Sentinel lymph node biopsy: validation technique at the medical centre of set bal-Portugal
P. Ferreira, Baía r., r. António Almeida, j., j. Simões Amaro, J.C., c. Quintana, l. Branco, M.V. Rigueira, m. Gonçalves Pereira, E.V., l. Mendonça-Ferreira
Objectives: To evaluate the accuracy of the Sentinel lymph node biopsy in breast cancer patients at this Institute, using combined sulphur colloid technetium-99 m (99mTc) and patent vital dye blue.
Methods: from March 2007 to July 2008, 50 patients with cancer, less than 3 cm with clinically negative axillary lymph nodes of Sentinel lymph node biopsy underwent (SLNB) followed by lymph node axillary dissection (ALND). Subareolar 99mTc sulphur presence injection was performed the day before surgery and patents vital dye blue was injected even subareolarly at least 5 minutes before surgery. Sentinel lymph node was identified during the surgical procedure using a probe of range and the direct sight.All Sentinel nodes immediately frozen section analysis. later haematoxylin & eosin immunohistochemical analysis were performed and colouring. Finally, SLNB was compared with standard ALND on his ability to accurately reflect the final pathological state of axillary nodes.
Results: The Sentinel lymph node (SLN) was identified in 48 50 patients (96%).The number of Sentinel Lymph nodes which ranged from 1-4 (means 1.48) and the Sentinel nodes not ranged from 7-27 (means 14.33).48 Patients with SLNs correctly identified, were positive histologically 29.17% (14/48). sensitivity of the .sln to predict the armpit was 93.75%;precision was 97.96%. The SLN has been falsely negative in a patient 6,25% (1/16).
Conclusions: this study validation proves the accuracy of SLNB and its reasonable rate of false negative. The SLNB represents a major step forward in surgical treatment of breast cancer as a minimally invasive procedure to provide for the State of axillary lymph nodes and now can be used as the standard method of staging in patients with early breast cancer to this institution.
Volume: 3 article number: 124 DOI: 10.3332/ecancer. 2008.124 received: 11/12/2008 published: 15/01/2009
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Comparing endoscopic treatment and surgical detected screen vs non-colorectal cancer screen-detected
B. Andreoni, Crust c., a. Sonzogni, m. Pirola, r. Pavan, l. Bisanti, c. Senore, r. Sguinzi dassatelli families, r., e. Bertani, P.P. Bianchi, Chiappa BC
Since 2005 the Italian national health system (NHS) has implemented a program of screening for colorectal cancer for all citizens over 50 years. Screening tests are free for the target population (so-called “Minimal Care Level” guaranteed to all Italian citizens).Guests are invited to take an immunological tests for faecal occult blood testing (FOBT) every 2 years. individuals with a positive FOBT test are requested to undergo a colonoscopy total in a Department of endoscopy accredited by SSN.
Each region has a coordination centre of screening program that employs a dedicated software that helps you find the course of each citizen within the program.
The “control center” have a database that can provide a detailed, real-time situation program: you can then compare the features of cancers detected screen and non-screen-detected.
The population targeted by the screening programme includes all citizens aged 50-70, except subject “high-risk” [family history;Serious and persistent IBD;previous; colorectal surgeryrecent screen not concerning the FOBT and/or colonoscopy;obvious symptoms digestive (proctorrhagia; abdominal pain, intestinal irregularities, etc..)].
Volume: 3 article number: 142 DOI: 10.3332/ecancer. 2009 142 received: 04/04/2009 published: 12/05/2009
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Potential contribution of aspirin to cancer control programs
G. Morgan
Abstract
Chemoprevention describes the potential of chemicals to intervene and stop the multistage carcinogenesis. Aspirin (Acetilsalicilato) is showing potential chemopreventivi cancer and medicine has potential for public health, since low-doses also reduce the risk of cardiovascular events up to 30%. While acknowledging that aspirin has undesirable effects, perhaps medicine can compliment other cancer control programs, such as screening and lifestyle measures.In addition, maybe the potential cancer chemopreventivi aspirin could be mediated in part by salicylate which is present in fruits and vegetables.Salicylate might be considered therefore a nutraceutical. Furthermore, there are a number of issues that arise including the potential for the public health sector to further support the agenda prior to self-care, which might include aspirin. Maybe now is appropriate for the potential of public health of aspirin to be convened a Conference.
Keywords:
aspirin, cancer control, salicylate, nutraceutical, public health
Volume: 2 article number: 100 DOI: 10.3332/100 ecancer. 2008. received: 12/10/2008 published: 12/11/2008
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Reply by tumor induced Gemcitabine progressive and constant in a patient with uterine Leiomyosarcoma Searing resistant
T. Pas de, g. Spitaleri, p. Della Vigna, f. Curigliano Toffalorio, g., r. Gambino, s. Boselli, f. de Braud
Background: Despite the combination of Gemcitabine (GCB) and docetaxel showed a benefit on the disease-free survival and overall survival than only GCB in patients with soft tissue sarcoma, GCB mono-chemotherapy should be a preferable option than the combination, because of its low toxicity profile and its ability to be administered permanently for a long date.
Causal relationship: We report a case report of a woman with advanced high degree uterine Leiomyosarcoma refractory to ifosfamide, doxorubicin and trabectedin, who have experienced a sustained response and progressive GCB alone.
Conclusions: Gemcitabine even when given as a mono-chemotherapy can achieve a lasting control of cancer in patients with pre-treated LMS heavy uterine and should be considered as a possible option for this subgroup of patients.
Volume: 2 article number: 102 DOI: 10.3332/ecancer. 2008 102 received: 22/10/2008 published: 24/11/2008
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QTc prolongation assessment in the development of anticancer medication: clinical and methodological aspects
G. Curigliano, g. Spitaleri, f. de Braud, Cardinal d., c. Onion, m. Craig, Colombo n., a. Colombo, m. Locatelli, r. Goldhirsch
Cardiac safety Assessments are commonly used in the development of investigational drugs of Clinical Oncology. In the development of anticancer medication were always more consideration to the potential of a compound of causing adverse elettrocardiografici changes, especially QT interval prolongation, that can be associated with risk for and torsades de he exhibited sudden death. Regardless of overt clinical toxicity, potentially QTc evaluation might influence the decision-making at many levels during clinical studies, including the eligibility for therapy protocol, delivery of dose or suspension and analysis of the optimal dose for subsequent development. Given the potential for serious and irreversible morbidity from adverse cardiac events, it is understandable that cardiac safety results may have broad impact on the management of conduct and patient study. The risk management methodologies of QTc prolongation for cardiac medications were developed from experience primarily of drugs used to treat diseases not fatal in a chronic setting or Antihistamines such as antibiotics. Extrapolation of these approaches to medicines to treat cancer for a period of acute may not be appropriate. Some specific guidelines is available for managing the risk of cardiac safety in the development and use of oncology drugs. In this manuscript, clinical and methodological aspects related QTc prolongation assessment will be reviewed. Discussions about the limitations being that design and development of oncology drugs will be highlighted.Efforts are needed to refine strategies for risk management, avoiding unintended consequences that negatively affect access patient and clinical development of promising new cancer treatments. a thoughtful risk management plan generated by organized collaboration between oncologists, cardiologists and regulatory agencies in support of an essential development program for oncology agents with heart problems.
Volume: 3 article number: 130 DOI: 10.3332/ecancer may.2009.130 received: 22/11/2008 published: 12/01/2009
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Report of Eurocan Plus: feasibility study for the co-ordination of national cancer research
Peter Boyle on behalf of project participants Eurocan Plus
The process that led the presentation and the financing of the project: Eurocan + Plus from the sixth framework programme was launched by the European Parliament.
This report summarises the main findings and conclusions of the Eurocan + Plus project that ran between October 2005 and December 2007, and outlines the proposals for action in the short and long term.
Project participants represented themselves and not the institution where they work.The project was in no way a formal collaboration between any governmental body, funding agency, research or medical institution of the 27 Member States. in this regard, proposals in this brief and other deliverables in no way constitute a formal commitment all governmental or nongovernmental entity, for any idea proposed by the project.
For more information about the topics developed in this report, interested readers are invited to consult the reports of the different work packages. these reports can be consulted on the draft http://www.eurocanplus.eu website.
Volume: 2 article number: 84 DOI: 10.3332/eCMS. 2008.84 received: 09/05/2008 published: 20/05/2008
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Imatinib in gastrointestinal stromal tumors (GIST): Northern Cancer Network Experience
F. Azribi, r. r. r. Razak, p. Dildey, j. Adam, j. Wilsdon and m. Verrill
Treatment of imatinib in unusable or metastatic gastrointestinal stromal tumors (GIST) has shifted the paradigm of treatment of this disease. Successful clinical trials of imatinib brought rapid regulatory approval and, in England and Wales, National Institute for Health and Clinical Excellence orientation (NICE) on the use of this technology.NICE detailed review of their recommended guidelines in clinical practice. Audit reflects that orientation and is designed to document the use of imatinib in routine clinical practice.
Methods: we conducted a retrospective audits of GIST patients treated with imatinib since 1 February 2002 to 31 March 2007. Information collected included patient demographics, the characteristics of the disease and details of the treatment administered, treatment response, toxicity and follow-up data.The primary goal was to record the disease control rate (DCR), defined as a lack of progress on computed tomography (CT) to 3 months. secondary end Points of the audits were devoid of overall survival and progression. These were compared with the results of published trials.
Results: were identified six thirty consecutive patients with diagnosed GIST treated with imatinib. The median age of patients was 70.1 years. During the analysis, patients were followed for a median of 41.6 months. In total, patients were treated to a median of 15,8 months.Treatment is generally well tolerated with a small percentage of patients experiencing the toxicity of grade 3/4. Control of the disease has been reported in 30 patients (DCR, 83.3%, 95% CI 67.2-93.6, intention to treat analysis).The median progression-free survival (PFS) in this cohort was 16.4 months (95% CI: 12.9-34,4);While the median overall survival (OS) was 39.7 months (95% CI: 22.8-56.5).
Conclusion: the data showed that treatment of patients with gist selected within the Guide NICE compares favorably to data previously published randomized studies of imatinib. registration of the note, the average age of this cohort is about 10 years earlier than the one reported in the trials. Imatinib was well tolerated with treatment related adverse events are acceptable.
Volume: 3 article number: 162 DOI: 10.3332/ecancer. 2010.162 received: 10/10/2009 published: 14/12/2009
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Methylation Detection in the islands of 16INK4A CpG P, RASSF 1 and promoters of gene methyl-guanine methyl-transferase (PT.2) in adenocarcinoma of the pancreas
D. Paikos, p. Voyatzi Stravoravdi, s., i. Boukovinas, p. Kiziridou Papakotoulas, r., g. Sibilidis and i. Stergiou
Pancreatic cancer consists of an accumulation of genetic and epigenetic alterations. Recently, aberrant methylation of CPG islands of cancer-related genes has emerged as an important epigenetic mechanism of their transcriptional dysregulation during development of the cancer.
Therefore, new diagnostic methods for the early detection, based on a better understanding of the molecular biology of cancer of the pancreas, are required.
We examin methylation status of p16INK4A, 1 RASSF and genes MGMT considered be inactivated by the promoter methylation in various cancers.
Volume: 3 article number: 131 DOI: 10.3332/ecancer. 2009 131 received: 22/12/2008 published: 15/01/2009
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Fase 0 workshop presso il XX Convegno EORTC-NSC-AACR, Geneva
S. Camporesi
Clinical studies of phase 0 are really necessary?
The question was raised by James Doroshow (National Cancer Institute, Bethesda, USA) at the Symposium EORT-NSC-AARC 20 molecular targets and Cancer Therapeutics (Geneva, 21-24 October 2008). Together with e. Leo (Beerse, Belgium), James Doroshow-since 2004 Director of the Division of cancer treatment and diagnosis NSC-was govern the workshop on clinical trials of phase 0. in his introduction to speakers, Doroshow raised six open questions, i.e. whether they are trials of phase 0 ethically acceptable, useful and feasible, if they accelerate the drug development process and save money, and if there is room for improvement.
Volume: 2 article number: 107 DOI: 10.3332/ecancer. 2008 107 received: 02/10/2008 published: 12/11/2008
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cancer3 