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4. 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

8. 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

9. 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

10. 776 Role of optimal cytoreduction in advanced stage malignant ovarian germ cell tumors, data from the MITO-9 trial

Author

Bergamini, A, primary, Cassani, C, additional, Raspagliesi, F, additional, Bogani, G, additional, Bocciolone, L, additional, Rabaiotti, E, additional, Cioffi, R, additional, Sabetta, G, additional, Scarfone, G, additional, Savarese, A, additional, Ferrandina, MG, additional, Mascilini, F, additional, Cormio, G, additional, Giorda, G, additional, Pignata, S, additional, Taccagni, G, additional, and Mangili, G, additional

Published
2021
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11. 101 Hysteroscopic compared to cervical injection for sentinel node detection in endometrial cancer: a multicenter prospective randomized controlled trial

Author

Ditto, A, primary, Roberti Maggiore, U Leone, additional, Martinelli, F, additional, Bogani, G, additional, Signorelli, M, additional, Chiappa, V, additional, Evangelista, MT, additional, Casarin, J, additional, Ghezzi, F, additional, Perrone, AM, additional, De Iaco, P, additional, Scollo, P, additional, Scibilia, G, additional, Giorda, G, additional, Paolini, B, additional, Lo Vullo, S, additional, Mariani, L, additional, and Raspagliesi, F, additional

Published
2021
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12. 800P Tailoring adjuvant treatments in high-risk early stage endometrial cancer: Clinical outcomes of sequential chemoradiation in a real-word scenario

Author

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

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

Author

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

Abstract

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

Published
2021

14. 23 Impact of COVID-19 in gynecologic oncology: a nationwide Italian survey

Author

Bogani, G, primary, Apolone, G, additional, Ditto, A, additional, Scambia, G, additional, Benedetti Panici, P, additional, Angioli, R, additional, Pignata, S, additional, Greggi, S, additional, Scollo, P, additional, Mezzanzanica, D, additional, Franchi, M, additional, Di Donato, V, additional, Valabrega, G, additional, Ferrandina, G, additional, Palaia, I, additional, Bergamini, A, additional, Bocciolone, L, additional, Savarese, A, additional, Ghezzi, F, additional, Casarin, J, additional, Trojano, V, additional, Chinatera, V, additional, Giorda, G, additional, Malzoni, M, additional, Salerno, G, additional, Sartori, E, additional, Testa, A, additional, Zannoni, GF, additional, Zullo, F, additional, Vizza, E, additional, Trojano, G, additional, Chiantera, A, additional, and Raspagliesi, F, additional

Published
2020
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16. EP806 First insight of a tailoring chemotherapy intensity regimen in a real life cohort of elderly patients with ovarian cancer: the CIRCE study

Author

Bortot, L, primary, Bartoletti, M, additional, Basile, D, additional, Gerratana, L, additional, Corvaja, C, additional, Lisanti, C, additional, Pelizzari, G, additional, Garattini, SK, additional, Garutti, M, additional, Buriolla, S, additional, Da Ros, L, additional, Bolzonello, S, additional, Di Nardo, P, additional, Spazzapan, S, additional, Nicoloso, MS, additional, Scalone, S, additional, Lombardi, D, additional, Giorda, G, additional, Sorio, R, additional, and Puglisi, F, additional

Published
2019
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18. Neutrophil-to-lymphocyte ratio predicts platinum sensitivity in epithelial ovarian cancer patients: A MITO24 retrospective study

Author

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

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

Author

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

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

Author

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

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

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

Published
2016

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

Author

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

Abstract

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

Published
2019

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

Author

Bergamini, A., primary, Ferrandina, G., additional, Candiani, M., additional, Cormio, G., additional, Giorda, G., additional, Lauria, R., additional, Perrone, A.M., additional, Scarfone, G., additional, Breda, E., additional, Savarese, A., additional, Frigerio, L., additional, Gadducci, A., additional, Mascilini, F., additional, Maneschi, F., additional, Cassani, C., additional, Marchetti, C., additional, Cecere, S.C., additional, Biglia, N., additional, De Giorgi, U., additional, Raspagliesi, F., additional, Lorusso, D., additional, and Mangili, G., additional

Published
2018
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23. Laparoscopic surgery in the treatment of stage I adult granulosa cells tumors of the ovary: Results from the MITO-9 study

Author

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

Abstract

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

Published
2018

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

Author

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

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

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

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

Author

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

Abstract

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

Published
2016

32. REQUISITI ESSENZIALI PER IL TRATTAMENTO DELLE NEOPLASIE GINECOLOGICHE

Author

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

Published
2010

33. [First abdominal access in gynecological laparoscopy: which method to utilize?]

Author

Tinelli A, Malvasi A, Aj, Schneider, Joerg Keckstein, Hudelist G, Barbic M, Casciaro S, Giorda G, Tinelli R, Perrone A, and Fg, Tinelli

Subjects
Gynecologic Surgical Procedures, Abdominal Wall, Humans, Female, Laparoscopy
Abstract

The choice of the technique to enter the peritoneal cavity, during a laparoscopy, depends on a lot of variables which hinder a standardized method and, actually, it appears impossible to show, with certainty, the best method to choose for the first abdominal access in gynecological laparoscopy. The preference for one or another technique depends on the operator experience, school and speciality of the surgeon, laparoscopical upgrading and the work environment; many surgical techniques are not yet used due the limits and fears of some surgeons to change the preference in first access approaching and for the lack of operating versatility by a method or another one. A review of the scientific literature, underlines that the major problems during the first laparoscopical abdominal access are two, vascular and intestinal and their percentage is variable. In this paper we describe the large range of methods for open and closed laparoscopy and for direct access, that permit to perform a first abdominal laparoscopical access, and their major possible problems.

Published
2006

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

Author

SOPRACORDEVOLE, F., CLEMENTE, N., CARPINI, G. DELLI, GIORDA, G., DEL FABRO, A., MORICONI, L., DE PIERO, G., ALESSANDRINI, L., CANZONIERI, V., BUTTIGNOL, M., NICODEMO, M., and CIAVATTINI, A.

Abstract

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

Published
2017

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

Author

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

Abstract

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

Published
2014

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