bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cell Kinetics Analysis in Patients Affected by Squamous Cell Carcinoma of the Head and Neck Treated with Primary Surgery and Adjuvant Radiotherapy
Authors: Corvò Renzo , Margarino Giovanni , Sanguineti Giuseppe , Geido Elio , Scala Marco , Mereu Paola , Cavallari Monica , Bonanno Salvatore , Garaventa Giacomo , Barbieri Marco , Giaretti Walter 
Published: April 2018

Background The increasing complexity of management strategies for patients with head and neck squamous cell carcinoma (HN-SCC) calls for the investigation of new objective prognostic parameters to subdivide patients according to the tumor's biological aggressiveness. Methods We evaluated in 35 HN-SCC patients the pretreatment cell kinetics parameters and DNA ploidy after in vivo infusion of bromodeoxyuridine and flow cytometric analysis. Patients were treated with radical surgery followed by conventional radiation therapy. Locoregional control data are available for follow-up times above five years. Results We found that the likelihood of locoregional control for patients with rapidly proliferating HN-SCC characterized by a short potential doubling time (Tpot <5 days) was significantly smaller than for HN-SCC patients with slow tumor proliferation (Tpot >5 days). Moreover, when patients were stratified according to DNA ploidy and Tpot value, we found that the locoregional failure rate for rapidly proliferating tumors was significantly higher for diploid HN-SCCs than for aneuploid HN-SCCs. Conclusion The present data suggest that patients with resectable HN-SCC characterized by fast growth might have a worse prognosis after surgery and adjuvant conventional radiotherapy and might benefit from more aggressive radiother-apeutic modalities.
Association between Cutaneous Melanoma and Neurofibromatosis Type 1: Analysis of Three Clinical Cases and Review of the Literature
Authors: Gallino Gianfrancesco , Belli Filiberto , Tragni Gabrina , Ferro Franca , Massone Pier Paolo Brega , Ditto Antonino , Leo Ermanno , Cascinelli Natale 
Published: April 2018

The authors report a rare association between cutaneous melanoma and Von Recklinghausen's disease (NF-1) and analyze the possible meaning of this occurrence. Various types of tumors have been associated with NF-1, in particular those of neuroectodermal origin, such as malignant peripheral nerve sheath tumors (MPNST) and phaeochromocytoma. The development of malignant melanoma in NF-1 patients is rare. Data from the literature is enable to demonstrate an increased incidence of cutaneous melanoma in patients with neurofibromatosis but the association of these two disorders seems reasonable in theory, as both are abnormalities of a neural crest origin. The cases described may represent not only a clinical report of two rarely associated disorders, but may also confirm the biological mechanisms responsible for these infrequent diseases.
Primary Carcinoid Tumor of the Ovary: Report of an Unusual Case
Authors: Sabatini Tony , Rozzini Renzo , Morandi Giovanni Battista , Meriggi Fausto , Zorzi Fausto 
Published: April 2018

Carcinoid tumors are endocrine malignancies that are often associated with a characteristic syndrome, the malignant carcinoid syndrome, which is most common in patients with small bowel tumors and liver metastases. In the rare instances when the syndrome is present without liver metastases the primary tumor is usually localized to the bronchus or ovary and secretes hormones directly into the systemic circulation. About two thirds of patients with carcinoid syndrome have evidence of carcinoid heart disease. We report on a case of a primary ovarian carcinoid tumor with an unusual clinical presentation.
Age at Diagnosis, Extent of Disease and Breast Cancer Survival: A Population-Based Study in Florence, Italy
Authors: Barchielli Alessandro , Balzi Daniela 
Published: April 2018

Background The effect of age at diagnosis on the prognosis of breast cancer is still controversial. The study described the variation by age at diagnosis of some clinical-pathologic features and evaluated the relationship between age and survival, taking into account the effect of extent of disease. Materials The study comprised a large population-based series of 1,182 invasive breast cancers, incident in the period 1985–1986 in the province of Florence. Results The proportion of cases without nodal involvement progressively lowered from 59% in the age group ≤39 years to 22% in the age group ≥80 years. The extent of disease was unknown in 14% of cases aged 70–79 years and in 43% of those aged ≥80 years (other age groups: 3%–5%). A lower rate of surgical treatment and axillary surgery were the main reasons for inadequate staging in the elderly. Ten-year observed survival progressively decreased from 71% for age ≤39 years to 12% for age ≥80 years. Ten-year relative survival showed less evident differences, dropping from 72% for age ≤39 years to 57% for age ≥80 years. In the relative survival analysis, the differences in relative risks of death among age groups were not significant, either in the univariate or multivariate analysis. Nevertheless, the model with adjustment for extension of disease showed a flattening of the estimated relative risks in age groups over 59 years. Conclusions Age at diagnosis was not significantly related to 10-year breast cancer relative survival, suggesting that the worse prognosis in the elderly was largely related to the risk of death from other causes, rather than to a different malignant potential of the tumor. The worse distribution by extent of disease in older women indirectly suggested that diagnostic delays also influenced the different prognosis observed among age groups.
The Availability of Histologic Grading among 5,923 Italian Cancer Patients and Its Relationship with Survival: A Population-Based Study
Authors: Crocetti Emanuele , Barchielli Alessandro , Amorosi Andrea , Omer Francesco Bartoloni Saint , Biancalani Massimo , Giannini Augusto , Zolfanelli Lucia 
Published: April 2018

Aim The specific goal of the study was to evaluate the availability of the histologic grading of cancer and its effect on survival in an Italian population-based cancer series. Methods Data were drawn from the Tuscany Cancer Registry, active in central Italy since 1985. Among the cases incident during the period 1985 to 1989, bladder, prostate, colon, corpus uteri, rectum and stomach cancers, for which the proportion of graded cases exceeded 50%, were analyzed. Overall, 5,923 cancer cases were included. Ten-year relative survival rates by grade were computed. Results Overall, data on histologic grading was available only for 38% of cases. The sites most frequently graded were urinary bladder (80%), prostate (73%), colon (71%), corpus uteri (69%), rectum (65%) and stomach (56%). For all the cancer sites analyzed, the 10-year relative survival rates increased as the histologic grading improved. The grade distribution resulted related also to the disease extension, more limited the extension higher the proportion of well differentiated cases. Conclusions Due to the evidenced importance of histologic grading as a valuable prognostic factor, it should be requested by clinicians and reported by pathologists more frequently than has been done in the area.
A Phase II Study of Paclitaxel/Cisplatin Combination in Patients with Metastatic Breast Cancer Refractory to Anthracycline-Based Chemotherapy
Authors: Rosati Gerardo , Riccardi Ferdinando , Tucci Aniello , De Rosa Patrizia , Pacilio Giovanni 
Published: April 2018

Aims and background To investigate the safety and efficacy of a paclitaxel and cisplatin regimen in a selected group of metastatic breast cancer patients with primary or acquired chemoresistance to anthracycline-based chemotherapy. Patients and methods Thirty-eight consecutive women with metastatic breast cancer (PS ≤2) were entered in this phase II trial; all patients had been previously treated for metastatic disease with chemotherapy containing anthracyclines and had shown a progression of the disease during drug administration or after a clinical response lasting less than 6 months. Fifteen patients had received 2 or more chemotherapeutic regimens for advanced disease; 31 patients had ≥2 sites of metastatic disease. Paclitaxel (135 mg/m2) was administered iv by a 3-hr infusion followed by iv infusion of cisplatin (75 mg/m2) on day 1, every 3 weeks for 6 cycles. After the completion of the planned chemotherapy administration, 9 responsive patients continued to receive paclitaxel alone (175 mg/m2) iv, on day 1, every 3 weeks, until disease progression or unacceptable toxicity. Results A partial clinical response was recorded in 17 cases (45%; 95% CI, 30–64%). The median duration of overall response was 8 months; for the 9 responsive patients who continued treatment with paclitaxel alone, 4 had maintained the partial clinical response at the median follow-up of 24 months from the onset of therapy. The median time to progression was 6 months and median overall survival 8 months. Neurotoxicity was the most frequent adverse effect and caused treatment discontinuation in 5 cases for grade 3–4 paresthesia and/or an arthralgia/myalgia syndrome. Grade 3–4 neutropenia occurred in 16 patients (44%). Conclusions Paclitaxel/cisplatin is an active regimen for the treatment of patients with metastatic breast cancer refractory to anthracycline-based chemotherapy. However, the cumulative neurotoxicity should limit the efficacy of prolonged paclitaxel monotherapy in responsive patients.
5-Fluorouracil plus Folinic Acid with or without Ifosfamide in Advanced Colorectal Cancer: A Phase II Randomized Trial
Authors: Sdrobolini Andrea , Contu Antonio , Massidda Bruno , Gasperoni Silvia , Recchia Francesco , Iannelli Annunziato , Tomao Silverio , Romiti Adriana , Raffaele Mimma , Ortu Salvatore , Campisi Costantino , Gebbia Vittorio , Olmeo Nina , lonta Maria Teresa , Angiona Sabrina , Di Costanzo Francesco 
Published: April 2018

Aim This phase II trial evaluated the biomodulation of 5-fluorouracil (5-FU) plus folinic acid (FA) with or without ifosfamide (IFO) in chemotherapy-naive patients with colorectal cancer. Patients and methods Forty-eight patients were randomized to receive: FA (25 mg/m2 iv bolus days 1 to 3), followed by 5-FU (750 mg/m2 iv bolus days 1 to 3), arm A; or FA (25 mg/m2 iv bolus days 1 to 3), followed by 5-FU (750 mg/m2 iv bolus days 1 to 3) plus IFO (2,000 mg/m2 in 1000 mL 5% dextrose in a 2-hr infusion, days 1 to 3), arm B. Mesna was added during and after IFO to prevent hemorrhagic cystitis. Treatment was repeated every 21 days in both arms. Results Forty-five patients were assessable for response: in arm A, 5 patients achieved a partial response (overall response, 25%), and in arm B, 2 patients achieved a complete and 1 a partial response (overall response, 12%). Time to failure was 3.5 months (range, 1–38) in patients treated with 5-FU plus FA, and 3 months (range, 1–21) in patients treated with the IFO combination. The median survival time was 13.5 months (range, 1–49 months) in arm A and 16 months (range, 1–43 months) in arm B. Diarrhea, stomatitis and vomiting were the most common nonhematologic toxicities in both arms. The most notable hematologic toxicity was leukopenia; 15% and 20% of patients experienced grade 4 in arm A and arm B, respectively. Conclusions IFO does not increase the activity of the 5-FU plus FA combination in advanced colorectal cancer.
Treatment of Cancer of the Base of the Tongue and Glosso-Epiglottic Region: A Multicenter Italian Survey
Authors: Grandi Cesare , Guzzo Marco , Cavina Raffaele , Gardani Gianstefano , Tana Silvia , Licitra Lisa , Rossi Nicoletta , Barbaccia Carmelo , Mingardo Massimo , Fallahdar Davud , Bruno Paolo , Molinari Roberto ,   the GLOCC Group, Barzan L. , Politi D. , Olmi P. , Fallai C. , Gabriele P. , Bussi L. , Cortesina G. , Succo G. , Sartoris G. , Armaroli L. , Cefaro G. Ausili , Gelosa G. , Grandini M. , Singarelli S. , Fracchia P. , Roselli R. , Spriano G. , Cosentino D. , Spinelli R. , Pia F. , Dosdegani R. , Squadrelli M. , Sarti E. , Bonetti B. , Bertoni F. , Oldini C. , Malusardi G. , Monica B. , Rampello G. , Zibordi F. , Banci F. , Maronchelli M. , Molinari R. 
Published: April 2018

Background The current treatment options for cancer of the base of the tongue and glosso-epiglottic region are surgery, radiotherapy, or a combination of both modalities. Comparisons between different modalities are not common in the literature, and a real standard of treatment has not yet been established. The purpose of our study was to evaluate the results of treatment in a large series of patients from 18 Italian institutions in relation to the main treatment adopted. Methods The present study is a retrospective survey. The series was divided into a combined surgery group and a radiotherapy group. The Kaplan-Meier method and the log-rank test were used for survival calculations and comparisons. Results Eight hundred patients were registered (25.7% stage III and 62% stage IV), 336 in the surgery and 372 in the radiotherapy group. Conventional fractionation was adopted in almost all cases. The five-year overall and disease free survival of the whole series was 32% and 38%, respectively. Survival was slightly better for patients with tumors of the glosso-epiglottic region than for those with a tumor of the base of the tongue. Five-year disease-free survival was 55% for patients treated with surgery +/- radiochemotherapy and 26% for those submitted to radiotherapy alone or in combination with chemotherapy. As far as the total dose and the treatment duration were concerned, only 26% of the patients of the radiotherapy group met the established criteria of adequacy, but in patients with adequate radiation the control rate was better only for small tumors (T1-T2). Conclusions The results in patients treated with surgery +/-postoperative radiotherapy were similar to or better than those reported in the best series in the literature. By contrast, the survival rate of irradiated patients was lower than those reported by other centers.
Preliminary Study on Immunoscintigraphy of a Murine Lymphoma Using Technetium-99M Labeled Chicken Antibody
Authors: Subbiah Krishnan , Myleru Udayachander , Ananthanarayanan Meenakshi 
Published: April 2018

Aims and background Radiolabeled antibodies generated against tumor-associated antigens are used for immunoscintigraphy to detect tumors and tumor metastases. Although successful tumor imaging has been achieved using trace-labeled murine monoclonal antibodies, such antibodies often lead to the development of human anti-murine antibodies (HAMA), which limit their subsequent administration for tumor imaging and therapy. It has been reported recently that chicken polyclonal antibodies have high affinity and specificity for the antigen against which they are raised and do not have any immunological cross-reactivity with HAMA. Methods The present study deals with immunoscintigraphy of Dalton's lymphoma, an experimental tumor model using chicken antibodies generated against Dalton's lymphoma-associated antigen (DLAA) and labeled with technetium-99m (99mTc). Results Scintigrams showed specific uptake of the radiolabel resulting in clear tumor images. The radioactivity uptake of the chicken anti-DLAA antibody was about twofold higher than that of the non-specific chicken antibody. Conclusions The results demonstrate the potential of chicken antibody for in vivo radioimmunodetection and localization of tumors.
Localization of the Sentinel Lymph Node in Breast Cancer by Combined Lymphoscintigraphy, Blue DYE and Intraoperative Gamma Probe
Authors: Villa Giuseppe , Gipponi Marco , Buffoni Ferdinando , Vecchio Carlo , Bianchi Pietro , Agnese Giuseppe , Di Somma Carmine , Catturich Alessandra , Rosato Francesco , Tomei Daniela , Nicolò Guido , Badellino Fausto , Mariani Giuliano , Canavese Giuseppe 
Published: April 2018

Axillary lymph node status represents the most important prognostic factor in patients with operable breast cancer. A severe limitation of this technique is the relatively high rate of false negative sentinel lymph nodes (>5%). We studied 284 patients suffering from breast cancer; 264 had T1 tumors (16 T1a, 37 T1b and 211 T1c), while 20 had T2 tumors. All patients underwent lymphoscintigraphy 18-h before surgery. At surgery, 0.5 mL of patent blue violet was injected subdermally, and the sentinel lymph node (SN) was searched by gamma probe and by the dye method. The surgically isolated SN was processed for intraoperative and delayed examinations. The SN was successfully identified by the combined radioisotopic procedure and patent blue dye technique in 278/284 cases (97.9%). Analysis of the predictive value of the SN in relation to the status of the axillary lymph nodes was limited to 191 patients undergoing standard axillary dissection irrespective of the SN status. Overall, 63/191 (33%) identified SNs were metastatic, the SN alone being involved in 37/63 (58.7%) patients; a positive axillary status with negative SN was found in 10/73 (13.7%) patients with metastatic involvement. In T1a-T1b patients the SN turned out to be metastatic in 9/53 patients (17.0%). In 7/9 patients the SN was the only site of metastasis, while in 2/9 patients other axillary lymph nodes were found to be metastatic in addition to the SN. None of the 44 patients in whom the SN proved to be non-metastatic showed any metastatic involvement of other axillary lymph nodes. Our results demonstrate a good predictive value of SN biopsy in patients with breast cancer; the predictive value was excellent in those subjects with nodules smaller than 1 cm.
Sentinel Lymph Node and Breast Cancer Staging: Final Results of the Turin Multicenter Study
Authors: Casalegno Paola Sorba , Sandrucci Sergio , Bellò Marilena , Durando Antonio , Danese Saverio , Silvestro Leandra , Pellerito Riccardo , Testori Ornella , Roagna Riccardo , Giai Maurizia , Giani Roberto , Bussone Roberto , Favero Alessandro , Bisi Gianni , Massobrio Marco , Giardina Giorgio , Mussa Gian Carlo , Sismondi Piero , Mussa Antonio 
Published: April 2018

Aim of the study Validation of the sentinel node (SN) technique in breast cancer by means of lymphoscintigraphy. Materials and methods From December 1996 to January 1999 102 T1-T2 breast carcinoma cases were recruited in Turin. 99mTc-human serum albumin colloids were injected subdermally the day before surgery (mean activity, 5.2 ± 2.5 MBq). Scintigraphic imaging was performed after injection. After identification of the SN during surgery by a hand-held gamma probe, the SN was excised and sent for histologic examination. SN histology was compared with that of other axillary nodes. Results The SN detection rate was 86.3%; among 88 cases with an identified SN, 37 (42%) had axillary metastases; the SN was metastatic in 35 cases (sensitivity, 94.6%); in 51.3% of pN+ cases (19/37) the SN was the only metastatic site. In two of the 53 negative SNs, SN histology did not match with that of the remaining axilla (negative predictive value, 96.2%; staging accuracy, 97.7%). Conclusions Our results agree with those reported in the literature; however, except in clinical trials and experienced structures axillary lymph node dissection should not be abandoned when mandatory for prognostic purposes, considering that at present SN biopsy alone is not completely accurate for axillary staging, especially in the absence of an adequate learning period.
Sentinel Node Biopsy for Malignant Melanoma: Analysis of a Four-Year Experience
Authors: Caggiati Alessio , Potenza Clemente , Gabrielli Fabrizio , Passarelli Francesca , Tartaglione Girolamo 
Published: April 2018

Aims and background Sentinel node (SN) biopsy has been introduced to solve the controversy concerning the effectiveness of prophylactic lymphadenectomy in intermediate thickness melanoma. The aim of this study was to evaluate the rate of metastases, the technical details of the procedure, and the main reasons of failure. Methods 235 patients affected by intermediate thickness melanoma (tumor thickness >0.75 mm and <4 mm) without clinical signs of systemic spread (N0M0) were submitted to sentinel node biopsy between 1996 and 2000. Preoperative lymphoscintigraphy was routinely performed in the last 184 patients. Intraoperative mapping with gamma probe was combined with the use of vital dye for identification of sentinel nodes in the last 113 patients. Results The SN detection rate was 95.6%, with significant differences depending on the site of dissection and the use of a gamma probe. The overall rate of micrometastases was 14.7%, but relevant differences were recorded between different subgroups of patients (T2, 5.1%; T3a, 19.6%; T3b, 29%). Conclusions Sentinel node biopsy requires a multidisciplinary approach (surgery, pathology and nuclear medicine) for reliable results. The association of vital dye and intraoperative gamma probe for sentinel node harvesting has made the procedure more effective, less time-consuming and less invasive. Failures may be due not only to surgical mistakes, but also to improper nuclear medicine procedures or inaccurate histological evaluation of SNs. Methods for histological examination of the SN are still debated and not standardized but promising results have recently been obtained with molecular oncology techniques (RT-PCR).
Mapping the Sentinel Lymph Node in Malignant Melanoma by Blue Dye, Lymphoscintigraphy and Intraoperative Gamma Probe
Authors: Villa Giuseppe , Agnese Giuseppe , Bianchi Pietro , Buffoni Ferdinando , Costa Rosario , Carli Franca , Peressini Alberto , Solari Nicola , Cafiero Ferdinando , Mariani Giuliano 
Published: April 2018

Eighty-eight consecutive patients (48 men and 40 women; mean age, 58.9 years; range, 16–84 years) with clinically localized cutaneous melanoma involving the trunk, extremities or head and neck underwent lymphatic mapping at our institution. The primary melanoma had a mean thickness of 2.74 mm (range, 0.95 to 9 mm). Patients were divided into two groups: group A (39 patients) underwent only vital blue dye (VBD) mapping, while group B (49 patients) underwent lymphatic mapping with VBD and radio-guided surgery (RGS) combined. In all patients 1-1.5 mL of VBD was injected subdermally around the biopsy scar 10–20 min before surgery. In group B 37 MBq in 150 μL of 99mTc-HSA nanocolloid was additionally injected intradermally 18 h before surgery (3–6 aliquots injected perilesionally). In all lymphatic basins where drainage was noted the sentinel lymph nodes (SNs) were identified and marked with a cutaneous marker. Final identification of the SN was then performed externally by a hand-held gamma probe. After the induction of anesthesia 0.5–1-0 mL of patent blue V dye was injected intradermally with a 25-gauge needle around the site of the primary melanoma. SNs were examined by routine hematoxylin and eosin (H&E) staining and immunohistochemistry. Patients with histologically positive SN(s) underwent standard lymph node dissection (SLND) in the involved lymph node basin. The SN was identified in 37/39 patients (94.9%) of group A and in 48/49 patients (98.0%) of group B. Blue dye mapping failed to identify the SN in 5 of the 88 patients (5.8%), while the radioisotope method failed in only 1 of 49 patients (2.0%). Similar results were obtained with the combined use of the two probes. The average number of SNs harvested was 1.9 per basin sampled, which does not differ significantly from the numbers reported by other authors114. The SN was histologically positive in 18 patients (20.5%). None of the 12 patients with a Breslow thickness less than 1.5 mm had positive SNs, whereas 18 of the 77 patients (23.4%) with a Breslow index exceeding 1.5 mm showed metastatic SNs with H&E or immunohistochemistry. The latter all underwent SLND of the affected basin. In 10 patients (55.6%) the SN was the only site of tumor invasion; eight patients (44.4%) with positive SNs had one or more metastatic lymph nodes in the draining basin.