Silvestris N.,National Cancer Research Center Instituto Tumori Giovanni Paolo |
Pantano F.,Biomedical University of Rome |
Ibrahim T.,IRCCS Romagnolo Scientific Institute for the Study and Treatment of Cancer |
Gamucci T.,Hospital of Frosinone |
And 24 more authors.
PLoS ONE | Year: 2013
Background:Bone metastasis represents an increasing clinical problem in advanced gastric cancer (GC) as disease-related survival improves. In literature, few data on the natural history of bone disease in GC are available.Patients and Methods:Data on clinicopathology, skeletal outcomes, skeletal-related events (SREs), and bone-directed therapies for 208 deceased GC patients with evidence of bone metastasis were statistically analyzed.Results:Median time to bone metastasis was 8 months (CI 95%, 6.125-9.875 months) considering all included patients. Median number of SREs/patient was one. Less than half of the patients (31%) experienced at least one and only 4 and 2% experienced at least two and three events, respectively. Median times to first and second SRE were 2 and 4 months, respectively. Median survival was 6 months after bone metastasis diagnosis and 3 months after first SRE. Median survival in patients who did not experience SREs was 5 months. Among patients who received zoledronic acid before the first SRE, the median time to appearance of first SRE was significantly prolonged compared to control (7 months vs 4 months for control; P: 0.0005).Conclusions:To our knowledge, this retrospective analysis is the largest multicenter study to demonstrate that bone metastases from GC are not so rare, are commonly aggressive and result in relatively early onset of SREs in the majority of patients. Indeed, our large study, which included 90 patients treated with ZOL, showed, for the first time in literature, a significant extension of time to first SRE and increase in the median survival time after diagnosis of bone metastasis. Taken together, these data may support the beneficial effects of ZOL in GC patients. © 2013 Silvestris et al.
Maffeis C.,Biology Genetics |
Banzato C.,Biology Genetics |
Brambilla P.,ASL Milan 2 |
Cerutti F.,University of Turin |
And 12 more authors.
Nutrition, Metabolism and Cardiovascular Diseases | Year: 2010
Background and aim: The prevalence of children with hypertension is increasing, especially in obese children. This study was to assess the relationship between blood pressure, indexes of adiposity, body fat distribution and insulin resistance. Methods and results: Sample: 1044 children (M/F: 484/560; aged 6-11 years). Anthropometry and blood pressure were measured and fasting blood samples were tested for triacylglycerol, total cholesterol, HDL cholesterol, glucose, insulin and ALT. The prevalence of high blood pressure in overweight males and females was 14.3 and 6.4%, respectively (χ2 = 16.73, p < 0.001) and in obese it was 40.4 and 32.8%, respectively (χ2 = 5.56, p < 0.001). High blood pressure increased progressively with BMI z-score categories (χ2 = 67.99, p < 0.001) as well as with waist/height ratio (W/Hr) categories (χ2 = 23.51, p < 0.001). Hypertensive subject had significantly higher insulin (15.6 ± 9.8 vs 11.9 ± 7.2, p < 0.001 and 20.63 ± 14.7 vs 15.26 ± 9.8, p < 0.001 in males and females respectively) and HOMAIR (3.23 ± 2.1 vs 2.42 ± 1.49, p < 0.001 and 4.12 ± 2.87 vs 3.07 ± 1.98, p < 0.001 in males and in females, respectively) than non-hypertensive ones. Among metabolic and cardiovascular risk factors, HOMAIR was the only variable able to predict high blood pressure in obese boys and girls, in addition to BMI or body fat distribution (waist, W/Hr). The highest HOMAIR category was the most important predicting factor of high blood pressure in overweight and obese children in addition to body size or body fat distribution. Conclusions: Blood pressure is associated with the degree of overweight and the indices of body fat distribution. Insulin resistance is an independent additional risk factor for hypertension. © 2009 Elsevier B.V. All rights reserved.