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Biomedical subjects

U Veronesi

Publications and source records attributed to U Veronesi.

At least 271 records · Page 15Linked to original sources
PubMedDate not supplied

[Reliability and value of diagnostic lymphography in carcinoma of the sigmoid, rectum and anus (author's transl)].

From 1963 to 1973, 253 patients with cancer of the sigmoid, rectum and anus underwent diagnostic lymphography at the Istituto Nazionale Tumori of Milan. In 218 patients lymphography was performed as part of the intial diagnostic work-up, while in 35 it was done during the follow up period, after surgery. The accuracy of radio-histological correlation was 95%. This confirms the reliability of diagnostic lymphography and its clinical usefulness. In view of these results, this diagnostic tool is essential in the initial evaluation in patients with carcinoma of the anus, because lymphography was superior (28%) to the clinical inspection (6%) in the evaluation of the inguino-iliac lymph nodes. Lymphography is also useful in rectal cancer since it permits, in case of nodal metastases, selection of a group of patients in whom the therapeutic program should be revised. The exam is useless in cancer of the sigmoid. In the small group of patients who had lymphography in the follow up period, this technique was the only to show, in symptomatic patients, the presence of pelvic and/or para-aortic nodal metastases. Lymphography is also useful in these patients for the evaluation of the results of the radio/chemotherapy on involved nodes.

Anus Neoplasms↗
PubMedDate not supplied

Evaluation of the risk of multiple primaries in malignant cutaneous melanoma.

The evaluation of the risk of a second primary melanoma has been done on a series of 521 cases of malignant melanoma observed at the National Cancer Institute of Milan from September 1967 to December 1974. It has been found that a malignant melanoma patient is about 900 times more likely to have a second primary than an individual in the general population is likely to contract the disease. The risk is age and sex dependent.

Adolescent↗
PubMedDate not supplied

Intravenous administration of BCG in advanced melanoma patients.

From June 1975 to August 1977, 19 patients with distant metastases of malignant melanoma of the skin that were no longer responsive to chemotherapy were treated with BCG given intravenously. A single dose of lyophilized Pasteur BCG ranging from 2 X 10(7) to 3 X 10(8) viable units was given in 500 ml of saline infused in 5 to 6 h. Seven of the 16 evaluable patients benefited from treatment; 3 showed an objective regression of more than 50% of the original tumor volume, and 4 an arrest of tumor growth. The objective regressions lasted from 2 to 5 months, and 1 case had an arrest of tumor growth for 29 months. The regression rate was related to the BCG dosage: 2 X 10(8) viable units appears to be the dosage that gives severe but reversible toxicity and is able to induce objective regression. The most responsive lesions were skin and subcutaneous deposits (5 of 7) and lung metastases (1 of 4). Toxic effects seem to be related to the number of bacilli injected. In the group of 10 cases treated with less than 10(8) units, toxicity was modest: 4 patients had fever (up to 38.5 degrees C) that lasted a few days, and in 3 cases it was associated with shivering during the infusion period and weakness. One case only had vomiting and jaundice. Toxicity was severe in the 9 patients that were treated with a dosage higher than 10(8): patients had fever and weakness for at least 4 days and shivering during the infusion. Two had adrenal insufficiency and 7 had liver enlargement and jaundice with return to normality by day 21. In the whole series 8 patients had leucopenia and 5 thrombocytopenia for 2 to 3 days: only 1 patient required blood and platelet transfusion. No significant variations in immunoglobulin levels were observed. No variations of PPD or BCG skin tests were observed after treatment. Three patients expired; the first treated with 6 X 10(7) unit, had an intercurrent disease (autopsy showed a heart infarction); the second, treated with 1.8 X 10(8), showed a rapid growth of lung metastases and died 15 days after treatment; the death of the third patient was probably due to anaphylactic shock. All 3 patients had been previously treated with BCG, given by scarification or intranodular injection.

Adolescent↗
PubMedDate not supplied

Chemoprevention of breast cancer with fenretinide (4-HPR): study of long-term visual and ophthalmologic tolerability.

BACKGROUND: Fenretinide (4-HPR) is a synthetic retinoid being clinically tested in the chemoprevention of different tumors and precancerous lesions. Though safer than many other retinoids in experimental models, in humans 4-HPR may induce adverse effects that mainly affect the eye and visual function. Such effects are thought to be caused by the reduction of plasma retinol levels, which occurs after administration of the retinoid. METHODS: A series of 826 women treated with 4-HPR was studied to quantify the incidence and temporal pattern of occurrence of visual (dark adaptation) and ophthalmologic complaints (ocular dryness, lacrimation, conjunctivitis or photophobia) and to investigate the possible association between their occurrence and plasma retinol levels. RESULTS: The cumulative incidence of visual complaints reached nearly 20% at 5 years. The occurrence of these symptoms was more frequent at the start of treatment. The probability of developing visual complaints was significantly higher in patients with lower plasma retinol concentrations following 4-HPR treatment. The cumulative incidence of ophthalmologic complaints was 8% at 5 years. The occurrence of these complaints was evenly distributed during treatment. Ophthalmologic complaints were not associated with a greater degree of reduction of plasma retinol concentrations, but rather with the patient's age, since symptomatic patients were generally older than asymptomatic patients. CONCLUSIONS: Visual and ophthalmologic complaints are common during 4-HPR treatment; their estimated 5-year cumulative incidence is close to 20% and 8%, respectively. However, the pattern of occurrence over time and the underlying mechanisms of these two types of complaints seem different.

Adult↗
PubMedDate not supplied

Chemoprevention trial of contralateral breast cancer with fenretinide. Rationale, design, methodology, organization, data management, statistics and accrual.

The Fenretinide (4-HPR) Breast Cancer Study is a randomized multicenter clinical trial originally designed and conducted by the investigators of the Istituto Nazionale Tumori of Milan. The study is sponsored by the National Cancer Institute of Bethesda and by the Italian National Research Council. The trial was designed to evaluate the effectiveness of the synthetic retinoid 4-HPR, at a dose of 200 mg per os every day for 5 years, in reducing the incidence of contralateral breast cancer in a population of patients previously operated on for breast cancer. Between 1987 and 1993, the Istituto Nazionale Tumori of Milan and 9 other collaborating Centers enrolled 2,972 women between the ages of 30 and 70 years who had been previously operated on for T1-T2 N- M0 breast cancer. This paper describes the rationale, design, methodology, organization, data management, statistics and accrual of the participating population.

Adult↗
PubMedDate not supplied

Accrual issues for chemoprevention trials: the example of the 4-HPR study for the prevention of contralateral breast cancer.

This paper describes the accrual of the controlled clinical trial with fenretinide for the prevention of contralateral breast cancer. Accrual screened 4,030 potentially eligible patients of whom 1,815 were randomized. Two strategies of recruitment were used, i.e. retrospective and prospective. In the retrospective accrual, the medical staff reviewed the records of breast cancer patients who had received curative surgery to select those who fulfilled the eligibility criteria of the study. For the prospective recruitment operated, patients were contacted after the beginning of the trial. The study started in March 1987 and accrual closed on July 31, 1993. The planned accrual period was extended by 19 months. The yearly accrual tended to decrease with time. This was mainly due to the end of the retrospective recruitment and to the introduction of adjuvant chemotherapy, a reason for exclusion from the trial, also for patients with negative axillary nodes. The known accrual difficulties of chemoprevention studies proved also to be true for the high-risk population of this trial.

Antineoplastic Agents↗
PubMedDate not supplied

Conservative treatment for breast cancer of limited extent. Results of a randomized trial.

From 1973 to 1980, a controlled clinical trial was carried out at the National Cancer Institute of Milan to compare the Halsted mastectomy with breast quadrantectomy and axillary dissection followed by radiotherapy in patients with breast cancer of less than 2 cm in size. Cases of breast cancer classified as T1N0 were randomized into the two treatment procedures: 349 cases were treated with the Halsted mastectomy and 352 with the quadrantectomy technique. The two series were comparable with regard to age distribution, size, site of primary tumor, menopausal status and frequency of axillary metastases. Three local recurrences occurred in the Halsted group and one in the quadrantectomy group. Actuarial curves showed no difference in the two series with regard to disease-free and overall survival. In view of these results, mastectomy appears to be an unnecessary mutilation for patients with breast carcinomas less than 2 cm in size and no palpable axillary nodes.

Breast Neoplasms↗