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R Fardelli

Publications and source records attributed to R Fardelli.

30 records · Page 2Linked to original sources
PubMed1985

Preoperative carcinoembryonic antigen and prognosis in patients with colorectal cancer.

The relationship between preoperative CEA, Dukes staging and disease recurrence, was analyzed in 92 patients with colon-rectal cancer, all who underwent curative surgery. Sixty-five of the 92 patients were followed for 36 months. A significant increase in disease recurrence risk is observable starting from a preoperative CEA value of greater than 7.5 ng/ml; corresponding values as such are verified by a significant fall in the actuarial survival curve in comparison to the progress of the curves of the other two groups with lower CEA values. A statistically significant correlation between preoperative CEA and staging was not observed, while both parameters result statistically very reliable (p less than 0.001) for prognosis; preoperative CEA values, less or greater than 7.5 ng/ml can help to stratify the Dukes tumours with respect to the probability of recurrence.

Adenocarcinoma↗
PubMedDate not supplied

Is intensive follow-up really able to improve prognosis of patients with local recurrence after curative surgery for rectal cancer?

BACKGROUND: Because more than 90% of local recurrences after curative surgery for rectal cancer appear within the first 36 months after surgery, an intensive and strict follow-up program during this period could improve early diagnosis and, thus, prognosis of patients. METHODS: Of the 216 patients who underwent surgery for rectal cancer, 127 entered an intensive follow-up program (median follow-up: 42 months); the clinical outcome of the remaining 89 patients was reconstructed with the help of their general practitioners. RESULTS: Fifty eight (26.8%) of the 216 patients who were treated with curative surgery alone developed a local recurrence; pelvic recurrences were prevalent. Eleven (30.5%) of the 36 patients who had recurrence during follow-up, and 6 of the 22 who had not undergone follow-up, had a reoperation with curative intent; the median survival was 19 months vs. 8 months, respectively (P = ns). Four (44.4%) curative reoperations were performed on the 9 asymptomatic patients and in 13 (26.5%) of the 49 cases with symptomatic local recurrences. Median survival was 15 months vs. 14 months, respectively (P = n.s). All patients except one (living after 42 months from reoperation) died within 48 months. CONCLUSIONS: In our study, adherence to a strict follow-up program unfortunately proved to be ineffective for improving long-term survival for patients who underwent reoperation with curative intent.

Adenocarcinoma↗
PubMedDate not supplied

Primary mucinous adenocarcinomas and signet-ring cell carcinomas of colon and rectum.

Of 352 patients with colorectal carcinoma followed for a minimum of 5 years after surgery, 39 cases (11.1%; median age 60 years) had mucinous adenocarcinoma, and 4 (1.1%; median age 62 years) had signet-ring cell carcinoma. Mucinous carcinomas were most frequently located in the rectum (61.5%) and in the sigmoid colon (15.3%) and presented with stage C and D disease in 41 and 15% of the cases, respectively. Disease recurrence was more frequently observed in patients with mucinous (51.7%) or signet-ring lesions (100%) as compared with adenocarcinomas. Five-year survival was 45 (median 48 months), 28 (median 27), and 0% (median 15 months) in patients with adenocarcinomas, mucinous adenocarcinomas, and signet-ring cell carcinomas, respectively (p < 0.05). Mucinous carcinomas of the rectum had had a significantly worse prognosis (5-year survival 17%, median 33 months) as compared with adenocarcinomas of the same site (5-year survival 34%, median 25 months; p < 0.05).

Adenocarcinoma↗
PubMedDate not supplied

Chromogranin-A expression in neoplastic neuroendocrine cells and prognosis in colorectal cancer.

AIMS: Chromogranin-A (CG), a cytoplasmic glycoprotein, is one of the markers most frequently used to identify the presence of neuroendocrine cells in the human gastrointestinal tract. Several authors have identified a subgroup of colorectal cancer patients with a sever prognosis whose tumors contained neuroendocrine CG-positive cells. In the present study, CG expression in 100 patients with colorectal adenocarcinoma treated from January 1983 to December 1988 with potentially curative surgery was analyzed and correlated with other prognostic factors and 5-year survival rate. METHODS: Samples tested immunohistochemically for CG were divided into three groups: I) negative; II) less than 1 CG-positive cell/mm2; III) more than 1 CG-positive cell/mm2. RESULTS: Of 100 patients with primary colorectal adenocarcinoma, 79% had tumors comprised of CG-negative cells, 17% had rare CG-positive cells, and 4% of cases could be classified in group III. No significant relation between CG expression and location of primary tumor, bowel wall infiltration, stage of disease or tumor grade according to Broders and Jass was observed. The 5-year survival was 53% and 52% for CG-positive and CG-negative lesions, respectively. Survival of patients with Dukes-Kirklin stage C and D was comparable in patients with CG-positive (33.3%) and CG-negative (30%) tumors. CONCLUSIONS: CG expression cannot, at present, be recommended as a marker to identify prognostic subgroups in colorectal cancer patients.

Adenocarcinoma↗
PubMedDate not supplied

Extension of lymph node dissection and survival in primary gastric cancer.

The histories of 429 patients who underwent surgery for primary gastric cancer at our ward from January 1970 to December 1985, were reviewed. All patients underwent surgery: potentially curative surgery, 54.8%, non-curative resection, 18.2%; palliative surgery, 27%. Nodal status was as follows: N0, 28%; N1, 17.7%; N2, 44.5%; N3, 9.8%. The incidence of N0 cases was significantly increased in Stage T1 and T2 disease compared to Stage T3 and T4 lesions (p < 0.001). In Stage T3 and T4 patients the incidence of distant metastases increased if lymph node involvement was also present (p < 0.005). In patients without nodal metastases 5-year survival was 70% (median survival: 60+ months) whereas, in patients with lymph node involvement survival was 32% (median survival: 24 months) (p < 0.001). Our data suggest that elective extensive lymph node dissection (R2) is indicated in all patients because survival is improved by this procedure. We recommend R3 lymph node dissection only in macroscopic N3 node involvement patients.

Adult↗
PubMedDate not supplied

CA 195 in colorectal cancer.

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Antigens, Tumor-Associated, Carbohydrate↗
PubMedDate not supplied

Gastric cancer: a review of 400 consecutive cases.

Four hundred out of 422 patients with primary gastric cancer seen from 1965 to 1979 underwent surgical treatment and were studied retrospectively. Fifty-eight percent underwent curative procedures. The five year survival rate was 19.14%. Subtotal and total gastrectomy gave survival rates of 35.8% and 9% respectively (p less than 0.05). Postoperative mortality (24.2%) was influenced by both the type of procedure performed (p less than 0.001) and the stage of the neoplasis (p less than 0.001). This study confirms the influence of staging on short, intermediate and long term survival and demonstrates the importance of the early diagnosis of gastric cancer in carrying out effective surgical treatment.

Adult↗
PubMedDate not supplied

[Choledochal calculosis due to a suture thread].

The authors recently observed a patient suffering from recurrent choledochal, postcholecystectomy calculosis caused by suture thread. Given the relative rarity of this pathology, the difficulty of preoperative diagnosis and the possible confusion with other anatomoclinical syndromes, they take this opportunity to make a number of diagnostic and therapeutic comments in the light of the latest literature on this subject.

Cholecystectomy↗
PubMedDate not supplied

Factors influencing incidence and extension of metachronous liver metastases of colorectal adenocarcinoma. A multivariate analysis.

BACKGROUND/AIM: Three hundred and eighty-seven patients surgically treated for colorectal adenocarcinoma were assessed by a multivariate analysis and the factors influencing incidence and extension of metachronous liver metastases studied. METHODOLOGY: A series of 387 patients which had been surgically treated for colorectal adenocarcinoma between January 1980 to December 1990 and followed-up over a minimum of a 5-year period was retrospectively studied. RESULTS: The most reliable prognostic markers are represented by tumor site (p < 0.05) and, more specifically, by wall infiltration (p < 0.01) and metastatic lymph-nodes (p < 0.05). The only independent variable with a significant impact on stage of metachronous liver metastases was proved to be the depth of wall infiltration (p < 0.05). CONCLUSION: This study confirms the reliability of some indicators of primary tumor in influencing incidence, but not extension, of metachronous liver metastases and this is the main problem when it comes to using prognostic factors in order to modulate the intervals of postoperative follow-up according to risk category.

Adenocarcinoma↗
PubMedDate not supplied

[Critical review of treatment outcome in 54 patients with synchronous liver metastasis of colorectal cancer].

Short- and long-term results of the treatment of 54 patients (12.5%) with synchronous hepatic metastases were critically reviewed by means of retrospective analysis of 431 colorectal cancer patients surgically treated over a period ranging from January 1980 to December 1989. Incidence and stage of hepatic metastases (Gennari Classification, 1984) are not significantly correlated to stage (T3), grade (G2-G3) and mucinous colorectal tumours; but they are significantly correlated to metastatic lymph nodes (p < 0.01). Actuarial survival is significantly influenced by surgery (p < 0.01) and stage of liver metastases (p < 0.05). The restriction of preoperative exclusion criteria and the simultaneous surgical treatment of primary colorectal and secondary hepatic metastases seem to be responsible for the high rates of operative mortality.

Adenocarcinoma↗