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Biomedical subjects

G Gardani

Publications and source records attributed to G Gardani.

At least 37 records · Page 2Linked to original sources

[Radiotherapy of local recurrences of surgically treated rectal and rectosigmoidal cancer].

Local surgical failures of rectal and rectosigmoidal cancer are often observed and represent a heavy clinical problem from the viewpoint of quality of life. After having referred bad results of radiotherapy in a group of 55 patients locally relapsed after radical surgery, the authors analyse causes of therapeutic failure, underlining that ineffectiveness of radiation treatment comes mainly from late and, frequently, not complete diagnosis. Computed tomography must be currently considered the best way for monitoring these patients in order to get an earlier detection and the most correct radiation treatment plan.

Humans↗

[Role of teletermography in the diagnosis of primary tumors of soft tissues and bones].

The thermographic behaviour of bone and soft tissue tumors (168 malignant), submitted to this examination from 1971 to 1981, has been retrospectively analyzed and statistically evaluated. In the group of malignant neoplasms, thermography reached a good sensitivity (81.5%), a little better (but not significantly) in soft tissue tumors. Mainly three pathological features have been analyzed: histological type, size and site of neoplastic masses. None of them appears to be related with the result of thermographic examination. The authors emphasize (also from a possible prognostic point of view) the peculiar behaviour of Ewing's sarcoma, whose tendency to uniform distribution through the different thermographic classes cannot be currently explained.

Bone Neoplasms↗

Oophorectomy in advanced breast cancer: clinical radiologic correlations.

The radiograms of the chest and skeleton of 49 patients with advanced breast cancer treated with bilateral ovariectomy were reviewed. The modifications in the secondary localizations and/or their appearance after castration were compared with the findings of the clinical examination. Appearance or progression of intrathoracic lesions, like the appearance or progression of osteolytic lesions, corresponded to a progression of the disease in other sites. Osteoblastic evolution of osteolytic lesions and the appearance of osteoblastic lesions in bones undamaged before ovariectomy were signs of a favorable response to therapy. The response of chest and bone metastases is usually rather early, and the first radiographic survey should be performed about 3 months after ovariectomy.

Bone Neoplasms↗

[Teleradiography and tomography in the search for pulmonary metastases in 132 cases of soft tissue and bone neoplasms].

In recent years whole lung tomography (WLT) has been considered mandatory in the staging of some neoplastic diseases, particularly of soft tissues and bone tumors. Since WLT is an exacting roentgen examination, its usefulness was evaluated by analysing 132 consecutive patients submitted to orthogonal chest roentgenograms and WLT, from January 1979 to October 1981 at the National Cancer Institute of Milan. A comparison between WLT and traditional chest X-ray examination was performed in order to evaluate how much tomography is significantly useful in improving diagnosis of lung metastases. From this analysis, the authors conclude that WLT is generally unnecessary when chest roentgenograms are negative, whereas it is useful when single or multiple lung metastases are already evident by traditional X-ray examination. In these cases WLT allows a more accurate identification of the metastases from the point of view of their number and site, which is important not only for the treatment choice but also for the check of its effectiveness.

Bone Neoplasms↗

[Radiological examination of the colon resected for neoplastic pathology in the study of complications and recurrence of the disease].

After resection for cancer of the large bowel, because of high incidence of recurrences, careful radiological examinations must be performed during the follow-up. From the experience of more than 1800 X-ray examinations, after large bowel surgery, the authors describe the roentgen findings, pointing out pathological changes. Roentgenographic findings are distinguished considering the interval between surgery and X-ray examinations (early surveys and late surveys) and their site (anastomosis, residual colonic loops, perivisceral tissues). The main diagnostic problem usually arises in the late surveys at the anastomosis where is often difficult to distinguish a late surgical complication from a neoplastic relapse. This diagnosis is easier by comparison with films from early postoperative examinations. If they are not available correct diagnosis is yet often possible looking for some radiological signs which are carefully described.

Colonic Neoplasms↗

Usefulness of chest and skeletal survey to assess the time of relapse in breast cancer.

The pertinent radiographs of 151 patients treated with radical mastectomy who showed relapse in the chest and/or in the skeleton as first site were reevaluated. Diagnostic accuracy was calculated by comparing the first examination considered as positive with the previous ones reported as negative. For chest lesions the accuracy was 80% (70% for parenchymal nodular densities), with no difference between symptomatic and asymptomatic patients. For bone metastases retrospective evaluation confirmed the radiological report (i.e., the time of relapse), in 73.8%, with a value of 89.7% in symptomatic and 53.4% in asymptomatic patients. The site of involvement and morphological characteristics of the lesions did not influence the diagnostic accuracy. Therefore chest examination and, for symptomatic patients, radiographic bone survey still represent a useful modality to assess the diffusion of breast cancer. For asymptomatic patients other modalities, such as bone scan and biochemical tests, should be utilized.

Bone Neoplasms↗

[Radiological diagnosis in 229 cases of breast fibroadenoma].

From 1976 to 1977, 705 patients with a fibroadenoma of the breast, histologically proven by biopsy, were observed at the Istituto Nazionale Tumori of Milan. In 229 cases, the clinical examination was followed by mammography or xeromammography; in 65/229 patients telethermography was also carried out. The aspects of fibroadenoma at x-ray examinations are described together with the difficulties to reach an exact diagnosis: the cases in which a false positive diagnosis of cancer was done are emphasized.

Adenofibroma↗

Adjuvant postoperative radiotherapy in locally advanced rectal and rectosigmoidal cancer.

A pelvic recurrence is the cause of death in about 1/3 of radically operated patients for rectal and rectosigmoidal cancer without clinical evidence of distant metastases. Preoperative and postoperative radiotherapy are largely used to reduce the incidence of locoregional relapses and to improve disease-free and overall survival and quality of life. Benefits from radiotherapy have been widely demonstrated, and adjuvant postoperative radiotherapy is at present strongly recommended. Twenty-one patients with locally advanced (stage B2, B3, C) rectal (11 cases) and rectosigmoidal cancer (10 cases) were treated with postoperative radiotherapy at the National Cancer Institute of Milan from 1975 to 1978. The pelvis received a median dose of 4500 rad (range, 4000-5200 rad) in 5 to 7 weeks through AP, PA opposed fields; 6 patients received a boost of 1000 rad on the perineum. Median follow-up after surgery is 83 months (range, 24-63 months). Only 1 case (< 5%) had a pelvic recurrence, at the perineum. The expected recurrence rate after surgery alone is 40% and our favorable results after postoperative radiotherapy are comparable with recent data from other institutions. Radiotherapy side effects were moderate and transient; no late damages to small bowel were observed.

Adenocarcinoma↗

[Clinical value of lymphography in cervical cancer (author's transl)].

From January 1961 to June 1978, 417 patients with cervical cancer were submitted to lymphangiography as part of the initial diagnostic work-up. As regards the distribution by clinical stage of the cases under consideration, there were 187 cases in Stage Ib (44.8%) 99 in Stage II (23.7%) and 131 in Stage III plus IV (31.5%). For the early stages preference was given to a radical surgery plus pre- or postoperative radiotherapy combination (154/417 patients, or 36.9%). On the contrary, the cases which were more developed locally or which presented contra-indications to surgery received radiological treatment alone (263/417 cases, or 63.1%). The overall incidence of positive examinations was 29.9% (10.7% in Stage Ib; 28.3% in Stage II; 58.7% in Stage III and 60.0% in Stage IV). The histologic type on its own did not seem to influence the incidence of lymph node metastases detectable by lymphography. In the 145 patients who had surgical exploration, the overall diagnostic accuracy of lymphography was 82.8% with 3 false positive and 22 false negative reports. The para-aortic chains were involved in 28/417 patients (6.7%). For the negative cases, with all the stages mixed together, a 74.7% 5-year survival rate free of disease was recorded, as compared with the 34.5% found for the positive cases (P less than 0.0001). Similar differences was recorded stage by stage.

Female↗

[Prognostic factors and clinical classification criteria of oral carcinomas (author's transl)].

The clinical classification of oral carcinomas presents some points still under discussion. In other respects the main questions about the treatment of these cancers could be resolved by cooperative clinical trials which impose the definition of a common clinical language. With a system based on an original computer program for the compiling, store and process essential data on cancer diseases we analyzed 736 consecutive and unselected oral carcinomas and we studied the prognostic value of main clinical factors. In our series, the main prognostic factors are tumor size, clinical appearance of the primary and clinical status of neck nodes. Sex, age and histological grade are unimportant. From our study we propose to complete the TN classification with two useful clinical criteria distinguishing the exophytic or minimally infiltrating tumors from the deeply infiltrating (greater than 1 cm) and the large metastatic omolateral nodes from the small ones (phi less than 3 cm).

Adult↗

The value of radiotherapy in the treatment of vaginal carcinoma.

Herein we report the retrospective survey of 48 consecutive unselected cases of vaginal carcinoma, mainly treated with radiotherapy in our Institute from 1959 to 1970. In this series irradiation was delivered almost always with a single and continuous application of sources of radium 226. Radiumtherapy treatment varied according to the extension in surface of the neoplasm, the clinical stage and especially the vaginal step involvement, considering the length of the organ. Despite the very good immediate response, failures of treatment locally or in paravaginal and pelvic areas were frequently observed, and success of the treatment after a brief follow-up was poor. The actuarial survival was 41.6% and 33.3% at 3 and 5 years, respectively. Stage I cases showed at the follow-up better therapeutic results (48.6% survival at 5 years) than stage II and III cases (28.3%). The poorest results were observed in neoplasms extended to the whole vagina, and all these patients died within 4 years of the beginning of treatment. This report stresses that radiotherapy of vaginal carcinomas demands individualization and a properly planned therapeutic program that combines external irradiation with renewed techniques of low dose rate and continuous irradiation with radioactive sources.

Adult↗

Nipple discharge as a sign of preneoplastic lesions and occult carcinoma of the breast: clinical and galactographic study in 103 consecutive patients.

A clinical and galactographic investigation was carried out on 103 patients with hematic, serous-hematic, and serous nipple discharge. The age of the patients ranged from 18 to 72 years. A single papilloma was found in 20 cases, diffuse papillomatosis in 2 cases, atypical ductal hyperplasia in 8 cases, and ductal carcinoma in 4 cases (3 of these were infiltrating and 1 was noninfiltrating associated with a diffuse papillomatosis). Mammography gave no indications of carcinoma in any of the 4 cases. In the remaining 49 patients, pictures of ductal hyperplasia, periductal mastitis or sclerosis, sclerosing adenosis, or ductal ectasia were observed. The various types of lesions were often associated. Lacunae, stenosis, or occlusion of the ducts, evidenced by galactography, correlated well with the histologic findings of proliferative lesions of the ductal epithelium. Nevertheless, in practice, it should be the type of discharge that indicates surgery rather than galactographic or cytologic data, which appeared to have little diagnostic value. The frequency with which preneoplastic (or limit) lesions, and also nonsuspect carcinomas were found in patients with a significant nipple discharge confirm the importance of this symptom for a secondary prevention of early diagnosis of mammary neoplastic lesions originating from galactophorous ducts. Finally, complete resection of the galactophorous ducts must be considered as the best treatment in all patients with a suspicious nipple discharge that requires surgery.

Adult↗

[X-ray diagnosis of malignant breast calcifications. (author's transl)].

The authors have taken into consideration the different features of malignant breast tumor calcification. Frequent, rare and extremely rare radiological pictures will be shown and a differential diagnosis with benign micro-calcifications will be considered. A correct mammographic and xerographic technical performance is absolutely necessary to enhance the images of the smallest micro-calcifications. At last we assess the importance of a radiographic control of the surgical blocks, after conservative surgery of the breast, to assure a complete removal of microcalcifications.

Breast Diseases↗