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Biomedical subjects

U Marone

Publications and source records attributed to U Marone.

8 recordsLinked to original sources

Age as predictor in patients with cutaneous melanoma submitted to sentinel lymph node biopsy.

AIMS: To analyse the age as prognostic factor exploring the melanoma database at the National Cancer Institute in Naples. METHODS: Three hundred and ninety-nine patients with cutaneous melanoma were treated with sentinel lymph node biopsy from 1996 to 2003 at the National Cancer Institute of Naples. The results were analysed with particular attention to the overall survival among patients younger or older than 50 years of age. RESULTS: No differences were recorded between the younger and older group in terms of the identification rate and incidence of metastases. The analyses of disease-free survival and overall survival showed a significantly more favourable outcome in younger patients. The 5-year overall survival and the 5-year disease free survival were 81.8% vs. 68.0% and 76.3% vs. 59.1% for the younger and older group, respectively. CONCLUSIONS: The results suggest that in the management of cutaneous melanoma, age might be considered as prognostic factor both for disease free survival and overall survival.

Adolescent↗

Merkel cell carcinoma: experience of 14 cases and literature review.

Merkel cell carcinoma is an aggressive skin cancer, with a significant incidence of locoregional lymphnode involvement, which requires timely diagnosis, adequate staging and aggressive therapy based essentially on surgical procedures. The aim of this study is to report our experience and to compare our results with literature findings, in order to discuss the role of the procedures adopted and their influence on prognosis. From July 1995 to April 2005, 14 patients were treated and followed-up for MCC in the National Cancer Institute of Naples. Tumor location was: buttocks (43%), extremities (36%) head (7%), unknown (14%). There were 7 Stage I, 5 Stage II and 2 Stage III patients. Surgical treatment consisted in wide excision (WE) in Stage I cases, WE and regional lymphadenectomy followed by radio- or chemo-therapy in Stage II and combined surgical and pre- and post-operative medical treatments in Stage III. Overall disease specific survival rate was 64% (median follow up 44 months). Recurrence occurred in 86% of Stage I and 20% of Stage II patients and involved, in 83.3% of Stage I patients, the lymph nodal draining basin. The treatment of recurrence implied surgery and radio or radiochemotherapy. Overall survival rate of recurrent patients was 57% (median follow-up 37.2 months). Due to the particular lymphotrophism of MCC, major care should be set on investigation and treatment of tumor lymph nodal draining basin. As long as the disease remains surgically manageable the prognosis for patients with MCC is favourable. The role of radio and chemotherapy is not yet assessed.

Adult↗

[Giant Spigelian hernia associated with inguinal hernia. Repair with polypropylene prosthesis].

Spigelian or lateral ventral hernia is a rare pathology, representing about 2% of all abdominal wall hernias. This kind of hernia can be found in the area limited from the umbilicus and anterosuperior iliac spine, near the lateral edge of the rectus abdominis. The authors describe a rare case of "giant" Spigelian hernia related with homolateral direct inguinal hernia. A seventy-year-old and obese patient had a painless huge intumescence in the right side of periumbilical area, and besides--he had a homolateral direct inguinal hernia. Abdominal computerized tomography visualized a hernial gap, which diameter is larger than 7 cm, in pararectal subumbilical site and a wide herniated bowel in interaponeurotic site. This double hernial pathology has been treated in an only solution, placing an only subfascial polypropylene prosthesis, overlapping both hernial defects. The authors believe prosthetic "tension free" repair, previous suture of the defect, represents a gold standard in the treatment of Spigelian hernia. Such refined technique allows an effective repair especially when aponeurotic defect is out of size and/or is related with subsequent homolateral hernia, also allowing an early patient's rehabilitation.

Aged↗

Drainage in thyroid surgery: a prospective randomised clinical study.

Drainage in thyroid surgery is still an area of controversy. We analysed the results of a prospective randomised trial conducted in our institution in order to assess the utility of drainage after thyroid surgery. Sixty patients were entered into the study, thirty of whom were drained after surgery and thirty who received no drainage. The two groups were well matched with regard to most characteristics. There was no difference between the two groups in terms of early or late postoperative complications. We therefore conclude that, in our experience, drainage after uncomplicated thyroid surgery is of no benefit.

Adult↗

[The right inferior laryngeal nerve with a non-recurrent course].

Two cases of a right non-recurrent laryngeal nerve were encountered during the performance of 992 thyroid operations. In its abnormal non-recurrent course the nerve passes transversely from under the carotid sheat hand takes a position which is at right-angles to the normal recurrent laryngeal nerve.

Aorta, Thoracic↗

[Cervico-mediastinal carcinoma of the parathyroid: report of a case].

Parathyroid carcinoma is a rare malignancy. We report the case of a 66 years old man referred to our department for a large substernal goiter suspected as a thyroid cancer associated with severe hyperparathyroidism. After normalization of serum levels of calcemia, total thyroidectomy and subtotal parathyroidectomy was performed. Histopathology revealed a parathyroid cancer of 450 g.

Adenocarcinoma, Clear Cell↗

[Histophenotypical variants of squamous cell carcinoma of the skin].

Cutaneous squamous cell carcinoma (SCC) is, in its most frequent presentation, a moderately aggressive neoplastic disease. It can, however, present in a moltitude of clinico-pathological variants, some of which are characterized by a more malignant attitude. It is important to determine which tumors, among the various histophenotypes, are high risk in order to establish the appropriate treatment and follow-up. Histologic subtype has been considered as a possible variable in determining the prognosis of cutaneous SCC. We report our experience with 3 cases of peculiar variants of cutaneous SCC.

Adult↗

[Role of lymphadenectomy in the treatment of Merkel-cell tumors in i and ii stages].

Merkel cell carcinoma (MCC) is a rare, malignant skin cancer, exhibiting neuroendocrine differentiation, with a significant incidence of locoregional lymph nodal involvement (40%-73%). The accepted staging system classifies MCC as: stage I, localized skin disease; stage II, regional lymph node disease; stage III, metastatic disease. The clinical differentiation of stage I and II patients is difficult and understaging is frequent. Surgery, as first approach, represents the leading treatment for this neoplasm and, depending on stage consists in: local wide excision for stage I patients and local excision and lymphadenectomy for stage II. In our experience, lymphadenectomy, included in the initial treatment of all stage II patients, seemed to influence positively the prognosis. In comparing stage related recurrence and survival rates the results we obtained were better in stage II patients, where lymphadenectomy was included in the initial treatment than in stage I subjects, who received local excision alone as first treatment and lymphadenectomy as secondary treatment for nodal recurrence (overall recurrence rate 86% vs 20%, survival rate 71% vs 80% in stage I vs stage II patients). The performance of lymphadenectomy for stage I MCC could be reconsidered both for a more reliable staging of the disease and for a positive impact on recurrence and survival rates.

Carcinoma, Merkel Cell↗