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G Bandieramonte

Publications and source records attributed to G Bandieramonte.

At least 37 records · Page 2Linked to original sources
PubMed1987

Diagnostic efficacy of the clinical-radiological-cytological triad in solid breast lumps: results of a second prospective study on 631 patients.

The clinical-radiological-cytological triad was used for diagnostic evaluation in 631 women over 30 years old with a solid breast lump, excluding clinically obvious cancers. All the lumps were subsequently removed surgically, except for 105 cases which spontaneously regressed within 2 months. 285 of the 526 nodules removed were cancers, and 162 of 285 (57%) did not exceed 20 mm in size. The sensitivity of the individual tests (physical examination, mammography and fine-needle aspiration cytology) of the malignant lumps was respectively 0.83, 0.73 and 0.60, and it increased to 0.95 when they were associated. Of the remaining 346 benign lumps the specificity of the three tests was respectively 0.60, 0.78 and 0.98. The predictive value of a positive response (certain or probable) to the three tests was 0.63, 0.74 and 0.94. The certain positive responses of cytology (131 of 285 cases) reached a predictive value of 1.00. The predictive value of a negative response for the three tests was respectively 0.81, 0.80 and 0.82; in the absence of positive responses, the predictive value for benignancy of the triad was 0.93 (177 of 190 cases). The systematic use of the diagnostic triad and the organizational platform allowed the clinicians to select malignant cases and plan inpatient/outpatient surgical treatment.

Adult↗
PubMed1986

Excision of oral leukoplakias by CO2 laser on an out-patient basis: a useful procedure for prevention and early detection of oral carcinomas.

Several epidemiologic studies have shown that oral cancer develops among individuals with a prior diagnosis of an oral premalignant lesion. Canceration chance in these patients is 17%, with the greatest rate occurring in the second year of observation. Based on this data, since 1981, 92 leukoplakias have been treated by out-patient laser surgery at the Istituto Nazionale Tumori of Milano. The therapeutic technique was laser excision to obtain a specimen for histology. Two groups were distinguished according to the diagnostic procedure. Thirty-three lesions (December 1981 to December 1982) were operated on without preliminary histologic examination, on the basis of a simple clinical diagnosis. Since January 1983 all leukoplakias have been biopsied in a systematic way and those negative for cancer treated with laser. Histology of the specimen showed 5 squamous cell carcinomas (15%) in the group of patients who did not undergo preoperative biopsy. Postoperative histology showed malignancy in 6 of 59 (10.2%) cases in spite of negative preoperative biopsies. Speckled and erosive leukoplakias had the highest canceration rate. Three of 11 patients with cancer were treated by knife excision or interstitial needle implantation because of margins in tumoral tissue or because they were not evaluable for injury by heat. Results have been satisfactory, only 2 of 54 followed leukoplakias and none of the cancers recurred during a 2 year follow-up.

Adult↗
PubMed1986

The use of laser in microsurgical oncology.

CO2 laser resection by freehand or microscopic technique versus laser vaporization were compared in a series of 136 consecutive surgical operations. Forty-nine lesions of the vulva, 61 of the oral cavity, and 19 of the penis were classified as dysplastic, in situ, or initially invasive lesions, ranging from 0.9 to 4.5 cm of maximum extension in width and from 0.4 to 4 mm in thickness (exophytic lesions). Twenty-two lesions were vaporized, whereas 114 were resected. An average of 12% discordance was found between pre- and postoperative histologic diagnosis among the resected group, thus indicating that the laser vaporization procedure is unsuitable for those lesions because it does not offer the entire surgical specimen. More constant depth of tissue removal, reduction of operating time, and safer use were also recognized as further advantages of the excisional technique. Resection under microscopic magnification (6 to 40 X) with the aid of the micromanipulation of the beam was used in 91 of the 114 resected lesions. This led to the optimal intraoperative resolution of the lesion borders, minimized the tissue burning effects because of the direction of the incision orthogonal to the tissue surface, and provided an 81% satisfactory histologic report of radicality, whereas the freehand-resected group reached only 40%. In conclusion, the maximum obtainable surgical precision can be achieved for the studied lesions with proper spot, focal length, and power density of the laser beam delivered through microscopic instrumentation.

Female↗
PubMed1986

Growth rate of primary breast cancer and prognosis: observations on a 3- to 7-year follow-up in 180 breast cancers.

The disease-free probabilities after 3 to 7 years of follow-up of 180 breast cancers of known doubling times were studied to assess the prognostic significance and clinical implications of the growth characteristics of primary breast cancer. Fast-growing tumours, N+ greater than 3, showed a prognosis significantly worse (P less than 0.01) than that of slow-growing tumours of the same class; no significant differences were found among N- or N+ (1-3) fast-, intermediate- and slow-growing tumours. Highly significant differences were found among fast- and intermediate-growing tumours with different degrees of lymph node involvement (respectively P less than 0.0001 and P less than 0.001), with the worst prognosis for N+ greater than 3 tumours. In contrast, no significant differences were found among slow-growing tumours of the different N classes. When the Cox model was applied, the relationship between lymph node involvement and doubling time was significant, as was the interaction term. It is suggested that growth rate and metastatic potential are not the same in primary breast cancers, and their relation should be investigated.

Breast Neoplasms↗
PubMed1985

Systematic use of the clinical-mammographic-cytologic triplet for the early diagnosis of mammary carcinoma.

Of about 8500 women with a minimum age of 30 years who had a breast examination at our Outpatient Clinic from April 1982 to March 1983, we found in 286 cases a clinically evident carcinoma, and in 534 cases an apparently benign or suspect solid lump. All 534 of these cases were subjected to the triplet clinical, mammographic and cytologic diagnostic investigation by needle aspiration within 1 to 4 days. The clinical judgment was based on a method of scoring of the characters of 9 physical features (Clinical Diagnostic Index) in use at our Institute. The results of the examinations were grouped into 5 categories: 1) certain benignancy or negativity of the examination; 2) probable benignancy (excluding the cytologic examination); 3) probable malignancy; 4) certain malignancy; 5) nonevaluability of the examination (excluding the clinical examination). Except for 80 cases with collectively negative examinations which were clearly or completely regressed at the control within 2 months, all the others were subjected to surgery. On the basis of the histologic examination (or if regression occurred), 284 of the 534 lumps examined were found to be benign or nontumoral, whereas the other 250 (47%) were carcinomas. Of the latter, 57% were not more than 20 mm in size, whereas in 67.6% there was no microscopic evidence of axillary metastases. Sensitivity of the clinical, mammographic and cytologic examinations was 0.79, 0.76 and 0.72, respectively; specificity 0.71, 0.75 and 0.94, respectively, and the predictive value for malignancy of the positive response of the three examinations 0.71, 0.75 and 0.93, respectively. The use of the diagnostic triplet demonstrated an overall sensitivity of 0.95, specificity of 0.59, and a predictive value for malignancy of 0.98 and 0.93 for benignancy. These results confirm the usefulness of the systematic use of the diagnostic triplet in solid breast lumps of over thirty aged women for the early detection of cancer.

Adult↗
PubMed1984

Laser phototherapy following HpD administration in superficial neoplastic lesions.

We report our preliminary clinical experience with hematoporphyrin derivative (HpD) injection and argon or dye laser irradiation for the treatment of 61 surface neoplastic lesions in 7 patients. Forty-three sites were multiple basal cell carcinoma in 5 patients, and the remaining 18 were cutaneous and subcutaneous recurrent breast carcinoma after mastectomy in the thoracic wall. The patients were selected on the basis of the lack of indication for conventional therapeutic modalities. The selection of irradiation procedures and laser source was based on the thickness of the lesion and extension of the disease. The photochemical reaction between HpD injected i.v. at a dose of 3 mg/kg body weight and the laser beam at a dose of 60 to 120 J/cm2 resulted in 75% favorable responses at the treated sites. Optimal therapeutic effects appeared to be critically dependent on total light dose and tumor infiltration patterns. The phototherapeutic technique proved to be effective in selected cases of neoplastic lesions, especially when conventional treatment modalities were poorly indicated or contraindicated.

Aged↗
PubMed1984

Carbon dioxide laser in scalp tumor surgery.

The widespread application of the CO2 laser in surgical treatment of tumor led us to verify its usefulness in selected cases of scalp tumor. Twelve selected patients underwent CO2 laser surgical excision plus vaporization of the wound base for infiltrating tumors during 1980-82. All patients showed associated pathologies that interfered with the traditional surgical excision and with anesthesiological practices. Our experience has confirmed the effectiveness of the laser technique under these conditions and with respect to subsequent plastic restoration.

Adenocarcinoma↗
PubMed1983

Pilot study with adjuvant hormone therapy in FIGO stage I endometrial carcinoma with myometrial invasion.

A pilot study with adjuvant hormone therapy in FIGO stage I endometrial carcinoma with myometrial invasion was carried out. All patients received total abdominal hysterectomy and bilateral salpingo-oophorectomy plus complementary radium therapy on the vaginal stump. After the conventional treatment, patients were randomly allocated to adjuvant hormone therapy or no further treatment. Hormone therapy consisted of gestonorone caproate (17 alpha-hydroxy-19-norpregn-4-en 3, 20 dione caproate) administered i.m. at the dose of 200 mg/week for 1 year. Of the 62 patients who entered the study, 51 were considered evaluable (24 with adjuvant hormone therapy and 27 with no further treatment). Five patients had a relapse: four of these were in the group with no further treatment. Actuarial relapse-free survival analysis at 5 years was 95.7% in the group of adjuvant-treated patients and 82.8% in the control group. Although there is no statistical significance, adjuvant therapy appears to result in an increase in relapse-free survival in the group of patients with deep myometrial invasion and undifferentiated carcinoma. Further studies are necessary to assess the effectiveness of hormone adjuvant treatment in FIGO stage I endometrial carcinoma with myometrial invasion.

Adenocarcinoma↗
PubMed1983

The outpatient-procedure effectiveness of laser treatments in oncology.

The outpatient procedure of CO2 laser surgery has been recently integrated into the routine activity of the National Cancer Institute, Milan. Specific operative protocols that are codified for laser outpatient selection after adequate staging by pathology are presented. Specific indications for gynecologic disease (preneoplastic disorders, CIN, VAIN, and VIN), and general-surgery neoplastic disorders (soft tissue sarcomas, lip and oral cavity lesions, breast lesions) are described. Details of the safety procedures, rules of application, laser instrumentation accessories and wattages, both with vaporization and excisional technique, are reported. An overall rate of 30% out of the 4,000 cases treated yearly are selected for laser treatment procedures on the basis of the evaluation of real advantages. The general advantages of laser surgical applications such as reduction of bleeding and postoperative pain, early and late complications; no-touch method; and patient acceptability--have been emphasized in the routine outpatient procedures. Reduction of the total costs and of the waiting list for hospitalization by the new procedures are finally considered.

Ambulatory Surgical Procedures↗
PubMed1983

CO2 lasers: beam patterns in relation to surgical use.

According to surgeons operating with a variety of CO2 lasers available at the National Cancer Institute of Milan (Coherent, Sharplan, Valfivre), these lasers have different cutting and coagulation properties. To identify what physical parameters might corroborate the subjective impression of the surgeons, a comparative study of the crater forms in perspex samples was performed. Perspex was chosen for its thermal properties (in fact, its thermal conductivity and diffusivity are similar to those of organic tissue) and because it allowed good visualization and measurement of crater characteristics. Depth of penetration, crater diameter, and extension of thermal damage were measured against power, focal length, and exposure time for each CO2 laser model. These results can be used as an index of behaviour of different surgical lasers. It appears that for fully characterizing the interaction of surgical lasers with the sample, it is necessary to specify either power, focal length, exposure time, or beam mode.

Biophysical Phenomena↗
PubMed1983

Laser oncology in Italy: experimental research and clinical applications at the National Cancer Institute, Milan.

CO2, Nd:YAG, and argon lasers have been used for 5 years for experimental and clinical procedures at the National Cancer Institute of Milan under the auspices of the National Research Council. Experimental data regarding tumor cell spread through lymphatic and hematic channels and cell viability in the fumes after CO2 laser irradiation are reported. New advantages in the combined treatment modalities have been demonstrated, since the synergism between the low power argon laser beam and chemotherapeutic agents (anthracyclines) was assessed on cell cultures and the least toxic and the most effective doses of the drugs were identified. Due to the optical properties of the laser beam, physical measurements of the delivered energy and mathematical calculation of the energy per tissue volume unit to be ablated increase the precision in microsurgery especially when conservative managements are indicated. Main applications in surgical oncology, and comparison versus conventional methods, both with vaporization and excisional techniques, according to specific therapeutic protocols, in general surgery, otolaryngology, gynecology, and endoscopy, even on an outpatient basis, are finally illustrated in a series of 600 cases.

Animals↗
PubMed1983

Androgen excretion in women with a family history of breast cancer or with epithelial hyperplasia or cancer of the breast.

Urinary testosterone and androstanediol were measured by gas chromatography in four groups of premenopausal subjects: 22 healthy women (control group), 21 healthy women with a family history of breast cancer (familiality group), 39 patients with breast lumps which consisted of ductal or lobular hyperplasia (hyperplasia group) and 18 patients with infiltrating breast carcinoma (carcinoma group). On the basis of normal values found in our laboratory, steroid levels were above normal in 4.5% of the controls, 4.7% of the familiality group, 38.5% of the hyperplasia group (P less than 0.01 vs controls) and 61.1% of the carcinoma group (P less than 0.001 vs control group). The mean testosterone level in the carcinoma group (11.3 +/- 6.78 S.D.) and the mean androstanediol level in the hyperplasia group (47.25 +/- 31.0 S.D.) were significantly higher than those of the control group (testosterone 6.25 +/- 3.48 S.D., androstanediol 32.55 +/- 20.0 S.D.). No significant difference was found in mean testosterone or androstanediol levels between the control group and the familiality group (testerone 5.41 +/- 3.6 S.D., androstanediol 29.38 +/- 15.89 S.D.). We conclude that increased excretion of androgenic steroids is a hormonal abnormality common to breast cancer patients and to patients with breast epithelial hyperplasia, but not to subjects with a family history of carcinoma of the breast.

Adult↗
PubMed1981

A clinical and pathologic study of 34 sarcomas of the uterus.

The clinical and pathologic features of 34 uterine sarcomas were studied to determine the natural history of the disease. Sixteen patients had leiomyosarcoma, five mixed mesodermal sarcoma, ten endometrial stromal sarcoma, two carcinosarcoma and one endolymphatic stromal myosis. The patients were treated without an unique protocol. At 3 years the actuarial relapse-free survival was 53.6%: 68.4% in stage I-II patients and 22.2% in stage III-IV patients. As regards the histologic subtype mixed mesodermal sarcomas had the best prognosis; endometrial stromal sarcomas the worst. The necessity of a uniform clinical and histologic classification as well as the importance of controlled clinical trials are pointed out.

Adult↗