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Biomedical subjects

I Cataldo

Publications and source records attributed to I Cataldo.

At least 55 records · Page 3Linked to original sources
PubMed1984

The growth rate in the interpretation of the natural history of lung cancer.

The relationship between growth rate, expressed as doubling time (DT), of 110 lung cancers from randomly collected patients and patient age, sex, histological type, symptoms, smoking habits, size and lymph node involvement was studied. Median DT values of epidermoid carcinomas and adenocarcinomas were superimposable (98 and 99 days, respectively), but 15% of adenocarcinomas had a DT of more than one year. Significant correlations were found with sex (slower growth rate in females) and symptoms (faster growth in symptomatic patients), but only for adenocarcinomas. The number of cigarettes smoked did not seem to affect the growth rate of lung cancers. There was no correlation between growth rate and tumor size or lymph node involvement.

Adult↗
PubMed1983

Surgical treatment for carcinoma of the gastric cardia: a modified proximal esophagogastrectomy.

Proximal esophagogastrectomy saving only the distal half of the greater curvature of the stomach was retrospectively evaluated in 91 consecutive patients with resectable carcinoma of the gastric cardia. Division of the right gastric artery at its beginning provided a free nodal margin if N1 diffusion was observed. Operative mortality was 6.5% and fatal leak rate 3.8%. Survival without dysphagia occurred in all but stage I tumors; for larger tumors recurrence and reflux esophagitis were not able to produce dysphagia because distant metastases were faster to kill the patients. Five-year survival was 0% for stage IV (i.e. incomplete macroscopic resection), 8% for stage III, 12% for stage II and 53% for stage I. Local recurrence occurred only at esophageal anastomosis and for every stage, whereas regional recurrence occurred only for tumors with nodal diffusion. The results of this study are not suitable for a comparison with total esophagogastrectomy by inductive logic, nevertheless deductive arguments are possible if patterns of recurrence are considered. The possibility of regional recurrence for N1 and not for N0 tumors means that the volume of nodal resection has diagnostic specificity for N0 but not for N1 tumors. If N2 nodal diffusion is really a sistemic disease, as indicated by current reports, than greater nodal resection by total esophagogastrectomy can only improve the diagnostic specificity of N1 assessment but not survival.

Aged↗
PubMed1982

Common-sense untoward factors in lung cancer resection.

Four common-sense untoward factors (age over 60, pneumonectomy, microresidual disease, and postoperative empyema) were retrospectively evaluated in a consecutive series of 199 surgically apparently complete non-oat cell lung cancer resections. By single-factor analysis all factors showed a lower survival that was contingent for microresidual disease and age over 60. For stage I tumors the negative impact on survival was significant for all except empyema, and for stage II and III tumors only for empyema. Without confounding factors, microresidual disease and age over 60 were negative prognostic factors only for distant mortality, empyema a negative prognostic factor only for early mortality, and pneumonectomy a probable negative prognostic factor for both early and distinct mortality. It is concluded that the scientific method used confirmed the prognostic assessment of common sense for these four factors.

Age Factors↗
PubMed1980

Estrogen receptors and MPA treatment in metastatic renal carcinoma. A preliminary report.

Ten previously untreated patients with metastatic renal carcinoma underwent transperitoneal radical nephrectomy followed by high dosage MPA treatment. Estrogen receptors were determined in the specimen of all cases by the dextran-coated charcoal method: both the neoplastic tissue and the healthy parenchyma were tested. The disease progressed in 8 cases, and 2 patients are alive without any evidence of progressive disease 12 and 27 months after the operation. Very low receptor levels were detected in these 2 cases and one of them could be defined as borderline with our threshold criterion. However, receptors were undetectable in the neoplastic tissue from 4 of 8 patients who progressed. These questionable results justified the start of a prospective multicentric trial to study in a large number of cases both hormone receptors and clinical response to hormone therapy in human renal cancer.

Adult↗
PubMed1980

Preoperative irradiation and surgery for esophageal cancer: causes of failure.

Twenty-seven patients with squamous esophageal cancer underwent small volume, low-dose, concentrated radiotherapy followed by esophageal resection whenever possible (esophagectomy for tumors of the thoracic esophagus and esophagogastrectomy for tumors of the lower esophagus). Curative resectability was 70% (19/27) with 4 operative deaths (21%). Recurrence rate was 66% after a mean period of 16 months, and the failure pathway was nodal in 53% of the cases. Historical comparison of the data suggests that preoperative irradiation increases the curative resectability rate without changing the early recurrence rate or failure pathway. Tumors with deeper invasion of the esophageal wall, which benefit by preoperative irradiation, are probably related to greater nodal diffusion, which is partly outside of the volume that may be resected or irradiated.

Adult↗
PubMed1979

Lobectomy with bronchoplastic procedures for lung cancer.

From April 1970 to October 1977, 19 patients with lung cancer of the upper lobar bronchus orifice underwent radical lobectomy with major bronchus resection. Sleeve lobectomy was accomplished in 11 cases and wedge lobectomy in the remaining 8. The length of the free bronchial margin in the surgical specimen was less than 1 cm in 3 cases, but limited pulmonary reserve did not allow pneumonectomy. Squamous carcinoma was diagnosed in 14 patients, adenocarcinoma in 2, oat-cell carcinoma in 2, and large cell carcinoma in one. Most cases (70%) were pathological stage I. There was one operative death due to anastomotic leakage (5%), and another patient required pneumonectomy completion. Of 13 patients with non oat-cell carcinoma and adequate bronchial resection, none had local recurrence: 3 patients developed distant metastases, and 10 are alive and disease-free after a follow-up period ranging from 16 to 104 months. The authors conclude that in selected lung cancer patients lobectomy with bronchoplastic procedures is superior to pneumonectomy for tissue sparing advantages.

Adenocarcinoma↗
PubMedDate not supplied

[Immediate and long-term results of anterior resection in tumors of the rectum and sigmoid (author's transl)].

127 anterior resections for adenocarcinoma of the rectum and sigmoid were performed at the Istituto Nazionale Tumori from 1950 to 1972. In 48% of cases the site of tumor was upper rectum and recto-sigmoid. The surgical mortality rate was 4,7%. Complications were observed in about 40%, fecal fistula being the most frequent. It seems correlable with the anastomotic technique and is significantly reduced by colostomy. Local failure occurred in 8,3% of patients with maximum rate (28,5%) for tumors located under 12 cm from the anus. The 5-year over-all survival rate was 73,3% with substantial differences according to the extent in initial disease.

Adenocarcinoma↗
PubMedDate not supplied

[Prognosis of melanoma of the vulva (author's transl)].

From 1930 to 1972, 27 cases of melanoma of the vulva were treated at the National Cancer Institute of Milan. Prognosis was evaluated in relation to the therapy, the anatomical site, the lymphnodes metastases and the classification according to Clark. The median survival was 20 months and the 4-yr survival was 19%. The authors reached the following conclusions: site and T of melanoma have no prognostic value; survival is strictly related to the lymphnodes metastases and to Clark's classification: no N+ patients survived longer than two years while 62% of N-- patients are still alive after four years. No survival after 2 years was observed in IV-V class of Clark while a 54% survival after 4 years was observed in II-III class of Clark. Surgery gives the best results while radiotherapy as single treatment is useless and its role as adjuvant postoperative therapy is still uncertain.

Female↗
PubMedDate not supplied

Lymphographic evaluation in bone and soft tissue sarcomas.

A group of 79 patients with soft tissue sarcomas and 46 with primary malignant bone tumors underwent lymphangiography as part of the initial diagnostic workup. In the group of soft tissue sarcomas, the overall incidence of metastases was 22 of 79 (28%). According to the site of origin, the highest incidence was found in tumors originating from the buttocks (57%), followed by those from the inferior limbs (31%). Considering the histology, the incidence ranges from 50% in anaplastic sarcoma, to 43% in rhabdomyosarcoma, to 23% for liposarcoma and fibrosarcoma. The incidence of lymphographically proven metastases in bone tumors was 8 to 46 (17%), with 1 out of 4 in reticulum cell sarcoma, 1/1 in chordoma, and 22% in Ewing's sarcoma. A radiographic/histologic correlation on the lymph nodes was obtained in 19/79 (24%) soft tissue sarcomas and in 4/46 (9%) bone tumors. In the 12 radiographically negative and 11 radiographically positive cases, this correlation was always correct. The results of this study suggest a larger use of lymphography in these tumors.

Bone Neoplasms↗
PubMedDate not supplied

Preoperative CEA, NSE, SCC, TPA and CYFRA 21.1 serum levels as prognostic indicators in resected non-small cell lung cancer.

In 62 patients affected by resectable non-small cell lung cancer (NSCLC) submitted to radical surgery we evaluated the prognostic significance of CEA, NSE, SCC, TPA, and CYFRA 21.1 serum levels at diagnosis, as well as the predictive ability of these tumor markers with respect to histological type and pathological stage. The group was composed of 56 male and 6 female patients; the median age was 62 years (range 29-73 years). Thirty-four patients had a histological diagnosis of adenocarcinoma and 28 of squamous cell carcinoma; with regard to pathological stage, 32 patients had stage 1, 4 patients stage II and 23 patients stage IIIA disease. A good predictive ability with respect to histological type was obtained with SCC serum levels; as for pathological stage, TPA and CYFRA 21.1 were found to have moderate predictive ability. In this series of patients, at a median follow-up of 55 months after surgery, we found that both TPA and CYFRA 21.1 serum levels at diagnosis were reliable predictors of overall survival, high values of these markers being associated with a worse prognosis.

Adult↗
PubMedDate not supplied

Tumour markers CEA, NSE, SCC, TPA and CYFRA 21.1 in resectable non-small cell lung cancer.

BACKGROUND: In the last few years, several prognostic factors have been investigated in order to identify among patients with completely resected non-small cell lung cancer (NSCLC) subsets at high risk of recurrence. In this context, the actual role of serum tumour markers is still unclear. The aim of this study was to evaluate the prognostic significance of preoperative CEA, NSE, SCC, TPA and CYFRA 21.1 serum levels in 62 patients submitted to radical surgery for non-small cell lung cancer (NSCLC). The predicting ability of these tumour markers with respect to histological type and pathological stage was also assessed. PATIENTS AND METHODS: After informed consent was obtained, the preoperative serum concentrations of the tumour markers CEA, NSE, SCC, TPA and CYFRA 21.1 were measured by means of immunometric assays in 62 patients referred to our Institutions from January to December 1992. All patients had resectable, histologically proven NSCLC and were submitted to radical surgery. Overall survival (OS) was calculated as the time elapsed from surgery to the date of death or last clinical evaluation; the prognostic effect of the tumour markers was investigated by Cox multiple regression models. RESULTS: Fifty-six patients were male and 6 female; median age was 62 years. Thirty-four patients had a histological diagnosis of adenocarcinoma and 28 of squamous cell carcinomas. With regard to pathological stage, 32 patients had stage I, 4 patients had stage II and 23 patients had stage IIIA disease. In this series of patients, at a median follow-up of 55 months after surgery, we found that both TPA and CYFRA 21.1 serum levels at the time of diagnosis were reliable predictors of overall survival high values of these markers being associated with worse prognosis. CONCLUSIONS: Our findings suggest that in completely resected NSCLC, TPA and CYFRA 21.1 preoperative serum levels might provide a useful tool for stratifying subgroups of patients with different chances of disease recurrence after surgery.

Adenocarcinoma↗
PubMedDate not supplied

[Pulmonary metastasis of basal cell carcinoma of the skin. 3 case reports].

The Authors describe three cases of lung metastasis from a basal cell carcinoma of the skin observed in the Department of Thoracic Surgery of the National Cancer Institute in Milan. The incidence of this rare occurrence reported in the literature is approximately 0.1%, The aim of the study was to evaluate the therapeutic treatment adopted in these unusual situations. In all cases the primary basal cell carcinoma of the skin was located in the head. All three patients had several local and regional recurrences and underwent multiple surgical excisions and subsequent plastic procedures. In each case complementary radiotherapy was implemented. The metastases appeared in the lung 9, 17 and 21 years, respectively, after onset of the primary tumour as bilateral nodules in two cases and as a single nodule in one. Curative surgery was possible only in one subject, consisting in a bilateral metastasectomy via a midline sternotomy, with 5-year survival. Surgery was withheld in the other two subjects owing to advanced age and the presence of bilateral nodules with concomitant bone metastasis, respectively. Both were treated by chemotherapy and the patient with synchronous bone metastasis also received radiotherapy. The elderly subject died after six months, and the other patient after 19 months despite partial remission of disease. In our experience, curative therapy proves difficult due to multiple metastases. In the literature there are few reports regarding this rare type of metastatic lung disease, but surgical intervention would appear to be the therapy offering the best chance of long-term survival while chemotherapy constitutes the second-choice treatment.

Aged↗
PubMedDate not supplied

[Surgery in the treatment of metachronous homolateral non-small cell lung cancer].

The authors describe their experience with the surgical treatment of metachronous homolateral lung cancer by completion pneumonectomy. In the Department of Thoracic Surgery of the National Cancer Institute of Milan, over a period ranging from 1982 to 1996, 30 completion pneumonectomies were performed for local relapses or second primary tumors. The patients submitted to this intervention had a lobectomy as their first operation in 23 cases (77%), a bilobectomy in 4 (13%) and a typical segmentectomy in 3 (10%). Associated with these interventions we performed 2 en bloc chest wall resections and a contralateral wedge resection. Two subjects received neoadjuvant chemo-therapy. Histology revealed squamous carcinoma in 14 cases (47%) and adenocarcinoma in 16 (53%). Seventeen patients (57%) were classified as stage I, 8 as stage II (26%), 4 as stage III (13%) and 1 as stage IV (4%). Four patients received adjuvant chemotherapy and/or radiotherapy. Lung cancer relapse occurred as a single lesion in 27 cases (90%) and as multiple lesions in 3 (10%). We performed 18 right (60%) and 12 left (40%) completion pneumonectomies. In 1 case (4%) a sleeve pneumonectomy was necessary. Associated with these interventions we performed 5 en bloc chest wall resections. The perioperative mortality was 10% and the postoperative morbidity 40%. Histological tests showed 12 squamous carcinomas (40%) and 18 adenocarcinomas (60%). Two patients (7%) had a different histology. Disease was classified as stage I in 13 cases (44%), as stage II in 9 (30%) and as stage III in 8 (26%). Four patients received adjuvant chemotherapy and/or radiotherapy. Two subjects developed a metachronous contralateral tumor (7%). The disease-free interval was 22.70 +/- 14.69 months, with a median value of 17 months (range: 7-53 months). Mean survival after completion pneumonectomy was 49.77 +/- 49.29 months, with a median value of 26.5 months (range: 4-190 months). The 5-year actuarial survival rate, calculated using the Kaplan-Meier method, was 30%. Completion pneumonectomy is a technically very demanding intervention carrying a high risk of morbidity. On the basis of the analysis of our data, we can affirm that mean postoperative survival seems to be satisfactory and to justify this aggressive attitude towards recurrent tumor. We should stress the importance of careful evaluation of indications and precise selection of patients.

Adult↗