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Biomedical subjects

C Uslenghi

Publications and source records attributed to C Uslenghi.

At least 73 records · Page 4Linked to original sources
PubMed1980

[Prognostic factors and clinical classification criteria of oral carcinomas (author's transl)].

The clinical classification of oral carcinomas presents some points still under discussion. In other respects the main questions about the treatment of these cancers could be resolved by cooperative clinical trials which impose the definition of a common clinical language. With a system based on an original computer program for the compiling, store and process essential data on cancer diseases we analyzed 736 consecutive and unselected oral carcinomas and we studied the prognostic value of main clinical factors. In our series, the main prognostic factors are tumor size, clinical appearance of the primary and clinical status of neck nodes. Sex, age and histological grade are unimportant. From our study we propose to complete the TN classification with two useful clinical criteria distinguishing the exophytic or minimally infiltrating tumors from the deeply infiltrating (greater than 1 cm) and the large metastatic omolateral nodes from the small ones (phi less than 3 cm).

Adult↗
PubMed1979

A computerized cancer patient information system.

The purpose of this study was to realize a computer system for cancer data automatic processing. A clinical research in oncological practice is usually time consuming and often not reliable or deceiving because of a number of various errors. Until now, only a few information systems have been specifically designed for cancer data processing, and these have a limited capacity of autonomous data elaboration. Our system, based on an original computer program, can compile, store and process essential data on cancer diseases, with a high degree of reliability and high speed of elaboration. Input and output of this system are simplified and user oriented, without limitations for the subject at study on clinical research, and no particular training of the physicians involved is necessary.

Computers↗
PubMed1978

Failures (cause and time) of radiotherapy in oral cancer.

The results of retrospective clinical evaluation concerning 434 cases of oral carcinomas treated with radiotherapy from January 1959 to December 1967 are presented. The analysis of the results obtained shows that radiotherapy alone may offer a reasonable possiblity of success in limited lesions (68.3% 5-year survival of Stage I patients). In more advanced local cases, and especially those with regional adenopathies, radiotherapy alone cannot consistently control the disease for a long period of time; 5-year survival from the onset of treatment was respectively 36.5% and 24.5% for Stage II and III cases. Moreover, if controlateral of bilateral metastatic adenopathies or fixed lymph nodes are present, the prognosis becomes dramatic (2.6% 5-year survival of Stage IV patients). Among the irradiation techniques currently available, curietherapy (intersitial applications or surface molds) presumably offers the best possibility of success, since the observed failures, both overall and stage by stage, are inferior. Radiotherapy alone may generally be of proven efficacy if the local or locoregional extension is limited. In more advanced cases a combined surgery-chemotherapy treatment method is recommended. The criteria for a combined therapeutic approach for these tumors are also discussed.

Aged↗
PubMed1978

[Radiotherapy of oral cancer. Late results (author's transl)].

Radiotherapy of the primary site was employed between 1959 and 1965 in the treatment of 335 unselected cases of mouth cancer. The series is examined with regard to the long-term results and gross survival is evaluated in accordance with an actuarial method. Differences dependent on sex and age, and on the type of cancer involved and the treatment modalities are illustrated and discussed.

Adult↗
PubMed1977

Conservative treatment of breast cancer. A trial in progress at the Cancer Institute of Milan.

The report describes a clinical trial on conservative surgery in progress at the National Cancer Institute of Milan, Italy. The randomized clinical trial compares radical mastectomy with a more conservative procedure consisting of mammary resection plus axillary dissection plus radiotherapy. The resection comprises an entire quadrant of the breast together with the overlying skin and the corresponding portion of the fascial sheet of the pectoralis major. The axillary dissection is performed in continuity with the resected breast quadrant except in cases with tumors of lower inner quadrants, who need two separate incisions. After surgery the patients receive 6000 rads to the residual breast tissue over five to six weeks, starting 15 days after operation. The cosmetic results are satisfactory in approximately 70% of cases. The trial is limited to cases with tumors less than 2 cm and no palpable axillary nodes (T1N0M0). Patients with histologically positive lymph nodes (N+) are submitted to adjuvant chemotherapy with CMF for one year. From September 1973, to October 1976, 331 cases entered the trial. One hundred sixty were treated with radical mastectomy and 164 with the conservative procedure. Axillary metastases were found in 23% of the radical and in 29% of the conservative surgery group. Four local-regional recurrences have occurred till now, two in each group. Five cases in the radical mastectomy group and one in the conservative group had distant metastases. The clinical trial will collect some 500 cases by the end of 1977 and significant preliminary results are expected to be available from 1978.

Adult↗
PubMed1976

Natural history and survival of inoperable breast cancer treated with radiotherapy and radiotherapy followed by radical mastectomy.

This retrospective study evaluates the time and site of relapse as well as the median survival of 454 consecutive patients with T3-T4 Nx Mo breast cancer treated with radiation therapy from 1968 to 1972. Radiotherapy was delivered with kilovoltage to the first 221 patients and with cobalt to 233 patients, respectively. A group of 133 selected patients was subjected to radical mastectomy 6-8 weeks after completion of the irradiation. The incidence of first relapse was 45% within the first 18 months from starting radiotherapy. The incidence of relapse was higher in presence than in absence of regional adenopathy, with no statistical difference between T3 and T4. Inflammatory carcinoma showed the highest percent of relapse during the first 12 months (48%). The relapse rate appeared independent from type of irradiation. The site of first relapse occurred more often (68%) in areas distant from irradiation fields. Sterilization of both primary tumor and regional nodes was obtained only in 10% of patients. The median survival for the whole series was 2.5 years, with no significant difference between roentgen therapy (3 years) and cobalt (2.5 years). Unfavorable survival was directly related to the presence of regional adenopathies (2.3 years), especially in the supraclavicular fossa (1.4 years) and of inflammatory carcinoma (1.2 years). Patients treated with radiotherapy followed by surgery showed a median survival of 3.9 years compared to 2.1 years for those given only irradiation. The importance of sequentially combining chemotherapy with radiotherapy is discussed.

Breast Neoplasms↗
PubMed1976

Lymphographic evaluation of 250 patients with malignant melanoma.

Foot lymphography was performed in a selected group of 250 patients with malignant melanoma, with different sites of origin and of various stages. The overall incidence of metastases was 40%. The case material was evaluated in detail; the tumors of the inferior limb and those on different sites, e.g., vulva and abdomen, were considered separately. In the group of 188 patients with melanoma of the inferior limb, the incidence of metastases was 42%. In 51%, histologic confirmation was obtained. In the group of 62 patients with melanoma of different sites of the body, the incidence of metastases was 34% and histologic confirmation was obtained in 21 patients. The values of accuracy, sensitivity, and specificity based on the histologic confirmation of the lymphographic reports ranged from 88% to 96%. These data justify the use of lymphography in the initial diagnostic work-up and in the follow-up of these patients.

Evaluation Studies as Topic↗
PubMed1975

Combination chemotherapy of Hodgkin's disease with adriamycin, bleomycin, vinblastine, and imidazole carboxamide versus MOPP.

This paper reports the preliminary results of a controlled study randomizing MOPP vs. a new four-drug combination (ABVD) in advanced Hodgkin's disease. ABVD consists of 6 cycles of adriamycin, bleomycin, vinblastine, and imidazole carboxamide. The purpose for designing this new combination was two-fold: to compare the efficacy of ABVD with MOPP, and to demonstrate absence of cross-resistance between the two regimens. Of 60 patients entered into the study, 45 (MOPP25, ABVD20) are presently evaluable for the analysis of remission induction. No patient was previously treated with chemotherapy; 20% had relapsed after primary radiotherapy. Whenever possible, complete remission was defined also through rebiopsy of known organ involvement. Complete remission occurred in 76% of patients treated with MOPP and in 75% of those given ABVD, with no difference between the two regimens as far as stage (IIIB-IIIS and IV), histologic type, and prior irradiation were concerned. Crossover carried out for progressive disease or for relapse after initial remission showed absence of cross-resistance between MOPP and ABVD. Toxic manifestations after ABVD were in general well tolerated and reversible. The percent of optimal dose for each drug was as follows: adriamycin 87%, vinblastine 87%, bleomycin 96%, and imidazole carboxamide 96%. These preliminary results indicate that in terms of complete remission, ABVD could represent a successful alternative to MOPP to be used either in MOPP failures or in sequential combination with MOPP. However, the lack of long-term followup limits at the present time an adequate comparison between the two treatments.

Adolescent↗
PubMed1975

Endolymphatic radiotherapy in malignant lymphomas: its potential "prophylactic" value in cases with negative lymphograms.

From 1961 to 1969 426 patients (208 with Hodgkin's disease and 218 with non-Hodgkin's lymphoma) underwent endolympatic radiotherapy with Lipiodol 131I at the National Cancer Institute of Milano. For this study, only those patients with stage I, II, or III disease (with or without systemic symptoms), who were not previously treated, and who had a complete follow-up were reviewed. It appears that while in the cases where there is lymphographic evidence of involved lymph nodes, endolymphatic radiotherapy is not of value, in the cases with apparently negative lymphography, endolymphatic radiotherapy can reduce the incidence of relapse in the inguino-retroperitoneal nodes to a statistically significant degree.

Abdomen↗