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Biomedical subjects

B Terracini

Publications and source records attributed to B Terracini.

At least 37 records · Page 2Linked to original sources
PubMed1996

Incidence of second primary malignancies after a malignant tumor in childhood: a population-based survey in Piedmont (Italy).

We have studied the frequency of second primary malignancies (SPM) among the 2,328 children registered in 1967-1969 at the Childhood Cancer Registry of Piedmont, the largest population-based childhood cancer registry in Southern Europe. Since the population of Piedmont is not served by a conventional cancer registry covering all ages, SPMs were identified through a number of ad hoc surveys within a variety of sources. Eighteen SPM (all histologically diagnosed) were observed after a thorough survey conducted in the ontological departments in Piedmont and after a postal questionnaire addressed to general practitioners. Death certificates were also examined. The crude incidence rate was 116.5 per 100,000 person-years. Risk was higher among children whose first malignancy was diagnosed more recently (SIR = 9.8 for diagnoses in 1983-1989 vs. 4.5 for diagnoses in 1967-1974). The same tendency was confirmed in analyses restricted to children in whom leukemia was diagnosed as the first cancer. Clinical data regarding the treatment of the first malignancy were available for 16 children out of 18: 15 had received chemotherapy and 12 radiotherapy (9 SPM originated in the irradiation field). The interest of measuring the risk of SPM on a population basis (and not only in clinical series) and the advantage of close cooperation between epidemiologists and clinical oncologists are underlined.

Adolescent↗
PubMed1996

Diet and cancers of the larynx and hypopharynx: the IARC multi-center study in southwestern Europe.

The main causes of cancer of the larynx and hypopharynx are smoking cigarettes and drinking alcohol. However, for these as well as for other cancers of the upper aerodigestive tract, some dietary components, mainly low consumption of fruit and vegetables, have been observed to be associated with increased cancer risk. We report results from a multicenter case-control study carried out in six regions of Europe located in northern Spain, northern Italy, Switzerland, and France. A total of 1,147 males with cancer (cases) and 3,057 population controls were interviewed on usual diet, lifelong drinking and smoking habits, and occupational history. Cancer cases had histologically verified epidermoid carcinomas. The cancers were classified in two anatomic sub-entities: the epilarynx (hypopharynx and upper part of the larynx), which enters into contact with the bolus and the air; and the endolarynx, through which air and tobacco smoke pass, but not the bolus. A previous report from this study found that alcohol drinking presents a greater risk factor for cancer of the epilarynx than for cancer of the endolarynx. The main results regarding diet indicate that high intake of fruit, vegetables, vegetable oil, fish, and low intake of butter and preserved meats were associated with reduced risk of both epilaryngeal and endolaryngeal cancers, after adjustment for alcohol, tobacco, socioeconomic status, and non-alcohol energy intake. Among nutrients, a reduced risk was found for high intake of vitamins C and E and for a high polyunsaturated/saturated fatty acids (P/S) ratio. While these variables are relevant in scoring nutritional behaviour, it remains unresolved whether the biologic properties of these nutrients play a role in the apparent protective effect.

Alcohol Drinking↗
PubMed1995

Relapse after first cessation of therapy in childhood acute lymphoblastic leukemia: a 10-year follow-up study. Italian Association of Pediatric Hematology-Oncology (AIEOP).

The outcome of 171 children with ALL who relapsed for the first time after elective cessation of therapy (1-86 mo) and followed over 10 years (median 60 mo; range 1-232 mo) has been evaluated. One hundred and three patients relapsed in the bone marrow (BM), 29 in the testis (T), 21 in the central nervous system (CNS), 14 in the BM plus another site and 4 in other sites. Second remission was achieved in 97% of patients (97% BM, 100% T, 90% CNS, respectively) with reinduction schedules including three or more drugs. All but 4 out of 100 patients who relapsed in the BM received cranial reprophylaxis with intrathecal CT alone or CT plus radiotherapy. Seven patients in second CR underwent allogeneic bone marrow transplantation from an HLA matched sibling. The overall survival was 34% and disease-free survival (DFS) probability at 100 years was 22%. A second relapse was observed in 73% of patients. Forty children are alive in second continuous remission and 24 are alive after a second or subsequent relapse. Patients with isolated T relapse showed a significant better outcome than those with BM or CNS involvement. Most patients (62%) with isolated BM relapse showed a further disease recurrence in BM, and DFS was shorter when relapse occurred within 12 months from off-therapy. Eighty-two patients in second CR stopped the treatment a second time and showed a survival and DFS probabilities, respectively, of 69% and 43%. Thus, children with ALL who relapse after cessation of therapy still have a high risk of further late relapses and should be treated with intensive chemotherapy and CNS reprophylaxis. BMT must be considered for all patients relapsing in the BM within 12 months from off-therapy.

Adolescent↗
PubMed1995

Malignant mesothelioma of the pleura: interobserver variability.

AIMS: To assess the consistency of histopathological diagnosis of pleural malignant mesothelioma by estimating interobserver agreement between five pathologists. METHODS: Eighty eight histological sets pertaining to original diagnoses of pleural malignant mesothelioma were reviewed separately by each pathologist. Diagnostic likelihood was graded as definite (A), probable (B), possible (C), improbable (D), and definitely not (E) malignant mesothelioma. The following indexes were estimated: observed proportion of agreement (Po), kappa statistics and proportion of agreement for "positive" (Ppos) and "negative" (Pneg) diagnoses. RESULTS: Sixty cases (68.2%) were rated by at least three reviewers as A or B and by none of the others as D or E. Five (5.7%) were rated by at least two reviewers as D or E and by none of the others as A or B. Nine (10.2%) showed a serious disagreement, rated A or B and D or E. Agreement for sets obtained at necropsy/surgery (median kappa w = 0.57) was similar to that for endoscopic material (median kappa w = 0.54). Agreement was poor on material obtained by needle biopsy (median kappa w = 0.21). The median value of Ppos varied between 0.94 (necropsy/surgery) and 0.67 (needle biopsy) and that of Pneg between 0.78 (necropsy/surgery) and 0.34 (unspecified biopsy). Interobserver agreement on histological typing was good overall (median kappa = 0.59). CONCLUSIONS: Of the original histological diagnoses, 70% were consistently reproduced through panel review. Most indexes of agreement between pathologists ranged from poor (needle biopsy) to moderate (necropsy/surgery). Agreement in confirming malignant mesothelioma was greater than that regarding exclusion of this diagnosis. Of the cases finally considered to have malignant mesothelioma, the reproducibility of histological typing was relatively satisfactory.

Aged↗
PubMed1995

Pleural malignant mesothelioma and non-occupational exposure to asbestos in Casale Monferrato, Italy.

OBJECTIVES: To assess and quantify the occurrence of pleural malignant mesotheliomas in people who neither experienced occupational exposure to asbestos nor were married to (or known to live with) workers exposed to asbestos in the workplace. The study was conducted in the area of the local health authority of Casale Monferrato, in north western Italy, where a large factory that produced asbestos cement was active up to 1985. No other major activities related to asbestos have ever been present in the area. METHODS: A retrospective survey covering the period 1980 to 1991 identified 126 incident pleural malignant mesotheliomas histologically diagnosed among residents in the local health authority (population at the 1981 census 98,000). Submission of 83 of 95 cases diagnosed during 1980-9 for revision by a panel of five expert pathologists led to the exclusion of 21. The 31 cases diagnosed in 1990-1 were not submitted for revision. For 64 of the 105 retained cases, information derived from different sources (rosters of the employees in the asbestos cement factory dated back to 1907, list of their spouses, clinical records) did not suggest occupational or paraoccupational exposure to asbestos. RESULTS: Incidence excludes cases for which there was some suggestion of occupational or paraoccupational exposure to asbestos. Incidence of histologically confirmed malignant mesothelioma among residents in the local health authority (annual x 100,000; age adjusted) was 4.2 in men and 2.3 in women (based on 26 and 18 cases respectively). In both sexes, rates in 1985-9 were higher than in the previous quinquennium. Corresponding estimates for 1990-1 (based on unrevised diagnoses) suggest similar rates in men and women. CONCLUSION: Rate ratios which are four to six times those measured by conventional Italian cancer registries can hardly be totally explained by bias produced by lack of recognition of occupational or paraoccupational exposure. The problem of proving this type of negative data is common to other circumstances of alleged cancer clusters of environmental (non occupational) origin.

Adult↗
PubMed1994

Second malignant tumors after elective end of therapy for a first cancer in childhood: a multicenter study in Italy.

To evaluate the incidence of second malignant tumors in a cohort of subjects previously treated for childhood cancer, we analyzed data from the Off-Therapy Registry (OTR) of the Italian Association of Pediatric Hematology/Oncology, which collects information on children treated for Hodgkin's disease, non-Hodgkin's lymphoma, Wilms' tumor, acute lymphoblastic leukemia (ALL) and acute non-lymphatic leukemia and who had been removed from treatment in the absence of clinical signs of disease, i.e. the off-therapy stage. Second malignant tumors (SMT), diagnosed before December 31, 1988, were identified through a special enquiry to the 36 institutions cooperating in the registry. Observed cases were compared to expected numbers estimated from age- and sex-specific incidence rates derived from the Cancer Registry of the Province of Varese. In a total of 3,310 study subjects, 27 SMTs have been registered. The Cumulative Risk (CR) of SMT was 2.9% 15 years after the end of treatment and the Standard Incidence Ratio (SIR) was 10.8. The ALL sub-cohort had the highest risk of SMT (SIR 13.6) and 9 cases of CNS tumor occurred in this group (SIR 58.9). All 9 had received prophylactic cranial radiotherapy (CRT) and 5 had been treated on one protocol, characterized by low-dose intrathecal methotrexate (IT MTX) given monthly for 2 years after CRT. The Off-Therapy Registry has unique criteria for inclusion; direct comparisons with similar studies are therefore somewhat problematic. However, our data suggest that the risk of SMT in childhood ALL cancer survivors may be greater than previously reported, and that CNS tumors are the most common SMT in this group. The administration schedule of IT MTX may be an important risk factor.

Adolescent↗
PubMed1994

A population-based study of prognostic factors in oral and oropharyngeal cancer.

Cases of oral cavity and oropharynx cancer diagnosed among the residents of Torino, Italy, between 1982 and 1984 (n = 143) were followed up to June 1990. During this period, 97 subjects (67.8%) died, 69 from oral or oropharyngeal cancer. 10 more cases died from causes possibly related to oral cancer. The overall relative 5-year survival rate was 37.2%. Men experienced a worse survival than women. No difference was shown according to age, education or occupation. Patients with smooth lesions had a poorer prognosis than those with fissured or granular lesions; no association between survival and colour, elevation, induration or bleeding from the lesion was found. Extension of the tumour and nodal involvement were strong and independent predictors of survival, but no difference was found between T1 and T2 lesions. Patients who reported a 2-3-month interval between onset of symptoms and diagnosis experienced a better survival than those with shorter or longer interval. Oropharynx cases had a better prognosis than cancers of the oral cavity.

Adult↗
PubMed1993

Survival of breast cancer patients from Piedmont, Italy.

A population-based series of 4,764 women from Piedmont, Italy, who were diagnosed with breast cancer during 1979-81 and for whom information on social and demographic factors was available, was followed-up for mortality until 1986 or 1987. Relative survival rates at one, three, and five years were 94.6, 81.6, and 71.1 percent, respectively, and were similar to those of other European series. Women aged 40-49 years at diagnosis experienced a better survival than women in other age groups. The mortality was highest between one and four years after diagnosis, and lowest between five and seven years. Survival rates were lowest for women above the age of 80, and single women had a worse prognosis than married women. Women with less than seven years of education had nonsignificantly lower survival rates than more educated women. No difference in survival was found according to occupation, size of town of residence, place of birth, or type of hospital.

Adult↗
PubMed1993

A cohort study on mortality among wives of workers in the asbestos cement industry in Casale Monferrato, Italy.

The study investigates mortality from cancer and other diseases in a cohort of wives of asbestos cement workers in Casale Monferrato (northwest Italy). After the exclusion of women with an occupational record in the asbestos cement industry, the cohort comprised 1964 women. Their domestic exposure was estimated according to their husbands' periods of employment in the plant: 1740 had a period of domestic exposure whereas the remaining 224 married an asbestos cement worker only after he definitely stopped his activity in the asbestos cement plant; these have, therefore, been considered as unexposed. The cohort of wives was constructed entirely through official records in the town offices and is both exhaustive and unaffected by recall bias. At the end of follow up (1988) 1669 women were alive, 270 were dead and 25 (1.2%) were untraced. Main mortality analyses were only up to age 79 to reduce the misclassification of causes of death. Expected mortality was based on local rates. Mortality analyses were limited to the period 1965-88 due to the availability of local rates: in that period 210 deaths occurred among women with domestic exposure v 229.1 expected. There were four deaths from pleural tumours (one diagnosed as mesothelioma at necropsis) and six from lung cancer v. 0.5 and 4.0 expected respectively. Two further cases of mesothelioma were diagnosed by histological examination after the end of follow up. None of the three wives with histologically diagnosed mesothelioma had been engaged in industrial activities. Corresponding information for the other three cases could not be traced.

Adult↗
PubMed1992

Childhood cancer registry of the Province of Torino, Italy. Survival, incidence, and mortality over 20 years.

Incident childhood cancers in the Province of Torino, Italy (population aged 0 to 14 years averaging 0.5 million) have been registered since 1967. Four population-based exhaustive surveys have been done to collect cases diagnosed during the periods 1967 to 1969, 1970 to 1975, 1976 to 1981, and 1982 to 1986. For each registered child, vital status on June 30, 1988 was assessed. This article reports incidence, mortality, and survival rates over a 20-year period. A statistically significant trend toward an increased incidence of soft tissue sarcomas was identified. Statistically insignificant trends included an increased incidence of brain tumors (probably reflecting improved diagnostic procedures) and a decreased incidence of thyroid tumors. Incidence rates of leukemias in the first year of life tended to decrease. As expected, survival rates of some childhood cancers dramatically improved throughout the 20-year period; this occurred in leukemias, brain tumors, soft tissue sarcomas, and renal tumors. Survival rates are compared with observations in comparable population-based series.

Adolescent↗
PubMed1992

[Prospects and indications for the prevention of respiratory tract tumors].

Respiratory cancers are suitable targets for primary prevention, since their causes are largely known and can be eliminated. Reasonable short-term objectives include the reduction of tobacco use (and alcohol abuse), the control of exposure to carcinogens in the workplace, as well as the reduction of air pollution in the general environment. The International Agency for Research on Cancer has estimated that in countries like Italy the elimination of cigarette smoking could reduce larynx cancer by 85% (if accompanied by a decrease in alcohol consumption), and lung cancer by 80% in males and 60% in females. An almost complete elimination of exposure to carcinogens in the workplace could potentially reduce lung cancer by 10%, whereas eliminating exposure to asbestos could certainly reduce pleural cancer by more than 50%. The proportion of lung cancer attributable to pollution in the general environment is unclear. Preventive measures require legislative support. Since October 1991, stores throughout Italy, in compliance with a new law, started carrying the first cigarette packages that included warnings against the hazards of smoking. Not since Law 584 of 1975, which forbids smoking in public places, has such an important legislative measure been passed. As a consequence of Law 584, smoking in many public places (e.g. movie theaters and, more recently, domestic flights) is today unthinkable, and these restrictions have been widely integrated into the Italian way of life. In developed countries, there is no doubt that the reduction of cancer due to the elimination of tobacco would be greater than that due to eliminating exposure to risk factors in the workplace.(ABSTRACT TRUNCATED AT 250 WORDS)

Alcohol Drinking↗
PubMed1991

Occupation and cancer of the oral cavity or oropharynx in Turin, Italy.

In a population-based case-referent study, the occupational experience of 86 men with oral or oropharyngeal cancer and 373 referents was analyzed with respect to employment in 41 occupations and 40 industries, as well as to exposure to 16 chemicals, as estimated via a job-exposure matrix. Among the occupations and industries at higher risk were machinery operator (odds ratio [OR] 2.0; 95% confidence interval [95% CI] 1.0-4.0), plumber (OR 5.0, 95% CI 1.2-21.5), building industry (OR 2.5; 95% CI 1.3-4.5), textile industry (OR 2.5; 95% CI 0.6-4.6), and electricity production (OR 2.8; 95% CI 0.7-12.1). All the OR estimates were adjusted for age, education, area of birth, tobacco smoking, and alcohol consumption. An association between formaldehyde exposure and oral cancer was suggested (OR for any exposure 1.6, 95% CI 0.9-2.8; OR for probable or definite exposure 1.8, 95% CI 0.6-5.5). No other chemical included in the matrix showed any risk pattern. The evidence of an association between formaldehyde exposure and oral or oropharyngeal cancer is strengthened by the results of this study.

Case-Control Studies↗
PubMed1991

Mortality from respiratory and digestive cancers among asbestos cement workers in Italy.

A cohort study is presented on the mortality of blue-collar workers in an asbestos-cement production plant that has been operating since 1907. Use of both crocidolite and chrysotile is reported. The cohort includes 2608 men and 759 women who were employed in the plant on Jan. 1, 1950 and those who started to work between 1950 and 1980. Follow-up was terminated on April 15, 1986 with 97.9% traced. Expected deaths were estimated from the age- and sex-specific regional mortality rates for the years 1969 to 1981. The data have been analyzed for the period 1964 to 1986 based on person-years at risk: 43,000 for men and 14,494 for women. A statistically significant increase was found in both sexes for mortality from all causes. From 1964 to 1986, 728 men died from all causes (608 expected), 275 with cancer at any site (158 expected) 110 with lung cancer (41 expected), 28 with pleural tumors (1 expected) and 85 with asbestosis (less than 1 expected). Corresponding figures for women were--all causes: 136 deaths versus 102 expected; all cancers: 79 verses 32 expected; lung cancer: 7 versus 2 expected; pleural tumor: 15 versus 0 expected and asbestosis: 4 versus 0 expected. Deaths from digestive tract cancer were in excess only among women (18 observed versus 10 expected, p less than 0.01). No excess was found for deaths from laryngeal cancer. Standardized mortality rates (SMR) for lung cancer among males showed a clear increase in direct relationship with length of follow-up. SMR according to length of employment were 234 for length 10 to 19 years, 363 for 20 to 29 years, and 256 for 30 years or longer (p less than 0.05 and lower).

Adult↗