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Biomedical subjects

F D'Addato

Publications and source records attributed to F D'Addato.

At least 37 records · Page 2Linked to original sources
PubMed1988

Complications of axillary, inguinal, pelvic and para-aortic lymphadenectomy.

Post-axillary lymphadenectomy complications have been checked in 1097 patients. Lymphedema occurred in 4.6% of cases, brachial injuries in 2% and necrosis with wound dehiscence in 0.44%. Pelvic lymphadenectomy complications have been studied in 139 patients who underwent Wertheim's operation and in 4 cases treated with Schauta-Mitra's operation for cervix or endometrium cancer. Para-aortic and pelvic lymphadenectomy complications have been considered in 92 patients who underwent Wertheim's operation, in 10 patients treated with anterior pelvic exenteration and in 1 patient who underwent posterior pelvic exenteration. The complications of para-aortic and pelvic selective lymphadenectomy have been checked in 101 patients. We had 3 peri-operatory deaths, 5 severe gastrointestinal complications (3 deceased for fistulae) and 2 intra-operatory iliac vessel injuries. Uretero-vaginal fistulae occurred in 6.2% of the cases also treated with radium-therapy and in 2.2% of the others. Intra/post-operatory bleeding was respectively 1500 +/- 450 ml and 450 +/- 300 ml. The complications of inguino-femoral and inguino-pelvic lymphadenectomy for vulvar cancer have been checked in 35 patients who had necrosis and wound dehiscence in all cases and lower limb thrombophlebitis in 2 cases.

Aorta↗
PubMed1988

Hormonal and surgical treatment of endometrial adenocarcinoma: actuarial survival.

We studied the survival period in two groups of patients with endometrial adenocarcinoma treated at the Chair B Institute of Gynecology and Obstetrics. The first series includes 30 of the 52 patients treated from 1976 to 1979. The second series includes 81 patients treated from 1980 to 1986. Lymph nodal positivity was present in 5 cases out of 30 patients belonging to Group I: all the interested lymph nodes were in the pelvic areas. Lymph nodal metastases were, instead, present in 10 cases as regard patients of Group II. Pelvic lymph nodes were involved in all the cases; in 5 of them also the paraaortic nodes were involved.

17-alpha-Hydroxyprogesterone↗
PubMed1987

Two cases of clinical Ib stage cervix carcinoma with exclusive metastases to presacral lymph-nodes.

There is regular progression of metastases through different stations of pelvic lymph nodes as far as para-aortic lymph-nodes in 81.1% of the cases examined of cervix carcinoma. In this paper we report two cases of squamous carcinoma of the cervix with metastases limited to one presacral lymph node, while other pelvic and para-aortic lymph nodes were free. These cases are two examples of irregularity of invasion of metastases from cervix carcinoma. It is extremely rare that presacral station is single and first invaded without extension of lower lymph nodal level. Our technique of pre-sacral lamina excision in connection with the inferior bridge of para-aortic and para-caval connective tissue during para-aortic lymphadenectomy is confirmed. The fatal outcome of the first patient's case is related to such risk factors lymph nodes metastases, deep infiltration of the cervix and involvement of lower section of the uterus. The second patient was free of disease within four months from surgery.

Aged↗
PubMed1987

Lymph nodal metastases and the clinical stage of cervix carcinoma.

It has been proved that surgery is essential both for therapy and for diagnostic staging of gynaecological cancer. We have studied 131 patients who underwent pelvic and paraaortic lymphadenectomy. Out of the cases of the 1st clinical stage, the staging error was 16.4%. 10 cases were understage: 3 belonged to the 2nd surgical stage, 6 to the 3rd one and 1 to the 4th one. Out of 61 patients at the 2nd clinical stage, 44.2% were overstaged and 36.1% were understaged; in fact 16 belonged to the 3rd and 6 to the 4th surgical stage. 1 woman of the 6 belonging to the 3rd stage was at the 4th surgical stage. All 3 patients of the 4th stage had both clinical and surgical correct staging. The results show the determinant meaning of node metastases and their spreading for a correct surgical staging. According to the regular distribution of metastases, it has been shown that in 81.1% there is a regular rule while in 18.9% there is not a metastatic regular distribution. This study confirms the reliability of our surgical statement based on lymph nodal radical excision.

Female↗
PubMed1987

Primary tumor receptorial status and axillary metastases: their prognostic significance.

Data on the prognostic value of receptorial status are controversial. On the basis of our results, receptorial status has no significance as an independent role; only the number of involved nodes and hormonal therapy have this prognostic role. Free of disease survival curves according Kaplan and Meier show that there are no statistically significant differences either in patients with low neoplastic recurrences (pN0) or in those patients with high risk (pN1) among women with tumor ER+ and ER-. Among 291 pN0 patients there was no relation between receptorial status (negative from 3 to 9 fmol/mg) and results of therapy on the follow-up. Among 248 pN1 patients therapy with tamoxifen had an influence on free interval both in the group with a low receptorial status and in particular in that with high receptorial level; no effects of therapy on the ER- patients. In the group of 248 pN1 patients with high receptorial status, the therapy was more successful in the group with a medium lymph nodal risk (from 1 to 3 positive nodes) and also in the group with G1 or G2. With regard to the study of the relation between lymph nodal metastases and receptorial status, we can state that lymph nodal levels data gives the main prognostic factor of risk. Therefore lymphadenectomy involving the three lymph nodal levels appears to be the crucial point in diagnostic and therapeutic surgical strategy of breast carcinoma.

Axilla↗
PubMed1987

Surgical strategy management following lymph nodal positivity at the three levels (a retrospective and perspective study).

The purpose of this study is to evaluate the type of distribution, regular or irregular, of metastases in lymph nodes of I, II and III level. We inted also to establish if the levels of lymph nodal areas represent an evaluation index of prognostic risk more effective than other ones. The results evidenced that in 19.2% of all the classes N+ metastases were not increasing regularly from the level I to the level III. The influence of seven factors on disease free survival has been evaluated: pT, pN, number of metastatic nodes, ER+ or ER-, PgR+ or PgR-, grading, metastatic level at axillary lymph nodes. The present report points out that only the extent of tumor and lymph nodal level have a statistically significant influence on disease free survival. Comparison among disease free survival curves stage N0 with N+ at I level and with N+ at II level revealed that there is no significant difference of survival among these classes, while the comparison between the first 3 classes and N+ at III level is statistically significant.

Adult↗
PubMed1985

Primary choriocarcinoma of the fallopian tube: report of a case.

A case of the relatively rare condition of a choriocarcinoma in the fallopian tube is presented. The patient apparently recovered completely and quantitative beta hCG assay demonstrated negative results after TAHBSO and adjuvant chemotherapy. This brings the total cases reported to 77.

Adult↗
PubMedDate not supplied

Pathologic features of endometrial carcinoma in elderly women.

It has been estimated that more than two-thirds of cancers occur in people over 65 years of age: endometrial cancer (EC) is the most common gynaecologic cancer in the U.S. and represents the fourth most common malignancy in women. Some authors have reported that EC in elderly women was more aggressive, histologically less-differentiated and often non-endometrioid when compared with EC in the younger population. The purpose of this retrospective study is to evaluate the pathologic features of EC in women 70 years old or over compared with those of younger patients. Between 1987 and 1997, 174 patients with EC were surgically treated: 52 women were 70 years old or over. Two-thirds of both groups had surgical Stage I tumors: 54% of surgical Stage I tumors in the elderly had myometrial invasion more than 50% compared with 32% in the younger group (p<0.01). On the whole 37% of elderly patients had Stage IC tumors compared with 21% in younger women (p<0.01). Seventy-five percent of elderly women had Grade 2 or 3 tumors compared with 55% of younger patients (p<0.005). The majority of EC was endometrioid in both groups: 8% of elderly patients had clear-cell carcinomas compared with 4% of younger women (p not significant). No elderly patients showed nodal metastasis (0 out of 10): 9% of younger women had pelvic or para-aortic metastasis. The median follow-up was 78 months. The overall survival in the elderly and in the younger group was 80% and 93%, respectively (p<0.01): in elderly women overall survival significantly varied according to histotype and depth of myometrial invasion in Stage I tumors. In conclusion patients 70 years old or over have a high probability of surgical Stage I EC but a significantly higher probability of deep myometrial invasion and less-differentiated tumors than younger women: the prognosis w as good but poorer than for younger patients.

Adult↗
PubMedDate not supplied

[Neuroendocrine factors in postpartum blues].

A very considerable proportion of women, estimated from 50 to 80 per cent, experience a noticeable period of emotional distress, usually mild or transistor, between the third and the tenth day postpartum (postpartum blues: PPB). The onset of this syndrome conform to a practically immutable of timing-symptoms are almost never noted before the third day postpartum (latent period). After this period, in approximately 10 per cent of women, occurs a depression: postpartum depression (PPD), and last to 8 weeks. Neuro endocrine factors in the pathogenesis of postpartum depression is discussed: thyroid, pituitary and adrenal cortex are reviewed. Considerable evidence support that the late postpartum syndromes are associated to psychological stress of childbirth with postpartum decrease of placental steroids, estrogen and progesteron, with high levels of pituitary prolactin.

Depression↗