Biomedical subjects

F Sartori

Publications and source records attributed to F Sartori.

At least 19 recordsLinked to original sources

PubMed2001

Surgical results for multiple primary lung cancers.

OBJECTIVE: The development of a multiple primary lung cancer (MPLC) is not rare in long-term survivors after curative resections. We analysed our experience in order to verify surgical results and long-term survival in our patients. METHODS: From 1971 to 1999, 80 patients with MPLC (two tumours each, total 160) were treated at the Division of Thoracic Surgery of the University of Padua. Our criteria for the definition of a synchronous or metachronous cancer are those proposed by Martini and Melamed. We had 19 patients with a synchronous tumour and 61 patients with a metachronous tumour. We performed 95 lobectomies, 5 completion pneumonectomies and 53 segmentectomies. Of 160 MPLCs, 60 were squamous carcinomas, 78 adenocarcinomas, 8 small cell lung cancers, 9 large cell lung cancers and 5 other tumours. Of 160 MPLCs, 140 were N0 disease (87.5%) and 20 were N1 or N2 disease (12.5%). RESULTS: The overall 30-day mortality was 2.5% (2 patients). Eighteen patients (22.5%) had postoperative complications. Survival at 5 and 10 years for all patients was 72% and 58%, respectively. Five-year survival for patients with metachronous and synchronous disease from the time of initial diagnosis of cancer was 85% and 20% (P=0.001), and 10-year survival was 58% and 0% (P=0.001), respectively. Survival after the development of a metachronous lesion was 51% at 5 years and 20% at 10 years. The 5-year survival of patients with metachronous tumours undergoing standard surgical procedures of the second tumour was 52%; the 5-year survival of patients undergoing atypical or segmental resections was 55%. CONCLUSIONS: Careful follow-up is recommended in all patients surviving curative resection. More accurate selection criteria for MPLC is required. An aggressive surgical approach is justified in patients with MPLC and offers the greatest chance for long-term survival even in the case of limited resection.

Adult↗

PubMed1999

The role of surgery in integrated therapies for non-small-cell lung cancer.

Surgery represents the best treatment for early-stage non-small-cell lung cancer (NSCLC). In selected cases, even locally-advanced cancers may be suitable for surgical treatment. The combination of chemotherapy (with or without radiotherapy) and surgery has proved potentially useful in improving survival, but pre-operative treatment may represent a risk factor for the onset of post-operative complications. Studies performed to date indicate the need for further multidisciplinary research with a view to identifying more advantageous treatment modalities, particularly for locally-advanced NSCLC.

Carcinoma, Non-Small-Cell Lung↗

PubMed1998

Cardiovascular adaptations to endurance training and detraining in young and older athletes.

In order to evaluate the influence of aging on cardiovascular adaptations to endurance training and detraining, 12 young (range 19-25 years) and 12 older (range 50-65 years) male cyclists were examined during the training and after 2 months of detraining. Twelve young and 12 older healthy sedentary males matched for age and body surface area were used as control groups. Each subject underwent a maximal exercise test using a cycle-ergometer in order to measure maximum oxygen consumption, an M-mode and 2D echocardiography in order to assess left ventricle morphology and systolic function, and a Doppler echocardiography for evaluating the diastolic filling pattern. During the training period both groups of athletes showed higher values of maximum oxygen consumption, left ventricular wall thicknesses, end-diastolic diameter and volume, as well as left ventricular mass, than their control subjects; in the older subjects the adaptation of the heart to aerobic training seems to be obtained mainly through a higher increase in left ventricular diastolic filling. In both groups no significant modifications in the ejection fraction and diastolic function parameters were recorded. After the detraining period the wall thicknesses decreased only in young athletes, while left ventricular mass and end-diastolic diameter and volume reduced only in older athletes. In conclusion, training and detraining induced nearly similar left ventricular morphological modifications in the two age groups, even though greater in the older athletes with respect to the ventricular mass and volume. No relevant differences were observed in the Doppler filling pattern between athletes and sedentary controls.

Adaptation, Physiological↗

PubMed1998

The role of diagnostic hysteroscopy and endometrial biopsy in assisted reproductive technologies.

OBJECTIVE: To study the incidence of unsuspected endouterine abnormalities in patients for whom IVF-ET repeatedly fails. DESIGN: Prospective study. SETTING: Infertility Unit of the Department of Obstetrics and Gynecology, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy. PATIENT(S): One hundred patients for whom two IVF-ET cycles failed in which > or =2 good-quality embryos were transferred. INTERVENTION(S): In-office diagnostic hysteroscopy and endometrial biopsy. MAIN OUTCOME MEASURE(S): Relation between IVF-ET failure and unsuspected endouterine abnormalities. RESULT(S): In 18 patients, hysteroscopy showed an important unsuspected endouterine abnormality. Fifteen of these patients did not become pregnant after IVF-ET, and 3 became pregnant but had a spontaneous abortion. Histologic examination of the endometrium revealed chronic endometritis in 1 patient and tuberculous endometritis in another. CONCLUSION(S): Previous studies have reported that the incidence of endouterine abnormalities is high in patients undergoing IVF-ET. Our data confirm the previous reports and lead us to conclude that diagnostic hysteroscopy should be performed on all patients before they undergo IVF-ET.

Adult↗

PubMed1998

Long term results of surgery and chemotherapy in small cell lung cancer.

OBJECTIVE: The aim of the study is to analyse long-term results of patients with small cell lung cancer (SCLC) treated at the same institution according to a prospective study including surgery, chemotherapy, and radiotherapy. METHODS: From 1981 to 1995, 104 patients with a proven histology of SCLC underwent surgery, chemotherapy, and radiotherapy. Fifty-one patients with operable stage I or II lesion received surgical resection followed by adjuvant chemotherapy and radiotherapy. Fifty-three patients with proved SCLC and clinical stage III received induction chemotherapy followed by surgery and radiotherapy. All patients received from four to six courses of chemotherapy and 36 had prophylactic cranial irradiation (PCI). All patients had follow-up for at least 1 year, and survival time was calculated from the date of the diagnosis until death or most recent follow-up. RESULTS: Ninety-six patients were male and eight female. We performed 29 pneumonectomies, eight bilobectomies, 66 lobectomies and one no resection. Regarding the clinical stage, 35 patients (33.6%) had stage I, 16 patients (15.4%) had stage II and 53 (51%) had stage III. Post-operative pathologic staging revealed stage I in 37 patients (35.6%), stage II in nine patients (8.6%), stage III in 45 patients (43.3%), and in 13 patients (12.5%) there was no more tumor. The 30-day mortality was 2% (two patients). Fourteen patients (13.4%) had post-operative complications. Fifty-one patients (49%) had a relapse. The median follow-up was 55 months. Twenty-six patients remain alive and 78 patients have died. The overall 5-year survival rate was 32%, with an estimate median survival time of 28 months; according to the pathologic stage, the survival data were 52.2%, 30% and 15.3% for stage I, II and III, respectively (P < 0.001). The 5-year survival was 41% in patients without SCLC after chemotherapy. CONCLUSION: As with non-small cell lung cancer, survival following surgery and chemotherapy clearly correlates with the stage. At present, it is not clear whether surgery is truly effective for patients with SCLC. In our experience, the complete elimination of small cell lung cancer is associated with an improvement in survival (41% at 5 years).

Adult↗

PubMed1997

Morbidity, mortality, and survival after bronchoplastic procedures for lung cancer.

OBJECTIVE: Bronchoplastic procedures represent an effective surgical therapy for benign lesions, tumors of low-grade malignancy and also bronchogenic carcinoma in patients with a limited pulmonary function. We analyzed our experience in order to verify the mortality, morbidity, and long term survival in our patients. METHODS: From 1980 to 1994, 217 patients underwent bronchoplastic procedures. We performed 92 bronchoplasties, 94 bronchial sleeves, and 31 tracheo-bronchial sleeves. Histologic examination revealed 133 epidermoid carcinomas, 28 adenocarcinomas, 11 small cells lung cancers, 5 large cells carcinomas, 2 adenosquamous carcinomas, 29 bronchial carcinoids, 6 adenoidocistic carcinomas, and 3 mucoepidermoid tumors. Regarding nodal status, 99 patients had N0 disease, 64 patients had N1 disease, and 54 patients had N2 disease. Thirty-six patients had preoperative irradiation and 181 patients had no preoperative irradiation. In 63 patients we used a perianastomotic pedicled flap; in 154 we did not use it. We considered all the 217 patients for the analysis of 30-day mortality and morbidity; of the 217 patients we analyzed long-term survival only in 179 because we excluded 38 patients with low grade malignant neoplasm. RESULTS: Twenty-seven patients (12.5%) had postoperative complications. The 30-day mortality was 6.2% (14 patients). Survival at 5 and 10 years for all patients but those with low grade malignant neoplasm was 49 and 38%, respectively. For patients with N0 status 5- and 10-year survival was 72.4 and 59.4%; for patients with N1 status these rates were 35.7 and 26.8%; for patients with N2 status, 5- and 10-year survival was 22 and 14.4%. Postoperative complication rates for patients with or without pedicled flap are not significantly different; however, the rates for patients with or without preoperative irradiation are significantly different. CONCLUSIONS: Bronchoplastic procedures are a safe and effective therapy for selected patients with pulmonary malignancy. Tracheo-bronchial sleeves are associated with high postoperative mortality and complication rates and these procedures should be limited to patients without N2 disease. Preoperative irradiation increases significantly the mortality and morbidity. A multivariate analysis shows that only the nodal status affects long-term survival (P = 0.0002).

Adult↗

PubMed1996

Pre-operative chemoradiotherapy in non-small cell lung cancer stage III patients. Feasibility, toxicity and long-term results of a phase II study.

The aim of this study was to evaluate the feasibility, the response rate and the effect on survival of full dose polychemotherapy delivered concurrently with bifractionated radiotherapy at a radical dose, in a subset of patients with marginally resectable or unresectable stage IIIA-B non-small cell lung cancer (NSCLC). Treatment consisted of two courses of cisplatin 100 mg/m2 for 1 day plus etoposide 120 mg/m2 for 3 days delivered from day 1 to day 22, plus radiotherapy delivered in two cycles of 2560 cGy each from day 3 to day 12 and from day 24 to 33 (total dose 5120 cGy in 31 days). The daily dose was 320 cGy in two equal fractions. After surgery, three additional courses of cisplatin plus etoposide were planned. From February 1988 to June 1991, 39 patients with stage III NSCLC (19 were judged as having marginally resectable, 20 as having unresectable disease) were entered into the study. Out of 39 patients (22 squamous cell carcinoma, 17 adeno/large cell carcinoma), 24 had stage IIIa (62%) and 15 stage IIIb (38%). Median PS was 80 (70-90). A total of 78 (74 evaluable) concurrent cycles of pre-operative chemoradiotherapy were delivered. The prominent side-effect was leucopenia: leucopenia > or = grade 3 at nadir occurred in 20 cycles (27%), thrombocytopenia > or = grade 3 at nadir in seven cycles (9%), 19 patients (54%) had a treatment delay of 1 week between the two cycles. Other important toxicities were sepsis in 5 patients (13%), oesophagitis > grade 2 in 9 patients (23%) and pneumonitis in 5 patients (13%). The response rate was 67% (6 CR (complete response), 16%; 19 PR (partial response), 51%). A resection was subsequently performed in 20 (51%) patients: 14 out of 19 marginally resectable (74%) and 6 out 20 initially unresectable (30%) patients. One other patient had an exploratory thoracotomy. Surgical specimens were tumour-free in 3 patients (14%); in 8 patients (38%) only microscopic tumour was found, and in 10 (48%) macroscopic residual tumour was found. Out of 23 patients attaining a CR, 5 relapsed locally and 11 only distantly. At present, with a follow-up ranging from 64 to 90 months, 34 patients have died, 1 is alive with recurrent disease and 4 (17%) are alive without evidence of disease. Median survival was 16 months, with 18% 3-year survivors and 13% 5-year survivors. Resected patients had a median survival of 21 months, versus 10 months for unresected patients (P = 0.01). No significant difference was evident between stage IIIa and stage IIIb patients.

Adult↗

PubMed1995

[Carcinoma of the lung involving the thoracic wall].

Carcinoma of the lung involving the chest wall causes severe pain. An unusual type of chest wall tumour is Pancoast's carcinoma, also called "the superior sulcus tumour". The long tumour involving the chest wall is considered a T3 lesion and hence stage IIIa. Reconstruction of the chest wall is generally achieved with autogenous tissue; The treatment of a superior sulcus tumour consists of preoperative radiotherapy followed by radical surgical resection of the lung, involving chest wall nerve endings. In Pancoast's tumour 5-year survival is reported as between 23% and 40% with combined irradiation and operation for T3-NO lesions.

Humans↗

PubMed1995

[Indications for and results of video-assisted thoracic surgery].

Between January 1991 and February 1996, and February 1996, 222 videothoracoscopic operations were conducted in 215 patients. Indications for video-assisted thoracic surgery (Vats) have included management of pneumothorax, (91), pleural effusion (59), lung nodules (41), mediastinal biopsy (8), need for lung biopsy (10), small endothoracic masses (6), haemothorax (4), gangliectomy in Raynaud syndrome (1), the removal of jugular vein catheter (1), and middle lobectomy for A-V fistula (1). Fifteen procedures were converted to thoracotomy; nine conversions were made for more extensive resection after a diagnosis of primary lung malignancy. Other reasons for conversion were adhesions (6). There was one complication (haemothorax). There were no intraoperative deaths. Mean operative time was 60 min. (median line); the median chest tube duration was three days and hospital stay five days. The video-assisted thoracic surgery procedures were safe, and for patients the advantages included less pain and earlier post-operative mobilization.

Adolescent↗

PubMed1994

Bilateral Pancoast syndrome in a patient with metachronous primary lung cancer.

A rare case of double Pancoast tumor in a patient with metachronous primary cancer of the lung was treated with irradiation and operation. Both tumors were managed with pulmonary wedge resection and excision of involved chest wall. Six years after the first operation the patient is doing well without pain and respiratory failure.

Adenocarcinoma↗

PubMed1993

Chemotherapy and operation for invasive thymoma.

Sixteen patients with invasive thymoma (stage III and stage IVA) were treated with chemotherapy and then operation. All tumors were considered nonresectable after first staging, and patients were treated with the following chemotherapy in 4-day courses, administered intravenously: cisplatin (50 mg/m2) and doxorubicin (40 mg/m2) on day 1, vincristine (0.6 mg/m2) on day 3, and cyclophosphamide (700 mg/m2) on day 4. The courses were repeated every 3 weeks, and toxic effects were well tolerated. Seven patients (43%) had a complete remission, and nine patients (57%) had a partial remission, with an overall complete remission plus partial remission rate of 100%. After chemotherapy all patients underwent operation. We performed 12 sternotomies and four posterolateral thoracotomies. At operation 11 patients had radical resection and five had partial resection. We administered radiotherapy in 11 patients who had histologically demonstrated tumor after operation. In five patients, the specimen showed only fibrosis; these patients received three cycles of chemotherapy but not radiotherapy. Median survival was 66 months with a 3-year survival of 70%. We believe that neoadjuvant chemotherapy with surgical intervention is justified for advanced invasive thymoma; a longer follow-up and a larger number of patients will determine the impact of this treatment on long-term survival.

Adult↗

PubMed1992

Carcinoma of the superior pulmonary sulcus. Results of irradiation and radical resection.

Fifty-six patients with superior sulcus syndrome were evaluated at the First Surgical Department of the University of Padua between 1981 and 1990. Forty-two patients with the characteristic of Pancoast's tumor received preoperative irradiation and then en bloc resection of the tumor, chest wall, and adjacent structures. Seven lobectomies and 35 segmentectomies or wedge resections were performed. There was one early postoperative death. Median survival was 14 months, and actuarial survival was 25% at 5 years. Patients with pain relief had better 5-year survival (36.4%) than patients without pain relief (9%). We have no patients with vertebral invasion who survived more than 1 year. Of the five patients with subclavian artery invasion, only one survived more than 1 year. Of five patients with N2 disease, only one survived more than 1 year. Our results suggest that pain relief after irradiation is a good prognostic factor, whereas N2 involvement and vertebral body and great vessel invasion are ominous factors. Another ominous prognostic factor is the Claude Bernard-Horner syndrome even if it is not a contraindication to resection.

Adenocarcinoma↗

PubMed1991

Anabolic steroid use in body builders: an echocardiographic study of left ventricle morphology and function.

To ascertain the effect of anabolic steroids (AS) on left ventricle size and function, M-mode and 2D echocardiographic evaluation was carried out in 14 body builders at the end of a phase of AS self-administration (8 +/- 3 weeks, mean +/- S.D.) and after a period (9 +/- 2 weeks, mean +/- S.D.) of drug withdrawal, as well as in 14 other body builders who had never made use of AS, and in 14 sedentary individuals. All the subjects were also examined anthropometrically. Ventricular septal thickness index was slightly greater in athletes using AS, compared to the other two groups (p less than 0.05), while left ventricle mass, the end-diastolic volume indexes and isovolumetric relaxation time, (a parameter of left ventricle diastolic function) were significantly increased (p less than 0.001) as well as the fat free mass (FFM), a marker of skeletal muscle mass. The non-users showed no differences in echocardiographic parameters, compared to sedentary controls. During the off treatment phase, the percentage of adipose mass increased and FFM decreased, while echocardiographic parameters did not vary significantly from on treatment values. The findings indicate that AS can induce an unfavourable enlargement and thickening of the left ventricle, which loses its diastolic properties with the mass increase. These modifications tend to persist following a short period of drug withdrawal.

Adult↗

PubMed1991

[Pleural fibroma: radiographic and CT findings].

Pleural fibroma is a rare and benign primary tumor, mainly asymptomatic and of big size due to its slow growth from visceral pleura. Six patients (5 males and 1 female) with this pathologic condition were studied; the tumors had diameters ranging 2.5-18 cm. The diagnosis was occasional in 4 patients, while the extant presented with dyspnea, cough, and thoracic pain. Two large fibromas originating from the left basal visceral pleura failed to be correctly diagnosed on plain films, while 2 small pedunculated lesions exhibited blurred outlines at the pleural origin. On chest films, neither rib erosions nor pleural effusions or calcifications were detected. CT scans showed 2 small lesions to have both shape and localization typical of pleural origin, while a third pedunculated fibroma mimicked an intrapulmonary mass. Three huge fibromas, especially 2 of them originating from left basal pleura, were misdiagnosed by CT and topographic criteria. CT images after intravenous injection of contrast medium showed mainly a mottled and irregular densitometric pattern. A correct diagnosis was very difficult to make also with the help of CT-guided biopsy (performed on 5 patients), because the specimens had a fibrous content and were very small due the elasticity of the mass against the needle. All patients underwent surgery and were cured when discharged. Histology was always necessary for a conclusive diagnosis to be made.

Aged↗

PubMed1990

Chemotherapy of invasive thymoma.

Thirty-two patients with stage III or IV invasive thymoma (14 women and 18 men; median age, 40 years) were treated at the Padua Medical Oncology Department from 1977 to 1988. All patients received the following chemotherapy in 4-day courses: 50 mg/m2 of cisplatin intravenously (IV) and 40 mg/m2 of doxorubicin IV on day 1; 0.6 mg/m2 of vincristine IV on day 3; and 700 mg/m2 of cyclophosphamide IV on day 4 (ADOC). The courses were repeated every 3 weeks, and toxic effects were tolerable. The radiologically defined overall clinical response rate (complete plus partial response) was 91% with 47% clinical complete remissions; median time to progression was 11 months (range, 0 to 96) and the median estimated (Kaplan-Meier) progression-free interval was 22 months. Five of the 15 clinical complete remissions were pathologically confirmed at thoracotomy. We believe the ADOC regimen qualifies for adjuvant and preoperative treatment of invasive thymoma due to the high complete response and overall response rates.

Adult↗

PubMed1990

[The effects of enalapril on basal arterial pressure at rest and during exercise and on cardiac performance in hypertensive athletes].

A dose of 10 mg of enalapril was administered once a day to regularly trained hypertensive athletes (mean age 39 +/- 8.9 range 29-51) in order to evaluate the effect of the drug on ambulatory blood pressure and on blood pressure and physical performance during stress testing. STUDY DESIGN. This investigation was a randomized, double blind, cross-over versus placebo trial. At first, subjects whose blood pressure met the entry criteria (casual diastolic blood pressure greater than or equal to 95 mmHg), were subjected to 24-hour ambulatory blood pressure monitoring and maximal upright bicycle stress testing including measurement of O2 uptake. Then they were randomly assigned to treatment with placebo or enalapril. After one month they repeated stress testing and then they were crossed over. Stress testing was repeated in all subjects after two months. The 24-hour ambulatory blood pressure monitoring was repeated in all subjects during enalapril treatment only, by a non-blind investigator. RESULTS. Ambulatory blood pressure decreased significantly during enalapril and no changes in heart rate were observed during the monitoring. The results of bicycle stress testing, both in basal and during the placebo test were comparable as regards blood pressure response, maximal workload, effort duration, maximal heart rate and VO2 max. With enalapril systolic and diastolic blood pressure decreased significantly during stress testing both versus basal test and placebo test at each workload considered including maximal workload. No changes were observed during enalapril as regards maximal workload, effort duration, maximal heart rate and VO2 max. CONCLUSION. Our results suggest that enalapril could be effective in treating hypertensive athletes because it reduces blood pressure during physical effort without affecting physical performance. We conclude that enalapril could be considered a first-choice drug in hypertensive athletes doing aerobic sports.

Adult↗

PubMed1990

[Pancoast's tumor].

Explore the source record for details and available documents.

Cobalt Radioisotopes↗

PubMed1990

[CT-guided percutaneous biopsy of adrenal masses. Experience of the technic in 54 neoplasm patients].

Cross-sectional CT and US imaging have allowed the visualization of adrenal glands anatomy and abnormalities. In cancer patients a unilateral or bilateral adrenal enlargement may result from metastasis because the adrenal gland is one of the most common locations for metastasis in thoracic and abdominal tumors. We report our experience in 54 patients who underwent adrenal biopsy for unilateral (44 cases) or bilateral (10 cases) masses during CT examination mostly for lung cancer studies. Twenty-nine of 54 patients (53.7%) had metastatic deposits in the enlarged parenchyma. Other lesions included various pathologic conditions such as primary malignant tumors (2 carcinomas, 2 lymphomas, and 1 pheochromoblastoma) (5.5%), pheochromocytomas (3.7%), nonfunctioning adenomas (14.8%), and simple hyperplasias (12.4%). Eight of 10 patients with bilateral enlargement were metastatic; the extant 2 had simple hyperplasia. Biopsy was useless in 5 cases (9.2%), especially in the beginning and due to poor technique. All procedures were carried out with 18 and 19 G needles and under CT guidance, after standard scanning. The posterior approach was initially used, for both right (15%) and left (7.4%) lesions, but 3 pneumothoraces occurred. At present, we prefer transhepatic approach for the right adrenal gland: this access route is, in our experience, the safest and quickest. Left adrenal masses were approached anteriorly through the left hepatic lobe; when possible, in other patients, we used an oblique posterior transrenal approach, even though macroscopic hematuria occurred in 2 patients, without sequelae. We never used trans-splenic approach, even though this access has been described in literature for pancreatic masses. Transhepatic and transrenal CT-guided biopsy for adrenal masses in cancer patients provides, in our opinion, a correct and unquestionable diagnosis of possible metastasis, also for lesions smaller than 3 cm.

Adenoma↗