PubMed Health⌕ Search

Biomedical subjects

Hugo Marsiglia

Publications and source records attributed to Hugo Marsiglia.

10 recordsLinked to original sources
PubMed2006

Medullary breast carcinoma: a case report with cytological features and histological confirmation.

We report the case of a 83-year-old woman who presented with a left-breast lump. On physical examination the patient had a well-demarcated mass located in the upper outer quadrant of her left breast with a palpable unilateral axillary lymph node. Mammography and ultrasonography depicted a heterogeneous well-defined lesion measuring 6 cm in diameter without calcifications. Fine-needle aspiration cytology of the lesion was performed. Cytological examination revealed highly cellular smears containing large atypical cells arranged in syncytial sheets and intimately admixed with lymphocytes and neutrophils. The nuclear to cytoplasmic ratio was high in tumor cells whose nucleus exhibited coarse chromatin with one or more conspicuous nucleoli. The diagnosis of medullary breast carcinoma, which was strongly suspected by cytology, was confirmed by histological examination of the surgical specimen after a modified radical mastectomy with axillary dissection.

Aged, 80 and over↗
PubMed2005

Pulsed dose-rate perioperative interstitial brachytherapy for soft tissue sarcomas of the extremities and skeletal muscles of the trunk.

BACKGROUND: This study evaluated the role of pulsed dose-rate (PDR) brachytherapy (BRT), delivered alone or as a boost to external beam radiotherapy, as adjuvant therapy for the local control of soft tissue sarcomas of the extremities and skeletal muscles of the trunk that have undergone surgical treatment. METHODS: Between July 1998 and January 2002, 42 patients were treated with a combination of surgery and BRT alone (18 patients) or BRT/external beam radiotherapy (24 patients) for the treatment of primary (n = 32) and recurrent (n = 10) soft tissue sarcomas located in the proximal extremity (n = 17), distal extremity (n = 17), and trunk (n = 8). Tumor size was <5 cm in 20 cases and >5 cm in 22 cases, with histological grading of 1 (n = 7), 2 (n = 18), or 3 (n = 17). The median BRT dose delivered was 15 Gy, and the median external beam irradiation dose was 50 Gy. RESULTS: With a median follow-up of 34 months, the 36-month survival was 83.9% (SE, 6.1%), and the local control was 89%. CONCLUSIONS: PDR interstitial BRT for soft tissue sarcoma is an effective, well-tolerated adjuvant radiation treatment that offers several practical advantages, among which are low acute and late toxicity with maximum normal tissue and critical structure sparing and overall shorter radiotherapy and hospital stay.

Adult↗
PubMed2004

MR and CT image fusion for postimplant analysis in permanent prostate seed implants.

PURPOSE: To compare the outcome of two different image-based postimplant dosimetry methods in permanent seed implantation. METHODS AND MATERIALS: Between October 1999 and October 2002, 150 patients with low-risk prostate carcinoma were treated with (125)I and (103)Pd in our institution. A CT-MRI image fusion protocol was used in 21 consecutive patients treated with exclusive brachytherapy. The accuracy and reproducibility of the method was calculated, and then the CT-based dosimetry was compared with the CT-MRI-based dosimetry using the dose-volume histogram (DVH) related parameters recommended by the American Brachytherapy Society and the American Association of Physicists in Medicine. RESULTS: Our method for CT-MRI image fusion was accurate and reproducible (median shift <1 mm). Differences in prostate volume were found, depending on the image modality used. Quality assurance DVH-related parameters strongly depended on the image modality (CT vs. CT-MRI): V(100) = 82% vs. 88%, p < 0.05. D(90) = 96% vs. 115%, p < 0.05. Those results depend on the institutional implant technique and reflect the importance of lowering inter- and intraobserver discrepancies when outlining prostate and organs at risk for postimplant dosimetry. CONCLUSIONS: Computed tomography-MRI fused images allow accurate determination of prostate size, significantly improving the dosimetric evaluation based on DVH analysis. This provides a consistent method to judge a prostate seed implant's quality.

Aged↗
PubMed2004

Breast-conserving surgery after neoadjuvant anthracycline-based chemotherapy for large breast tumors.

BACKGROUND: Randomized trials comparing neoadjuvant versus adjuvant chemotherapy show that primary chemotherapy allows more frequent breast-preserving surgery even though no survival advantage has been demonstrated. The aim of the current study was to determine the predicting factors and the survival impact of breast conservation in patients with large breast tumors treated with neoadjuvant chemotherapy. METHODS: Between January 1987 and December 2001, 594 patients with invasive T2-3 breast carcinoma who were ineligible for breast-conserving surgery (the mean initial tumor diameter was 49 mm) were treated with 3 or 4 courses of an anthracycline-based primary chemotherapy, surgery, and radiotherapy. Various clinicopathologic factors were tested as possible predicting factors of breast-preserving surgery. Survival analyses were performed to determine the implications of breast-conserving surgery on outcome. RESULTS: After primary chemotherapy, 287 (48%) patients were eligible for breast-conserving surgery and 307 patients underwent a mastectomy. Initial tumor diameter > 5 cm, low histologic grade, lobular histology, and multicentricity were independent predicting factors of breast conservation ineligibility in the multivariate analysis (logistic regression). In the univariate survival analysis, a failure of breast-preserving surgery was associated with a poor outcome. Local disease recurrence-free survival rates were similar in patients treated with lumpectomy and mastectomy. CONCLUSIONS: The results reported in the current study suggested that initial diameter, histologic type and grade, and multicentricity are potential prechemotherapy predicting factors of breast conservation. When carefully selected, patients treated with breast conservation had a risk of local disease recurrence similar to the risk of chest wall disease recurrence after mastectomy.

Adult↗
PubMed2004

Breast cancer with synchronous metastases: trends in survival during a 14-year period.

PURPOSE: Although new drugs were approved during the 1990s for the treatment of metastatic breast cancer, it is not clear whether their use has changed the outcome of patients in daily practice. This study sought to determine whether survival has improved over time for breast cancer patients who had metastases at diagnosis. PATIENTS AND METHODS: A total of 724 patients have been treated in three French cancer centers for an initially metastatic breast cancer between 1987 and 2000; 343 were diagnosed between 1987 and 1993, and 381 were diagnosed between 1994 and 2000. Tumor characteristics, treatments, and outcomes of these patients were compared by chi(2) test, log-rank test, and Cox regression analysis. RESULTS: Characteristics were not different between the patients diagnosed from 1987 to 1993 and those diagnosed from 1994 to 2000. Ten percent of patients treated from 1987 to 1994 and 58% of patients treated from 1994 to 2000 have received either a taxane or a new aromatase inhibitor. The 3-year overall survival rates were 27% for patients treated from 1987 to 1993 and 44% for patients treated from 1994 to 2000 (P <.001). The treatment period (1994 to 2000 v 1987 to 1993) was a prognostic factor in multivariate analysis (relative risk, 0.6; P <.001). CONCLUSION: The survival of breast cancer patients presenting with metastases at diagnosis has improved over time. This study strongly suggests that this improvement is related to treatment.

Antineoplastic Agents, Phytogenic↗
PubMed2003

[The sentinel lymph node in cancer of the breast: clinical aspects].

Sentinel lymph node (SLN) biopsy is effective to assess axillary nodal status and avoiding axillary lymph node dissection (ALND) in patients with clinically node-negative early stage breast cancer. No standardization of the technique has yet been established. This review discusses the feasibility, the accuracy and the different techniques for this procedure. Although the SLN can be successfully identified by either the dye or gamma probe-guided method, its identification is facilitated when the two techniques are combined. To increase the sensitivity of the pathological examination of the SLN, it is necessary to make multiple step sections with hematoxylin and eosin staining immunohistochemistry on permanent sections. The intraoperative frozen sections and imprint cytology examinations of the SLN may be useful in determining its status, but further studies are needed to establish their performance. In clinical practice, routine ALND can be avoided for small tumours when the multidisciplinary team has an extensive experience of this technique. However, long-term regional control and survival have to be studied in prospective randomised trials, before SLN biopsy can replace routine ALND as the preferred staging method for women with localized breast cancer.

Axilla↗
PubMed2002

Brachytherapy for T1-T2 floor-of-the-mouth cancers: the Gustave-Roussy Institute experience.

PURPOSE: In a retrospective analysis, we evaluated the Gustave-Roussy Institute's experience of locoregional control, survival, and complications of low-dose rate brachytherapy for carcinoma of the floor of the mouth. METHODS AND MATERIALS: Between 1970 and 1985, 160 patients with previously untreated carcinoma of the floor of the mouth received interstitial brachytherapy as definitive treatment. Of the 160 patients, 79 (49%) had T1 and 81 (51%) had T2 lesions, and 127 (79%) had N0 and 33 (21%) had N1; 84% of tumors arose from the anterior floor of the mouth. Brachytherapy was performed with 192Ir wires, according to the Paris system rules, followed by neck dissection (T2 or N1) or follow-up (T1N0). RESULTS: With a follow-up period of 9-19 years, the observed survival rates were 89% at 2 years and 76% at 5 years, and the local control rates were 93% in T1 and 88% in T2 tumors. A low rate of distant metastases was noticed (5%); 31% of patients developed a second primary cancer. Severe mucosal necrosis was observed in <10% of patients. Any grade of bone necrosis was seen in 18% of cases (only 2.5% had G3 necrosis). This complication occurred more frequently in patients with poor dental status and in those treated without dental protection during implantation (p <0.001). CONCLUSION: Radical brachytherapy offers excellent local control (89%) and an acceptable rate of complications (<10% severe necrosis) that may be significantly decreased with dental care and the use of protective devices. The high incidence of second malignancies remains a major concern in these patients.

Analysis of Variance↗
PubMedDate not supplied

Primary and recurrent retroperitoneal sarcoma: factors affecting survival and long-term outcome.

BACKGROUND/AIMS: To analyze treatment and survival in a series of 39 patients with primary or recurrent retroperitoneal sarcoma treated and prospectively followed at a single institution. METHODOLOGY: Between July 1994 and January 2002, 39 patients (20M, 19F; mean age: 56 years, range: 25-77) were evaluated. RESULTS: Thirty-two out of 39 patients (82%) (18 were affected by primary retroperitoneal sarcoma, and 14 by recurrent retroperitoneal sarcoma), were submitted for resection. Twenty-four out of 32 patients (75%) underwent removal of contiguous intra-abdominal organs. Peroperative mortality was nil and significant peroperative complications occurred in 6 cases only (19%). High tumor grade results were a significant variable for a worse survival in all 32 patients (100% 5 years survival for low grade vs. 0% for high grade; P=0.0004). Among 27 radically resected patients, only histology gradeand peroperative blood transfusions affected survival (100% 5-year survival for low grade vs. 24% for high grade; P=0.003); (100% 5-year survival for nontransfused patients vs. 43% for transfused patients; P=0.03). Similar effects were noted for disease-free survival. CONCLUSIONS: Histology grade and peroperative blood transfusions were the only factors which affected overall and disease-free survival. An aggressive surgical approach in both primary and recurrent retroperitoneal sarcoma is associated with long-term survival.

Adult↗