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Biomedical subjects

F Cicconetti

Publications and source records attributed to F Cicconetti.

At least 19 recordsLinked to original sources
PubMed2005

[Surgical treatment of breast cancer in the elderly].

AIM: The aim of this study is to evaluate the prognosis and survival of patients aged over 70 years and affected by breast cancer. METHODS: From January 1994 through December 2000, 56 patients with breast cancer aged 70 years or older were submitted to surgical treatment. Associated diseases were present in 24 patients, while no patient showed distant metastases at the time of hospital admission. All patients underwent breast preserving surgery regardless the tumour size and in 31 subjects out of 56, the surgical procedure was performed under local anesthesia. An axillary lymphectomy was associated in 46 patients. According to the TNM staging system, tumours were classified as follows: 10 T1Nx, 18 T1N0, 9 T1N1, 7 T2N0, 10 T2N1 and 2 T3N1. RESULTS: There was no postoperative mortality and in 6 cases an axillary seroma was observed. Radiotherapy and tamoxifen treatment followed surgery in all cases. The median follow-up was 44 months. Nineteen patients (34%) died during the follow-up: 6 patients of cancer progression with a specific cancer-death of 10.7% while 13 patients (23.2%) died because of concurrent diseases. A local relapse (1.8%) was observed in a single patient 2 years after the primary surgical treatment and, at 3 years, 37 patients (66%) are alive and disease-free. Long-term survival was significantly related to the stage of disease at the time of surgery, while our data do not allow any conclusions concerning the impact of axillary dissection on long-term outcome. CONCLUSIONS: In conclusion, results for breast cancer therapy are comparable in old and young patients and therefore strategies and treatment protocols should be similar, breast preserving surgery followed by radiotherapy and ormonal treatment being ''the gold standard''.

Adenocarcinoma↗
PubMed2003

The surgeon's decision as a prognostic factor in a pool of patients with colorectal cancer coming from different institutions.

Different pathological and predictive factors are used to stratify patients submitted to radical surgery for colorectal carcinoma. In addition to stage and histotype, the surgeon's technique and decisions also appeared to affect the prognosis. The aim of the present study was to evaluate if the extent of lymphadenectomy was associated with a different long-term outcome in a pool of 117 patients. In particular, in patients classified as Dukes' B, some evidences seem to suggest that the staging procedure depends on a correct surgical lymphadenectomy with a higher risk of understaging colorectal carcinomas when the number of removed nodes is limited. Moreover, the promptness in forwarding patients to the chemotherapist seems to influence the disease-free survival.

Colorectal Neoplasms↗
PubMed1997

Increased number of cancer cells in bronchial washing fluid detected by combining conventional cytology and high-resolution flow cytometry.

The present study was performed to improve early lung cancer diagnosis in bronchial washing fluid, thereby increasing the diagnostic sensitivity of bronchoscopy by means of high-resolution flow cytometry (FC). We combined dual-parameter DNA/protein FC and conventional cytology in bronchial washing fluid samples from 112 patients with neoplastic and non-neoplastic lung diseases and found 43% of histologically confirmed tumor cases to be cytologically positive; 63% of the tumor samples were aneuploid, 52% of the aneuploid cases were cytologically positive and 48% were negative. In the negative cases, FC was an independent diagnostic factor. In 32% of the cases, FC also failed to detect abnormalities. However, the combination of both techniques increased the sensitivity in detecting neoplastic cells to 73%. Furthermore, simultaneous DNA/protein analysis allowed the recognition of aneuploid cell lines not detectable by single DNA measurement. Identification of aneuploid subpopulations by dual-parameter analysis in cytologically negative one-parameter FC "diploid" samples assumes an important diagnostic value. Dual-parameter DNA/protein FC is a valuable technique that increases the diagnostic yield of bronchoscopy with no risk for the patient and a low additional cost.

Aneuploidy↗
PubMed1997

[Use of endoprosthesis in the treatment of airway pathology].

In patients affected by benign or malignant inoperable airway obstructions, therapeutical options include endoscopic treatment by Nd-YAG laser therapy, tracheobronchial dilatations with rigid or flexible bronchoscope, and inflating balloon dilators. Metal self-expanding or silicone stents allow to obtain stable results. Our experience is based on the use of 14 stents (10 Dumon and 4 Wallstent) in 13 cases of stenosis either due to vegetating malignant tumours not amenable to surgery or benign stenosis. In the following 24-48 hours both subjective and objective changes of the pulmonary function, blood gas analysis and radiologic aspects were observed. The results showed an improvement in the respiratory parameters and a sensible improvement in the quality of life.

Aged↗
PubMed1995

[Lung transplantation. Progress and perspectives].

Techniques and indications for lung transplantation evolved significantly in the past few decades, at present there is a resurgence of interest in single- and double-lung transplantation for end-stage disease. The surgical procedure has been recently simplified and complications at the tracheal anastomosis have been significantly decreased. Many problems, common to organ transplantation, remain to be solved including availability of suitable donor organs, the ability to effectively treat organ rejection and improve the immunosuppressive regimens. The authors report a review of the international literature of the last three years, carrying on a critical analysis with the aim of identifying the problems related to this organ transplantation, progress in the research filed, complications and results.

Anastomosis, Surgical↗
PubMed1993

The importance of heterogeneity and of multiple site sampling in the prospective determination of deoxyribonucleic acid flow cytometry.

Multiple fresh specimens from 59 nonsmall cell carcinomas of the lung, 38 carcinomas of the gastric tract and 55 carcinomas of the colon and rectum were analyzed by deoxyribonucleic acid (DNA) flow cytometry (FC) after radical resection to evaluate tumor ploidy as an independent prognostic factor. The minimum follow-up period was five years (range of five to ten years). Aneuploidy was observed in 98.0 percent of carcinomas of the lung, in 70.9 percent of carcinomas of the colon and rectum and in 63.1 percent of carcinomas of the gastric tract. FC DNA heterogeneity, in terms of different number of DNA stem lines or different DNA indices between core and periphery, or both, was found in 50.0 percent of carcinomas of the lung, 47.0 percent of carcinomas of the colon and rectum and in 34.5 percent of carcinomas of the gastric tract. A diploid pattern was more frequently observed in less advanced stages of the gastrointestinal tract. By univariate analysis (Kaplan-Meier), patients with carcinoma of the lung with hypodiploid or hypertetraploid peaks, or both, and aneuploid gastric tumors had poorer prognosis. These differences were only marginally significant. Cox analysis demonstrated that the single most important prognostic variable for predicting the overall survival rate was the stage of disease. Tumor DNA content can be considered a marker of advanced stages, particularly in tumors of the gastrointestinal tract, but there is no evidence that it is an independent prognostic variable able to predict long term survival in patients who have been radically resected.

Adenocarcinoma↗
PubMed1991

Closure of a tracheoesophageal fistula by bronchoscopic application of fibrin glue and decontamination of the oral cavity.

A tracheoesophageal fistula was successfully closed with a fibrin adhesive applied by means of a fiberoptic bronchoscope, instead of by esophagoscopy. To facilitate closure of the fistula, the technique was combined with decontamination of the oral cavity, to avoid bacterial contamination. The procedure is proposed as an alternative to surgery for critically ill patients.

Administration, Topical↗
PubMed1987

Prognostic significance of flow cytometry in lung cancer. A 5-year study.

Flow cytometrically determined cellular DNA content has been measured on specimens from 101 patients affected by lung cancer (40 epidermoid cell carcinoma, 22 adenocarcinoma, 21 large cell carcinoma, 11 small cell carcinoma, and seven undifferentiated carcinoma), and one by mesothelioma. Ninety-eight of 102 (96%) patients with neoplastic disease evidenced the occurrence of at least one cytometrically aneuploid cell subpopulation. Fifty-five of 102 (54%) cases evidenced the occurrence of multiclonality, that is, the presence of more than one aneuploid stem cell line. However, the incidence of multiclonality in lung carcinoma was statistically different in surgical cases (where multiple site sampling from the primary and lymph nodes was possible) in comparison to the nonsurgical ones (e.g., bronchial washing): 48/77 (62%) and six of 24 (25%), respectively. Therefore, only the 77 surgical patients were used for further analysis. The cases were classified according to the DNA index (DI) in the following way: Group A (tumors with one or more stem lines with DI ranging from 1 to 2) and Group B (tumors with at least one stem line with DI less than 1 or greater than 2). A significant correlation has been found between the cytometric ploidy condition so defined (Groups A and B) and the tumor mass doubling time (DT), Group B being associated with fast growing tumors (DT lower than 90 days). A statistically better 12-month survival rate (5-year maximum follow-up) was observed in Group A (88%) in respect to Group B (47%) and is evident in the patient survival time course. A better prognostic indication can be achieved by stratifying the patients according to both the cytometric ploidy condition and the tumor DT. Flow cytometric data can usefully contribute to the prognostic assessment of lung carcinoma provided that representative cellular material is collected by multiple site sampling.

Actuarial Analysis↗
PubMed1985

Role of delayed cutaneous hypersensitivity reaction in classifying patients with bronchial carcinoma.

Cell-mediated immune response was evaluated in 150 patients with histologically confirmed bronchopulmonary carcinoma using bacterial and fungal recall antigens injected intradermally (PPD, candida, trichophyton). In the study group negative skin test reaction was found in 51 of 150 patients (34.0%), whereas in the control population it was found in 5 of 33 cases (15.1%) (p less than 0.05). Histologic cell type and stage of disease were defined for each patient. It was possible to calculate the growth rate of the primary tumor only in 68 of 150 patients, and it was recorded as doubling time. Evaluation of the skin test reaction in each prognostic subgroup showed no statistically significant differences. The only statistically significant differences were found when each prognostic subgroup was compared with the control population according to the frequency of a negative response to the skin test, particularly in stage III M1 (p less than 0.05) and stage III M0 (p less than 0.02). The delayed cutaneous hypersensitivity studied with recall antigen stimulation was mainly correlated with the stage of disease, and it should not be considered as an independent prognostic factor.

Candida↗
PubMed1983

A new multiparametric classification in lung cancer patients - S.M.I.G.

The classification of bronchogenic carcinoma as a function of the prognosis is still an open field. The evaluation of stage, by use of the TNM system, and histologic cell type is not sufficient to guarantee a correct prognosis. The growth rate of the neoplasm is another important parameter. We propose a classification that takes into account the stage (S), histologic cell type (M), immune status (I) and the growth rate of the primary tumor (G): S.M.I.G. We studied 90 lung cancer patients according to the S.M.I.G. classification and we observed that their prognoses were directly correlated with their S.M.I.G. scores (the higher the score, the higher the 10-month mortality rate). The mortality rates within the first 10 months of follow-up were respectively 0%, 0%, 36.36%, 68%, 90.9% for the 5 groups obtained by S.M.I.G. The difference is statistically significant (P less than 0.0075) and there is a linear correlation between the mortality rate and the score assigned to each group (R = 0.943; P less than 0.05). The S.M.I.G. classification can predict the prognosis more efficiently than the usual classification (TNM) and histological cell type.

Adenocarcinoma↗
PubMed1982

TNM staging in lung cancer: role of computed tomography.

Current procedures to determine the clinical staging of disease in patients with lung cancer are lacking in accuracy, particularly regarding the presence of metastatic disease. We have evaluated the use of computed tomography (CT) of the chest, brain, and upper abdomen for clinical staging of the extent of disease in 113 consecutive patients with histologically confirmed carcinoma of the lung. Comparisons with mediastinoscopy and surgical findings were made regarding the extent of primary tumor in 47 patients and nodal involvement in 41 patients. The CT scan showed a sensitivity of 86.9%, a specificity of 91.6%, and an accuracy of 89.3% for extrapulmonary extension of the primary tumor and a sensitivity of 50%, a specificity of 96.5% and an accuracy of 82.9% for mediastinal node involvement. Thirty-two of the 85 patients studied by total body CT scan had distant metastasis, of which 24 (75%) were clinically silent. Thus 28.2% of the 85 patients studied had asymptomatic metastatic disease. We conclude that CT of the chest, brain, and upper abdomen is a reliable procedure for staging lung cancer.

Brain↗
PubMed1980

[Bronchopulmonary carcinoma: influence of type of resection on long term survival].

A statistical comparison between survival and type of resection: Lobectomy and pneumonectomy was made out of 108 patients who had undergone curative resection for lung cancer (with a minimum 3 years follow-up). Analysis was first made on the whole series, then the patients were classified according to histological type (W-PL) or staging (TNM) and finally stratified in 2 control levels (stage and histological type). There was a better prognosis for lobectomy than for pneumonectomy, referring to a single subgroup, but not in a statistically significant way. There was a better prognosis for patients who had been operated for lobectomy S(2) 2 LOB with a 36 months survival for 85%. There were better results for squamous cell carcinoma stage I and II S(2) 1 PNE, for those patients who had been operated for pneumonectomy with a median survival of 32 months and over 3 years survival for 41.7%.

Follow-Up Studies↗
PubMedDate not supplied

Activity of ruboxyl, a nitroxyl derivative of daunorubicin, on experimental models of colorectal cancer metastases.

We evaluated the activity of ruboxyl (Rbx), a nitroxyl analogue of daunorubicin (Dauno), in experimental models of hepatic metastases from colorectal carcinoma (CRC) and compared it with its parent compound and with 5-fluorouracil (5FU). In mice treated by intraperitoneal injections Rbx and 5FU proved more effective than Dauno: the Index of Inhibition of Metastases in comparison with controls was 43% for Dauno, 70% for 5FU and 84% for Rbx. In BDIX rats implanted with the syngeneic cell line DHD K12/TRb, both Rbx and 5FU, administered as a continuous intravenous infusion for 7 days, reduced the development of liver metastases from a median of 23.8 +/- 2.16 for controls to 3.2 +/- 1.3 for 5FU and 1.0 +/- 1.4 for Rbx (p < 0.0001 versus controls for both treatments): the comparison of Rbx and 5FU showed a trend in favour of this new anthracycline. Median survival was prolonged from 40.6 +/- 3.4 days in controls to 56.0 +/- 5.8 days with Rbx and 58.0 +/- 4.69 days with 5FU. Considering that in a phase I study Rbx showed only minor and manageable toxic side effect, its activity in the clinical treatment of CRC metastases may deserve further attention.

Adenocarcinoma↗