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

Author

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

Abstract

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

Published
2022

5. Severity of spleep apnea syndrome and life-threatening tachyarrhythmias in patients with implantable cardioverter defibrillator

Author

Bencardino, G., Vitulano, N., Bisignani, A., Gabrielli, F. A., Pelargonio, G., Narducci, M. L., Perna, F., Pinnacchio, G., Comerci, G., Lanza, G. A., Massetti, M., Crea, F., Bencardino G., Bisignani A., Gabrielli F. A., Pelargonio G., Narducci M. L., Perna F., Pinnacchio G., Comerci G., Lanza G. A. (ORCID:0000-0003-2187-6653), Massetti M. (ORCID:0000-0002-7100-8478), Crea F. (ORCID:0000-0001-9404-8846), Bencardino, G., Vitulano, N., Bisignani, A., Gabrielli, F. A., Pelargonio, G., Narducci, M. L., Perna, F., Pinnacchio, G., Comerci, G., Lanza, G. A., Massetti, M., Crea, F., Bencardino G., Bisignani A., Gabrielli F. A., Pelargonio G., Narducci M. L., Perna F., Pinnacchio G., Comerci G., Lanza G. A. (ORCID:0000-0003-2187-6653), Massetti M. (ORCID:0000-0002-7100-8478), and Crea F. (ORCID:0000-0001-9404-8846)

Abstract

Background: Sleep apnea syndrome (SAS) has been reported to be associated with a higher incidence of ventricular arrhythmias. The aim of this study was twofold: (1) to investigate whether in SAS patients receiving an implantable cardioverter defibrillator (ICD) the severity of SAS was associated with the occurrence of ventricular arrhythmias; (2) to assess whether changes in nocturnal apnoic/hypopnoic episodes may favor the occurrence of life-threatening arrhythmias, that is, sustained ventricular tachycardia (VT)/fibrillation (VF), requiring ICD intervention. Methods: We enrolled 46 patients with documented SAS at polysomnography (apnea/hypopnea index [AHI] > 5) who also had a left ventricle ejection fraction (LVEF) < 35% and, according to primary prevention indications, implanted an ICD (Boston Scientific Incepta) able to daily monitor apnoic/hypopnoic episodes occurring during sleep. Patients were followed at 3-month intervals. Results: At a mean follow-up of 18 months, 21 episodes of sustained VT/FV requiring ICD intervention were documented in eight patients (17.4%). Baseline AHI was significantly higher in patients with compared to those without ICD intervention. ICD interventions, however, were not preceded by any worsening of apnoic/hypopnoic episodes. The respiratory disturbance index (RDI) of the week during the event, indeed, was not different from that recorded during the previous 2 weeks (25.4 ± 11, 25.6 ± 10 and 25.1 ± 10, respectively; p =.9). Conclusions: In patients with SAS who received an ICD for primary prevention of sudden death, those with ICD interventions showed a more severe form of the disease at baseline. ICD interventions, however, were not preceded by any significant changes in SAS severity.

Published
2021

6. Long-Term Arrhythmic Risk Assessment in Biopsy-Proven Myocarditis

Author

Pelargonio, G., Pinnacchio, G., Narducci, M. L., Pieroni, M., Perna, F., Bencardino, G., Comerci, G., Dello Russo, A., Casella, M., Bartoletti, S., Russo, E., Crea, F., Pelargonio G., Pinnacchio G., Narducci M. L., Pieroni M., Perna F., Bencardino G., Comerci G., Dello Russo A., Casella M., Bartoletti S., Crea F. (ORCID:0000-0001-9404-8846), Pelargonio, G., Pinnacchio, G., Narducci, M. L., Pieroni, M., Perna, F., Bencardino, G., Comerci, G., Dello Russo, A., Casella, M., Bartoletti, S., Russo, E., Crea, F., Pelargonio G., Pinnacchio G., Narducci M. L., Pieroni M., Perna F., Bencardino G., Comerci G., Dello Russo A., Casella M., Bartoletti S., and Crea F. (ORCID:0000-0001-9404-8846)

Abstract

Objectives: This study sought to assess long-term arrhythmic risk in patients with myocarditis who received an implantable cardioverter-defibrillator (ICD). Background: The arrhythmic risk of patients with myocarditis overtime remains poorly known. Methods: The study enrolled 56 patients with biopsy-proven myocarditis who received an ICD for either primary (57%) or secondary prevention (43%) according to current guidelines. Clinical characteristics, biopsy findings, electrophysiological data from endocardial 3-dimensional electroanatomic voltage mapping, and device interrogation data were analyzed to detect arrhythmic events overtime. Coronary angiography excluded significant coronary artery disease in all patients. Results: At a mean follow-up of 74 ± 60 months (median 65 months), 25 (45%) patients had major ventricular arrhythmias treated by ICD intervention (76% being terminated by ICD shock and 24% by antitachyarrhythmia burst pacing). At multivariable analysis, the presence of sustained ventricular tachycardia on admission (hazard ratio: 13.0; 95% confidence interval: 2.0 to 35.0; p = 0.032) and the extension of the areas of low potentials at the bipolar endocardial mapping (hazard ratio: 1.19; 95% confidence interval: 1.04 to 1.37; p = 0.013) were the only independent predictors of appropriate ICD interventions. A cutoff value of 10% of abnormal bipolar area at electroanatomical ventricular mapping discriminated patients with appropriate ICD interventions with a sensitivity of 89% and a specificity of 85%. Conclusions: The study demonstrates that the prevalence of life-threatening ventricular arrhythmias in patients with myocarditis receiving an ICD according to current guidelines is high and the arrhythmic risk persists late overtime. Electroanatomical ventricular mapping may be a useful tool to identify patients at greater arrhythmic risk.

Published
2020

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

Author

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

Abstract

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

Published
2022

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

Author

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

Abstract

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

Published
2022

9. O004/#393 Does intensive follow-up improve overall survivalin endometrial cancer patients? Results from the totem randomized controlled trial

Author

Zola, P, primary, Ciccone, G, additional, Angioli, R, additional, Terranova, C, additional, Piovano, E, additional, Fuso, L, additional, Di Cuonzo, D, additional, Peirano, E, additional, Perrone, AM, additional, Mandato, VD, additional, Zavallone, L, additional, Chiudinelli, F, additional, Berretta, R, additional, Loda, S, additional, Greggi, S, additional, Adorni, M, additional, Busato, E, additional, Comerci, G, additional, Fambrini, M, additional, and Ferrero, A, additional

Published
2021
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10. 259 The impact of intensive follow-up on health-related quality of life and costs in endometrial cancer patients: data from the TOTEM trial NCT00916708

Author

Zola, P, primary, Ciccone, G, additional, Piovano, E, additional, Fuso, L, additional, Peirano, E, additional, Cuonzo, DDI, additional, Pagano, E, additional, Castiglione, A, additional, Perrone, AM, additional, Mandato, VD, additional, Zavallone, L, additional, Chiudinelli, F, additional, Berretta, R, additional, Loda, S, additional, Valenzano Menada, M, additional, Greggi, S, additional, Adorni, M, additional, Comerci, G, additional, Fambrini, M, additional, and Ferrero, A, additional

Published
2021
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12. The potential impact of acute coronary syndromes on automatic sensing system in Subcutaneous-ICDs

Author

Narducci, Maria Lucia, Scacciavillani, Roberto, Pinnacchio, Gaetano, Bencardino, Gianluigi, Perna, Francesco, Comerci, Gianluca, Campisi, M., Ceccarelli, I., Pavone, Chiara, Spera, F., Bisignani, Antonio, Crea, Filippo, Pelargonio, Gemma, Narducci M. L., Scacciavillani R., Pinnacchio G., Bencardino G., Perna F., Comerci G., Pavone C., Bisignani A., Crea F. (ORCID:0000-0001-9404-8846), Pelargonio G., Narducci, Maria Lucia, Scacciavillani, Roberto, Pinnacchio, Gaetano, Bencardino, Gianluigi, Perna, Francesco, Comerci, Gianluca, Campisi, M., Ceccarelli, I., Pavone, Chiara, Spera, F., Bisignani, Antonio, Crea, Filippo, Pelargonio, Gemma, Narducci M. L., Scacciavillani R., Pinnacchio G., Bencardino G., Perna F., Comerci G., Pavone C., Bisignani A., Crea F. (ORCID:0000-0001-9404-8846), and Pelargonio G.

Abstract

Background: The Subcutaneous-ICD (S-ICD) is emerging as a suitable option for most ICD candidates, however some open issues regarding the sensing algorithm still remain. Objectives: We aimed to examine the performance of the S-ICD sensing algorithm in patients hospitalized for ST elevation myocardial infarction (STEMI), non ST elevation acute coronary syndrome (NSTE-ACS) or chronic coronary syndrome (CCS), before and after revascularization. Methods: We performed a S-ICD automated screening on 75 patients, 21 hospitalized for STEMI, 23 for NSTE-ACS and 31 for CCS, before and after percutaneous revascularization, regardless their eligibility to ICD implantation. Results: Patients did not differ in clinical, electrocardiographic and echocardiographic parameters. Rates of screening pass were significantly lower in STEMI patients compared to NSTE-ACS and CCS (5% vs 56.7% vs 81% respectively, p < .0001). The viability of the primary vector was lower in STEMI patients compared to NSTE-ACS and CCS (33% vs 56% vs 71%, p .027 respectively). After revascularization, there were no more significant differences between groups. Pairing subjects at baseline and after revascularization, STEMI subjects percentages of screening success were respectively 5% and 81% (p < .001) and the rates of primary vector viability were 33% and 81% (p .002). STEMI was the only independent predictor of screening failure at multivariate logistic regression analysis (odds ratio 10.68 confidence interval 2.77–41.38, p = .001) Conclusion: The performance of the S-ICD and possible malfunction detections in the context of an acute ischemic event deserve further evaluation. Adequate patient selection and the development of dynamic device programming are warranted.

Published
2021

13. Minimally Invasive Aortic Valve Surgery in Octogenarians: Reliable Option or Fallback Solution?

Author

Cammertoni, Federico, Bruno, P., Rosenhek, Raphael, Pavone, Natalia, Farina, Piero, Mazza, A., Iafrancesco, M., Nesta, Marialisa, Chiariello, Giovanni Alfonso, Comerci, Gianluca, Pasquini, Annalisa, Cavaliere, Franco, Guarneri, Sergio, Marzetti, Emanuele, Rabini, Alessia, Piarulli, Alessandra, Sanesi, Valerio, D'Errico, D., Massetti, Massimo, Cammertoni F., Rosenhek R., Pavone N., Farina P., Nesta M., Chiariello G. A., Comerci G., Pasquini A., Cavaliere F. (ORCID:0000-0003-3278-1940), Guarneri S. (ORCID:0000-0003-4707-3293), Marzetti E. (ORCID:0000-0001-9567-6983), Rabini A. (ORCID:0000-0002-6065-161X), Piarulli A., Sanesi V., Massetti M. (ORCID:0000-0002-7100-8478), Cammertoni, Federico, Bruno, P., Rosenhek, Raphael, Pavone, Natalia, Farina, Piero, Mazza, A., Iafrancesco, M., Nesta, Marialisa, Chiariello, Giovanni Alfonso, Comerci, Gianluca, Pasquini, Annalisa, Cavaliere, Franco, Guarneri, Sergio, Marzetti, Emanuele, Rabini, Alessia, Piarulli, Alessandra, Sanesi, Valerio, D'Errico, D., Massetti, Massimo, Cammertoni F., Rosenhek R., Pavone N., Farina P., Nesta M., Chiariello G. A., Comerci G., Pasquini A., Cavaliere F. (ORCID:0000-0003-3278-1940), Guarneri S. (ORCID:0000-0003-4707-3293), Marzetti E. (ORCID:0000-0001-9567-6983), Rabini A. (ORCID:0000-0002-6065-161X), Piarulli A., Sanesi V., and Massetti M. (ORCID:0000-0002-7100-8478)

Abstract

Objective: Aortic valve disease is more and more common in western countries. While percutaneous approaches should be preferred in older adults, previous reports have shown good outcomes after surgery. Moreover, advantages of minimally invasive approaches may be valuable for octogenarians. We sought to compare outcomes of conventional aortic valve replacement (CAVR) versus minimally invasive aortic valve replacement (MIAVR) in octogenarians. Methods: We retrospectively collected data of 75 consecutive octogenarians who underwent primary, elective, isolated aortic valve surgery through conventional approach (41 patients, group CAVR) or partial upper sternotomy (34 patients, group MIAVR). Results: Mean age was 81.9 ± 0.9 and 82.3 ± 1.1 years in CAVR and MIAVR patients, respectively (P = 0.09). MIAVR patients had lower 24-hour chest drain output (353.4 ± 207.1 vs 501.7 ± 229.9 mL, P < 0.01), shorter mechanical ventilation (9.6 ± 2.4 vs 11.3 ± 2.3 hours, P < 0.01), lower need for blood transfusions (35.3% vs 63.4%, P = 0.02), and shorter hospital stay (6.8 ± 1.6 vs 8.3 ± 4.3 days, P < 0.01). Thirty-day mortality was zero in both groups. Survival at 1, 3, and 5 years was 89.9%, 80%, and 47%, respectively, in the CAVR group, and 93.2%, 82.4%, and 61.8% in the MIAVR group, with no statistically significant differences (log-rank test, P = 0.35). Conclusions: Aortic valve surgery in older patients provided excellent results, as long as appropriate candidates were selected. MIAVR was associated with shorter mechanical ventilation, reduced blood transfusions, and reduced hospitalization length, without affecting perioperative complications or mid-term survival.

Published
2021

16. Preserved cardiorespiratory function and NT-proBNP levels before and during exercise in patients with recent onset of rheumatoid arthritis: the clinical challenge of stratifying the patient cardiovascular risks

Author

Zoli, Angelo, Bosello, Silvia Laura, Comerci, Gianluca, Galiano, N, Forni, A, Loperfido, Francesco, Ferraccioli, G F, Zoli, A (ORCID:0000-0003-1597-058X), Bosello, S (ORCID:0000-0002-4837-447X), Comerci, G, Loperfido, F, Zoli, Angelo, Bosello, Silvia Laura, Comerci, Gianluca, Galiano, N, Forni, A, Loperfido, Francesco, Ferraccioli, G F, Zoli, A (ORCID:0000-0003-1597-058X), Bosello, S (ORCID:0000-0002-4837-447X), Comerci, G, and Loperfido, F

Abstract

Rheumatoid arthritis (RA) is associated with an increased risk of myocardial infarction and congestive heart failure. In RA patients, elevated NT-proBNP levels have been reported to be a prognostic marker of left ventricular dysfunction. In this study, we evaluated cardiorespiratory functional capacity and NT-proBNP levels before and during cardiopulmonary exercise test in early RA (ERA) patients. Twenty ERA patients and 10 healthy controls were studied by color Doppler echocardiography to evaluate ventricular systolic and diastolic function. Arterial stiffness and wave reflections were quantified non-invasively using applanation tonometry of the radial artery. Cardiopulmonary treadmill test was performed to measure peak VO2 and VE/VCO2 parameters. NT-proBNP plasma levels were measured before and at the exercise peak during cardiopulmonary exercise. The peak oxygen uptake [VO2 (ml/min/kg)], the ventilatory equivalents for carbon dioxide (EqCO(2)), respiratory exchange ratio and arterial stiffness were similar between patients and controls during cardiopulmonary exercise test. Basal and peak cardiopulmonary exercise NT-proBNP plasma levels were comparable in ERA patients with respect to healthy controls. When we analyzed patients according to disease characteristics and cardiovascular risk factors, ERA patients with high disease activity, BMI > 25 kg/m(2) and ACPA positivity presented significantly higher baseline and exercise peak NT-proBNP levels. Cardiorespiratory function is preserved in patients with recent onset of rheumatoid arthritis. The increased basal and exercise peak NT-proBNP plasma levels in patients with negative disease prognostic factors represent a possible marker to stratify the cardiovascular risk in patients with early rheumatoid arthritis.

Published
2017

21. Correlazione tra attività leucocitaria ed infezione da chlamydia pneumoniae o helicobacter pylori in un gruppo omogeneo di pazienti con cardiopatia ischemica

Author

Galante A, Bergamaschi A, Possati G, Lapenna E, Pietroiusti A, Carta S, Magrini A, Comerci G, Aquilani S, Razzini C, Favalli C, Mastino A. 59th Congresso Nazionale della Società Italiana di C.a.r.d.i.o.l.o.g.i.a. Roma, 12 16 Dicembre 1998 Cardiologia v.o.l. 43, 1998 : page 5.3., DE BONIS , MICHELE, Galante, A, Bergamaschi, A, Possati, G, DE BONIS, Michele, Lapenna, E, Pietroiusti, A, Carta, S, Magrini, A, Comerci, G, Aquilani, S, Razzini, C, Favalli, C, Roma, Mastino A. 59th Congresso Nazionale della Società Italiana di C. a. r. d. i. o. l. o. g. i. a., 12 16 Dicembre 1998 Cardiologia v. o. l., 43, and 1998 : page, 5. 3.

Published
1998

22. Appraising cardiotoxicity associated with liposomal doxorubicin by means of tissue Doppler echocardiography end-points: rationale and design of the LITE (Liposomal doxorubicin-Investigational chemotherapy-Tissue Doppler imaging Evaluation) randomized pilot study

Author

Lotrionte, M., Palazzoni, G., Natali, R., Comerci, G., Abbate, A., Di Persio, S., and BIONDI ZOCCAI, Giuseppe

Subjects
Antibiotics, Antineoplastic, cardiotoxicity, Breast Neoplasms, Pilot Projects, anthracycline, randomized clinical trial, Echocardiography, Doppler, Doxorubicin, echocardiography, tissue doppler imaging, Liposomes, Humans, Female, Cardiomyopathies
Abstract

Cardiomyopathy following anthracycline chemotherapy may have ominous clinical implications in cancer patients treated with this effective yet potentially toxic therapy. Early detection at subclinical stage is pivotal to minimize the risk of overt cardiotoxicity. Liposomal anthracyclines have the potential for more selective uptake by cancer cells and reduced cardiac toxicity.We designed a single-center randomized clinical trial, the Liposomal doxorubicin-Investigational chemotherapy-Tissue Doppler imaging Evaluation (LITE) pilot study to compare the safety of liposomal doxorubicin vs standard epirubicin in terms of clinical and subclinical cardiotoxicity.Whereas diagnostic and prognostic instruments effective at early recognition of cardiomyopathy are lacking, promising data have been reported for tissue Doppler imaging (TDI) echocardiography. The study will enroll 80 patients with breast cancer and indication to anthracycline chemotherapy, randomizing them in a 1:1 ratio to liposomal doxorubicin or standard epirubicin. The primary end-point will be the comparison of changes from baseline to 12-month follow-up of left ventricular TDI systolic function parameters, and the co-primary end-point will be based instead on changes in TDI diastolic function parameters. Among secondary end-points, we will adjudicate changes in standard 2-dimensional echocardiography parameters, including ejection fraction, peak values of biochemical markers of cardiac damage and heart failure, ie cardiac troponin T and BNP, overall survival, functional class, freedom from cancer recurrence, and adverse effects of chemotherapy.Results of the LITE pilot study should provide important clinical and mechanistic insights on the promising role of liposomal anthracyclines in patients with breast cancer and indication to anthracycline chemotherapy (ClinicalTrials.gov identifier NCT00531973).

Published
2007

23. Assessment of left ventricular systolic dysfunction by tissue Doppler imaging to detect subclinical cardiomyopathy early after anthracycline therapy

Author

Lotrionte, M., Palazzoni, G., Natali, R., Comerci, G., Abbate, A., Loperfido, F., and Giuseppe Biondi-Zoccai

Subjects
Adult, Male, anthracyclines, Time Factors, Systole, echocardiography, toxicity, Breast Neoplasms, Middle Aged, Ventricular Dysfunction, Left, Diastole, Data Interpretation, Statistical, Humans, Female, Cardiomyopathies, Follow-Up Studies
Abstract

Anthracycline (ANT) chemotherapy for breast cancer, while associated with high response rates, is fraught by risks of irreversible cardiotoxicity. Unfortunately means to detect such cardiotoxicity early on and at a sublinical stage are lacking. We evaluated the role of systolic tissue Doppler imaging (TDI) in appraising postchemotherapy left ventricular (LV) remodelling.Patients undergoing ANT-chemotherapy for breast cancer were enrolled, and underwent baseline and6-months echocardiography (standard and TDI). According to the pattern of LV-TDI systolic remodelling from baseline to follow-up, patients were stratified in: group 1 (no LV-TDI worsening), group 2 (minor LV-TDI worsening), and group 3 (major LV-TDI worsening). Fifty-six patients were included (follow-up 9+/-6 months).At baseline, no patient had abnormal LV ejection fraction (LVEF), LV-TDI systolic dysfunction or New York Heart Association (NYHA)1. Follow-up overall analysis showed significant deterioration in LVEF, end-diastolic diameter (EDD) end-systolic diameter (ESD), and TDI-systolic parameters (all P0.05). Specifically, 29 (51.8%) patients showed no adverse LV-TDI systolic remodelling, while 17 (30.4%) were in group 2, and 10 (17.9%) in group 3. All groups shared similar conditions at baseline. Patients with adverse LV-TDI remodelling had significant increases in EDD and ESD, as well as a significantly decreased LVEF (all P0.05). No patient in group 1 had abnormal LVEF at follow-up, while 1 patient in group 2 and 2 patients in group 3 had abnormal LVEF (P0.05).Subclinical systolic dysfunction occurs in almost 50% of patients early after chemotherapy for breast cancer, with a more adverse by LV-TDI remodelling implying a more pronounced deterioration of standard echocardiographic parameters.

Published
2007

24. Efforts by the American Academy of Pediatrics to prevent and reduce violence and its effects on children and adolescents

Author

Comerci, G. D.

Subjects
Adult, Domestic Violence, Firearms, Schools, Adolescent, Substance-Related Disorders, Health Personnel, Child Welfare, Infant, Violence, Social Environment, Pediatrics, Community-Institutional Relations, Mental Health, Risk Factors, Child, Preschool, Humans, Family, Mass Media, Child, Health Education, Poverty, Prejudice, Societies, Medical, Research Article
Abstract

The American Academy of Pediatrics (AAP) is an organization of 53,000 pediatricians committed to the attainment of optimal physical, mental, and social health for all infants, children, adolescents, and young adults. Recognizing the major impact that violence has on children and youth, the AAP has been working to prevent and reduce violence and its effects on the pediatric population. This article will describe AAP efforts intended to help pediatricians, other professionals, and the public to combat the problem.

Published
1996

25. Presurgical assessment and therapy of microinvasive carcinoma of the cervix

Author

Giuseppe Martinelli, Silvano Costa, Orlandi C, Patrizia Terzano, Martellini L, Comerci G, and Guerra B

Subjects
Adult, medicine.medical_specialty, medicine.medical_treatment, Uterine Cervical Neoplasms, Stromal Invasion, Lesion, Therapeutic approach, Preoperative Care, Medicine, Humans, Neoplasm Invasiveness, Stage (cooking), Cervix, Pathological, Aged, Colposcopy, Hysterectomy, medicine.diagnostic_test, business.industry, Carcinoma, Obstetrics and Gynecology, Middle Aged, Surgery, medicine.anatomical_structure, Oncology, Female, medicine.symptom, business, Follow-Up Studies
Abstract

Retrievable pathological specimens and clinical data on 70 patients with microinvasive carcinoma diagnosed on surgical specimens from cone biopsy or hysterectomy (Stage IA) were reviewed and compared to pertinent findings in the literature with the intent of evaluating diagnostic criteria and defining pathological features that may influence the outcome by therapy. Emphasis was given to the preoperative assessment emphasizing that both an accurate colposcopic evaluation and a detailed pathological analysis may reliably point to a conservative therapeutic approach. Increasing depth of stromal invasion was associated with lesion width as well as with endocervical extension, as measured on colposcopy, microcolpohisteroscopy, and histology. Lymph–vascular space involvement was significantly related to depth of invasion. Two patients of 28 with dissected nodes had node metastases as well as lymph–vascular space involvement. Both developed a pelvic recurrence. One had a >1- to ≤3-mm invasion depth, the other a >3- to ≤5-mm lesion invasion. While advocating a conservative procedure for Stage IA1, we suggest discrimination with regard to Stage IA2 because we believe that lymph–vascular involvement should be meticulously evaluated. In fact, >1- to ≤3-mm lesions without lymph–vascular space involvement can be conservatively treated, while for any other lesion falling within the Stage IA2 category a modified radical histerectomy plus pelvic lymphadenectomy should be recommended.

Published
1995

26. Poster session V * Saturday 11 December 2010, 08:30-12:30

Author

Pham, Q. H., primary, Von Lueder, T. G., additional, Namtvedt, S. K., additional, Rosjo, H., additional, Omland, T., additional, Steine, K., additional, Timoteo, A. T., additional, Mota Carmo, M., additional, Simoes, M., additional, Branco, L. M., additional, Ferreira, R. C., additional, Kato, R., additional, Ito, J., additional, Tahara, T., additional, Yokoyama, Y., additional, Ashikaga, T., additional, Satoh, Y., additional, Na, J. O., additional, Hong, H. E., additional, Kim, M. N., additional, Shin, S. Y., additional, Choi, C. U., additional, Kim, E. J., additional, Rha, S. W., additional, Park, C. G., additional, Seo, H. S., additional, Oh, D. J., additional, Ticulescu, R., additional, Brigido, S., additional, Vriz, O., additional, Sparacino, L., additional, Popescu, B. A., additional, Ginghina, C., additional, Carerj, S., additional, Nicolosi, G. L., additional, Antonini-Canterin, F., additional, Onaindia Gandarias, J. J., additional, Romero, A., additional, Laraudogoitia, E., additional, Velasco, S., additional, Quintana, O., additional, Cacicedo, A., additional, Rodriguez, I., additional, Alarcon, J. A., additional, Gonzalez, J., additional, Lekuona, I., additional, Subinas, A., additional, Abdula, G., additional, Lund, L. H., additional, Winter, R., additional, Brodin, L., additional, Sahlen, A., additional, Masaki, M., additional, Cha, Y. M., additional, Yuasa, T., additional, Dong, K., additional, Dong, Y. X., additional, Mankad, S. V., additional, Oh, J. K., additional, Vallet, F., additional, Lequeux, B., additional, Diakov, C., additional, Sosner, P., additional, Christiaens, L., additional, Coisne, D., additional, Kihara, C., additional, Murata, K., additional, Wada, Y., additional, Uchida, K., additional, Ueyama, T., additional, Okuda, S., additional, Susa, T., additional, Matsuzaki, M., additional, Cho, E. J., additional, Choi, K. Y., additional, Kwon, B. J., additional, Kim, D. B., additional, Jang, S. W., additional, Cho, J. S., additional, Jung, H. O., additional, Jeon, H. K., additional, Youn, H. J., additional, Kim, J. H., additional, Cikes, M., additional, Bijnens, B., additional, Velagic, V., additional, Kopjar, T., additional, Milicic, D., additional, Biocina, B., additional, Gasparovic, H., additional, Almuntaser, I., additional, Brown, A., additional, Foley, B., additional, Mulvihill, N., additional, Crean, P., additional, King, G., additional, Murphy, R., additional, Takata, Y., additional, Taniguchi, M., additional, Nobusada, S., additional, Sugawara, M., additional, Toh, N., additional, Kusano, K., additional, Itoh, H., additional, Wellnhofer, E., additional, Kriatselis, C., additional, Nedios, S., additional, Gerds-Li, J. H., additional, Fleck, E., additional, Poulsen, M. K., additional, Henriksen, J. E., additional, Dahl, J., additional, Johansen, A., additional, Haghfelt, T., additional, Hoilund-Carlsen, P. F., additional, Beck-Nielsen, H., additional, Moller, J. E., additional, Dankowski, R., additional, Wierzchowiecki, M., additional, Michalski, M., additional, Nowicka, A., additional, Szymanowska, K., additional, Pajak, A., additional, Poprawski, K., additional, Szyszka, A., additional, Kasner, M., additional, Westermann, D., additional, Schultheiss, H. P., additional, Tschoepe, C., additional, Watanabe, T., additional, Iwai-Takano, M., additional, Kobayashi, A., additional, Machii, H., additional, Takeishi, Y., additional, Paelinck, B. P., additional, Van Herck, P. L., additional, Bosmans, J. M., additional, Vrints, C. J., additional, Lamb, H. J., additional, Doltra, A., additional, Vidal, B., additional, Silva, E., additional, Poyatos, S., additional, Mont, L., additional, Berruezo, A., additional, Castel, A., additional, Tolosana, J. M., additional, Brugada, J., additional, Sitges, M., additional, Dencker, M., additional, Bjorgell, O., additional, Hlebowicz, J., additional, Szelenyi, Z. S., additional, Szenasi, G., additional, Kiss, M., additional, Prohaszka, Z., additional, Patocs, A., additional, Karadi, I., additional, Vereckei, A., additional, Saha, S. K., additional, Anderson, P. L., additional, Govind, S., additional, Govindan, M., additional, Moggridge, J. C., additional, Kiotsekoglou, A., additional, Gopal, A. S., additional, Loegstrup, B. B., additional, Christophersen, T. B., additional, Hoefsten, D. E., additional, Moeller, J. E., additional, Boetker, H. E., additional, Egstrup, K., additional, Graefe, M., additional, Huang, F. Q., additional, Zhang, R. S., additional, Le, T. T., additional, Tan, R. S., additional, Sattarzadeh Badkoubeh, R., additional, Tavoosi, A., additional, Elahian, A. R., additional, Drapkina, O., additional, Ivashkin, V. I., additional, Fazakas, A., additional, Pepo, L., additional, Janosi, O., additional, Kopitovic, I., additional, Goncalves, A., additional, Marcos-Alberca, P., additional, Almeria, C., additional, Feltes, G., additional, Rodriguez, E., additional, Garcia, E., additional, Hernandez-Antolin, R., additional, Macaya, C., additional, Silva Cardoso, J., additional, Zamorano, J. L., additional, Navarro, M. S., additional, Valentin, M., additional, Banes, C. M., additional, Rigo, F., additional, Grolla, E., additional, Tona, F., additional, Cuaia, V., additional, Moreo, A., additional, Badano, L., additional, Raviele, A., additional, Iliceto, S., additional, Tarzia, P., additional, Sestito, A., additional, Nerla, R., additional, Di Monaco, A., additional, Infusino, F., additional, Matera, D., additional, Greco, F., additional, Tacchino, R. M., additional, Lanza, G. A., additional, Crea, F., additional, Nemes, A., additional, Balazs, E., additional, Pinter, K. S., additional, Egyed, A., additional, Csanady, M., additional, Forster, T., additional, Holte, E., additional, Vegsundvag, J., additional, Hole, T., additional, Hegbom, K., additional, Wiseth, R., additional, Sharif, D., additional, Sharif-Rasslan, A., additional, Shahla, C., additional, Khalil, A., additional, Rosenschein, U., additional, Zagatina, A., additional, Zhuravskaya, N., additional, Tyurina, T. V., additional, Tagliamonte, E., additional, Cirillo, T., additional, Coppola, A., additional, Marinelli, U., additional, Romano, C., additional, Riccio, G., additional, Citro, R., additional, Astarita, C., additional, Capuano, N., additional, Quaranta, G., additional, Desiderio, A., additional, Frattini, S., additional, Faggiano, P., additional, Zilioli, V., additional, Locantore, E., additional, Longhi, S., additional, Bellandi, F., additional, Faden, G., additional, Triggiani, M., additional, Dei Cas, L., additional, Dalsgaard, M., additional, Kjaergaard, J., additional, Iversen, K., additional, Hassager, C., additional, Dinh, W., additional, Nickl, W. N., additional, Smettan, J. S., additional, Koehler, T. K., additional, Scheffold, T. D., additional, Coll Barroso, M. C. B., additional, Guelker, J. G., additional, Fueth, R. F., additional, Kamperidis, V., additional, Hadjimiltiades, S., additional, Sianos, G., additional, Efthimiadis, G., additional, Karvounis, H., additional, Parcharidis, G., additional, Styliadis, I. H., additional, Velasco Del Castillo, M. S., additional, Onaindia, J. J., additional, Telleria, M., additional, Carstensen, H. G., additional, Nordenberg, C., additional, Sogaard, P., additional, Fritz-Hansen, T., additional, Bech, J., additional, Galatius, S., additional, Jensen, J. S., additional, Mogelvang, R., additional, Bartko, P. E., additional, Graf, S., additional, Rosenhek, R., additional, Burwash, I. G., additional, Bergler-Klein, J., additional, Clavel, M.-A., additional, Baumgartner, H., additional, Pibarot, P., additional, Mundigler, G., additional, Kirilmaz, B., additional, Eser, I., additional, Tuzun, N., additional, Komur, B., additional, Dogan, H., additional, Taskiran Comez, A., additional, Ercan, E., additional, Cusma-Piccione, M., additional, Zito, C., additional, Oreto, G., additional, Piluso, S., additional, Tripepi, S., additional, Oreto, L., additional, Longordo, C., additional, Ciraci, L., additional, Di Bella, G., additional, Piatkowski, R., additional, Kochanowski, J., additional, Scislo, P., additional, Grabowski, M., additional, Marchel, M., additional, Roik, M., additional, Kosior, D., additional, Opolski, G., additional, Sknouril, L., additional, Dorda, M., additional, Holek, B., additional, Gajdusek, L., additional, Chovancik, J., additional, Branny, M., additional, Fiala, M., additional, Szymanski, P., additional, Lipczynska, M., additional, Klisiewicz, A., additional, Hoffman, P., additional, Jander, N., additional, Minners, J., additional, Martin, G., additional, Zeh, W., additional, Allgeier, M., additional, Gohlke-Baewolf, C., additional, Gohlke, H., additional, Nistri, S., additional, Porciani, M. C., additional, Attanasio, M., additional, Abbate, R., additional, Gensini, G. F., additional, Pepe, G., additional, Duncan, R. F., additional, Piantadosi, C., additional, Nelson, A. J., additional, Wittert, G., additional, Dundon, B., additional, Worthley, M. I., additional, Worthley, S. G., additional, Jung, P., additional, Berlinger, K., additional, Rieber, J., additional, Sohn, H. Z., additional, Schneider, P., additional, Leibig, M., additional, Koenig, A., additional, Klauss, V., additional, Tomkiewicz-Pajak, L., additional, Kolcz, J., additional, Olszowska, M., additional, Pieculewicz, M., additional, Podolec, P., additional, Przewlocki, T., additional, Suchon, E., additional, Sobien, B., additional, Wilkolek, P., additional, Ziembicka, A., additional, Hlawaty, M., additional, Van De Bruaene, A., additional, Hermans, H., additional, Buys, R., additional, Vanhees, L., additional, Delcroix, M., additional, Voigt, J.-U., additional, Budts, W., additional, De Cillis, E., additional, Acquaviva, T., additional, Basile, D., additional, Bortone, A. S., additional, Kalimanovska-Ostric, D., additional, Nastasovic, T., additional, Vujisic-Tesic, B., additional, Jovanovic, I., additional, Milakovic, B., additional, Dostanic, M., additional, Stosic, M., additional, Frogoudaki, A., additional, Andreou, K., additional, Parisis, J., additional, Triantafyllidi, E., additional, Gaitani, S., additional, Paraskevaidis, J., additional, Anastasiou-Nana, M., additional, De Pasquale, G., additional, Kuehn, A., additional, Petzuch, K., additional, Mueller, J., additional, Meierhofer, C., additional, Fratz, S., additional, Hager, A., additional, Hess, J., additional, Vogt, M., additional, Attenhofer Jost, C. H., additional, Dearani, J. A., additional, Scott, C. G., additional, Burkhart, H. M., additional, Connolly, H. M., additional, Vitarelli, A., additional, Battaglia, D., additional, Caranci, F., additional, Padella, V., additional, Continanza, G., additional, Dettori, O., additional, Capotosto, L., additional, Vitarelli, M., additional, De Cicco, V., additional, Cortez Morichetti, M., additional, Mohanan Nair, K. K., additional, Sasidaharan, B., additional, Thajudeen, A., additional, Tharakan, J. M., additional, Mertens, L., additional, Ahmad, N., additional, Kantor, P. K., additional, Grosse-Wortmann, L., additional, Friedberg, M. K., additional, Bernard, Y. F., additional, Morel, M. A., additional, Descotes-Genon, V., additional, Jehl, J., additional, Meneveau, N., additional, Schiele, F., additional, Kaldararova, M., additional, Simkova, I., additional, Tittel, P., additional, Masura, J., additional, Trojnarska, O., additional, Szczepaniak, L., additional, Mizia -Stec, K., additional, Cieplucha, A., additional, Bartczak, A., additional, Grajek, S., additional, Tykarski, A., additional, Gasior, Z., additional, Babovicvuksanovic, D., additional, Bonnichsen, C. R., additional, Morgan, G. J., additional, Slorach, C., additional, Hui, W., additional, Sarkola, T., additional, Lee, K. J., additional, Chaturvedi, R., additional, Benson, L., additional, Bradley, T., additional, Iancu, M. E., additional, Ghiorghiu, I., additional, Serban, M., additional, Craciunescu, I., additional, Hodo, A., additional, Morgan, J., additional, Roche, L., additional, Lee, K., additional, Milanesi, O., additional, Favero, V., additional, Padalino, M., additional, Biffanti, R., additional, Cerutti, A., additional, Maschietto, N., additional, Reffo, E., additional, Vida, V., additional, Stellin, G., additional, Irtyuga, O., additional, Gamazin, D., additional, Voronkina, I., additional, Tsoyi, N., additional, Gudkova, E., additional, Moiseeva, O., additional, Aggeli, C., additional, Kazazaki, C., additional, Felekos, I., additional, Lagoudakou, S., additional, Roussakis, G., additional, Skoumas, J., additional, Pitsavos, C., additional, Stefanadis, C., additional, Cueff, C., additional, Keenan, N., additional, Steg, P. G., additional, Cimadevilla, C., additional, Ducrocq, G., additional, Vahanian, A., additional, Messika-Zeitoun, D., additional, Petrella, L., additional, Mazzola, A. M., additional, Villani, C. V., additional, Giancola, R. G., additional, Ciocca, M. C., additional, Di Eusanio, D. E. M., additional, Nolan, S., additional, Ionescu, A., additional, Skaug, T. R., additional, Amundsen, B. H., additional, Hergum, T., additional, Torp, H., additional, Haugen, B. O., additional, Lopez Aguilera, J., additional, Mesa Rubio, D., additional, Ruiz Ortiz, M., additional, Delgado Ortega, M., additional, Villanueva Fernandez, E., additional, Cejudo Diaz Del Campo, L., additional, Toledano Delgado, F., additional, Leon Del Pino, M., additional, Romo Pena, E., additional, Suarez De Lezo Cruz-Conde, J., additional, De Marco, E., additional, Colucci, A., additional, Comerci, G., additional, Gabrielli, F. A., additional, Natali, R., additional, Garramone, B., additional, Savino, M., additional, Lotrionte, M., additional, Sonaglioni, A., additional, Loperfido, F., additional, Zdravkovic, M., additional, Perunicic, J., additional, Krotin, M., additional, Ristic, M., additional, Vukomanovic, V., additional, Zaja, M., additional, Radovanovic, S., additional, Saric, J., additional, Zdravkovic, D., additional, Cotrim, C., additional, Almeida, A. R., additional, Miranda, R., additional, Almeida, A. G., additional, Picano, E., additional, Carrageta, M., additional, D'andrea, A., additional, Cocchia, R., additional, Riegler, L., additional, Golia, E., additional, Scarafile, R., additional, Caso, P., additional, Russo, M. G., additional, Bossone, E., additional, Calabro', R., additional, Noman, H., additional, Adel, A., additional, Elfaramawy, A. M. R., additional, Abdelraouf, M., additional, Elnaggar, W. A. E. L., additional, Baligh, E., additional, Sargento, L., additional, Silva, D., additional, Goncalves, S., additional, Ribeiro, S., additional, Vinhas Sousa, G., additional, Almeida, A., additional, Lopes, M., additional, Rodriguez-Manero, M., additional, Aguado Gil, L., additional, Azcarate, P., additional, Lloret Luna, P., additional, Macias Gallego, A., additional, Castano, S. A. R. A., additional, Garcia, M., additional, Pujol Salvador, C., additional, Barba, J., additional, Redondo, P., additional, Tomasoni, L., additional, Sitia, S., additional, Atzeni, F., additional, Gianturco, L., additional, Ricci, C., additional, Sarzi-Puttini, P., additional, Turiel, M., additional, De Gennaro Colonna, V., additional, Uejima, T., additional, Jaroch, J., additional, Polombo, C., additional, Hughes, A., additional, Vinereanu, D., additional, Evanvelista, A., additional, Leftheriotis, G., additional, Fraser, A. G., additional, Lewczuk, A., additional, Sobkowicz, B., additional, Tomaszuk-Kazberuk, A., additional, Sawicki, R., additional, Hirnle, T., additional, Michalski, B. W., additional, Filipiak, D., additional, Kasprzak, J. D., additional, Lipiec, P., additional, Dalen, H., additional, Mjolstad, O. C., additional, Klykken, B. E., additional, Graven, T., additional, Martensson, M., additional, Olsson, M., additional, Brodin, L.-A., additional, Enache, R., additional, Leiballi, E., additional, Penhall, A., additional, Perry, R., additional, Altman, M., additional, Sinhal, A., additional, Bennetts, J., additional, Chew, D. P., additional, Joseph, M. X., additional, Larsen, L. H., additional, Kristensen, T., additional, Kober, L. V., additional, Kofoed, K. F., additional, Moscoso Costa, F., additional, Ribeiras, R., additional, Brito, J., additional, Boshoff, S., additional, Neves, J., additional, Teles, R., additional, Canada, M., additional, Andrade, M. J., additional, Gouveia, R., additional, Silva, A., additional, Miskovic, A., additional, Poerner, T. P., additional, Stiller, C. S., additional, Goebel, B. G., additional, Moritz, A. M., additional, Stefani, L., additional, Galanti, G. G., additional, Moraldo, M., additional, Bergamini, C., additional, Pabari, P. A., additional, Dhutia, N. M., additional, Malaweera, A. S. N., additional, Willson, K., additional, Davies, J., additional, Hughes, A. D., additional, Xu, X. Y., additional, Francis, D. P., additional, Jasaityte, R., additional, Amundsen, B., additional, Barbosa, D., additional, Loeckx, D., additional, Kiss, G., additional, Orderud, F., additional, Robesyn, V., additional, Claus, P., additional, D'hooge, J., additional, Nao, T., additional, Miura, T., additional, Shams, K., additional, Samir, S., additional, Samir, R., additional, El-Sayed, M., additional, Anwar, A. M., additional, Nosir, Y., additional, Galal, A., additional, Chamsi-Pasha, H., additional, Ciobanu, A., additional, Dulgheru, R., additional, Bennett, S., additional, De Luca, A., additional, Toncelli, L., additional, Cappelli, F., additional, Cappelli, B., additional, Vono, M. C. R., additional, Galanti, G., additional, Zorman, Y., additional, Yilmazer, M. S., additional, Akyildiz, M., additional, Gurol, T., additional, Aydin, A., additional, Dagdeviren, B., additional, and Kalangos, A., additional

Published
2010
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31. 235

Author

Bulletti, C., primary, Colombo, F., additional, and Comerci, G., additional

Published
2005
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40. Characteristics and patterns of care of endometrial cancer before and during COVID-19 pandemic

Author

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

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

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

Published
2022

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

Author

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

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

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

Published
2022

44. Prophylactic risk-reducing salpingo-oophorectomy in BRCA mutation carriers: what is going on in a region of northern Italy?

Author

M. Stefanetti, Fabio Facchinetti, Giovanni Grandi, Roberto Berretta, Laura Cortesi, Ruby Martinello, Angela Toss, P. De Iaco, A. Perrone, R. De Domenico, Andrea Amadori, Lorenzo Aguzzoli, Vincenzo Dario Mandato, Stefano Friso, C. Merisio, G Comerci, Pantaleo Greco, Gennaro Scutiero, Anna Myriam Perrone, F. Rosati, M. D. Nuzzo, V. Arcangeli, Margaret Sammarini, Grandi G., Perrone A.M., Perrone A., Mandato V.D., Comerci G., Sammarini M., Merisio C., Amadori A., Stefanetti M., Martinello R., Facchinetti F., De Iaco P., Aguzzoli L., Arcangeli V., Berretta R., Cortesi L., De Domenico R., Nuzzo M.D., Friso S., Greco P., Rosati F., Scutiero G., and Toss A.

Subjects
endocrine system diseases, medicine.medical_treatment, BRCA, 0302 clinical medicine, Medicine, 030212 general & internal medicine, Young adult, skin and connective tissue diseases, Ovarian Neoplasms, 030219 obstetrics & reproductive medicine, Obstetrics, BRCA1 Protein, Obstetrics and Gynecology, Middle Aged, female genital diseases and pregnancy complications, Risk-reducing salpingo-oophorectomy, Serous fluid, Italy, Female, Breast cancer survivor, Hysterectomy, Ovarian cancer, Prophylactic, pathology, Adult, Aged, BRCA2 Protein, Breast Neoplasms, Humans, Mutation, Risk, Young Adult, Salpingo-oophorectomy, Breast Neoplasm, Human, medicine.medical_specialty, Prophylactic, General Biochemistry, Genetics and Molecular Biology, NO, 03 medical and health sciences, Breast cancer, business.industry, Ovarian Neoplasm, BRCA mutation, Cancer, medicine.disease, Concomitant, pathology, business
Abstract

Background BRCA1 mutation carriers are recommended to undergo prophylactic risk-reducing salpingo-oophorectomy (RRSO) between the ages of 35 and 40 or when child bearing is complete, with a possible delay until age 40–45 for BRCA2 mutation carriers. Study Question Primary outcome was the rate of unsuspected cancer findings during RRSO in a region of northern Italy (Emilia Romagna) and secondary outcomes were details of RRSO: age at surgical intervention, the venue of the procedures in relation to the surgical/pathological quality and the rate/role of concomitant opportunistic hysterectomies. Study Design Multicentre data collection by invitation to report current RRSO practices. Results A total of 222 RRSOs (54.5 % BRCA1, 34.7 % BRCA2, 1.8 % BRCA1 and BRCA2 combined, 5.8 % BRCA-VUS and 3.2 % BRCA not better specified) were reported from 9 different centres, half in non-university hospitals and the remainder in university hospitals. Breast cancer survivors (56.3 %) underwent the RRSO at a younger age (47.8 vs 50.6 years, p = 0.02). The mean and median ages at surgical intervention (49.0 and 48.0, respectively) were similar for BRCA1 and BRCA2 mutation carriers, as was the temporal trend in age distribution, and proportions treated in university and non-university hospitals. A diagnosis of ovarian invasive cancer was reported in 3.5 % of subjects, all BRCA1 or BRCA-combined subjects, at a median and mean age of 57 years (range 42–68). Abnormal tubal findings, such as serous tubal intraepithelial lesions (STIL) (100 %), secretory cell outgrowth (SCOUT) (100 %) and STIC (71.4 %), were mainly reported by pathologists in university hospitals. Of the 222 procedures, 15 (6.7 %) included hysterectomies: in none of these cases was a primitive uterine endometrioid or serous cancer found. Conclusions The results from this multicentre regional study should guide future preventive health policies for RRSO in BRCA mutation carriers.

Published
2021

45. Remote Monitoring of Cardiac Implantable Electronic Devices in Very Elderly Patients: Advantages and Specific Problems.

Author

Scacciavillani R, Koliastasis L, Doundoulakis I, Chiotis S, Kordalis A, Narducci ML, Kotoulas S, Pinnacchio G, Bencardino G, Perna F, Comerci G, Gatzoulis KA, Tsiachris D, and Pelargonio G

Abstract

Cardiac implantable electronic devices (CIEDs) offer the benefit of remote monitoring and decision making and find particular applications in special populations such as the elderly. Less transportation, reduced costs, prompt diagnosis, a sense of security, and continuous real-time monitoring are the main advantages. On the other hand, less physician-patient interactions and the technology barrier in the elderly pose specific problems in remote monitoring. CIEDs nowadays are abundant and are mostly represented by rhythm control/monitoring devices, whereas hemodynamic remote monitoring devices are gaining popularity and are evolving and becoming refined. Future directions include the involvement of artificial intelligence, yet disparities of availability, lack of follow-up data, and insufficient patient education are still areas to be improved. This review aims to describe the role of CIED in the very elderly and highlight the merits and possible drawbacks.

Published
2024
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46. Acute myocardial infarction revealed by recurrent ventricular tachyarrhythmias detected by remote monitoring.

Author

Bencardino G, Telesca A, Comerci G, and Burzotta F

Subjects
Humans, Heart, Defibrillators, Implantable, Tachycardia, Ventricular diagnosis, Tachycardia, Ventricular therapy, Myocardial Infarction complications, Myocardial Infarction diagnosis, Myocardial Infarction therapy, Heart Failure diagnosis
Abstract

Remote monitoring (RM) of cardiac implantable electronic devices (CIED) represented a major improvement in clinical practice and has been used with multiple indications. Many parameters monitored on a daily basis by current CIED can indeed assist in clinical practice (eg, decompensated heart failure) by providing the patient with optimal timing for anticipated outpatient visit or urgent medical care. Recognition of acute myocardial infarction (AMI) is not usually considered among the capabilities of RM. We present the case of an AMI occurring without any ischaemic symptoms but associated with recurrent ventricular tachyarrhythmias effectively treated by multiple interventions of the implantable cardioverter defibrillator and promptly detected by RM personnel, who recommended the patient to quickly access to the emergency department where diagnosis and revascularization of an otherwise untreated myocardial infarction was performed., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Published
2024
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47. Mechanisms, prevalence and management of cardiac arrhythmias in cancer patients: a comprehensive review.

Author

Flore F, Scacciavillani R, Iannaccone G, Narducci ML, Pinnacchio G, Bencardino G, Perna F, Spera FR, Comerci G, Camilli M, Lombardo A, Lanza GA, Crea F, and Pelargonio G

Subjects
Humans, Prevalence, Atrial Fibrillation complications, Neoplasms complications, Neoplasms epidemiology, Neoplasms therapy, Heart Failure complications
Abstract

Recently, prognosis and survival of cancer patients has improved due to progression and refinement of cancer therapies; however, cardiovascular sequelae in this population augmented and now represent the second cause of death in oncological patients. Initially, the main issue was represented by heart failure and coronary artery disease, but a growing body of evidence has now shed light on the increased arrhythmic risk of this population, atrial fibrillation being the most frequently encountered. Awareness of arrhythmic complications of cancer and its treatments may help oncologists and cardiologists to develop targeted approaches for the management of arrhythmias in this population. In this review, we provide an updated overview of the mechanisms triggering cardiac arrhythmias in cancer patients, their prevalence and management.

Published
2023
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48. Clinical Impact of Cardiac Fibrosis on Arrhythmia Recurrence after Ablation in Adults with Congenital Heart Disease.

Author

Perna F, Telesca A, Scacciavillani R, Narducci ML, Bencardino G, Pinnacchio G, Spera FR, Sabarese R, Comerci G, and Pelargonio G

Abstract

Background: Adults with congenital heart disease (ACHD) are often affected by cardiac arrhythmias requiring catheter ablation. Catheter ablation in this setting represents the treatment of choice but is flawed by frequent recurrencies. Predictors of arrhythmia relapse have been identified, but the role of cardiac fibrosis in this setting has not been investigated. The aim of this study was to determine the role of the extension of cardiac fibrosis, detected by electroanatomical mapping, in predicting arrhythmia recurrencies after ablation in ACHD., Materials and Methods: Consecutive patients with congenital heart disease and atrial or ventricular arrhythmias undergoing catheter ablation were enrolled. An electroanatomical bipolar voltage map was performed during sinus rhythm in each patient and bipolar scar was assessed according to the current literature data. During follow-up, arrhythmia recurrences were recorded. The relationship between the extent of myocardial fibrosis and arrhythmia recurrence was assessed., Results: Twenty patients underwent successful catheter ablation of atrial (14) or ventricular (6) arrhythmias, with no inducible arrhythmia at the end of the procedure. During a median follow-up period of 207 weeks (IQR 80 weeks), eight patients (40%; five atrial and three ventricular arrhythmias) had arrhythmia recurrence. Of the five patients undergoing a second ablation, four showed a new reentrant circuit, while one patient had a conduction gap across a previous ablation line. The extension of the bipolar scar area (HR 1.049, CI 1.011-1.089, p = 0.011) and the presence of a bipolar scar area >20 cm 2 (HR 6.101, CI 1.147-32.442, p = 0.034) were identified as predictors of arrhythmia relapse., Conclusion: The extension of the bipolar scar area and the presence of a bipolar scar area >20 cm 2 can predict arrhythmia relapse in ACHD undergoing catheter ablation of atrial and ventricular arrhythmias. Recurrent arrhythmias are often caused by circuits other than those previously ablated.

Published
2023
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49. Clinical Impact of Next-Generation Sequencing Multi-Gene Panel Highlighting the Landscape of Germline Alterations in Ovarian Cancer Patients.

Author

Gurioli G, Tedaldi G, Farolfi A, Petracci E, Casanova C, Comerci G, Danesi R, Arcangeli V, Ravegnani M, Calistri D, Zampiga V, Cangini I, Fonzi E, Virga A, Tassinari D, Rosati M, Ulivi P, and De Giorgi U

Subjects
Humans, Female, Genetic Predisposition to Disease, BRCA1 Protein genetics, Mutation, Genes, BRCA2, Germ-Line Mutation, High-Throughput Nucleotide Sequencing, Ovarian Neoplasms drug therapy, Breast Neoplasms genetics
Abstract

BRCA1 and BRCA2 are the most frequently mutated genes in ovarian cancer (OC) crucial both for the identification of cancer predisposition and therapeutic choices. However, germline variants in other genes could be involved in OC susceptibility. We characterized OC patients to detect mutations in genes other than BRCA1/2 that could be associated with a high risk of developing OC and permit patients to enter the most appropriate treatment and surveillance program. Next-generation sequencing analysis with a 94-gene panel was performed on germline DNA of 219 OC patients. We identified 34 pathogenic/likely pathogenic variants in BRCA1/2 and 38 in other 21 genes. The patients with pathogenic/likely pathogenic variants in the non-BRCA1/2 genes mainly developed OC alone compared to the other groups that also developed breast cancer or other tumors (p = 0.001). Clinical correlation analysis showed that the low-risk patients were significantly associated with platinum sensitivity (p < 0.001). Regarding PARP inhibitors (PARPi) response, the patients with pathogenic mutations in the non-BRCA1/2 genes had worse PFS and OS. Moreover, a statistically significantly worse PFS was found for every increase of one thousand platelets before PARPi treatment. To conclude, knowledge about molecular alterations in genes beyond BRCA1/2 in OC could allow for more personalized diagnostic, predictive, prognostic, and therapeutic strategies for OC patients.

Published
2022
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50. Short-Term Atrioventricular Dysfunction Recovery after Post-TAVI Pacemaker Implantation.

Author

Pinnacchio G, Ruscio E, Rocco E, Trani C, Burzotta F, Aurigemma C, Romagnoli E, Scacciavillani R, Narducci ML, Bencardino G, Perna F, Spera FR, Comerci G, Bisignani A, and Pelargonio G

Abstract

Permanent pacemaker implantation (PPI) represents a frequent complication after transcatheter aortic valve implantation (TAVI) due to atrio-ventricular (AV) node injury. Predictors of early AV function recovery were investigated. We analyzed 50 consecutive patients (82 ± 6 years, 58% males, EuroSCORE: 7.8 ± 3.3%, STS mortality score: 5 ± 2.8%). Pacemaker interrogations within 4−6 weeks from PPI were performed to collect data on AV conduction. The most common indication of PPI was persistent third-degree (44%)/high-degree (20%) AV block/atrial fibrillation (AF) with slow ventricular conduction (16%) after TAVI. At follow-up, 13 patients (26%) recovered AV conduction (i.e., sinus rhythm with stable 1:1 AV conduction/AF with a mean ventricular response >50 bpm, associated with a long-term ventricular pacing percentage < 5%). At multivariate analysis, complete atrio-ventricular block independently predicted pacemaker dependency at follow-up (p = 0.019). Patients with persistent AV dysfunction showed a significant AV conduction time prolongation after TAVI (PR interval from 207 ± 50 to 230 ± 51, p = 0.02; QRS interval from 124 ± 23 to 147 ± 16, p < 0.01) compared to patients with recovery, in whom AV conduction parameters remained unchanged. Several patients receiving PPI after TAVI have recovery of AV conduction within a few weeks. Longer observation periods prior to PPI might be justified, and algorithms to minimize ventricular pacing should be utilized whenever possible.

Published
2022
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