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Biomedical subjects

M Campanacci

Publications and source records attributed to M Campanacci.

At least 91 records · Page 5Linked to original sources
PubMed1988

Adjuvant chemotherapy with six drugs (adriamycin, methotrexate, cisplatinum, bleomycin, cyclophosphamide and dactinomycin) for non-metastatic high grade osteosarcoma of the extremities. Results of 32 patients and comparison to 127 patients concomitantly treated with the same drugs in a neoadjuvant form.

Between March, 1983 and June, 1986, 32 patients with localized high grade osteosarcoma of the extremities who refused chemotherapy before surgery (neoadjuvant chemotherapy), were immediately operated on and treated with a protocol of adjuvant chemotherapy. This was performed with adriamycin, methotrexate, cisplatinum, bleomycin, cyclophosphamide and dactinomycin. At a median follow-up of 40 months (12-57), 20 patients (63%) remained continuously disease-free. These results appear to be better than the results achieved in our institution in 108 patients treated between 1980 and 1982 with an adjuvant chemotherapy protocol in which only adriamycin and methotrexate were employed. They also seem comparable to the results obtained in 127 contemporary patients treated with neoadjuvant chemotherapy in which the same drugs were used (methotrexate i.v., cisplatinum i.a. preoperatively; adriamycin- methotrexate- cisplatinum or adriamycin -bleomycin -cyclophosphamide-dactinomycin postoperatively, depending on the degree of necrosis achieved by preoperative treatment). These data seem to indicate that the improved survival with neoadjuvant chemotherapy compared to a previous group of patients treated with adjuvant chemotherapy may be related to the improved effectiveness of the agents used rather than the sequence of treatment.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1988

Neoadjuvant chemotherapy for osteosarcoma of the extremities. Good response of the primary tumor after preoperative chemotherapy with high-dose methotrexate followed by cisplatinum and adriamycin. Preliminary results.

Forty-nine patients with localized osteosarcoma of the extremities were treated with a new protocol of neoadjuvant chemotherapy. Preoperatively the patients received high-dose methotrexate intravenously, followed after a week by cisplatinum intra-arterially for a continuous infusion over a 72-hour period, plus adriamycin intravenously infused over an 8-hour period. In all cases the clinical and radiographic response was good and in 44 cases (89.7%) it was possible to perform conservative surgery. The histologic examination of the surgical specimen resulted in necrosis being "good" (greater than or equal to 90% of necrosis) in 41 patients (83.6%). This percentage of "good necrosis" was significantly higher than the percentage previously obtained in our Center as well as in others for preoperative treatment of this tumor. Up to now, patients with localized osteosarcoma of the extremities who showed a good histologic response to the preoperative chemotherapy have had a very good prognosis (82% of patients are continuously disease-free). These results suggest that this new regimen represents a substantial improvement in the treatment of this disease.

Adolescent↗
PubMed1988

Vertebral osteosarcoma.

A review of the total number of cases of osteosarcoma referred to the Tumour Centre at the Rizzoli Orthopaedic Institute between 1904 and 1986, revealed 11 cases of the disease localised in the vertebrae, 9 of which were fully documented. We excluded secondary forms of the disease due to irradiation or malignant degeneration in Paget's disease, also metastases from osteosarcoma of the limbs localised in the sacrum. It is extremely important to distinguish osteosarcoma from osteoblastoma; and this problem is even more highlighted by the statistical evidence that both neoplasms have an almost equal probability of being localised in the spine. Treatment has progressed from the initial purely palliative approach to a more aggressive type of surgery which, in association with modern chemotherapy, makes it a more reliable type of treatment from the oncological point of view. To this aim, we emphasize the importance of performing biopsy according to the required criteria.

Adolescent↗
PubMed1988

Dedifferentiated chondrosarcoma.

The cases of forty-six patients who had dedifferentiated chondrosarcoma were reviewed. Two groups were identified: one in which a low-grade malignant chondrosarcoma was the precursor lesion and one in which a moderate to high-grade malignant chondrosarcoma was the precursor lesion. The radiographic features of these lesions ranged from that of a cartilaginous lesion that appeared to be benign to that of a destructive osteolytic tumor in which the cartilaginous component was overshadowed by the dedifferentiated component. Only three of the forty-six patients survived for more than two years. Resection alone, even when it was wide or radical, was not successful in controlling this lethal sarcoma.

Adult↗
PubMed1987

[Therapy of non-metastatic Ewing's sarcoma (pelvis excluded). Results obtained in 48 cases combining local therapy (radiation and/or surgical) and adjuvant chemotherapy with vincristine, adriamycin, dactinomycin and cyclophosphamide].

Combined therapy was used on a consecutive series of 48 patients with extrapelvic Ewing's sarcoma at the Rizzoli Orthopaedic Institute. The adjuvant chemotherapy protocol (VCR, ADM, D-ACT, EDX) was identical in all patients whereas local treatment consisted of amputation, resection and radiation treatment or radiation alone. At a mean follow-up of 58 months (39-78) 30 patients (60%) were free of the disease. This is a significantly higher percentage than that obtained in the same period with adjuvant chemotherapy using only 3 drugs (VCR, ADM, EDX). As far as the type of local treatment is concerned, the percentage of local recurrences and metastases was lower when the primary lesion was treated with surgery or surgery combined with radiotherapy, rather than radiation treatment alone. These suggest that if associated with radiation treatment and chemotherapy, surgery can play an important role that should be considered in the treatment of extrapelvic Ewing's sarcoma.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

Complications of pelvic resections.

The authors report on complications that occurred with 63 pelvic resections. There were 43 complications: 13 infections, seven cases of nerve palsy, 12 cases of vascular or visceral damage, six mechanical and five aesthetic complications. Infection and vascular and visceral damage were more frequent in anterior arch resections, neurological damage in iliac wing resections, and mechanical complications in periacetabular resections. The treatment and outcome of the complications are reported.

Adult↗
PubMed1987

Resection of the distal tibia in bone tumours.

The authors report five cases of tumour of the distal tibia treated by resection and reconstruction by autoplastic grafting and tibiotarsal arthrodesis with fixation by a Kuntscher nail or a plate. This type of surgery is indicated for the treatment of benign tumours, aggressive pseudotumours (Enneking stage 3), or for Enneking stage 1A or 2A malignant tumours. Infection was the most frequent complication (2 out of 5 cases, both of which healed after surgical cleansing). The long-term functional results were good in all cases, and there was neither pseudoarthrosis nor recurrence.

Adolescent↗
PubMed1987

Neoadjuvant chemotherapy for osteosarcoma of the extremity.

Eighty-five patients with nonmetastatic, high-grade osteosarcoma of an extremity received intravenous methotrexate and intraarterial cisplatinum and then a definitive surgical resection. The preliminary results suggest that preoperative chemotherapy with a delayed surgical resection is as safe as immediate surgery. More patients are candidates for limb salvage after chemotherapy. The tumor response to the preoperative chemotherapy also has prognostic value. Reducing the postoperative chemotherapy can be dangerous. A high dose methotrexate may not be necessary.

Adolescent↗
PubMed1987

Giant-cell tumor of bone.

Of 327 patients who had a giant-cell tumor of bone and were seen at the Istituto Rizzoli, 293 were treated at the Institute, and 280 of these were followed for two to forty-four years. The distribution according to sex and age of the patient and site of the tumor was similar to the distributions in major reports of large series. The tumor usually involved the metaphysis and the epiphysis, but was occasionally limited to the metaphysis, and in only 2 per cent of the patients was it adjacent to an open growth plate. The tumor on occasion invaded the articular space, also involving the ligaments and the synovial membrane. Extension to an adjacent bone through the joint occurred in 5 per cent of the tumors. Our radiographic grading, which is roughly comparable with the staging system of Enneking et al., was Grade I in 4 per cent, II in 74 per cent, and III in 22 per cent of 266 patients before treatment. A pathological fracture was apparent on the first radiograph in 9 per cent of the patients. In the 280 patients with adequate follow-up, 331 surgical procedures were performed. The rate of local recurrence was 27 per cent in the 151 intralesional procedures, 8 per cent in the 122 marginal excisions, and zero in the fifty-eight wide or radical procedures. These results did not correlate with the radiographic grade of the lesion. Of the fifty-one local recurrences that were seen after treatment at our institution, 90 per cent appeared in the first three years after surgery.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1986

Therapy for primary non-Hodgkin's lymphoma of bone and a comparison of results with Ewing's sarcoma. Ten years' experience at the Istituto Ortopedico Rizzoli.

The authors report on the results obtained in 30 consecutive cases of primary non-Hodgkin's lymphoma of bone (PNHLB) treated at the Istituto Ortopedico Rizzoli between 1972 and 1982. Four patients were treated with radiotherapy only and 26 were treated with radiotherapy plus adjuvant chemotherapy. At a median follow-up of 86 months (range, 30-160), among the 26 patients treated with chemotherapy also there were 3 relapses (2 had meningeal involvement and 1 had recurrence in another bone). Relapse (local recurrence plus multiple new localizations) was observed in one of the four patients treated with radiotherapy only. These results are compared with the results of 68 patients with Ewing's sarcoma who were treated during the same period with radiation therapy and adjuvant chemotherapy and reported in a previous study. In this group, the disease-free survival rate was only 32% (20/68) with a much higher incidence of local recurrence (31%). The necessity of making a clear distinction between PNHLB and Ewing's sarcoma is discussed.

Adolescent↗
PubMed1986

Giant cell reparative granuloma and other giant cell lesions of the bones of the hands and feet.

The present paper is a clinico-pathologic study of 52 osteolytic lesions containing giant cells, affecting the hands and feet and comprising 11 giant cell reparative granulomas, nine giant cell tumors, six chondroblastomas, and 26 aneurysmal bone cysts. The nature of osteolytic lesions of hands and feet must be carefully established in order to plan appropriate treatment without damaging the surrounding structures. Giant cell reparative granuloma has to be distinguished from other lesions containing giant cells. Clinical and radiologic findings proved of limited diagnostic value; the definitive diagnosis can be established only by histologic examination. Surgical treatment is discussed.

Bone Cysts↗
PubMed1986

Sacral osteoid osteoma and osteoblastoma: a report of 13 cases.

The authors present 13 cases (nine males and four females) of osteoid osteoma and osteoblastoma of the sacrum. All patients were less than 20 years old. Clinical and radiographic findings, histological features, and therapy of these rare lesions are discussed. Surgical excision with a posterior approach is considered the treatment of choice, except for tumors localized in the body of S-1, which require an anterior approach. The prognosis is good, even when the neoplasm has been incompletely removed. Nevertheless, a marginal or wide resection is the recommended surgical treatment. Radiotherapy is necessary only for inoperable tumors.

Adolescent↗
PubMed1986

Aneurysmal bone cysts of the pelvis.

Twenty-three cases of pelvic aneurysmal bone cysts treated at the Istituto Ortopedico Rizzoli were reviewed after a mean follow-up of 7 years. Eighteen cysts involved the anterior arch, four extended into the iliac wing and the anterior arch, and one invaded the entire hemipelvis. The acetabulum was involved in 56.5% of the cases. Fourteen patients were treated with surgery (curettage 11; resection 3), and five with radiation therapy; two patients had both modalities; two additional patients refused any treatment after biopsy. The overall recurrence rate was 13% (one case after curettage, one after radiation therapy, and one after combined treatment). Significant complications affected the final functional result in four of seven patients who received radiation therapy, while only one minor complication was seen in the surgical group.

Adolescent↗
PubMed1986

A humeral modular prostheses for bone tumour surgery: a study of 56 cases.

Fifty six humeral prostheses were inserted from 1974 to 1984 for primary bone tumours of the shoulder. In 40 patients a proximal humeral resection was performed and in the remaining 16 cases a Tikhoff-Linberg procedure was employed. The length of humeral resection ranged from 9 cm to 24 cm. A detailed analysis of the oncological and functional results was made. The resection was well clear in 42 patients (75%), marginal in 12 (21.5%), and through tumour in 2 (3.5%). Eight local recurrences were noted. The functional results were satisfactory, the patients having a wide range of active rotation and being able to do sedentary work. A new modified humeral modular prosthesis was introduced in 1984 and is presented.

Adolescent↗
PubMed1986

Reconstruction after resection of the distal fibula for bone tumor.

We have reviewed 11 patients after distal fibular resection for benign or malignant tumors with different techniques of reconstruction. Seven patients had normal function and four had reduced mobility, one of whom had a lateral subluxation of the talus. All the patients were without pain. After resection of the lateral malleolus without replacement the soft tissues should be reinforced.

Adolescent↗
PubMed1986

Benign fibrous histiocytoma of bone.

The cases of seven patients who had a lytic lesion that was histologically similar to a metaphyseal fibrous defect (non-ossifying fibroma) of bone were studied. The patients all were adults and had pain without a fracture. These features were considered distinctive for the lesion, which has the same histological appearance as benign fibrous histiocytoma of soft tissue. The lesion is a benign tumor with fibroblastic and histiocytic differentiation. This picture may be seen in foci in other lesions of bone (aneurysmal bone cyst, fibrous dysplasia, and giant-cell tumor). Ten cases of giant-cell tumor of bone that had a large component of the same foci were also reviewed. It should be emphasized that these areas are secondary reactive tissue rather than the true neoplastic tissue of benign fibrous histiocytoma.

Adult↗