bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hypofractionated Intensity-Modulated Simultaneous Integrated Boost and Image-Guided Radiotherapy in the Treatment of High-Risk Prostate Cancer Patients: A Preliminary Report on Acute Toxicity
Authors: Valeriani Maurizio , Carnevale Alessia , Osti Mattia Falchetto , Minniti Giuseppe , De Sanctis Vitaliana , Agolli Linda , Bracci Stefano , Enrici Riccardo Maurizi 
Published: February 2018

Aims and background To evaluate acute toxicity of hypofractionated intensity-modulated radiotherapy with simultaneous integrated boost and image-guided radiotherapy in the treatment of high-risk prostate cancer patients. Methods Between November 2009 and March 2012, 59 patients with high-risk prostate cancer were enrolled. The eclipse inverse planning system (Varian) was used to calculate an IMRT plan with simultaneous integrated boost, delivering 68.75 Gy (2.75 Gy per fraction) to the prostate, 55 Gy (2.2 Gy per fraction) to the seminal vesicles and positive nodes, and 45 Gy (1.8 Gy per fraction) to the pelvis, 4 fractions per week, 25 fractions. Prior to each treatment, patients underwent a kilo-voltage cone-beam CT performing an image-guided radiation therapy (IGRT). All patients were submitted to neoadjuvant, concomitant and adjuvant hormone therapy. Results The median follow-up for all patients was 13 months (range, 3–28). At the last follow-up, no grade 3 or 4 side effect was observed. Toxicity occurred as follows during the treatment: grade 1 and 2 gastrointestinal toxicity 5.2% and 6.9%, respectively; grade 1 and 2 genitourinary toxicity 24.1% and 1.7%, respectively. Only 1.7% of the patients developed grade 3 genitourinary toxicity. No grade 3 gastrointestinal toxicity was observed. Conclusions The present study demonstrated that 4/w hypofractionated intensity-modulated radiotherapy with simultaneous integrated boost and image-guided radiotherapy in patients with high-risk prostate cancer is feasible and safe. Low acute toxicity rates were verified. Longer follow-up is needed to evaluate the outcomes in terms of late toxicity and survival.
Reconstructive Head and Neck Surgery: Oncological and Functional Results
Authors: Checcoli Emanuele , Bianchini Chiara , Ciorba Andrea , Candiani Marco , Riberti Carlo , Pelucchi Stefano , Pastore Antonio 
Published: February 2018

Aims The aim of this retrospective study is to review the experience in performing head and neck reconstruction surgery between 1989 and 2009 at the ENT Department of the University Hospital of Ferrara, Italy, considering the oncological as well as the functional and psychological outcome. Methods and study design Thirty-three consecutive patients were enrolled. Patients underwent flap reconstruction following primary or salvage surgery for squamous cell carcinoma of the oral cavity or oropharynx. Oncological results in terms of survival rate and disease-free interval, as well as functional and psychological results were evaluated. Results The oncological results, i.e. survival rate related to cancer stage and disease-free interval, were in agreement with those of the literature. Functional assessment, swallowing function and speech intelligibility were statistically poorer in patients affected by oropharyngeal malignancies than in patients affected by oral cancer. Quality of life was compromised in terms of reduced relationships and onset of depression or irritability. Conclusions Reconstructive surgery can be considered a relatively standard procedure in the treatment of head and neck cancer. The main drawback is still related to the major impact on patients' quality of life and functional status.
Radicality effect of adding an interpectoral to a subpectoral approach for dissection of level III axillary lymph nodes in breast cancer
Authors: SD Barros Alfredo Carlos , Andrade Felipe Eduardo M , Bevilacqua José Luiz B , Barros Maria Aparecida C , Piato José Roberto , Santos Donizeti R , Filassi José Roberto , Nimir Cristiane CBA 
Published: February 2018

Aims and background The extent of axillary lymph node dissection for breast cancer treatment is tailored to each patient. When the surgeon assumes that full dissection, including level III, is needed, there are basically two ways for reaching the apical nodes while preserving the pectoralis muscles: a subpectoral approach, below the joined pectoralis muscles, and another that includes an additional interpectoral dissection between the muscles. We conducted a study to evaluate the radicality of dissection using these two approaches. Methods To determine whether the harvest of level III axillary lymph nodes is equivalent with the different approaches, we prospectively studied 75 patients with breast cancer. Careful axillary lymph node dissection was done to as radical an extent as possible, first below the lateral edge of the joined pectoralis muscles (subpectoral approach) and sequentially after opening the space between the muscles (additional interpectoral approach). The number of patients with extra level III nodes retrieved by the addition of an interpectoral dissection as well as the number of complementary nodes obtained in such patients were determined. Results We excised 1701 axillary lymph nodes in 75 patients (mean, 22.7). Using first the subpectoral approach, we resected 259 level III nodes in 68 patients (mean, 3.8); in 56 patients, we removed 132 additional level III nodes using the supplementary interpectoral approach (mean, 2.4). In 7 patients (9.3%), we found at least one metastatic node with the interpectoral approach. Two of these patients had positive level III nodes that were discovered only by addition of the interpectoral dissection. Conclusions The dissection of level III axillary nodes is more radical when an additional interpectoral dissection is performed after a subpectoral approach has been used. The exclusive subpectoral approach frequently leaves residual nodes at the apex of the axilla.
Thoracoscopic Lobectomy: Comparison of Intraoperative and Postoperative Outcomes between 3 and 4 Incision Accesses
Authors: Billè Andrea , Okiror Lawrence , Draaisma Werner , Choudhuri Debajeet , Harrison-Phipps Karen , Routledge Tom 
Published: February 2018

Aims and background Several techniques have been proposed to perform a video-assisted thoracic lobectomy. We compared the results of a 3 versus 4-port procedure, analyzing intraoperative data, morbidity, and mortality. Methods Prospective analysis of 30 consecutive patients who underwent a 4-port approach video-assisted thoracic lobectomy (group A) and comparison with a historical series with 30 patients who had a 3-port video-assisted thoracic lobectomy (group B). Results The groups were comparable for clinical characteristics and pathological staging. There was no difference in operating time: median, 128 min for group A versus 129 min for group B (P = 0.9). There was a significant difference in rate of conversion to thoracotomy: 1 of 30 (3.3%) in group A and 7 of 30 (23.3%) in group B (3 ports) (P = 0.02). In group A, 11 patients (36.7%) experienced postoperative complications and in group B, 13 patients (43.3%; P = 0.6). The difference in median time to drain removal and median length of hospital stay between the two groups was not significant. There was a significant difference in persistent pain between group A and group B: 6 patients (20%) in group B presented with persistent neuropathic pain on regular medication (P = 0.02). Conclusions Our study showed that the 4-port approach was similar in operative time, length of drain and hospital stay but showed a statistically significant lower conversion rate and lower rate of persistent pain than the 3-port access.
Gastric remnant cancer patients had a better prognosis than upper-third gastric cancer patients in a case-control study after surgical treatment
Authors: Li Fangxuan , Zhang Rupeng , Liang Han , Quan Jichuan , Liu Hui , Zhang Hui 
Published: February 2018

Background The aim was to compare the clinicopathological features and prognostic outcomes of gastric remnant carcinoma patients with those of patients with upper-third gastric cancer. Methods Clinical data extracted from 112 gastric remnant carcinomas and 367 upper-third gastric cancer patients were analyzed to explore the clinicopathologic differences between two groups. After radical resection, prognostic difference between them was evaluated through a 1:2 matched case-control study. Results The pattern of gastric remnant carcinomas showed a male predominance. Undifferentiated type histology, depth at T4 stage and distant metastases were more frequent in gastric remnant carcinomas than in upper-third gastric cancers (P <0.05). The radical resectability of gastric remnant carcinomas was lower and the multi-visceral resectabilitiy was relatively higher than the other group (P = 0.00). Gastric remnant carcinomas trended to have a higher incidence of metastases to either mesojejunum or lower mediastinal lymph nodes than upper-third gastric cancers, but patient survival was not significantly different. In the case-control study, gastric remnant carcinomas had a better prognosis than upper-third gastric cancers after radical resection when the clinicopathologic features and surgical treatment were matched. Conclusions Although there was no significant prognostic distinction between gastric remnant carcinomas and upper-third gastric cancer, after radical surgical treatment, patients with the former had an even better prognosis.
Prognostic Role of Neutrophil-to-Lymphocyte Ratio in Advanced Pancreatic Ductal Adenocarcinoma: Impact of Baseline Fluctuation and Changes during Chemotherapy
Authors: Teo MinYuen , Sharial Mohd Syahizul Nuhairy Mohd , McDonnell Felicity , Conlon Kevin C , Ridgway Paul F , McDermott Ray S 
Published: February 2018

Aims and background Inflammation has been implicated in carcinogenesis and progression of pancreatic cancer. The neutrophil-to-lymphocyte ratio is an index of systemic inflammation. We examined the prognostic role of the neutrophil-to-lymphocyte ratio at baseline and the significance of intrapersonal variability of the ratio before and during chemotherapy. Methods and study design Advanced pancreatic adenocarcinoma patients who had received chemotherapy were included. Baseline clinical and biochemical parameters, including the neutrophil-to-lymphocyte ratio, were extracted and analyzed. The neutrophil-to-lymphocyte ratio threshold was determined via recursive partitioning and assessed at diagnosis, prior to chemotherapy and during treatment. Overall survival was estimated via the Kaplan-Meier method and compared between groups with the logrank test. Results Between 2005 and 2011, 85 patients with locally advanced (n = 38) and metastatic disease were identified: 68% with a neutrophil-to-lymphocyte ratio >3 had shorter median overall survival than patients with a neutrophil-to-lymphocyte ratio <3 (3.4 vs 9.4 months, P = 0.001). Pretreatment, 35% of repeat neutrophil-to-lymphocyte ratios crossed the threshold of 3. A persistently elevated neutrophil-to-lymphocyte ratio >3 suggested a worse overall survival than in patients with a decreasing, increasing or persistently low neutrophil-to-lymphocyte ratio (1.9 vs 8.2, 12.3 and 11.7 months, respectively, P <0.001). Twenty-three percent of patients had a >50% decrease in neutrophil-to-lymphocyte ratio following 4 weeks of chemotherapy, with a trend towards improvement in overall survival (12.5 vs 5.0 mo, P = 0.068). Conclusions The baseline neutrophil-to-lymphocyte ratio is a validated marker for a poor prognosis. Multiple assessments of the pre-treatment neutrophil-to-lymphocyte ratio might be required. Reduction in the neutrophil-to-lymphocyte ratio during chemotherapy may be associated with improved survival.
Clinical application of serum alpha-fetoprotein-IgM complexes on the diagnosis of primary hepatocellular carcinoma in Kazakh and Han populations
Authors: Wu Jun , Zou Han , Jiang Jing-Ting , Li Xiao-Dong , Zhao Xue-Mei , Jar Ken , Wang Hong , Xu Bin , Wu Chang-Ping 
Published: February 2018

Aims and background We detected serum AFP-IgM levels in patients with primary hepatocellular carcinoma in Kazakh and Han populations to investigate the clinical significance of AFP-IgM in the diagnosis of hepatocellular carcinoma. Methods and study design Serum AFP-IgM levels were examined in 28 cases of hepatocellular carcinoma and 164 controls in the Kazakh population and in 85 cases of hepatocellular carcinoma and 187 controls in the Han population. AFP-IgM was detected with the ELISA assay. Results In general, serum AFP-IgM levels of hepatocellular carcinoma patients in the Han population and hepatocellular carcinoma patients in the Kazakh population were statistically higher than those of controls, but there was no statistical significance between hepatocellular carcinoma patients in the Han and hepatocellular carcinoma patients in the Kazakh population. Conclusions AFP-IgM is an encouraging serological marker and may be useful in the diagnosis of hepatocellular carcinoma.
Increased expression of biological markers as potential therapeutic targets in Saudi women with triple-negative breast cancer
Authors: Sayed-Ahmed Mohamed Mohamed , Hafez Mohamed Mahmoud , Al-Shabanah Othman Abdualla , Al-Rejaie Salim Salih , Aleisa Abdulaziz Mohamed , Al-Yahya Abdulaziz Abdulrhman , Alsheikh Abdulmalik , Diab Abdurrahman Ibrahim Al , Al-Akeely Mohammad Hamad 
Published: February 2018

Aims and background Triple-negative breast cancer (TNBC) is an aggressive subtype of breast cancer that lacks the expression of hormone receptors and human epidermal growth factor receptor 2 (HER2). Although TNBC represents only 15% of all types of breast cancer, it accounts for a large number of metastatic cases and deaths. Because of the high metastatic rate and both local and systemic recurrence associated with TNBC, extensive research efforts are actively looking for target therapies to effectively treat this aggressive disease. Accordingly, this study has been initiated to investigate the differential expression of biological markers in TNBC and non-TNBC Saudi women that might be utilized as potential targeted therapy and/or predict the sensitivity to currently available therapeutic regimens. Methods and study design Two hundred formalin-fixed, paraffin-embedded (FFPE) breast cancer tissues were selected and divided into 3 groups: benign breast tissues (20), TNBC tissues (80) and non-TNBC tissues (100). Expression of mRNA in FFPE tissues was analyzed using real-time polymerase chain reaction (RT-PCR) for the following genes: poly (ADP-ribose) polymerase 1 (PARP-1), topoisomerase 2A (TOPO-2A), vascular endothelial growth factor (VEGF), C-MYC, basic fibroblast growth factor (bFGF), matrix metalloproteinases (MMP-2 and MMP-9), human epidermal growth factor 1 (HER1) and multidrug resistance (MDR) genes. Results In the TNBC group, expression of PARP-1, TOPO-2A, HER1, C-MYC, VEGF, bFGF and MMP-2 showed a highly significant increase compared to the non-TNBC group. Conclusions The results of this study suggest that (1) TNBC patients will benefit more from TOPO-2A inhibitors as well as antiangiogenic and antimetastatic therapies; (2) inhibition of these target genes is emerging as one of the most exciting and promising targeted therapeutic strategies to treat TNBC in which the intended targets are DNA repair, tumor angiogenesis and metastasis.
Recurrence Due to Neoplastic Seeding in Head and Neck Cancer: Report of Two Cases and Review of the Literature
Authors: Nisa Lluïs , Khanfir Kaouthar , Giger Roland 
Published: February 2018

Aims and background Tumor progression due to seeding of tumor cells after definitive treatment for squamous cell carcinomas of the head and neck is an uncommon condition that can considerably worsen the outcome of patients with head and neck cancer. Methods and study design We report two cases of recurrence due to neoplastic seeding from oropharyngeal and oral cancer, respectively. We performed a literature review with MEDLINE as the main search engine. Results Seeding was found to occur most often in tracheotomy scars and gastrostomy sites. The oral cavity, hypopharynx and oropharynx were the primary sites in most cases, and advanced tumor stage seemed to be a risk factor for seeding. Treatment options include salvage surgery, which requires thorough resections, radiotherapy when possible, and palliative management. The prognosis of such events is poor. Conclusion Although neoplastic seeding is a well-known phenomenon in cancer surgery, many questions remain unanswered, especially regarding preventive measures and management strategies.
Compliance with Breast and Cervical Cancer Screening Programs in Women: Results from a Population-Based Study
Authors: Berardi Rossana , Nacciarriti Dania , Tamburrano Tiziana , Carbonari Giovanna , Romagnoli Emanuela , Duca Monia , Burattini Michela , Silva Rosa Rita , Cellerino Riccardo , Cascinu Stefano 
Published: February 2018

Aims and background Women's adherence to mammography and PAP test screening guidelines is a fundamental topic regarding women's health. The aim of the study was to evaluate the knowledge and compliance to breast and cervical cancer screening programs in women living in three Italian towns, where a public screening program, consisting of free mammography every two years and free PAP test every three years, is ongoing. Methods An anonymous survey was mailed to a random sample of women. Eight 120-min focus discussions with groups of women exploring perceptions, knowledge and practices were carried out after analysis of the returned surveys. Results Replies were received from 1345 women (response rate, 27%). Almost every woman knew of the screening program, but women's practice of mammography was age-dependent: up to 72% of the women performed it before the age of 50. Conversely, the age of the first PAP test was rather late: up to 70% of the women performed it at over 30 years of age. Women with a lower educational level reported being screened less than those with a higher level. During the group discussions, women's perceptions, knowledge and beliefs regarding cancer and screening, together with aspects of the health care system, appeared to strongly influence the preventive practices. Many women deplored being infrequently instructed by health professionals. Conclusions Despite the limitations of the study due to the low response rate, we believe that health professionals should invest on encouraging factors and reduce the deterring factors to optimize screening practices.
Prostatic Metastases from Testicular Nonseminomatous Germ Cell Cancer: Two Case Reports and a Review of the Literature
Authors: Torelli Tullio , Lughezzani Giovanni , Catanzaro Mario , Nicolai Nicola , Colecchia Maurizio , Biasoni Davide , Piva Luigi , Maffezzini Massimo , Stagni Silvia , Necchi Andrea , Giannatempo Patrizia , Farè Elena , Salvioni Roberto 
Published: February 2018

Background Prostatic metastases from testicular germ cell tumors (TGCTs) are extremely uncommon. To the best of our knowledge, only five cases of prostatic metastases from seminoma have been reported in the literature. Conversely, no cases of metastases to the prostate from nonseminomatous germ cell tumors (NSGCT) have been previously reported. Case presentation We present two patients who developed prostatic metastases 5 and 21 years after the initial diagnosis. The first case concerned a 28-year-old Caucasian man who underwent a right orchiectomy and right retroperitoneal lymph node dissection (RPLND) for a stage I NSGCT in 1999 and five years later was diagnosed with prostatic metastases. The second case concerned a 30-year-old man treated with a right orchiectomy and right RPLND for stage I NSGCT in 1985 who was diagnosed with prostatic metastases in 2006, 21 years after primary surgery. We reviewed the available literature on the topic. Conclusion Prostatic metastases from TCGTs are highly unusual. Lower urinary tract symptoms in patients treated for previous testicular cancer require immediate clinical attention. However, because of their extreme rarity, specific clinical investigations to screen for possible prostatic involvement from TGCT should not be recommended.
Treatment of Cutaneous Angiosarcoma of the Face: Efficacy of Combined Chemotherapy and Radiotherapy
Authors: Ravo Vincenzo , Falivene Sara , De Chiara Annarosaria , De Palma Giampaolo , Pizzolorusso Antonio , Di Franco Rossella , Muto Paolo , Apice Gaetano 
Published: February 2018

Introduction Cutaneous angiosarcoma (AS) is a rare form of soft tissue sarcoma. It is aggressive and has a poor prognosis. The aim of our report is to show that with combined chemotherapy and radiotherapy it is possible to obtain good results in terms of local control, complete response, and aesthetic outcome. Case report We present the case of a 60-year-old man affected by AS covering the entire surface of the nose. Surgery, although indicated, was excluded because it was considered mutilating and would give a poor cosmetic result. The patient was treated with chemotherapy consisting of paclitaxel 80 mg/m2 for 6 cycles followed by radiotherapy at a dose of 50 Gy. Then 3 additional cycles of chemotherapy were administered according to the same scheme. A complete response was obtained. At 40 months after treatment, the patient did not show any signs of late toxicity, all lesions had disappeared, and all laboratory tests were negative. Conclusions Our experience shows that concomitant chemoradiotherapy can be delivered safely and can be tolerated with low toxicity and good results in terms of local control and complete response. We obtained an excellent aesthetic result with improvement of the patient's quality of life.
Platinum doublets as first-line treatment for elderly patients with advanced non-small cell lung cancer
Authors: Piacentini Paolo , Greco Filippo , Mercanti Anna , Trolese Anna Rita , Durante Emilia , Moratello Giacomo , Tognetto Michele , Furini Lara , Giuliani Jacopo , Bonetti Andrea 
Published: February 2018

Aims and background More than 50% of patients with advanced non-small cell lung cancer are diagnosed in the elderly. Few prospective clinical data with cisplatin-based chemotherapy are available, and some authors have suggested that a non-platinum single agent should be the preferred form of cure in these patients. The aim of the study was to evaluate the efficacy and safety of first-line chemotherapy based on platinums (carboplatin or cisplatin) plus a third generation compound (vinorelbine or gemcitabine) in elderly patients with advanced non-small cell lung cancer in daily clinical practice. Methods A retrospective analysis of consecutive elderly (≥70 years of age) patients with advanced non-small cell lung cancer treated at our Medical Oncology Unit from February 2005 to September 2011 was performed. Results A total of 249 cycles of chemotherapy was administered to 62 patients (median age, 72 years; range, 70–81) presenting a median Charlson comorbidity index of 1 and a good ECOG PS (0–1, 52 patients; 2, 10 patients). The median number of cycles/patient was 4, and all 62 patients received a platinum-based doublet as first-line chemotherapy: 57 with carboplatin (92%) and 5 with cisplatin (8%). As best response to the treatment, 19 (31%) partial responses and 20 (32%) stable diseases were observed. Median overall survival was 9.8 months. Toxicity was mild; grade III-IV neutropenia was the most frequently observed side effect in 19 administered cycles (8%). Conclusions Advanced non-small cell lung cancer in elderly patients can be safely treated with a platinum-based doublet. Observed toxicity is manageable, and overall survival is in keeping with data from the literature.