Search PubMed⌕ Search

Biomedical subjects

A Gadducci

Publications and source records attributed to A Gadducci.

At least 109 records · Page 6Linked to original sources

Preoperative evaluation of CA 125 and CA 19-9 serum levels in patients with ovarian masses.

Serum CA 125 and CA 19-9 were presurgically measured in 40 patients with ovarian carcinoma and in 108 with benign ovarian pathologies. The sensitivity for ovarian carcinoma of CA 125 (cut-off value = 65 U/ml) and CA 19-9 (cut-off value = 40 U/ml) were 67.5% and 37.5% respectively. In particular serum CA 125 was elevated in 71.9% of non-mucinous and in 50% of mucinous carcinomas, while serum CA 19-9 was high in 25% of non-mucinous and in 87.5% of mucinous malignancies. The correlation of CA 19-9 with mucinous histotype was significant. Elevated serum levels of CA 125 and CA 19-9 were observed respectively in 14.7% and in 13.8% of benign adnexal masses. The percentages of elevated serum marker levels were significantly higher in patients with ovarian carcinoma than in women bearing benign ovarian pathology (P less than 0.001 for CA 125; P less than 0.01 for CA 19-9). Serum CA 125 and CA 19-9 alone cannot clarify the nature of an adnexal mass. However, the measurement of serum levels of these markers could give additional information to other diagnostic methods, such as ultrasonography, for discriminating benign from malignant ovarian pathologies.

Antigens, Neoplasm↗

Correlation of CA125 and CA19-9 serum levels with clinical course and second-look findings in patients with ovarian carcinoma.

CA125 and CA19-9 levels were serially evaluated in blood samples from 21 patients during and after integrated surgical and chemotherapeutic treatment for ovarian carcinoma. Serial measurement of CA125 and CA19-9 correlated with clinical course of disease in 89.7 and 72.7% of instances, respectively. The decrease of serum CA125 and/or CA19-9 in the normal range at the end of chemotherapy does not exclude the presence of residual disease, which can be accurately evaluated only by second-look laparotomy. Serum CA125 and/or CA19-9 can raise some months before clinical and ultrasonographic detection of recurrence. CA125 is the most reliable marker in ovarian carcinoma; however, the concomitant measurement of CA19-9 could offer some benefit in the monitoring of patients with this neoplasia.

Antigens, Neoplasm↗

Second look laparotomy in the management of malignant epithelial ovarian neoplasias.

In the present study we examined 15 patients with malignant epithelial ovarian neoplasms who underwent primary surgery and chemotherapy at the Institute of Obstetric and Gynecologic Clinic of the University of Pisa between 1983 and 1985. At the time of diagnosis and monthly during chemotherapy plasma levels of CEA, CA 19-9, CA 125 and TPA were detected. At the end of pharmacological treatment a second-look laparotomy was performed in each patient to assess the status of cancer. At this time the clinical response was complete in 13 patients and partial in 2. These results were confirmed at second-look laparotomy in 11 of 13 cases of complete clinical remission and in 1 of the 2 cases of partial clinical remission. Two patients in complete clinical remission showed persistent disease. The other one in partial clinical remission was surgically found to have unmodified tumor. Tumoral markers, and especially CA 125, have a good correlation with the clinical course of the disease. However these tumor associated antigens cannot replace second-look laparotomy for assessing the response to cytostatic drugs. In fact patients with normal serum levels of these markers at the end of chemotherapy, were surgically found to have both complete pathological remission and persistent disease. Therefore we have come to the conclusion that the second-look laparotomy and the evaluation of tumor markers have to be performed together in the management of malignant ovarian neoplasms.

Aged↗

Combined evaluation of some tumor associated antigens in the monitoring of integrated surgical and chemotherapeutic treatment of epithelial ovarian cancer.

The authors measured the presurgical serum levels of some tumor associated antigens in 36 patients bearing primitive ovarian carcinoma and in 284 controls. Ca125, which has shown a sensitivity (SE) of 63.8% and a specificity (SP) of 92.6%, was elevated especially in serous and undifferentiated carcinomas, while Ca19-9 (SE = 33.3% and SP = 89.7%) and CEA (SE = 19.4% and SP = 96.4%) were more often pathological in mucinous ones. TPA (SE = 75.0% and SP = 81.3%) had no particular correlation with any histotype. Parallel assessment of Ca125 and Ca19-9 showed a SE = 83.3% and a SP = 83.8%. In patients with epithelial ovarian cancer, the circulating concentrations of tumor markers were periodically measured during and after chemotherapy. Ca125 levels correlated with the course of disease in 87.1% of instances, while Ca19-9 ones correlated in 72.2% and TPA ones in 78.6%. Constantly high concentrations of one or more markers during chemotherapy are indicative for unresponsiveness of cancer to cytostatic drugs. Serum levels of one or more tumor antigens elevated at diagnosis and in the normal range at the end of primary treatment can be associated both with a pathological complete regression and with a persistence of neoplastic disease at second look laparotomy. Considering the different sensitivity of every single marker in carcinomas of different histotype, the combined evaluation of multiple tumor associated antigens seems to offer the best information in the monitoring of epithelial ovarian cancer.

Adult↗

Synchronous adenoacanthoma of the ovary and endometrial adenocarcinoma. Report of two cases.

Two cases of synchronous endometrioid adenocarcinoma of the endometrium and ovary are here presented. The clinical aspects and the pathologic findings support an autochthonous origin of these neoplasias. The existence of the extended Müllerian system can explain such a possibility. The recognition of this possible association is really important because it implies a different therapeutic approach.

Adenocarcinoma↗

Wertheim's radical hysterectomy with pelvic lymphadenectomy in the treatment of cervical carcinoma at the Obstetric and Gynecological Clinic of the University of Pisa.

The Authors report their experience in 49 operations of radical hysterectomy with pelvic lymphadenectomy in the treatment of stage I b and stage II cervical cancer. They describe particularly the precocious and late urinary complications and the arrangements made for their prevention. We had no uretero-vaginal fistula in 21 of the 49 patients, on whom a kind of roof and floor around the terminal tract of the ureters was created by placing some surgical stitches between the posterior wall of the bladder and the anterior lateral wall of the rectum.

Adult↗

Evaluation of the central dopaminergic activity in gestational hyperprolactinaemia by means of the electroretinographic technique.

Electroretinography, a simple, bloodless technique commonly used in ophthalmological diagnostic practice, seems to give important informations on the level of activity of the retinal and/or other central dopaminergic systems. The Authors have employed this technique in a group of 30 normal pregnant women in the ninth month of gestation, in order to evaluate the dopaminergic activity in a condition of physiological hyperprolactinemia, such as pregnancy, and in a group of 25 normal nonpregnant control women. The b wave amplitude of the electroretinographic traces was significantly higher in pregnant women than in controls, suggesting an over-activity of dopaminergic systems in late pregnancy. The possible interpretations of these data are discussed.

Brain↗

Polychemotherapy with carmustine, cyclophosphamide plus adriamycin in the treatment of advanced ovarian cancer.

The Authors describe their experience with a combination therapy with carmustine (BCNU), cyclophosphamide (CTX) plus adriamycin (ADM) in the treatment of advanced ovarian cancer. The complete remission was obtained in 33.3% of subjects, the partial remission in 37.5%. Almost all patients suffered nausea, vomiting and alopecia. Myelosuppression was acceptable. No heart damage was observed. This pharmacological association can be considered an effective medical treatment in the management of ovarian carcinomas in advanced stages.

Adenocarcinoma↗

Computerized tomography (CT) semeiotics in the presurgical evaluation of gynaecological neoplasias.

Computerized tomography has been introduced in studies concerning neoplastic pathology of the pelvis. In this study, we have attempted to define a series of radiological signs, resulting from CT tests of pelvis or abdomen in patients with gynaecological tumors, each of which corresponds to a particular anatomopathologic situation. For each gynaecologic tumor, there is a set of more frequently found signs, the presence of which, in the single case, depends on the stage of evolution of the disease. In the staging of cervical or endometrial carcinoma, the evaluation of the relation to the bladder and rectum is very important, just like vaginal, parametrial and ureteral infiltration. In the presurgical staging of ovarian carcinoma the CT can reveal the size and shape of mono- or bilateral ovarian tumour masses and the relation that they have established with the pelvic organs and with the intestine. In spite of inevitable limitations the CT plays an essential role in gynaecologic oncologic diagnostics.

Diagnostic Errors↗

Struma ovarii. Observations on three cases.

The true struma ovarii is a rare teratomatous neoplasia, composed with typical thyroid tissue. Generally it is asymptomatic or only determines a mild hypogastric weighting feeling. In a few subjects this neoplasm is secreting and rise to hyperthyroidism. The Authors describe the clinical and anatomopathological characteristics of 3 cases of true struma ovarii come to their observation. No malignant histologic features in any of them was seen. In the relatively short period of post surgical observations no women showed relapses or metastases. This confirms that true struma ovarii is usually a benign tumor.

Adult↗

Transrectal ultrasonography and cervical neoplasia. A preliminary report.

Transrectal ultrasonography is a new diagnostic method recently introduced in the study of normal and pathologic pelvis. The Authors describe their preliminary experience with the use of a rectal linear probe in the evaluation of the carcinoma of the cervix. This ultrasonographic method has resulted very useful in providing an imaging of cervical cancer in evaluating its effective diffusion and in precising demeasurements of the neoplastic mass. The results are particularly encouraging and justify continued experimentation.

Female↗

Brenner's tumor. Observations on six cases.

Brenner's tumor is a rare fibroepithelial ovarian neoplasia, histologically characterized by an epithelial component similar to the transitional epithelium of the urinary tract. The histogenesis of neoplasm, which only rarely secretes estrogens, is still controversial. The Authors describe the clinical and anatomopathological features of six cases come to their observation. Only one of these was malignant; the woman died 18 months after diagnosis. There is no strict correlation between histological picture and biological behaviour. Only this one can give assurance on the benign or malignant nature of Brenner's tumor.

Adult↗

The role of computerized tomography of the pelvis in the presurgical staging of carcinoma of the cervix and of the ovary.

Computerized Tomography (CT) has largely contributed to the diagnosis of the pathology of the female pelvis. After setting up a technique to outline the different viscera the authors have employed this method in the staging of neoplastic pathology of the cervix and ovary. They describe the successes obtained and the main cause of error in the interpretation of the images of CT.

Diagnostic Errors↗

Incidence of malignant ovarian neoplasms in the provinces of Pisa, Lucca, Livorno and La Spezia during the period 1976-1981.

The Authors report a critical review of all the cases of ovarian neoplasia observed in the provinces of Pisa, Livorno, Lucca and La Spezia between 1976 and 1981. This study does not take into account all the cases in which incomplete clinical and histologic data were available or the first histologic diagnosis was not confirmed by a second examination. The incidence rate and distribution characteristics of all the histologic types of ovarian neoplasia are described.

Adult↗

Clinical behavior of 203 stage II endometrial cancer cases: the impact of primary surgical approach and of adjuvant radiation therapy.

The aim of this study was to verify the impact of primary surgical approach and adjuvant radiation therapy (RT) on survival, recurrence rate, and pattern of relapse in stage II endometrial cancer patients. Two hundred three subjects were retrospectively reviewed; 135 (66%) underwent simple hysterectomy (SH) and 68 (34%) radical hysterectomy (RH). Sixty-six of 111 (59%) of stage IIA and 67 of 92 (73%) of stage IIB patients underwent adjuvant radiation therapy. Actuarial survival rates for stage IIA and IIB were 86% and 74% at 5 years and 82% and 68% at 10 years, respectively. Survival rates by surgical procedure were 79% in the SH group and 94% in the RH group at 5 years and 74% and 94% at 10 years, respectively (P < 0.05). The overall recurrence rate was 13.8% (28/203); by adjuvant treatment it was 18.6% (13/70) in the observation group and 11.3% (15/133) in the RT group. Most of the relapses were locoregional in the observation group and distant in the RT group. Survival rates by RT were not statistically different. Subjects treated with RH improved their survival compared with the SH group; the difference was significant, but randomized studies should confirm this trend. Although adjuvant RT seemed to reduce the recurrence rate, there was no significant difference in survival, and so the role of RT still needs further verification.

Adenocarcinoma↗