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1. Hysterectomy alone vs. hysterectomy plus sentinel node mapping in endometrial cancer: Perioperative and long-term results from a propensity-score based study

Author

Bogani, G, Di Donato, V, Papadia, A, Buda, A, Casarin, J, Multinu, F, Plotti, F, Gasparri, M, Pinelli, C, Perrone, A, Ferrero, S, Sorbi, F, Landoni, F, Palaia, I, Perniola, G, De Iaco, P, Cianci, S, Alletti, S, Petrillo, M, Vizzielli, G, Fanfani, F, Angioli, R, Muzii, L, Ghezzi, F, Vizza, E, Mueller, M, Scambia, G, Panici, P, Raspagliesi, F, Bogani G., Di Donato V., Papadia A., Buda A., Casarin J., Multinu F., Plotti F., Gasparri M. L., Pinelli C., Perrone A. M., Ferrero S., Sorbi F., Landoni F., Palaia I., Perniola G., De Iaco P., Cianci S., Alletti S. G., Petrillo M., Vizzielli G., Fanfani F., Angioli R., Muzii L., Ghezzi F., Vizza E., Mueller M. D., Scambia G., Panici P. B., Raspagliesi F., Bogani, G, Di Donato, V, Papadia, A, Buda, A, Casarin, J, Multinu, F, Plotti, F, Gasparri, M, Pinelli, C, Perrone, A, Ferrero, S, Sorbi, F, Landoni, F, Palaia, I, Perniola, G, De Iaco, P, Cianci, S, Alletti, S, Petrillo, M, Vizzielli, G, Fanfani, F, Angioli, R, Muzii, L, Ghezzi, F, Vizza, E, Mueller, M, Scambia, G, Panici, P, Raspagliesi, F, Bogani G., Di Donato V., Papadia A., Buda A., Casarin J., Multinu F., Plotti F., Gasparri M. L., Pinelli C., Perrone A. M., Ferrero S., Sorbi F., Landoni F., Palaia I., Perniola G., De Iaco P., Cianci S., Alletti S. G., Petrillo M., Vizzielli G., Fanfani F., Angioli R., Muzii L., Ghezzi F., Vizza E., Mueller M. D., Scambia G., Panici P. B., and Raspagliesi F.

Abstract

Objective: To compare outcomes after hysterectomy and hysterectomy plus sentinel node mapping (SNM) in endometrial cancer (EC) patients. Materials and methods: This is a retrospective study, collecting data of EC patients treated between 2006 and 2016 in nine referral centers. Results: The study population included 398 (69.5%) and 174 (30.5%) patients having hysterectomy and hysterectomy plus SNM. As the results of the adoption of a propensity-score matched analysis, we selected two homogeneous cohort of patients (150 having hysterectomy only vs. 150 having hysterectomy plus SNM). The SNM group had a longer operative time, but did not correlate with length of hospital stay and estimated blood loss. Overall severe complication rates were similar between groups (0.7% in the hysterectomy group vs. 1.3% in the hysterectomy plus SNM group; p = 0.561). No lymphatic-specific complication occurred. Overall, 12.6% of patients having SNM were diagnosed with disease harboring in their lymph nodes. Adjuvant therapy administration rate was similar between groups. Considering patients having SNM, 4% of patients received adjuvant therapy on the basis of nodal status alone; all the other patients received adjuvant therapy also on the basis of uterine risk factors. Five-year disease-free (p = 0.720) and overall (p = 0.632) survival was not influenced by surgical approach. Conclusions: Hysterectomy (with or without SNM) is a safe and effective method for managing EC patients. Potentially, these data support the omission of side specific lymphadenectomy in case of unsuccessful mapping. Further evidence is warranted in to confirm the role SNM in the era of molecular/genomic profiling.

Published
2023

2. The endogenous oxytocin after manipulative osteopathic treatment in full-term pregnant women.

Author

RAGUSA, A., SVELATO, A., FOGOLARI, M., FICAROLA, F., PLOTTI, F., DE LUCA, C., D'AVINO, S., DAVINI, F., DE CESARIS, M., MESSINA, G., BERTOLINI, A., MARCI, R., ANGELETTI, S., ANGIOLI, R., and TERRANOVA, C.

Abstract

OBJECTIVE: The aim of this study is to assess whether the touch of osteopathic manipulative treatment (OMT) can affect the endogenous production of oxytocin in fullterm pregnant women and the assessment of well-being following the treatment. PATIENTS AND METHODS: In this study have been enrolled 57 pregnant women at full-term pregnancy (37th-41st week) for evaluation of the concentration of salivary oxytocin 2 minutes before and 2 minutes after a single session of OMT by an osteopath lasting for 30 minutes. Pre-OMT and post-OMT saliva samples were collected with the use of Salivette® salivary swabs. 7 salivary swabs were excluded from the analysis. 50 samples were analyzed with an appropriate ELISA kit. RESULTS: The mean OT salivary concentration pre-OMT was 89.98±16.39, and post-OMT was 100.60±19.13 tends to increase with p=0.0000051. In multivariate analysis, two subgroups show interesting data in the mean difference in OT salivary concentration post-OMT: women with painful contractions (p=0.06) and women under 35 years (p=0.09). CONCLUSIONS: The results of this study demonstrate that the effectiveness of OMT-increasing endogenous oxytocin is statistically significant in full-term pregnant women. The sensation of well-being found in most women indicates that there has been a predominantly central rather than peripheral oxytocin release after OMT. [ABSTRACT FROM AUTHOR]

Published
2024

3. 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

4. Corrigendum to “Assessing the role of minimally invasive radical hysterectomy for early-stage cervical cancer” [Eur. J. Obstet. Gynecol. 275 (2022) 64–69, (S0301211522003797), (10.1016/j.ejogrb.2022.06.004)]

Author

Bogani G., Bogani, G, Di Donato, V, Muzii, L, Casarin, J, Ghezzi, F, Malzoni, M, Greggi, S, Landoni, F, Bazzurini, L, Zanagnolo, V, Multinu, F, Angioli, R, Plotti, F, Caruso, G, Fischetti, M, Ferrandina, G, Palaia, I, Benedetti Panici, P, Scambia, G, Raspagliesi, F, Bogani G., Di Donato V., Muzii L., Casarin J., Ghezzi F., Malzoni M., Greggi S., Landoni F., Bazzurini L., Zanagnolo V., Multinu F., Angioli R., Plotti F., Caruso G., Fischetti M., Ferrandina G., Palaia I., Benedetti Panici P., Scambia G., Raspagliesi F., Bogani G., Bogani, G, Di Donato, V, Muzii, L, Casarin, J, Ghezzi, F, Malzoni, M, Greggi, S, Landoni, F, Bazzurini, L, Zanagnolo, V, Multinu, F, Angioli, R, Plotti, F, Caruso, G, Fischetti, M, Ferrandina, G, Palaia, I, Benedetti Panici, P, Scambia, G, Raspagliesi, F, Bogani G., Di Donato V., Muzii L., Casarin J., Ghezzi F., Malzoni M., Greggi S., Landoni F., Bazzurini L., Zanagnolo V., Multinu F., Angioli R., Plotti F., Caruso G., Fischetti M., Ferrandina G., Palaia I., Benedetti Panici P., Scambia G., and Raspagliesi F.

Published
2022

7. Outcomes of High-Grade Cervical Dysplasia with Positive Margins and HPV Persistence after Cervical Conization

Author

Giannini, A., Di Donato, V., Sopracordevole, F., Ciavattini, A., Ghelardi, A., Vizza, E., D’Oria, O., Simoncini, T., Plotti, F., Casarin, J., Golia D’Augè, T., Cuccu, I., Serati, M., Pinelli, C., Bergamini, A., Gardella, B., Dell’Acqua, A., Monti, E., Vercellini, P., D’Ippolito, G., Aguzzoli, L., Dario Mandato, V., Giannella, L., Scaffa, C., Ditto, A., Falcone, F., Borghi, C., Malzoni, M., Di Giovanni, A., Salerno, M. G., Liberale, V., Contino, B., Donfrancesco, C., Desiato, M., Perrone, A. M., De Iaco, P., Ferrero, S., Sarpietro, G., Matarazzo, M. G., Cianci, A., Cianci, S., Bosio, S., Ruisi, S., Mosca, L., Tinelli, R., De Vincenzo, Rosa Pasqualina, Zannoni, Gian Franco, Ferrandina, Maria Gabriella, Petrillo, M., Capobianco, G., Carlea, A., Zullo, F., Muschiato, B., Palomba, S., Greggi, S., Spinillo, A., Ghezzi, F., Colacurci, N., Angioli, R., Benedetti Panici, P., Muzii, L., Scambia, Giovanni, Raspagliesi, F., Bogani, G., De Vincenzo R. (ORCID:0000-0001-7408-0435), Zannoni G. F. (ORCID:0000-0003-1809-129X), Ferrandina G. (ORCID:0000-0003-4672-4197), Scambia G. (ORCID:0000-0003-2758-1063), Giannini, A., Di Donato, V., Sopracordevole, F., Ciavattini, A., Ghelardi, A., Vizza, E., D’Oria, O., Simoncini, T., Plotti, F., Casarin, J., Golia D’Augè, T., Cuccu, I., Serati, M., Pinelli, C., Bergamini, A., Gardella, B., Dell’Acqua, A., Monti, E., Vercellini, P., D’Ippolito, G., Aguzzoli, L., Dario Mandato, V., Giannella, L., Scaffa, C., Ditto, A., Falcone, F., Borghi, C., Malzoni, M., Di Giovanni, A., Salerno, M. G., Liberale, V., Contino, B., Donfrancesco, C., Desiato, M., Perrone, A. M., De Iaco, P., Ferrero, S., Sarpietro, G., Matarazzo, M. G., Cianci, A., Cianci, S., Bosio, S., Ruisi, S., Mosca, L., Tinelli, R., De Vincenzo, Rosa Pasqualina, Zannoni, Gian Franco, Ferrandina, Maria Gabriella, Petrillo, M., Capobianco, G., Carlea, A., Zullo, F., Muschiato, B., Palomba, S., Greggi, S., Spinillo, A., Ghezzi, F., Colacurci, N., Angioli, R., Benedetti Panici, P., Muzii, L., Scambia, Giovanni, Raspagliesi, F., Bogani, G., De Vincenzo R. (ORCID:0000-0001-7408-0435), Zannoni G. F. (ORCID:0000-0003-1809-129X), Ferrandina G. (ORCID:0000-0003-4672-4197), and Scambia G. (ORCID:0000-0003-2758-1063)

Abstract

The objective of this work is to assess the 5-year outcomes of patients undergoing conization for high-grade cervical lesions that simultaneously present as risk factors in the persistence of HPV infection and the positivity of surgical resection margins. This is a retrospective study evaluating patients undergoing conization for high-grade cervical lesions. All patients included had both positive surgical margins and experienced HPV persistence at 6 months. Associations were evaluated with Cox proportional hazard regression and summarized using hazard ratio (HR). The charts of 2966 patients undergoing conization were reviewed. Among the whole population, 163 (5.5%) patients met the inclusion criteria, being at high risk due to the presence of positive surgical margins and experiencing HPV persistence. Of 163 patients included, 17 (10.4%) patients developed a CIN2+ recurrence during the 5-year follow-up. Via univariate analyses, diagnosis of CIN3 instead of CIN2 (HR: 4.88 (95%CI: 1.10, 12.41); p = 0.035) and positive endocervical instead of ectocervical margins (HR: 6.44 (95%CI: 2.80, 9.65); p < 0.001) were associated with increased risk of persistence/recurrence. Via multivariate analyses, only positive endocervical instead of ectocervical margins (HR: 4.56 (95%CI: 1.23, 7.95); p = 0.021) were associated with worse outcomes. In this high-risk group, positive endocervical margins is the main risk factor predicting 5-year recurrence.

Published
2023

8. Hysterectomy Alone vs. Hysterectomy Plus Sentinel Node Mapping in Endometrial Cancer: Long-Term Results from a Multi-Institutional Study

Author

Bogani, G., primary, Papadia, A., additional, Casarin, J., additional, Buda, A., additional, Multinu, F., additional, Plotti, F., additional, Perrone, A.M., additional, De Iaco, P., additional, Ghezzi, F., additional, Ferrero, S., additional, Angioli, R., additional, Muzii, L., additional, Landoni, F., additional, Mueller, M.D., additional, Benedetti Panici, P., additional, Raspagliesi, F., additional, and di Donato, V., additional

Published
2022
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9. Three Lymphadenectomy Strategies in Endometrial Carcinoma: Analysis of Long-Term Outcomes

Author

Bogani, G., primary, di Donato, V., additional, Casarin, J., additional, Plotti, F., additional, Papadia, A., additional, Buda, A., additional, Multinu, F., additional, Perrone, A.M., additional, De Iaco, P., additional, Gasparri, M.L., additional, Ghezzi, F., additional, Ferrero, S., additional, Sorbi, F., additional, Angioli, R., additional, Landoni, F., additional, Mueller, M.D., additional, Muzii, L., additional, Benedetti Panici, P., additional, and Raspagliesi, F., additional

Published
2022
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11. Factors predicting morbidity in surgically-staged high-risk endometrial cancer patients

Author

Bogani, G, Papadia, A, Buda, A, Casarin, J, Di Donato, V, Plotti, F, Gasparri, M, Cimmino, C, Pinelli, C, Perrone, A, Barra, F, Cromi, A, Di Martino, G, Palaia, I, Ferrero, S, Indini, A, De Iaco, P, Angioli, R, Luvero, D, Muzii, L, Ghezzi, F, Landoni, F, Mueller, M, Benedetti Panici, P, Raspagliesi, F, Bogani G., Papadia A., Buda A., Casarin J., Di Donato V., Plotti F., Gasparri M. L., Cimmino C., Pinelli C., Perrone A. M., Barra F., Cromi A., Di Martino G., Palaia I., Ferrero S., Indini A., De Iaco P., Angioli R., Luvero D., Muzii L., Ghezzi F., Landoni F., Mueller M. D., Benedetti Panici P., Raspagliesi F., Bogani, G, Papadia, A, Buda, A, Casarin, J, Di Donato, V, Plotti, F, Gasparri, M, Cimmino, C, Pinelli, C, Perrone, A, Barra, F, Cromi, A, Di Martino, G, Palaia, I, Ferrero, S, Indini, A, De Iaco, P, Angioli, R, Luvero, D, Muzii, L, Ghezzi, F, Landoni, F, Mueller, M, Benedetti Panici, P, Raspagliesi, F, Bogani G., Papadia A., Buda A., Casarin J., Di Donato V., Plotti F., Gasparri M. L., Cimmino C., Pinelli C., Perrone A. M., Barra F., Cromi A., Di Martino G., Palaia I., Ferrero S., Indini A., De Iaco P., Angioli R., Luvero D., Muzii L., Ghezzi F., Landoni F., Mueller M. D., Benedetti Panici P., and Raspagliesi F.

Abstract

Objective: To investigate factors predicting the risk of developing 90-day postoperative complications and lymphatic-specific morbidity in patients undergoing surgical staging for high-risk endometrial cancer. Methods: This is a multi-institutional retrospective cohort study. Patients affected by apparent early-stage high-risk endometrial cancer (endometrioid FIGO grade 3 with deep myometrial invasion and non-endometrioid endometrial cancer) undergoing surgical staging between 2007 and 2019. Complications were graded according to the Clavien-Dindo classification system. Martin criteria were applied to improve quality of complications reporting. Results: Charts of 279 patients were evaluated. Lymphadenectomy, sentinel node mapping (SNM), and SNM followed by back-up lymphadenectomy were performed in 83 (29.7%), 50 (17.9%), and 146 (52.4%) patients, respectively. The former group of patients included 13 patients who had lymphadenectomy after the failure of the SNM technique. Thirteen (4.6%) patients developed severe postoperative events (grade 3 or worse). At multivariate analysis, body mass index (OR: 1.08 (95%CI: 1.01, 1.17)) and open abdominal surgery (OR: 2.27 (95%CI: 1.02, 5.32)) were the two independent factors predictive of surgery-related morbidity. Seven severe lymphatic complications occurred. The adoption of laparoscopic approach (p < 0.001, log-rank test) and SNM (p = 0.038, log-rank test) correlated with a lower risk of developing surgery-related events. Independently, open abdominal surgery was associated with an increased risk of developing lymphatic morbidity (OR: 37.4 (95%CI: 4.38, 319.5); p = 0.001). Conclusion: The adoption of the laparoscopic approach and SNM technique were associated with lower 90-day complication rates than open surgery in high-risk endometrial cancer undergoing staging surgery.

Published
2021

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

Author

Bogani, G, Papadia, A, Buda, A, Casarin, J, Di Donato, V, Gasparri, M, Plotti, F, Pinelli, C, Paderno, M, Lopez, S, Perrone, A, Barra, F, Guerrisi, R, Brusadelli, C, Cromi, A, Ferrari, D, Chiapp, V, Signorelli, M, Maggiore, U, Ditto, A, Palaia, I, Ferrero, S, De Iaco, P, Angioli, R, Panici, P, Ghezzi, F, Landoni, F, Mueller, M, Raspagliesi, F, Bogani G., Papadia A., Buda A., Casarin J., Di Donato V., Gasparri M. L., Plotti F., Pinelli C., Paderno M. C., Lopez S., Perrone A. M., Barra F., Guerrisi R., Brusadelli C., Cromi A., Ferrari D., Chiapp V., Signorelli M., Maggiore U. L. R., Ditto A., Palaia I., Ferrero S., De Iaco P., Angioli R., Panici P. B., Ghezzi F., Landoni F., Mueller M. D., Raspagliesi F., Bogani, G, Papadia, A, Buda, A, Casarin, J, Di Donato, V, Gasparri, M, Plotti, F, Pinelli, C, Paderno, M, Lopez, S, Perrone, A, Barra, F, Guerrisi, R, Brusadelli, C, Cromi, A, Ferrari, D, Chiapp, V, Signorelli, M, Maggiore, U, Ditto, A, Palaia, I, Ferrero, S, De Iaco, P, Angioli, R, Panici, P, Ghezzi, F, Landoni, F, Mueller, M, Raspagliesi, F, Bogani G., Papadia A., Buda A., Casarin J., Di Donato V., Gasparri M. L., Plotti F., Pinelli C., Paderno M. C., Lopez S., Perrone A. M., Barra F., Guerrisi R., Brusadelli C., Cromi A., Ferrari D., Chiapp V., Signorelli M., Maggiore U. L. R., Ditto A., Palaia I., Ferrero S., De Iaco P., Angioli R., Panici P. B., Ghezzi F., Landoni F., Mueller M. D., and Raspagliesi F.

Abstract

Objective: Sentinel node mapping (SLN) has replaced lymphadenectomy for staging surgery in apparent early-stage low and intermediate risk endometrial cancer (EC). Only limited data about the adoption of SNM in high risk EC is still available. Here, we evaluate the outcomes of high-risk EC undergoing SNM (with or without back-up lymphadenectomy). Methods: This is a multi-institutional international retrospective study, evaluating data of high-risk (FIGO grade 3 endometrioid EC with myometrial invasion >50% and non-endometrioid histology) EC patients undergoing SNM followed by back-up lymphadenectomy and SNM alone. Results: Chart of consecutive 196 patients were evaluated. The study population included 83 and 113 patients with endometrioid and non-endometrioid EC, respectively. SNM alone and SNM followed by back-up lymphadenectomy were performed in 50 and 146 patients, respectively. Among patients having SNM alone, 14 (28%) were diagnosed with nodal disease. In the group of patients undergoing SNM plus back-up lymphadenectomy 34 (23.2%) were diagnosed with nodal disease via SNM. Back-up lymphadenectomy identified 2 (1%) additional patients with nodal disease (in the para-aortic area). Back-up lymphadenectomy allowed to remove adjunctive positive nodes in 16 (11%) patients. After the adoption of propensity-matched algorithm, we observed that patients undergoing SNM plus back-up lymphadenectomy experienced similar disease-free survival (p = 0.416, log-rank test) and overall survival (p = 0.940, log-rank test) than patients undergoing SLN alone. Conclusions: Although the small sample size, and the retrospective study design this study highlighted that type of nodal assessment did not impact survival outcomes in high-risk EC. Theoretically, back-up lymphadenectomy would be useful in improving the removal of positive nodes, but its therapeutic value remains controversial. Further prospective evidence is needed.

Published
2021

13. The role of peritoneal lavage in benign gynecologic laparoscopic surgery.

Author

DE CICCO NARDONE, C., FICAROLA, F., PLOTTI, F., MONTERA, R., FEOLE, L., RAMPELLO, S., MESSINA, G., LUVERO, D., MARCI, R., ANGIOLI, R., and TERRANOVA, C.

Abstract

OBJECTIVE: Laparoscopic surgery offers many advantages compared to invasive surgery but one of the main problems is postoperative pain, partially resulting from the peritoneal inflammatory process mediated by inflammatory cytokines. The rationale of this study is that intraperitoneal washing could remove inflammatory mediators that are the cause of postoperative pain and could help in the removal of CO2 from the abdominal cavity. This article aims to analyze the effects of peritoneal lavage in the reduction of postoperative shoulder pain. PATIENTS AND METHODS: 277 patients enrolled to undergo laparoscopic gynecologic surgery were included in the study. Women are randomized into two groups, according to the use or non-use of peritoneal lavage with saline solution at the end of laparoscopic gynecological major procedures. RESULTS: Data show that the peritoneal lavage can significantly reduce postoperative pain in the first 36 hours after surgery, as well as patients’ requests for analgesics: during the first 3 postoperative days, requests for paracetamol were lower in the YW (Yes Washing) group than the NW (No Washing) group (77 vs. 101; p<0.05); similar results are obtained considering ketorolac administration (62 vs. 71; p<0.05). CONCLUSIONS: Peritoneal lavage after gynecological laparoscopic procedures may be effective in the reduction of postoperative pain and use of analgesics. [ABSTRACT FROM AUTHOR]

Published
2023

14. Evaluating long-term outcomes of three approaches to retroperitoneal staging in endometrial cancer

Author

Bogani, G, Di Donato, V, Papadia, A, Buda, A, Casarin, J, Multinu, F, Plotti, F, Cuccu, I, D'Auge, T, Gasparri, M, Pinelli, C, Perrone, A, Barra, F, Sorbi, F, Cromi, A, Di Martino, G, Palaia, I, Perniola, G, Ferrero, S, De Iaco, P, Perrone, C, Angioli, R, Luvero, D, Muzii, L, Ghezzi, F, Landoni, F, Mueller, M, Benedetti Panici, P, Raspagliesi, F, Bogani, Giorgio, Di Donato, Violante, Papadia, Andrea, Buda, Alessandro, Casarin, Jvan, Multinu, Francesco, Plotti, Francesco, Cuccu, Ilaria, D'Auge, Tullio Golia, Gasparri, Maria Luisa, Pinelli, Ciro, Perrone, Anna Myriam, Barra, Fabio, Sorbi, Flavia, Cromi, Antonella, Di Martino, Giampaolo, Palaia, Innocenza, Perniola, Giorgia, Ferrero, Simone, De Iaco, Pierandrea, Perrone, Chiara, Angioli, Roberto, Luvero, Daniela, Muzii, Ludovico, Ghezzi, Fabio, Landoni, Fabio, Mueller, Michael D, Benedetti Panici, Pierluigi, Raspagliesi, Francesco, Bogani, G, Di Donato, V, Papadia, A, Buda, A, Casarin, J, Multinu, F, Plotti, F, Cuccu, I, D'Auge, T, Gasparri, M, Pinelli, C, Perrone, A, Barra, F, Sorbi, F, Cromi, A, Di Martino, G, Palaia, I, Perniola, G, Ferrero, S, De Iaco, P, Perrone, C, Angioli, R, Luvero, D, Muzii, L, Ghezzi, F, Landoni, F, Mueller, M, Benedetti Panici, P, Raspagliesi, F, Bogani, Giorgio, Di Donato, Violante, Papadia, Andrea, Buda, Alessandro, Casarin, Jvan, Multinu, Francesco, Plotti, Francesco, Cuccu, Ilaria, D'Auge, Tullio Golia, Gasparri, Maria Luisa, Pinelli, Ciro, Perrone, Anna Myriam, Barra, Fabio, Sorbi, Flavia, Cromi, Antonella, Di Martino, Giampaolo, Palaia, Innocenza, Perniola, Giorgia, Ferrero, Simone, De Iaco, Pierandrea, Perrone, Chiara, Angioli, Roberto, Luvero, Daniela, Muzii, Ludovico, Ghezzi, Fabio, Landoni, Fabio, Mueller, Michael D, Benedetti Panici, Pierluigi, and Raspagliesi, Francesco

Abstract

Objective: Sentinel lymph node mapping (SNM) has gained popularity in managing apparent early-stage endometrial cancer (EC). Here, we evaluated the long-term survival of three different approaches of nodal assessment. Methods: This is a multi-institutional retrospective study evaluating long-term outcomes of EC patients having nodal assessment between 01/01/2006 and 12/31/2016. In order to reduce possible confounding factors, we applied a propensity-matched algorithm. Results: Overall, 940 patients meeting inclusion criteria were included in the study, of which 174 (18.5%), 187 (19.9%), and 579 (61.6%) underwent SNM, SNM followed by backup lymphadenectomy (LND) and LND alone, respectively. Applying a propensity score matching algorithm (1:1:2) we selected 500 patients, including 125 SNM, 125 SNM/backup LND, and 250 LND. Baseline characteristics of the study population were similar between groups. The prevalence of nodal disease was 14%, 16%, and 12% in patients having SNM, SNM/backup LND and LND, respectively. Overall, 19 (7.6%) patients were diagnosed with low volume nodal disease. The survival analysis comparing the three techniques did not show statistical differences in terms of disease-free (p = 0.750) and overall survival (p = 0.899). Similarly, the type of nodal assessment did not impact survival outcomes after stratification based on uterine risk factors. Conclusion: Our study highlighted that SNM provides similar long-term oncologic outcomes than LND.

Published
2022

15. Assessing the role of minimally invasive radical hysterectomy for early-stage cervical cancer

Author

Bogani, G, Di Donato, V, Muzii, L, Casarin, J, Ghezzi, F, Malzoni, M, Greggi, S, Landoni, F, Bazzurini, L, Zanagnolo, V, Multinu, F, Angioli, R, Plotti, F, Caruso, G, Fischetti, M, Ferrandina, G, Palaia, I, Benedetti Panici, P, Scambia, G, Raspagliesi, F, Bogani, Giorgio, Di Donato, Violante, Muzii, Ludovico, Casarin, Jvan, Ghezzi, Fabio, Malzoni, Mario, Greggi, Stefano, Landoni, Fabio, Bazzurini, Luca, Zanagnolo, Vanna, Multinu, Francesco, Angioli, Roberto, Plotti, Francesco, Caruso, Giuseppe, Fischetti, Margherita, Ferrandina, Gabriella, Palaia, Innocenza, Benedetti Panici, Pierluigi, Scambia, Giovanni, Raspagliesi, Francesco, Bogani, G, Di Donato, V, Muzii, L, Casarin, J, Ghezzi, F, Malzoni, M, Greggi, S, Landoni, F, Bazzurini, L, Zanagnolo, V, Multinu, F, Angioli, R, Plotti, F, Caruso, G, Fischetti, M, Ferrandina, G, Palaia, I, Benedetti Panici, P, Scambia, G, Raspagliesi, F, Bogani, Giorgio, Di Donato, Violante, Muzii, Ludovico, Casarin, Jvan, Ghezzi, Fabio, Malzoni, Mario, Greggi, Stefano, Landoni, Fabio, Bazzurini, Luca, Zanagnolo, Vanna, Multinu, Francesco, Angioli, Roberto, Plotti, Francesco, Caruso, Giuseppe, Fischetti, Margherita, Ferrandina, Gabriella, Palaia, Innocenza, Benedetti Panici, Pierluigi, Scambia, Giovanni, and Raspagliesi, Francesco

Abstract

Surgery is the mainstay of treatment in the management of early-stage cervical cancer. Until the publication of the Laparoscopic Approach to Cervical Cancer (LACC) trial, minimally invasive radical hysterectomy was the recommended approach to treat patients with early-stage disease. The results of the LACC trial questioned the adoption of minimally invasive surgery in cervical cancer. In comparison with the open approach, minimally invasive surgery correlated with worse disease-free and cancer-specific survival. Similarly, other retrospective studies highlighted this correlation, thus corroborating the results of the LACC trials. In the present review, we evaluated current evidence and further prospective of the adoption of minimally invasive radical hysterectomy in cervical cancer. Moreover, we sought to assess some unsolved issues regarding the role of minimally invasive surgery in early-stage cervical cancer patients.

Published
2022

16. 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

17. 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

19. EPV140/#62 Survival outcomes in endometrial cancer patients having lymphadenectomy, sentinel node mapping plus back-up lymphadenectomy and sentinel node mapping alone

Author

Bogani, G, primary, Ghezzi, F, additional, Angioli, R, additional, Papadia, A, additional, Buda, A, additional, Di Donato, V, additional, Plotti, F, additional, De Iaco, P, additional, Perrone, AM, additional, Ferrero, S, additional, Roberti Maggiore, U Leone, additional, Gasparri, ML, additional, Casarin, J, additional, Muzii, L, additional, Mueller, M, additional, Malzoni, M, additional, Landoni, F, additional, Benedetti Panici, P, additional, and Raspagliesi, F, additional

Published
2021
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20. Lymphadenectomy, Sentinel Node Mapping Plus Backup Lymphadenectomy and Sentinel Node Mapping Alone in Endometrial Cancer

Author

Bogani, G., primary, Ghezzi, F., additional, Malzoni, M., additional, di Donato, V., additional, Casarin, J., additional, Ferrero, S., additional, Angioli, R., additional, Plotti, F., additional, Muzii, L., additional, De Iaco, P., additional, Perrone, A.M., additional, Papadia, A., additional, Gasparri, M.L., additional, Buda, A., additional, Landoni, F., additional, Mueller, M.D., additional, Panici, P. Benedetti, additional, and Raspagliesi, F., additional

Published
2021
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21. 10 The adoption of sentinel node mapping with or without backup lymphadenectomy in endometrial cancer

Author

Bogani, G, primary, Angioli, R, additional, Plotti, F, additional, Donato, VDI, additional, Papadia, A, additional, Muzii, L, additional, Benedetti Panici, P, additional, Ferrero, S, additional, Buda, A, additional, Landoni, F, additional, Casarin, J, additional, Ghezzi, F, additional, De Iaco, P, additional, Perrone, AM, additional, and Raspagliesi, F, additional

Published
2021
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24. Prenatal genetic diagnosis: fetal therapy as a possible solution to a positive test

Author

Kiani, A. K., Paolacci, S., Scanzano, P., Michelini, S., Capodicasa, N., D'Agruma, L., Notarangelo, A., Tonini, G., Piccinelli, D., Farshid, K. R., Petralia, P., Fulcheri, E., Buffelli, F., Chiurazzi, P., Terranova, C., Plotti, F., Angioli, R., Castori, M., Pos, O., Szemes, T., and Bertelli, M.

Subjects
prenatal gene therapy, Fetal Therapies, prenatal diagnosis, prenatal stem cell therapy, Pregnancy, fetal drug therapy, Humans, Original Article, Female, prenatal interventions, Aneuploidy, Hernias, Diaphragmatic, Congenital, Fetal drug therapy, Prenatal diagnosis, Prenatal gene therapy, Prenatal interventions, Prenatal stem cell therapy
Abstract

Background: Fetal abnormalities cause 20% of perinatal deaths. Advances in prenatal genetic and other types of screening offer great opportunities for identifying high risk pregnancies. Methods: Through a literature search, here we summarise what are the prenatal diagnostic technique that are being used and how those techniques may allow for prenatal interventions. Results: Next generation sequencing and non-invasive prenatal testing are fundamental for clinical diagnostics because of their sensitivity and accuracy in identifying point mutations, aneuploidies, and microdeletions, respectively. Timely identification of genetic disorders and other fetal abnormalities enables early intervention, such as in-utero gene therapy, fetal drug therapy and prenatal surgery. Conclusion: Prenatal intervention is mainly focused on conditions that may cause death or lifelong disabilities, like spina bifida, congenital diaphragm hernia and sacrococcygeal teratoma; and may be an alternative therapeutic option to termination of pregnancy. However, it is not yet widely available, due to lack of specialized centers. (www.actabiomedica.it)

Published
2020

25. Diet and Chemotherapy: The Effects of Fasting and Ketogenic Diet on Cancer Treatment

Author

Plotti, F., Terranova, C., Luvero, D., Bartolone, M., Messina, G., Feole, L., Cianci, S., Scaletta, G., Marchetti, C., Di Donato, V., Fagotti, A., Scambia, G., Benedetti Panici, P., Angioli, R., Cianci S., Scaletta G., Marchetti C. (ORCID:0000-0001-7098-8956), Fagotti A. (ORCID:0000-0001-5579-335X), Scambia G. (ORCID:0000-0003-2758-1063), Plotti, F., Terranova, C., Luvero, D., Bartolone, M., Messina, G., Feole, L., Cianci, S., Scaletta, G., Marchetti, C., Di Donato, V., Fagotti, A., Scambia, G., Benedetti Panici, P., Angioli, R., Cianci S., Scaletta G., Marchetti C. (ORCID:0000-0001-7098-8956), Fagotti A. (ORCID:0000-0001-5579-335X), and Scambia G. (ORCID:0000-0003-2758-1063)

Abstract

Introduction: Diet may influence various aspects of human health. In fact, it is well known that diet can favour or not the development of various human pathologies, like diabetes, hypertension, and hypercholesterolaemia. Interestingly, diet has an influence in cancer development too (e.g., this relation has been studied for pancreatic, colonic, gastric, and breast cancers). Between the mechanisms that could explain this relation, there is epigenetic. In fact, thanks to epigenetic reprogramming, certain substances introduced with diet could affect gene expression, especially of those genes involved in cells' proliferation and growth. In recent years, some studies have been published about the role that diet could have on chemotherapy outcome. Especially, various studies have analysed the effects of fasting and ketogenic diet (KD) during chemotherapy. The aim of this study is to summarize scientific evidences about diet and its effects on chemotherapy on humans and to better understand if these approaches deserve to be further investigated and might be suitable and beneficial during cancer treatment. Materials and Methods: We performed an electronic literature search of the PubMed database, using the combination of following terms: "fasting"or "ketogenic"with "chemotherapy,""cancer treatment."We included studies on humans about fasting and KD during chemotherapy, excluding reviews, case series including <10 patients, studies conducted on animals or limited to radiotherapy treatment, and studies that were mostly about molecular mechanisms. Results/Discussion In our analysis we included 4 studies (1 randomized controlled trial, 1 retrospective study, and 2 prospective pilot studies) about KD and 4 studies (1 prospective cohort study, 1 case series report, and 2 randomized trials) about fasting during oncological treatments. Authors suggested an improvement of quality of life (QoL) and fatigue in patients under chemotherapy, especially in the 8 days after chemotherap

Published
2020

26. Front-line chemo-immunotherapy with carboplatin-paclitaxel using oregovomab indirect immunization in advanced ovarian cancer: A randomized phase II study

Author

Brewer, M., Angioli, R., Scambia, Giovanni, Lorusso, D., Terranova, C., Panici, P. B., Raspagliesi, F., Scollo, P., Plotti, F., Ferrandina, Maria Gabriella, Salutari, Vanda, Ricci, C., Braly, P., Holloway, R., Method, M., Madiyalakan, M., Bayever, E., Nicodemus, C., Scambia G. (ORCID:0000-0003-2758-1063), Ferrandina G. (ORCID:0000-0003-4672-4197), Salutari V., Brewer, M., Angioli, R., Scambia, Giovanni, Lorusso, D., Terranova, C., Panici, P. B., Raspagliesi, F., Scollo, P., Plotti, F., Ferrandina, Maria Gabriella, Salutari, Vanda, Ricci, C., Braly, P., Holloway, R., Method, M., Madiyalakan, M., Bayever, E., Nicodemus, C., Scambia G. (ORCID:0000-0003-2758-1063), Ferrandina G. (ORCID:0000-0003-4672-4197), and Salutari V.

Abstract

Background: This randomized phase II study tested the hypothesis that schedule dependent chemo-immunotherapy with oregovomab improves progression free survival (PFS) and overall survival (OS) in optimally resected, Stage III/IV ovarian cancer. Methods: Patients from both academic centers and private practice in the US and Italy with Stage III/IV optimally cytoreduced ovarian cancer were randomized to standard six cycle IV carboplatin-paclitaxel chemotherapy (CP) versus CP plus four immunizations with oregovomab (CPO). A translational assessment of a cellular immune response was the primary endpoint; PFS and OS were measured as secondary endpoints. Findings: 97 patients at thirteen centers were accrued to the protocol, 47 to CPO and 50 to CP. Technical issues led to inconsistent performance of the primary CA125 ELISPOT leading to unevaluable results. At a median follow up of 42 months, PFS and OS outcomes revealed an unexpectedly large treatment effect for CPO relative to CP alone, with median PFS of 41.8 months (95% C.I.: 21.8 - N.E.) for CPO and 12.2 months (10.4–18.6) for CP (p = 0.0027, HR 0.46, CI 0.28–0.7). For OS, the median for CPO has not yet been reached (NE) (45.2-NE) and for CP was 43.2 months (31.8-NE) (p = 0.043, HR 0.35, CI 0.16–0.74). The oregovomab treatment resulted in no change in toxicity profile from CP. Interpretation: The previously identified potential clinical benefit of IV CP when administered with oregovomab was further refined in this randomized phase II study. Increases of PFS and OS of statistically and clinically significant magnitude were evident in this study of a front line chemo-immunotherapy treatment of ovarian cancer.

Published
2020

27. Validation of REM score to predict endometrial cancer in patients with ultrasound endometrial abnormalities

Author

Capriglione, S., primary, Plotti, F., additional, Lopez, S., additional, Scaletta, G., additional, Miranda, A., additional, Tatangelo, V., additional, Moncelli, M., additional, Gatti, A., additional, Schirò, M.T., additional, Montera, R., additional, Luvero, D., additional, Aloisi, A., additional, De Cicco Nardone, C., additional, Terranova, C., additional, and Angioli, R., additional

Published
2017
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29. Gynecological cancers in developing countries: the challenge of chemotherapy in low-resources setting

Author

Basile, Stefano, Angioli, R., Manci, N., Palaia, Innocenza, Plotti, F., Panici, P. B., and BENEDETTI PANICI, Pierluigi

Subjects
medicine.medical_specialty, Cyclophosphamide, Genital Neoplasms, Female, medicine.medical_treatment, Medically Underserved Area, Antineoplastic Agents, chemotherapy, medicine, Humans, Intensive care medicine, developing countries, gynecological cancer, Cervical cancer, Vaginal cancer, Chemotherapy, business.industry, Endometrial cancer, Obstetrics and Gynecology, Cancer, medicine.disease, Surgery, Oncology, Health Resources, Female, business, Ovarian cancer, Developed country, medicine.drug
Abstract

The epidemiologic pattern of cancers in developing countries differs in many aspects from that of industrialized nations. Cancer natural history, microbiologic environment, patient's immune system, and drug availability may differ as well. Four of five new cases of cervical cancer and most of cervical cancer deaths occur in developing countries. Where chemoradiation and supportive care facilities are unavailable, it would be logical to consider an inexpensive effective drug. In locally advanced cases, neoadjuvant chemotherapy followed by surgery should be considered the treatment of choice. For ovarian cancer, it may be reasonable to maintain a secure supply of platinum and/or taxanes. For endometrial cancer, platinum compounds are proved active chemotherapic single agents. Oral medroxyprogesterone acetate (MPA) may represent a good chance for treating an advanced or recurrent disease. For vulvar/vaginal cancer, the role of chemotherapy alone is currently considered limited, and it is mostly used as palliative treatment in advanced or recurrent cases. Whenever possible, standard western chemotherapic regimens should be applied in developing countries as well. When standard therapies are unavailable, drugs of choice should be easily accessible, inexpensive, and effective. The most commonly used drugs are cisplatin, cyclophosphamide, and MPA.

Published
2006

33. Carcinoma Epiteliale Dell’ovaio

Author

BENEDETTI PANICI, Pierluigi, DI DONATO, Violante, Fischetti, Margherita, Lo Prete, E., Musella, Angela, Esposito, F., Plotti, F., Gallegati, F., and Bellati, Filippo

Published
2011

34. Carcinoma Dell' Endometrio

Author

BENEDETTI PANICI, Pierluigi, DI DONATO, Violante, Fischetti, M, Lo Prete, E, Musella, A, Plotti, F, Casorelli, A, and Bellati, Filippo

Published
2011

35. Carcinoma Dell’ Cervice Uterina

Author

BENEDETTI PANICI, Pierluigi, DI DONATO, Violante, Loprete, E., Fischetti, M., Musella, A., and Besharat Plotti, F.

Published
2011

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