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Sampogna G, Caraci F, Carmassi C, Dell'Osso B, Ferrari S, Martinotti G, Sani G, Serafini G, Signorelli MS, Fiorillo A. Efficacy and tolerability of desvenlafaxine in the real-world treatment of patients with major depression: a narrative review and an expert opinion paper. Expert Opin Pharmacother 2023; 24:1511-1525. [PMID: 37450377 DOI: 10.1080/14656566.2023.2237410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 07/11/2023] [Accepted: 07/13/2023] [Indexed: 07/18/2023]
Abstract
INTRODUCTION Major depressive disorder (MDD) is a common severe mental disorder, requiring a tailored and integrated treatment. Several approaches are available including different classes of antidepressants various psychotherapeutic approaches, and psychosocial interventions. The treatment plan for each patient with MDD should be differentiated on the basis of several clinical, personal, and contextual factors. AREAS COVERED Desvenlafaxine - a serotonine-noradrenergic reuptake inhibitor (SNRI) antidepressant - has been approved in the United States in 2008 for the treatment of MDD in adults, and has been recently rediscovered by clinicians due to its good side-effect profile and its clinical effectiveness. A narrative review on efficacy, tolerability and use of desvenlafaxine in clinical practice was carried out. The keywords: 'major depression', 'depression,' 'desvenlafaxine,' 'efficacy,' 'clinical efficacy,' 'side effects', 'tolerability,' 'elderly patients', 'consultation-liaison', 'menopausal', 'young people', 'adolescent' were entered in PubMed, ISI Web of Knowledge, Scopus and Medline. No time limit was fixed, the search strategy was implemented on May 10, 2023. EXPERT OPINION Desvenlafaxine should be listed among the optimal treatment strategies for managing people with MDD, whose main strengths are: 1) ease of dosing; 2) favorable safety and tolerability profile, 3) absence of sexual dysfunctions, weight gain and low rate of discontinuation symptoms; 4) low risk of drug-drug interactions.
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Affiliation(s)
- Gaia Sampogna
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Filippo Caraci
- Department of Drug and Health Sciences, University of Catania, Catania, Italy
- Unit of Neuropharmacology and Translational Neurosciences, Oasi Research Institute-IRCCS, Troina, Italy
| | | | - Bernardo Dell'Osso
- Neuroscience Research Center, Department of Biomedical and Clinical Sciences and Aldo Ravelli Center for Neurotechnology and Brain Therapeutic, University of Milan, Milano, Italy
- Department of Psychiatry and Behavioural Sciences, Stanford University, Stanford, USA
| | - Silvia Ferrari
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Dipartimento Ad attività Integrata di Salute Mentale E Dipendenze Patologiche, Azienda USL-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. D'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Gabriele Sani
- Institute of Psychiatry, Department of Neuroscience, Catholic University of the Sacred Hearth, Rome, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health, Psychiatry Section, University of Genoa, IRCCS, San Martino, Genoa, Italy
| | - Gianluca Serafini
- Department of Psychiatry, Department of Neuroscience Head, Neck and Thorax, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Maria Salvina Signorelli
- Department of Clinical and Experimental Medicine, AOU Policlinico Hospital, University of Catania, Catania, Italy
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
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Intrinsic Molecular Subclassification of Urothelial Carcinoma of the Bladder: Are We Finally there? Adv Anat Pathol 2019; 26:251-256. [PMID: 31188799 DOI: 10.1097/pap.0000000000000235] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Bladder cancer is a highly prevalent disease throughout the world usually encountered in older patients, and associated with substantial morbidity, mortality, and cost. The treatment of bladder cancer has remained unchanged for the last several decades. However, in recent years the availability of comprehensive genomic data from The Cancer Genome Atlas and other large projects have considerably improved our understanding of the pathogenesis of these tumors. These studies demonstrated that bladder cancers can be grouped into 2 broad categories namely basal and luminal molecular subtypes with recognizable subgroups in each of these categories. Clinical data suggest that invasive basal cancers are more sensitive to neoadjuvant chemotherapy (NAC), such that most patients with basal cancers who are aggressively managed with NAC have excellent outcomes. Patients with luminal cancers do not appear to derive much clinical benefit from NAC, but some may appear to be sensitive to anti-programmed death-ligand 1 (PDL1) antibodies and possibly other immune checkpoint inhibitors. It is hoped that future studies will also identify biomarkers such as immunohistochemical markers which may be used to predict therapeutic response of these tumors. This will contribute substantially toward efficient and cost-effective diagnosis and management of these neoplasms.
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Abbaoui B, Lucas CR, Riedl KM, Clinton SK, Mortazavi A. Cruciferous Vegetables, Isothiocyanates, and Bladder Cancer Prevention. Mol Nutr Food Res 2018; 62:e1800079. [PMID: 30079608 DOI: 10.1002/mnfr.201800079] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 06/11/2018] [Indexed: 12/16/2022]
Abstract
Bladder cancer is a significant health burden due to its high prevalence, risk of mortality, morbidity, and high cost of medical care. Epidemiologic evidence suggests that diets rich in cruciferous vegetables, particularly broccoli, are associated with lower bladder cancer risk. Phytochemicals in cruciferous vegetables, such as glucosinolates, which are enzymatically hydrolyzed to bioactive isothiocyanates, are possible mediators of an anticancer effect. In vitro studies have shown inhibition of bladder cancer cell lines, cell cycle arrest, and induction of apoptosis by these isothiocyanates, in particular sulforaphane and erucin. Although not yet completely understood, many mechanisms of anticancer activity at the steps of cancer initiation, promotion, and progression have been attributed to these isothiocyanates. They target multiple pathways including the adaptive stress response, phase I/II enzyme modulation, pro-growth, pro-survival, pro-inflammatory signaling, angiogenesis, and even epigenetic modulation. Multiple in vivo studies have shown the bioavailability of isothiocyanates and their antitumoral effects. Although human studies are limited, they support oral bioavailability with reasonable plasma and urine concentrations achieved. Overall, both cell and animal studies support a potential role for isothiocyanates in bladder cancer prevention and treatment. Future studies are necessary to examine clinically relevant outcomes and define guidelines on ameliorating the bladder cancer burden.
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Affiliation(s)
- Besma Abbaoui
- Foods for Health Discovery Theme, The College of Food, Agricultural and Environmental Sciences, The Ohio State University, Columbus, OH, 43210.,Department of Food Science and Technology, The College of Food, Agricultural, and Environmental Sciences, The Ohio State University, Columbus, OH, 43210.,Integrated Biomedical Science Graduate Program, College of Medicine, The Ohio State University, Columbus, OH, 43210
| | - Christopher R Lucas
- Integrated Biomedical Science Graduate Program, College of Medicine, The Ohio State University, Columbus, OH, 43210.,Department of Mechanical and Aerospace Engineering, The College of Engineering, The Ohio State University, Columbus, OH, 43210.,Comprehensive Cancer Center, The Ohio State University, Columbus, OH, 43210
| | - Ken M Riedl
- Department of Food Science and Technology, The College of Food, Agricultural, and Environmental Sciences, The Ohio State University, Columbus, OH, 43210.,Comprehensive Cancer Center, The Ohio State University, Columbus, OH, 43210
| | - Steven K Clinton
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, 43210.,Division of Medical Oncology, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, 43210
| | - Amir Mortazavi
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, 43210.,Division of Medical Oncology, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, 43210
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2 - Epidemiologia E Classificazione Istopatologica. TUMORI JOURNAL 2018; 104:S8-S13. [PMID: 29893175 DOI: 10.1177/0300891618766105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Abstract
Aims To analyze the prevalence of colorectal cancer (CRC) in different areas of Italy by age, interval since diagnosis and disease stage at diagnosis, and to estimate the prevalence of CRC. These data provide estimates of patient demand on health resources. Patients and Methods Eleven Italian cancer registries (CRs) provided data on 33,740 patients observed for up to 15 years. For the 1,829 cases from the specialized colorectal cancer registry of Modena we analyzed prevalence by Dukes’ stage and family history. PREVAL software produced observed prevalence figures by time from diagnosis; to determine the total prevalence, correction factors were applied to the observed data. Results At the end of 1992, five-year CRC prevalence was high (close to 200 per 100,000) in Genova, Parma, Romagna and Firenze, and low (around 75 per 100,000) in the southern areas of Latina and Ragusa. For all CRs, 86 patients per 100,000 population were alive up to 2 years from diagnosis and 77 per 100,000 between 2 and 5 years from diagnosis. The 5-year prevalence of patients diagnosed with Dukes’ B or C (high risk of recurrence and requiring postoperative surveillance) was 152 per 100,000; that of Dukes’ A patients 36 per 100,000 (considered cured after surgery and not requiring intensive follow-up or care); that of unstaged patients plus those with distant metastasis at diagnosis was 28 per 100,000 at 5 years (requiring palliative care but not follow-up). The 12-year prevalence of HNPCC was 23 per 100,000, or about 7% of the total; for such patients knowledge of the long-term prevalence is important because they are diagnosed young and are at high risk of multiple tumor development. Conclusions 70% of the prevalent patients diagnosed within 5 years prior to the prevalence date were likely to require care for cancer recurrence, while 13% of the prevalent cases required care for distant metastases.
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Affiliation(s)
- G Gatta
- Epidemiology Division, National Cancer Institute, Milan, Italy
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Matsuda Y, Seki A, Nonaka K, Kakizaki M, Wang T, Aida J, Ishikawa N, Nakano Y, Kaneda D, Takata T, Takahashi-Fujigasaki J, Murayama S, Takubo K, Ishiwata T, Sawabe M, Arai T. Clinicopathological characteristics of distant metastases of adenocarcinoma, squamous cell carcinoma and urothelial carcinoma: An autopsy study of older Japanese patients. Geriatr Gerontol Int 2017; 18:211-215. [DOI: 10.1111/ggi.13165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 07/09/2017] [Accepted: 07/17/2017] [Indexed: 01/06/2023]
Affiliation(s)
- Yoko Matsuda
- Department of Pathology; Tokyo Metropolitan Geriatric Hospital; Tokyo Japan
| | - Atsuko Seki
- Department of Pathology; Tokyo Metropolitan Geriatric Hospital; Tokyo Japan
| | - Keisuke Nonaka
- Department of Pathology; Tokyo Metropolitan Geriatric Hospital; Tokyo Japan
| | - Mototsune Kakizaki
- Department of Pathology; Tokyo Metropolitan Geriatric Hospital; Tokyo Japan
| | - Tan Wang
- Department of Pathology; Tokyo Metropolitan Geriatric Hospital; Tokyo Japan
| | - Junko Aida
- Research Team for Geriatric Pathology; Tokyo Metropolitan Institute of Gerontology; Tokyo Japan
| | - Naoshi Ishikawa
- Research Team for Geriatric Pathology; Tokyo Metropolitan Institute of Gerontology; Tokyo Japan
| | - Yuta Nakano
- Department of Neuropathology (Brain Bank for Aging Research); Tokyo Metropolitan Institute of Gerontology; Tokyo Japan
| | - Daita Kaneda
- Department of Neuropathology (Brain Bank for Aging Research); Tokyo Metropolitan Institute of Gerontology; Tokyo Japan
| | - Tadayuki Takata
- Department of Neuropathology (Brain Bank for Aging Research); Tokyo Metropolitan Institute of Gerontology; Tokyo Japan
| | - Junko Takahashi-Fujigasaki
- Department of Neuropathology (Brain Bank for Aging Research); Tokyo Metropolitan Institute of Gerontology; Tokyo Japan
| | - Shigeo Murayama
- Department of Neuropathology (Brain Bank for Aging Research); Tokyo Metropolitan Institute of Gerontology; Tokyo Japan
| | - Kaiyo Takubo
- Research Team for Geriatric Pathology; Tokyo Metropolitan Institute of Gerontology; Tokyo Japan
| | - Toshiyuki Ishiwata
- Research Team for Geriatric Pathology; Tokyo Metropolitan Institute of Gerontology; Tokyo Japan
| | - Motoji Sawabe
- Graduate School of Health Care Sciences; Tokyo Medical and Dental University; Tokyo Japan
| | - Tomio Arai
- Department of Pathology; Tokyo Metropolitan Geriatric Hospital; Tokyo Japan
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Bournakis E, Dimopoulos MA, Bamias A. Management of advanced bladder cancer in patients with impaired renal function. Expert Rev Anticancer Ther 2014; 11:931-9. [DOI: 10.1586/era.10.197] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Leiba A, Kark JD, Afek A, Levi Z, Barchana M, Tzur D, Derazne E, Vivante A, Shamiss A. Overweight in adolescence is related to increased risk of future urothelial cancer. Obesity (Silver Spring) 2012; 20:2445-50. [PMID: 22510956 DOI: 10.1038/oby.2012.83] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Obesity has been linked to various malignancies, but a clear relation of overweight with urothelial cancer has not been established. We assessed the association between adolescent obesity and future risk for urothelial cancer. Medical data on 1,110,835 Israeli adolescents examined for fitness for military duty between 1967 and 2005 were linked to the National Cancer Registry in this nationwide population-based cohort study. We used Cox proportional hazards modeling to estimate the covariate-adjusted hazard ratio (HR) for urothelial cancer associated with BMI measured at age 17. The mean follow-up of 17.6 ± 10.8 years reflected 19,576,635 person years, during which 661 examinees developed urothelial cancer of the bladder, ureter, or renal pelvis. BMI ≥ 85 th standard percentile in adolescence significantly predicted increased risk of urothelial cancer with a HR (adjusted for year of birth, education and religiosity) of 1.42 (95% confidence interval (CI), 1.13-1.77, P = 0.002). Similar results were observed using the ≥ 25 kg/m(2) definition of overweight (HR = 1.36 (95% CI, 1.08-1.72), P = 0.008). Incidence of urothelial cancer was significantly lower in the more educated and among those who attended religious schools. Overweight in adolescence is related to increased risk of future urothelial cancer. In view of the growing incidence of both urothelial cancer and adolescent obesity, our study suggests an avenue for possible prevention of urothelial cancer.
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Affiliation(s)
- Adi Leiba
- Medical Corps, Israeli Defense Force, Tel Aviv, Israel.
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Metastatic pattern of bladder cancer: correlation with the characteristics of the primary tumor. AJR Am J Roentgenol 2011; 196:117-22. [PMID: 21178055 DOI: 10.2214/ajr.10.5036] [Citation(s) in RCA: 148] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the metastatic pattern of muscle-invasive bladder cancer and to correlate the findings with the characteristics of the primary tumor. MATERIALS AND METHODS From a clinic population of 392 patients with muscle-invasive (pT2-4) bladder cancer seen at our institution from January 2004 through December 2009, we studied the cases of 150 consecutively registered patients with pathologically proven metastatic disease. The metastasis-free intervals and metastatic patterns of different T categories were compared by Kruskal-Wallis test and Freeman-Halton extension of Fisher's exact test. Patients were divided into two histologic categories, those with transitional cell carcinoma and those with atypical histologic features. The metastasis-free interval and metastatic pattern of these two groups were compared by Mann-Whitney test and Fisher's exact test. RESULTS The study group consisted of 150 patients (116 men [77%], 34 women [23%]; median age, 64 years). The transitional cell carcinoma group consisted of 94 (63%) patients and the atypical histologic features group of 56 (37%) patients. The most common metastatic sites were lymph nodes (104 patients, 69%), bone (71 patients, 47%), lung (55 patients, 37%), liver (39 patients, 26%), and peritoneum (24 patients, 16%). Patients with tumors of a more advanced T category had shorter metastasis-free intervals (p = 0.001, df = 2). There was no significant difference in the metastatic patterns of tumors in the different T categories. Patients with atypical histologic features had a shorter median metastasis-free interval (3 months; range, 0-29 months) than patients with transitional cell carcinoma (12 months; range, 0-192 months) (p = 0.0001). Patients with atypical histologic features had a significantly higher incidence of peritoneal metastasis (p < 0.0002). CONCLUSION Lymph nodes, bones, lung, liver, and peritoneum are the most common sites of metastasis from bladder cancer. Tumors in a more advanced T category and those with atypical histologic features metastasize earlier. Tumors with atypical histologic features also have a higher frequency of peritoneal metastasis.
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Molaschi M, Martinelli E. Apparato gastrointestinale nell’anziano: modificazioni età-correlate e patologie più comuni. RADIOLOGIA GERIATRICA 2007:351-356. [DOI: 10.1007/88-470-0486-1_36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Morra E, Cesana C, Klersy C, Barbarano L, Varettoni M, Cavanna L, Canesi B, Tresoldi E, Miqueleiz S, Bernuzzi P, Nosari AM, Lazzarino M. Clinical characteristics and factors predicting evolution of asymptomatic IgM monoclonal gammopathies and IgM-related disorders. Leukemia 2004; 18:1512-7. [PMID: 15322559 DOI: 10.1038/sj.leu.2403442] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We evaluated the prognostic features of 384 asymptomatic IgM-monoclonal gammopathies (aIgM-MGs) and 74 IgM-related disorders (IgM-RDs), two clinically distinct groups as proposed by the Second International Workshop on Waldenström's Macroglobulinemia (WM). The cumulative probability of evolution to lymphoid malignancy at 5 and 10 years was 8% (95% CI, 5-13%) and 29% (95% CI, 21-38%), respectively, in aIgM-MGs; it was 9% (95% CI, 4-20%) and 16% (95% CI, 7-31%), respectively, in IgM-RDs (P=0.26). At a median follow-up of 45 months (12-233), 45 aIgM-MGs (11.7%) evolved to symptomatic WM (n=41), non-Hodgkin's lymphoma (NHL) (n=2), IgM multiple myeloma (n=1), and primary amyloidosis (n=1). At a median follow-up of 60 months (13-195), seven IgM-RDs (9.5%) evolved to symptomatic WM (n=6), and B-chronic lymphocytic leukaemia (n=1). At univariate analysis, in aIgM-MGs bone marrow lymphoplasmacytic infiltration, high erythrocyte sedimentation rate (ESR), haemoglobin level, IgM size, and lymphocytosis significantly correlated with evolution probability. At multivariate analysis, the latter two parameters strongly correlated with prognosis, haemoglobin being associated with a trend for a higher progression risk. In IgM-RDs IgM size, neutropenia, lymphocytosis, detectable Bence Jones proteinuria, and high ESR were associated with evolution probability. In conclusion, asymptomatic IgM-MGs and IgM-RDs are distinct clinical entities with similar probability of transformation to lymphoid malignancy.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Amyloidosis/diagnosis
- Amyloidosis/immunology
- Amyloidosis/metabolism
- Biological Evolution
- Biomarkers, Tumor/metabolism
- Disease Progression
- Female
- Follow-Up Studies
- Humans
- Immunoglobulin M/immunology
- Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis
- Leukemia, Lymphocytic, Chronic, B-Cell/immunology
- Lymphoma, Non-Hodgkin/diagnosis
- Lymphoma, Non-Hodgkin/immunology
- Male
- Middle Aged
- Monoclonal Gammopathy of Undetermined Significance/diagnosis
- Monoclonal Gammopathy of Undetermined Significance/immunology
- Multiple Myeloma/diagnosis
- Multiple Myeloma/immunology
- Predictive Value of Tests
- Prognosis
- Survival Rate
- Waldenstrom Macroglobulinemia/diagnosis
- Waldenstrom Macroglobulinemia/immunology
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Affiliation(s)
- E Morra
- Division of Hematology Niguarda Ca' Granda Hospital, Milan, Italy.
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Villa S, Bedini N, Fallai C, Olmi P. External beam radiotherapy in elderly patients with clinically localized prostate adenocarcinoma: age is not a problem. Crit Rev Oncol Hematol 2003; 48:215-25. [PMID: 14607384 DOI: 10.1016/j.critrevonc.2003.05.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The files of 183 elderly patients aged >70 years, with localized prostate cancer (T1-3, N0-X, M0), treated with radical external radiation therapy (ERT) from January 1992 to December 2001 at the Radiotherapy Department of the Istituto Nazionale Tumori of Milan, were reviewed. Median age was 75 years. ERT represented the sole treatment for 73 patients (39.9%); in 110 cases (60.1%) hormonal therapy (HT) was associated with neoadjuvant intent. Five-year overall, disease-specific and biochemical NED (bNED) survival rates were 90.2, 93.7 and 63.2%, respectively. A subset of 23 patients aged 80 years and over were analyzed and compared to 160 men aged 70-79 years. Acute toxicity and late complications were analyzed in the two groups of patients according to the RTOG scoring system. Only 10 patients (5.4%) showed grades 2-3 (G2-3) late sequelae. The results obtained in this single-institute series highlight the pivotal role of ERT in the management of clinically localized prostate cancer in the elderly.
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Affiliation(s)
- Sergio Villa
- Department of Radiotherapy, Istituto Nazionale Tumori, Milan, Italy.
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Motta M, Ferlito L, Malaguarnera L, Vinci E, Bosco S, Maugeri D, Malaguarnera M. Alterations of the lymphocytic set-up in elderly patients with cancer. Arch Gerontol Geriatr 2003; 36:7-14. [PMID: 12849094 DOI: 10.1016/s0167-4943(02)00053-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
It is assumed that the increased incidence of neoplastic pathologies with advancing age is correlated with the immunosenescence and with the altered immune-surveillance. The present study was aimed at evaluating the role of the immunocompetent system and immunosenescence in carcinogenesis. A pool of 99 subjects (38 females, 61 males) has been analyzed in three groups as follows. Group A: 51 elderly subjects with cancer (16 females and 35 males, average age 73.7 +/- 7.5 years). Group B: 24 young subjects with cancer (12 females, 12 males, average age 49.5 +/- 10.3 years). Group C: 24 elderly subjects without any clinical evidence of cancer (10 females, 14 males, average age 74.6 +/- 6.3 years). Hemo-chromocytometric analysis and cytofluorimetric typifying have been performed in all subjects. A decrease of T (CD3+)-lymphocytes has been observed in group A, if compared to group B (P < 0.007), and to group C (P < 0.01), The T (CD4+)-lymphocytes were fewer in group A, than in group C (P < 0.004), and also the NK cells showed the same trend (P < 0.002). The numbers of leukocytes and monocytes increased in group A compared to group C (P < 0.01 and P < 0.004, respectively). Red cell numbers, hemoglobin and hematocrit values were lower in group A than in group B (P < 0.03, P < 0.03, P < 0.01, respectively), and also than in group C (P < 0.007, P < 0.001, P < 0.01, respectively), The results demonstrate that the alterations of the immunocompetent cells, particularly of the T-cell pool, may play an important role in the carcinogenesis of the elderly.
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Affiliation(s)
- M Motta
- Department of Longevity Sciences, Urology and Neurology, University of Catania, Cannizzaro Hospital, Via Messina 829, I-95124 Catania, Italy
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Alonso Gordo JM, Bárcena Marugán A, Jiménez Del Val D, Palacios Rojo JJ, Royo Sánchez C, Urbina Torija J. [Prevalence of cancer in the Guadalajara health area]. Aten Primaria 2003; 32:150-7. [PMID: 12975102 PMCID: PMC7681869 DOI: 10.1016/s0212-6567(03)79237-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To quantify the prevalence of cancerand its distribution in adults. DESIGN Descriptive study of point prevalence through research into primary and secondary sources. SETTING Primary care, Guadalajara Health Region. 133 539 people over 14 years old. PARTICIPANTS Patients previously diagnosed with cancer, who had a health card in the health area in June 1999. MEASUREMENTS Demographic and diagnostic details (location according to CIE-9, date and diagnostic method). DATA SOURCES primary care clinical records, cancer morbidity records and attendance orders. Overall crude and adjusted rates, in function of sex and age group, and specific to locations, were calculated. They were compared with data from other studies and data calculated for Spain on the basis of WHO information. RESULTS 2717 tumours (2595 patients). Mean age, 68.2 (95% CI, 67.6-68.7); diagnostic age, 62.8 (95% CI, 62.1-63.5), in both cases higher in men (P<.01). Most common tumours: prostate, bladder, colon and lung (men); breast, colon, endometrium and ovaries (women). Crude prevalence: men, 2303.8/100 000; women, 1763.8. Adjusted to world population: 1394.2 and 1227.4/100 000, respectively (prevalence ratio, 1.14; 95% CI, 1.03-1.25). Truncated rate higher in women than in men (1638/100 000 against 1308). Five-year period with highest prevalence: 75-79 years old in men (8763.5/100 000) and 80-84 in women (4558.7/100 000). CONCLUSIONS Cancer prevalence in adults is slightly above 2%. Once adjusted for age, values are similar to other studies and as expected for our country. The most common tumours are in the digestive apparatus, breast and the genito-urinary system. The man/woman proportion is higher than that described in other studies.
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Malaguarnera L, Ferlito L, Di Mauro S, Imbesi RM, Scalia G, Malaguarnera M. Immunosenescence and cancer: a review. Arch Gerontol Geriatr 2001; 32:77-93. [PMID: 11313099 DOI: 10.1016/s0167-4943(01)00087-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The human neoplastic pathologies are age-dependent. The increased occurrence of tumors observed with advancing age may be determined by the accumulation of certain phenomena promoting different phases of neoplastic processes. In these events, important roles can be attributed to mutations of the genome that accumulate during aging and to the immunosenescence. It may be hypothesized that certain tumors controlled by the immune system may become more frequent in the elderly as a consequence of the decreased functionality of this important defense system of the organism. Nevertheless, the problems of the interrelationships between the immunosenescence and tumors are seriously contradictory. Therefore, on the one hand, one has to establish how much the immunodeficit of the elderly patient may be responsible for the neoplastic pathology, while on the other hand, one cannot neglect important environmental and pathophysiological factors in these cases.
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Affiliation(s)
- L Malaguarnera
- Department of Biomedical Sciences, Via Androne, 83, Catania, Italy
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