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G Pizzocaro

Publications and source records attributed to G Pizzocaro.

At least 73 records · Page 4Linked to original sources
PubMed1985

[Hormone receptors and endocrine therapy of renal carcinoma].

One hundred sixty-five consecutive patients with resectable renal cancer entered a cooperative study to evaluate hormone treatment and steroid receptors. Twenty-nine patients with concomitant distant metastases (category M1) received intramuscular medroxyprogesterone acetate (MPA) 500 mg/day for at least two months after the operation. No measurable remission was observed, but 8 of 24 evaluable patients (33%) had disease stabilization for a median duration of 6 months. One hundred thirty-six cases with category M0 cancer were randomly allocated to a control group or to a treatment group with MPA 500 mg/3 times a week for one year. After a median follow-up period of over 3 years, 30 of 121 evaluable patients (24.8%) had a relapse, usually in distant sites. Relapses and survival were independent from postoperative treatment and sex. Only the extent of the disease and the presence of steroid receptors in the tumor were related with prognosis, but no relation could be found between receptors and response to hormone treatment. The presence of low concentrations of hormone receptors in a proportion of renal cancers remains unclear. However, MPA is confirmed to be only marginally active in metastatic renal cancer and the drug cannot be recommended as adjuvant to radically resected patients because of significant toxicity and lack of therapeutic activity.

Adolescent↗
PubMed1984

Retroperitoneal lymphadenectomy and aggressive chemotherapy in nonbulky clinical Stage II nonseminomatous germinal testis tumors.

In a former series of 60 resected Stage II nonseminomatous germinal testis tumors the authors succeeded in demonstrating that adjuvant cisplatin, vinblastine, and bleomycin (PVB) was able to significantly improve survival (100% in 11 treated versus 28.5% in 7 historical controls, P less than 0.01) only in patients with retroperitoneal metastases greater than 5 cm, macroscopic extranodal spread, tumor invasion into retroperitoneal veins (pathologic Stage II-C). Forty-eight evaluable patients with clinical nonbulky Stage II nonseminomatous testis cancer underwent retroperitoneal lymphadenectomy as primary treatment. Four courses of postoperative PVB were administered only to 18 clinically understaged patients (14 pathologic Stage II-C, and 4 postoperatively reclassified as Stage III). The remaining 30 patients were followed at monthly intervals. After a median follow-up of 25 months, relapses were: 1 (10%) in 10 pathologic Stage I patients; 8 (40%) in 20 pathologic Stage II-A and II-B; null in the 18 treated. Eight of the nine patients (89%) who had relapse entered continuous complete remission following salvage therapy. The overall 2-year disease-free survival in this case series is 98%. Retroperitoneal lymphadenectomy followed by compulsive follow-up and selective use of aggressive chemotherapy is an alternative to remission induction chemotherapy as primary treatment in clinical nonbulky Stage II nonseminomatous testis cancer, and to immediate adjuvant chemotherapy in all patients with resected Stage II disease.

Adolescent↗
PubMed1984

Steroid hormone receptors in normal and malignant human renal tissue: relationship with progestin therapy.

Documented hormone dependence of renal tumors in animal models, hypothetical hormonal environment of human kidney neoplasms and their controversial response to endocrine therapy prompted us to undertake a prospective multicentric cooperative study to evaluate the hormone-dependence/responsiveness of renal tumors. Patients with renal carcinoma were stratified according to the TNM classification and after nephrectomy were treated with high-dose medroxyprogesterone acetate (MPA). Specimens of tumor and healthy surrounding kidney tissue were studied for titration of steroid receptor proteins (78 for androgen, AR, 89 for estrogen, ER, and progestin, PgR). Their true receptor nature was estimated. Very low titers (on an average less than 10 fmol/mg protein) were found, especially for ER and PgR in neoplastic samples. Occurrence rate of AR was low for both tissues (less than 20%), whereas ER and PgR were detected at a higher frequency in healthy parenchyma than in tumor tissue (42.2 vs 23.3% and 30.7 vs 11.2%, respectively). AR was moderately affected by metastatic status of the disease and by sex. All three steroid receptors were simultaneously detected in normal tissue in 11.7% of cases and in tumor tissue in only 3.8%. No significant correlation between receptor status in the tumor and clinical response to hormone therapy was found. In 27 cases who received adjuvant MPA therapy, relapses were respectively 43.8 and 18.2% in the patients with negative receptors or with at least one detectable receptor. In metastatic renal carcinoma, stabilization of the disease with MPA was achieved more frequently in receptor-negative patients. Therefore, we conclude that the receptor assay is not a valid tool to select renal carcinoma patients for therapy with MPA.

Adolescent↗
PubMed1984

Mitoxantrone in advanced renal cancer: a phase II study in previously untreated patients from the EORTC Genito-Urinary Tract Cancer Cooperative Group.

Mitoxantrone at a dose of 15 mg/m2 i.v. q 3 weeks failed to produce responses in 29 adequately treated patients with measurable advanced renal cell carcinoma. The side-effects observed in this group of patients with a good performance status were generally mild. On the basis of this negative result, the application of mitoxantrone in this disease is not recommended.

Adult↗
PubMed1984

No adjuvant chemotherapy in selected patients with pathologic stage II nonseminomatous germ cell tumors of the testis.

In a previous report on patients with resected stage II nonseminomatous germinal cell testis tumors the findings of retroperitoneal metastases larger than 5 cm., macroscopic extranodal spread and tumor invasion into retroperitoneal veins (pathologic stage IIC) almost invariably were associated with relapse and poor survival in the absence of adjuvant chemotherapy, while postoperative cisplatin, vinblastine and bleomycin therapy was effective in preventing relapses in all cases. From February 1980 to January 1982, 40 consecutive patients underwent retroperitoneal lymphadenectomy for stage II disease. Only patients with pathologically assessed stage IIC cancer received 4 cycles of adjuvant cisplatin, vinblastine and bleomycin, while those with pathologic stages IIA and IIB disease, with or without microscopic extracapsular extension of the tumor, received no further therapy and were followed carefully at monthly intervals. After a median followup of 26 months or more relapses were noted in none of the 14 treated patients compared to 9 of 26 untreated patients (35 per cent). Of the latter 9 patients 8 (89 per cent) had continuous complete remission after salvage therapy and 39 of 40 patients (97.5 per cent) currently are free of disease. No difference was observed in the relapse rate and survival between patients with stages IIA and IIB disease. We conclude that patients with pathologic stages IIA and IIB disease can be treated safely only at the time of relapse, while the usefulness of adjuvant chemotherapy has been confirmed in those with stage IIC cancer.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1984

Adjuvant chemotherapy in resected stage-II nonseminomatous germ cell tumors of testis. In which cases is it necessary?

In an attempt to reduce the recurrence rate and to improve survival in resected stage-II nonseminomatous testicular cancer, two consecutive series of patients were treated with adjuvant vinblastine-bleomycin (VB) continuous infusion, or cisplatin, vinblastine, bleomycin (PVB). 11 former patients who received no adjuvant chemotherapy and 5 who refused the adjuvant treatment were considered historical controls. After a median follow-up of 5 years, relapses were 4 in 15 patients treated with VB (27%), 1 in 29 treated with PVB (3%) and 8 in the untreated (50%). Adjuvant PVB significantly reduced the recurrence rate (p less than 0.001), while VB did not (p = 0.4). However, the advantage of adjuvant PVB was evident only in patients with retroperitoneal metastases larger than 5 cm, macroscopic extranodal spread, and tumor invasion into retroperitoneal veins, who were classified as pathologic stage II-C: no relapse and 100% survival following adjuvant PVB in 11 cases, versus 86% relapses and 28.5% survival in 7 untreated patients (p less than 0.01); 2 relapses and 2 survivors in 3 treated with VB. On the other hand, only 1 of the 39 patients with less extensive retroperitoneal disease died of testicular cancer, and he was in the VB adjuvant treatment group. We conclude that only aggressive adjuvant chemotherapy significantly reduces the recurrence rate and improves survival in resected stage-II nonseminomatous testis cancer. However, it is mandatory only in the very high risk subset II-C of patients, while the others could be carefully followed at monthly intervals and safely treated with aggressive chemotherapy only in the event of relapse.

Adolescent↗
PubMed1984

Transient left homonymous hemianopsia during treatment of testicular carcinoma with cisplatinum, vinblastine, and bleomycin.

This is the third case, reported in the literature, of transient cortical blindness that occurred during treatment of testicular carcinoma with cisplatinum, vinblastine and bleomycin. The presence of transiently pathological computerized tomography and brain scan suggests that this alarming event may not only be a toxic side effect of chemotherapy, but also a symptom related to eradicable subclinical metastases.

Adult↗
PubMed1984

The antiemetic effect of methylprednisolone in patients treated with cis-platinum (CDDP) for advanced testicular germ cell tumors.

In cis-platinum treatment, nausea and vomiting are very serious side-effects and patients may be reluctant to accept or continue therapy. The purpose of this study is to verify the antiemetic effect of methylprednisolone in patients treated with cis-platinum in combination with other chemotherapeutic agents. Methylprednisolone in doses of 100 mg/m2 i.v. per 5 consecutive days was given to 33 patients receiving cis-platinum combination chemotherapies (134 cycles) at the Istituto Nazionale Tumori of Milan for advanced germ cell tumors of the testis. Seventy percent of cycles were partially or completely protected from vomiting. Only minor side-effects caused by methylprednisolone were observed. From this study it appears that methylprednisolone is an effective antiemetic drug in patients receiving cis-platinum combination chemotherapy.

Adolescent↗
PubMed1983

Hormone treatment and sex steroid receptors in metastatic renal cell carcinoma: report of a multicentric prospective study.

Twenty-eight patients with metastatic renal cell carcinoma entered a multicentric prospective study to evaluate the response to high-dose medroxyprogesterone acetate (MPA) and testosterone in MPA failures in relation to sex steroid receptors. No objective remission was seen in the 24 evaluable patients, and only disease stabilizations of short duration were achieved in one-third of treated patients. Stabilizations achieved with second line testosterone were all seen in patients unresponsive to MPA. Receptor studies demonstrated that estrogen, progesterone, or androgen receptors were found in low concentrations and in only 6 of 23 tumors (26%) and 13 normal tissue samples (56%). Surprisingly, no disease stabilization was achieved in patients positive for receptors. It can be concluded that the occasional objective responses to hormone therapy reported in the literature may have been due to some cytotoxic effect of hormone therapy rather than to a true hormonal mechanism.

Adenocarcinoma↗
PubMed1983

Lymph node dissection in radical nephrectomy for renal cell carcinoma: is it necessary?

Lymph node dissection is an essential step in radical nephrectomy for renal cell carcinoma, but lymph node metastases are present in no more than 15% of category M0 renal cell cancers and the cure rate of patients with lymph node involvement is usually poor. Therefore it can be assumed that less than 5% of patients benefit from lymphadenectomy. Lymph node dissection of limited extent is useful in enabling easier control of the great vessels, and radical dissection may be confined to patients of high T categories in whom the chance for nodal involvement is higher.

Adenocarcinoma↗
PubMed1983

Adjunctive medroxyprogesterone acetate to radical nephrectomy in category M0 renal cell carcinoma. Preliminary report of a prospective randomized trial.

From July 1979 to December 1981, 83 patients from 6 centers in the Lombardy underwent radical nephrectomy for category M0 renal cell carcinoma. Postoperatively they were randomly allocated to adjunctive medroxyprogesterone acetate (MPA) or to a control group. After the first year of follow-up, the relapse rate was 13% in the controls (5 of 38 evaluable patients) versus 28% in the MPA treatment group (9 of 32). Sex steroid receptors were studied in both the tumor and in the surrounding healthy parenchyma by the dextran-coated charcoal technique in 52 of 70 clinically evaluable patients. There was no significant correlation between receptor studies and the relapse rate. Besides, receptors were more often detected in the healthy than in the neoplastic tissue, and values rarely exceeded 10 fmol/mg protein. Due to the negative trend in the MPA treatment group, the admittance of patients to this study was stopped after 120 patients had been accepted.

Adenocarcinoma↗
PubMed1981

Staging and surgery in testicular cancer.

Both staging and surgery in testicular cancer are thoroughly analysed. Extensive experiences from various authors are reported and compared. The essentials for staging are suggested and a new detailed stage grouping is proposed. The role of surgery in diagnosis, staging and therapy is examined. It is stressed that in non-seminomas, retroperitoneal lymph node dissection is not only a staging procedure, but it may be also a curative operation in several cases of patients with lymph node metastases and a prospective randomized clinical trial is advocated in order to clarify the usefulness of adjunctive chemotherapy in these cases. Surgery is also useful as adjuvant to chemotherapy in several patients with advanced non-seminomas and it is underlined that it should be undertaken early, after only 2 or 3 cycles of chemotherapy, in order to avoid the strong fibrosis that often occurs after long-term chemotherapy and which makes surgical dissection very difficult or even impossible. Lastly, even if extensive, surgery seems to be a safe procedure in these young patients.

Antineoplastic Agents↗
PubMed1980

Estrogen receptors and MPA treatment in metastatic renal carcinoma. A preliminary report.

Ten previously untreated patients with metastatic renal carcinoma underwent transperitoneal radical nephrectomy followed by high dosage MPA treatment. Estrogen receptors were determined in the specimen of all cases by the dextran-coated charcoal method: both the neoplastic tissue and the healthy parenchyma were tested. The disease progressed in 8 cases, and 2 patients are alive without any evidence of progressive disease 12 and 27 months after the operation. Very low receptor levels were detected in these 2 cases and one of them could be defined as borderline with our threshold criterion. However, receptors were undetectable in the neoplastic tissue from 4 of 8 patients who progressed. These questionable results justified the start of a prospective multicentric trial to study in a large number of cases both hormone receptors and clinical response to hormone therapy in human renal cancer.

Adult↗