Francisco Gentil Research Articles

Relationship between squamous cell carcinoma of the anterior two thirds of the tongue and removable denture use: a pioneer study in a Portuguese population

The aim of the study was to determine whether there is any relationship between the presence of removable dentures and squamous cell carcinoma of the anterior two thirds of the tongue in a Portuguese population. A retrospective cross-sectional study was conducted on patients with a biopsy-proven diagnosis of squamous cell carcinoma of the tongue, who were seen and treated at the Department of Head and Neck Surgery of the Portuguese Institute of Oncology 'Francisco Gentil', Lisbon, Portugal, during a 3-year period. Several factors were examined: gender, use of removable dentures, age, location of the lesion, and alcohol and tobacco consumption. One hundred and six cases were selected from the initial 151 cases, with a male:female ratio of 3:1 and the lateral borders being the most commonly affected site. The prevalence in both genders was between the sixth and seventh decade of life. Men were more likely to consume alcohol and tobacco than women, and no relationship was observed between denture use and presence of carcinoma of the tongue. In light of the data obtained, it may be considered that female use of a denture plays an important role, but it cannot be identified as a remarkable etiologic factor.

Oral tongue squamous cell carcinoma (OTSCC): alcohol and tobacco consumption versus non-consumption. A study in a Portuguese population

There has been an increase in the incidence of carcinoma of the tongue, particularly among alcohol and tobacco non-users. However, the number of studies that would allow a better understanding of etiological factors and clinical features, particularly in the Portuguese population, is very limited. This study was based on patients with squamous cell carcinoma of the anterior two thirds of the tongue that were treated at the Department of Head and Neck Surgery of the "Instituto Portugues de Oncologia de Lisboa - Francisco Gentil" (IPOLFG) in Lisbon, Portugal, between January 1, 2001 and December 31, 2009. The patients were divided in alcohol and tobacco users and non-users in order to evaluate the differences between these 2 groups based on gender, age, tumor location, denture use, and tumor size, metastasis and stage. Of the 354 cases, 208 were users and 146 were non-users. The main location in both groups was the lateral border of the tongue. Denture use showed no significant effect in both study groups. It was possible to conclude that patients who did not drink or smoke were older and presented with smaller tumor size, lower incidence of ganglion metastasis and lower tumor stage compared with alcohol and tobacco users.

Targeting non-viral vectors to tumor cells and the tumor microenvironment

Targeted therapy towards tumor cells has been regarded as a promising strategy, since it offers the possibility of directing and concentrating the therapeutic agent only at the desired target site, increasing therapeutic efficacy through increased tumor cell death and decreased incidence of side effects in healthy tissues. Nonetheless, choosing only one cellular target within the tumor microenvironment is an approach with low probabilities to succeed. In this respect, we aim at designing a nonviral vector that targets, simultaneously, tumor cells and endothelial cells from tumor blood vessels. It is hypothesized that such nanoparticle, with this dual targeting ability, will present an active tumor accumulation. Specific intracellular release of the encapsulated payload will strongly contribute to improve the therapeutic outcome. Our results show a substantial increase in the levels of association for ligand-targeted nanoparticles, on a ligandand cell-specific manner, both in vitro and ex vivo (in breast tumor cells removed from patients, after mastectomy or tumorectomy). Cytotoxicity studies show that targeted nanoparticles containing doxorubicin are more cytotoxic than the non-targeted formulation (4 to 180-fold), against tumor and endothelial cells, indicating that internalization of the former is contributing to a more efficient delivery of the payload to the target cells. Experiments with tumor-bearing mice report a higher tumor accumulation of the radiolabeled targeted nanoparticle over the non-targeted counterpart. Overall, these results represent a novel and a valuable contribution for delivery strategies targeting tumor cells and the tumor microenvironment. Author details Faculty of Pharmacy, University of Coimbra, Coimbra, Portugal. Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal. Portuguese Institute of Oncology Francisco Gentil, Coimbra, Portugal. Research Institute for Medicines and Pharmaceutical Sciences, Faculty of Pharmacy, University of Lisbon, Lisbon, Portugal. Department of Life Sciences, University of Coimbra, Coimbra, Portugal.

Lip cancer: A 5-year review in a tertiary referral centre

Lip cancer is second only to skin cancer in terms of frequency in the head and neck region. Surgery is the treatment of choice for most of these cancers. Although there are several strategies to reconstruct lip tumours after tumour ablation, scarce attention has been paid to the impact of the specific reconstructive modality on recurrence and survival. A retrospective review of 228 patients treated for lip cancer in the Head and Neck Surgery Department of the Portuguese Institute of Oncology Francisco Gentil, Lisbon, Portugal, from 1993 to 2000 with at least 2 years of follow-up was conducted. All the cases were evaluated for demographic features, tumour characteristics, lip reconstructive surgery used and recurrence and survival. There were 184 male and 44 female patients (4:1 ratio), with an average age of 67.6±13.3 years. Most tumours were squamous cell carcinomas (94.7%), and were located in the lower lip (99.5%). Squamous cell carcinomas were well differentiated in 70.8% of cases. Tumour size and neck staging were strongly correlated (Pearson's coefficient of 0.805; p<0.001). Microscopical signs of neuroinvasion or lymphatic invasion were associated an increased risk of death due to cancer (chi-square=18.5; df=3; p=0.016). The different strategies used for lip reconstruction after tumour ablation did not differ significantly in the probability of later recurrence or death. Our data seem to lend support to the classical view that the most significant aspect of lip cancer surgery is tumour ablation, and that this is not affected by the subsequent reconstructive strategy. Hence, this seems to indicate that experienced surgeons are rightly not willing to compromise complete excision of the tumour for the sake of an easier or better reconstruction.

Estimating the microcosts of blood transfusion for hemato-oncological patients

There are several ways of treating and preventing chemotherapy-associated anaemia, namely with erythropoiesis stimulating agents and blood transfusion, that remains an option. Since erythropoiesis stimulating agents have a high unitary cost, it is crucial to evaluate their cost-effectiveness, namely versus transfusion. The objective of this study is to calculate the cost of a blood transfusion, carried out at the Immunohemotherapy Outward of Instituto Português de Oncologia, Francisco Gentil, in Lisbon as treatment for neoplasia-associated anaemia. Cross sectional, observational study from the perspective of the Hospital and the National Health Service, which evaluates the resources and direct costs, associated with a blood transfusion of two erythrocyte concentrate (EC) units in hemato-oncology patients. Data regarding consumables, human resources, laboratory analysis and occupation of facilities was collected for a period of seven consecutive days, regarding both blood donation and transfusion procedures in the Immunohemotherapy Outward of Instituto Português de Oncologia, Francisco Gentil, in Lisbon. The total cost of a two EC unit transfusion was estimated at euro 676.2, with the greatest part of this cost being attributed to blood preparation, analysis and storage. Determining reliable costs in relation to medical actions and procedures is essential in analysing the cost-effectiveness of new drugs. This study evaluated the cost for the transfusion of two EC units and the results presented are similar to those obtained in other European countries by several authors.

P229 - The influence of eicosapentaenoic acid (EPA) on TNF-α production by peripheral blood mononuclear cells of Crohn's disease (CD) patients and cell kinetics accordingly to TNF-α −857C/T polymorphism

P229 - The influence of eicosapentaenoic acid (EPA) on TNF-α production by peripheral blood mononuclear cells of Crohn's disease (CD) patients and cell kinetics accordingly to TNF-α −857C/T polymorphism

Caution should be taken in the methodology used to confirm c.156_157insAlu BRCA2 mutation

To the Editor We read with great interest the article by Peixoto et al. [1] about the screening of the c.156_157insAlu BRCA2 mutation in Northern Portugal. As we previously reported, [2] this BRCA2 rearrangement first described by Teugels et al. [3] in a Portuguese family living in Belgium, will surely be the explanation for breast and ovarian cancer risk in several families of Portuguese ancestry. Most of these families have been, as reported by Peixoto et al. [1], considered negative by the usual screening methods. We are writing this letter to comment about the methodology that must be used to confirm the splicing effect of the c.156_157insAlu mutation. Peixoto et al. report RT–PCR data in their paper, that corroborates our own data concerning the segregation of c.156_157insAlu BRCA2 mutation and cancer in individuals from positive families, but this should not be taken as the most appropriate methodology for the confirmation of this rearrangement. The primers used for their RT–PCR reactions amplify not only the pathogenic Alu-mediated splicing product, lacking exon 3, but also a physiologic, ubiquitous splicing product, also exon 3-deficient, observed in individuals with sporadic cancers and healthy persons [4–8]. Although both splicing products lack exon 3, only the one associated with c.156_157insAlu mutation includes at least the first part of BRCA2 exon 10 and this distinguishes them [9]. Primers like the ones used by Peixoto et al., located in exons 1 and 6 of BRCA2 cDNA, amplify (as shown in Fig. 1a of their report) three fragments in all samples, both c.156_157insAlu carriers and wild type carriers. As a confirmation step, RT–PCR is expected to amplify only true positive samples, originating from really positive c.156_157insAlu carriers. Although the authors explain the three bands observed, as a rule, for diagnosis, we should avoid relying on subjective observations like band intensity. For reasons of length, we did not include the reference to the ubiquitous exon 3-defficient transcript in our original paper [2] but we did discuss it when, very pertinently, Diez et al. [4] wrote a letter raising doubts about our methodology to confirm c.156_157insAlu as a pathogenic BRCA2 mutation. They were very well aware of previous data showing a physiological BRCA2 transcript lacking exon 3 [5–8]. Their questions allowed us, in a reply [9], to explain that indeed, we had tried several primers for our RT–PCR confirmation step and eventually chose primers 1FcDNA/ 10RcDNA, first described by Nordling et al. [10], because these never amplify the ubiquitous splicing transcript. As in the case of our families, and in the case of the BRCA2 family described by Nordling et al., they only amplify a BRCA2-mutated associated transcript. Our three-step-PCR (patent pending) was optimized and every step decided after several studies. The first two steps described by Peixoto et al., are so similar to our own that we believe that no false positive was reported: from our experience, with a total of 29 c.156_156insAlu families already diagnosed, if the first two steps are positive the third always confirms it. But BRCA1 and BRCA2 molecular diagnosis has implications for individuals and their families at clinical, emotional, legal and ethical levels. No doubt must remain in the methodologies for screening, P. Machado F. Vaz (&) Molecular Biology Department, Instituto Portugues de Oncologia de Lisboa, Francisco Gentil, Lisbon, Portugal e-mail: fvaz@ipolisboa.min-saude.pt

Case 53

HomeRadiologyVol. 224, No. 2 PreviousNext Diagnosis PleaseCase 53Alexandra Borges, Ana CatarinoAlexandra Borges, Ana CatarinoAuthor Affiliations1From the Departments of Radiology (A.B.) and Pathology (A.C.), Instituto Português de Oncologia Francisco Gentil, Centro de Lisboa, Rua Prof Lima Basto, 1093 Lisbon Codex, Portugal. Received March 23, 2001; revision requested May 2; revision received July 9; accepted August 9. Address correspondence to A.B. (e-mail: [email protected]).Alexandra BorgesAna CatarinoPublished Online:Aug 1 2002https://doi.org/10.1148/radiol.2242010662MoreSectionsFull textPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked In Article HistoryPublished in print: Aug 2002 FiguresReferencesRelatedDetailsRecommended Articles RSNA Education Exhibits RSNA Case Collection Vol. 224, No. 2 Metrics Altmetric Score PDF download

Cancer nursing education, 1992?93

This paper details our experiences in Post-Basic Cancer Nursing Education at the Lisbon centre of the ‘Instituto Português de Oncologia Francisco Gentil’, the Portuguese Cancer Institute, hereafter designated as IPOFG. The purpose, aims, methods and organization of the course will be described, and the role of the nurse in cancer prevention and early detection, stomatherapy, treatment, social reintegration and palliative care will be evaluated.

Complicações pouco habituais da transplantação de medula óssea (TMO). Experiência da Unidade de TMO do Instituto Português de Oncologia de Francisco Gentil, Centro de Lisboa.

Over the past 20 years allogeneic bone marrow transplantation has been increasingly utilized in the treatment of acute and chronic leukemias, aplastic anemia, severe forms of thalassemia, immunodeficiency syndromes and metabolic disorders due to a lack of specific enzymes in the monocyte-macrophage system. Despite the overall success of this approach and besides the so-called classic complications arising from the toxicity of the conditioning regimen, occurrence of GVH disease and interstitial pneumonitis, there are other less common complications which have been reported mainly by teams transplanting on a large number of patients. With only a limited experience, concerning 60 patients with transplants between May 1987 and May 1991, we have seen some unusual complications such as toxoplasma encephalitis, myasthenia gravis and aseptic bone necrosis, which may give rise to difficult diagnostic and therapeutic decisions.

Human pappiloma virus (HPV) infection and carcinoma of the oesophagus in Portugal: assessment of citopathogenetic pattern and in situ hybridization : P. Fidalgo, P. Gemeiro, P. Chaves, C. Lopes, P. Borralho, C. Nobre Leitão, F. Costa Mira. Gastrenterologia, Serv. Anatomia Patológica e Lab. Virologia. Instituto Português Oncologia Francisco Gentil, Lisboa, Portugal

Human pappiloma virus (HPV) infection and carcinoma of the oesophagus in Portugal: assessment of citopathogenetic pattern and in situ hybridization : P. Fidalgo, P. Gemeiro, P. Chaves, C. Lopes, P. Borralho, C. Nobre Leitão, F. Costa Mira. Gastrenterologia, Serv. Anatomia Patológica e Lab. Virologia. Instituto Português Oncologia Francisco Gentil, Lisboa, Portugal

Meningeal carcinomatosis. A one year's case load; review of the literature

10 cases of meningeal carcinomatosis treated in the Neurological Unit at the Instituto Português de Oncologia de Francisco Gentil in Lisbon are presented. Pertinent bibliography is reviewed, particularly the one concerned with physiopathology and treatment. Some research topics about biological response modifiers and drug transport systems are mentioned.

Hodgkin disease clinical stages I, II, and III (A, B): results of radiotherapy with or without chemotherapy.

Between 1961 and 1976, 387 patients with Hodgkin disease were examined, evaluated, and treated at the Instituto Portugues de Oncologia de Francisco Gentil. After reviewing histological and clinical staging presentation, the authors retrospectively analyzed the results obtained with 303 patients classified in clinical stages I, II, and III (A, B) who were treated with or without chemotherapy in two time periods (before and after 1970) according to individual therapeutic modalities. The improvement of the 5-year survival rates in the last period was associated with the introduction of extended-field irradiation and multidrug chemotherapy (MOPP). However, the incidence of serious complications was higher in the group of patients subjected to combined field irradiation and MOPP. The authors suggest a stricter protocol based on the current recommendations for the treatment of Hodgkin disease in order to achieve better results with minimum possible hazards.

Is total nephrectomy always advisable in the treatment of nephroblastoma?: [formula omitted], [formula omitted], [formula omitted], [formula omitted], [formula omitted]. - Clinica Oncologica IV (Pediatria), Instituto Pertuguês de Oncologia de Francisco Gentil, Lisboa - Portugal

Is total nephrectomy always advisable in the treatment of nephroblastoma?: [formula omitted], [formula omitted], [formula omitted], [formula omitted], [formula omitted]. - Clinica Oncologica IV (Pediatria), Instituto Pertuguês de Oncologia de Francisco Gentil, Lisboa - Portugal

Conservativeness versus radicality in the surgical treatment of female genital tumors in children: [formula omitted], [formula omitted], [formula omitted], [formula omitted], [formula omitted] — Clinica Oncologica IV ( Pediatria ), Instituto Português de Oncologica de Francisco Gentil — Lisboa, Portugal

Conservativeness versus radicality in the surgical treatment of female genital tumors in children: [formula omitted], [formula omitted], [formula omitted], [formula omitted], [formula omitted] — Clinica Oncologica IV ( Pediatria ), Instituto Português de Oncologica de Francisco Gentil — Lisboa, Portugal

Treatment of stages i and ii cancer of the cervix: Analysis of 5 year survival and recurrence rates

Abstract Eight hundred and thirty five patients with a diagnosis of Stages I or II carcinoma of the cervix were treated at Instituto Portugues de Oncologia de Francisco Gentil, in Lisbon, from 2 January 1965 to 30 June 1971. The purpose of this study was to calculate the 5 year survival rates and to analyze the treatment failures according to the modality of treatment applied. Two series of Stages Ib and IIa patients were available; one group was treated with radiotherapy, and the other with radical hysterectomy and pelvic lymphadenectomy after previous intracavitary radiumtherapy. No statistically significant difference was found in the 5 year survival of both groups. Most Stage IIb patients were treated with radiotherapy. When residual tumor was found in the uterus of patients who underwent radical surgery after intracavitary radiumtherapy it did not influence survival. On the other hand, the presence of metastatic pelvic lymph nodes after intracavitary radium treatment was related to a lowered survival rate. The number of severe injuries was higher in patients who were treated surgically. Recurrences developed within 5 years after completion of treatment in 10.8% of Stage Ib patients, 21.5% of Stage IIa patients, and 34.5% of Stage IIb patients. Ninety per cent of these recurrences appeared within 3 years after therapy.

Radiosurgical treatment of endometrial carcinoma: The value of simple surgery versus extended surgery

Abstract A series of 236 patients with endometrial carcinoma Stages I and II were treated with combined surgery and radiotherapy at the Instituto Portuguis de Oncologia de Francisco Gentil in Lisbon, from 1963 to 1971. The authors discuss factors that influence survival, i.e. stage, histology, grade, myometrial penetration, residual tumor, lymph node histology, recurrences and distant metastases; they analyze these results in order to evaluate surgical procedures in combination with radiotherapy; the analysis shows that extended surgery has no advantage over simple surgery: In Stage I disease the survival rate was 77.9% for simple surgery vs 77.7% for extended surgery; in Stage II disease it was 64% vs 58.8%. These patients were subject to the hazards of more extended resection as the higher incidence of complications demonstrates.

Fluorouracil ointment treatment of porokeratosis of Mibelli.

To the Editor.— The good results obtained in the treatment of hyperkeratotic lesions with a 5% fluorouracil ointment1-3suggested the possibility of treating patients who have porokeratosis of Mibelli with this drug. This rare disease is not grave but recurs frequently, when treated by surgery, electrocoagulation, or dry ice.4,5 Clinical Data Six patients from the outpatient Department of Dermatology of the Instituto Portugues de Oncologia de Francisco Gentil, Lisbon, were selected. As the lesion of porokeratosis of Mibelli is so typical and the clinical diagnosis so easy, histologic confirmation was not considered necessary; the resulting surgical trauma in such tiny lesions could, eventually, hinder the evaluation of the treatment. The patients were two men and four women, with ages ranging from 30 to 51 years. Two of the women were sisters. The lesions had been present for three months in one case, six months in one, four years