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Lo Russo G, Sgambelluri F, Prelaj A, Galli F, Manglaviti S, Bottiglieri A, Di Mauro R, Ferrara R, Galli G, Signorelli D, De Toma A, Occhipinti M, Brambilla M, Rulli E, Triulzi T, Torelli T, Agnelli L, Brich S, Martinetti A, Dumitrascu A, Torri V, Pruneri G, Fabbri A, de Braud F, Anichini A, Proto C, Ganzinelli M, Mortarini R, Garassino M. PEOPLE (NCT03447678), a first-line phase II pembrolizumab trial, in negative and low PD-L1 advanced NSCLC: clinical outcomes and association with circulating immune biomarkers. ESMO Open 2022; 7:100645. [PMID: 36455507 PMCID: PMC9808469 DOI: 10.1016/j.esmoop.2022.100645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 09/25/2022] [Accepted: 10/26/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The PEOPLE trial aimed to identify new immune biomarkers in negative and low programmed death-ligand 1 (PD-L1) (0%-49%) advanced non-small-cell lung cancer (aNSCLC) patients treated with first-line pembrolizumab. Here we report the main outcomes and the circulating immune biomarkers analysis. PATIENTS AND METHODS The primary endpoint of this phase II trial was the identification of immune biomarkers associated with progression-free survival (PFS). Overall survival (OS), objective response rate (ORR), disease control rate (DCR), duration of response (DoR) and safety were secondary endpoints. Absolute cell counts for 36 subsets belonging to innate and adaptive immunity were determined by multiparametric flow cytometry in peripheral blood at baseline and at first radiologic evaluation. An orthoblique principal components-based clustering approach and multivariable Cox regression model adjusted for clinical variables were used to analyze immune variables and their correlation with clinical endpoints. RESULTS From May 2018 to October 2020, 65 patients were enrolled. After a median follow-up of 26.4 months, the median PFS was 2.9 months [95% confidence interval (CI) 1.8-5.6 months] and median OS was 12.1 months (95% CI 8.7-17.1 months). The ORR was 21.5%, DCR was 47.7% and median DoR was 14.5 months (95% CI 6.4-24.9 months). Drug-related grade 3-4 adverse events were 9.2%. Higher T cell and natural killer (NK) cell count at baseline and at the first radiologic evaluation were associated with improved PFS, DCR and OS. On the contrary, higher myeloid cell count at baseline or at the first radiologic evaluation was significantly associated with worse OS and DCR. CONCLUSIONS Circulating immune biomarkers can contribute to predict outcomes in negative and low PD-L1 aNSCLC patients treated with first-line single-agent pembrolizumab.
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Affiliation(s)
- G. Lo Russo
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy,Correspondence to: Dr Giuseppe Lo Russo Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, via Giacomo Venezian 1, 20133 Milan, Italy. Tel: +39-0223903829
| | - F. Sgambelluri
- Department of Research, Human Tumors Immunobiology Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - A. Prelaj
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy,Department of Electronics, Information, and Bioengineering, Politecnico di Milano, Milan, Italy
| | - F. Galli
- Oncology Department, Istituto di Ricerche Farmacologiche Mario Negri Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - S. Manglaviti
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - A. Bottiglieri
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - R.M. Di Mauro
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - R. Ferrara
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - G. Galli
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy,Medical Oncology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia, Italy
| | - D. Signorelli
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy,Medical Oncology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - A. De Toma
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - M. Occhipinti
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - M. Brambilla
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - E. Rulli
- Oncology Department, Istituto di Ricerche Farmacologiche Mario Negri Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - T. Triulzi
- Molecular Targeting Unit, Department of Research, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - T. Torelli
- Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - L. Agnelli
- Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - S. Brich
- Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - A. Martinetti
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - A.D. Dumitrascu
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - V. Torri
- Oncology Department, Istituto di Ricerche Farmacologiche Mario Negri Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - G. Pruneri
- Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - A. Fabbri
- Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - F. de Braud
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - A. Anichini
- Department of Research, Human Tumors Immunobiology Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - C. Proto
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - M. Ganzinelli
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - R. Mortarini
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - M.C. Garassino
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy,Department of Medicine, University of Chicago Comprehensive Cancer Center, University of Chicago, Chicago, USA
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Nazzani S, Catanzaro M, Macchi A, Torelli T, Stagni S, Biasoni D, Lorusso V, Darisi R, Lanocita R, Cascella T, Maccauro M, Lorenzoni A, Cattaneo L, Montanari E, Salvioni R, Nicolai N. Bilateral inguinal lymph-node dissection versus unilateral inguinal lymph-node dissection and contralateral dynamic sentinel node biopsy in clinical N1 squamous cell carcinoma of the penis. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)01215-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Nazzani S, Catanzaro M, Torelli T, Macchi A, Biasoni D, Stagni S, Tesone A, Lanocita R, Cascella T, Salvioni R, Nicolai N. Perioperative outcomes of post chemotherapy laparoscopic retroperitoneal lymph node dissection in stage IIA-III non seminomatous germ-cell tumors. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00926-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Nazzani S, Catanzaro M, Macchi A, Torelli T, Stagni S, Biasoni D, Tesone A, Lanocita R, Cascella T, Piva L, Salvioni R, Nicolai N. Long term outcomes of initial observation in patients with CN0 low-risk penile squamous cell carcinoma: a single institution analysis. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00922-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Nazzani S, Catanzaro M, Macchi A, Zaborra C, Biasoni D, Torelli T, Stagni S, Tesone A, Lanocita R, Cascella T, Morosi C, Spreafico C, Marchianò A, Salvioni R, Nicolai N. Renal tumor biopsy (RTB) in patients with cT1b-t4-m0 disease susceptible to radical nephrectomy: analysis of safety, accuracy and clinical impact on definitive management. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)01006-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Merola C, Lai O, Conte A, Crescenzo G, Torelli T, Alloro M, Perugini M. Toxicological assessment and developmental abnormalities induced by butylparaben and ethylparaben exposure in zebrafish early-life stages. Environ Toxicol Pharmacol 2020; 80:103504. [PMID: 32980526 DOI: 10.1016/j.etap.2020.103504] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 09/17/2020] [Accepted: 09/21/2020] [Indexed: 06/11/2023]
Abstract
Toxicological effects of butylparaben (BuP) and ethylparaben (EtP) on zebrafish (Danio rerio) early-life stages are not well established. The present study evaluated, using zebrafish embryos and larvae, the toxicity of BuP and EtP through benchmark dose (BMD) approach. BuP was more toxic than EtP to zebrafish larvae. In fact, Lethal Concentration 50 (LC50) values at 96 h post-fertilization (hpf) for BuP and EtP were 2.34 mg/L and 20.86 mg/L, respectively. Indeed, BMD confidence interval (lower bound (BMDL) - upper bound (BMDU) was 0.91-1.92 mg/L for BuP and 10.8-17.4 mg/L for EtP. Zebrafish embryos exposed to 1 mg/L, 2.5 mg/L of BuP and 5 mg/L, 10 mg/L, 20 mg/L, 30 mg/L of EtP showed several developmental abnormalities and teratological effects compared to negative control. Exposed zebrafish developed reduced heartbeat, reduction in blood circulation, blood stasis, pericardial edema, deformed notochord and misshaped yolk sac. Embryos exposed to the highest concentrations of the chemicals (2.5 mg/L of BuP, 10 mg/L, 20 mg/L and 30 mg/L of EtP) showed the developmental abnormalities at 48 hpf while those treated with 1 mg/L of BuP and 10 mg/L of EtP reported behavioral changes at 72 hpf, including trembling of head, pectoral fins and spinal cord. This research identified the lethal and sublethal effects of BuP and EtP in zebrafish early-life stages and could be helpful to elucidate the developmental pathways of toxicity of parabens.
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Affiliation(s)
- C Merola
- Faculty of Bioscience and Agro-Food and Environmental Technology, University of Teramo, 64100, Teramo, Italy
| | - O Lai
- Department of Veterinary Medicine, University of Bari, S.P. per Casamassima, Km 3, 70010, Valenzano (Bari), Italy
| | - A Conte
- Istituto Zooprofilattico Sperimentale "G. Caporale", via Campo Boario, 64100, Teramo, Italy
| | - G Crescenzo
- Department of Veterinary Medicine, University of Bari, S.P. per Casamassima, Km 3, 70010, Valenzano (Bari), Italy
| | - T Torelli
- Faculty of Bioscience and Agro-Food and Environmental Technology, University of Teramo, 64100, Teramo, Italy
| | - M Alloro
- Faculty of Bioscience and Agro-Food and Environmental Technology, University of Teramo, 64100, Teramo, Italy
| | - M Perugini
- Faculty of Bioscience and Agro-Food and Environmental Technology, University of Teramo, 64100, Teramo, Italy.
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Catanzaro M, Nazzani S, Macchi A, Aceti A, Tesone A, Stagni S, Torelli T, Colecchia M, Maccauro M, Lanocita R, Cascella T, Biasoni D, Salvioni R, Nicolai N. Determinants of inguinal lymph node involvement and predicted rates of inguinal nodal disease in clinical N0 penile squamous cell carcinoma patients. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35547-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Nazzani S, Catanzaro M, Macchi A, Tesone A, Aceti A, Torelli T, Stagni S, Maccauro M, Colecchia M, Lanocita R, Cascella T, Piva L, Biasoni D, Carmignani L, Montanari E, Salvioni R, Nicolai N. Dynamic sentinel node biopsy versus observation in clinical N0 penile squamous cell carcinoma: a large tertiary national referral center experience. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35546-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Nicolai N, Nazzani S, Catanzaro M, Tesone A, Macchi A, Torelli T, Stagni S, Celso F, Agostini E, Cloecchia M, Avuzzi B, Lanocita R, Necchi A, Raggi D, Giannatempo P, Farè E, Salvioni R, Biasoni D. Retroperitoneal lymph-node dissection (RPLND) as upfront management in stage II germ-cell tumours: evaluation of safety and efficacy of open and laparoscopic procedures. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35543-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Catanzaro M, Nazzani S, Torelli T, Aceti A, Macchi A, Tesone A, Stagni S, Maccauro M, Colecchia M, Lanocita R, Cascella T, Necchi A, Raggi D, Giannatempo P, Biasoni D, Salvioni R, Nicolai N. Dynamic sentinel node biopsy for clinical N0 squamous cell penile carcinoma: a large, contemporary analysis. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35548-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Badenchini F, Marenghi C, Avuzzi B, Bellardita L, Casale A, Catanzaro M, Claps M, Colecchia M, De Luca L, Di Florio T, Donegani S, Dordoni P, Macchi A, Messina A, Morlino S, Noris Chiorda B, Stagni S, Tesone A, Torelli T, Villa S, Zollo F, Magnani T, Rancati T, Valdagni R, Nicolai N. A predictive model to personalize follow up schedules for patients in active surveillance. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33880-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Torrente S, Andreani S, Badenchini F, Rancati T, Marenghi C, Avuzzi B, Morlino S, Bedini N, Villa S, Noris Chiorda B, Palorini F, Andreoli L, Di Florio T, Catanzaro M, Stagni S, Biasoni D, Torelli T, Tesone A, Nicolai N, Valdagni R. Clinical Results for an Active Surveillance Cohort with Localized Prostate Cancer Receiving RT after Exiting Active Surveillance. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Scattoni V, Bolognesi A, Cozzarini C, Francesca F, Grasso M, Galli L, Torelli T, Campo B, Villa E, Rigatti P. Neoadjuvant CMV Chemotherapy plus Radical Cystectomy in Locally Advanced Bladder Cancer: The Impact of Pathologic Response on Long-Term Results. Tumori 2018; 82:463-9. [PMID: 9063525 DOI: 10.1177/030089169608200511] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims and Background Neoadjuvant systemic chemotherapy in infiltrating transitional cell carcinoma of the bladder has proved to be effective and to provide a pathologic complete response in about 30% of patients. No survival benefit has yet been proved. Methods We analyzed the outcome of 75 patients with advanced bladder cancer (stages T2-T4 N+/N0 M0) treated from 1985 to 1993 at two institutions in the same geographic area with 2 or 3 cycles of neoadjuvant CMV (cisplatin, methotrexate and vinblastine) chemotherapy plus cystectomy. Transurethral resection of the tumor was expressly avoided in order to keep the tumor intact as a marker lesion to evaluate response to chemotherapy. Results At the time of analysis, the median follow-up of 67 assessable patients was 51.5±3.9 (SE) months. Forty-six patients (69%) had clinical evidence of extravesical spread of the bladder tumor and 6 of lymph node metastases at presentation. After cystectomy, a pathologic complete response (pT0, pN0) was achieved in only 6 cases (9%) and a pathologic partial response in 32 patients (48%). The overall 5-year survival rate of all patients was 61 ±6%. Those patients who had a major response to chemotherapy (pCR + pPR) had a 5-year disease-free survival rate of 74%, which was statistically higher (P=0.0021) than the 44% for the remaining nonresponding patients (pNR). Overall, 43% of the patients with stage T2-T3a disease achieved tumor downstaging (CR, 5%; PR, 38%) compared with 63% of the patients with T3b-T4 (CR, 11%; PR, 52%), although there was no significant difference in 5-year survival curves between the two groups. Conclusions A pathologic complete response was achieved in less than 10% of the cases without a preoperative tumor resection. Unfortunately, most of the responses were only partial. Even though the study appears to suggest a survival advantage for those patients who achieved a downstaging, CMV chemotherapy had a limited curative potential in most of the patients. It seems unlikely that determinant proof will be obtained that neoadjuvant chemotherapy may improve survival over a nontreatment control arm. The intrinsic chemoresistance or the suboptimal response to chemotherapy of bladder cancer remains the most adverse prognostic factor.
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Affiliation(s)
- V Scattoni
- Department of Urology, Scientific Institute Ospedale San Raffaele, Milan, Italy
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Campo B, Zanitzer L, Torelli T, Bacchioni AM, Ferrari C, Ordesi G, Macchi RM. Renal Cell Carcinoma and Transitional Cell Carcinomas of the Pelvis and Bladder in a Patient Affected by Chronic Renal Failure Due to Abuse of Phenacetin. Tumori 2018; 72:215-7. [PMID: 3705197 DOI: 10.1177/030089168607200218] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This is a report on a case of 2 concurrent neoplasms of different histology within the same kidney: a renal cell carcinoma and a transitional cell carcinoma of the renal pelvis in a patient affected by chronic renal failure due to abuse of phenacetin. There was also a transitional cell carcinoma of the urinary bladder.
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Torelli T, Leidi GL, Corrada P, Bacchioni AM, Ordesi G, Zanitzer L, Campo B. The Role of Partial Cystectomy in the Management of Transitional Bladder Cancer. Tumori 2018; 74:233-6. [PMID: 3130703 DOI: 10.1177/030089168807400220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A study on 81 patients who underwent partail cystectomy for bladder cancer is presented. The low postoperative mortality (2.46%) and the high 5-year survival (72%) show that this type of surgery is effective and without major complications. Thirty-eight patients were treated with endovesical thiotepa (OTT); the remaining 41 patients were untreated after surgery. Results showed that survival and number of relapses were similar in the two groups. This fact seems to prove that chemotherapy with OTT is not essential after segmental cystectomy. To explain this assertion, several hypotheses are presented.
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Affiliation(s)
- T Torelli
- Divisione di Urologia, Ospedale, Predabissi, Melegnano, Milano
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Abstract
Sacral chordoma is one of the rarest tumors of the central nervous system (less than 1 % of the entire group). Mictional disorders are among the most frequent symptoms and are caused by the extrinsic compression brought to bear on the cauda equina and by surgical demolition of the sacrum. Seven patients who had undergone sacral resection for chordoma, starting from S2, were followed for at least one year. It was observed that mictional disorders were often early symptoms signalling the presence of chordoma. Several patients were affected by a complete bladder denervation (infrasacral lesion) after surgery. Early rehabilitative treatment given after surgery for one year restored normal bladder functions in all the patients whose bladder denervation seemed to be not total (negative Lapides’ test). Even when a complete infrasacral lesion of the bladder has been ascertained, early rehabilitative treatment may well prevent serious renal damage.
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Affiliation(s)
- T Torelli
- Urology Department, Ospedale Predabissi, Melegnano, Milano, Italia
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Necchi A, Mariani L, Colecchia M, Giannatempo P, Raggi D, Calareso G, Nicolai N, Catanzaro M, Torelli T, Perrone F, Salvioni R. Cabozantinib in patients with advanced penile squamous cell carcinoma (PSCC): the open-label, single-arm, single-center, phase 2, CaboPen trial. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx371.081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Necchi A, Giardiello D, Raggi D, Giannatempo P, Nicolai N, Catanzaro M, Torelli T, Biasoni D, Piva L, Stagni S, Calareso G, Togliardi E, Mariani L, Salvioni R. Dacomitinib as first-line treatment of locally-advanced (LA) or metastatic penile squamous cell carcinoma (PSCC): Interim analysis of an open-label, single-group, phase 2 trial. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw373.67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Necchi A, Giannatempo P, Mariani L, Raggi D, Nicolai N, Piva L, Biasoni D, Catanzaro M, Torelli T, Stagni S, Calareso G, Togliardi E, Colecchia M, Busico A, Perrone F, Pelosi G, Maffezzini M, Salvioni R. 2643 Neoadjuvant sorafenib, gemcitabine, and cisplatin (SGC) for muscle-invasive urothelial bladder cancer (UBC): Updated clinical and translational findings of an open-label, single group, phase 2 study. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31460-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Giannatempo P, Greco T, Mariani L, Nicolai N, Tana S, Farè E, Raggi D, Piva L, Catanzaro M, Biasoni D, Torelli T, Stagni S, Avuzzi B, Maffezzini M, Landoni G, De Braud F, Gianni A, Sonpavde G, Salvioni R, Necchi A. Radiotherapy or chemotherapy for clinical stage IIA and IIB seminoma: a systematic review and meta-analysis of patient outcomes. Ann Oncol 2015; 26:657-668. [DOI: 10.1093/annonc/mdu447] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
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Necchi A, Mariani L, Di Nicola M, Lo Vullo S, Nicolai N, Giannatempo P, Raggi D, Farè E, Magni M, Piva L, Matteucci P, Catanzaro M, Biasoni D, Torelli T, Stagni S, Bengala C, Barone C, Schiavetto I, Siena S, Carlo-Stella C, Pizzocaro G, Salvioni R, Gianni AM. High-dose sequential chemotherapy (HDS) versus PEB chemotherapy as first-line treatment of patients with poor prognosis germ-cell tumors: mature results of an Italian randomized phase II study. Ann Oncol 2015; 26:167-172. [PMID: 25344361 DOI: 10.1093/annonc/mdu485] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND In the late 1990s, the use of high-dose chemotherapy (HDCT) and stem-cell rescue held promise for patients with advanced and poor prognosis germ-cell tumors (GCT). We started a randomized phase II trial to assess the efficacy of sequential HDCT compared with cisplatin, etoposide, and bleomycin (PEB). PATIENTS AND METHODS Patients were randomly assigned to receive four cycles of PEB every 3 weeks or two cycles of PEB followed by a high-dose sequence (HDS) comprising HD-cyclophosphamide (7.0 g/m(2)), 2 courses of cisplatin and HD-etoposide (2.4 g/m(2)) with stem-cell support, and a single course of HD-carboplatin [area under the curve (AUC) 27 mg/ml × min] with autologous stem-cell transplant. Postchemotherapy surgery was planned on responding residual disease in both arms. The primary end point was progression-free survival (PFS). The study was designed to detect a 30% improvement of 5-year PFS (from 40% to 70%), with 80% power and two-sided α at 5%. RESULTS From December 1996 to March 2007, 85 patients were randomized: 43 in PEB and 42 in HDS arm. Median follow-up was 114.2 months [interquartile range (IQR): 87.7-165.8]. Complete or partial response with normal markers (PRm-) were obtained in 28 (65.1%) and 29 (69.1%) patients, respectively. Five-year PFS was 55.8% [95% confidence interval (CI) 42.8-72.8] and 54.8% (95% CI 41.6%-72.1%) in PEB and HDS arm, respectively (log-rank test P = 0.726). Five-year overall survival was 62.8% (95% CI 49.9-79.0) and 59.3% (95% CI 46.1-76.3). One toxic death (PEB arm) was recorded. CONCLUSIONS The study failed to meet the primary end point. Furthermore, survival estimates of conventional-dose chemotherapy higher than expected should be accounted for and will likely limit further improvements in the first-line setting. CLINICALTRIALS.GOV: NCT02161692.
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Affiliation(s)
| | - L Mariani
- Clinical Epidemiology and Trials Organization Unit
| | | | - S Lo Vullo
- Clinical Epidemiology and Trials Organization Unit
| | - N Nicolai
- Department of Surgery, Urology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | | | - D Raggi
- Department of Medical Oncology
| | - E Farè
- Department of Medical Oncology
| | - M Magni
- Department of Medical Oncology
| | - L Piva
- Department of Surgery, Urology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | | | - M Catanzaro
- Department of Surgery, Urology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | - D Biasoni
- Department of Surgery, Urology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | - T Torelli
- Department of Surgery, Urology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | - S Stagni
- Department of Surgery, Urology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | - C Bengala
- Department of Medical Oncology, Ospedale Misericordia, Grosseto
| | - C Barone
- Department of Medical Oncology, Oncologia Medica ASL TO5 Ospedale di Carmagnola, Turin
| | - I Schiavetto
- Niguarda Cancer Center, Ospedale Niguarda Ca' Granda, Milan
| | - S Siena
- Niguarda Cancer Center, Ospedale Niguarda Ca' Granda, Milan
| | - C Carlo-Stella
- Department of Oncology and Hematology, Humanitas Cancer Center, Humanitas Clinical and Research Center, Rozzano; Department of Medical Biotechnology and Translational Medicine
| | - G Pizzocaro
- Department of Surgery, Urology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | - R Salvioni
- Department of Surgery, Urology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | - A M Gianni
- Department of Medical Oncology; Department of Pathophysiology and Transplantation, University of Milano, Milan, Italy
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Farè E, Vullo SL, Giannatempo P, Nicolai N, Raggi D, Piva L, Biasoni D, Catanzaro M, Torelli T, Marongiu M, Stagni S, Maffezzini M, Mariani L, Gianni A, Salvioni R, Necchi A. Clinical Outcomes of Poor Prognosis Germ Cell Tumors (Gct): an Analysis of a Series from a Single Referral Center. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu337.52] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Giannatempo P, Greco T, Tana S, Nicolai N, Raggi D, Farè E, Avuzzi B, Marongiu M, Piva L, Catanzaro M, Biasoni D, Torelli T, Stagni S, Maffezzini M, Gianni A, Salvioni R, Mariani L, Necchi A. Radiotherapy or Chemotherapy for Clinical Stage Iia and Iib Seminoma: a Systematic Review and Meta-Analysis of Patient Outcomes. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu337.48] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Giannatempo P, Alessi A, Raggi D, Farè E, Tana S, Nicolai N, Serafini G, Marongiu M, Padovano B, Piva L, Biasoni D, Torelli T, Catanzaro M, Stagni S, Maffezzini M, Gianni A, Mariani L, Salvioni R, Crippa F, Necchi A. Interim [18F] Fluorodeoxyglucose Positron Emission Tomography (Pet) for Early Metabolic Assessment of Response to Peb Chemotherapy for Metastatic Seminoma: Preliminary Findings. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu337.50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Giannatempo P, Magazzù D, Raggi D, Farè E, Marongiu M, Coradeschi E, Nicolai N, Piva L, Catanzaro M, Biasoni D, Torelli T, Maffezzini M, Stagni S, Valagussa P, Salvioni R, Necchi A. A Phase 2 Study of Paclitaxel and Ifosfamide Plus Either Cisplatin or Carboplatin for Patients with Metastatic Non-Transitional Cell Carcinoma of the Bladder and the Urinary Tract. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu337.66] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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26
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Necchi A, Nicolai N, Mariani L, Raggi D, Farè E, Giannatempo P, Catanzaro M, Biasoni D, Torelli T, Stagni S, Milani A, Piva L, Pizzocaro G, Gianni A, Salvioni R. Modified cisplatin, etoposide, and ifosfamide (PEI) salvage therapy for male germ cell tumors: long-term efficacy and safety outcomes. Ann Oncol 2013; 24:2887-92. [DOI: 10.1093/annonc/mdt271] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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Necchi A, Nicolai N, Colecchia M, Piva L, Catanzaro M, Torelli T, Biasoni D, Stagni S, Milani A, Salvioni R. PP 32 Pilot study of cisplatin, 5-fluorouracil and a taxane (TPF) in patients (pts) with advanced squamous-cell carcinoma (SCC) of the penis: results from a single-institution series. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)72684-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Necchi A, Nicolai N, Colecchia M, Catanzaro M, Torelli T, Biasoni D, Stagni S, Milani A, Piva L, Salvioni R. 7146 POSTER Pilot Investigation of Cisplatin, 5-Fluorouracil and a Taxane (TPF) in Patients (pts) With Advanced Squamous-cell Carcinoma (SCC) of the Penis – Results From a Single-Institution Series. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)72061-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Salvioni R, Nicolai N, Piva L, Catanzaro M, Torelli T, Biasoni D, Stagni S, Milani A, Necchi A. Pilot study of cisplatin, 5-fluorouracil, and a taxane (TPF) for advanced squamous cell carcinoma (SCC) of the penis. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.4639] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Procopio G, Verzoni E, Iacovelli R, Guadalupi V, Nicolai N, Torelli T, Biasoni D, Colecchia M, Salvioni R. Is there a role for targeted therapies in the collecting ducts of Bellini carcinoma? J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.7_suppl.396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
396 Background: Carcinoma of Bellini collecting ducts (CDC) is very uncommon but it is one of the most aggressive urological entities. For this tumor, originating from the epithelium of Bellini ducts in the distal tubule and preferentially occurring in young populations, no standard effective therapy has been so far established. Results of previous clinical experiences with chemo- or immunotherapy have been disappointing. We report our experience in 7 cases of CDC treated with targeted therapies. Methods: From December 2004 to May 2010, 333 patients with advanced renal cell carcinoma have been treated with targeted therapies at Istituto Nazionale Tumori of Milan. From the global database analysis, seven cases with histological subtype of CDC have been identified. All patients had advanced disease and received a targeted therapy as first-line treatment. Six of them underwent previous nephrectomy, all had nodal involvement, and three had two or more sites of disease including lung, liver, and adrenal glands. Four patients received sorafenib as first-line treatment, two sunitinib, and one temsirolimus. After sorafenib failure, two patients received a second-line treatment consisting of both sunitinib and temsirolimus. Results: Five patients developed early progression of disease with a very short 4-month survival. One patient had a long term partial response of 33 months with sorafenib, he underwent second-line sunitinib and had no progression for further 10 months. The last patient reached a progression-free survival of 6 months with temsirolimus; when progressed, he achieved a disease control for further 9 months during sunitinib therapy. Both patients are alive after 50 and 15 months of treatment, respectively. The most common adverse events, low or moderate in severity, consisted of fatigue, hand-foot skin reaction, diarrhea, hypertension, and anemia. Conclusions: Prognosis of advanced CDC remains unfavorable. New target agents may be active in this disease and need further prospective phase II studies. [Table: see text]
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Affiliation(s)
- G. Procopio
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Division of Medical Oncology, Sapienza University of Rome, Rome, Italy
| | - E. Verzoni
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Division of Medical Oncology, Sapienza University of Rome, Rome, Italy
| | - R. Iacovelli
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Division of Medical Oncology, Sapienza University of Rome, Rome, Italy
| | - V. Guadalupi
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Division of Medical Oncology, Sapienza University of Rome, Rome, Italy
| | - N. Nicolai
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Division of Medical Oncology, Sapienza University of Rome, Rome, Italy
| | - T. Torelli
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Division of Medical Oncology, Sapienza University of Rome, Rome, Italy
| | - D. Biasoni
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Division of Medical Oncology, Sapienza University of Rome, Rome, Italy
| | - M. Colecchia
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Division of Medical Oncology, Sapienza University of Rome, Rome, Italy
| | - R. Salvioni
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Division of Medical Oncology, Sapienza University of Rome, Rome, Italy
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Nicolai N, Necchi A, Piva L, Stagni S, Catanzaro MA, Biasoni D, Milani A, Torelli T, Salvioni R. [Retroperitoneal surgery in the treatment of germ-cell tumors of the testis: retroperitoneal lymph node dissection (RPLND)]. Urologia 2010; 77:84-87. [PMID: 20890864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2009] [Indexed: 05/29/2023]
Abstract
Germ-cell tumors of the testis (GCTT) are rare, but have a high social impact. In fact they represent no more than 1% of male tumors (about 700 new cases per year in Italy), but electively occur in young patients, 20 to 40 years old, during their fully mature social and working life. More than 80% of patients are cured and return to a normal social, sexual, and working life. Improvements achieved both in diagnosis, with the use of scans (CT, MRI, US and recently PET) and of serum tumor markers alpha-fetoprotein (AFP), beta-fraction of human chorionic gonadotropin (b-HCG) and lactate dehydrogenase (LDH), and mainly in treatment, through the amelioration of radiotherapy and surgical techniques and, especially, with the introduction of Cisplatin, Etoposide and Ifosfamide in chemotherapic regimens, have made germ-cell tumor a model of "curable disease". Retroperitoneal lymph node dissection (RPLND) has indications in patients with clinical stage I (CS1) as well as in advanced disease, where it is integrated in the multimodality treatment. Anatomical studies, as well as a long-term experience, have gradually but consistently modified the surgical techniques of RPLND. Currently, "nerve sparing" RPLND represents a safe management of CS1 nonseminomatous germ cell testicular tumor with minimal morbidity and excellent outcomes. Nonetheless, surveillance and adjuvant chemotherapy are as effective as RPLND, but, in our opinion, associated with some discomforts for the patients. Laparoscopic retroperitoneal lymph node dissection (Lap-RPLND) is gaining popularity as a minimally invasive staging procedure for clinical stage I nonseminomatous testicular carcinoma, but its therapeutic role is still under investigation.
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Affiliation(s)
- N Nicolai
- SC Chirurgia Urologica, Fondazione IRCCS Istituto Tumori, Milano.
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Nicolai N, Necchi A, Piva L, Stagni S, Catanzaro M, Biasoni D, Milani A, Torelli T, Salvioni R. Retroperitoneal Surgery in the Treatment of Germ-Cell Tumors of the Testis: Retroperitoneal Lymph Node Dissection (RPLND). Urologia 2010. [DOI: 10.1177/039156031007700202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Germ-cell tumors of the testis (GCTT) are rare, but have a high social impact. In fact they represent no more than 1% of male tumors (about 700 new cases per year in Italy), but electively occur in young patients, 20 to 40 years old, during their fully mature social and working life. More than 80% of patients are cured and return to a normal social, sexual, and working life. Improvements achieved both in diagnosis, with the use of scans (CT, MRI, US and recently PET) and of serum tumor markers alpha-fetoprotein (AFP), beta-fraction of human chorionic gonadotropin (β-HCG) and lactate dehydrogenase (LDH), and mainly in treatment, through the amelioration of radiotherapy and surgical techniques and, especially, with the introduction of Cisplatin, Etoposide and Ifosfamide in Chemotherapic regimens, have made germ-cell tumor a model of “curable disease”. Retroperitoneal lymph node dissection (RPLND) has indications in patients with clinical stage I (CS1) as well as in advanced disease, where it is integrated in the multimodality treatment. Anatomical studies, as well as a long-term experience, have gradually but consistently modified the surgical techniques of RPLND. Currently, “nerve sparing” RPLND represents a safe management of CS1 nonseminomatous germ cell testicular tumor with minimal morbidity and excellent outcomes. Nonetheless, surveillance and adjuvant chemotherapy are as effective as RPLND, but, in our opinion, associated with some discomforts for the patients. Laparoscopic retroperitoneal lymph node dissection (Lap-RPLND) is gaining popularity as a minimally invasive staging procedure for clinical stage I nonseminomatous testicular carcinoma, but its therapeutic role is still under investigation.
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Affiliation(s)
- N. Nicolai
- SC Chirurgia Urologica, Fondazione IRCCS Istituto Tumori, Milano
| | - A. Necchi
- SC Chirurgia Urologica, Fondazione IRCCS Istituto Tumori, Milano
| | - L Piva
- SC Chirurgia Urologica, Fondazione IRCCS Istituto Tumori, Milano
| | - S. Stagni
- SC Chirurgia Urologica, Fondazione IRCCS Istituto Tumori, Milano
| | - M.A. Catanzaro
- SC Chirurgia Urologica, Fondazione IRCCS Istituto Tumori, Milano
| | - D. Biasoni
- SC Chirurgia Urologica, Fondazione IRCCS Istituto Tumori, Milano
| | - A. Milani
- SC Chirurgia Urologica, Fondazione IRCCS Istituto Tumori, Milano
| | - T. Torelli
- SC Chirurgia Urologica, Fondazione IRCCS Istituto Tumori, Milano
| | - R. Salvioni
- SC Chirurgia Urologica, Fondazione IRCCS Istituto Tumori, Milano
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Salvioni R, Nicolai N, Necchi A, Torelli T, Piva L, Stagni S, Catanzaro MA, Biasoni D, Milani A, Rosselliniss I. [State of the art and controversies in the treatment of testis germ-cell tumors (TGT)]. Urologia 2009; 76:221-229. [PMID: 21086281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Many different, intersecting strategies are available for managing germ-cell cancers,particularly in early-stage disease. Which is 'right' remains a matter of debate, and requires balancing efficacy against late effects, bearing in mind the complexity of treatment strategies and the available expertise. </font></font></i>
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Salvioni R, Nicolai N, Necchi A, Torelli T, Piva L, Stagni S, Catanzaro MA, Biasoni D, Milani A. State of the Art and Controversies in the Treatment of Testis Germ-Cell Tumors (TGT). Urologia 2009. [DOI: 10.1177/039156030907600401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Many different, intersecting strategies are available for managing germ-cell cancers, particularly in early-stage disease. Which is ‘right’ remains a matter of debate, and requires balancing efficacy against late effects, bearing in mind the complexity of treatment strategies and the available expertise.
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Affiliation(s)
- R. Salvioni
- SC di Chirurgia Urologica, Fondazione IRCCS Istituto Tumori, Milano
| | - N. Nicolai
- SC di Chirurgia Urologica, Fondazione IRCCS Istituto Tumori, Milano
| | - A. Necchi
- SC di Chirurgia Urologica, Fondazione IRCCS Istituto Tumori, Milano
| | - T. Torelli
- SC di Chirurgia Urologica, Fondazione IRCCS Istituto Tumori, Milano
| | - L. Piva
- SC di Chirurgia Urologica, Fondazione IRCCS Istituto Tumori, Milano
| | - S. Stagni
- SC di Chirurgia Urologica, Fondazione IRCCS Istituto Tumori, Milano
| | - M. A. Catanzaro
- SC di Chirurgia Urologica, Fondazione IRCCS Istituto Tumori, Milano
| | - D. Biasoni
- SC di Chirurgia Urologica, Fondazione IRCCS Istituto Tumori, Milano
| | - A. Milani
- SC di Chirurgia Urologica, Fondazione IRCCS Istituto Tumori, Milano
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Nicolai N, Biasoni D, Piedra Aguilera J, Necchi A, Piva L, Stagni S, Torelli T, Milani A, Pizzocaro G, Salvioni R. Open versus laparoscopic retroperitoneal lymph node dissection (RPLND) in clinical stage I nonseminomatous germ-cell tumors (NSGCTs): Two contemporary series from a single institution. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.5084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5084 Background: Primary RPLND is our choice for clinical stage I (CSI) NSGCTs. Open RPLND (O-RPLND) has been our standard policy since 1985, while laparoscopic RPLND (L-RPLND) has been introduced since the late-1990s. Methods: Between June 2003-March 2008, 150 consecutive CSI NSGCT patients (pts) have been submitted to O-RPLND (n = 91) or L-RPLND (n = 59). Pts with high risk disease (vascular invasion/embryonal carcinoma > 90% in the primary tumor) were more frequently offered O-RPLND, while pts with low risk disease (none of the 2 above) were usually considered for L-RPLND. We reviewed our data focusing on: complications, operating time (OT), hospital stay (HS), number of removed nodes, occurrence of nodal metastases as well as of metastasis during follow-up and global need of chemotherapy (CT). Results: O-RPLND (91). 59/91 (64.8%) were high-risk patients. Median OT was 140 min (IQR 110–150). Five (5.5%) complications occurred: 4 lymphorrea and 1 hemorrhage. Median HS was 6 days (IQR 5–7). Nodal metastases were found in 24 (26.4%) pts. Median number of removed nodes was 20 (IQR 14–25). L-RPLND (59). 54/59 (91.2%) were low-risk patients. Median OT was 210 min (IQR 180–240). Ten (16.9%) complications occurred: 5 required conversions to open procedure due to intraoperative bleeding (4) or technical impossibility to conclude the procedure (1). Median HS was 4 days (IQR 4–5). Nodal metastases were found in 5 (8.5%) pts: 2 of them received immediate adjuvant CT. Median number of removed nodes was 14 (IQR 11–20). OT and HS were significantly better in O-RPLND and L-RPLND series, respectively (p.0001 at Mann Whitney test). After a median follow-up of 15.1 months (1–52), distant metastases were observed in 10 (0.7%) pts: 7/91 (7.7%) following O-RPLND and 1/59 (1.7%) following L-RPLND. CT was administered to 7 (7.7%) pts following O-RPLND and to 3 (5.1%) pts following L-RPLND. Conclusions: In this large case-series, no excess of recurrences but a higher rate of complications were recorded in L-RPLND pts. O-RPLND had a significant better OT while HS was shorter in L-RPLND series. Both procedures are still being applied: pts are currently offered one of the 2 modalities after counseling. No significant financial relationships to disclose.
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Affiliation(s)
- N. Nicolai
- Fondazione IRCCS-Istituto Nazionale dei Tumori, Milan, Italy; S. Giuseppe Hospital, Milan, Italy
| | - D. Biasoni
- Fondazione IRCCS-Istituto Nazionale dei Tumori, Milan, Italy; S. Giuseppe Hospital, Milan, Italy
| | - J. Piedra Aguilera
- Fondazione IRCCS-Istituto Nazionale dei Tumori, Milan, Italy; S. Giuseppe Hospital, Milan, Italy
| | - A. Necchi
- Fondazione IRCCS-Istituto Nazionale dei Tumori, Milan, Italy; S. Giuseppe Hospital, Milan, Italy
| | - L. Piva
- Fondazione IRCCS-Istituto Nazionale dei Tumori, Milan, Italy; S. Giuseppe Hospital, Milan, Italy
| | - S. Stagni
- Fondazione IRCCS-Istituto Nazionale dei Tumori, Milan, Italy; S. Giuseppe Hospital, Milan, Italy
| | - T. Torelli
- Fondazione IRCCS-Istituto Nazionale dei Tumori, Milan, Italy; S. Giuseppe Hospital, Milan, Italy
| | - A. Milani
- Fondazione IRCCS-Istituto Nazionale dei Tumori, Milan, Italy; S. Giuseppe Hospital, Milan, Italy
| | - G. Pizzocaro
- Fondazione IRCCS-Istituto Nazionale dei Tumori, Milan, Italy; S. Giuseppe Hospital, Milan, Italy
| | - R. Salvioni
- Fondazione IRCCS-Istituto Nazionale dei Tumori, Milan, Italy; S. Giuseppe Hospital, Milan, Italy
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Necchi A, Nicolai N, Piva L, Biasoni D, Torelli T, Milani A, Stagni S, Pizzocaro G, Salvioni R. Long-term results of a combination of paclitaxel, oxaliplatin and gemcitabine as far rescue in heavily pre-treated male germ-cell tumors (GCT). J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.16036] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Torelli T, Mitas L. Electron correlation in C(4N+2) carbon rings: aromatic versus dimerized structures. Phys Rev Lett 2000; 85:1702-1705. [PMID: 10970593 DOI: 10.1103/physrevlett.85.1702] [Citation(s) in RCA: 70] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2000] [Indexed: 05/23/2023]
Abstract
The electronic structure of C(4N+2) carbon rings exhibits competing many-body effects of Huckel aromaticity, second-order Jahn-Teller (SOJT), and Peierls instability at large sizes. This leads to possible ground state structures with aromatic, bond angle, or bond length alternated geometry. Highly accurate quantum Monte Carlo results indicate the existence of a crossover between C10 and C14 from bond angle to bond length alternation. The aromatic isomer is always a transition state. The gap opening mechanism is the SOJT effect, which coalesces with the Peierls regime as N-->infinity.
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Affiliation(s)
- T Torelli
- Department of Physics, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
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38
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Corrada P, Torelli T, Ordesi G, Bergamaschi F, Zanitzer L, Santagati C, Remotti M, Campo B. [Comparison of orthotopic neobladders: Studer vs modified Camey II]. Arch Ital Urol Androl 1996; 68:289-91. [PMID: 9026228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
A comparative study between modified Camey II and Studer ileal orthotopic neobladder was performed. The Camey II was modified as follows: 1) The ureters were implanted, using wallace technique, in an undetubularized ileal loop, 15-18 cm. long, to prevent vesico-ureteral reflux; 2) The neobladder was made using staplers. In such a way, time is saved (about one hour) and results are quite similar, with a low rate of ureteral stenosis in both groups.
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Affiliation(s)
- P Corrada
- Divisione di Urologia, Ospedale Predabissi di Melegnano
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Scattoni V, Da Pozzo L, Nava L, Broglia L, Galli L, Torelli T, Campo B, Maffezzini M, Rigatti P. Five-year results of neoadjuvant cisplatin, methotrexate and vinblastine chemotherapy plus radical cystectomy in locally advanced bladder cancer. Eur Urol 1995; 28:102-7. [PMID: 8529731 DOI: 10.1159/000475030] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Neoadjuvant systemic cisplatin, methotrexate and vinblastine chemotherapy has been used in the treatment of 69 patients with advanced bladder cancer (stages T2-T4 N+/N0 M0). Sixty patients were evaluable for response at a median follow-up of 48 months. Preoperative resection of the tumor was purposely avoided in order to keep a marker lesion. After planned radical cystectomy, pathological complete responses (pCRs) and partial responses (pPRs) were documented in 5 (8.3%) and 29 cases (43.4%), respectively. These patients had a 5-year disease-free survival rate of 80%, which was statistically superior (p = 0.0013) to 35% for the remaining nonresponding patients. One patient (20%) with a pCR died of systemic disease after 14 months, while the remaining 4 patients (80%) are alive and free of disease after a median follow-up of 57 months. A higher percentage of pCRs and pPRs was observed in the group of patients with stage T3b-T4 tumor (pCR 11%, pPR 63%) in contrast to the patients with stage T2-T3a disease (pCR 4.5%, pPR 45.5%), even if no significant difference in the 5-year survival rate was observed between the 2 groups. Patients with a G2 tumor before chemotherapy survived longer (5-year survival rate of 78%) than those with G3 disease (5-year survival rate of 61%), but no significant difference was achieved.
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Affiliation(s)
- V Scattoni
- Department of Urology, Scientific Institute H San Raffaele, Milan, Italy
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40
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Benini E, Costa A, Pizzocaro G, Campo B, Milani A, Torelli T, Veneroni S, Ordesi G, Pilotti S, Silvestrini R. Biological markers in transurethral biopsies from bladder-cancer - preliminary-results. Int J Oncol 1993; 3:817-21. [PMID: 21573436 DOI: 10.3892/ijo.3.5.817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
A biologic profile including proliferative.activity, evaluated as H-3-thymidine labeling index (H-3-dT LI), DNA ploidy, p53 tumor-suppressor gene and P-glycoprotein (P-170), as an expression of the multidrug resistance gene, was defined for 50 primary transitional cell carcinomas of the bladder. H-3-dT LI was evaluated by autoradiography on histologic sections after incubation of fresh tumor biopsies with H-3-thymidine. Ploidy was defined by flow cytometric analysis of DNA content on nuclei suspensions obtained from frozen material. Expression of p53 protein and P-170 glycoprotein was detected by immunohistochemistry using the PAb1801 and C219 monoclonal antibody respectively, on sections from paraffin-embedded tumor biopsies. Invasive tumors showed a higher median H-3-dT LI (12.7% vs 4.2%) and a higher frequency of aneuploidy (73% vs 43%) and more frequently expressed p53 (82% vs 36%) than superficial tumors. Further analysis showed that proliferative activity was higher in invasive than in superficial cancers only in p53-positive or aneuploid tumors and not in p53-negative or diploid tumors. Moreover, proliferative activity and p53 overexpression, but not ploidy, were directly related to histologic grading and tumor stage. Generally, P-170 was not significantly related to any biologic or clinico-pathologic factor. Kinetic and phenotypic biologic markers are differently related to clinico-pathologic factors. A panel of biologic features can be easily evaluated on small transurethral biopsies at diagnosis, during endocavitary treatment or follow-up in bladder cancer patients.
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Affiliation(s)
- E Benini
- IST NAZL STUDIO & CURA TUMORI,VIA VENEZIAN 1,I-20133 MILAN,ITALY. OSPED PREDABISSI,MELEGNANO,ITALY
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41
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Corrada P, Bacchioni A, Torelli T, Leidi G, Ordesi G, Zanitzer L, Campo B. Inguinal hernioplasty according to Nyhus and simultaneous surgical prostatic adenomectomy. Urologia 1992. [DOI: 10.1177/039156039205900317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Benign prostatic hypertrophy and inguinal hernia are frequently associated. 59 patients underwent transvesical prostatic adenomectomy and simultaneous pre-peritoneal hernioplasty by Nyhus' technique. Results lead the Authors to consider this technique effective, quick to perform, with a recurrence rate similar to that after inguinal hernioplasties.
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Affiliation(s)
- P. Corrada
- Divisione Urologica - Ospedale Predabissi di Melegnano (Milano)
| | - A.M. Bacchioni
- Divisione Urologica - Ospedale Predabissi di Melegnano (Milano)
| | - T. Torelli
- Divisione Urologica - Ospedale Predabissi di Melegnano (Milano)
| | - G.L. Leidi
- Divisione Urologica - Ospedale Predabissi di Melegnano (Milano)
| | - G. Ordesi
- Divisione Urologica - Ospedale Predabissi di Melegnano (Milano)
| | - L. Zanitzer
- Divisione Urologica - Ospedale Predabissi di Melegnano (Milano)
| | - B. Campo
- Divisione Urologica - Ospedale Predabissi di Melegnano (Milano)
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Torelli T, Bacchioni A, Corrada P, Leidi G, Ordesi G, Zanitzer L, Campo B. Methotrexate and estramustine phosphate in the treatment of hormone-refractory prostatic carcinoma. Preliminary study. Urologia 1992. [DOI: 10.1177/039156039205901s50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The authors report preliminary results of a study performed on six patients with by advanced, hormone-refractory prostate cancer. These patients were treated by estramustine phosphate (10 mg/kg) and methotrexate (60 mg/mq). Low toxicity allows the use of this therapy in outpatient regimens. Moreover, the high rate of partial responses (five patients) shows the remarkable efficacy of this therapy, even if follow-up and number of patients are not sufficient to reach definitive conclusions.
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Affiliation(s)
| | | | | | | | - G. Ordesi
- Divisione di Urologia - Melegnano (MI)
| | | | - B. Campo
- Divisione di Urologia - Melegnano (MI)
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Torelli T, Corrada P, Bacchioni A, Leidi G, Ordesi G, Zanitzer L, Campo B. Pieloplastica Sec. Anderson-Hynes: Risultati a Otto Anni Su Settanta Pazienti. Urologia 1991. [DOI: 10.1177/039156039105800406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Corrada P, Torelli T, Leidi G, Bacchioni A, Ordesi G, Zanitzer L, Campo B. Analisi Delle Complicanze Intra- E Post-Operatorie Della Chemioterapia Neoadiuvante M.V.C. Nel Carcinoma Vescicale Infiltrante. Urologia 1991. [DOI: 10.1177/039156039105800306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Maffezzini M, Torelli T, Villa E, Corrada P, Bolognesi A, Leidi GL, Rigatti P, Campo B. Systemic preoperative chemotherapy with cisplatin, methotrexate and vinblastine for locally advanced bladder cancer: local tumor response and early followup results. J Urol 1991; 145:741-3. [PMID: 2005692 DOI: 10.1016/s0022-5347(17)38440-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
A total of 44 patients with infiltrating, locally advanced bladder cancer (stages T 3a-b, T 4a-b and N+/N0) were treated with the systemic chemotherapy regimen of cisplatin, methotrexate and vinblastine (CMV) in the neoadjuvant setting, of whom 39 were evaluable for response. After planned radical cystectomy and 2 to 3 cycles of chemotherapy no tumor was found on the pathological specimen of 4 patients (10%), the tumor was downstaged in 19 (49%) and no change was observed in 16 (41%). Toxicity included leukopenia in 29 patients (66%), 1 of whom died of granulocytopenic sepsis, nausea and vomiting in 39 (89%) and mild to moderate mucositis in 18 (41%). Median followup is 12 months with a range of 6 to 39 months. Of 32 patients followed for longer than 6 months 6 (19%) experienced progression or recurrence of disease. We conclude that preoperative CMV chemotherapy is effective in inducing downstaging of the tumor, although systemic toxicity limits its use to cautiously selected patients.
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Affiliation(s)
- M Maffezzini
- Department of Urology, Istituto Scientifico San Raffaele, Milano, Italy
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Campo B, Torelli T, Leidi GL, Corrada P, Bacchioni AM, Ordesi G, Zanitzer L. [Neoadjuvant chemotherapy with MVC (methotrexate, vinblastine, cisplatin)in the treatment of infiltrating transitional carcinoma of the bladder]. Arch Ital Urol Nefrol Androl 1990; 62:237-42. [PMID: 2142807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Of 19 patients with advanced transitional bladder cancer (T2-T4, N0-N+, M0) who received two or three cycles of pre-emptive MVC (Methotrexate, Vinblastine, Cisplatin), pathological partial (PR) and complete (CR) remissions were observed in 67% (50% and 17% respectively). The toxicity of chemotherapy was generally acceptable but 5 patients required hospitalization for neutropenia and thrombopenia . In one of them chemotherapy was stopped for severe sepsis. No death was observed. In 11 patients follow-up is greater than 12 months. In this group, 10 patients are actually alive and disease-free, while the other one was dead owing to brain metastasis, after eight months from surgery.
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Affiliation(s)
- B Campo
- Divisione di Urologia, Ospedale Predabissi, Melegnano, MI
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Abstract
A clinical study was made of 21 patients (13 men and eight women) who had undergone anterior resection of the rectum for cancer at the National Tumour Institute of Milan between April 1984 and April 1985. After surgery, 13 patients (including three men with benign prostatic hypertrophy) showed voiding dysfunctions (hesitancy, dysuria, and weak stream) and bladder areflexia. Two of them also had positive Lapides' tests. An early rehabilitative treatment was started after surgery and the entire group was thoroughly reexamined one year later. Only the two patients with positive Lapides' tests still had bladder areflexia with residual urine greater than 100 ml. One of them also had a urinary tract infection. None of them showed decreased renal function.
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Affiliation(s)
- R Zanolla
- Rehabilitation Department Istituto Nazionale Tumori, Milano, Italy
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Ordesi G, Leidi GL, Campo B, Bacchioni A, Ferrari C, Zanitzer L, Corrada P, Torelli T. Complicanza a Lungo Termine Di Reimpianto Uretero-Ileale in Un Caso Di « Undiversion ». Urologia 1986. [DOI: 10.1177/039156038605300616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | | | - B. Campo
- Ospedale Predabissi di Melegnano, Milano, Divisione di Urologia - Primario
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Ordesi G, Sasanelli F, Ferrari C, Corrada P, Zanitzer L, Bacchioni A, Torelli T, Leidi GL, Campo B. Alterazione Della Funzione Minzionale Come Sintomo Di Esordio Di Un Ependimoma Del Filum Terminale. Urologia 1986. [DOI: 10.1177/039156038605300632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Gucchi A, Torelli T, Zecca E, Chieppi F. Variazioni Meteorologiche E Coliche Renali. Urologia 1983. [DOI: 10.1177/039156038305000406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
| | | | | | - F. Chieppi
- Già Direttore dell'Osservatorio Geofisico di Pavia
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