cancer, and this may be an indication of their heterogeneity.
Pseudomyxoma Peritonei Treated with Cytoreductive Surgery and Hyperthermic Chemotherapy: A 7-Year Single-Center Experience
Authors: Virzì Salvatore , Iusco Domenico , Bonomi Serena , Grassi Antonio 
Published: February 2018

Aims and background Pseudomyxoma peritonei (PMP) is a rare clinical entity characterized by diffuse intraabdominal gelatinous collections with mucinous implants on the peritoneal surfaces and omentum. This condition should be considered a borderline malignancy with disease progression over time. Encouraging treatment results have been recently reported with the combination of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). Methods From December 2003 to December 2010, 18 patients with PMP were referred to our institution. All patients underwent peritonectomy and CRS combined with HIPEC in accordance with Sugarbaker's procedure. Results The mean Peritoneal Cancer Index score was 27.6 (range, 5–39). Twelve (67%) patients had disseminated peritoneal adenomucinosis and 6 (33%) peritoneal mucinous carcinomatosis. Optimal cytoreduction with no visible residual disease or residual disease ≤2.5 mm in diameter was achieved in all patients. The mean duration of the surgical procedure including HIPEC was 9 hours and 30 minutes (range, 5–13 hours); major morbidity occurred in 30% of patients and the mortality was 11%. The mean follow-up was 27 months (range, 1–72) and the 5-year overall survival 66%. Conclusions In line with the existing literature, our experience suggests that patients with PMP could benefit from CRS + HIPEC in terms of survival and locoregional disease control.
Effects of Preoperative Radiochemotherapy with Capecitabine for Resectable Locally Advanced Rectal Cancer in Elderly Patients
Authors: Cèfaro Giampiero Ausili , Genovesi Domenico , Vinciguerra Annamaria , Augurio Antonietta , Di Tommaso Monica , Marchese Rita , Borzillo Valentina , Tasciotti Lucia , Taraborrelli Maria , Innocenti Paolo , Colecchia Giuseppe , Di Nicola Marta 
Published: February 2018

Aims and background Rectal cancer is a common disease of elderly people. However, patients over 70 years of age are often not included in clinical trials. There is a lack of data concerning the use of radiochemotherapy with capecitabine in elderly patients. The aim of this study was to retrospectively evaluate the impact of preoperative radiochemotherapy with capecitabine on downstaging and sphincter preservation and to assess treatment compliance and toxicity in elderly patients. Methods Twenty-six patients with resectable locally advanced rectal cancer (stage II-III/TNM) aged >70 years received preoperative radiotherapy and concurrent oral capecitabine 825 mg/m2 twice daily during the whole period of radiotherapy. Two patients who refused surgery after chemoradiation therapy were excluded from the analysis. Results Eighty-one percent of patients underwent anterior resection and 18.1% underwent abdominoperineal resection. Overall tumor downstaging, considering both T and N categories, was observed in 18/24 patients (75%). Treatment compliance was good and toxicity rates were similar to those of younger people. Conclusions Age is not a contraindication to any therapy and elderly patients who can tolerate radiochemotherapy should be treated like younger patients. Preoperative radiochemotherapy with capecitabine for patients aged >70 years has a good impact on tumor downstaging, increases the feasibility of sphincter-preserving surgery, and is also safe and well tolerated.
Role of PET/CT in the Clinical Management of Locally Advanced Pancreatic Cancer
Authors: Picchio Maria , Giovannini Elisabetta , Passoni Paolo , Busnardo Elena , Landoni Claudio , Giovacchini Giampiero , Bettinardi Valentino , Crivellaro Cinzia , Gianolli Luigi , Di Muzio Nadia , Messa Cristina 
Published: February 2018

Aim To evaluate the role of 18F-fluorodeoxyglucose (FDG) PET/CT in: a) the selection of patients with locally advanced pancreatic cancer for helical tomotherapy with concurrent chemotherapy (HTT-ChT); b) monitoring HTT-ChT treatment efficacy in comparison with contrast-enhanced CT (c.e.CT). Methods Forty-two consecutive patients with unresectable locally advanced pancreatic cancer referred for HTT-ChT were enrolled in the study. All patients were pretreated with induction ChT. Before the beginning of HTT-ChT treatment patients underwent diagnostic c.e.CT (CT0) and FDG PET/CT (PET/CT0) for staging. After staging, patients received HTT-ChT. Three months after the end of HTT-ChT a control c.e.CT (CT1) was done. FDG PET/CT (PET/CT1) was repeated only in patients with positive PET/CT0. PET/CT1 and CT1 were compared with baseline imaging results to assess treatment efficacy. Results In 31/42 cases (74%) PET/CT0 documented pathological uptake in pancreatic lesions, while in the remaining 11/42 cases it showed no uptake. In 7/42 (17%) patients, PET/CT0 also detected distant metastases, prompting a change in the therapeutic approach. Compared to PET/CT0, PET/CT1 (n = 18) documented 3 complete metabolic responses, 9 partial metabolic responses, 2 instances of stable metabolic disease, and 4 instances of progressive metabolic disease. In the same group of 18 patients, CT1 showed 0 complete responses, 3 partial responses, 8 instances of stable disease, and 7 instances of progressive disease compared to CT0. Concordance between PET/CT and CT response was seen in 33% of cases. In 50% of cases, PET/CT1 documented a response to therapy that was not evident on CT. Conclusions PET/CT influenced the treatment strategy by detecting distant metastases not documented by CT, thus accurately selecting patients for HTT-ChT after induction ChT. In monitoring treatment efficacy, PET/CT can detect a metabolic response to treatment not identified by CT.
Expression of RON in colorectal cancer and its relationships with tumor cell behavior and prognosis
Authors: Park Young-Lan , Lee Gi-Hoon , Kim Kyu-Yeol , Myung Eun , Kim Jong-Sun , Myung Dae-Seong , Park Kang-Jin , Cho Sung-Bum , Lee Wan-Sik , Jung Young-Do , Kim Hyun-Soo , Joo Young-Eun 
Published: February 2018

Aims and background The aims of the current study were to evaluate whether recepteur d'origine nantais (RON) affects tumor cell behavior and oncogenic signaling pathways in colorectal cancer, and to examine the relationship of its expression with various clinicopathological parameters and patient survival. Methods Immunohistochemistry, Western blot and RT-PCR were used to detect the expression of the RON gene in human colorectal cancer tissue. To study the biological role of RON in tumor cell behavior and cellular signaling pathways, we used small interfering RNA (siRNA) to knock down RON gene expression in human colorectal cancer cell lines. Results Knockdown of RON inhibited the induction of the invasive growth phenotype and the activation of oncogenic signaling pathways including Akt, MAPK and β-catenin. RON overexpression was associated with tumor size, lymphovascular invasion, depth of invasion, lymph node metastasis, distant metastasis, tumor stage and poor survival. Conclusions These results suggest that RON overexpression may help in predicting poor clinical outcomes in colorectal cancer.
At Least we can Send Some Flowers…
Authors: Clerici Carlo Alfredo , Ferrari Andrea , Veneroni Laura , Casiraghi Giovanna , Giacon Barbara , Armiraglio Mariangela , Massimino Maura 
Published: February 2018

Aims and background Cancer may demand lengthy treatment and the emotional attachment between care providers and the patient may become intense, especially when the latter is a child. If patients die, their families and the care-providing staff need help to cope with the loss. Short communication We describe a procedure in use at the Istituto Nazionale Tumori in Milan for taking leave of families whose children die. This practice is based on simply sending flowers to families who have lost their child, and was started after an emotionally very demanding case. Conclusion Our sending flowers with a handwritten condolence letter is a simple gesture that seems to have helped both the patients' families and the members of our care-providing team in the process of mourning.
Patient-Reported Outcomes in Breast Oncology: A Review of Validated Outcome Instruments
Authors: Kanatas Anastasios , Velikova Galina , Roe Brenda , Horgan Kieran , Ghazali Naseem , Shaw Richard J , Rogers Simon N 
Published: February 2018

Aims and background Patient-reported outcomes (PROs) include areas of health-related quality of life but also broader concepts such as patient satisfaction with care. The aim of this review is to give an account of all instruments with potential use in patients with a history of treatment for breast cancer (including surgery, chemotherapy and/or radiotherapy) with evidence of validation in the breast cancer population. Methods All instruments included in this review were identified as PRO measures measuring breast-related quality of life and/or satisfaction that had undergone development and validation with breast oncology patients. We specifically looked for PRO measures examining patient satisfaction and/or quality of life after breast cancer treatment. Following an evaluation of 323 papers, we identified 15 instruments that were able to satisfy our inclusion criteria. Results These instruments are the EORTC QOL-C30 and QLQ-BR23 (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Breast Cancer Module), the FACT-B (Functional Assessment of Cancer Therapy-Breast Cancer), the SLDS-BC (Satisfaction with Life Domains Scale for Breast Cancer), the BIBCQ (Body Image after Breast Cancer Questionnaire), the HIBS (Hopwood Body Image Scale), the PBIS (Polivy Body Image Scale), the MBROS (Michigan Breast Reconstruction Outcomes Study) Satisfaction and Body Image Questionnaires, the BREAST-Q, the BCTOS (Breast Cancer Treatment Outcome Scale), the BCQ, the FACT-ES (Functional Assessment of Cancer Therapy-Endocrine System), the MAS (Mastectomy Attitude Scale), and the Breast Cancer Prevention Trial Symptom Checklist (BCPT). Conclusions Suggestions for future directions include (1) to use and utilize validated instruments tailored to clinical practice; (2) to develop a comprehensive measurement of surgical outcome requiring the combination of objective and subjective measures; (3) to aim for a compromise between these two competing considerations in the form of a scale incorporating both generalizability in cancer-related QOL and specificity in breast cancer issues.
Intraoperative radiotherapy in patients with breast cancer treated by breast-conserving therapy
Authors: Zhang Yan-jun , Liu Lei , Ma Lin , Yu Wei , Liu Mei , Cheng Liu-quan , Li Jie , Zheng Yi-qiong , Wang Jian-dong , Kong Qing-long , Li Xi-ru 
Published: February 2018

Objective To assess the safety, cosmetic effects, and clinical efficacy of breast-conserving surgery combined with intraoperative radiation therapy for the treatment of Chinese patients with breast cancer. Methods Breast-conserving surgery combined with intraoperative radiation therapy was performed in 64 breast cancer patients. The postoperative short-term efficacy, safety, and cosmetic effects were assessed. Results Of the 64 patients, 1 case (1.6%) had local recurrence one year later, 7 cases (10.9%) had grade I postoperative radiation-induced lung injury, 10 cases (15.6%) had local hardening at the surgical sites, 8 cases (12.5 %) had changes in skin color, and 8 cases (12.5%) had pain at the surgical sites. Excellent or good levels of cosmetic effects were achieved in 95.3% of the patients. Conclusions The application of intraoperative radiation therapy with breast-conserving surgery can yield satisfactory short-term curative efficacy, a high level of clinical safety, and good cosmetic effects.
Clinical Significance of Programmed Death-1 Ligand-1 Expression in Patients with Non-Small Cell Lung Cancer: A 5-year-follow-up Study
Authors: Chen Yan-bin , Mu Chuan-Yong , Huang Jian-An 
Published: February 2018

Aims and background The programmed death-1-ligand 1 (PD-L1) has been recently suggested to play a pivotal role in the immune evasion of tumors from host immune system. In the study, we tried to reveal the clinical significance of PD-L1 in patients with non-small cell lung cancer (NSCLC), which is one of the most aggressive and intractable malignant tumors. Methods and study design PD-L1 expression in 120 NSCLC tissue specimens and 10 benign control samples embedded with wax were retrospectively detected by immunohistochemistry. Results No PD-L1 was detected in the 10 benign controls, whereas 57.5% of NSCLC tissue specimens showed PD-L1 expression. There was no relationship between PD-L1 expression and patient age, gender or histopathological type. However, PD-L1 expression was significantly correlated to the degree of tumor cell differentiation, stage of tumor node metastasis (TNM) and patient survival. Poor tumor cell differentiation and advanced TNM stage were related to higher PD-L1 expression. PD-L1-negative NSCLC patients had longer overall 5-year survival than PD-L1-positive patients (P <0.0001). PD-L1 status was a significant independent prognostic factor of NSCLC (χ2 = 18.153, RR = 2.946, P <0.001). Conclusions Up-regulated PD-L1 expression in NSCLC is related to the degree of tumor cell differentiation and TNM stage. PD-L1 status may be a new predictor of prognosis for patients with NSCLC.
GHPSS Multicenter Italian Survey: Smoking Prevalence, Knowledge and Attitudes, and Tobacco Cessation Training among Third-Year Medical Students
Authors: Saulle Rosella , Bontempi Claudio , Baldo Vincenzo , Boccia Giovanni , Bonaccorsi Guglielmo , Brusaferro Silvio , Donato Francesco , Firenze Alberto , Gregorio Pasquale , Pelissero Gabriele , Sella Alberto , Siliquini Roberta , Boccia Antonio , La Torre Giuseppe 
Published: February 2018

Aims and background Healthcare professionals have an important role to play both as advisers – influencing smoking cessation – and as role models. The aims of this study were to examine smoking prevalence, knowledge and attitudes among Italian university students attending medical schools using the Global Health Professions Student Survey (GHPSS) approach. Methods and study design A multicenter cross-sectional study was conducted among University students of 9 Italian medical schools (age ranging between 19 and 29 years). The GHPSS questionnaire was self-administered. A logistic regression model was used to identify possible factors associated with tobacco smoking status. Data were analyzed with the software SPSS 19.0 for Windows. Results Seven hundred thirty medical students (response rate 100%) were enrolled. The prevalence of current smokers was 20.4% (males 22.4%, females 19.1%). Of the total sample, 87.7% believed that health professionals should receive specific training in techniques to quit smoking, and 65% believed that health professionals had a role in giving advice or information about smoking cessation. However, 89.4% answered that they had not received specific training on smoking cessation techniques. Multivariate analysis showed that students belonging to universities in southern Italy were more likely to be smokers (OR = 2.00; 95% CI: 1.03–3.97). Conclusions This Italian multicenter survey found that one fifth of future medical doctors are smokers. There is a need to adopt a standard undergraduate curriculum containing comprehensive tobacco prevention and cessation training to improve their effectiveness as role models.
Malignant Sacrococcygeal Germ Cell Tumors in Children: A 30-year Experience from a Single Institution
Authors: Büyükpamukcu Münevver , Varan Ali , Küpeli Serhan , Ekinci Saniye , Yalcin Sule , Kale Gülsev , Yalcin Bilgehan , Kutluk Tezer , Akyüz Canan 
Published: February 2018

Background Our aim was to analyze treatment results and survival characteristics of our patients with malignant sacrococcygeal germ cell tumors. Procedure Patient files of children with malignant sacrococcygeal germ cell tumors, treated at our institution between 1979 and 2009, were searched. Patient characteristics, histopathological subtypes, extension of disease, alpha-fetoprotein (AFP) level at the time of diagnosis and relapse, extent of surgical resection, chemotherapy protocols, details of radiotherapy and survival characteristics were recorded. Results A total of 58 patients (M/F = 20/38) with malignant sacrococcygeal germ cell tumor was included in analysis. With a mean follow-up of 156 months (range, 26 days to 288.8 months) overall and event-free survival rates of the 58 patients were 50.9% and 43.8%, respectively. AFP status of the patients (37% in patients with <10,000 ng/ml, 68.9% in patients with ≥10,000 ng/ml), type of resection (total vs others), coccygeal resection, chemotherapy protocol (PEB vs others) and number of chemotherapy courses had an impact on event-free survival in univariate analysis. In multivariate analysis, AFP status had the greatest effect on prognosis. Conclusions Our treatment results are worse than those reported in the literature. Elevated AFP level at the time of diagnosis had a beneficial effect on prognosis, but year of diagnosis, tumor stage, presence of metastasis, tumor size and histopathological subtype had no impact on survival in patients with malignant sacrococcygeal germ cell tumors.