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M Berretta

Publications and source records attributed to M Berretta.

At least 19 recordsLinked to original sources
PubMed2006

Metastatic angiosarcoma of the kidney: a case report with treatment approach and review of the literature.

Angiosarcomas are rare soft tissue malignancies. Typically they originate from the skin of the scalp or face, whereas visceral sarcomas are very rare. We report the case of a 67-year-old man affected by a large angiosarcoma of the kidney. After surgical removal, a rapid peritoneal, visceral and cutaneous diffusion developed. Palliative chemotherapy, based on anthracycline and ifosfamide, which are normally used to treat all other high-grade spindle cell sarcomas, was totally inactive. On the basis of these results and of the biological characteristics of these rare neoplasms it is mandatory to develop other therapeutic approaches. Antiangiogenetic agents are of interest for this disease due to the peculiar origin of the cells of these sarcomas.

Aged↗
PubMed2004

Dysphonia as an unusual toxic event of oxaliplatin-based chemotherapy.

Oxaliplatin is a new, third-generation platinum complex. It has a good safety profile characterized by low hematological-gastrointestinal toxicity. No significant nephro-ototoxicity has been observed. Acute peripheral neuropathy is a common event affecting, as grade 1 or 2, 85-95% of patients. Recently, data on dysphonia toxicity, after the administration of oxaliplatin, has been reported in literature. This toxicity with acute onset can be misunderstood if not carefully looked for. However, it is self-limiting and a non-permanent (grade 1-2) neurotoxic phenomenon, which impairs transiently the quality of life of a percentage of oxaliplatin-treated patients. We report our experience in consecutive patients affected by advanced colorectal cancer treated with oxaliplatin-based chemotherapy. Overall, we observed 13 (16%) cases of dysphonia out of 81 consecutive patients treated with oxaliplatin-based chemotherapy. This toxic effect was self-limiting and all patients recovered rapidly. Nonetheless, a deeper understanding of this phenomenon is essential to give correct information to the patients.

Adult↗
PubMed2003

Treatment of older breast cancer patients with high recurrence risk.

Adjuvant treatment of elderly women affected by breast cancer who have a high risk of recurrence is one of the most questionable issues in clinical oncology. The use of tamoxifen in women with hormone receptor-positive tumors is a relatively simple therapeutic option considering the favourable toxicity profile, whereas the administration of adjuvant chemotherapy is more complicated and a variety of aspects need to be considered. The estimated life expectancy, the presence and degree of comorbid conditions, the geriatric assessment and estimated benefit from treatment should be taken into account. Due to the lack of data from clinical trials in women over the age of 70, the approach is still experimental. Clinical trials evaluating the role of adjuvant chemotherapy in high risk patients are currently being developed and hopefully in the near future, more convincing data on the best drugs, regimens and benefits for the treatment of elderly breast cancer patients will become available.

Aged↗
PubMed2003

Ifosfamide in the adjuvant therapy of soft tissue sarcomas.

Ifosfamide and anthracyclines are the only active agents in advanced soft tissue sarcomas. Doxorubicin was always used in sarcomas, whereas ifosfamide was reintroduced in the clinic after the discovery of mesna which prevents its typical dose-limiting toxicity: hemorrhagic cystitis. In the adjuvant setting, doxorubicin was used alone or in combination in the first-generation trials, whereas its parent compounds epirubicin and ifosfamide were employed in the second-generation adjuvant trials, which started in the early 90s. Other relevant aspects of the second-generation trials are the use of the hematopoietic growth factors and the increase of the dose intensity, the introduction of more restrictive selection criteria and the use of the two most active agents, ifosfamide and anthracyclines. Only the Italian cooperative trial has been concluded, and the results reported and updated. After a median follow-up of 89.6 months (range 56-119), the intention-to-treat analysis still reveals a difference in overall survival which, however, is not statistically significant. However, the 5-year overall survival estimate, which is a reasonable end point for the survival analysis of adjuvant treatment in soft tissue sarcomas, was 66.0 and 46.1% for the treatment and the control groups, respectively (p = 0.04).

Antineoplastic Agents, Alkylating↗
PubMed2001

[Frantz's solid cystic papillary pancreatic carcinoma].

The authors report their own case of a young woman recently operated for a rare form of pancreatic tumor of exocrine origin, so-called Frantz's solid-cystic-papillary carcinoma, for which only a little more than 300 cases have been reported in the world literature. The authors discuss the pathogenesis (it is possible that Frantz's tumor is related to female sex hormones that may play a role in its growth but not in its genesis), clinical (the presentation is not specific and, despite the aid of modern diagnostic imaging, the preoperative diagnosis may be very difficult and this unusual tumor should be considered in the differential diagnosis of large abdominal masses, especially in young females), histological, radiological and surgical features of this tumor. The recommended treatment, given the low grade of malignancy of the tumor and the excellent overall prognosis, has to be as conservative as possible, with respect to the oncological radicality, but every attempt should be made for complete excision since surgical curability is high and radio-chemo-therapy is of no use for its treatment. Since regrowth of the tumor may occur, prolonged follow-up is mandatory.

Adult↗
PubMed2000

[Our experience with the Hartmann's operation in colorectal emergencies].

BACKGROUND: The role of Hartmann's operation has been revised during the past few years in the context of emergency colorectal surgery: it represents an obligatory choice that enables the simultaneous treatment of the primary disorder and the complication. This study aims to emphasise the importance of this unique surgical choice and to stress that surgeons should not underestimate it. METHODS: The authors review the literature on the subject and make a retrospective analysis of 228 cases of colorectal surgery from 1988 to 1997 in which Hartmann's operation was performed in 16 patients with the following indications: Hinchey's stage III and IV peritonitis secondary to perforating diverticulitis of the sigma (elective indication) or occlusion of the left colon when preparation could not be accomplished in spite of intraoperative washout. RESULTS: Post-Hartmann recanalisation was successfully performed in 14 patients. CONCLUSIONS: The authors' experience and these results concord with the general view that this operation should be reserved for selected cases, in particular colorectal emergencies of a perforating nature; it is less appropriate for intestinal occlusion, although it is always preferable to be too prudent by resorting to Hartmann's operation or protective colostomy rather than risk anastomotic dehiscence.

Colonic Diseases↗
PubMed2000

Ranitidine in the prevention of gastroduodenal damage during antiblastic polychemotherapy.

BACKGROUND: The authors report their personal experience of the use of ranitidine in the prevention of gastroduodenal damage induced by antiblastic drugs during antiblastic polychemotherapy. METHODS: A heterogeneous group of cancer patients was monitored from January 1984 to December 1999 (293 males and 204 females), aged between 36 and 80 years old, a11 of whom were undergoing antineoplastic polychemotherapy. Preventive treatment with ranitidine at a dose of 300 mg/die per os in a single evening bolus continued through the entire period of antiblastic treatment ranging from a minimum of six months to one year or more. The study was carried out in the General Surgery Department of Valdichiana Senese, Local Health Unit 7 in Siena and in the Department of Surgical Oncology at the University of Catania. The study consisted of a clinical and instrumental follow-up using esophagogastroduodenoscopy at the time patients were enrolled and at 3, 6 and 12 months, or at the end of treatment if longer. RESULTS: Ranitidine was useful and could significantly reduce the harmful gastric effects of antiblastic drugs, as has been extensively shown by the literature. These drugs can lead to the suspension of treatment owing to intolerance or even death. In this study ranitidine reduced the damaging effects on the upper digestive tract in respectively 78% of the cases treated compared to 22% of non-responders. CONCLUSIONS: The action of ranitidine made antiblastic treatment more acceptable by mitigating or even blocking the damaging effects on the stomach and duodenum, leading to an improved quality of life for cancer patients.

Journal Article↗
PubMedDate not supplied

Metastatic angiosarcoma of the spleen. A case report and treatment approach.

We report a case of a 28-year-old man with angiosarcoma of the spleen and liver metastases. The aim of this paper is to underline the importance of planned splenectomy in these patients even if they have metastatic disease, and to propose an intensive chemotherapy regimen consisting of anthracyclines, ifosfamide and mesna with G-CSF support.

Adult↗
PubMedDate not supplied

Occult small cell lung cancer associated with paraneoplastic neurologic syndrome: case report.

Cancer is often associated with paraneoplastic syndromes, which may be misinterpreted. We report a case of a patient with occult small cell lung cancer that was initially compounded by clinical features of a paraneoplastic neurologic syndrome. The presence of antineuronal antibodies and positron emission tomography scan guided the search for the underlying tumor. Following chemo-radiotherapy the patient showed no evidence of disease for the next 18 months, whereas only a slight improvement in the neurologic disorders was observed. The course of the small cell lung cancer was very indolent and the paraneoplastic neurologic syndrome did not worsen with the use of cisplatin.

Ataxia↗