bluuebunny/crossref_metadata_2025_split huggingface dataset:
Regional Estimates of Colorectal Cancer Burden in Italy
Authors: Grande Enrico , Inghelmann Riccardo , Francisci Silvia , Verdecchia Arduino , Micheli Andrea , Baili Paolo , Capocaccia Riccardo , De Angelis Roberta 
Published: February 2018

Aims and background In terms of new diagnoses, colorectal cancer is one of the most important cancers in Italy and worldwide. The aim of this paper is to present estimates of the mortality, incidence and prevalence of colorectal cancer in Italy at a national and regional scale over the period 1970-1999, with projections up to 2010. Methods The estimates were obtained by applying the MIAMOD method, a statistical back-calculation approach to derive incidence and prevalence estimates from mortality and relative survival data. Published data from the Italian cancer registries were modelled to obtain regional and national estimates of colorectal cancer survival. Results Different incidence patterns were observed for men and women, especially in the projection period: the national age-standardized rate is estimated to increase throughout the study period 1970-2010 for men from 30 to 70 per 100,000, and to stabilize from the end of the 1990s for women at around 38 per 100,000. A stabilization or a slight decrease in age-standardized incidence rates is expected in most regions for women and in most northern-central regions for men. The most critical situation is estimated among men for southern regions, where the rise in incidence is accompanied by a dramatic increase in mortality. About 46,000 incident cases, 267,000 prevalent cases, and 16,000 deaths from colorectal cancer are estimated in Italy for the year 2005. Conclusions Despite the risk reduction estimated in most northern-central regions among men and in the large majority of regions among women, the colorectal cancer burden in Italy is expected to remain relevant in the next years. Prospects for reducing this burden appear mainly connected to the adoption of prevention policies aimed at increasing the awareness of the risk related to dietary habits and lifestyles and at promoting colorectal cancer screening.
Cancer Chemotherapy near the End of Life: The Time has come to set Guidelines for its Appropriate Use
Authors: Martoni Andrea Angelo , Tanneberger Stephan , Mutri Vita 
Published: February 2018

Aims and Background This study retrospectively analyzes the use of chemotherapy in patients who died of advanced cancer either after having been in care at the Medical Oncology Unit (MOU) of the University Hospital of Bologna, Italy, or after having been assisted in their terminal disease phase by the Bologna Oncological Hospice at Home (OHH) of the Associazione Nazionale Tumori (ANT) Italia Foundation. In the latter group, the prescription and delivery of chemotherapy had been performed by doctors of medical oncology departments other than the MOU. Results Between January 2003 and September 2005, 793 deaths of patients were recorded (MOU: 312; OHH: 481). At least one cycle of chemotherapy had been received by 445 patients (56.1%). The most common cancer types were lung cancer (26.7%), colorectal cancer (14.8%), and breast cancer (11.2%). At the time of the last chemotherapy (l-CT), the median age of the patients was 68 years (range, 22–98 years) and the median KPS was 70 (range, 40–100). The median interval between l-CT and death was 71 days (range, 1-1913 days). One hundred and one patients (22.7%) had received their l-CT in the last 30 days of their life, 86% of them having intermediately chemosensitive (71%) or chemoresistant (14%) tumors. The l-CT in the last month of life was first line in 56% of cases and consisted of costly new-generation drugs in 36.6% of cases. Conclusions The study suggests the urgent need to lay down guidelines for the appropriate use of chemotherapy in advanced cancer patients with a short life expectancy.
Patterns of Care for Brachytherapy in Europe, in Spain and Italy: Comparative Results
Authors: Guedea Ferran , Ventura Montse , Marchetti Cristina , Polo Alfredo , Torrecilla José López , Bilbao Pedro , Borràs Josep Maria 
Published: February 2018

Aims and Background The aim of the study was to compare the facilities for brachytherapy in two similar countries, as are Italy and Spain. This survey reports the differences in the use of brachytherapy in these countries. Methods The data regarding brachytherapy was obtained in 2002 by means of a specially designed web site, because Internet allowed the access to the questionnaire in an easy and safe way. In the first edition of the survey, only the countries in which more than 50% of its centers had completed the questionnaire were included. Among these countries there were Italy and Spain. Results Data was available in 127 centers in Italy and 72 centers in Spain, where 35 and 39, respectively, provided brachytherapy. Although both countries had a similar number of radiotherapy patients and the average number of radiotherapy patients per center was similar in both countries (P = 0.29), there were several differences related to brachytherapy. For instance, the mean number of radiation oncologists regularly performing brachytherapy per center was higher in Spain (P = 0.001). There were also differences in the average number of patients per center in the following tumor sites: breast (P <0.001) and gynaecological (P <0.001). In fact, the average number of patients per center who were treated with brachytherapy in these tumor sites was higher in Spain than Italy. Conclusions Although the estimated workload of the radiation oncologists, physicists and radiation technologists was higher in Spain, no statistically significant differences were found in the average number of patients per center for the following tumor sites: bronchus, head and neck, intracoronary, esophagus, prostate, rectum and skin. Several differences in the use of the brachytherapy procedures applied were also found.
Her2/neu Expression by Reverse Transcriptase-Polymerase Chain Reaction in the Peripheral Blood of Prostate Cancer Patients
Authors: Fantinato Ana Paula , Tobias-Machado Marcos , Fonseca Fernando , Pinto Jorge Luiz Freire , Wroclawski Marcelo Langer , Wroclawski Eric , Verotti Maurício , Del Giglio Auro 
Published: February 2018

Background/Aims Evaluation of Her2/neu expression in the peripheral blood mononuclear cell fraction of prostate cancer patients by RT-PCR may afford an opportunity for the detection of circulating tumor cells and thus serve as a marker of micrometastatic disease. Methods We studied Her2/neu expression by reverse transcriptase-polymerase chain reaction in peripheral blood mononuclear cell fraction samples of 21 controls and serially in 43 patients with prostate cancer. Results None of the 21 controls expressed Her2/neu whereas 23.25% (95% CI, 11.75–38.63) of the patients were positive at entry into the study, and 65.11% (95% CI, 49.07–78.99) of them had at least one positive result during the follow-up period. Her2/neu positivity at study entry did not correlate significantly with PSA level, Gleason score, clinical stage or time to PSA progression. When we analyzed only patients with advanced disease, we observed a trend towards a shorter time to PSA progression in patients with at least one positive Her2/neu result during the follow-up (log-rank test, P = 0.08). Conclusions We conclude that Her2/neu expression in the peripheral blood mononuclear cell fraction of prostate cancer patients is frequent and therefore this assay may potentially be useful to detect the presence of micrometastatic disease in men with prostate cancer and for monitoring patients enrolled in trastuzumab-based therapeutic protocols.
Low Frequency of p53AND k-ras Codon 12 Mutations in Non-Small Cell Lung Carcinoma(NSCLC) Tumors and Surgical Margins
Authors: Vatan Ozgur , Bilaloglu Rahmi , Tunca Berrin , Cecener Gulsah , Gebitekin Cengiz , Egeli Unal , Yakut Tahsin , Urer Nur 
Published: February 2018

Aims and Background Lung cancer is one of the most common cancers and has became a predominant cause of cancer-related death throughout the world. The k-ras codon 12 mutation, which is the most common lung cancer mutation, is found in 15 to 30% of all lung cancers. Furthermore, the p53 gene has a very important role in the biological properties of tumor cells, and it is mutated in about 50% of non-small cell lung cancers. Residual tumor cells remain in surgical margins diagnosed as tumor free by histopathological techniques, and they can play a role in forming any local recurrence. Molecular methods may be exploited that are sensitive enough to detect small numbers of tumor cells. Methods In the present study, we examined p53 gene mutations and k-ras codon 12 mutations from the tumor samples and surgical margins of 34 non-small-cell lung cancer patients. P53 gene mutations were analyzed by single strand conformational polymorphism analysis, heterodublex analysis and DNA sequencing. K-ras codon 12 mutations were analyzed by the mutagenic PCR-restricted fragment length polymorphism method. Results A p53 mutation was detected only in primary tumors of 3 out of 34 patients (8.82%). These mutations were clustered in exon 5. Moreover, a k-ras codon 12 mutation was detected in both the primary tumor and the surgical margin tissues of 2 out of 34 patients (5.88%). Conclusions The detected mutation rate was low, in the range given in the literature. We think that different mechanisms related to other genes and individual genetic differences might play a role in cancer formation in our study group. We believe that molecular studies are necessary to identify biomarkers and to determine genetic alterations in histopathologically normal surgical margins.
Development and Validation of a Patient-Physician Relationship Index in the Advanced Cancer Setting
Authors: Ostacoli Luca , Costantini Massimo , Beccaro Monica , Dellai Monica , Gorzegno Gabriella , Picci Rocco Luigi , Sguazzotti Erica , Berruti Alfredo , Torta Riccardo , Furlan Pier Maria 
Published: February 2018

Background The quality of the relationship between patient and medical staff is crucial in oncological settings. We have developed and validated a short, self-administered questionnaire to measure patients’ satisfaction with their relationship with the physician: the Patient-Physician Relationship Index (PPRI). Materials and Methods Content validity was evaluated by a two-stage (development and judgment) process. One hundred and nine cancer patients with metastatic disease were assessed during the second cycle of chemotherapy and 59 were reassessed eight weeks later. Quality of life and anxiety and depression were also evaluated. Results The PPRI is monofactorial. Cronbach's alpha coefficient was 0.81. Sensitivity to change was shown by the correlation with changes in patients’ conditions. The PPRI scores were only weakly correlated with the majority of the EORTC and HAD subscale scores. Conclusion The PPRI is an easy-to-use, self-administered questionnaire, developed in a population of patients with advanced cancer. It has good internal consistency and sensitivity to change.
Survival Benefit with GM-CSF Use after High-Dose Chemotherapy in High-Risk Breast Cancer
Authors: Kuzhan Okan , Özet Ahmet , Ulutin Cüneyt , Kömürcü Şeref , Arpaci Fikret , Öztürk Bekir , Öztürk Mustafa 
Published: February 2018

Aims and background The role of high-dose chemotherapy in breast cancer has not been fully defined. It has been concluded that new trials should focus on defining potential subgroups that are more likely to benefit from high-dose chemotherapy. We compared survival differences in patients receiving human granulocyte-colony stimulating factor (G-CSF) or granulocyte-monocyte colony stimulating factor (GM-CSF) after high-dose chemotherapy with stem cell support. Methods High-risk non-metastatic breast cancer patients (axillary lymph node involvement more than 8) aged 16 to 65 years and with a performance status ≤1 underwent high-dose chemotherapy with autograft. Written informed consent was obtained from every patient, and the study was approved by the local ethics committee. Results For 54 eligible women, the median follow-up was 41.4 months. The five-year disease-free survival was 45.7%. The five-year projected overall survival rate was 53.9%. Among them, patients who received GM-CSF (n = 12) posttransplant lived longer than the patients who received G-CSF (n = 15) (five year survival rates, 46.6% vs 75%, P <0.050). The patients who received GM-CSF posttransplant had fewer relapses (5 vs 9). However, between the two groups there was no statistically significant difference regarding disease-free survival rates calculated with the Kaplan-Meier method (58.8% vs 40%; P = 0.121). Conclusions Patients receiving GM-CSF posttransplant lived longer and they had fewer relapses than those who received G-CSF. This result merits consideration. The antitumor activity of GM-CSF should be investigated further in prospective randomized trials.
Neutropenic Enterocolitis: Is There Aright Timing for Surgery? Assessment of a Clinical Case
Authors: Bagnoli Pietro , Castagna Luca , Cozzaglio Luca , Rossetti Carlo , Quagliuolo Vittorio , Zago Mauro , Santoro Armando , Doci Roberto 
Published: February 2018

Neutropenic enterocolitis is a severe and potentially life-threatening complication that may affect patients undergoing chemotherapy for acute leukemia or lymphoma. These patients may develop systemic sepsis through bacterial or fungal translocation across the intestinal wall. In many cases neutropenic enterocolitis is confined to the cecum, but the entire colon is sometimes involved. Most patients are treated conservatively because an improvement occurs when the absolute neutrophil count rises. However, a surgical approach consisting of resection of the colon may sometimes be necessary, even in patients with complete aplasia and a high risk of complications. The right time to perform surgery is hard to define. Intestinal wall thickness, evaluated by ultrasound, is an important prognostic factor which could act as a guide to surgical indication. We analyze a case of neutropenic enterocolitis which occurred in a patient with acute myeloid leukemia during chemotherapy and we suggest that, as well as intestinal wall thickness, hemodynamic worsening should be considered an indication for surgery.
Long-term Outcome after Colorectal Cancer Resection. Patients’ Self-Reported Quality of Life, Sexual Dysfunction and Surgeons’ Awareness of Patients’ needs
Authors: Di Fabio Francesco , Koller Michael , Nascimbeni Riccardo , Talarico Carlo , Salerni Bruno 
Published: February 2018

Aims and background Current follow-up care programs focus mainly on detection of tumor recurrence or metachronous cancer. Other aspects that affect the quality of life (QoL) of long-term survivors, such as sexual dysfunction, psychological distress or depressive symptoms, have been poorly investigated. We studied these issues, and also investigated the surgeons’ awareness of their patients’ needs in order to determine how to improve follow-up care programs. Methods QoL of 62 colorectal cancer patients was assessed during follow-up using the European Organization for Research and Treatment of Cancer (EORTC) questionnaire QLQ-C30 and the symptom-specific module (QLQ-CR38). Postoperative sexual problems were evaluated with a 6-item questionnaire. Relevant needs to be examined during follow-up were investigated among patients and surgeons, by filling in the same checklist. Results During long-term follow-up (range, 14–74 months), rectal cancer patients reported lower QoL than colon cancer patients regarding defecation-related problems (P = 0.0001). Sixty-one percent of colon cancer patients reported no sexual dysfunction, whereas only 24% of individuals with rectal cancer reported no problems (P = 0.007). Patients reporting no sexual problems had significantly better QoL than the others, particularly with respect to physical functioning (P = 0.001), social functioning (P = 0.05), financial problems (P = 0.01) and body image (P = 0.0001). Addressing emotional problems during follow-up was important for 26% of the patients, while this was neglected by surgeons (P = 0.03). Conclusions QoL measurement in a clinical setting may help to detect QoL problems that could otherwise go unnoticed in the routine of follow-up care. Specifically, it was useful to detect defecation-related problems, sexual dysfunction and a mismatch in judging the importance of psychological distress between patients and their doctors. Neglecting these issues may cause long-term postoperative dissatisfaction.
Shoulder Function in Various Types of Neck Dissection. Role of Spinal Accessory Nerve and Cervical Plexus Preservation
Authors: Selcuk Adin , Selcuk Barin , Bahar Secil , Dere Huseyin 
Published: February 2018

Aims and background The aim of this study is to determine the effects of two different types of nerve-sparing neck dissection on shoulder function. Even if the spinal accessory nerve is spared in functional neck dissection, some degree of shoulder syndrome may occur. The role of the cervical plexus in shoulder function and the effects of dissection of level 5 are emphasized. Methods Twenty-six patients with laryngeal carcinoma were studied prospectively. Seventeen anterolateral and 15 functional neck dissections were performed. Electromyographic evaluation was carried out in all patients to assess spinal accessory nerve function preoperatively and at the sixth week and sixth month postoperatively. Shoulder disability was evaluated by a questionnaire (shoulder pain disability index) and goniometric measurements were done preoperatively and at the sixth postoperative month. Results In patients who underwent anterolateral neck dissection, the goniometric results were better than in the functional neck dissection group. The questionnaire results also showed better quality of life of patients who underwent anterolateral neck dissection. Electrophysiological evaluation of the trapezius muscles of both groups at the sixth week showed significant differences. The distal motor latency values of the anterolateral neck dissection group were shorter than those of the other group. Electrophysiological evaluation at the sixth postoperative month showed shorter distal latency values in the anterolateral dissection group, without statistical significance. Conclusions Preservation of the cervical plexus and less disturbance of the spinal accessory nerve are important to diminish postoperative shoulder disability. The type of neck dissection has an important influence on shoulder function.
Oncogene and Tumor Suppressor Gene Expression Changes in the Peripheral Blood Leukocytes of Patients with Colorectal Cancer
Authors: Csontos Zsolt , Nádasi Edit , Csejtey András , Illényi László , Kassai Miklós , Lukács László , Kelemen Dezső , Kvarda Attila , Zólyomi Annamária , Horváth Örs Péter , Ember István 
Published: February 2018

Aims and background The mortality of colorectal cancer continues to stagnate despite the development of new therapeutic approaches. Therefore, identifying high-risk population groups could contribute to the prevention of a considerable part of deaths caused by colorectal tumors. Methods Fifty patients with colon cancer and 50 patients with other, nonmalignant diseases were selected for the study. Expression of the c-myc, Ha-ras and p53 genes was determined in the peripheral leukocytes of the participants. Results Marked elevations of the expression of all three investigated genes were seen in the colon cancer patients when compared to the controls. Conclusions Our investigations showed that increases in the expression of c-myc, Ha-ras and p53 genes can be demonstrated in the peripheral leukocytes of colon cancer patients. By applying our method to clinical investigations, individuals with a high risk of having developed colon cancer may be identified and early diagnosis may be established.
Therapeutic Reactive Oxygen Generation
Authors: Scharff Peter , Ritter Uwe , Matyshevska Olga P , Prylutska Svitlana V , Grynyuk Iryna I , Golub Alexandr A , Prylutskyy Yuriy I , Burlaka Anatoliy P 
Published: February 2018

An increase of the intracellular reactive oxygen species (ROS) concentration leads to the development of oxidative stress and, thus, to the damage of cell components. The cause-and-effect relations between these processes have not been fully established yet. The ability of photo excited supramolecular composites containing fullerenes C60 immobilized at nanosilica particles to generate reactive oxygen species (ROS) in cells of two types (rat thymocytes, and transformed cells of ascite Erlich carcinoma, EAC, and leucosis L1210) is demonstrated. The damaging effect of photo excited C60-composites are shown, which appeared to be selective and manifested in transformed cells, but not in thymocytes. It has been shown that after the irradiation of aqueous solutions or cell suspensions in the presence of fullerene C60, the generation of reactive oxygen species is observed. It has been shown that the influence of photo excited fullerene C60 on metabolic processes depends on the composition of C60-containing complex and on the type of the cells. The damaging effects of photo excited fullerene C60-containing composites were demonstrated to be selective. The data presented suggest that the application of fullerene C60-containing composites for the selective activation of ROS-dependent death program in certain types of tumor cells is very promising.
Rectus Abdominis Muscle Resection for Abdominal Wall Recurrence of Mucinous Adenocarcinoma or Peritoneal Mesothelioma
Authors: Yan Tristan , Sugarbaker Paul 
Published: February 2018

Aims and Background Diagnostic technologies which penetrate the abdominal wall in an attempt to definitively diagnose an intraabdominal malignancy by biopsy can contaminate the abdominal wall by cancerous cells. With follow-up these entrapped cancer cells may progress as an abdominal wall recurrence of the disease process. Frequently, laparoscopy is the definitive diagnostic study which results in the abdominal wall cancer progression. Methods We examined recurrences within the abdominal wall and attempted to establish a surgical approach to this problem which would maximize a functional result and minimize the incidence of disease persistence within the abdominal wall. Results Eighteen patients with abdominal wall recurrence were studied. Laparoscopy port sites resulted in the abdominal wall disease in eight patients, in four the recurrence was at a previous ostomy site, in three it was in a Pfannenstiel incision and in three it was in a McBurney incision site. All of these patients were treated by total resection of the rectus abdominis muscle. This resulted in a complete removal of visible disease that was dissecting along the fibers of the rectus abdominis muscle. Conclusions No patients required reoperation for abdominal wall hernia and mesh repair was not used in any of these patients. Disease control within the abdominal wall has been excellent.