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Biomedical subjects

L Sangiorgi

Publications and source records attributed to L Sangiorgi.

27 records · Page 2Linked to original sources
PubMed1993

Prognostic significance of histopathologic response to chemotherapy in nonmetastatic Ewing's sarcoma of the extremities.

PURPOSE: To evaluate more accurately the effectiveness of preoperative chemotherapy in the treatment of patients with Ewing's sarcoma, we studied histopathologically the chemotherapeutic response and correlated it to oncologic outcome. PATIENTS AND METHODS: Between June 1983 and December 1989, 68 patients with nonmetastatic Ewing's sarcoma of the extremities were treated at our institute with preoperative chemotherapy (without radiation therapy) and surgery. The specimens were retrospectively evaluated for areas of viable tumor cells and graded from I to III (macroscopic, microscopic, or no residual disease, respectively) in a blinded fashion. Clinical follow-up data were available on all patients for a mean of 60 months (range, 32 to 111). RESULTS: This histopathologic analysis was strongly correlated with oncologic outcome (P = .004). Patients who demonstrated grade III response (no identifiable viable tumor nodules present) had improved 5-year disease-free survival rates as compared with patients with grade II (microscopic nodes present; P = .023; 90% v 53%) and grade I responses (macroscopic nodules present; P = .0003; 90% v 32%). Patients with grade II necrosis had statistically improved survival rates over those with grade I necrosis (53% v 32%; P = .074). CONCLUSION: This new histopathologic analysis technique for the evaluation of neoadjuvant chemotherapy effectiveness (which does not rely on tumor volume for its assessment) is a valuable prognostic indicator for patients with Ewing's sarcoma treated with surgery. Based on this preliminary report, cases of grade I or II chemotherapeutic tumor response should be considered clinical failures and a different, more aggressive postoperative chemotherapy regimen should be considered.

Adolescent↗
PubMedDate not supplied

Bone hemangioendothelioma: an immunohistochemical study related to histological malignancy and proliferative activity (NORs).

AIMS AND BACKGROUND: Forty-four bone hemangioendotheliomas (HEs) of different histological grades were studied to evaluate the expression and distribution of laminin, type IV collagen, cathepsin G and cathepsin D in cell differentiation and malignancy. RESULTS: In poorly-differentiated HEs the discontinuous distribution of laminin and type IV collagen around angioblastic cords, tubes and cavities revealed an irregular and disorganized basement membrane (BM) architecture corresponding to an increased cell proliferation and secretion of cathepsin D and cathepsin G by tumor cells. CONCLUSIONS: The mean nucleolar organizer region (NOR) area, as a measure of cell proliferation, was significantly higher in grade 4 malignancies than in lower grades, revealing novel prognostic parameters.

Adult↗
PubMedDate not supplied

A histomorphologic study of explants of massive allografts: preliminary results.

The authors report their experience in the histologic study of massive allografts, explanted as a result of oncological, mechanical or biological complications. The study was conducted according to the method of inclusion in methyl methacrylate that does not involve decalcification. A description is provided of all of the phases of fusion between graft and host bone in the site of the osteotomies, as well as distribution of revascularization and rehabilitation of the graft, attachment of the soft tissues, and finally, modifications in the joint cartilage of the osteoarticular grafts. The allograft must be considered to be osteoconductive, and is only weakly osteoinductive. Incorporation of the graft is a slow and incomplete process that follows sequential phases. The Volkmann's canals in the osteotomies constitute the preferred paths for rehabilitation of the graft that is on the order of millimeters on the surface and centimeters in the site of the osteotomies. The greatest modifications have been observed in the joint cartilage. The cartilaginous cells appear to be vital only from a morphological point of view.

Adolescent↗
PubMedDate not supplied

Neoadjuvant chemotherapy for the treatment of osteosarcoma of the extremities: excellent response of the primary tumor to preoperative treatment with methotrexate, cisplatin, adriamycin, and ifosfamide. Preliminary results.

A total of 48 patients with non-metastatic osteosarcoma of the extremities were treated with a new neoadjuvant chemotherapy protocol which, prior to surgery, included the use of high dose methotrexate, cisplatin, adriamycin and ifosfamide. Cisplatin was administered intra-arterially, whereas the other drugs were given intravenously. In all of the cases response to this chemotherapy protocol was very good, allowing for conservative treatment in 46 out of 48 patients. Histological evaluation of chemotherapy response showed good (> 90%) and total necrosis in 87 and 54% of the cases, respectively. Drug toxicity was acceptable. Results were significantly better than those previously obtained in our and in other institutes when only three drugs were used (methotrexate, cisplatin, and adriamycin) in the preoperative treatment scheme. Since it has been demonstrated that grade of histological response to preoperative chemotherapy, and prognosis are closely related in osteosarcoma of the extremities treated with neoadjuvant chemotherapy, in addition to allowing for the use of conservative surgery in the majority of cases, this new protocol may also lead to a significant increase in the patient cure rate.

Adolescent↗
PubMedDate not supplied

Register of primary malignant tumors of the bone at the Rizzoli Orthopaedic Institute in Bologna.

2,123 cases of primitive malignant bone tumors were collected from January 1982 to December 1992 at the Registry of Rizzoli Orthopaedic Institute. General data (name, age, gender, site, diagnosis) and histological and imaging documentation for each patient were filed. Considering the incidence of these tumors, we can assume that this registry (with contribution of more than 50 institutions) collect about 50% of italian cases of primitive malignant bone tumors. This registry permits informations regarding epidemiology, diagnosis and therapy of these rare neoplasms.

Adolescent↗
PubMedDate not supplied

Additional methods of diagnosis in the histopathology of the musculoskeletal system.

In recent years because of their diagnostic importance techniques of immunohistochemistry have been increasingly employed; The use of specific cellular antibodies has allowed for the recognition of tumors of mesenchymal, epithelial, muscular, endothelial, and neuroendocrine origin, and, within these classes, for the revelation of different cellular populations. These techniques together with histochemical and ultramicroscopic studies help define not only the genesis but also the stage of differentiation and the cell function, which are important factors in the prognosis of tumors. These have proven to be particularly useful for the differential diagnosis of highly undifferentiated forms in which cellular morphology differs from that of the tissue of origin.

Bone Neoplasms↗