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Biomedical subjects

L Luciani

Publications and source records attributed to L Luciani.

At least 55 records · Page 3Linked to original sources
PubMed1985

Comparative study of lymphography and aspiration cytology in the staging of prostatic carcinoma. Report of 35 cases with histological control and review of the literature.

Accurate staging of prostatic carcinoma is essential in determining the prognosis and establishing the most adequate therapy of the disease. Lymphography is the most widely used method in staging prostatic carcinoma but shows false-positive rates varying up to 58% and false-negative rates varying from 11 to 66%. Aspiration biopsy was proposed to enhance the reliability of lymphography. In our study we performed transcutaneous aspiration biopsy of the pelvic nodal chains in 35 patients with clinically localized prostatic carcinoma using a long-beveled side-holed modified Chiba needle. 124 nodal chains were punctured and malignant cells were found in 26 aspiration biopsies of 15 patients. In determining the true stage of the disease, aspiration cytology and lymphography showed accuracy of 91 versus 57%; sensitivity of 83 versus 67% and specificity of 100 versus 47%, respectively. Positive cytologic findings are conclusive for stage D disease, while negative cytology may be accepted as definitive only when the neoplasm is well differentiated or the Gleason sum is 2-3-4. Combined use of lymphography and aspiration cytology permits surgical staging to be limited to those patients with undifferentiated neoplasm, intermediate or high Gleason sum (5-10) and negative cytology.

Biopsy, Needle↗
PubMed1984

[The role of transcutaneous fine-needle aspiration biopsy of the regional lymph nodes in the management of cancer of the penis].

Knowledge of the status of the regional lymph-nodes is essential for establishing the stage and the optimal treatment of carcinoma of the penis. Lymphadenectomy cannot be performed routinely because of its morbidity (30-50%) and mortality. Various noninvasive procedures such as lymphography, T.A.C. and echography have been proposed but are of limited diagnostic value because of the unacceptable frequency of the false positive and false negative findings. The transcutaneous fine-needle aspiration biopsy of the draining nodes visualized by lymphography is an innocuous, non invasive, excellent procedure, alternative to staging surgery in determining or excluding the presence of the nodal metastases. The positive cytology is conclusive of stage III and implies early, sometime, curative lymphadenectom. If the aspirate is abundant and largely representative the negative findings may also be considered to indicate the reactive nature of the lymphadenopathy.

Biopsy, Needle↗
PubMed1984

Hormonal and receptor status in postmenopausal women with endometrial carcinoma before and after treatment with tamoxifen.

Twenty-four patients with endometrial carcinoma received tamoxifen (Nolvadex) for 7 days. Before and after administration, circulating hormones (estradiol, testosterone, progesterone, gonadotropins FSH and LH) were evaluated. Estrogen (ER) and progesterone receptors (PgR) in neoplastic tissue were also assayed. Our results show a net increase in PgR content and a significant decrease in gonadotropin levels after the treatment. The authors suggest that clinical trials be conducted using tamoxifen and progestins for adjuvant therapy after surgery of endometrial carcinoma and for the therapeutic approach of advanced carcinoma.

Carcinoma↗
PubMed1984

Percutaneous lymph node aspiration biopsy and tumor grade in staging of prostatic carcinoma.

Percutaneous fluoroscopy-guided fine-needle aspiration biopsy was performed for staging procedures in 31 patients with clinically localized carcinoma of the prostate and showed overall accuracy of 93.54%, with a false-negative rate of 6.46%. The Gleason grading system was found to be highly accurate in predicting the absence or presence of nodal metastases in low- and high-grade tumors (Gleason's sums 2, 3, or 4, and 8, 9, or 10). The combination of pelvic node biopsy aspiration and tumor grade can result in a very accurate prediction of nodal involvement, and may spare patients a staging lymphadenectomy or even an unnecessary radical operation.

Aged↗
PubMed1984

Association of xanthogranulomatous pyelonephritis with small renal cell carcinoma. Case report and review of the literature.

A case of xanthogranulomatous pyelonephritis associated with 'small' renal carcinoma is presented. The urinary sediment showed atypical cells, suspect of malignancy. The renal neoplasm measured only 1.5 cm, had the typical papillary configuration of a 'small' renal carcinoma and was composed of atypical cells with finely granular cytoplasm and hyperchromatic nuclei. The xanthogranulomatous pyelonephritis was a primary lesion, spacially separate one from the other. The clinicopathological features of reported examples of coexistence of these diseases have been reviewed.

Adenocarcinoma↗
PubMed1984

Value and role of percutaneous regional node aspiration cytology in the management of penile carcinoma.

The determination of the status of regional draining lymph nodes is crucial in the prognosis and treatment of penile carcinoma. Tumor staging is inaccurate without histologic examination of the nodes, but the high attendant morbidity rate of lymphadenectomy mandates careful case selection rather than routine prophylactic dissection. Since the penile and pedal lymphography opacifies all lymph nodes involved by penile carcinoma, fine needle aspiration cytology of regional nodes is an innocuous, accurate, easy, and inexpensive diagnostic procedure and alternative to surgical staging in determining the nodal extension of neoplasm. Positive cytology enables rapid, early and even curative lymphadenectomy in patients with clinically negative but microscopically positive nodes. Since radiopaque contrast medium opacifies the nodes for 6-9 months, repeated fine needle aspiration cytology may be used for accurate, careful and regular follow-up examination of patients with penile carcinoma.

Aged↗
PubMed1984

'True' sarcomatoid carcinoma of the renal pelvis. First case report with immunocytochemical study.

A case of sarcomatoid carcinoma of the renal pelvis is reported. The neoplasm showed polypoid configuration and was composed exclusively of plump, spindle and pleomorphic cells. Light microscopy did not reveal any epithelial differentiation of the neoplastic cells. Immunoperoxidase staining for keratins and for epithelial membrane antigen was strongly positive in the spindle elements and showed the epithelial nature of the proliferation. The present case suggests that pleomorphic tumors, when occurring in visceral organs, should be carefully sampled and immunocytochemical markers for epithelial and sarcomatous differentiation studied, before diagnosis of carcinosarcoma or sarcoma may be accepted.

Carcinosarcoma↗
PubMed1984

Accuracy of lymphography in staging of prostatic and bladder carcinoma: 88 cases with aspirative cytological and postlymphadenectomy histological verification.

Lymphography was performed in 88 patients with prostatic (n = 51) or bladder (n = 37) carcinoma. The lymphographic findings were correlated to the cytological and histological staging obtained by means of transcutaneous fine-needle aspiration biopsy and/or pelvic lymphadenectomy performed after lymphography on the most frequently involved glands. The lymphographic diagnosis was confirmed in 90.7% of the patients. In 16 cases (18.1%) histology was not in accordance with the positive lymphogram and in 5 cases (5.6%) lymphography was false negative. The authors emphasize the high rate (35.5%) of normal-sized nodes with evident but minimal metastatic changes, cytohistologically verified. These are, in fact, metastatic lymphonodal lesions which escape ultrasonography and computed tomography.

Aged↗
PubMed1984

Preoperative 'dynamic' antegrade phlebography of the spermatic vein: physiological detection of spontaneous reflux in clinical and subclinical varicocele. A study of 142 patients.

From March 1977 to December 1982, 142 patients with varicocele of various sizes underwent preoperative antegrade or retrograde phlebography of the left spermatic vein. In 8 of them both procedures were carried out. A retrospective analysis of 68 preoperative antegrade venographies in supine (0 degree) and upright (30 degrees, 45 degrees and 90 degrees) positions was made and compared with 66 retrograde venograms. The preoperative 'dynamic' antegrade phlebography has been performed in order to study the hemodynamic conditions of the varicocele, avoiding any pressure interference on the valvular function of the venous renospermatic area. This technique has allowed us to get useful anatomoradiological and physiopathological information about the spontaneous reflux into the internal spermatic vein by its positional filling and emptying. It has also permitted a good visualization of collateral channels, particularly in the pelvic, femorosaphenous and scrotal areas. We could, at the same time, simultaneously sample blood from the cubital and intrascrotal spermatic veins to determine the testosterone, cortisol and serotonin levels, in different positions; the evaluation of these biochemical data is being pursued. In our opinion, this diagnostic procedure is easy to perform and inexpensive. The procedure and the results are discussed in detail.

Adolescent↗
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

Radiotherapy versus surgery in the treatment of cervix stage Ib cancer.

In the years 1971-77 we have treated 250 Stage Ib patients with cancers of the cervix. One hundred twenty-three (49.2%) underwent a radical surgery, 37 had a classical Wertheim-Meigs operation, and 86 had a lymphadenectomy that was extended to the lumbar-aortic region. When feasible, all patients received postoperative radium therapy on the vaginal vault. The remaining 127 patients received a complete course of radiotherapy. This was not a randomized clinical trial. In fact surgery was preferred for patients who were younger (mean age: 49.6 years) and more physically fit, while radiotherapy was the treatment chosen for those who were older (mean age: 57.7) and generally less fit or obese. The 5 year NED survival was 89.3% in the surgical group and 90.9% in the radiotherapy group (P less than .05). Four fatal complications were observed in the surgical group (3.2%). Rate and causes of failures or complications are analyzed in detail.

Adenocarcinoma↗
PubMed1983

Accuracy of transcutaneous aspiration biopsy in the definitive assessment of nodal involvement in prostatic carcinoma.

The inaccuracy of lymphangiography in predicting nodal involvement and the complications of pelvic lymphadenectomy prompted us to evaluate other methods of staging prostatic cancer. On the basis of the results obtained in 24 patients with carcinoma of the prostate, the authors suggest transcutaneous fluoroscopy-guided fine needle aspiration biopsy as a satisfactory alternative to lymphadenectomy. In 95-8% of patients pelvic lymphadenectomy confirmed the cytological findings of transcutaneous aspiration biopsy of pelvic lymph nodes using a "long-bevelled, side-holed" thin needle. It is considered essential to perform aspiration biopsy on most of the pelvic lymph node chains opacified, regardless of lymphographic diagnosis.

Biopsy, Needle↗