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Biomedical subjects

G Corrado

Publications and source records attributed to G Corrado.

At least 19 recordsLinked to original sources

Chemotherapy with cisplatin, epirubicin, methotrexate in the treatment of locally advanced or metastatic transitional cell cancer of the bladder (TCC).

Forty patients with advanced transitional cell cancer (TCC) of the bladder were treated with cisplatin, epirubicin, methotrexate (PEM, every 3-4 weeks). If creatinine clearance was reduced to 40 ml/min, the usual full doses of cisplatin and methotrexate, 50 mg/m2, were proportionally reduced. 23 patients had full-dose (FD) therapy, 17 had reduced dose (RD) (40-20 mg/m2). Two patients achieved complete response and 17 partial response. The overall response rate was 19/40 (47.5%), 11/23 (48%) for FD and 8/17 (47%) for RD (p = 1.000). 17/40 pts (42.5%) had no-change and 4/40 (10%) had disease progression. The median duration of CR and PR was 32 weeks, range 4-82 (22 weeks, range 12-52 for FD; 32 weeks, range 4-82 for RD, cisplatin p = .7362). The main side effect was vomiting (35/40 pts, 87.5%, 20/23 = 87% for FD, 15/17 = 90% for RD, p = 1.000). Leukopenia was observed in 12 patients (30%, nadir 3,240 range 900-3,800, 6/23 = 26% for FD, 6/17 = 35% for RD, p = .7285), alopecia in 18 patients (45%, 15/23 = 65% for FD, 3/17 = 18% for RD, p = .004). The results of this study show that a dose escalation to 50 mg/m2 for cisplatin, epirubicin and methotrexate in the PEM regimen results in an increase in overall response (OR) (19/40 = 47.5%) with respect to a historical control using the same drugs at doses of 40 mg/m2 (12/35 = 34%). In patients with normal renal function the escalated dose was tolerated without a corresponding increase in toxicity.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged

The prognostic significance of DNA ploidy pattern in transitional cell cancer of the renal pelvis and ureter: continuing follow-up.

Among 190 patients operated on for transitional cell cancer of the renal pelvis and/or ureter from 1976 to 1990, 95 had their tumor studied by flow cytometry. Of these, the prognostic significance of the DNA ploidy pattern with respect to the standard pathologic features was assessed in a retrospective analysis, where survival information were updated to October 1991 and the mean follow-up of patients exceeded 5.5 years (longest follow-up: 15.5 years). Five and ten-year survival probabilities for the whole group were, respectively, 65.5 and 51%. Patients with a diploid tumor had significantly better survival rates than patients with tetraploid/aneuploid cancer (p less than 0.00001). The impact of the DNA ploidy on survival was confirmed by a multivariate analysis of prognostic factors, where only tumor grade (p less than 0.0001), tumor stage (p less than 0.0001), number of neoplastic foci (p = 0.022) and nuclear DNA pattern (p less than 0.068) had a significant influence on survival. In the group of patients with low-stage (pTa-pT1) and low-grade (G1-G2) transitional cell cancer of the upper urinary tract, the DNA analysis was unable to identify any subset of patients at higher risk for disease progression.

Carcinoma, Transitional Cell

Transitional cell carcinoma of the upper urinary tract: evaluation of prognostic factors by histopathology and flow cytometric analysis.

Prognostic factors in transitional cell carcinoma of the upper urinary tract were assessed with histopathological examination and flow cytometric analysis in a series of 127 patients operated upon between 1976 and 1988. In particular, we evaluated the usefulness of flow cytometry to identify patients who require adjuvant treatment among those with low grade and low stage disease (51% in this series). A multivariate analysis was done on 92 cases, considering patient age and sex, stage, grade and number of lesions (unifocal versus multifocal), site (renal pelvis versus ureter), presence of vesical tumors, recurrences along the urinary tract or in the bladder, type of operation and nuclear deoxyribonucleic acid (DNA) ploidy (diploid versus tetraploid/aneuploid tumors). Only the stage (p = 0.001), grade (p = 0.001) and, to a lesser extent, the DNA pattern (p = 0.031), as well as the number of lesions (p = 0.061) were determinant for prognosis. In regard to the subgroup of 41 patients with grade 2 or less, stage P1 or less tumors, no significant difference in survival was demonstrated between diploid and nondiploid tumor patients. However, 7 of 10 patients from the latter group are still under observation. Therefore, our conclusions may have to be modified in the future.

Adult

[Atherosclerosis and pediatrics. Role of nutrition of healthy children].

In the last few years many authors have studied atherosclerosis prevention in paediatrics. In our paper the most recent advances concerning the role of dietary intake in the normal child are described. Human milk and "prudent" diet with low intake of lipids and dietary cholesterol are discussed.

Adolescent

Low dose intermittent 5-fluorouracil, epirubicin and cyclophosphamide (FEC) in poor risk patients with advanced transitional cell bladder cancer: a pilot study.

Fifteen patients with locally advanced or metastatic bladder carcinoma and with cardiac and/or renal impairment were treated with a combination of 5-fluorouracil, 400 mg/m2, epirubicin, 40 mg/m2, and cyclophosphamide, 400 mg/m2. No complete or partial remissions were observed among the 14 evaluable patients. The toxicity level was very low. We are now trying to "tailor" platinum-based combinations to renal function.

Aged

Oncocytoma and low-grade oncocytic carcinoma of the kidney.

Oncocytoma is a term generally used to describe a neoplasm of the renal parenchyma consisting of well-differentiated cells with prominently eosinophilic granular cytoplasm. We report our experience with such tumors and with 4 cases of granular cell carcinoma (grade 2). We present the histopathology, surgical staging studies, treatment, and clinical outcome. Of the 10 patients, 7 are alive without evidence of tumor at a mean follow-up of 5 years from the initial treatment. Three patients have died, 2 from nontumor-related causes while the cause of death of the third patient is uncertain, possibly due to the tumor. Although well-differentiated oncocytic renal tumors are usually considered as uncommon when the diagnosis is made, nonaggressive behavior is expected. However, careful radiographic and pathologic examination is required to avoid the pitfall of overlooking a higher-grade, more lethal neoplasm which may be mixed with the well-differentiated oncocytic neoplasm and form a minority component. A wide resection, which in most cases is nephrectomy, is apparently curative and assures that complete pathological examination of the specimen can be accomplished. In more than 90% of the cases, the tumor is solitary and unilateral. Cases in which there are multiple tumors are often bilateral, and this finding may create diagnostic confusion.

Adenoma

Intratumoral echo-guided injection of interleukin-2 and lymphokine-activated killer cells in hepatocellular carcinoma.

Interleukin-2 has proved to be effective for the intralesional treatment of tumors of the bladder. There are examples in literature of hepatocellular carcinoma (HCC) treatment with lymphokine-activated killer (LAK) cells infused in the hepatic artery. We decided to check the effects of echo-guided intralesional injection of these cells in this disease. We treated 5 patients with inoperable hepatocellular carcinoma, following cirrhosis; in 4 cases the mass had a diameter less than 3 cm (small HCC) while in the remaining case it measured 7 cm. Tumor size remained unchanged in 3 of the 4 small HCC, and increased only slightly in the other (over a period of 10 months). This would appear to indicate that treatment halted neoplasm growth or at least slowed it down. The echo pattern of the lesions changed, with a constant reduction in echogenicity. Finally, in multiple control biopsies, fibrosis, present in only one case before treatment, was found fairly constantly after treatment. There were no significant side effects, apart from slight water retention in one patient. On the basis of our preliminary results, we consider it worthwhile continuing this study to establish the most suitable IL-2 doses and analyze in more detail the modifications induced in the neoplasm.

Aged

[Immunotherapy with transfer factor in hormone-resistant metastasized carcinoma of the prostate].

Fifty-six patients with metastatic hormone-resistant carcinoma of prostate (stage D3) were submitted to immunotherapy with a monthly intramuscular injection of predominantly specific transfer factor (TF) produced in vitro. Patient follow-up ranging from 1 to 8 years revealed completed remission was achieved in one patient, partial remission in 6, and there was no progression of the metastatic disease in 14 patients. The mean patient survival was 17 months, higher than the survival rates reported elsewhere. No negative side effects ascribable to the treatment regimen were observed. All the foregoing findings, particularly the absence of side effects, provide encouraging data on this treatment modality.

Bone Neoplasms

Spontaneous circadian fluctuations of prostate specific antigen and prostatic acid phosphatase serum activities in patients with prostatic cancer.

Spontaneous circadian variations of prostate specific antigen (PSA) and prostatic acid phosphatase (PAP), determined simultaneously by radioimmunoassay (RIA), were investigated by multiple sampling, over a 24-hour period, in 32 patients with prostatic cancer. In 29/32 patients (91%), the coefficient of variation of 24-hour values, for either marker, was greater than that of the RIA method at the same range of values; stage D patients showed the greatest spontaneous variability. Fluctuations around the mean of 24-hour values ranged from -65% to +85% for PAP, from -72% to +190% for PSA, occurring random and independently for each marker. Variability was about 20% greater for PSA than for PAP. The existence of spontaneous fluctuations should be considered in multiple marker evaluation of prostatic cancer patients.

Acid Phosphatase

[Papillary nephrocarcinoma: radiographic and echographic aspects].

Between 1976 and 1987, 395 patients with kidney tumors were studied with radiological techniques and sonography. In 37 cases (9.4%) histopathology diagnosed pure papillary renal cell carcinoma. Analyzing the radiographic patterns of these neoplasms, the authors observed constantly diminished vascularity (100%), frequent calcifications (35.1%) and necrotic areas (51.3%). Such X-ray features are not specific: nevertheless, their coexistence is strongly suggestive of papillary renal cell cancer. No consistent US pattern was found; however, necrotic areas were easily demonstrated in most cases. It must be stressed how patients with papillary carcinoma experienced a longer postoperative survival; it has not yet been established whether such favorable behavior is due to low biological aggressiveness or to earlier diagnosis.

Adult

Serum lipid pattern in beta-thalassaemia.

Serum lipids, phospholipid fractions and the composition of serum lipid fatty acids were studied in 20 children presenting beta-thalassaemia major, 20 heterozygous children and 20 normal controls. Total serum phospholipids, their fractions and cholesterol were significantly lower in patients with thalassaemia major. These changes were referred to hepatic damage and to severe anaemia, respectively. Some serum lipid polyunsaturated fatty acids were significantly decreased in patients with thalassaemia major as compared to heterozygotes and normal controls. Since these alterations are a sign of lipid oxidation, the causes of this phenomenon are discussed.

Child

[Efficacy and tolerability of nimesulide in inflammatory diseases of the genito-urinary system].

In a controlled clinical trial 80 patients of both sexes, aged between 19 and 70 years, with acute or chronic reacutized flogistic bacterial affections of the genito-urinary tract, were randomly assigned to anti-inflammatory treatment with nimesulide (200 mg/day p.o.) or placebo for a mean period of 9 days, in association to the specific antibiotic therapy. In the group treated with nimesulide a significant clinical improvement of the symptomatology was observed in the majority of cases. The therapeutic activity appeared quickly and complete remission of the symptomatology was achieved in a number of cases significantly higher than in the reference group. The tolerability of nimesulide was good.

Adult