Author: "Antonino Ditto" - Searchworks@Jio Institute Digital Library Search Results

212 results on '"Antonino Ditto"'

1. Laser Therapy in Heavily Treated Oncological Patients Improves Vaginal Health Parameters

Author: Marco Di Stanislao, Camelia Alexandra Coada, Francesca De Terlizzi, Stella Di Costanzo, Enrico Fiuzzi, Francesco Mezzapesa, Giulia Dondi, Damiano Paoli, Gianluca Raffaello Damiani, Francesco Raspagliesi, Giorgio Bogani, Antonino Ditto, Alessio Giuseppe Morganti, Pierandrea De Iaco, and Anna Myriam Perrone
Subjects: gynecological cancer, breast cancer, laser therapy, radiotherapy, sexual function, vulvo-vaginal atrophy, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract: This study aimed to investigate the efficacy and duration of multiple non-ablative intravaginal CO2 laser (V-lase®) cycles in breast cancer patients, gynecological and other pelvic cancers previously subjected to multiple oncological treatments. This prospective study enrolled women under the age of 65 years who reported vaginal symptoms. Data on the Vaginal Health Index (VHI), vaginal length (VL), vaginal pain measured using a Visual Analog Scale (VAS), and the Female Sexual Function Index (FSFI) were collected at baseline and before each laser application, and at subsequent follow-up visits. A total of 170 laser applications were performed on 113 women with various types of cancer. Most patients (57.5%) had received radiotherapy-based treatments before receiving laser treatment. Vaginal health parameters and sexual function improved significantly with each laser application. However, a temporary decline in these improvements occurred during the intervals between cycles. Such worsening was reversed with the subsequent cycle in all groups of patients, irrespective of the type of oncological treatments they had undergone. Multiple course vaginal laser therapy showed promising results as a potential treatment for vaginal atrophy in heavily treated gynecological and breast cancer patients, necessitating further research to determine the optimal time interval between cycles to ensure sustained positive effects.
Published: 2024
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2. Diagnostic Accuracy of Magnetic Resonance Imaging in the Pre-Operative Staging of Cervical Cancer Patients Who Underwent Neoadjuvant Treatment: A Clinical–Surgical–Pathologic Comparison

Author: Antonino Ditto, Umberto Leone Roberti Maggiore, Giulio Evangelisti, Giorgio Bogani, Valentina Chiappa, Fabio Martinelli, and Francesco Raspagliesi
Subjects: MRI staging, cervical cancer, radical hysterectomy, histopathologic findings, neoadjuvant treatment, chemotherapy, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract: Magnetic resonance imaging (MRI) has been proven to ensure high diagnostic accuracy in the identification of vaginal, parametrial, and lymph node involvement in patients affected by cervical cancer (CC), thus playing a crucial role in the preoperative staging of the disease. This study aims to compare the accuracy of MRI for the preoperative staging of patients with CC who underwent neoadjuvant treatment (NAT) or direct surgery. Retrospective data analysis of 126 patients with primary CC International Federation of Gynecology and Obstetrics stage IB3-IIB who underwent NAT before radical surgery (NAT group = 94) or received surgical treatment alone (control arm = 32) was prospectively performed. All enrolled patients were clinically assessed with both a pelvic examination and MRI before surgical treatment. Data from the clinical examination were compared with the histopathological findings to assess the accuracy of MRI for staging purposes after NAT or before direct surgery. MRI showed an overall accuracy of 46.1%, proving it to be not superior to pelvic and physical examination. The overall MRI accuracy for the evaluation of parametrial, vaginal, and lymph node status was 65.8%, 79.4%, and 79.4%, respectively. In the NAT group, the accuracy for the detection of parametrial, lymph node, and vaginal involvement was lower than the control group; however, the difference was not significant (p ≥ 0.05). The overall accuracy of MRI for the preoperative staging of CC after NAT is shown to be not unsatisfactory. The limits of MRI staging are especially evident when dealing with pre-treated patients.
Published: 2023
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3. Outcomes of High-Grade Cervical Dysplasia with Positive Margins and HPV Persistence after Cervical Conization

Author: Andrea Giannini, Violante Di Donato, Francesco Sopracordevole, Andrea Ciavattini, Alessandro Ghelardi, Enrico Vizza, Ottavia D’Oria, Tommaso Simoncini, Francesco Plotti, Jvan Casarin, Tullio Golia D’Augè, Ilaria Cuccu, Maurizio Serati, Ciro Pinelli, Alice Bergamini, Barbara Gardella, Andrea Dell’Acqua, Ermelinda Monti, Paolo Vercellini, Giovanni D’Ippolito, Lorenzo Aguzzoli, Vincenzo Dario Mandato, Luca Giannella, Cono Scaffa, Antonino Ditto, Francesca Falcone, Chiara Borghi, Mario Malzoni, Alessandra Di Giovanni, Maria Giovanna Salerno, Viola Liberale, Biagio Contino, Cristina Donfrancesco, Michele Desiato, Anna Myriam Perrone, Pierandrea De Iaco, Simone Ferrero, Giuseppe Sarpietro, Maria G. Matarazzo, Antonio Cianci, Stefano Cianci, Sara Bosio, Simona Ruisi, Lavinia Mosca, Raffaele Tinelli, Rosa De Vincenzo, Gian Franco Zannoni, Gabriella Ferrandina, Marco Petrillo, Giampiero Capobianco, Annunziata Carlea, Fulvio Zullo, Barbara Muschiato, Stefano Palomba, Stefano Greggi, Arsenio Spinillo, Fabio Ghezzi, Nicola Colacurci, Roberto Angioli, Pierluigi Benedetti Panici, Ludovico Muzii, Giovanni Scambia, Francesco Raspagliesi, and Giorgio Bogani
Subjects: HPV, conization, positive margins, HPV persistence, Medicine
Abstract: The objective of this work is to assess the 5-year outcomes of patients undergoing conization for high-grade cervical lesions that simultaneously present as risk factors in the persistence of HPV infection and the positivity of surgical resection margins. This is a retrospective study evaluating patients undergoing conization for high-grade cervical lesions. All patients included had both positive surgical margins and experienced HPV persistence at 6 months. Associations were evaluated with Cox proportional hazard regression and summarized using hazard ratio (HR). The charts of 2966 patients undergoing conization were reviewed. Among the whole population, 163 (5.5%) patients met the inclusion criteria, being at high risk due to the presence of positive surgical margins and experiencing HPV persistence. Of 163 patients included, 17 (10.4%) patients developed a CIN2+ recurrence during the 5-year follow-up. Via univariate analyses, diagnosis of CIN3 instead of CIN2 (HR: 4.88 (95%CI: 1.10, 12.41); p = 0.035) and positive endocervical instead of ectocervical margins (HR: 6.44 (95%CI: 2.80, 9.65); p < 0.001) were associated with increased risk of persistence/recurrence. Via multivariate analyses, only positive endocervical instead of ectocervical margins (HR: 4.56 (95%CI: 1.23, 7.95); p = 0.021) were associated with worse outcomes. In this high-risk group, positive endocervical margins is the main risk factor predicting 5-year recurrence.
Published: 2023
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4. Gynecological Cancers in Lynch Syndrome: A Comparison of the Histological Features with Sporadic Cases of the General Population

Author: Valentina Elisabetta Bounous, Elisabetta Robba, Stefania Perotto, Barbara Pasini, Nicoletta Tomasi Cont, Maria Teresa Ricci, Antonino Ditto, Marco Vitellaro, Francesco Raspagliesi, and Nicoletta Biglia
Subjects: Lynch syndrome, endometrial cancer, ovarian cancer, mismatch repair genes, Medicine
Abstract: Introduction: About 5% of endometrial cancers (ECs) are attributed to an inherited predisposition, for which Lynch syndrome (LS) accounts for the majority of cases. Women with LS have a 40–60% predicted lifetime risk of developing EC, in addition to a 40–80% lifetime risk of developing colorectal cancer and other cancers. In this population, the lifetime risk of developing ovarian cancer (OC) is 10–12%. Object: to compare the histopathological features of LS-associated EC and OC with sporadic cancers in order to evaluate whether there are differences in terms of age at diagnosis, site of occurrence in the uterus, histological type, stage at diagnosis, and tumor grading. Materials and methods: we compared data obtained from 96 patients with LS-associated gynecological cancers (82 with EC and 14 with OC) to a control group (CG) of 209 patients who developed sporadic EC, and a CG of 187 patients with sporadic OC. Results: The mean age at diagnosis of LS-associated EC and OC was much lower than in the control groups. In both groups with EC, the endometrioid histotype was the most frequently occurring histotype. However, among LS women there was a significantly higher incidence of clear cell tumors (11% versus 2.4% in the CG, p = 0.0001). Similar to the sporadic cancer cases, most of the LS-associated ECs presented at an early stage (89% of cases at FIGO I-II stage). In the LS group, the tumor frequently involved only the inner half of the endometrium (77% of cases, p < 0.01). In the LS group, 7.3% of ECs were localized to the lower uterine segment (LUS), whereas no cancer developed in the LUS in the CG. No serous OCs were diagnosed in the LS group (versus 45.5% in the CG, p = 0.0009). Most of the LS-associated OCs presented at an early stage (85% of cases at FIGO I-II stages, p < 0.01). Conclusion: LS-associated EC and OC seem to have peculiar features, occurring at a younger age and at an earlier stage. In LS, EC less frequently involves the outer half of the endometrium, with a more frequent occurrence in the LUS. The presence of clear cell EC was more frequently observed, whereas in OC, the predominant histotype was endometrioid.
Published: 2022
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5. Sentinel Node Mapping in Endometrial Cancer

Author: Giorgio Bogani, Antonino Ditto, Mauro Signorelli, Valentina Chiappa, Fabio Martinelli, and Francesco Raspagliesi
Subjects: Surgery, RD1-811
Published: 2021
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6. Fertility-Sparing Treatment of Patients with Endometrial Cancer: A Review of the Literature

Author: Umberto Leone Roberti Maggiore, Rola Khamisy-Farah, Nicola Luigi Bragazzi, Giorgio Bogani, Fabio Martinelli, Salvatore Lopez, Valentina Chiappa, Mauro Signorelli, Antonino Ditto, and Francesco Raspagliesi
Subjects: endometrial cancer, fertility-sparing, hysteroscopy, metformin, progestin, Medicine
Abstract: Endometrial cancer (EC) is currently the most common malignancy of the female genital tract in developed countries. Although it is more common in postmenopausal women, it may affect up to 25% in the premenopausal age and 3–5% under the age of 40 years. Furthermore, in the last decades a significant shift to pregnancy at older maternal ages, particularly in resource-rich countries, has been observed. Therefore, in this scenario fertility-sparing alternatives should be discussed with patients affected by EC. This study summarizes available literature on fertility-sparing management of patients affected by EC, focusing on the oncologic and reproductive outcomes. A systematic computerized search of the literature was performed in two electronic databases (PubMed and MEDLINE) in order to identify relevant articles to be included for the purpose of this systematic review. On the basis of available evidence, fertility-sparing alternatives are oral progestins alone or in combination with other drugs, levonorgestrel intrauterine system and hysteroscopic resection in association with progestin therapies. These strategies seem feasible and safe for young patients with G1 endometrioid EC limited to the endometrium. However, there is a lack of high-quality evidence on the efficacy and safety of fertility-sparing treatments and future well-designed studies are required.
Published: 2021
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7. Investigating the Role of Minimally Invasive Radical Hysterectomy in Cervical Cancer

Author: Giorgio Bogani, Antonino Ditto, Fabio Martinelli, Valentina Chiappa, Umberto Leone Roberti Maggiore, Domenica Lorusso, and Francesco Raspagliesi
Subjects: Surgery, RD1-811
Published: 2020
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8. Assessing the Long-Term Role of Vaccination against HPV after Loop Electrosurgical Excision Procedure (LEEP): A Propensity-Score Matched Comparison

Author: Giorgio Bogani, Francesco Raspagliesi, Francesco Sopracordevole, Andrea Ciavattini, Alessandro Ghelardi, Tommaso Simoncini, Marco Petrillo, Francesco Plotti, Salvatore Lopez, Jvan Casarin, Maurizio Serati, Ciro Pinelli, Gaetano Valenti, Alice Bergamini, Barbara Giannella, Andrea Dell’Acqua, Ermelinda Monti, Paolo Vercellini, Giovanni D’ippolito, Lorenzo Aguzzoli, Vincenzo D Mandato, Paola Carunchio, Gabriele Carlifante, Luca Giannella, Cono Scaffa, Francesca Falcone, Stefano Ferla, Chiara Borghi, Antonino Ditto, Mario Malzoni, Andrea Giannini, Maria Giovanna Salerno, Viola Liberale, Biagio Contino, Cristina Donfrancesco, Michele Desiato, Anna Myriam Perrone, Giulia Dondi, Pierandrea De Iaco, Umberto Leone Roberti Maggiore, Mauro Signorelli, Valentina Chiappa, Simone Ferrero, Giuseppe Sarpietro, Maria G Matarazzo, Antonio Cianci, Sara Bocio, Simona Ruisi, Rocco Guerrisi, Claudia Brusadelli, Lavinia Mosca, Raffaele Tinelli, Rosa De Vincenzo, Gian Franco Zannoni, Gabriella Ferrandina, Salvatore Dessole, Roberto Angioli, Stefano Greggi, Arsenio Spinillo, Fabio Ghezzi, Nicola Colacurci, Margherita Fischetti, Annunziata Carlea, Fulvio Zullo, Ludovico Muzii, Giovanni Scambia, Pierluigi Benedetti Panici, and Violante Di Donato
Subjects: HPV, vaccination, conization, LEEP, Medicine
Abstract: Background: Primary prevention through vaccination is a prophylactic approach aiming to reduce the risk of developing human papillomavirus (HPV)-related lesions. No mature and long-term data supported the adoption of vaccination in women undergoing conization. Methods: This is a retrospective multi-institutional study. Charts of consecutive patients undergoing conization between 2010 and 2014 were collected. All patients included had at least 5 years of follow-up. We compared outcomes of patients undergoing conization plus vaccination and conization alone. A propensity-score matching algorithm was applied in order to reduce allocation biases. The risk of developing recurrence was estimated using Kaplan-Meir and Cox hazard models. Results: Overall, charts of 1914 women were analyzed. The study group included 116 (6.1%) and 1798 (93.9%) women undergoing conization plus vaccination and conization alone, respectively. Five-year recurrence rate was 1.7% (n = 2) and 5.7% (n = 102) after conization plus vaccination and conization alone, respectively (p = 0.068). After the application of a propensity-score matching, we selected 100 patients undergoing conization plus vaccination and 200 patients undergoing conization alone. The crude number of recurrences was 2 (2%) and 11 (5.5%) for patients undergoing conization plus vaccination and conization alone, respectively (p = 0.231). Vaccination had no impact on persistent lesions (no negative examination between conization and new cervical dysplasia; p = 0.603), but reduced the risk of recurrent disease (patients who had at least one negative examination between conization and the diagnosis of recurrent cervical dysplasia; p = 0.031). Conclusions: Patients having vaccination experience a slightly lower risk of recurrence than women who had not, although not statistically significantly different. Further evidence is needed to assess the cost effectiveness of adopting vaccination in this setting.
Published: 2020
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9. The Adoption of Viral Capsid-Derived Virus-Like Particles (VLPs) for Disease Prevention and Treatments

Author: Giorgio Bogani, Francesco Raspagliesi, Antonino Ditto, and José de la Fuente
Subjects: n/a, Medicine
Abstract: In the present paper, Mohosen et al [...]
Published: 2020
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10. Ten-year outcomes following laparoscopic and open abdominal radical hysterectomy for 'low-risk' early-stage cervical cancer: A propensity-score based analysis

Author: Violante Di Donato, Giorgio Bogani, Jvan Casarin, Fabio Ghezzi, Mario Malzoni, Francesca Falcone, Marco Petrillo, Giampiero Capobianco, Filippo Calò, Tullio Golia D’Augè, Ludovico Muzii, Pierluigi Benedetti Panici, Elisa Ervas, Antonino Ditto, Francesco Raspagliesi, Francesco Sopracordevole, Enrico Vizza, and Andrea Giannini
Subjects: Oncology, Obstetrics and Gynecology
Published: 2023

11. Validation of MiROvaR, a microRNA-based predictor of early relapse in early stage epithelial ovarian cancer as a new strategy to optimise patients' prognostic assessment

Author: Antonino Ditto, Loris De Cecco, Biagio Paolini, Paola Alberti, Fabio Martinelli, Umberto Leone Roberti Maggiore, Giorgio Bogani, Paolo Chiodini, Sandro Pignata, Antonella Tomassetti, Francesco Raspagliesi, Delia Mezzanzanica, Marina Bagnoli, Ditto, A., De Cecco, L., Paolini, B., Alberti, P., Martinelli, F., Leone Roberti Maggiore, U., Bogani, G., Chiodini, P., Pignata, S., Tomassetti, A., Raspagliesi, F., Mezzanzanica, D., and Bagnoli, M.
Subjects: Adult, Aged, 80 and over, Male, microRNA signature, Cancer Research, Carcinoma, Ovarian Epithelial, Middle Aged, Prognosis, Progression-Free Survival, MicroRNAs, Young Adult, Oncology, Early-stage ovarian cancer, Disease Progression, Humans, Female, Neoplasm Recurrence, Local, Aged, Neoplasm Staging, Retrospective Studies
Abstract: Aim: Early-stage epithelial ovarian cancer (eEOC) patients have a generally favorable prognosis but unpredictable recurrence. Accurate prediction of risk of relapse is still a major concern, essentially to avoid overtreatment. Our robust tissue-based miRNA signature named MiROvaR, predicting early EOC recurrence in mostly advanced-stage EOC patients, is here challenged in an independent cohort to extend its classifying ability in the early-stage EOC setting. Methods: We retrospectively selected patients who underwent comprehensive surgical staging at our institution including stages from IA to IIB. miRNA expression profile was analysed in 89 cases and MiROvaR algorithm was applied using the previously validated cut-off for patients' classification. The primary endpoint was progression-free survival (PFS) at 5 years. Complete follow-up time (median = 112 months) was also considered as secondary analysis. Results: MiROvaR was assessable on 87 cases (19 events of disease progression) and classified 68 (78%) low-risk and 19 (22%) high-risk patients. Recurrence rate at primary end-point was 39% for high-risk patients as compared to 9.5% for low-risk ones. Accordingly, their Kaplan–Meier PFS curves were significantly different at both primary and secondary analysis (p = 0.0006 and p = 0.03, respectively). While none of the prominent clinical variables had prognostic relevance, MiROvaR significantly predicted disease recurrence at the 5-year assessment (primary endpoint analysis; HR:5.43, 95%CI:1.82–16.1, p = 0.0024; AUC = 0.78, 95%CI:0.53–0.82) and at complete follow-up time (HR:2.67, 95%CI:1.04–6.8, p = 0.041; AUC:0.68, 95%CI:0.52–0.82). Conclusions: We validated MiROvaR performance in identifying at diagnosis eEOC patients' at higher risk of early relapse thus enabling selection of the most effective therapeutic approach.
Published: 2022

12. Uterine serous carcinoma: role of surgery, risk factors and oncologic outcomes. Experience of a tertiary center

Author: Biagio Paolini, Valentina Chiappa, Monika Ducceschi, Mara Mantiero, Claudia Brusadelli, Giorgio Bogani, Mariateresa Evangelista, Antonino Ditto, Luigi Mariani, Salvatore Lopez, Mauro Signorelli, Fabio Martinelli, Salvatore Lo Vullo, Francesco Raspagliesi, and Umberto Maggiore
Subjects: Adult, medicine.medical_specialty, Neoplasm, Residual, Multivariate analysis, Uterus, Kaplan-Meier Estimate, Disease, Hysterectomy, Uterine serous carcinoma, Tertiary Care Centers, Positron Emission Tomography Computed Tomography, Cytology, Humans, Medicine, Neoplasm Invasiveness, Retroperitoneal Neoplasms, Stage (cooking), Peritoneal Neoplasms, Aged, Neoplasm Staging, Proportional Hazards Models, Sentinel Lymph Node Biopsy, business.industry, Carcinoma, Significant difference, Cytoreduction Surgical Procedures, General Medicine, Middle Aged, medicine.disease, Progression-Free Survival, Confidence interval, Endometrial Neoplasms, Surgery, medicine.anatomical_structure, Oncology, Myometrium, Lymph Node Excision, Female, Lymph Nodes, Neoplasms, Cystic, Mucinous, and Serous, business
Abstract: Objective To evaluate factors impacting survival outcomes in patients with uterine serous carcinoma (USC). Methods Data of consecutive patients diagnosed with USC undergoing surgery between 2000 and 2020 at Fondazione IRCCS Istituto Nazionale Tumori of Milan (Italy) were reviewed. Progression-free (PFS) and overall survival (OS) outcomes were evaluated using Kaplan-Meier and Cox proportional hazard models. Results Records of 147 consecutive patients meeting the inclusion criteria were analyzed. Stage distribution was: 67 (45.6%) patients with early-stage with uterine confined disease and 80 (54.4%) with advanced stages disease. Minimally invasive surgery was performed in 43 patients (29.5%). The median follow-up period was 78.6 months (IQ range = 35.7–117.3 months). The overall recurrence rate was 41% (60 patients): 19/67 patients (28.4%) with early-stage disease and 41/80 patients (51.3%) with advanced stage. The 5-year PFS rate was 35.0% (95% confidence interval [CI]: 27.5–44.7%). In multivariate analysis, age, BMI, depth of myometrial invasion, cytology, and optimal cytoreduction with postoperative residual tumor absent significantly impacted on PFS. The 5-year OS rates were 46.5% (95% CI: 38.1–56.8). The result of multivariate analysis showed that there was significant difference in OS based only on optimal cytoreduction and accuracy of retroperitoneal surgery. Conclusions In apparent early-stage USC, peritoneal and retroperitoneal staging allows to identify patients with disease harboring outside the uterus. Optimal cytoreduction is the most significant prognostic factor. Further collaborative studies are warranted in order to improve outcomes of USC patients.
Published: 2022

13. 2022-RA-1076-ESGO Low pressure laparoscopic procedures in morbidly obese gynecological patients using a new subcutaneous abdominal wall-retraction device: a safety and feasibility study

Author: Antonino Ditto, Umberto Leone Roberti Maggiore, Vincenzo Granato, Fabio Martinelli, Valentina Chiappa, Salvatore Lopez, Mauro Signorelli, Matteo Maruccio, Simona Palladino, Giulia Chiarello, Ludovica Spanò Bascio, and Francesco Raspagliesi
Published: 2022

14. Spotlight on the role of human papillomavirus vaccines

Author: Tommaso Simoncini, Antonino Ditto, Claudia Brusadelli, Andrea Ciavattini, Violante Di Donato, Ciro Pinelli, Jvan Casarin, Giorgio Bogani, Francesco Sopracordevole, Anna Del Fabro, Fabio Ghezzi, Rocco Guerrisi, and Francesco Raspagliesi
Subjects: Adult, 0301 basic medicine, Dysplasia, HPV, Pediatrics, medicine.medical_specialty, Cost-Benefit Analysis, Conization, Uterine Cervical Neoplasms, Cervical Cancer, Disease cluster, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Vaccine, Papillomavirus Vaccines, Human papillomavirus, Young adult, Randomized Controlled Trials as Topic, Cervical cancer, business.industry, Incidence (epidemiology), Papillomavirus Infections, Age Factors, Obstetrics and Gynecology, Cancer, Middle Aged, medicine.disease, Transplantation, Vaccination, 030104 developmental biology, Oncology, 030220 oncology & carcinogenesis, Female, business
Abstract: In high income setting, the massive implementation of screening programs has reduced the incidence of cervical cancer, dramatically. However, cervical cancer still remains a major health concern, being one of the most common cause of death for cancer among women. The adoption of primary prevention through vaccination against HPV aims to reduce the prevalence of HPV-related lesions and cervical cancer. Accumulating data highlighted the cost-effectiveness of introducing HPV vaccination for adolescent and young adults. In the present review, we critically evaluated the role of vaccination against HPV, focusing much more on the role of vaccination in specific cluster of subjects (eg, post-treatment and older adults). Additionally, we evaluated the available evidence on the role of vaccination in HIV-positive subjects and in women receiving solid organs transplantation. We observed that although vaccination might be considered effective in those cluster of subjects; further evidence is needed to assess the cost-effectiveness of vaccination in these settings.
Published: 2021

15. Cancer patients affected by COVID-19: Experience from Milan, Lombardy

Author: Claudia Brusadelli, Sara Bosio, Antonino Ditto, Giorgio Bogani, and Francesco Raspagliesi
Subjects: 0301 basic medicine, Pediatrics, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Genital Neoplasms, Female, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), medicine.medical_treatment, Pneumonia, Viral, Asymptomatic, Article, Betacoronavirus, 03 medical and health sciences, 0302 clinical medicine, Obstetrics and Gynaecology, medicine, Humans, Pandemics, Cancer, Aged, Retrospective Studies, Aged, 80 and over, COVID-19, cancer, oncology, SARS-CoV-2, Chemotherapy, business.industry, Mortality rate, Obstetrics and Gynecology, Retrospective cohort study, Middle Aged, medicine.disease, 030104 developmental biology, Italy, Oncology, 030220 oncology & carcinogenesis, Female, Active treatment, medicine.symptom, Coronavirus Infections, business
Abstract: Objective SARS-CoV-2 pandemic is continuing to spread. There are growing concerns on the impact of COVID-19 in cancer patients. Several papers reporting recommendations and guidelines are published. But few data on cancer patients affected by COVID-19 are available. Methods This is a retrospective study including all consecutive patients affected by gynecological cancer who developed COVID-19. All patients were treated in an academic setting (in Milan, Lombardy, Italy) between February and March 2020. Results Overall, 355 patients had active treatment during the study period due to newly diagnosed or recurrent gynecological disease. Among those, 19 (5.3%) patients affected developed COVID-19. All patients were asymptomatic at the time of COVID-19 detection. Six patients were diagnosed before starting planned treatments; while the remaining 13 were diagnosed for COVID-19 after their started their treatments. Considering the first group of six patients, one patient died due to COVID-19 3 days after the diagnosis; while the other patients recovered from COVID-19 after a median of three weeks. The latter group of 13 patients (treatments started) included five patients who underwent surgery and eight patients who underwent chemotherapy. Focusing on five patients who were diagnosed after surgery, we observed that two patients died during postoperative course, while in other two cases prolonged hospitalization was needed. One patient had no issues. Chemotherapy was delayed for the remaining patents without sequelae. Conclusions Our report highlights that COVID-19 impacts the quality of treatments for cancer patients. Mortality rate is high, especially after surgery. More important, patients under active treatment for cancer are at high risk of developing severe evolution of COVID-19. Prioritizing patients journey during COVID-19 is of paramount importance., Highlights • There are growing concerns on the impact of COVID-19 in cancer patients. • COVID-19 is impacting oncologic practice directly and indirectly. • Prioritizing patients journey during COVID-19 is of paramount importance.
Published: 2020

16. Primary conization overcomes the risk of developing local recurrence following laparoscopic radical hysterectomy in early stage cervical cancer

Author: Ciro Pinelli, Valentina Chiappa, Giorgio Bogani, Francesco Raspagliesi, Antonino Ditto, and Cristina Sonetto
Subjects: medicine.medical_specialty, Blood Loss, Surgical, Conization, Uterine Cervical Neoplasms, Cervix Uteri, Disease, Hysterectomy, Disease-Free Survival, Blood loss, medicine, Humans, Radical Hysterectomy, Stage (cooking), Laparoscopy, Pathological, Retrospective Studies, Cervical cancer, medicine.diagnostic_test, business.industry, Obstetrics and Gynecology, General Medicine, Length of Stay, Middle Aged, medicine.disease, Surgery, Laparoscopic radical hysterectomy, Italy, Case-Control Studies, Female, Neoplasm Recurrence, Local, business
Abstract: OBJECTIVE To investigate whether primary conization might overcome the risk of local dissemination in patients undergoing laparoscopic radical hysterectomy. METHODS Consecutive data of 262 patients with early stage cervical cancer were retrieved: 88 women had conization followed by radical hysterectomy. A propensity-matched comparison (1:1) was carried out in order to compare laparoscopy and open surgery. Accumulating data highlighted that minimally invasive surgery has been associated with higher recurrence rates and worse overall survival than open surgery in women with early stage cervical cancer. RESULTS Data of 35 paired patients (total 70 patients) were analyzed. No between-group differences in baseline, disease, and pathological variables were observed. Patients undergoing laparoscopy correlated with lower blood loss (50 [range 30-100] vs 150 [range 50-500] mL; P
Published: 2020

17. Ten‐year follow‐up study of long‐term outcomes after conservative surgery for early‐stage ovarian cancer

Author: Antonino Ditto, Ciro Pinelli, Salvatore Lopez, Valentina Chiappa, Francesco Raspagliesi, and Giorgio Bogani
Subjects: Adult, medicine.medical_specialty, Multivariate analysis, Conservative Treatment, Single Center, Disease-Free Survival, medicine, Humans, Radical surgery, Stage (cooking), Propensity Score, Contraindication, Neoplasm Staging, Proportional Hazards Models, Retrospective Studies, Ovarian Neoplasms, business.industry, Hazard ratio, Obstetrics and Gynecology, General Medicine, Middle Aged, Confidence interval, Surgery, Italy, Case-Control Studies, Propensity score matching, Female, Neoplasm Recurrence, Local, business, Follow-Up Studies
Abstract: Objective To evaluate long-term outcomes after surgery for apparent early-stage ovarian cancer (OC). Methods Retrospective analysis of women who underwent staging surgery for apparent early-stage OC at a single center in Milan, Italy, from 1990 to 2008, and had a follow-up longer than 10 years (living women with no recurrence). Univariate and multivariate analyses and propensity score matching were carried out. Results Overall, 182 women underwent radical (n=148, 81.3%) or conservative (n=34, 18.7%) procedures for early-stage OC. Ten-year disease-free and overall survival were 82.9% (n=151) and 87.9% (n=160), respectively. Conservative or radical surgery had similar disease-free (log-rank test, P=0.783) and overall (log-rank test, P=0.783) survival. These data were confirmed after the application of propensity score matching. High-risk features correlated with non-significant worse disease-free survival (P=0.080). In the high-risk group (≥Grade 3 or ≥ Stage IC), type of surgical approach (conservative vs radical) did not affect survival (hazard ratio, 0.81; 95% confidence interval, 0.18-3.56; P=0.781). Conclusion Women with early-stage OC had encouraging long-term survival. The presence of high-risk disease had detrimental effects on survival, regardless of surgical approach. High-risk disease should not be considered a contraindication to conservative surgery.
Published: 2020

18. The added value of SLN mapping with indocyanine green in low- and intermediate-risk endometrial cancer management: a systematic review and meta-analysis

Author: Lara C. Burg, Shenna Verheijen, Ruud L.M. Bekkers, Joanna IntHout, Robert W. Holloway, Salih Taskin, Sarah E. Ferguson, Yu Xue, Antonino Ditto, Glauco Baiocchi, Andrea Papadia, Giorgio Bogani, Alessandro Buda, Roy F.P.M. Kruitwagen, and Petra L.M. Zusterzeel
Subjects: Indocyanine Green, Oncology, Sentinel Lymph Node Biopsy, Humans, Lymph Node Excision, Obstetrics and Gynecology, Female, General Medicine, Sentinel Lymph Node, Coloring Agents, Women's cancers Radboud Institute for Health Sciences [Radboudumc 17], Endometrial Neoplasms
Abstract: Contains fulltext : 283074.pdf (Publisher’s version ) (Open Access) OBJECTIVE: The aim of this study was to assess the SLN detection rate in presumed early stage, low- and intermediate-risk endometrial cancers, the incidence of SLN metastases, and the negative predictive value of SLN mapping performed with indocyanine green (ICG). METHODS: A systematic review with meta-analyses was conducted. Study inclusion criteria were A) low- and intermediate-risk endometrial cancer, B) the use of ICG per cervical injection; C) a minimum of twenty included patients per study. To assess the negative predictive value of SLN mapping, D) a subsequent lymphadenectomy was an additional inclusion criterion. RESULTS: Fourteen studies were selected, involving 2,117 patients. The overall and bilateral SLN detection rates were 95.6% (95% confidence interval [CI]=92.4%-97.9%) and 76.5% (95% CI=68.1%-84.0%), respectively. The incidence of SLN metastases was 9.6% (95% CI=5.1%-15.2%) in patients with grade 1-2 endometrial cancer and 11.8% (95% CI=8.1%-16.1%) in patients with grade 1-3 endometrial cancer. The negative predictive value of SLN mapping was 100% (95% CI=98.8%-100%) in studies that included grade 1-2 endometrial cancer and 99.2% (95% CI=97.9%-99.9%) in studies that also included grade 3. CONCLUSION: SLN mapping with ICG is feasible with a high detection rate and negative predictive value in low- and intermediate-risk endometrial cancers. Given the incidence of SLN metastases is approximately 10% in those patients, SLN mapping may lead to stage shifting with potential therapeutic consequences. Given the high negative predictive value with SLN mapping, routine lymphadenectomy should be omitted in low- and intermediate-risk endometrial cancer.
Published: 2022

19. Lynch syndrome-related non-endometrioid endometrial cancer: analysis of outcomes

Author: Antonino Ditto, Giorgio Bogani, Francesco Raspagliesi, Valentina Chiappa, Maria Grazia Tibiletti, Massimo Milione, Fabio Ghezzi, Biagio Paolini, Ileana Carnevali, Maria Teresa Ricci, Marco Vitellaro, Viola Liberale, and Ferdinando Murgia
Subjects: Adult, medicine.medical_specialty, endometrial neoplasms, Disease-Free Survival, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Lynch syndrome II, Internal medicine, medicine, Humans, Survival rate, Aged, Retrospective Studies, 030304 developmental biology, 0303 health sciences, business.industry, Endometrial cancer, Case-control study, Obstetrics and Gynecology, Retrospective cohort study, Middle Aged, medicine.disease, Colorectal Neoplasms, Hereditary Nonpolyposis, Lynch syndrome, DNA-Binding Proteins, Survival Rate, uterine neoplasms, MutS Homolog 2 Protein, Oncology, Case-Control Studies, 030220 oncology & carcinogenesis, Population study, Lynch Syndrome II, Female, MutL Protein Homolog 1, Ovarian cancer, business, Carcinoma, Endometrioid
Abstract: ObjectiveWomen with Lynch syndrome have a risk up to 40–60% of developing endometrial cancer, which is higher than their risk of developing colorectal or ovarian cancer. To date, no data on the outcomes of patients with Lynch syndrome diagnosed with non-endometrioid endometrial cancer are available. The goal of this study was to evaluate the outcome of patients with Lynch syndrome diagnosed with non-endometrioid endometrial cancer.MethodsData from consecutive patients diagnosed with Lynch syndrome and with a histological diagnosis of non-endometrioid endometrial cancer were retrospectively collected in two referral institutes in Italy. A case–control comparison (applying a propensity matching algorithm) was performed in order to compare patients with proven Lynch syndrome and controls. Inclusion criteria were: (a) histologically-proven endometrial cancer; (b) detection of a germline pathogenic variant in one of the MMR genes; (c) adequate follow-up. Only carriers of pathogenic or likely pathogenic variants (ie, class 5 and 4 according to the InSiGHT classification) were included in the study. Survival outcomes were assessed using KaplanMeier and Cox models.ResultsOverall, 137 patients with Lynch syndrome were collected. Mean patient age was 49.2 (10.9) years. Genes involved in the Lynch syndrome included MLH1, MSH2, and MSH6 in 43%, 39%, and 18% of cases, respectively. The study population included 27 patients with non-endometrioid endometrial cancer, who were matched 1:2 with patients with sporadic cancers using a propensity matching algorithm. After a median follow-up of 134 months (range 1–295), 2 (7.4%) of the 27 patients developed recurrent disease (3 and 36 months) and subsequently died of disease (7 and 91 months). Patients diagnosed with Lynch syndrome experienced better disease-free survival (HR 7.86 (95% CI 1.79 to 34.5); p=0.006) and overall survival (HR 5.33 (95% CI 1.18 to 23.9); p=0.029) than controls.ConclusionsNon-endometrioid endometrial cancer occurring in patients with Lynch syndrome might be associated with improved oncologic outcomes compared with controls. Genetic/molecular profiling should be investigated in order to better understand the mechanism underlying the prognosis.
Published: 2019

20. Fertility-Sparing Treatment of Patients with Endometrial Cancer: A Review of the Literature

Author: Valentina Chiappa, Fabio Martinelli, Umberto Maggiore, Antonino Ditto, Giorgio Bogani, Francesco Raspagliesi, Salvatore Lopez, Mauro Signorelli, Nicola Luigi Bragazzi, and Rola Khamisy-Farah
Subjects: fertility-sparing, medicine.medical_specialty, medicine.drug_class, MEDLINE, Review, Malignancy, Endometrium, medicine, Levonorgestrel, Pregnancy, hysteroscopy, business.industry, Obstetrics, Endometrial cancer, General Medicine, medicine.disease, progestin, medicine.anatomical_structure, endometrial cancer, Medicine, business, metformin, Developed country, Progestin, medicine.drug
Abstract: Endometrial cancer (EC) is currently the most common malignancy of the female genital tract in developed countries. Although it is more common in postmenopausal women, it may affect up to 25% in the premenopausal age and 3–5% under the age of 40 years. Furthermore, in the last decades a significant shift to pregnancy at older maternal ages, particularly in resource-rich countries, has been observed. Therefore, in this scenario fertility-sparing alternatives should be discussed with patients affected by EC. This study summarizes available literature on fertility-sparing management of patients affected by EC, focusing on the oncologic and reproductive outcomes. A systematic computerized search of the literature was performed in two electronic databases (PubMed and MEDLINE) in order to identify relevant articles to be included for the purpose of this systematic review. On the basis of available evidence, fertility-sparing alternatives are oral progestins alone or in combination with other drugs, levonorgestrel intrauterine system and hysteroscopic resection in association with progestin therapies. These strategies seem feasible and safe for young patients with G1 endometrioid EC limited to the endometrium. However, there is a lack of high-quality evidence on the efficacy and safety of fertility-sparing treatments and future well-designed studies are required.
Published: 2021

21. Burden of lymphatic disease predicts efficacy of adjuvant radiation and chemotherapy in FIGO 2018 stage IIICp cervical cancer

Author: Francesco Raspagliesi, Ferdinando Murgia, Giorgio Bogani, Valentina Chiappa, Daniele Vinti, Antonino Ditto, Fabio Martinelli, and Umberto Leone Roberti Maggiore
Subjects: Adult, Oncology, medicine.medical_specialty, Adolescent, cervical cancer, medicine.medical_treatment, node positive, radiation and chemotherapy, stage IIIC, Aged, Chemotherapy, Adjuvant, Disease-Free Survival, Female, Humans, Hysterectomy, Lymph Nodes, Lymphatic Metastasis, Middle Aged, Neoadjuvant Therapy, Neoplasm Staging, Radiotherapy, Adjuvant, Retrospective Studies, Uterine Cervical Neoplasms, Young Adult, Internal medicine, medicine, Chemotherapy, Stage IIIC, Radical Hysterectomy, Stage (cooking), Adjuvant, Cervical cancer, Radiotherapy, Proportional hazards model, business.industry, Obstetrics and Gynecology, medicine.disease, Lymphatic disease, Lymphadenectomy, business
Abstract: ObjectiveNodal involvement is one of the most important prognostic factors in cervical cancer patients. We aimed to assess the prognostic role in relation to the burden of nodal disease in stage IIICp cervical cancer.MethodsData on all consecutive patients diagnosed with cervical cancer undergoing primary surgery (radical hysterectomy plus lymphadenectomy) or neoadjuvant chemotherapy followed by radical hysterectomy plus lymphadenectomy, between January 1980 and December 2017, were collected in a dedicated database. Exclusion criteria were: (1) consent withdrawal; (2) synchronous malignancies (within 5 years). Survival outcomes were assessed using Kaplan-Meier and Cox models.ResultsOverall, 177 (14.1%) of 1257 patients with cervical cancer were diagnosed with positive lymph nodes. After a median follow-up of 58 (range 4–175) months, 66 (37.3%) and 37 (20.9%) patients developed recurrent disease and died of disease, respectively. Via multivariate analysis, positive para-aortic nodes (HR 2.62, 95% CI 1.12 to 6.11; p=0.025) and the number of positive nodes (HR 1.06, 95% CI 1.02 to 1.11; p=0.002) correlated with worse disease-free survival. Furthermore, the number of positive nodes (HR 1.06, 95% CI 1.01 to 1.12; p=0.021) correlated with worse overall survival. Number of positive nodes (1, 2 or ≥3) strongly correlated with both disease-free survival (pConclusionsIn stage IIICp cervical cancer, adjuvant radiation and chemotherapy provides adequate overall survival in patients diagnosed with only one metastatic node, while survival outcomes are poor in patients with two or more metastatic nodes. This highlights the need for innovative treatments in patients with a high burden of lymphatic disease.
Published: 2019

22. Sentinel node mapping vs. lymphadenectomy in endometrial cancer: A systematic review and meta-analysis

Author: Antonino Ditto, Francesco Raspagliesi, Giorgio Bogani, and Ferdinando Murgia
Subjects: 0301 basic medicine, detection rate, medicine.medical_specialty, medicine.medical_treatment, survival, Pelvis, 03 medical and health sciences, 0302 clinical medicine, endometrial cancer, lymphadenectomy, sentinel node mapping, Humans, Medicine, Pooled data, Limited evidence, Aorta, Neoplasm Staging, Nodal involvement, Sentinel Lymph Node Biopsy, business.industry, Endometrial cancer, Obstetrics and Gynecology, Sentinel node, medicine.disease, Endometrial Neoplasms, 030104 developmental biology, Systematic review, Oncology, Lymphatic Metastasis, 030220 oncology & carcinogenesis, Meta-analysis, Lymph Node Excision, Female, Lymphadenectomy, Radiology, Neoplasm Recurrence, Local, Sentinel Lymph Node, business
Abstract: Sentinel node mapping is increasingly being utilized for endometrial cancer staging. However, only limited evidence supporting the adoption of sentinel node mapping instead of conventional lymphadenectomy is still available. Here, we aimed to review the current evidence comparing sentinel node mapping and lymphadenectomy in endometrial cancer staging. This systematic review was registered in the International Prospective Register of Systematic Reviews. Six comparative studies were included. Overall, 3536 patients were included: 1249 (35.3%) and 2287 (64.7%), undergoing sentinel node mapping and lymphadenectomy, respectively. Pooled data suggested that positive pelvic nodes were detected in 184 out of 1249 (14.7%) patients having sentinel node mapping and 228 out of 2287 (9.9%) patients having lymphadenectomy (OR: 2.03; (95%CI: 1.30 to 3.18); p = 0.002). No difference in detection of positive nodes located in the paraaortic was observed (OR: 93 (95%CI: 0.39 to 2.18); p = 0.86). Overall recurrence rate was 4.3% and 7.3% after sentinel node mapping and lymphadenectomy, respectively (OR: 0.90 (95%CI: 0.58 to 1.38); p = 0.63). Similarly, nodal recurrences were statistically similar between groups (1.2% vs. 1.7%; OR: 1.51 (95%CI: 0.70 to 3.29); p = 0.29). In conclusion, our meta-analysis underlines that sentinel node mapping is non-inferior to standard lymphadenectomy in term of detection of paraaortic nodal involvement and recurrence rates (any site and nodal recurrence); while, focusing on the ability to detect positive pelvic nodes, sentinel node mapping could be consider superior to lymphadenectomy. Further randomized studies are needed to asses long term effectiveness of sentinel node mapping.
Published: 2019

23. Predicting Factors for High-Grade Cervical Dysplasia in Women With Low-Grade Cervical Cytology and Nonvisible Squamocolumnar Junction

Author: Cono Scaffa, Francesca Taverna, Antonino Ditto, Claudia Lombardo, Fabio Martinelli, Valentina Chiappa, Umberto Leone Roberti Maggiore, Domenica Lorusso, Ilaria Sabatucci, Francesco Raspagliesi, Lavinia Mosca, Mauro Signorelli, and Giorgio Bogani
Subjects: Adult, 0301 basic medicine, HPV, medicine.medical_specialty, unsatisfactory colposcopy, Reproductive medicine, Cervix Uteri, Cervical intraepithelial neoplasia, Hpv persistence, Lesion, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, medicine, Humans, CIN, Retrospective Studies, Gynecology, 030219 obstetrics & reproductive medicine, business.industry, Papillomavirus Infections, Squamocolumnar Junction, Obstetrics and Gynecology, Cervical cytology, Middle Aged, high-grade dysplasia, Uterine Cervical Dysplasia, medicine.disease, Hpv testing, 030104 developmental biology, Colposcopy, Dysplasia, Female, medicine.symptom, business
Abstract: To assess the risk of developing high-grade cervical dysplasia among women with low-grade cervical cytology and nonvisible squamocolumnar junction (SCJ) at colposcopic examination.Data of consecutive women with low-grade intraepithelial lesion(≤LSIL) undergoing colposcopic examination, which was unsatisfactory (due to the lack of the visualization of the entire SCJ), were retrospectively reviewed. The risk of developing high-grade cervical intraepithelial neoplasia (CIN2+) was assessed using Kaplan-Meier and Cox models.Data of 86 women were retrieved. Mean (standard deviation [SD]) age was 36.3 (13.4) years. A total of 71 (82.5%) patients had high-risk human papillomavirus (HR-HPV) at the time of diagnosis. Among the 63 patients undergoing repetition of HPV testing, 15 (24%) and 48 (76%) women had positive and negative tests for HR-HPV at 12 months, respectively. We observed that 5 (33%) of 15 patients with HPV persistence developed CIN2+, while only 1 (2%) patient of 48 patients without HPV persistence developed CIN2+ (odds ratio [OR]: 23.5; 95% confidence interval [CI]: 2.46-223.7; P.001). The length of HR-HPV persistence correlated with an increased risk of developing CIN2+ ( P.001; P for trend). High-risk HPV persistence is the only factor predicting for CIN2+ (hazard ratio: 3.19; 95% CI: 1.55-6.57; P = .002).High-risk HPV persistence predicts the risk of developing CIN2+ in patients with unsatisfactory colposcopic examination. Further studies are warranted in order to implement the use of HPV testing in patients with unsatisfactory colposcopy.
Published: 2019

24. Minimally invasive surgery in cervical cancer

Author: Giorgio, Bogani, Violante, DI Donato, Valentina, Chiappa, Salvatore, Lopez, Marco, Monti, Ludovico, Muzii, Pierluigi, Benedetti Panici, Antonino, Ditto, and Francesco, Raspagliesi
Subjects: Humans, Minimally Invasive Surgical Procedures, Uterine Cervical Neoplasms, Obstetrics and Gynecology, Female, Neoplasm Recurrence, Local, Hysterectomy, Tumor Burden
Abstract: In recent years, minimally invasive surgery has replaced open surgery for almost all surgical indications in gynecological practice. Recently, the results of the laparoscopic approach to cervical cancer (LACC) trial questioned the role of minimally invasive surgery for patients affected by early-stage cervical cancer. In the present paper, we discussed the current evidence regarding the adoption of minimally invasive surgery for patients with cervical cancer. We evaluated the current evidence focusing on four interesting features: 1) the impact of tumor volume; 2) reasons explaining worse outcomes of patients undergoing minimally invasive surgery; 3) methods to reduce the risk of recurrence during minimally invasive surgery; and 4) the effect of minimally invasive surgery in patients with locally advanced cervical cancer. At the moment, in the light of current evidence, minimally invasive radical hysterectomy should be offered only in the context of clinical trials. Extensive counseling and appropriate patients' selection are needed. Further prospective evidence is warranted to identify the better approach for cervical cancer patients.
Published: 2021

25. Sentinel node mapping vs. sentinel node mapping plus back-up lymphadenectomy in high-risk endometrial cancer patients: Results from a multi-institutional study

Author: Simone Ferrero, Valentina Chiapp, Francesco Raspagliesi, Maria Luisa Gasparri, Violante Di Donato, Ciro Pinelli, Pierandrea De Iaco, Salvatore Lopez, Debora Ferrari, Maria Chiara Paderno, Mauro Signorelli, Jvan Casarin, Andrea Papadia, Claudia Brusadelli, Pierluigi Benedetti Panici, Antonella Cromi, Alessandro Buda, Innocenza Palaia, Michael D. Mueller, Anna Myriam Perrone, Fabio Barra, Giorgio Bogani, Fabio Ghezzi, Umberto Maggiore, Fabio Landoni, Francesco Plotti, Roberto Angioli, Antonino Ditto, Rocco Guerrisi, Bogani, G, Papadia, A, Buda, A, Casarin, J, Di Donato, V, Gasparri, M, Plotti, F, Pinelli, C, Paderno, M, Lopez, S, Perrone, A, Barra, F, Guerrisi, R, Brusadelli, C, Cromi, A, Ferrari, D, Chiapp, V, Signorelli, M, Maggiore, U, Ditto, A, Palaia, I, Ferrero, S, De Iaco, P, Angioli, R, Panici, P, Ghezzi, F, Landoni, F, Mueller, M, Raspagliesi, F, Bogani G., Papadia A., Buda A., Casarin J., Di Donato V., Gasparri M.L., Plotti F., Pinelli C., Paderno M.C., Lopez S., Perrone A.M., Barra F., Guerrisi R., Brusadelli C., Cromi A., Ferrari D., Chiapp V., Signorelli M., Maggiore U.L.R., Ditto A., Palaia I., Ferrero S., De Iaco P., Angioli R., Panici P.B., Ghezzi F., Landoni F., Mueller M.D., and Raspagliesi F.
Subjects: survival rate, 0301 basic medicine, medicine.medical_specialty, endometrial neoplasms, Staging, disease-free survival, Survival, medicine.medical_treatment, lymph node excision, Nodal disease, 03 medical and health sciences, sentinel lymph node, 0302 clinical medicine, Endometrial cancer, lymph nodes, middle aged, 80 and over, medicine, Overall survival, risk factors, humans, neoplasm staging, sentinel lymph node biopsy, 610 Medicine & health, Aged, 80 and over, business.industry, adult, Obstetrics and Gynecology, Small sample, Retrospective cohort study, Lymphadenectomy, Sentinel node, medicine.disease, aged, retrospective studies, female, 030104 developmental biology, endometrial cancer, lymphadenectomy, sentinel node, staging, survival, Oncology, 030220 oncology & carcinogenesis, Population study, Radiology, business
Abstract: OBJECTIVE Sentinel node mapping (SLN) has replaced lymphadenectomy for staging surgery in apparent early-stage low and intermediate risk endometrial cancer (EC). Only limited data about the adoption of SNM in high risk EC is still available. Here, we evaluate the outcomes of high-risk EC undergoing SNM (with or without back-up lymphadenectomy). METHODS This is a multi-institutional international retrospective study, evaluating data of high-risk (FIGO grade 3 endometrioid EC with myometrial invasion >50% and non-endometrioid histology) EC patients undergoing SNM followed by back-up lymphadenectomy and SNM alone. RESULTS Chart of consecutive 196 patients were evaluated. The study population included 83 and 113 patients with endometrioid and non-endometrioid EC, respectively. SNM alone and SNM followed by back-up lymphadenectomy were performed in 50 and 146 patients, respectively. Among patients having SNM alone, 14 (28%) were diagnosed with nodal disease. In the group of patients undergoing SNM plus back-up lymphadenectomy 34 (23.2%) were diagnosed with nodal disease via SNM. Back-up lymphadenectomy identified 2 (1%) additional patients with nodal disease (in the para-aortic area). Back-up lymphadenectomy allowed to remove adjunctive positive nodes in 16 (11%) patients. After the adoption of propensity-matched algorithm, we observed that patients undergoing SNM plus back-up lymphadenectomy experienced similar disease-free survival (p��=��0.416, log-rank test) and overall survival (p��=��0.940, log-rank test) than patients undergoing SLN alone. CONCLUSIONS Although the small sample size, and the retrospective study design this study highlighted that type of nodal assessment did not impact survival outcomes in high-risk EC. Theoretically, back-up lymphadenectomy would be useful in improving the removal of positive nodes, but its therapeutic value remains controversial. Further prospective evidence is needed.
Published: 2021

26. High-risk HPV-positive and -negative high-grade cervical dysplasia: Analysis of 5-year outcomes

Author: Giovanni Scambia, Mario Malzoni, Lavinia Mosca, Lorenzo Aguzzoli, Nicola Colacurci, Gabriele Carlinfante, Marco Petrillo, Stefano Greggi, Paolo Vercellini, Antonio Cianci, Francesco Raspagliesi, Andrea Giannini, Andrea Ciavattini, Viola Liberale, Sara Bosio, Luca Giannella, Maurizio Serati, Rocco Guerrisi, Simone Ferrero, Michele Desiato, Pierandrea De Iaco, Anna Myriam Perrone, Giorgio Bogani, Fabio Ghezzi, Biagio Contino, Francesca Falcone, Arsenio Spinillo, Francesco Sopracordevole, Claudia Brusadelli, Antonio Simone Laganà, Simona Ruisi, Maria Grazia Matarazzo, Pierluigi Benedetti Panici, Paola Carunchio, Giuseppe Sarpietro, Alessandro Ghelardi, Barbara Gardella, Francesco Plotti, Alice Bergamini, Margherita Fischetti, Antonino Ditto, Gian Franco Zannoni, Gabriella Ferrandina, Vincenzo Dario Mandato, Valentina Chiappa, Violante Di Donato, Raffaele Tinelli, Ermelinda Monti, Roberto Angioli, Salvatore Dessole, Annunziata Carlea, Ciro Pinelli, Fulvio Zullo, Salvatore Lopez, Sara Lovati, Tommaso Simoncini, Maria Giovanna Salerno, Mauro Signorelli, Rosa De Vincenzo, Cono Scaffa, Jvan Casarin, Chiara Borghi, Cristina Donfrancesco, Ludovico Muzii, Giovanni D'ippolito, Gaetano Valenti, Andrea Dell'Acqua, Giulia Dondi, Bogani, G., Sopracordevole, F., Di Donato, V., Ciavattini, A., Ghelardi, A., Lopez, S., Simoncini, T., Plotti, F., Casarin, J., Serati, M., Pinelli, C., Valenti, G., Bergamini, A., Gardella, B., Dell'Acqua, A., Monti, E., Vercellini, P., Fischetti, M., D'Ippolito, G., Aguzzoli, L., Mandato, V. D., Carunchio, P., Carlinfante, G., Giannella, L., Scaffa, C., Falcone, F., Borghi, C., Ditto, A., Malzoni, M., Giannini, A., Salerno, M. G., Liberale, V., Contino, B., Donfrancesco, C., Desiato, M., Perrone, A. M., Dondi, G., De Iaco, P., Chiappa, V., Ferrero, S., Sarpietro, G., Matarazzo, M. G., Cianci, A., Bosio, S., Ruisi, S., Guerrisi, R., Brusadelli, C., Mosca, L., Lagana', A. S., Tinelli, R., Signorelli, M., De Vincenzo, R., Zannoni, G. F., Ferrandina, G., Lovati, S., Petrillo, M., Dessole, S., Carlea, A., Zullo, F., Angioli, R., Greggi, S., Spinillo, A., Ghezzi, F., Colacurci, N., Muzii, L., Benedetti Panici, P., Scambia, G., Raspagliesi, F., Bogani G., Sopracordevole F., Di Donato V., Ciavattini A., Ghelardi A., Lopez S., Simoncini T., Plotti F., Casarin J., Serati M., Pinelli C., Valenti G., Bergamini A., Gardella B., Dell'acqua A., Monti E., Vercellini P., Fischetti M., D'ippolito G., Aguzzoli L., Mandato V.D., Carunchio P., Carlinfante G., Giannella L., Scaffa C., Falcone F., Borghi C., Ditto A., Malzoni M., Giannini A., Salerno M.G., Liberale V., Contino B., Donfrancesco C., Desiato M., Perrone A.M., Dondi G., De Iaco P., Chiappa V., Ferrero S., Sarpietro G., Matarazzo M.G., Cianci A., Bosio S., Ruisi S., Guerrisi R., Brusadelli C., Mosca L., Lagana' A.S., Tinelli R., Signorelli M., De Vincenzo R., Zannoni G.F., Ferrandina G., Lovati S., Petrillo M., Dessole S., Carlea A., Zullo F., Angioli R., Greggi S., Spinillo A., Ghezzi F., Colacurci N., Muzii L., Benedetti Panici P., Scambia G., and Raspagliesi F.
Subjects: 0301 basic medicine, Adult, medicine.medical_specialty, HPV, Uterine Cervical Neoplasm, Prognosi, CIN, conization, negative, positive, Conization, Uterine Cervical Neoplasms, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Risk Factors, Retrospective Studie, medicine, Humans, Cervical Intraepithelial Neoplasia, Prospective cohort study, Propensity Score, Papillomavirus Infection, Retrospective Studies, Obstetrics, Proportional hazards model, business.industry, Risk Factor, Papillomavirus Infections, Obstetrics and Gynecology, Retrospective cohort study, Middle Aged, Prognosis, medicine.disease, Negative, Uterine Cervical Dysplasia, female genital diseases and pregnancy complications, 030104 developmental biology, Settore MED/40 - GINECOLOGIA E OSTETRICIA, Oncology, Dysplasia, 030220 oncology & carcinogenesis, Cohort, Propensity score matching, Population study, Female, business, Positive, Cohort study, Human
Abstract: Objective: To evaluate the outcomes of high-risk (HR) HPV-positive and -negative women affected by high-grade cervical dysplasia. Methods: This is a retrospective multi-institutional study. Medical records of consecutive patients with high-grade cervical dysplasia undergoing conization between 2010 and 2014 were retrieved. All patients included had at least 5 years of follow-up. A propensity-score matching was adopted in order to reduce the presence of confounding factors between groups. Kaplan-Meir and Cox hazard models were used to estimate 5-year outcomes. Results: Overall, data of 2966 women, affected by high-grade cervical dysplasia were reviewed. The study population included 1478 (85%) and 260 (15%) women affected by HR-HPV-positive and HR-HPV-negative high-grade cervical dysplasia. The prevalence of CIN2 and CIN3 among the HR-HPV-positive and -negative cohort was similar (p = 0.315). Patients with HR-HPV-positive high-grade cervical dysplasia were at higher risk of 5-year recurrence (after primary conization) that HR-HPV-negative patients (p < 0.001, log-rank test). Via multivariate analysis, HR-HPV-negative women were at low risk of recurrence (HR: 1.69 (95%CI: 1.05, 4.80); p = 0.018, Cox Hazard model). A propensity-score matched comparison was carried out in order to reduce biases that are related to the retrospective study design. In comparison to HR-HPV-negative patients, thosewith HR-HPV-positive CIN3 was associate with a 8-fold increase in the risk of recurrence (p < 0.001, log-rank test). Conclusions: HR-HPV-negative high-grade cervical dysplasia is not uncommon, accounting for 15% of our study population. Those patients experience more favorable outcomes than patients with documented HR-HPV infection(s). Further prospective studies are needed to corroborate our data.
Published: 2021

27. Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study

Author: Dmitri, Nepogodiev, Joana Ff Simoes, Elizabeth, Li, Maria, Picciochi, James, C Glasbey, Glauco, Baiocchi, Ruth, Blanco-Colino, Daoud, Chaudhry, Ehab, Alameer, Kariem, El-Boghdadly, Funmilola, Wuraola, Dhruva, Ghosh, Rohan, R Gujjuri, Ewen, M Harrison, Herman, Lule, Haytham, Kaafarani, Mohammad, Khosravi, Irmgard, Kronberger, Sezai, Leventoğlu, Harvinder, Mann, Kenneth, A Mclean, Mengistu Gebreyohanes Mengesha, Maria Marta Modolo, Faustin, Ntirenganya, Lisa, Norman, Oumaima, Outani, Riinu, Pius, Peter, Pockney, Ahmad Uzair Qureshi, April Camilla Roslani, Sohei, Satoi, Catherine, Shaw, Aneel, Bhangu, Omar, M Omar, Waheed-Ul-Rahman, Ahmed, Leah, Argus, Alasdair, Ball, Edward, P Bywater, Amanpreet, Brar, Brett, E Dawson, Irani, Duran, Muhammed, Elhadi, Conor, S Jones, Sivesh, K Kamarajah, James, M Keatley, Samuel, Lawday, Ella, J Marson, Riinu, Ots, Irène, Santos, Elliott, H Taylor, Isobel, M Trout, Chris, Varghese, Mary, L Venn, William, Xu, Irida, Dajti, Arben, Gjata, Salah Eddine Oussama Kacimi, Luis, Boccalatte, Daniel, Cox, Philip, Townend, Felix, Aigner, Irmgard Elisabeth Kronberger, Elgun, Samadov, Amer, Alderazi, Kamral, Hossain, Greg, Padmore, Gabrielle van Ramshorst, Ismaïl, Lawani, Anis, Cerovac, Samir, Delibegovic, Gustavo Mendonça Ataíde Gomes, Igor Lima Buarque, Muhammad, Gohar, Mihail, Slavchev, Chukwuemeka, Nwegbu, Arnav, Agarwal, Janet, Martin, Joshua, Ng-Kamstra, Maricarmen, Olivos, Wenhui, Lou, Dong-Lin, Ren, Jose Andres Calvache, Carlos, J Perez Rivera, Ana Danic Hadzibegovic, Tomislav, Kopjar, Jakov, Mihanovic, Pablo Mijahil Avilés Jiménez, Nikolaos, Gouvas, Jaroslav, Klat, René, Novysedlák, Nicolas, Amisi, Peter, Christensen, Alaa, El-Hussuna, Sylvia, Batista, Eddy, Lincango-Naranjo, Sameh, Emile, Danilo Alfonso Arévalo Sandoval, Hailu, Dhufera, Samuel, Hailu, Mengistu, G Mengesha, Joonas, H Kauppila, Alexis, P Arnaud, Zaza, Demetrashvili, Markus, Albertsmeier, Hans, Lederhuber, Markus, W Löffler, Daniel Kwesi Acquah, Bernard, Ofori, Stephen, Tabiri, Symeon, Metallidis, Georgios, Tsoulfas, Maria-Lorena, Aguilera-Arevalo, Gustavo, Recinos, Tamás, Mersich, Dániel, Wettstein, Gabriele, Kembuan, Peiman Brouki Milan, Mohammad Hossein Khosravi, Masoud, Mozafari, Ahmed, Hilmi, Helen, Mohan, Oded, Zmora, Gaetano, Gallo, Francesco, Pata, Gianluca, Pellino, Yuki, Fujimoto, Naoto, Kuroda, Mohamad, K Abou Chaar, Faris, Ayasra, Ildar, Fakhradiyev, Intisar Hisham Said Hamdun, Jang, Jin-Young, Mohammad, Jamal, Lina, Karout, Aiste, Gulla, Fanjandrainy, Rasoaherinomenjanahary, Luc Hervé Samison, Iran Irani Durán Sánchez, Diana Samantha Gonzalez, Laura, Martinez, María José Martínez, Alejandra, Nayen, Antonio Ramos-De la Medina, Jade, Nunez, Pueya Rashid Nashidengo, Rakesh, Shah, Ashish Lal Shrestha, Pascal, Jonker, Schelto, Kruijff, Milou, Noltes, Pieter, Steinkamp, Deborah, Wright, Lukman, Abdur-Rahman, Adesoji, Ademuyiwa, Adewale, Adisa, Babatunde, Osinaike, Justina, Seyi-Olajide, Omolara, Williams, Emmanuel, Williams, Sofija, Pejkova, Zainab Al Balushi, Raza, Sayyed, Mustafa Abo Mohsen, Sadi, A Abukhalaf, Moises, Cukier, Hugo, Gomez-Fernandez, Sebastian Shu Yip, Ximena Paola Vasquez Ojeda, Marie Dione Sacdalan, Piotr, Major, José, Azevedo, Miguel, F Cunha, Ahmad, Zarour, Eduard-Alexandru, Bonci, Ionut, Negoi, Sergey, Efetov, Viktor, Kochetkov, Andrey, Litvin, Jc Allen Ingabire, Georges, Bucyibaruta, Ntirenganya, Faustin, Sosthene, Habumuremyi, Alphonsine, Imanishimwe, Haragirimana Jean de Dieu, Emmanuel, Munyaneza, Isaie, Ncogoza, Abdourahmane, Ndong, Dejan, Radenkovic, Min Hoe Chew, Frederick, Koh, James, Ngu, Arpád, Panyko, Uros, Bele, Jurij Aleš Košir, Hassan, Daoud, Ana Maria Minaya Bravo, Umesh, Jayarajah, Dakshitha, Wickramasinghe, Mohammed Elmujtba Adam Essa Adam, Martin, Rutegård, Malin, Sund, Michel, Adamina, Eleftherios, Gialamas, Karoline, Horisberger, Muhammad, Alshaar, Abel, Huang, Varut, Lohsiriwat, Shane, Charles, Haithem, Jlassi, Arda, Isik, Hervé Monka Lekuya, Slava, Kopetskyi, Hayder, Alsaadi, Sattar, Alshryda, Osaid, Alser, Brittany, Bankhead-Kendall, Kerry, Breen, Hassan, Mashbari, Fernando Bonilla Cal, Hamza, Al-Naggar, Mayaba, Maimbo, Dennis, Mazingi, Tom, Abbott, Melika, Akhbari, Ruth, Benson, Shivam, Bhanderi, Bruce, Biccard, Edward, Caruana, Sohini, Chakrabortee, Reema, Chapatwala, Ainhoa, Costas-Chavarri, Andreas, K Demetriades, Anant, Desai, Salomone Di Saverio, Thomas, Drake, John, Edwards, Jonathan, Evans, Marco, Fiore, Samuel, Ford, Christina, Fotopoulou, Alexander, Fowler, Kaori, Futaba, Ian, Ganly, Harelimana Grace James, Ewen, Griffiths, Alessandro, Gronchi, Peter, Hutchinson, Gabriella Yael Hyman, Joseph, Incorvia, Ritu, Jain, Michael, Jenkinson, Tabassum, Khan, Stephen Richard Knight, Angelos, Kolias, Søren, Kudsk-Iversen, Tsun Yu Kwan, Elaine, Leung, Julio, Mayol, Siobhan, Mckay, John, G Meara, Emily, Mills, Susan, Moug, Akshay, Patel, Roberto, Perinotti, Henry, E Rice, Keith, Roberts, Andrew, Schache, Richard, Shaw, Neil, Smart, Matthew, Stephens, Grant, D Stewart, Ella, Teasdale, Peter, Vaughan-Shaw, Raghavan, Vidya, Naomi, Wright, Natalie, Zimmelman, Ervis, Agastra, Dariel, Thereska, Sergio Martin Lucchini, Veronica, Laudani, Carina, Chwat, Ivana Ines Pedraza Salazar, Diana Alejandra Pantoja Pachajoa, Agustin, Duro, José Alfredo Calderón Arancibia, Giuliana, D'Aulerio, Nagendra, Dudi-Venkata, Natasha, Egoroff, Shebani, Farik, Natalie, Lott, Jana-Lee, Moss, Sarah, Rennie, Lorwai, Tan, Uyen Giao Vo, David, Watson, David, Watters, Tim, Bright, Paul, Hollington, Xuanyu, Zhou, Hidde, M Kroon, Anthony, Farfus, John, Barker, Eleanor, Watson, Sean, Stevens, Haider, Latif, Amanda Caroline Dawson, Alwin, Chuan, Vijayaragavan, Muralidharan, Enoch, Wong, Travis, Ackermann, Maurizio, Pacilli, Russell, Hodgson, Alexander, Heriot, Peter, Choong, Wendy, Brown, Surjit, Lidder, Justin, Yeung, Luke, Traeger, Guillermo, Regalo, Ralph, Gourlay, Sarit, Badiani, Cherry, Koh, Soni, Putnis, Fayza, Haider, Ashrarur Rahman Mitul, Niels, Komen, Bert, Dhondt, Serge, Cappeliez, Manon, Pigeolet, Martijn, Schoneveld, Jasper, Stijns, Wouter, Oosterlinck, Nicolas, Flamey, Cyrille, Kpangon, Mouhamed, Agbadebo, Sèmèvo Romaric Tobome, Aldo Vieira Barros, Samuel Aguiar Júnior, Heloisa Galvão do Amaral Campos, Jefferson, Gross, Felipe José Fernandez Coimbra, Luiz Paulo Kowalski, Fabiana, Makdissi, Suely, Nakagawa, Joao Pedreira Duprat Neto, Jose Guilherme Vartanian, Guilherme, Yazbek, Stenio, C Zequi, Ronald, Flumignan, Natalia, Jaworska, Angela, Dell, Harsha, Shanthanna, Abdollah, Behzadi, Carolyn, Nessim, Michelle, Mozel, Pascal, St-Germain, Crispin, Russell, Gary, Groot, Najib, Safieddine, Duminda, Wijeysundera, Antoine, Eskander, Sami, Chadi, Shawn, Mackenzie, Alana, Flexman, Fernando, Heredia, Julio, Villanueva, Sofia, Waissbluth, Roberto, Macchiavello, Mario, I Escudero, Tyare, Fuentes, Ximena, Mimica, Dinimo Bolivar Saenz, Lina, Caicedo, Juan Pablo Alzate, Joaquin, Luna, Nestor Fabian Pedraza Alonso, Camilo Ortiz Silva, Juliana, Rodriguez, Liliana, Silva-Igua, Martha Luz Torres, Lina María Trujillo, Albaro José Nieto Calvache, Julián, Balanta-Melo, Rafael, Figueroa-Casanova, Oscar-Julián, García-Montoya, Carlos Andres Marulanda Toro, Marcela Velez Botero, Maria Clara Mendoza Arango, Eneida Diaz Martinez, Valentina Gutiérrez Perdomo, Emileth, Montenegro, Julia, Rodriguez-Abreu, Dolores, Mejía, Galal, Abouelnagah, Sameh, Shehata, Ahmed Hossam Eldin Fouad Rida, Ramy, A Hassan, Mahmoud, M Saad, Mohamed Reda Loaloa, Badr, Mostafa, Mohamed, Qassem, Mohamed, Fahmy, Hesham, Abozied, Ahmed, Y Azzam, Sherief, Ghozy, Asser, Sallam, Ahmed, Shehta, Mohamed, Abdelkhalek, Rehab, Samaka, Amr, Morsy, Ahmed Elshawadfy Sherif, Abraham, Negussie, Tigist, Fisseha, Kibruyisfaw, Shumbash, Metasebia, Abebe, Seid Mohammed Yasin, Yemisirach Bizuneh Akililu, Abebe, Megersa, Teshome, Tefera, Melatework, Assefa, Bahru, Atnafu, Bereket, Tsegaye, Yoseph Solomon Bezabih, Silamlak, Sisay, Kebebe, Bekele, Moa, Jira, Habtamu, Derilo, Eyueal, Degefa, Anteneh, Tadesse, Melkamu, Nidaw, Elise, Sarjanoja, Sylvie, Testelin, Sophie, Boucher, Lionel, Jouffret, Zaher, Lakkis, Alban Zarzavadjian Le Bian, Luke, Harper, Marc Danguy des Déserts, Benoît, André, Karem, Slim, Romain, Verhaeghe, Andrea, Police, Edouard, Girard, Alexandre, Chebaro, Armande Subayi Nkembi, Laurent, Arnalsteen, Quentin, Ballouhey, Diane, Mege, Clement, Jeandel, Emilie, Duchalais, Pierre-Alban, Bouche, Gilles, Manceau, Célia, Crétolle, Erik, Hervieux, Noémie, Girard, Agathe, Seguin-Givelet, Sebastien, Gaujoux, Belinda De Simone, Matthieu, Boisson, Damien, Bergeat, Fabien, Fredon, Francesco, Nappi, Radwan, Kassir, Aurélien, Scalabre, Federico, Migliorelli, Anne-Cecile, Ezanno, Barbara, Seeliger, Charlotte, Vaysse, Helene, Charbonneau, Vincent, Misrai, Olivier, Abbo, Martina Aida Angeles, Laurent, Brunaud, Ali, Modabber, Sebastian, Wolf, Carsten, Kamphues, Philipp, Höhn, Tim, R Glowka, Alexander Christopher Rokohl, Ulrich, Bork, Georg, Fluegen, Raymund, E Horch, Andrea, Schmedding, Andreas, Schnitzbauer, Helge, Eberbach, Daniel, Schlager, Fritz, Spelsberg, Lena, Keppler, Andreas, Hecker, Susanne, Wolfer, Ulrich, Ronellenfitsch, Christine, Nitschke, Christian, Peiper, Ibrahim, Hakami, Stefan, Welter, Karine, Nikolaieva, Andreas, Roth, Judith, Lindert, Konstantinos, Gousias, Anke, Rissmann, Valerie Catherine Linz, Nuh, Rahbari, Marie-Claire, Rassweiler-Seyfried, Anna Eleonora Gut, Jens, Gempt, Daniel, Reim, Arthur, Wagner, Alexander, M Keppler, Mircea Gabriel Stoleriu, Tim, Saier, Josef, Stadler, Julia Christina Kaiser, Stefan, M Brunner, Karin, Pfister, Jonas, Herzberg, Kai, Nowak, Tobias, Reinhard, Gregor, A Stavrou, Alfred, Königsrainer, Christian, Konrads, Markus, Quante, Simon, Laban, Silke von Pusch, Markus, Hirschburger, Johannes, Doerner, Armin, Wiegering, Ekaterini Christina Tampaki, Alitza Gutiérrez Ruiz, Alejandra, Rodas, Ana Lucía Portilla, Jacqueline, Carrera, Amalia Barrios Duarte, Megan, Lowey, Sabrina, Barillas, Atul, Suroy, Dhaivat, Vaishnav, Raghunandan Gorantlu Chowdappa, Irappa, Madabhavi, Dhananjaya, Bhat, Sunil Kumar Venkatappa, Sumit, Thakar, Kavitha, Jain, Aruna, Kumar, Manoj, Nagar, Tushar, Mishra, Arunkumar, Sekar, Anand, Gupta, Lileswar, Kaman, Madhivanan, Karthigeyan, Manjul, Tripathi, Ashwin, Rammohan, Sudheer Othiyil Vayoth, Anupama, Rajanbabu, Anbukkani, Subbian, Rahul, Gupta, Monish, Raut, Nissi, Evelyn, R Lavanya Kannaiyan, Anil, Matai, Sanjeev, Misra, Vishal, Bhende, Sathish, Muthu, Indranil, Ghosh, Abhishek, Sharma, Ankur, Bajaj, Shiv, Rajan, Gaurav, Agarwal, Pranay, Pawar, Philip, Alexander, M Vijayakumar Vijayakumar, Zeeshan, Hameed, Badareesh, L, Navneet Kumar Chaudhry, Lipika, Baliarsing, Satish, Dharap, Amruta, Kulkarni, Yuvaraja, Thyavihally, Rahul Deo Sharma, S Pramesh, C, Rajesh, Soni, Surya Kumar Dube, Shilpa, Sharma, Harvinder, Singh, Lovenish, Bains, Rahul, Ghodke, Ashwani, Kumar, Vivek, Sodhai, Suvendu, Maji, Somprakas, Basu, Chandrashekhar, Mahakalkar, Ravi, Kannan, Asif, Mehraj, Ranganath, N, Ashish, Phadnis, Yadev, I, Alfie, Kavalakat, Rohin, Mittal, Karthik Chandra Vallam, Hamed, Akhavizadegan, Esmaeil Rezghi Maleki, Naser Yousefzadeh Kandevani, Hilary, Ikele, Catherine, Mcnestry, Christina, Fleming, Stephen, O'Brien, Sami Abd Elwahab, Niall, Davis, Mohsen, Javadpour, Brendan, Mcdonnell, Clare, O Connor, Jarlath, Bolger, Cillian, Clancy, Stefanie, M Croghan, Noel, Donlon, Carolyn, Cullinane, Ben, Creavin, Muheilan, Muheilan, Helen, Earley, Syed Mohammad Umar Kabir, Muhammad, Fahadullah, Éanna, Ryan, Tara, Connelly, Daisuke, Hashimoto, Majdi Ali Alqudah, Amer, Alajalen, Rand, Y Omari, Abdulrahman, Qasem, Yazan, Alawneh, Amer, Ahmad, Omar, Aladawi, Bourhan, Alrayes, Hanan, Haidar, Shatha, Husain, Faisal, Qassem, Adnan, Sumadi, Ala'a Abu Salhiyeh, Balqees Mahmoud Al-Manaseer, Zaid, Alsunna, Hazim, Ra'Ed, Faten Reyad Bani Hamad, Amro, Abuleil, Elmi Ahmed Mohamed Jimaale, Marah, Abu-Mehsen, Noor, Olaywah, Omar, Wafi, Hazim, Ababneh, Luai, Abu-Ismail, Almu'Atasim, Khamees, Ahmad, Alkhatib, Raikhan, Bolatbekova, Mukhtar, Kulimbet, Talgat, Nurgozhin, Timur, Saliev, Baurzhan, Zhussupov, Ydyrys, Almabayev, Dilyara, Kaidarova, Khalil, Tamoos, Ahmed, Aqeelah, Alsnosy Abdullah Khalefa Mohammed, Faraj Al Maadany, Ghadah, Alkadeeki, Milad, Gahwagi, Wafa, Aldressi, Mohamed, Amnaina, Arowa Hassan Abdulrahman Alansari, Akram, Alkaseek, Ghozlan, Yagoub, Anass Ben Amer, Marwa, Salem, Ayman, Almugaddami, Dania, Burgan, Mohammed, Abdelkabir, Khayriyah, Alshareef, Rayet Al Islam Ben Jouira, Ayman, Meelad, Ahmad, Bouhuwaish, Sumayya Essayah Dwaga, Houda, Khalifa, Bushray, Almiqlash, Taha, Suliaman, Mohammed, Alawami, Fras, Elhajdawe, Hajir, Aboazamazem, Ibrahim, Ellojli, Ahmed, Msherghi, Ismail Ali Saleh, Mohammed, Alayan, Marcel Didier Ndayishyigikiye, Akutu, Munyika, Philipp, Plarre, David, W Borowski, Cameron, Wells, Rebecca, Teague, Brodie, Elliott, David, Kieser, Omar, Mohyieldin, Nick, Mcintosh, Cheyaanthan, Haran, Jasmin, King, Jeong, Ha, Matthew James McGuinness, Opeoluwa, Adesanya, Julius, Olaogun, Akinola, Akinmade, Kefas, Bwala, Peter, Agbonrofo, Akinwale, Afolabi, Usang, Usang, Sebastian, Ekenze, Samson, Olori, Taiwo Akeem Lawal, Abiodun, Okunlola, Stephen, Kache, Danjuma, Sale, Lofty-John, Anyanwu, Chukwuma, Okereke, Musliu Adetola Tolani, Venko, Filipce, Lazar, Todorovic, Sotir, Stavridis, John George Massoud, Sareyah, Alsibai, Rizwan, Sultan, Humera Naz Altaf, Abu Bakar Hafeez Bhatti, Shahzad Hussain Waqar, Aliya, Aziz, Asad Ali Kerawala, Lajpat, Rai, Mariyah, Anwer, Aiman, Tariq, Bushra, Ayub, Sami Ullah Niazi, Muhammad Yasir Naseem, Muhammad Zeeshan Sarwar, Muhammad Imran Khokhar, Imdad Ahmad Zahid, Haroon Javaid Majid, Nabila, Talat, Muhammad, Asif, Muhammad Hamid Chaudhary, Umer, Farooq, Siddique, Ahmad, Waleed, Mabood, Syed Imran Bukhari, Muhammad, Tariq, Eesha, Yaqoob, Saad, Javed, Muhammad Usman Malik, Hassan Nawaz Yaqoob, Glenda Marina Falcon Pacheco, Robinson Mas Melendez, Arazzelly Del Pilar Paucar Urbina, Jose Rios Chiuyari, Carlos Eduardo Otiniano Alvarado, Lorena Fuentes Rivera Lau, Giuliano, Borda-Luque, Milagros, Niquen-Jimenez, Claudia, Arias, Sergio, Zegarra, Jenner Betalleluz Pallardel, Regina Amparo Ugarte Oscco, Gian, Mendiola, Yahaira Tatiana Carpio Colmenares, Carlos Shiraishi Zapata, Maria Rosa Ortiz, Filipe Castro Borges, Octavio, Viveiros, Pedro, Serralheiro, Paulo, Santos-Costa, Filipa, Mendes, Miguel Rocha Melo, Paulo, Cardoso, Ana, Soares, Rita Gonçalves Pereira, Nelson, Silva, André, Caiado, Maria Luís Sacras, Pedro, Azevedo, Rui, Almeida-Reis, João, Oliveira, Jorge, Nogueiro, Mafalda, Sampaio-Alves, Luciana Cidade Costa, Catarina, Baía, Ana Cláudia Deus, Rita, Branquinho, André, Marçal, André, Tojal, Silviu Tiberiu Makkai-Popa, Aurel, Mironescu, Florin, Grama, Elena Adelina Toma, Daniela, Filipescu, Nicolae, Bacalbasa, Natalia, Motas, Sebastian, Ionescu, Octav, Ginghina, Radu, Costea, Narcis Octavian Zarnescu, Radu, Drasovean, Mihail-Gabriel, Dimofte, Vlad, Porumb, Mikhail, Kirov, Yegor, Molitvin, Vadim, Pykhteev, Marianna, Raevskaya, Aleksandr, Butyrskii, Mushabab, Alshahrani, Azah, Althumairi, Nasser, Alzerwi, Ahmed Al Ameer, Tariq, Madkhali, Abddulrahman Saleh Almulhim, Salman, Ghazwani, Abdu, Ayoub, Othman, Iskander, Mohammed, Ghunaim, Mohammed, Alharthi, Turki, M Alzaidi, Mohammad, Alyami, Abdulrahman Al Amri, Abdullah, Alfakhri, Amal, Alhefdhi, Sharfuddin, Chowdhury, Thamer, Nouh, Ameen, Alshehri, Abdulrahman, Alzahrani, Yousef, Alalawi, Selmy, Awad, Ibrahima, Konate, Jacques, Tendeng, Nan Zun Teo, Sabra, Aqil, Cristina Barrena López, Ana Sánchez Mozo, Antonio Rodriguez Infante, Patricia Caja Vivancos, Mikel, Prieto, Igor Alberdi San Roman, Laura Gomez Fernandez, Josep Maria Muñoz Vives, Anna, Carreras-Castañer, Berta, Díaz-Feijoo, Ramon, Sieira-Gil, Victor, Turrado-Rodriguez, Anna Sánchez López, Santiago, Sánchez-Cabús, Marta Jimenez Toscano, MªPilar Canals Sin, Saura García Laura, Oriol Martin Sole, Pedro Palazon Bellver, Sonia, Pérez-Bertólez, Jordi, Prat-Ortells, Mireia Riba Martínez, Josep, Rubio-Palau, Xavier, Tarrado, Jorge, Nuñez, Veronica Alonso Mendoza, Coro, Bescós, Eloy, Espin-Basany, Martin, Espinosa-Bravo, Daniel, Gil-Sala, Susana, González-Suárez, Nuria Montferrer Estruch, Lucia Porteiro Mariño, Ana, Rodríguez-Tesouro, Fabian Rojas Portilla, M Pilar Tormos Pérez, Inmaculada, Vives, Unai Garcia De Cortazar, Kiara, Tudela, Aitor, Landaluce-Olavarria, Mercedes Estaire Gómez, Jorge, Almoguera, Bakarne, Ugarte-Sierra, Virginia, Jimenez, Marta, Bertrand, Laura Cárdenas Puiggrós, Olga, Delisau-Puig, Jorge, Garcia-Adamez, David Julià Bergkvist, Eloy, Maldonado-Marcos, Lucia Diego García, Marta Roldón Golet, Iván, Soto-Darias, Aida Cristina Rahy-Martín, Diego, Enjuto, Adolfo, Ramos-Luengo, Juan Delgado Fernandez, Carolina Lugo Duarte, Cristina Ojeda Thies, Lucila, Marquez, Diana Crego Vita, Jana, Dziakova, Jorge Caño Velasco, Olga, Mateo-Sierra, Begoña, Quintana-Villamandos, Cristina Rey Valcarcel, Javier, Rio, Laura Román García de León, Marcello Di Martino, Jorge, Prada, Javier Serrano González, Manuel, Losada, Jose Tomas Castell Gomez, Ramon, Corripio-Sanchez, Alexander, Forero-Torres, José Manuel Morales-Puebla, Hanna, Perez-Chrzanowska, Santiago Valderrabano Gonzalez, Alvaro, Yebes, Ignacio, Zapardiel, Manuel Diez Alonso, Nelson Morales Palacios, Alberto Cabañero Sánchez, Fátima Sánchez Fernández, Alfredo Abad Gurumeta, Ane, Abad-Motos, Fernando, Corella, Javier, Ripollés-Melchor, Rosa, Sanz-Gonzalez, Marta Alcaraz Fuentes, Maria Teresa Fernández Martín, Pablo Calvo Espino, Milagros Carrasco Prats, Antonio-José, Fernández-López, Damián García Escudero, Vanesa Garcia Soria, Jesús Aarón Martínez Alonso, Miguel, Ruiz-Marín, Beatriz Gómez Pérez, Joaquin, Moya-Angeler, Daniel Fernández Martínez, Heura Llaquet Bayo, Enrique, Colás-Ruiz, Susana Bella Romera, M Teresa Gavaldà Pellicé, Misericòrdia Jordà Solé, Enrique Jose Ruiz Velasquez, Bernardo, Núñez, Raul, Jimenez, Jon, Zabaleta, Maria Jose González-Gimeno, Irene Ortega Vázquez, Antonio Perez Ferrer, Rubén, Martín-Láez, Marcelo Moreno Suarez, Miguel Angel Freiria Eiras, Irene, Ramallo-Solís, Juan-Carlos, Gomez-Rosado, Jose Ramon Oliver Guillen, Mar Achalandabaso Boira, Juan Carlos Catalá Bauset, Julio, Domenech, Rafael, Badenes, Juan Carlos Bernal-Sprekelsen, Jorge, Sancho-Muriel, Beatriz De Andrés-Asenjo, Francisco, J Tejero-Pintor, Marc, Vallve-Bernal, Alba Vazquez Melero, Laura Sánchez Blasco, Jorge, Escartin, Victoria Duque Mallén, Selvaratnam, Srishankar, Charitha, Sooriyabandara, Oshan, Basnayake, Nalaka, Gunawansa, Prabuth Dulanjan Weeraddana, Thanusan, Vimalakanthan, Shanthamoorthy, Gishanthan, Pramodh, Chandrasinghe, Marc-Olivier, Sauvain, Ahmad, Ghazal, Yusra, Al-Sabbagh, Turki, Alhassoun, Sara Maa Albared, Antoine, Naem, Hareth, Alnahr, Ghassan, Jisry, Ali, Hammed, Okedi Francis Xaviour, Gaston, Turinawe, Isaac, Mubezi, Franck, K Sikakulya, Andrew, Kakeeto, Wilberforce, M Kabweru, Ronald, Kiweewa, Paul, Matovu, Otolia, Isaac, Mohamed, Mashhour, Amin El Helw, Safeena, Kherani, Awadelkarim, Mohamed, Ferial Mohamed Ali Abbas, Diary, Mohammed, Ehab, Aldlyami, Rakesh, Kundra, Antony Louis Rex Michael, Kareem, S Khalil, Rachel, Dbeis, Shafaque, Shaikh, Jenny, Ferry, Aiman, Jamal, Haleema, Siddique, Rishi, Das, Nikhil, Ponugoti, Pornjittra, Rattanasirivilai, Asma, Sultana, Frances, Mosley, Matthew, Chan, Antony, Bateman, Gareth, Davies-Jones, Fanourios, Georgiades, Navid, Ahmadi, Aman, Coonar, Mariam, Baig, Chetan, Khatri, Arthika, Surendran, Julian, Sonksen, Robert, Sinnerton, Caitlin, Brennan, Gemma, Faulkner, Michael, Greenhalgh, Hannah, Emerson, Kiran, Singisetti, Joshua, Totty, Michael, Wilson, Terence, Lo, Harriet, Corbett, Ijeoma, Okonkwo, Gill, Arbane, Cyrus, Kerawala, Chetan, Parmar, Michael, Bath, Funlayo, Odejinmi, Jayesh, Sagar, Rishi, Talwar, Samuel, Newman, John, Hammond, John, Moir, Natalie, Duric, Tamas, Szakmany, Ahmar Iftikhar Talib, Mina, Youssef, Christopher, Lewis-Lloyd, Mariam, Lami, Khurram, Ayub, Benjamin, Dean, Supriya, Balasubramanya, Sathya, Lakpriya, Luke, Rogers, Paul, Turner, Mark, Maher, Kohila, Sigamoney, Jihène El Kafsi, John, Hardie, David, Johnson, Christin, Henein, Marianne, Hollyman, Ketan, Agarwal, Simon, Powell, Govind Singh Chauhan, Rakesh, Patel, Joel, Gagnier, Heather, Carmichael, Aurora, Kristofor, A Olson, Eric, Etchill, Sameer, Hirji, Matthew, Naunheim, Frederick, Drake, Caroline, Reinke, Anna, Alecci, Dennis, Vaysburg, Jennifer, Rodriquez, Emily, Shih, Vin Shen Ban, Julia, Coleman, Krista, Kaups-Fresno, Emmanouil, Giorgakis, Maggie, Dinome, Neal, Bhutiani, Omar, Alnachoukati, Taylor, Aiken, Thomas, Diehl, Ankush, Gosain, Rishi, Rattan, Muhammad Owais Abdul Ghani, Nensi Melissa Ruzgar, Anna, Liveris, Nina, Glass, Charu, Paranjape, Theresa, Chin, Antonio, Meola, Kristina, Nicholson, John, Squiers, Stephanie, Lueckel, Janani, Reisenauer, Rachael, Callcut, Ahmed, Mansour, Allison, Berndtson, Lucy, Kornblith, Sara, Seegert, Paulo, 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Amanda Lira Dos Santos Leite, Laercio, Pol-Fachin, Tainá Santos Bezerra, Alcimar Lavareda Dos Santos Junior Alcimar, Robson, Amorim, Maria Eduarda Bellotti Leão, João José Corrêa Bergamasco, Cintia Cardoso Pinheiro, Rubem Alves Da Silva Neto, Elaine Francisca De Araújo, Lilian, Guimaraes, Tatiana, Liborio-Kimura, Isabelle Melo da Camara, Victor Ripardo Siqueira, Juan, Rodriguez, Jeancarllo, Silva, Rubem Alves Silva Junior, Cláudio, Cardoso, Andre, Guimaraes, Wislene Sarajane Moreira Alves, Agna Soares Da Silva Menezes, Marcelo, Araujo, Kattiucy, Brito, Josie Marcelle Lira Albuquerque, Jairo Alberto Dussan-Sarria, Andressa, Souza, Andre Ricardo Stüker, Tiago, Bresciani, Luciana Cadore Stefani, Leandro Totti Cavazzola, Tainá, Costa, Matheus, Dasqueve, Gustavo De Bacco Marangon, Otávio Ritter Silveira Martins, Josy, Rodrigues, Guilherme Roloff Cardoso, Brasil Silva Neto, Tilaê, Soares, Aline, Zanella, Lucas Torelly Filippi, Enilde Eloena Guerra, Ricardo Pedrini Cruz, Antonio Nocchi Kalil, Gustavo, Laporte, Moacyr, Salem, Murilo de Lima Brazan, Caio Antonio de Campos Prado, Elaine Christine Dantas Moises, Hilda Satie Suto, Alice Gadotti Yasuda, Ana Carolina Tagliatti Zani, Roberto Cardoso Cardoso Dos Santos, Geraldo, Duarte, Edwaldo Edner Joviliano, Carolina Lourenço Gomes Dos Santos, Silvana Maria Quintana, Edwin, Tamashiro, Fabiana Cardoso Pereira Valera, Marília Veccechi Bijos Zaccaro, Isis, Andreotti, Leonardo, Lima, Wilson Salgado Jr, Alonço da Cunha Viana Júnior, Lana, Moutinho, Cora Pichler de Oliveira, Isabela Trindade Martins, Isabela Vieira Toledo, Marco Antonio Correa Guimaraes-Filho, Rodrigo, Arrivabeno, Claudio Bovolenta Murta, Danniel Frade Said, Jose Pontes Junior, Felipe Guimarães Pugliesi, Paulo, Gregorio, Alessandro, Mariani, Fabio, Minamoto, Juliana Lourenço da Silva, Bruno, Muller, Caio, Zanon, Vladimir, C Carvalho, Ana Lucia Munhoz Lima, Priscila, R Oliveira, Jorge Dos Santos Silva, Mariana Faccini Teixeira, Marco, Kulcsar, Leandro, Matos, Kamilla Schmitz Nunes, Joel Abdala Junior, Emne, Abdallah, Genival Barbosa Carvalho, Igor Correia de Farias, Cassia da Silva, Fabio Fernando Eloi Pinto, Luciana, Facure, André, Godoy, Bruna, Kupper, Fernanda, Leite, Matheus de Melo Lôbo, Henrique, Mantoan, Narimã, Marques, Tomas, Marques, João Paulo Medici, Silvio Melo Torres, Katheryne Merlos Garcia, Rafael Ribeiro Meduna, Ana Carolina Scintini Herbst, Silvana Soares Dos Santos, Bruna Tirapelli Gonçalves, Marcelo, Antonini, Carolina, Brienze, José Francisco Farah, Rodrigo, Gonçalves, Vinicius, Machado, Luis Roberto Nadal, Danilo Nadal Rodrigues, Adrieli, Pansani, Maria Luiza Rocha, Marcelo, Simonsen, Daniela, Tsuchiya, Rafaela, Vasques, Jorge, Amorim, Ana Alyra Carvalho, Rebeca, Correia, Brena Costa Dos Santos, Henrique Jorge Guedes Neto, Luis, Nakano, Mariana, Pereda, Vladimir, Vasconcelos, Jamile Barakat Awada, Guilherme, Gava, Tiago Riuji Ijichi, Nam Jin Kim, Rafael, Nunes, Fabio, Pinto, Thiago Henrique Sigoli Pereira, Gustavo Jardim Volpe, Arthur, Gatti, Caroline, Nardi, Ramon, Oliva, Layze Braz de Oliveira, Herica Emilia Félix de Carvalho, Ivonizete Pires Ribeiro, Gabriel Renan Soares Rodrigues, Álvaro Francisco Lopes de Sousa, Michel, Chebel, Paulo Henrique de Sousa Fernandes, Marcelo Augusto Faria Freitas, Juliano Rodrigues da Cunha, Zeenia, Ather, Dobromir, Dimitrov, Emil, Filipov, Elitsa, Gyokova, Ivelina, Ilieva, Tsvetomir, Ivanov, Martin, Karamanliev, Vasil, Neykov, Boyko, Atanasov, Nikolay, Belev, Paolina, Kamenova, Kaloyan, Tonev, Tsanko, Yotsov, Evguenia, Hristova, Kolyo, Spassov, Tsanko, Tsankov, Dragomir, Dardanov, Petar, Gribnev, Manol, Sokolov, James, Brown, John, Tanyi, Heather, Hurdle, Anthony, Maclean, Michael, Sander, Salim Al Riyami, Krittika, Bali, David, Bigam, Khaled, Dajani, Mehran, Anvari, Rafik, Bolis, David, Choi, Susan, Ellis, Michael, Gupta, Wael, Hanna, Dennis, Hong, Cynthia, Horner, Lea, Luketic, Peter, Moisiuk, Yaron, Shargall, Hilda, Alfaro, Nawar, Alkhamesi, Laura, Allen, Muriel, Brackstone, Eunice, Chan, Davy, Cheng, Jason, Chui, Nelson, Gonzalez, Brent, Lanting, S Danielle MacNeil, Robert, Mayer, Jacob, Mcgee, Mahesh, Nagappa, Nicholas, Power, Agya, Prempeh, Mehdi, Qiabi, Hassan, Razvi, Emil, Schemitsch, Herman, Sehmbi, Ushma, Shah, Yamini, Subramani, Edward, Vasarhelyi, Kelly, Vogt, Homer, Yang, Ali Ghorbani Abdehgah, Saba, Balvardi, Liane, Feldman, Julio Flavio Fiore Jr, Melissa, Hanson, Brent, Hopkins, Pepa, Kaneva, Lawrence, Lee, Julia, Leonard, Jad, Abou-Khalil, Andre, Martel, James, Stevenson, Susan, Lee, Richard, Merchant, Samuel, Avoine, Laurence, Belanger, Mathieu, Belanger, Etienne, Belzile, Anne-Sophie, Blais, Sofia, Boucher-Kovalik, Cindy, Boulanger-Gobeil, Etienne, Cardinal, Pierre-Olivier, Champagne, Jonathan, Cloutier, Simon, Corriveau-Durand, Mathieu, Cote, Maxime, Cote, Mathilde, Côté, Valérie, Courval, Suzanne, Demers, Christine, Desbiens, Mehdi El Ouazzani, Karine, Girard, Ève-Marie, Girard, Karo, Gosselin, Helene, Khuong, Nathalie, 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Philemon, Leung, Andrew, Lindberg, Juan Mata Gutierrez, Kelly, Mayson, Adam, Meneghetti, Drew, Phillips, John, Street, Carolina Carvajal Calderón, Daniel Alejandro Donoso Pizarro, Esteban, Fernández, Ángela, Molero, Nastassja, Mutarello, Jorge Núñez Lucic, Katherine Ochoa Gaete, Catalina Ruiz Lopez, Rina, Sepúlveda, Camila, Ulloa, Mauricio, Barreda, Matias, Dallaserra, Matías Günther Wood, Mauricio Sandoval Tobar, Francisco, Garcia-Huidobro, Jimena, Dona, Carolina Soto Diez, Daniel, Igor, Javier, Mena, José Tomás Reyes, Catalina Arredondo Soto, Jose, Campos, Javier, Gonzalez, Barbara, Rivera, Jaime, Altamirano-Villarroel, David, Cohn, Luis Marin de Amesti, Pedro, Recabal, Camilo, Sandoval, Bruno Catoia Fonseca, Monica, Contador, Andres, Hodali, Camila, Pincheira, Andrea Ramos Mantilla, Claudio Salas Garrido, Janina, Torres, Marco, Valenzuela, Zehua, Chen, Jiankun, Hu, Jin, Tao, Kun, Yang, Yuexin, Zhang, Yuan, Chen, Wang, Cunchuan, Wah, Yang, Xueli, Bai, Tingbo, Liang, Tao, Ma, Ning, Pu, Hanlin, Yin, Camilo, Caicedo, Diego Felipe Tellez Beltran, Alejandro, Escobar, Carolina Perez Granados, Lisbeth Alexandra Urueña Pinzon, Carlos, Bonilla, Diana, Santana, Oscar, Serrano, Andrea, Garcia, Fernando Giron Luque, Nasly, G Patino-Jaramillo, Laura Giselle Contreras Baquero, Nestor Augusto Muñoz Botero, Jhoana Andrea Murillo Castellanos, Andrea Juliana Vega Calvera, Lina, M Acosta Buitrago, Maria Paz Bohórquez-Tarazona, Paulo Andrés Cabrera Rivera, J Felipe Casas, Valeria Cormane Alfaro, Julian, Corso, Bayron, Guerra, Albert Franz Guerrero-Becerra, Akram Kadamani Abiyomaa, Felix Ramon Montes, Manuel Santiago Mosquera Paz, Camilo Andrés Polanía Sandoval, Natalia, Quintana, Carlos Fernando Roman Ortega, Carlos, Santacruz, Manuela, Téllez, Camilo Alejandro Velandia Sánchez, Fernando, Arias-Amézquita, Luis Felipe Cabrera Vargas, Natalia Cortes Murgueitio, Elkin, Escorcia, Kemel Ahmed Ghotme Ghotme, Jorge Luis Gomez-Mayorga, Alvaro Felipe Guerrero Vergel, Gabriel, Herrera-Almario, Eduardo, Londono-Schimmer, Juan, A Mejia, Guillermo, Monsalve, Camilo, Rodriguez, Juan Nicolas Rodriguez Niño, Luis Martín Rodríguez Ortegón, Daniel, Sanabria, Andres, Alvarez, Arnulfo, Andrade, Javier, Ardila-Montealegre, David, Baquero, Edgar Mauricio Barrios Vidales, María Alejandra Caicedo Giraldo, María Camila Carvajal, Maria, Castillo, Maria Carolina Castillo Florez, María Angelica Cendales, Danny Conde Monroy, Henry, Cortes, Mario, Daniel, Jairo De la Peña, Elena Leonor Delgado-Nieto, Hernando, Espitia, Carlos Figueroa Avendaño, Edgar Oswaldo Hernandez Burgos, Andres, Isaza-Restrepo, German, Londono, Margarita Maria Maldonado, Andrea, Montenegro, Juan Carlos Navarro, Jorge, Navarro-Alean, Katherine Parra Abaunza, Eliana, Pulido, Erika, M Ramírez Amaya, Carlos Eduardo Rey Chaves, Natalia Andrea Rivera Rincón, William Mauricio Riveros Castillo, Lizeth Rodriguez Sanchez, Wilson, Rubiano, Maria, Russi, Juan Carlos Sabogal Olarte, Javier Mauricio Salgado Tovar, Maria Juliana Sanchez, David Mauricio Solano Varela, Paula Torres Gomez, Marcial, Trillos, Ana María Vargas Patiño, Felipe, Vargas-Barato, Juan Pablo Villate Leon, María Alejandra Wagner Useche, Jesus, Acosta, Adriana, Almeciga, Luis Becerra Mendez, Rafael Jose Beltran, Ana, Bonilla, Miguel, Buitrago, Marino, Cabrera, Pedro Hernando Calderon Quiroz, Diego, Camacho-Nieto, Carlos Andrés Carvajal Fierro, Sergio Cervera Bonilla, Sandra, Diaz, Helena, Facundo, Jorge, Forero, Mauricio Garcia Mora, Karena Victoria Garcia Tirado, German Fabian Godoy Perez, Felipe, Gonzalez, Oscar, Guevara, Jairo Alonso Hernandez, David Ricardo Herrera Mora, Juan David Lalinde, Carlos, Lehmann, Eduardo Leon Llanos, Byron Eduardo Lopez De Mesa Lopez, Ivan, Mariño, Monica, Medina, Raúl Eduardo Pinilla Morales, Angela, Puerto, Andrea, Quintero-Ortíz, Juliana Rendón Hernández, Elio Fabio Sánchez Cortés, Alvaro Eduardo Sánchez Hernández, Raul, Suarez, Oscar, Suescun, Marco, Vanegas, Rodolfo, Varela, Jorge Luis Velez Bernal, David, Viveros-Carreño, Daniela Camargo Gómez, Angelica, Fletcher, Abel, Merchan, Euler Javier Burbano Luna, Indira, Cujiño, Mauricio Velasquez Galvis, Lina Maria Vergara Galliadi, Orlando Abonia Gonzalez Abonia Gonzalez, Maria Fernanda Acuna Saravia, Roberto, Arroyave, Jose Maria Barreto Angulo, Francisco Javier Bonilla-Escobar, Uriel, Cardona, Ivan Castañeda Giacometto, José Luis Castillo, Diego Fernando Castillo-Cobaleda, Diego Jose Caycedo Garcia, Brenda Marcela Coll Tello, Juan Carlos Dueñas-Ramirez, Oscar Andres Escobar Vidarte, Luis, Figueroa, Herney, Garcia-Perdomo, Alden, Gomez, Laura, Gomez, Alejandro, Gomez, Ana María Grande-Gil, David, Guarin, Natalia, Guzman, Enrique Herrera Castañeda, Marisol, Hinaoui, Anuar Armando Idrobo Escobar, Christian Kammerer Kammerer, Sergio, Leon, Carlos Antonio Llanos Lucero, Angie, López, Alexander Maximiliano Martinez-Blanco, Antonio José Montoya Casella, Ricardo Andres Niño Corredor, Sebastian, Ordoñez, Diego Alfredo Palta Uribe, 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Alvarez, Cesar David Galindo Regino, Angela Maria Giraldo Velasquez, Carlos Enrique Melo Moreno, Jorman, H Tejada, Jesus Hernan Tovar, German Alirio Tovar, Edison Alexander Benavides Hernández, Claudia Milena Orozco-Chamorro, Gustavo Adolfo Angel, Christian Ali Buesaquillo, Victor David Olave Montaño, Andrés, Sánchez-Gómez, Daniela Patricia Escalante Ureche, Jairo Martinez Garrido, Eben-Ezer, Genda, Fabrice, Eboma, Kristina, Bitunjac, Karlo, Grulović, Marijana, Vučković, Goran, Šantak, Emanuel, Borovic, Ana Bosak Versic, Damir, Hasandić, Natasa Poldan Grabar, Suzana Srsen Medancic, Lucija, Brkic, Sara, Cokarić, Petra Pavic Palac, Zeljka, Samac, Josipa, Tomić, Marija, Vrdoljak, Ivan, Bacic, Bernarda, Bakmaz, Nikolina Bratošević Vučičić, Domagoj, Brzic, Samir, Canovic, Emilio, Dijan, Maja Grgec Dragicevic, Robert, Karlo, Suzana, Konjevoda, Petra, Kovačević, Ivan, Kovačić, Frane, Markulić, Luka, Matak, Domagoj, Morović, Gordan, Perišić, Andrea, Simic, Neven, Skitarelić, Matea, Veršić, 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Ioanna, Pozotou, Olga, Stavrinidou, Anneza, Yiallourou, Lukáš, Burda, Michal, Dosoudil, Lubomir, Martinek, Wladyslaw, B Gawel, Milan, Lerch, Matúš, Peteja, Jan, Žatecký, Toman, Daniel, Martin, Formánek, Veronika, Javurkova, Markéta, Kepičová, Nicole, Macečková, Petr, Matousek, Ondrej, Simetka, Petr, Vavra, Karol, Zelenik, Jan, Černý, Sami, Khan, Robert, Lischke, Martin, Přibyl, Temoore, Younus, Yenuksha, Amarasena, Karel, Klíma, Setareh, Pirmorad, Zuzana, Hotová, Aleš, Mladěnka, Nulvin, Bozo, Julie Lykke Harbjerg, Louise, Hviid, Helle, Ø Kristensen, Mira, Mekhael, Mette Fugleberg Nielsen, Laerke, Paulsen, Saija, Sinimäki, Louise Zinck Mogensen, Peter, Bonde, Anders Lyng Ebbehøj, Anne-Sophie, Fenger, Aleksander Fjeld Haugstvedt, Christine Hangaard Hansen, Maria Lovisa Jönsson, Lars, N Jorgensen, Peter-Martin, Krarup, Anne-Louise, Lihn, Christian, Meyhoff, Helena, Otte, Anas Ould Si Amar, Henrik, Palm, Nis, Schlesinger, Henry, Smith, Ida, Tryggedsson, Anne Reiss Axelsen, Jens Kristian Baelum, Mark Bremholm Ellebaek, Signe Bremholm Ellebaek, Anders, Hogh, Maria, Acosta, Yancy, Acosta, Pedro, Baez, Luis Alfredo Betances, Luis Rodolfo Bonilla, Daniel, Cabreja, Wilton Cabrera Cruz, María Mabel Collado Expósito, Aldo, Crespo, Octavio, Cruz-Pineda, Claudio Samuel D'óleo García, Pedro, Díaz, Remberto, Escoto, Jatnna, Figueroa, Luis, Garcia, U Garcia-Dubus Rodriguez, Humberto, Gomez, Adrian, Grullon, Fatherin, Guerrero, Lillian, Guzman, Thelma Rocío Jiménez Mosquea, Engels, Lazala, Ariela, Lopez, Leeany Maletta Francisco, Jhomayri, Mercado, Herisardy, Munoz, Jeffrey, Paulino, Maricely Ambar Perez Fernandez, Rudeily, Reyes, Lilia Rosa Reyes Guilamo, Ruben, Rivas, Claudia Alejandra Rivas Torres, Ada, Rodríguez, Madelin Tamar Rosario Villa, Eleazar, Santana, Joel, Soto, Nassin, Tactuk, Cristina Kristel Tonos Sardiñas, Raul, Ubinas, Jose, Victoria, Aaron, Villegas, Ricardo, Acra-Tolari, Larissa, Beltran, Luis Fernand Betances, Alejandro, Blaubach, Denisse Idalia Campos Mejía, Nathalia, Capellan, María Fernanda Cedeño Bruzual, Saray Cordero Spencer, Gabriella Cuevas Lantigua, Luis De Jesus, Gabriela, Díaz, Pedro Pablo Díaz Vásquez, Karla, Disla, Jesús Antonio Echavarría Uceta, Paola Irina Eusebio Jimenez, Damaris, Fernandez, Marlin Fernandez Camilo, Jiomar Manuel Figueroa Germosen, Maruel, Fortunato, Leyla Gabriel Fernández, Alicia German Dihmes, Héctor, Herrera, Elizabeth Leon Cuevas, Jose Alejandro Mata, Mirian Mateo De La Cruz, Dolores Mejia De la Cruz, Marcos, Mirambeaux, Fabio Ortiz De La Cruz, Henry, Paulino, Gabriela, Pelletier, Merycarla, Pichardo, Rodriguez Pumarol Próspero Enrique, Julio, Rivas, Ann Stephany Sanchez Marmolejos, Roman Santana Santana, Irina Suero Almanzar, María Magdalena Vásquez Sánchez, Nicolás, Campuzano, José Ricardo Negrete Ocampo, Maria, Armas, Alvaro Santiago LeMarie Guerra, Gustavo León Vizcaya, Omar Ahmed Abdelwahab, Ahmed, O Elmehrath, Mohammed Ezzat Mostafa, Gamal, Amira, Ibrahim, Sallam, Mohamed, Sherief, Ahmed, 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Maher, Hosain, Ahmed, Hossam, Hamza Hussein Aly Salama Aly, Mohamed, Ibrahim, Abdelrahman, Ibrahim, Nourhan, Ibrahim, Noha Mohamed Salah Ibrahim Moussa Hamouda, Monica, Iskander, Islam, Khalifa, Mostafa, Kotb, Nada, Mahmoud, Alaa Mahmoud Abo Shabana, Nora, Mamdouh, Maram, Metwalli, Khaled, Metwally, Mahmoud, Moghazy, Moustafa, Mohamed, Mohamed, Mourad, Esraa, Moustafa, Kamilia, Mubarek, Nour Eldin Nader, Ahmed, Nasser, Samaa, Omar, Mostafa Shehata Qatora, Mohamed, Ragab, Marawan, Ragal, Dina, Ramadan, Rana, Ramadan, Sara, Ramadan, John, Romany, Ahmed, Sabry, Yasmeen, Said, Sara, Salamah, Ahmed Mostafa Saleh, Mona Saleh Mesbah Mohamed Elkaffas, Alaa, Salem, Hashem, Salim, Ahmed, Samih, Ahmed Samir Abdelaal, Ahmed, Shaheen, Yassmeen Sharafeldin Mohammed, Abdelrahman, Shehata, Mohamed, Shemeis, Karim, Shenit, Mennatallah, Sheta, Asmaa, Soffar, Yousef, Tanas, Ahmed, Tarek, Nermin, Yehia, Omar Khaled Mohamed Eid, Ammar Yasser Abdulfattah, Ahmed, Elsaghir, Mohamed Fouad Elganainy, Omar Ibrahim Elsayed, Omar, Elmandouh, Omar, Hamam, Mostafa Ahmed Shehata, Areej, A Abdelaziz, Ahmed, M Abbas, Wael Abd El-Ghani, Hossam Aldein, S Abd Elazeem, Mustafa Abd Elsayed, Ahmed Yassien Abd-Elkariem, Shimaa, Abdalla, Mahmoud, Abdel-Aleem, Khaled, Abdelazeem, Mahmoud, Abdelfattah, Mohammed, Abdelhafez, Mohamed, M Abdelkarem, Ali, Abdelraouf, Lamess, Abdullaha, Hossam, Abubeih, Moaiad Eldin Ahmed, Nagm Eldin Abu Elnga Ahmed, Ahmed, Ahmed, Sarah Ahmed Saad, Sherif, Alaa, Ali, Alhussaini, Abdelrahman Ahmed Abdelrahman Ali, Ibrahim, Ali, Wagdi, Ali, Mohamed Ali Mohamed, Mohamed, Ashraf, Muhammad, Bassiouni, Mohamed, G El-Adawy, Mohammad, El-Sharkawi, Hussein, Elkhayat, Khaled, Elmaghraby, Shady, Elsdfy, Mohamed, Elsharkawy, Almoutaz, Eltayeb, Mohamed Esmat Mohamed, Esraa, Essam, Mahmoud, Fahd, Osama, Farouk, Rabea, Gadelkareem, Ahmed, Ghoneim, Mohammed Hamada Takrouney, Ahmed, Hamdan, Abd El-Rahman Hamed, Ahmad, Hasan, Mohamed Abdelghafor Hassanin, Islam, Hawal, Kerollos, Henes, Mohamed Omar Herdan, Helal, F Hetta, Omar, Ibrahem, Mostafa, Ibrahim, Islam, H Ibrahim, Mahmoud, Kamel, Mohamed, Khallaf, Shrouk, M Elghazaly, Abobakr, Mahfouz, Osman, Mahmoud, Wesam, Mahran, Doha, Mahrous, Abadeer, Marsis, Ayman, Mohamed, Aliae Mohamed Hussein, Amr Mohamed Sayed, Mahmoud, M Mohammed, Ahmed, Mokhtar, Fatma, A Monib, Ahmed, Nageeb, Mariam Albatoul Nageh, Mohammed, Nageh, Nehal Gamal Omar, Abdelrahman, Ragab, Abdelrahman, Ramadan, Abdallah Rashad Temerik, Aya, Sabry, Hadeer, Safwat, Omar, Salah, Ahmed Elhussiny Salah Mahmoud, Ahmed, Saleh, Mahmoud, Sallam, Ahmed, Samir, Reem, Sayad, Esraa, Sayed, Ahmed, S Sedik, Mohammed, Shahine, Antonios, Soliman, Wael, Soliman, Mohamed Gamal Taher, Randa, Wanees, Ebrahim Ahmed Yousof, Ahmed, Youssef, Omar Zein Elabedeen, Ahmed Emad Sayed Hassan, Shrouk Abdel Fattah, Ahmed, Abostate, Samar, Ali, Saad Ali Saad Salama, Mohamed, Allam, Ahmed, Alsadek, Ebrahim, Arafa, Ahmed, Barakat, Mohammed El Sherpiny, Gehad, Elbehairy, Mahmoud, Eleisawy, 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David, Walawah, Makafui, Yigah, Safia, Yussif, Nuna, Jiagge, Emmanuel, Nachelleh, Jane, Acquaye, Kwabena, Agbedinu, Fareeda, Agyei, Akosua, Agyemang-Prempeh, Kwabena, Amo-Antwi, Michael, Amoah, George, Amoah, Yaw, A Amoako, Daniel Gyawu Aning, Frank, Ankobea-Kokroe, Dominic Annor Mintah, David, Anyitey-Kokor, Adu, Appiah-Kubi, Joshua, Arthur, Vincent, Ativor, Isaac, Barnor, Yasmine, Braimah, Regina, Darko-Asante, Anthony, Davor, Mohammed Duah Issahalq, Mawutor, Dzogbefia, Tano, Emile, Papa, Fiifi-Yankson, Valerie, Gaveh, Senyo, Gudugbe, Solomon, Gyabaah, Frank Enoch Gyamfi, Adam, Gyedu, Derrick, Gyimah, Bernard, Hammond, Boakye-Yiadom, Jonathan, Yorke, Joseph, Thomas Okpoti Konney, Anna, Konney, Kwasi, Kusi, Ishmael, Kyei, Agbenya, Lovi, Nuhu, Naabo, Boateng, Nimako, Beauty, Nyadu, Obed Ofori Nyarko, Ben Blay Ofosu-Barko, Philip Peprah Oppong, Anita, Osabutey, Martha, Poku, Robert, Sagoe, Abiboye, Yifieyeh, George, Ansong, Adam, Abass, Alhassan, Abdul-Mumin, Theophilus, Adjeso, John Abanga Alatiiga, Munira, Amadu, Nathaniel, Annan, German Azahares Leal, Mohammed, Bukari, Alexis, Buunaaim, Ernest, Cheyuo, Latif Daboo Salifu, Michael, Damah, Malcolm, Dery, Edem Kojo Dzantor, Odoniel Guerra Garcia, Yabasin Iddrisu Baba, Adamu, Issaka, Abdul-Jalilu Mohammed Muntaka, James, Murphy, Yaa Nyarko Agyeman, Wisdom Opoku Amankwaa, Imoro, Osman, Samuel, Pie, Anwar Sadat Seidu, Mohammed, Sheriff, Ana Maria Simono Charadan, Abraham, Titigah, Mundashiru, Yahaya, Musah, Yakubu, Edwin Mwintiereh Ta-Ang Yenli, Ioannis, Grypiotis, Nikolaos, Kiriakopoulos, Georgios, Koliopoulos, Vasilis, Kyvelos, Georgia, Micha, Triada, Papadopoulou, Dimitrios, Balalis, Evangelos, Fradelos, Dimitrios, Korkolis, Nicholas, Alexakis, Kyveli, Angelou, Dimitrios, Haidopoulos, Anastasia, Prodromidou, Alexandros, Rodolakis, Nikolaos, Thomakos, Dimitris, Psychogios, Pantelis, Antonakis, Konstantinos, Bramis, Leonidas, Chardalias, Ioannis, Contis, Nikos, Dafnios, Dionysios, Dellaportas, Papalouka, Dimitra, 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Liolis, Elias, Ioannis, Maroulis, Francesk, Mulita, Kerasia-Maria, Plachouri, Michail, Vailas, Charalampos, Doitsidis, Eva, Filo, Ioanna, Gkalonaki, Eleni, Kogia, Konstantina, Kontopoulou, Magdalini, Mitroudi, Christina, Panteli, Ioannis, Patoulias, Olga Ioulia Semkoglou, Dimitrios, Sfoungaris, Ioannis, Valioulis, Ioannis, Astreidis, Panagiotis, Christidis, Orestis, Ioannidis, Lydia, Loutzidou, Antonis, Mantevas, Konstantinos, Paraskevopoulos, Dimitris, Tatsis, Apostolos, Athanasiadis, Themistoklis, Dagklis, Ioannis, Kalogiannidis, Georgios, Kapetanios, Apostolos, Mamopoulos, Chrysoula, Margioula-Siarkou, Stamatios, Petousis, Ioannis, Tsakiridis, Christos, Anthoulakis, Chrysanthos, Christou, Antonios, Fantakis, Eirini, Iordanidou, Christos, Kaselas, Sousana, Panagiotidou, Vasileios, Papadopoulos, Kyriakos, Papavasiliou, Athanasios, Piachas, Ioannis, Siasios, Ioannis, Spyridakis, Theodoros, Theodoridis, Andreas, Tooulias, Eleftherios, Tsiridis, Maria, Tsopozidi, María, Alemán, Estuardo, Brolo, Ana Lucia Lemus, Jennifer, Greenberg, Krisna Mishel Morales Chew, José Rodrigo Oliva, María Alejandra De León Lima, Ismar Lopez Muralles, Felipe, Solares, Gaby, Ajcip, Claudia, Anton, Jose, Cojulun, Mario-Andrés, Flores, Noriega, José, Carlos Adolfo Marroquín Paiz, Steffanía, Morales, Ramiro, Najera, Eduardo Quiñónez Lorenzana, Pablo, Rivera, Lesly, Rodas, Victor, Santos, Dianne, Sosa, Natalia, Ybarra, José David Pérez Cajti, Carlos, Régil, Walter, A Osorio, Rember Rosales Arriola, Luis-Fernando, Talé-Rosales, Danilo, Herrera, Servio Tulio Torres Rodríguez, Sergio Alejandro Villeda, Joshua, Anicetti, Andrea Michelle Lowey Medina, Javier, Ardebol, Kathia, Barillas, Francis De Leon, Salvador, Recinos, Miguel-Angel, Marroquin-Alpirez, Yessica, Yax, Sophie, Hon, Yuk Ho Liu, Alex Qinyang Liu, Shirley, Liu, Hei Tung Natalie Chiu, Chi Man Tom Chow, Victor, Hau, Ho Wai Ip, Brian, Mak, Chung Ying Mok, Dennis, Ng, Yin Yu Eva Siu, Kiu Fung Wong, Jingya Jane Pu, Yu-Xiong, Su, Kit Ying Au-Yeung, David Yuen Chung Chan, Albert, Chan, Shannon Melissa Chan, Tsz Ching Chang, Tor Wo Chiu, Wang Kei Chiu, Zhexi, He, Man Fung Ho, Kevin Ki Wai Ho, Jacky Yan Kit Ho, Janet Wui Cheung Kung, Cheuk Ho Lam, Rainbow W, H Lau, Samuel Ka Kin Ling, Hon Ting Lok, Tony Wing Chung Mak, Chi-Fai, Ng, Simon, Ng, Kelvin Kwok-Chai Ng, Calvin S, H Ng, Michael Tim Yun Ong, Teresa, Tan, Sui Fan Tang, Jeremy Yuen-Chun Teoh, Anthony, Teoh, Bess Siu Yan Tsui, George Kwok Chu Wong, Randolph, Wong, Kwok Chuen Wong, Chi Hang Yee, Zsuzsanna, Antal, Attila, Kalman, Peter, Voros, Kiarash, Bahrehmand, Timea, Echim, Zoltan, Novak, Tamás, Sztipits, Laszló Ádám Bihari, László, Hidi, Laszlo, Piros, Balazs, Rózsa, Peter, Sotonyi, Lilla, Szatai, György, Herczeg, Bálint, Pordány, Fanni, Tornyi, Kristof, Dede, Tamás, Egyed, György, Saftics, Judit, Kulcsicka-Gut, Zsófia, Sipos, Dezso, Toth, Bhavin, Patel, Hardil, Majmudar, Saptak, Mankad, Sohilkhan, Pathan, Sharathkumarkl, L, Lokesh, Sasatti, Subramanyam, Mahankali, Santhosh Kumar Sampengere Annayappa, Tulika, Agrawal, Premkumar, Anandan, Aditya, Baindur, Manjunath, Bd, Savitha, C, S Anitha, G, Sandeep, Harigond, K Tejeswini, K, Venkatesh, Kesarla, Mallikarjuna, Manangi, B Hareesh, P, Jyothi K, R Ranjan, Athish, Shetty, Santhosh Shivashankar Chikkanayakanahalli, Tanvi, Sunil, Shreya, Syamala, Kavya, Tharanath, Aditya, Atal, Niranjana, Rajagopal, S Srinath, B, Vinod, Nk, L Thirumanikandan, P, Nitu, Mishra, Sushruta, Shrivastava, Rekha, Wadhwani, Reyaz, Ahmad, Zainab Ahmad Haq, Prateek, Behera, Ritika, Dhurwe, Rehan, Haq, Vaibhav, Jain, Anuj, Jain, Sunaina, Karna, Kameshwarachari, Pushpalatha, Sumit, Raj, John Ashutosh Santoshi, Pooja, Singh, Virendra, Verma, Vaishali, Waindeskar, Moorat Singh Yadav, Zaheda, Aziz, Koyel, Chakraborty, Preetam, Chappity, Gurudip, Das, Debajyoti, Datta, Saubhagya Kumar Jena, Madhabananda, Kar, Susanta, Khuntia, Pankaj, Kumar, Ravi, Kumar, Aswathi, Kv, Abhijeet, Mishra, Swastik, Mishra, Yash, Mittal, Dillip, Muduly, 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Somil, Jaiswal, Yashpal, Jaware, Navneet, Kala, Ruchi, Karnatak, Apjit, Kaur, Vijay, Kumar, Manoj, Kumar, Ambrish, Kumar, Upander, Kumar, Amit Kumar Shrivastava, Seema, Mehrotra, Brijesh, Mishra, Anand, Mishra, Namrata, Bal Krishna Ojha, Ahmad, Ozair, Uma Shanker Pal, Amita, Pandey, Nancy, Raja, Pooja, Ramakant, Ashutosh, Roy, Rekha, Sachan, Satyanarayan, Sankhwar, Pushp, Sankhwar, Divya, Sarin, Ayushi, Shukla, Sushil, Singh, Mohit, Singh, Kul Ranjan Singh, Renu, Singh, Uma, Singh, Urmila, Singh, Vandana, Solanki, Abhinav Arun Sonkar, Chhitij, Srivastava, Parijat, Suryawanshi, Vivek, Tewarson, Rajat, Verma, Manju Lata Verma, Awdhesh, Yadav, Gyan, Chand, K M, M Vishvak Chanthar, Dileep, Hoysal, Anjali, Mishra, Nitin, Batra, Arun, Bhatti, Rupali, Chopra, Shakina, David, Tapasya, Dhar, Uma Kant Dutt, Rohini, Dutta, Sumir, Gandhi, Parvez David Haque, B Paul Sudhakar John, Sreejith Kannummal Veetil, Gurvinder, Kaur, Navneet, Kumar, Anil, Luther, Anupam, Mahajan, Amit, Mahajan, Kavita, Mandrelle, Shefin, Mathews, Vishal, Michael, Partho, Mukherjee, Pinki, Pargal, Rajesh, Paul, Anupam, Phillip, Rachel, Phillips, Abhishek, Samuel, Noel, Singh, Inderjot, Singh, Abhijit, Singh, Sarvpreet Singh Grewal, Anusha, Singhania, Selven, Thirumalai, Ashish, Varghese, Joshua, Wesley, Josy, Thomas, Pradeep, Zechariah, Mariam Anjum Ifthikar, Rohan Thomas Mathew, Rohan, Shetty, M Vijayakumar Vijaykumar, Bm Zeeshan Hameed, Sufyan, Ibrahim, Gayathri, Jyothish, Sunil, Krishna, Stanley, Mathew, Arjun Suresh Kumar, Narinder, Singh, Piyush Kumar Sinha, Rachith, Sridhar, Sunny, Agarwal, Srikant, Balasubramaniam, Swati, Chhatrapati, Charulata, Deshpande, Ashni, Dharia, Sarita, Fernandes, Suraj, Gandhi, Mangesh, Gore, Abhilash, Jayakumar, Rameshwar, Mhamane, Anand, Nirgude, Sandesh, Parab, Manish, Patil, Amit, Peswani, Anjana, Sahu, Sarika, Samel, Fagun, Shah, Dipti, Haridas, Vijay, Shetty, Bejoy, Abraham, Varun, Agarwal, Quazi, Ahmad, Ashishkumar, Asari, Mohammad Ismail Attar, Nagaraja Sekhar Ayyalasomayajula, Sutej, Bachawat, Shivani, Bachhav, Vivek, Badhe, Sanjiv, Badhwar, Shubhabrata, Banerjee, Vikas, Basa, Vipul, Bothara, Somnath, Chattopadhyay, Sohin, Chaudhari, Rahul, Chavan, Priyank, Chawathe, Shailja, Dadhich, Anuj, Dalal, Avinash, Date, Mandar, Deshpande, Preetham, Dev, Niren, Dongre, Anirudha, Doshi, Maya, Gade, Shreyash, Gajjar, Mohan, Gawande, Amol, Ghalme, Bhavisha, Ghugare, Ishita, Gupta, Manoj, Jain, Divakar, Jain, Saumya Sekhar Jenasamant, Vaishali, Joshi, Vinay, Joshi, Neha, Kalwadia, Nandkishore, Kapadia, Hari Bipin Radhakrishnan Kattana, Tirathram, Kaushik, Akshat, Kayal, Shama, Kovale, Yogesh, Kulkarni, Abhaya, Kumar, Kranthi, Kumar, Kashmira, Kumawat, Vidyadhar, Lad, Namrata, Maskara, Rajesh, Mistry, Smruti Ranjan Mohanty, Kanchan, Motwani, Manoj, Mulchandani, Mandar, Nadkarni, Sanjay, Pandey, Mrunal, Parab, Dinshaw, Pardiwala, Amrita, Patkar, Neha, Pawar, Abhijit, Pawar, Abhinav, Pednekar, Vishal, Peshattiwar, Harshwardhan, Pokharkar, Ojas, Potdar, 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Reddy Voppuru, Anushri, Soni, Gira, Soni, Junaid, Alam, Dinesh, Bagaria, Minu, Bajpai, Akshay Kumar Bisoi, Arvind, Chaturvedi, Sandeep, Chauhan, Narendra, Choudhary, Rajendra Singh Chouhan, Sunil, Chumber, Kamran, Farooque, Vasubabu, Gudala, Amit, Gupta, Mohit, Joshi, Apoorva, Kabra, Shashank Sharad Kale, Abhinav, Kumar, Subodh, Kumar, Dhruv, Mahajan, Rajesh, Malhotra, P Ramesh Menon, Biplap, Misra, Samarth, Mittal, Rajinder, Parshad, Pratyusha, Priyadarshini, Sushma, Sagar, Pradeep Brijkishor Sharma, Vijay, Sharma, Vivek, Trikha, Mayank, Tyagi, Kuldeep, Bansal, Kalyan, Varma, Anurag, Mishra, Rajdeep, Singh, Rohit, Bhardwaj, Abhishek, Mittal, Sabarirajan, Ponnusamy, Gyan Ranjan Singh, Isha, Tuli, Pramod, Bhor, Sanjay, Dhar, Sachin, Kale, Manisha, Aggarwal, Himani, Gupta, Gurleen, Kaur, Ajinkya, Deshpande, Anup, Gadekar, Tanmay, Jaysingani, Taufiq, Panjwani, Rakesh, Patil, Narendra, Vaidya, Sunil Kumar Vishwakarma, Utkarsha, Wayal, Debnarayan, Dutta, Rajnish, Arora, Mohit, Dhingra, Pankaj Kumar Garg, Farhanul, Huda, Pankaj, Kandwal, Ravi, Kant, Rajkumar Kottayasamy Seenivasagam, Navin, Kumar, Shashank, Kumar, Lokavarapu Manoj Joshua, Radheyshyam, Mittal, Dharma Ram Poonia, Deepak, Rajput, Saravanan, Sadhasivam, Sudhir, Singh, Vivek, Singh, Kshitija, Chandanwale, Melissa, Philip, Vaibhav, Thorat, Yousuf, Choudhury, Devishmita, Das, Mautushi, Das, Subhadra, Goala, Farhana Yasmin Laskar, Parbin, Laskar, Kapil, Malik, Poulome, Mukherjee, Abhishek, Sarkar, S Thoibisana Singha, M Nongalei Singha, Damayanti, Singha, Gowtham, Srungavarapu, Ritesh, Tapkire, Siempui, Tling, Syed Muzamil Ishaq Andrabi, Gowhar Aziz Bhat, Nisar, Chowdri, Robindera, Kour, Fazl, Parray, Raahil, Shah, Zamir Ahmad Shah, Rauf, Wani, Soujanya, Adamala, Ravikanth, Gowder, Siddhi, Hegde, S Mashitha, M, Shreya, Sreeram, Sushil, Ankadavar, Darshan, Bafna, Bharat, Dhanani, Nikhil, Ingle, Piyush, Jadhao, Sinu, Joseph, Swapnil, Kapote, Shirin, Karkada, Parag, Lad, Rajan, Lohia, Suyog, Madje, Venkateshwaran, Narasiman, Meer, Chisthi, Gejoe, George, Harihara, Jothi, Dilber, Pareed, Godwin David, C Mathew, Livingston, Abel, Mansi, Agrawal, Rabindranath, B, Manish, Baldia, Ravi Kishore Barla, Manisha, Beck, Santosh, Benjamin, Jeremy, Bliss, Lisa, Cherian, Sreekar, Devarakonda, Geley, Ete, Arun Jacob Philip George, Amish, Gohil, Deeptiman, James, Mark Ranjan Jesudason, Lallu, Joseph, Treasa, Joseph, Kathir, Joyson, Gomathi, Karnan, Albert, Kota, Pushplata, Kumari, Anitha, Loganathan, Vasanth Mark Samuel, John, Mathew, Senthil, K Nathan, Joby Elizabeth Ninan, Ajay, Philip, R Priyadarshini Priyadarshini, Suganya, S, Habie, Samuel, Gilbert, Samuel, Daniel, Selvaraj, Srujan, Sharma, Suraj, Surendran, D Hariharan, T, Santhosh Kumar Thangaraj, Vinotha, Thomas, Varghese, Thomas, John, K Thomas, S Harish, Y, Manobhiram, Boggavarapu, Murali Krishna Voonna, Marilaeta Cindryani Lolobali, Christopher, Ryalino, Tjokorda Gde Agung Senapathi, Mahadewa, Tjokorda, I Made Gede Widnyana, Dita, Aditianingsih, Aino, Auerkari, Susilo, Chandra, Fachreza Aryo Damara, Mohammad Adya Firmansha Dilmy, Achmad Kemal Harzif, Sidharta Kusuma Manggala, Dedy, Pratama, Affan, Priyambodo, Andi Ade Ramlan, Ratna Farida Soenarto, Adhrie, Sugiarto, Ilham Utama Surya, Tamara, Tango, Aida Rosita Tantri, Raihanita, Zahra, Dedy, Fachrian, Andi, Hasyim, Ade, Susanti, Teddy, Saputra, Erwin, Syarifuddin, Andi Asadul Islam, Hendra, Pajan, Ahmad Hannan Amrullah, Khoirul, Anam, Thirza, Hadipranata, Julius Albert Sugianto, Aidyl, Fitrisyah, Mayang Indah Lestari, Nur Rachmat Lubis, Rizal, Zainal, Zulkifli, Zulkifli, Erick Gamaliel Amba, Warren, Lie, Andika Adiputra Thehumury, Tedy, Apriawan, Yunus Kuntawi Aji, Roidah Taqiyya Zahra Wathoni, Sumadi Lukman Anwar, Teguh, Aryandono, Wirsma Arif Harahap, Juni, Kurniawaty, Djayanti, Sari, Artanto, Wahyono, Yunita, Widyastuti, Akhmad Yun Jufan, Parisa, Arjmand, Mohammad, Etezadpour, Babak, Ganjeifar, Masoumeh, Hosseinpoor, Hassan, Mehrad-Majd, Mohsen, Rajati, Reza, Assadi, Ehsan, Noori, Parisa, Rajaei, Samira, Hajisadeghi, Mohammad, Mehdizadeh, Mina, Soltani, Narges, Alizadeh, Gholamreza Azarnia Azar Nia, Hamid, Heidari, Seyedmohamad Hosseini Zavareh Hosseini Zavareh, Ali Moazami Pour Moazami Pour, Farokh, Savaddar, Mostafa, Vahedian, Hoora, Amouzegar, Mojdeh, Bahadorzadeh, Seyedeh Homa Hemmasi, Ahmad, Kachoie, Ali Karimi Karimi, Sepideh, Miraj, Monireh, Mirzaie, Hossein Mokarami Mokarami, Amrollah, Salimi, Roghayyeh, Ahangari, Ali, Ahmadvand, Ali, Bashiri, Morteza, Borhani, Mohammad, Haidari, Mohammad Taghi Imani Khosroshahi, Shahrokh Jahan Bini, Mohsen, Koosha, Mohammad Kazem Moslemi, Ali, Naghibi, Shahrzad, Tehrani, Zahra, Yazdi, Seyyed Hassan Adeli, Majid, Alborzi, Hamed, Bagheri, Mohsen, Eshraghi, Hassan Fatemi Manesh, Mohammad, Ghomeisi, Seyed Fakhreddin Hejazi, Saeed, Madani, Nima Najafian Motahaver, Samieh, Norouzi, Mahdi Pezeshki Modarres, Ali, Shafiee, Jamshid, Vafaeimanesh, Hossein, Yusefi, Elahe, Hosseini, Pourya, Medhati, 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Marshall, Darya, Musa, Zeeshan, Ahmad, Emmet, Andrews, Bruno Chan Chin, Mark, Corrigan, Amy Edwards Murphy, Niamh, Foley, Padraig, Gardiner, Daniel, Hechtl, Michelle, Hsiao, Mohd Yasser Kayyal, Shane, Killeen, Maria, Lyons, Cathy, Burke, Matt, Hewitt, Marwa, Mohamed, Syeda Farah Nazir, Mei Yee Ng, Nor Azlia Abdul Wahab, Cathy, Monteith, Oladayo, Oduola, Lylas, Aljohmani, Timothy, Nugent, Paula, Corr, Lauren, Crone, Johnathon, Harris, Arnold, Hill, David, Kearney, Robert Anthony Keenan, Deirdre, Nolan, James, Ryan, Mark Philip Hehir, Carmen, Regan, Michael, Geary, Fergal, Malone, Claire, Mccarthy, Donal, B O'Connor, Shane, Considine, Emma, Donohoe, Caroline, Herron, John, Larkin, Thomas Hugh Lynch, Barry, Maguire, Rustom, Manecksha, Andrea Mc Carthy, Katharina, Nagassima, Erica, O'Sullivan, Pat, Rohan, Ryan, Roopnarinesingh, Salloum, Salloum, Thomas, Aherne, Mary, Barry, Gareth John Bowen, Ellen, Boyle, Joseph, Dowdall, Ann, Hanly, Ahmed, Hassanin, Helen, Heneghan, Conor, Hurson, Orlaith, Kelly, Rory, Kennelly, Aoife, Kiernan, Sean, T Martin, Nawar, Masarani, Damian, Mccartan, Enda, W McDermott, Ben, Murphy, Kin Cheung Ng, Nwabundo, Njeze, Aine, O'Neill, Ruth, S Prichard, Ned, Quirke, Ian Sean Reynolds, Des, Winter, Rowan, Casey, Mutaz, Elamin, Amy, Gillis, Dara, Kavanagh, Michael, Kelly, Áine, Mcnamee, Paul, Neary, Patrick, Owens, Akshaya, Ravi, Paul, Ridgway, Paul, Carroll, Chris, Collins, Amenah, Dhannoon, Amy, Fowler, Aisling, Hogan, Aoife, Lowery, Peter, Mcanena, Charlie, Timon, Stewart, Walsh, Wisam, Al-Ramli, Imran, Azeem, Muhammad Usaama Bahadoor, Zsolt, Bodnar, Hassan, Elmusharaf, Faisal Saeed Hassan, Adam, Hingum, Huilun, Huan, Seamus, Jennings, Mohamed Hamed Khalid, Mariya, Kuteva, Syed Nadeem Mujtaba, Shanell, Peeriyah, Hina, Rehman, Muhammad Assam Sarwar, Tony, Shaju, Ian, Stephens, Michael, Sugrue, Joseph, Thomas, Manvydas, Varzgalis, Saqib, Zeeshan, Alisha, Jaffer, Larne, Jones-Whiting, Colin, Peirce, Sean, Johnston, Seantee, Lim, Alwaleed, 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Massimiliano, Gennaro, Lorenzo, Giannini, Marcello, Guaglio, Marco, Guzzo, Andrea, Leva, Alberto, Macchi, Elena, Manzo, Fabio, Martinelli, Ilaria, Mattavelli, Vincenzo Maria Mazzaferro, Francesco, Raspagliesi, Luigi, Rolli, Laura, Sala, Roberto, Salvioni, Mario, Santinami, Silvia, Segattini, Luca, Sorrentino, Carlotta, Zaborra, Alexandre, Anesi, Gianmaria Casoni Pattacini, Mattia Di Bartolomeo, Francesca, Pecchini, Arrigo, Pellacani, Micaela, Piccoli, Federico, Fusini, Andrea, Gattolin, Marco, Migliore, Roberto, Rimonda, Diego, Sasia, Elisabetta, Travaglio, Federica, Brunetti, Marco, Cereda, Marco, Ceresoli, Luca, Cigagna, Cristina, Dell'Oro, Alessandro, Fogliati, Robert, Fruscio, Tommaso, Grassi, Maini Marzia Isabella, Luca Carlo Nespoli, Massimo, Oldani, Sara, Ornaghi, Nicolò, Tamini, Carmine, Antropoli, Antonio, Castaldi, Alessio, Palumbo, Gaia, Altieri, Umberto, Bracale, Francesco, Corcione, Marcello De Luca, Giovanni Domenico De Palma, Maria Michela Di Nuzzo, Ruggero, Lionetti, 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Matteo, Filardo, Marika Sharmayne Milani, Franco, Ragni, Andrea de Manzoni Garberini, Edoardo, Baldini, Diana, Carpaneto, Michele, Cauteruccio, Corrado, Ciatti, Luigi, Conti, Serena, Gattoni, Pietro, Maniscalco, Gerardo, Palmieri, Calogero Puma Pagliarello, Giuseppe, Caristo, Raffaele, Galleano, Michele, Malerba, Marcello, Calabrò, Francesca, Farnesi, Elia Giuseppe Lunghi, Andrea, Muratore, Nicoletta Sveva Pipitone Federico, Joel Reuben Abel, Lorenzo, Andreani, Darienzo, Antonio, Vittorio, Aprile, Riccardo, Balestri, Giacomo, Benettini, Stefano, Berrettini, Luca, Bruschini, Massimo, Chiarugi, Federico, Coccolini, Simone, Colangeli, Camilla, Cremonini, Lodovica Cristofani Mencacci, Iacopo, Dallan, Silvia De Santi, Gregorio Di Franco, Lorena Di Girolami, Giacomo, Fiacchini, Niccolò, Furbetta, Stylianos, Korasidis, Marco, Lucchi, Andrea, Morandi, Luca, Morelli, Serena, Musetti, Carlo Maria Neri, Matteo, Palmeri, Miriana, Picariello, Francesco, Porcelli, Marco, Puccini, Nicolo, Roffi, Erica, Statuti, Dario, Tartaglia, Alberto, Tonelli, Matteo, Vianini, Gianluca, Baronio, Mauro, Montuori, Enrico, Pinotti, Stefano Maria Massimiliano Basso, Federica, Maffeis, Paolo, Ubiali, Lorenzo, Aguzzoli, Saverio, Coiro, Giuseppe, Falco, Vincenzo Dario Mandato, Valentina, Mastrofilippo, Simone, Mele, Caterina, Baldi, Carlo, Corbellini, Gianluca Matteo Sampietro, Massimo, Dugo, Mauro, Garino, Chiara, Marafante, Antonio, Masciandaro, Elisabetta, Moggia, Alessandra, Murgese, Felice Eugenio Agro, Gabriella Teresa Capolupo, Filippo, Carannante, Marco, Caricato, Vincenzo, Denaro, Erica, Mazzotta, Rocco, Papalia, Giuseppe, Pascarella, Alessandro, Strumia, Biagio, Zampogna, Matteo, Cinquepalmi, Marco, Colasanti, Celeste Del Basso, Federica, Falaschi, Nicola, Guglielmo, Roberto Luca Meniconi, Alessandra, Pecoraro, Sofia, Usai, Giacomo, Crescentini, Antonella, Larcinese, Emanuele, Picone, Giovanni, Sinibaldi, Annamaria, Agnes, Salvatore, Agnes, Sergio, Alfieri, Francesco, Belia, Valentina, Bianchi, Giuseppe, Bianco, Alberto, Biondi, Paola, Campennì, Valerio, Cozza, Sabatino, D'Archi, Domenico, D'Ugo, Veronica De Simone, Marta Di Grezia, Sofia Di Lorenzo, Federica, Ferracci, Valeria, Fico, Gianluca, Franceschini, Pietro, Fransvea, Giulio, Gasparini, Luca, Gordini, Antonio La Greca, Francesco, Litta, Celestino Pio Lombardi, Angelo Alessandro Marra, Angelo, Parello, Marco Maria Pascale, Romeo, Patini, Gilda, Pepe, Roberto, Persiani, Caterina, Puccioni, Carlo, Ratto, Fausto, Rosa, Gianmarco, Saponaro, Lorenzo, Scardina, Tedesco, Silvia, Giuseppe, Tropeano, Maria, Benevolo, Daniele, Bugada, Flaminia, Campo, Maria Gabriella Dona, Valentina, Manciocco, Paolo, Marchesi, Riccardo, Mastroianni, Francesco, Mazzola, Silvia, Moretto, Raul, Pellini, Gerardo, Petruzzi, Barbara, Pichi, Giuseppe, Simone, Gabriele, Tuderti, Jacopo, Zocchi, Luigi Marino Cosentino, Andrea, Sagnotta, Roberta, Angelico, Vittoria, Bellato, Michela, Campanelli, Marzia, Franceschilli, Michele, Grande, Giorgio, Lisi, Tommaso Maria Manzia, Lorenzo, Petagna, Bruno, Sensi, Giuseppe, Sica, Leandro, Siragusa, Giuseppe, Tisone, Marco, Assenza, Barbara, Binda, Massimo, Biondi, Gioia, Brachini, Placido, Bruzzaniti, Mauro, Casagrande, Flavia, Ciccarone, Pierfranco Maria Cicerchia, Bruno, Cirillo, Daniele, Crocetti, Giancarlo, D'Ambrosio, Vito, D'Andrea, Francesca De Felice, Giorgio De Toma, Carlo Della Rocca, Giulia, Duranti, Pietro, Familiari, Enrico, Fiori, Giovanni Battista Fonsi, Alessandro, Frati, Stefania La Rocca, Filippo La Torre, Pierfrancesco, Lapolla, Giovanni, Marruzzo, Simona, Meneghini, Andrea, Mingoli, Andrea, Picchetto, Antonella, Polimeni, Diego, Ribuffo, Maurizio, Salvati, Antonio, Santoro, Paolo, Sapienza, Luigi, Simonelli, Valentino, Valentini, Martina, Zambon, Giuseppa, Zancana, Emma, Zuppi, Simone, D'Annunzio, Cosimo De Nunzio, Silvia, Fiorelli, Mohsen, Ibrahim, Chiara, Loffredo, Domenico, Massullo, Cecilia, Menna, Rocco, Monica, Massimiliano, Pelli, Erino Angelo Rendina, Leonardo, Teodonio, Andrea, Tubaro, Giulio, Argenio, Giulio, Accarino, Accarino, Giancarlo, Antonio Nicola Giordano, Luca, Cardinali, Elisa, Sebastiani, Grazia, Travaglini, Erika, Andreatta, Emanuele Luigi Giuseppe Asti, Daniele, Bernardi, Luigi, Bonavina, Caterina, Froiio, Andrea, Lovece, Chiara, Copelli, Alfonso, Manfuso, Pasquale Di Maio, Marco, Giudice, Oreste, Iocca, Rosario, Cennamo, Tommaso, Cornali, Francesco Di Marzo, Cristian, Altana, Francesco, Bussu, Giampiero, Capobianco, Anna Giacomina Carta, Sandro, Ciccarello, Maria Laura Cossu, Pietrina, Cottu, Giacomo De Riu, Salvatore, Dessole, Francesco, Dessole, Salvatora, Dettori, Carlo, Doria, Alessandro, Fancellu, Claudio, F Feo, Giorgio Carlo Ginesu, Giuliana, Giuliani, Marco Giuseppe Iannuccelli, Massimo, Madonia, Roberto, Mancino, Olindo, Massarelli, Gianfranco, Meloni, Fabio, Milia, Andrea, Mulliri, Teresa, Perra, Marco, Petrillo, Antonio, Piras, Franco, Piredda, Francesco, Pisanu, Alberto, Porcu, Davide, Rizzo, Angelino, Sanna, Antonio Mario Scanu, Fabrizio, Scognamillo, Damiano, Soma, Anna Rita Tanca, Alessandro, Tedde, Matteo, Tedde, Luigi Angelo Vaira, Andrea Bartalini Cinughi de Pazzi, Osvaldo Carpineto Samorani, Daniele, Fusario, Luigi, Marano, Gaia, Oldrà, Anna Lisa Pesce, Stefania Angela Piccioni, Luca, Resca, Vincenzo, Ricchiuti, Franco, Roviello, Vinno, Savelli, Alberto, Abrate, Pierpaolo, Bordoni, Lorenzo, Bosio, Guglielmo, Clarizia, Francesco, Fleres, Marco, Franzini, Antonio, Fratto, Pierluigi, Giumelli, Alessandro, Grechi, Alessandro, Longhini, Fabrizio, Lorusso, Elisa, Scarnecchia, Federica, Scolari, Alessandro, Spolini, Vincenzo, Maiuri, Matteo, Papandrea, Arturo, Roncone, Lorenzo, Conti, Andrea, Rizzi, Marco, Rovagnati, Alberto, Brolese, Tommaso, Cai, Francesco Antonio Ciarleglio, Francesca, Dalprà, Gianni, Malossini, Liliana, Mereu, Irene, Tamanini, Saverio, Tateo, Giovanni, Viel, Enrico, Battistella, Paolo Boscolo Rizzo, Cristoforo, Fabbris, Marco, Massani, Giacomo, Spinato, Roberta, Tutino, Ugo, Grossi, Alessandro, Iacomino, Simone, Novello, Maurizio, Romano, Serena, Rossi, Giulio, Santoro, Giacomo, Zanus, Sokol, Trungu, Giada, Aizza, Gabriele, Bellio, Selene, Bogoni, Marina, Bortul, Biagio, Casagranda, Sara, Cortinovis, Nicolò de Manzini, Davide, Drigo, Paola, Germani, Manuela, Mastronardi, Lucia, Paiano, Silvia, Palmisano, Pier Luigi Filosso, Francesco, Guerrera, Matteo, Marro, Mauro, Rinaldi, Enrico, Ruffini, Stefano, Salizzoni, Laura, Bardelli, Mattia, Berselli, Giacomo, Borroni, Eugenio, Cocozza, Matteo, Desio, Bottazzoli, Elisa, Giuseppe, Ietto, Valentina, Iori, Domenico, Iovino, Lorenzo, Livraghi, Valentina, Marchionini, Stefano, Megna, Emma Amal Nahal, Mara, Palumbo, Valeria, Quintodei, Alessandra, Zullo, Lucrezia, D'Alimonte, Giovanni, Pirozzolo, Chiara, Vignotto, Tommaso, Campagnaro, Andrea, Caravati, Simone, Conci, Carlotta De Cristofaro, Gabriele, Gecchele, Tommaso, Giuliani, Jacopo, Graziosi, Alfredo, Guglielmi, Salvatore, Paiella, Corrado, 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Rakotoarisoa, Maharo, Ramifehiarivo, Solonirina Harinarindra Ranaivoson, Hajamihamina Marina Parfaite Randriantsoa, Narindra Njarasoa Mihaja Razafimanjato, Jeannie Ba Razafindrahita, Solofoarimanana, Solofoarimanana, Guillaume Odilon Tsiambanizafy, Rakotonaivo Mamisoa Judicaël, Corinne Eulalie Solo, Tojomamy Herinjaka Ralaizafindraibe, Fanonjomahasoa Safiry Andofenohasina, Hanta, Rasataharifetra, Vanona Barijaona Razafindraibe, Angelin Sablon Herinirina, Andre, Das, Thanga, Ganapathy, Yohesuwary, Gunarasa, Kalyani, Mariapan, Maathichsudhaar, Muniandy, Mohd Firdauss Osman, Mohd Azem Fathi Mohammad Azmi, Jien Yen Soh, Wan Zainira Wan Zain, Andee Dzulkarnaen Zakaria, Zaidi, Zakaria, Kheng Hooi Chan, Firdaus, Hayati, Syamim, Johan, Jin Jiun Mah, Ratha Krishnan Sriram, Sentilnathan, Subramaniam, Nur Shahirah Binti Muhammad Shahimi, Khairul Hazim Hamdan, Mohd Razali Ibrahim, Guhan, Muthkumaran, Ju Ann Tan, Mohana Raj Thanapal, Dayang Anita Abdul Aziz, Mae-Lynn, Bastion, Mohd Hairul Nizam Harun, Farrah-Hani, Imran, Norshamsiah Md Din, Ayesha Mohd Zain, Mushawiahti, Mustapha, Syed, Nabil, Ainal Adlin Naffi, Abd Jabar Nazimi, Roszalina, Ramli, Bee Hong Soon, Pavin, Bal, Joo Qing Cheng, Mohd Rusdi Draman, Ahmad Nazran Fadzli, Sakina, Ghauth, Weipin, Hung, Suniza, Jamaris, Peng Soon Koh, Sivakumar, Krishnasamy, Yeong Sing Lee, Yew Toong Liew, Jeffery Zk Lim, Raymond Chung Siang Lim, Hiong Chin Lim, Siti Farhan Moh Pauzi, Shireen Anne Nah, Ashvin Krishna Nair, Doris Sin Wen Ng, Yuki Julius Ng We Yong, Kamarajan, Ramayah, Rahmah, Saaid, Anand, Sanmugam, Mee Hoong See, Kanesh Kumaran Seevalingam, Neha, Sethi, Srihari, Singaravel, Syeda Nureena Syed Jafer Hussain Zaidi, Chu Yik Tang, Li Ying Teoh, Kian Boon Wong, Ruben, Xavier, Ahmad Shuib Yahaya, Norhafiza, Ab, Rahman, Islah Munjih Ab, Rashid, Mohd Fahmi Abd Aziz, Mohd Norhisham Azmi Abdul Rahman, Nasser Muhammad Amjad, Shahidah Che Alhadi, Faisal, Elagili, Mohd Nazli Kamarulzaman, Azmi Md Nor, Ahmad Faidzal Othman, Mohd Yusof Sainal, Mat Salleh Sarif, Richelle, Chua, Aini Fahriza Ibrahim, Abdul Rauf Bin Ahmad, Yii Ling Lau, Ka Yee Liew, Kandasami, Palayan, Hui Yu Wong, Jasiah, Zakaria, Nor Azimah Abd Aziz, Norazila Abdul Rahim, Noorneza Abdul Rahman, Bahiyah, Abdullah, Mohamed Faizal Bin Sikkandar, Fatin, Firman, Nik Mohd Hazleigh, Intan Kartika Kamarudin, Shahril, Khalid, Mohd Fairudz Mohd Miswan, Akmal Zulayla Mohd Zahid, Norasyikin, Mustafa, Kadhim, Obaid, Mohd Yusoff Bin Yahaya Yahaya, Ahmad Ramzi Yusoff, Predrag, Andrejevic, Jeremy Borg Myatt, Svetlana, Brincat, Clifford, Caruana, Kurt Lee Chircop, Francesca, Chircop, Daniel Mario Chircop, Charles, Cini, Viktoria, Czok, Melanie, Farrugia, Gabriella, Grima, Fatimah Mj Hassan Almukhariq, Esther, Muscat, Darryl, Pisani, Mohsin Hassan Khan Roshan, Nicholas, Schembri, Mohamed, Shoukry, Neville, Spiteri, Gilbert, Tanti, Ziad Aboharp Hasan, Alberto Bazan Soto, Cedillo Rodrìguez Jonathan Rubén, Gustavo Esteban Lugo Zamudio, David Gerardo Miranda Gómez, José Alfredo Pérez Meave, Victor Pinto Angulo, Antonio Rojas Aguilar, Erik Efrain Sosa Duran, Alejandro Vàzquez Perez, Diego, Arroyo, Jose, Corona-Cruz, Hector, Martinez-Said, Heriberto, Medina-Franco, Manuel, Mendez, Teresa Moreno, Y Suárez Ma, Dolores Orta Díaz, Martha Patricia Pérez de León Vázquez, Angélica Azucena Soto Carvajal, Fidel Soto Hernández, Juan Ignacio Stenner, Adriana Valenzuela López, Mauricio Rene Hernandez, Rey Jesus Romero, Aldo Bernal Hernandez, Ana Olivia Cortes-Flores, Carlos Jose Zuloaga Fernandez Del Valle, Carlos Andres Colunga Tinajero, Jaime, Orozco-Perez, Laura Gabriela Peña Balboa, Guillermo, Yanowsky-Reyes, Víctor Hugo Alcalá Torres, Francisco José Barbosa Camacho, Irma Valeria Brancaccio Perez, Miguel Angel Calderon-Llamas, Aldo Camacho Gomez, Edgar-Joaquin, Cortes-Torres, Esteban, Cueva-Martinez, Oscar Durán Anguiano, Isaac Esparza Estrada, Roberto, Fierro-Rizo, Paola Flores Becerril, Clotilde Fuentes Orozco, Miguel García Castillo, Alejandro Gonzalez Ojeda, Ana Sofia Gonzalez Rubio, Erick Alonso González-García de Rojas, Luis Humberto Govea-Camacho, Jose Aldo Guzman Barba, Juan Carlos Ibarrola Peña, César Íñiguez Martínez, Francisco Javier Llamas-Macias, Ruben Eduardo Morán Galaviz, Cesar, Nuño-Escobar, Oscar-Everardo, Olvera-Flores, Jaqueline, Osuna-Rubio, Jose Victor Pérez-Navarro, Rodrigo, Prieto-Aldape, Luis Ricardo Ramirez Gonzalez, Marco Vinicio Ramírez Sánchez, Emilio, Reyes, Olaya Moramay Romero-Limón, Carlos Beas Ruiz-Velasco, José Antonio Sánchez Martínez, Guillermo, Sanchez-Villaseñor, Ismael, Sedano-Portillo, Gabriela Ambriz Gonzalez, Pedro Berrones Moreno Berrones Moreno, Ana Beatriz Calderon Alvarado, José de Jesús Cárdenas Barón, Araceli, Hernández, Francisco Javier León Frutos, Edgard Efren Lozada Hernandez, Eduardo Morales Valencia, Karla Daniela Pérez, Francina, Bolanos-Morales, Julio, Herrera-Zamora, Patricio, Santillan-Doherty, David Omar Arriaga Zavala, Salvador Francisco Campos Campos, Lizette, Carmona, 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Alexander, Borgstein, Suzanne, Gisbertz, Sarah, Mikdad, Mark van Berge Henegouwen, Roel, Bakx, Marc, Besselink, Daniel Hl Lemmers, Anne-Jasmin, Roelofs, Paul van Amstel, Claire van Helsdingen, Ludi, Smeele, Niels, Harlaar, Frederik, Jonker, Sjirk van der Burg, Justin, Y van Oostendorp, Saranda, Ombashi, Tim van der Voort, Martijn van Geldorp, Lisanne, Posma-Bouman, Hans Donald de Boer, Annette, Olieman, Henriette, Smid-Nanninga, Jean-Paul P, M De Vries, Rianne, Hogenbirk, Tyche, Derksen, Josephine, Franken, Steven, Oosterling, Peter, Nolte, Jelle van der List, Ian, Alwayn, Okker, Bijlstra, Andries, Braat, Ruth, Bulder, Michèle de Kok, Robin, Faber, Ben, Goudsmit, Jaap, Hamming, Sven, Mieog, Alexander, Vahrmeijer, Fenna E, M van de Leemkolk, Joost van der Vorst, Jan van Schaik, Merel, Verhagen, Kim, Albers, Larsa, Gawria, Harry Van Goor, Michiel, Warle, Tessa, M van Ginhoven, Charlotte, Viëtor, Evert-Jan, Boerma, Lara, Lallitsch, Donald, Schweitzer, Wouter, Leclercq, Julie, Sijmons, 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Asensio, Luis Asensio Gomez, Diego, Carrion, Nuria, Chavarrias, Alvaro de Arriba, Jose Antonio Gazo Martínez Gazo, Alberto Gegúndez Simón, Juan Gómez Rivas, Natalia Gonzalez Alcolea, Carolina, Gonzalez-Gomez, Sara Gortázar de Las Casas, María Alexandra Heras Garceau, Alicia Hernández Gutierrez, Luis, Lassaletta, Fuad Samir Lopez Fernández, Marta, Mancheño, Blanca, Mateos-Serrano, Isabel Pascual Miguelañez, Maria Fernanda Pedrero Escalas, Julio, Peñarrocha, Yolanda, Perez, Maria Isabel Prieto-Nieto, Teresa Rivera Schmitz, Laura, Rodrigáñez, Ines, Rubio-Perez, Isabel Sanchez Cuadrado, José Ignacio Sánchez Méndez, Jorge Fernando Tone, Carlos Toribio Vazquez, Aitor, Urbieta, Diego Córdova García, Francisca Garcia-Moreno Nisa, Laura, Jiménez, Inmaculada, Lasa, Belen, Matías-García, Fernando, Mendoza-Moreno, Marina Pérez González, Ana Sánchez Gollarte, Alejandro Sanchez Pellejero, Cristina Vera Mansilla, Rafael, Barberá, Lourdes, Montes-Jovellar, Sara Fra Fernández, Nicolas Moreno Mata, Barbara, Algar-Yañez, Gutiérrez, Bérénice, Olga De La Varga-Martínez, Paula, Fernandez-Valdes-Bango, Sandra Maria Gadin-Lopez, José María Martínez-Gómiz, Elena, Nieto-Moreno, Ana, Nieto-Moreno, Montserrat Ocampos Hernandez, Maria Laura Pelegrina-Lopez, Alicia Ruiz Escobar, Elena, Sáez-Ruiz, Beatriz, Vazquez-Rivero, Antonio, Lara, Belén Vielva Del Campo, Fernando Alcaide Matas, Simbad, Costas-Ochoa, José María García Pérez, Elizabeth, Marmol, Paula Troncoso Pereira, Maria Del Pilar Concejo Cutoli, Juan Ramón Gómez López, Juan Carlos Martín Del Olmo, Paloma Guillamot Ruano, Javier Páramo Zunzunegui, Antonio Albarracín Marín Blázquez, Alfonso, Aliaga-Sanchez, Marta María Arroyo Domingo, Miriam Artés Artés, Ana Isabel Avellaneda Camarena, Aida, Blaya, Emny Rochell Bobadilla Romero, Pedro Vicente Fernández-Fernández, Lorena Galindo Iñiguez, Víctor Javier García Porcel, Clara Giménez Francés, Antonio Javier Gomez Poveda, Rebeca Gonzalez Celdran, Francisco Miguel González Valverde, Laura Guillamon Vivancos, Elena, Gurrea-Almela, Alejandra Jara Maquilón, Jose David Jimenez Parra, Abd Al Aziz Lanagrán Torres, Raquel Lax Perez, Carmen Maria Lopez Lopez, Francisco, Machado, Alfonso Marco Garrido, Florencio Manuel Marin Martinez, Victoria Martínez Muñoz, Esther, Medina, Olimpia, Molina, José Manuel Muñoz Camarena, Julian, Onate, Pedro Antonio Parra Baños, Emilio Peña Ros, Enrique, Rubio, Marina Sánchez Robles, Carlos Sanchez Rodriguez, María Valero Soriano, María Teresa Yepes García, Felipe, Alconchel, Andrés Balaguer Román, Valentín, Cayuela, Ana, Conesa, Ana Delegido García, Pedro José Gil Vázquez, Paula Gómez Valles, Francisco, Gómez-Bosch, Vicente, J León-Muñoz, Francisco, Martínez, Alvaro, Navarro-Barrios, Tatiana, Nicolás-López, Pablo Ramirez Romero, Emiliano, Cano-Trigueros, María Concepcion Alonso González, Leticia Gómez Viana, Ana Pastor Zapata, Elisa Contreras Saiz, Tamara Díaz Vico, Maria, Fernandez-Hevia, Luis Joaquín García Flórez, Raquel, Rodríguez-Uria, Sandra, Sanz, Lorena, Solar-Garcia, Aida Suárez Sánchez, Jaume, Gelonch, Dietmar, Reinaldo, Miriam Abdulkarim Polo, Asier, Aguirre, Marta Alomar Bofill, Santiago, Baena, Ashish, Bartakke, Carmen Cabeza Oliver, Marta Castro Suárez, José Andrés Cifuentes Rodenas, Olga Claramonte Bellmunt, Ant Onia Crespí Mir, Anabel De La Llave Serralvo, Mar, Escales, Isabel Rosa Fernández Burgos, Pablo Gandia Gonzalez, Juan Lliteras Jorge, María Cristina Martínez Canto, Javier, Mata, Andreu, Morell, Naila, Pagès, Sara Pérez Palao, Cristian Plaza Valiente, Catalina Ramon Barcelo, Carmen Reyero Fernández, Albert Reyes Claret, Leticia Rodriguez Vaquero, Maialen Saez de Vicuña Salinas, Pilar Santos Cidon, Concepcion, Segura, Aina, Serra, Maria Serra Guivernau, Maria Soler Pedrola, Marta, Tasende, Marta Torrent Lluch, María Inmaculada Valldeperas Hernández, Rosa-Maria, Yañez-Lpez, Andrea, Craus-Miguel, Laura Fernández Vega, Natalia Pujol Cano, Juan José Segura-Sampedro, Laura Colet Oliver, Ivan Dot Pascuet, Mireia, Duart, Isabel Tello Galindo, Eduardo Arrea Salto, Jaume Cámara Cabrera, Marta Camats Terré, Juan Gabriel Castro Ríos, Marta de la Rosa-Estadella, Anna, Fernandez-Colorado, Anna, Gasulla-Rodriguez, Antonio, Gimenez-Gaibar, Elena, Gonzalez, Yeray Maldonado Sotoca, Matilde, Molina-Corbacho, Montserrat Monfort Mira, Josep, Rodoreda, Marta Santos Espí, Arnau Verdaguer Figuerola, Elisa Angela Diego-Alonso, Jaime, López-Sánchez, Luis, Muñoz-Bellvis, Jacobo, Trebol, Borja, Aguinagalde, Cristina Gabriela Alzate Arsuaga, Ainhoa Andres Imaz, Iñigo, Arana, Coro Aranzabal Urrutia, Mikel, Armendariz, Lorena, Arrabal, Iñigo, Augusto, Adolfo, Beguiristain, Laura, Busto, Ainhoa, Cuevas, Itziar De Ariño, Alejandro, Elúa, Leticia, Fernandez, Arantza, Fernandez-Monge, Lander, Gallego, Alba, Garcia, Amaia Garcia Dominguez, Gregorio, Garmendia, Carmen, Grañén, Pelayo Hevia Rodríguez, Maria, Iraola, José Miguel Izquierdo, Aintzane, Lizarazu, Jon Ander Lizarbe, Claudia Cristina Lopes Moreira, Iker, López, Ruth Marquina González, Tania, Pastor, Adrián Recio Ayesa, Ana Paula Riverola Aso, Carballo, Rodríguez, Araceli, Rodrìguez, Maria Inmaculada Ruiz Montesinos, Patricia, Torres, Jose, Undabeitia, Ainara, Villafruela, Maria Barrionuevo Ramos, David, Blanco, Marta, Calderón, Eva Corral Rubio, Angel, Cuadrado-García, Daniela, Cubek, Ignacio, Fariña, Maria Fernandez LLorente, Natalia Flores Amador, Mariana García Virosta, Luis Garcia-Sancho Tellez, Adelina Gonzalez Martinez, María, Hernandez, Rubén Herreros Ruiz-Valdepeñas, Carmen Jimenez Sanchez, Eduardo Llamazares Cobo, María, López, Javier, López-Martin, Teresa Martínez Marivela, Luis Miguel Martinez Parra, Paloma Maté Mate, Paloma, Medrano, Manuel Moriche Carretero, Sara Núñez O'Sullivan, Manuel Ortega Oria de Rueda, María Begoña Pastor Nieto, Clara, Pérez, Antonio, L Picardo, Remedios Revilla Amores, Carmen Rodríguez Haro, Jose Alberto Rojo López, Fatima Sanchez Cabezudo Noguera, Cristina, Sanz, Daniel Serralta de Colsa, Cristina Valor Garcia, Marta Velasco Martinez, Iván Andújar Lara, Aranzazu, Calero-Lillo, Enrique, López-Ruiz, Alberto Díaz García, Alejandro Menéndez Moreno, Luis Eduardo Pérez-Sánchez, Ángela, Pascual, Miguel Adeba García, Marta Alonso Fernández, Javier Alvarez Gama, Roberto, Ballestero, Loreto Berjon De La Vega, Paola Calleja Hermosa, Mariana, Carrillo-Rivas, Alfonso, Casado, Andrea, Cerveró, Bonifacio Cimadevilla Calvo, Patricia Corriols Noval, Paloma de la Dehesa Cueto-Felgueroso, Miren Jasone Diez Zapirain, José Estevez Tesouro, José Antonio Fernández-Dívar Sánchez, Lucia Garcia Alcalde, Juan García Cardo, Tito García Moreno, Daniel, García-López, Belen Garcia-Montesinos Perea, Miren Gonzalez Benito, Rocio, Gonzalez-Aguado, Miguel Ángel Gordo Vega Gordo-Vega, Jose, Gutierrez-Banos, Jaime Jimeno Fraile, Yolanda Jubete Castañeda, Patricia Lopez Gomez, Antonia Jesús López López, David Mato Mañas, Carmelo, Morales-Angulo, Dieter, Morales-Garcia, Sara, Naranjo, Jose Luis Rabago, Jose Manuel Rabanal, Rocio Revuelta Zorrilla, Adriana Reyes Echeverría, Juan Carlos Rodríguez-Sanjuán, Juan Ramón Sanz, Isabel Simal Badiola, Guillermo, Tejón, Enrique Toledo Martínez, Raquel Varea Malo, Begoña, Fadrique, Tania, Funes, Elena González Revilla, Isaias, Alarcón, Daniel Aparicio Sánchez, Pablo Beltran Miranda, Carmen, Cepeda-Franco, María Josefa Cuevas López, Sandra, Dios-Barbeito, Virginia María Durán Muñoz-Cruzado, Carlos Gonzalez De Pedro, Rosa, M Jimenez-Rodriguez, Francisco, Manresa-Manresa, Gabriel, Marin, Cristobalina, Martin-Garcia, Sara, Martínez-Núñez, Juan Manuel Martos Martinez, Lucas, Mengíbar, Felipe Pareja Ciuro, Eduardo Perea Del Pozo, Veronica Pino Diaz, José, Pintor-Tortolero, Claudia, Quintero-Pérez, Maria Luisa Reyes Diaz, Mercedes Rubio Manzanares Dorado, Alejandro Sanchez Arteaga, Ana, Senent-Boza, Luis, Tallon-Aguilar, Jose, Tinoco-Gonzalez, Luis-Cristobal, Capitan-Morales, Juan Cintas Catena, Javier, Valdes-Hernandez, María Del Campo Lavilla, Alina López De Fernández, Miriam Abellan Lucas, Alba Diaz Padillo, Maria Gómez Romero, Linda Grace Puerto Tamayo, El Mostafa El Yaqine Er Raoudi, Melody García Domínguez, María Ángeles Gascón Domínguez, Marta González Pérez, Alba Hernáez Arzoz, Joana San Anton, Cristian, Ruminot, Hander Guillermo Acosta Diaz, Daniella, Laguado, Kristina, Aghababyan, Alba, Jr, Enrique, Artigues, Rocío, Belda, Miguel, Beltran, Jose Ignacio Blanes, Elena Campos Carot, Miriam, Cantos, Laura, Costa, Carolina Ferrer Gomez, José María Gallego Sánchez, Oscar, Gil-Albarova, Juan, Gilabert-Estellés, Emilio Lopez Alcina, Isabel López Sánchez, Severiano Marin Bertolin, Carolina, Martinez-Perez, Antonio Melero Abellán, Claudia Mulas Fernández, Beatriz, Novoa, Ruth, Nuñez, Pablo Renovell Ferrer, Guijarro-Jorge, Ricardo, Carolina Soledad Romero Garcia, Miguel Sanfeliu Giner, Silvia, M West, Enrique, Zapater, Ignacio, Miranda, Ana, Monís, Alejandro Roselló Añón, María José Sangüesa, Jorge Sanz Romera, Marcos, Adrianzén, Maria Barrios Carvajal, Mireia, Bauzá, Ana Benítez Riesco, Jose Antonio Carbonell Lopez, María-Carmen, Fernández-Moreno, Ricardo Gadea Mateo, Francisco, Garcia, Maris Luisa García-Pérez, Luisa Paola Garzon, Ana, Izquierdo, Maria Lapeña Rodríguez, Carlos, León-Espinoza, Fernando, Lopez, Rosa Martí Fernández, Sara Martínez Castro, Berta Monleón López, Isabel Mora Oliver, David, Moro-Valdezate, Ernesto Muñoz Sornosa, Sara Palomares Casasús, Leticia Pérez Santiago, Mara Albert Fort, Reyes, Balanzá, Lorena Bermell Marco, Carla Carratalá Pérez, Claudia Pilar Clemente Tomas, Marta, Córcoles, Jose Ángel Diez Ares, Carlos Domingo Del Pozo, Nuria Estellés Vidagany, Gonzalo, Garrigos, Mar Gimeno Gimeno Vicente, Blanca Alastrue Giner, Segundo, Gomez-Abril, Paloma, Gonzalez, Paula Gonzálvez Guardiola, Guillermo Sebastian Martínez Fernández, Charo Martínez García, Lucía, Martínez-Costa, Luz María Moratalla Charcos, Sergio Navarro Martínez, Carmen, Payá-Llorente, Álvaro Pérez Rubio, Nuria, Peris, Eduardo Picazo Pineda, Jordi Planelles Gómez, Francisco Ripoll Vidal, Andrea, Roca, Enrique, Salmerón-González, Raquel Segura Roselló, Ramon Trullenque Juan, Cristina Verdejo Gimeno, Jose Miguel Zaragozá García, Gema Zomeño Bravo, Marcos Bruna Esteban, Hanna, Cholewa, Milton de Jesus, Matteo, Frasson, Luis Oliver García, Héctor, J Aguado, Antonio Jose Alonso Villalba, Francisco, Ardura, Carmen Elena Badillo Bercebal, María Bedate Núnez, Alvarez-Ramos Begoña Aranzazu, Juan Beltrán de Heredia, Hugo, Bermejo, Juan Berrocal Cuadrado, Maria Bragado González, Juan, Bustamante-Munguira, Raul Calvo Gonzalez, Yolanda, Carrascal, Ana Belén Casas Marcos, María Carmen Cervera, Sergio Chávez Valladares, Ángel Cilleruelo Ramos, Susana, Cortes, Jesús, Crespo-Sanjuán, María, Cuaresma, Luis Antonio Cuellar Martin, Carlos Ferreras García, Alvaro, Fuentes-Martín, Abel, Ganso, Elena García García, Luis, Garcia-Florez, Virginia, Garcia-Virto, Juan, Gatón, Julio Alberto Gobernado Tejedor, Tania Gómez Sanz, Jose Ignacio González Martín, María Begoña Gregorio Crespo, Ana Herranz Arriero, Jose, Herreros, Marta Ibáñez Nieto, César, Infante, Carlos, Jezieniecki, Moises, Juarez, Gregorio de Jesus Labrador Hernandez, Ana Patricia Legido Morán, Ricardo León Fernández, Alejandro, Leon-Andrino, Almudena, Llorente, Maria Lopez Pais, Mauricio Loucel Bellino, Sergio, Martin, Miguel Angel Martin-Ferrero, Gonzalo Martinez Municio, Elvira Mateos Alvarez, José María Matilla, Luis María Merino Peñacoba, Mario, Montes-Manrique, Fernando Natal Álvarez, David, C Noriega, Henar Nuñez Del Barrio, Francisco Javier Ortiz de Solórzano Aurusa, Lucía, Pañeda, Victoria Pascual Escudero, Miguel Pascual Samaniego, Adela, Pereda, Marta Pérez Febles, Laura, Pesquera, Maria, Plata, Emma Puertas Ruiz, Mario, Rodriguez-Lopez, Alejandro Romero de Diego, Ana, Ruano, María Ruiz Soriano, Cristina Sánchez Torralvo, Silvia Santiago Maniega, Bárbara, Segura-Méndez, Clarisa Simon Perez, José, Soro-García, Paula Suárez Mansilla Suárez-Mansilla, Jeancarlos Trujillo Díaz, Mª Esther Valsero Herguedas, Andrea Vazquez Fernandez, Eduardo Velasco García, Ana, Zabalza, Álvaro Zamora Horcajada, Fernando Acebes García, Enrique Asensio Díaz, Martín, Bailón, Alejandro David Bueno Cañones, Alvaro Centeno Velasco, Ekta Choolani Bhojwani, Fernando Labarga Rodríguez, Sara, Mambrilla, Pablo, Marcos-Santos, Toledano, Miguel, David Pacheco Sánchez, Baltasar, Pérez-Saborido, Pilar, Pinto, Katherine, Plua, Javier Sanchez Gonzalez, Vicente, Simo, Rosalía Velasco López, Sandra Veleda Belanche, Fabiola Eugenia Michel Campos, Iciar Muñoz Lindez, Maria, Balluerca, Maite, Camuera, Pablo, Helguera, Imanol, Herrero, Patricia Paunero Vazquez, María, Sánchez-Rubio, Isami, Soeda, María Dolores Arribas Del Amo, Vicente Manuel Borrego Estella, Estefania, Casas, Néstor Castán Villanueva, Daniel Delfau Lafuente, Elena Delgado Blanco, María, Domingo, Ismael Gil Romea, Azucena, Gonzalo, Emilio Lagunas Lostao, Noelia Lete Aguirre, Yaiza Martinez Lahoz, Jesús Víctor Pérez-Tierra Ruiz, Maria Del Mar Soriano, Isabel Valero Lázaro, Esmeralda Carnicer Escusol, Guillermo Pola Bandres, Juan Luis Blas Laina, Beatriz, Cros, Patricio Andrés Freile Pazmiño, David, Garcia-Aguilera, Ana Mejía Casado, Ana, Nogués, Issa Talal El-Abur, Carlos, Yánez, Isabel Gascon Ferrer, Carlos, Gracia-Roche, Ursula María Jariod Ferrer, María Victoria Simón Sanz, Tomas, Uson, Waseem, Ahamed, Sumudu, Jayasinghe, Eranda, Karunadasa, Prathibha, Nelihela, Sujeewa Priyantha Bandara Thalgaspitiya, Dickson, Wickramarathna, Nagenthiram, Harivallavan, Pirashanthan, Nagarasa, Eranga, Perera, Kanapathipillai, Piratheep, Vithranage Srimantha Dewsiri Rodrigo, Meera, Thayalan, Rajendram, Thayaparren, Arulprashanth, Arulanantham, Kanishka De Silva, Gagana, Ganga, Anuja Nadeeshan Kumarasinghe, Mahanada, Udukala, Koculen, Vimaleswaran, Prashanthan, Yogarajah, Ravindri, Jayasinghe, Probhodana, Ranaweera, Mohamed, Rishard, Dharmabandhu, N Samarasekera, Sanjeewa, Seneviratne, Sivasuriya, Sivaganesh, Chamal, Fernando, Nishantha, Mendis, Balasingam, Balagobi, Balasupramaniam, Sathesan, Lanka, Dasanayake, Malitha, Patabendige, Wickramasooriya, Dj, Kugarajh, Ganeshapillai, Sathyamoorthy, Prasanna, Dileepa, Ediriweera, Sumudu, Kumarage, Asanka, Jayawardane, Athula, Kaluarachchi, Pituwala Liyanage Adithya Sirisena, Abubakr, Abubakr, Hozifa, Mohamed, Ismail, Mustafa, Mogahid, Sharfeldein, Samir, Ismail, Reem, Musa, Monira, Sarih, Mussab, Abaker, Eman Adam Abdalla, Mohamad, Abdelbagi, Alsafe, Adlan, Ahmed, Alnaeem, Safa, Atyah, Yasir, Awad, Rsheeda, Dawelbait, Mohamed El Hag, Ibrahim, Elbashir, Sami, Eldirdiri, Samwal, Eldirdiri, Mohammed Eltahier Abdalla Omer, Lana Abdalgadir Ahmed Mohamed, Hiba Hassan Rehmtallah Ahmed, Mohammed Balla Yousif Balla, Abdulmoiz, Aljafari, Abdulmalek, Aljafari, Elsagad, Mohamed, Abdulkader, Mohammad, Abdulkader, Shaar, Mohamed Nafea Shaar, Maab Hussein Yousif Elhafiz, Mohammed Husien Yosif Elhafiz, Abubakr Ali Mohammed Alhassan Humidan, Almigdad, Ali, Hisham, Eljack, Mohamedyasin, Elrashid, Manhal, Ahmed, Albrra, Alhag, Douaa, Ali, Mohammed Ahmed Babikir, Imad, Bakheit, Hytham K, S Hamid, Sami, Mohamed, Walid, Shaban, Nidhal, Siddig, Mohamed, Suliman, Rihab Yasir Abdelmagid, Abubaker, Yassin, Omer, Abbas, Eltahir, Abdelrahim, Muhammed, Ahmed, Mohamed, Elobaid, Adil, Hashim, Ali, Mohamed, Omer, Mohamed, Khalid, Osman, Abdallah, Yousif, Safaa, Abdulaal, Marwa, Elsadig, Mohammed, Hussain, Malaz Amir Ataalmanan, Doha Amir AtaAlmanan, Tebyan Amir AtaAlmanan, Alaa, Elgaili, Maria, Mohamed, Usra, Omara, Alkhansa, Osman, Amna, Osman, Safaa, Saad, Abdelkareem, Ahmed, Ali Adil Ali Karar, Aya, Alhassan, Mohanad, Alsidig, Mohamed, Eljack, Mohammed Ibrahim Mohammed Ali, Awad Kamal Awad Osman, Liena, Mohamed, Samah Ibrahim Omer Mohamed Osman Mohamed Osman, Altayeb, Mohammed, Ayman, Mohammed, Khadija, Muhmmed, Eltahir, Musa, Egbal Sahal Abdelmajed, Khalid Z M, Y Hamid, Omnia M, M Yousif, Mahmoud, Saleh, Osman, Bashir, Yassein, Elhussein, Omar, Madani, Eva, Angenete, Jennifer, Park, Lars, Gillberg, Monir, Jawad, Linas, Pieteris, Yousif, Saeed, Sergej, Safonov, Martin, Spångfors, Henrik, Andersson, Hans, Bahlmann, Karin Björnström Karlsson, Michelle, Chew, Lara, Daham, Lina De Geer, Helen, Didriksson, Gunilla, Gagnö, Carina, Jonsson, Anna, Oscarsson, Pamela, Buchwald, Mathilde, Delorme, Marie-Louise, Lydrup, Shahin, Mohseni, Arvid, Pourlotfi, Souheil, Reda, Kajsa, Anderin, Nina, Blomme, Josefin, Segelman, Malin, Simlund, Anders, Thorell, Fredrik, Wogensen, Daniel, Danielsson, Peter, Elbe, Rebecka, Hultgren, Boel, Hynning, Fredrik, Klevebro, Karin, Lind, Ebba, K Lindqvist, Carl, Montan, Ernesto, Sparrelid, Clara Svenberg Lind, Jeremy, Wales, Andreas, Älgå, Martin, Nordberg, Emil, Pieniowski, Ioannis, Gkekas, Niklas, Löfgren, Karolina, Niska, Robert, Zürner, Silvio, Däster, Otto, Kollmar, Savas, Soysal, Stephanie, Taha-Mehlitz, Athanasios, Tampakis, Dominik Valentin Flury, Marie, Heyne-Pietschmann, Gregor Jan Kocher, Ana, M Calinescu, Barbara, Wildhaber, Markus, Gass, Jürg, Metzger, Andreas, Scheiwiller, Lukas, Briner, Oliver, Dwidar, Steven, Grandjean, Pietro, Ricciardi, Alexandra, Calmels, Christodoulou, Michel, Morena, Antonilli, Dimitrios, Christoforidis, Alessandra, Cristaudi, Jacopo, Galafassi, Maria Luisa Gasparri, Francesco, Mongelli, Martino, Munini, Andrea, Papadia, Sotirios Georgios Popeskou, Alex, Alfieri, Thomas, Bächler, Matteo, Giardini, Christian, Gingert, Laura, Guglielmetti, Inna, Meyer, Tobias, Müller, Daniel, Schöni, Folco, Solimene, Frank, Weidner, Marco, Bueter, Daniel, Gero, Amelie, Müller, Carmen, Portenkirchner, Andreas, Thalheimer, Jeannette, Widmer, Ahmad, Hmaideh, Alaa, Kour, Saleem, Swaes, Omar, Alannaz, Ramez, Aljasem, Ezeddin, Dabbagh, M Wafa Hamoud Alhussein, Amr, Hamza, Mazen, Mohammad, Abd El-Fattah Mouhandes, Mohamad, Shareeda, Mohammad Nour Shashaa, Mousa, Sifat, Sheraa, Tahhan, Rahaf, Toutounji, Mohamed, Abdulrahman, Albaraa, Abdulsalam, Ziad Al Jarad, Hala, Alayyoubi, Dina, Alfarra, Ahmad, Alhamid, Mahmoud, Alnasser, Mulham, Gharib, Ruwaid, Gharib, Obaida, Kabel, Osama, Kherallah, Abdulqader, Klaho, Mohamed Shukri Najjar, Ahmad, Razouk, Joud, Shiekhoni, Wael, Alkhaleel, Amira, Almosa, Mohammad, Aloulou, Maen, Alzaeem, Khaled, Arnaout, Muhamad Zakaria Brimo Alsaman, Mohamad, Estanbouli, Hanadi, Hawa, Ahmad Nbrass Kabawi, Ghina, Maarawi, Yehia, Mashhadany, Sana Shaikh Torab, Waleed, Abd, Tayma Abd Alghafour, Hani, Abdalnour, Nazeeh Al Aktaa, Marwan Al Aliwy, M Maher Al Arje, Tasneem Al Najjar, Ahmad, Al-Mouakeh, Ahmad, Aldakhil, Aos, Alhamid, Hasan, Alhasan, Mohamad Shadi Alkarrash, Jumaa, Alkhamis, Sara, Alshekh, Ahmad Yamen Arnaout, Oula, Azizeh, Mohammed, Dalaleh, Aghyad, Danial, Zain, Douba, Raghad, Ghadri, Mohammad Maen Ghannam, Anas, Ghawi, Luma Haj Kassem, M Yasser Halwani, Shahed, Hamadieh, Mohammad, Hanino, Ala Aldeen Hasan, Haya, Jawish, Nasr Ullah Kabbani, Saadullah, Kabbany, Mohamad, Kadi, Lama, Kadoura, Ahmad Amir Kayali, Ammar, Kayyali, Aya, Kelzia, Amana, Kezze, Abdullah, Khalaf, Maymona, Khayata, Mohammad Nour Kitaz, Mohammad, Kour, Raghad, Makki, Ruqaya, Masri, Joseph, Masri, Noor, Masri, Muhammad, Mazketly, Shiar, Mustafa, Ezzeldin, Nashed, Yaman Qoudra Danial, Hasan, Raslan, Rima, Salem, Mohammed Asaad Salem, Thabet Sayed Bakir, Manaf, Sharabaji, Majd Sheikh Alganameh, Duaa Sheikh Kadro, Joudy, Shurbatji, Mohammad Noor Sultan, Dana, Sultan, Hala, Swied, Bakri Tarras Jarkas, Tayf, Toutounji, Fadi, Ward, Rama, Zazo, Aya, Zazo, Zainab, Zeino, Mohamed, Alaktaa, Wael, Alsado, Hala, Fares, Nouran, Hawa, Hamza, Ibrahim, Abdulmonem, Kawas, Mourad, Niazi, Bayan, Toutounji, Mohammad, Abdow, Mohamad, Ahmad, Tareq, Ahmad, Rawan Al Azhar, Hiba Al Hage Diab, Rahaf Al Mulke, Mohammad, Al-Jadaan, Ahmad, Alhussein, Zahra, Alnajem, Omar, Alneser, Bayan, Alsaid, Elias, Azar, Lubna, Bakr, Ammar, Hamza, Yara, Houdifa, Sami, Jomaa, Samer, Kefo, Hiba, Mardini, Alaa, Mohammad, Fadi, Rayya, Fatima, Razzouk, Mohannad, Saleh, Anwar, Shamandi, Ammar Youzkatli Alkhatib, Omar Abdul Salam, Dany, Ajami, Mohammad, Alhamid, Ahmad, Alkhaledi, Danny, Hadidi, Massa, Jabra, Mamdouh, Kallas, Antoine, Laktine, Joelle, Naem, Naya, Naoum, Ghena Mohammed Fawaz Ashour, Ahmad, Alhouri, Deema, Fallouh, Ahmad, N Mohammad, Ahmad, Rmman, Ali, Slitin, Christine, Tanos, Ibrahim, Wakim, Hanaa, Zahrawi, Majd, Abouassi, Layth, Abouassi, Ayham, Aboutrab, Basel, Ahmad, Ahmad Mustafa Ahmad, Aya, Ahmad, Afaf, Ahmad, Mohamad, Alabras, Mohammad, Albasheer, Ola, Alkasser, Mhd Khaled Alkasser, Ali, Alkhdor, Marah, Azkoul, Mohammad Karam Chaaban, Haya, Deeb, Basel, Jazieh, Basel, Kouz, Youssef, Kozah, Raied, Mohamad, Ammar, Mohammad, Mhd Zied Nasri, Mohammed Mouaz Shebani, Mohammed, Shwin, Alaa, Sommaq, Amal, Youssef, Tala Al Asadi, Suhad, Alkhateb, Rasha Khalil Alsayyad, Roula, Altom, Mhd Amin Alzabibi, Batoul, Bakkar, Hlma, Ismail, Salma Khadem Alsrouji, Sara, Melhem, Mohamad, Sankari, Mosa, Shibani, Noura, Shujaa, Ibrahim, 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Giuseppe Salamone, Francesca Toia, Massimiliano Tripoli, Nepogodiev, D, Rosati, R, Surgery, Medicine and Pharmacy academic/administration, Basic (bio-) Medical Sciences, Surgical clinical sciences, Faculty of Medicine and Pharmacy, Gastroenterology, Medical Oncology, Clinical sciences, Breda, João, ARD - Amsterdam Reproduction and Development, Paediatric Surgery, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, AGEM - Endocrinology, metabolism and nutrition, Graduate School, Tytgat Institute for Liver and Intestinal Research, Laura Alberici, Filippo Antonacci, Alessandro Arena, Angela Belvedere, Fabio Bernagozzi, Paolo Bernante, Pietro Bertoglio, Lorenzo Bianchi, Maria Bisulli, Barbara Bonfanti, Safia Boussedra, Jury Brandolini, Crescenzo Cacciapuoti, Stefano Cardelli, Riccardo Casadei, Matteo Cescon, Alessandro Cipolli, Riccardo Cipriani, Alfredo Conti, Luca Contu, Francesco Costa, Niccolo’ Daddi, Eugenia De Crescenzo, Pierandrea De Iaco, Alessandra De Palma, Massimo Del Gaudio, Anna Nunzia Della Gatta, Giampiero Dolci, Giulia Dondi, Matteo Droghetti, Sergio Nicola Forti Parri, Elena Garelli, Chiara Gelati, Giuliana Germinario, Federico A. Giorgini, Carlo Ingaldi, Elio Jovine, Kenji Kawamukai, Antonio Lanci Lanci, Raffaele Lombardi, Maria Elisa Lozano Miralles, Claudio Marchetti, Michele Masetti, Francesco Minni, Daniele Morezzi, Daniele Parlanti, Alice Pellegrini, Anna Myriam Perrone, Anna paola Pezzuto, Marco Pignatti, Gianluigi Pilu, Valentina Pinto, Gilberto Poggioli, Silvana Bernadetta Puglisi, Diego Raimondo, Matteo Ravaioli, Claudio Ricci, Sara Ricciardi, Francesco Ricotta, Roberta Rizzo, Angela Romano, Matteo Rottoli, Riccardo Schiavina, Renato Seracchioli, Matteo Serenari, Margherita Serra, Piergiorgio Solli, Gioia Sorbi, Mario Taffurelli, Marta Tanzanu, Achille Tarsitano, Marco Tesei, Gabriele Vago, Tommaso Violante, Simone Zanotti, Tommaso Frisoni, leonardo solaini, giorgio ercolani, Fruscio, R, Ornaghi, S, Collaborative, Covidsurg, Collaborative, Globalsurg, Palmisano, Silvia, de Manzini, Nicolo', Žundienė, Laura, Dulskas, Audrius, Kuliavas, Justas, Čekauskas, Albertas, Kielaitė-Gulla, Aistė, Poškus, Tomas, Strupas, Kęstutis, Želvys, Arūnas, COVIDSurg Collaborative, GlobalSurg Collaborative, Department of Surgery, HUS Abdominal Center, Simoes, Jff, Li, E, Picciochi, M, Glasbey, Jc, Baiocchi, G, Blanco-Colino, R, Chaudhry, D, Alameer, E, El-Boghdadly, K, Wuraola, F, Ghosh, D, Gujjuri, Rr, Harrison, Em, Lule, H, Kaafarani, H, Khosravi, M, Kronberger, I, Leventoglu, S, Mann, H, Mclean, Ka, Mengistu, Gm, Modolo, Mm, Ntirenganya, F, Norman, L, Outani, O, Pius, R, Pockney, P, Qureshi, Au, Roslani, Ac, Satoi, S, Shaw, C, Bhangu, A, Omar, Om, Ahmed, Wur, Argus, L, Ball, A, Bywater, Ep, Brar, A, Dawson, Be, Duran, I, Elhadi, M, Jones, C, Kamarajah, Sk, Keatley, Jm, Lawday, S, Marson, Ej, Ots, R, Santos, I, Taylor, Eh, Trout, Im, Varghese, C, Venn, Ml, Xu, W, Dajti, I, Gjata, A, Kacimi, Seo, Boccalatte, L, Cox, D, Townend, P, Aigner, F, Kronberger, Ie, Samadov, E, Alderazi, A, Hossain, K, Padmore, G, van Ramshorst, G, Lawani, I, Cerovac, A, Delibegovic, S, Gomes, Gma, Buarque, Il, Gohar, M, Slavchev, M, Nwegbu, C, Agarwal, A, Martin, J, Ng-Kamstra, J, Olivos, M, Lou, Wh, Ren, Dl, Calvache, Ja, Rivera, Cjp, Hadzibegovic, Ad, Kopjar, T, Mihanovic, J, Jimenez, Pma, Gouvas, N, Klat, J, Novysedlak, R, Amisi, N, Christensen, P, El-Hussuna, A, Batista, S, Lincango-Naranjo, E, Emile, S, Sandoval, Daa, Dhufera, H, Hailu, S, Mengesha, Mg, Kauppila, Jh, Arnaud, Ap, Demetrashvili, Z, Albertsmeier, M, Lederhuber, H, Loffler, Mw, Acquah, Dk, Ofori, B, Tabiri, S, Metallidis, S, Tsoulfas, G, Aguilera-Arevalo, Ml, Recinos, G, Mersich, T, Wettstein, D, Kembuan, G, Milan, Pb, Khosravi, Mh, Mozafari, M, Hilmi, A, Mohan, H, Zmora, O, Gallo, G, Pata, F, Pellino, G, Fujimoto, Y, Kuroda, N, Abou Chaar, Mk, Ayasra, F, Fakhradiyev, I, Hamdun, Ih, Jin-Young, J, Jamal, M, Karout, L, Gulla, A, Rasoaherinomenjanahary, F, Samison, Lh, Sanchez, Iid, Gonzalez, D, Martinez, L, Martinez, Mj, Nayen, A, and Ramos-De la Medina, A
Subjects: Male, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], MULTICENTER, infectious diseases, 0302 clinical medicine, 030202 anesthesiology, Anesthesiology, Cirugía, 80 and over, Prospective Studies, Young adult, Child, Lung, Aged, 80 and over, COVID-19, delay, SARS-CoV-2, surgery, timing, SARS‐CoV‐2 infection, Operative, Child, Preschool, Pneumonia & Influenza, Infection, Cohort study, Human, medicine.medical_specialty, Clinical Sciences, Sars-cov-2, GlobalSurg Collaborative, Settore MED/28 - MALATTIE ODONTOSTOMATOLOGICHE, 03 medical and health sciences, Clinical Research, Biodefense, Correspondence, Humans, PULMONARY COMPLICATIONS, CRIANÇAS EM IDADE PRÉ-ESCOLAR, Aged, Science & Technology, Cirurgia, Prevention, Infant, Odds ratio, Pneumonia, Prospective Studie, Clinical research, Surgery, Human medicine, 610 Medizin und Gesundheit, 1109 Neurosciences, Internationality, Settore MED/29 - CHIRURGIA MAXILLOFACCIALE, Settore MED/18 - CHIRURGIA GENERALE, Adolescent, Adult, Cohort Studies, Female, Middle Aged, Surgical Procedures, Operative, Time, Young Adult, Practice Guidelines as Topic, gastroenterology, Medicine and Health Sciences, 030212 general & internal medicine, Prospective cohort study, Mortality rate, Covid19, Infectious Diseases, Patient Safety, medicine.symptom, 6.4 Surgery, Life Sciences & Biomedicine, 610 Medicine & health, COVID-19, SARS-CoV-2, delay, surgery, timing, Asymptomatic, NO, COVIDSurg Collaborative, Vaccine Related, All institutes and research themes of the Radboud University Medical Center, medicine, Mortalitat, ddc:610, Mortality, Preschool, LS7_4, Surgical Procedures, business.industry, Neurosciences, Evaluation of treatments and therapeutic interventions, 1103 Clinical Sciences, 3126 Surgery, anesthesiology, intensive care, radiology, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], Anesthesiology and Pain Medicine, Emerging Infectious Diseases, Good Health and Well Being, Mortalidad, Cohort Studie, business
Abstract: Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre-operative SARS-CoV-2 infection were compared with those without previous SARS-CoV-2 infection. The primary outcome measure was 30-day postoperative mortality. Logistic regression models were used to calculate adjusted 30-day mortality rates stratified by time from diagnosis of SARS-CoV-2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre-operative SARS-CoV-2 diagnosis. Adjusted 30-day mortality in patients without SARS-CoV-2 infection was 1.5% (95%CI 1.4-1.5). In patients with a pre-operative SARS-CoV-2 diagnosis, mortality was increased in patients having surgery within 0-2 weeks, 3-4 weeks and 5-6 weeks of the diagnosis (odds ratio (95%CI) 4.1 (3.3-4.8), 3.9 (2.6-5.1) and 3.6 (2.0-5.2), respectively). Surgery performed ≥ 7 weeks after SARS-CoV-2 diagnosis was associated with a similar mortality risk to baseline (odds ratio (95%CI) 1.5 (0.9-2.1)). After a ≥ 7 week delay in undertaking surgery following SARS-CoV-2 infection, patients with ongoing symptoms had a higher mortality than patients whose symptoms had resolved or who had been asymptomatic (6.0% (95%CI 3.2-8.7) vs. 2.4% (95%CI 1.4-3.4) vs. 1.3% (95%CI 0.6-2.0), respectively). Where possible, surgery should be delayed for at least 7 weeks following SARS-CoV-2 infection. Patients with ongoing symptoms ≥ 7 weeks from diagnosis may benefit from further delay. ispartof: ANAESTHESIA vol:76 issue:6 pages:748-758 ispartof: location:England status: published
Published: 2021

28. 558 Fertility-sparing treatment for early stage cervical cancer: a single center experience with conization and nodal evaluation

Author: Umberto Maggiore, Edgardo Somigliana, Francesco Raspagliesi, Fabio Martinelli, Salvatore Lopez, Mauro Signorelli, Antonino Ditto, Mariateresa Evangelista, Francesca Filippi, Giorgio Bogani, and Valentina Chiappa
Subjects: Cervical cancer, medicine.medical_specialty, Hysterectomy, Obstetrics, Adenosquamous carcinoma, business.industry, medicine.medical_treatment, Single Center, medicine.disease, Miscarriage, Squamous carcinoma, medicine, Stage (cooking), Live birth, business
Abstract: Introduction/Background To evaluate oncological and obstetrical outcomes of early stage cervical cancer patients who attempted a conservative management to retain their childbearing potential. Methodology Data of women (aged Results Overall, 44 patients met the inclusion criteria. Forty-one (93.2%) women were nulliparous. There were: 3 (6.8%) IA1-LVSI+; 11 (25%) IA2; 25 (56.8%) IB1; 5 (11.4%) IB2 cervical cancers, according to 2018 FIGO stage. Hystological type were: 25 (56.8%) squamous carcinoma; 18 (40.9%) adenocarcinoma and 1 (2.3%) adenosquamous carcinoma. Pelvic lymphadenectomy was performed in 31 (70.4%) cases, while 13 (29.6%) patients had only sentinel node mapping. Four (9.1%) patients received neoadjuvant chemotherapy. In 7 (15.9%) patients conservative treatment was discontinued (5 nodal involvement, 2 no response to chemotherapy) and 2 (4.5%) patients asked for definitive treatment (hysterectomy) following a negative nodal evaluation. Among 35 (79.6%) patients who retained their childbearing potential: 17 (48.6%) had a second conization; 2 (5.7%) relapsed and underwent definitive treatment. After a median follow-up of 51 (range 1–184) months no deaths were reported. Twenty-two (66.7%) women attempted to conceive. There were 13 natural pregnancies among 12 (54.5%) women who got pregnant. Live birth rate was 76.9%: nine (69.2%) term and one (7.7%) preterm (at 32w) deliveries. Two (15.4%) miscarriage (1st and 2nd trimester) and one (7.7%) termination of pregnancy for medical reasons were recorded. Conclusion Conization plus laparoscopic nodal evaluation is an ultraconservative but feasible option in the setting of fertility-sparing treatment for early-stage cervical cancer patients. Disclosures The authors declare that there are no conflicts of interest. No funding sources supported this investigation.
Published: 2020

29. Assessing the Long-Term Role of Vaccination against HPV after Loop Electrosurgical Excision Procedure (LEEP): A Propensity-Score Matched Comparison

Author: Mario Malzoni, Gaetano Valenti, Lavinia Mosca, Stefano Ferla, Nicola Colacurci, Paolo Vercellini, Antonio Cianci, Rocco Guerrisi, Claudia Brusadelli, Biagio Contino, Giovanni Scambia, Andrea Ciavattini, Umberto Leone Roberti Maggiore, Pierluigi Benedetti Panici, Gabriella Ferrandina, Stefano Greggi, Gabriele Carlifante, Giorgio Bogani, Barbara Gardella, Margherita Fischetti, Simone Ferrero, Maurizio Serati, Ciro Pinelli, Salvatore Lopez, Fulvio Zullo, Anna Myriam Perrone, Mauro Signorelli, Rosa De Vincenzo, Andrea Giannini, Raffaele Tinelli, Vincenzo Dario Mandato, Jvan Casarin, Arsenio Spinillo, Francesco Sopracordevole, Francesco Plotti, Violante Di Donato, Viola Liberale, Maria Grazia Matarazzo, Antonino Ditto, Annunziata Carlea, Ermelinda Monti, Lorenzo Aguzzoli, Maria Giovanna Salerno, Cono Scaffa, Francesca Falcone, Michele Desiato, Valentina Chiappa, Pierandrea De Iaco, Roberto Angioli, Alice Bergamini, Salvatore Dessole, Marco Petrillo, Simona Ruisi, Francesco Raspagliesi, Giulia Dondi, Fabio Ghezzi, Giovanni D'ippolito, Sara Bocio, Andrea Dell'Acqua, Giuseppe Sarpietro, Chiara Borghi, Alessandro Ghelardi, Paola Carunchio, Luca Gianella, Tommaso Simoncini, Cristina Donfrancesco, Ludovico Muzii, Gian Franco Zannoni, Bogani, G., Raspagliesi, F., Sopracordevole, F., Ciavattini, A., Ghelardi, A., Simoncini, T., Petrillo, M., Plotti, F., Lopez, S., Casarin, J., Serati, M., Pinelli, C., Valenti, G., Bergamini, A., Gardella, B., Dell'Acqua, A., Monti, E., Vercellini, P., D'Ippolito, G., Aguzzoli, L., Mandato, V. D., Carunchio, P., Carlifante, G., Giannella, L., Scaffa, C., Falcone, F., Ferla, S., Borghi, C., Ditto, A., Malzoni, M., Giannini, A., Salerno, M. G., Liberale, V., Contino, B., Donfrancesco, C., Desiato, M., Perrone, A. M., Dondi, G., De Iaco, P., Maggiore, U. L. R., Signorelli, M., Chiappa, V., Ferrero, S., Sarpietro, G., Matarazzo, M. G., Cianci, A., Bocio, S., Ruisi, S., Guerrisi, R., Brusadelli, C., Mosca, L., Tinelli, R., De Vincenzo, R., Zannoni, G. F., Ferrandina, G., Dessole, S., Angioli, R., Greggi, S., Spinillo, A., Ghezzi, F., Colacurci, N., Fischetti, M., Carlea, A., Zullo, F., Muzii, L., Scambia, G., Panici, P. B., Di Donato, V., Bogani G., Raspagliesi F., Sopracordevole F., Ciavattini A., Ghelardi A., Simoncini T., Petrillo M., Plotti F., Lopez S., Casarin J., Serati M., Pinelli C., Valenti G., Bergamini A., Gardella B., Dell'acqua A., Monti E., Vercellini P., D'ippolito G., Aguzzoli L., Mandato V.D., Carunchio P., Carlifante G., Giannella L., Scaffa C., Falcone F., Ferla S., Borghi C., Ditto A., Malzoni M., Giannini A., Salerno M.G., Liberale V., Contino B., Donfrancesco C., Desiato M., Perrone A.M., Dondi G., De Iaco P., Maggiore U.L.R., Signorelli M., Chiappa V., Ferrero S., Sarpietro G., Matarazzo M.G., Cianci A., Bocio S., Ruisi S., Guerrisi R., Brusadelli C., Mosca L., Tinelli R., De Vincenzo R., Zannoni G.F., Ferrandina G., Dessole S., Angioli R., Greggi S., Spinillo A., Ghezzi F., Colacurci N., Fischetti M., Carlea A., Zullo F., Muzii L., Scambia G., Panici P.B., and Di Donato V.
Subjects: medicine.medical_specialty, HPV, Cost effectiveness, Immunology, lcsh:Medicine, Lower risk, Article, 03 medical and health sciences, conization, 0302 clinical medicine, Primary prevention, Drug Discovery, medicine, Recurrent disease, LEEP, Pharmacology (medical), 030212 general & internal medicine, leep, vaccination, Pharmacology, Obstetrics, business.industry, lcsh:R, medicine.disease, Vaccination, Settore MED/40 - GINECOLOGIA E OSTETRICIA, Infectious Diseases, Loop electrosurgical excision procedure, Dysplasia, 030220 oncology & carcinogenesis, Propensity score matching, business
Abstract: Background: Primary prevention through vaccination is a prophylactic approach aiming to reduce the risk of developing human papillomavirus (HPV)-related lesions. No mature and long-term data supported the adoption of vaccination in women undergoing conization. Methods: This is a retrospective multi-institutional study. Charts of consecutive patients undergoing conization between 2010 and 2014 were collected. All patients included had at least 5 years of follow-up. We compared outcomes of patients undergoing conization plus vaccination and conization alone. A propensity-score matching algorithm was applied in order to reduce allocation biases. The risk of developing recurrence was estimated using Kaplan-Meir and Cox hazard models. Results: Overall, charts of 1914 women were analyzed. The study group included 116 (6.1%) and 1798 (93.9%) women undergoing conization plus vaccination and conization alone, respectively. Five-year recurrence rate was 1.7% (n = 2) and 5.7% (n = 102) after conization plus vaccination and conization alone, respectively (p = 0.068). After the application of a propensity-score matching, we selected 100 patients undergoing conization plus vaccination and 200 patients undergoing conization alone. The crude number of recurrences was 2 (2%) and 11 (5.5%) for patients undergoing conization plus vaccination and conization alone, respectively (p = 0.231). Vaccination had no impact on persistent lesions (no negative examination between conization and new cervical dysplasia, p = 0.603), but reduced the risk of recurrent disease (patients who had at least one negative examination between conization and the diagnosis of recurrent cervical dysplasia, p = 0.031). Conclusions: Patients having vaccination experience a slightly lower risk of recurrence than women who had not, although not statistically significantly different. Further evidence is needed to assess the cost effectiveness of adopting vaccination in this setting.
Published: 2020
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30. Oncological outcomes of laparoscopic radical hysterectomy versus radical abdominal hysterectomy in patients with early-stage cervical cancer: a multicenter analysis

Author: Antonino Ditto, Jaime Siegrist, Gabriel Jaime Rendon Pereira, Diego Odetto, David Isla, Lina Echeverry, Florencia Noll, Mindy Hernandez Nava, Lina Maria Trujillo, Alicia Hernández, Rene Pareja, Shuangshuang Fu, James Saenz, Fabio Martinelli, Jose Alejandro Rauh-Hain, Juliana Rodriguez, José Saadi, Francesco Raspagliesi, Henry Valdivia, Aldo Lopez, M. Milagros Pérez, Marcela Hernandez, Ignacio Zapardiel, and Vladimir Villoslada
Subjects: Adult, medicine.medical_specialty, medicine.medical_treatment, Uterine Cervical Neoplasms, Hysterectomy, Disease-Free Survival, Cohort Studies, Young Adult, Laparotomy, medicine, Humans, Stage (cooking), Radical Hysterectomy, Laparoscopy, Neoplasm Staging, Retrospective Studies, Cervical cancer, medicine.diagnostic_test, business.industry, Obstetrics and Gynecology, Cancer, Retrospective cohort study, Middle Aged, medicine.disease, Surgery, Treatment Outcome, Oncology, Female, business
Abstract: IntroductionRecent evidence has shown adverse oncological outcomes when minimally invasive surgery is used in early-stage cervical cancer. The objective of this study was to compare disease-free survival in patients that had undergone radical hysterectomy and pelvic lymphadenectomy, either by laparoscopy or laparotomy.MethodsWe performed a multicenter, retrospective cohort study of patients with cervical cancer stage IA1 with lymph-vascular invasion, IA2, and IB1 (FIGO 2009 classification), between January 1, 2006 to December 31, 2017, at seven cancer centers from six countries. We included squamous, adenocarcinoma, and adenosquamous histologies. We used an inverse probability of treatment weighting based on propensity score to construct a weighted cohort of women, including predictor variables selected a priori with the possibility of confounding the relationship between the surgical approach and survival. We estimated the HR for all-cause mortality after radical hysterectomy with weighted Cox proportional hazard models.ResultsA total of 1379 patients were included in the final analysis, with 681 (49.4%) operated by laparoscopy and 698 (50.6%) by laparotomy. There were no differences regarding the surgical approach in the rates of positive vaginal margins, deep stromal invasion, and lymphovascular space invasion. Median follow-up was 52.1 months (range, 0.8–201.2) in the laparoscopic group and 52.6 months (range, 0.4–166.6) in the laparotomy group. Women who underwent laparoscopic radical hysterectomy had a lower rate of disease-free survival compared with the laparotomy group (4-year rate, 88.7% vs 93.0%; HR for recurrence or death from cervical cancer 1.64; 95% CI 1.09–2.46; P=0.02). In sensitivity analyzes, after adjustment for adjuvant treatment, radical hysterectomy by laparoscopy compared with laparotomy was associated with increased hazards of recurrence or death from cervical cancer (HR 1.7; 95% CI 1.13 to 2.57; P=0.01) and death for any cause (HR 2.14; 95% CI 1.05–4.37; P=0.03).ConclusionIn this retrospective multicenter study, laparoscopy was associated with worse disease-free survival, compared to laparotomy.
Published: 2020

31. Conization and lymph node evaluation as a fertility-sparing treatment for early stage cervical cancer

Author: Francesca Filippi, Umberto Leone Roberti Maggiore, Antonino Ditto, Daniele Vinti, Salvatore Lopez, Mauro Signorelli, Fabio Martinelli, Giorgio Bogani, Francesco Raspagliesi, Valentina Chiappa, Edgardo Somigliana, and Mariateresa Evangelista
Subjects: Adult, medicine.medical_specialty, medicine.medical_treatment, Conization, Uterine Cervical Neoplasms, Cervix Uteri, medicine, Humans, Stage (cooking), Lymph node, Neoplasm Staging, Retrospective Studies, Cervical cancer, Pregnancy, Hysterectomy, Obstetrics, business.industry, Obstetrics and Gynecology, Fertility Preservation, Sentinel node, medicine.disease, Squamous carcinoma, medicine.anatomical_structure, Oncology, Lymph Node Excision, Female, Lymph Nodes, business, Live birth
Abstract: IntroductionTo evaluate oncological and obstetrical outcomes of early stage cervical cancer patients who underwent conservative management to retain childbearing potential.MethodsData of women (aged ResultsOverall, 39 patients met inclusion criteria; 36 (92.3%) women were nulliparous. There were: 3 (7.7%) IA1-LVSI+; 11 (28.2%) IA2; and 25 (64.1%) IB1 cervical cancers, according to 2018 FIGO stage classification. Histological types were 22 (56.4%) squamous carcinoma and 17 (43.6%) adenocarcinoma. Pelvic lymphadenectomy was performed in 29 (74.4%) patients, while 10 (25.6%) patients had only sentinel node mapping. In 4 (10.3%) patients conservative treatment was discontinued due to nodal involvement and 2 (5.1%) patients requested definitive treatment (hysterectomy) after a negative lymph node evaluation. Among 33 (84.6%) patients who retained their childbearing potential, 17 (51.5%) had a second conization. 2 (6.1%) patients relapsed and underwent definitive treatment. After a median follow-up of 51 months (range 1–184) no deaths were reported. 22 (70.9%) patients attempted to conceive. There were 13 natural pregnancies among 12 (54.5%) women who got pregnant. Live birth rate was 76.9%: 9 (69.2%) term and 1 (7.7%) preterm (at 32 weeks) deliveries. 2 (15.4%) miscarriages (first and second trimester) and 1 (7.7%) termination of pregnancy for medical reasons were recorded.ConclusionConization plus laparoscopic nodal evaluation may be a safe and feasible conservative option in the setting of fertility-sparing treatment for early-stage cervical cancer patients.
Published: 2020

32. The role of sentinel lymph node mapping in lower genital tract melanoma

Author: Giorgio Bogani, Antonino Ditto, Rocco Guerrisi, Claudia Brusadelli, Francesco Raspagliesi, and Salvatore Lopez
Subjects: medicine.medical_specialty, Vaginal Neoplasms, medicine.medical_treatment, Sentinel lymph node, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Lymph node, Melanoma, Retrospective Studies, 030219 obstetrics & reproductive medicine, Vulvar Neoplasms, business.industry, Sentinel Lymph Node Biopsy, Obstetrics and Gynecology, Technetium, Retrospective cohort study, medicine.disease, Occult, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Lymph Node Excision, Vaginal Melanoma, Lymphadenectomy, Female, Radiology, Radiopharmaceuticals, Sentinel Lymph Node, business, Vulvar melanoma
Abstract: Introduction Vulvar and vaginal melanomas are rare cancers of the female genital tract and account for 1% to 3% of all melanomas diagnosed in women. Due to the rarity of the disease, few data are available on the clinical and pathologic features of these cancers. Furthermore, treatment options are generally based on extrapolations of the information available for the more common cutaneous counterparts. Surgery represents the mainstay of treatment for lower genital tract melanoma. Moreover, the role of sentinel lymph node (SLN) assessment is controversial because no prospective data are available. Evidence acquisition Data were collected from MEDLINE, EMBASE, Web of Sciences and Scopus databases. On July 10, 2020, we used the search comprising the terms "vulvar melanoma", "genital melanoma" and "vulvovaginal melanoma" including only studies in which SLN biopsy was performed. Evidence synthesis Ten retrospective studies have been found. No randomized trials have been reported. The studies included 132 patients while only 63 (47%) undergone SLN. 99mTC with or without blue dye followed by ultrastaging was highly accurate and is currently the gold standard. Mean detection rate was 98.3%. No clear evidence supported the execution of back lymphadenectomy (after SLN mapping), in fact, extrapolating data from cutaneous melanomas of other sites, completion of lymphadenectomy does not confer a melanoma-specific survival advantage. Conclusions Although the small amount of available data, sentinel lymph node procedure is feasible and capable of identifying patients who have occult lymph node metastases. However, the potential role of the sentinel lymph node procedure as an alternative method of lymph node staging in patients with vulvar or vaginal melanoma needs further investigation.
Published: 2020

33. Trends in prevalence in human papillomavirus types and their association with cervical dysplasia: an analysis on 15 138 women over 20 years

Author: Valentina Chiappa, Francesco Raspagliesi, Antonino Ditto, Francesca Taverna, Giorgio Bogani, Claudia Lombardo, Ciro Pinelli, Salvatore Lopez, and Mauro Signorelli
Subjects: Adult, Cancer Research, medicine.medical_specialty, Epidemiology, Uterine Cervical Neoplasms, Disease, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Human papillomavirus DNA, Prevalence, Humans, Sex organ, 030212 general & internal medicine, Papillomavirus Vaccines, Papillomaviridae, Human papillomavirus types, Retrospective Studies, business.industry, Papillomavirus Infections, Public Health, Environmental and Occupational Health, Cancer, medicine.disease, Prognosis, Uterine Cervical Dysplasia, Vaccination, Oncology, Italy, Dysplasia, 030220 oncology & carcinogenesis, Female, business, International agency, Follow-Up Studies
Abstract: To investigate trends in prevalence of various human papillomavirus types in order to assess the unmet clinical needs for women affected by human papillomavirus-related disease. Data of consecutive 15 138 patients undergoing human papillomavirus DNA testing from 1998 to 2018 were retrospectively identified. Human papillomavirus types were classified at high-risk according to the classification of the International Agency for Research on Cancer. The International Agency for Research on Cancer included seven human papillomavirus types covered by nine-valent vaccine and five not yet covered by any available vaccines. Overall, 4159 (65.3%), 1500 (23.5%) and 714 (11.2%) women had human papillomavirus types covered by nine-valent vaccination, not covered by nine-valent vaccination and co-infections of human papillomavirus types of both groups. At least one high-risk human papillomavirus type(s) was detected in 1241 patients with genital dysplasia: 832 (67.1%), 291 (23.4%) and 118 (9.5%) women had human papillomavirus types covered by nine-valent vaccination, not covered by nine-valent vaccination and co-infections of human papillomavirus types of both groups. Over the twenty-year study period, the number of human papillomavirus types not covered by nine-valent vaccine increased dramatically (from 4 to 16%; P < 0.001, P for trend). Similarly, looking at patients with genital dysplasia, high-risk human papillomavirus types not covered by nine-valent vaccine increased from 3 to 13% (P < 0.001, P for trend). Our data highlight that human papillomavirus types covered by nine-valent vaccine represent are the main types associated with genital dysplasia. However, over the study period, we observed an increasing prevalence of confections and high-risk human papillomavirus types not covered by the nine-valent vaccine, thus suggesting the need of developing more complete vaccines against human papillomavirus.
Published: 2020

34. Patterns of recurrence after laparoscopic versus open abdominal radical hysterectomy in patients with cervical cancer: a propensity-matched analysis

Author: Francesco Raspagliesi, Luis Chiva, Andrea Dell'Acqua, Baldo Gisone, Giorgio Bogani, Antonino Ditto, Ciro Pinelli, Fabio Ghezzi, and Jvan Casarin
Subjects: Laparoscopic surgery, Adult, medicine.medical_specialty, medicine.medical_treatment, Population, Uterine Cervical Neoplasms, Hysterectomy, medicine, Clinical endpoint, Humans, Minimally Invasive Surgical Procedures, Radical Hysterectomy, Laparoscopy, education, Propensity Score, Aged, Neoplasm Staging, Retrospective Studies, Cervical cancer, Aged, 80 and over, education.field_of_study, medicine.diagnostic_test, business.industry, Obstetrics and Gynecology, Middle Aged, medicine.disease, Surgery, Oncology, Italy, Propensity score matching, Female, Neoplasm Recurrence, Local, business, Abdominal surgery
Abstract: ObjectiveRecent evidence has suggested that laparoscopic radical hysterectomy is associated with an increased risk of recurrence in comparison with open abdominal radical hysterectomy. The aim of our study was to identify patterns of recurrence after laparoscopic and open abdominal radical hysterectomy for cervical cancer.MethodsThis a retrospective multi-institutional study evaluating patients with recurrent cervical cancer after laparoscopic and open abdominal surgery performed between January 1990 and December 2018. Inclusion criteria were: age ≥18 years old, radical hysterectomy (type B or type C), no recurrent disease, and clinical follow-up >30 days. The primary endpoint was to evaluate patterns of first recurrence following laparoscopic and open abdominal radical hysterectomy. The secondary endpoint was to estimate the effect of the primary surgical approach (laparoscopy and open surgery) in post-recurrence survival outcomes (event-free survival and overall survival). In order to reduce possible confounding factors, we applied a propensity-matching algorithm. Survival outcomes were estimated using the Kaplan-Meier model.ResultsA total of 1058 patients were included in the analysis (823 underwent open abdominal radical hysterectomy and 235 patients underwent laparoscopic radical hysterectomy). The study included 117 (14.2%) and 35 (14.9%) patients who developed recurrent cervical cancer after open or laparoscopic surgery, respectively. Applying a propensity matched comparison (1:2), we reduced the population to 105 patients (35 vs 70 patients with recurrence after laparoscopic and open radical hysterectomy). Median follow-up time was 39.1 (range 4–221) months and 32.3 (range 4–124) months for patients undergoing open and laparoscopic surgery, respectively. Patients undergoing laparoscopic radical hysterectomy had shorter progression-free survival than patients undergoing open abdominal surgery (HR 1.98, 95% CI 1.32 to 2.97; p=0.005). Patients undergoing laparoscopic radical hysterectomy were more likely to develop intrapelvic recurrences (74% vs 34%; pConclusionsPatients undergoing laparoscopic radical hysterectomy are at higher risk of developing intrapelvic recurrences and peritoneal carcinomatosis. Further evidence is needed in order to corroborate our findings.
Published: 2020

35. Patterns of failure after adjuvant 'sandwich' chemo-radio-chemotherapy in locally advanced (stage III–IVA) endometrial cancer

Author: Clelia Teresa Delle Curti, F. Bertolina, Giorgio Bogani, Sara Bosio, Violante Di Donato, Andrea Dell'Acqua, Valentina Chiappa, Antonino Ditto, Ciro Pinelli, Jvan Casarin, Fabio Ghezzi, Giuseppe Sarpietro, Francesco Raspagliesi, and Anna Maria Cerrotta
Subjects: 0301 basic medicine, Adult, Cancer Research, medicine.medical_specialty, medicine.medical_treatment, sandwich, chemotherapy, Disease-Free Survival, 03 medical and health sciences, 0302 clinical medicine, locally advanced, medicine, Humans, Treatment Failure, Stage (cooking), radiotherapy, Aged, Neoplasm Staging, Retrospective Studies, Aged, 80 and over, business.industry, Endometrial cancer, Retrospective cohort study, General Medicine, Chemoradiotherapy, Adjuvant, Sentinel node, Middle Aged, medicine.disease, Endometrial Neoplasms, Radiation therapy, Survival Rate, Regimen, Dissection, 030104 developmental biology, Oncology, endometrial cancer, 030220 oncology & carcinogenesis, Lymphatic Metastasis, Lymphadenectomy, Female, Radiology, Lymph Nodes, Neoplasm Recurrence, Local, business
Abstract: To investigate oncological outcomes and patterns of recurrence of patients undergoing adjuvant “sandwich” chemo-radio-chemotherapy for locally advanced endometrial cancer. This is a multi-institutional retrospective study evaluating chart of consecutive patients undergoing chemo-radio-chemotherapy for FIGO stage III–IVA endometrial caner. The study population included 45 patients who had adjuvant sandwich regimen. Median age of the study population was 66 years. The majority of patients were diagnosed with endometrioid histology and with stage III disease. After a median follow-up of 35 months, 15 patients developed recurrent disease. Three-year disease-free and overall survivals was 45% and 81%, respectively. Three-years site-specific disease-free survival was 85%, 92% and 48% for local, loco-regional, and distant recurrence, respectively. All patients included in the study had nodal dissection. Nodal assessment included: sentinel node mapping, sentinel node mapping plus backup lymphadenectomy and lymphadenectomy in 15, 6 and 24 patients, respectively. The latter group included four patients detected by suspected enlarged nodes, intraoperatively. Even after the exclusion of patients with enlarged nodes, the type of nodal assessment did not impact on survival outcomes (p > 0.2). Positive peritoneal cytology was the only factor associated with an increased risk of developing (any site) recurrence and distant-specific recurrence, independently. No factor predicted for overall survival. Adjuvant “sandwich” chemo-radio-chemotherapy for locally advanced endometrial cancer guarantee promising local and loco-regional controls, but distant failure rate is high, thus suggesting the need for applying other systemic treatment strategies for these patients.
Published: 2020

36. Survival implication of lymphadenectomy in patients surgically treated for apparent early-stage uterine serous carcinoma

Author: Francesco Raspagliesi, Stefano Greggi, Franco Odicino, Federico Ferrari, Nicoletta Donadello, Mario Malzoni, Elisa Piovano, Ferdinando Bonfiglio, Antonio Simone Laganà, Giorgio Bogani, Antonino Ditto, Andrea Puppo, Fabio Ghezzi, Ciro Pinelli, Jvan Casarin, and Francesca Falcone
Subjects: Adult, medicine.medical_specialty, endometrial neoplasms, medicine.medical_treatment, Urology, Hysterectomy, survival, Pelvis, Uterine serous carcinoma, Endometrial Neoplasms, Gynecology, Lymphadenectomy, Survival, Therapeutics, 03 medical and health sciences, 0302 clinical medicine, Uterine Corpus, therapeutics, medicine, Humans, Stage (cooking), Aged, Neoplasm Staging, Retrospective Studies, Aged, 80 and over, 030219 obstetrics & reproductive medicine, Proportional hazards model, business.industry, gynecology, Hazard ratio, Age Factors, Obstetrics and Gynecology, Cancer, General Medicine, Middle Aged, medicine.disease, Confidence interval, Cystadenocarcinoma, Serous, Survival Rate, Editorial, Oncology, 030220 oncology & carcinogenesis, Uterine Neoplasms, lymphadenectomy, Lymph Node Excision, Original Article, Female, Lymph Nodes, Neoplasm Recurrence, Local, business
Abstract: Objective Uterine serous carcinoma (USC) is a rare highly aggressive disease. In the present study, we aimed to investigate the survival implication of the systematic lymphadenectomy in patients who underwent surgery for apparent early-stage USC. Methods Consecutive patients with apparent early-stage USC surgically treated at six Italian referral cancer centers were analyzed. A comparison was made between patients who underwent retroperitoneal staging including at least pelvic lymphadenectomy “LND” vs. those who underwent hysterectomy alone “NO-LND”. Baseline, surgical and oncological outcomes were analyzed. Kaplan- Meier curves were calculated for disease-free survival (DFS) and disease-specific survival (DSS). Associations were evaluated with Cox proportional hazard regression and summarized using hazard ratio (HR). Results One hundred forty patients were analyzed, 106 LND and 34 NO-LND. NO-LND group (compared to LND group) included older patients (median age, 73 vs.67 years) and with higher comorbidities (median Charlson Comorbidity Index, 6 vs. 5) (p
Published: 2020

37. 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

38. Survival outcomes in endometrial cancer patients having lymphadenectomy, sentinel node mapping followed by lymphadectomy and sentinel node mapping alone: Long-term results of a propensity-matched analysis

Author: Umberto Leone Roberti Maggiore, Giorgio Bogani, Rocco Guerrisi, Francesco Raspagliesi, Claudia Brusadelli, Simone Ferrero, Valentina Chiappa, Fabio Ghezzi, Antonino Ditto, Andrea Dell'Acqua, Ciro Pinelli, Salvatore Lopez, and Jvan Casarin
Subjects: 0301 basic medicine, medicine.medical_specialty, Survival, medicine.medical_treatment, 03 medical and health sciences, 0302 clinical medicine, Endometrial cancer, medicine, Humans, Stage IIIC, Propensity Score, Survival analysis, Proportional Hazards Models, Retrospective Studies, sentinel node mapping, Sentinel Lymph Node Biopsy, business.industry, Endometrial cancer, sentinel node mapping, Lymphadenectomy, Micrometastasis, Obstetrics and Gynecology, Retrospective cohort study, Middle Aged, Sentinel node, medicine.disease, Endometrial Neoplasms, Survival Rate, Treatment Outcome, 030104 developmental biology, Oncology, endometrial cancer, lymphadenectomy, survival, 030220 oncology & carcinogenesis, Propensity score matching, Lymph Node Excision, Female, Lymph Nodes, Radiology, Sentinel Lymph Node, business
Abstract: Objective Sentinel node mapping (SLNM) has replaced lymphadenectomy for staging surgery in apparent early-stage endometrial cancer (EC). Here, we evaluate long-term survival of three different approaches of nodal assessment in EC. Methods This is a multi-institutional retrospective study evaluating long-term outcomes (at least 3 years) of EC patients having lymphadenectomy, SLNM followed by lymphadenectomy and SLNM alone. In order to reduce possible confounding factors we applied a propensity-matched algorithm. Survival outcomes were assessed using Kaplan-Meier and Cox proportional hazard models. Results Applying a propensity score matching algorithm we selected 180 patients having SLNM (90 SLNM vs. 90 SLNM followed by lymphadenectomy). Additionally, a control group of 180 patients having lymphadenectomy was selected using the same criteria. Overall, 10% of patients were diagnosed with positive nodes. Low volume disease was observed in 16 cases (5 micrometastasis and 11 isolated tumor cells). Patients having SLNM followed by lymphadenectomy had a higher possibility to be diagnosed with a stage IIIC disease in comparison to lymphadenectomy alone (p=0.02); while we did not observe difference in the diagnostic value of SLNM followed by lymphadenectomy and SLNM (p=0.389). Median follow-up time was 69 months (range, 7–206). The survival analysis comparing the three techniques did not show statistical differences in terms of disease-free (p=0.570, log-rank test) and overall survival (p=0.911, log-rank test); Similarly, they did not impact on survival outcomes after stratification by low, intermediate and high risk patients. Conclusions Our study highlighted that SLNM provides similar long-term oncologic outcomes than lymphadenectomy. Further evidence is warranted to assess the prognostic value of low-volume disease detected by ultrastaging in patients following SLNM.
Published: 2020

39. Age-specific predictors of cervical dysplasia recurrence after primary conization: analysis of 3,212 women

Author: Giorgio Bogani, Antonino Ditto, Valentina Chiappa, Francesco Raspagliesi, Fabio Martinelli, Ciro Pinelli, and Salvatore Lopez
Subjects: Adult, medicine.medical_specialty, Multivariate analysis, Population, Uterine Cervical Neoplasms, Cervix, 03 medical and health sciences, conization, 0302 clinical medicine, Obstetrics and gynaecology, squamous intraepithelial lesions of the cervix, medicine, Humans, Prospective Studies, Prospective cohort study, education, Papillomaviridae, Retrospective Studies, education.field_of_study, 030219 obstetrics & reproductive medicine, Human papillomavirus 18, business.industry, Obstetrics, Proportional hazards model, Hazard ratio, Age Factors, Obstetrics and Gynecology, General Medicine, Middle Aged, medicine.disease, Uterine Cervical Dysplasia, Confidence interval, female genital diseases and pregnancy complications, human papillomavirus 16, papillomavirus infections, Oncology, Dysplasia, 030220 oncology & carcinogenesis, Female, Original Article, Neoplasm Recurrence, Local, business
Abstract: Objective This study aimed to identify predictors of recurrence/persistence of cervical intraepithelial neoplasia grade 2+ (CIN2+) lesion (r-CIN2+) after primary conization. Methods Retrospective analysis involving all consecutive women having conization for CIN2+ between 1998 and 2018. The risk of r-CIN2+ was assessed using Kaplan-Meier and Cox models. Results Data of 3,212 women were retrospectively identified. After a mean follow-up of 47 (±22.2) months, 112 (3.5%) patients developed r-CIN2+. Mean time interval between prior conization and diagnosis of r-CIN2+ was 26.2 (±13.2) months. Via multivariate analysis, presence of high-risk human papillomavirus (HPV) types at the time of CIN2+ diagnosis, hazard ratio (HR)=3.40 (95% confidence interval [CI]=1.66-6.95) for HPV16/18 and HR=2.59 (95% CI=1.21-5.55) for HPV types other than 16/18, positive margins at primary conization, HR=4.11 (95% CI=2.04-8.26) and HPV persistence after conization, HR=16.69 (95% CI=8.20-33.9), correlated with r-CIN2+, independently. Considering age-specific HPV types distribution, we observed that HPV16/18 infection correlated to an increased risk of r-CIN2+ only in young women (aged ≤25 years; p=0.031, log-rank test); while in the older population (>25 years) HPV type(s) involved had not impact on r-CIN2+ risk (p>0.200, log-rank test). Conclusion HPV persistence is the main factor predicting r-CIN2+. Infection from HPV16/18 has a detrimental effect in young women, thus highlighting the need of implementing vaccination against HPV in this population. Further prospective studies are warranted for tailoring clinical decision-making for post-conization follow-up on the basis of risk factors.
Published: 2020

40. Recurrence rate after loop electrosurgical excision procedure (LEEP) and laser Conization: A 5-year follow-up study

Author: Giuseppe Sarpietro, Giovanni D'ippolito, Gabriele Carlinfante, Marco Petrillo, Claudia Brusadelli, Paola Carunchio, Maria Giovanna Salerno, Cono Scaffa, Arsenio Spinillo, Francesco Sopracordevole, Gian Franco Zannoni, Violante Di Donato, Francesco Plotti, Viola Liberale, Francesco Raspagliesi, Giovanni Scambia, Fabio Ghezzi, Antonino Ditto, Simona Ruisi, Michele Desiato, Ermelinda Monti, Valentina Chiappa, Pierandrea De Iaco, Stefano Greggi, Francesca Falcone, Lorenzo Aguzzoli, Roberto Angioli, Salvatore Dessole, Paolo Vercellini, Antonio Cianci, Gaetano Valenti, Giulia Dondi, Luca Giannella, Maurizio Serati, Andrea Giannini, Sara Bosio, Margherita Fischetti, Raffaele Tinelli, Tommaso Simoncini, Cristina Donfrancesco, Ludovico Muzii, Nicola Colacurci, Alessandro Ghelardi, Andrea Dell'Acqua, Ciro Pinelli, Salvatore Lopez, Rocco Guerrisi, Giorgio Bogani, Mauro Signorelli, Rosa De Vincenzo, Jvan Casarin, Pierluigi Benedetti Panici, Andrea Ciavattini, Lavinia Mosca, Umberto Leone Roberti Maggiore, Biagio Contino, Barbara Gardella, Vincenzo Dario Mandato, Mario Malzoni, Maria Grazia Matarazzo, Simone Ferrero, Gabriella Ferrandina, Anna Myriam Perrone, Chiara Borghi, Alice Bergamini, Bogani, G., DI DONATO, V., Sopracordevole, F., Ciavattini, A., Ghelardi, A., Lopez, S., Simoncini, T., Plotti, F., Casarin, J., Serati, M., Pinelli, C., Valenti, G., Bergamini, A., Gardella, B., Dell'Acqua, A., Monti, E., Vercellini, P., Fischetti, M., D'Ippolito, G., Aguzzoli, L., Mandato, V. D., Carunchio, P., Carlinfante, G., Giannella, L., Scaffa, C., Falcone, F., Borghi, C., Ditto, A., Malzoni, M., Giannini, A., Salerno, M. G., Liberale, V., Contino, B., Donfrancesco, C., Desiato, M., Perrone, A. M., Dondi, G., De IACO, P., LEONE ROBERTI MAGGIORE, U., Signorelli, M., Chiappa, V., Ferrero, S., Sarpietro, G., Matarazzo, M. G., Cianci, A., Bosio, S., Ruisi, S., Guerrisi, R., Brusadelli, C., Mosca, L., Tinelli, R., DE VINCENZO, R., Zannoni, G. F., Ferrandina, G., Petrillo, M., Dessole, S., Angioli, R., Greggi, S., Spinillo, A., Ghezzi, F., Colacurci, N., Muzii, L., BENEDETTI PANICI, P., Scambia, G., Raspagliesi, F., BOGANI G., DI DONATO V., SOPRACORDEVOLE F., CIAVATTINI A., GHELARDI A., LOPEZ S., SIMONCINI T., PLOTTI F., CASARIN J., SERATI M., PINELLI C., VALENTI G., BERGAMINI A., GARDELLA B., DELL'ACQUA A., MONTI E., VERCELLINI P., FISCHETTI M., D'IPPOLITO G., AGUZZOLI L., MANDATO V.D., CARUNCHIO P., CARLINFANTE G., GIANNELLA L., SCAFFA C., FALCONE F., BORGHI C., DITTO A., MALZONI M., GIANNINI A., SALERNO M.G., LIBERALE V., CONTINO B., DONFRANCESCO C., DESIATO M., PERRONE A.M., DONDI G., De IACO P., LEONE ROBERTI MAGGIORE U., SIGNORELLI M., CHIAPPA V., FERRERO S., SARPIETRO G., MATARAZZO M.G., CIANCI A., BOSIO S., RUISI S., GUERRISI R., BRUSADELLI C., MOSCA L., TINELLI R., DE VINCENZO R., ZANNONI G.F., FERRANDINA G., PETRILLO M., DESSOLE S., ANGIOLI R., GREGGI S., SPINILLO A., GHEZZI F., COLACURCI N., MUZII L., BENEDETTI PANICI P., SCAMBIA G., and RASPAGLIESI F.
Subjects: 0301 basic medicine, Uterine Cervical Neoplasm, Neoplasm, Residual, Conization, Uterine Cervical Neoplasms, Cervix Uteri, Laser conization, Hpv persistence, Cervical dysplasia, 0302 clinical medicine, Risk Factors, Retrospective Studie, Aged, 80 and over, Medical record, Obstetrics and Gynecology, Margins of Excision, Middle Aged, Oncology, 030220 oncology & carcinogenesis, HPV, LEEP, Female, Human, Adult, medicine.medical_specialty, 5 year follow up, Adolescent, Electrosurgery, Laser, Follow-Up Studie, 03 medical and health sciences, Young Adult, medicine, Humans, In patient, Cervical Intraepithelial Neoplasia, Papillomavirus Infection, Retrospective Studies, Aged, business.industry, Lasers, Risk Factor, Papillomavirus Infections, Uterine Cervical Dysplasia, medicine.disease, Surgery, Settore MED/40 - GINECOLOGIA E OSTETRICIA, 030104 developmental biology, Uterine cervix, Increased risk, Dysplasia, Loop electrosurgical excision procedure, Neoplasm Grading, Neoplasm Recurrence, Local, business, Follow-Up Studies
Abstract: Objective: Conization aims to remove pre-neoplastic lesions of the uterine cervix. Several techniques for conization have been compared, but evidence regarding the most effective therapeutic option is scant. Here, we aimed to compare the recurrence rate following laser conization and loop electrosurgical excision procedure (LEEP) in patients with high-grade cervical dysplasia (HSIL/CIN2+). Methods: This is a retrospective multi-institutional study. Medical records of consecutive patients with HSIL/CIN2+ undergoing conization between 2010 and 2014 were retrieved. A propensity-score matching (PSM) was applied in order to reduce allocation bias. The risk of developing recurrence was estimated using Kaplan-Meir and Cox hazard models. Results: Overall, 2966 patients had conization over the study period, including 567 (20%) and 2399 (80%) patients having laser conization and LEEP, respectively. Looking at predictors of recurrence, diagnosis of CIN3 (HR:3.80 (95%CI:2.01,7.21); p < 0.001) and HPV persistence (HR:1.81 (95%CI:1.11,2.96); p < 0.001) correlated with an increased risk of recurrence. After applying a PSM we selected 500 patients undergoing laser conization and 1000 undergoing LEEP. Patients undergoing LEEP were at higher risk of having positive surgical margins in comparison to patients undergoing laser conization (11.2% vs. 4.2%). The risk of having persistence of HPV was similar between the two groups (15.0% vs. 11.6%;p = 0.256). Five-year recurrence rate was 8.1% and 4% after LEEP and laser conization, respectively (p = 0.023). HPV persistence was the only factor associated with [5-]year recurrence after both laser conization (p = 0.003) and LEEP (p = 0.001). Conclusions: HPV persistence is the only factor associated with an increased risk of recurrence after either laser conization or LEEP. Owing to the lack of data regarding obstetrical outcomes, we are not able to assess the best therapeutic option for women with cervical dysplasia.
Published: 2020

41. Sentinel lymph node mapping in endometrial cancer: Performance of hysteroscopic injection of tracers

Author: Francesco Raspagliesi, Fabio Martinelli, Antonino Ditto, Valentina Chiappa, Umberto Leone Roberti Maggiore, Giorgio Bogani, and Mauro Signorelli
Subjects: Adult, Indocyanine Green, endometrial neoplasms, medicine.medical_treatment, Sentinel lymph node, hysteroscopes, sentinel lymph node, SLN and lympadenectomy, surgery, Aged, Aged, 80 and over, Coloring Agents, Endometrial Neoplasms, Female, Humans, Hysterectomy, Hysteroscopy, Lymph Nodes, Lymphatic Metastasis, Middle Aged, Neoplasm Staging, Radiopharmaceuticals, Retrospective Studies, Sentinel Lymph Node, Sentinel Lymph Node Biopsy, Technetium, Diagnostic accuracy, chemistry.chemical_compound, Patient age, 80 and over, Medicine, Relapse risk, business.industry, Endometrial cancer, Obstetrics and Gynecology, medicine.disease, Sentinel lymph node mapping, Oncology, chemistry, Lymphadenectomy, business, Nuclear medicine, Indocyanine green
Abstract: ObjectiveTo report on the performance of hysteroscopic injection of tracers (indocyanine green (ICG) and technetium-99m (Tc-99m)) for sentinel lymph node (SLN) mapping in endometrial cancer.MethodsSingle-center retrospective evaluation of consecutive patients who underwent SLN mapping following hysteroscopic peritumoral injection of tracer. Detection rate (overall/bilateral/aortic) diagnostic accuracy, and oncologic outcomes were evaluated.ResultsA total of 221 procedures met the inclusion criteria. Mean patient age was 60 (range 28–84) years and mean body mass index was 26.9 (range 15–47) kg/m2 . In 164 cases (70.9%) mapping was performed laparoscopically. The overall detection rate of the technique was 94.1% (208/221 patients). Bilateral pelvic mapping was found in 62.5% of cases with at least one SLN detected and was more frequent using ICG than with Tc-99m (73.8% vs 53.3%; pConclusionsHysteroscopic injection of tracers for SLN mapping in endometrial cancer is as accurate as cervical injection with a higher detection rate in the aortic area. ICG improves the bilateral detection rate. Adding lymphadenectomy to SLN mapping does not reduce the risk of relapse.
Published: 2020

42. Investigating the Role of Minimally Invasive Radical Hysterectomy in Cervical Cancer

Author: Domenica Lorusso, Giorgio Bogani, Valentina Chiappa, Fabio Martinelli, Antonino Ditto, Umberto Leone Roberti Maggiore, and Francesco Raspagliesi
Subjects: Cervical cancer, Female, Humans, Hysterectomy, Recovery of Function, Urinary Bladder, Laparoscopy, Uterine Cervical Neoplasms, medicine.medical_specialty, 030219 obstetrics & reproductive medicine, business.industry, General surgery, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, Text mining, 030220 oncology & carcinogenesis, Medicine, Surgery, Radical Hysterectomy, business
Published: 2020

43. Management of patients with ovarian cancer in the COVID-19 era

Author: Violante Di Donato, Simona Ruisi, Giorgio Bogani, Rocco Guerrisi, Sara Bosio, Fabio Ghezzi, Giuseppe Sarpietro, Ciro Pinelli, Antonino Ditto, Jvan Casarin, Claudia Brusadelli, and Francesco Raspagliesi
Subjects: Pediatrics, medicine.medical_specialty, Infectious Disease Transmission, Patient-to-Professional, Coronavirus disease 2019 (COVID-19), medicine.medical_treatment, Infectious Disease Transmission, Pneumonia, Viral, Disease, chemotherapy, surgery, Patient-to-Professional, 03 medical and health sciences, Betacoronavirus, 0302 clinical medicine, Gynecologic Surgical Procedures, COVID‐19, medicine, Humans, Viral, Surgical treatment, Pandemics, Ovarian Neoplasms, Chemotherapy, Infection Control, business.industry, SARS-CoV-2, Advanced stage, Outbreak, SARS‐CoV, COVID-19, SARS-CoV, General Medicine, Pneumonia, medicine.disease, ovarian cancer, Coronavirus Infections, Female, Laparoscopy, Surgical Oncology, Oncology, 030220 oncology & carcinogenesis, Commentary, Severe morbidity, 030211 gastroenterology & hepatology, Ovarian cancer, business
Abstract: At the beginning of 2020, coronavirus disease 2019 (COVID‐19) spreads worldwide. Patients with ovarian cancer should be considered at high‐risk of developing severe morbidity related to COVID‐19. Most of them are diagnosed in advanced stages of disease, and they are fragile. Here, we evaluated the major impact of COVID‐19 on patients with ovarian cancer, discussing the effect of the outbreak on medical and surgical treatment.
Published: 2020

44. Gynecologic oncology at the time of COVID-19 outbreak

Author: Antonino Ditto, Rocco Guerrisi, Francesco Raspagliesi, Giorgio Bogani, Claudia Brusadelli, Salvatore Lopez, and Mauro Signorelli
Subjects: medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Genital Neoplasms, Female, Pneumonia, Viral, Guidelines as Topic, Gynecologic oncology, gynecologic oncology, World health, Disease Outbreaks, surgery, Betacoronavirus, 03 medical and health sciences, 0302 clinical medicine, Pandemic, Humans, Medicine, Laparoscopy, Special Report, Pandemics, Oncologists, 030219 obstetrics & reproductive medicine, medicine.diagnostic_test, business.industry, SARS-CoV-2, Public health, Obstetrics and Gynecology, Outbreak, COVID-19, General Medicine, medicine.disease, Oncology, Gynecology, 030220 oncology & carcinogenesis, Female, Medical emergency, Coronavirus Infections, business, Vaginal surgery
Abstract: The World Health Organization (WHO) classified the novel coronavirus (i.e., coronavirus disease 2019 [COVID-19]) as a global public health emergency. COVID-19 threatens to curtail patient access to evidence-based treatment. Medicine is changing, basically due to the limited available resources. In the field of gynecologic oncology, we have to re-design our treatments' paradigm. During COVID-19 pandemic outbreak, the highest priority is to achieve the maximum benefit from less demanding procedures. Extensive procedures should be avoided, in order to reduce hospitalization and postoperative events that might increase the in-hospital spread of the virus. There are ongoing concerns on the use of laparoscopic procedures, related to the possible contamination of the staff working in the operation room. Other minimally invasive techniques, including, vaginal surgery as well as robotic-assisted and isobaric procedures would be preferred over laparoscopy. A fair allocation of resources is paramount adequate treatments.
Published: 2020

45. Hysteroscopic versus cervical injection for sentinel node detection in endometrial cancer: A multicenter prospective randomised controlled trial from the Multicenter Italian Trials in Ovarian cancer (MITO) study group

Author: Paolo Scollo, Fabio Ghezzi, Mariateresa Evangelista, Salvatore Lo Vullo, Giorgio Giorda, Ciro Pinelli, Rosanna Montone, Anna Myriam Perrone, Antonino Ditto, Mauro Signorelli, Giorgio Bogani, Fabio Martinelli, Jvan Casarin, Luigi Mariani, Valentina Chiappa, Umberto Leone Roberti Maggiore, Giuseppe Scibilia, Biagio Paolini, Francesco Raspagliesi, Pierandrea De Iaco, Ditto A., Casarin I., Perrone A.M., Scollo P., Martinelli F., Bogani G., Maggiore U.L.R., Signorelli M., Chiappa V., Giorda G., Scibilia G., De Iaco P., Evangelista M., Ghezzi F., Paolini B., Lo Vullo S., Mariani L., Montone R., and Raspagliesi F.
Subjects: 0301 basic medicine, Cancer Research, Injection, medicine.medical_treatment, law.invention, 0302 clinical medicine, Randomized controlled trial, Endometrial cancer, law, Prospective Studies, Prospective cohort study, Ovarian Neoplasms, Aged, 80 and over, Sentinel node mapping, medicine.diagnostic_test, Lymph Node, Sentinel node, Middle Aged, Oncology, Italy, Hysteroscopy, 030220 oncology & carcinogenesis, Lymphatic Metastasis, Female, Sentinel Lymph Node, Human, Adult, Indocyanine Green, medicine.medical_specialty, Pelvi, Sentinel lymph node, Hysteroscopic injection of tracer, Hysterectomy, Gynaecologic oncology, Surgery, Injections, Pelvis, 03 medical and health sciences, Young Adult, Statistical significance, medicine, Humans, Endometrial Neoplasm, Aged, business.industry, Sentinel Lymph Node Biopsy, Ovarian Neoplasm, Lymphatic Metastasi, medicine.disease, Endometrial Neoplasms, Prospective Studie, 030104 developmental biology, Lymph Nodes, business
Abstract: Aim During the last years, the role of sentinel lymph node mapping (SLNM) for endometrial cancer (EC) surgical treatment has increased in popularity. However, several controversies remain about different technical steps of SLNM. Thus, a randomised control trial was designed to compare cervical (CI) and hysteroscopic (HI) indocyanine green (ICG) injection for SLNM of newly diagnosed EC undergoing surgical staging. The primary end-point of the study was to compare these two techniques in terms of para-aortic detection rate. Methods Patients with apparent stage I or II histologically confirmed EC undergoing surgery were included in the study. This randomised trial distinguished patients in two study groups according to two different techniques of ICG SLNM: CI versus HI injection. Patients who met the inclusion criteria were randomly assigned to CI or HI injection in a 1:1 ratio. The central randomisation system allocated patient randomisation numbers sequentially in the order in which the patients were enrolled. This randomised trial was not blinded for either patients or the surgeons. Results From March 2017 until April 2019, a total of 165 patients were randomised in this study: 85 (51.5%) in the CI group and 80 (48.5%) in the HI group. After randomisation, 14 (8.5%) patients were excluded from the study. Finally, 151 patients were included in the analysis: 82 (54.3%) in the CI group and 69 (45.7%) in the HI group. Hysteroscopy injection shows an ability to detect Sentinel nodes (SNLs) in the para-aortic area of about 10% greater compared with CI injection, although this difference did not reach statistical significance. The HI technique was superior in detecting isolated para-aortic SLNs (5.8% Versus 0%). The CI injection was correlated with higher SLN detection rates at the pelvic level compared with HI injection. Pelvic and overall detection was higher in the CI group. Conclusions The present study supports the adoption of CI instead of HI injection because the former allows better identification of sentinel nodes (especially in the pelvic area). Detection of SLN in the para-aortic area was slightly higher in patients receiving a HI injection, but the difference with the CI route was not statistically significant.
Published: 2020

46. The impact of HPV-specific infection in women diagnosed with atypical glandular cells: results from the HPV-AGC study

Author: Francesco Raspagliesi, Claudia Brusadelli, Umberto Leone Roberti Maggiore, Giorgio Bogani, Antonino Ditto, Maurizio Serati, Rocco Guerrisi, Francesco Sopracordevole, Ciro Pinelli, Salvatore Lopez, Andrea Dell'Acqua, Jvan Casarin, Fabio Ghezzi, and Simone Ferrero
Subjects: Adult, 0301 basic medicine, Atypical glandular cells, medicine.medical_specialty, HPV, Uterus, Uterine Cervical Neoplasms, Cervix Uteri, Adenocarcinoma, Endometrium, Cervical dysplasia, Pathology and Forensic Medicine, Lesion, 03 medical and health sciences, 0302 clinical medicine, Humans, Medicine, Retrospective Studies, Gynecology, business.industry, Endometrial cancer, Papillomavirus Infections, HPV infection, Retrospective cohort study, Cell Biology, Middle Aged, Uterine Cervical Dysplasia, medicine.disease, female genital diseases and pregnancy complications, Endometrial hyperplasia, 030104 developmental biology, medicine.anatomical_structure, 030220 oncology & carcinogenesis, adenocarcinoma, atypical glandular cells, cervical dysplasia, Endometrial Hyperplasia, Uterine Neoplasms, Female, medicine.symptom, business
Abstract: To evaluate the impact of various HPV types on the risk of developing lesions of the uterus (either uterine cervix and endometrium) in women diagnosed with "atypical glandular cells" (AGC) at Pap smear.This is a multi-institutional retrospective study. Data of women diagnosed with AGC were retrospectively reviewed. All patients included had data about HPV DNA testing and 1-year clinical follow-up.Overall, chart of 480 patients were evaluated. After the exclusion of 286 patients, data of 194 patients were available for the analysis. Mean age was 43.9 (±6.0) years. HPV infection was documented in 136 women (70.1 %). Among HPV positive patients the risk of having/developing a lesion was 33.8 % (n = 46). Lesions included low- (L-SIL) and high- (H-SIL) squamous intraepithelial lesions, in situ adenocarcinoma of the uterine cervix, invasive cancer of the uterine cervix, endometrial hyperplasia and endometrial cancer in 16 (11.7 %), 18 (13.2 %), 6 (4.4 %), 3 (2.2 %), 2 (1.5 %) and 1 (1%), respectively. Among HPV negative patients the risk of having/developing a lesion was 15.5 %. They included l-SIL, H-SIL, in situ adenocarcinoma, endometrial hyperplasia and endometrial cancer in 1 (1.7 %), 1 (1.7 %), 1 (1.7 %), 3 (5.1 %) and 3 (5.1 %), respectively. Patients diagnosed with HPV16 were at higher risk of having/developing cervical lesions in comparison to patients with other HPV infections (p 0.01). In comparison to other HPV types, the presence of HPV 18, 31, 33, and 45 did not increase the risk of developing a lesion over the time (p 0.2). HPV positive patients were at higher risk of being diagnosed with a cervical lesion within 6 months from detection of AGC.Patients diagnosed with AGC are at risk to have / developing cervical and uterine lesions. Further prospective evidence is needed.
Published: 2020

47. The addition of lymphadenectomy to secondary cytoreductive surgery in comparison with bulky node resection in patients with recurrent ovarian cancer

Author: Antonino Ditto, Fabio Martinelli, Lavinia Mosca, Valentina Chiappa, Umberto Leone Roberti Maggiore, Domenica Lorusso, Giorgio Bogani, Ilaria Sabatucci, and Francesco Raspagliesi
Subjects: Reoperation, Secondary cytoreductive surgery, medicine.medical_specialty, medicine.medical_treatment, Bulky nodes, Disease-Free Survival, 03 medical and health sciences, 0302 clinical medicine, Cytoreduction Surgical Procedures, Humans, Medicine, Salvage surgery, Disease-free interval, Survival rate, Survival analysis, Aged, Retrospective Studies, Ovarian Neoplasms, 030219 obstetrics & reproductive medicine, business.industry, Proportional hazards model, Obstetrics and Gynecology, Cancer, Lymphadenectomy, Retrospective cohort study, General Medicine, Middle Aged, medicine.disease, Morbidity, Recurrent ovarian cancer, Chronic Disease, Female, Lymphatic Metastasis, Neoplasm Recurrence, Local, Survival Rate, Lymph Node Excision, Surgery, Neoplasm Recurrence, Local, 030220 oncology & carcinogenesis, business, Ovarian cancer
Abstract: OBJECTIVE To evaluate the role of full lymphadenectomy in patients with isolated nodal recurrence of ovarian cancer. METHODS In a retrospective study, the data of women undergoing secondary cytoreduction at the National Cancer Institute, Milan, Italy, between January 1, 2001, and December 31, 2015, were collected and patients with isolated nodal recurrence were identified. Factors predicting for disease-free interval (DFI) and overall survival were estimated using Kaplan-Meier survival analysis and Cox regression analysis. RESULTS Of the 199 consecutive patients whose data were collected, isolated nodal recurrence (defined as the presence of lymphatic disease) was observed in 35 women. Among this study cohort, lymphadenectomy and bulky node removal were performed in 11 (31%) and 24 (69%) patients, respectively. Women who underwent lymphadenectomy experienced better DFI compared with those who had bulky node removal only (median 21 and 12 months, respectively; P=0.019), and lymphadenectomy, but not bulky node removal, significantly improved rates of DFI (P=0.043). No factors were independently associated with overall survival; however, a trend toward an improved overall survival rate was observed in patients undergoing complete resection at the time of primary surgery (P=0.055). CONCLUSION Lymphadenectomy at the time of secondary cytoreduction improved DFI but did not have a significant effect on overall survival.
Published: 2018

48. Corrigendum to 'Cervical intraepithelial neoplasia in women who had vaccination against HPV' [Int J Gynecol Obstet 147(2019) 233-237.]

Author: Arsenio Spinillo, Maurizio Serati, Barbara Gardella, Umberto Leone Roberti Maggiore, Simone Ferrero, Antonino Ditto, Giorgio Bogani, Francesco Raspagliesi, and Fabio Ghezzi
Subjects: Gynecology, Vaccination, medicine.medical_specialty, business.industry, INT, medicine, Obstetrics and Gynecology, General Medicine, Cervical intraepithelial neoplasia, medicine.disease, business
Published: 2019

49. Corrigendum to 'Advances in laparoscopic surgery for cervical cancer' [Crit. Rev. Oncol. Hematol. 143 (August) (2019) 76-80]

Author: Antonino Ditto, Ilaria Sabatucci, Fabio Martinelli, Valentina Chiappa, Umberto Leone Roberti Maggiore, Stefano Ferla, Domenica Lorusso, Alice Indini, Giorgio Bogani, Francesco Raspagliesi, and Diego Rossetti
Subjects: Laparoscopic surgery, Cervical cancer, medicine.medical_specialty, Oncology, business.industry, medicine.medical_treatment, General surgery, MEDLINE, Medicine, Hematology, business, medicine.disease
Published: 2019

50. Adjuvant chemotherapy vs. observation in stage I clear cell ovarian carcinoma: A systematic review and meta-analysis

Author: Valentina Chiappa, F. Bertolina, Ciro Pinelli, Salvatore Lopez, Ferdinando Murgia, Antonino Ditto, Francesco Raspagliesi, and Giorgio Bogani
Subjects: 0301 basic medicine, Oncology, medicine.medical_specialty, observation, recurrence, medicine.medical_treatment, Population, adjuvant chemotherapy, clear cell ovarian cancer, survival, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, Stage (cooking), Clear-cell ovarian carcinoma, education, Watchful Waiting, Neoplasm Staging, Randomized Controlled Trials as Topic, Ovarian Neoplasms, education.field_of_study, Chemotherapy, business.industry, Obstetrics and Gynecology, medicine.disease, 030104 developmental biology, Systematic review, Chemotherapy, Adjuvant, 030220 oncology & carcinogenesis, Meta-analysis, Population study, Female, Ovarian cancer, business, Adenocarcinoma, Clear Cell
Abstract: The role of adjuvant chemotherapy in surgically staged stage I clear cell ovarian cancer (OCCC) is unclear. Here, we performed a systematic review and meta-analysis in order to evaluate the role of chemotherapy vs. observation in stage I OCCC. This systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO; ID: #129628). A protocol was defined prior to the search include the population criteria, description of interventions, comparisons, and the outcomes of interest, according to the PRIMA guidelines. Overall, the study population included 5073 women. Stage I OCCC experienced a 5-year disease-free survival and a 5-year overall survival of 83.7% and 86.9%, respectively. Pooled data suggested that in the overall population adjuvant chemotherapy did not impact on 5-year disease free survival (test for overall effect, Z = 0.18; p = 0.86) and 5-year overall survival (test for overall effect, Z = 0.62; p = 0.53). Focusing on 2264 stage IC OCCC we observed that adjuvant correlated with an improvement in overall survival (OR: 0.70 (95%CI: 0.52 to 0.93); Z = 2.44; p = 0.01). In conclusion our study underlines that adjuvant chemotherapy could be reserved for patients with stage IC OCCC; while in stage IA and IB it could be safely omitted. Owing to the inherent biases of the studies included in the meta-analysis further prospective evidences are needed.
Published: 2019

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