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1. Development of evidence-based guidelines for follow up of women treated for cervical intraepithelial neoplasia grade 2 or 3 (CIN2/3) in Italian screening programmes

Author

Rossi, PG, Iossa, A, Visioli, CB, Venturelli, F, Garutti, P, Maina, G, Andersson, KL, Anselmi, R, Baldoni, A, Boselli, F, Campari, C, Carozzi, FM, Cianferoni, L, Costa, S, Cristiani, P, Del Mistro, A, Fantin, GP, Fumia, C, Landoni, F, Lelli, L, Maggino, T, Minucci, D, Mariani, L, Piazzesi, G, Raggi, P, Ribaldone, R, Sandri, MT, Spolti, N, Torrini, B, Troncone, MG, Tufi, M, Venturoli, S, Rossi, P, Iossa, A, Visioli, C, Venturelli, F, Garutti, P, Maina, G, Andersson, K, Anselmi, R, Baldoni, A, Boselli, F, Campari, C, Carozzi, F, Cianferoni, L, Costa, S, Cristiani, P, Del Mistro, A, Fantin, G, Fumia, C, Landoni, F, Lelli, L, Maggino, T, Minucci, D, Mariani, L, Piazzesi, G, Raggi, P, Ribaldone, R, Sandri, M, Spolti, N, Torrini, B, Troncone, M, Tufi, M, and Venturoli, S

Subjects
Human papillomavirus, Evidence-based medicine, medicine.medical_specialty, Evidence-based practice, Obstetrics, business.industry, Obstetrics and Gynecology, Guidelines, Guideline, Cervical cancer, Cervical intraepithelial neoplasia (CIN) grade 2 or grade 3, Posttreatment follow up, Test of cure, Human papillomaviru, Oncology, Cervical intraepithelial neoplasia grade 2, medicine, business
Abstract

Background: The Italian Group for Cervical Cancer Screening (GISCi) promoted the update of recommendations for post Cervical Intraepithelial Neoplasia grade 2 or 3 (CIN2/3) treatment follow up. Methods: A multidisciplinary panel including all the professionals involved in cervical cancer screening and CIN treatment was set up. Systematic reviews have been conducted searching in PubMed. The GRADEpro online tool was used for: defining and prioritizing clinical questions framed in PICOs (Population Intervention Comparator Outcomes); defining and scoring outcomes as critical, important or not important; synthetizing results of the systematic reviews in Evidence to Decision tables and to grade recommendations. Results: A systematic review identified the main prognostic factors, but these have almost no impact in HPV-negative women. Six questions were prioritized for the first phase: 3 about the test (Pap, HPV-DNA or Pap + HPV cotesting or co-testing + colposcopy); 1 about the number of episodes before returning to screening; 2 about the timing of episodes. For the test accuracy direct evidence was available, while for other questions mostly indirect evidence was retrieved in systematic reviews. Conclusions: The panel recommends HPV test or co-testing (conditional either the two), but not Pap test as follow up test (strong). Colposcopy can be added to assess surgical outcomes (conditional either yes or not). Two episodes instead of one, before referring women to regular screening, should be preferred (conditional). The first episode should be 6 months (vs. 12) after treatment (strong), in order to avoid progression of undiagnosed prevalent invasive cancers; the interval between first and second episode may be either 6 or 12 months (conditional).

Published
2021

2. Cancer in pregnancy: proposal of an Italian multicenter study. Gynecologic Oncology Group of the Italian Society of Gynæcology and Obstetrics (SIGO)

Author

Sartori, E., Franchi, M., Capelli, G., Cicinelli, E., Colacurci, N., Vincenzo, R., Landoni, F., Maggino, T., Masturzo, B., Parazzini, F., Scarfone, G., Peccatori, F., Romagnolo, C., Scibilia, G., Scollo, P., Zola, P., Garzon, S., Raffaelli, R., Busato, E., Cetin, I., Giovannini, M., Zanni, G. C., Greggi, S., Marconi, A. M., Rizzo, N., Ruspa, G., Meroni, M. G., Volpi, E. O., Simoncini, T., Gadducci, A., Ghezzi, F., Laganà, A. S., Melis, G. B., Paoletti, A. M., Strobelt, N., Spinillo, A., Severi, F. M., Frusca, T., Greco, P., Nappi, L., Ricci, G., Enrico Vizza, Papaccio, M., Ratti, M., Scambia, G., Sartori, E, Franchi, M, Capelli, G, Cicinelli, E, Colacurci, N, De Vincenzo, R, Landoni, F, Maggino, T, Masturzo, B, Parazzini, F, Scarfone, G, Peccatori, F, Romagnolo, C, Scibilia, G, Scollo, P, Zola, P, Garzon, S, Raffaelli, R, Busato, E, Cetin, I, Giovannini, M, Zanni, G, Greggi, S, Marconi, A, Rizzo, N, Ruspa, G, Meroni, M, Volpi, E, Simoncini, T, Gadducci, A, Ghezzi, F, Lagana, A, Melis, G, Paoletti, A, Strobelt, N, Spinillo, A, Severi, F, Frusca, T, Greco, P, Nappi, L, Ricci, G, Vizza, E, Papaccio, M, Ratti, M, Scambia, G, Sartori, Enrico, Franchi, Massimo, Capelli, Giovanni, Cicinelli, Ettore, Colacurci, Nicola, De Vincenzo, Rosa, Landoni, Fabio, Maggino, Tiziano, Masturzo, Bianca, Parazzini, Fabio, Scarfone, Giovanna, Peccatori, Fedro, Romagnolo, Cesare, Scibilia, Giuseppe, Scollo, Paolo, Zola, Paolo, Garzon, Simone, Raffaelli, Ricciarda, Busato, Enrico, Cetin, Irene, Giovannini, Massimo, Zanni, Giuliano Carlo, Greggi, Stefano, Marconi, Anna Maria, Rizzo, Nicola, Ruspa, Giovanni, Meroni, Mario Giuseppe, Volpi, Eugenio Oreste, Simoncini, Tommaso, Gadducci, Angiolo, Ghezzi, Fabio, Laganà, Antonio Simone, Melis, Gian Benedetto, Paoletti, Anna Maria, Strobelt, Nicola, Spinillo, Arsenio, Severi, Filiberto Maria, Frusca, Tiziana, Greco, Pantaleo, Nappi, Luigi, Ricci, Giuseppe, Vizza, Enrico, Papaccio, Marta, Ratti, Martina, and Scambia, Giovanni

Subjects
TIGER Trial, fetal development, Pregnancy related cancer, chemotherapy, teratogenic risk, fetal development, multicenter observational study, TIGER Trial, Obstetrics and Gynecology, Chemotherapy, Fetal development, Multicenter observational study, Pregnancy related cancer, Teratogenic risk, Tiger trial, multicenter observational study, chemotherapy, teratogenic risk
Abstract

A pregnancy related cancer is defined as a neoplasm diagnosed in a woman during gestation or within 12 months following childbirth or abortion. Breast, thyroidal, melanoma, cervical and hematological malignancies are those most commonly diagnosed during pregnancy, with a reported incidence considered lower than those estimated of 1 case on 1000 pregnancies. The clinical complexity is generated by the co-presence of mother and fetus, and the consequent conflict represented by the need to identify a therapeutic strategy that is effective for the maternal prognosis and, at the same time, safeguards the fetal well-being. Moreover, the counseling, diagnosis, staging and management of these cases are further complicated because most of the scientific literature consists in case reports or small retrospective studies and lacks in guidelines and prospective clinical trials. On that basis, the Study Group on Cancer in Pregnancy (members of S.I.G.O.-Italian Society of Gynecology and Obstetrics) presents the TIGRE Trial, an Italian multicenter observational study aimed at establishing a shared database for the collection of epidemiological and clinical data of the patients affected by pregnancy related cancer in Italy, with the final objective to improve the outcome of a mother and a child involved in a such pathology.

Published
2018

3. Strategies for preventing group B streptococcal infections in newborns: A nation-wide survey of Italian policies

Author

Tzialla, C, berardi, A, farina, C, clerici, P, borghesi, A, viora, E, scollo, P, stronati, M, Task Force for group B streptococcal infections for the Italian Society of Neonatology including Stival, G, barbaglia, Ma, guala, A, giunta, E, parola, L, grossignani, Mr, perri, P, tubaldi, L, alletto, G, daidone, S, flacco, V, dani, C, sterpa, A, rapisardi, G, elicio, Mr, faldella, G, capretti, Mg, messner, H, bandiera, M, achille, C, azzali, A, montrasio, G, mariani, S, galvagno, G, giacosa, E, de Angelis, F, spandrio, M, serra, A, garofalo, F, perona, A, porcelli, F, ferrero, F, De Franco, S, paollilo, P, picone, S, besana, R, varisco, T, farina, M, memo, L, nicolini, G, lietti, D, Di Chiara, G, rottoli, A, Bonabitacola, T, Cortis, E, Neri, E, Martinelli, S, Ilardi, L, Rondanini, Gf, Calzi, P, Gatta, A, Quntadamo, Pa, Ivaldi, M, Terenzani, L, Di Lascio, N, Travaglio, Md, Vetrano, G, Furcolo, G, Vitacco, V, Intini, C, Frigerio, M, Stroppiana, P, Policicchio, G, Mesirca, P, Gianino, P, Audenio, E, Paludetto, R, Raimondi, F, Pugliese, A, Valentino, L, Nosari, N, Marchesano, G, Chirico, G, Bellù, R, Menchini, M, Poletti, A, E T, Vacchiano, Pinto, L, E D, Perri, Coppola, R, Perini, R, Vetrella, A, De Luca, G, Lista, G, Cavigioli, F, Bettinelli, A, Massironi, E, Franco, C, Bernardo, L, Poli, S, Palladini, M, Tota, V, Spadavecchia, F, Zuccotti, Gv, Pogliani, L, Bracaglia, G, Mancini, Al, Zocco, F, Iozzia, G, Auriemma, A, Teani, M, Mangilli, G, Tempra, Am, Di Terlizi, L, Bottino, R, Salvi, C, Fortunato, V, Musaico, R, Gargantini, G, Carrera, G, Magaldi, R, Taurino, L, D'Onofrio, Am, Buffone, E, Tempera, A, Agosti, M, Garzia, P, Mosca, F, Pugni, L, Tagliabue, P, Colombo, C, Demi, M, Picco, G, Carlucci, A, Zorzi, G, Padula, D, Cardone, Ml, Buonocore, G, Muraca, Mc, Boldrini, A, Ciantelli, M, Lanari, M, Serra, L, Felici, L, Banderalli, G, Brambilla, C, Dall'Agnola, A, Viviani, E, Zonca, Mc, Licardi, G, Chiara, A, Ancora, G, Papa, I, Gancia, P, Pomero, G, Deloglu, A, Villani, P, Mussini, P, Canidio, E, Migliavacca, D, Di Fabio, S, Cipollone, I, Biasucci, G, Rubbi, P, Piepoli, M, Guastaferro, N, Infriccioli, F, Bertino, E, Perathoner, C, Parmigiani, S, Suriano, G, Ianniello, C, Biasini, A, Azzalli, M, Timpani, G, Barresi, S, Caoci, G, Ciccotti, R, De Curtis, M, Natale, F, Finocchi, M, Haass, C, Milillo, F, Lucieri, S, Guercio, E, Canepa, Sa, Scozia, G, Antonucci, R, Limongelli, O, Macciò, S, Mongelli, F, Colonna, F, Dragovic, D, Calipa, Mt, Cohen, A, Moresco, L, Italian Society of Obstetricians and Gynecologists including La Spina, R, Ruggeri, R, Luehwink, A, Brattoli, M, Fedi, A, Lacchi, L, Ettore, G, Pappalardo, E, Conoscenti, G, Zeni, B, Spellecchia, D, Favretti, L, Spagna, L, Zaglio, S, Bresciani, D, Bandini, A, Mancini, R, Mustoni, P, Dodero, D, Grimaldi, M, Di Mario, M, Migliorini, P, Kemeny, A, Anastasio, Ps, Riccardi, T, Maggino, T, Cerri, G, Puggina, P, Marconi, Am, Morgia, S, Bellia, G, D'Anna, Mr, Catania, M, Bacchi Modena, A, Franchi, L, Calonaci, N, Schettini, S, Paradiso, R, Saccucci, P, Ioppi, M, Zorzi, M, Stellin, G, Patacchiola, F, Carrata, L, Bassini, D, San Marco, L, Todros, T, Tibadi, C, Liborio, M, Italian Association of Clinical Microbiologists including Laricchia, R, Tauro, L, Ferrara, F, Nuara, C, Ghiraldi, E, Molinari, F, Comessatti, A, Rocchetti, A, Di Matteo, L, Miconi, V, Calvi, P, Pernigotti, A, Fabozzi, F, Micca, G, Monticone, G, Sarti, M, Da Rin, G, Zoppelletto, M, Modolo, E, Landini, Mp, Furlini, G, Galluppi, E, Pagani, E, Aschbacher, R, Innocenti, P, Bresolin, N, Raggi, Me, Bonfanti, C, De Francesco, M, Santer, P, Griessmaier, A, De Francesco, D, Pirali, A, Prasciolu, C, Usai, F, Cuzzone, G, Scutellà, M, Tramacere, P, Fossati, D, Piaserico, G, Bordignon, G, Sciacca, A, Di Vincenzo, F, Imbriani, A, Melotti, D, Catanoso, G, Rivetti, I, Neri, G, Bruno, R, Bacelle, L, Sartore, P, Giana, G, Sala, E, Giraldi, C, Cavalcanti, P, Perugini, M, Perugini, A, Ginardi, C, Maritano, D, Ferrini, A, Bonettini, A, Avanzini, A, Gasperoni, S, Pieretti, B, Montanari, E, Carillo, C, Rossi, Mr, Laureti, A, Baldoni, Ml, Serra, D, Melioli, G, Bandettini, R, Oneto, F, Colla, R, Storchi Incerti, S, Lanzini, F, Pauri, P, Tili, E, Leone, Ra, Verdastro, G, Megha, M, Luzzaro, F, Conti, A, Busulini, L, Mirri, P, Diodati, R, Vettori, C, Pittalis, S, Anesi, A, Fiore, A, Goglia, L, Vitullo, E, Sinno, A, Platzgummer, S, Spitaler, C, Trabucchi, Mc, Besozzi, M, Cesana, E, Inghilleri, G, Grosso, S, D'Angelo, R, Fogato, E, Lavarda, F, Ortisi, G, Clementi, M, Cichero, P, Rumpianesi, F, Venturelli, C, Mortillaro, F, Daffara, S, Catania, Mr, Iula, D, Andreoni, S, Politi, A, Agostinelli, C, Paparella, C, Capozzi, D, Notaris, P, Bistoni, F, Mencacci, A, Valentini, M, Filippetti, A, Confalonieri, M, Novarese, O, Bonini, F, Salamone, D, Camporese, A, De Rosa, R, Casprini, P, Degl'Innocenti, R, Giordano, R, Allù, Mt, Zanella, D, Malandrino, M, Tronci, M, Valmarin, M, Leonetti, G, Falco, S, Meledandri, M, Ballardini, M, Spanò, A, Cava, Mc, Mascellino, Mt, Schinella, M, Gualdi, P, Casari, E, Scattolo, N, Motta, C, Perfetti, C, Bassano, M, Cera, G, Iafisco, P, Mura, I, Palmieri, A, Migliardi, M, Ferlini, M, Grandi, G, Giardini, F, Albano, F, Latino, M, Ferrero, Mp, Bellizia, L, Russolo, M, Russolo, S, Pesenti, A, Fasano, Ma, Previato, S, Radillo, O, Busetti, M, Ferrari, P, Siderini, V, Puzzolante, L, Scarparo, C, Arzese, A, Cappuccia, N, Lodolo, L, Delledonne, L, Gramoni, A, Maiolo, V, Gheller, A, Spadaro, S, Balzaretti, M, Tzialla, C., Berardi, A., Farina, C., Clerici, P., Borghesi, A., Viora, E., Scollo, P., Stronati, M., Stival, G., Barbaglia, M. A., Guala, A., Giunta, E., Parola, L., Grossignani, M. R., Perri, P., Tubaldi, L., Alletto, G., Daidone, S., Flacco, V., Dani, C., Sterpa, A., Rapisardi, G., Elicio, M. R., Faldella, G., Capretti, M. G., Messner, H., Bandiera, M., Achille, C., Azzali, A., Montrasio, G., Mariani, S., Galvagno, G., Giacosa, E., de Angelis, F., Spandrio, M., Serra, A., Garofalo, F., Perona, A., Porcelli, F., Ferrero, F., De Franco, S., Paollilo, P., Picone, S., Besana, R., Varisco, T., Farina, M., Memo, L., Nicolini, G., Lietti, D., Di Chiara, G., Rottoli, A., Bonabitacola, T., Cortis, E., Neri, E., Martinelli, S., Ilardi, L., Rondanini, G. F., Calzi, P., Gatta, A., Quntadamo, P. A., Ivaldi, M., Terenzani, L., Di Lascio, N., Travaglio, M. D., Vetrano, G., Furcolo, G., Vitacco, V., Intini, C., Frigerio, M., Stroppiana, P., Policicchio, G., Mesirca, P., Gianino, P., Audenio, E., Paludetto, R., Raimondi, F., Pugliese, A., Valentino, L., Nosari, N., Marchesano, G., Chirico, G., Bell(`u), R., Menchini, M., Poletti, A., Vacchiano, T., Pinto, L., Perri, D., Coppola, R., Perini, R., Vetrella, A., De Luca, G., Lista, G., Cavigioli, F., Bettinelli, A., Massironi, E., Franco, C., Bernardo, L., Poli, S., Palladini, M., Tota, V., Spadavecchia, F., Zuccotti, G. V., Pogliani, L., Bracaglia, G., Mancini, A. L., Zocco, F., Iozzia, G., Auriemma, A., Teani, M., Mangilli, G., Tempra, A. M., Di Terlizi, L., Bottino, R., Salvi, C., Fortunato, V., Musaico, R., Gargantini, G., Carrera, G., Magaldi, R., Taurino, L., D?onofrio, A. M., Buffone, E., Tempera, A., Agosti, M., Garzia, P., Mosca, F., Pugni, L., Tagliabue, P., Colombo, C., Demi, M., Picco, G., Carlucci, A., Zorzi, G., Padula, D., Cardone, M. L., Buonocore, G., Muraca, M. C., Boldrini, A., Ciantelli, M., Lanari, M., Serra, L., Felici, L., Banderalli, G., Brambilla, C., Dall?agnola, A., Viviani, E., Zonca, M. C., Licardi, G., Chiara, A., Ancora, G., Papa, I., Gancia, P., Pomero, G., Deloglu, A., Villani, P., Mussini, P., Canidio, E., Migliavacca, D., Di Fabio, S., Cipollone, I., Biasucci, G., Rubbi, P., Piepoli, M., Guastaferro, N., Infriccioli, F., Bertino, E., Perathoner, C., Parmigiani, S., Suriano, G., Ianniello, C., Biasini, A., Azzalli, M., Timpani, G., Barresi, S., Caoci, G., Ciccotti, R., De Curtis, M., Natale, F., Finocchi, M., Haass, C., Milillo, F., Lucieri, S., Guercio, E., Canepa, S. A., Scozia, G., Antonucci, R., Limongelli, O., Macci(`o), S., Mongelli, F., Colonna, F., Dragovic, D., Calipa, M. T., Cohen, A., Moresco, L., La Spina, R., Ruggeri, R., Luehwink, A., Brattoli, M., Fedi, A., Lacchi, L., Ettore, G., Pappalardo, E., Conoscenti, G., Zeni, B., Spellecchia, D., Favretti, L., Spagna, L., Zaglio, S., Bresciani, D., Bandini, A., Mancini, R., Mustoni, P., Dodero, D., Grimaldi, M., Di Mario, M., Migliorini, P., Kemeny, A., Anastasio, P. S., Riccardi, T., Maggino, T., Cerri, G., Puggina, P., Marconi, A. M., Morgia, S., Bellia, G., D?anna, M. R., Catania, M., Bacchi Modena, A., Franchi, L., Calonaci, N., Schettini, S., Paradiso, R., Saccucci, P., Ioppi, M., Zorzi, M., Stellin, G., Patacchiola, F., Carrata, L., Bassini, D., San Marco, L., Todros, T., Tibadi, C., Liborio, M., Laricchia, R., Tauro, L., Ferrara, F., Nuara, C., Ghiraldi, E., Molinari, F., Comessatti, A., Rocchetti, A., Di Matteo, L., Miconi, V., Calvi, P., Pernigotti, A., Fabozzi, F., Micca, G., Monticone, G., Sarti, M., Da Rin, G., Zoppelletto, M., Modolo, E., Landini, M. P., Furlini, G., Galluppi, E., Pagani, E., Aschbacher, R., Innocenti, P., Bresolin, N., Raggi, M. E., Bonfanti, C., De Francesco, M., Santer, P., Griessmaier, A., De Francesco, D., Pirali, A., Prasciolu, C., Usai, F., Cuzzone, G., Scutell(`a), M., Tramacere, P., Fossati, D., Piaserico, G., Bordignon, G., Sciacca, A., Di Vincenzo, F., Imbriani, A., Melotti, D., Catanoso, G., Rivetti, I., Neri, G., Bruno, R., Bacelle, L., Sartore, P., Giana, G., Sala, E., Giraldi, C., Cavalcanti, P., Perugini, M., Perugini, A., Ginardi, C., Maritano, D., Ferrini, A., Bonettini, A., Avanzini, A., Gasperoni, S., Pieretti, B., Montanari, E., Carillo, C., Rossi, M. R., Laureti, A., Baldoni, M. L., Serra, D., Melioli, G., Bandettini, R., Oneto, F., Colla, R., Storchi Incerti, S., Lanzini, F., Pauri, P., Tili, E., Leone, R. A., Verdastro, G., Megha, M., Luzzaro, F., Conti, A., Busulini, L., Mirri, P., Diodati, R., Vettori, C., Pittalis, S., Anesi, A., Fiore, A., Goglia, L., Vitullo, E., Sinno, A., Platzgummer, S., Spitaler, C., Trabucchi, M. C., Besozzi, M., Cesana, E., Inghilleri, G., Grosso, S., D?angelo, R., Fogato, E., Lavarda, F., Ortisi, G., Clementi, M., Cichero, P., Rumpianesi, F., Venturelli, C., Mortillaro, F., Daffara, S., Catania, M. R., Iula, D., Andreoni, S., Politi, A., Agostinelli, C., Paparella, C., Capozzi, D., Notaris, P., Bistoni, F., Mencacci, A., Valentini, M., Filippetti, A., Confalonieri, M., Novarese, O., Bonini, F., Salamone, D., Camporese, A., De Rosa, R., Casprini, P., Degl?innocenti, R., Giordano, R., All(`u), M. T., Zanella, D., Malandrino, M., Tronci, M., Valmarin, M., Leonetti, G., Falco, S., Meledandri, M., Ballardini, M., Span(`o), A., Cava, M. C., Mascellino, M. T., Schinella, M., Gualdi, P., Casari, E., Scattolo, N., Motta, C., Perfetti, C., Bassano, M., Cera, G., Iafisco, P., Mura, I., Palmieri, A., Migliardi, M., Ferlini, M., Grandi, G., Giardini, F., Albano, F., Latino, M., Ferrero, M. P., Bellizia, L., Russolo, M., Russolo, S., Pesenti, A., Fasano, M. A., Previato, S., Radillo, O., Busetti, M., Ferrari, P., Siderini, V., Puzzolante, L., Scarparo, C., Arzese, A., Cappuccia, N., Lodolo, L., Delledonne, L., Gramoni, A., Maiolo, V., Gheller, A., Spadaro, S., Balzaretti, M., Tzialla, Chryssoula, Berardi, Alberto, Farina, Claudio, Clerici, Pierangelo, Borghesi, Alessandro, Viora, Elsa, Scollo, Paolo, Stronati, Mauro, [.., Lanari, Marcello, Faldella, Giacomo, and ]

Subjects
Male, Pediatrics, Group B, 0302 clinical medicine, Neonate, Pregnancy, Surveys and Questionnaires, Prevalence, Mass Screening, Blood culture, 030212 general & internal medicine, Antibiotic prophylaxis, Survey, GBS, Group B streptococcus, Infection, Newborn infant, Adult, Antibiotic Prophylaxis, Female, Health Surveys, Humans, Infant, Newborn, Italy, Neonatal Screening, Pregnancy Complications, Infectious, Prenatal Care, Primary Prevention, Risk Assessment, Streptococcal Infections, Streptococcus agalactiae, reproductive and urinary physiology, Group B streptococcu, medicine.diagnostic_test, lcsh:RJ1-570, Infectious, Perinatology and Child Health, Pediatrics, Perinatology and Child Health, medicine.medical_specialty, Antibiotic sensitivity, Group B Streptococcal Infection, Prenatal care, 03 medical and health sciences, 030225 pediatrics, medicine, Intensive care medicine, Mass screening, business.industry, Public health, Infant, lcsh:Pediatrics, Newborn, Pregnancy Complications, business
Abstract

Background There are no Italian data regarding the strategies for preventing neonatal group B streptococcal (GBS) infection. We conducted a national survey in order to explore obstetrical, neonatal and microbiological practices for the GBS prevention. Methods Three distinct questionnaires were sent to obstetricians, neonatologists and microbiologists. Questionnaires included data on prenatal GBS screening, maternal risk factors, intrapartum antibiotic prophylaxis, microbiological information concerning specimen processing and GBS antimicrobial susceptibility. Results All respondent obstetrical units used the culture-based screening approach to identify women who should receive intrapartum antibiotic prophylaxis, and more than half of the microbiological laboratories (58%) reported using specimen processing consistent with CDC guidelines. Most neonatal units (89 out of 107, 82%) reported using protocols for preventing GBS early-onset sepsis consistent with CDC guidelines. Conclusions The screening-based strategy is largely prevalent in Italy, and most protocols for preventing GBS early-onset sepsis are consistent with CDC guidelines. However, we found discrepancies in practices among centers that may reflect the lack of Italian guidelines issued by public health organizations.

Published
2017

4. Ovarian metastases in early-stage cervical cancer (IA2-IIA): a multicenter retrospective study of 1965 patients (a Cooperative Task Force study)

Author

Landoni, F, Zanagnolo, V, LOVATO DIAZ, L, Maneo, A, Rossi, R, Gadducci, A, Cosio, S, Maggino, T, Sartori, E, Tisi, C, Zola, Paolo, Maroccolandoni, F, Zola, P, Marocco, F, Botteri, E, Ravanelli, K., Landoni, F, Zanagnolo, V, Lovato-Diaz, L, Maneo, A, Rossi, R, Gadducci, A, Cosio, S, Maggino, T, Sartori, E, Tisi, C, Zola, P, Marocco, F, Botteri, E, and Ravanelli, K

Subjects
Oncology, Adult, medicine.medical_specialty, Adolescent, Uterine Cervical Neoplasms, Adenocarcinoma, Gastroenterology, Ovarian preservation, Risk Factors, Retrospective Studie, Internal medicine, Carcinoma, Humans, Medicine, Stage (cooking), Lymph node, Retrospective Studies, Aged, Neoplasm Staging, Ovarian Neoplasms, Cervical cancer, Univariate analysis, business.industry, Ovarian Neoplasm, Risk Factor, Obstetrics and Gynecology, Retrospective cohort study, Middle Aged, medicine.disease, medicine.anatomical_structure, Carcinoma, Squamous Cell, Quality of Life, Histopathology, Female, business, Human
Abstract

This is a retrospective study of patients treated for early-stage cervical cancer to identify pathologic risk factors associated with ovarian metastases and, therefore, to establish when ovarian preservation can be performed without increasing the risk of relapse in order to improve the quality of life in premenopausal patients. Between 1982 and 2004, 1965 patients with FIGO stage IA2-IB-IIA cervical squamous cell carcinoma and nonsquamous histology types were surgically treated; 1695 (86%) patients underwent primary radical hysterectomy, bilateral salpingo-oophorectomy, and pelvic node dissection, the remaining 270 patients (14%) had their ovaries preserved. The clinical records were reviewed for all patients and clinical features at presentation, the histopathology and follow-up data were recorded. Overall, ovarian metastases were diagnosed in 16 of 1695 patients, for an incidence rate of 0.9%. Univariate analysis shows age (≤45 vs >45 years: P = 0.0079), FIGO stage (IB1-IIA ≤4 cm vs IB2-IIA >4 cm: P = 0.0133), histology (squamous vs nonsquamous, P = 0.0014), noninvolved peripheral stromal thickness (3 mm: P = 0.0001), lymphvascular space involvement (present vs absent, P = 0.0007), lymph node status (positive vs negative, P = 0.00009) to be statistically associated with the presence of ovarian metastases. Multivariate analysis shows only age (P = 0.0119), FIGO stage (P = 0.011), histology (P = 0.001), and unaffected peripheral stromal thickness (

Published
2007

5. Could follow-up different modalities play a role in asymptomatic cervical cancer relapses diagnosis? An Italian multicenter retrospective analysis

Author

Zola P., Fuso L., Mazzola S., Piovano E., Perotto S., Gadducci A., Galletto L., Landoni F., Maggino T., Raspagliesi F., Sartori E., Scambia G., Zola, P, Fuso, L, Mazzola, S, Piovano, E, Perotto, S, Gadducci, A, Galletto, L, Landoni, F, Maggino, T, Raspagliesi, F, Sartori, E, and Scambia, G

Subjects
Vaginal Smears, Uterine Cervical Neoplasm, Follow-up, Uterine Cervical Neoplasms, Follow-Up Studie, Retrospective Studie, Recurrence, Multivariate Analysis, Cervical cancer, Proportional Hazards Model, Humans, Female, Relapse, Neoplasm Recurrence, Local, Multivariate Analysi, Human, Follow-Up Studies, Papanicolaou Test, Proportional Hazards Models, Retrospective Studies
Abstract

Objective: The aim of this study was to evaluate how much clinical surveillance performed by follow-up scheduled appointments may correctly identify asymptomatic recurrences and describe the pattern of relapse detected by procedures. Methods: The records of 327 consecutive women with recurrent cervical cancer treated from 1980 to 2005 were retrospectively collected in 8 Italian Institutions. Primary disease and recurrence data were picked up: diagnosis, type of treatment, FIGO stage, tumour grade, histology, clinical lesion size, number of localizations and site of relapse, presence of symptoms and primary method of detection, the type of treatment of recurrence and follow-up data, such as appointment date, clinical status and procedure performed. A multivariate analysis was carried out using the Cox proportional hazards regression model. Survival curves were calculated using the Kaplan-Meier technique. Survival differences were evaluated by the log-rank test. Results: Sixty-seven out of 327 patients (20.5%) had a local recurrence on vaginal vault, 120 (36.7%) in central pelvis, 31 (9.5%) in pelvic wall, 16 cases (4.9%) in lymph nodes. Seventy-nine patients (24.2%) showed a distant relapse while 14 (4.3%) developed both a distant and local relapse. Among patients with distant relapses 39 (49.4%) had lung metastasis, 41 (51.9%) an hepatic recurrence, 4 (5.1%) a bone relapse. Among distant sites 32 out of 79 patients (40.5%) had single relapse and 46 (58.2%) had multiple localizations. The site of relapse influenced survival since patients with vaginal vault recurrences lived significantly longer than patients with recurrences in other sites. Ninety-seven (29.7%) patients were symptomatic and anticipated the scheduled visit, 66 (20.2%) reported their symptoms during the follow-up visit and 164 (50.1%) were asymptomatic and the diagnostic path was introduced by a planned visit or exam. Between asymptomatic patients the first procedure was clinical visit for 85 patients out of 164 patients (51.8%), imaging for 60 patients (36.6%), both clinical visit and imaging for 14 (8.5%) and cytology for 5 (3%, Pap smear test). The median OS of symptomatic patients was 37months versus 109months of asymptomatic patients (Log rank, p = 0.00001). The median survival since recurrence was 9months for symptomatic patients and median was not reached for asymptomatic patients (p < 0.0001). The median disease-free interval was 24months for asymptomatic patients vs. 36months for symptomatic patients (p = 0.03). Conclusions: Our study helps demonstrate the great need of prospective cost-effectiveness studies which are lacking at the present time

Published
2007

6. An analysis of different approaches to ovarian cysts in Italy

Author

Romagnolo, C., Maggino, T., Zola, P., Sartori, E., Gadducci, A., fabio landoni, Romagnolo, C, Maggino, T, Zola, P, Sartori, E, Gadducci, A, and Landoni, F

Subjects
Ovarian Neoplasms, Ovarian Neoplasm, Ovariectomy, Hysterectomy, Ovarian Cyst, Ovarian Cysts, Gynecologic Surgical Procedures, Italy, Gynecologic Surgical Procedure, Gynecology, CA-125 Antigen, Surveys and Questionnaires, Surveys and Questionnaire, Humans, Fallopian Tube, Female, Laparoscopy, Practice Patterns, Physicians', Fallopian Tubes, Human, Ultrasonography
Abstract

The management of pelvic masses represent a rising problem due to the need to obtain an early diagnosis and treatment of ovarian cancers. Materials and Methods: In order to evaluate the clinical and surgical approach to ovarian cysts in Italy, we sent a multiple choice questionnaire to 214 members of the Italian Society of Gynecologic Oncology (SIOG) and to 230 members of the Italian Society of Gynecologic Endoscopy (SEGi). Ninety-six resulted evaluable. Results: Transabdominal and transvaginal ultrasound associated with CA125 determination represent the basis for the diagnosis, even if there is no univocal agreement on the ultrasound aspects that may define an ovarian cyst as doubtful. If an ovarian cyst, classified as suspicious, has been diagnosed in a postmenopausal woman, a wide range of therapeutic options have been reported: laparotomic hysterectomy and bilateral salpingo-oophorectomy represent the treatment of choice for 49% of SIOG members, whereas laparoscopic bilateral (45%) or monolateral (39%) salpingo-oophorectomy represents the standard for SEGi members. Ultrasound criteria to distinguish among benign or probably malignant or doubtful ovarian cysts, the treatment of an ovarian cyst during pregnancy, and the management of an unexpected intraoperative diagnosis of borderline ovarian neoplasia are discussed on the basis of answers received by SIOG and SEGi members.

Published
2004

7. The clinical outcome of patients with stage Ia1 and Ia2 squamous cell carcinoma of the uterine cervix: a Cooperation Task Force (CTF) study

Author

Gadducci, Angiolo, Sartori, E, Maggino, T, Bandoni, F, Zola, P, Cosio, S, Pasinetti, B, Alessi, C, Maneo, A, Ferrero, A., Gadducci, A, Sartori, E, Maggino, T, Landoni, F, Zola, P, Cosio, S, Pasinetti, B, Alessi, C, Maneo, A, and Ferrero, A

Subjects
Neoplasm Invasivene, Adult, Aged, 80 and over, Conization, Uterine Cervical Neoplasms, Middle Aged, Hysterectomy, Medical Records, Treatment Outcome, Italy, Retrospective Studie, Carcinoma, Squamous Cell, Medical Record, Humans, Lymph Node Excision, Female, Neoplasm Invasiveness, Neoplasm Recurrence, Local, Human, Aged, Neoplasm Staging, Retrospective Studies
Abstract

Purpose of investigation: The objective of this retrospective multicenter study was to assess the clinical outcome of patients with microinvasive squamous cell carcinoma of the uterine cervix. Methods: The hospital records of 166 patients with microinvasive squamous cell carcinoma of the uterine cervix were reviewed. All cases were retrospectively staged according the 1994 International Federation of Gynecology and Obstetrics (FIGO) nomenclature. One hundred and forty-three cases were in Stage Ia1 and 23 in Stage Ia2 disease. Surgery consisted of conization alone in 30 (18.1%) patients, total hysterectomy in 82 (49.4%), and radical hysterectomy in 54 (32.5%). All patients in whom conization was the definite treatment had Stage Ia1 disease and had cone margins negative for intraepithelial or invasive lesions. Results: None of the 67 patients submitted to pelvic lymphadenectomy had histologically proven metastatic lymph nodes. Of the 166 patients, eight (4.8%) had an intraepithelial recurrence and four (2.4%) had an invasive recurrence. With regard to FIGO substage, disease recurred in nine (6.3%) out of 143 patients with Stage Ia1 and three (13.0%) out of 23 with Stage Ia2 cervical cancer. With regard to type of surgery, disease recurred in three (10.0%) out of the patients treated with conization alone, four (4.9%) out those who underwent total hysterectomy, and five (9.3%) out of those who underwent radical hysterectomy. It is worth noting that none of the 30 patients treated with conization alone had recurrent invasive cancer after a median follow-up of 45 months. However three (10%) of these patients developed a cervical intraepithelial neoplasia (CIN) III after 16, 33, and 94 months, respectively, from conization. Conclusions: Conization can represent the definite treatment for patients with Stage Ia1 squamous cell cervical cancer, if cone margins and apex are disease-free. For patients with Stage Ia2 cervical cancer extrafascial hysterectomy with pelvic lymphadenectomy might be an adequate standard therapy, although the need for lymph node dissection is questionable

Published
2003

9. Establishment and growth regulation of a novel ovarian cancer cell line from a poorly-differentiated adenocarcinoma: proposal for a new treatment

Author

Mancini, A., Borrelli, A., Formisano, S., Masucci, M. T., Maffeo, A., Perla, G., Martino, L., Bevilacqua, N., Gerardo Botti, Maggino, T., Mancini, A, Borrelli, A, Formisano, S, Masucci, Mt, Maffeo, A, Perla, G, DE MARTINO, Luisa, Bevilacqua, N, Botti, G, and Maggino, T.

Subjects
Ovarian Neoplasms, p53, Genes, myc, c-myc oncogene, Apoptosis, DNA, Neoplasm, Adenocarcinoma, apoptosi, Translocation, Genetic, Microscopy, Electron, ovarian cancer, Culture Media, Conditioned, Tumor Cells, Cultured, Humans, Female, Genes, Tumor Suppressor, Chromosomes, Human, Pair 8, Neoplasm Staging
Abstract

A continuously growing cultured cell line has been obtained in vitro, starting from a specimen of ascites fluid obtained from a patient with ovarian cancer, in whom a poorly-differentiated adenocarcinoma was diagnosed. This cell line, named OC-A1, is routinely grown in standard, serum-supplemented culture medium and has been fully stabilized to long-term growth and characterized for both cultural and genetic parameters. OC-A1 cells express a set of characteristics, as determined in vitro which, when compared with the in vivo primary tumor, confirm the high malignity of this cancer. In addition, karyotype analysis showed a translocation of chromosome 8 which is correlated with the amplification of c-myc oncogene. However, the expression of this oncogene was found to be significantly inhibited by a new regulatory activity, recently found to be present in a liposarcoma cell line. Conditioned medium from these cells was indeed able to inhibit the growth of OC-A1 cells, arresting their cell cycle in the G1 phase and inducing them to apoptosis. Finally, the cell programmed death appeared to be related to the expression of antioncogene p53.

Published
1999

10. Non-hormonal treatment of vasomotor symptoms in gynecological cancer patients

Author

Lino Del Pup and Maggino, T.

Subjects
Genital Neoplasms, Female, Humans, Female, Phytoestrogens, Clonidine, Selective Serotonin Reuptake Inhibitors
Abstract

Gynaecological cancer patients generally suffer from an earlier and more severe menopausal syndrome than the general female population. Hormone replacement therapy is often contraindicated and there are non-hormonal treatments that are proven to be more effective than placebo in randomized controlled trials, e.g., some antidepressants, gabapentine and clonidine. The main limits to the use of these drugs in controlling hot flashes are the off-label use for this purpose, the very short follow-up and the fact that data come from studies performed on breast cancer, not on gynecological cancer patients. Patients believe that drugs derived from plants could be effective in relieving hot flashes and that they are harmless. Evidence is contrary to this belief and estrogen-sensitive cancer patients should be warned of the potential, though very weak, estrogenic effect of phytoestrogens and other "natural" drugs, and that their efficacy is close to that of a placebo.

Published
2010

12. Neoadjuvant chemotherapy or primary surgery in stage IIIC or IV ovarian cancer

Author

Vergote, I, Tropé, Cg, Amant, F, Kristensen, Gb, Ehlen, T, Johnson, N, Verheijen, Rh, van der Burg ME, Lacave, Aj, Panici, Pb, Kenter, Gg, Casado, A, Mendiola, C, Coens, C, Verleye, L, Stuart, Gc, Pecorelli, S, Reed, Ns, Angioli, R, Bentley, J, Berteloot, P, Bessette, P, Boman, K, Buist, M, Chan, K, Chan, S, Coronado Martín, P, Counsell, R, Cruickshank, Dj, Davis, J, De Greve, J, De Oliveira CF, De Valk, B, Dittrich, C, Elit, L, Favalli, G, Floquet, A, Gauthier, P, Gerdin, E, Ghatage, P, Gilby, E, Gleeson, N, Gotlieb, W, Green, Ja, Grimshaw, R, Heywood, M, Hirsch, V, Hoekman, K, Honkoop, A, Hoskins, P, Kannisto, P, Kaern, J, Katsaros, D, Kieser, K, Kristeller, Tv, Leblanc, E, Ledermann, J, Leunen, K, Lotocki, R, Maggino, T, Marth, C, Martin, L, Massuger, L, Miller, D, Mosgaard, B, Mota, F, Neven, P, Nooij, M, Nordal, R, Nordin, A, Ottevanger, Pb, Papadopoulos, A, Petru, E, Plante, M, Popadiuk, C, Provencher, D, Redman, C, Roozendaal, Kj, Rustin, G, Sadozye, Ah, Sandvei, R, Seoane, Jm, Sereni, Mi, Sert, B, Siddiqui, N, Speiser, P, Tholander, B, Tognon, G, Trimbos, B, Trudeau, M, Van Baal, M, Van Doorn HC, Van der Velden, J, Van Eygen, K, Vermorken, Jb, Vidart Aragon JA, Wensveen, Cw, Zola, Paolo, Anastosopoulou, A, Bethe, U, Dehaes, K, Demeester, A, Demonty, G, De Heusch, E, De Rouck, M, Giurgea, L, Hoctin Boes, G, Teodorovic, I, Ven, K, Van Luijk, I, Bacon, M, and Eisenhauer, E.

Subjects
ovarian cancer neoadjuvant chemotherapy
Published
2010

16. Phase III randomised study to evaluate the role of adjuvant pelvic radiotherapy in the treatment of uterine sarcomas stages I and II: an European Organisation for Research and Treatment of Cancer Gynaecological Cancer Group Study (protocol 55874)

Author

Reed, Ns, Mangioni, C, Malmström, H, Scarfone, G, Poveda, A, Pecorelli, S, Tateo, S, Franchi, M, Jobsen, Jj, Coens, C, Teodorovic, I, Vergote, I, Vermorken, Jb, Malmstrom, H, Favalli, G, Jobsen, J, van Bunningen, B, Splinter, T, van der Burg ME, Drouin, P, Zola, Paolo, Frankendaal, B, Schepansky, A, Swenerton, K, Stuart, G, Scarabelli, C, Mangili, G, van Rijswijk, R, Van, Putten, Chevalier, B, Stoot, Je, Beex, L, Souhami, L, Heintz, Ap, Bonnefoi, H, Koelbl, H, Kobierska, A, Guthrie, D, Maggino, T, di Palumbo VS, Bessette, P, van Wijk, A, and Verheijen, R.

Subjects
Adult, Leiomyosarcoma, Oncology, Cancer Research, medicine.medical_specialty, Randomization, Sarcoma, Endometrial Stromal, medicine.medical_treatment, Disease-Free Survival, Carcinosarcoma, Internal medicine, medicine, Humans, Stage (cooking), Aged, Aged, 80 and over, uterine sarcoma radiotherapy, Radiotherapy, Uterine sarcoma, business.industry, Cancer, Middle Aged, Pelvic cavity, medicine.disease, Surgery, Radiation therapy, Clinical trial, Treatment Outcome, medicine.anatomical_structure, Uterine Neoplasms, Disease Progression, Female, Radiotherapy, Adjuvant, Neoplasm Recurrence, Local, business, Adjuvant
Abstract

The management of uterine sarcomas continues to present many difficulties. Primary surgery is the optimal treatment but the role of post-operative radiation remains uncertain. In the mid-1980s, the European Organisation for Research and Treatment of Cancer Gynaecological Cancer Group Study proposed a trial to evaluate adjuvant radiotherapy, as previous non-randomised studies had suggested a survival advantage and improved local control when post-operative radiation was administered. The study opened in 1987 taking 13 years to accrue 224 patients. All uterine sarcoma subtypes were permitted. Patients were required to have undergone as a minimum, TAH and BSO and wahsings (166 patients) but nodal sampling was optional. There were 103 leiomyosarcomas (LMS), 91 carcinosarcomas (CS) and 28 endometrial stromal sarcomas (ESS). Patients were randomised to either observation or pelvic radiation, 51Gy in 28 fractions over 5 weeks. Hundred and twelve were recruited to each arm. The initial analysis has shown a reduction in local relapse (14 versus 24, p =0.004) but no effect on either OS or PFS. No unexpected toxicity was seen in the radiation arm. No difference in either overall or disease-free survival was demonstrated but there is an increased local control for the CS patients receiving radiation but without any benefit for LMS. Prognostic factor analysis shows that stage, age and histological subtype were important predictors of behaviour which may explain differences between CS and LMS. CS appears to show more kinship to poorly differentiated endometrial carcinomas in behaviour. LMS did not show the same benefit from radiation. These results will help shape future management and clinical trials in uterine sarcomas.

Published
2008

21. Prospective multicenter study on CA 125 in postmenopausal pelvic masses

Author

Maggino, T, Gadducci, A, D'Addario, V, Pecorelli, S, Stella, M, Romagnolo, C, Federghini, M, Zucca, S, Trio, D., LISSONI, ANDREA ALBERTO, Maggino, T, Gadducci, A, D'Addario, V, Pecorelli, S, Lissoni, A, Stella, M, Romagnolo, C, Federghini, M, Zucca, S, and Trio, D

Subjects
Aged, 80 and over, Adult, Pelvic Neoplasm, Ovarian Neoplasm, MED/40 - GINECOLOGIA E OSTETRICIA, Predictive Value of Test, Middle Aged, Sensitivity and Specificity, Postmenopause, Prospective Studie, Antibody Specificity, Female, Antigens, Tumor-Associated, Carbohydrate, Human, Aged
Abstract

The purpose of this study was to determine the diagnostic value of CA 125 in comparison with transabdominal ultrasound (US) in the evaluation of postmenopausal women with pelvic mass to detect malignant epithelial ovarian tumors. Postmenopausal patients with pelvic mass were studied with gynecologic examination, US and CA 125 determination. Three hundred eighty-eight patients were entered in the study. According to stratification based on US (probably benign, equivocal, possibly malignant) and CA 125 (< 35 U/ml, negative; between 35 and 65 U/ml, borderline; > 65 U/ml, positive), 290 patients were considered eligible for surgery. Specificity, sensitivity, positive and negative predictive value, and accuracy of US and CA 125 were calculated with respect to histological examination. Out of 290 operated patients, 134 had a benign ovarian pathology, 34 had extraovarian benign pathology, 106 had an ovarian malignancy, and 16 presented with an extraovarian malignant pathology. The results according to ovarian malignant pathology were as follows. CA 125 (> 65 U/ml): Specificity, 92.5%; sensitivity, 71.7%; accuracy, 83.3%. CA 125 (> 35 U/ml): Specificity, 82.0%; sensitivity, 78.3%; accuracy, 80.4%. US: Specificity, 77.6%; sensitivity, 84.9%; accuracy, 80.3%. Combination of US and CA 125 (> 65 U/ml): Specificity, 96.1%; sensitivity, 91.7%; accuracy, 94.3%. Determination of CA 125 is a highly specific method in predicting ovarian cancer in postmenopausal women with a pelvic mass. The association with US significantly improves the overall accuracy and may support therapeutical decision making by distinguishing between a significant percentage of women most likely to benefit from prompt intervention and women who may be managed following minor surgical diagnostic approach, such as fine-needle aspiration.

Published
1994

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