bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differences in Cancer Mortality Trends between Four Neighboring North-Eastern Areas and Italy, 1970-1990
Authors: Bidoli Ettore , Franceschi Silvia , Simonato Lorenzo , Piffer Silvano , Tognazzo Sandro , Vian Paolo , Prati Sabrina , Fascioli Silvia , Cristofolini Mario ,   The Gruppo Epidemiologico del Nord-Est, Simonato L. , Zambon P. , Giorio M.P. , Rodella S. , Franceschi S. , Talamini R. , Bidoli E. , Barbone F. , Stanta G. , Cuttini M. , Bovenzi M. , Piffer S. 
Published: April 2018

Aims and background The present report combines descriptive statistics (partly never published) on four neighboring areas of north-eastern (NE) Italy [Friuli-Venezia Giulia (1970-89) and Veneto (1970-87) regions and the provinces of Trento (1970-89) and Bolzano (1971-90)], and all Italy (1970-89). The aim was to highlight potential differences in mortality trends and promote a more systematic sharing of data and methodologies. Methods Death certificates stratified by cause, sex, age and residence were obtained from official publications of the Italian Central Institute of Statistics. Absolute numbers of deaths from different causes, age-standardized rates (on the basis of the European standard population) and percentage of change over the examined period for both sexes were computed for each geographic area. Results Unfavorable trends were seen for neoplasms of the upper aerodigestive tract, lung, breast, colorectum, bladder, kidney and pancreas and cutaneous malignant melanoma. Increases in most of these neoplasms were more marked in the 4 NE areas than in Italy, especially with respect to cancers of the upper aerodigestive tract in both sexes and cancer of the lung and ovary in women. In Bolzano, rates of neoplasms associated with tobacco and alcohol consumption were lower and less steeply increasing than in the other NE areas, most notably Trento, therefore, contributing to produce the lowest overall cancer mortality rates of NE areas. Cancers of the stomach, uterus, and testis and Hodgkin's disease presented consistent downward trends in all examined areas. Conclusions The analysis of mortality trends across areas is consistent with elevated and still increasing cancer rates in the 4 NE areas considered, especially for tobacco and alcohol-related neoplasms and skin melanoma. Preventive strategies, based on epidemiologic knowledge, especially against tobacco and heavy alcohol consumption, and intense intermittent sun exposure, seem to be priorities and may benefit from systematic sharing of information, expertise and intervention tools in NE Italy. At least part of the lack of cancer deaths in Bolzano must be attributable to the deaths of Bolzano residents abroad (especially in Austria) and/or to differences in coding practices. This should be elucidated in future studies.
Mitomycin-C and Lonidamine as Second-Line Therapy for Colorectal Cancer: A Phase II Study
Authors: Zaniboni Alberto , Meriggi Fausto , Alghisi Alberto , Mutti Stefano , Distefano Luciana , Rizzi Anna , Bettini Lamberto , Simoncini Edda , Marpicati Patrizia , Montini Elisabetta , Marini Giovanni 
Published: April 2018

Aims and background Recent preclinical data have suggested that lonidamine may potentiate the activity of mitomycin C in human colon cancer cell lines LoVo and HT29. Study design A phase II study was carried out in 14 patients with advanced colorectal cancer pretreated with fluorouracil and folinic acid. Treatment consisted of lonidamine, 600 mg po, followed after 2 h by mitomycin, 20 mg/m2 by iv bolus, followed by lonidamine, 150 mg tid for 5 days; the cycle was repeated every 6 weeks. Results No objective response was seen. Three patients had stable disease; the median survival for the whole group was 4 months. Although hematologic toxicity was negligible, lonidamine-related side effects were moderate to severe in most patients and mainly represented by myalgia and gastric pain. Discussion Despite a sound preclinical rationale, this schedule of lonidamine and mitomycin C was ineffective and toxic in patients with advanced colorectal cancer. More experimental data about lonidamine are needed in order to design more effective regimens based on the combination of this interesting drug with other anticancer agents.
Renal Angiomyolipoma: Report of three cases with Regional Lymph Node Involvement and/or with Renal Cell Carcinoma
Authors: Csanaky György , Szereday Zoltán , Magyarlaki Tamás , Méhes Gábor , Herbert Tamás , Buzogány István 
Published: April 2018

Aims and background Angiomyolipomas (AMLs) are benign hamartoid tumors which frequently occur in tuberous sclerosis (TS). They may be manifest at different organ sites such as kidneys, lymph nodes, liver and lung and may be associated with renal cell carcinoma (RCC). The nature of multiple organ involvement in AML (metastasis versus multicentric synchronous tumors), the malignant transformation and the relation of AML to RCC have not been sufficiently clarified. Study design Three cases of renal AMLs in patients with tuberous sclerosis associated with lymphangioleiomyomatosis of the paraaortic lymph nodes and/or with RCC are reported. The concise clinical history of the patients as well as the findings of histology, immunohistochemistry and quantitative DNA analysis are presented. Results The multicentric form of AML and coincidence of renal AML and RCC were observed in 2 patients. AML and RCC were found within the same focus in one of the cases. RCCs were either aneuploid or “near diploid”, whereas one of the multicentric AMLs showed a discordant DNA ploidy pattern, namely aneuploidy in the kidney and diploidy in the lymph nodes. Conclusions The presented cases (all of them underwent periaortic lymphadenectomy) suggest that lymph node involvement in renal AML may be more frequent than expected (1-2% of all AMLs) on the basis of the few reported cases. The discordant DNA ploidy (renal versus lymph node lesions) observed in one of the cases with multicentric AML implies synchronous tumor growth at different sites rather than metastatic disease. The intimate coexistance of RCC and AML (RCC revealed by immunohistochemistry within a larger mass of renal AML) may indicate that malignant transformation of an AML should only be accepted, if such a coincidence is unequivocally excluded.
A Phase II Study of Mitomycin C, Vindesine and Cisplatin Combined with Alpha Interferon in Advanced Non-Small Cell Lung Cancer
Authors: Silva Rosa Rita , Bascioni Romeo , Rossini Simonetta , Zuccatosta Lina , Mattioli Rodolfo , Pilone Alberta , Delprete Stefano , Battelli Nicola , Gasparini Stefano , Battelli Tullio 
Published: April 2018

Aims and background MVP chemotherapy (mitomycin C, vindesine or vinblastine, cisplatin) is one of the most commonly used regimens for advanced non-small cell lung cancer (NSCLC). Experimental data suggest a synergistic cytotoxic activity of alpha-interferon (α-IFN) when combined with cisplatin, mitomycin C, and vinca alkaloids. In an effort to improve MVP chemotherapy activity, we have combined this regimen with α-IFN. Patients and methods Thirty-five patients with advanced NSCLC (19 stage IV) were treated with the MVP regimen (mitomycin C, 8 mg/m2; vindesine, 3 mg/m2; cisplatin, 75 mg/m2, all on day 1) plus α-2a-IFN, 3×106 U im from day 1 to 7. The cycles were repeated every 28 days. Results There were no complete responses and 18 partial responses, for an overall response rate of 51%. Median time to treatment failure was 6 months (range, 1-18), and median survival was 9.5 months (range, 1-32). WHO grade 3 toxicity was recorded in up to 8% of patients, flu-like syndrome was a common complaint; one toxic death occurred. Conclusions The combination yielded a level of response comparable to that of other cisplatin-based regimens. Larger randomized trials are needed to assess the role of α-IFN combined with chemotherapy in advanced NSCLC.
Characterization of Cancer-Related Disseminated Intravascular Coagulation in Relation to Tumor Necrosis Factor-Alpha Blood Concentrations: Possible Therapeutic Role of Pentoxifylline
Authors: Lissoni Paolo , Ardizzoia Antonio , Barni Sandro , Pittalis Salvatore , Rossini Fausto , Porta Alvaro , Tancini Gabriele 
Published: April 2018

Aims and background Preliminary experimental data suggest the involvement of tumor necrosis factor (TNF) in determining endothelial damage related to disseminated intravascular coagulation (DIC). The present study was performed to investigate TNF secretion in DIC occurring in metastatic solid tumor patients and to evaluate the possible therapeutic role of pentoxifylline, which has been proven to have a TNF-lowering activity. Methods The study included 20 metastatic solid tumor patients who showed clinical and laboratory signs of DIC. Pentoxifylline was given orally at a dose of 1200 mg/day for 28 days. Results Abnormally high levels of TNF were found in 13/20 patients, and mean TNF serum levels observed in patients were significantly higher than those seen in a control group of 50 healthy subjects. Fibrinogen plasma concentrations were low in 11 cases. Patients with low fibrinogen values showed significantly higher mean TNF levels than those with normal or elevated concentrations. Pentoxifylline therapy induced a significant decrease in mean TNF concentrations and a significant increase in mean platelet number, which returned to within the normal range in 11/20 patients. An increase in platelets in response to pentoxifylline was more evident in patients with elevated pretreatment TNF values. Conclusions Our results suggest the existence of abnormally high blood levels of TNF in cancer-related DIC, mainly in the presence of low fibrinogen values. Moreover, they indicate that pentoxifylline therapy may determine a decrease in TNF levels in DIC patients, an event associated with an increase in platelet number.
Indications, Results and Techniques of Radiotherapy in the Treatment of Small-Cell Lung Cancer
Authors: Palazzi Mauro , Villa Sergio , Leonardi Maria Cristina , Milani Franco 
Published: April 2018

Aims and background To define the role of radiotherapy in the treatment of small-cell lung cancer (SCLC) on the basis of clinical data reported in the medical literature. Methods Published reports are critically reviewed, with particular attention to randomized trials. Results Thoracic radiotherapy has an important role in improving local control and 3-year survival in limited-stage SCLC; radiation should be delivered early in the course of the chemotherapy program, avoiding large volumes and total doses exceeding 40-50 Gy. Thoracic radiotherapy probably has no role in resected patients treated with adjuvant chemotherapy and may even be detrimental in patients with extensive SCLC. Prophylactic cranial irradiation has been shown to reduce the risk of brain relapse, but it is not associated with a consistent increase in survival or cure rate: its use in clinical practice is therefore not advised. Conclusions Survival rates approaching 50% at 2 years are now possible in limited SCLC with the integrated effort of the surgeon, the medical oncologist and the radiation oncologist; their strict cooperation appears to be of the utmost importance in the earliest phase of treatment planning.
Molecular Characterization of Cellular Proteins from Colorectal Tumors
Authors: Szymczyk Piotr , Krajewska Wanda M. , Jakubik Jaroslaw , Berner Andrzej , Janczukowicz Janusz , Mikulska Urszula , Berner Jan , Kiliańska Zofia M. 
Published: April 2018

Aims and background Recent evidence has suggested that progressive stages of colorectal tumorigenesis can be defined by a sequence of genetic events characterized by altered expression of certain genes and the appearance of cancer-specific proteins. Although the significance of these events is still not clear, expression of cancer-specific protein components may be directly involved in the neoplastic transformation. The purpose of the present study was to compare molecular characteristics of cellular proteins from human colorectal tumors and normal colonic mucosa. Methods Normal mucosa and colorectal tumors from 18 patients were fractionated by a differential centrifugation scheme into four cellular fractions, i.e., nuclear, mitochondrial (10P), microsomal (100P) and cytosolic (100S). The proteins of these fractions from normal and tumorigenic mucosa were analyzed by one-dimensional polyacrylamide gel electrophoresis followed by Coomassie brilliant blue R-250 and silver nitrate staining. Nuclear proteins from normal and neoplastic tissues which had revealed the most significant diversities were further characterized by two-dimensional gel electrophoresis. Electrophoretically cancer-specific nuclear proteins in the molecular mass zone 35-40 kDa were used as immunogen to produce rabbit polyclonal antibodies. Results Electrophoretic analysis by one-dimensional gel electrophoresis showed clear differences in molecular characteristics of cellular proteins between normal and tumorigenic mucosa, especially among nuclear fractions. The latter were also confirmed by their two-dimensional electrophoresis results. Rabbit antibodies raised against electrophoretically specific nuclear proteins characterized by molecular mass of 35-40 kDa cross-reacted with 36 kDa polypeptide in 15 of 18 (83.3%) studied nuclear fractions of colorectal tumors but not with any normal mucosa. In some cases, nuclear cancer-associated components of 38 and 40 kDa were also recognized by these antibodies. Conclusions During colorectal carcinogenesis, specific expression of several nuclear proteins takes place. One of them, the polypeptide of 36 kDa not found in normal colonic epithelium, was shared by over 83% of the studied carcinomas despite variations in detailed cancer properties. This particular nuclear protein may be considered as a potential marker for the colon malignancy.
Attitudes of Non-Oncology Physicians Dealing with Cancer Patients. A Survey Based on Clinical Scenarios in Ancona Province, Central Italy
Authors: Piga Andrea , Graziano Francesco , Zahra Georges , Cellerino Riccardo 
Published: April 2018

Aims and Background With this study we attempted to determine to what extent recent acquisitions in clinical oncology had reached categories of physicians involved in the management of patients with cancer, namely general surgeons, internists and family doctors. Methods A questionnaire was prepared with scenarios based on the following clinical situations: Scenario A, Adjuvant therapy in colon cancer; Scenario B, Treatment of small-cell lung cancer; Scenario C, Adjuvant therapy in high-risk, node-negative breast cancer; Scenario D, Treatment of early stage breast cancer; Scenario E, Asymptomatic transient myelosuppression during chemotherapy. Questionnaires were mailed to 365 family doctors, 54 general surgeons and 61 internists of the Province of Ancona in central Italy. Results A total of 198 completed questionnaires were returned (41%). Respondents were 36.7% of family doctors, 54.1% of internists and 57.4% of surgeons. Less than half of respondents selected an adequate approach such as adjuvant chemotherapy for colon cancer and high-risk, node-negative breast cancer or chemotherapy as first-line treatment for small-cell lung cancer. Conservative surgery plus radiotherapy (QUART) for early stage breast cancer was indicated by 69% of respondents. Over three quarters of physicians would give treatment for asymptomatic transient chemotherapy-induced leukopenia. In most of the scenarios, significant differences were detected in the distribution of preferences according to category of physicians. Family doctors and young physicians (<40 years) generally performed worse than hospital-based physicians (general surgeons and internists) and older physicians. Conclusions Non-oncology physicians showed insufficient awareness of currently available knowledge in cancer treatment. Basic concepts in cancer management should be part of the professional knowledge of all medical doctors, and key advances in clinical oncology should spread outside the oncologic environment more promptly, with a wide circulation among all physicians who care for cancer patients.
Results. of a Mammographic and Clinical Screening in a Health District (USSL) of Brescia, Italy
Authors: Filippini Luigi , Braga Marco , Perna Egidio , Bianchi Anna Maria , Bettoni Carlo , Lucini Laura , Pezzola Diego , Pinelli Domenico , Tonini Gabriele , Tonini Gerolamo , Callea Francesco 
Published: April 2018

Aims and Background Screening by mammography has been shown to be effective in reducing breast cancer mortality. We present the results of a mammographic and clinical screening program carried out in an Italian health district. Methods The first screening round started in June 1987 and ended in July 1990, and 25,100 women between the age of 50 and 60 years were invited. The second screening round invited 34,332 women between the age of 50 and 64 years and was carried out from September 1990 to September 1993. Women with positive or equivocal results at palpation or mammography were referred for immediate diagnostic assessment followed by surgery, when required. Results The attendance rate was 67.3% at the first and 62.1% at the repeat screening. At the first screening, 206 biopsies were advised and 197 were performed; 129 of the 197 were found to be malignant. At repeat screening, 248 biopsies were recommended, 208 were performed, and 125 were found to be malignant. The cancer detection rate was 7.7 per thousand at the first and 5.9 per thousand at repeat screening. Of 129 cancers, 107 (83.0%) were T1 at first screening; 6.2% were in situ carcinomas. Axillary lymph nodes were histologically positive in 24% of cases. At repeat screening, 77.6% (97/125) of cancers were T1; 11.2% were in situ carcinomas. Positive axillary lymph nodes were found in 16.8% of cases. Conclusions The attendance to screening was satisfactory. A higher frequency of small tumors (83.0%) was found at first screening than before the introduction of screening (56.6%). A marked difference in lymph node positivity (24.0% vs 40.6% in the pre-screening era) was also observed. Such a difference was even more evident at repeat screening. Quality standards of the screening in our study proved to be higher than those currently recommended. The reported results are encouraging, also considering the greater chance for conservative treatment.
Agreement Estimate among three Italian Cancer Registries in the Coding of Multiple Primary Cancers
Authors: Buiatti Eva , Crocetti Emanuele , Gafà Lorenzo , Falcini Fabio , Amorosi Andrea , Milandri Carlo , La Rosa Maria 
Published: April 2018

Aims The aim of the study was to compare agreement on the coding of multiple primary cancers (MPs) between three Italian cancer registries, the Ragusa Cancer Registry (RCR), the Cancer Registry of Romagna (RTRo), and the Tuscany Tumor Registry (RTT), that adhere to different rules for accepting MPs and to study whether coding according to common international rules (IARC-IACR) increased comparability. Methods One hundred cases were randomly extracted from the archives of each registry from those recorded as having more than one cancer. For each of the 300 patients, the number of independent cancers was attributed independently by one coder from each registry. The coders coded the series twice: once following the local registry rules and once according to the IARC-IACR rules. The agreement was estimated by couples of coders by means of Cohen's kappa statistics. Results The agreement on MP status between coders using local rules and definitions was good between the RTT and RCR (kappa = 0.77) and very good between the RTRo and RCR (kappa = 0.81) and the RTT and RTRo (kappa = 0.96). Exclusion of 23 expected discordant cases increased the agreement. The agreement reached with the use of the IARC-IACR rules was very good (RTRo vs RCR, 0.95; RTT vs RTR, 0.94; RTT vs RTRo, 0.95). Conclusions The comparison among the RTT, RTRo and RCR confirmed that the number of tumors considered MPs may be modified depending on the rules adopted. There were minor differences between the RTT and the RTRo since their rules were very similar. Most differences in agreement were with the RCR since its classification was conceptually different from the other two. The result on agreement with IARC-IACR rules is encouraging from the point of view of conducting a cooperative study among different registries on the incidence of MPs.
New Scm (Structuredness of the Cytoplasmatic Matrix)-Based Approach in Breast Cancer Detection
Authors: Birindelli Sarah , Colnaghi Maria Ines , Pilotti Silvana 
Published: April 2018

Aims and Background We evaluate the possibility to use a combination of techniques such as lymphocyte stimulation and the Cell Scan instrument for early detection of breast cancer. This method can detect differences in lymphocytes activation in the presence or absence of cancer. Methods The Cell Scan is a static cytometer system able to examine cellular membrane polarization. We screened 88 women with benign breast lesions, 207 women with mammary carcinoma and 325 healthy blood donors. After lymphocytes separation, each blood sample was incubated with encephalitogenic factor (EF), phytohaemagglutinin (PHA) and Breast Antigen (BrAg) then SCM test was performed. Results Positivity was 50% among breast cancer patients, 34% among women affected by benign disease and 27% and 22% respectively among healthy female and male controls with an increase of the specific predictivity of the test during the period of ovulation. A significant difference ( P <0.0001) was observed between healthy donors and breast cancer patients. Conclusions This results suggest that the Cell Scan test could be useful to investigate patient's immunogenicity to molecules known to be involved in tumor development and progression, such as oncogene or suppressor gene products, which could be appropriate targets for immune-derived therapeutic approaches.
Treatment of Recurrent Sarcoma of the Extremities by Isolated Limb Perfusion Using Tumor Necrosis Factor Alpha and Melphalan
Authors: Santinami Mario , Deraco Marcello , Azzarelli Alberto , Cascinelli Federico , Chiti Arturo , Costagli Valerio , Inglese Maria Grazia , Manzi Renato , Quagliolo Vittorio , Rebuffoni Giacomo , Santoro Nicola , Vaglini Maurizio 
Published: April 2018

Background 24-60% of patients with soft tissue sarcoma shows local recurrences after treatment of the primary tumor. The event is associated with a high incidence of macroscopic or microscopic metastases and a poor survival. Our goal is to preserve a patient's functional limb by treating such cases with isolated limb perfusion (ILP) with recombinant human tumor necrosis factor alpha (rHu TNF-α) and melphalan, which have demonstrated a potent antitumor activity in vivo and in vitro studies. Methods During the period November 1991 to November 1995, 10 patients with unresectable recurrent soft tissue sarcoma of the limb were treated by ILP at intermediate hyperthermia (40-40.5 °C) with rHu TNF-α and melphalan. Two patients also received recombinant interferon gamma (rIFN-γ) before and during ILP. We used a range of 2-4 mg for rHu TNF-α and 50-100 mg of melphalan. rIFN-γ was administered on days -2 and -1 (15x106 IU) subcutaneously and the same dose was injected in the arterial line during ILP. Results No perioperative surgical complication was observed. Local toxicity was moderate (grade I or II); general toxicity was observed in 6 patients (2 grade I and 4 grade III). Complete response was obtained in 7 cases; 2 patients had a partial response and finally 1 was a nonresponder and showed local progression, which required surgical amputation. Tumor necrosis (observed in 5 cases) was maximal in 4 patients (80-100%) and absent in the patient who had local progression. Conclusions The results we obtained with the treatment of soft tissue sarcoma confirm the efficacy of ILP as a limb-sparing methodology for unresectable recurrences. Furthermore, rHu TNF-α and melphalan confirmed their antitumor activity when associated with hyperthermia. Amputation or disarticulation may be reliable as a second-choice treatment for these patients.