bluuebunny/crossref_metadata_2025_split huggingface dataset:
Feasibility of Peritonectomy Associated with Intraperitoneal Hyperthermic Perfusion in Patients with Pseudomyxoma Peritonei
Authors: Deraco Marcello , Gronchi Alessandro , Mazzaferro Vincenzo , Inglese Maria Grazia , Pennacchioli Elisabetta , Kusamura Shigeki , Rizzi Maurilia , Anselmi Raul Alberto , Vaglini Maurizio 
Published: April 2018

Aims and background Pseudomyxoma peritonei is a rare disease characterized by a complete redistribution of mucin within the peritoneal cavity. It can be classified into three histologic groups: disseminated peritoneal adenomucinosis, peritoneal mucinous carcinomatosis, and an intermediate group. The aim of the present study was to evaluate the feasibility of cytoreductive surgery requiring peritonectomy procedures associated with intraperitoneal hyperthermic perfusion, a technique that combines hyperthermia and high drug doses administered locally. Methods Twenty-seven patients with pseudomyxoma peritonei (19 males and 8 females) were enrolled in a phase II clinical trial. Twenty-two cases underwent cytoreductive surgery plus intraperitoneal hyperthermic perfusion, and 6 received de-bulking surgery only. One patient was operated on twice for disease recurrence. All patients with peritoneal mucinous carcinomatosis presented serous ascites, whereas all but one patient with disseminated peritoneal adenomucinosis or in the intermediate group presented mucinous ascites. Cytoreductive surgery was performed with peritonectomy procedures. The closed abdomen technique was adopted for intraperitoneal hyperthermic perfusion using a preheated poly-saline perfusate containing cisplatin (25 mg/m2/L) plus mitomycin-C (3.3 mg/m2/L) through a heart-lung pump at a mean flow of 600 mL/min for 60 mins from the hyperthermic phase (42.5 °C). Results All but one of the patients with disseminated peritoneal adenomucinosis and 2 of the 3 patients in the intermediate group were optimally cytoreduced. Patients with serous ascites (all patients with peritoneal mucinous carcinomatosis and 1 patient with disseminated peritoneal adenomucinosis) were considered ineligible for treatment because of tumor diffusion. The morbidity rate was 22%. There was one case of treatment-related mortality 30 days after treatment. Conclusions The following conclusions can be drawn from this phase II clinical trial: 1) patients with pseudomyxoma peritonei originating from undifferentiated mucinous adenocarcinoma (peritoneal mucinous carcinomatosis), with complete distribution into the peritoneal cavity, are not eligible for the cytoreductive surgery plus intraperitoneal hyperthermic perfusion technique; 2) the presence of serous ascites would seem to exclude patients from the treatment; 3) cytoreductive surgery associated with intraperitoneal hyperthermic perfusion is the most suitable approach for patients with disseminated peritoneal adenomucinosis and in the intermediate group.
Prognostic Effects of Local Recurrence after Conservative Treatment for Early Infiltrating Breast Carcinoma
Authors: Barros Alfredo Carlos SD , Teixeira Luis Carlos , Nisida Antonio Carlos , Pinotti Marianne , Pinotti José Aristodemo 
Published: April 2018

Aim A study was carried out to determine whether local recurrence after quadrantectomy, axillary dissection and radiotherapy (QUART) affects the oncologic prognosis of patients with early infiltrating breast carcinoma. Methods A total of 149 patients were submitted to QUART between 1981 and 1990 and followed by an average period of 120.9 months (range, 16–213). Local recurrence was not observed in 132 cases (group 1) but was detected in 17 patients (group 2). Results In group 1, 39 cases (29.5%) presented distant metastases and 34 (25.8%) evolved to death. In group 2, 10 (51.8%) distant metastases and 9 deaths (52.9%) were verified. The survival curves estimated by the Kaplan-Meier method and analyzed by the logrank test were statistically different for distant metastases-free survival (P = 0.03) and for overall survival (P = 0.01). The relative risk in patients with post-QUART local recurrence for distant metastases was 2.09 and for death 2.34. Conclusions It was concluded that post-QUART local recurrences are a poor prognostic factor in patients with early infiltrating breast carcinoma.
The Efficacy of Orgotein in the Treatment of Acute Toxicity Due to Radiotherapy on Head and Neck Tumors
Authors: Valencia Javier , Velilla Carmen , Urpegui Angel , Alvarez Ignacio , Llorens M Angeles , Coronel Pilar , Polo Sonia , Bascón Natiyidad , Escó Ricardo 
Published: April 2018

Aims and background To assess the efficacy of orgotein in the treatment of acute secondary effects of radiotherapy on head and neck tumors. Material and methods Data were collected on 41 patients who received radiotherapy for tumors of the head and neck. Radiotherapy was the exclusive treatment in 19.5% of cases, with surgery in 24.4%, chemotherapy in 48.8%, and with both in 7.3%. The toxicity requiring use of orgotein was: oropharynx mucositis (26.8%), dysphagia (34.2%), or both (39%), in grade 2 or more according to the RTOG scale. Orgotein (8 mg im) was administered every 48 hrs until radiotherapy was finished. Results The overall response rate was 92.5%; a complete response was obtained in 12 patients (30%) and partial in 25 (62.5%). The reduction in toxicity at the end of radiotherapy was one grade in 18 patients (45%), 2 grades in 16 (40%), 3 in 2 patients (5%), and 4 grades in the only patient with grade 4 acute toxicity. A statistically significant influence was shown in obtaining complete response: laryngeal tumor location (P = 0.037), duration of radiotherapy of more than 53 days (P = 0.002), discontinuation for non-toxic reasons (P = 0.008). Conclusions We consider that orgotein is highly effective in dealing with acute secondary effects of radiotherapy on the head and neck area.
Prognostic Significance of Blood Group Antigen Expression of Tumor Tissue in Lung Cancer Patients
Authors: Ülger Aybe Füsun , Keklik Tülay , Kumbasar Özlem Özdemir , Arbak Peri , Demirkazýk Ahmet , Güngör Adem , Erekul Selim , Alper Doğanay 
Published: April 2018

Aims and background Many prognostic factors have been evaluated both for SCLC and NSCLC. The prognostic significance of blood group antigen expression of tumor tissues has been studied particularly in NSCLC, yielding divergent results. The aim of the present study was to investigate the prognostic value of the tumoral expression of blood group antigens ABH in lung cancer. Methods The presence of blood group antigens was assessed immunohistochemically in paraffin-embedded tumor samples from 92 patients diagnosed between 1996 and 1997. Monoclonal antibodies were used to detect blood group antigens. Results The median survival was longer in NSCLC patients whose tumors were positive for blood group antigen A (P = 0.009). Since the expression of blood group antigen A in tumor cells was limited to patients with type A or AB blood, survival analysis of these patients showed survival to be longer in non-small cell lung cancer patients with blood group antigen A-positive tumors (P = 0.0019). Conclusions Expression of blood group antigen A in tumor cells is an important, favorable prognostic factor in patients with non-small cell lung cancer, which could be useful to stratify patients with blood group A or AB according to possible outcome, and to guide therapeutic decision-making. The expression of blood group antigens ABH should be evaluated in larger series of lung cancer patients (including small and non-small cell lung cancer) with all blood types.
Significance of the Relative Size of a Breast Tumor in Deciding the Method of Surgical Treatment
Authors: Lesar Miroslav , Stanec Mladen , Banović Miroslav 
Published: April 2018

Aim In the surgical treatment of breast cancer there are basically two options: radical and breast-sparing surgery. The main criterion in deciding the mode of treatment is the absolute size of the primary tumor. The purpose of this study was to analyze the relative size of a breast tumor as a prognostic factor and to establish boundary values of the relative tumor size for breast-sparing or radical surgery. Methods The relative volume of the breast tumor was analyzed in 200 female patients treated at the Zagreb University Hospital for Tumors. All patients were diagnosed with ductal invasive carcinoma and underwent radical surgery. Results The study found the correlation between the relative volume of the tumor and tumor grade (r = 0.805, P = 0.24) and between the relative volume of the tumor and the involvement of regional lymph nodes (r = 0.493, P = 0.14). These correlations confirmed the possible prognostic value of the relative size of a breast tumor. Conclusions Three percent is the boundary value of the relative volume of a tumor at which its biological potential changes and the pathohistological level of a tumor and the number of affected lymph nodes increases. The relative size of 3% could therefore be considered a boundary value in making a decision about the method of surgical treatment (breast-sparing or radical surgery). For tumors with a relative size of less than 3%, breast-conserving surgery is recommended for its lesser malignant potential and the possibility of performing wide extirpation (extirpation 1-2 cm from the tumor margin), regardless of the size of the breast.
Disclosure of Cancer Diagnosis to Patients and their Relatives in Turkey: Views of Accompanying Persons and Influential Factors in Reaching those Views
Authors: Öksüzoğrlu Berna , Abalı Hüseyin , Bakar Meral , Yıldıirıim Nuriye , Zengin Nurullah 
Published: April 2018

Aims and Background In Turkey, it is a common belief that most family members of patients with cancer would not want them to be informed of a diagnosis of cancer. Our aim was to evaluate the attitudes and opinions of people accompanying cancer patients, regarding cancer diagnosis disclosure. Methods In a cross-sectional study 270 caregivers accompanying cancer patients during outpatient chemotherapy sessions were asked to fill in a questionnaire to determine their opinions regarding whether the diagnosis of cancer should be disclosed to the patients and their relatives or not. Timing of telling the diagnosis and from whom it should be learned were queried as well. Possible influential factors for the answers were analyzed with the chi-square test. Results Of the 270 accompanying persons, 130 (48.2%) said that the patients should be informed of the diagnosis, whereas a greater number (236, 87.4%) believed that the patient's relatives should be informed. Being younger than 40 years old (P = 0.0005), being unmarried (P = 0.002), having a higher educational status (P = 0.0001) and having passed less than four months since the diagnosis (P = 0.005) positively affected opinions regarding telling the truth to the patient. Higher education (P = 0.012) and high monthly income (P = 0.002) positively affected opinions regarding disclosing a diagnosis of cancer to the patient's relatives. Conclusion As a result, in a survey of caregivers’ points of view, more than half of the accompanying persons did not agree with disclosing a cancer diagnosis to patients, whereas the majority agreed with disclosing it to the relatives, and educational level seemed to be the major influential factor.
Folfox4 in Advanced Colorectal Cancer: A Monoinstitutional Experience
Authors: Boscolo Giorgia , Pasetto Lara Maria , Jirillo Antonio , Monfardini Silvio 
Published: April 2018

Aims and background Patients included in clinical trials are “selected”, and they usually differ from those commonly treated. Methods: From 1999 to 2004, in the Medical Oncology Department of Padua (Italy), 70 metastatic colorectal cancers were treated with FOLFOX4. Results Our results, compared with those of the registration trial (response rate, duration of response and progression-free survival) appeared lower; overall survival was improved. Conclusions The number of therapeutic regimens more than their type influenced the results.
Localized Prostate Cancer Treated with Intensity-Modulated Radiotherapy
Authors: Livi Lorenzo , Paiar Fabiola , Banci-Buonamici Fabrizio , Simontacchi Gabriele , Detti Beatrice , Gacci Mauro , Mondaini Nicola , Nelli Federico , Bastiani Paolo , Pertici Maurizio , Mungai Raffaello , Ponticelli Pietro , Biti Giampaolo 
Published: April 2018

Aims and background The development and use of new radiotherapy techniques, especially 3D conformal radiotherapy or intensity-modulated radiotherapy, has allowed the safe application of high doses of external beam radiotherapy without increasing toxicity. The aim of this analysis was to describe the acute and when possible late toxicity and the feasibility on using intensity-modulated radiotherapy into our routine work. Patients and methods From June 2003 to December 2004, 60 patients with prostate cancer underwent high dose (80 Gy) radiotherapy treatment with intensity-modulated radiotherapy at the University of Florence. In the current analysis, we included patients without clinical or radiographic evidence of distant disease at the time of the first evaluation in the radiotherapy unit. Results Intensity-modulated radiotherapy treatments were delivered successfully without any interruption or technical problem. High-dose intensity-modulated radiotherapy was well tolerated acutely. Four patients (10%) developed grade 1 late rectal toxicity after completion of intensity-modulated radiotherapy and 8 patients (20%) developed grade 1 late urinary symptoms. Conclusions Intensity-modulated radiotherapy is the approach of choice for high-dose radiotherapy delivery. No patient had severe toxicity (grade 3) despite the high dose delivered. From a cost-benefit point of view, our experience shows that delivery of intensity-modulated radiotherapy requires only minor corrections to the ordinary activity schedule.
The Value of Postoperative Radiotherapy in Renal Cell Carcinoma: A Single-Institution Experience
Authors: Ulutin H Cuneyt , Aksu Gorkem , Fayda Merdan , Kuzhan Okhan , Tahmaz Lutfu , Beyzadeoglu Murat 
Published: April 2018

Aim To evaluate the efficacy of postoperative irradiation in renal cell carcinoma. Patients and methods Forty patients with localized renal cell carcinoma admitted to our hospital between 1986 and 1999 were evaluated. All patients were initially treated with radical nephrectomy. Postoperative radiotherapy was given to 26 of 40 patients (65%). Fourteen patients (35%) received no adjuvant therapy. Median age was 55 years (range, 20–70 years). Twenty-four patients (60%) were men and 16 patients (40%) were women. Histopathological diagnosis was renal cell carcinoma in all of the patients. N+ disease was present in 3 patients (7%). Stage I and II disease was present in 25 patients (63%) and stage III and IV disease in 15 patients (37%). Two patients (5%) had T1a disease, 11 patients (27%) had T1b, 15 patients (38%) had T2, 11 patients (27%) had T3a and 1 (3%) patient had T3b. In the radiotherapy group, renal bed and regional lymphatic fields were irradiated with daily fractions of 180–200 cGy/fraction to a total dose of 46–50 Gy, using parallel opposing fields. Results The 5-year overall survival rates were 70% in the postoperative radiotherapy group and 20% in the no adjuvant treatment group, showing no significant difference (P = 0.1). The 5-year disease-free survival rates were 66% in the radiotherapy group and 16% in the no treatment group, with a significant difference in both univariate and multivariate analyses (P = 0.045 and P = 0.0007, respectively). Stage III and IV disease, tumor size ≥7 cm, presence of distant metastasis and lactate dehydrogenase level >450 U/L were found to be adverse prognostic factors for overall survival in both univariate and multivariate analyses. Analyzing the factors affecting disease-free survival, absence of postoperative radiotherapy and tumor size ≥7 cm were found to be adverse prognostic factors in univariate and multivariate analyses. Conclusion Multi-institutional prospective randomized trials using modern radiotherapy techniques such as conformal radiotherapy and intensity-modulated radiotherapy are necessary to evaluate the real role of radiotherapy and its effect on survival in renal cell carcinoma, especially in selected patients with a high risk of local or regional failure.
Clinical Application of Spectral Electromagnetic Interaction in Breast Cancer: Diagnostic Results of a Pilot Study
Authors: De Cicco Concetta , Mariani Luigi , Vedruccio Clarbruno , Ricci Carla , Balma Massimo , Rotmensz Nicole , Ferrari Mahila Esmeralda , Alitino Elena , Trifirò Giuseppe , Sacchini Virgilio , Viale Giuseppe , Paganelli Giovanni 
Published: April 2018

Aims and background There is a need for a cost-effective method to safely reduce the number of diagnostic procedures women undergo for breast cancer. We tested a new procedure for breast cancer diagnosis based on breast tissue response to low level electromagnetic incident waves. Methods We tested 101 patients with suspicious palpable breast lesions detected by mammography or ultrasonography, who were scheduled to undergo an open biopsy. Using an electromagnetic field generator (tissue resonance interaction method probe [TRIMprobTM]), we passed the TRIMprobTM over the breast area and recorded the signal variation of one or more spectral lines (dB1, dB2, dB3). The results were compared with those of a control group as well as with pathology data obtained from excisional biopsy. Results No adverse effects of the test were observed. Pathology revealed 86 malignant breast cancers (72 invasive, 14 in situ) and 15 benign conditions. We achieved the best discrimination between normal breasts and lesions using dB1 (dB1 AUC-ROC = 0.8; dB2 AUC-ROC = 0.61; dB3 AUC-ROC = 0.76). With a specificity of 75% to 95%, the sensitivity ranged from 49% to 84%. Tumor or patient variables did not influence the results. Conclusions The TRIMprobTM test was able to provide some degree of discrimination between normal breast tissue and lesions but not between benign and malignant lesions. The lack of influence of patient age and tumor size on test results might be advantageous in terms of early diagnosis in young women. These preliminary results need to be verified and extended in a preclinical-stage disease setting before clinical applicability can be envisaged.
Role of Cytomegalovirus and Epstein-Barr virus in Patients with de Novo Colon Cancer after Renal Transplantation
Authors: Adani Gian Luigi , Baccarani Umberto , Lorenzin Dario , Bresadola Vittorio , Currò Giuseppe , Sainz Mauricio , Gropuzzo Maria , Montanaro Domenico , Tulissi Patrizia , Risaliti Andrea , Bresadola Fabrizio 
Published: April 2018

Aims The development of new effective immunosuppressive agents has provided long-term survival for transplant recipients, thereby increasing the risk of de novo malignancy in chronic immunocompromised hosts. Although de novo post-transplant lymphoproliferative diseases and skin cancer have been shown to have an increased incidence in long-term surviving solid organ transplant recipients, the association with colon cancer is controversial. Patients and methods Over a 12-year period, 20 patients (5%) out of 400 renal transplant recipients (treated at the University Hospitals of Udine and Ancona) developed 24 de novo tumors; 11 skin cancers and 13 non-skin cancers. Three patients developed de novo colon cancer. Immunosuppressive therapy was reduced immediately after diagnosis, and all patients were shifted from cyclosporine to rapamicine within 30 days. The tumor was surgically resected with curative intent in 2 cases, and 1 patient had only palliative surgery due to metastatic disease. The postoperative course was uneventful, and all patients maintained normal graft function. Results Two of 3 patients died of progression of the neoplasm, within a median time from the diagnosis of 12 months. We analyzed the possible correlations between de novo colon cancer and “serology (hepatitis C virus-hepatitis B virus, HCV-HBV) status'’ infections, cytomegalovirus and Epstein-Barr virus reactivation, episodes of rejection, and blood transfusions. Conclusions Differently from other de novo skin and non-skin tumors, our cases developed cytomegalovirus and Epstein-Barr virus reactivation within 3 months of transplantation. Therefore, we suggest a closer follow-up for de novo colon cancer in renal transplants with early cytomegalovirus and Epstein-Barr virus reactivation in order to avoid a delay in diagnosis.
Relationships among unmet needs, depression, and anxiety in non–advanced cancer patients
Authors: Ferrari Martina , Ripamonti Carla I. , Hulbert-Williams Nicholas J. , Miccinesi Guido 
Published: April 2018

Introduction: In oncology settings, less attention is given to patients’ unmet needs and to existential and emotional distress compared to physical symptoms. We aimed to evaluate correlations between unmet needs and emotional distress (self-reported anxiety and depression) in a consecutive cohort of cancer patients. The influence of sociodemographic and clinical factors was also considered. Methods: A total of 300 patients with cancer recruited from an outpatient Supportive Care Unit of a Comprehensive Cancer Centre completed the Need Evaluation Questionnaire and the Edmonton Symptom Assessment System (ESAS). Unmet needs covered 5 distinct domains (informational, care/assistance, relational, psychoemotional, and material). Results: After removal of missing data, we analyzed data from 258 patients. Need for better information on future health concerns (43%), for better services from the hospital (42%), and to speak with individuals in the same condition (32%) were the most frequently reported as unmet. Based on the ESAS, 27.2% and 17.5% of patients, respectively, had a score of anxiety or depression >3 and needed further examination for psychological distress. Female patients had significantly higher scores for anxiety ( p < 0.001) and depression ( p = 0.008) compared to male patients. Unmet needs were significantly correlated with both anxiety ( rs = 0.283) and depression ( rs = 0.284). Previous referral to a psychologist was significantly associated with depression scores ( p = 0.015). Results were confirmed by multiple regression analysis. Conclusions: Screening for unmet needs while also considering sociodemographic and clinical factors allows early identification of cancer patients with emotional distress. Doing so will enable optimal management of psychological patient-reported outcomes in oncology settings.