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Biomedical subjects

U Veronesi

Publications and source records attributed to U Veronesi.

At least 217 records · Page 12Linked to original sources
PubMed1977

Surgical treatment of primary breast cancer according to disease extent.

Radical mastectomy should be replaced by a number of different types of operation, either more conservative or more extended according to the extent of the disease. For cases T1NO a new procedure consisting of the removal of a quadrant of the breast, with axillary dissection plus radio-therapy on the residual breast tissue, is under evaluation. In cases T2NO modified radical mastectomy is suggested as a procedure of choice, whilst T3 cases and all N1 cases should still be submitted to radical mastectomy. Cases with tumor of inner quadrants with positive axillary nodes will benefit from the removal of the internal mammary nodes. Superradical mastectomy is limited to special selected cases with extensive lymph-node invasion. All N+ cases are submitted to adjuvant chemotherapy (CMF). In locally advanced cases "reductive" surgery may be part of an aggressive chemotherapy program.

Adult↗
PubMed1977

[Conservative treatment of breast cancer. A therapeutic 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. After surgery the patients receive 6 000 rads to the residual breast tissue over five to six weeks, starting 15 days after operation. The cosmetic results are satisfactory in the majority of cases. The trial is limited to cases with tumors less than 2 cm (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 seven were treated with radical mastectomy and 164 with conservative procedure. Axillary metastases were found in 23 per cent of the radical and in 29 per cent 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 the beginning of 1979.

Axilla↗
PubMed1976

Combination chemotherapy as an adjuvant treatment in operable breast cancer.

Prolonged cyclic combination chemotherapy with cyclophosphamide, methotrexate and fluorouracil was evaluated as adjuvant treatment to radical mastectomy in primary breast cancer with positive axillary lymph nodes. After 27 months of study, treatment occurred in 24 per cent of 179 control patients and in 5.3 per cent of 207 women given combination chemotherapy (P less than 10(-6)), the advantage appearing statistically significant in all subgroups of patients. Patients with four or more positive axillary nodes had a higher per cent of relapses than those with fewer nodes. The initial new clinical manifestations occurred in distant sites in 81.5 per cent of relapsed patients. Long-term chemotherapy produced an acceptable toxicity, thus allowing the administration of a high percentage of drug dosage. These results should be considered with caution, since, at present, the effect of this therapy on survival and possible long-term side effects remain unknown.

Adult↗
PubMed1976

Radical mastectomy versus radical mastectomy plus internal mammary dissection. Five-year results of an international cooperative study.

From 1963 to 1968, the international group collected 1580 cases of breast cancer, randomized into two therapeutic groups: radical mastectomy and extended mastectomy. The data were processed on the UNIVAC 1107 computer of the I.N.S.E.R.M. Computing Center. No significant difference was observed between the two groups in the overall five-year survival rate. However, a more detailed analysis, according to certain prognostic features, showed that extended mastectomy improved the results in one subgroup: cancers of inner or medial quadrants, axillary N+. Within this group the difference was highly significant for a smaller subgroup (190 patients) including only tumors T1 and T2. In conclusion, there is no indication for extended mastectomy in any cancers of the outer quadrants or in those of the inner or medial quadrants without axillary involvement. A limited indication for extended mastectomy may be provisionally retained for T1 and T2 cancers of the inner or medial quadrants with axillary involvement.

Breast Neoplasms↗
PubMed1976

Antibodies to BK virus structural and tumor antigens in human sera from normal persons and from patients with various diseases, including neoplasia.

Sera from 1,279 patients with various diseases were examined for the presence of antibodies to BK virus (BKV) capsid antigens. The percentage of positive sera was comparable in all the diseases except rheumatoid arthritis and chronic nephropathies, where a slightly higher prevalence was found. Sera from 952 patients with tumors were examined for the presence of antibodies to BKV tumor and capsid antigens in comparison with a matched control group of 501 blood donors. Sera from 11 tumor patients (1.15%) and from 4 normal controls (0.80%) had antibodies to BKV tumor antigen. No higher prevalence of antibodies to BKV capsid antigens was found in any cancer type except in carcinomas of the urinary bladder, where the percentage of positive sera and of sera with high titers was higher than in other groups. BKV infection is discussed in relation to its possible connection with human non-neoplastic diseases as well as with human tumors and to its activation under conditions of immunosuppressive therapy.

Antibodies, Viral↗
PubMed1976

Comparative evaluation of three combination regimens for advanced malignant melanoma: results of an international cooperative study.

The therapeutic results of a controlled study with three multiple-drug regimens (regimen A: DTIC, vincristine, BCNU; regimen B: DTIC, vincristine, hydroxyurea; and regimen C: DTIC, actinomycin D, BCNU) in a total of 274 evaluable patients with advanced malignant melanoma are reported. CRs were significantly more frequent (P less than 0.01) in regimens A (9.3%) and C (16.4%) compared with regimen B (1.1%). No significant difference in terms of CR plus PR was detected among the three regimens. In all regimens a higher number of CRs plus PRs was seen in patients with soft tissue metastases only, compared with those who had visceral involvement. In all three regimens patients achieving CR showed a longer duration of response and survival in comparison with patients achieving PR. The incidence of brain metastases was neither lowered nor delayed by the presence of BCNU in regimens A and C.

Adolescent↗
PubMed1976

Combination chemotherapy with DTIC (NSC-45388) in advanced malignant melanoma, soft tissue sarcomas, and Hodgkin's disease.

The results of three controlled studies with multiple-drug regimens which included DTIC are reported for advanced melanoma, soft tissue sarcomas, and Hodgkin's disease. In malignant melanoma, no statistical difference was observed between (a) DTIC, BCNU, and vincristine, and (b) DTIC, BCNU, and actinomycin D in terms of response rate, median duration of response, and survival. In sarcomas, the combination of adriamycin and DTIC produced a higher incidence of complete plus partial responders when compared to cyclophosphamide, vincristine, and methotrexate. However, no significant difference was seen in the median duration of response or survival. In Hodgkin's disease, a new four-drug combination including adriamycin, bleomycin, vinblastine, and DTIC (ABVD) produced an incidence of complete remissions and a median duration of response comparable to that achieved with mechlorethamine, vincristine (Oncovin), predinisone, and procarbazine (MOPP). Preliminary data indicate that ABVD is not cross resistant to MOPP. It is concluded that DTIC can be successfully and safely employed in combination with conventional agents in susceptible neoplastic diseases.

Antineoplastic Agents↗
PubMed1975

Staging laparotomy in non-Hodgkin's lymphomata.

Staging laparotomy was performed in 106 selected untreated adults and in 6 children. In adults the histological pattern at initial biopsy was interpreted as nodular lymphoma in 33% and as diffuse lymphoma in 67%. Diffuse histiocytic was the most frequently observed histological subtype in the present series (54%). Diffuse undifferentiated lymphoma was noted in 2/6 children. Waldeyer's ring involvement was noted in 27% of adult patients. Systemic symptoms were present in 7%. Surgery detected occult lesions in 27% of patients (para-aortic nodes 3%, spleen 12%, liver 12%, coeliac nodes 15%, splenic hilar nodes 26%, mesenteric nodes 15%, gastrointestinal tract 1%, bone marrow 12%). The chance of detecting splenic and hepatic involvement was definitely higher in patients with nodal disease above and below the diaphragm in comparison with those with either supra-diaphragmatic or infra-diaphragmatic adenopathy. Lymphography yielded a 96% accuracy proving once more to be a sufficiently reliable diagnostic method. Staging laparotomy is a useful procedure in non-Hodgkin's lymphomata in order to gain information on the natural history and to plan treatment. It remains to be determined whether findings observed through surgical staging will lead to improved treatment and survival.

Adolescent↗
PubMed1975

Oophorectomy for advanced carcinoma of the breast.

From 1960 to 1972, 639 patients have undergone bilateral oophorectomy for carcinoma of the breast. The over-all regression rate was 29.5 per cent; regressions lasted on an average of 16 months, and 19 per cent of the patients who responded to surgical castration survived five years or longer. The best results were achieved when the patients were premenopausal and over 35 years of age or not more than one year menopausal, if the free interval was longer than two years or if the patient had primary advanced carcinoma and when the lesions were localized to the soft tissues, bones, lung and pleura. Attempts to demonstrate the hormone-dependence of the tumor by correlating the response rate to preoperative urinary steroid determination or by cytologic examination of the vaginal smear were inconclusive.

Adrenalectomy↗