ABSTRACTS OF THE 21st ANNUAL MEETING OF THE ITALIAN ...

day three after surgery, with thyroid substitutive therapy.
Discussion: The thyroid gland is a rare site of solid tumor
metastasis, despite its rich blood supply: the prevalence of
intrathyroid metastasis ranges from 1.9% to 25% in autopsy
series of patients who have died of malignant tumors of other
primary sites. The most common carcinomas metastasizing to
the thyroid gland are lung, breast, kidney, stomach and
melanoma (2). Leva was the first to describe, in 1891, thyroid
metastasis from RCC. Thompson et al., in one of the largest
series of RCC metastasis to thyroid, described the microscopic
pattern as neoplastic cells infiltrating the capsule with invasion
of vessels; nevertheless, macroscopic involvement of the
internal jugular vein was reported in only four other cases.
Complete excision of a single intrathyroid metastasis is
associated with a better prognosis (2). Patients with metastases
from RCC have a longer survival (80% at two years after
thyroidectomy) than those with any other type of metastasis
(20% at two years after thyroidectomy) (3). Conclusion:
Invasion of the internal jugular vein by the neoplastic thrombus
of a RCC thyroid metastasis is very rare. Radical surgery may
improve survival, especially in case of synchronous metastasis.
A robot-assisted (minimally invasive) approach allowed a
successfully radical nephrectomy, associated with total
thyroidectomy.
1 Nakhjavani MK, Gharib H, Goellner JR and van Heerden
JA: Metastases to the thyroid gland. A report of 43 cases.
Cancer 79: 574-578, 1997.
2 Dionigi G, Uccella S, Gandolfo M, Lai A, Bertocchi V,
Rovera F and Tanda ML: Solitary intrathyroidal metastasis
of renal clear cell carcinoma in a toxic substernal
multinodular goiter. Thyroid Res 1(1): 6, 2008.
3 Heffess CS, Wenig BM and Thompson LD: Metastatic renal
cell carcinoma to the thyroid: a clinicopathologic study of
36 cases. Cancer 95: 1869-1878, 2002.
165
SALVAGE RADIOTHERAPY IN MUSCLE-
INVASIVE BLADDER CANCER:
EXPERIENCE OF THE S. GIOVANNI CALIBITA
FATEBENEFRATELLI HOSPITAL IN ROME
Palmira Caparrotti, Giorgio Mazzarella, Adelina Petrone,
Carlo Guidi, Orietta Caspiani, Ceasre Giubilei, Mariavittoria
Leone, Alessio Bonanni and Luca Marmiroli
UOC Radioterapia, Ospedale San Giovanni Calibita
Fatebenefratelli, Italy
Aim: The object of this study was to report on the use and
results of salvage radiotherapy, in terms of overall survival
(OS) and disease free survival (DFS), in the treatment of
1898
ANTICANCER RESEARCH 31: 1807-1956 (2011)
muscle-invasive bladder cancer, at the Department of
Radiotherapy, Ospedale San Giovanni Calibita Fatebenefratelli
in Rome. Patients and Methods: From January 2006 to
September 26 patients (18 men and 8 women) with muscle
invasive bladder cancer, who had previously been treated
surgically, underwent salvage radiation therapy; 21 of those
patients underwent transurethral endoscopic resection and 5 of
them underwent radical cystectomy. The median age was 75
(range 49-90) years. Up until 2007, patients were treated with
3D conformational technique and from 2008 until the time of
writing, with intensity-modulated radiation therapy (IMRT).
Treatment volumes included pelvis and bladder in 18 patients,
with total doses of 45-50 Gy prescribed to the pelvic nodes
and up to 60-70 Gy to the bladder or bladder bed, with single
daily fractions of 1.8-2 Gy. In eight patients, the treatment was
directed only to the bladder, with doses of 60 Gy in two
patients, of 66 Gy in two patients and of 70 Gy in four
patients. Five patients received concomitant chemotherapy,
based on cisplatin with or without gemcitabine. Results: The
median follow-up was 14 (range 6-39) months. Radiation
therapy-related toxicity was acceptable with G3-G4 acute
toxicity of the gastrointestinal tract (GIT) in 10% of patients
and G3-G4 acute toxicity of the genitourinary tract (GUT) in
15% patients. Late toxicity of the GIT two years after
completing radiotherapy was absent, and was G4 in 2%
patients in the GUT. The median OS and DFS were 19 and 18
(range 1-39) months, respectively. At the time of writing, 54%
of the patients were alive and 71% were without clinical
evidence of disease. Over 80% of the patients who previously
underwent bladder-sparing therapy retained bladder function.
Discussion and Conclusion: Our data suggest a clear benefit
from salvage radiotherapy in terms of OS and DFS, allowing
more than 80% of patients, alive without disease progression,
to retain bladder function.
166
DIABETES MELLITUS IN RENAL CELL
CARCINOMA: ROLE OF OGG1 AND TUBERIN
Antonio Vavallo1 , Giuseppe Lucarelli2 , Monica Rutigliano1 ,
Marco Spilotros1 , Simona Simone5 , Stefano Impedovo1 ,
Silvano Palazzo1 , Carlo Bettocchi1 , Antonia Loverre2 ,
Marica Cariello2 , Giuseppe Grandaliano3 , Michele Battaglia1 and Pasquale Ditonno1 1Department of Emergency and Organ Transplantation
(DETO), Section of Urology, Andrology and Kidney
Transplantation and 2Section of Nephrology and Kidney
Transplant, University of Bari, Italy;
3Section of Nephrology, University of Foggia, Italy
Background: There is strong evidence that the incidence of
renal cell cancer (RCC) increases in patients with diabetes