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1. Practice patterns and 90-day treatment-related morbidity in early-stage cervical cancer

Author

Bogani, G, Donato, V, Scambia, G, Landoni, F, Ghezzi, F, Muzii, L, Panici, P, Raspagliesi, F, Casarin, J, Di Martino, G, Grassi, T, Perrone, A, De Iaco, P, Multinu, F, Berretta, R, Capozzi, V, Zupi, E, Centini, G, Pellegrino, A, Corso, S, Stevenazzi, G, Boschi, A, Comerci, G, Greco, P, Scutiero, G, Sopracordevole, F, Giorda, G, Fichera, M, Simoncini, T, Caretto, M, Sartori, E, Ferrari, F, Cianci, A, Sarpietro, G, Matarazzo, M, Giampaolino, P, Bifulco, G, Morelli, M, Dio, M, Ferrero, A, Biglia, N, Barra, F, Ferrero, S, Cianci, S, Chiantera, V, Sozzi, G, Ercoli, A, Schettini, S, Orlando, T, Cannone, F, Ettore, G, Puppo, A, Olearo, E, Leone Roberti Maggiore, U, Artuso, V, Palaia, I, Perniola, G, Tripodi, R, D'Auge, T, Cuccu, I, Fischetti, M, Santangelo, G, Casorelli, A, Giannini, A, D'Oria, O, Vizzielli, G, Restaino, S, Bergamini, A, Bocciolone, L, Plotti, F, Angioli, R, Mantovani, G, Ceccaroni, M, Cassini, C, Dominoni, M, Giambanco, L, Amodeo, S, Leo, L, Thommaset, R, Raimondo, D, Seracchioli, R, Malzoni, M, Falcone, F, Gorlero, F, Di Luca, M, Busato, E, Kilzie, S, Dell'Acqua, A, Scarfone, G, Vercellini, P, Petrillo, M, Capobianco, G, Ciavattini, A, Mereu, L, Scollo, P, Sorbi, F, Fambrini, M, Romano, F, Ricci, G, Trojano, G, Damiani, G, Consonni, R, Di Lorenzo, N, Lippolis, A, Tinelli, R, Aguzzoli, L, Mandato, V, Palomba, S, Tripodi, M, Calandra, D, Pellegrini, F, Zullo, F, Surico, D, Remorgida, V, Ruscitto, F, Beretta, P, Vizza, E, Bogani G., Donato V. D., Scambia G., Landoni F., Ghezzi F., Muzii L., Panici P. B., Raspagliesi F., Casarin J., Di Martino G., Grassi T., Perrone A. M., De Iaco P., Multinu F., Berretta R., Capozzi V. A., Zupi E., Centini G., Pellegrino A., Corso S., Stevenazzi G., Boschi A. C., Comerci G., Greco P., Scutiero G., Sopracordevole F., Giorda G., Fichera M., Simoncini T., Caretto M., Sartori E., Ferrari F., Cianci A., Sarpietro G., Matarazzo M. G., Giampaolino P., Bifulco G., Morelli M., Dio M. D., Ferrero A., Biglia N., Barra F., Ferrero S., Cianci S., Chiantera V., Sozzi G., Ercoli A., Schettini S., Orlando T., Cannone F. G., Ettore G., Puppo A., Olearo E., Leone Roberti Maggiore U., Artuso V., Palaia I., Perniola G., Tripodi R., D'Auge T. G., Cuccu I., Fischetti M., Santangelo G., Casorelli A., Giannini A., D'Oria O., Vizzielli G., Restaino S., Bergamini A., Bocciolone L., Plotti F., Angioli R., Mantovani G., Ceccaroni M., Cassini C., Dominoni M., Giambanco L., Amodeo S., Leo L., Thommaset R., Raimondo D., Seracchioli R., Malzoni M., Falcone F., Gorlero F., Di Luca M., Busato E., Kilzie S., Dell'Acqua A., Scarfone G., Vercellini P., Petrillo M., Capobianco G., Ciavattini A., Mereu L., Scollo P., Sorbi F., Fambrini M., Romano F., Ricci G., Trojano G., Damiani G. R., Consonni R., Di Lorenzo N., Lippolis A., Tinelli R., Aguzzoli L., Mandato V. D., Palomba S., Tripodi M., Calandra D., Pellegrini F., Zullo F., Surico D., Remorgida V., Ruscitto F., Beretta P., Vizza E., Bogani, G, Donato, V, Scambia, G, Landoni, F, Ghezzi, F, Muzii, L, Panici, P, Raspagliesi, F, Casarin, J, Di Martino, G, Grassi, T, Perrone, A, De Iaco, P, Multinu, F, Berretta, R, Capozzi, V, Zupi, E, Centini, G, Pellegrino, A, Corso, S, Stevenazzi, G, Boschi, A, Comerci, G, Greco, P, Scutiero, G, Sopracordevole, F, Giorda, G, Fichera, M, Simoncini, T, Caretto, M, Sartori, E, Ferrari, F, Cianci, A, Sarpietro, G, Matarazzo, M, Giampaolino, P, Bifulco, G, Morelli, M, Dio, M, Ferrero, A, Biglia, N, Barra, F, Ferrero, S, Cianci, S, Chiantera, V, Sozzi, G, Ercoli, A, Schettini, S, Orlando, T, Cannone, F, Ettore, G, Puppo, A, Olearo, E, Leone Roberti Maggiore, U, Artuso, V, Palaia, I, Perniola, G, Tripodi, R, D'Auge, T, Cuccu, I, Fischetti, M, Santangelo, G, Casorelli, A, Giannini, A, D'Oria, O, Vizzielli, G, Restaino, S, Bergamini, A, Bocciolone, L, Plotti, F, Angioli, R, Mantovani, G, Ceccaroni, M, Cassini, C, Dominoni, M, Giambanco, L, Amodeo, S, Leo, L, Thommaset, R, Raimondo, D, Seracchioli, R, Malzoni, M, Falcone, F, Gorlero, F, Di Luca, M, Busato, E, Kilzie, S, Dell'Acqua, A, Scarfone, G, Vercellini, P, Petrillo, M, Capobianco, G, Ciavattini, A, Mereu, L, Scollo, P, Sorbi, F, Fambrini, M, Romano, F, Ricci, G, Trojano, G, Damiani, G, Consonni, R, Di Lorenzo, N, Lippolis, A, Tinelli, R, Aguzzoli, L, Mandato, V, Palomba, S, Tripodi, M, Calandra, D, Pellegrini, F, Zullo, F, Surico, D, Remorgida, V, Ruscitto, F, Beretta, P, Vizza, E, Bogani G., Donato V. D., Scambia G., Landoni F., Ghezzi F., Muzii L., Panici P. B., Raspagliesi F., Casarin J., Di Martino G., Grassi T., Perrone A. M., De Iaco P., Multinu F., Berretta R., Capozzi V. A., Zupi E., Centini G., Pellegrino A., Corso S., Stevenazzi G., Boschi A. C., Comerci G., Greco P., Scutiero G., Sopracordevole F., Giorda G., Fichera M., Simoncini T., Caretto M., Sartori E., Ferrari F., Cianci A., Sarpietro G., Matarazzo M. G., Giampaolino P., Bifulco G., Morelli M., Dio M. D., Ferrero A., Biglia N., Barra F., Ferrero S., Cianci S., Chiantera V., Sozzi G., Ercoli A., Schettini S., Orlando T., Cannone F. G., Ettore G., Puppo A., Olearo E., Leone Roberti Maggiore U., Artuso V., Palaia I., Perniola G., Tripodi R., D'Auge T. G., Cuccu I., Fischetti M., Santangelo G., Casorelli A., Giannini A., D'Oria O., Vizzielli G., Restaino S., Bergamini A., Bocciolone L., Plotti F., Angioli R., Mantovani G., Ceccaroni M., Cassini C., Dominoni M., Giambanco L., Amodeo S., Leo L., Thommaset R., Raimondo D., Seracchioli R., Malzoni M., Falcone F., Gorlero F., Di Luca M., Busato E., Kilzie S., Dell'Acqua A., Scarfone G., Vercellini P., Petrillo M., Capobianco G., Ciavattini A., Mereu L., Scollo P., Sorbi F., Fambrini M., Romano F., Ricci G., Trojano G., Damiani G. R., Consonni R., Di Lorenzo N., Lippolis A., Tinelli R., Aguzzoli L., Mandato V. D., Palomba S., Tripodi M., Calandra D., Pellegrini F., Zullo F., Surico D., Remorgida V., Ruscitto F., Beretta P., and Vizza E.

Abstract

Background: To evaluate the impact of the Laparoscopic Approach to Cervical Cancer (LACC) Trial on patterns of care and surgery-related morbidity in early-stage cervical cancer. Methods: This is a retrospective, a multi-institutional study evaluating 90-day surgery-related outcomes of patients undergoing treatment for early-stage cervical cancer before (period I: 01/01/2016–06/01/2018) and after (period II: 01/01/2019–06/01/2021) the publication of the results of the LACC trial. Results: Charts of 1295 patients were evaluated: 581 (44.9%) and 714 (55.1%) before and after the publication of the LACC trial, respectively. After the publication of the LACC trial, the number of patients treated with minimally invasive radical hysterectomy decreased from 64.9% to 30.4% (p < 0.001). Overall, 90-day complications occurred in 110 (18.9%) and 119 (16.6%) patients in the period I and period II, respectively (p = 0.795). Similarly, the number of severe (grade 3 or worse) complications did not differ between the two periods (38 (6.5%) vs. 37 (5.1%); p = 0.297). Overall and severe 90-day complications were consistent between periods even evaluating stage IA (p = 0.471), IB1 (p = 0.929), and IB2 (p = 0.074), separately. Conclusions: The present investigation highlighted that in referral centers the shift from minimally invasive to open radical hysterectomy does not influence 90-day surgery-related morbidity.

Published
2022

3. Characteristics and patterns of care of endometrial cancer before and during COVID-19 pandemic

Author

Bogani, G., Scambia, Giovanni, Cimmino, C., Fanfani, Francesco, Costantini, Barbara, Loverro, Matteo, Ferrandina, Maria Gabriella, Landoni, F., Bazzurini, L., Grassi, T., Vitobello, D., Siesto, G., Perrone, A. M., Zanagnolo, V., De Iaco, P., Multinu, F., Ghezzi, F., Casarin, J., Berretta, R., Capozzi, V. A., Zupi, E., Centini, G., Pellegrino, Antonio Agostino, Corso, S., Stevenazzi, G., Montoli, Stefano, Boschi, A. C., Comerci, Gianluca, Greco, Pierfrancesco, Martinello, R., Sopracordevole, F., Giorda, G., Simoncini, T., Caretto, M., Sartori, E., Ferrari, F., Cianci, A., Sarpietro, G., Matarazzo, M. G., Zullo, F., Bifulco, G., Morelli, Marco, Ferrero, A., Biglia, N., Barra, F., Ferrero, S., Maggiore, U. L. R., Cianci, Stefano, Chiantera, V., Ercoli, Alfredo, Sozzi, G., Martoccia, A., Schettini, Sergio Crescenzo, Orlando, T., Cannone, F. G., Ettore, G., Puppo, A., Borghese, M., Martinelli, C., Muzii, L., Di Donato, V., Driul, L., Restaino, S., Bergamini, A., Candotti, G., Bocciolone, L., Plotti, F., Angioli, R., Mantovani, G., Ceccaroni, Marcello, Cassani, C., Dominoni, M., Giambanco, L., Amodeo, Silvia, Leo, Maria Laura, Thomasset, R., Raimondo, D., Seracchioli, R., Malzoni, M., Gorlero, F., Di Luca, M., Busato, E., Kilzie, S., Dell'Acqua, Antonio, Scarfone, G., Vercellini, P., Petrillo, Marco, Dessole, S., Capobianco, G., Ciavattini, A., Delli Carpini, G., Giannella, L., Mereu, L., Tateo, S., Sorbi, F., Fambrini, M., Cicogna, S., Romano, Federica, Ricci, Giuseppe, Trojano, G., Consonni, R., Cantaluppi, S., Lippolis, A., Tinelli, R., D'Ippolito, G., Aguzzoli, L., Mandato, V. D., Palomba, S., Calandra, D., Rosati, M., Gallo, C., Surico, D., Remorgida, V., Ruscitto, F., Beretta, P., Panici, P. B., Raspagliesi, F., Scambia G. (ORCID:0000-0003-2758-1063), Fanfani F. (ORCID:0000-0003-1991-7284), Costantini B., Loverro M., Ferrandina G. (ORCID:0000-0003-4672-4197), Pellegrino A., Montoli S., Comerci G., Greco P., Morelli M., Cianci S., Ercoli A., Schettini S., Ceccaroni M., Amodeo S., Leo L., Dell'acqua A. (ORCID:0000-0002-8697-3115), Petrillo M., Romano F., Ricci G., Bogani, G., Scambia, Giovanni, Cimmino, C., Fanfani, Francesco, Costantini, Barbara, Loverro, Matteo, Ferrandina, Maria Gabriella, Landoni, F., Bazzurini, L., Grassi, T., Vitobello, D., Siesto, G., Perrone, A. M., Zanagnolo, V., De Iaco, P., Multinu, F., Ghezzi, F., Casarin, J., Berretta, R., Capozzi, V. A., Zupi, E., Centini, G., Pellegrino, Antonio Agostino, Corso, S., Stevenazzi, G., Montoli, Stefano, Boschi, A. C., Comerci, Gianluca, Greco, Pierfrancesco, Martinello, R., Sopracordevole, F., Giorda, G., Simoncini, T., Caretto, M., Sartori, E., Ferrari, F., Cianci, A., Sarpietro, G., Matarazzo, M. G., Zullo, F., Bifulco, G., Morelli, Marco, Ferrero, A., Biglia, N., Barra, F., Ferrero, S., Maggiore, U. L. R., Cianci, Stefano, Chiantera, V., Ercoli, Alfredo, Sozzi, G., Martoccia, A., Schettini, Sergio Crescenzo, Orlando, T., Cannone, F. G., Ettore, G., Puppo, A., Borghese, M., Martinelli, C., Muzii, L., Di Donato, V., Driul, L., Restaino, S., Bergamini, A., Candotti, G., Bocciolone, L., Plotti, F., Angioli, R., Mantovani, G., Ceccaroni, Marcello, Cassani, C., Dominoni, M., Giambanco, L., Amodeo, Silvia, Leo, Maria Laura, Thomasset, R., Raimondo, D., Seracchioli, R., Malzoni, M., Gorlero, F., Di Luca, M., Busato, E., Kilzie, S., Dell'Acqua, Antonio, Scarfone, G., Vercellini, P., Petrillo, Marco, Dessole, S., Capobianco, G., Ciavattini, A., Delli Carpini, G., Giannella, L., Mereu, L., Tateo, S., Sorbi, F., Fambrini, M., Cicogna, S., Romano, Federica, Ricci, Giuseppe, Trojano, G., Consonni, R., Cantaluppi, S., Lippolis, A., Tinelli, R., D'Ippolito, G., Aguzzoli, L., Mandato, V. D., Palomba, S., Calandra, D., Rosati, M., Gallo, C., Surico, D., Remorgida, V., Ruscitto, F., Beretta, P., Panici, P. B., Raspagliesi, F., Scambia G. (ORCID:0000-0003-2758-1063), Fanfani F. (ORCID:0000-0003-1991-7284), Costantini B., Loverro M., Ferrandina G. (ORCID:0000-0003-4672-4197), Pellegrino A., Montoli S., Comerci G., Greco P., Morelli M., Cianci S., Ercoli A., Schettini S., Ceccaroni M., Amodeo S., Leo L., Dell'acqua A. (ORCID:0000-0002-8697-3115), Petrillo M., Romano F., and Ricci G.

Abstract

Objective: Coronavirus disease 2019 (COVID-19) outbreak has correlated with the disruption of screening activities and diagnostic assessments. Endometrial cancer (EC) is one of the most common gynecological malignancies and it is often detected at an early stage, because it frequently produces symptoms. Here, we aim to investigate the impact of COVID-19 outbreak on patterns of presentation and treatment of EC patients. Methods: This is a retrospective study involving 54 centers in Italy. We evaluated patterns of presentation and treatment of EC patients before (period 1: March 1, 2019 to February 29, 2020) and during (period 2: April 1, 2020 to March 31, 2021) the COVID-19 outbreak. Results: Medical records of 5,164 EC patients have been retrieved: 2,718 and 2,446 women treated in period 1 and period 2, respectively. Surgery was the mainstay of treatment in both periods (p=0.356). Nodal assessment was omitted in 689 (27.3%) and 484 (21.2%) patients treated in period 1 and 2, respectively (p<0.001). While, the prevalence of patients undergoing sentinel node mapping (with or without backup lymphadenectomy) has increased during the COVID-19 pandemic (46.7% in period 1 vs. 52.8% in period 2; p<0.001). Overall, 1,280 (50.4%) and 1,021 (44.7%) patients had no adjuvant therapy in period 1 and 2, respectively (p<0.001). Adjuvant therapy use has increased during COVID-19 pandemic (p<0.001). Conclusion: Our data suggest that the COVID-19 pandemic had a significant impact on the characteristics and patterns of care of EC patients. These findings highlight the need to implement healthcare services during the pandemic.

Published
2022

4. Characteristics and patterns of care of endometrial cancer before and during COVID-19 pandemic

Author

Bogani, G, Scambia, G, Cimmino, C, Fanfani, F, Costantini, B, Loverro, M, Ferrandina, G, Landoni, F, Bazzurini, L, Grassi, T, Vitobello, D, Siesto, G, Perrone, A, Zanagnolo, V, De Iaco, P, Multinu, F, Ghezzi, F, Casarin, J, Berretta, R, Capozzi, V, Zupi, E, Centini, G, Pellegrino, A, Corso, S, Stevenazzi, G, Montoli, S, Boschi, A, Comerci, G, Greco, P, Martinello, R, Sopracordevole, F, Giorda, G, Simoncini, T, Caretto, M, Sartori, E, Ferrari, F, Cianci, A, Sarpietro, G, Matarazzo, M, Zullo, F, Bifulco, G, Morelli, M, Ferrero, A, Biglia, N, Barra, F, Ferrero, S, Leone Roberti Maggiore, U, Cianci, S, Chiantera, V, Ercoli, A, Sozzi, G, Martoccia, A, Schettini, S, Orlando, T, Cannone, F, Ettore, G, Puppo, A, Borghese, M, Martinelli, C, Muzii, L, Di Donato, V, Driul, L, Restaino, S, Bergamini, A, Candotti, G, Bocciolone, L, Plotti, F, Angioli, R, Mantovani, G, Ceccaroni, M, Cassani, C, Dominoni, M, Giambanco, L, Amodeo, S, Leo, L, Thomasset, R, Raimondo, D, Seracchioli, R, Malzoni, M, Gorlero, F, Di Luca, M, Busato, E, Kilzie, S, Dell'Acqua, A, Scarfone, G, Vercellini, P, Petrillo, M, Dessole, S, Capobianco, G, Ciavattini, A, Delli Carpini, G, Giannella, L, Mereu, L, Tateo, S, Sorbi, F, Fambrini, M, Cicogna, S, Romano, F, Ricci, G, Trojano, G, Consonni, R, Cantaluppi, S, Lippolis, A, Tinelli, R, D'Ippolito, G, Aguzzoli, L, Mandato, V, Palomba, S, Calandra, D, Rosati, M, Gallo, C, Surico, D, Remorgida, V, Ruscitto, F, Beretta, P, Benedetti Panici, P, Raspagliesi, F, Bogani, Giorgio, Scambia, Giovanni, Cimmino, Chiara, Fanfani, Francesco, Costantini, Barbara, Loverro, Matteo, Ferrandina, Gabriella, Landoni, Fabio, Bazzurini, Luca, Grassi, Tommaso, Vitobello, Domenico, Siesto, Gabriele, Perrone, Anna Myriam, Zanagnolo, Vanna, De Iaco, Pierandrea, Multinu, Francesco, Ghezzi, Fabio, Casarin, Jvan, Berretta, Roberto, Capozzi, Vito A, Zupi, Errico, Centini, Gabriele, Pellegrino, Antonio, Corso, Silvia, Stevenazzi, Guido, Montoli, Serena, Boschi, Anna Chiara, Comerci, Giuseppe, Greco, Pantaleo, Martinello, Ruby, Sopracordevole, Francesco, Giorda, Giorgio, Simoncini, Tommaso, Caretto, Marta, Sartori, Enrico, Ferrari, Federico, Cianci, Antonio, Sarpietro, Giuseppe, Matarazzo, Maria Grazia, Zullo, Fulvio, Bifulco, Giuseppe, Morelli, Michele, Ferrero, Annamaria, Biglia, Nicoletta, Barra, Fabio, Ferrero, Simone, Leone Roberti Maggiore, Umberto, Cianci, Stefano, Chiantera, Vito, Ercoli, Alfredo, Sozzi, Giulio, Martoccia, Angela, Schettini, Sergio, Orlando, Teresa, Cannone, Francesco G, Ettore, Giuseppe, Puppo, Andrea, Borghese, Martina, Martinelli, Canio, Muzii, Ludovico, Di Donato, Violante, Driul, Lorenza, Restaino, Stefano, Bergamini, Alice, Candotti, Giorgio, Bocciolone, Luca, Plotti, Francesco, Angioli, Roberto, Mantovani, Giulia, Ceccaroni, Marcello, Cassani, Chiara, Dominoni, Mattia, Giambanco, Laura, Amodeo, Silvia, Leo, Livio, Thomasset, Raphael, Raimondo, Diego, Seracchioli, Renato, Malzoni, Mario, Gorlero, Franco, Di Luca, Martina, Busato, Enrico, Kilzie, Sami, Dell'Acqua, Andrea, Scarfone, Giovanna, Vercellini, Paolo, Petrillo, Marco, Dessole, Salvatore, Capobianco, Giampiero, Ciavattini, Andrea, Delli Carpini, Giovanni, Giannella, Luca, Mereu, Liliana, Tateo, Saverio, Sorbi, Flavia, Fambrini, Massimiliano, Cicogna, Stefania, Romano, Federico, Ricci, Giuseppe, Trojano, Giuseppe, Consonni, Roberto, Cantaluppi, Simona, Lippolis, Antonio, Tinelli, Raffaele, D'Ippolito, Giovanni, Aguzzoli, Lorenzo, Mandato, Vincenzo D, Palomba, Stefano, Calandra, Davide, Rosati, Maurizio, Gallo, Cinzia, Surico, Daniela, Remorgida, Valentino, Ruscitto, Francesco, Beretta, Paolo, Benedetti Panici, Pierluigi, Raspagliesi, Francesco, Bogani, G, Scambia, G, Cimmino, C, Fanfani, F, Costantini, B, Loverro, M, Ferrandina, G, Landoni, F, Bazzurini, L, Grassi, T, Vitobello, D, Siesto, G, Perrone, A, Zanagnolo, V, De Iaco, P, Multinu, F, Ghezzi, F, Casarin, J, Berretta, R, Capozzi, V, Zupi, E, Centini, G, Pellegrino, A, Corso, S, Stevenazzi, G, Montoli, S, Boschi, A, Comerci, G, Greco, P, Martinello, R, Sopracordevole, F, Giorda, G, Simoncini, T, Caretto, M, Sartori, E, Ferrari, F, Cianci, A, Sarpietro, G, Matarazzo, M, Zullo, F, Bifulco, G, Morelli, M, Ferrero, A, Biglia, N, Barra, F, Ferrero, S, Leone Roberti Maggiore, U, Cianci, S, Chiantera, V, Ercoli, A, Sozzi, G, Martoccia, A, Schettini, S, Orlando, T, Cannone, F, Ettore, G, Puppo, A, Borghese, M, Martinelli, C, Muzii, L, Di Donato, V, Driul, L, Restaino, S, Bergamini, A, Candotti, G, Bocciolone, L, Plotti, F, Angioli, R, Mantovani, G, Ceccaroni, M, Cassani, C, Dominoni, M, Giambanco, L, Amodeo, S, Leo, L, Thomasset, R, Raimondo, D, Seracchioli, R, Malzoni, M, Gorlero, F, Di Luca, M, Busato, E, Kilzie, S, Dell'Acqua, A, Scarfone, G, Vercellini, P, Petrillo, M, Dessole, S, Capobianco, G, Ciavattini, A, Delli Carpini, G, Giannella, L, Mereu, L, Tateo, S, Sorbi, F, Fambrini, M, Cicogna, S, Romano, F, Ricci, G, Trojano, G, Consonni, R, Cantaluppi, S, Lippolis, A, Tinelli, R, D'Ippolito, G, Aguzzoli, L, Mandato, V, Palomba, S, Calandra, D, Rosati, M, Gallo, C, Surico, D, Remorgida, V, Ruscitto, F, Beretta, P, Benedetti Panici, P, Raspagliesi, F, Bogani, Giorgio, Scambia, Giovanni, Cimmino, Chiara, Fanfani, Francesco, Costantini, Barbara, Loverro, Matteo, Ferrandina, Gabriella, Landoni, Fabio, Bazzurini, Luca, Grassi, Tommaso, Vitobello, Domenico, Siesto, Gabriele, Perrone, Anna Myriam, Zanagnolo, Vanna, De Iaco, Pierandrea, Multinu, Francesco, Ghezzi, Fabio, Casarin, Jvan, Berretta, Roberto, Capozzi, Vito A, Zupi, Errico, Centini, Gabriele, Pellegrino, Antonio, Corso, Silvia, Stevenazzi, Guido, Montoli, Serena, Boschi, Anna Chiara, Comerci, Giuseppe, Greco, Pantaleo, Martinello, Ruby, Sopracordevole, Francesco, Giorda, Giorgio, Simoncini, Tommaso, Caretto, Marta, Sartori, Enrico, Ferrari, Federico, Cianci, Antonio, Sarpietro, Giuseppe, Matarazzo, Maria Grazia, Zullo, Fulvio, Bifulco, Giuseppe, Morelli, Michele, Ferrero, Annamaria, Biglia, Nicoletta, Barra, Fabio, Ferrero, Simone, Leone Roberti Maggiore, Umberto, Cianci, Stefano, Chiantera, Vito, Ercoli, Alfredo, Sozzi, Giulio, Martoccia, Angela, Schettini, Sergio, Orlando, Teresa, Cannone, Francesco G, Ettore, Giuseppe, Puppo, Andrea, Borghese, Martina, Martinelli, Canio, Muzii, Ludovico, Di Donato, Violante, Driul, Lorenza, Restaino, Stefano, Bergamini, Alice, Candotti, Giorgio, Bocciolone, Luca, Plotti, Francesco, Angioli, Roberto, Mantovani, Giulia, Ceccaroni, Marcello, Cassani, Chiara, Dominoni, Mattia, Giambanco, Laura, Amodeo, Silvia, Leo, Livio, Thomasset, Raphael, Raimondo, Diego, Seracchioli, Renato, Malzoni, Mario, Gorlero, Franco, Di Luca, Martina, Busato, Enrico, Kilzie, Sami, Dell'Acqua, Andrea, Scarfone, Giovanna, Vercellini, Paolo, Petrillo, Marco, Dessole, Salvatore, Capobianco, Giampiero, Ciavattini, Andrea, Delli Carpini, Giovanni, Giannella, Luca, Mereu, Liliana, Tateo, Saverio, Sorbi, Flavia, Fambrini, Massimiliano, Cicogna, Stefania, Romano, Federico, Ricci, Giuseppe, Trojano, Giuseppe, Consonni, Roberto, Cantaluppi, Simona, Lippolis, Antonio, Tinelli, Raffaele, D'Ippolito, Giovanni, Aguzzoli, Lorenzo, Mandato, Vincenzo D, Palomba, Stefano, Calandra, Davide, Rosati, Maurizio, Gallo, Cinzia, Surico, Daniela, Remorgida, Valentino, Ruscitto, Francesco, Beretta, Paolo, Benedetti Panici, Pierluigi, and Raspagliesi, Francesco

Abstract

Objective: Coronavirus disease 2019 (COVID-19) outbreak has correlated with the disruption of screening activities and diagnostic assessments. Endometrial cancer (EC) is one of the most common gynecological malignancies and it is often detected at an early stage, because it frequently produces symptoms. Here, we aim to investigate the impact of COVID-19 outbreak on patterns of presentation and treatment of EC patients. Methods: This is a retrospective study involving 54 centers in Italy. We evaluated patterns of presentation and treatment of EC patients before (period 1: March 1, 2019 to February 29, 2020) and during (period 2: April 1, 2020 to March 31, 2021) the COVID-19 outbreak. Results: Medical records of 5,164 EC patients have been retrieved: 2,718 and 2,446 women treated in period 1 and period 2, respectively. Surgery was the mainstay of treatment in both periods (p=0.356). Nodal assessment was omitted in 689 (27.3%) and 484 (21.2%) patients treated in period 1 and 2, respectively (p<0.001). While, the prevalence of patients undergoing sentinel node mapping (with or without backup lymphadenectomy) has increased during the COVID-19 pandemic (46.7% in period 1 vs. 52.8% in period 2; p<0.001). Overall, 1,280 (50.4%) and 1,021 (44.7%) patients had no adjuvant therapy in period 1 and 2, respectively (p<0.001). Adjuvant therapy use has increased during COVID-19 pandemic (p<0.001). Conclusion: Our data suggest that the COVID-19 pandemic had a significant impact on the characteristics and patterns of care of EC patients. These findings highlight the need to implement healthcare services during the pandemic.

Published
2022

5. 800P Tailoring adjuvant treatments in high-risk early stage endometrial cancer: Clinical outcomes of sequential chemoradiation in a real-word scenario

Author

de Scordilli, M., primary, Bartoletti, M., additional, Palazzari, E., additional, Mazzeo, R., additional, Michelotti, A., additional, Alberti, M., additional, Gerratana, L., additional, Nicoloso, M.S., additional, Corsetti, S., additional, Scalone, S., additional, Gigante, M., additional, Forte, S., additional, Clemente, N., additional, Del Fabro, A., additional, Lucia, E., additional, Ganis, A., additional, Giorda, G., additional, Canzonieri, V., additional, Sorio, R., additional, and Puglisi, F., additional

Published
2021
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6. Randomized Trial of Cytoreductive Surgery for Relapsed Ovarian Cancer

Author

Philipp, H, Jalid, S, Ignace, V, Gwenael, F, Alexander, R, Werner, M, Stefano, G, Berit J, M, Frederic, S, Frédéric, G, Christophe, P, Fabrice, L, Rongyu, Z, Elisabeth, A, Jae-Weon, K, Jordi, P, Francesco, R, Gunnar, K, Jean-Marc, C, Peter, H, Pernille, J, Annette, H, Sadaf, G, Mansoor R, M, Bente, L, Ana, S, Adeola, O, Felix, H, Andreas, D, Buchholz, S, Burges, A, Canzler, U, Denschlag, D, El-Balat, A, Emons, G, Felberbaum, R, de Gregorio, N, Gropp-Meier, M, Hanf, V, Hanker, L, Hils, R, Kurzeder, C, Lampe, B, Mustea, A, Schmidt, M, Schutz, R, Weigel, M, Weiser, S, Zorr, A, Marth, C, Petru, E, Scholl, T, Beltran, M, Bover, I, Gomez di Laino, A, Lainez, N, Martinez, S, Poveda Velasco, A, Romeo, M, Crouet, H, de Gournay, E, Deplanque, G, Follana, P, Floquet, A, Lanvin, D, Leveque, J, Pujade-Lauraine, E, Raban, N, Resch, B, M Savoye, A, Aletti, G, Giorda, G, Landoni, F, Scaffa, C, Abu, J, Alexander-Sefre, F, Barton, D, Butler-Manuel, S, Clayton, R, Crawford, R, Duncan, T, El-Ghobashy, A, Fotopoulou, C, Hall, M, Intrivici, C, Lawrence, A, Luesley, D, Naik, R, Nordin, A, Tidy, J, Fokdahl, L, Hofsjö, A, Kjolhede, P, Eyjolfsdottir, B, Y Dai, Z, Zhang, P, Aminossadati, B, Hahmann, M, Nasemann, C, Yahiaoui, S, Wittenberg, M, Schade-Brittinger, C, Elser, G, Reddig, D, Kuncke, M, Polleis, S, Mattukat, Y, Riha, A, Berger, R, de Roover, J, Kaur, B, Crook, J, Nepote, F, Votan, B, Andriamamonjy, M, Bryce, J, Ristinge, S, Harter, Philipp, Sehouli, Jalid, Vergote, Ignace, Ferron, Gwenael, Reuss, Alexander, Meier, Werner, Greggi, Stefano, Mosgard, Berit J, Selle, Frederic, Guyon, Frédéric, Pomel, Christophe, Lécuru, Fabrice, Zang, Rongyu, Avall-Lundqvist, Elisabeth, Kim, Jae-Weon, Ponce, Jordi, Raspagliesi, Francesco, Kristensen, Gunnar, Classe, Jean-Marc, Hillemanns, Peter, Jensen, Pernille, Hasenburg, Annette, Ghaem-Maghami, Sadaf, Mirza, Mansoor R, Lund, Bente, Reinthaller, Alexander, Santaballa, Ana, Olaitan, Adeola, Hilpert, Felix, du Bois, Andreas, S Buchholz, A Burges, U Canzler, D Denschlag, A El-Balat, G Emons, R Felberbaum, N de Gregorio, M Gropp-Meier, V Hanf, L Hanker, R Hils, C Kurzeder, B Lampe, A Mustea, M Schmidt, R Schutz, M Weigel, S Weiser, A Zorr, C Marth, E Petru, T Scholl, M Beltran, I Bover, A Gomez di Laino, N Lainez, S Martinez, A Poveda Velasco, M Romeo, H Crouet, E de Gournay, G Deplanque, P Follana, A Floquet, D Lanvin, J Leveque, E Pujade-Lauraine, N Raban, B Resch, A M Savoye, G Aletti, G Giorda, F Landoni, C Scaffa, J Abu, F Alexander-Sefre, D Barton, S Butler-Manuel, R Clayton, R Crawford, T Duncan, A El-Ghobashy, C Fotopoulou, M Hall, C Intrivici, A Lawrence, D Luesley, R Naik, A Nordin, J Tidy, L Fokdahl, A Hofsjö, P Kjolhede, B Eyjolfsdottir, Z Y Dai, P Zhang, B Aminossadati, M Hahmann, C Nasemann, S Yahiaoui, M Wittenberg, C Schade-Brittinger, G Elser, D Reddig, M Kuncke, S Polleis, Y Mattukat, A Riha, R Berger, J de Roover, B Kaur, J Crook, F Nepote, B Votan, M Andriamamonjy, J Bryce, S Ristinge, Philipp, H, Jalid, S, Ignace, V, Gwenael, F, Alexander, R, Werner, M, Stefano, G, Berit J, M, Frederic, S, Frédéric, G, Christophe, P, Fabrice, L, Rongyu, Z, Elisabeth, A, Jae-Weon, K, Jordi, P, Francesco, R, Gunnar, K, Jean-Marc, C, Peter, H, Pernille, J, Annette, H, Sadaf, G, Mansoor R, M, Bente, L, Ana, S, Adeola, O, Felix, H, Andreas, D, Buchholz, S, Burges, A, Canzler, U, Denschlag, D, El-Balat, A, Emons, G, Felberbaum, R, de Gregorio, N, Gropp-Meier, M, Hanf, V, Hanker, L, Hils, R, Kurzeder, C, Lampe, B, Mustea, A, Schmidt, M, Schutz, R, Weigel, M, Weiser, S, Zorr, A, Marth, C, Petru, E, Scholl, T, Beltran, M, Bover, I, Gomez di Laino, A, Lainez, N, Martinez, S, Poveda Velasco, A, Romeo, M, Crouet, H, de Gournay, E, Deplanque, G, Follana, P, Floquet, A, Lanvin, D, Leveque, J, Pujade-Lauraine, E, Raban, N, Resch, B, M Savoye, A, Aletti, G, Giorda, G, Landoni, F, Scaffa, C, Abu, J, Alexander-Sefre, F, Barton, D, Butler-Manuel, S, Clayton, R, Crawford, R, Duncan, T, El-Ghobashy, A, Fotopoulou, C, Hall, M, Intrivici, C, Lawrence, A, Luesley, D, Naik, R, Nordin, A, Tidy, J, Fokdahl, L, Hofsjö, A, Kjolhede, P, Eyjolfsdottir, B, Y Dai, Z, Zhang, P, Aminossadati, B, Hahmann, M, Nasemann, C, Yahiaoui, S, Wittenberg, M, Schade-Brittinger, C, Elser, G, Reddig, D, Kuncke, M, Polleis, S, Mattukat, Y, Riha, A, Berger, R, de Roover, J, Kaur, B, Crook, J, Nepote, F, Votan, B, Andriamamonjy, M, Bryce, J, Ristinge, S, Harter, Philipp, Sehouli, Jalid, Vergote, Ignace, Ferron, Gwenael, Reuss, Alexander, Meier, Werner, Greggi, Stefano, Mosgard, Berit J, Selle, Frederic, Guyon, Frédéric, Pomel, Christophe, Lécuru, Fabrice, Zang, Rongyu, Avall-Lundqvist, Elisabeth, Kim, Jae-Weon, Ponce, Jordi, Raspagliesi, Francesco, Kristensen, Gunnar, Classe, Jean-Marc, Hillemanns, Peter, Jensen, Pernille, Hasenburg, Annette, Ghaem-Maghami, Sadaf, Mirza, Mansoor R, Lund, Bente, Reinthaller, Alexander, Santaballa, Ana, Olaitan, Adeola, Hilpert, Felix, du Bois, Andreas, S Buchholz, A Burges, U Canzler, D Denschlag, A El-Balat, G Emons, R Felberbaum, N de Gregorio, M Gropp-Meier, V Hanf, L Hanker, R Hils, C Kurzeder, B Lampe, A Mustea, M Schmidt, R Schutz, M Weigel, S Weiser, A Zorr, C Marth, E Petru, T Scholl, M Beltran, I Bover, A Gomez di Laino, N Lainez, S Martinez, A Poveda Velasco, M Romeo, H Crouet, E de Gournay, G Deplanque, P Follana, A Floquet, D Lanvin, J Leveque, E Pujade-Lauraine, N Raban, B Resch, A M Savoye, G Aletti, G Giorda, F Landoni, C Scaffa, J Abu, F Alexander-Sefre, D Barton, S Butler-Manuel, R Clayton, R Crawford, T Duncan, A El-Ghobashy, C Fotopoulou, M Hall, C Intrivici, A Lawrence, D Luesley, R Naik, A Nordin, J Tidy, L Fokdahl, A Hofsjö, P Kjolhede, B Eyjolfsdottir, Z Y Dai, P Zhang, B Aminossadati, M Hahmann, C Nasemann, S Yahiaoui, M Wittenberg, C Schade-Brittinger, G Elser, D Reddig, M Kuncke, S Polleis, Y Mattukat, A Riha, R Berger, J de Roover, B Kaur, J Crook, F Nepote, B Votan, M Andriamamonjy, J Bryce, and S Ristinge

Abstract

BACKGROUND Treatment for patients with recurrent ovarian cancer has been mainly based on systemic therapy. The role of secondary cytoreductive surgery is unclear. METHODS We randomly assigned patients with recurrent ovarian cancer who had a first relapse after a platinum-free interval (an interval during which no platinum-based chemotherapy was used) of 6 months or more to undergo secondary cytoreductive surgery and then receive platinum-based chemotherapy or to receive platinumbased chemotherapy alone. Patients were eligible if they presented with a positive Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) score, defined as an Eastern Cooperative Oncology Group performance-status score of 0 (on a 5-point scale, with higher scores indicating greater disability), ascites of less than 500 ml, and complete resection at initial surgery. A positive AGO score is used to identify patients in whom a complete resection might be achieved. The primary end point was overall survival. We also assessed quality of life and prognostic factors for survival. RESULTS A total of 407 patients underwent randomization: 206 were assigned to cytoreductive surgery and chemotherapy, and 201 to chemotherapy alone. A complete resection was achieved in 75.5% of the patients in the surgery group who underwent the procedure. The median overall survival was 53.7 months in the surgery group and 46.0 months in the no-surgery group (hazard ratio for death, 0.75; 95% confidence interval, 0.59 to 0.96; P = 0.02). Patients with a complete resection had the most favorable outcome, with a median overall survival of 61.9 months. A benefit from surgery was seen in all analyses in subgroups according to prognostic factors. Quality-of-life measures through 1 year of follow-up did not differ between the two groups, and we observed no perioperative mortality within 30 days after surgery. CONCLUSIONS In women with recurrent ovarian cancer, cytoreductive surgery followed by chemotherapy resulted in longer overa

Published
2021

8. Neutrophil-to-lymphocyte ratio predicts platinum sensitivity in epithelial ovarian cancer patients: A MITO24 retrospective study

Author

Farolfi, A., primary, Scarpi, E., additional, Greco, F., additional, Bergamini, A., additional, Longo, L., additional, Pignata, S., additional, Casanova, C., additional, De Vecchio, V.l., additional, Bologna, A., additional, Orditura, M., additional, Zavallone, L., additional, Ventriglia, J., additional, Gallà, V., additional, Franzese, E., additional, Pigozzi, E., additional, Loizzi, V., additional, Giorda, G., additional, Giardina, D., additional, Cioffi, R., additional, and De Giorgi, U., additional

Published
2019
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9. Advanced ovarian cancer: Is residual disease after debulking surgery affected by genetics factors involved in angiogenesis and immunity pathways?

Author

Bartoletti, M., primary, Gagno, S., additional, Poletto, E., additional, Garziera, M., additional, Scalone, S., additional, Dreussi, E., additional, Zanusso, C., additional, Roncato, R., additional, Cecchin, E., additional, De Mattia, E., additional, Sorio, R., additional, Giorda, G., additional, Quartuccio, L., additional, De Vita, S., additional, Romualdi, C., additional, Puglisi, F., additional, and Toffoli, G., additional

Published
2019
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10. Conservative treatment of coexisting microinvasive squamous and adenocarcinoma of the cervix: report of two cases and literature review

Author

Sopracordevole F, Di Giuseppe J, Cervo S, Buttignol M, Giorda G, Ciavattini A, and Canzonieri V

Subjects
micro-invasive squamous cell carcinoma, Micro-invasive adenocarcinoma, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, uterine cervical neoplasms, lcsh:RC254-282
Abstract

Francesco Sopracordevole,1,* Jacopo Di Giuseppe,2,* Silvia Cervo,3,4 Monica Buttignol,1 Giorgio Giorda,1 Andrea Ciavattini,2 Vincenzo Canzonieri3,5 1Gynecologic Oncology Unit, Department of Surgical Oncology, CRO Aviano National Cancer Institute, Aviano, Pordenone, 2Woman’s Health Sciences Department, Gynaecologic Section, Polytechnic University of Marche, Ancona, 3CRO-Biobank, 4Clinical Cancer Pathology, 5Pathology Unit, CRO Aviano National Cancer Institute, Aviano, Pordenone, Italy *These authors contributed equally tothis work Abstract: Coexistence of microinvasive squamous cell carcinoma (MISCC) and microinvasive adenocarcinoma (MIAC) of the cervix is a rare phenomenon with very few clinically significant cases described in the literature. While a conservative approach has been studied, and may be effective in MISCC, a lower number of studies that recommend conservative treatment are available for MIAC. We report two cases of synchronous cervix lesions in two separate foci, MISCC and MIAC, who underwent fertility-sparing treatment with long-term follow-up. We describe clinical, histological, and immunohistochemical features of the two cases. The first case is a 41-year-old female with a diagnosis of MIAC of endocervical type, grade 1 differentiation, with a stromal invasion, associated with a separate area of squamous cell carcinoma (International Federation of Gynecology and Obstetrics/TNM stage: pT1a1G1). The second case is a 45-year-old female with a diagnosis of plurifocal MISCC, associated with an MIAC of endocervical type with a stromal invasion (International Federation of Gynecology and Obstetrics/TNM stage: pT1a1G1). After multidisciplinary counseling, both patients accepted conization as definitive treatment. Eleven years after the conization, all tests (Papanicolaou smear, colposcopy, cervical curettage, and hybrid capture 2-human papillomavirus test) planned quarterly in the first year and every 6 months in the subsequent years were negative in both patients. In women affected by stage IA1 squamous cervical cancer coexisting with stage IA1 adenocarcinoma endocervical type, with clear margins, and without lymphovascular space invasion, cervical conization may be considered a fertility-preserving, safe, and definitive therapeutic option. Keywords: cervical conization, cervical lesions, FIGO stage, microinvasive adenocarcinoma, microinvasive squamous cell carcinoma, uterine cervical neoplasms

Published
2016

11. Conservative surgery in stage I adult type granulosa cells tumors of the ovary: Results from the MITO-9 study

Author

Bergamini, A, Cormio, G, Ferrandina, Maria Gabriella, Lorusso, D, Giorda, G, Scarfone, G, Bocciolone, L, Raspagliesi, F, Tateo, S, Cassani, C, Savarese, A, Breda, E, De Giorgi, U, Mascilini, Floriana, Candiani, M, Kardhashi, A, Biglia, N, Perrone, A M, Pignata, S, Mangili, G, Ferrandina, G (ORCID:0000-0003-4672-4197), Mascilini, F, Bergamini, A, Cormio, G, Ferrandina, Maria Gabriella, Lorusso, D, Giorda, G, Scarfone, G, Bocciolone, L, Raspagliesi, F, Tateo, S, Cassani, C, Savarese, A, Breda, E, De Giorgi, U, Mascilini, Floriana, Candiani, M, Kardhashi, A, Biglia, N, Perrone, A M, Pignata, S, Mangili, G, Ferrandina, G (ORCID:0000-0003-4672-4197), and Mascilini, F

Abstract

Objective. About 30% of Adult type granulosa cell tumors of the ovary (AGCTs) are diagnosed in fertile age. In stage I, conservative surgery (fertility-sparing surgery, FSS), either unilateral salpingo-oophorectomy (USO) or cystectomy are possible options. The aim of this study is to compare oncological outcomes of FSS and radical surgery (RS) in apparently stage I AGCTs treated within the MITO group (Multicenter Italian Trials in Ovarian cancer). Methods. Survival curves were calculated using the Kaplan-Meiermethod and comparedwith log-rank test. The role of clinicopathological variables as prognostic factors for survival was assessed using Cox's regression. Results. Two-hundred and twenty-nine patients were included; 32.6% received FSS, 67.4% RS. In the FSS group, 62.8% underwent USO, 16.7% cystectomy, 20.5% cystectomy followed by USO. After a median follow up of 84 months, median DFS was significantly worse in the FSS-group (10 yr DFS 50% vs 74%, in FSS and RS group, p = 0.006). No significant difference was detected between RS and USO (10 yr DFS 75% vs 70%, p = 0.5). Cystectomy-group showed a significantly worse DFS compared to USO (10 yr DFS 16% vs 70%, p b 0.001). Patients receiving cystectomy and subsequent USO showed a better prognosis, even though significantly worse compared to USO (10 yr DFS 41% vs 70%, p=0.05). Between FSS and RS, no difference in OS was detected. Atmultivariate analysis,FIGO stage IC and cystectomy retained significant predictive value for worse survival. Conclusions. This study supports the oncological safety of FSS in stage I AGCTs, provided that cystectomy is avoided; USO should be the preferred approach

Published
2019

12. Laparoscopic surgery in the treatment of stage I adult granulosa cells tumors of the ovary: Results from the MITO-9 study

Author

Bergamini, A., Ferrandina, G., Candiani, M., Cormio, G., Giorda, G., Lauria, R., Perrone, A. M., Scarfone, G., Breda, E., Savarese, A., Frigerio, L., Gadducci, A., Mascilini, F., Maneschi, F., Cassani, C., Marchetti, C., Cecere, S. C., Biglia, N., De Giorgi, U., Raspagliesi, F., Lorusso, D., Mangili, G., Ferrandina, G. (ORCID:0000-0003-4672-4197), Marchetti, C. (ORCID:0000-0001-7098-8956), Bergamini, A., Ferrandina, G., Candiani, M., Cormio, G., Giorda, G., Lauria, R., Perrone, A. M., Scarfone, G., Breda, E., Savarese, A., Frigerio, L., Gadducci, A., Mascilini, F., Maneschi, F., Cassani, C., Marchetti, C., Cecere, S. C., Biglia, N., De Giorgi, U., Raspagliesi, F., Lorusso, D., Mangili, G., Ferrandina, G. (ORCID:0000-0003-4672-4197), and Marchetti, C. (ORCID:0000-0001-7098-8956)

Abstract

Objective: Surgery represents the mainstay of treatment of stage I adult type granulosa cell tumors of the ovary (AGCTs). Because of the rarity and indolent course of the disease, no prospective trials are available. Open surgery has long been considered the traditional approach; oncological safety of laparoscopy is only supported by small series or case reports. The aim of this study was to compare the oncological outcomes between laparoscopic and open surgery in stage I AGCTs treated within the MITO (Multicenter Italian Trials in Ovarian cancer) Group. Methods: Data from patients with stage I AGCTs were retrospectively collected. Clinicopathological features were evaluated for association with relapse and death. Survival curves were calculated using the Kaplan-Meier method and compared with the log-rank test. The role of clinicopathological variables as prognostic factors for survival was evaluated using Cox's regression model. Results: 223 patients were identified. Stage 1A, 1B and 1C were 61.5%, 1.3% and 29.6% respectively. 7.6% were apparently stage I. Surgical approach was laparoscopic for 93 patients (41.7%) and open for 130 (58.3%). 5-years DFS was 84% and 82%, 10-years DFS was 68% and 64% for the laparoscopic and open-group (p = 0.6).5-years OS was 100% and 99%, 10 years OS was 98% and 97% for the laparoscopic and open-surgery group (p = 0.8). At multivariate analyses stage IC, incomplete staging, site of primary surgery retained significant prognostic value. Conclusion: The present study suggests that surgical route does not affect the oncological safety of patients with stage I AGCTs, with comparable outcomes between laparoscopic and open approach.

Published
2018

14. Tertiary cytoreductive surgery in recurrent epithelial ovarian cancer: A multicentre MITO retrospective study

Author

Falcone, F., Scambia, Giovanni, Benedetti Panici, P., Signorelli, M., Cormio, G., Giorda, G., Bogliolo, S., Marinaccio, M., Ghezzi, F., Rabaiotti, E., Breda, E., Casella, G., Fanfani, Francesco, Di Donato, V., Leone Roberti Maggiore, U., Greggi, Stefano, Scambia, G. (ORCID:0000-0003-2758-1063), Fanfani, F. (ORCID:0000-0003-1991-7284), Greggi, S., Falcone, F., Scambia, Giovanni, Benedetti Panici, P., Signorelli, M., Cormio, G., Giorda, G., Bogliolo, S., Marinaccio, M., Ghezzi, F., Rabaiotti, E., Breda, E., Casella, G., Fanfani, Francesco, Di Donato, V., Leone Roberti Maggiore, U., Greggi, Stefano, Scambia, G. (ORCID:0000-0003-2758-1063), Fanfani, F. (ORCID:0000-0003-1991-7284), and Greggi, S.

Abstract

Objectives To evaluate the impact of tertiary cytoreductive surgery (TCS) on survival in recurrent epithelial ovarian cancer (EOC), and to determine predictors of complete cytoreduction. Methods A multi-institutional retrospective study was conducted within the MITO Group on a 5-year observation period. Results A total of 103 EOC patients with a â ¥ 6 month treatment-free interval (TFI) undergoing TCS were included. Complete cytoreduction was achieved in 71 patients (68.9%), with severe post-operative complications in 9.7%, and no cases of mortality within 60 days from surgery. Multivariate analysis identified the complete tertiary cytoreduction as the most potent predictor of survival followed by FIGO stage Iâ II at initial diagnosis, exclusive retroperitoneal recurrence, and TCS performed â ¥ 3 years after primary diagnosis. Patients with complete tertiary cytoreduction had a significantly longer overall survival (median OS: 43 months, 95% CI 31â 58) compared to those with residual tumor (median OS: 33 months, 95% CI 28â 46; p < 0.001). After multivariate adjustment the presence of a single lesion and good (ECOG 0) performance status were the only significant predictors of complete surgical cytoreduction. Conclusions This is the only large multicentre study published so far on TCS in EOC with â ¥ 6 month TFI. The achievement of postoperative no residual disease is confirmed as the primary objective also in a TCS setting, with significant survival benefit and acceptable morbidity. Accurate patient selection is of utmost importance to have the best chance of complete cytoreduction.

Published
2017

16. Prevention of lymphocele in female pelvic lymphadenectomy by a collagen patch coated with the human coagulation factors: a pilot study

Author

Tinelli A., Giorda G., Manca C., Pellegrino M., Prudenzano R., Dell'Edera D., Malvasi A., GUIDO, Marcello, Tinelli, A., Giorda, G., Manca, C., Pellegrino, M., Prudenzano, R., Guido, Marcello, Dell'Edera, D., and Malvasi, A.

Subjects
pelvic lymphadenectomy, radical hysterectomy, endometrial cancer, lymphocele, complication, pelvis, lymph node, lymphocyst, drainage
Abstract

Background and Objectives: The prevention of lymphoceles was tested using collagen patch coated with the human coagulation factors (TachoSil) on 58 consecutive patients with endometrial cancer who had undergone hysterectomy and pelvic lymphadenectomy (PL). Methods: Patients were randomized in two groups: standard technique plus TachoSil (30 patients, group 1) and standard technique only (28, group 2). All surgical parameters were collected and patients underwent ultrasound examination on postoperative days 7, 14, and 28. The main outcome measures were: the development of symptomatic or asymptomatic lymphoceles, the need for further surgical intervention, as adverse effect of surgery and the drainage volume and duration. Results: Same number of lymph nodes in both groups was removed; group 1 showed a lower drainage volume. Lymphoceles developed in 7 patients in group 1 and 16 in group 2, but only 3 were symptomatic in group 1 and 9 symptomatic in group 2, with statistical difference. Percutaneous drainage proved necessary in five cases: only one was in group 1 and four in group 2. Conclusions: Intraoperative application of TachoSil reduced rate of postoperative lymphocysts after PL, and it seems to provide a useful additional treatment option for reducing drainage volume and preventing lymphocele development after PL.

Published
2012
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20. Adjuvant chemotherapy does not improve disease-free survival in FIGO stage IC ovarian granulosa cell tumors: The MITO-9 study

Author

Mangili, G, Ottolina, J., Cormio, G., Loizzi, Vera, De Iaco, P., Pellegrini, D. A., Candiani, M., Giorda, G., Scarfone, G., Cecere, S. C., Frigerio, L., Gadducci, A., Marchetti, Claudia, Ferrandina, Maria Gabriella, Marchetti, C. (ORCID:0000-0001-7098-8956), Ferrandina, Maria Gabriella (ORCID:0000-0003-4672-4197), Mangili, G, Ottolina, J., Cormio, G., Loizzi, Vera, De Iaco, P., Pellegrini, D. A., Candiani, M., Giorda, G., Scarfone, G., Cecere, S. C., Frigerio, L., Gadducci, A., Marchetti, Claudia, Ferrandina, Maria Gabriella, Marchetti, C. (ORCID:0000-0001-7098-8956), and Ferrandina, Maria Gabriella (ORCID:0000-0003-4672-4197)

Abstract

Objective Evidence-based management of granulosa cell tumors of the ovary (GCT) has been not yet standardized: surgery, including fertility-sparing procedures for young women, has been traditionally the standard treatment; on the other hand, chemotherapy has been used for treatment of advanced and/or recurrent disease. However, very limited experience, has been selectively focused on the role of adjuvant chemotherapy in stage IC patients. The objective of this retrospective study was to assess the efficacy of first line postoperative chemotherapy in patients with stage IC treated at the Italian Centers involved in the MITO (Multicenter Italian Trials in Ovarian cancer) Group. Patients and methods A retrospective multi-institutional review of patients with GCT of the ovary at FIGO stage IC treated or referred to MITO centers was conducted. Surgical outcome, pathological findings and follow-up data were analysed. Kaplan–Meier and Cox proportional hazards analyses were used to determine the predictors factors for disease free survival. Results A total of 40 patients with primary GCT of the ovary at FIGO stage IC were identified. The median follow-up period was 96 months (range 7–300). At multivariate analysis, surgical treatment outside MITO centers and incomplete surgical staging were independent poor prognostic indicators for recurrence; adjuvant chemotherapy did not retain significant predictive value for recurrence. Conclusions This study raises the question about the value of adjuvant chemotherapy in stage IC GCT: a comprehensive evaluation of a larger series is urgently needed in order to characterize stage IC substages who can be spared treatment toxicity.

Published
2016

21. REQUISITI ESSENZIALI PER IL TRATTAMENTO DELLE NEOPLASIE GINECOLOGICHE

Author

Angioli, R, BENEDETTI PANICI, Pierluigi, Bianchi, Ua, Biglia, N, Campagnutta, E, Carinelli, S, Cherchi, Pl, Colombo, A, Colombo, N, Ditto, A, DI VAGNO, G, Ferrandina, G, Franchi, M, Frigerio, L, Gadducci, A, Ghezzi, F, Giorda, G, Fiudici, S, Greggi, S, Lukic, Ankica, Maggioni, A, Maneo, A, Mangili, G, Mangioni, C, Mariani, L, Micheletti, L, Odicino, F, Pecorelli, S, Raspagliesi, F, Sartori, E, Scambia, G, Scibilia, G, Scollo, P, Sismondi, P, and Zanaboni

Published
2010

23. Management of endometrial cancer in Italy: A national survey endorsed by the Italian Society of Gynecologic Oncology

Author

Greggi, S., Franchi, M., Aletti, G., Biglia, N., Ditto, A., Fagotti, Anna, Giorda, G., Mangili, G., Odicino, F., Salerno, M. G., Vizza, E., Scaffa, C., Scollo, P., Fagotti A. (ORCID:0000-0001-5579-335X), Greggi, S., Franchi, M., Aletti, G., Biglia, N., Ditto, A., Fagotti, Anna, Giorda, G., Mangili, G., Odicino, F., Salerno, M. G., Vizza, E., Scaffa, C., Scollo, P., and Fagotti A. (ORCID:0000-0001-5579-335X)

Abstract

Introduction: Endometrial carcinoma (EC) is a frequent cancer in developed countries, but with evidence for discrepant clinical management. Under the auspices of the Italian Society of Gynecologic Oncology (SIOG), we conducted a survey among Italian centers with ≥20 surgeries for gynecological cancer per year, trying to depict a reliable picture of EC management in our country. Methods: The questionnaire focused on preoperative/surgical staging and adjuvant treatment. Of the 283 questionnaires delivered, 35% were sent back. Results: Diagnostic hysteroscopy is performed in 78% of centers. In clinical stage I, 52% adopt a laparotomic access, 15% totally laparoscopic, 9% laparoscopic/vaginal, 2% vaginal, 22% tailored approach. Elective use of laparoscopy significantly differs between institutions (. p<0.001): 40% (≥20EC/yr) vs. 12% (<20). Pelvic and aortic lymphadenectomy is selectively performed by 77% and 68% of centers, respectively, depending on pre/intraoperative factors. Non-endometrioid histology, poor-grade and deep myoinvasion are indicated as the highest-risk factors. Adjuvant therapy is given to pathologically node-negative patients by 60%, and to intermediate-risk patients by 47%. Elective adjuvant treatment is still radiotherapy, but chemotherapy is adopted, mostly combined with radiation, by 40%. There is a multidisciplinary team in 64% of centers, but in 59% adjuvant treatment is to be administered outside the institution. Conclusions: These data demonstrate a significant improvement in the clinical care achieved over the last decades in Italy. Centralization of EC treatment would not be feasible neither useful. High-risk cases could be selected by an appropriate clinical screening, and these only referred to reference centers.

Published
2014

26. Trend of decreasing length of cervical cone excision during the last 20 years

Author

Sopracordevole, F., Clemente, N., Giovanni Delli Carpini, Giorda, G., Del Fabro, A., Moriconi, L., Piero, G., Alessandrini, L., Canzonieri, V., Buttignol, M., Nicodemo, M., Ciavattini, A., Sopracordevole, F., Clemente, N., Delli Carpini, G., Giorda, G., Del Fabro, A., Moriconi, L., De Piero, G., Alessandrini, L., Canzonieri, V., Buttignol, M., Nicodemo, M., and Ciavattini, A.

Subjects
Adult, Conization, Cervical excision, Uterine Cervical Neoplasms, Cervix Uteri, Middle Aged, Cervical conization, CO2 laser conization, CIN, Cervical excision, Colposcopy, Lasers, Gas, Humans, Female, CIN, Retrospective Studies
Abstract

OBJECTIVE: The aim of the present investigation was to evaluate the cervical conizations performed in the last 20 years in a single institution, with a particular interest in analyzing the trend of the length of cone excisions.PATIENTS AND METHODS: A retrospective cohort study of women who underwent a CO2-laser cervical conization between January 1996 and December 2015. Cytological abnormalities on referral pap smear, colposcopic findings and pertinent clinical and socio-demographic characteristics of each woman were collected. In particular, the length of cone specimen was evaluated, taking into account all the factors potentially influencing the length of excision.RESULTS: A total of 1270 women who underwent cervical conization from January 1996 to December 2015 were included in the analysis. A mean cone length of 15.1 ± 5.7 mm was reported, and we observed a significant decrease in the length of cone excisions over the whole study period. Age (rpartial = 0.1543, p < 0.0001), see & treat procedure (rpartial = -0.1945, p < 0.0001) and grade II colposcopic findings (rpartial = 0.1540, p < 0.0001) were significantly associated with the length of cone excision on multivariate analysis.CONCLUSIONS: In the last 20 years, a significant decrease in the length of cone excision was observed. In our opinion, this can be due to the acquired awareness by the gynecologists of the potential disadvantages of wide cone excision in term of adverse obstetric outcomes in future pregnancies.

27. Fertility preservation methods for female neoplastic patients

Author

Del Pup, L., Campagnutta, E., Giorda, G., Piero, G., Francesco Sopracordevole, and Sisto, R.

Abstract

Background. The ability to have biological children is of great importance to cancer patients and fertility preservation before the oncological treatment isnowadays not rare. Oncologists have the responsibility to inform patients about the risks that their cancer treatment will permanently impair fertility and about the ways to limit this iatrogenic damage. Methods of fertility preservation are evolving quickly, yet the medical oncology literature is still poor regarding this topic. Indications and contraindications, limits andcontroversies of the fertility sparing techniques are reviewed in order to help the oncologist to counsel patients. Conclusions. Any oncologist seeing reproductive-aged patients should discuss the fertility implications of the oncological treatment and the fertility preservation options. A referral to appropriate fertility specialists as early as possible is recommended. People attempting fertility preservation in the context of cancer treatment are encouraged to enrol in clinical trials. Izhodišča. Biološko starševstvo je pomembno tudi za bolnike z rakom, zato vedno pogosteje že pred pričetkom onkološkega zdravljenja zaščitimo njihovo plodno sposobnost. Naloga onkologov je bolnike seznaniti z možnostjo, da bo onkološko zdravljenje lahko trajno okvarilo njihovo plodnost in kakšne so možnosti, da bi to jatrogeno okvaro zmanjšali ali preprečili. Metode zaščite plodnosti se zelo hitro razvijajo, čeprav o njih v strokovni literaturi ne poročajo velikokrat. Da bi onkologom pomagali pri svetovanju bolnicam z rakom,v članku navajamo indikacije, kontraindikacije, omejitve in kontraverznosti različnih zaščit plodnosti. Zaključki. Ko onkolog obravnava bolnice z rakom, ki so v rodnem obdobju, naj bolnice seznani z možnimi posledicami zdravljenja in z načini, da bi bolnica ohranila plodno sposobnost.Priporočamo, da bolnico čim prej napoti na posvet k strokovnjaku, ki ima izkušnje z zdravljenjem plodnosti. Če se bolnice odločijo za eno od metod zaščite plodnosti, predlagamo vključitve v študijske raziskave, ki bodo lahko pokazale učinkovitost posamičnih metod.

28. Lymphocele Prevention After Pelvic Laparoscopic Lymphadenectomy by a Collagen Patch Coated With Human Coagulation Factors A Matched Case-Control Study

Author

Tinelli A., Mynbaev O.A., Tsin D.A., Giorda G., Malvasi A., Guido M., Nezhat F.R., Tinelli A., Mynbaev O.A., Tsin D.A., Giorda G., Malvasi A., Guido M., and Nezhat F.R.

Abstract

Objective: Lymphoceles are among the most common postoperative complications of pelvic lymphadenectomy (PL), with a reported incidence of 1% to 50%. Symptoms are pelvic pain, leg edema, gastrointestinal obstruction, obstructive uropathy, and deep vein thrombosis, and severe complications such as sepsis and lymphatic fistula formation. After laparoscopic PL, we tested the prevention of lymphoceles using collagen patch coated with the human coagulation factors (TachoSil, Nycomed International Management GmbH, Zurich, Switzerland) on 55 patients with endometrial cancer stages IB to II who had undergone laparoscopy. Materials and Methods: The authors divided the patients into 2 laparoscopy groups: PL plus TachoSil (group 1: 26 patients) and PL without TachoSil in a control group (group 2: 29 patients), as historical cohort of patients who underwent PL between 2010 and 2012. We collected surgical parameters, and the patients underwent ultrasound examination on postoperative days 7, 14, and 28. The main outcome measures were the development of symptomatic or asymptomatic lymphoceles, the need for further surgical intervention, as adverse effect of surgery, and the drainage volume and duration. Results: The same number of lymph nodes in both groups was removed; group 1 showed a lower drainage volume. Lymphoceles developed in 5 patients in group 1 and in 15 patients in group 2; of these, only 2 patients were symptomatic in group 1 and 5 patients were symptomatic in group 2, without statistical difference and no percutaneous drainage request. Conclusions: In this preliminary investigation, the intraoperative laparoscopy application of TachoSil seems to reduce the rate of postoperative lymphoceles after PL, providing a useful additional treatment option for reducing drainage volume and preventing lymphocele development after PL.

29. Characteristics and patterns of care of endometrial cancer before and during COVID-19 pandemic

Author

Giorgio Bogani, Giovanni Scambia, Chiara Cimmino, Francesco Fanfani, Barbara Costantini, Matteo Loverro, Gabriella Ferrandina, Fabio Landoni, Luca Bazzurini, Tommaso Grassi, Domenico Vitobello, Gabriele Siesto, Anna Myriam Perrone, Vanna Zanagnolo, Pierandrea De Iaco, Francesco Multinu, Fabio Ghezzi, Jvan Casarin, Roberto Berretta, Vito A Capozzi, Errico Zupi, Gabriele Centini, Antonio Pellegrino, Silvia Corso, Guido Stevenazzi, Serena Montoli, Anna Chiara Boschi, Giuseppe Comerci, Pantaleo Greco, Ruby Martinello, Francesco Sopracordevole, Giorgio Giorda, Tommaso Simoncini, Marta Caretto, Enrico Sartori, Federico Ferrari, Antonio Cianci, Giuseppe Sarpietro, Maria Grazia Matarazzo, Fulvio Zullo, Giuseppe Bifulco, Michele Morelli, Annamaria Ferrero, Nicoletta Biglia, Fabio Barra, Simone Ferrero, Umberto Leone Roberti Maggiore, Stefano Cianci, Vito Chiantera, Alfredo Ercoli, Giulio Sozzi, Angela Martoccia, Sergio Schettini, Teresa Orlando, Francesco G Cannone, Giuseppe Ettore, Andrea Puppo, Martina Borghese, Canio Martinelli, Ludovico Muzii, Violante Di Donato, Lorenza Driul, Stefano Restaino, Alice Bergamini, Giorgio Candotti, Luca Bocciolone, Francesco Plotti, Roberto Angioli, Giulia Mantovani, Marcello Ceccaroni, Chiara Cassani, Mattia Dominoni, Laura Giambanco, Silvia Amodeo, Livio Leo, Raphael Thomasset, Diego Raimondo, Renato Seracchioli, Mario Malzoni, Franco Gorlero, Martina Di Luca, Enrico Busato, Sami Kilzie, Andrea Dell'Acqua, Giovanna Scarfone, Paolo Vercellini, Marco Petrillo, Salvatore Dessole, Giampiero Capobianco, Andrea Ciavattini, Giovanni Delli Carpini, Luca Giannella, Liliana Mereu, Saverio Tateo, Flavia Sorbi, Massimiliano Fambrini, Stefania Cicogna, Federico Romano, Giuseppe Ricci, Giuseppe Trojano, Roberto Consonni, Simona Cantaluppi, Antonio Lippolis, Raffaele Tinelli, Giovanni D'Ippolito, Lorenzo Aguzzoli, Vincenzo D Mandato, Stefano Palomba, Davide Calandra, Maurizio Rosati, Cinzia Gallo, Daniela Surico, Valentino Remorgida, Francesco Ruscitto, Paolo Beretta, Pierluigi Benedetti Panici, Francesco Raspagliesi, Bogani G., Scambia G., Cimmino C., Fanfani F., Costantini B., Loverro M., Ferrandina G., Landoni F., Bazzurini L., Grassi T., Vitobello D., Siesto G., Perrone A.M., Zanagnolo V., De Iaco P., Multinu F., Ghezzi F., Casarin J., Berretta R., Capozzi V.A., Zupi E., Centini G., Pellegrino A., Corso S., Stevenazzi G., Montoli S., Boschi A.C., Comerci G., Greco P., Martinello R., Sopracordevole F., Giorda G., Simoncini T., Caretto M., Sartori E., Ferrari F., Cianci A., Sarpietro G., Matarazzo M.G., Zullo F., Bifulco G., Morelli M., Ferrero A., Biglia N., Barra F., Ferrero S., Maggiore U.L.R., Cianci S., Chiantera V., Ercoli A., Sozzi G., Martoccia A., Schettini S., Orlando T., Cannone F.G., Ettore G., Puppo A., Borghese M., Martinelli C., Muzii L., Di Donato V., Driul L., Restaino S., Bergamini A., Candotti G., Bocciolone L., Plotti F., Angioli R., Mantovani G., Ceccaroni M., Cassani C., Dominoni M., Giambanco L., Amodeo S., Leo L., Thomasset R., Raimondo D., Seracchioli R., Malzoni M., Gorlero F., Di Luca M., Busato E., Kilzie S., Dell'acqua A., Scarfone G., Vercellini P., Petrillo M., Dessole S., Capobianco G., Ciavattini A., Delli Carpini G., Giannella L., Mereu L., Tateo S., Sorbi F., Fambrini M., Cicogna S., Romano F., Ricci G., Trojano G., Consonni R., Cantaluppi S., Lippolis A., Tinelli R., D'ippolito G., Aguzzoli L., Mandato V.D., Palomba S., Calandra D., Rosati M., Gallo C., Surico D., Remorgida V., Ruscitto F., Beretta P., Panici P.B., Raspagliesi F., Bogani, Giorgio, Scambia, Giovanni, Cimmino, Chiara, Fanfani, Francesco, Costantini, Barbara, Loverro, Matteo, Ferrandina, Gabriella, Landoni, Fabio, Bazzurini, Luca, Grassi, Tommaso, Vitobello, Domenico, Siesto, Gabriele, Perrone, Anna Myriam, Zanagnolo, Vanna, De Iaco, Pierandrea, Multinu, Francesco, Ghezzi, Fabio, Casarin, Jvan, Berretta, Roberto, Capozzi, Vito A, Zupi, Errico, Centini, Gabriele, Pellegrino, Antonio, Corso, Silvia, Stevenazzi, Guido, Montoli, Serena, Boschi, Anna Chiara, Comerci, Giuseppe, Greco, Pantaleo, Martinello, Ruby, Sopracordevole, Francesco, Giorda, Giorgio, Simoncini, Tommaso, Caretto, Marta, Sartori, Enrico, Ferrari, Federico, Cianci, Antonio, Sarpietro, Giuseppe, Matarazzo, Maria Grazia, Zullo, Fulvio, Bifulco, Giuseppe, Morelli, Michele, Ferrero, Annamaria, Biglia, Nicoletta, Barra, Fabio, Ferrero, Simone, Leone Roberti Maggiore, Umberto, Cianci, Stefano, Chiantera, Vito, Ercoli, Alfredo, Sozzi, Giulio, Martoccia, Angela, Schettini, Sergio, Orlando, Teresa, Cannone, Francesco G, Ettore, Giuseppe, Puppo, Andrea, Borghese, Martina, Martinelli, Canio, Muzii, Ludovico, Di Donato, Violante, Driul, Lorenza, Restaino, Stefano, Bergamini, Alice, Candotti, Giorgio, Bocciolone, Luca, Plotti, Francesco, Angioli, Roberto, Mantovani, Giulia, Ceccaroni, Marcello, Cassani, Chiara, Dominoni, Mattia, Giambanco, Laura, Amodeo, Silvia, Leo, Livio, Thomasset, Raphael, Raimondo, Diego, Seracchioli, Renato, Malzoni, Mario, Gorlero, Franco, Di Luca, Martina, Busato, Enrico, Kilzie, Sami, Dell'Acqua, Andrea, Scarfone, Giovanna, Vercellini, Paolo, Petrillo, Marco, Dessole, Salvatore, Capobianco, Giampiero, Ciavattini, Andrea, Delli Carpini, Giovanni, Giannella, Luca, Mereu, Liliana, Tateo, Saverio, Sorbi, Flavia, Fambrini, Massimiliano, Cicogna, Stefania, Romano, Federico, Ricci, Giuseppe, Trojano, Giuseppe, Consonni, Roberto, Cantaluppi, Simona, Lippolis, Antonio, Tinelli, Raffaele, D'Ippolito, Giovanni, Aguzzoli, Lorenzo, Mandato, Vincenzo D, Palomba, Stefano, Calandra, Davide, Rosati, Maurizio, Gallo, Cinzia, Surico, Daniela, Remorgida, Valentino, Ruscitto, Francesco, Beretta, Paolo, Benedetti Panici, Pierluigi, Raspagliesi, Francesco, Bogani, G., Scambia, G., Cimmino, C., Fanfani, F., Costantini, B., Loverro, M., Ferrandina, G., Landoni, F., Bazzurini, L., Grassi, T., Vitobello, D., Siesto, G., Perrone, A. M., Zanagnolo, V., De Iaco, P., Multinu, F., Ghezzi, F., Casarin, J., Berretta, R., Capozzi, V. A., Zupi, E., Centini, G., Pellegrino, A., Corso, S., Stevenazzi, G., Montoli, S., Boschi, A. C., Comerci, G., Greco, P., Martinello, R., Sopracordevole, F., Giorda, G., Simoncini, T., Caretto, M., Sartori, E., Ferrari, F., Cianci, A., Sarpietro, G., Matarazzo, M. G., Zullo, F., Bifulco, G., Morelli, M., Ferrero, A., Biglia, N., Barra, F., Ferrero, S., Leone Roberti Maggiore, U., Cianci, S., Chiantera, V., Ercoli, A., Sozzi, G., Martoccia, A., Schettini, S., Orlando, T., Cannone, F. G., Ettore, G., Puppo, A., Borghese, M., Martinelli, C., Muzii, L., Di Donato, V., Driul, L., Restaino, S., Bergamini, A., Candotti, G., Bocciolone, L., Plotti, F., Angioli, R., Mantovani, G., Ceccaroni, M., Cassani, C., Dominoni, M., Giambanco, L., Amodeo, S., Leo, L., Thomasset, R., Raimondo, D., Seracchioli, R., Malzoni, M., Gorlero, F., Di Luca, M., Busato, E., Kilzie, S., Dell'Acqua, A., Scarfone, G., Vercellini, P., Petrillo, M., Dessole, S., Capobianco, G., Ciavattini, A., Delli Carpini, G., Giannella, L., Mereu, L., Tateo, S., Sorbi, F., Fambrini, M., Cicogna, S., Romano, F., Ricci, G., Trojano, G., Consonni, R., Cantaluppi, S., Lippolis, A., Tinelli, R., D'Ippolito, G., Aguzzoli, L., Mandato, V. D., Palomba, S., Calandra, D., Rosati, M., Gallo, C., Surico, D., Remorgida, V., Ruscitto, F., Beretta, P., Benedetti Panici, P., Raspagliesi, F., Bogani, G, Scambia, G, Cimmino, C, Fanfani, F, Costantini, B, Loverro, M, Ferrandina, G, Landoni, F, Bazzurini, L, Grassi, T, Vitobello, D, Siesto, G, Perrone, A, Zanagnolo, V, De Iaco, P, Multinu, F, Ghezzi, F, Casarin, J, Berretta, R, Capozzi, V, Zupi, E, Centini, G, Pellegrino, A, Corso, S, Stevenazzi, G, Montoli, S, Boschi, A, Comerci, G, Greco, P, Martinello, R, Sopracordevole, F, Giorda, G, Simoncini, T, Caretto, M, Sartori, E, Ferrari, F, Cianci, A, Sarpietro, G, Matarazzo, M, Zullo, F, Bifulco, G, Morelli, M, Ferrero, A, Biglia, N, Barra, F, Ferrero, S, Leone Roberti Maggiore, U, Cianci, S, Chiantera, V, Ercoli, A, Sozzi, G, Martoccia, A, Schettini, S, Orlando, T, Cannone, F, Ettore, G, Puppo, A, Borghese, M, Martinelli, C, Muzii, L, Di Donato, V, Driul, L, Restaino, S, Bergamini, A, Candotti, G, Bocciolone, L, Plotti, F, Angioli, R, Mantovani, G, Ceccaroni, M, Cassani, C, Dominoni, M, Giambanco, L, Amodeo, S, Leo, L, Thomasset, R, Raimondo, D, Seracchioli, R, Malzoni, M, Gorlero, F, Di Luca, M, Busato, E, Kilzie, S, Dell'Acqua, A, Scarfone, G, Vercellini, P, Petrillo, M, Dessole, S, Capobianco, G, Ciavattini, A, Delli Carpini, G, Giannella, L, Mereu, L, Tateo, S, Sorbi, F, Fambrini, M, Cicogna, S, Romano, F, Ricci, G, Trojano, G, Consonni, R, Cantaluppi, S, Lippolis, A, Tinelli, R, D'Ippolito, G, Aguzzoli, L, Mandato, V, Palomba, S, Calandra, D, Rosati, M, Gallo, C, Surico, D, Remorgida, V, Ruscitto, F, Beretta, P, Benedetti Panici, P, Raspagliesi, F, Maggiore, U. L. R., and Panici, P. B.

Subjects
medicine.medical_specialty, endometrial neoplasms, Coronavirus disease 2019 (COVID-19), Endometrial Cancer, COVID-19, Uterine cancer, SARS-CoV-2, covid-19, endometrial cancer, sars-cov-2, uterine cancer, female, humans, pandemics, retrospective studies, NO, Retrospective Studie, Pandemic, medicine, Patterns of care, Obstetrics, business.industry, Endometrial cancer, Obstetrics and Gynecology, General Medicine, medicine.disease, Endometrial Neoplasms, Settore MED/40 - GINECOLOGIA E OSTETRICIA, Oncology, Original Article, Female, business, Human
Abstract

Objective Coronavirus disease 2019 (COVID-19) outbreak has correlated with the disruption of screening activities and diagnostic assessments. Endometrial cancer (EC) is one of the most common gynecological malignancies and it is often detected at an early stage, because it frequently produces symptoms. Here, we aim to investigate the impact of COVID-19 outbreak on patterns of presentation and treatment of EC patients. Methods This is a retrospective study involving 54 centers in Italy. We evaluated patterns of presentation and treatment of EC patients before (period 1: March 1, 2019 to February 29, 2020) and during (period 2: April 1, 2020 to March 31, 2021) the COVID-19 outbreak. Results Medical records of 5,164 EC patients have been retrieved: 2,718 and 2,446 women treated in period 1 and period 2, respectively. Surgery was the mainstay of treatment in both periods (p=0.356). Nodal assessment was omitted in 689 (27.3%) and 484 (21.2%) patients treated in period 1 and 2, respectively (p, Synopsis The prevalence of patients with early-stage endometrial cancer (EC) has been lower during coronavirus disease 2019 (COVID-19) pandemic than before its onset. Further evidence is needed to assess the impact of COVID-19 pandemic on survival outcomes of EC patients.

Published
2022

31. Uterine Papillary Serous Carcinoma Arising in a Polyp: A Multicenter Retrospective Analysis on 75 Patients

Author

Francesca Sanseverino, Emilio Lucia, Vincenzo Dario Mandato, Massimo Franchi, Stefano Palomba, Federica Torricelli, Lorenzo Aguzzoli, Fabio Ghezzi, Valentina Mastrofilippo, Pierandrea De Iaco, Gino Ciarlini, Giorgio Giorda, Antonino Ditto, Martino Abrate, Giovanni Battista La Sala, Giuseppe Bifulco, Stefano Uccella, Debora Pirillo, Mandato, V. D., Torricelli, F., Palomba, S., Uccella, S., Pirillo, D., Ciarlini, G., De Iaco, P., Lucia, E., Giorda, G., Ditto, A., Ghezzi, F., Sanseverino, F., Franchi, M., Bifulco, G., Mastrofilippo, V., Abrate, M., Aguzzoli, L., La Sala, G. B., and Mandato VD, Torricelli F, Palomba S, Uccella S, Pirillo D, Ciarlini G, De Iaco P, Lucia E, Giorda G, Ditto A, Ghezzi F, Sanseverino F, Franchi M, Bifulco G, Mastrofilippo V, Abrate M, Aguzzoli L, La Sala GB

Subjects
Cancer Research, Biopsy, medicine.medical_treatment, Papillary, Kaplan-Meier Estimate, endometrial carcinoma, endometrial polyp, hypertension, recurrence-free survival, staging procedures, uterine papillary serous carcinoma, Aged, Aged, 80 and over, Biopsy, Needle, Cancer Care Facilities, Carcinoma, Papillary, Cohort Studies, Disease-Free Survival, Female, Humans, Hysterectomy, Immunohistochemistry, Italy, Middle Aged, Multimodal Imaging, Polyps, Precancerous Conditions, Prognosis, Proportional Hazards Models, Retrospective Studies, Risk Assessment, Survival Analysis, Treatment Outcome, Uterine Neoplasms, 0302 clinical medicine, Retrospective Studie, 80 and over, Needle, Medicine, 030212 general & internal medicine, Fisher's exact test, Oncology, 030220 oncology & carcinogenesis, staging procedure, symbols, Survival Analysi, Radiology, Human, medicine.medical_specialty, Prognosi, Gynecologic oncology, Precancerous Condition, 03 medical and health sciences, symbols.namesake, Polyp, Endometrial Polyp, Carcinoma, Survival analysis, Cancer staging, Cancer Care Facilitie, business.industry, Proportional hazards model, medicine.disease, Proportional Hazards Model, Cohort Studie, business, uterine papillary serous carcinoma, staging procedures,endometrial polyp, recurrence-free survival, endometrial carcinoma,hypertension
Abstract

Supplemental Digital Content is available in the text.Objectives:The objectives of this study were to evaluate whether the international recommendations on the management of uterine papillary serous carcinoma arising in a polyp are uniformly followed in Italian Oncologic Centers and whether the strategy adopted is effective.Materials and Methods:Patients with uterine papillary serous carcinoma arising in a polyp and who had undergone a hysterectomy were identified in the 2003-2013 database of 7 Italian Gynecologic Oncology Centers. Clinical and pathologic characteristics and outcomes were compared between staging procedure types. Survival curves of the women were plotted using the Kaplan-Meier method and analyzed using Cox regression hazard model and the log-rank test. Associations between clinical parameters and the incidence of recurrence were assessed by generalized linear models and the Fisher test.Results:A total of 75 patients met the inclusion criteria. Recurrence-free survival was affected positively by type of surgical staging and negatively by preoperative diagnosis of hypertension. The association between surgical staging and recurrence-free survival resulted significant at univariate survival analysis (P=0.048 and 0.045) and maintained a trend of significance (P=0.070) in multivariate analysis, whereas hypertension was demonstrated to be the principal influencing factor.Conclusions:The international recommendations on the management of uterine papillary serous carcinoma are not uniformly followed in daily practice, although the extension of the surgery seems to be associated with lower recurrence rates also when uterine papillary serous carcinoma is confined to a polyp or endometrial surface.

Published
2019

32. Conservative surgery in stage I adult type granulosa cells tumors of the ovary: Results from the MITO-9 study

Author

Massimo Candiani, Alice Bergamini, Francesco Raspagliesi, Floriana Mascilini, Enrico Breda, Gabriella Ferrandina, Giorgio Giorda, Antonella Savarese, Giovanna Scarfone, Luca Bocciolone, Saverio Tateo, U. De Giorgi, Domenica Lorusso, Gennaro Cormio, G. Mangili, Anila Kardhashi, Anna Myriam Perrone, Nicoletta Biglia, Chiara Cassani, Salvatore Antonio Pignata, Bergamini A., Cormio G., Ferrandina G., Lorusso D., Giorda G., Scarfone G., Bocciolone L., Raspagliesi F., Tateo S., Cassani C., Savarese A., Breda E., De Giorgi U., Mascilini F., Candiani M., Kardhashi A., Biglia N., Perrone A.M., Pignata S., Mangili G., Bergamini, A., Cormio, G., Ferrandina, G., Lorusso, D., Giorda, G., Scarfone, G., Bocciolone, L., Raspagliesi, F., Tateo, S., Cassani, C., Savarese, A., Breda, E., De Giorgi, U., Mascilini, F., Candiani, M., Kardhashi, A., Biglia, N., Perrone, A. M., Pignata, S., and Mangili, G.

Subjects
0301 basic medicine, medicine.medical_treatment, Granulosa cell tumor, 0302 clinical medicine, Retrospective Studie, Cystectomy, Fertility sparing surgery, Granulosa cell tumors, Ovary, Unilateral oophorectomy, Organ Sparing Treatment, Granulosa Cell Tumor, Ovarian Neoplasms, Obstetrics and Gynecology, Middle Aged, Oncology, 030220 oncology & carcinogenesis, Female, Case-Control Studie, Human, Adult, medicine.medical_specialty, Ovariectomy, Salpingo-oophorectomy, 03 medical and health sciences, Median follow-up, medicine, Humans, Radical surgery, Survival rate, Survival analysis, Cancer staging, Proportional Hazards Models, Retrospective Studies, Proportional hazards model, business.industry, Ovarian Neoplasm, medicine.disease, Surgery, 030104 developmental biology, Settore MED/40 - GINECOLOGIA E OSTETRICIA, Case-Control Studies, Proportional Hazards Model, business, Ovarian cancer, Organ Sparing Treatments
Abstract

Objective: About 30% of Adult type granulosa cell tumors of the ovary (AGCTs) are diagnosed in fertile age. In stage I, conservative surgery (fertility-sparing surgery, FSS), either unilateral salpingo-oophorectomy (USO) or cystectomy are possible options. The aim of this study is to compare oncological outcomes of FSS and radical surgery (RS) in apparently stage I AGCTs treated within the MITO group (Multicenter Italian Trials in Ovarian cancer). Methods: Survival curves were calculated using the Kaplan-Meier method and compared with log-rank test. The role of clinicopathological variables as prognostic factors for survival was assessed using Cox's regression. Results: Two-hundred and twenty-nine patients were included; 32.6% received FSS, 67.4% RS. In the FSS group, 62.8% underwent USO, 16.7% cystectomy, 20.5% cystectomy followed by USO. After a median follow up of 84 months, median DFS was significantly worse in the FSS-group (10 yr DFS 50% vs 74%, in FSS and RS group, p = 0.006). No significant difference was detected between RS and USO (10 yr DFS 75% vs 70%, p = 0.5).Cystectomy-group showed a significantly worse DFS compared to USO (10 yr DFS 16% vs 70%, p < 0.001). Patients receiving cystectomy and subsequent USO showed a better prognosis, even though significantly worse compared to USO (10 yr DFS 41% vs 70%, p = 0.05). Between FSS and RS, no difference in OS was detected. At multivariate analysis, FIGO stage IC and cystectomy retained significant predictive value for worse survival. Conclusions: This study supports the oncological safety of FSS in stage I AGCTs, provided that cystectomy is avoided; USO should be the preferred approach.

Published
2019

33. Laparoscopic surgery in the treatment of stage I adult granulosa cells tumors of the ovary: Results from the MITO-9 study

Author

U. De Giorgi, Giorgio Giorda, Sabrina Chiara Cecere, Massimo Candiani, Gennaro Cormio, Giovanna Scarfone, A Gadducci, Claudia Marchetti, Nicoletta Biglia, Chiara Cassani, Rossella Lauria, G. Mangili, Gabriella Ferrandina, Francesco Raspagliesi, Francesco Maneschi, Antonella Savarese, Enrico Breda, L. Frigerio, Domenica Lorusso, Alice Bergamini, Floriana Mascilini, Anna Myriam Perrone, Bergamini, A., Ferrandina, G., Candiani, M., Cormio, G., Giorda, G., Lauria, R., Perrone, A. M., Scarfone, G., Breda, E., Savarese, A., Frigerio, L., Gadducci, A., Mascilini, F., Maneschi, F., Cassani, C., Marchetti, C., Cecere, S. C., Biglia, N., De Giorgi, U., Raspagliesi, F., Lorusso, D., Mangili, G., Bergamini A., Ferrandina G., Candiani M., Cormio G., Giorda G., Lauria R., Perrone A.M., Scarfone G., Breda E., Savarese A., Frigerio L., Gadducci A., Mascilini F., Maneschi F., Cassani C., Marchetti C., Cecere S.C., Biglia N., De Giorgi U., Raspagliesi F., Lorusso D., and Mangili G.

Subjects
Laparoscopic surgery, Adult, medicine.medical_specialty, medicine.medical_treatment, Biopsy, Kaplan-Meier Estimate, Hysterectomy, Disease-Free Survival, 03 medical and health sciences, 0302 clinical medicine, Retrospective Studie, Medicine, Humans, Stage (cooking), Laparoscopy, Survival rate, Survival analysis, Aged, Granulosa Cell Tumor, Neoplasm Staging, Retrospective Studies, Aged, 80 and over, 030219 obstetrics & reproductive medicine, medicine.diagnostic_test, business.industry, Ovary, Retrospective cohort study, General Medicine, Middle Aged, medicine.disease, Surgery, Survival Rate, Settore MED/40 - GINECOLOGIA E OSTETRICIA, Treatment Outcome, Oncology, Italy, Granulosa cell tumors, 030220 oncology & carcinogenesis, Female, business, Ovarian cancer, Human
Abstract

Objective Surgery represents the mainstay of treatment of stage I adult type granulosa cell tumors of the ovary (AGCTs). Because of the rarity and indolent course of the disease, no prospective trials are available. Open surgery has long been considered the traditional approach; oncological safety of laparoscopy is only supported by small series or case reports. The aim of this study was to compare the oncological outcomes between laparoscopic and open surgery in stage I AGCTs treated within the MITO (Multicenter Italian Trials in Ovarian cancer) Group. Methods Data from patients with stage I AGCTs were retrospectively collected. Clinicopathological features were evaluated for association with relapse and death. Survival curves were calculated using the Kaplan-Meier method and compared with the log-rank test. The role of clinicopathological variables as prognostic factors for survival was evaluated using Cox's regression model. Results 223 patients were identified. Stage 1A, 1B and 1C were 61.5%, 1.3% and 29.6% respectively. 7.6% were apparently stage I. Surgical approach was laparoscopic for 93 patients (41.7%) and open for 130 (58.3%). 5-years DFS was 84% and 82%, 10-years DFS was 68% and 64% for the laparoscopic and open-group (p = 0.6).5-years OS was 100% and 99%, 10 years OS was 98% and 97% for the laparoscopic and open-surgery group (p = 0.8). At multivariate analyses stage IC, incomplete staging, site of primary surgery retained significant prognostic value. Conclusion The present study suggests that surgical route does not affect the oncological safety of patients with stage I AGCTs, with comparable outcomes between laparoscopic and open approach.

Published
2017

34. Adjuvant chemotherapy does not improve disease-free survival in FIGO stage IC ovarian granulosa cell tumors: The MITO-9 study

Author

Jessica Ottolina, Sabrina Chiara Cecere, Claudia Marchetti, Giovanna Scarfone, A Gadducci, Gabriella Ferrandina, Massimo Candiani, Giorgio Giorda, D. A Pellegrini, L. Frigerio, Vera Loizzi, Gennaro Cormio, P. De Iaco, G. Mangili, Mangili, G., Ottolina, J., Cormio, G., Loizzi, V., De Iaco, P., Pellegrini, D. A., Candiani, M., Giorda, G., Scarfone, G., Cecere, S. C., Frigerio, L., Gadducci, A., Marchetti, C., Ferrandina, G., Mangili, G, Ottolina, J, Cormio, G, Loizzi, V, De Iaco, P, Pellegrini, Da, Candiani, M, Giorda, G, Scarfone, G, Cecere, Sc, Frigerio, L, Gadducci, A, Marchetti, C, and Ferrandina, G

Subjects
Oncology, Stage IC, Adult, medicine.medical_specialty, Ovarian Granulosa Cell, medicine.medical_treatment, adjuvant chemotherapy, granulosa cell tumors of the ovary, MITO, prognostic factors, relapse, stage IC, oncology, obstetrics and gynecology, Adjuvant chemotherapy, Granulosa cell tumors of the ovary, Prognostic factors, Relapse, Aged, Chemotherapy, Adjuvant, Disease-Free Survival, Female, Granulosa Cell Tumor, Humans, Middle Aged, Neoplasm Staging, Retrospective Studies, Obstetrics and Gynecology, Ovary, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Chemotherapy, Stage (cooking), Adjuvant, Prognostic factor, 030219 obstetrics & reproductive medicine, Settore MED/06 - ONCOLOGIA MEDICA, Proportional hazards model, business.industry, Standard treatment, Retrospective cohort study, medicine.disease, Surgery, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Ovarian cancer, business
Abstract

OBJECTIVE: Evidence-based management of granulosa cell tumors of the ovary (GCT) has been not yet standardized: surgery, including fertility-sparing procedures for young women, has been traditionally the standard treatment; on the other hand, chemotherapy has been used for treatment of advanced and/or recurrent disease. However, very limited experience, has been selectively focused on the role of adjuvant chemotherapy in stage IC patients. The objective of this retrospective study was to assess the efficacy of first line postoperative chemotherapy in patients with stage IC treated at the Italian Centers involved in the MITO (Multicenter Italian Trials in Ovarian cancer) Group. PATIENTS AND METHODS: A retrospective multi-institutional review of patients with GCT of the ovary at FIGO stage IC treated or referred to MITO centers was conducted. Surgical outcome, pathological findings and follow-up data were analysed. Kaplan-Meier and Cox proportional hazards analyses were used to determine the predictors factors for disease free survival. RESULTS: A total of 40 patients with primary GCT of the ovary at FIGO stage IC were identified. The median follow-up period was 96months (range 7-300). At multivariate analysis, surgical treatment outside MITO centers and incomplete surgical staging were independent poor prognostic indicators for recurrence; adjuvant chemotherapy did not retain significant predictive value for recurrence. CONCLUSIONS: This study raises the question about the value of adjuvant chemotherapy in stage IC GCT: a comprehensive evaluation of a larger series is urgently needed in order to characterize stage IC substages who can be spared treatment toxicity. Copyright © 2016. Published by Elsevier Inc.

Published
2016

35. Practice patterns and 90-day treatment-related morbidity in early-stage cervical cancer

Author

Giorgio Bogani, Violante Di Donato, Giovanni Scambia, Fabio Landoni, Fabio Ghezzi, Ludovico Muzii, Pierluigi Benedetti Panici, Francesco Raspagliesi, Jvan Casarin, Giampaolo Di Martino, Tommaso Grassi, Anna Myriam Perrone, Pierandrea De Iaco, Francesco Multinu, Roberto Berretta, Vito A. Capozzi, Errico Zupi, Gabriele Centini, Antonio Pellegrino, Silvia Corso, Guido Stevenazzi, Anna Chiara Boschi, Giuseppe Comerci, Pantaleo Greco, Gennaro Scutiero, Francesco Sopracordevole, Giorgio Giorda, Mariasole Fichera, Tommaso Simoncini, Marta Caretto, Enrico Sartori, Federico Ferrari, Antonio Cianci, Giuseppe Sarpietro, Maria Grazia Matarazzo, Pierluigi Giampaolino, Giuseppe Bifulco, Michele Morelli, Michele Di Dio, Annamaria Ferrero, Nicoletta Biglia, Fabio Barra, Simone Ferrero, Stefano Cianci, Vito Chiantera, Giulio Sozzi, Alfredo Ercoli, Sergio Schettini, Teresa Orlando, Francesco G. Cannone, Giuseppe Ettore, Andrea Puppo, Elena Olearo, Umberto Leone Roberti Maggiore, Valeria Artuso, Innocenza Palaia, Giorgia Perniola, Rossana Tripodi, Tullio Golia D'Augè, Ilaria Cuccu, Margherita Fischetti, Giusi Santangelo, Assunta Casorelli, Andrea Giannini, Ottavia D’Oria, Giuseppe Vizzielli, Stefano Restaino, Alice Bergamini, Luca Bocciolone, Francesco Plotti, Roberto Angioli, Giulia Mantovani, Marcello Ceccaroni, Chiara Cassini, Mattia Dominoni, Laura Giambanco, Silvia Amodeo, Livio Leo, Raphaël Thommaset, Diego Raimondo, Renato Seracchioli, Mario Malzoni, Francesca Falcone, Franco Gorlero, Martina Di Luca, Enrico Busato, Sami Kilzie, Andrea Dell'Acqua, Giovanna Scarfone, Paolo Vercellini, Marco Petrillo, Giampiero Capobianco, Andrea Ciavattini, Liliana Mereu, Paolo Scollo, Flavia Sorbi, Massimiliano Fambrini, Federico Romano, Giuseppe Ricci, Giuseppe Trojano, Gianluca Raffaello Damiani, Roberto Consonni, Nadia Di Lorenzo, Antonio Lippolis, Raffaele Tinelli, Lorenzo Aguzzoli, Vincenzo D. Mandato, Stefano Palomba, Marcello Tripodi, Davide Calandra, Franco Pellegrini, Fulvio Zullo, Daniela Surico, Valentino Remorgida, Francesco Ruscitto, Paolo Beretta, Enrico Vizza, Bogani, Giorgio, Donato, Violante Di, Scambia, Giovanni, Landoni, Fabio, Ghezzi, Fabio, Muzii, Ludovico, Panici, Pierluigi Benedetti, Raspagliesi, Francesco, Giampaolino, Pierluigi, Bogani, G, Donato, V, Scambia, G, Landoni, F, Ghezzi, F, Muzii, L, Panici, P, Raspagliesi, F, Casarin, J, Di Martino, G, Grassi, T, Perrone, A, De Iaco, P, Multinu, F, Berretta, R, Capozzi, V, Zupi, E, Centini, G, Pellegrino, A, Corso, S, Stevenazzi, G, Boschi, A, Comerci, G, Greco, P, Scutiero, G, Sopracordevole, F, Giorda, G, Fichera, M, Simoncini, T, Caretto, M, Sartori, E, Ferrari, F, Cianci, A, Sarpietro, G, Matarazzo, M, Giampaolino, P, Bifulco, G, Morelli, M, Dio, M, Ferrero, A, Biglia, N, Barra, F, Ferrero, S, Cianci, S, Chiantera, V, Sozzi, G, Ercoli, A, Schettini, S, Orlando, T, Cannone, F, Ettore, G, Puppo, A, Olearo, E, Leone Roberti Maggiore, U, Artuso, V, Palaia, I, Perniola, G, Tripodi, R, D'Auge, T, Cuccu, I, Fischetti, M, Santangelo, G, Casorelli, A, Giannini, A, D'Oria, O, Vizzielli, G, Restaino, S, Bergamini, A, Bocciolone, L, Plotti, F, Angioli, R, Mantovani, G, Ceccaroni, M, Cassini, C, Dominoni, M, Giambanco, L, Amodeo, S, Leo, L, Thommaset, R, Raimondo, D, Seracchioli, R, Malzoni, M, Falcone, F, Gorlero, F, Di Luca, M, Busato, E, Kilzie, S, Dell'Acqua, A, Scarfone, G, Vercellini, P, Petrillo, M, Capobianco, G, Ciavattini, A, Mereu, L, Scollo, P, Sorbi, F, Fambrini, M, Romano, F, Ricci, G, Trojano, G, Damiani, G, Consonni, R, Di Lorenzo, N, Lippolis, A, Tinelli, R, Aguzzoli, L, Mandato, V, Palomba, S, Tripodi, M, Calandra, D, Pellegrini, F, Zullo, F, Surico, D, Remorgida, V, Ruscitto, F, Beretta, P, Vizza, E, Casarin, Jvan, Di Martino, Giampaolo, Grassi, Tommaso, Perrone, Anna Myriam, De Iaco, Pierandrea, Multinu, Francesco, Berretta, Roberto, Capozzi, Vito A., Zupi, Errico, Centini, Gabriele, Pellegrino, Antonio, Corso, Silvia, Stevenazzi, Guido, Boschi, Anna Chiara, Comerci, Giuseppe, Greco, Pantaleo, Scutiero, Gennaro, Sopracordevole, Francesco, Giorda, Giorgio, Fichera, Mariasole, Simoncini, Tommaso, Caretto, Marta, Sartori, Enrico, Ferrari, Federico, Cianci, Antonio, Sarpietro, Giuseppe, Matarazzo, Maria Grazia, Bifulco, Giuseppe, Morelli, Michele, Dio, Michele Di, Ferrero, Annamaria, Biglia, Nicoletta, Barra, Fabio, Ferrero, Simone, Cianci, Stefanoa, Chiantera, Vitoa, Ercoli, Alfredo, Schettini, Sergio, Orlando, Teresa, Cannone, Francesco G., Ettore, Giuseppe, Puppo, Andrea, Olearo, Elena, Maggiore, Umberto Leone Roberti, Artuso, Valeria, Palaia, Innocenza, Perniola, Giorgia, Tripodi, Rosanna, D'Augè, Tullio Golia, Cuccu, Ilaria, Fischetti, Margherita, Santangelo, Giusi, Casorelli, Assunta, Giannini, Andrea, D’Oria, Ottvaio, Vizzielli, Giuseppe, Restaino, Stefano, Bergamini, Alice, Bocciolone, Luca, Plotti, Francesco, Angioli, Roberto, Mantovani, Giulia, Ceccaroni, Marcello, Cassini, Chiara, Dominoni, Mattia, Giambanco, Laura, Amodeo, Silvia, Leo, Livio, Thommaset, Raphaël, Raimondo, Diego, Seracchioli, Renato, Malzoni, Mario, Falcone, Francesca, Gorlero, Franco, Di Luca, Martina, Busato, Enrico, Kilzie, Sami, Dell'Acqua, Andrea, Scarfone, Giovanna, Vercellini, Paolo, Petrillo, Marco, Capobianco, Giampiero, Ciavattini, Andrea, Mereu, Liliana, Scollo, Paolo, Sorbi, Flavia, Fambrini, Massimiliano, Romano, Federico, Ricci, Giuseppe, Trojano, Giuseppe, Damiani, Gianluca Raffaello, Consonni, Roberto, Di Lorenzo, Nadia, Lippolis, Antonio, Tinelli, Raffaele, Aguzzoli, Lorenzo, Mandato, Vincenzo D., Palomba, Stefano, Tripodi, Marcello, Calandra, Davide, Pellegrini, Franco, Zullo, Fulvio, Surico, Daniela, Remorgida, Valentino, Ruscitto, Francesco, Beretta, Paolo, and Vizza, Enrico.

Subjects
Complications, Obstetrics and Gynecology, Uterine Cervical Neoplasms, Hysterectomy, Settore MED/40 - GINECOLOGIA E OSTETRICIA, Oncology, Retrospective Studie, Laparoscopy, Morbidity, Radical hysterectomy, Female, Humans, Neoplasm Staging, Retrospective Studies, Complication, Human
Abstract

Background. To evaluate the impact of the Laparoscopic Approach to Cervical Cancer (LACC) Trial on patterns of care and surgery-related morbidity in early-stage cervical cancer. Methods. This is a retrospective, a multi-institutional study evaluating 90-day surgery-related outcomes of patients undergoing treatment for early-stage cervical cancer before (period I: 01/01/2016-06/01/2018) and after (period II: 01/01/2019-06/01/2021) the publication of the results of the LACC trial. Results. Charts of 1295 patients were evaluated: 581 (44.9%) and 714 (55.1%) before and after the publication of the LACC trial, respectively. After the publication of the LACC trial, the number of patients treated with minimally invasive radical hysterectomy decreased from 64.9% to 30.4% (p < 0.001). Overall, 90-day complications occurred in 110 (18.9%) and 119 (16.6%) patients in the period I and period II, respectively (p = 0.795). Similarly, the number of severe (grade 3 or worse) complications did not differ between the two periods (38 (6.5%) vs. 37 (5.1%); p = 0.297). Overall and severe 90-day complications were consistent between periods even evaluating stage IA (p = 0.471), IB1 (p = 0.929), and IB2 (p = 0.074), separately. Conclusions. The present investigation highlighted that in referral centers the shift from minimally invasive to open radical hysterectomy does not influence 90-day surgery-related morbidity. (c) 2022 Elsevier Inc. All rights reserved.

Published
2022

36. Randomized Trial of Cytoreductive Surgery for Relapsed Ovarian Cancer

Author

Harter, Philipp, Sehouli, Jalid, Vergote, Ignace, Ferron, Gwenael, Reuss, Alexander, Meier, Werner, Greggi, Stefano, Mosgard, Berit J, Selle, Frederic, Guyon, Frédéric, Pomel, Christophe, Lécuru, Fabrice, Zang, Rongyu, Avall-Lundqvist, Elisabeth, Kim, Jae-Weon, Ponce, Jordi, Raspagliesi, Francesco, Kristensen, Gunnar, Classe, Jean-Marc, Hillemanns, Peter, Jensen, Pernille, Hasenburg, Annette, Ghaem-Maghami, Sadaf, Mirza, Mansoor R, Lund, Bente, Reinthaller, Alexander, Santaballa, Ana, Olaitan, Adeola, Hilpert, Felix, du Bois, Andreas, S Buchholz, A Burges, U Canzler, D Denschlag, A El-Balat, G Emons, R Felberbaum, N de Gregorio, M Gropp-Meier, V Hanf, L Hanker, R Hils, C Kurzeder, B Lampe, A Mustea, M Schmidt, R Schutz, M Weigel, S Weiser, A Zorr, C Marth, E Petru, T Scholl, M Beltran, I Bover, A Gomez di Laino, N Lainez, S Martinez, A Poveda Velasco, M Romeo, H Crouet, E de Gournay, G Deplanque, P Follana, A Floquet, D Lanvin, J Leveque, E Pujade-Lauraine, N Raban, B Resch, A M Savoye, G Aletti, G Giorda, F Landoni, C Scaffa, J Abu, F Alexander-Sefre, D Barton, S Butler-Manuel, R Clayton, R Crawford, T Duncan, A El-Ghobashy, C Fotopoulou, M Hall, C Intrivici, A Lawrence, D Luesley, R Naik, A Nordin, J Tidy, L Fokdahl, A Hofsjö, P Kjolhede, B Eyjolfsdottir, Z Y Dai, P Zhang, B Aminossadati, M Hahmann, C Nasemann, S Yahiaoui, M Wittenberg, C Schade-Brittinger, G Elser, D Reddig, M Kuncke, S Polleis, Y Mattukat, A Riha, R Berger, J de Roover, B Kaur, J Crook, F Nepote, B Votan, M Andriamamonjy, J Bryce, S Ristinge, Philipp, H, Jalid, S, Ignace, V, Gwenael, F, Alexander, R, Werner, M, Stefano, G, Berit J, M, Frederic, S, Frédéric, G, Christophe, P, Fabrice, L, Rongyu, Z, Elisabeth, A, Jae-Weon, K, Jordi, P, Francesco, R, Gunnar, K, Jean-Marc, C, Peter, H, Pernille, J, Annette, H, Sadaf, G, Mansoor R, M, Bente, L, Ana, S, Adeola, O, Felix, H, Andreas, D, Buchholz, S, Burges, A, Canzler, U, Denschlag, D, El-Balat, A, Emons, G, Felberbaum, R, de Gregorio, N, Gropp-Meier, M, Hanf, V, Hanker, L, Hils, R, Kurzeder, C, Lampe, B, Mustea, A, Schmidt, M, Schutz, R, Weigel, M, Weiser, S, Zorr, A, Marth, C, Petru, E, Scholl, T, Beltran, M, Bover, I, Gomez di Laino, A, Lainez, N, Martinez, S, Poveda Velasco, A, Romeo, M, Crouet, H, de Gournay, E, Deplanque, G, Follana, P, Floquet, A, Lanvin, D, Leveque, J, Pujade-Lauraine, E, Raban, N, Resch, B, M Savoye, A, Aletti, G, Giorda, G, Landoni, F, Scaffa, C, Abu, J, Alexander-Sefre, F, Barton, D, Butler-Manuel, S, Clayton, R, Crawford, R, Duncan, T, El-Ghobashy, A, Fotopoulou, C, Hall, M, Intrivici, C, Lawrence, A, Luesley, D, Naik, R, Nordin, A, Tidy, J, Fokdahl, L, Hofsjö, A, Kjolhede, P, Eyjolfsdottir, B, Y Dai, Z, Zhang, P, Aminossadati, B, Hahmann, M, Nasemann, C, Yahiaoui, S, Wittenberg, M, Schade-Brittinger, C, Elser, G, Reddig, D, Kuncke, M, Polleis, S, Mattukat, Y, Riha, A, Berger, R, de Roover, J, Kaur, B, Crook, J, Nepote, F, Votan, B, Andriamamonjy, M, Bryce, J, and Ristinge, S

Subjects
EPITHELIAL OVARIAN, Oncology, medicine.medical_specialty, BEVACIZUMAB, MULTICENTER, Antineoplastic Agents, PACLITAXEL, Systemic therapy, law.invention, Antineoplastic Agent, Randomized controlled trial, law, Internal medicine, Humans, Medicine, RECURRENT, Proportional Hazards Models, Aged, Ovarian Neoplasms, SECONDARY CYTOREDUCTION, business.industry, Ovarian Neoplasm, Antineoplastic Agents/therapeutic use, Obstetrics and Gynecology, Ovarian Neoplasms/drug therapy, Cytoreduction Surgical Procedures, General Medicine, CHEMOTHERAPY, Middle Aged, OPEN-LABEL, medicine.disease, Survival Analysis, Combined Modality Therapy, Neoplasm Recurrence, Local/drug therapy, Recurrent Ovarian Cancer, Proportional Hazards Model, Quality of Life, Female, Survival Analysi, Neoplasm Recurrence, Local, business, Cytoreductive surgery, Ovarian cancer, Human
Abstract

BACKGROUND: Treatment for patients with recurrent ovarian cancer has been mainly based on systemic therapy. The role of secondary cytoreductive surgery is unclear. METHODS: We randomly assigned patients with recurrent ovarian cancer who had a first relapse after a platinum-free interval (an interval during which no platinum-based chemotherapy was used) of 6 months or more to undergo secondary cytoreductive surgery and then receive platinum-based chemotherapy or to receive platinum-based chemotherapy alone. Patients were eligible if they presented with a positive Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) score, defined as an Eastern Cooperative Oncology Group performance-status score of 0 (on a 5-point scale, with higher scores indicating greater disability), ascites of less than 500 ml, and complete resection at initial surgery. A positive AGO score is used to identify patients in whom a complete resection might be achieved. The primary end point was overall survival. We also assessed quality of life and prognostic factors for survival. RESULTS: A total of 407 patients underwent randomization: 206 were assigned to cytoreductive surgery and chemotherapy, and 201 to chemotherapy alone. A complete resection was achieved in 75.5% of the patients in the surgery group who underwent the procedure. The median overall survival was 53.7 months in the surgery group and 46.0 months in the no-surgery group (hazard ratio for death, 0.75; 95% confidence interval, 0.59 to 0.96; P = 0.02). Patients with a complete resection had the most favorable outcome, with a median overall survival of 61.9 months. A benefit from surgery was seen in all analyses in subgroups according to prognostic factors. Quality-of-life measures through 1 year of follow-up did not differ between the two groups, and we observed no perioperative mortality within 30 days after surgery. CONCLUSIONS: In women with recurrent ovarian cancer, cytoreductive surgery followed by chemotherapy resulted in longer overall survival than chemotherapy alone. (Funded by the AGO Study Group and others; DESKTOP III ClinicalTrials.gov number, NCT01166737.).

Published
2021
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37. CDKN1B mutation and copy number variation are associated with tumor aggressiveness in luminal breast cancer

Author

Giovanni Franchin, Martina Cusan, Luigi Barzan, Giorgio Giorda, Samuele Massarut, Maura Sonego, Andrea Vecchione, Alessandra Dall'Acqua, Francesca Russo, Lorena Musco, Monica Schiappacassi, Gustavo Baldassarre, Lorenzo Gerratana, Tiziana Perin, Vincenzo Canzonieri, Fabio Puglisi, Roberto Sorio, Francesca Citron, Filippo Vit, Giorgia Mungo, Sandro Sulfaro, Jerry Polesel, Emilio Lucia, Vittorio Giacomarra, Sara D'Andrea, Milena S. Nicoloso, Maria Chiara Mattevi, Davide Viotto, Ilaria Anania, Ilenia Segatto, Barbara Belletti, Gian Luca Rampioni Vinciguerra, Federica Toffolutti, Riccardo Bomben, V. Gattei, Viotto, D., Russo, F., Anania, I., Segatto, I., Rampioni Vinciguerra, G. L., Dall'Acqua, A., Bomben, R., Perin, T., Cusan, M., Schiappacassi, M., Gerratana, L., D'Andrea, S., Citron, F., Vit, F., Musco, L., Mattevi, M. C., Mungo, G., Nicoloso, M. S., Sonego, M., Massarut, S., Sorio, R., Barzan, L., Franchin, G., Giorda, G., Lucia, E., Sulfaro, S., Giacomarra, V., Polesel, J., Toffolutti, F., Canzonieri, V., Puglisi, F., Gattei, V., Vecchione, A., Belletti, B., and Baldassarre, G.

Subjects
Male, 0301 basic medicine, DNA Copy Number Variations, CNV, Breast Neoplasms, Neuroendocrine tumors, medicine.disease_cause, head and neck squamous cell carcinoma, Pathology and Forensic Medicine, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, breast cancer, Intestinal Neoplasms, medicine, Humans, Copy-number variation, CDKN1B, copy number variation, liquid biopsy, mutation, ovarian cancer, p27, young breast cancer patients, Original Paper, Mutation, copy number variation, CNV, business.industry, Prostatic Neoplasms, medicine.disease, Original Papers, Head and neck squamous-cell carcinoma, Squamous carcinoma, Neuroendocrine Tumors, 030104 developmental biology, 030220 oncology & carcinogenesis, MCF-7 Cells, Cancer research, Female, business, Ovarian cancer, Cyclin-Dependent Kinase Inhibitor p27, CDK inhibitor
Abstract

The CDKN1B gene, encoding for the CDK inhibitor p27kip1, is mutated in defined human cancer subtypes, including breast, prostate carcinomas and small intestine neuroendocrine tumors. Lessons learned from small intestine neuroendocrine tumors suggest that CDKN1B mutations could be subclonal, raising the question of whether a deeper sequencing approach could lead to the identification of higher numbers of patients with mutations. Here, we addressed this question and analyzed human cancer biopsies from breast (n = 396), ovarian (n = 110) and head and neck squamous carcinoma (n = 202) patients, using an ultra‐deep sequencing approach. Notwithstanding this effort, the mutation rate of CDKN1B remained substantially aligned with values from the literature, showing that essentially only hormone receptor‐positive breast cancer displayed CDKN1B mutations in a relevant number of cases (3%). However, the analysis of copy number variation showed that another fraction of luminal breast cancer displayed loss (8%) or gain (6%) of the CDKN1B gene, further reinforcing the idea that the function of p27kip1 is important in this type of tumor. Intriguingly, an enrichment for CDKN1B alterations was found in samples from premenopausal luminal breast cancer patients (n = 227, 4%) and in circulating cell‐free DNA from metastatic luminal breast cancer patients (n = 59, 8.5%), suggesting that CDKN1B alterations could correlate with tumor aggressiveness and/or occur later during disease progression. Notably, many of the identified somatic mutations resulted in p27kip1 protein truncation, leading to loss of most of the protein or of its C‐terminal domain. Using a gene‐editing approach in a luminal breast cancer cell line, MCF‐7, we observed that the expression of p27kip1 truncating mutants that lose the C‐terminal domains failed to rescue most of the phenotypes induced by CDKN1B gene knockout, indicating that the functions retained by the C‐terminal portion are critical for its role as an oncosuppressor, at least in luminal breast cancer. © 2020 The Authors. The Journal of Pathology published by John Wiley & Sons, Ltd. on behalf of The Pathological Society of Great Britain and Ireland.

Published
2020

38. Impact of covid-19 in gynecologic oncology: A nationwide italian survey of the sigo and mito groups

Author

Giuseppe Trojano, G. Salerno, Mezzanzanica Delia, Stefano Greggi, Gabriella Ferrandina, Francesco Raspagliesi, Vito Trojano, Alice Bergamini, Giovanni Scambia, Giorgio Giorda, Giorgio Valabrega, Paolo Scollo, Francesco Sopracordevole, Antonio Chiantera, Gianfranco Zannoni, Ciro Pinelli, Giorgio Bogani, Salvatore Lopez, Pierluigi Benedetti Panici, Fulvio Zullo, Mauro Signorelli, Jvan Casarin, Roberto Angioli, Vito Chiantera, Luca Bocciolone, Antonino Ditto, Antonia Carla Testa, Violante Di Donato, Massimo Franchi, Antonella Savarese, Enrico Vizza, Giovanni Apolone, Enrico Sartori, Mario Malzoni, Sandro Pignata, Innocenza Palaia, Fabio Ghezzi, Fabio Martinelli, Bogani G., Apolone G., Ditto A., Scambia G., Panici P.B., Angioli R., Pignata S., Greggi S., Scollo P., Delia M., Franchi M., Martinelli F., Signorelli M., Lopez S., Di Donato V., Valabrega G., Ferrandina G., Palaia I., Bergamini A., Bocciolone L., Savarese A., Ghezzi F., Casarin J., Pinelli C., Trojano V., Chiantera V., Giorda G., Sopracordevole F., Malzoni M., Salerno G., Sartori E., Testa A., Zannoni G., Zullo F., Vizza E., Trojano G., Chiantera A., and Raspagliesi F.

Subjects
International Cooperation, Computer-assisted web interviewing, COVID-19, Health Care Surveys, SARS-CoV-2 Infection, Surgical Oncology, Betacoronavirus, Coronavirus Infections, Female, Genital Neoplasms, Female, Gynecologic Surgical Procedures, Gynecology, Humans, Infection Control, Italy, Medical Oncology, Pandemics, Pneumonia, Viral, SARS-CoV-2, Societies, Medical, Surveys and Questionnaires, Triage, 0302 clinical medicine, Surgical oncology, Gynecologic Surgical Procedure, Pandemic, Health care, Medicine, Infection control, Viral, Statistics & numerical data, Survey, 030219 obstetrics & reproductive medicine, Obstetrics and Gynecology, General Medicine, Oncology, 030220 oncology & carcinogenesis, Original Article, Genital Neoplasms, medicine.medical_specialty, Gynecologic oncology, 03 medical and health sciences, Medical, Betacoronaviru, business.industry, Coronavirus Infection, Pneumonia, Settore MED/40 - GINECOLOGIA E OSTETRICIA, Health Care Survey, Family medicine, business, Societies
Abstract

Objective Coronavirus disease 2019 (COVID-19) has caused rapid and drastic changes in cancer management. The Italian Society of Gynecology and Obstetrics (SIGO), and the Multicenter Italian Trials in Ovarian cancer and gynecologic malignancies (MITO) promoted a national survey aiming to evaluate the impact of COVID-19 on clinical activity of gynecologist oncologists and to assess the implementation of containment measures against COVID-19 diffusion. Methods The survey consisted of a self-administered, anonymous, online questionnaire. The survey was sent via email to all the members of the SIGO, and MITO groups on April 7, 2020, and was closed on April 20, 2020. Results Overall, 604 participants completed the questionnaire with a response-rate of 70%. The results of this survey suggest that gynecologic oncology units had set a proactive approach to COVID-19 outbreak. Triage methods were adopted in order to minimize in-hospital diffusion of COVID-19. Only 38% of gynecologic surgeons were concerned about COVID-19 outbreak. Although 73% of the participants stated that COVID-19 has not significantly modified their everyday practice, 21% declared a decrease of the use of laparoscopy in favor of open surgery (19%). However, less than 50% of surgeons adopted specific protection against COVID-19. Additionally, responders suggested to delay cancer treatment (10%-15%), and to perform less radical surgical procedures (20%-25%) during COVID-19 pandemic. Conclusions National guidelines should be implemented to further promote the safety of patients and health care providers. International cooperation is of paramount importance, as heavily affected nations can serve as an example to find out ways to safely preserve clinical activity during the COVID-19 outbreak.

Published
2020

39. Clonal Evolution of TP53 c.375+1G>A Mutation in Pre- and Post- Neo-Adjuvant Chemotherapy (NACT) Tumor Samples in High-Grade Serous Ovarian Cancer (HGSOC)

Author

Marica Garziera, Giorgio Giorda, Giuseppe Toffoli, Sara Gagno, Elena Poletto, Simona Scalone, Erika Cecchin, Rossana Roncato, Fabrizio Ecca, Elena De Mattia, Loredana Romanato, Vincenzo Canzonieri, Roberto Sorio, Garziera, M., Cecchin, E., Giorda, G., Sorio, R., Scalone, S., De Mattia, E., Roncato, R., Gagno, S., Poletto, E., Romanato, L., Ecca, F., Canzonieri, V., and Toffoli, G.

Subjects
endocrine system diseases, medicine.medical_treatment, Cystadenocarcinoma, Case Report, Somatic evolution in cancer, Loss of heterozygosity, Clonal Evolution, chemistry.chemical_compound, symbols.namesake, Germline mutation, medicine, Biomarkers, Tumor, chemoresistance, HGSOC, NACT, NGS, TP53, Chemotherapy, Adjuvant, Cystadenocarcinoma, Serous, Female, Humans, Middle Aged, Mutation, Neoadjuvant Therapy, Ovarian Neoplasms, Tumor Suppressor Protein p53, Chemotherapy, Allele, lcsh:QH301-705.5, Adjuvant, Sanger sequencing, Tumor, business.industry, Ovarian Neoplasm, Serous, tp53, General Medicine, Debulking, Carboplatin, Cystadenocarcinoma, Serou, lcsh:Biology (General), chemistry, Cancer research, symbols, business, Biomarkers, Human
Abstract

Carboplatin/paclitaxel is the reference regimen in the treatment of advanced high-grade serous ovarian cancer (HGSOC) in neo-adjuvant chemotherapy (NACT) before interval debulking surgery (IDS). To identify new genetic markers of platinum-resistance, next-generation sequencing (NGS) analysis of 26 cancer-genes was performed on paired matched pre- and post-NACT tumor and blood samples in a patient with stage IV HGSOC treated with NACT-IDS, showing platinum-refractory/resistance and poor prognosis. Only the TP53 c.375+1G>A somatic mutation was identified in both tumor samples. This variant, associated with aberrant splicing, was in trans configuration with the 72Arg allele of the known germline polymorphism TP53 c.215C>G (p. Pro72Arg). In the post-NACT tumor sample we observed the complete expansion of the TP53 c.375+1G>A driver mutant clone with somatic loss of the treatment-sensitive 72Arg allele. NGS results were confirmed with Sanger method and immunostaining for p53, BRCA1, p16, WT1, and Ki-67 markers were evaluated. This study showed that (i) the splice mutation in TP53 was present as an early driver mutation at diagnosis; (ii) the mutational profile was shared in pre- and post-NACT tumor samples; (iii) the complete expansion of a single dominant mutant clone through loss of heterozygosity (LOH) had occurred, suggesting a possible mechanism of platinum-resistance in HGSOC under the pressure of NACT.

Published
2019

40. Malignant struma ovarii harboring a unique NRAS mutation: case report and review of the literature

Author

Chiara Bampo, Eugenio Borsatti, Giorgio Giorda, Alessandro Sindoni, Lara Alessandrini, Tanja Baresic, Vincenzo Canzonieri, Carlo Gobitti, Giovanni Franchin, Gobitti, C, Sindoni, A, Bampo, C, Baresic, T, Giorda, G, Alessandrini, L, Canzonieri, V, Franchin, G, and Borsatti, E

Subjects
Adult, Malignant struma ovarii, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, 030209 endocrinology & metabolism, Adnexal mass, GTP Phosphohydrolases, Malignant transformation, Iodine Radioisotopes, 03 medical and health sciences, 0302 clinical medicine, Positron Emission Tomography Computed Tomography, medicine, Presacral space, Humans, Ovarian Teratoma, Ovarian Neoplasms, Ovarian cyst, Struma ovarii, business.industry, Thyroidectomy, Membrane Proteins, I-131, General Medicine, Malignant Struma Ovarii, medicine.disease, Struma Ovarii, Treatment, Treatment Outcome, Papillary thyroid carcinoma, 030220 oncology & carcinogenesis, Radioiodine, Female, Radiology, business
Abstract

Struma ovarii (SO), a rare tumor containing at least 50% of thyroid tissue, represents approximately 5% of all ovarian teratomas; its malignant transformation rate is reported to occur in up to 10% of cases and metastases occur in about 5-6% of them. We describe a 36-year old woman who underwent laparoscopic left annessectomy two years earlier because of an ovarian cyst. Follow-up imaging revealed a right adnexal mass, ascitis and peritoneal nodes that were diagnosed as comprising a malignant SO with peritoneal secondary localizations at histopathology performed after intervention. Restaging with F-18-FDG-PE T/CT scan, abdominal CT and ultrasonography showed abnormalities in the perihepatic region and presacral space and left hypochondrium localizations. The patient underwent thyroidectomy, hepatic nodulectomy and cytoreductive peritonectomy: histopathological examination did not show any malignant disease in the thyroid and confirmed the presence of peritoneal localizations due to malignant SO; molecular analysis detected NRAS Q61K mutation in exon 3, whereas no mutations were identified on the BRAF gene. The patient underwent radioiodine treatment: serum Tg was decreased at first follow-up after three months of I-131-therapy. We believe that our case raises some interesting considerations. First, pathologists should be aware of this entity and should check for the presence of point mutations suggesting an aggressive disease behavior, which could be beneficial for an optimal therapeutic approach. Second, although most of the knowledge in this field comes from case reports, efforts should be made to standardize the management of patients affected by malignant SO, including use of practice guidelines.

Published
2017
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41. Is the endometrial evaluation routinely required in patients with adult granulosa cell tumors of the ovary?

Author

Enrico Breda, Domenica Lorusso, Giorgia Mangili, Paolo Scollo, Fulvio Zullo, Antonella Savarese, Massimo Candiani, Jessica Ottolina, Angiolo Gadducci, Gabriella Ferrandina, Giorgio Giorda, Ottolina, J, Ferrandina, G, Gadducci, A, Scollo, P, Lorusso, D, Giorda, G, Breda, E, Savarese, A, Candiani, Massimo, Zullo, F, Mangili, G., Ottolina, Jessica, Ferrandina, Gabriella, Gadducci, Angiolo, Scollo, Paolo, Lorusso, Domenica, Giorda, Giorgio, Breda, Enrico, Savarese, Antonella, Zullo, Fulvio, and Mangili, Giorgia

Subjects
Adult, medicine.medical_specialty, Endometrial hyperplasia, Ovary, Endometrial carcinoma, Hyperestrogenism, Asymptomatic, Atypical hyperplasia, Endometrial sampling, Carcinoma, medicine, 80 and over, Humans, Aged, Granulosa Cell Tumor, Retrospective Studies, Gynecology, Aged, 80 and over, Ovarian Neoplasms, business.industry, Endometrial cancer, Granulosa cell tumor of the ovary, Obstetrics and Gynecology, Hyperplasia, Middle Aged, medicine.disease, Endometrial Neoplasms, medicine.anatomical_structure, Settore MED/40 - GINECOLOGIA E OSTETRICIA, Oncology, Female, medicine.symptom, Endometrial Hyperplasia, business
Abstract

Objective. Granulosa cell tumors (GCTs) are the most common estrogen-secreting ovarian tumors; perhaps due to the persistent hyperestrogenism, a wide spectrum of associated endometrial pathologies ranging from endometrial hyperplasia to carcinoma has been documented in patients with GCTs. The aim of this study is to evaluate the incidence of endometrial pathologies in a large series of GCT patients treated in MITO centers. Methods. A retrospective multi-institutional review of patients with granulosa cell tumors of the ovary treated or referred to MITO centers was conducted. Descriptive statistics were used to characterize the patient population and to assess the association of GCT and endometrial abnormalities at the time of diagnosis; multivariate regression analysis was also performed to identify independent predictors of endometrial abnormalities. Results. A total of 150 patients with primary adult GCT was identified. During the preoperative assessment, endometrial pathology was found in 35.9% of symptomatic patients and in 90.9% of asymptomatic women with endometrial thickening at transvaginal ultrasound. At the time of surgery, hyperplasia was documented in 29.2% of patients, whereas endometrial cancer occurred in 7.5% of patients. Almost all of the patients (97.6%) with endometrial hyperplasia were older than 40 years. All patients with endometrial cancer were older than 40 years and postmenopausal. Conclusions. Endometrial carcinoma/atypical hyperplasia were commonly observed in GCT patients > 40 years; based on these data, endometrial sampling should be performed in symptomatic women at least 40 years of age. In asymptomatic women < 40 years, endometrial sampling is of low yield.

Published
2015

42. Lymphocele prevention after pelvic laparoscopic lymphadenectomy by a collagen patch coated with human coagulation factors: a matched case-control study

Author

Andrea Tinelli, Antonio Malvasi, Marcello Guido, Ospan A. Mynbaev, Farr R. Nezhat, Daniel A. Tsin, Giorgio Giorda, Tinelli, A., Mynbaev, O. A., Tsin, D. A., Giorda, G., Malvasi, A., Guido, Marcello, and Nezhat, F. R.

Subjects
Surgical Sponges, medicine.medical_specialty, Percutaneous, Complications, Deep vein, Lymphocele, Lymphocyst, TachoSil, Pelvis, Postoperative Complications, Endometrial cancer, medicine, Radical hysterectomy, Humans, Neoplasm Invasiveness, Pelvic lymphadenectomy, Laparoscopy, Obstructive uropathy, Neoplasm Staging, medicine.diagnostic_test, business.industry, Pelvic pain, Thrombin, Obstetrics and Gynecology, Fibrinogen, Middle Aged, medicine.disease, Prognosis, Blood Coagulation Factors, Surgery, Endometrial Neoplasms, Drug Combinations, medicine.anatomical_structure, Oncology, Case-Control Studies, Myometrium, Drainage, Lymph Node Excision, Lymph node, Female, medicine.symptom, Neoplasm Grading, business, Follow-Up Studies
Abstract

ObjectiveLymphoceles are among the most common postoperative complications of pelvic lymphadenectomy (PL), with a reported incidence of 1% to 50%. Symptoms are pelvic pain, leg edema, gastrointestinal obstruction, obstructive uropathy, and deep vein thrombosis, and severe complications such as sepsis and lymphatic fistula formation. After laparoscopic PL, we tested the prevention of lymphoceles using collagen patch coated with the human coagulation factors (TachoSil, Nycomed International Management GmbH, Zurich, Switzerland) on 55 patients with endometrial cancer stages IB to II who had undergone laparoscopy.Materials and MethodsThe authors divided the patients into 2 laparoscopy groups: PL plus TachoSil (group 1: 26 patients) and PL without TachoSil in a control group (group 2: 29 patients), as historical cohort of patients who underwent PL between 2010 and 2012. We collected surgical parameters, and the patients underwent ultrasound examination on postoperative days 7, 14, and 28. The main outcome measures were the development of symptomatic or asymptomatic lymphoceles, the need for further surgical intervention, as adverse effect of surgery, and the drainage volume and duration.ResultsThe same number of lymph nodes in both groups was removed; group 1 showed a lower drainage volume. Lymphoceles developed in 5 patients in group 1 and in 15 patients in group 2; of these, only 2 patients were symptomatic in group 1 and 5 patients were symptomatic in group 2, without statistical difference and no percutaneous drainage request.ConclusionsIn this preliminary investigation, the intraoperative laparoscopy application of TachoSil seems to reduce the rate of postoperative lymphoceles after PL, providing a useful additional treatment option for reducing drainage volume and preventing lymphocele development after PL.

Published
2013

43. Stathmin regulates mutant p53 stability and transcriptional activity in ovarian cancer

Author

Delia Mezzanzanica, Francesca Lovat, Marco Napoli, Barbara Pivetta, Monica Schiappacassi, Sara Lovisa, Alfonso Colombatti, Massimo Libra, Marina Bagnoli, Maura Sonego, Alessandra Dall'Acqua, Silvana Canevari, Loredana Militello, Giannino Del Sal, Barbara Belletti, Mattia Barbareschi, Giorgio Giorda, Sara D'Andrea, Barbara Valeri, Gustavo Baldassarre, Vincenzo Canzonieri, Sonego, M, Schiappacassi, M, Lovisa, S, Dall'Acqua, A, Bagnoli, M, Lovat, F, Libra, M, D'Andrea, S, Canzonieri, V, Militello, L, Napoli, Marco, Giorda, G, Pivetta, B, Mezzanzanica, D, Barbareschi, M, Valeri, B, Canevari, S, Colombatti, A, Belletti, B, DEL SAL, Giannino, and Baldassarre, G.

Subjects
Cell cycle checkpoint, Mutant, Apoptosis, Mice, RNA interference, Tumor Cells, Cultured, Phosphorylation, RNA, Small Interfering, Research Articles, Ovarian Neoplasms, biology, Protein Stability, mutant p53, Ovarian cancer, Transcription, Cell biology, ovarian cancer, Molecular Medicine, Female, RNA Interference, Corrigendum, carboplatinum, Protein Binding, Programmed cell death, stathmin, Cell Survival, Transplantation, Heterologous, Antineoplastic Agents, Stathmin, macromolecular substances, DNA-PK, medicine, Animals, Humans, Mitosis, Transcriptional activity, Calcium-Binding Proteins, Cell Cycle Checkpoints, medicine.disease, Molecular biology, Molecular medicine, Transplantation, Cancer cell, Mutation, biology.protein, Cancer research, Tumor Suppressor Protein p53
Abstract

Stathmin is a p53-target gene, frequently overexpressed in late stages of human cancer progression. Type II High Grade Epithelial Ovarian Carcinomas (HG-EOC) represents the only clear exception to this observation. Here, we show that stathmin expression is necessary for the survival of HG-EOC cells carrying a p53 mutant (p53(MUT) ) gene. At molecular level, stathmin favours the binding and the phosphorylation of p53(MUT) by DNA-PKCS , eventually modulating p53(MUT) stability and transcriptional activity. Inhibition of stathmin or DNA-PKCS impaired p53(MUT) -dependent transcription of several M phase regulators, resulting in M phase failure and EOC cell death, both in vitro and in vivo. In primary human EOC a strong correlation exists between stathmin, DNA-PKCS , p53(MUT) overexpression and its transcriptional targets, further strengthening the relevance of the new pathway here described. Overall our data support the hypothesis that the expression of stathmin and p53 could be useful for the identification of high risk patients that will benefit from a therapy specifically acting on mitotic cancer cells.

Published
2013

44. Revisiting the Clinical Value of F-18-FDG PET/CT in Detection of Recurrent Epithelial Ovarian Carcinomas Correlation With Histology, Serum CA-125 Assay, and Conventional Radiological Modalities

Author

Rosa Tatta, Lidija Antunovic, Giorgio Giorda, Eugenio Borsatti, Roberto Sorio, Agostino Steffan, Giovanna Pepe, Vincenzo Canzonieri, Marino Cimitan, Diego Cecchin, Luca Balestreri, Tanja Baresic, Domenico Rubello, Antunovic, L, Cimitan, M, Borsatti, E, Baresic, T, Sorio, R, Giorda, G, Steffan, A, Balestreri, L, Tatta, R, Pepe, G, Rubello, D, Cecchin, D, and Canzonieri, V

Subjects
medicine.medical_specialty, Carcinoma, Ovarian Epithelial, Multimodal Imaging, Fluorodeoxyglucose F18, Recurrence, Carcinoma, medicine, Medical imaging, Humans, Radiology, Nuclear Medicine and imaging, Neoplasms, Glandular and Epithelial, Neoplasm Metastasis, Ovarian Neoplasms, Modalities, medicine.diagnostic_test, business.industry, Histology, General Medicine, Middle Aged, medicine.disease, Positron emission tomography, Radiological weapon, CA-125 Antigen, Positron-Emission Tomography, Ovarian carcinomas, Fdg pet ct, Female, Radiology, business, Tomography, X-Ray Computed
Abstract

This study aimed to evaluate the efficiency of 18F-FDG PET/CT in suspected recurrence of epithelial ovarian cancer, after treatment, comparing outcomes of PET/CT with histological tumor subtype, CA-125 serum levels, and findings of conventional diagnostic imaging modalities (CI).Data from 121 women who underwent FDG PET/CT for suspected recurrence of epithelial ovarian cancer after treatment were reviewed retrospectively.Of all patients, 80% had recurrent disease and 20% were disease-free on the final clinical diagnosis. PET/CT showed true-positive findings in 82% of patients, whereas CI demonstrated true-positives in 70% of cases. At the time of PET/CT scanning, only 55 patients had serum CA-125 level greater than 35 U/mL, whereas 52 patients presented with CA-125 levels in a reference range. PET/CT sensitivity (82%) was significantly higher than that of CA-125 (59%), whereas difference in sensitivity between PET/CT and CI (69%) was limited. PET/CT specificity (87%) was significantly better than that of CI (47%), although no difference in specificity between PET/CT and CA-125 (80%) was found. However, no difference in CA-125 serum levels between patients with local tumor relapse and those with distant metastases was found. PET/CT showed the highest positive predictive value (96%) and negative predictive value (55%) when compared with other modalities. In high-grade tumors (n = 66), PET/CT accuracy was 80%, better than that of serum CA-125 (64%) and that of CI (62%). Equally in low-grade ovarian carcinomas (n = 55), PET/CT accuracy (87%) was significantly higher than that of the tumor marker (60%) and also higher than that of CI (70%).FDG PET/CT was proven to be more efficient than serum CA-125 assay and CI in detecting recurrences of ovarian cancer after treatment. The sensitivity of FDG PET/CT is not influenced by tumor histology. FDG PET/CT should be considered a useful diagnostic tool in the surveillance of patients that received treatment for epithelial ovarian carcinoma.

Published
2012

45. Devotees, A New Ordeal and A Sense of Belonging: Ethnography and Nethnography of Saint Agatha

Author

Elisabetta Di Giovanni, Giorda, G, Pace, E, and Di Giovanni, E

Subjects
Patronage and Devotion, New Ordel, Religiosity, biology, Anthropology, Agatha, SAINT, Trial by ordeal, biology.organism_classification, Martyr, Religiosity, Honor, Ethnography, Settore M-DEA/01 - Discipline Demoetnoantropologiche, Sociology, Religious studies, Everyday life
Abstract

In 2004 and in 2008, the author conducted ethnographic research in Catania (Southern Italy) on one of the most important religious feasts in honor of Saint Agatha. This chapter relates Agatha's story, which is that of a Sicilian virgin martyr persecuted in the fourth century by a Roman proconsul. At the feast of St. Agatha, the three elements: the extra-ecclesial nature of popular religiosity, the transmission of knowledge through vehicles other than seminaries and other official religious institutions, and the expression of popular religiosity with signs and symbols that transmit the presence of the supernatural in everyday life, can be found. A starting point was to identify and understand the intention of tastes, desires, symbolic systems of reference, and their influences on the decision-making powers of consumer groups. Hence, nethnography or "digital ethnography" is configured as a methodology of qualitative research, which explores cultures and communities emerging through Internet-mediated communication. Keywords:ethnography; Internet-mediated communication; nethnography; religiosity; Saint Agatha; Sicilian virgin martyr

Published
2012
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46. USP1 deubiquitinates PARP1 to regulate its trapping and PARylation activity.

Author

Nespolo A, Stefenatti L, Pellarin I, Gambelli A, Rampioni Vinciguerra GL, Karimbayli J, Barozzi S, Orsenigo F, Spizzo R, Nicoloso MS, Segatto I, D'Andrea S, Bartoletti M, Lucia E, Giorda G, Canzonieri V, Puglisi F, Belletti B, Schiappacassi M, Baldassarre G, and Sonego M

Subjects
Humans, Female, Cell Line, Tumor, Drug Resistance, Neoplasm genetics, Drug Resistance, Neoplasm drug effects, Poly ADP Ribosylation, Protein Binding, Poly (ADP-Ribose) Polymerase-1 metabolism, Ubiquitination, Poly(ADP-ribose) Polymerase Inhibitors pharmacology, Ubiquitin-Specific Proteases metabolism, Ubiquitin-Specific Proteases genetics, Ovarian Neoplasms drug therapy, Ovarian Neoplasms metabolism, Ovarian Neoplasms pathology, Ovarian Neoplasms genetics, DNA Damage
Abstract

PARP inhibitors (PARPi) represent a game-changing treatment for patients with ovarian cancer with tumors deficient for the homologous recombination (HR) pathway treated with platinum (Pt)-based therapy. PARPi exert their cytotoxic effect by both trapping PARP1 on the damaged DNA and by restraining its enzymatic activity (PARylation). How PARP1 is recruited and trapped at the DNA damage sites and how resistance to PARPi could be overcome are still matters of investigation. Here, we described PARP1 as a substrate of the deubiquitinase USP1. At molecular level, USP1 binds PARP1 to remove its K63-linked polyubiquitination and controls PARP1 chromatin trapping and PARylation activity, regulating sensitivity to PARPi. In both Pt/PARPi-sensitive and -resistant cells, USP1/PARP1 combined blockade enhances replicative stress, DNA damage, and cell death. Our work dissected the biological interaction between USP1 and PARP1 and recommended this axis as a promising and powerful therapeutic choice for not only sensitive but also chemoresistant patients with ovarian cancer irrespective of their HR status.

Published
2024
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48. Platinum-induced upregulation of ITGA6 promotes chemoresistance and spreading in ovarian cancer.

Author

Gambelli A, Nespolo A, Rampioni Vinciguerra GL, Pivetta E, Pellarin I, Nicoloso MS, Scapin C, Stefenatti L, Segatto I, Favero A, D'Andrea S, Mucignat MT, Bartoletti M, Lucia E, Schiappacassi M, Spessotto P, Canzonieri V, Giorda G, Puglisi F, Vecchione A, Belletti B, Sonego M, and Baldassarre G

Subjects
Humans, Female, Animals, Cell Line, Tumor, Platinum pharmacology, Platinum therapeutic use, Carcinoma, Ovarian Epithelial drug therapy, Carcinoma, Ovarian Epithelial genetics, Carcinoma, Ovarian Epithelial metabolism, Carcinoma, Ovarian Epithelial pathology, Antineoplastic Agents pharmacology, Antineoplastic Agents therapeutic use, Gene Expression Regulation, Neoplastic drug effects, Integrin alpha6 metabolism, Integrin alpha6 genetics, Drug Resistance, Neoplasm genetics, Drug Resistance, Neoplasm drug effects, Ovarian Neoplasms drug therapy, Ovarian Neoplasms genetics, Ovarian Neoplasms pathology, Ovarian Neoplasms metabolism, Up-Regulation drug effects
Abstract

Platinum (PT)-resistant Epithelial Ovarian Cancer (EOC) grows as a metastatic disease, disseminating in the abdomen and pelvis. Very few options are available for PT-resistant EOC patients, and little is known about how the acquisition of PT-resistance mediates the increased spreading capabilities of EOC. Here, using isogenic PT-resistant cells, genetic and pharmacological approaches, and patient-derived models, we report that Integrin α6 (ITGA6) is overexpressed by PT-resistant cells and is necessary to sustain EOC metastatic ability and adhesion-dependent PT-resistance. Using in vitro approaches, we showed that PT induces a positive loop that, by stimulating ITGA6 transcription and secretion, contributes to the formation of a pre-metastatic niche enabling EOC cells to disseminate. At molecular level, ITGA6 engagement regulates the production and availability of insulin-like growth factors (IGFs), over-stimulating the IGF1R pathway and upregulating Snail expression. In vitro data were recapitulated using in vivo models in which the targeting of ITGA6 prevents PT-resistant EOC dissemination and improves PT-activity, supporting ITGA6 as a promising druggable target for EOC patients., (© 2024. The Author(s).)

Published
2024
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49. Long-Term Follow-Up Outcomes in Women with In Situ/Microinvasive Adenocarcinoma of the Uterine Cervix Undergoing Conservative Treatment-Cervical Adenocarcinoma Study Group Italian Society of Colposcopy and Cervico-Vaginal Pathology.

Author

Giannella L, Delli Carpini G, Di Giuseppe J, Grelloni C, Bogani G, Dri M, Sopracordevole F, Clemente N, Giorda G, De Vincenzo R, Evangelista MT, Gardella B, Dominoni M, Monti E, Alessi C, Alessandrini L, Guerriero A, Pagan A, Caretto M, Ghelardi A, Amadori A, Origoni M, Barbero M, Raspagliesi F, Simoncini T, Vercellini P, Spinillo A, Scambia G, and Ciavattini A

Abstract

Objective: The present study aimed to assess long-term follow-up outcomes in women with in situ/microinvasive adenocarcinoma (AC) of the uterine cervix treated conservatively., Methods: Retrospective multi-institutional study including women with early glandular lesions and 5-year follow-up undergoing fertility-sparing treatment. Independent variables associated with recurrence were evaluated. Logistic regression analysis and Kaplan-Meier survival analysis with Logrank test were performed., Results: Of 269 women diagnosed with in situ/microinvasive AC, 127 participants underwent conservative treatment. During follow-up, recurrences were found in nine women (7.1%). The only factor associated with recurrence during follow-up was positive high-risk Human Papillomavirus (hr-HPV) testing (odds ratio 6.21, confidence interval 1.47-26.08, p = 0.012). HPV positivity in follow-up showed a recurrence rate of 21.7% against 3.8% in patients who were HPV-negative ( p = 0.002, Logrank test). Among women with negative high-risk HPV tests in follow-up, recurrences occurred in 20.0% of non-usual-type histology vs. 2.1% of usual-type cases ( p = 0.005)., Conclusion: HPV testing in follow-up is of pivotal importance in women with early glandular lesions undergoing conservative treatment, given its recurrence predictive value. However, women who are high-risk HPV-negative in follow-up with non-usual-type histopathology may represent a sub-population at increased risk of recurrences. Further studies should confirm these findings.

Published
2024
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50. Concurrent Endometrial Cancer in Women with Atypical Endometrial Hyperplasia: What Is the Predictive Value of Patient Characteristics?

Author

Giannella L, Piva F, Delli Carpini G, Di Giuseppe J, Grelloni C, Giulietti M, Sopracordevole F, Giorda G, Del Fabro A, Clemente N, Gardella B, Bogani G, Brasile O, Martinello R, Caretto M, Ghelardi A, Albanesi G, Stevenazzi G, Venturini P, Papiccio M, Cannì M, Barbero M, Fambrini M, Maggi V, Uccella S, Spinillo A, Raspagliesi F, Greco P, Simoncini T, Petraglia F, and Ciavattini A

Abstract

Background: The rate of concurrent endometrial cancer (EC) in atypical endometrial hyperplasia (AEH) can be as high as 40%. Some patient characteristics showed associations with this occurrence. However, their real predictive power with related validation has yet to be discovered. The present study aimed to assess the performance of various models based on patient characteristics in predicting EC in women with AEH., Methods: This is a retrospective multi-institutional study including women with AEH undergoing definitive surgery. The women were divided according to the final histology (EC vs. no-EC). The available cases were divided into a training and validation set. Using k-fold cross-validation, we built many predictive models, including regressions and artificial neural networks (ANN)., Results: A total of 193/629 women (30.7%) showed EC at hysterectomy. A total of 26/193 (13.4%) women showed high-risk EC. Regression and ANN models showed a prediction performance with a mean area under the curve of 0.65 and 0.75 on the validation set, respectively. Among the best prediction models, the most recurrent patient characteristics were age, body mass index, Lynch syndrome, diabetes, and previous breast cancer. None of these independent variables showed associations with high-risk diseases in women with EC., Conclusions: Patient characteristics did not show satisfactory performance in predicting EC in AEH. Risk stratification in AEH based mainly on patient characteristics may be clinically unsuitable.

Published
2023
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