PubMed Health⌕ Search

Biomedical subjects

M Campanacci

Publications and source records attributed to M Campanacci.

At least 217 records · Page 12Linked to original sources
PubMedDate not supplied

Prognostic significance of serum lactic acid dehydrogenase in Ewing's tumor of bone.

Pretreatment serum lactic acid dehydrogenase (LDH) levels were examined in 82 patients with Ewing's tumor of bone (23 metastatic and 59 localized). The percentage of patients with increased serum LDH levels was significantly higher in the metastatic group than in the group of patients with localized disease (87 vs. 45%). After treatment with combined therapy, in this latter group the recurrence rate was significantly higher in patients with elevated serum LDH levels at admission than in those with normal serum LDH levels (50 vs. 9%). Of the 16 patients with localized disease who relapsed, 13 (81%) had elevated serum LDH levels at the time of recurrence. These results indicate that in Ewing's tumor serum LDH levels may serve as useful prognostic markers and could be valuable in monitoring the effectiveness of combined therapy.

Adolescent↗
PubMedDate not supplied

[Osteosarcoma].

Osteosarcoma includes several distinct varieties. It is therefore essential to rely upon a very specialized pathologist. It is necessary to stage the tumor and to histologically define the oncologic quality of the surgical removal (surgical margins). The limb salvage surgery in osteosarcoma involves several areas of risk: the biopsy, the extension of the tumor in the marrow spaces and canal, the impingement or plugging of the vessels by the tumor, the invasion of the joint tissues, the contamination of the joint space and/or soft tissue compartments. The reconstruction after bone segmental resection involves many problems, including long-lasting prostheses, bone bank, microsurgical techniques--the preoperative chemotherapy dramatically reduced the need for amputation, in favour of conservative surgery. A good response to chemotherapy (almost total necrosis of the tumor), is the most important factor correlated with a favorable prognosis. The more recent protocols aim to increase the tumor response and the survival rate through a very intense primary chemotherapy, using Adriamycin, high-dose Methotrexate, Cisplatin and Ifosfamide.

Amputation, Surgical↗
PubMedDate not supplied

[KMFTR (Kotz Modular Femur Tibia Reconstruction System) modular tumor endoprosthesis system for the lower extremity].

206 patients with tumorendoprosteses of the KMFTR-type at the lower extremity were operated at the Institute Rizolli Bologna and at the University Clinic of Vienna. The minimum follow up was 2 years (mean 3.2, max. 8 years). In order to bridge the defect caused by tumor resection the proximal femur was replaced in 42 cases, the distal femur in 119 cases and in 6 patients a total femur prosthesis was used. The proximal tibia was replaced in 35 cases and in 4 cases a total knee prosthesis was implanted. Clinical evaluation according to Enneking revealed 71.6% excellent and good results. In 83.4% the radiological score was higher then 20. We saw deep infections in 8.2% (17 patients), breakage of the prosthesis in 6.8% and aseptic loosening in 5.8%. 3 patients had to be amputated due to infection. In the remaining cases of infection in 66% of the patients healing was observed. All cases of aseptic loosening or breakage could be revised successfully by an exchange of the prostheses and therefore salvage of the leg was achieved.

Adolescent↗
PubMedDate not supplied

Direct cortisone injection in eosinophilic granuloma of bone: a preliminary report on 11 patients.

Eleven patients, between 3 and 16 years of age (average 6.5 years), with eosinophilic granuloma of bone were treated with direct injection of methylprednisolone acetate. Methylprednisolone acetate was used at the dilution of 40 mg/ml. Each single injected dose varied from 1 to 4 ml, depending on the sizes of the radiolucent defect and the soft tissue mass. One patient had four separate injections, one had three injections, five had two injections, and four had a single injection. All 11 patients healed without complications. This method of management is recommended.

Adolescent↗
PubMedDate not supplied

Follow-up protocols in orthopedic oncology.

Little has been written about the specific timing and elements Involved in the follow-up of orthopedic oncology patients. The experience with bone tumor treatment at the First Clinic of the Istituto Rizzoli started 30 years ago and more than 15,000 patients have been treated to date. The increment of limb salvage surgery is linked with the improvements in imaging and surgical skills and with the availability of new reconstructive techniques. For this purpose it is mandatory to carry out meticulous monitoring of the patients. A large number of patients are still followed up to evaluate the results in terms of oncological and functional status. Based on this experience we developed a time schedule to better respond to the need for adequate patient evaluation.

Bone Neoplasms↗
PubMedDate not supplied

Neoadjuvant chemotherapy for osteosarcoma of the extremity in patients in the fourth and fifth decade of life.

From January 1986 to March 1993, 29 patients aged between 40 and 60 years with primary high grade osteosarcoma of the extremity were treated at Rizzoli Institute with neoadjuvant chemotherapy. Before surgery patients received cisplatin and adriamycin. Postoperatively, patients with a good histologic response received the same two drugs preoperatively used, while in case of poor response ifosfamide and etoposide were added to cisplatin and adriamycin. Twenty-five patients (86%) were surgically treated with a limb salvage, whereas 4 patients (14%) were amputated. With a median follow-up of 8 years (5-12), the 8-year event-free survival was 57% and the 8-year overall survival was 62%. No chemotherapy-related deaths were recorded and toxicity was manageable. These results are significantly better than those achieved in 24 patients of the same age, treated at Rizzoli Institute between 1975 and 1985 only with surgery (87% of amputation and 17% of 8-year event-free and overall survival) and indicate an advantage for the use of neo-adjuvant chemotherapy also in patients with high grade osteosarcoma of the extremity older than 40 years.

Adult↗
PubMedDate not supplied

Induction of HLA class II antigens in osteosarcoma cells by interferons and tumor necrosis factor alpha.

In this study we have evaluated the ability of interferons (IFNs) alpha, beta, gamma and Tumor Necrosis Factor (TNF) alpha to modulate the expression of the Major Histocompatibility Complex (MHC) antigens in human osteosarcoma cells. The osteosarcoma cell lines Saos-2 and U-2 OS, treated in vitro with IFNs and TNF alpha, showed an increased expression of class I HLA antigens. However, only IFN gamma and, to a lower extent, IFN beta induced the expression of class II HLA antigens. These effects were dose and time-dependent. Simultaneous treatment with IFN gamma and IFN beta or TNF alpha, which by itself was unable to induce the expression of class II HLA antigens, produced different effects on the two osteosarcoma cell lines: in Saos-2 IFN beta and TNF alpha amplified the effects obtained with IFN gamma alone; in U-2 OS, TNF alpha increased the expression induced by IFN gamma on class II HLA antigens, whereas IFN beta antagonized the effects of IFN gamma. IFN alpha did not influence the induction of class II HLA antigens by IFN gamma in the two osteosarcoma cell lines. IFNs have been introduced in some clinical protocols for the treatment of osteosarcoma, based on their antiproliferative activity. Our findings may contribute to a better knowledge of the effects of IFNs and TNF alpha in osteosarcoma by showing the existence of more complex interactions.

Cell Division↗
PubMedDate not supplied

Selective arterial embolization in the treatment of lesions of the musculoskeletal apparatus.

The authors describe 42 cases of lesions of the musculoskeletal apparatus (traumatic, pseudoneoplastic or tumorous) in which selective arterial transcatheter percutaneous embolization (SAE) was indicated. In 3 patients SAE was not performed because the angiography had shown it to be too dangerous for the spinal cord. Out of 39 patients 2 were embolized in order to stop unrestrainable hemorrhaging (1 post-traumatic and 1 post-bioptic), 7 in order to reduce intraoperative bleeding, while in 7 cases (aneurysmal bone cyst, angioma of bone) the aim was curative. In the remaining 23 patients SAE was performed for adjuvant (8) or palliative (15) purposes in association with radio-and/or chemotherapy (11). In these last 15 cases the clinical results obtained were good in 67% of the cases, with partial or total regression of pain. Healing was obtained in 100% of the patients treated for curative purposes.

Adolescent↗
PubMedDate not supplied

[Magnetic resonance for the study of osteosarcoma].

The authors report their experience with MR imaging in the study of osteosarcoma. Two main elements were evaluated: signal characteristics and loco-regional staging. Seventy-one patients were studied: 65 of them had central long-bone osteosarcoma, and 6 had telangiectatic long-bone osteosarcoma. T1- and T2-weighted spin-echo sequences were employed and all cases were scanned on 3 planes (sagittal, coronal, and axial). In 28 patients MR imaging was performed both before and after preoperative chemotherapy. The obtained data were compared to surgical and pathological findings. With the exception of the typical signal patterns of quite-osteoblastic osteosarcoma (which presents with low signal on both T1- and T2-weighted sequences), no particular signal features were observed which could help distinguish the different types of osteosarcoma. MR imaging is the method of choice in loco-regional staging for, in our series, it allowed a rational and adequate surgical planning. For this purpose, at least a longitudinal T1- and an axial T2-weighted images are required.

Adolescent↗
PubMedDate not supplied

The role of surgery in the treatment of localized Ewing's sarcoma.

This study includes 193 patients affected with localized Ewing's sarcoma and treated at the Rizzoli Orthopaedic Institute between April 1972 and May 1988. It is the purpose of this study to evaluate the efficacy of surgical treatment with regard to the prognosis of patients affected with E.S. and to define its indications as well as its limits as compared with radiotherapy. Ninety patients were treated surgically: 13 underwent amputation (localization of the disease in the leg and foot), 4 underwent debulking, 48 had resection of the tumor without any reconstruction (expendable bones), while for 25 other patients resection of the tumor required alloplastic or allograft replacement. In cases of E.S. localized in the pelvis and spine, surgery did not obtain improvement in prognosis. In the other sites, the percentage of disease-free patients increased from 57% to 72% in cases where surgery +/- radiotherapy was used instead of radiotherapy alone, while the percentage of local recurrences decreased from 18% to 5.5%, respectively. As for functional results, the highest incidence of excellent to good scores was obtained with surgery associated with radiotherapy (69%). The incidence of complications was only slightly different for the two groups.

Amputation, Surgical↗