bluuebunny/crossref_metadata_2025_split huggingface dataset:
Colorectal Cancer: What has Changed in Diagnosis and Treatment over the Last 50 Years?
Authors: Gennari Leandro , Russo Antonio , Rossetti Carlo 
Published: February 2018

Aims and background This overview focuses on what has changed in the diagnosis and treatment of colorectal cancer over the last 50 years. Methods The most important international registers (SEER, European and Italian) as well as the literature have been consulted. Furthermore, many prognostic factors are analyzed with the aim to understand the reasons why 5-year survival has improved over the last two decades. Results Since the biologic characteristics of the tumor cannot be changed, improved survival must be supported by concomitant multiple factors, such as earlier diagnosis (as given by a more informed educational behavior and the advent of screening) as well as the wide use of colonoscopy and the technical improvement of surgical and medical treatment. However, it seems that the greatest improvement in survival is limited to 5-year controls, whereas long-term survival does not appear to show any significant improvement. Conclusions We can hypothesize that our efforts have just delayed the inevitable end: death. Nevertheless, further research should be done to confirm this hypothesis, perhaps in the field of molecular biology, which may also be the right approach to understanding the biologic aggressiveness of each tumor.
A Pilot Phase ii Study of Chemotherapy with Oxaliplatin, Folinic acid, 5-Fluorouracil and Irinotecan in Metastatic Gastric Cancer
Authors: Chiesa Matteo Dalla , Buti Sebastiano , Tomasello Gianluca , Negri Federica , Buononato Massimo , Brunelli Antonio , Lazzarelli Silvia , Brighenti Matteo , Donati Gianvito , Passalacqua Rodolfo 
Published: February 2018

Aims and background Previous phase II studies have reported that combinations of oxaliplatin, folinic acid and 5-fluorouracil or irinotecan, folinic acid and 5-fluorouracil are associated with good efficacy and an acceptable safety profile in metastatic gastric cancer. The aim of this study was to evaluate chemotherapy with oxaliplatin, folinic acid, 5-fluorouracil and irinotecan (COFFI regimen) in metastatic gastric cancer. Methods Patients received oxaliplatin (85 mg/m2 d 1), irinotecan (140 mg/m2 d 1), and L-folinic acid (200 mg/m2 d 1) followed by 5-fluorouracil bolus (400 mg/m2 d 1) and then 5-fluorouracil (2,400 mg/m2 48-h continuous infusion), every 14 days. Results Seventeen patients with metastatic gastric cancer were enrolled. Eight patients were pretreated for advanced disease. Of the 9 chemo-naïve patients, 8 were evaluated for response (1 patient was lost to follow-up): one complete response, 5 partial responses and 2 progressions of disease occurred, giving an overall response rate, at intention-to-treat analysis, of 67%. Of the 8 pretreated patients, 6 were evaluated for response (2 patients had nonmeasurable disease): one partial response, 2 disease stabilizations and 3 progressions of disease occurred, giving an overall response rate, at intention-to-treat analysis, of 12%. Median progression-free and overall survival in chemo-naïve patients were 8.2 and 10.2 months, respectively, and in pretreated patients 2.7 and 3 months. Grade 3-4 neutropenia occurred in 55% of chemo-naïve patients. Thrombocytopenia, and anemia were observed in 18% and 29%, respectively. Grade 3 nausea/vomiting occurred in 12% and grade 3 diarrhea in 6%. Conclusions The COFFI regimen is active and well tolerated, therefore phase III studies are warranted.
Tumor vs Non-Tumor Origin of Occult and Obscure Gastrointestinal Bleeding Requiring Hospitalization
Authors: Costantini Raffaele , De Nicola Pierpaolo , Bianco Francesco , Cotroneo Antonio Raffaele , Iezzi Roberto , Di Bartolomeo Nicola , Innocenti Paolo 
Published: February 2018

Aims and Background Occult/obscure gastrointestinal bleeding is often problematic to diagnose. It often leads to delayed treatment, a particularly dangerous circumstance when tumor origins are involved. This study reports the six-year experience of an Italian Surgery Center in the identification of the nature (tumor versus non tumor) and site of origin (upper, middle, lower gastrointestinal tract) of occult/obscure bleeding requiring hospitalization, as well as in its treatment. Methods Diagnostic instrumental examinations employed were: esophagogastroduodenoscopy, rectocolonoscopy, computerized tomography small bowel follow-through examination, capsule endoscopy, biopsy, angiography, abdominal computerized tomography scans and ultrasound. Therapies included: interventional radiology and surgery. Results Thirty-five cases of obscure and 27 cases of occult bleeding were examined; all received a definite diagnosis during hospitalization. In the cases with obscure bleeding the diagnosis was inflammatory bowel disease (n = 7), angiodysplasia (5 gastric, 2 duodenal, 2 jejunal, 3 ileal, 4 right colon), small bowel tumors (4 non-Hodgkin lymphomas, 1 leiomyoma, 6 adenocarcinomas), and gastric metaplasia of Meckel's diverticulum (n = 1). There were significantly more nontumor lesions than tumors (P <0.005), and a middle tract source was significantly more frequent than upper/lower tract sources (P <0.0001). Intestinal resections were performed for all small bowel tumors (8 laparotomic, 3 laparoscopic), 5 angiodysplasias, all cases of inflammatory bowel disease and gastric metaplasia of Meckel's diverticulum; arterial embolization was performed for 11 angiodysplasias. In the cases with occult bleeding the diagnosis was sigmoid colon polyps in 6 (treatment, endoscopic polypectomy) and right colon cancer in 21 (treatment, right hemicolectomy). There were significantly more tumors than nontumor lesions (P <0.0001); all derived from the lower gastrointestinal tract. In all cases, the interventions resolved the bleeding completely. Conclusions The results show that more than 50% of cases with obscure/occult bleeding requiring hospitalization are motivated by malignant gastrointestinal tumors, 34% of which are located in the small bowel, usually a difficult tract to explore. Thanks to modern technology, however, their diagnosis and treatment can nowadays be promptly and successfully achieved.
Nonsurgical Treatment of an Incompletely Excised Primary Adenocarcinoma of Nonpigmented Ciliary Epithelium
Authors: Lee Sei Won , Park Sung Hye , Kim Il Han , Chung Hum , Kim Tae Yoo , Heo Dae Seog 
Published: February 2018

Primary adenocarcinoma of the nonpigmented ciliary epithelium (NPCE) is a very rare disease and the majority of acquired cases were treated by enucleation. We report the case of a 19-year-old man who had an adenocarcinoma arising from the NPCE. The tumor was found incidentally due to changed pupil shape. An excisional biopsy was performed and histopathological examination showed primary adenocarcinoma of the NPCE with a positive resection margin. Because of the positive resection margin and to save the eye, radiotherapy rather than enucleation was performed, followed by chemotherapy. Two years after the diagnosis, the patient continues to be followed up without evidence of relapse or cataract change. Our case suggests that adjunctive radiotherapy should be considered as a sight-saving treatment modality for primary malignant tumors of the NPCE.
Primary Squamous Cell Carcinoma of the Thyroid: Immunohistochemical Profile and Literature Review
Authors: Fassan Matteo , Pennelli Gianmaria , Pelizzo Maria Rosa , Rugge Massimo 
Published: February 2018

Background Squamous cell carcinoma accounts for 1% of primary thyroid malignancies and is characterized by a rapidly unfavorable outcome. Case Presentation A 64-year-old woman presented with a painless mass in the left neck, coexisting with thyroid goiter. Total thyroidectomy with lymphadenectomy was performed and a primary thyroid squamous cell cancer was confirmed histo-logically after excluding any other possible primary malignancies. The tumor's immunohistochemical profile was explored using a large panel of antibodies. The tumor featured a positive immunoreaction to cytokeratins 7–19 and to squamous cell carcinoma antigen. Low-molecular-weight cytokeratins 5–6 and epithelial membrane antigen were also expressed. The neoplasm's proliferative index (Mib1) was 60%. No immunostaining was detected for cytokeratins 10–20, thyroglobulin, TTF-1, CD5, galectin-3 or p53. Conclusions This case of primary thyroid squamous cell carcinoma immunohistochemically profiled using a large panel of immunoreactions may offer useful information on the histological differentiation of thyroid squamous cell carcinoma from other (uncommon) thyroid carcinomas and the distinction between primary and secondary thyroid cancers.
Aberrant Promoter Methylation Can be Useful as a Marker of Recurrent Disease in Patients with Cervical Intraepithelial Neoplasia Grade III
Authors: Terra Ana Paula Sarreta , Murta Eddie Fernando Candido , Maluf Paulo José , Caballero Otávia Luísa Silva Damas , Brait Mariana , Adad Sheila Jorge 
Published: February 2018

Introduction Although studies of risk factor profiles have been conducted to identify biological markers to predict the natural history of cervical intraepithelial neoplasia (CIN) grade III, there is not sufficient information to support the routine clinical use of any biomarker. Objectives The purpose of this study was to examine aberrant promoter methylation, which is implicated in cancer development and progression, in CIN III lesions in order to identify markers associated with more aggressive biological behavior that could be used to recognize women who are at higher risk of recurrence. Patients and methods We used methylation-specific polymerase chain reaction to analyze promoter hypermethylation of 8 genes ( p16, RARβ, GSTP1, MGMT, p14, TIMP3, E-cad and DAPk) in 33 uterine cervix cones with CIN III that were also submitted to human papillomavirus (HPV) genotyping. All 33 patients in this study had been clinically followed after conization with Papanicolaou smears, colposcopy, and biopsy when indicated, every 6 months during 5 years. Results Of the 33 patients, 12 (36%) underwent immediate hysterectomy after conization for having compromised cone margins, 14 (43%) have not relapsed, and 7 (21%) presented CIN relapse. The frequency of HPV infection in this group was 97% and no significant difference between the groups was observed. HPV of high oncogenic risk was present in 29 (87.9%) cases; HPV 16 was the most frequent (69.7%), while HPV 18 was found in 33.3%; however, it was associated with HPV 16 in 15.1%. Concomitant infection by HPV 6/11 was detected in 21.2% (15.1% with HPV 16 and 6.1 with HPV 18). 85.7% (6/7) of patients with recurrence had HPV 18 vs 0% (0/14) of patients without recurrence ( P = 0.0001). At least 1 of the 8 genes was found hypermethylated in all samples. Concomitant hypermethylation of several genes was frequently found. However, CIN relapse was only seen in the cases with hypermethylation of 3 or more of the 8 genes studied ( P = 0.0039). Conclusion We suggest that aberrant promoter methylation may play a role and may serve as a useful biomarker in the recurrence of CIN.
Investigation of Mutations and Expression of the FHIT Gene in Turkish Patients with Brain Metastases Derived from Non-Small Cell Lung Cancer
Authors: Bekar Ahmet , Çeçener Gülşah , Tunca Berrin , Guler Gulnur , Egeli Unal , Tolunay Sahsine 
Published: February 2018

Aims and background Brain metastases occur in 20–40% of patients with cancer, and their frequency has increased over time. Lung, breast and skin (melanoma) are the most common sources of brain metastases. Recent studies show that several genes such as CD44 and PTEN have roles in the suppression of metastatic growth. Although it has been determined that there is a relationship between the FHIT gene and several primary tumors, its role in the initiation and progression of brain tumors has not yet been entirely explained. Furthermore, it is not known whether the FHIT gene has a role in the formation of brain metastases. Patients and methods The present study investigated mutations of the FHIT gene in Turkish patients with brain metastases derived from non-small cell lung cancer (NSCLC). Single-strand conformational polymorphism and sequencing analysis of the coding exons (5–9) of the FHIT gene were performed on 26 tissues. Furthermore, the level of Fhit protein expression of 36 tumor tissues was identified by immunohistochemistry. Results Using single-strand conformational polymorphism and sequencing analyses, no point mutations of the FHIT gene were detected in brain metastases derived from NSCLC. However, it was observed that Fhit protein expression was reduced in 88.9% of subjects. Conclusions We suggest that the FHIT gene may be turned off in brain metastases via other genetic/epigenetic mechanisms rather than mutations.
Primary Pulmonary High Grade Non-Hodgkin's Lymphoma in an Elderly Patient. A Case Report
Authors: Pagani Mauro , Antico Andrea , Bellarosa Sergio , Cavazzini Giovanna , Aitini Enrico 
Published: February 2018

An 82-year-old non-smoker female was admitted with cough, fever and poor general health. Radiological examination revealed a right parahilar mass and a transbronchial biopsy confirmed the presence of a tumor. Immunohistochemical analysis established the diagnosis of high-grade primary pulmonary lymphoma. The rare nature of this disease, its non-specific clinical presentation and particular prognosis, also in elderly patients, are discussed in this article.
Thin-Walled Cysts as a Pathognomonic CT Finding in Cystic Mesothelioma
Authors: Sugarbaker Paul , Yan Tristan , Zappa Luis , Haveric Namik , Brun Erwin 
Published: February 2018

Aim Cystic mesothelioma is a rare disease that results in abdominal distention and poorly defined abdominal pain. Diagnosis has always been made by tissue biopsy rather than by radiologic studies. Materials and methods Our experience with 7 patients with cystic mesothelioma includes 4 patients who had not had prior surgery before the performance of a high resolution CT scan. A special review of the radiology of these cases was performed in order to identify any pathognomonic signs of this disease. Results In all patients who did not have a distortion of the radiologic images (as a result of surgical interventions) prior to the performance of a high resolution CT scan at our institution, a pathognomonic thin-wall cystic structure located within the gelatinous appearing mass was observed. These thin-walled cysts were of variable size and preferentially located within the greater omentum, pelvis and beneath the right hemidiaphragm. Conclusion Cystic mesothelioma can be diagnosed preoperatively by a high resolution abdominal and pelvic CT. The thin-walled cysts with great variation in size are located beneath the right hemidiaphragm, within the greater omentum and in the pelvis. No other disease with these radiologic findings has been identified.
Assessment of Treatment-Related Thyroid Dysfunction in Patients with Head and Neck Cancer
Authors: Cetinayak Oguz , Akman Fadime , Kentli Suleyman , Duzen Murat , Eyiler Ferhat , Sen Mehme , Kinay Munir 
Published: February 2018

Objective To assess thyroid dysfunction in head and neck cancer patients who have received external beam radiotherapy according to radiotherapy fields and dose, tumor site and other local or systemic treatments retrospectively and prospectively and propose a follow-up schedule. Material and methods A total of 378 patients was classified into two groups. Group I (n = 345) consisted of surgically treated 153 laryngeal, 80 nasopharyngeal and 112 oral cavity/oropharyngeal carcinoma patients; these patients were evaluated retrospectively for treatment-related thyroid dysfunction using their data files. Group II included 33 patients with head and neck cancer who were evaluated prospectively. Thyroid function tests were performed at the beginning of the radiotherapy and every three months after the radiotherapy course, and thyroid dysfunction regarding surgery, radiotherapy and chemotherapy was evaluated. Results In Group I, the median follow-up for 153 operated laryngeal carcinoma patients was 44 months. Four (2.6%) of them were found to have clinically apparent hypothyroidism. After a median follow-up of 36 months, none of the 80 nasopharyngeal carcinoma patients showed signs of hypothyroidism. Clinically apparent hypothyroidism was detected in only 1 (0.8%) of the oral cavity/oropharyngeal carcinoma patients after a median follow-up of 25 months. In Group II, 1 (3%) patient was found to have thyroid dysfunction postoperatively prior to radiotherapy. At the time of analysis, 29 (87.8%) patients were euthyroidic, 2 (6.1%) patients had subclinical and 2 (6.1%) patients had clinical hypothyroidism. All patients with thyroid dysfunction have had combined surgery and radiotherapy, and none of the patients treated with radical radiotherapy has experienced hypothyroidism. Conclusions Even after a short follow-up, the incidence of thyroid dysfunction was 12.2% in head and neck cancer patients treated with combined surgery and radiotherapy. We recommend thyroid function tests in these patients prior to and once every 3–6 months after the radiotherapy course.
Radiotherapy Resources for the Care of Head and Neck Patients in Italy. A Survey by the Head and Neck Group of the Italian Association for Radiation Oncology (AIRO)
Authors: Frata Paolo , Ponticelli Pietro , Cosentino Dorian , Buffoli Alberto , Di Pilla Angelo , Morrica Brunello , Palazzi Mauro 
Published: February 2018

Aims and background In 2006 a survey was performed to define the resources available in Italy for the provision of radiotherapy services to head and neck cancer patients. This was the first initiative of the newly founded Head and Neck Group of the Italian Association for Radiation Oncology. Methods A questionnaire was sent to all 138 radiotherapy centers active in the country. Items investigated included total numbers of head and neck cancer patients treated per year, waiting time before the start of treatment, general technical issues, and integration with surgery and chemotherapy. Results Sixty-nine questionnaires were returned (50% response rate). The total number of patients treated was 4,670, averaging 68 cases per center. The larynx was the primary site most frequently involved. Average waiting time was 30 days and 47 days for nonresected and postoperative cases, respectively. The combination of chemotherapy and radiotherapy was delivered to nonresected and resected patients in 96% and 54% of centers, respectively. Survey response rates, waiting time, and the use of organ preservation protocols were the issues showing more variations across the country. Conclusions This survey provides important data on radiotherapy resources available for head and neck cancer patients in Italy. The evidence of significant differences across the country concerning several relevant issues and the potential for cooperative clinical efforts in this relatively rare group of diseases urge the Group to plan further initiatives.
Biotherapy of Cancer: Break the Barriers to Foster Translation oF knowledge
Authors: Ferrantini Maria , Lombardo Claudio , Moretti Franca , Belardelli Filippo 
Published: February 2018

Biotherapy of cancer holds great promise for its potential to lead to the identification of novel, selective, and effective treatments against cancer. However, the clinical development of biopharmaceuticals and biotherapy products is hampered by several and diverse barriers. Herein, we will address some of the critical issues identified both at the national and European level as the major obstacles for the translation of knowledge into clinical applications in the field of biotherapy and immunotherapy of cancer. We will also illustrate specific initiatives undertaken both in Europe and in Italy in order to support the translational and clinical research and that are expected to have a favorable impact on the process of clinical development of novel and more effective therapeutic interventions against cancer. The contents of this article are directly referred to the event “International Clinical Trials’ Day on Biotherapy of Cancer” organized in the context of the OECI Genoa 2008, with the sponsorship of Alliance Against Cancer (ACC) and the Istituto Superiore di Sanità (ISS, the Italian National Institute of Health), and under the auspices of the European Clinical Research Infrastructures Network (ECRIN). This event sees the active participation of representatives of the ISS and of the Italian Network for Tumor Biotherapy, both involved in a project recently funded by ACC and aimed at the promotion of clinical research in the field of cancer biotherapy and immunotherapy, through the creation of a national network of clinical cancer research centers and GMP facilities dedicated to the production of biological drugs and advanced medicinal products.
MR and Iron Magnetic Nanoparticles. Imaging Opportunities in Preclinical and Translational Research
Authors: Neumaier Carlo Emanuele , Baio Gabriella , Ferrini Silvano , Corte Giorgio , Daga Antonio 
Published: February 2018

Ultrasmall superparamagnetic iron oxide nanoparticles and magnetic resonance imaging provide a non-invasive method to detect and label tumor cells. These nanoparticles exhibit unique properties of superparamagnetism and can be utilized as excellent probes for magnetic resonance imaging. Most work has been performed using a magnetic resonance scanner with high field strength up to 7 T. Ultrasmall superparamagnetic iron oxide nanoparticles may represent a suitable tool for labeling molecular probes that target specific tumor-associated markers for in vitro and in vivo detection by magnetic resonance imaging. In our study, we demonstrated that magnetic resonance imaging at 1.5 T allows the detection of ultrasmall superparamagnetic iron oxide nanoparticle conjugated antibody specifically bound to human tumor cells in vitro and in vivo, and that the magnetic resonance signal intensity correlates with the concentration of ultrasmall superparamagnetic iron oxide nanoparticle antibody used and with the antigen density at the cell surface. The experiments were performed using two different means of targeting: direct and indirect magnetic tumor targeting. The imaging of tumor antigens using immunospecific contrast agents is a rapidly evolving field, which can potentially aid in early disease detection, monitoring of treatment efficacy, and drug development. Cell labeling by iron oxide nanoparticles has emerged as a potentially powerful tool to monitor trafficking of a large number of cells in the cell therapy field. We also studied the labeling of natural killer cells with iron nanoparticles to a level that would allow the detection of their signal intensity with a clinical magnetic resonance scanner at 1.5 T. Magnetic resonance imaging and iron magnetic nanoparticles are able to increase the accuracy and the specificity of imaging and represent new imaging opportunities in preclinical and translational research.