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L Selvaggi

Publications and source records attributed to L Selvaggi.

At least 19 recordsLinked to original sources
PubMed1998

Combined carboplatin plus ifosfamide and cisplatin in patients with advanced ovarian carcinoma. A phase I-II study. GOCS (Gynecological Oncology Cooperative Study).

Because of the relative lack of overlapping toxicity, carboplatin (PPL) and cisplatin (CDDP) can be easily combined for treatment of ovarian cancer to increase total platinum dose intensity. Ifosfamide (IFO), one of the most effective single agents in ovarian cancer, has a low hematological toxicity when administered in continuous infusion. From January 1991 to December 1993, 34 patients with advanced ovarian cancer, previously untreated with chemo- or radiotherapy, were enrolled in a phase I-II study with the aim of determining the maximum tolerated dose (MTD) of CDDP (on day 8 of a 28-day cycle) in combination with PPL (300 mg/m2 on day 1) and IFO (4,000 mg/m2/24 h by continuous infusion on day 1). The initial dose level of CDDP was 40 mg/m2, which was continuously increased by 10 mg/m2 up to the MTD defined as one dose level below that inducing dose-limiting toxicity (DLT) in at least two-thirds of treated patients; no dose escalation was allowed in the same patient. Grade 3-4 leukopenia and thrombocytopenia were observed in 54 and 49% of patients, respectively. The DLT was reached at 70 mg/m2 and therefore the dose recommended for the phase II study was 60 mg/m2. Complete (CR) plus partial response was observed in 88% of patients with a 21% pathological CR. With a minimum follow-up of 32 months (median 40 months), median progression-free survival and overall survival were 21 and 39 months, respectively. In conclusion, the combination of CDDP, PPL, and IFO provides an effective regimen for ovarian cancer with an acceptable toxicity profile.

Adult↗
PubMed1998

Down-regulated expression of transforming growth factor beta 1 mRNA in endometrial carcinoma.

Transforming growth factor beta1 (TGF-beta1) is a potent modulator of cell proliferation in vitro, and recent studies have demonstrated its overexpression in several different tumours; nevertheless, the molecular mechanisms of TGF-beta1 action on cell growth and differentiation have not been fully elucidated. To clarify the role of TGF-beta and its receptor in human endometrial proliferation and differentiation, TGF-beta1 expression at both the mRNA and protein levels has been evaluated by using Northern blotting and immunohistochemistry, in both normal (atrophic, proliferative and secretory) and neoplastic (adenocarcinoma) endometrial samples. This study demonstrates that TGF-beta1 mRNA expression is dramatically reduced in endometrial carcinomas with respect to non-neoplastic tissues, whereas the immunohistochemical expression of TGF-beta1 is enhanced in the epithelial component of endometrial carcinomas compared with non-neoplastic tissues. These data suggest that TGF-beta1 acts as a paracrine regulator of endometrial cell proliferation and that it may contribute to the carcinogenic mechanisms of endometrial carcinoma.

Activin Receptors, Type I↗
PubMed1998

Expression of tenascin is related to angiogenesis in pre-eclampsia.

METHODS: Ten samples of decidua basalis from pre-eclamptic women and 10 from healthy primigravid women subjected to caesarean section (control tissues) were investigated immunohistochemically for changes in angiogenesis and expression of tenascin, an extracellular matrix protein thought to modulate angiogenesis. In addition, pre-eclamptic and control samples were grafted onto the chick embryo chorioallantoic membrane (CAM) to study their possible angiogenic activity in vivo. RESULTS: Although the microvessel area was low in control samples, it increased significantly in the pre-eclamptic decidua. In parallel, the area covered by tenascin staining underwent a significant expansion that was highly correlated with the microvessel area. Angiogenic activity was assessed both macroscopically and microscopically on histological sections 4 days after grafting. In contrast to control samples, pre-eclamptic decidua induced an intense capillary growth, and numerous capillaries converging towards the implant and forming a spoke-wheel pattern were evident. Histological examination using a planimetric point-count method showed that microvessel counts in the CAM area under and around the pre-eclamptic implants were significantly higher than those of control samples. Again, the extracellular matrix of nearby microvessels was strongly immunoreactive with tenascin. CONCLUSION: It is suggested that, unlike normal decidua, pre-eclamptic decidua displays an intense, autonomous angiogenic activity, probably mediated by tenascin in addition to its own angiogenic factors.

Allantois↗
PubMed1998

Transforming growth factor-beta1 in hemangioma of the ovary.

Hemangioma of the ovary is extremely rare. We report the case of a 32-year-old woman who complained of pelvic pain due to a large right adnexal mass. On surgical exploration a 10 x 8 cm hemangioma of the ovary was resected. Expression of transforming growth factor-beta1 was studied, and the possible role of this molecule in the development of the tumor is discussed.

Adult↗
PubMed1998

[Angiogenesis and endometrial carcinoma. Correlations with blood flow analysis by transvaginal color Doppler ultrasonography].

Neoangiogenesis is a basic event in the evolution and spread of several solid neoplasms. Angiogenesis is an active phenomenon in physiological endometrium in the reproductive age and seems to disappear in postmenopause. Endometrial hyperplasia and adenocarcinoma are associated with signs of angiogenetic activity. The factors promoting angiogenesis in endometrial carcinoma are still unknown. Similarly it is not possible to recognize which endometrial carcinoma is potentially angiogenetic, but a relationship between angiogenesis and early metastatic spread has been established. Angiogenesis is definitely a late component of invasive tumour, but an early angiogenetic behaviour of some neoplastic clones, that could be a main prognostic factor for endometrial carcinoma is hypothesized.

Adult↗
PubMed1998

Hemangioma of the ovary. A case report.

BACKGROUND: Ovarian hemangioma is extremely rare. CASE: We report a case of a 32-year-old woman who complained of pelvic pain due to a large right adnexal mass. On color Doppler sonography the mass showed very rich and complex vascularity, with prominent blood flow. A 10 x 8-cm hemangioma of the right ovary was resected. CONCLUSION: Hemangiomas should be considered when a richly vascularized tumor with prominent blood flow is detected on color Doppler sonography or magnetic resonance imaging.

Adult↗
PubMed1998

Non-Hodgkin lymphoma in a gynecologic service. A report of three cases.

Primary lymphoma arising in female genital tract organs is extremely rare. We report three cases of non-Hodgkin lymphoma which were encountered during a four-year period at our gynecologic department. One patient presented with an inguinal mass; another had a primary lymphoma of the vagina and the third had massive pelvic and para-aortic lymphomatous involvement. The gynecologists should be aware that, although rarely, lymphomas may arise in the genital tract, and that a massive involvement of inguinal, pelvic or para-aortic nodes may be related to a lymphoproliferative disease.

Adult↗
PubMed1997

Serous papillary cystadenoma of borderline malignancy of the broad ligament.

Serous papillary cystadenoma of borderline malignancy arising in the broad ligament is extremely rare. We report the case of a 28-year-old female with a cystic mass in the broad ligament, who underwent complete excision of the mass, right salpingo-oophorectomy, omentectomy and multiple peritoneal biopsies. Pathology showed a serous papillary cystadenoma of borderline malignancy of the broad ligament, without peritoneal and omental involvement. A review of the literature about this rare pathologic condition is reported.

Adnexal Diseases↗
PubMed1997

A vaginoscopic approach to reduce the pain of office hysteroscopy.

We developed a new approach to diagnostic hysteroscopy that reduces patient discomfort and increases the possible applications of hysteroscopy. Between February 1992 and March 1996, 1200 hysteroscopies were performed at our institution. Of these, the last 680 were done using the vaginoscopic approach without preselection. Discomfort was reduced in all patients, including those with moderate stenosis of the internal cervical os. Vaginoscopy is easy to perform and incurs no additional cost for the patient. It is ideal for office hysteroscopy and in patients who otherwise might require general anesthesia, such as virgins and older women with somewhat stenotic vaginas.

Ambulatory Surgical Procedures↗
PubMed1997

Transvaginal color Doppler sonography in predicting the response to chemotherapy in advanced cervical cancer.

The role of Doppler ultrasonography in the diagnosis of advanced cervical cancer continues to be controversial. This study was designed to assess the clinical value of the technique in terms of predicting the response to chemotherapy in patients with advanced cervical cancer. Twenty-three patients with cancer of the cervix (FIGO stages Ib bulky-IIIb) and 20 healthy women underwent transvaginal color Doppler assessment of the uterine arteries (both ascending and descending branches) and the intracervical vessels. Statistical analysis was performed by Student's t test for paired and unpaired data. The intracervical vessels were the only site to show significant differences both in the resistance and in velocity parameters. A subgroup of 14 patients, scheduled for neoadjuvant chemotherapy, were evaluated before and at the completion of treatment. A significant increase in resistance and pulsatility index values and a decrease in peak systolic velocity were observed in the ten patients who responded to chemotherapy. Preliminary results of our study suggest that Doppler parameters can be clinically useful in the evaluation of the response to neoadjuvant chemotherapy. More patients, sampled in a prospective way in order to increase the number of non-responders, would be necessary to assess the possible role of Doppler ultrasound in predicting which patients will respond to chemotherapy.

Aged↗
PubMed1997

Central nervous system involvement secondary to metastatic mixed müllerian tumor of the uterus.

The central nervous system is traditionally considered an uncommon site for metastatic disease from female genital tract tumors. We report the case of a 48-year-old woman with malignant mixed müllerian tumor of the uterus, who developed spinal cord compression by epidural metastasis a few days after the diagnosis of the uterine malignancy. Emergency decompressive laminectomy was performed and a good recovery of the neurological function was achieved. In the following days, while submitted to extensive staging for the uterine malignancy, the patient complained of headache, confusion and visual disturbance. CT scan revealed multiple brain metastases. No other site of metastatic disease could be detected. The patient refused any further treatment and died 1 month later from progressive cerebral disease. Attention should be paid to the possibility of unusual distant metastases associated to uterine sarcoma in order to treat these patients promptly.

Brain Neoplasms↗
PubMed1997

Transvaginal color Doppler ultrasound for monitoring the response to neoadjuvant chemotherapy in advanced cervical cancer.

BACKGROUND: To evaluate the role of transvaginal color Doppler ultrasound in monitoring the response to neoadjuvant chemotherapy in patients with locally-advanced cervical cancer. METHODS: Fourteen patients with locally-advanced cervical cancer, scheduled for neoadjuvant chemotherapy, were investigated with transvaginal color Doppler ultrasonography before and at the completion of chemotherapy in order to study hemodynamic changes in cervical and intratumoral vessels. Twenty healthy women matched for age and parity served as a control group. Statistical analysis was performed with Student's t test for paired data. RESULTS: Statistically different blood flow recording between patients with cervical cancer and healthy controls could be observed only in intratumoral vessels. A significant increase of RI and PI values, recorded in both cervical artery and intratumoral vessels, have been observed in the group of patients responding to neoadjuvant chemotherapy. In patients with stable disease at the completion of chemotherapy, flow characteristics did not change significantly. CONCLUSION: Preliminary results of our study suggest that transvaginal color Doppler ultrasound evaluation of flow characteristics in the cervical and intratumoral vessels might be useful in monitoring the response to neoadjuvant chemotherapy in patients with invasive cervical cancer.

Aged↗
PubMed1997

Fibromatosis of the female pelvis.

BACKGROUND AND AIMS: Desmoid tumour is a rare entity characterized by benign proliferation of fibroblasts. Although non malignant, this tumour can be life-threatening due to its invasive property and high recurrence rate. MATERIAL AND METHODS: We report a case of pelvic fibromatosis whereby the tumour was completely resected without sacrificing organs or major vessels. RESULTS: Thirty months after surgery the patient is asymptomatic, without any sign of recurrent disease. CONCLUSIONS: Radical surgery represents the main primary treatment for pelvic fibromatosis. The other available therapeutic options are discussed.

Adult↗
PubMed1997

Giant malignant fibrous histiocytoma of the uterus.

A case of giant (32 Kg) malignant fibrous histiocytoma (MFH) arising from the uterus and occupying the entire abdomen and the pelvis is reported. The patient had debulking surgery, followed by combination chemotherapy, but died 7 months after diagnosis.

Fatal Outcome↗
PubMed1996

Lipoperoxidation and antioxidant enzymes activity in pregnancy complicated with hypertension.

OBJECTIVE: To assess maternal circulating levels of lipid peroxidation breakdown products and antioxidant enzymes activity in pregnancies complicated with hypertension. STUDY DESIGN: Ten women with uncomplicated pregnancies and nine women with hypertension antedating pregnancy were prospectively sampled. Eight women, who had developed preeclampsia, were also cross-sectionally included. Twenty healthy non pregnant volunteers were the control group. Thiobarbituric acid reactive substances (TBA-RS), as lipid peroxidation products, and the activity of catalase (CAT), glutathione peroxidase (GPX) and superoxide dismutase (SOD), as antioxidant enzymes, were assayed in red blood cell hemolysates. A prooxidant/antioxidant (P/A) ratio (TBA-RS/CAT + GPX + SOD) was determined from the mean value of the volunteers. RESULTS: In women with chronic hypertension, TBA-RS levels were higher than those in normal pregnant women, whereas antioxidant enzymes activities were either stable or decreased. Therefore the P/A ratio was progressively lower in the second and third trimester. Similar result were found in patients with preeclampsia. CONCLUSIONS: Normal gestation induces an increase of lipid peroxidation products, whereas antioxidant activity seems stable. In pregnancies complicated by chronic hypertension, a deficiency of the oxidative system balance is detectable, which consistently progresses in the second and third trimester, strongly suggesting a failure of the protective mechanisms.

Adult↗
PubMed1996

Pathological significance of first-trimester fetal nuchal oedema.

The pathological mechanism that causes the transient phenomenon sonographically defined as "nuchal translucency' is still poorly understood. Seven pregnancies in which the fetuses clearly presented this ultrasonic sign at 10-14 weeks' gestation were terminated because of an abnormal fetal karyotype. The pathological specimens, compared by morphometric analysis with normal fetuses of the same gestational age, showed oedema and dilatation of lymphatic capillary vessels. No particular relationship was found with any structural abnormality. We speculate that nuchal oedema is a transient non-specific phenomenon which is probably related to an early disarrangement of lymphatic connections.

Aneuploidy↗
PubMed1996

Diagnostic accuracy of hysteroscopy in endometrial hyperplasia.

OBJECTIVES: To determine the diagnostic accuracy of hysteroscopy in the diagnosis of endometrial hyperplasia in women with abnormal uterine bleeding. METHODS: From 1993 through 1995, 980 women referred to our institution for abnormal uterine bleeding underwent diagnostic hysteroscopy with eye direct biopsy of the endometrium in case of macroscopic abnormalities. Hysteroscopic features were compared with pathologic findings in order to detect the reliability of the endoscopic procedure. Statistical analysis was performed with the McNemar test. RESULTS: Positive predictive value of hysteroscopy in the diagnosis of endometrial hyperplasia accounted for 63%. In fact hysteroscopic diagnosis of endometrial hyperplasia was confirmed at pathologic examination in 81 out of 128 patients. Sensitivity and specificity of the endoscopic procedure accounted for 98% and 95%, respectively. Negative predictive value accounted for 99%, as only two cases of atypical hyperplasia were missed at hysteroscopy. Positive predictive value was higher in postmenopausal patients compared to women in the fertile age (72 vs. 58%). CONCLUSIONS: Overall, results appear encouraging, since no case of endometrial hyperplasia was missed by hysteroscopy. The high diagnostic accuracy, associated with a minimal trauma, renders hysteroscopy the ideal procedure for both diagnosis and follow-up of conservative management of endometrial hyperplasia.

Adult↗