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T Maggino

Publications and source records attributed to T Maggino.

At least 55 records · Page 3Linked to original sources
PubMed1992

Carcinoma of the vulva: critical analysis of survival and treatment of recurrences.

Survival analysis of 181 vulvar cancer patients shows that stage and lymph nodal spread remain the most important prognostic factors. Other prognostic elements are: depth of stromal infiltration, thickness and site of the lesion, vascular space invasion. Precise definition of these pathological prognostic elements may be obtained only after appropriate surgical pathological evaluation of the primary lesion and regional nodes. Treatment must be adequate in the cost-benefit balance and surgery is the cornerstone in vulvar cancer management. Risk of relapse is statistically correlated with site of primary tumour, depth of infiltration, lymph nodal invasion and vascular space invasion. The treatment of recurrence is personalized for different sites but surgery is the elective treatment of the local recurrences.

Aged↗
PubMed1992

Clinical experience in gynecological cancer management. d). Ovarian tumors--1) Epithelial: report from the Gynaecological Institutes of Padua University (1963-1990).

A complete review of case series from 1963 to 1990 allows some considerations and conclusions on the clinical management of epithelial ovarian cancer. In the aim of early diagnosis, the ovarian condition must be evaluated also by ultrasound scans, in every woman, at every gynaecological control, and every ovarian or pelvic mass must be carefully examined and removed. Staging is generally recognized as reliable only by surgical pathological evaluation, (SPS) as in post-surgical FIGO staging. Therapy is based on adequate chemosurgical strategy. Surgery, performed in maximum effort, must aim at radicality or adequate debulking, avoiding, however too heavy mutilations, almost always useless for prognosis. Lymphadenectomy, in advanced cases, should be selectively and not systematically performed. Cyclophosphamide and Cis-Platinum appear to be, today too, the most effective regimens as first line chemotherapy. Neoadjuvant chemotherapy must still be well evaluated in its cost-benefit balance and personalized in particular cases. Second laparotomic look must be personalized in respect to residual disease after primary surgery and tumoral aggressiveness factors.

Clinical Protocols↗
PubMed1991

Clinical experience in gynecological cancer management. c). Cervical cancer: report from the Gynecologic Institutes of Padua University (1963-1989).

The retrospective analysis of 1876 cases of invasive cervical cancer allows some considerations and conclusions on the clinical management of this neoplasia. Always led by the Gynaecologist, in the aims of prophylaxis and early diagnosis, personalized screening are necessary, with regard to risk factors. Surgical Pathological Staging (SPS) is mandatory for adequate treatment and prognosis. By personalizing surgical radicality and avoiding the application, in all cases, of the routine and standard extended operations of the past, it may be possible to reduce the complication rate with 5 year survival rate unchanged. In early stages personalized radical operations with systemic pelvic lymphadenectomy allow the best results (94% 5 year survival rate). Integrated therapies must be planned only in lymph nodal positive or in vascular space invasion cases. In advanced cases, surgery must be personalized in enlarged operations and integrated with adjuvant treatments on the basis of surgical pathological findings. In very advanced stages, integrated therapies, even without surgery, are justified, due to the poor prognosis of these cases.

Combined Modality Therapy↗
PubMed1991

Early detection of endometrial cancer and hyperplasia: a reappraisal.

It is widely recognized that endometrial carcinoma represents one of the most frequent types of pelvic malignancy in women. Recent improved knowledge about population at risk, the criteria of classification of endometrial hyperplasia, different potential for neoplastic transformation for each type of neoplasia, and asymptomatic latency of the pathology allow some considerations. Endometrial cytology is of basic importance in a mass screening programme due to its low cost, accuracy and feasibility. The combination of hysteroscopy and endometrial biopsy is the diagnostic method of choice for symptomatic patients. It permits the elimination of curettage in the diagnostic management in over 95% of cases, with obvious advantages, better diagnostic accuracy and greater convenience for patients and doctors.

Biopsy↗
PubMed1990

Clinical experience in gynecological cancer management. b) Vulvar cancer: report from the Gynecologic Institutes of Padua University (1963-1989).

A review of the case series of our Institute from 1963 to 1989 (197 patients) permits some considerations and conclusions on the clinical management of vulvar cancer. In the aim of prophylaxis, prevention and early detection, personalized screening must be systematically performed in clinical practice by the Gynecologist. Surgical Pathological Staging (post-surgical FIGO stages) is mandatory for the exact knowledge of local tumor spread, lymph nodal involvement, aggressiveness factors and possible neoplastic multicentricity. In our experience operability is now 93%, with pathological radicality in 93% of operated cases. In early stages lymph nodal involvement is low (8.6% in tumor less than 2 cm; post surgical FIGO stage I) but it is very high in advanced cases. Surgery is the treatment of choice both in early and advanced stages. The increasing incidence of early vulvar cancer in young women has obliged us to reduce the cost to the patient of the surgical strategy to avoid mutilation in order to improve the quality of life without endangering survival. With this aim, since 1975 we have been performing an enlarged non mutilant radical vulvectomy which allows a better post operative period, with a low rate of complications and the preservation of anatomo-functional integrity. Furthermore 5 year survival rate appears unchanged while the quality of life greatly improves in cases treated by non mutilant operation. In any case of invasive tumor bilateral systemic inguinal lymphadenectomy must be performed and frozen biopsies are useful for planning the best surgical strategy. Integrated therapies are useful in advanced cases and in lymph nodal involvement. Close follow-up is mandatory.

Combined Modality Therapy↗
PubMed1990

Clinical experience in gynecological cancer management. Endometrial cancer: report from the gynecological institutes of Padua university (1963-1989).

A complete review of case series from 1963 to 1969 (603 patients) permits some considerations and conclusions on the clinical management of endometrial cancer. In the aims of prophylaxis, prevention and early diagnosis, personalized, not routine mass screenings, are the best in clinical practice by gynecologists. Surgical Pathological Staging (SPS) is mandatory for adequate treatment and prognosis. Operability is now 96%, with surgical pathological radicality in 98% of operated patients. In early stages lymphnode involvement was low (5%), in advanced, high (31%). In uterine cancer the simple surgical exploration, when negative, is reliable in 90.9% for parametrial and 89.9% for lymphnodal status; consequently in early stages surgical exploration can lead to pelvic lymphadenectomy, or not. Simple surgical operations are almost always enough for good radicality, while enlarged operations must be personalized only in particular advanced cases. Five-year survival is better with surgery alone in the early stages (SPS A1-A2) rather than surgery plus integrated therapies. On the contrary, in advanced stages limited to the corpus uteri (SPS A3) surgery plus integrated therapies gives the best results in 5-year survival rates. In advanced cases growing outside the corpus uteri (SPS B) both surgery alone and surgery plus integrated therapy are disappointing, and the 5-year survival is the same. The incidence of vaginal cuff relapses is the same, with or without complementary radiotherapy, which we have abandoned. Close follow-up allows for the early treatment of relapses, improving quality of life and survival.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1988

Antiblastic chemotherapy and reproductive life.

In the present work the Authors, on the basis of most recent literature have tried to show some general outline with regard to the effects of antiblastic chemotherapy on the "ovarian function" in patients of pre-puberal and fertile age, understood that this would mean complex interference between endocrine and gametogenic; they have besides faced the problem of the gestational capacity of such patients. Notable difficulties have derived from the fact that the data in Literature are often non-comparable among themselves and, at times, discordant. However, although they have been unable to reach unequivocal conclusions, they hope to have made some practical contribution to those who, ever more often, find themselves having to face such problems.

Abnormalities, Drug-Induced↗
PubMed1988

Management of cervical cancer and surgical-pathological staging (SPS). Report of our clinical case series.

FIGO staging is imprecise in a relevant number of cases of cervical cancer, especially in advanced stages, when the prognosis and the choice of the therapy are most delicate. The Authors examine their case series about the index of correction of FIGO staging after Surgical Pathological Staging (SPS). Surgical Pathological Staging was applied systematically in 788 cases and revealed errors in FIGO staging in 16% of cases at stage I; 77% at stage II; and 96% at stage III. SPS allows a more precise knowledge of neoplastic diffusion and consequently to the elimination of many false advanced stages and to adequate the treatment. Furthermore 5 year survival rate confirms the role of SPS and Surgical therapy alone or combined with Radiotherapy and Chemotherapy in every stages of diffusion of cervical cancer.

Female↗
PubMed1987

CA-125 serum level in the diagnosis of pelvic masses: comparison with other methods.

The Authors have evaluated the diagnostic contribution offered by the serum dosage of the antigen CA-125 in the diagnostics of pelvic masses. This method has been compared with the objective and echographic evaluation, as a noninvasive method of enquiry in the diagnosis of malignant neoplasias of the ovary. The Authors endorse the increase in diagnostic sensitivity brought about by the evaluation of this marker, above all if it is inserted into an integrated diagnosis.

Adult↗
PubMed1987

Clinical considerations on the metastases of mammarian cancer.

The Authors examine the prognostic value of metastatic breast cancer and the consequent possibility of therapy. They discuss the role of steroid receptor determination both in prognosis and in planning treatment. Their personal experience confirms the positivity of Progestinic receptors as a more specific index of hormono-sensitivity in regard to the positivity of the single estrogen receptors. Concerning therapy, in metastatic breast cancer the association between chemo- and hormono-therapy may offer better results, acting on different cell populations, though it probably does not improve the survival rate.

Breast Neoplasms↗
PubMed1986

Localized ovarian cancer: surgery plus chemotherapy.

Fifty-four patients were referred to Medical Oncology after operation for "limited" ovarian cancer; 7 were excluded because immediate restaging showed evidence of macroscopic spread to structures outside the true pelvis, and 10 will be considered separately because of microscopic spread shown only by cytology. Thirty-seven patients (31 stage I and 6 stage II) were accordingly accepted as "localized", because peritoneal cytology and diaphragm and omental plus parietal peritoneum histology could rule out the spread to the large abdominal cavity. Some of the referred patients had been operated in nearby hospitals; the Padua GYN Cin. performed 14 of the 37 first surgery operations and 30 of the 37 second look operations. All patients soon after surgery underwent first-line chemotherapy with 5 courses of high dose adriamycin plus cyclophosphamide for 4 months, then surgical second look, and second-line non-cross-resistant chemotherapy for 3 months. During the second look the organ and tissue removal was completed in those 21 patients having received "limited" first surgery. Two patients died within 5 years from admission, so that the overall 5 year actuarial survival from referral is 93% for the entire group with 11 patients still at risk; 87% are disease free 5 years after the second look with 7 at risk. Subdivision of the patients according to "adequate" vs. "limited" first surgery, may select a group (the "adequate" one, composed of 16 patients) completely free from relapses, up to now. The complex therapeutic program described seems to offer long term relapse-free survival to the majority of patients, while the few failures seem closely related with inadequacies of the initial surgical procedure.

Adolescent↗
PubMed1986

Malignant trophoblastic neoplasias. Clinical experiences.

The Authors describe a treatment program for malignant trophoblastic disease based on a combination chemotherapy. The results of their clinical experience concerning 41 cases confirms the high cure rate for low risk metastatic disease (100%) with the only failures limited to the high risk patients (64.7% cure rate).

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1986

Endometrial hormonal receptors as marker of benign breast disease (B.B.D.).

The problem of hormonal treatment of benign disease and mastodynia is still dividing Clinicians and Researchers. The Authors, in order to select the patients suitable to be treated, propose the assay of Estradiol and Progesterone Receptors in the most accessible hormone-dependent tissue: the Endometrium. Author's data point out a quite different behaviour of Estradiol and Progesterone cytoplasmic receptors in the Endometrium of women with B.B.D. and controls. The knowledge of this information in the single patients will release from subjectivity when deciding about B.B.D. therapy or when trying to correct unsatisfactory treatment.

Adult↗
PubMed1985

Peptichemio in pretreated patients with ovarian cancer.

From January 1978 to October 1982, 47 patients with histological diagnosis of epithelial cancer of the ovary received peptichemio (PTC) at a dose of 70 mg/m2 (maximum, 120 mg total) every 15 days. Forty-two patients are now evaluable: 27 with stage III and 15 with stage IV disease. All patients but four with stage IV disease had been pretreated and had received at least one drug combination (median, three drugs per patient, including alkylating agents). Before the administration of PTC, the tumor extension in the abdomen was carefully assessed in all patients: ten patients had residual tumor less than 2 cm in diameter, while 32 patients had tumor greater than 2 cm in diameter. Objective responses were obtained in ten patients (23.8%): six complete remissions and one partial remission were observed in stage III patients and one complete remission and two partial remissions were observed in stage IV patients. Of the ten responding patients, eight had tumors less than 2 cm in diameter before receiving PTC. The median duration of response was 16 months. The most frequent side effects were myelosuppression and phlebosclerosis. Bone marrow depression was a common finding after the third course in heavily pretreated patients. Accordingly, in these patients a schedule interval of 3 weeks should be more appropriate. Since most of the responders were in the "small tumor" category, PTC appears to be an active drug in patients with ovarian cancer having small tumors (less than 2 cm). On the other hand, the response rate in a nonselected population of patients remains to be clearly defined with further studies.

Adult↗