bluuebunny/crossref_metadata_2025_split huggingface dataset:
Critical factors influencing the establishment, maintenance and sustainability of population-based cancer control programs
Authors: Trapido Edward J , Borras Josep Maria , Burton Robert , Samiei Massoud , Elwood Mark ,   ICCC-3 Session F group
Published: February 2018

Developing and maintaining a comprehensive cancer control program are two distinct entities. Key issues related to building and sustaining cancer control programs include how to integrate initiatives and efforts across multiple constituencies addressing components of the implementation of cancer control and non-communicable disease programs, the processes used in different resource settings to achieve effective drug budgeting, health technology assessment and health economics, and how countries can support public and societal engagement. There are promising examples in both resource-rich and resource-challenged countries of constituencies that have developed programs which can contribute to comprehensive cancer control. Some take advantage of newer technology and information services, while others are more people and patient focused. Critical issues and factors for establishing and maintaining population-based comprehensive cancer control programs are identified and reviewed.
Cancer Mortality in Italy, 2003
Authors: Malvezzi Matteo , Bertuccio Paola , Chatenoud Liliane , Negri Eva , La Vecchia Carlo , Decarli Adriano 
Published: February 2018

Aims and Background This report provides data and statistics for cancer mortality in Italy in 2003, updating previous work on the issue. Methods Cancer death certification numbers by cause and estimates of the resident population in 2003, stratified by sex and quinquennium of age, were obtained from the World Health Organization database. In 2003, cause of death encoding was changed from the 9th to the 10th Revision of the International Classification of Diseases (ICD). All cancers and groups of cancers, classified according to the 10th revision of the ICD, were grouped into 30 categories, besides other and unspecified sites. Mortality rates were age-standardized on the world standard population in five-year age groups up to 80-84 years and 85+. Results The total number of cancer deaths in Italy was 167,144 in 2003 (96,127 men and 71,017 women), with age-standardized death rates of 160.63 and 89.32 per 100,000 inhabitants, respectively. Lung cancer mortality in men confirmed the favorable trend, with rates of 43.72/100,000 and 51.68/100,000 in the all ages and truncated groups, respectively. Most other tobacco-related cancers were also declining in men but not in women. Cancers of the female breast and uterus (cervix and corpus) continue to decrease, with overall rates of 17.11/100,000 and 3.71/100,000. Declines were also observed in stomach and testis cancers. A few cancer sites such as prostate and multiple myeloma appeared to rise, but these trends were mainly due to the ICD change and the stricter age-standardization categories (80-84 and 85+ instead of 80+). Conclusions Trends in cancer mortality remained favorable for most major cancer sites, mainly in men for tobacco-related cancers. Due to the classification changes brought about by the change of ICD and the stricter age standardization, the present mortality rates should only be compared to previous ones with due caution.
Mitomycin C and Vinblastine: An Active Regimen in Previously Treated Breast Cancer Patients
Authors: Ospovat Inna , Siegelmann-Danieli Nava , Grenader Tal , Hubert Ayala , Hamburger Tamar , Peretz Tamar 
Published: February 2018

Background Metastatic breast cancer has a substantial mortality burden on women worldwide. Presented herein is our experience with the combination of mitomycin-C and vinblastine in heavily pretreated breast cancer patients. Methods Candidates were women with measurable metastatic disease, previously exposed to two or more chemotherapy regimens. Mitomycin-C was given at the dose of 10 mg/mý on day 1 and vinblastine at 6 mg/mý on days 1 and 21 of each 42-day cycle. Analysis included patients exposed to one or more cycles of therapy. Kaplan-Meier curves were used to generate overall survival and time-to-treatment progression curves. Results Forty patients previously exposed to a median of three prior regimens were included. Partial response and stable disease were reported in 14 (35%) and 10 (25%), patients, respectively, for a clinical benefit of 60%. With a median follow-up of 11 months, the median time to progression and survival durations lasted 4 and 12 months, respectively. In a subgroup of 17 women with prior anthracycline and taxane exposure, partial response and stable disease were reported in 4 (23.5%) and 5 (29%), respectively. Treatment was generally well tolerated, with grade 3-4 hematologic and non-hematologic toxicity reported in 8 (20%) and 3 (7.5%) patients, respectively. Two cases of fatalities (5%) occurred with pulmonary toxicity in women heavily exposed to mitomycin-C (cumulative doses of ≥40 mg/mý) and soon after red blood cell transfusion. Conclusions Chemotherapy with mitomycin-C and vinblastine is active and well-tolerated in heavily pretreated breast cancer patients. Caution should be taken to avoid blood transfusion alone with mitomycin-C therapy.
Surgical Treatment of Primitive Thyroid Lymphoma
Authors: Avenia Nicola , Ragusa Mark , Cirocchi Roberto , Puxeddu Efisio , Cavaliere Antonio , De Feo Pierpaolo , Sidoni Angelo , Roila Fausto , Sanguinetti Alessandro , Puma Francesco 
Published: February 2018

Aims and Background Primitive thyroid lymphoma, although rare, is becoming more frequent. Its incidence is increasing, from 0.5% in the sixties to 1-5% of all thyroid neoplasms today. The diagnosis of such neoplasms is not always straightforward. In fact, it is often the result of pathologic findings on a gland resected for an apparently benign disease. Surgical dissection may prove more complicated than in standard cases of thyroidectomy for the possible tight adhesions existing between the gland's capsule and the surrounding structures. In cases of capsular infiltration, postoperative external local radiotherapy is indicated. Methods A retrospective observational analysis was performed to establish whether patients with incidental thyroid lymphomas who underwent total thyroidectomy for another pathology had major surgical complications and worse prognostic results than patients with an accurate preoperative diagnosis. Results Six cases of thyroid lymphoma were retrospectively reviewed: 4 diffuse large B-cell lymphomas and 2 MALT lymphomas. Of these, 2 were correctly preoperatively identified by fine-needle aspiration biopsy and 4 were an unexpected finding at histology: 3 cases of total thyroidectomy carried out for huge hypothyroid goiter in patients affected by Hashimoto's thyroiditis and in 1 case of total thyroidectomy carried out for anaplastic carcinoma in a patient affected by Hashimoto's thyroiditis. Conclusions In our experience, a correct preoperative diagnosis was extremely difficult (33%). In patients who underwent fine-needle aspiration, a correct diagnosis was made in 66% of cases. All patients with stage IE lymphoma who underwent total thyroidectomy had equivalent surgical complications and prognosis.
Radiation Therapy for Gastric Cancer Bleeding
Authors: Lee Jung Ae , Lim Do Hoon , Park Won , Ahn Yong Chan , Huh Seung Jae 
Published: February 2018

Aims and Background To evaluate the outcome of palliative radiotherapy (RT) for patients with gastric cancer bleeding. Methods A retrospective review of 30 patients with gastric cancer bleeding who underwent palliative RT was conducted. Twenty-three patients who received a dose of ≥30 Gy in 10 fractions were eligible. The palliative effect was evaluated both in a subjective and objective manner. Subjective symptomatic relief of bleeding was determined and an objective response was evaluated by identifying the amount of transfused packed red blood cells (PRBC) and the mean hemoglobin (Hb) level of patients before and after RT. Results Subjective symptom relief was observed in 21 patients. The number of transfused PRBC units was 2 to 25 (median, 6) during the month before RT and 0 to 16 (median, 0) during the month after RT ( P <0.001). The average level of Hb increased from 9.1 ± 1.6 g/dL to 10.6 ± 1.6 g/dL ( P <0.001). In 9 patients whose laboratory findings were available for ≥3 months after RT, the mean Hb at one, two, and three months after RT was 10.7 ± 1.7 g/dL ( P = 0.004), 10.5 ± 1.0 g/dL ( P = 0.039), and 9.9 ± 1.0 g/dL ( P = 0.164), respectively. The median number of transfused PRBC units decreased from 6 to 0 during the three months after RT. Conclusion RT may be an effective treatment for gastric cancer bleeding when other modalities are not feasible. In this study, 91% of the patients experienced symptomatic palliation with an elevated Hb level and a decreased number of transfusions after RT.
Prognostic Relevance of MLH1 and MSH2 Mutations in Hereditary Non-Polyposis Colorectal Cancer Patients
Authors: Russo Antonio , Sala Paola , Alberici Paola , Gazzoli Isabella , Radice Paolo , Montefusco Claudia , Torrini Margherita , Mareni Cristina , Fornasarig Mara , Santarosa Manuela , Viel Alessandra , Benatti Piero , Pedroni Monica , De Leon Maurizio Ponz , Lucci-Cordisco Emanuela , Genuardi Maurizio , Messerini Luca , Stigliano Vittoria , Cama Alessandro , Curia Maria Cristina , De Lellis Laura , Signoroni Stefano , Pierotti Marco A , Bertario Lucio 
Published: February 2018

Aims and Background Colorectal carcinoma patients from hereditary non-polyposis colorectal cancer families are suggested to have a better prognosis than sporadic colorectal carcinoma cases. Since the majority of hereditary non-polyposis colorectal cancer-related colorectal carcinomas are characterized by microsatellite instability due to germline mutations in DNA mismatch repair genes, this is consistent with the prolonged survival observed in sporadic microsatellite instability-positive colorectal carcinoma compared to microsatellite stable cases. However, a fraction of colorectal carcinoma cases belongs to families that, despite fulfilling the clinical criteria for hereditary non-polyposis colorectal cancer, do not carry mismatch repair gene mutations. Our aim was to verify to what extent the genotypic heterogeneity influences the prognosis of hereditary non-polyposis colorectal cancer patients. Methods A survival analysis was performed on 526 colorectal carcinoma cases from 204 Amsterdam Criteria-positive hereditary non-polyposis colorectal cancer families. Enrolled cases were classified as MLH1-positive, MSH2-positive and mutation-negative, according to the results of genetic testing in each family. Results Five-year survival rates were 0.73 (95% CI, 0.66-0.80), 0.75 (95% CI, 0.66-0.84) and 0.62 (95% CI, 0.55-0.68) for MLH1-positive, MSH2-positive and mutation-negative groups, respectively (logrank test, P = 0.01). Hazard ratio, computed using Cox regression analysis and adjusted for age, sex, tumor site and stage, was 0.71 (95% CI, 0.51-0.98) for the mutation-positive compared to the mutation-negative group. Moreover, in the latter group, patients with microsatellite instability-positive colorectal carcinomas showed a better outcome than microsatellite stable cases (5-year survival rates, 0.81 and 0.60, respectively; logrank test, P = 0.006). Conclusions Our results suggest that the prognosis of hereditary non-polyposis colorectal cancer-related colorectal carcinoma patients depends on the associated constitutional mismatch repair genotype.
Tanshinone II-A Inhibits Invasion and Metastasis of Human Hepatocellular Carcinoma Cells in Vitro and in Vivo
Authors: Yuxian Xu , Feng Tian , Ren Li , Zhengcai Liu 
Published: February 2018

Aims and Background Tanshinone II-A is an alcohol extract of the root of the traditional Chinese medicinal plant Salvia miltiorrhiza Bunge, whose effects and mechanism in tumor metastasis are still unclear. The aim of this study was to investigate the effects of tanshinone II-A on tumor invasion and metastasis in human hepatocellular carcinoma (HCC) and its possible mechanism of action. Methods and Study Design The HCC cell lines HepG2 and SMMC-7721 were treated with tanshinone II-A at different doses. Invasion and metastasis of tumor cells were examined by in vitro and in vivo assays. The molecular mechanisms of tanshinone II-A for inhibiting invasion and metastasis of HCC cells were investigated by Western blot and gelatin zymography. Results Treatment with tanshinone II-A had inhibitory effects on the migration and invasion of HCC cells. Increasing doses resulted in enhanced inhibitory effects. At 0.5 mg/L, the inhibitory effect was noticeable. At 1 mg/L, the inhibitory rate was 53.15%. The inhibitory effect became stronger with time; among 24, 48, 72 and 96 hours of treatment, the most significant effects were observed at 72 hours. Tanshinone II-A also significantly inhibited in vivo metastasis of HepG2 cells. Tanshinone II-A inhibited in vitro and in vivo invasion and metastasis of HCC cells by reducing the expression of the metalloproteinases MMP2 and MMP9 and by blocking NF-kappa B activation. Conclusions Tanshinone II-A effectively inhibited invasion and metastasis of HCC cells in vitro and in vivo, partly by inhibiting the activity of MMP2 and MMP9, and partly via the NF-kappa B signal transduction pathway.
The Sequencing of Chemotherapy and Radiotherapy in Breast Cancer Patients after Mastectomy
Authors: Kim Hak Jae , Kim Jae-Sung , Chie Eui Kyu , Noh Dong-young , Bang Yung-jue , Ha Sung Whan 
Published: February 2018

Background The purpose of the study was to retrospectively evaluate the outcome according to the sequencing of radiotherapy and chemotherapy after mastectomy in high-risk patients with breast cancer. Methods From January 1986 through September 2000, 275 women with stage I-IIIB breast cancer were treated with chemotherapy and radiotherapy after mastectomy. The patients were divided into four groups. Chemotherapy was given first in 116 patients (CTRT), concurrent chemoradiotherapy in 77 (CCRT), sandwich therapy in 65 (SAND), and radiotherapy first in 17 (RTCT). Prognostic factors such as age, primary tumor size and nodal status were not statistically different among the four groups. There was a higher proportion of patients with close or positive margins in CCRT and RTCT groups than in the CTRT and SAND groups (22/77, 5/17 vs 3/116, 2/65, P <0.001). Results Median follow-up was 145 months (range, 10–210). Five-year overall and disease-free survival were 69.4% and 56.1%, respectively. Survival outcomes were not statistically different among the four groups (5-year overall/disease-free survival, 68.0%/63.0%, 71.3%/60.8%, 65.0%/48.1%, 81.9%/58.8%, in CTRT, CCRT, SAND, and RTCT, respectively) (P = 0.3422/P = 0.6333). The incidence of local-regional recurrence was not different in the early radiotherapy group (CCRT/RTCT, 11%/12%) and delayed radiotherapy group (CTRT/SAND, 7%/8%). Conclusions This study suggests that in these high-risk breast cancer patients after mastectomy, delay in the start of radiotherapy does not increase local-regional recurrence, and the final survival outcomes are not affected by the sequencing of chemotherapy and radiotherapy.
Long-term Anorectal Function after Postoperative Chemoradiotherapy in High-Risk Rectal Cancer Patients
Authors: Lupattelli Marco , Mascioni Francesca , Bellavita Rita , Draghini Lorena , Tarducci Roberto , Castagnoli Paolo , Russo Giuseppe , Aristei Cynthia 
Published: February 2018

Aims and background After sphincter-preserving surgery for rectal cancer and postoperative radiochemotherapy, many patients have unsatisfactory anorectal functional results which are not considered by the most common toxicity scales. The aim of the present study was to retrospectively assess the long-term incidence of impaired anorectal function in rectal cancer patients who underwent anterior resection and postoperative radiochemotherapy. Methods Ninety-nine patients who underwent sphincter-saving surgery and postoperative radiochemotherapy for stage II-III rectal cancer from July 1991 to January 2002 were given a questionnaire on anorectal function. Postoperative incontinence was evaluated according to a scale proposed by Jorge and Wexner. Factors influencing anorectal function were examined. Results The median follow-up from surgery was 10 years. Ten (10.1%) patients reported ≥ 5 bowel movements per day and 26 (26.3%) experienced clustering. The median frequency of bowel movements per 24 h was 2 (range, 1–10). Stool fragmentation was recorded in 56 (56.6%) cases, and 36 (36.4%) patients experienced urgency to defecate with inability to delay defecation for more than 15 min. The mean continence score was 4.91 (median 1, range 0–18). Incontinence to flatus, liquid and solid stools was reported at least once a week in 24 (24.2%), 11 (11.1%) and 5 (5.1%) patients, respectively. According to the study criteria, 61% of patients had good functional results. None of the variables analyzed showed a significant correlation with functional outcome. Conclusions Although retrospective, the present study included a large selected series that had undergone uniform adjuvant treatment and was followed for a median of 10 years. Our data demonstrated that 39% of patients did not have good functional results and suffered some degree of urgency, increased frequency and occasional incontinence even many years after the surgery. Anorectal function assessment should enter routinely in clinical practice and should have importance in the therapeutic decisions.
Adjuvant Whole Pelvic Radiotherapy in 43 Patients with Uterine Serous Cancer: Outcome and Patterns of Failure
Authors: Borghesi Simona , Scotti Vieri , Petrucci Alessia , Paoletti Lisa , Rossi Francesca , Galardi Alessandra , Biti Giampaolo 
Published: February 2018

Aims and background Uterine serous cancer is associated with a poor outcome and poses a therapeutic challenge. We retrospectively evaluated the experience of the Radiotherapy Department of the University of Florence. Methods Forty-three patients with stage I-III uterine serous cancer underwent surgery with (18 patients, group 1) or without complete surgical staging (25 patients, group 2) followed by adjuvant whole pelvic radiotherapy alone or combined with vaginal brachytherapy (in 35 and 8 cases, respectively). The median dose delivered with whole pelvic radiotherapy was 50Gy (range, 45–56) and for brachytherapy was 20 Gy (range, 20–30). Results Actuarial overall survival and disease-free survival rates at 5 years were 62.5% and 61%, respectively. Local failure was observed in 17 patients (39.5%) and distant metastasis in 10 (23.2%). Nine patients had both local failure and distant metastasis, which had developed concurrently in 7 cases. Isolated abdominal failure occurred in 4 cases (9.3%). Local relapse was noted in 22.2% of patients in group 1 compared to 52% in group 2. A trend towards a better 5-year overall survival (67.2% vs 58%), disease-free survival (63% vs 59%) and local control (70% vs 59%) was observed in group 1 than group 2, although the difference between the two groups failed to reach statistical significance. Conclusions Given the patterns of failure of patients with uterine serous cancer, adjuvant whole pelvic radiotherapy may be a reasonable approach, although novel integrated strategies are needed because the results achieved remain disappointing. Adjuvant whole pelvic radiotherapy might improve overall survival, disease-free survival and local control in complete surgically staged patients, but further investigations are required.
Short-term Radiotherapy followed by Adjuvant Chemotherapy in Poor-Prognosis Patients with Glioblastoma
Authors: Muni Roberta , Minniti Giuseppe , Lanzetta Gaetano , Caporello Paola , Frati Alessandro , Enrici Maurizio Maurizi , Marchetti Paolo , Enrici Riccardo Maurizi 
Published: February 2018

Objectives The optimal treatment for patients with glioblastoma with unfavorable prognostic factors, such as old age and low performance status, remains controversial. We conducted a prospective study to assess the effect of temozolomide and short-course radiation versus short-course radiation alone in the treatment of poor-prognosis patients with newly diagnosed glioblastoma. Patients and methods Forty-five patients with a newly diagnosed glioblastoma, older than 70 years or aged 50–70 years and with a Karnofsky performance score ≤70 were enrolled in this prospective study. Twenty-three patients were treated with an abbreviated course of radiotherapy (30 Gy in 6 fractions over 2 weeks) and 22 patients with the same radiotherapy schedule plus adjuvant temozolomide at the dose of 150–200 mg/m2 for 5 days every 28-day cycle. The primary end point was overall survival. Secondary end points included progression-free survival and toxicity. Results Median overall survival was 7.3 months in the radiotherapy group and 9.4 months in the radiotherapy plus temozolomide group (P = 0.003), with respective 6-month overall survivals of 78% and 95%, respectively. Median progression-free survival was 4.4 months in the radiotherapy group and 5.5 months in the radiotherapy plus temozolomide group (P = 0.01), and respective 6-month progression-free survival rates were 22% and 45%. In multivariate analysis, Karnofsky performance score was the only significant independent predictive factor of survival (P = 0.03). Adverse effects of radiotherapy were mainly represented by neurotoxicity (24%), which resolved in most cases with the use of steroids. Grade 3-4 hematologic toxicity occurred in 36% of patients treated with temozolomide. Conclusions The addition of temozolomide to short-term radiotherapy resulted in a statistically significant survival benefit with minimal additional toxicity in poor-prognosis patients with newly diagnosed glioblastoma. Future studies need to define the best combined regimens of radiotherapy and temozolomide on survival and quality of life in this subgroup of patients.
Surgical Management of Bronchopulmonary Carcinoid Tumors: Experience over 8 years and Review of the Literature
Authors: Belak Jozef , Kudlac Marian , Zak Vladimir , Cavarga Ivan , Kocan Pavol , Böör Andrej , Stebnicky Milan , Somos Andrej , Tkacova Ruzena 
Published: February 2018

Aims and background An increased incidence of neuroendocrine tumors in the last decade has been noticed worldwide. Our purpose was to study the characteristics, surgical approaches and outcome in patients with primary bronchopulmonary carcinoid tumors. Methods Between 2001 and 2007, bronchopulmonary carcinoid tumors were removed in 11 of a total of 287 patients who underwent surgery for primary lung malignancies in our tertiary referral center. Results The patient group consisted of 3 men and 8 women (mean age 52.9 ± 5.2 years, range 19–76 years). At presentation, 10 of 11 patients were symptomatic, with cough, pneumonia, breathlessness and hemoptysis being the most frequent symptoms. Histological findings revealed typical carcinoid in 10 patients and atypical carcinoid in one. The surgical approach included 8 lung resections (6 lobectomies, 1 bilobectomy, 1 segmentectomy), and 3 bronchoplastic tumor removals. In 2008, clinical examination and chest X-ray revealed no recurrence of the carcinoid and no long-term postoperative complications in any patient. Conclusions In the light of our study and the review of the literature we conclude that early recognition of primary bronchopulmonary carcinoid tumors followed by adequate surgical removal of the malignancy are essential for complete remission of the disease.