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C Botti

Publications and source records attributed to C Botti.

At least 55 records · Page 3Linked to original sources
PubMed1997

Technetium-99m-MIBI scintigraphy in the assessment of neoadjuvant chemotherapy in breast carcinoma.

UNLABELLED: Presurgical neoadjuvant chemotherapy (PSNC) is the treatment of choice for patients with locally advanced breast carcinoma (LABC). Accurate assessment of tumor response is important in planning subsequent treatments. Conventional response assessment by mammography and clinical evaluation is not fully reliable. This study evaluates the diagnostic yield of serial 99mTc-MIBI scintigraphy in the assessment of LABC response to PSNC. METHODS: Twenty-nine patients affected by LABC underwent clinical, mammographic and 99mTc-MIBI scintigraphy before and after 3 cycles of FEC (500 mg/m2 5-fluorouracil, 50 mg/m2 epirubicin and 400 mg/m2 cyclophosphamide) on Days 1 and 8. Surgery was planned for 15 days after the third cycle of chemotherapy. Pathological status was obtained after surgery in all patients. RESULTS: Sensitivities (i.e., true-positive ratios) for a correct prediction of tumor presence after PSNC were 65% for scintigraphy, 35% for clinical evaluation and 69% for mammography. Specificities (i.e., true-negative ratios) for a correct prediction of tumor absence after PSNC were 100% for scintigraphy, 67% for clinical evaluation and 33% for mammography. Technetium-99m-MIBI uptake in this series did not correlate with P-170 expression, proliferating cell nuclear antigen, Her-2/neu oncogene protein, antihuman endothelial cell CD31 antigen and estrogenic and progestinic receptor status. CONCLUSION: Technetium-99m-MIBI scintigraphy is effective in monitoring the response to PSNC in LABC patients. Its diagnostic yield is clearly superior to clinical evaluation alone. Scintigraphy performs as does mammography in patients with negative response, but it is clearly superior in patients with positive response.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1996

Expression of fatty acid synthase (FAS) as a predictor of recurrence in stage I breast carcinoma patients.

BACKGROUND: Fatty acid synthase (FAS) is a molecule found in tumor cells from breast carcinomas of patients whose prognosis is very poor. Recently, this molecule has been identified as the key enzyme in fatty acid biosynthesis. This study was done to test the strength of FAS as a prognostic indicator for disease free survival (DFS) and overall survival (OS). METHODS: Clinical records, histologic features, immunohistochemical expression of cathepsin D and c-erbB-2, and estrogen and progesterone receptor status of 110 Stage I breast carcinoma patients were all associated with FAS by a chi-square test. The patterns of DFS and OS were estimated over a ten-year follow-up period using the Kaplan-Meier method. Univariate and multivariate analysis were evaluated using a log logistic regression model. Multivariate regression analysis was based on the Cox proportional hazard model. To detect FAS, cathepsin D and c-erbB-2 expression as well as estrogen and progesterone receptor status, we used the unlabeled immunoperoxidase technique on formalin fixed, paraffin embedded tissue. RESULTS: FAS was significantly associated with a higher risk of recurrence because it predicted both DFS (P = 0.0001) and OS (P = 0.003) when evaluated as a continuous variable and DFS (P = 0.0001) when evaluated with other prognostic markers. Peritumoral lymphatic vessel invasion was the other most significant independent predictor for DFS (P = 0.001) and OS (P = 0.003). CONCLUSIONS: FAS is a reliable prognostic marker to predict DFS and OS in patients with early breast cancer.

Adult↗
PubMed1995

Parkinson's disease affects automatic and spares intentional verbal learning. A stochastic approach to explicit learning processes.

We studied word list and paired associates learning in patients with idiopathic Parkinson's disease and normal controls by means of a two-stage stochastic model, which allows independent measurements of encoding, storage and retrieval abilities. We preliminarily ascertained that the model components were both sufficient and necessary to account for the overall performance of the subjects, and then compared the learning abilities between the two groups. Parkinson's disease patients were selectively impaired in identifying well-known engrams, for which learning is superfluous, and in automatic retrieval, namely in abilities that do not need attentional effort. By contrast, they were unimpaired in encoding and intentional retrieval, which require a purposeful effort. The automatic-voluntary dissociation of Parkinson's disease patients' motor behaviour is, therefore, paralleled by some features of their memory performance.

Aged↗
PubMed1995

[The role of hysteroscopy in the follow up of post-mastectomy patients undergoing adjuvant therapy with Tamoxifen].

The authors report on up to date knowledge of the risk of endometrial carcinoma women operated on mastectomy for breast carcinoma and treated with TAM. Starting from their own clinical and scientific experience, the authors follow a group of such patients with a strict monitoring, to ascertain the eventual comparison of dysplastic and neoplastic endometrial pathologies. The group numbers 18 patients and the aim of the study is to evaluate the importance of hysteroscopy as a diagnostic approach for this iatrogenic pathology. The authors affirm the validity of this partially invasive diagnostic method that has to be integrated with clinical and laboratory parameters that are justified by the cost/benefit ratio always favourable for the diagnosis of a neoplastic pathology.

Aged↗
PubMed1995

Prognostic value of lymph node metastases after neoadjuvant chemotherapy for large-sized operable carcinoma of the breast.

BACKGROUND: Neoadjuvant chemotherapy followed by surgery or radiation therapy, or both, has become the treatment of choice for patients with large-sized resectable carcinoma of the breast in whom mastectomy is the conventional option. Since tumor regression before surgery is considered a favorable prognostic factor, there is still controversy regarding the need to perform an axillary dissection after a good response to systemic induction treatment. STUDY DESIGN: Between February 1990 and December 1993, we conducted a prospective study of 56 consecutive patients receiving high-dose anthracycline-based preoperative chemotherapy for large but potentially resectable carcinoma of the breast. Patients who had a good clinical response to induction systemic treatment received the same chemotherapy in the adjuvant phase, while those whose response was less than optimal received alternative adjuvant chemotherapy regimens. A multivariate analysis was made to evaluate the relative influence on disease-free survival rates of 11 clinicopathologic and treatment-related variables, including clinical response to primary chemotherapy, primary pathological (p-T) staging, and the number of metastatic lymph nodes. RESULTS: At a median follow-up period of 36 months, only the number of metastatic lymph nodes was found to be an independent predictor of relapse. Clinical response to systemic induction treatment and p-T staging did not correlate with prognosis. In the group of patients with axillary lymph node involvement, those who did not respond to preoperative chemotherapy showed a lower relapse rate compared with those who achieved an objective response. CONCLUSIONS: These findings suggest that axillary lymphadenectomy should be considered an important component of the combined modality therapy for patients with large-sized resectable carcinoma of the breast in order to identify subgroups of patients that may benefit from alternative treatments in the adjuvant setting.

Aged↗
PubMed1995

Gastric cancer: prognosis and lymph node reactivity.

OBJECTIVE: To assess the prognostic value of various immunomorphological variables in the prognosis of gastric cancer after curative resection. DESIGN: Retrospective study. SETTING: University hospital, Italy. SUBJECTS: 180 Patients who underwent curative resection for carcinoma of the distal two thirds of stomach between January 1960 and December 1978. Curative was defined as no residual cancer at the resection margins and no distant metastases. INTERVENTIONS: All living patients were followed-up, and missing survival data were obtained from the Official Census Registry. MAIN OUTCOME MEASURES: Correlation between survival and nuclear grade, lymphocytic infiltration, and types of lymph node reaction such as sinus histiocytosis, paracortical lymphoid cellular hyperplasia, and follicular hyperplasia in the cortical area. RESULTS: Crude 5 year and 10 year survival rates were 46% and 36%, respectively. Sex, site, and histological type of the tumour did not correlate with survival. Multivariate analysis showed that only pTNM stage of disease and degree of sinus histiocytosis were significantly related to survival. CONCLUSION: There may be an argument for using the presence or absence of sinus histiocytosis to stratify patients in prospective studies of adjuvant treatment.

Female↗
PubMed1994

Improved local control and survival with the "sandwich" technique of pelvic radiotherapy for resectable rectal cancer. A retrospective, multivariate analysis.

PURPOSE: The following study was done to evaluate the therapeutic value of radiotherapy as an adjunct to surgery for rectal cancer patients. METHODS: One-hundred twenty-four patients underwent curative resection by one surgeon (RC) from 1982 to 1991. Forty patients received combined preoperative and postoperative (sandwich) radiotherapy, 30 patients received postoperative radiotherapy, and 54 patients were treated by surgery alone. During the study period sandwich radiotherapy was primarily offered as a free treatment option for patients with tumors which were believed to be transmurally invasive, whereas postoperative radiotherapy was an alternative therapeutic option offered to patients with tumor classified as Dukes B and C at histopathologic examination. RESULTS: Operative mortality was 2 percent in the sandwich radiotherapy group vs. 7 percent in the surgery alone group. After a median follow-up of 60 months, the actuarial locoregional recurrence rate at five years was 3 percent for the sandwich radiotherapy group compared with 18 and 30 percent for the postoperative radiotherapy and surgery alone groups, respectively (P = 0.019). A multivariate analysis using the Cox model confirmed the favorable independent influence of sandwich radiotherapy on local tumor control, especially in distal tumors. The therapeutic benefit of sandwich radiotherapy translated into increased survival in the low-rectum Dukes B subgroup of patients. The actuarial five-year survival rates were 86 percent, 50 percent, and 28 percent in the sandwich radiotherapy, postoperative radiotherapy and surgery alone groups, respectively (P = 0.05). CONCLUSIONS: Preoperative radiotherapy has a significant effect on the prognosis of rectal cancer patients.

Adult↗
PubMed1994

Phase II trial of high-dose epirubicin and cyclophosphamide in advanced breast cancer.

Between February 1990 and December 1991 high-dose epirubicin (Epi)(120 mg/m2) plus cyclophosphamide (CTX)(600 mg/m2) were given every 3 weeks to 52 patients with locally advanced and metastatic breast cancer. 26 patients with locally advanced disease received four courses of this regimen before and after local treatments. 26 patients had metastatic disease: they received eight courses unless progression or unacceptable toxicity occurred. Responses were seen in 37/48 (77%) evaluable patients including 14 complete responses (CR), 23 partial responses (PR), nine stable disease, two progressive disease. Among the 25 evaluable patients with locally advanced disease, 9 had a CR and 11 a > 80% decrease in tumour volume. 6 patients (24%) had a pathologically confirmed complete response. 18 patients (72%) had a tumour reduction to 0-2 cm. The 3-year disease-free survival was 60%. Of the 23 evaluable patients with metastatic disease, 5 obtained a CR and 10 a PR, yielding an overall response rate of 65%. Myelosuppression was substantial with a grade 3-4 leucopenia in 76% of the patients even if neutropenic fever occurred in only 7% of the courses. A clinical congestive heart failure occurred in 1 patient following a total Epi dose of 960 mg/m2 and a bilateral quadrantectomy and radiotherapy. We conclude that (1) high-dose Epi + CTX is a very active regimen, in particular for the patients with locally advanced breast cancer; (2) breast conservation after this regimen in some of these patients may be considered; (3) neutropenia is the dose-limiting toxicity. Currently, a phase II study using the same combination given every 2 weeks together with r-methuG-CSF is ongoing.

Adult↗
PubMed1994

Results of curative gastrectomy for carcinoma.

BACKGROUND: In the western literature, controversy exists regarding the operative management of carcinoma of the stomach. Still debated are the extent of gastric resection, the role of splenectomy, and the significance of lymphadenectomy. STUDY DESIGN: We performed a retrospective study of 646 consecutive patients who underwent curative gastrectomy for carcinoma of the stomach from 1950 to 1989. A multivariate analysis of nine clinicopathologic and treatment-related variables, including type of gastrectomy, splenectomy, and extent of lymphadenectomy was done to assess the relative influence of these variables on survival. RESULTS: The following variables emerged as independent predictors of death: serosal involvement, distant lymph node metastases, and total gastrectomy. Splenectomy and lymphadenectomy were not related to prognosis. However, a separate analysis on defined subsets of patients revealed that radical lymphadenectomy (removal of N2 nodes) provided a survival benefit in patients with T1-2 N0-1 disease. CONCLUSIONS: These findings suggest that although prognosis of carcinoma of the stomach is mainly determined by the stage of disease at time of operation, the choice of the surgeon can affect survival. Total gastrectomy should be avoided when it is not necessary for proximal tumor location. Subtotal gastrectomy in distally located tumors seems to be the best option. Radical lymph node dissection should be performed when nodal involvement is expected to be limited or absent.

Adult↗
PubMed1994

[Some philosophical assumptions of the debate on the ethics of environmental epidemiology].

The aim of this paper is to analyse the existing debate on the ethical problems concerning environmental epidemiological research. The analysis is mostly focused on the philosophical assumptions of this debate. We try to show that, beside the traditional deontological considerations, it is important to formulate other considerations on different issues. We try to demonstrate, on the basis of some reflections on the structure of environmental epidemiology and on science in general, that there is room for subjective choices of researchers in the production of data. We finally show how some of the subjective choices are grounded in moral options and how those moral values can belong to different moral theories.

Environmental Health↗
PubMed1993

How to differentiate retrieval from storage deficit: a stochastic approach to semantic memory modeling.

Some of the methods currently used to differentiate retrieval from storage deficits in brain damaged patients are revisited. Indices based on association or agreement measures among the responses given by the subject on repeated trials, as well as direct estimates of storage and retrieval abilities based on crude percentages, are open to criticism. A simple Markov chain stochastic approach, which is free of the drawbacks of the other methods and which distinguishes storage from retrieval deficits more reliably and powerfully, is proposed.

Association Learning↗
PubMed1993

Sample preparation for bivariate flow cytometric analysis of breast tumor specimens.

The availability of monoclonal antibodies (MAbs) raised against functional or phenotypic cell markers can improve the suitability of flow cytometry (FCM) in assessing and validating prognostic parameters of human neoplasia. The major problems encountered in this type of study, when performed on solid tumors, are the recovery of a large and representative number of tumor cells and the possibility of performing a DNA analysis on antigen-selected populations. A panel of MAbs was chosen on the basis of the recognized membrane antigens important to the biologic characterization of human breast cancer cell populations. The possibility of performing bivariate FCM analysis of cell surface antigens and DNA content was investigated on 4 breast tumor cell lines and 10 fresh breast biopsies. Different fixations and tumor disaggregation procedures were considered. The results indicate that ethanol fixation is the most effective procedure for performing biparametric FCM analysis and that a combined enzymatic-mechanical disaggregation procedure applied on breast tumor specimens allows great recovery of intact cells without affecting antigen detection or DNA distribution.

Antibodies, Monoclonal↗
PubMed1992

Breast cancer is associated with loss of the c-kit oncogene product.

The proto-oncogene c-kit encodes a tyrosine kinase receptor related to the PDGF/CSF-1 receptors. Mutations of this gene result in impairment of hematopoiesis, melanogenesis and gametogenesis. Using monoclonal antibodies to the c-kit gene product, we have analyzed its expression in normal and transformed human tissues. Unexpectedly, the receptor was found to be expressed in normal mammary epithelium. While in benign breast lesions, the c-kit gene product was detected at variable levels in 82% of the instances, in primary tumors, no product could be identified in 87% of the cases. This phenotype is maintained in metastatic foci. These findings were confirmed by paired Northern blot analysis of RNA preparations from normal and tumor tissues. These results demonstrate that the c-kit receptor may also be involved in the growth control of mammary epithelium and that this function may be impaired following malignant transformation and de-differentiation.

Blotting, Northern↗
PubMed1992

A model-based study of learning and memory following transient global amnesia attacks.

Verbal learning and forgetting were studied in patients one month after an episode of Transient Global Amnesia and in normal control subjects by means of a two-stage stochastic model, which allows independent measurements of encoding, storage and forgetting. We preliminarily ascertained both the necessity and the sufficiency of the model to account for several performance scores of the two experimental groups, and then compared the learning and forgetting functions between groups. In spite of the analytical power of the statistical method adopted. Transient Global Amnesia was not found to entail persistent impairment of encoding and storage, as well as of retaining memory traces and retrieval algorhythm.

Cerebral Cortex↗