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V Castel

Publications and source records attributed to V Castel.

60 records · Page 4Linked to original sources
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Long-term follow-up and prognostic factors in Ewing's sarcoma. A multivariate analysis of 116 patients from a single institution.

The records of 116 patients from a single center (1970-1993) with newly diagnosed Ewing's sarcoma or primitive neuroectodermal tumor were reviewed retrospectively. The aim of this study was to ascertain the impact of pretreatment variables on disease-free survival. Median age was 14 years (range 1-34). Twenty patients presented with metastatic disease. Treatment consisted of systemic multiagent chemotherapy plus local irradiation (39%), wide resection (22%), or both (35%). Median potential follow-up was 10.7 years (range 2-26). Three patients developed second malignancies (1 breast carcinoma, 2 acute myeloid leukemias). Median time to relapse was 24 months (range 3-143). The actuarial disease-free survival was 37.4% at 5 years, 33.3% at 10 years and 27.8% at 15 years. Neoadjuvant chemotherapy and a therapy-induced tumor necrosis > or = 90% were associated with a better outcome. Patients undergoing surgical resection had a superior disease-free survival than those treated without surgery (45 vs. 18% at 10 years, p = 0.0009). Multiple regression analysis showed that raised serum lactate dehydrogenase levels (p < 0.001), hypoalbuminemia (p = 0.001) and distant metastases at diagnosis (p = 0.03) were independent adverse prognostic factors. In conclusion, one third of patients with Ewing's sarcoma become long-term survivors with combined modality treatment. Late relapses and second neoplasms are of concern. Prognostic factors should be considered in the selection of therapy, and the value of serum albumin warrants confirmatory studies.

Actuarial Analysis↗
PubMedDate not supplied

Immunosuppression. Role on the infectious diseases of oncologic children.

Cancer patients show an immune deficit whose beginnings are influenced to one extent or another, by two factors: the cancer itself, and the antimitotic-immunosuppressive treatment to which the patient is subjected. The immune deficit will have repercussions in the anti-infectious defense that these patients show: --Greater number of infections. --Greater severity of infections. --Tendency towards generalization and showing of septicemic states. The problem is most serious in hematological tumors (leukemia, lymphosarcoma) where the primary cause of death is infection. During the period of activity of the disease, and also in relation to the antimitotic treatment, the PMN will decrease in absolute count and will function poorly. The consequence will be a high frequency of bacterial infections, sepsis, pneumonia, skin infections, etc., predominantly caused by gram-negative germs and staphylococcus (any germ considered not to be "very virulent" can be found); and it will result in a high mortality rate. When these children are in remission or have solid tumors, the problem is not so acute, and bears more relation to antimitotic treatment and other extraneous factors (hospitalization, catheters, antibiotics, gastrointestinal ulcers...). Patients most frequently show localized bacterial, viral and protozoon infections (varicella, zooster, herpes simplex, cytomegalia, pneumocystis) because of the predominance of cellular immunity deficit.

Antibody Formation↗
PubMedDate not supplied

Study of bcl-2 protein expression and the apoptosis phenomenon in neuroblastoma.

BACKGROUND: Prognosis in neuroblastoma is based upon several clinical factors such as age, tumoral staging and other genetic factors like N-myc oncogene amplification or deletion of the short arm of chromosome 1 (del 1p). Recent reports indicate that bcl-2 protein expression is associated with a poor outcome in patients with neuroblastoma. MATERIALS AND METHODS: We present a study of 80 cases from the files of the Spanish neuroblastoma study group (N-II-92) analysing bcl-2 protein expression by means of immunohistochemical methods and its relation with other parameters such as histopathology, PCNA expression, N-myc amplification and DNA study of apoptosis. RESULTS: We found a statistical correlation between bcl-2 protein expression and unfavourable histopathology, N-myc amplification and PCNA nuclear staining. An inverse relation between bcl-2 staining and apoptosis was detected. CONCLUSIONS: Based on present findings it can be concluded that the determination of bcl-2 protein provides prognostic information when associated with other biological factors involved in neuroblastomas.

Apoptosis↗
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Expression of type I interferon receptor and its relation with other prognostic factors in human neuroblastoma.

Expression of type I interferon receptor (IFN-R) has been found in several normal tissues and in malignant neoplasms, mainly those with epithelial differentiation. In order to analyze the immunohistochemical expression of type I IFN-R we studied 79 cases of neuroblastoma. Results of expression of type I IFN-R were statistically correlated with histopathology, stage, bcl-2 and PCNA expression, N-myc amplification and apoptosis. We found expression of type I IFN-R in 54/79 cases showing statistical correlation with bcl-2 expression (P=0.017) and favourable histopathology (P=0.015). The overexpression found in ganglion cells suggests that IFN-R could be involved in the pathway of neuroblastoma differentiation. Moreover, the expression of type I IFN-R in stage 4 cases (12/20), even with N-myc amplification (6/8), opens new possibilities for therapeutic management in advanced cases that do not respond to any chemotherapeutic protocol.

Apoptosis↗