Power Flush, a Novel Bailout Technique for Stumpless Aorto-Ostial CTOs: A Case-Based Approach.

Background: Aorto-ostial coronary artery flush chronic total occlusions are a challenging subset of lesion with peculiar characteristic: the near complete lack of guiding catheter support, the presence of a thicker layer of muscular fibers and a greater collagen and calcium content, responsible for balloon dilatation's resistance and greater recoil tendency. We introduce a novel bailout technique to overcome retrograde wire failure in accessing aorta, a variation of the Carlino technique which we named Power Flush.

Materials And Methods: Power Flush consists in a forceful injection of contrast dye directly through the guiding catheter positioned against the aortic wall in correspondence to the coronary ostium location, to gain access to the extra-plaque space and proceed with the vessel's recanalization.

Second-generation inflammation-related scores are more effective than systemic inflammation ratios in predicting prognosis of patients with unresectable or metastatic pancreatic cancer receiving cytotoxic chemotherapy.

Inflammation is known to play an important role in the biology of metastatic pancreatic adenocarcinoma (mPDAC), and systemic inflammatory response (SIR) is reported to be closely related to outcome in mPDAC. The aim of the present paper is to assess the prognostic performance of SIR-related variables in patients with mPDAC receiving cytotoxic chemotherapy. Data of patients with mPDAC, who were registered in the database of the division of Medical Oncology of the G.

Phase III study with FOLFIRI + cetuximab versus FOLFIRI + cetuximab followed by cetuximab alone in RAS and BRAF WT mCRC.

The optimal duration and intensity of first-line therapy in metastatic colorectal cancer patients once they have achieved an objective response is controversial. In a molecularly selected RAS and BRAF wild-type (wt) population, this concern is amplified. Once disease control has been achieved with a combination therapy including an anti-EGFR antibody, further exposure both to cytotoxic drugs and targeted therapy might result only in increased toxicity.

Pre-treatment carcinoembryonic antigen and outcome of patients with rectal cancer receiving neo-adjuvant chemo-radiation and surgical resection: a systematic review and meta-analysis.

Neo-adjuvant chemo-radiation is the standard of care for patients with locally advanced rectal carcinoma. The aim of the present paper is to evaluate the relationship of the baseline serologic concentration of the carcinoembryonic antigen with the outcome. Data sources included MEDLINE and Web of Science databases.

Role of family history and tumor location on prognosis of patients with colorectal cancer and synchronous metastases.

Background/aims: Family history of colorectal cancer and tumor location along colon-rectum have been reported as prognostic factors. The aim of the current study is to analyze the role of both on overall survival in a series of patients with metastatic colorectal cancer with synchronous metastases.

Methods: A retrospective mono-institutional analysis has been performed on patients, who received chemotherapy from 2004 to 2008.

Alcohol consumption pattern and risk of Barrett's oesophagus and erosive oesophagitis: an Italian case-control study.

Knowledge about the association between alcohol and Barrett's oesophagus and reflux oesophagitis is conflicting. In this case-control study we evaluated the role of specific alcoholic beverages (red and white wine, beer and liquors) in 339 Barrett's oesophagus and 462 oesophagitis patients compared with 619 endoscopic controls with other disorders, recruited in twelve Italian endoscopic units. Data on alcohol and other individual characteristics were obtained from structured questionnaires.

Trial-level analysis of progression-free survival and response rate as end points of trials of first-line chemotherapy in advanced ovarian cancer.

Progression-free survival (PFS) has been reported as surrogate end point of overall survival (OS) in trials of advanced ovarian cancer (AOC). However, there is not a trial-level evaluation of surrogacy. The aim of this study is to perform an analysis of randomized trials enrolling patients with AOC receiving a first-line systemic chemotherapy, in order to evaluate the results of PFS, the other intermediate end points and their relationship with OS.

CA19-9-related tumor kinetics after first-line chemotherapy of patients with advanced pancreatic cancer: a monoinstitutional experience.

The absolute value of carbohydrate antigen 19-9 (CA19-9) pretreatment and its reduction after chemotherapy are established prognostic variables for patients with advanced pancreatic cancer. The present study is a retrospective monoinstitutional evaluation of the prognostic role of the CA19-9 reduction and some CA19-9-related tumor kinetics parameters, such as tumor growth rate constant (G), kinetic tumor response and log ratio. Forty-one cases met the selection criteria.

Analysis of Clinical End Points of Randomised Trials Including Bevacizumab and Chemotherapy versus Chemotherapy as First-line Treatment of Metastatic Colorectal Cancer.

Aims: Progression-free survival is recognised as an appropriate end point for randomised clinical trials of chemotherapy of patients with metastatic colorectal cancer, although it is not clear if it is reliable after chemotherapy plus bevacizumab.

Materials And Methods: A literature search of randomised trials of systemic treatment including chemotherapy plus bevacizumab versus chemotherapy in patients with metastatic colorectal cancer was undertaken. For each trial the differences in overall survival and in either time-to-event or response-related end points were calculated.

Tumor Growth Kinetics Before and After First-line Chemotherapy in Metastatic Castration-resistant Prostate Cancer: A Prostate-specific Antigen-based Retrospective Analysis.

Objectives: The role of the tumor growth fraction has been investigated poorly in metastatic castration-resistant prostate cancer (mCRPC). The aim of this study was to assess whether some prostate-specific antigen (PSA)-related variables of tumor cell kinetics predict the overall survival in early and late mCRPC, and to explore changes in the tumor growth fraction after chemotherapy.

Methods: A retrospective analysis of 3 tumor cell kinetic variables in patients with mCRPC receiving first-line chemotherapy has been performed.

Analysis of Response-Related and Time-to-event Endpoints in Randomized Trials of Gemcitabine-Based Treatment Versus Gemcitabine Alone as First-Line Treatment of Patients With Advanced Pancreatic Cancer.

Background: Gemcitabine-based combinations in advanced pancreatic cancer have been reported to have superior activity compared with gemcitabine alone. The results of the commonly used endpoints of clinical trials after chemotherapy or targeted therapy have been poorly reported.

Methods And Materials: We performed a search of randomized trials of systemic treatment that included gemcitabine plus chemotherapy or targeted therapy versus gemcitabine alone.

Feasibility and Acceptability of Office-Based Polypectomy With a 16F Mini-Resectoscope: A Multicenter Clinical Study.

Study Objective: To investigate the feasibility and acceptability of office hysteroscopic polypectomy using a novel continuous-flow operative 16F mini-resectoscope.

Design: Multicenter prospective case series (Canadian Task Force classification III).

Setting: "SS Antonio e Biagio" Hospital, Alessandria, and University "Federico II" of Naples.

CA125-related tumor cell kinetics variables after chemotherapy in advanced ovarian cancer: a systematic review.

Various kinetic parameters, based on a minimum of two time points, have been built with CA125 determinations. The aim of this study is to review studies about the clinical application of CA125-related tumor cell kinetics variables in patients with advanced ovarian cancer (AOC) receiving chemotherapy. A literature search for studies about CA125-related variables in patients with AOC was undertaken on three databases, by predefined search criteria, and a selection of studies was performed.

Incidence and Correlates of Fatigue in Metastatic Castration-Resistant Prostate Cancer: A Systematic Review.

Prostate cancer is the second most common malignancy of men in the western countries. Fatigue is the most stressful symptom of which patients with metastatic castration-resistant prostate cancer (mCRPC) complain. The aim of this article was to report available data about the incidence of fatigue in mCRPC and its correlates.

A Safe and Simple Laparoscopic Cold Knife Section Technique for Bulky Uterus Removal.

Background: Morcellation of a bulky uterus after total laparoscopic hysterectomy (TLH) is a challenge for those dealing with advanced laparoscopic surgery. However, there are no laparoscopic standardized procedures available to date. We developed a laparoscopic cold knife technique with the aim of demonstrating a simple and reproducible method of sectioning and vaginal retrieval of the bulky uterus.

Endoscopic "rescue" treatment for gastrointestinal perforations, anastomotic dehiscence and fistula.

Luminal perforations and anastomotic leaks of the gastrointestinal tract are life-threatening events with high morbidity and mortality. Early recognition and prompt therapy is essential for a favourable outcome. Surgery has long been considered the "gold standard" approach for these conditions; however it is associated with high re-intervention morbidity and mortality.

The Effects of Social Support on Health-Related Quality of Life of Patients with Metastatic Prostate Cancer.

Patients with metastatic prostate cancer (PC) live longer than patients with metastatic tumours of other sites. Consequently, their social network can influence their quality of life (QoL) during a remarkable life span. The aim of this article is to present the findings of a systematic review of the studies that focused on social network supporting the quality of life of these patients.

Medical and surgical treatments for tinnitus: the efficacy of combined treatment with sulodexide and melatonin.

Aim: Tinnitus is the perception of sound in the absence of an apparent acoustic stimulus. A widespread and highly debilitating disease difficult to cure. Several treatments have been advocated for tinnitus in the last years, including surgery, pharmacotherapy, counseling, cognitive behavioral therapy, sound therapy, but unfortunately without definitive conclusions.

Evaluating the physiological reserves of older patients with cancer: the value of potential biomarkers of aging?

Aging of an individual entails a progressive decline of functional reserves and loss of homeostasis that eventually lead to mortality. This process is highly individualized and is influenced by multiple genetic, epigenetic and environmental factors. This individualization and the diversity of factors influencing aging result in a significant heterogeneity among people with the same chronological age, representing a major challenge in daily oncology practice.

Prostate-specific antigen growth rate constant after first-line cytotoxic chemotherapy in metastatic castration-resistant prostate cancer: a monoinstitutional experience.

Objective: Validation in clinical practice, after first-line chemotherapy (CT) of metastatic castration-resistant prostate cancer (PC), of prostate-specific antigen growth rate constant logarithm (PSA-G), calculated by a formula developed by Stein et al. in comparison with PSA decrease (PSA-D), calculated as recommended by PCWG2.

Patients And Methods: This study is a retrospective monoinstitutional assessment of PSA-G and PSA-D after 12 weeks from the beginning of first-line cytotoxic CT in 49 patients with metastatic castration-resistant PC treated from 2006 to 2011, and whose pre-CT PSA and post-CT PSA determinations have been measured at specific time points.

CA125-related measures of tumor kinetics and outcome of patients with recurrent ovarian cancer receiving chemotherapy: a retrospective evaluation.

Objective: Defining the reliability of cancer antigen-125-related kinetics criteria versus Gynecologic Cancer Inter Group criteria in predicting the tumor outcome after chemotherapy in patients with recurrent ovarian cancer.

Methods: A retrospective monoinstitutional assessment of CA125-related versus Gynecologic Cancer Inter Group-related parameters was performed after cytotoxic chemotherapy in patients with metastatic ovarian cancer treated from 2006 to 2011. A correlation analysis between the response and progression measurements has been performed, and the outcome has been reported.

Anthracycline-based chemotherapy in metastatic endometrial carcinoma: an update.

The purpose of this review is to analyze clinical evidence about the activity and efficacy of anthracycline-based chemotherapy in metastatic endometrial cancer and to identify the most important preclinical findings that would address future clinical trials. A literature search of published studies was undertaken. Studies were selected by predefined criteria.

Docetaxel for metastatic breast cancer: two consecutive phase II trials.

Background: Docetaxel is the most active agent for metastatic breast cancer, but the optimal treatment regimen as a single agent has yet to be defined.

Patients And Methods: Two consecutive monocentric phase II trials of docetaxel in metastatic breast cancer were carried out. In Trial I, 36 patients received docetaxel 35 mg/m2 weekly for 6 weeks every 8 weeks and in Trial II, 29 patients received docetaxel 100 mg/m2 day 1 every 21 days.