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Biomedical subjects

M R De Marco

Publications and source records attributed to M R De Marco.

7 recordsLinked to original sources
PubMed2002

An assessment of factors related to tumor thickness and delay in diagnosis of melanoma in southern Italy.

BACKGROUND: Since survival of patients with melanoma is strongly correlated with the Breslow tumor thickness of the primary lesion, factors that influence stage at diagnosis and delay in diagnosis are considered to be crucial. To test the relationship between tumor thickness and some social and clinical variables (including diagnosis/treatment delay) and the relationship between the diagnosis/treatment delay and some clinical variables, we analyzed data on 530 patients with melanoma from our Institute. METHODS: In the analysis, Breslow tumor thickness was categorized into two categories (< or =1.49, > or =1.5). Three time intervals were examined to evaluate diagnostic delay: patient delay, time from first symptom to seeking medical advice; medical delay, time from first medical consultation to hospital admission; total delay, time from first symptom to resection. The variables evaluated in the analysis were: age at diagnosis, education, occupational status, first symptom, visibility of tumor, anatomic site, and physician who made the initial diagnosis. RESULTS: A significant risk of having a Breslow tumor thickness > or =1.5 mm was noted in patients who had a low level of education (odds ratio 3.0, 95% confidence interval 1.9-5.0) or who were unemployed (odds ratio 1.7, 95% confidence interval 1.1-2.8). With respect to patient delay, a delay >3 months for anatomic locations visible to patients was associated with significant risk (odds ratio 1.7, 95% confidence interval 1.1-2.6); with respect to medical delay, a delay >3 months was associated with a higher risk in patients examined by a dermatologist (odds ratio 2.0, 95% confidence interval 1.2-3.4). CONCLUSIONS: Our results clearly indicate that in Southern Italy poorly educated and unemployed subjects are at risk of being diagnosed at a more advanced stage, and admission to an oncological hospital causes a delay (waiting list) in the time interval related to the doctor (medical delay).

Diagnostic Errors↗
PubMed2001

HHV-8 prevalence, immunosuppression and Kaposi's sarcoma in South Italy.

The identification of HHV-8 has opened the way for numerous epidemiological studies aimed at determining both the prevalence of HHV-8 in various sub-groups of the population (affected or not by KS) and at identifying possible cofactors necessary for the development of KS. We set up a study to evaluate the prevalence of HHV-8 in the South of Italy in KS cases, hospital patients and blood donors and to verify the role of immunosuppression in KS. In KS patients the prevalence of lytic and latent antigens were both 91% (29 positive cases). Lytic and latent antigens have prevalence rates of 20% and 15% respectively in hospital patients. In the donor group the rates were 16% for lytic antigens and 2% for latent antigens. The most recurrent chronic pathology in KS patients was cardiopathy (5 cases). The pathological case histories report 4 cases of Herpes Zoster, 6 of diabetes, one case of hepatitis C who had also had gonorrea. There was also a case, negative to HHV-8, who had had malaria after residing for three years in Oristano in Sardinia (a zone with high endemic malaria). Our study confirms that in Southern Italy there are relatively high prevalences of HHV-8 both in the general population and in blood donors and that immunodysregulation may be involved in the pathogenesis of KS. Other studies are necessary to confirm the sexual transmission of the HHV-8 virus and to better understand the natural history of HHV-8 infection.

Adult↗
PubMed1998

Multimodal treatment strategy for locally advanced breast cancer.

Between 1990 and 1995, 87 patients with locally advanced breast cancer were treated with initial chemotherapy consisting of 3-4 cycles of epirubicin and then with surgery, radiotherapy and chemotherapy. All patients with positive or unknown estrogen receptor status were administered tamoxifen. A complete response was observed in 9 patients and a partial response in 64. At a mean follow-up of 29.22 months, 25 patients had died of metastatic disease, and 48 patients are disease-free. 54% patients are alive at 5 years. Statistical analysis confirmed that neither age, menopausal status, size of the primary tumor nor histology seemed to influence the Disease Free and Overall Survival. Improved survival was observed in patients with negative lymph nodes and positive receptor status. The presence of a positive receptor status may be correlated with conserved integrity of hormone sensitivity and with a good response to the hormone therapy.

Adolescent↗
PubMed1995

Epidemiology and survival of endometrial cancer. Valuation of data of National Cancer Institute in Naples 1987-1992.

Cancer of the endometrium is a neoplasm which essentially strikes postmenopausal women and in which the predominant risk factors are recognized as an excessive imbalance of estrogen and obesity. The survival rate is good in the first stage and is acceptable in the second, while in the third and especially the fourth stage is unfavorable. To verify and evaluate such facts we have carried out a study of survival rates on patients admitted in our Institute surgery division from 1987 to 1992. The results confirm the importance of the stage and histologic grading of the determining variables, while there appears to be more controversy regarding the role of myometrial invasion. In conclusion, our data show that intervention by pelvic-aortic lymphadenectomy contributes to an improvement in survival rates independently of stage.

Adult↗
PubMed1993

Survival in ovarian cancers treated at National Cancer Institute in Naples Italy 1985-1990.

Ovarian cancer was reported to be increasing in all developed countries, with the exception of Japan. This increase may partly be due to modified reproductive habits which caused a rise in the age of the first pregnancy, a decrease in the number of pregnancies and a shortening of lactation period. To these factors must be added an extension of ovarian activity caused by early menarche and late menopause. For the reasons stated above and in view of the high mortality of this tumor, a survival study was performed with patients who had undergone operations for ovarian cancer from 1985 to 1990 at the National Cancer Institute in Naples (356 beds, 6500 admissions yearly) where the Hospital Cancer Registry (RTO) is an active service. A total of 159 patients was studied; three of them were lost during the follow-up. The results show a good survival rate both global (28%) and in each stage; a few differences with respect to histological type were also detected.

Adolescent↗
PubMedDate not supplied

High mortality rates from liver cancer in the urban area of Campania Region: prevalence of hepatitis and sociodemographic factors.

The incidence of liver cancer appears lower in Europe and the USA and it is often looked upon as a problem in developing countries. Liver cancer has two main risk factors: the abuse of alcohol and the elevated prevalence of hepatitis B and C viruses. In Italy the first one is mainly present in the North and the second one in Southern less developed areas. Our study evaluates the relationship between living in urban and suburban zones in South of Italy in conditions of overcrowding, poor health services and high incidence of hepatitis and liver cancer.

Adolescent↗