259 results on '"Franco Lumachi"'
Search Results
2. Diagnostic Accuracy of Pleural Fluid Cytology, Carcinoembryonic Antigen and C-Reactive Protein Together in Patients With Pulmonary Metastases and Malignant Pleural Effusion
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Stefano M.M. Basso, Mario Ermani, Giovanni Fanti, Paolo Ubiali, Alessandro Del Conte, Umberto Zuccon, Sandro Sulfaro, Franco Lumachi, and Federica Maffeis
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Adult ,Male ,Cancer Research ,medicine.medical_specialty ,Pleural effusion ,Cytodiagnosis ,Gastroenterology ,Diagnosis, Differential ,Carcinoembryonic antigen ,Neoplasms ,Cytology ,Internal medicine ,Biopsy ,Biomarkers, Tumor ,medicine ,Humans ,Malignant pleural effusion ,Aged ,Aged, 80 and over ,L-Lactate Dehydrogenase ,medicine.diagnostic_test ,biology ,business.industry ,C-reactive protein ,Cancer ,General Medicine ,Middle Aged ,medicine.disease ,Carcinoembryonic Antigen ,Pleural Effusion, Malignant ,C-Reactive Protein ,Oncology ,biology.protein ,Pleura ,Female ,Differential diagnosis ,business - Abstract
Background/aim Pleural effusion (PE) has a heterogeneous aetiology, and differential diagnosis between benign and malignant disease may require invasive procedures in up to 60% of cases. The sensitivity of pleural cytology is limited, and several strategies have been tested to reduce the need of invasive diagnostic approaches. The aim of this study was to evaluate the usefulness of pleural fluid cytology, compared to, and combined with, carcinoembryonic antigen (CEA), C reactive protein (CRP), and lactate dehydrogenase (LDH) assay of pleural fluid (PF) in patients with a history of cancer, exudative non-purulent PE, and suspicion of malignant PE on imaging studies. Patients and methods The medical records of 40 patients with pulmonary metastases and malignant PE, and 57 controls with benign exudative PE were reviewed. All the patients underwent pleural cytology and CEA, CRP, and LDH assay before VATS-guided biopsy. Results The sensitivity and specificity were 55.0% and 98.2% (cytology), 35.0% and 98.2% (CEA), 92.5% and 71.9% (CRP), 70.0% and 54.4% (LDH). The multivariate analysis excluded LDH, and the final AUC (cytology+CEA+CRP) was 0.894. Conclusion In all patients with a history of cancer and PE of uncertain origin, the combination of PF cytology plus pleural CEA and CRP assay together should be suggested to recognize malignant plural effusion (MPE), minimising the use of unnecessary invasive investigations.
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- 2020
3. Diagnosis of Malignant Pleural Effusion Using CT Scan and Pleural-Fluid Cytology Together. A Preliminary Case–Control Study
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Federica Maffeis, Alessandro Del Conte, Sandro Sulfaro, Paolo Ubiali, Franco Lumachi, and Stefano M.M. Basso
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Male ,Cancer Research ,Biopsy ,medicine.medical_treatment ,specificity ,0302 clinical medicine ,pleural effusion ,Cytology ,Malignant pleural effusion ,Cancer ,Aged, 80 and over ,accuracy ,medicine.diagnostic_test ,General Medicine ,Middle Aged ,Oncology ,030220 oncology & carcinogenesis ,Female ,Radiology ,pleural fluid cytology ,Adult ,CT scan ,medicine.medical_specialty ,thoracentesis ,Cytodiagnosis ,VATS ,colorectal cancer ,Thoracentesis ,Sensitivity and Specificity ,Diagnosis, Differential ,03 medical and health sciences ,breast cancer ,medicine ,Thoracoscopy ,Humans ,metastasis ,Lung cancer ,Aged ,business.industry ,Case-control study ,sensitivity ,medicine.disease ,Cancer, malignancy, pleural effusion, metastasis, VATS, cytology, CT scan, thoracentesis, lung cancer, breast cancer, colorectal cancer, pleural fluid cytology, sensitivity, specificity, accuracy ,Pleural Effusion, Malignant ,lung cancer ,Case-Control Studies ,cytology ,Differential diagnosis ,Tomography, X-Ray Computed ,business ,malignancy - Abstract
Background/aim The purposes of this study were to evaluate the usefulness of chest computed tomographic (CT) scan plus pleural fluid cytology (PFC) together in patients with malignant pleural effusion (PE), and to compare the results of these diagnostic tools in patients with malignant PE due to non-small-cell lung cancer and pulmonary metastases from other malignancies. Patients and methods The medical records of 185 patients with PE, who underwent chest CT, PFC and video-assisted thoracoscopy (VATS) thoracentesis followed by VATS-guided biopsy for diagnostic purpose, were reviewed. At the final diagnosis, 123 (66.5%) patients had malignant PE (cases), and 62 (33.5%) had benign PE (controls). Results Overall, the sensitivity, specificity, and accuracy of CT and PFC were 65.0% vs. 67.5% 98.4% vs. 98.4%, and 76.2% vs. 77.8%, respectively. The combination of CT plus PFC significantly improved sensitivity (86.2%, p=0.003) and accuracy (90.8%, p=0.02). Conclusion CT and PFC used together may lead to approximately 100% specificity and >90% sensitivity in distinguishing between benign and malignant PE.
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- 2020
4. World Congress on Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (WCO-IOF-ESCEO 2017): Author Index
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Paolo Ubiali, Camozzi, A. Del Conte, Smm Basso, and Franco Lumachi
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biology ,business.industry ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Advanced breast ,Cancer ,medicine.disease ,Malignancy ,Menopause ,Insulin-like growth factor ,Breast cancer ,medicine ,Cancer research ,Osteocalcin ,biology.protein ,Alkaline phosphatase ,business - Published
- 2017
5. Image-guided fine-needle aspiration cytology and flow cytometry phenotyping of neck lymphadenopathy for the diagnosis of recurrent lymphoma
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Franco Lumachi, S.M.M. Basso, Ambrogio Fassina, A. Tregnaghi, Renato Tozzoli, and Mario Ermani
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Adult ,Image-Guided Biopsy ,Male ,medicine.medical_specialty ,Adolescent ,Lymphoma ,Biopsy, Fine-Needle ,Neck mass ,Lymphadenopathy ,Logistic regression ,030218 nuclear medicine & medical imaging ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Cervical lymphadenopathy ,Cytology ,medicine ,Humans ,Aged ,Retrospective Studies ,Ultrasonography ,Receiver operating characteristic ,business.industry ,Reproducibility of Results ,Histology ,Retrospective cohort study ,Middle Aged ,Flow Cytometry ,medicine.disease ,Surgery ,Phenotype ,Otorhinolaryngology ,030220 oncology & carcinogenesis ,Female ,Lymph Nodes ,Neoplasm Recurrence, Local ,medicine.symptom ,business ,Neck ,Follow-Up Studies - Abstract
Objective In patients with a history of lymphoma, each lymphadenopathy should be carefully evaluated. The aims of this study were to evaluate (i) the usefulness of high-resolution ultrasonography (US), US-guided fine-needle aspiration cytology (FNAC) and flow cytometry phenotyping (FCP) together in the diagnosis of recurrent lymphoma, and (ii) whether these tools were independent predictors of correct results. Design Retrospective cohort study with stepwise forward logistic regression analysis of results. Setting Tertiary referral centre. Participants A total of 151 patients with history of lymphoma who developed a cervical mass during follow-up. Methods On neck US, a lymphadenopathy was shown in 129 (85.4%) patients (median age 57 years, range 18-78 years), and US-guided FNAC combined with FCP were immediately performed. All patients had surgical excision and subsequent histological examination of the enlarged node(s), to establish lymphoma subclassification. Results Final histology confirmed recurrence in 82 (63.6%) patients. According to the logistic regression analysis, FNAC and FCP were independent predictors of correct results (p=0.009 and 0.028, respectively) and did not interfere with each other. The sensitivity, specificity and accuracy of the combination of all of the tools were 98.8%, 100%, and 99.2%, respectively, and the area under the receiver operating characteristic curve was 0.902 (95% CI: 0.797-0.896). Conclusion This minimally-invasive procedure is easily performed and should be recommended for all patients with cervical lymphadenopathy and a history of lymphoma, avoiding the need of core-biopsy or surgical excision if recurrence was excluded. This article is protected by copyright. All rights reserved.
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- 2017
6. Bone turnover markers in women with early stage breast cancer who developed bone metastases. A prospective study with multivariate logistic regression analysis of accuracy
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Mario Ermani, Roberto Spaziante, Franco Lumachi, Valentina Camozzi, Stefano M.M. Basso, and Renato Tozzoli
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0301 basic medicine ,Oncology ,Clinical Biochemistry ,bone ,Biochemistry ,Bone remodeling ,Metastasis ,Breast cancer ,0302 clinical medicine ,bone metastases ,Breast cancer, breast disease, breast, cancer, malignancy, luminal, bone metastases, bone markers, bone, metastasis, tumor marker, alkaline phosphatase, CTX, ICTP, NTX, PINP, TRACP5b ,Prospective Studies ,Stage (cooking) ,Prospective cohort study ,Carcinoma, Ductal, Breast ,General Medicine ,Middle Aged ,Postmenopause ,030220 oncology & carcinogenesis ,Female ,Bone Remodeling ,Breast disease ,Procollagen ,medicine.medical_specialty ,Bone Neoplasms ,Breast Neoplasms ,NTX ,bone markers ,03 medical and health sciences ,Internal medicine ,Biomarkers, Tumor ,medicine ,cancer ,metastasis ,Humans ,breast ,Aged ,Tumor marker ,luminal ,Tartrate-Resistant Acid Phosphatase ,business.industry ,Biochemistry (medical) ,breast disease ,Cancer ,TRACP5b ,ICTP ,Alkaline Phosphatase ,medicine.disease ,Peptide Fragments ,Logistic Models ,030104 developmental biology ,PINP ,Case-Control Studies ,tumor marker ,CTX ,business ,malignancy - Abstract
The skeleton is the most common site of metastasis for breast cancer and the periodic measurement of circulating bone turnover markers (BTMs) can be useful. The aim of this study was to prospectively evaluate the diagnostic accuracy of a panel of BTMs in the early detection of bone metastases (BMs).We reviewed the medical records of 297 postmenopausal women with early stage luminal-type invasive ductal carcinoma (IDC). Twenty-six patients who developed isolated BMs during follow-up and 24 randomly selected controls were studied. The two groups were matched according to age, final disease staging, and follow-up. All patients underwent periodic measurement of total and bone-specific (BSAP) alkaline phosphatase, CTX, ICTP, osteocalcin, NTX, PINP, and TRACP5b.Only BSAP, CTX, PINP, and TRACP5b were significantly (p0.05) associated with the group, and the logistic regression analysis excluded CTX from the model. The AUC (ROC curve) for TRACP5b alone, which was the most accurate marker, and for the combination of BSAP+PINP+TRACP5b was 0.784 (95% CI: 0.651-0.916) and 0.889 (95% CI: 0.798-0.981), respectively.According to our results, the measurement of these three markers together should be performed in all postmenopausal patients with luminal-type IDC, when an early diagnosis of BMs is required.
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- 2016
7. Serum Tumor Markers in Stage I-II Breast Cancer
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Renato Tozzoli, Franco Lumachi, Federica D'Aurizio, Stefano M.M. Basso, and Flavio Falcomer
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CA15-3 ,Breast Neoplasms ,Disease ,Malignancy ,Bioinformatics ,03 medical and health sciences ,breast cancer ,0302 clinical medicine ,Breast cancer ,Antigen ,HER2 ,CSF1 ,0502 economics and business ,Drug Discovery ,microRNA ,Biomarkers, Tumor ,Humans ,Medicine ,Trx1 ,early breast cancer ,breast ,Cancer ,Neoplasm Staging ,breast diseases ,business.industry ,05 social sciences ,MicroRNA ,030206 dentistry ,medicine.disease ,serum tumor markers ,breast cancer treatment ,Cancer research ,Cancer, malignancy, breast, breast cancer, breast diseases, early breast cancer, breast cancer treatment, biomarker, serum tumor markers, ELISA, HER2, Trx1, CSF1, MicroRNA, HER2 ,biomarker ,Biomarker (medicine) ,ELISA ,Female ,050211 marketing ,business ,malignancy - Abstract
The prognosis of breast cancer is strongly influenced by the stage of the disease; therefore, it is essential that breast cancer lesions be diagnosed at the earliest stages. There is an urgent need to identify different biomarkers with a high accuracy for the early detection of this cancer to facilitate clinical management of the disease. A wide number of substances named serum tumor markers can be detected in the serum of patients with breast cancer, including tumor-associated proteins, cytokines, stimulating or inhibiting factors, autoantibodies to antigen tumor-associated substances and miRNAs. Despite ASCO and NACB recommendations, the routine use of breast cancer tumor markers by a significant proportion of oncologists is common, particularly after primary treatment of early tumors. The new promising circulating markers are HER2/neu, Trx 1, CSF1, autoantibodies against these tumor-associated antigens, and miRNAs, which are non-coding RNA molecules that regulate the translation of mRNA and control a number of biological processes, including oncogenic cells proliferation. The expression of single miRNA results in a miRNA signature, and is considered a potential biomarker for early breast cancer. However, additional studies are needed to identify its real usefulness.
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- 2016
8. Arnica compositum, Hekla lava and Acidum Nitricum Together are Superior to Arnica compositum Alone in the Local Treatment of Symptomatic Calcific Periarthritis of the Shoulder: A Pilot Study
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Francesco Buccelletti, Gianpaolo Sacchetti, Claudio Ramponi, Franco Lumachi, Francesco Franceschi, Federica Spagnolli, Giovanna Oliva, and Simone Zanella
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Adult ,Male ,medicine.medical_specialty ,Visual analogue scale ,Pilot Projects ,arnica compositum ,Group B ,Arnica ,medicine ,Humans ,Calcific periarthritis ,Range of Motion, Articular ,Adverse effect ,anti-inflammatory activity ,HEKLA LAVA ,Aged ,Aged, 80 and over ,Pharmacology ,biology ,Plant Extracts ,Shoulder Joint ,business.industry ,Calcinosis ,General Medicine ,Middle Aged ,Ibuprofen ,biology.organism_classification ,Acidum nitricum, anti-inflammatory activity, arnica compositum, calcific periarthritis of the shoulder, hekla lava ,hekla lava ,Treatment Outcome ,Acidum nitricum ,Anesthesia ,calcific periarthritis of the shoulder ,Orthopedic surgery ,Drug Therapy, Combination ,Female ,Periarthritis ,business ,Phytotherapy ,medicine.drug - Abstract
Background To evaluate the usefulness of Arnica compositum (AC) + Acidum nitricum (AN) + Hekla lava (HL) ointment in Emergency Medicine Department (EMD) as alternative nonpharmacological local treatment of patients with symptomatic calcific periarthritis of the shoulder (CPS) and to compare the effectiveness of this mixture against AC ointment alone. Methods A series of 41 consecutive patients (20 women, 19 men, median age 49 years, range 25-80 years) with non-traumatic painful unilateral CPS were randomly assigned to receive local treatment with AC+AN+HL ointment mixture (Group A, cases, N=21) or AC ointment alone (Group B, controls, N=20). The radiological Gartner classification of the CPS, and the quantification of pre- and post-treatment pain intensity using a Visual Analogue Scale (VAS) were obtained. The orthopedic evaluation of Shoulder Motion (SM) was also performed. The use of painkillers was reported as a number of doses needed. Results Age, gender distribution, Gartner type, main calcification size, baseline VAS (VAS-0) and degree of SM did not differ (p=NS) between Groups. After 3-day therapy, the reduction of pain in Group A (4.5±2.5) was superior to that observed in Group B (2.7±2.6) (p =0.03). The same result was observed in the improvement of SM in Group A (69.4±24.9) than in Group B (51.1±21.1) (p =0.015). No local or general adverse effects were noted. The number of doses of paracetamol was similar, but Group A patients used less ibuprofen (p =0.007). Conclusion Local administration of the AC+AN+HL ointment mixture, which in our pilot study was superior to AC alone, could be safely suggested as an alternative uneventful treatment of patients with CPS.
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- 2018
9. Bone mineral density as a potential predictive factor for luminal-type breast cancer in postmenopausal women
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Franco Lumachi, Paolo Ubiali, Mario Ermani, Valentina Camozzi, Roberto Spaziante, and Stefano M.M. Basso
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Cancer Research ,Bone density ,medicine.medical_treatment ,Osteoporosis ,luminal-type ,menopause ,BMD, Breast cancer, Luminal-type, Menopause, Osteoporosis, Predictive factors, Aged, Area Under Curve, Bone Diseases, Metabolic, Breast Neoplasms, Case-Control Studies, Female, Humans, Middle Aged, Osteoporosis, Postmenopause, ROC Curve, Bone Density, Oncology, Cancer Research, Breast disease, Breast, Cancer, Malignancy, BMD, osteopenia, breast, breast diseases, breast cancer, breast cancer treatment, estrogen receptor, cancer, malignancy, BMD, bone mineral density, luminal-type, menopause, osteoporosis, risk factors, survival, DXA, postmenopausal ,Breast disease ,030218 nuclear medicine & medical imaging ,0302 clinical medicine ,Bone Density ,Medicine ,risk factors ,Breast ,DXA ,education.field_of_study ,postmenopausal ,Obstetrics ,Hormone replacement therapy (menopause) ,General Medicine ,Middle Aged ,Menopause ,Postmenopause ,breast cancer treatment ,Oncology ,030220 oncology & carcinogenesis ,Area Under Curve ,Female ,Bone Diseases ,Predictive factors ,estrogen receptor ,medicine.medical_specialty ,Population ,Breast Neoplasms ,survival ,03 medical and health sciences ,Breast cancer ,breast cancer ,BMD ,Humans ,cancer ,education ,Aged ,breast diseases ,business.industry ,Malignancy ,Stepwise regression ,medicine.disease ,osteoporosis ,Osteopenia ,Bone Diseases, Metabolic ,osteopenia ,ROC Curve ,Case-Control Studies ,Metabolic ,business ,bone mineral density - Abstract
BACKGROUND/AIM We performed a case-control study to evaluate whether bone mineral density (BMD) can be considered a potential predictive factor for luminal-type breast cancer (BC), that could be useful in constructing a predictive risk model. MATERIALS AND METHODS The medical records of 297 postmenopausal women with luminal-type node-negative BC who underwent lumbar-spine dual-energy X-ray absorptiometry (DXA) with BMD measurement before surgery, were analyzed and compared with those of 297 age-matched randomly selected healthy controls. The correlations between women's reproductive history, including the age at menarche and menopause, parity, oral contraceptives and hormone replacement therapy (HRT) use, the results of DXA, and BC risk were evaluated in univariate and multivariate analyses. RESULTS Overall, 168 (28.3%) women had osteoporosis and/or osteopenia (low BMD). Both bone alterations were protective factors for BC, especially when they were considered together (p=0.001). Only the interval between menarche and menopause (MMI), dichotomized at 37.5 years as an optimal cut-off, and the HRT use reached a statistical significance (p
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- 2018
10. Mini-invasive distal pancreatectomy: a feasible and cost-effective technique
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Paolo Ubiali, Federica Maffeis, Michele Ciocca Vasino, Alessandro Patanè, Stefano M.M. Basso, and Franco Lumachi
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mini-invasive ,medicine.medical_specialty ,medicine.diagnostic_test ,cost-effective ,business.industry ,pancreatic cancer ,laparoscopy ,Cancer ,cancer, pancreatic cancer, malignancy, mini-invasive, distal pancreatectomy, laparoscopy, cost-effective ,medicine.disease ,Malignancy ,Mini invasive surgery ,Pancreatic cancer ,cancer ,General Earth and Planetary Sciences ,Medicine ,distal pancreatectomy ,Radiology ,Distal pancreatectomy ,business ,Laparoscopy ,malignancy ,General Environmental Science - Published
- 2017
11. Direct linear correlation between serum vascular endothelial growth factor (VEGF) and Ki-67 (MIB-1 rate) in women with pT1-2 breast cancer
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P. Ubiali, Smm Basso, Franco Lumachi, Renato Tozzoli, and Sandro Sulfaro
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Oncology ,Cancer Research ,medicine.medical_specialty ,medicine.medical_treatment ,VEGF receptors ,menopause ,Malignancy ,elderly ,serum markers ,surgery ,chemistry.chemical_compound ,Breast cancer ,breast cancer ,Internal medicine ,HER2 ,medicine ,breast ,Cancer ,breast diseases ,MIB1 ,biology ,business.industry ,Cancer, malignancy, breast, breast cancer, breast diseases, mastectomy, surgery, elderly, menopause, tumor markers, serum markers, VEGF, HER2, Ki-67, MIB-1, Ki67, MIB1, HER-2, luminal type ,mastectomy ,medicine.disease ,MIB-1 ,luminal type ,VEGF ,Vascular endothelial growth factor ,Menopause ,chemistry ,tumor markers ,HER-2 ,Ki-67 ,biology.protein ,business ,Ki67 ,Mastectomy ,malignancy - Published
- 2017
12. Analysis of factors affecting short-term results in elderly patients undergoing elective surgical resection for stage I-II colon cancer
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Paolo Ubiali, Patrizio Pianon, Giovanni Fanti, Stefano M.M. Basso, Franco Lumachi, and Federica Maffeis
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Surgical resection ,Adult ,Male ,medicine.medical_specialty ,Cancer Research ,Complications ,Colorectal cancer ,Comorbidity ,Adenocarcinoma ,Group B ,Comorbidities ,03 medical and health sciences ,0302 clinical medicine ,Elderly ,Postoperative Complications ,Risk Factors ,Neoplasms ,medicine ,80 and over ,Humans ,030212 general & internal medicine ,Stage (cooking) ,Cancer ,Aged ,Neoplasm Staging ,Aged, 80 and over ,Polypharmacy ,business.industry ,Age Factors ,Malignancy ,General Medicine ,Cancer, Malignancy, Neoplasms, Colorectal cancer, Comorbidities, Complications, Elderly ,Short-term results, Adenocarcinoma, Adult ,Age Factors, Aged, Aged, 80 and over, Colonic Neoplasms, Comorbidity, Female, Humans, Male, Middle Aged, Neoplasm Staging, Prognosis, Risk Factors, Elective Surgical Procedures, Postoperative Complications, Oncology, Cancer Research ,Middle Aged ,medicine.disease ,Prognosis ,Surgery ,Oncology ,Elective Surgical Procedures ,030220 oncology & carcinogenesis ,Colonic Neoplasms ,Female ,Short-term results ,Elective Surgical Procedure ,business - Abstract
AIM The aim of this study was to analyze the influence of comorbidities and to compare the short-term results of elective surgical resection of stage I-II colon adenocarcinoma in elderly (≥65 years) versus younger patients. PATIENTS AND METHODS Two groups of sex-matched younger and older patients were compared: Group A: N=36, median age 58 (range=43-65) years; and group B: N=67, median age 73 (range=66-86) years. RESULTS Overall, 71 out of 103 (68.9%) patients had one or more comorbidities. A greater number of older patients had an American Society of Anesthesiologists (ASA) score >2 (p=0.004) and were on multiple medications (polypharmacy) (p=0.016), but the distribution of the other parameters was similar (p≥0.05). Intra- and postoperative complications in group A vs. B occurred in 25.0% vs. 26.9%, and 47.2% vs. 64.2%, respectively (p≥0.05). CONCLUSION Elderly patients with colon cancer scheduled to elective surgical resection should not be considered at increased risk of intra- or short-term postoperative complications with respect to younger patients. However, they require careful individual preoperative evaluation because they are usually polypharmacy users and have a higher ASA score.
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- 2017
13. Adjuvant and Neoadjuvant Chemotherapy for Soft Tissue Sarcomas
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Marco Maruzzo, Marco Rastrelli, Franco Lumachi, Umberto Basso, and Vittorina Zagonel
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Oncology ,medicine.medical_specialty ,sarcoma ,medicine.medical_treatment ,media_common.quotation_subject ,Disease ,soft tissue sarcomas ,Biochemistry ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,Drug Discovery ,Humans ,cancer ,Medicine ,Neoadjuvant therapy ,media_common ,Pharmacology ,Selection bias ,Adjuvant chemotherapy, neoadjuvant chemotherapy, soft tissue sarcomas, cancer, malignancy, sarcoma ,Chemotherapy ,business.industry ,Organic Chemistry ,Soft tissue ,medicine.disease ,Neoadjuvant Therapy ,Adjuvant chemotherapy ,Clinical trial ,Chemotherapy, Adjuvant ,Molecular Medicine ,Sarcoma ,business ,Adjuvant ,neoadjuvant chemotherapy ,malignancy - Abstract
Sarcomas of the soft tissue are a heterogeneous, rare and complex group of mesenchymal malignant tumors, accounting for less than 1% of all adult malignancies and about 10-15% of childhood cancer. Despite local disease control obtained with surgery and pre- or postoperative radiotherapy, roughly one half of patients with high-grade tumors experience metastatic disease. The adjunction of chemotherapy, either before or after resection, is not currently viewed as standard practice due to the lack of reproducible impact on survival. The 1997 SMAC meta-analysis based on individual data from randomized studies confirmed a significant impact of adjuvant chemotherapy on both local and metastatic relapse, without any significant benefit on survival. Further meta-analyses demonstrated a significant benefit also in overall survival. Yet, the latest adjuvant EORTC trial was disappointedly negative. To date, adjuvant chemotherapy may be recommended as a reasonable option for the high-risk individual patient who should be well informed on the possible risks and benefits of treatment. Also the indications for neoadjuvant chemotherapy remain controversial. A local benefit may be gained, facilitating surgery, but data on survival are limited and affected by a strong patient selection bias. In order to improve our knowledge on sarcomas and to offer patients the best of current standards, we strongly recommend that all patients be referred to a sarcoma multidisciplinary group, under whose supervision they could receive the correct combined-modality management as well as have access to new clinical trials appropriately stratified for risk and histological and/or molecular subtypes.
- Published
- 2013
14. Evaluation of predictive value of pleural CEA in patients with pleural effusions and histological findings: A prospective study and literature review
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Franco Lumachi, Paolo Metus, Stefano M.M. Basso, Federica D'Aurizio, and Renato Tozzoli
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medicine.medical_specialty ,Pleural effusion ,medicine.medical_treatment ,Clinical Biochemistry ,Thoracentesis ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,Carcinoembryonic antigen ,Predictive Value of Tests ,Biopsy ,medicine ,Malignant pleural effusion ,Humans ,Mesothelioma ,Lung cancer ,neoplasms ,biology ,medicine.diagnostic_test ,business.industry ,General Medicine ,respiratory system ,medicine.disease ,digestive system diseases ,respiratory tract diseases ,Carcinoembryonic Antigen ,Pleural Effusion ,030228 respiratory system ,030220 oncology & carcinogenesis ,biology.protein ,Pleura ,Radiology ,business ,Biomarkers - Abstract
Objectives Pleural effusion recognizes heterogeneous etiology and pathogenesis and requires invasive diagnostic procedures. Usually, after pleural fluid analysis, 30–50% of patients with malignant pleural effusion exhibit negative pleural cytology, and the sensitivity of image-guided pleural needle-aspiration biopsy ranges between 60% and 70%. With the aim of differentiating between benign (BPE) and malignant (MPE) pleural effusions, several tumor markers have been assayed in the pleural fluid and the majority of studies focus on pleural carcinoembryonic antigen (p-CEA). The aims of this study were to evaluate (i) the diagnostic accuracy of p-CEA of patients with pleural effusions undergoing video-assisted thoracoscopic surgery (VATS) for diagnostic purpose, (ii) the relationship between p-CEA and serum CEA (s-CEA), and (iii) the usefulness of the p-CEA/s-CEA ratio in the diagnosis of malignant pleural effusions (MPE). Design & methods We prospectively enrolled in the study 134 consecutive patients with pleural effusions, scheduled for having VATS and biopsy. The final diagnosis, based on histopathology of the VATS-guided specimens, was available for all patients. p-CEA and s-CEA was assayed with a chemiluminescence immunoassay method (CLIA), applied on the Maglumi 2000 Plus automated platform (SNIBE, Shenzen, China). Results The sensitivity and accuracy of p-CEA was significantly higher than that of pleural cytology at the same specificity comparing BPE with MPE and BPE with non-small lung cancer. The sensitivity of p-CEA and PC together reached 100% (BPE vs. NSCLC) and 91.5% (BPE vs. MPE excluding mesothelioma), respectively. Conclusions The p-CEA measurement in patients with pleural effusion of uncertain etiology is a safe and cost-effective procedure, everywhere easily available, which may help clinicians in selecting patients for further evaluations. An elevated p-CEA level in a patient with pleural effusion and negative pleural cytology suggests the need of more invasive procedure (e.g. VATS-guided biopsies), whilst low p-CEA may support a follow-up.
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- 2016
15. 200P: Video-assisted thoracoscopic versus open pulmonary metastasectomy in patients with stage IV colorectal cancer and solitary lung metastasis. A preliminary case–control study and factors affecting survival
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Smm Basso, A. Del Conte, Franco Lumachi, Gb Chiara, and F. Mazza
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Oncology ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Colorectal cancer ,business.industry ,Case-control study ,Cancer ,medicine.disease ,Malignancy ,Metastasis ,Breast cancer ,Internal medicine ,medicine ,Metastasectomy ,Lung cancer ,business - Published
- 2016
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16. 51P Diagnostic value of carcinoembryonic antigen, lactate dehydrogenase and C-reactive protein in patients with pleural effusion undergoing VATS thoracentesis
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Smm Basso, Franco Lumachi, Gb Chiara, Renato Tozzoli, and A. Del Conte
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Pulmonary and Respiratory Medicine ,Pathology ,medicine.medical_specialty ,biology ,business.industry ,Pleural effusion ,medicine.medical_treatment ,C-reactive protein ,Thoracentesis ,medicine.disease ,Metastasis ,chemistry.chemical_compound ,Carcinoembryonic antigen ,chemistry ,Oncology ,Lactate dehydrogenase ,medicine ,biology.protein ,Malignant pleural effusion ,business ,Lung cancer - Published
- 2016
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17. Editorial: Adjuvant systemic treatment strategy for early breast cancer
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Franco Lumachi
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Oncology ,medicine.medical_specialty ,ovary suppression ,medicine.medical_treatment ,EGFR ,Estrogen receptor ,Breast Neoplasms ,Malignancy ,aromatase inhibitors ,Breast cancer ,breast cancer ,Internal medicine ,Cancer, malignancy, breast, breast cancer, breast diseases, early breast cancer, breast cancer treatment, HER2, estrogen receptors, GnRH, SERM, EGFR, endocrine therapy, ovary suppression, GnRH-agonist, tamoxifen, aromatase inhibitors ,HER2 ,Drug Discovery ,Antineoplastic Combined Chemotherapy Protocols ,Medicine ,Humans ,early breast cancer ,GnRH-agonist ,breast ,Early breast cancer ,Neoplasm Staging ,Cancer ,breast diseases ,tamoxifen ,business.industry ,endocrine therapy ,estrogen receptors ,medicine.disease ,SERM ,breast cancer treatment ,Chemotherapy, Adjuvant ,GnRH ,Treatment strategy ,Female ,business ,Adjuvant ,Tamoxifen ,medicine.drug ,malignancy - Published
- 2016
18. Hypercalcemia: An Overview of its Pathology
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Stefano M.M. Basso and Franco Lumachi
- Subjects
Parathyroidectomy ,medicine.medical_specialty ,TRPV5 ,medicine.medical_treatment ,PTHrP ,Hypercalcemia, calcium, hyperparathyroidism, vitamin D, breast cancer, malignancy, cancer, PTH, PTHrP, vitamin D, menopause, osteoporosis, BMD, bone densitometry, calcemia ,menopause ,vitamin D ,hyperparathyroidism ,breast cancer ,BMD ,Internal medicine ,Medicine ,cancer ,Klotho ,Calcium metabolism ,calcium ,business.industry ,Metabolic disorder ,Cancer ,bone densitometry ,medicine.disease ,osteoporosis ,calcemia ,Endocrinology ,Calcitonin ,Hypercalcemia ,business ,hormones, hormone substitutes, and hormone antagonists ,Primary hyperparathyroidism ,malignancy ,PTH - Abstract
Calcium is essential for several human physiological processes, including the function of cellular membranes, nerves and muscles, enzymatic activities, and blood clotting. The endocrine control of Ca2+ is achieved by a homeostatic mechanism involving PTH, 1,25-dihydroxyvitamin D, and calcitonin, but other factors, such as FGF-23, TRPV5, and Klotho, regulate calcium metabolism. Hypercalcemia is a relatively common disorder largely related to primary hyperparathyroidism that accounts for approximately 80% of cases. Malignancy-associated hypercalcemia (MAH) is the most common metabolic disorder in malignancy, that can be observed in 10–15% of cancer patients. Two different mechanisms may lead to MAH. The so-called humoral hypercalcemia is largely caused by the secretion of parathyroid hormone-related protein (PTHrP) by the malignant cells. On the contrary, local osteolytic hypercalcemia is induced directly by cancer cells invading the bone leading to the degradation of mineral matrix. All patients with hypercalcemia require early diagnosis and treatment to prevent the development of serious mid- and long-term complications. These complications are now uncommon in patients with primary hyperparathyroidism, in whom effective parathyroidectomy leads to complete recovery, but they can be observed in cancer patients with cancer-related skeletal events.
- Published
- 2016
19. Treatment of Chronic Hypercalcemia
- Author
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Franco Lumachi, Valentina Camozzi, Piero Cappelletti, Giovanni Luisetto, Renato Tozzoli, and Stefano M.M. Basso
- Subjects
musculoskeletal diseases ,medicine.medical_specialty ,endocrine system diseases ,PTHrP ,vitamin D ,Malignancy ,parathyroidectomy ,Gastroenterology ,Bone resorption ,hyperparathyroidism ,Internal medicine ,Drug Discovery ,Hypercalcemia Therapy ,medicine ,cancer ,Humans ,bisphosphonates ,calcium ,biology ,business.industry ,zoledronate ,RANKL ,denosumab ,Hypercalcemia, hyperparathyroidism, calcium, PTH, PTHrP, parathyroid glands, vitamin D, parathyroid tumors, parathyroidectomy, calcemia, bisphosphonates, malignancy, cancer, denosumab, zoledronate, RANKL ,medicine.disease ,calcemia ,Endocrinology ,Denosumab ,Calcitonin ,Chronic Disease ,Hypercalcemia ,biology.protein ,parathyroid glands ,parathyroid tumors ,Antibody ,business ,Algorithms ,hormones, hormone substitutes, and hormone antagonists ,Primary hyperparathyroidism ,PTH ,malignancy ,medicine.drug - Abstract
Hypercalcemia is a relatively frequent alteration, mostly associated to primary hyperparathyroidism (PHPT) and malignancy-associated hypercalcemia (MAH). Treatment first includes rehydration and loop diuretics, as general measures. Bisphosphonates are considered the drugs of choice due to their long-term management. Calcitonin is preferable in the short-term control of severe hypercalcemia. The antireabsorptive action of bisphosphonates has been considered the most effective in the disorders characterized by an excessive bone resorption. Zoledronate is superior to both clodronate or pamidronate in the treatment of MAH. Calcimimetic agents has been recently introduced to control hypercalcemia in selected cases of PHPT. They are used when surgery is not possible or patients do not meet surgical criteria. Malignancy- associate hypercalcemia is broadly divided into two categories: humoral MAH and osteolytic MAH. The first concerns the paraneoplastic release of humoral factors, mainly parathyroid hormone-related peptide (PTHrP). Recently a humanized monoclonal antibody against human PTHrP has been generated and is still under evaluation. The receptor activator of nuclear factor-κ ligand (RANKL) has a critical role in the etiology of malignancy skeletal complications. The fully humanized anti-RANKL antibody (denosumab) would seem to be even more effective than bisphosphonates to suppress bone resorption, as shown in preliminary results .
- Published
- 2012
20. Predictive markers of survival in patients with pulmonary metastases and malignant pleural effusion
- Author
-
Paolo Ubiali, Franco Lumachi, Umberto Zuccon, Renato Tozzoli, Smm Basso, and A. Del Conte
- Subjects
medicine.medical_specialty ,Predictive marker ,Oncology ,business.industry ,Medicine ,Malignant pleural effusion ,In patient ,Hematology ,Radiology ,business ,medicine.disease - Published
- 2017
21. Carcinoembryonic antigen, C-reactive protein and lactate dehydrogenase measurement in pleural fluid of patients with malignant pleural effusion. A case–control study with multivariate analysis
- Author
-
A. Del Conte, Renato Tozzoli, Paolo Ubiali, Franco Lumachi, M. Ermani, and Smm Basso
- Subjects
Cancer Research ,Pathology ,medicine.medical_specialty ,LDH ,Pleural effusion ,markers ,menopause ,VATS ,Malignancy ,elderly ,serum markers ,Metastasis ,thoracoscopic surgery ,CEA ,Carcinoembryonic antigen ,pleural effusion ,medicine ,metastasis ,Malignant pleural effusion ,pulmonary metastases ,metastases ,Cancer ,biology ,business.industry ,C-reactive protein ,Case-control study ,lung metastases ,medicine.disease ,pleural cytology ,Oncology ,tumor markers ,cytology ,biology.protein ,Cancer, malignancy, metastases, metastasis, lung metastases, pulmonary metastases, pleural effusion, markers, serum markers, tumor markers, CEA, LDH, CRP, cytology, pleural cytology, VATS, thoracoscopic surgery, elderly, menopause ,CRP ,business ,malignancy - Published
- 2017
22. P1.06-025 Analysis of Risk Factors for Development of Skeletal-Related Events in Women with Bone Metastases from NSCLC and Breast Cancer
- Author
-
Paolo Ubiali, Franco Lumachi, Francesco Mazza, Alessandro Del Conte, and Stefano M.M. Basso
- Subjects
Pulmonary and Respiratory Medicine ,Oncology ,medicine.medical_specialty ,business.industry ,Skeletal related events ,Cancer ,medicine.disease ,Malignancy ,Metastasis ,Menopause ,Malignant hypercalcemia ,Breast cancer ,Internal medicine ,Medicine ,business - Published
- 2017
23. P2.01-003 Serum VEGF, MMP-7 and CYFRA 21-1 as Predictive Markers of Lung Metastases from Colorectal Cancer
- Author
-
Renato Tozzoli, Franco Lumachi, Alessandro Del Conte, Paolo Ubiali, Stefano M.M. Basso, and Federica D'Aurizio
- Subjects
Pulmonary and Respiratory Medicine ,Oncology ,medicine.medical_specialty ,Lung ,biology ,business.industry ,Colorectal cancer ,VEGF receptors ,Matrix metalloproteinase ,medicine.disease ,medicine.anatomical_structure ,Internal medicine ,medicine ,biology.protein ,business ,CYFRA 21-1 - Published
- 2017
24. P2.03b-066 Diagnostic Value of Pleural Cytology Together with Pleural CEA and VEGF in Patients with NSCLC and Lung Metastases from Breast Cancer
- Author
-
Paolo Ubiali, Renato Tozzoli, Sandro Sulfaro, Stefano M.M. Basso, and Franco Lumachi
- Subjects
Pulmonary and Respiratory Medicine ,Oncology ,medicine.medical_specialty ,Lung ,biology ,business.industry ,Pleural effusion ,VEGF receptors ,Cancer ,medicine.disease ,Malignancy ,Metastasis ,Breast cancer ,medicine.anatomical_structure ,Internal medicine ,Cytology ,medicine ,biology.protein ,business - Published
- 2017
25. Unusual Development of Iatrogenic Complex, Mixed Biliary and Duodenal Fistulas Complicating Roux-en-Y Antrectomy for Stenotic Peptic Disease of the Supraampullary Duodenum Requiring Whipple Procedure: An Uncommon Clinical Dilemma
- Author
-
Alessandro Settin, F. Polistina, Franco Lumachi, Giovanni Ambrosino, and Giorgio Costantin
- Subjects
Published: October 2010 ,medicine.medical_specialty ,Fistula ,medicine.medical_treatment ,Whipple Procedure ,medicine ,pancreas ,lcsh:RC799-869 ,Pancreatoduodenectomy ,business.industry ,General surgery ,Mortality rate ,Biliary fistula ,Gastroenterology ,Pancreatic fistula, pancreas ,medicine.disease ,Pancreaticoduodenectomy ,Roux-en-Y anastomosis ,Surgery ,medicine.anatomical_structure ,Biliary fistulas ,Gastric surgery complications ,Duodenal Fistula ,Duodenum ,Duodenal fistulas ,lcsh:Diseases of the digestive system. Gastroenterology ,business ,Pancreatic fistula - Abstract
Complex fistulas of the duodenum and biliary tree are severe complications of gastric surgery. The association of duodenal and major biliary fistulas occurs rarely and is a major challenge for treatment. They may occur during virtually any kind of operation, but they are more frequent in cases complicated by the presence of difficult duodenal ulcers or cancer, with a mortality rate of up to 35%. Options for treatment are many and range from simple drainage to extended resections and difficult reconstructions. Conservative treatment is the choice for well-drained fistulas, but some cases require reoperation. Very little is known about reoperation techniques and technical selection of the right patients. We present the case of a complex iatrogenic duodenal and biliary fistula. A 42-year-old Caucasian man with a diagnosis of postoperative peritonitis had been operated on 3 days earlier; an antrectomy with a Roux-en-Y reconstruction for stenotic peptic disease was performed. Conservative treatment was attempted with mixed results. Two more operations were required to achieve a definitive resolution of the fistula and related local complications. The decision was made to perform a pancreatoduodenectomy with subsequent reconstruction on a double jejunal loop. The patient did well and was discharged on postoperative day 17. In our experience pancreaticoduodenectomy may be an effective treatment of refractory and complex iatrogenic fistulas involving both the duodenum and the biliary tree.
- Published
- 2010
26. Medical Treatment of Hirsutism in Women
- Author
-
Franco Lumachi and S M M Basso
- Subjects
antiandrogens ,Hirsutism ,Pediatrics ,medicine.medical_specialty ,medicine.drug_class ,Antiandrogens ,silodosin ,doxazosin ,cyproterone acetate ,5alpha reductase inhibitor ,androgen ,Hair Removal ,Antiandrogen ,Biochemistry ,hyperandrogenism ,chemistry.chemical_compound ,Drug Discovery ,medicine ,Humans ,hirsutism ,oral contraceptives ,Pharmacology ,Gynecology ,dutasteride ,business.industry ,Hirsutism, alpha adrenergic receptor blocking agent, doxazosin, dutasteride, finasteride, placebo, silodosin, steroid, 5alpha reductase inhibitor, tamsulosin, terazosin, hypertricosis, hyperandrogenism, antiandrogens, oral contraceptives, spironolactone, cyproterone acetate, androgen ,alpha adrenergic receptor blocking agent ,steroid ,Organic Chemistry ,Hyperandrogenism ,Cyproterone acetate ,Androgen Antagonists ,Estrogens ,medicine.disease ,finasteride ,spironolactone ,chemistry ,Estrogen ,tamsulosin ,placebo ,Spironolactone ,Molecular Medicine ,Female ,Progestins ,business ,hypertricosis ,Progestin ,terazosin ,Contraceptives, Oral - Abstract
Hirsutism is the presence of excess hair growth in women in the typical male hair growth areas, thereby reflecting a deviation from the normal female hair pattern. It affects from 5% to 10% of women, depending on age, menopausal status and ethnic background. The presence of hirsutism is very distressing for women, and subsequently may have a negative impact on their psychosocial life. In the treatment of hirsutism several options are now available, including pharmacologic regimens and cosmetic measures. Both the hormonal profile of the patient and her expectations and preferences should guide the therapeutic approach. The aims of the medical therapy are suppression of excessive androgen production, inhibition of peripheral action of androgens, and treatment of patients at risk for metabolic disorders or reproductive cancers. For other diseases related to endocrine abnormalities, such as thyroid disorders or Cushing's syndrome, specific treatment is mandatory. After an ineffective local approach by direct hair removal, a pharmacological treatment should be suggested, using estrogen and progestin combinations, antiandrogens (i.e. cyproterone acetate, spironolactone) or both as a first line. Finasteride, gonadotropin-releasing hormone agonists, and glucocorticoids should be used in selected cases. Adequate contraception is also recommended if antiandrogens are used. Unfortunately, since systemic therapy reduces hair growth in less than 50% of cases, hirsute women frequently require cosmetic measures. The use of a logical combination of different options has been shown to achieve a satisfactory result in most cases. This review provides information and suggestions about the current options of treating hirsutism.
- Published
- 2010
27. posters
- Author
-
Gb Chiara, A Galella, Smm Basso, Franco Lumachi, Elisa Milan, and B Marzano
- Subjects
Oncology ,medicine.medical_specialty ,business.industry ,Colorectal cancer ,Cancer ,Hematology ,medicine.disease ,Malignancy ,Menopause ,Internal medicine ,Medicine ,In patient ,CA19-9 ,business - Published
- 2010
28. Bone Mineral Density, Osteocalcin, and Bone-specific Alkaline Phosphatase in Patients with Insulin-dependent Diabetes Mellitus
- Author
-
Franco Lumachi, Giovanni Luisetto, Valeria Tombolan, and Valentina Camozzi
- Subjects
Adult ,Male ,musculoskeletal diseases ,medicine.medical_specialty ,Osteocalcin ,Osteoporosis ,menopause ,General Biochemistry, Genetics and Molecular Biology ,History and Philosophy of Science ,BMD ,Bone Density ,Reference Values ,Diabetes mellitus ,Internal medicine ,Bone mineral density ,medicine ,Humans ,Femoral neck ,Bone mineral ,calcium ,biology ,business.industry ,General Neuroscience ,Middle Aged ,Alkaline Phosphatase ,musculoskeletal system ,medicine.disease ,Bone mineral density, BMD, osteocalcin, alkaline phosphatase, ALP, diabetes mellitus, osteoporosis, osteopenia, menopause, PTH, calcium ,osteoporosis ,Osteopenia ,Bone Diseases, Metabolic ,osteopenia ,Diabetes Mellitus, Type 1 ,medicine.anatomical_structure ,Endocrinology ,Parathyroid Hormone ,Creatinine ,diabetes mellitus ,biology.protein ,ALP ,Alkaline phosphatase ,Female ,business ,Body mass index ,PTH - Abstract
The aims of this study were to evaluate the prevalence of osteopenia and the relationships between osteocalcin (OC), bone alkaline phosphatase (bALP), and bone mineral density (BMD) in patients with insulin-dependent diabetes mellitus (IDDM). A group of 18 patients (median age 47, range 36-51) with uncomplicated IDDM (Group A) were matched by sex, age, and body mass index with 21 healthy control volunteers (Group B). All subjects underwent osteodensitometry with measurement of BMD at the lumbar spine and femoral neck. Osteopenia was present in 11 (61.1%) and 2 (9.5%) of Group A and B patients (P= 0.01), respectively. Both OC (28.4 +/- 16.4 versus 41.2 +/- 14.6 ng/mL; P= 0.005) and bALP (51.3 +/- 11.8 versus 61.7 +/- 10.6 U/L; P= 0.006) serum levels were significantly lower in patients with IDDM. BMD did not correlate with either OC or bALP. In conclusion, osteopenia is common among patients with IDDM, but the relationship between bone formation markers and BMD is still unclear.
- Published
- 2009
29. Ninth European Congress on Clinical and Economic Aspects of Osteoporosis and Osteoarthritis – ECCEO 9 – IOF
- Author
-
Franco Lumachi, Giovanni Luisetto, and Valentina Camozzi
- Subjects
medicine.medical_specialty ,biology ,business.industry ,Endocrinology, Diabetes and Metabolism ,Osteoporosis ,Bone markers ,chemistry.chemical_element ,Bone Specific Alkaline Phosphatase ,Calcium ,medicine.disease ,Menopause ,Endocrinology ,chemistry ,Internal medicine ,medicine ,Osteocalcin ,biology.protein ,Alkaline phosphatase ,Densitometry ,business - Published
- 2009
30. Lumbar Spine Bone Mineral Density Changes in Patients with Primary Hyperparathyroidism According to Age and Gender
- Author
-
Valentina Camozzi, Mario Ermani, Franco Lumachi, Giovanni Luisetto, and A. Nardi
- Subjects
Male ,Time Factors ,parathyroid disease ,medicine.medical_treatment ,menopause ,Parathyroid hormone ,Bone remodeling ,Absorptiometry, Photon ,Bone Density ,Bone mineral ,Lumbar Vertebrae ,biology ,Hyperparathyroidism ,General Neuroscience ,Age Factors ,bone densitometry ,Middle Aged ,Hyperparathyroidism, Primary ,musculoskeletal system ,Postmenopause ,Parathyroid Hormone ,Osteocalcin ,parathyroid tumors ,Female ,alkaline phosphatase ,PTH ,Adult ,musculoskeletal diseases ,Parathyroidectomy ,medicine.medical_specialty ,General Biochemistry, Genetics and Molecular Biology ,Sex Factors ,Lumbar ,History and Philosophy of Science ,BMD ,Internal medicine ,medicine ,Humans ,Genetic Predisposition to Disease ,calcium ,business.industry ,Estrogens ,medicine.disease ,osteoporosis ,Endocrinology ,Hypercalcemia ,biology.protein ,parathyroid glands ,ALP ,Hyperparathyroidism, parathyroid tumors, parathyroid disease, Parathyroidectomy, PTH, Hypercalcemia, calcium, menopause, parathyroid glands, BMD, bone mineral density, bone densitometry, osteoporosis, ALP, alkaline phosphatase ,bone mineral density ,business ,Primary hyperparathyroidism - Abstract
Primary hyperparathyroidism (PHPT) results from excessive secretion of parathyroid hormone (PTH), and catabolic and anabolic effects of PTH on bone may lead to overall deleterious effects on skeleton. The aim of this study was to analyze the changes in lumbar spine bone mineral density (BMD) in patients with PHPT who underwent parathyroidectomy (PTx), and to correlate the main demographics and biochemical parameters with pre- and postoperative BMD values. Two groups of age-matched patients (group A = 14 postmenopausal women; group B = 13 men, overall median age 53 years, range 26-56 years) with confirmed PHPT were enrolled in the study. All patients underwent lumbar (L2-L4 region) spine osteodensitometry using a dual-energy X-ray absorptiometry (DXA) prior to surgery. A significant correlation between alkaline phosphatase (ALP) and PTH (R = 0.73, P = 0.003) was found in group A patients. In group B correlations were found between calcemia and ALP (R = 0.71, P = 0.007), and between osteocalcin and both PTH (R = 0.65, P = 0.01) and ALP (R = 0.59, P = 0.03). No correlation (P = NS) was found between BMD, both basal and postoperative, and age or biochemical parameters. The 1-year BMD were 0.937 +/- 0.115 and 0.940 +/- 0.201 g/cm(2) (P = NS) in group A and B, respectively. A significant (P = 0.03) difference between basal and 1-year BMD was found only in group A, while in group B the difference was not significant. In conclusion, in patients with PHPT bone turnover is increased and consequently the BMD is reduced, but unfortunately PTx does not allow for complete bone restoring. However, in premenopausal women the BMD values of the lumbar spine significantly improve after PTx, suggesting a higher bone sensitivity to serum PTH normalization due to a synergic action with estrogens.
- Published
- 2007
31. High Risk of Malignancy in Patients with Incidentally Discovered Adrenal Masses: Accuracy of Adrenal Imaging and Image-Guided Fine-Needle Aspiration Cytology
- Author
-
Gennaro Favia, Alberto Tregnaghi, Franco Lumachi, Maria Cristina Marzola, Pietro Zucchetta, Filippo Marino, Maurizio Iacobone, Simonetta Borsato, Ambrogio Fassina, Diego Cecchin, and Franco Bui
- Subjects
Male ,Cancer Research ,Hydrocortisone ,medicine.medical_treatment ,Adrenal Gland Diseases ,Adrenal Gland Neoplasms ,Adrenal incidentaloma ,Adrenocortical adenoma ,Iodine Radioisotopes ,Norepinephrine ,0302 clinical medicine ,Renin ,Adrenocortical Carcinoma ,Adrenocortical carcinoma ,Prospective Studies ,Aldosterone ,Incidental Findings ,medicine.diagnostic_test ,Adrenalectomy ,General Medicine ,Middle Aged ,Magnetic Resonance Imaging ,19-Iodocholesterol ,Oncology ,030220 oncology & carcinogenesis ,Adrenocortical Adenoma ,Female ,Radiology ,FNAB, adrenal gland, adrenal tumors, cancer, malignancy, pheochromocytoma ,Adult ,Radiography, Abdominal ,FNAB ,medicine.medical_specialty ,Epinephrine ,Biopsy, Fine-Needle ,Adrenal Gland Neoplasm ,030209 endocrinology & metabolism ,Pheochromocytoma ,Malignancy ,Sensitivity and Specificity ,03 medical and health sciences ,adrenal tumors ,Predictive Value of Tests ,medicine ,cancer ,Humans ,Ganglioneuroma ,Aged ,adrenal gland ,business.industry ,Magnetic resonance imaging ,medicine.disease ,Laparoscopy ,Tomography, X-Ray Computed ,business ,malignancy - Abstract
Aims and background The incidental finding of nonfunctioning adrenal masses (incidentalomas) is common, but no reliable criteria in differentiating between benign and malignant adrenal masses have been defined. The aim of this preliminary study was to assess the usefulness of adrenal imaging and image-guided fine-needle aspiration cytology in patients with nonfunctioning adrenal incidentalomas with the aim of excluding or confirming malignancy before surgery. Methods Forty-two consecutive patients (18 men and 24 women; median age, 54 years; range, 25-75 years) with incidentally discovered adrenal masses of 3 cm or more in the greatest diameter were prospectively enrolled in the study. All patients underwent helical computerized tomography scan and image-guided fine-needle aspiration cytology, 33 (78.6%) underwent magnetic resonance imaging, and 26 (61.9%) underwent norcholesterol scintigraphy before adrenalectomy. Results The revised final pathology showed 30 (71.4%) benign (26 adrenocortical adenomas, of which 3 were atypical, 2 ganglioneuromas, and 2 nonfunctioning benign pheochromocytomas) and 12 (28.6%, 95% CI = 15-42) adrenal malignancies (8 adrenocortical carcinomas and 4 unsuspected adrenal metastases). The definitive diagnosis of adrenocortical carcinoma was made according to Weiss criteria and confirmed on the basis of local invasion at surgery or metastases. The sensitivity, specificity and accuracy were 75%, 67% and 83% for computerized tomography scan, 92%, 95% and 94% for magnetic resonance imaging, 89%, 94% and 92% for norcholesterol scintigraphy, and 92%, 100% and 98% for fine-needle aspiration cytology. The sensitivity and accuracy of image-guided fine-needle aspiration cytology and magnetic resonance imaging together reached 100%. Immediate periprocedural complications of fine-needle aspiration cytology occurred in 2 (4.7%) patients: self-limited pneumothorax (n = 1), and severe pain (n = 1) requiring analgesic therapy. No postprocedural or late complications were observed. Conclusions With the aim of selecting for surgery patients with a non-functioning adrenal incidentaloma of 3 cm or more in diameter, the combination of magnetic resonance imaging and fine-needle aspiration cytology should be considered the strategy of choice.
- Published
- 2007
32. Adjuvant Hormonal Therapy in Women with Early-stage Breast Cancer
- Author
-
Davide Adriano Santeufemia, Stefano M.M. Basso, Giovanni Fadda, Giordano B. Chiara, Franco Lumachi, and Renato Tozzoli
- Subjects
Oncology ,medicine.medical_specialty ,ovary suppression ,Antineoplastic Agents, Hormonal ,letrozole ,medicine.drug_class ,anastrozole ,Estrogen receptor ,Anastrozole ,Breast Neoplasms ,aromatase inhibitors ,breast cancer ,HER2 ,Internal medicine ,Drug Discovery ,medicine ,Humans ,early breast cancer ,LHRH agonists ,breast ,Cancer ,Neoplasm Staging ,breast diseases ,Aromatase inhibitor ,tamoxifen ,Molecular Structure ,endocrine therapy ,business.industry ,Letrozole ,SERM ,breast cancer treatment ,ovariectomy ,Selective estrogen receptor modulator ,Estrogen ,Chemotherapy, Adjuvant ,GnRH agonists ,Hormonal therapy ,Cancer, malignancy, breast, breast cancer, breast diseases, early breast cancer, breast cancer treatment, estrogen receptor, endocrine therapy, GnRH agonists, LHRH agonists, SERM, tamoxifen, aromatase inhibitors, HER2, ovary suppression, anastrozole, letrozole, ovariectomy ,business ,hormones, hormone substitutes, and hormone antagonists ,Tamoxifen ,malignancy ,estrogen receptor ,medicine.drug - Abstract
For decades, adjuvant hormonal therapy has become the standard treatment of patients with estrogen receptor-positive breast cancer. Currently, the drugs available are GnRH agonists, selective estrogen receptor modulators, and aromatase inhibitors. The use of GnRH agonists represents a potentially reversible treatment that can restore ovarian function after chemotherapy. In premenopausal women, systemic therapy based on selective estrogen receptor modulators administration (e.g., tamoxifen) usually represents the standard adjuvant treatment. There are not sufficient data to recommend the routine addition of GnRH agonists to other endocrine therapies. In postmenopausal women, the disease-free survival was significantly prolonged in patients treated with aromatase inhibitor compared with those treated with tamoxifen, but the survival benefit was modest. Better results were obtained when the two drugs were administered sequentially. According to the ASCO guidelines, after 5 years of tamoxifen treatment, either tamoxifen or aromatase inhibitors therapy should be suggested for an additional 5 years. Unfortunately, most adverse events are consistent with estrogen deprivation and are common to all therapies, and the cumulative toxicity causes discontinuation and nonadherence to therapy in up to 50% of patients. Switching tamoxifen to an aromatase inhibitor may reduce adverse event incidence. Molecular-targeted therapy is useful in patients with advanced, relapsed or hormonal therapy-resistant tumors, usually as second- or third-line treatment. These drugs are usually added to aromatase inhibitors; however, currently, they have not yet been used in patients with early breast cancer.
- Published
- 2015
33. Current medical treatment of estrogen receptor-positive breast cancer
- Author
-
Franco Lumachi, Stefano M.M. Basso, and Davide Adriano Santeufemia
- Subjects
Oncology ,medicine.medical_specialty ,ovary suppression ,palbociclib ,letrozole ,anastrozole ,Anastrozole ,Estrogen receptor ,everolumus ,Palbociclib ,Pharmacology ,aromatase inhibitors ,Breast cancer ,Internal medicine ,medicine ,Adjuvant therapy ,cancer ,GnRH-agonist ,breast ,Fulvestrant ,tamoxifen ,business.industry ,endocrine therapy ,Letrozole ,Minireviews ,estrogen receptors ,SERM ,ovariectomy ,Selective estrogen receptor modulator ,mTOR ,ovary ,business ,Breast cancer, breast, endocrine therapy, ovary, ovary suppression, GnRH-agonist, SERM, tamoxifen, aromatase inhibitors, cancer, malignancy, estrogen receptors, anastrozole, letrozole, mTOR, everolumus, palbociclib, ovariectomy ,Tamoxifen ,medicine.drug ,malignancy - Abstract
Approximately 80% of breast cancers (BC) are estrogen receptor (ER)-positive and thus endocrine therapy (ET) should be considered complementary to surgery in the majority of patients. The advantages of oophorectomy, adrenalectomy and hypophysectomy in women with advanced BC have been demonstrated many years ago, and currently ET consist of (1) ovarian function suppression (OFS), usually obtained using gonadotropin-releasing hormone agonists (GnRHa); (2) selective estrogen receptor modulators or down-regulators (SERMs or SERDs); and (3) aromatase inhibitors (AIs), or a combination of two or more drugs. For patients aged less than 50 years and ER+ BC, there is no conclusive evidence that the combination of OFS and SERMs (i.e., tamoxifen) or chemotherapy is superior to OFS alone. Tamoxifen users exhibit a reduced risk of BC, both invasive and in situ, especially during the first 5 years of therapy, and extending the treatment to 10 years further reduced the risk of recurrences. SERDs (i.e., fulvestrant) are especially useful in the neoadjuvant treatment of advanced BC, alone or in combination with either cytotoxic agents or AIs. There are two types of AIs: type I are permanent steroidal inhibitors of aromatase, while type II are reversible nonsteroidal inhibitors. Several studies demonstrated the superiority of the third-generation AIs (i.e., anastrozole and letrozole) compared with tamoxifen, and adjuvant therapy with AIs reduces the recurrence risk especially in patients with advanced BC. Unfortunately, some cancers are or became ET-resistant, and thus other drugs have been suggested in combination with SERMs or AIs, including cyclin-dependent kinase 4/6 inhibitors (palbociclib) and mammalian target of rapamycin (mTOR) inhibitors, such as everolimus. Further studies are required to confirm their real usefulness.
- Published
- 2015
34. Preoperative serum C-reactive protein and its prognostic significance in patients with stage III-IV colorectal cancer
- Author
-
Franco Lumachi, Basso, S. M. M., Santeufemia, D. A., Ermani, M., Lo Re, G., and Chiara, G. B.
- Subjects
Male ,prognostic factors ,colorectal cancer ,C-reactive protein, colorectal cancer, prognostic factors, cancer, malignancy, C-reactive protein, CRP ,Middle Aged ,Survival Rate ,C-Reactive Protein ,Multivariate Analysis ,Preoperative Period ,Biomarkers, Tumor ,cancer ,Humans ,Female ,CRP ,Colorectal Neoplasms ,malignancy ,Aged ,Neoplasm Staging ,Proportional Hazards Models - Abstract
The molecular mechanism underlying the development of colorectal cancer (CRC) is not yet fully-understood, but there is evidence that inflammation plays a key role. Several circulating tumor and inflammatory markers can be useful for studying patients with CRC. It has been suggested that high serum levels of C-reactive protein (CRP) are associated with elevated risk of various malignancies and that CRP may affect survival of patients with CRC. We analyzed the relationship existing between the stage of the disease and baseline CRP serum levels in a group of 91 patients undergoing surgery for stage III (N=72, 79.1%) and IVa (N=19, 20.9%) CRC. There were 51 (56%) men and 40 (44%) women, with a median age of 66 years. Prior to surgery, all patients underwent quantitative serum CRP measurement. The overall 5-year survival was 37.1 ± 13.0 months. Patients with stage III disease and the sub-group with CRP3 mg/l (N=43, 47.3%) had a longer survival (p0.01) than patients with stage IVa and the sub-group with CRP ≥ 3 mg/l (N=48, 52.7%). No relationship between the age of the patients and CRP levels was found (R=-0.005, p=0.96), whilst there was a significant inverse relationship between survival and CRP level (R=-0.37, y=37.5343-0.5868x, p=0.0003). Using multivariate Cox model analysis (forward stepwise method), adjusted for age, CRP and CRC stage were independent parameters related to survival, with a relative risk of 3.5 (95% confidence interval=1.5-8.2) and 8.1 (95% confidence interval=3.0-21.3), respectively. In conclusion, CRP is a sensitive and easily detectable serum marker that can be useful in patients with CRC, allowing their better clinical stratification.
- Published
- 2014
35. Pathophysiology and treatment of nonfamilial hyperparathyroidism
- Author
-
Franco Lumachi and Stefano M.M. Basso
- Subjects
parathyroid autotransplantation ,Parathyroidectomy ,medicine.medical_specialty ,Calcitriol ,medicine.drug_class ,PTHrP ,medicine.medical_treatment ,Hyperparathyroidism, hypercalcemia, calcium metabolism, calcium, PTH, bisphosphonates, parathyroid glands, parathyroidectomy, PTHrP, parathyroid tumors, RANKL, denosumab, parathyroid autotransplantation, parathyroid cancer, calcemia ,Urology ,calcium metabolism ,Hyperphosphatemia ,Drug Discovery ,Medicine ,Humans ,Pharmacology (medical) ,bisphosphonates ,parathyroid cancer ,Hyperparathyroidism ,calcium ,business.industry ,RANKL ,hypercalcemia ,denosumab ,medicine.disease ,Phosphate binder ,calcemia ,Psychiatry and Mental health ,Hypoparathyroidism ,Quality of Life ,parathyroid glands ,parathyroid tumors ,business ,Primary hyperparathyroidism ,PTH ,Kidney disease ,medicine.drug - Abstract
Primary hyperparathyroidism (HPT) is the main cause of hypercalcemia and the most common parathyroid glands disease. The diagnosis is easy in patients with hypercalcemia and elevated PTH serum level. Minimally invasive parathyroidectomy (PTx) represents the treatment of choice for symptomatic patients, leading to several advantages, including immediate normalization of hypercalcemia and significant improvement of bone mineral density, cardiovascular dysfunctions, neuropsychological symptoms and quality of life. Secondary and tertiary HPT are relatively common complications in patients with chronic kidney disease (CKD) or advanced kidney failure, and in kidney transplant recipients who did not achieve complete calcium/phosphate metabolism normalization, respectively. The drugs available for patients with secondary HPT, and to treat hyperphosphatemia include non-calcium-containing phosphate binder, calcitriol analogues, calcimimetic agents, or a combination of two or more drugs. Although recent studies report that PTx significantly improves survival also in patients with CKD and severe secondary HPT, the indications for surgery are not yet well established. Subtotal or total PTx with or without autotransplantation are the surgical options for treating all patients with secondary HPT. Total PTx leads to a faster reduction in serum calcium level and normalization of PTH, but the risk of hypoparathyroidism is higher than after subtotal PTx. Further studies are needed to confirm the usefulness of the drugs currently recommended, and others will have to be tested in the near future.
- Published
- 2014
36. Measurement of serum carcinoembryonic antigen, carbohydrate antigen 19-9, cytokeratin-19 fragment and matrix metalloproteinase-7 for detecting cholangiocarcinoma: a preliminary case-control study
- Author
-
Franco, Lumachi, Giovanni, Lo Re, Renato, Tozzoli, Federica, D'Aurizio, Flavio, Facomer, Giordano B, Chiara, and Stefano M M, Basso
- Subjects
Male ,CA-19-9 Antigen ,diagnosis ,Enzyme-Linked Immunosorbent Assay ,Cholangiocarcinoma ,CEA ,Antigens, Neoplasm ,liver calcer ,Biomarkers, Tumor ,cancer ,Humans ,Aged ,Retrospective Studies ,Keratin-19 ,Cholangiocarcinoma, diagnosis, CEA, CA 19-9, CYFRA 21-1, MMP7, tumor markers, cancer, malignancy, liver calcer ,MMP7 ,Middle Aged ,Prognosis ,Carcinoembryonic Antigen ,Bile Ducts, Intrahepatic ,Bile Duct Neoplasms ,ROC Curve ,tumor markers ,CA 19-9 ,Case-Control Studies ,Matrix Metalloproteinase 7 ,CYFRA 21-1 ,Female ,malignancy ,Follow-Up Studies - Abstract
Cholangiocarcinoma is a malignant tumor of the liver arising from the bile duct epithelium, accounting for 10-25% of all primary hepatic cancers. The clinical presentation of this tumor is not specific and the diagnosis of early cholangiocarcinoma is difficult, especially in patients with other biliary diseases. Measurement of serum carbohydrate antigen (CA) 19-9 and carcinoembryonic antigen (CEA) are commonly used to monitor response to therapy, but are also useful for confirming the presence of a cholangiocarcinoma. In this setting, other biomarkers have been previously tested, including cytokeratin-19 fragment (CYFRA 21-1) and the matrix metalloproteinase-7 (MMP7). The purpose of this retrospective study was to determine the clinical usefulness of the assay of serum CEA, CA 19-9, CYFRA 21-1 and MMP7, individually and together, as tumor markers for the diagnosis of cholangiocarcinoma. Twenty-four patients (14 men, 10 women, 62.6±8.2 years of age) with histologically-confirmed cholangiocarcinoma (cases) and 25 age- and sex-matched patients with benign liver disease (controls) underwent measurement of these biomarkers. The mean values of all serum markers of patients with cholangiocarcinoma were significantly higher (p0.01) than that of the controls. No correlation was found between serum tumor markers and total bilirubin, aspartate aminotransferase (AST) and alkaline phosphatase (ALP). The sensitivity, specificity and accuracy were: CEA: 52%, 55%, and 58%; CA 19-9: 74%, 82% and 78%; CYFRA 21-1: 76%, 79% and 78%; MMP7: 78%, 77% and 80%, respectively. The combination of all serum markers afforded 92.0% sensitivity and 96% specificity in detecting cholangiocarcinoma, showing the highest diagnostic accuracy (94%). In conclusion, our preliminary results suggest that the measurement of all four biomarkers together can help in the early detection of cholangiocarcinoma.
- Published
- 2014
37. Seroma prevention following axillary dissection in patients with breast cancer by using ultrasound scissors: a prospective clinical study
- Author
-
Franco Lumachi, Alba A. Brandes, P Burelli, Mario Ermani, Maurizio Iacobone, and Smm Basso
- Subjects
Ultrasonic Therapy ,medicine.medical_treatment ,menopause ,Mastectomy, Segmental ,Logistic regression ,Body Mass Index ,Breast cancer ,Postoperative Complications ,Risk Factors ,Prospective Studies ,Hematoma ,Ultrasound ,axillary dissection ,mastectomy ,General Medicine ,Middle Aged ,Surgical Instruments ,Treatment Outcome ,Oncology ,Drainage ,Female ,Ultrasonography, Mammary ,Mastectomy ,Adult ,medicine.medical_specialty ,Breast surgery ,Breast Neoplasms ,Modified Radical Mastectomy ,axillary nodes ,breast conserving surgery ,medicine ,cancer ,Humans ,Breast cancer, breast diseases, breast, cancer, malignancy, axillary nodes, axillary dissection, mastectomy, breast conserving surgery, menopause, seroma, ultrasound scissor ,breast ,Aged ,breast diseases ,business.industry ,medicine.disease ,Surgery ,ultrasound scissor ,seroma ,Seroma ,Axilla ,Lymph Node Excision ,Lymph Nodes ,Complication ,business ,malignancy - Abstract
Aims . Seroma formation following axillary dissection is a common complication of breast surgery. The aims of this study were (1) to analyse the risk factors of seroma formation, and (2) to evaluate the role of ultrasound scissors in performing axillary dissection in patients with primary breast cancer undergoing mastectomy and breast-conserving surgery. Methods . Ninety-two women (median age 55 years, range 33–73 years) requiring surgery for known unilateral primary breast cancer (pT1a=1, pT1b=20, pT1c=43, pT2=25, pT3=3) were prospectively randomised to undergo axillary dissection by either using (Group A, 45 patients) or not using (Group B, 47 patients) ultrasound scissors (US). Thirty-eight (41.3%) patients underwent modified radical mastectomy, while 54 (58.7%) underwent breast-conserving surgery. Results . Twenty-eight (30.4%) patients (Group A=9 out of 45, 20%; Group B=19 out of 47, 42%; P=NS) developed a wound seroma. Multivariate analysis using a logistic regression model showed that surgical procedure (RR=8.9; 95% CI: 3.2–25.3), total amount of drainage (RR=7.8; 95% CI: 2.8–22.0), and size of the tumour (RR=6.0; 95% CI: 2.2–16.5) independently correlated with seroma formation. The logistic regression function (RR=19.4; 95% CI: 6–62) correctly allocated 75 out of 92 (81.5%) patients. Conclusions . Size of the tumour, and total amount of drainage represent the principal factors of seroma formation following axillary dissection in patients undergoing surgery for breast cancer. Although the use of ultrasound cutting devices may reduce the risk of seroma formation, further studies are need to verify the real impact on long-term morbidity of such technique.
- Published
- 2004
38. 50P Accuracy of serum/pleural fluid lactate dehydrogenase ratio measurement in patients with malignant pleural effusion
- Author
-
Smm Basso, Franco Lumachi, Renato Tozzoli, Gb Chiara, and F. Mazza
- Subjects
Pulmonary and Respiratory Medicine ,Oncology ,medicine.medical_specialty ,business.industry ,Pleural effusion ,Cancer ,medicine.disease ,Malignancy ,Gastroenterology ,Metastasis ,chemistry.chemical_compound ,Breast cancer ,chemistry ,Internal medicine ,Lactate dehydrogenase ,Medicine ,Malignant pleural effusion ,business ,Lung cancer - Published
- 2016
39. Short- and Long-Term Changes in Bone Mineral Density of the Lumbar Spine After Parathyroidectomy in Patients with Primary Hyperparathyroidism
- Author
-
Smm Basso, Franco Lumachi, Gennaro Favia, A. Nardi, Mario Ermani, Valentina Camozzi, and Giovanni Luisetto
- Subjects
Adult ,Male ,Parathyroidectomy ,medicine.medical_specialty ,Time Factors ,Primary hyperparathyroidism ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Urology ,menopause ,Primary hyperparathyroidism, Hyperparathyroidism, Parathyroid disease, Parathyroidectomy, PTH, Hypercalcemia, calcium, Parathyroid scintigraphy, MIBI, CT-scan, menopause, parathyroid glands, BMD, bone mineral density, bone densitometry, hypercalcemia ,Hyperthyroidism ,Group B ,Bone remodeling ,Absorptiometry, Photon ,Endocrinology ,BMD ,Bone Density ,medicine ,Humans ,Orthopedics and Sports Medicine ,MIBI ,Parathyroid disease ,Aged ,Aged, 80 and over ,Bone mineral ,Hyperparathyroidism ,calcium ,Lumbar Vertebrae ,business.industry ,hypercalcemia ,Parathyroid scintigraphy ,bone densitometry ,CT-scan ,Middle Aged ,medicine.disease ,Surgery ,Postmenopause ,Menopause ,Treatment Outcome ,parathyroid glands ,Female ,bone mineral density ,business ,PTH - Abstract
The aims of this study were (1) to analyze whether correlations exist between lumbar spine (LS) bone mineral density (BMD) and the main preoperative biochemical parameters in a large population of patients with primary hyperparathyroidism (HPT); and (2) to evaluate the LS-BMD changes after parathyroidectomy (PTx) at long-term follow-up. Sixty-two patients (median age 57 years, range 23–82 years) with confirmed primary HPT underwent LS osteodensitometry by dual-energy X-ray absorptiometry with BMD measurements at the L2–L4 region before surgery and at 1 year and 2 years after successful PTx. Three groups of patients were considered: Group A (men, n = 14, 22.6%), Group B (premenopausal women, n = 12, 19.3%), and Group C (postmenopausal women, n = 36, 58.1%). There were no linear correlations (P = NS) among the main biochemical parameters, the age of the patients, and their baseline LS-BMD values that were significantly (P < 0.01) lower in Group C patients. At 2-year follow-up the LS-BMD improved by 13.0%, 11.5%, and 11.7% in Groups A, B, and C, respectively (P = NS). In order to compare groups with the same linear relationship between age and LS-BMD, a subgroup of postmenopausal patients aged ≤60 years (Group C2) was considered. ANOVA showed that the improvement of the LS-BMD at l- and 2-year follow-up was higher (P = 0.002) in Group B than in Group C2 patients. The result was confirmed by using the Mann-Whitney U-test (P = 0.0078). Improvement of LS-BMD after successful PTx was significantly (P < 0.01) higher in premenopausal women, suggesting a possible role of estrogen hormone in complete bone remodeling.
- Published
- 2003
40. Abstracts
- Author
-
Franco Lumachi, Giovanni Luisetto, Gennaro Favia, Maurizio Iacobone, and Valentina Camozzi
- Subjects
Parathyroidectomy ,medicine.medical_specialty ,Hyperparathyroidism ,education.field_of_study ,Histology ,Physiology ,business.industry ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Osteoporosis ,Population ,medicine.disease ,Surgery ,Menopause ,medicine ,Parathyroid disease ,business ,education ,Pathological ,Primary hyperparathyroidism - Published
- 2003
41. ABSTRACTS
- Author
-
Franco Lumachi, Maria Cristina Marzola, M. Ermani, Pietro Zucchetta, Franco Bui, and Aa Brandes
- Subjects
Oncology ,medicine.medical_specialty ,Multivariate analysis ,Scintimammography ,business.industry ,General Medicine ,Logistic regression ,medicine.disease ,Breast cancer ,Internal medicine ,Medicine ,Surgery ,business - Published
- 2002
42. Apoptosis: Life Through Planned Cellular Death Regulating Mechanisms, Control Systems, and Relations with Thyroid Diseases
- Author
-
Stefano M.M. Basso and Franco Lumachi
- Subjects
p53 ,Endocrinology, Diabetes and Metabolism ,Cellular homeostasis ,Apoptosis ,Biology ,Thyroid carcinoma ,Endocrinology ,thyroid cancer ,medicine ,Extracellular ,Humans ,Thyroid Neoplasms ,Thyroid diseases, thyroid cancer, Apoptosis, p53, thyroid gland ,thyroid gland ,Mechanism (biology) ,Thyroid ,Cellular death ,Genes, p53 ,Thyroid Diseases ,Cellular suicide ,medicine.anatomical_structure ,Proto-Oncogene Proteins c-bcl-2 ,Mutation ,Immunology ,Cancer research - Abstract
Apoptosis is an active biologic process that represents a form of programmed cellular suicide, activated either by genetic factors or by cellular lesions caused by various extracellular traumatic agents. The alterations of its functional mechanisms control cellular homeostasis are involved in the genesis of many illnesses. There are different control systems that can both stimulate and inhibit apoptosis, such as the p53 and Bcl-2 proteins. Different injuries may cause a rapid increase in the levels of p53 and the activation of the complex mechanism which leads either to damage repair or cellular apoptosis. The concept of tumor growth as a dynamic balance between cellular development and death is well applicable to differentiated thyroid carcinomas, which are generally not highly invasive and present excellent prognosis. On the contrary, in aggressive anaplastic thyroid carcinoma there is an increase in p53, whereas in normal thyroid cells there is a high expression of Bcl-2, so as to interfere with apoptosis when physiologic hormone levels are normal. However, only some of the biomolecular mechanisms behind the genesis of thyroid tumors have been explained, and the role of apoptosis in thyroid diseases has not been well defined. This review provides information about relationship between apoptosis and thyroid diseases.
- Published
- 2002
43. Relationship between overall survival and preoperative parameters in patients with colorectal cancer and synchronous liver and lung metastases
- Author
-
Paolo Ubiali, A. Del Conte, Umberto Zuccon, Franco Lumachi, Federica Maffeis, and Smm Basso
- Subjects
Oncology ,medicine.medical_specialty ,Lung ,business.industry ,Colorectal cancer ,Hematology ,medicine.disease ,medicine.anatomical_structure ,Internal medicine ,Overall survival ,Medicine ,In patient ,business - Published
- 2017
44. Analysis of factors affecting survival in patients with simultaneous liver and pulmonary metastases from colorectal cancer
- Author
-
Federica Maffeis, Umberto Zuccon, Franco Lumachi, A. Del Conte, Smm Basso, and Paolo Ubiali
- Subjects
Oncology ,medicine.medical_specialty ,Colorectal cancer ,business.industry ,Internal medicine ,medicine ,In patient ,Hematology ,medicine.disease ,business - Published
- 2017
45. Flow cytometry immunophenotyping of pleural fluid cytology in patients with diffuse large B-cell lymphoma (DLBCL) and malignant pleural effusion
- Author
-
Franco Lumachi, Smm Basso, Paolo Ubiali, Sandro Sulfaro, and Renato Tozzoli
- Subjects
Pathology ,medicine.medical_specialty ,business.industry ,Hematology ,medicine.disease ,Immunophenotyping ,Oncology ,Cytology ,medicine ,Pleural fluid ,Malignant pleural effusion ,In patient ,business ,Diffuse large B-cell lymphoma ,Cytometry - Published
- 2017
46. Analysis of factors affecting survival in patients with lung metastases from colorectal cancer who underwent VATS-assisted surgical excision
- Author
-
Smm Basso, Paolo Ubiali, G. Lo Re, and Franco Lumachi
- Subjects
Cancer Research ,medicine.medical_specialty ,Lung ,business.industry ,Colorectal cancer ,Cancer ,medicine.disease ,Malignancy ,Surgery ,Metastasis ,Menopause ,medicine.anatomical_structure ,Oncology ,medicine ,Metastasectomy ,business ,Lung cancer - Published
- 2017
47. Serum tumor markers carcinoma antigen (CA) 72–4 versus carcinoembryonic antigen (CEA) in patients with early stage (IA–IB) gastric cancer
- Author
-
Paolo Ubiali, Franco Lumachi, Smm Basso, Renato Tozzoli, and A. Del Conte
- Subjects
CA 72-4 ,Oncology ,Cancer Research ,medicine.medical_specialty ,markers ,menopause ,CA 15-3 ,02 engineering and technology ,010402 general chemistry ,elderly ,01 natural sciences ,Cancer, malignancy, gastric cancer, CEA, CA 72-4, cancer antigen, markers, tumor markers, serum markers, surgery, gastrectomy, elderly, menopause ,serum markers ,surgery ,CEA ,Carcinoembryonic antigen ,Internal medicine ,Carcinoma ,Medicine ,In patient ,Antigen ca ,Stage (cooking) ,Cancer ,biology ,business.industry ,gastric cancer ,021001 nanoscience & nanotechnology ,medicine.disease ,gastrectomy ,0104 chemical sciences ,tumor markers ,cancer antigen ,biology.protein ,0210 nano-technology ,business ,malignancy - Published
- 2017
48. Quality of life in elderly patients with breast cancer after mastectomy evaluated using the short form of the Medical Outcomes Study questionnaire (MOS-SF-36)
- Author
-
P. Ubiali, L. Di Gennaro, Smm Basso, and Franco Lumachi
- Subjects
Oncology ,Cancer Research ,medicine.medical_specialty ,medicine.medical_treatment ,menopause ,elderly ,surgery ,medical outcome study ,breast cancer ,Breast cancer ,Quality of life ,Internal medicine ,medicine ,breast ,Cancer ,breast diseases ,business.industry ,questionnaire ,mastectomy ,medicine.disease ,Mos sf 36 ,Cancer, malignancy, breast, breast cancer, breast diseases, mastectomy, surgery, elderly, menopause, MOS-36, quality, quality of life, medical outcome study, questionnaire ,quality of life ,MOS-36 ,quality ,Physical therapy ,business ,Mastectomy ,malignancy - Published
- 2017
49. P3.03-022 Serum CEA, VEGF and MMP-7 in Patients with Malignant Pleural Effusion. A Prospective Study with Logistic Regression Analysis of Accuracy
- Author
-
Franco Lumachi, Stefano M.M. Basso, Paolo Ubiali, Francesco Mazza, and Renato Tozzoli
- Subjects
Pulmonary and Respiratory Medicine ,Oncology ,medicine.medical_specialty ,biology ,business.industry ,VEGF receptors ,Matrix metalloproteinase ,medicine.disease ,Logistic regression ,Internal medicine ,medicine ,biology.protein ,Malignant pleural effusion ,In patient ,Mesothelioma ,business ,Prospective cohort study - Published
- 2017
50. P2.04-054 Pleural CEA and C-Reactive Protein in Patients with Lung Metastases and Malignant Pleural Effusion. A Prospective Case-Control Study
- Author
-
Stefano M.M. Basso, Renato Tozzoli, Alessandro Del Conte, Paolo Ubiali, and Franco Lumachi
- Subjects
Pulmonary and Respiratory Medicine ,Pathology ,medicine.medical_specialty ,Lung ,biology ,Pleural effusion ,business.industry ,C-reactive protein ,Cancer ,Esophageal cancer ,medicine.disease ,Malignancy ,Gastroenterology ,Metastasis ,medicine.anatomical_structure ,Oncology ,Internal medicine ,medicine ,biology.protein ,Malignant pleural effusion ,business - Published
- 2017
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