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  • 1
    Electronic Resource
    Electronic Resource
    Survey on the treatment of non-small-cell lung cancer in Italy (2000)
    Springer
    Annals of oncology 11 (2000), S. 807-813 
    Details
    ISSN: 1569-8041
    Keywords: adjuvant chemotherapy ; clinicians' opinions ; non-small-cell lung cancer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:The results of the Italian part of an internationalsurvey on therapeutic preferences and opinions about prognosis of patientsaffected by non-small-cell lung cancer (NSCLC) are shown. Patients and methods:The investigation was conducted by the meansof a postal questionnaire aiming to gather information on preferences abouttreatment and beliefs about survival of three hypothetical patients affectedby NSCLC in different stages (T2N1M0,T2N3M0, M1); three sources ofItalian physicians potentially treating patients affected by NSCLC were thetarget population: participants in the Adjuvant Lung Project Italy (Alpi)trial, a 20% random sample of the Italian Medical Oncology Association(AIOM) and representatives of almost all the pneumology wards in Italy. Results:Overall, there were 287 evaluable responses, 89%of respondents were males, mean age was 46 years, years from graduation 21 andcharge of patients per clinician 82. The most important result is the widevariation of answers both about therapy and prognosis. Expectations about sizeof prognosis improvement with a new chemotherapy seem to be excessive. Conclusions:The results are discussed in relation to the twinsurveys of Canada and England and Wales and to the meta-analyses on theefficacy of chemotherapy as an adjunct to primary treatment and onpostoperative radiotherapy in non-small-cell lung cancer.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008313731133
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  • 2
    Electronic Resource
    Electronic Resource
    Efficacy of adjuvant chemotherapy after curative resection for gastric cancer: A meta-analysis of published randomised trials (2000)
    Springer
    Annals of oncology 11 (2000), S. 837-843 
    Details
    ISSN: 1569-8041
    Keywords: adjuvant ; chemotherapy ; gastric cancer ; meta-analysis ; randomised clinical trial
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:Several studies have investigated the possible roleof the adjuvant chemotherapy after curative resection for gastric cancerfailing to show a clear indication; previous meta-analyses suggested smallsurvival benefit of adjuvant chemotherapy, but the statistical methods usedwere open to criticisms. Materials and methods:Randomised trials were identified by meansof Medline and CancerLit and by selecting references from relevant articles.Systematic review of all randomised clinical trials of adjuvant chemotherapyfor gastric cancer compared with surgery alone, published before January 2000,were considered. Pooling of data was performed using the fixed effect model.Death for any cause was the study endpoint. The hazard ratio and its95% confidence intervals (95% CI), derived according to themethod of Parmar, were the statistics chosen for summarising the relativebenefit of chemotherapyversuscontrol. Results:Overall 20 articles (21 comparisons) were considered foranalysis. Three studies used single agent chemotherapy, seven combination of5-fluorouracil (5-FU) with anthracyclin, ten combination of 5-FU withoutanthracyclines. Information on 3658 patients, 2180 deaths, was collected. Chemotherapy reduced the risk of death by 18% (hazard ratio 0.82,95% CI: 0.75–0.89, P 〈 0.001). Association ofAnthracyclines to 5-FU did not show a statistically significant improvementwhen compared with the effect of the other regimens. Conclusions:Chemotherapy produces a small survival benefit inpatients with curatively resected gastric cancer. However, taking into accountthe limitations of literature based meta-analyses, adjuvant chemotherapy isstill to be considered as an investigational approach.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008377101672
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  • 3
    Electronic Resource
    Electronic Resource
    Assessing the effectiveness of follow-up care for colorectal cancer: A great conceptual and methodological challenge for clinical oncology (1997)
    Springer
    Annals of oncology 8 (1997), S. 1059-1062 
    Details
    ISSN: 1569-8041
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008260413568
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  • 4
    Electronic Resource
    Electronic Resource
    The accuracy of staging: An important prognostic determinator in stage I ovarian carcinoma (1998)
    Springer
    Annals of oncology 9 (1998), S. 1097-1101 
    Details
    ISSN: 1569-8041
    Keywords: conservative surgery ; lymph node ; prognosis ; ovarian cancer ; staging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Several prognostic factors for stage I ovarian carcinoma have been analyzed. Some of them are biological and clinical in nature, but others such as the thoroughness of the staging procedure, the extent of the surgery and the philosophy of treatment, are defined by the human element. Patients and methods: We reviewed the records of 351 patients with Stage I ovarian cancer who had been treated from 1981 to 1991. For all patients the following information was available: age, size of the tumor, FIGO sub-stage, tumor grade, histologic type, rupture of the tumor, cytology, extent of the staging and of the surgery (hysterectomy and bilateral salpingo-oophorectomy vs. fertility-conserving surgery) and use of adjuvant treatments. The thoroughness of the staging was defined as: optimal staging: total abdominal hysterectomy and bilateral salpingo-oophorectomy or fertility-conserving surgery, peritoneal cytology or washing, omentectomy, multiple peritoneal biopsies, sampling of the retroperitoneal nodes or formal lymphadenectomy. peritoneal staging: all the criteria described above were met with the exception of retroperitoneal sampling. incomplete staging: lack of any of the previously-cited criteria. Results: An optimal staging was performed in 100 patients, a peritoneal staging in 107 and an incomplete staging in 144. Radical surgery was performed in 295 women and fertility-conserving surgery in 56. With a median follow-up of 108 months (range 14–184) 64 patients had recurrence of the tumor. Fifty-three died of the disease, two are currently alive with disease and nine were salvaged by surgery and/or chemotherapy. In a multivariate analysis only the tumor grade and the type of staging were significant independent prognostic factors for both disease-free and overall survival. Conclusions: As described by other authors, we confirm that tumor grade is the single most important biological prognostic factor in early ovarian carcinoma. The thoroughness of the staging impacts significantly on survival, particularly in poorly differentiated carcinomas. Fertility-sparing surgery is not associated with a worse outcome than standard radical surgery.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008424527668
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  • 5
    Electronic Resource
    Electronic Resource
    Long-term follow-up of isolated optic neuritis: the risk of developing multiple sclerosis, its outcome, and the prognostic role of paraclinical tests (1999)
    Springer
    Journal of neurology 246 (1999), S. 770-775 
    Details
    ISSN: 1432-1459
    Keywords: Key words Optic neuritis ; Multiple sclerosis ; Magnetic resonance ; imaging ; CSF examination ; Oligoclonal bands ; Evoked ; potentials
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We evaluated the risk of developing clinically definite multiple sclerosis (CDMS) after an acute attack of isolated optic neuritis (ON) in 112 patients, in relation to demographic and paraclinical findings. Patients were examined by brain MRI, CSF analysis, and multiple evoked potentials (EPs); 10 were lost to follow-up, and the other 102 were enrolled in a prospective study (follow-up duration 6.3 ± 2.2 years). Of these, 37 (36.3%) developed CDMS after a mean interval of 2.3 ± 1.6 years. The risk of developing CDMS was 13% after 2 years, 30% after 4, 37% after 6, and 42% after 8 and 10 years. Gender, age, and season of ON onset did not affect the risk. MS occurred in 37 of 71 patients (52.1%) with one MRI lesion or more; no patient with a normal MRI developed the disease. MS developed more frequently in patients with intrathecal IgG synthesis than in those without (43% vs. 28%), but the difference was not statistically significant. Multiple EPs showed a slight predictive value only including somatosensory EPs of the lower limb. Multiple sclerosis was mild in most cases (EDSS 2.2 ± 1.9). The EDSS was less than 4 in 32 cases (86%), between 4 and 6 in 2 (5%), higher than 6.5 in 3 (8%).
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004150050453
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  • 6
    Electronic Resource
    Electronic Resource
    Isolated optic neuritis and its prognosis for multiple sclerosis: a clinical and paraclinical study with evoked potentials. CSF examination and brain MRI (1996)
    Springer
    Neurological sciences 17 (1996), S. 325-332 
    Details
    ISSN: 1590-3478
    Keywords: Optic neuritis ; Multiple sclerosis ; Intrathecal IgG synthesis ; Evoked potentials ; Brain MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Sommario Il nostro studio ha valutato la frequenza di sviluppo di sclerosi multipla (SM) dopo un attacco acuto di nevrite ottica retrobulbare (NORB), la possibile associazione con fattori di rischio quali l'età e il sesso, il ruolo diagnostico e prognostico di test paraclinici. Sono stati studiati 100 pazienti affetti da NORB con età media 28,9 anni (SD 8,9), 85 dei quali seguiti in follow-up ad intervalli periodici. Sessantasei pazienti sono stati sottoposti a potenziali evocati (PE) multimodali, esame liquorale ed esame di risonanza magnetica cerebrale entro 6 mesi dalla NORB. Dopo un follow-up medio di 5,2 anni, la SM si è sviluppata in 28/85 casi. A 4 anni il rischio di sviluppare la SM è risultato pari allo 0,35 allo studio mediante tavole di sopravvivenza, indipendentemente dal sesso e dall'età dei pazienti. I PE visivi sono apparsi alterati nel 25,4% degli occhi non colpiti da NORB, i PE acustici nel 6,5%, i sensoriali nell'8,1%, i motori dell'arto superiore nel 6,8% (su 44 casi). Cinquantacinque pazienti sottoposti a test paraclinici presentavano un follow-up maggiore di 1 anno. La SM si è sviluppata in 13: tutti presentavano lesioni all'esame RMN, 9 presentavano indici di sintesi intratecale di IgG, 2 alterazioni ai PE extravisivi. Il rischio di sviluppare la SM a 4 anni è risultato di 0.33 nei pazienti con lesioni RMN, la presenza di indici di sintesi intratecale di IgG aumentava il rischio a 0,46.
    Notes: Abstract Our study evaluated the frequency of developing multiple sclerosis (MS) after acute isolated optic neuritis (ON), the possible association with risk factors (gender, age), and the diagnostic and prognostic role of paraclinical tests. We studied 100 ON patients (mean age 28.9 years: SD 8.9): 85 patients were regularly followed up. Sixty-six patients underwent multimodality evoked potential (EP) test, CSF examination and brain MRI within six months of the onset of ON. Over a mean follow-up of 5.2 years, MS occurred in 28/85 cases. The risk of developing MS after four years was 0.35 at life-table analysis, regardless of gender or age at the onset of ON. Visual EPs in unaffected eyes were abnormal in 25.4%, brainstem auditory EPs in 6.5%, somatosensory EPs in 8.1%, upper limb motor EPs in 6.8% of the tested patients; intrathecal IgG synthesis was revealed in 51.7% and MRI lesions in 73.8%. Fifty-one of the patients who underwent paraclinical tests were followed up for more than one year, and MS occurred in 13 cases. All of these presented MRI lesions, nine intrathecal IgG synthesis, and two abnormal extraocular EPs. The risk of developing MS after four years was 0.33 in patients with MRI lesions; the simultaneous presence of intrathecal IgG synthesis increased the risk to 0.46.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01999894
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