bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neoplastic and Non-Neoplastic Thyroid Lesions in Surgical Material: Historical Review of Five Decades in São Paulo, Brazil
Authors: Bisi Helio , Fernandes Vilma S.O. , Rosalinda Y. , De Camargo Asato , Filho Adhemar Longatto , Ruggeri Glaucia Berreta , Abdo Anete H. 
Published: April 2018

Aims and background The goal of the study was to report and discuss the neoplastic and non-neoplastic diseases of the thyroid gland present in a historical series of surgical material examined during the period 1945 to 1989 at the Pathology Department of the Sao Paulo University Medical School. Methods Records of 281,175 cases were reviewed to select those which affected the thyroid gland. The slides of these selected cases were analyzed and classified according to current terminology. Results Non-neoplastic lesions comprised 86.68% of the cases (n = 7024), and most of them were nodular goiter (n = 6458). Neoplastic lesions were divided into two groups: primary and metastatic. Of 1072 primary neoplasms, 530 were benign and 542 were malignant. Of the malignant neoplasms, papillary and follicular were the most frequent types (n = 201 and 187, respectively), followed by undifferentiated (n = 86), Hürthle (n = 46), medullary (n = 16) and others (n = 6). Of 8 metastatic neoplasms, 4 were from and undetermined primary epidermoid carcinoma. Conclusions We concluded that owing to the high incidence of neoplastic lesions (13.32%), half of which were malignant, examination of the thyroid gland should be done with strict criteria in view of the therapeutic and prognostic implications.
Distribution of the Carbohydrate Antigens, Du-Pan-2 and Ca19-9, in Tumors of the Lung
Authors: Ohshio Gakuji , Yamaki Kenichirou , Imamura Takaashi , Suwa Hirofumi , Chang Chien Yih , Wada Hiromi , Sueno Yurika , Imamura Masayuki 
Published: April 2018

Aims and background The carbohydrate chains of malignant cells appear to be related to oncofetal differentiation. The serum levels of CA19-9 have been reported to be evaluated in some patients with lung carcinomas, however, the distribution of carbohydrate antigens were not precisely described. We have investigated in this study the distribution of DU-PAN-2 and CA19-9 antigens in lung tumors. Methods Ninety five specimens of lung tumors were selected from surgical specimens. The expression of DU-PAN-2 and CA19-9 were studied by immunohystochemical techniques. The relationship between the expression of these antigens and the classification or the differentiation degree of the tumors were examined. Results DU-PAN-2 or CA19-9 antigens were detected in 41 (54%) and 45 (59%) cases of the 76 malignant epithelial tumors investigated. These antigens were detected in all types of malignant epithelial tumors, including squamous cell carcinomas, where they were mainly localized to the entire cell surface of malignant cells. In adenocarcinomas, large cell carcinomas and small cell carcinomas, however, these antigens were commonly detected both on the cell membrane and in the cytoplasm. There was positive correlation between the degree of differentiation and DU-PAN-2, but not CA19-9 expression. Among the non-epithelial tumors investigated, those antigens were detected in pulmonary blastomas but not in mesotheliomas. Conclusions Immunohistochemical studies for DU-PAN-2 and CA19-9 are useful for defining characteristics of the lung tumors. DU-PAN-2 could be a marker for differentiating between malignant epithelial tumors and mesotheliomas.
Quality of Life among Mastectomy Patients Using External Breast Prostheses
Authors: Hart Stacey , Meyerowitz Beth E. , Apolone Giovanni , Mosconi Paola , Liberati Alessandro 
Published: April 2018

Background Most women who undergo mastectomy for breast cancer use external breast prostheses. Yet, little is known about patterns of use, satisfaction levels, and quality of life associated with their use as compared to other options. Patients and Methods We report longitudinal, self-report questionnaire data regarding prosthetic use from 592 Italian mastectomy patients. Women who report satisfaction with their prostheses are compared on medical, demographic, and quality of life variables to a matched sample of women who report dissatisfaction. We also compare matched samples of women who do not use prostheses and women who had reconstruction to prosthetic users. Results Most women used and were satisfied with their prostheses. However, there was a small group of women who were dissatisfied. These women reported greater disruption to their sense of feminility and worse quality of life in some areas. We found few differences between prosthetic users and women who used either of the other two options available following mastectomy - taking no action to restore the appearance of the amputated breast or having reconstructive surgery. Conclusions No one technique for restoring the appearance of the mastectomized breast is necessary to optimize quality of life for all women. Physicians should describe the options to women, along with the average satisfaction rates for women choosing those options, and help women to make the best personal decisions.
Postoperative Adjuvant Chemoradiotherapy for Rectal Cancer: Analysis of Acute and Chronic Toxicity
Authors: Bertuccelli Maurizio , Cartei Francesco , Falcone Alfredo , Campoccia Salvatrice , Sainato Aldo , Ducci Francesco , Moda Stefano , Pfanner Elisabetta , Lencioni Monica , Brunetti Isa , Giulianotti Pier Cristoforo , Mosca Franco , Laddaga Michele , Conte Pier Franco 
Published: April 2018

Aims and background The aim of the study was to evaluate acute and chronic toxicity of combined postoperative standard radiation therapy to the pelvis and 5-fluorouracil plus levamisole in resectable rectal cancer. Methods Between July 1990 and September 1993, 58 patients with histologically confirmed adenocarcinoma of the rectum entered the prospective study. The schedule consisted of 5-fluorouracil, 450 mg/m2 i.v. for 5 days, and from day 28 5-fluorouracil, 450 mg/m2 i.v. weekly for 24 weeks, plus levamisole given orally at the dose of 150 mg every day for 3 days every 2 weeks for 6 months; radiotherapy (180 cGy/day) 5 days a week for a total dose of 45 Gy was administered from day 28. Results After the first cycle of chemotherapy (before radiotherapy), overall toxicity was mild. During chemoradiotherapy, dose-limiting toxicity was grade 3 diarrhea and proctitis, for which the combined treatment was interrupted for more than 7 cumulative days in 28 patients. During the 24 weeks of weekly 5-fluorouracil (after radiotherapy), no severe toxicity was reported. Three-year survival and progression-free survival were 65% and 50–55%, respectively. Conclusions Although adjuvant chemoradiotherapy is usually feasible, in our study toxicity was severe in a substantial proportion of patients, probably due to the schedule applied. We are evaluating the feasibility and toxicity of a combined treatment which includes 5-fluorouracil in continuous chronomodulated infusion during radiotherapy.
High-Dose Epirubicin in Locally Advanced Operable Noninflammatory Breast Cancer: A Feasibility Trial
Authors: Crivellari Diana , Buonadonna Angela , Sacco Cosimo , Bidoli Ettore , Candiani Ezio , Massarut Samuele , Roncadin Mario , Rossi Carlo , Galligioni Enzo 
Published: April 2018

Aims and background Anthracyclines are among the most active agents for the treatment of patients with locally advanced breast cancer. The aim of our study was to evaluate the feasibility and activity of a relatively high-dose regimen with 4-epirubicin plus normal doses of cyclophosphamide over a short period of time without the use of hematologic growth factors as adjuvant in resected locally advanced breast cancer. Methods. Between January 1990 and June 1992, 43 consecutive patients, premenopausal or postmenopausal «60 yrs, were surgically resected and then treated with epirubicin plus cyclophosphamide for at least 4 cycles (maximum 6). Electron beam (6–10 MeV energy) radiotherapy was delivered on the chest wall in patients with pathological skin infiltration (pT4b). Results Median age was 46 years (range, 27–59); 37 were premenopausal and 6 postmenopausal. The total number of administered cycles was 202 (6 in 15 patients and 4 in 28 patients); 195/202 (96.5%) were administered at full dose, and 7 (3.5%) were reduced to 75% of the planned dosage. The three-year disease-free survival was 67% for stage IlIa and 61% for stage IIIb patients. The three-year overall survival was 88% and 79%, respectively. Local relapse only was reported in one patient (2%), distant relapse in 11 patients (25%), and local and distant relapse in four patients (9%). Toxicity was acceptable and mainly hematologic. Conclusions. Our trial showed that the regimen is feasible without the use of hematologic growth factors. In this era of cost containment, the use of this short-term, high-dose induction course instead of repetitive courses of conventional dose regimens merits further evaluation, possibly in a large randomized trial.
Intermittent Continuous Infusion of Fluorouracil and Low-Dose Oral Leucovorin in Pretreated Breast Cancer: A Pilot Study
Authors: Colleoni Marco , Vicario Giovanni , Nelli Patrizia , Sgarbossa Gigliola , Pancheri Francesca , Manente Paolo 
Published: April 2018

Aims and background There is evidence that fluorouracil (FU), when administered by protracted venous infusion, has antitumor activity in pretreated breast cancer. The aims of the study were to assess, in a population of heavily pretreated breast cancer patients (≥2 lines of chemotherapy previously administered), the feasibility and activity of a new combination of oral L-leucovorin and continuous FU infusion. Methods Patients were treated with the following combination: oral L-leucovorin, 5 mg/m2 days 1 through 14, plus FU, 250 mg/m2 days 1 through 14, with cycles repeated every 21 days. Results Since November 1994, 22 patients have entered the study and 20 are assessable for response and side effects. Major patient characteristics were: ECOG performance status, 0-2; median age, 56 years (range, 41–70); sites of metastasis, bone 9, lung 8, liver 2, pleura 7; 2 or more metastatic sites, 18. A total of 74 cycles has been administered (median/patient, 3 cycles). Five partial remissions (25%), 4 disease stabilizations and 11 disease progressions have been observed. Median time to progression was 3 months (range 1–6+). Grade I–II mucositis was observed in 8 patients and grade III–IV in 6 patients. Other side effects have included diarrhea and thrombocytopenia. Conclusions The schedule has demonstrated moderate activity in heavily pretreated breast cancer, with mucositis as the dose-limiting toxicity.
The Role of Fluorine-18-Deoxyglucose (Fdg) Positron Emission Tomography (Pet) Whole Body Scan (Wbs) in the Staging and Follow-Up of Cancer Patients: Our First Experience
Authors: Ferlin Giorgio , Rubello Domenico , Chierichetti Franca , Zanco Pierluigi , Bergamin Roberta , Trento Paolo , Fini Alberto , Cargnel Serena 
Published: April 2018

We report the results of FDG PET whole body scan in 75 cancer patients in whom tumor extent was defined by surgical, histological or cytological findings and clinical follow-up. Twenty-five had malignant lymphomas, 24 lung carcinomas, and 26 other types of solid tumors. Twenty-three patients were evaluated at disease onset, before therapy, and 37 at the moment of tumor recurrence; the remaining 15 patients were in complete remission after treatment and were taken as controls. Visual and quantitative PET results were compared with conventional imaging (US, CT scan and/or MRI, and Tc99m MDP bone scan). In the 60 patients with active disease, PET as well as conventional imaging were able to locate the primary tumor in all 23 patients studied at disease onset. However, with regard to lymph node and distant metastases, PET provided the same information as conventional imaging in 31 cases (51.6%), but revealed further neoplastic foci in 29 cases (48.4%), 21 in lymph nodes and 8 at distant sites. The sensitivity of PET, in comparison with conventional imaging, was 100% versus 100% for the detection of the primary tumor, 97.6% versus 55.8% for the localization of node metastases, and 100% versus 55.5% for the visualization of distant metastases. The specificity, calculated in the group of 15 disease-free patients, was 100% for PET and 86.6% for conventional imaging. The therapeutic approach was modified in 12 patients (20%) on the basis of the PET results. Furthermore, in 14 cases (23.3%) with advanced disease, PET provided complete information on tumor spread, otherwise obtainable only by taking together the results of all other diagnostic procedures. Our data indicate a higher accuracy of FDG PET whole body scan compared to conventional imaging techniques in the evaluation of metastatic spread both at initial diagnosis and during follow-up, with an important impact on therapeutic decision-making. Moreover, by providing complete information on tumor spread in some cases, PET can become a profitable tool in terms of cost reduction.
Surgery or Radiotherapy for Early Stages Carcinomas of the Glottic Larynx
Authors: Magnano Mauro , Cavalot Andrea L. , Gervasio Carmine F. , Lerda Walter , Gabriele Pietro , Orecchia Roberto , Ruo-Redda Maria Grazia , Beltramo Guido , Ragona Riccardo , Cortesina Giorgio 
Published: April 2018

Aims and Background The choice of treatment in limited squamous cell carcinoma of the glottic larynx often depends on individual and tumor factors. Data of the literature clearly show that surgery and radiotherapy tend to give identical results in terms of survival. We examined 196 cases of T1-T2/N0 cancers of the glottic larynx. We review the literature and discuss the indications and the efficacy of the various available treatments. Methods and Study Design 196 consecutive cases of T1-T2/N0 cancers of the glottic larynx were examined. In 54.5% the tumor was confined to the vocal cord; in 38.2% it extended to the anterior commissure, in 4.6% to the arytenoid cartilage and in 2.5% to the floor of the ventricle. We performed partial laryngeal surgery in 41.3% (81 cases). Radiotherapy alone was employed in 58.6% (115 cases). Results In T1a and T1b cases there was no statistically significant difference in 5-year disease-free survival. In T2 cases the NED survival of patients who underwent partial laryngectomies (90% of cases) was significantly better (P <0.05) than among patients given radiotherapy (73%). NED survival at 5 years in patients with the primary tumor on a vocal cord, ventricle or anterior commissure was 78%, 80% and 81%, respectively, with no statistically significant difference among the various sites. It is possible that involvement of the anterior commissure exposes patients to greater risk of recurrence when radiotherapy alone is used (5 out of 23 cases, 21.7%, compared to 3 out of 52 cases, 5.7%, among our surgically treated patients). Conclusions When the tumor is confined to the vocal cord and mobility is not impaired (T1a), surgery and radiotherapy give comparable results, and the latter yields a better functional outcome. When the anterior commissure is involved, recurrences appear to be less likely after surgery. In T2 glottic carcinoma, surgery gives better results than radiotherapy alone. In any event, the choice of treatment should be patient-specific and based on a careful analysis of the factors involved in each case.
Locally Advanced Breast Cancer Treated with Primary Chemotherapy: Comparison between Magnetic Resonance Imaging and Pathologic Evaluation of Residual Disease
Authors: Trecate Giovanna , Ceglia Errico , Stabile Fernando , Tesoro-Tess John David , Mariani Gabriella , Zambetti Milvia , Musumeci Renato 
Published: April 2018

Aims and Background We evaluated the response of locally advanced breast cancer to induction chemotherapy using MRI techniques. The size and vitality of any residual pathologic tissue was quantified by means of morphologic and dynamic analysis. A curve derived from the dynamic parameters shows the uptake intensity with respect to the time elapsed since administration, which is related to vascularization and therefore indirectly reflects the angiogenesis of malignant tissue. Methods and Study Design A group of 30 patients were examined with MRI for staging purposes before undergoing treatment and subsequently to assess the response to treatment. Alterations in size and dynamic parameters were closely monitored. Results The overall accuracy was 90%, the sensitivity 96%, the specificity 75%, the positive predictive value 92.5% and the negative predictive value 66%. Interestingly, analysis of the dynamic curves made it possible to obtain additional information regarding the angiogenetic activity of the residual tumor. Conclusions Evaluation of the response to treatment by means of conventional imaging and clinical examination can be particularly difficult because of the fibrosis induced by cytotoxic drugs or the small volume of residual disease. The additional information supplied by MRI could therefore allow a more conservative surgical approach in selected cases of optimal response to treatment, as well as a much more accurate follow-up. Furthermore, the variation in dynamic parameters according to the vitality of residual disease could in the future become a useful tool for monitoring the effectiveness of anti-angiogenetic drugs.
High Doses of 5-Fluorouracil and Epirubicin with or without Cisplatin in Advanced Gastric Cancer: A Randomized Study
Authors: Roth Anton , Kolaric Krsto , Zupanc Darko , Oresic Vladimir , Roth Andrej , Ebling Zdravko 
Published: April 2018

Background A prospective randomized clinical study was performed in patients with locally advanced or metastatic gastric cancer. The purpose of the study was to determine the activity of high doses of 5-fluorouracil and epirubicin (FE) vs the same combination + cisplatin (FEP), and particularly the value of cisplatin in the combination. Patients and Methods A total of 122 patients was included in the study; 110 of them were assessable. In the FE arm, the treatment involved 1000 mg/m2 in a 6-hr infusion of 5-fluorouracil on days 1, 2, 3, 4 and 5 and 120 mg/m2 of epirubicin iv on day 1. In the FEP arm, the same combination of cytostatics + cisplatin (30 mg/m2) was administered on days 2 and 4. The cycles were repeated after 4 weeks. Altogether, 468 cycles of chemotherapy were given (FE, 240; FEP, 228). Results In the FE arm, 56 patients were assessable, with 2 complete and 14 partial remissions (28.6%); in the FEP arm, 4 complete and 19 partial remissions (42.6%) were observed in 54 assessable patients. Median survival in the FE group was 7.1 months and in the FEP group 9.6 months. The survival difference was statistically significant (Cox's test, P<0.05). The most frequent side effects included grade 2 and 3 alopecia (FE, 93%; FEP, 94%) and grade 2 and 3 vomiting (FE, 20%; FEP, 35%). Grade 3 and 4 leukopenia was observed in 9% of patients in the FE group and in 13% of patients in the FEP group, with 6 cases of febrile neutropenia (FE, 4%; FEP, 7%). Stenocardia was registered in 1 patient in the FE group and in 2 patients in the FEP group. No treatment-related death was registered. Conclusions The addition of cisplatin to high doses of 5-fluorouracil and epirubicin resulted in a statistically significant better survival of treated patients.
Cold Knife Conization and Loop Excision for Cervical Intraepithelial Neoplasia
Authors: Takač Iztok , Gorišek Borut 
Published: April 2018

Aims and Background Our aim was to investigate whether loop excision is an acceptable alternative to traditional cold knife conization of the cervix. Patients and Methods 240 with cervical intraepithelial neoplasia (CIN) were randomly assigned to loop excision (n = 120) or cold knife conization (n = 120). Success and complication rates of both methods were analysed. Results 100% of cold knife conization and 98% of loop excision surgical specimens were positive for dysplasia. The rate of complete resection was 91% in the cold knife and 82% in the loop excision group, but histologic confirmation of residual CIN was obtained in only 2 (1.7%) women after cold knife conization and in 5 (4.2%) after loop excision. Loop excision cones were significantly shallower than those obtained by a cold knife. Secondary surgical procedures due to early hemorrhage were performed in 9 (7.5%) patients treated with cold knife conization and in 8 (6.7%) treated with loop excision. Elevated temperature postoperatively was observed in 16.4% of patients after cold knife conization and in 13.9% after loop excision. There were no other postoperative complications. Conclusions The results suggest that cold knife conization and loop excision are comparable and equally effective diagnostic and therapeutic procedures for CIN.
Retroperitoneal Soft Tissue Sarcoma: Effect of Hyperthermic Total Abdominal Perfusion
Authors: Eroğlu Aydan , Kocaoğlu Hilmi , Demirci Salim , Akgül Hikmet 
Published: April 2018

Aims and Background Soft tissue sarcomas (STS) of the retroperitoneum are rare tumors. Surgery remains the principal modality of therapy in the management of primary and recurrent retroperitoneal STS. However, little is known about the effect of regional chemotherapy using hyperthermic total abdominal perfusion (HTAP). We analyzed independent prognostic variables in 33 patients with STS in the retroperitoneum admitted from November 1990 through December 1996. Methods and Study Design Data regarding patients’ age, gender, tumor size, histological tumor type, tumor location, type of operation (primary or secondary surgery), extent of surgical management (marginal or extended), use of HTAP, tumor grade, and tumor stage according to the TNM classification were examined by univariate and multivariate analyses. Results All 33 patients underwent complete resections (marginal or extended). Eleven of them received locoregional chemotherapy by HTAP. The overall cumulative 5-year survival rates in patients with stage IIA and advanced disease were 82% and 22%, respectively (log-rank test, P <0.01). Using Cox's proportional hazard model, tumor stage, use of HTAP and type of operation were found to have significant influence on overall survival (P <0.05). Conclusions Our results showed that complete resection along with HTAP chemotherapy may improve survival in patients with retroperitoneal STS. These phase II data could be used to support the initiation of a phase III trial to test HTAP in patients submitted to complete resection of retroperitoneal STS.
Improving the Quality of Life for Children with Cancer
Authors: Jankovic Momcilo , Van Dongen-Melman Jeanette E.W.M. , Vasilatou-Kosmidis Helen , Jenney Meriel E.M. 
Published: April 2018

There are now more than one million new cases of cancer every year in the European Community (EC) including the children to whom particular needs should be addressed. Besides the disease-free survival other outcomes reflecting the impact of treatment on the patient and their families must also be assessed and include their physical, psychological and social functioning throughout their care: during therapy, after completion of treatment or, for some, in the terminal phase of their illness. To provide optimal care and thus improve the quality of life for these children needs: a) an appropriately structured Paediatric Cancer Unit; b) well trained and permanent staff members: comprising doctors, nurses, psychologists, social workers and other health care professionals; c) facilities such as a specific out-patient clinic, a hospital school, a residence for parents; d) a well defined programme for the terminally ill children; e) a well defined programme for controlling the late effects of therapy.