bluuebunny/crossref_metadata_2025_split huggingface dataset:
Muscle-Invasive Bladder Cancer in Elderly-Unfit Patients with Concomitant Illness: Can a Curative Radiation Therapy be Delivered?
Authors: Santacaterina Anna , Settineri Nicola , De Renzis Costantino , Frosina Pasquale , Brancati Antonietta , Delia Pietro , Palazzolo Carmela , Romeo Antonino , Sansotta Giuseppe , Pergolizzi Stefano 
Published: April 2018

Aims and background There is no standard treatment for elderly-unfit patients with muscle-invasive bladder cancer. Pelvic irradiation alone is an usual approach in this instance, and some reports have demonstrated that curative radiotherapy is feasible in elderly patients. To our knowledge, no data exist about the feasibility of a curative treatment in elderly patients with concomitant illness and a Charlson Comorbidity Index (an index of comorbidity that includes age) greater than 2. The main purpose of the present study was to establish the feasibility of irradiation in a cohort of elderly patients in poor general condition. Methods The records of 45 elderly-unfit patients (median age, 75 years; range, 70-85), with a comorbid Charlson score >2, treated with curative dose, planned continuous-course, external beam radiotherapy for muscle-invasive bladder cancer were reviewed. The patients were treated to a median total dose of 60 Gy (range, 56–64), with an average fractional dose of 190 ± 10 cGy using megavoltage (6–15 MV). All patients were treated with radiation fields encompassing the bladder and grossly involved lymph nodes with a radiographic margin of at least 1.5 cm. Results No treatment-related mortality and clinically insignificant acute morbidity was recorded. No patient was hospitalized during or after the irradiation because of gastrointestinal or urogenital side effects. In one patient a week rest from therapy was necessary due a febrile status. Median survival was 21.5 months; overall 3- and 5-year survival was 36% and 19.5%, respectively. Conclusions Elderly-unfit patients with comorbidities and >70 years of age can be submitted to radical pelvic irradiation. The results observed in this retrospective analysis have encouraged us to use non-palliative radiotherapy doses in these patients with muscle-invasive bladder cancer.
The Safe Association of Intraoperative Evaluation of Surgical Margins and Neoadjuvant Chemotherapy in Breast Cancer Larger than 3 Centimeters
Authors: Kurbet Silvio , de Barros Alfredo CSD , Pinotti José A 
Published: April 2018

Objectives and background The objective of the present study was to determine whether neoadjuvant chemotherapy in women with breast cancer larger than 3 cm associated with breast-conserving surgery plus intraoperative evaluation of surgical margins is safe. Methods A total of 164 patients with breast cancer larger than 3 cm in diameter were submitted to neoadjuvant chemotherapy between 1992 and 1998 and followed until 2003. We used neoadjuvant chemotherapy in pulses at 21-day intervals with 5-fluorouracil (500 mg/m2), epirubicin (50 mg/m) and cyclophosphamide (500 mg/m2) (FEC). Initially, 3 cycles of chemotherapy were administered, followed by surgery and 6 additional chemotherhapy cycles. During surgery, an evaluation of the surgical margins was performed. Results Quadrantectomy was performed in 102 patients (62.2%) and mastectomy in 62 (37.8%). Local recurrence in 8 patients, metastasis in 37, and 21 deaths were observed. The curves of local recurrence for quadrantectomy and mastectomy were similar (P = 0.654 and P = 0.841, respectively), and so were the numbers of local recurrence (P = 0.4438). The curves of disease-free survival for quadrantectomy and mastectomy were different (P = 0.034 and P = 0.033, respectively). However, no statistically significant difference was observed in the number of events (P = 0.1283). A statistically significant difference was observed for the curves (P = 0.001 and P = 0.000) and the number (P = 0.0034) of deaths between patients undergoing quadrantectomy or mastectomy. Conclusions Neoadjuvant chemotherapy can reduce surgery complexity and is safe when associated with intraoperative evaluation of the surgical margins, without changing the local recurrence rate, disease-free survival, and overall survival.
Atypical Squamous Cells of Undetermined Significance: Analysis of Microbiology, Cytological Criteria and Clinical Conduct
Authors: Barcelos Ana Cristina Macêdo , Adad Sheila Jorge , Michelin Márcia Antoniazi , Murta Eddie Fernando Candido 
Published: April 2018

Aims To differentiate between two types of atypical squamous cells of undetermined significance (ASCUS): probably neoplastic (PN) or probably reactive (PR), and, in accordance with the recommendations on screening protocols of the Emilia-Romagna Region (PSRER), Italy, to define the best management to follow and the prognosis. Furthermore, the associations between ASCUS and infectious agents and human papillomavirus (HPV) were evaluated. Methods Fifty-eight ASCUS smears were reviewed and sorted; if a diagnosis of ASCUS was confirmed, the smear was classified as PR or PN, and the PSRER group was identified. Then, colposcopy was performed with checks for infectious agents (culture evaluation with cytological or clinical criteria) and HPV (hybrid capture). Results The ASCUS frequency was 3.96%. Of the 58 cases, 33 (56.9%) were diagnosed as ASCUS on review, of which 15 cases were PN and 18 were PR, while 23 (39.7%) smears were normal and 2 (3.4%) showed cervical intraepithelial neoplasia (CIN). There was a higher frequency of bacterial vaginosis (BV) and HPV in ASCUS PR patients compared with normal cytology, and a higher frequency of CIN in ASCUS PN patients compared with normal controls (P <0.05). By grouping ASCUS 1 and 3, we observed a higher frequency of CIN and of high-grade colposcopy findings compared with ASCUS 2 and 4 (P <0.05). From the 23 cases not found to be ASCUS, 18 (87.5%) had normal cytology and colposcopy results on the first follow-up. Conclusions Classification of ASCUS as either PN or PR helps in clinical conduct and prognosis, because a higher frequency of CIN is found in ASCUS PN. ASCUS subdivisions, based on PSRER and colposcopy, may facilitate the clinical conduct because ASCUS 1 and 3 with high-grade colposcopic findings proved to be related to the presence of CIN. We propose that initial ASCUS cytology be reviewed, and if it is confirmed, colposcopy should be performed. For those cases found to be normal on review of the cytology results, it is suggested that a cytological check-up be carried out every 6 months.
Iperplasia Collaterale Nella Oncogenesi Sperimentale Del Ratto: 1. - Rilievi in corso di avitaminosi a combinata a depilazione
Authors: Carminati V. , Baglioni T. 
Published: April 2018

Two lots, of 20 female rats each, were inoculated with 10 mg of 3,4-benzpyrene and submitted, one month later, to a Vitamin A-deficient diet. One of the lots was then subjected to periodic skin depilation in the site of tumour occurrence as well as in the contralateral side. In the vitamin-deficient and depilated animals, a considerable hair reduction and hypoplasia was observed in the skin overlying the tumour, whereas such phenomenon appeared to be moderate in the animals only submitted to the Vitamin A-deficient diet. In all animals a hypoplasia of the sebaceous glands was observed, especially above the tumour. An epidermal hyperkeratosis was demonstrated in vitamin-deficient and depilated animals as well as in only vitamin-deficient ones, mainly at the tumour level.
Influence of a Diet Low in Pyridoxine on Tumorigenesis in Rats Ingesting N-2-Fluorenylacetamide
Authors: Morris Harold P. , Sidransky Herschel , Wagner Billie P. 
Published: April 2018

Early histological changes in the liver and cancer development in the liver and at other sites have been studied in male and female Buffalo-strain rats ingesting a diet containing N-2-Huorenylacetamide (2-FAA) and a low level of pyridoxine’ H'Cl, A month's delay in the appearance in the liver of mitotic figures in bile-duct cells and in the gradual increase in number of oval or ductal cells in the periportal areas were found in the low-pyridoxine groups when compared to previous studies with diets containing 2-FAA and high in pyridoxine (19). The overall incidence of liver tumors in male and female rats induced by 2-FAA was not influenced by a low level of dietary pyridoxine, but there was a delayed appearance of tumors. Males fed the low pyridoxine-2-FAA diet developed a higher incidence of liver tumors than did females. The highest incidence of ear duct tumors developed in females. These females had the longest survival. The amount of 2-FAA ingested does not appear to have been a deciding factor in the development of tumors in this experiment.
Pathogenesis of Metastatic Recurrences on the Operative Field after Radical Neck Dissection for Oropharyngeal Cancer
Authors: Molinari Roberto , Zingo Lorenzo 
Published: April 2018

In 1080 patients operated on at the National Cancer Institute of Milan from 1937 to 1964, 84 recurrences appeared on the operative field after radical neck dissection for oropharyngeal cancer. There was no evidence of the primary tumor almost 2 years after treatment. 78 recurrences concerned 930 determined cases (8.9%): 7 appeared among 407 dissections in which no microscopic involvement of lymph nodes was demonstrated (1.72%); 77 among 673 operations for histologically positive nodes. Most recurrences (75/84) were localized in the upper regions of the operative field (upper carotid, retromandibular, submastoid area). In all but 3 cases they occurred in the region nearest to the primary. Clinically, recurrences appeared as isolated or multiple tumor nodes adherent to the skin or to deep structures or both; only in 7 cases they were movable, and among these 5 were external to the operative field. Histological examination of the node was performed in 35 cases; residual lymph node tissue was found only in the movable ones. In nearly all cases isolated « foci» were found, and these findings suggest a sowing of cancer cells. Pathogenesis of recurrences is discussed, and the conclusions are that: — In 50% of cases cancer cells spread out actively from the walls of the lymph node by an invasive mechanism; — In 40% of cases sowing was due to the surgical section of lymph vessels or, rarely, of the lymph node capsule; — In 2.7% of cases the recurrence was localized in lymph nodes not removed at surgery; — In 4.7% of cases the typical dissection was not sufficiently extensive, and recurrences can appear outside the operative field, often in the parotid gland, very seldom in the spinal chain. Since the therapy of cervical recurrences is very deceptive prognosis can be improved only by preventing them, and this can be attained by earlier operations (prophylactic dissections) and surgical refinements in technique and tactics.
Comparability Issues within the Itacare Data Base
Authors: Buiatti Eva , Crocetti Emanuele , Conti Ettore , Falcini Fabio , Gafà Lorenzo 
Published: April 2018

Aims and background The aim of the study was to describe the extent of variability among Italian cancer registries in data managing practices that may affect differences in incidence and possibly in survival estimates. Methods a self-administered questionnaire was sent to each participating registry. The definitions of the disease, of the start point and of the end point of survival computation were investigated. Moreover, information on the proportion of histologic confirmation, of ill-defined sites and of DCO (death certificate only) was also considered. Results There were some differences in cancer registration techniques among Italian cancer registries. As regards disease definition, the most relevant problems arose for urinary bladder. Skin melanoma should also be considered with some caution, due to variability among registries in coding in situ cases. For the CNS and meninges, the proportion of cases that could be differently considered was so limited that no effect on survival is expected. For female breast, colorectum and cervix uteri, the effect of early diagnosis services (which are active only in some areas) may lead to better survival estimates. The variability in incidence date definition was high among registries and sites, but its effect on survival was very limited. There was a wide variability in the proportion of DCOs and of DCIs (initially known from death certificate), which should be considered in survival comparisons. All the registries stated that they carried out an active follow-up of their patients. Conclusions In general, quality standards of the registries are good and allow comparability of survival data. The variability of rules adopted by Italian registries may affect geographic survival differences only in a limited number of cancer sites, so that results should be interpreted with caution.
Survival in Adult Italian Cancer Patients, 1978–1989
Authors: Verdecchia Arduino ,   The ITACARE Working Group, Verdecchia Arduino , Capocaccia Riccardo , De Angelis Roberta , Valente Fulvia , Chessa Egidio , Sant Milena , Gatta Gemma , Micheli Andrea , Berrino Franco , Zanetti Roberto , Rosso Stefano , Magnani Corrado , Terracini Benedetto , Vercelli Marina , Casella Claudia , Parodi Stefano , De Lisi Vincenzo , Serventi Lidia , Barchielli Alessandro , Buiatti Eva , Balzi Daniela , Crocetti Emanuele , Falcini Fabio , Nanni Oriana , de Leon Maurizio Ponz , Roncucci Luca , Federico Massimo , Mangone Lucìa , Conti Ettore , Ramazzotti Valerio , Gafà Lorenzo , La Rosa Maria 
Published: April 2018

Aims To present a systematic analysis of population-based cancer patient survival in Italy. Methods Population-based survival data have been made available from 10 Italian cancer registries within the ITACARE project. Data, collected and validated using a common protocol, included over 100,000 patients with cancer diagnosed between 1978 and 1989. Multivariate weighted analysis was used to provide relative survival estimates attributable to Italy at national level. Results Results are presented, according to a systematic frame, as the main object of the ITACARE study, involving crude and relative survival figures for adult Italian cancer patients, by age, sex, period of diagnosis and registry area. An estimate with reference to Italy as a whole is also presented by cancer site and for all malignant neoplasms combined. Age-standardized relative survival figures are presented to allow comparisons between Italian registries and also to give a basis for international comparisons with countries involved in the EUROCARE study. Conclusions For the fist time, population-based survival of cancer patients is made available in Italy on a large scale analysis of data from all the Italian cancer registries in a combined action. Estimates of cancer patient survival at a national level in Italy allow proper international comparisons with European countries and give elements of evaluation and discussion on the performance of the Italian health care system.
Accelerated Bifractionated Radiation with Concurrent Cisplatin Administration in Locally Advanced Head and Neck Cancer: A Feasibility Study
Authors: Fountzilas George , Athanassiadis Athanassios , Nikolaou Angelos , Kalogera-Fountzila Anna , Tzitzikas John , Samantas Epaminontas , Skarlos Dimosthenis , Zamboglou Nicolaos , Daniilidis John 
Published: April 2018

Aims and Background To test the feasibility of accelerated interrupted twice-daily radiation and concurrent cisplatin administration in patients with locally advanced head and neck cancer. Patients and Methods Nineteen patients with locally advanced head and neck cancer were treated with accelerated bifractionated radiation with concurrent administration of cisplatin. There were 18 men and 1 female with a median age of 60 years (range, 17–71) and median performance status of 90 (-range, 80–100). Sixteen patients (85%) presented with stage IV disease. Primary site included the nasopharynx (n = 7), oropharynx (n = 5), hypopharynx (n = 1) and larynx (n = 6). Radiation consisted of two fractions of 1.6 Gy each daily, five times weekly to a total dose of 64 Gy. Cisplatin was administered at a dose of 100 mg/m2 on days 2 and 28 of the treatment period. Results Nine patients achieved a complete response (47%; 95% CI, 25%–70%) and 5 a partial response (26%; 95% CI, 7%–46%). Grade III–IV toxicity included leukopenia (16%), mucositis (26%), dry mouth (5%), weight loss (16%) and infection (5%). After a median follow-up of 27.11 months (range, 1–33+), 9 patients have died. Median time to progression was 11 months (range, 1–32+) and median survival 25 months (range, 1–32+). Conclusions Accelerated twice-daily radiation with concurrent cisplatin is effective in locally advanced head and neck cancer and can be safely given with manageable toxicity.
Immunophenotypes and Cytotoxic Functions of Lymphocytes in Patients with Hepatocellular Carcinoma
Authors: Chavan Sangeeta S. , Chiplunkar Shubhada V. 
Published: April 2018

Aims and background Hepatocellular carcinoma (HCC) is one of the most common cancers in Asia. Immunological mechanisms are thought to play an important role in the control of tumor progression. The immune responses in HCC patients are poorly understood. In the present study, the proliferation and cytotoxic functions of lymphocytes from tumor tissues and peripheral blood of HCC patients were analysed. Simultaneously, the microcultures were phenotyped in order to determine the involvement of different lymphocyte subsets in mediating the cytotoxic function. Methods The frequencies of proliferating and cytotoxic lymphocytes from three tumor tissues and peripheral blood from ten HCC patients and nine healthy individuals were assessed by limiting dilution microculture analysis. These microcultures were phenotyped by single and dual color flow cytometry using monoclonal antibodies specific for CD4, CD8, CD56 and HLA-DR markers. Results The precursor frequencies of both proliferating and cytotoxic lymphocytes were found to be comparable in the peripheral blood of HCC patients and healthy individuals. Compared to peripheral blood, a marked reduction in the precursor frequencies of proliferating and cytotoxic lymphocytes was observed in the tumor tissues of HCC patients. In the tumor tissues, a significantly higher frequency of cytotoxic T cells compared to natural killer cells was observed. Dual color flow cytometric analysis revealed increased percentages of CD8+ HLA-DR+ lymphocytes compared to CD4+ HLA-DR+ cells in the tumor tissues. Conclusions Our results suggest that depressed immune responses at the tumor site might be responsible for the escape of tumor cells from the immune surveillance of the host.
Radiation Therapy for Local-Regional Recurrences of Rectal Carcinoma following Primary Surgery
Authors: Osti Mattia F. , Bonanni Alessio , Zurlo Alfredo , Enrici Riccardo Maurizi , Biagini Carissimo 
Published: April 2018

Aims and background Several studies have emphasized the role of radiation therapy for patients with pelvic recurrences of rectal carcinoma following primary surgery. The occurrence of local-regional relapse usually means a poor prognosis and often a poor quality of life, so that different authors consider the prognosis of patients relapsing after surgery worse than those with primary inoperable tumors or those with residual disease after resection. Methods Between January 1988 and January 1995, 43 patients with local recurrence of rectal carcinoma were treated at our Institution. Twenty-three had previously been operated by abdominoperineal resection and 20 by anterior resection. Thirteen cases also received adjuvant chemotherapy. All patients underwent irradiation with a 6-15 MeV linear accelerator; 8 (19%) received a total dose of up to 45 Gy on the pelvis and 35 (81%) higher than 45 Gy. Eighteen cases (42%) underwent 3-6 courses of chemotherapy with 5-fluorouracil and folates during radiation. Results Treatment tolerance was satisfactory. All cases underwent restaging at 45 days from completion of treatment. Sixteen cases (37%) showed a radiologic response >50%. Median overall survival after relapse was 18.8 months. There were no statistical significant differences in survival between patients treated exclusively with radiation and those treated with chemo-radiothera-py (17 vs 22 months). The results of patients who received doses higher than 45 Gy were statically better (P < 0.05) than those irradiated up to 45 Gy. A slight increase in survival was demonstrated in cases submitted to radical surgery after combined treatment (25 months). Twenty-seven cases (63%) obtained pain control after radiation therapy (median pain remission, 11 months). Conclusions Our results seem to encourage radiation therapists, surgeons and oncologists to have a more curative attitude in the treatment of selected patients with local-regional recurrences of rectal cancers by using multi-modality therapy.
Intraperitoneal Chemotherapy with Mitoxanthrone in Ovarian Cancer
Authors: Le Donne Maria , Messina Giovanna , Buda Concetta , Corrado Francesco , Pettineo Giuseppe , Salimbeni Vincenzino , Irato Stefano 
Published: April 2018

Aims and background Ovarian carcinoma remains confined to the peritoneal cavity for the greater part of its natural history, so intraperitoneal (IP) administration of chemotherapy could result in greater total drug exposure of the tumor and minimize systemic antiblastic drug side effects. The aim of this study was to evaluate the therapeutic efficacy and toxic effects of intraperitoneal mitoxanthrone in patients affected by ovarian carcinoma with macroscopic absence of disease or minimal residual disease. Methods Ten patients were enrolled (stage II and III) who had been previously treated with neoadjuvant systemic chemotherapy (CDDP or CBDCA + CTX) and radical surgery resulting in macroscopic absence of disease or minimal residual disease (<1 cm). Mitoxanthrone (25 mg/m2) was instilled in 2 liters of normal saline every four weeks for 2-4 cycles. Results A total of 26 courses was administered; two patients discontinued IP therapy, one for chemoperitonitis and another for bowel perforation requiring catheter removal. Of the 10 patients receiving IP chemotherapy, 7 are alive at 5 years from radical surgery, and 3 had relapses at 13, 14 and 57 months, respectively, from radical surgery. Conclusions Intraperitoneal mitoxanthrone appears to be an effective second-line therapy in ovarian cancer; it is well tolerated as far as toxic effects are concerned, allowing cost reduction and improved patient compliance. For those cases requiring a limited number of peritoneal accesses traditional percutaneous systems have a more favorable cost/benefit ratio.