[Observations and treatment of 328 cases of bladder neoplasms].
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Adult↗
Biomedical subjects
C Botti
Publications and source records attributed to C Botti.
[Hyperthermic-antiblastic perfusion in the treatment of tumor of the extremities].
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Chemotherapy, Cancer, Regional Perfusion↗
[Anti-blastic hyperthermic perfusion in the treatment of melanoma of the extremities in the loco-regional diffusion phase].
Primary limb melanoma may recur in terms of satellitosis, in transit metastases and/or regional node involvement. Hyperthermic antiblastic perfusion (HAP) permits the isolation of involved extremity from the systemic circulation and to deliver high doses of antineoplastic drugs. The association of cytostatic drugs to hyperthermia (> or = 41.5 degrees C) results in a synergistic effect with an increased therapeutic effectiveness. The overall 5 and 10-year survival rates in relation to the disease stages are st. II 75% and 67%; st. IIIA 59% and 42%; st. IIIAB 36% and 30% respectively. The results confirm that HAP is considered the treatment of choice of loco-regional spreading limb melanoma. Recently, the tumor necrosis factor (TNF) has been combined with Melphalan and hyperthermia. This trimodality association seems to be superior to Melphalan and hyperthermia alone only in patient with bulky tumors (i.e., multiple nodules), as a matter of fact the complete tumor response rates observed in these patients have been 67% and 20% respectively. The greater effectiveness of trimodality association has to be confirmed by multicentric randomized trials.
Antineoplastic Agents, Alkylating↗
The influence of tumor lymphocytic infiltration on long term survival of surgically treated colorectal cancer patients.
Prognostic significance of host-immune response, as gathered by the degree of tumour lymphocytic infiltration (TLI), and its relationship to other prognostic variables were investigated in 361 colorectal cancer patients admitted to our Institution for curative resection from January 1960 to December 1978. The presence of a local immune reactivity was significantly related to a less advanced stage of disease and a better differentiated tumour. A poorer prognosis was detected in patients with minor or no lymphocytic infiltration. TLI was the single most important prognostic parameter, according to the Cox model and to logistic regression analysis. These findings suggest that also TLI should be considered in the current Staging System of colorectal cancer.
Adult↗
[Doxorubicin in antiblastic hyperthermic perfusion in the treatment of advanced soft-tissue sarcoma of the limbs].
Different antineoplastic drugs have been associated to hyperthermia in the treatment of advanced soft tissue limb sarcoma with a good results in terms of conservative surgery (77%-97%), locoregional control (77%-87%) and overall survival (72%). Two different studies were performed: the first was carried out to analyze the doxorubicin-TNFalpha-hyperthermia association (three different trials) in terms of toxicity and efficacy of the treatment (tumor response, locoregional control, disease free and overall survival). The results showed that the trimodality association (doxorubicin TNFalpha and hyperthermia) is the best regimen able to obtain a 77% of objective response and 77% of limb sparing in patients candidate to amputation but may result in high local toxicity if high temperatures (>41.5 degrees C) were maintained during perfusion. The second study describes the employment of liposomal doxorubicin in hyperthermic antiblastic perfusion (HAP) in terms of tumor response, conservative surgery and toxicity; the maximum tolerable dose (MTD) of doxorubicin was 16 mg/l of perfused limb volume at the temperature of 41.5 degrees C; the conservative surgery was possible in 91% of the cases and mild (grade I and II) toxicity was observed in the perfused limb with high temperature (>41.5 degrees C).
Antibiotics, Antineoplastic↗
Extracapsular lymphnode metastases in the staging and prognosis of gastric cancer.
The aim of this study was to evaluate the influence of the degree of nodal involvement (extracapsular vs intracapsular) on survival of 121 patients radically resected for gastric adenocarcinoma with nodal metastases at the Department of Clinica Chirurgica I of "La Sapienza" University of Rome. Patients with extracapsular nodal metastases had a worse 10-year survival rate than those with intracapsular nodal involvement (7.9% vs 22.4%). A better prognosis among patients with intracapsular node metastases was observed in each p-TN subgroup. In the multifactorial analysis (3-way ANOVA) survival was correlated with the depth of invasion of the gastric wall and the degree of lymphnode involvement (p less than 0.01) but not with the level of nodal involvement (N1 vs N2). Our results suggest that the degree of nodal involvement is an important independent prognostic factor that should be considered in the current staging system for curative resection in gastric carcinoma.
Adenocarcinoma↗
[Tracheobronchial carcinoids: current therapeutic trends].
Tracheobronchial carcinoids are relatively uncommon neoplasms potentially curable with surgery. However, the extent of excision which results in the best long term local and distant tumour control is still controversial. A series of 522 patients who underwent surgical treatment for tracheobronchial carcinoids reported by the literature which included 52 cases of tracheobronchial neuroendocrine tumours observed between 1960 and december 1983 at the Institute of I Clinica Chirurgica of Università "La Sapienza" Rome was reviewed. Local recurrence rate range between 1% and 1.8% after major surgery and between 11.8% and 16.7%, after bronchial wall resection and endoscopic treatment respectively. Local recurrences were detected after a mean period of 110.2 month (median = 9 years). 15 years survival rate was above 70%. Long term prognosis was related to the degree of malignancy (typical or atypical forms) and locoregional (N) and distant metastases (M). Factors related to the possibility to obtain free margins by the surgical procedure (pneumonectomy/lobectomy or sleeve resections vs simple bronchial wall resection or endoscopic resection), the degree of bronchial wall involvement (endobronchial, iceberg, peripheral), the biology of primary tumour (atypical vs typical) and the presence of regional and/or distant metastases are of prognostic importance for both local and distant tumour control. The Authors describe their strategy for managing this disease: endoscopic treatment or simple bronchial wall resection are available for endobronchial typical carcinoid tumours. Atypical carcinoid neoplasms or tumours involving bronchial wall or peripheral lung parenchyma need more extended resection and lymphadenectomy.
Bronchial Neoplasms↗
[Age as a prognostic factor following excisional surgery for colorectal cancer].
On a series of 369 patients with colorectal cancer who underwent curative resections at the I Instituto di Clinica Chirurgica della Università "La Sapienza" of Rome between 1960 and 1980, age was related to survival. All patients were followed for a minimum of ten years; 79 of them were aged over 65 years and 290 under at the time of the operation. The survival was correlated to the age and to other prognostic parameters: post surgical stage (TNM UICC classification) degree of differentiation of the tumour (NG--Black classification), degree of lymphocytic infiltration of neoplasm (LI Black classification) as expression of immunological immune-response of the host. Patients less than 65 years old had a better survival than patients greater than = 65 years old (median survival 72 months and 44 months respectively) (p = 0.006). These differences where true in subgroups with stage 2 of disease (p TNM UICC) and a favourable immunological reactivity (LI greater than = 2). These results suggest a possible independent role of age in defining the outcome of patients with colorectal cancer.
Age Factors↗
[Immediate breast reconstruction and oncologic criteria: our current definition].
After a review of the literature, the authors attempt at a definition of the oncologically safe candidate to an immediate reconstruction after modified radical mastectomy for breast cancer. The analysis of the natural history of locally recurrent breast cancer indicates that the potential for its masking is negligible. Survival curves of patients submitted to immediate breast reconstruction are similar to those reported for historical controls. The ideal candidate for an immediate reconstruction is a stage I (negative axillary nodes) patient. As immediate breast reconstruction does not alter the prognosis of breast cancer patients nor does it harm the use of adjuvant therapies, the authors believe that even a well motivated stage II (positive axillary nodes) patient should be considered as a candidate for an immediate reconstructive procedure.
Breast↗
[Bilateral renal angiomyolipoma and the Bourneville Pringle syndrome in a leveled-off form. Description of a case and its treatment].
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Female↗
[Classification of therapeutic institutions according to the diagnosis of the patients hospitalized in them].
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Diagnosis↗
Biochemical characteristics and clinical applications of alpha-fetoprotein isoforms.
Alphafetoprotein (AFP) is an oncofetal glycoprotein that frequently reappears in sera of patients affected by hepatocellular carcinoma (HCC) and yolk-sac tumours (YST). In these cases AFP determination represents a useful marker for monitoring the therapeutic response and the clinical evolution of the neoplastic disease. AFP is a heterogeneous molecule with respect to the carbohydrate moiety and the different AFP glycoforms can be separated and characterized by their affinity for lectins, such as Concanavalin A (con A), and Lens culinaris agglutinin (LCA). Increased production of LCA-reactive AFP has been proposed as a specific and early marker for HCC, while Con A non-reactive AFP could be a marker for YST and gastrointestinal malignancies. In this review the molecular basis of AFP microheterogeneity and the clinical application of AFP isoforms will be discussed.
Carbohydrate Sequence↗
[Prognosis and immunomorphological characteristics in rectal cancer: results of a multivariate analysis].
The survival advantage of a pronounced lymphocytic infiltration within and around the primary tumor and some hyperplastic reactions in the regional lymph nodes in specimens of colorectal cancer has been reported in many studies. However, none of these studies allowed the grade of these immunomorphological reactivities to compete with more traditional prognostic variables, using the proportional hazard models. In this study the survival rates of 219 patients who underwent operation for rectal cancer were analyzed statistically according to sex, age, tumor site, type of operation, histology, nuclear grade, p-TNM stage of disease and to the following immunomorphological parameters: lymphocytic infiltration (LI) within and around the primary tumor, paracortical activity (PCA), cortical activity (CA) and sinus histiocytosis (SH) of the regional lymph nodes. The presence of an evident local and regional immune reactivity was significantly related to a less advanced stage of disease and better differentiated tumor. The multivariate survival analysis (Cox model) identified LI, PCA and SH and p-TNM stage as independent prognostic factors. Survival within each stage progressively increased in presence of one or more favourable immunomorphologic features. These results indicate that an adequate prospective evaluation of LI, PCA and SH should improve our ability to assess prognosis in rectal cancer and, therefore, allow a more rational utilization of adjuvant therapy.
Female↗
The role of the administration time of prophylactic antibiotic therapy in colorectal cancer surgery: a review of 6,069 patients from 36 randomized clinical trials.
The aim of the present report was to establish the effectiveness of different prophylactic antibiotic regimens and administration times in colorectal cancer surgery. Six thousand and sixty nine patients from 36 selected randomized clinical trials, published between 1980 and 1989, were reviewed. The occurrence of septic events, isolated bacterial strains, fever and postoperative hospitalization times were also analyzed. The therapeutic schedules that included the perioperative administration of antibiotics provided better results that those that did not (p. less than .0001 for infections both specifically related and unrelated to colorectal surgery). The number of postoperative administrations did not affect the clinical results, even if the predominant choice was to give more than one administration of antibiotics. A factorial design demonstrated that prolonging the perioperative administrations up to the postoperative period provided statistically significant benefits (p less than .0001) only with regard to the risk of infections that were not specifically related to colorectal surgery.
Anti-Bacterial Agents↗
[The effect of the degree of lymphocytic infiltration on the long-term survival of patients undergoing surgery for the exeresis of gastric cancer].
The predictive value of tumor lymphocytic infiltration was studied in 186 gastric cancer patients curatively resected. All patients were followed-up for over 10 years. LI was negatively correlated with p-TN stage of disease. A poorer prognosis was detected in patients with minor or no tumor lymphocytic infiltration. LI was an independent prognostic parameter according to the Cox model and logistic regression analysis. These findings suggest that LI should also have been considered in the current staging of gastric cancer.
Adult↗
[Alkaline phosphatase isoenzymes in a case of transient hyperphosphatasemia].
Authors reports the case of a seven months toddler with transient hyperphosphatasemia without clinical manifestations and no other hepatic or bone disfunctions. Resolution of both enzymes and bone isoenzymes occurs within 5 months.
Alkaline Phosphatase↗
Pattern of mucin gene expression in normal and neoplastic lung tissues.
This work evaluates the expression in lung cancer of the most well characterized mucin genes (MUC1, MUC2, MUC3) and of the recently described MUC4 in lung tissues, to check a correlation between the expression of any particular gene and this tumor. Hybridization with synthetic oligonucleotides obtained from a part of the sequences of MUC1, MUC2, MUC3 and MUC4, was performed on blotted RNA from 18 lung cancer tissue specimens and from 10 normal tissues samples taken, when possible, from the normal lung counterpart. By means of Northern blot analysis MUC1 revealed to be the most expressed mucin gene in lung cancer, followed by MUC4; by contrast, the expression of MUC2 and MUC3 was almost undetectable in all cancer specimens. The intensity of expression of MUC1 and MUC4 was always superior in cancer tissue than in the normal counterpart. As expected, the highest reactivity for MUC1 and MUC4 expression was observed mainly in the adenocarcinoma histotype which is mucin secreting. These findings represent a contribution to the study of mucin gene pattern in lung cancer, and, in particular, indicate that MUC4, in association with the MUC1 gene, seems to be strongly expressed in this neoplastic disease.
Base Sequence↗
EGF-R expression in ductal breast cancer: proliferation and prognostic implications.
We studied epidermal growth factor receptor (EGF-R) expression in relation to steroid receptor status, flow cytometric DNA content and S-phase fraction (%S) in a selected case series of 129 ductal primary operable breast cancer to determine the possible role of EGF-R in prognosis assessment. EGF-R expression was positively related with proliferation activity, suggesting that EGF-R could be involved in the regulation of breast cancer cell growth. We found about 80% of highly proliferating DNA aneuploid tumors in the EGF-R positive category, while the EGF-R negative tumors showed a lower frequency of highly proliferating DNA aneuploid tumors (57%), confirming the important role of EGF-R in breast cancer aggressiveness and progression. No relationship between EGF-R expression and steroid receptor status was observed. To better understand how EGF-R and estrogen receptor (ER) operate together to stimulate breast cancer cell growth, we analyzed the %S in the two groups of ER negative (ER-) and ER positive (ER+) tumors, stratifying the patients on the basis of EGF-R tumor positivity. Here breast tumor proliferation activity seems mainly to be induced by the stimulus of EGF-R, the %S values of the EGF-R negative tumors in the ER- and ER+ groups being 6.1 and 6.9%, respectively. Instead, the median %S of EGF-R positive tumors was 10% in the ER- class and 14% in the ER+ group. The analysis of the percentages of 5-year patient disease free survival were 84% for patients with EGF-R negative tumors and 61% for patients with EGF-R positive lesions, respectively. The data reported here further show the crucial role of EGF-R in breast cancer cell growth and that the EGF-R overexpression is indicative of a poor prognosis.
Adult↗