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E Marubini

Publications and source records attributed to E Marubini.

At least 73 records · Page 4Linked to original sources
PubMed1991

Alcohol and breast cancer risk: a case-control study from northern Italy.

From May 1982 to June 1985 a hospital-based case-control study of diet and breast cancer (214 cases and 215 controls) was conducted in Milan in northern Italy, an area where wine consumption is widespread. The study used a detailed diet questionnaire to obtain an estimation of total calories as well as major micro- and macro-nutrient intake. The data thus allowed an investigation of the role of alcohol in breast cancer risk, adjusting for other dietary factors, in particular total energy intake. We found positive associations between breast cancer risk and total caloric intake (chi 2 trend = 6.05, P = 0.014) but no effect for the other nutrients, when adjusted for total caloric intake. The relative risk of breast cancer, for women reporting more than 24.35 g/day of alcohol consumption (highest quintile), was 2.1 (95% confidence interval (CI): 1.1-3.9) when adjusted for non-dietary risk factors for breast cancer and 1.8 (95% CI: 1.0-3.3) when adjusted for non-alcohol caloric intake. The relative risks were moderately elevated (50% or less) for low levels of consumption and comparable to those recorded in most American studies. This finding provides further support for a moderate association between alcohol consumption and breast cancer risk, even when allowance is made for potentially relevant nutrients.

Adult↗
PubMed1990

Diet and cancer risk in northern Italy: an overview from various case-control studies.

A critical overview is presented of selected findings from a series of case-control studies conducted in the greater Milan area on cancers of the digestive tract, breast, female genital tract, prostate and bladder. Even using very simple data collection instruments (based on the frequency of use of a restricted number of food items), a number of consistent and strong associations emerged. In particular, frequent green vegetable consumption appeared to exert substantial protection against most of the cancer sites considered, which could not be explained in terms of information, selection or confounding bias. Other interesting clues, such as a moderately positive relation between fats and breast cancer, and a positive association between maize and esophageal or gastric cancer are discussed in order to illustrate the potential scope of studies of diet and cancer risk based on populations with considerable heterogeneity and modifications in dietary patterns, and recent changes in mortality from various common cancers.

Aged↗
PubMed1990

The role of diet history and biologic assays in the study of "diet and breast cancer".

Nutritional factors related to breast cancer were investigated by means of a hospital-based case-control study in Milan (Italy) and Montpellier (France). Liposoluble vitamins, cholesterol and triglycerides were measured in blood samples taken from interviewed subjects (319 cases and 344 controls). In addition serum zinc and copper was assessed in the Italian samples and serum fatty acids and malonyl-di-aldehyde in the French samples. A significant difference was found between cases and controls in total fat and cholesterol intake in both populations, and in saturated fatty acid and mono-unsaturated fatty acid consumption in the French samples. No difference emerged in liposoluble vitamin consumption in both populations nor in zinc and copper consumption in the Italian samples. A statistically significant higher serum level of cholesterol and plasma level of vitamin E was observed in cases compared to controls in both populations. The difference in plasma vitamin E was confirmed after adjustment on total cholesterol and triglycerides. Similarly, zinc serum level was higher in Italian cases than in Italian controls, while malonyl-di-aldehyde was lower in French cases than French controls. A multivariate analysis was performed after classification of cases and controls according to quantile distribution of controls. Nutrient consumption and relevant blood markers were directly or partially correlated in both populations. All known risk factors plus age, serum total cholesterol and triglycerides were used as covariates. The odds ratio values for the highest quantiles are: Dietary cholesterol, OR = 1.9 (1.1-3.4); total dietary lipids, OR = 1.9 (1.0-3.4); plasma vitamin E, OR = 4.2 (1.9-9.0); serum zinc, OR = 12.2 (5.4-27.7); serum malonyl-di-aldehyde, OR = 0.56 (0.33-0.97).

Breast Neoplasms↗
PubMed1990

Dietary factors and risk of breast cancer: combined analysis of 12 case-control studies.

We conducted a combined analysis of the original data to evaluate the consistency of 12 case-control studies of diet and breast cancer. Our analysis shows a consistent, statistically significant, positive association between breast cancer risk and saturated fat intake in postmenopausal women (relative risk for highest vs. lowest quintile, 1.46; P less than .0001). A consistent protective effect for a number of markers of fruit and vegetable intake was demonstrated; vitamin C intake had the most consistent and statistically significant inverse association with breast cancer risk (relative risk for highest vs. lowest quintile, 0.69; P less than .0001). If these dietary associations represent causality, the attributable risk (i.e., the percentage of breast cancers that might be prevented by dietary modification) in the North American population is estimated to be 24% for postmenopausal women and 16% for premenopausal women.

Body Height↗
PubMed1990

Clinically useful measures to assess the effectiveness of treatments: hints for a proper choice with special emphasis on cancer research.

Several absolute and relative measures useful to assess the consequences of treatments in cancer research are presented together with statistical methods suitable for computing the pertinent confidence intervals. The relationship of these measures with the parameters of the regression models commonly used in the analysis of survival data is elaborated upon. Three examples are elaborated, and conditions of interchangeability of the measures are discussed in detail. Finally, suggestions for the choice of the measure most appropriate for a specified data set are given.

Clinical Trials as Topic↗
PubMed1990

Long term survival analysis: breast cancer and age at diagnosis.

The role of age at surgery of breast cancer patients as a determinant of relative survival after making allowance for clinical profile was investigated on a case series of 716 women followed for more than 20 years in one single institution. Multiplicative and additive models for grouped data were adopted to model the standardized mortality ratio and the excess death rate respectively. The models were fitted by the GLIM system assuming a Poisson error function. We conclude that operable breast cancer has a relatively lower impact on total mortality in older patients (65 years or more) than in younger ones and, moreover, the older patients have a more favourable course.

Age Factors↗
PubMed1990

A linear model suitable for assessing graft patency in controlled clinical trials. SINBA Group.

In clinical trials carried out to assess the efficacy of different drugs in reducing the frequency of occlusion after coronary artery bypass, the ratio of the number of patients with at least one occluded anastomosis to the number of patients catheterized up to a given day is a widely adopted statistic. In the early evaluation (at 1 or 2 months after surgery), this is affected by the distribution of timing of angiography and it tends to underestimate the cumulative probability of occlusion because patients whose anastomoses are all patent at angiography and occlude between angiography and the day at which the ratio is estimated do not contribute their events to the numerator of the ratio. One may sensibly assume that this underestimate does not affect the evaluation of the efficacy of treatments tested "within" the trial. In contrast, since the distributions of the timing of angiography vary substantially from trial to trial, it can make comparisons "between" trials unclear and possibly biased. The aim of this article is to suggest an alternative approach of statistical analysis in terms of logistic regression. By modeling the dichotomous response given by each patient in function of time at angiography, type of treatment, and other possible covariates, asymptotically unbiased estimates of the cumulative probability of occlusion are attained. Furthermore, the pertinent hazard function can be estimated. The main features of the model are discussed and the results obtained by fitting early data collected in the Studio Indobufen Nel Bypass Aortocoronarico (SINBA) are given.

Anastomosis, Surgical↗
PubMed1990

Breast conservation is the treatment of choice in small breast cancer: long-term results of a randomized trial.

From 1973 to 1980, 701 women with small breast cancer (less than 2 cm in diameter) were randomized into two different treatments. 349 patients received classic Halsted mastectomy and 352 patients received quadrantectomy, axillary dissection and radiotherapy on the ipsilateral breast. 24.6% of the patients in the mastectomy group and 27.0% of the patients in the conservation group had axillary metastases. Overall 10 year survival was 76% in the Halsted patients and 79% in the quadrantectomy patients; 13 year survival was 69% and 71%, respectively. No differences were observed after analysis by site and size of the primary tumour and age of the patients. Patients with positive axillary nodes had consistently better survival curves in the quadrantectomy group compared with the Halsted group (not significant). Among the quadrantectomy patients there were 11 local recurrences (with 4 deaths) while among the Halsted patients, 7 had local recurrences (5 deaths). There were 19 cases of contralateral breast carcinomas in the quadrantectomy group and 20 in the Halsted group. At 16 years from the beginning of the trial no evidence of oncogenic radiation risk was observed. In patients with small size carcinomas total mastectomy should have no role.

Breast Neoplasms↗
PubMed1990

Identification of high risk groups for breast cancer by means of logistic models.

In order to identify high risk groups for breast cancer, unconditional multiple logistic regression models based on 5 widely recognized and easily identifiable risk factors (age at menarche, at menopause and at first birth, family history of breast cancer and body mass index) were applied to a large dataset including 2085 cases and 1936 controls aged 50 or over derived from two unmatched hospital-based case-control studies conducted in Italy. Although various models provided an excellent fitting, both on the whole dataset and using a training-testing approach to a priori identified separate subset, the observed extent of variation in breast cancer risk between highest and lowest decile of the distribution was limited to a factor 2. This indicates that the 5 variables considered did not allow identification of subgroups with substantially elevated risk of breast cancer to have practical implications for screening/prophylactic treatment purposes.

Adolescent↗
PubMed1989

Methodological issues in a multicentric study of gastric cancer and diet in Italy: study design, data sources and quality controls.

The authors examine the problems of planning and conducting a multicentric case-control study on diet and gastric cancer in Italy. The solutions chosen for the study design, cases and controls identification, dietary interview, production of a common protocol for the field work are discussed. Results on the evaluation of the quality and comparability of collected data are presented. Further, compliance of cases and controls to the interview and to the blood and urine sampling with reasons of non-response are shown. Finally, the phases of the study and the methods for improving and controlling homogeneity among Centers are summarized.

Aged↗
PubMed1989

Adjuvant chemotherapy with fluorouracil and CCNU in colon cancer. Results of a multicentric randomized study.

To establish the effectiveness of adjuvant chemotherapy in patients with colon cancer after radical surgery, from 1980 to December 1983, 263 patients were randomized in a multicentric study to no further treatment (131 patients) or to a combination of fluorouracil (5-FU) (400 mg/m2 i.v., days 1-5) and lomustine (CCNU) (100 mg/m2 per os on day 5) every 6 weeks for 9 cycles (132 patients). The two groups were well balanced for age, sex, histology, tumor and nodal extent. Chemotherapy was not given to 30 of the 132 randomized patients, and of 98 treated patients only 38 completed the entire protocol. Analysis, as intention to treat, at 54 months did not show any significant difference between the two treatment groups in terms of relapse-free survival (surgery alone, 74.5%; surgery + adjuvant chemotherapy, 70.9%; p = 0.91). In contrast, a significant difference was observed in overall survival (surgery alone, 78.8%; surgery + adjuvant chemotherapy, 60.8%; p = 0.04). The sites of relapse were identical in the two treatment arms. In conclusion, from this study it appears that adjuvant chemotherapy with 5-FU and CCNU seems to have no efficacy in the cure rate of colon cancer patients.

Aged↗
PubMed1989

Individual growth curves and longitudinal growth charts between 0 and 3 years.

From a statistical viewpoint, the construction of longitudinal growth norms involves two classes of problems: (a) the choice of a mathematical function having a few constants as possible, but suitable for describing individual growth process in the growth period of concern; (b) the estimation of the mean growth constants for a homogeneous group of subjects, and of the covariance matrix of data collected longitudinally, to compute tolerance intervals which enable us to draw growth charts. Although growth constants should have some biological interpretation, the choice of functions rests mainly on the criterion of following observed growth as closely as possible. As to the second problem, the simplest situation implies that growth function is linear in the constants and all subjects have measures on the same prefixed occasions: in this case, multivariate Potthoff-Roy model (1964) directly applies. In longitudinal growth studies, however, it happens that subjects do not come for measurements at exactly the age specified: two-stage models seem to be more appropriate to this latter case. They consist of (a) fitting individual growth curve on each subject to obtain estimates of 1st-stage constants; (b) obtaining estimates of 2nd-stage constants, characteristic of the whole group of subjects, in terms of weighted averages of the estimates of the 1st-stage constants. This paper deals with the application of a two-stage model to the growth in length of 203 girls and 217 boys born in Naples between 1977 and 1981. Children, whose growth records are used to trace longitudinal standards, have been measured at birth, and at least 5 times in the course of a follow-up made up of 8 visits, between 3 months and 3 years of life.

Child, Preschool↗
PubMed1988

Liposoluble vitamins and lipid parameters in breast cancer. A joint study in northern Italy and southern France.

The relationship between breast cancer, liposoluble vitamins, cholesterol and triglycerides was investigated by means of a hospital-based case-control study conducted at Milan (Italy) and Montpellier (France). These parameters were measured in blood samples taken from 319 cases and 344 controls. The interview included an evaluation of dietary intake of liposoluble vitamins. No difference emerged in liposoluble vitamin consumption, whereas a statistically significantly higher serum level of cholesterol and plasma level of vitamin E existed in cases compared to controls. The difference in plasma vitamin E was confirmed after adjustment for total cholesterol and triglycerides. In contrast, vitamin A variations appear to follow triglyceride trends. A multivariate analysis of the vitamin E plasma level was performed after classification of cases and controls according to quintile distribution of controls. All known risk factors plus age, serum total cholesterol and triglycerides were used as covariates. The odds ratio value for the highest quintile of plasma vitamin E is: 4.2 (1.9-9.0).

Adult↗
PubMed1988

The relationship of dietary intake and serum levels of retinol and beta-carotene with breast cancer. Results of a case-control study.

The possible association between the risk of breast cancer, blood level, and dietary intake of preformed Vitamin A (retinol) and beta-carotene was investigated in a case-control study carried out from May 1982 to June 1985. The patients studied were 214 previously untreated individuals with T1-2, N0-1, M0 breast cancer admitted to the National Cancer Institute of Milan and 215 controls admitted for conditions other than neoplastic or metabolic disorders. Both cases and controls were selected from an age group ranging from 30 to 65 years old. Plasma levels of retinol and beta-carotene were tested from blood samples drawn during the first day after admission to the hospital. A questionnaire about diet was used to estimate the mean intake of 69 food items from which a daily dietary index of retinol and beta-carotene intake was computed. Information relating to the woman's history, socioeconomic status, and known risk factors for breast cancer was also collected. No association was found between beta-carotene (in the diet or blood) or dietary retinol and the risk of breast cancer. As for blood retinol, our data show a significant trend of increasing risk with higher levels; multivariate relative risk for subsequent serum levels based on the control quintiles, are 1, 1.5, 1.8, 1.7; (test for linear trend: chi-square = 8.26). Thus, these findings, together with the results of other studies, suggest that retinol and beta-carotene are unlikely to be related to the risk of breast cancer.

Adult↗
PubMed1988

Adjuvant chemotherapy with vincristine, cyclophosphamide, and doxorubicin after radiotherapy in local-regional nasopharyngeal cancer: results of a 4-year multicenter randomized study.

To evaluate the effect of adjuvant chemotherapy in patients with local-regional nasopharyngeal carcinoma (NPC) (squamous or undifferentiated) in complete remission at the end of curative radiotherapy (RT) 229 patients were randomized from 1979 to 1983 in a multicenter study to no further therapy (116 patients) or a combination of vincristine, cyclophosphamide, and Adriamycin (doxorubicin; Adria Laboratories, Columbus, OH) (VCA) for six monthly cycles (113 patients). The RT and RT + VCA groups were well balanced for median age (50 v 49 years), histology (undifferentiated carcinoma, 73% v 70%), tumor extent (tumor limited to nasopharynx, 57% v 57%), and nodal extent (negative nodes 26% v 24%, nodes in the lower cervical levels, 17% v 16%). RT was delivered to the nasopharynx, the base of the skull, and bilateral cervical nodes using a split course technique over 10 weeks up to the dose of 60 to 70 Gy in involved sites and 50 Gy to negative nodes. Response to RT was evaluated within 65 days post-RT treatment. Analysis at 48 months did not show significant difference between the two treatment groups in terms of relapse-free survival (RT, 55.8%, RT + VCA, 57.7%, P = .45) and overall survival (RT, 67.3%, RT + VCA, 58.5%, P = .13). The pattern of relapse was similar in the two treatment arms. Distant metastases were the cause of treatment failure in about 50% of relapsing patients. Although the results of the present study did not show any benefit from VCA administered after curative RT, combined systemic chemotherapy should be further explored due to the high incidence of local and distant failure after intensive RT.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

Vitamin A and female lung cancer: a case-control study on plasma and diet.

Plasma and dietary levels of retinol and beta-carotene were evaluated in a consecutive series of 47 females with histologically proven primary lung cancer and 159 nonneoplastic hospital controls. The dietary questionnaire included 69 different items: special care was given to foods rich in vitamin A and seasonal foods (e.g., vegetables and fruits), whereas serum analysis was focused on retinol and beta-carotene. Age-adjusted mean values for cases and controls were, respectively, 458.3 vs. 551.3 mg for plasma retinol, 276.1 vs. 390.1 mg for plasma carotene; 598.1 vs 820.6 mg for daily retinol, and 628.0 vs. 882.5 mg for dietary carotene. The odds ratios for low vs. high tertile, adjusted for age, smoking, retinol or carotene, cholesterol, and triglycerides by multivariate analysis were, respectively, 1.13 for plasma retinol, 5.04 for plasma carotene, 3.27 for dietary retinol, and 2.93 for dietary carotene. For all the examined items, there was a trend of increased risk for the second and third tertile, and statistical significance was reached for plasma beta-carotene (p less than 0.05). The hypothesis that a higher risk of lung cancer is related to a low vitamin A consumption is supported by these data.

Aged↗
PubMed1986

Descriptive epidemiology of gastric cancer in Italy.

National trends in death certification rates from cancer of the stomach in Italy over the period 1955 to 1979 were analyzed using a standard cross-sectional approach and a log-linear Poisson model to isolate the effects of birth cohort, calendar period, and age. Overall, age-standardized death certification rates decreased from 47.04 to 30.74/100,000 males (average annual rate of change, assuming that the decrease has been constant, -1.8%) and from 34.55 to 19.27/100,000 females (average annual rate of change -2.4%). The decreases were even larger in middle age for both sexes. Both cohort and period of death curves were markedly downwards. However, cohort values did not decrease for generations born around the second world war (1935-1945), thus indirectly confirming the importance of (dietary) habits in childhood on subsequent gastric cancer risk. Further, the geographic distribution of certified mortality from gastric cancer in the 95 Italian provinces over the period 1975 to 1977 was analyzed. Death certification rates were about 10% lower for both sexes in the 14 provinces including the largest urban concentrations (over 250,000 inhabitants) than in the remaining areas. This finding might be related to earlier availability of modern food processing and storage in urban areas. It is, however, more difficult to explain the lower mortality rates (about 50% in both sexes) in the southern compared with the central and northern areas, since southern Italy is the less developed part of the country. Likewise, there appears to be at present little satisfactory explanation for the several clusters of exceedingly high mortality areas scattered in northern and central Italy, since some of these areas are several hundred kilometers apart, and there is no obvious common denominator in diet or other environmental factors that may explain their higher gastric cancer mortality rates.

Adult↗