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Palassini E, Baldi GG, Sulfaro S, Barisella M, Bianchi G, Campanacci D, Fiore M, Gambarotti M, Gennaro M, Morosi C, Navarria F, Palmerini E, Sangalli C, Sbaraglia M, Trama A, Asaftei S, Badalamenti G, Bertulli R, Bertuzzi AF, Biagini R, Bonadonna A, Brunello A, Callegaro D, Cananzi F, Cianchetti M, Collini P, Comandini D, Curcio A, D'Ambrosio L, De Pas T, Dei Tos AP, Ferraresi V, Ferrari A, Franchi A, Frezza AM, Fumagalli E, Ghilli M, Greto D, Grignani G, Guida M, Ibrahim T, Krengli M, Luksch R, Marrari A, Mastore M, Merlini A, Milano GM, Navarria P, Pantaleo MA, Parafioriti A, Pellegrini I, Pennacchioli E, Rastrelli M, Setola E, Tafuto S, Turano S, Valeri S, Vincenzi B, Vitolo V, Ivanescu A, Paloschi F, Casali PG, Gronchi A, Stacchiotti S. Clinical recommendations for treatment of localized angiosarcoma: A consensus paper by the Italian Sarcoma Group. Cancer Treat Rev 2024; 126:102722. [PMID: 38604052 DOI: 10.1016/j.ctrv.2024.102722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 03/17/2024] [Accepted: 03/26/2024] [Indexed: 04/13/2024]
Abstract
Angiosarcoma (AS) represents a rare and aggressive vascular sarcoma, posing distinct challenges in clinical management compared to other sarcomas. While the current European Society of Medical Oncology (ESMO) clinical practice guidelines for sarcoma treatment are applicable to AS, its unique aggressiveness and diverse tumor presentations necessitate dedicated and detailed clinical recommendations, which are currently lacking. Notably, considerations regarding surgical extent, radiation therapy (RT), and neoadjuvant/adjuvant chemotherapy vary significantly in localized disease, depending on each different site of onset. Indeed, AS are one of the sarcoma types most sensitive to cytotoxic chemotherapy. Despite this, uncertainties persist regarding optimal management across different clinical presentations, highlighting the need for further investigation through clinical trials. The Italian Sarcoma Group (ISG) organized a consensus meeting on April 1st, 2023, in Castel San Pietro, Italy, bringing together Italian sarcoma experts from several disciplines and patient representatives from "Sofia nel Cuore Onlus" and the ISG patient advocacy working group. The objective was to develop specific clinical recommendations for managing localized AS within the existing framework of sarcoma clinical practice guidelines, accounting for potential practice variations among ISG institutions. The aim was to try to standardize and harmonize clinical practices, or at least highlight the open questions in the local management of the disease, to define the best evidence-based practice for the optimal approach of localized AS and generate the recommendations presented herein.
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Affiliation(s)
- Elena Palassini
- Medical Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
| | | | | | - Marta Barisella
- Department of Pathology, ASST Fatebenefratelli Sacco, Milano, Italy
| | - Giuseppe Bianchi
- Department of Surgery, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Domenico Campanacci
- Department of Surgery, Azienda Ospedaliera Universitaria Careggi, Firenze, Italy
| | - Marco Fiore
- Department of Surgery, Sarcoma Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Marco Gambarotti
- Department of Pathology, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Massimiliano Gennaro
- Department of Surgery, Breast Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Carlo Morosi
- Department of Radiology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Federico Navarria
- Department of Radiation Oncology, IRCCS Centro di Riferimento Oncologico di Aviano, Aviano, Pordenone, Italy
| | - Emanuela Palmerini
- Department of Medical Oncology, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Claudia Sangalli
- Department of Radiation Therapy, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Marta Sbaraglia
- Department of Pathology, Università di Padova, Padova, Italy
| | - Annalisa Trama
- Department of Edidemiology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Sebastian Asaftei
- Department of Pediatric Oncology, Ospedale Infantile Regina Margherita , Torino
| | - Giuseppe Badalamenti
- Department of Medical Oncology, Azienda Universitaria Policlinico Giaccone, Palermo, Italy
| | - Rossella Bertulli
- Medical Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Alexia Francesca Bertuzzi
- Department of Medical Oncology, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milano, Italy
| | - Roberto Biagini
- Department of Oncological Orthopedics, IRCCS Istituto Nazionale Tumori Regina Elena - Istituti Fisioterapici Ospitalieri, Roma, Italy
| | - Angela Bonadonna
- Department of Medical Oncology, IRCCS Centro di Riferimento Oncologico di Aviano, Aviano, Pordenone, Italy
| | - Antonella Brunello
- Department of Medical Oncology, Istituto Oncologico Veneto IOV IRCCS, Padova, Italy
| | - Dario Callegaro
- Department of Surgery, Sarcoma Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Ferdinando Cananzi
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milano, Italy; Sarcoma, Melanoma and Rare Tumors Surgery Unit, Humanitas Cancer Center, Department of Surgery, IRCCS Humanitas Research Hospital, Rozzano, Milano, Italy
| | | | - Paola Collini
- Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Danila Comandini
- Department of Medical Oncology, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Annalisa Curcio
- Department of Surgery, Ospedale Morgagni e Pierantoni, Forlì, Italy
| | - Lorenzo D'Ambrosio
- Department of Medical Oncology, Ospedale S. Luigi, Orbassano, Torino, Italy
| | - Tommaso De Pas
- Department of Medical Oncology, Humanitas Gavazzeni, Bergamo, Italy
| | | | - Virginia Ferraresi
- Sarcomas and Rare Tumors Departmental Unit, IRCCS Istituto Nazionale Tumori Regina Elena - Istituti Fisioterapici Ospitalieri, Roma, Italy
| | - Andrea Ferrari
- Department of Pediatric Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Alessandro Franchi
- Department of Pathology, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - Anna Maria Frezza
- Medical Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Elena Fumagalli
- Medical Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Matteo Ghilli
- Breast Centre, Department of Oncology, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - Daniela Greto
- Department of Radiation Therapy, Azienda Ospedaliera Universitaria Careggi, Firenze, Italy
| | - Giovanni Grignani
- Department of Medical Oncology, Azienda Ospedaliera Univerisitaria Città della Salute e della Scienza, Torino, Italy
| | - Michele Guida
- Department of Medical Oncology, IRCCS Istituto Tumori di Bari Giovanni Paolo II, Bari, Italy
| | - Toni Ibrahim
- Department of Medical Oncology, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Marco Krengli
- Department of Radiation Therapy, Istituto Oncologico Veneto IOV IRCCS, Padova, Italy
| | - Roberto Luksch
- Department of Pediatric Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Andrea Marrari
- Department of Medical Oncology, Istituto Ortopedico Rizzoli, Bologna, Italy
| | | | - Alessandra Merlini
- Department of Medical Oncology, Ospedale S. Luigi, Orbassano, Torino, Italy
| | | | - Piera Navarria
- Department of Radiation Therapy, IRCCS Humanitas Research Hospital, Rozzano, Milano, Italy
| | - Maria Abbondanza Pantaleo
- Department of Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna', University of Bologna, Bologna, Italy
| | | | - Ilaria Pellegrini
- Medical Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | | | - Marco Rastrelli
- Department of Surgical Oncology, Istituto Oncologico Veneto IOV IRCCS, Padova, Italy; Department of Surgery, Oncology and Gastroenterology (DISCOG), Università di Padova, Padova, Italy
| | - Elisabetta Setola
- Department of Medical Oncology, Istituto Europeo Oncologia, Milano, Italy
| | - Salvatore Tafuto
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale Tumori G. Pascale, Napoli, Italy
| | - Salvatore Turano
- Department of Medical Oncology, Azienda Ospedaliera S.S. Annunziata, Cosenza, Italy
| | - Sergio Valeri
- Department of Surgery, Università Campus Bio-Medico, Roma, Italy
| | - Bruno Vincenzi
- Department of Medical Oncology, Università Campus Bio-Medico, Roma, Italy
| | - Viviana Vitolo
- Department of Radiation Therapy, Centro Nazionale di Adroterapia Oncologica, Fondazione CNAO, Pavia, Italy
| | | | | | - Paolo Giovanni Casali
- Medical Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Alessandro Gronchi
- Department of Surgery, Sarcoma Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Silvia Stacchiotti
- Medical Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
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Ghilli M, Lisa AVE, Salgarello M, Papa G, Rietjens M, Folli S, Curcio A, Ferrari G, Caruso F, Altomare V, Friedman D, De Santis MC, De Rose F, Meduri B, De Felice F, Marino L, Cucciarelli F, Montemezzi S, Panizza P, Belli P, Caumo F, Vinci V, De Santis G, Klinger M, Roncella M. Oncoplastic and reconstructive surgery in SENONETWORK Italian breast centers: lights and shadows. Breast 2024; 73:103601. [PMID: 38043223 PMCID: PMC10731356 DOI: 10.1016/j.breast.2023.103601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 11/08/2023] [Accepted: 11/10/2023] [Indexed: 12/05/2023] Open
Abstract
•Despite the significance of oncoplastic procedure, an italian database is lacking. •Senonetwork established a multidisciplinary survey to assess their safety and efficacy. •Reconstructive outcomes were positive across low and high-volume centers. •After mastectomy, implant-based techniques are common. DTI reconstruction is advantageuos. •This contributes to the global understanding of effective strategies against breast cancer.
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Affiliation(s)
- Matteo Ghilli
- Breast Centre, University Hospital of Pisa (AOUP), Pisa, Italy.
| | - Andrea Vittorio Emanuele Lisa
- Reconstructive and Aesthetic Plastic Surgery School, Department of Medical Biotechnology and Translational Medicine BIOMETRA - Plastic Surgery Unit, University of Milan, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Marzia Salgarello
- Department of Plastic Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCSDirector of the Residency Program of Plastic Surgery, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giovanni Papa
- Department of Plastic Surgery, UCO, University of Trieste, Trieste Italy
| | - Mario Rietjens
- Division of Plastic and Reconstructive Surgery, IEO, IRCCS European Institute of Oncology, Milan Italy
| | - Secondo Folli
- Chirurgia Senologica, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan Italy
| | - Annalisa Curcio
- Chirurgia Senologica Forlì-Ravenna, ASL della Romagna, Italy
| | - Guglielmo Ferrari
- S.C. di Chirurgia Senologica, A.U.S.L.-IRCCS di Reggio Emilia, Italy
| | - Francesco Caruso
- Breast centre, UO Chirurgia oncologica - Dipartimento Oncologico - Humanitas Istituto Clinico Catanese, Misterbianco (CT), Italy
| | - Vittorio Altomare
- UOC Chirurgia Senologica, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Daniele Friedman
- UOC Chirurgia Senologica, Ospedale Policlinico San Martino di Genova, Italy
| | - Maria Carmen De Santis
- SC Radioterapia, SS Radioterapia Tumori della Mammella, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Fiorenza De Rose
- Department of Radiation Oncology, Santa Chiara Hospital, Trento, Italy
| | - Bruno Meduri
- Department of Radiation Oncology, Azienda Ospedaliera - Universitaria di Modena, Italy
| | - Francesca De Felice
- Radiation Oncology, Policlinico Umberto I, Department of Radiological, Oncological and Pathological Sciences, "Sapienza" University of Rome, Italy
| | - Lorenza Marino
- Radioterapia Oncologica, Humanitas Istituto Clinico Catanese, Misterbianco (CT), Italy
| | - Francesca Cucciarelli
- Radiotherapy Department, Azienda Ospedaliero Universitaria delle Marche, Ancona, Italy
| | - Stefania Montemezzi
- Dipartimento Patologia e Diagnostica Azienda Ospedaliera Universitaria Integrata di Verona, Italy
| | - Pietro Panizza
- IRCCS Ospedale San Raffaele, U.O. Radiologia Senologica, Milan, Italy
| | - Paolo Belli
- Dipartimento Diagnostica per Immagini, Radioterapia Oncologica Ed Ematologia, Policlinico Gemelli IRCCS, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Francesca Caumo
- UOC Radiologia Senologica Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy
| | - Valeriano Vinci
- Reconstructive and Aesthetic Plastic Surgery School, Department of Medical Biotechnology and Translational Medicine BIOMETRA - Plastic Surgery Unit, University of Milan, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, IRCCS Humanitas Research Hospital, Rozzano - Milan, Italy
| | - Giorgio De Santis
- Dipartimento di Scienze Mediche e Chirurgiche Materno-Infantili e dell'Adulto, UNIMORE, Modena, Italy
| | - Marco Klinger
- Reconstructive and Aesthetic Plastic Surgery School, Department of Medical Biotechnology and Translational Medicine BIOMETRA - Plastic Surgery Unit, University of Milan, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
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Rocco N, Ghilli M, Curcio A, Bortul M, Burlizzi S, Cabula C, Cabula R, Ferrari A, Folli S, Fortunato L, Frittelli P, Gentilini O, Grendele S, Grassi MM, Grossi S, Magnoni F, Murgo R, Palli D, Rovera F, Sanguinetti A, Taffurelli M, Tazzioli G, Terribile DA, Caruso F, Galimberti V. Is routine axillary lymph node dissection needed to tailor systemic treatments for breast cancer patients in the era of molecular oncology? A position paper of the Italian National Association of Breast Surgeons (ANISC). Eur J Surg Oncol 2024; 50:107954. [PMID: 38217946 DOI: 10.1016/j.ejso.2024.107954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 12/17/2023] [Accepted: 01/05/2024] [Indexed: 01/15/2024]
Abstract
BACKGROUND De-escalation of axillary surgery in breast cancer (BC) management began when sentinel lymph node biopsy (SLNB) replaced axillary lymph node dissection (ALND) as standard of care in patients with node-negative BC. The second step consolidated ALND omission in selected subgroups of BC patients with up to two macrometastases and recognized BC molecular and genomic implication in predicting prognosis and planning adjuvant treatment. Outcomes from the recent RxPONDER and monarchE trials have come to challenge the previous cut-off of two SLN in order to inform decisions on systemic therapies for hormone receptor-positive (HR+), human epidermal growth factor receptor type-2 (HER2) negative BC, as the criteria included a cut-off of respectively three and four SLNs. In view of the controversy that this may lift in surgical practice, the Italian National Association of Breast Surgeons (Associazione Nazionale Italiana Senologi Chirurghi, ANISC) reviewed data regarding the latest trials on this topic and proposes an implementation in clinical practice. MATERIAL AND METHODS We reviewed the available literature offering data on the pathological nodal status of cN0 breast cancer patients. RESULTS The rates of pN2 status in cN0 patients ranges from 3.5 % to 16 %; pre-surgical diagnostic definition of axillary lymph node status in cN0 patients by ultrasound could be useful to inform about a possible involvement of ≥4 lymph nodes in this specific sub-groups of women. CONCLUSIONS The Italian National Association of Breast Surgeons (ANISC) considers that for HR + HER2-/cN0-pN1(sn) BC patients undergoing breast conserving treatment the preoperative workup should be optimized for a more detailed assessment of the axilla and the technique of SLNB should be optimized, if considered appropriate by the surgeon, not considering routine ALND always indicated to determine treatment recommendations according to criteria of eligibility to RxPONDER and monarch-E trials.
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Affiliation(s)
- Nicola Rocco
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.
| | - Matteo Ghilli
- Breast Unit, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | | | - Marina Bortul
- SSD Chirurgia Senologica e Breast Unit, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy Naples, Italy
| | - Stefano Burlizzi
- UOSD Chirurgia Senologica, Ospedale "A. Perrino", Brindisi, Italy
| | - Carlo Cabula
- Chirurgia Senologica Azienda Ospedaliera Brotzu, Cagliari, Italy
| | - Roberta Cabula
- Cagliari University Hospital, Surgery Unit, Cagliari, Italy
| | - Alberta Ferrari
- SSD Chirurgia Tumori eredo-famigliari, SC Chirurgia Generale 3, Senologia, Fondazione IRCCS Policlinico san Matteo, Pavia, Italy
| | - Secondo Folli
- SC di Chirurgia Oncologica-Senologia, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Lucio Fortunato
- Breast Center, San Giovanni-Addolorata Hospital, Rome, Italy
| | - Patrizia Frittelli
- UOC Chirurgia senologica, Ospedale Isola Tiberina Gemelli Isola, Rome, Italy
| | - Oreste Gentilini
- Breast Unit, IRCCS Ospedale San Raffaele di Milano, Milan, Italy
| | - Sara Grendele
- Breast Surgery, Department of Functional Oncology, Alto Vicentino Hospital, Santorso, Vicenza, Italy
| | | | | | - Francesca Magnoni
- Division of Senology, European Institute of Oncology, IRCCS, Milan, Italy
| | - Roberto Murgo
- Chirurgia Senologica, IRCCS Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy
| | - Dante Palli
- UOC di Chirurgia Generale ad Indirizzo Senologico-Breast Unit AUSL Piacenza, Italy
| | - Francesca Rovera
- S.S.D. Breast Unit - Ospedale Universitario, Varese, Italy; Dipartimento di Medicina e Innovazione Tecnologica, Università degli Studi dell'Insubria, Varese, Italy
| | - Alessandro Sanguinetti
- SSD Chirurgia della Mammella - Dipartimento di Chirurgia, Azienda Ospedaliera "S.Maria", Terni, Italy
| | - Mario Taffurelli
- Breast Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico di Sant'Orsola, Bologna, Italy
| | | | | | - Francesco Caruso
- Breast Unit, Humanitas Istituto Clinico Catanese, Misterbianco, (CT), Italy; National Association of Breast Surgeons (ANISC), Italy
| | - Viviana Galimberti
- Division of Senology, European Institute of Oncology, IRCCS, Milan, Italy
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Gasparri ML, Albasini S, Truffi M, Favilla K, Tagliaferri B, Piccotti F, Bossi D, Armatura G, Calcinotto A, Chiappa C, Combi F, Curcio A, Della Valle A, Ferrari G, Folli S, Ghilli M, Listorti C, Mancini S, Marinello P, Mele S, Pertusati A, Roncella M, Rossi L, Rovera F, Segattini S, Sgarella A, Tognali D, Corsi F. Low neutrophil-to-lymphocyte ratio and pan-immune-inflammation-value predict nodal pathologic complete response in 1274 breast cancer patients treated with neoadjuvant chemotherapy: a multicenter analysis. Ther Adv Med Oncol 2023; 15:17588359231193732. [PMID: 37720495 PMCID: PMC10504832 DOI: 10.1177/17588359231193732] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 07/24/2023] [Indexed: 09/19/2023] Open
Abstract
Background Systemic inflammatory markers draw great interest as potential blood-based prognostic factors in several oncological settings. Objectives The aim of this study is to evaluate whether neutrophil-to-lymphocyte ratio (NLR) and pan-immune-inflammation value (PIV) predict nodal pathologic complete response (pCR) after neoadjuvant chemotherapy (NAC) in node-positive (cN+) breast cancer (BC) patients. Design Clinically, cN+ BC patients undergoing NAC followed by breast and axillary surgery were enrolled in a multicentric study from 11 Breast Units. Methods Pretreatment blood counts were collected for the analysis and used to calculate NLR and PIV. Logistic regression analyses were performed to evaluate independent predictors of nodal pCR. Results A total of 1274 cN+ BC patients were included. Nodal pCR was achieved in 586 (46%) patients. At multivariate analysis, low NLR [odds ratio (OR) = 0.71; 95% CI, 0.51-0.98; p = 0.04] and low PIV (OR = 0.63; 95% CI, 0.44-0.90; p = 0.01) were independently predictive of increased likelihood of nodal pCR. A sub-analysis on cN1 patients (n = 1075) confirmed the statistical significance of these variables. PIV was significantly associated with axillary pCR in estrogen receptor (ER)-/human epidermal growth factor receptor 2 (HER2)+ (OR = 0.31; 95% CI, 0.12-0.83; p = 0.02) and ER-/HER2- (OR = 0.41; 95% CI, 0.17-0.97; p = 0.04) BC patients. Conclusion This study found that low NLR and PIV levels predict axillary pCR in patients with BC undergoing NAC. Registration Eudract number NCT05798806.
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Affiliation(s)
- Maria Luisa Gasparri
- Department of Gynecology and Obstetrics, Ospedale Regionale di Lugano EOC, Lugano, Switzerland
- Centro di Senologia della Svizzera Italiana, Ospedale Regionale di Lugano EOC, Lugano, Switzerland
| | - Sara Albasini
- Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Marta Truffi
- Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Karin Favilla
- Scuola di specializzazione in Chirurgia Generale, Università di Milano, Milano, Italy
| | | | | | - Daniela Bossi
- Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Giulia Armatura
- Chirurgia Generale, Ospedale Centrale di Bolzano, Azienda Sanitaria dell’Alto Adige, Bolzano, Italy
| | - Arianna Calcinotto
- Institute of Oncology Research (IOR), Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
- Università della Svizzera italiana, Faculty of Biomedical Sciences, Lugano, Switzerland
| | | | - Francesca Combi
- International PhD School in Clinical and Experimental Medicine (CEM), University of Modena and Reggio Emilia, Modena, Italy
- Division of Breast Surgical Oncology, Department of Medical and Surgical, Maternal-Infantile and Adult Sciences, University Hospital of Modena, Modena, Italy
| | - Annalisa Curcio
- Chirurgia Senologica, Ospedale Morgagni Pierantoni, Ausl Romagna, Forlì, Italy
| | - Angelica Della Valle
- General Surgery 3- Breast Surgery, Department of Surgery, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Secondo Folli
- Breast Unit, Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Matteo Ghilli
- Breast Cancer Centre, University Hospital of Pisa, Pisa, Italy
| | - Chiara Listorti
- Breast Unit, Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Stefano Mancini
- Breast Surgery, Department of Surgery, ASST Fatebenefratelli Sacco, Milano, Italy
| | - Peter Marinello
- Chirurgia Generale, Ospedale Centrale di Bolzano, Azienda Sanitaria dell’Alto Adige, Bolzano, Italy
| | - Simone Mele
- Breast Surgery Unit, AUSL-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Anna Pertusati
- Breast Surgery, Department of Surgery, ASST Fatebenefratelli Sacco, Milano, Italy
| | | | - Lorenzo Rossi
- Centro di Senologia della Svizzera Italiana, Ospedale Regionale di Lugano EOC, Lugano, Switzerland
- Institute of Oncology of Southern Switzerland (IOSI), Bellinzona, Switzerland
| | | | - Silvia Segattini
- Division of Breast Surgical Oncology, Department of Medical and Surgical, Maternal-Infantile and Adult Sciences, University Hospital of Modena, Modena, Italy
| | - Adele Sgarella
- General Surgery 3 – Breast Surgery, Department of Surgery, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Università degli studi di Pavia, Pavia, Italy
| | - Daniela Tognali
- Chirurgia Senologica, Ospedale Morgagni Pierantoni, Ausl Romagna, Forlì, Italy
| | - Fabio Corsi
- Istituti Clinici Scientifici Maugeri IRCCS, Via Maugeri 4, Pavia, Lombardia, Italy
- Dipartimento di Scienze Biomediche e Cliniche, Università di Milano, Milano, Italy
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Santonastaso DP, de Chiara A, Righetti R, Marandola D, Sica A, Bagaphou CT, Rosato C, Tognù A, Curcio A, Lucchi L, Russo E, Agnoletti V. Efficacy of bi-level erector spinae plane block versus bi-level thoracic paravertebral block for postoperative analgesia in modified radical mastectomy: a prospective randomized comparative study. BMC Anesthesiol 2023; 23:209. [PMID: 37328817 PMCID: PMC10273752 DOI: 10.1186/s12871-023-02157-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 05/29/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND Postoperative analgesia in breast surgery is difficult due to the extensive nature of the surgery and the complex innervation of the breast; general anesthesia can be associated with regional anesthesia techniques to control intra- and post-postoperative pain. This randomized comparative study aimed to compare the efficacy of the erector spinae plane block and the thoracic paravertebral block in radical mastectomy procedures with or without axillary emptying. METHODS This prospective randomized comparative study included 82 adult females who were randomly divided into two groups using a computer-generated random number. Both groups, Thoracic Paraverterbal block group and Erector Spinae Plane Block group (41 patients each), received general anesthesia associated with a multilevel single-shot thoracic paravertebral block and a multilevel single-shot erector spinae plane block, respectively. Postoperative pain intensity (expressed as Numeric Rating Scale), patients who needed rescue analgesic, intra- and post-operative opioid consumption, post-operative nausea and vomiting, length of stay, adverse events, chronic pain at 6 months, and the patient's satisfaction were recorded. RESULTS At 2 h (p < 0.001) and 6 h (p = 0.012) the Numeric Rating Scale was significantly lower in Thoracic Paraverterbal block group. The Numeric Rating Scale at 12, 24, and 36 postoperative hours did not show significant differences. There were no significant differences also in the number of patients requiring rescue doses of NSAIDs, in intra- and post-operative opioid consumption, in post-operative nausea and vomiting episodes and in the length of stay. No failures or complications occurred in the execution of techniques and none of the patients reported any chronic pain at six months from the surgery. CONCLUSIONS Both thoracic paravertebral block and erector spinae plane block can be effectively used in controlling post-mastectomy pain with no significant differences between the two blocks. TRIAL REGISTRATION The study was prospectively registered on Clinicaltrials.gov (trial identifier NCT04457115) (first registration 27/04/2020).
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Affiliation(s)
- Domenico P Santonastaso
- Anesthesia and Intensive Care Unit, AUSL Romagna, M.Bufalini Hospital, Viale Ghirotti 286-47521, Cesena, Italy.
| | - Annabella de Chiara
- Anesthesia and Intensive Care Unit, AUSL Romagna, M.Bufalini Hospital, Viale Ghirotti 286-47521, Cesena, Italy
| | - Roberto Righetti
- Anesthesia and Intensive Care Unit, AUSL Romagna, Santa Maria Delle Croci Hospital, Viale Randi 5, 48121, Ravenna, Italy
| | - Diego Marandola
- Anesthesia and Intensive Care Unit, AUSL Romagna, M.Bufalini Hospital, Viale Ghirotti 286-47521, Cesena, Italy
| | - Andrea Sica
- Anesthesia and Intensive Care Unit, AUSL Romagna, M.Bufalini Hospital, Viale Ghirotti 286-47521, Cesena, Italy
| | - Claude T Bagaphou
- Section of Anesthesia, Intensive Care and Pain Medicine, Ospedale Di Città Di Castello - USL Umbria1, Città Di Castello, Perugia, Italy
| | - Chiara Rosato
- Anesthesia and Intensive Care Unit, AUSL Romagna, M.Bufalini Hospital, Viale Ghirotti 286-47521, Cesena, Italy
| | - Andrea Tognù
- Section of Anesthesia and Intensive Care Unit, Istituto Ortopedico Rizzoli, Ospedale Mazzolani Vandini, Via Nazionale Ponente, 7, 44011, Argenta, Italy
| | - Annalisa Curcio
- General Surgery Unit, AUSL Romagna, Santa Maria Delle Croci Hospital, Viale Randi 5, 48121, Ravenna, Italy
| | - Leonardo Lucchi
- Day Surgery - Breast Unit, AUSL Romagna, M.Bufalini Hospital, Viale Ghirotti, 286-47521, Cesena, FC, Italy
| | - Emanuele Russo
- Anesthesia and Intensive Care Unit, AUSL Romagna, M.Bufalini Hospital, Viale Ghirotti 286-47521, Cesena, Italy
| | - Vanni Agnoletti
- Anesthesia and Intensive Care Unit, AUSL Romagna, M.Bufalini Hospital, Viale Ghirotti 286-47521, Cesena, Italy
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6
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Merloni F, Palleschi M, Gianni C, Casadei C, Curcio A, Romeo A, Rocchi M, Cima S, Sirico M, Sarti S, Cecconetto L, Mariotti M, Di Menna G, De Giorgi U. Locoregional treatment of de novo stage IV breast cancer in the era of modern oncology. Front Oncol 2023; 13:1083297. [PMID: 36793604 PMCID: PMC9923000 DOI: 10.3389/fonc.2023.1083297] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 01/09/2023] [Indexed: 01/31/2023] Open
Abstract
Approximately 6% of metastatic breast cancers arise de novo. While systemic therapy (ST) remains the treatment backbone as for patients with metachronous metastases, locoregional treatment (LRT) of the primary tumor remains a controversial method. The removal of the primary has an established role for palliative purposes, but it is unclear if it could also determine a survival benefit. Retrospective evidence and pre-clinical studies seem to support the removal of the primary as an effective approach to improve survival. On the other hand, most randomized evidence suggests avoiding LRT. Both retrospective and prospective studies suffer several limitations, ranging from selection bias and outdated ST to a small sample of patients. In this review we discuss available data and try to identify subgroups of patients which could benefit the most from LRT of the primary, to facilitate clinical practice decisions, and to hypothesize future studies design on this topic.
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Affiliation(s)
- Filippo Merloni
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Michela Palleschi
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Caterina Gianni
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Chiara Casadei
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Annalisa Curcio
- Breast Surgery Unit, Pierantoni-Morgagni Hospital Forlì and Santa Maria delle Croci Hospital Ravenna, Forli, Italy
| | - Antonino Romeo
- Radiotherapy Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Maddalena Rocchi
- Breast Surgery Unit, Pierantoni-Morgagni Hospital Forlì and Santa Maria delle Croci Hospital Ravenna, Forli, Italy
| | - Simona Cima
- Radiotherapy Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Marianna Sirico
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Samanta Sarti
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Lorenzo Cecconetto
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Marita Mariotti
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Giandomenico Di Menna
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Ugo De Giorgi
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
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7
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Sirico M, Virga A, Conte B, Urbini M, Ulivi P, Gianni C, Merloni F, Palleschi M, Gasperoni M, Curcio A, Saha D, Buono G, Muñoz M, De Giorgi U, Schettini F. Neoadjuvant endocrine therapy for luminal breast tumors: State of the art, challenges and future perspectives. Crit Rev Oncol Hematol 2023; 181:103900. [PMID: 36565894 DOI: 10.1016/j.critrevonc.2022.103900] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 12/16/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
Neoadjuvant endocrine treatment (NET) associates to satisfactory rates of breast conservative surgery and conversions from inoperable to operable hormone receptor-positive (HR+)/HER2-negative breast cancer (BC), with less toxicities than neoadjuvant chemotherapy (NACT) and similar outcomes. Hence, it has been proposed as a logical alternative to NACT in patients with HR+/HER2- BC candidate to a neoadjuvant approach. Nevertheless, potential barriers to the widespread use of NET include the heterogeneous nature of patient response coupled with the long duration needed to achieve a clinical response. However, interest in NET has significantly increased in the last decade, owing to more in-depth investigation of several biomarkers for a more adequate patient selection and on-treatment benefit monitoring, such as PEPI score, Ki67 and genomic assays. This review is intended to describe the state-of-the-art regarding NET, its future perspectives and potential integration with molecular biomarkers for the optimal selection of patients, regimen and duration of (neo)adjuvant treatments.
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Affiliation(s)
- Marianna Sirico
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Alessandra Virga
- Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Benedetta Conte
- Translational Genomics and Targeted Therapies in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Milena Urbini
- Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Paola Ulivi
- Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Caterina Gianni
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Filippo Merloni
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Michela Palleschi
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Marco Gasperoni
- Breast Surgery Unit, Morgagni-Pierantoni Hospital, AUSL Romagna, Forlì, Italy
| | - Annalisa Curcio
- Breast Surgery Unit, Morgagni-Pierantoni Hospital, AUSL Romagna, Forlì, Italy
| | - Debjani Saha
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Giuseppe Buono
- Department of Breast and Thoracic Oncology, National Cancer Institute, Fondazione G. Pascale, Naples, Italy
| | - Montserrat Muñoz
- Translational Genomics and Targeted Therapies in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; Medical Oncology Department, Hospital Clinic of Barcelona, Barcelona, Spain; Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - Ugo De Giorgi
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Francesco Schettini
- Translational Genomics and Targeted Therapies in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; Medical Oncology Department, Hospital Clinic of Barcelona, Barcelona, Spain; Faculty of Medicine, University of Barcelona, Barcelona, Spain
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8
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Ferri S, Cacciola F, Zaccaria R, Ghetti I, Curcio A, Germanò AF. Neuronavigated Retropharyngeal Anterior Screw Fixation of the Odontoid for the Treatment of C2 Type II Fractures: Case Report. Acta Neurochir Suppl 2023; 135:279-282. [PMID: 38153482 DOI: 10.1007/978-3-031-36084-8_43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
Odontoid fractures, frequently observed in patients over the age of 70, often involve the base of the axis (Anderson-D'Alonzo type 2). For surgical treatment, posterior C1-C2 fixation is the traditional method, whose fusion rates range between 93 and 100%. However, morbidity and mortality rates are high. In addition, cervical motion, especially axial rotation, is postoperatively reduced. Nakanishi and Bohler introduced the anterior screw fixation approach for the surgical treatment of odontoid fracture type II. This procedure preserves the atlantoaxial complex motion, provides immediate stability and high fracture healing rates, and, most importantly, has a low incidence of complications with good fusion rates. The surgical strategy must take into account the patient's anatomy, the morphological characteristics of the fracture, the quality of the bone, and any concomitant injuries. In this chapter, we describe a C2 type II fracture treated via a neuronavigated anterior retropharyngeal approach.
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Affiliation(s)
- S Ferri
- Department of Biomedical and Dental Science and Morphofunctional Imaging, Unit of Neurosurgery, University of Messina, Messina, Italy
| | - F Cacciola
- Department of Biomedical and Dental Science and Morphofunctional Imaging, Unit of Neurosurgery, University of Messina, Messina, Italy
| | - R Zaccaria
- Department of Biomedical and Dental Science and Morphofunctional Imaging, Unit of Neurosurgery, University of Messina, Messina, Italy
| | - I Ghetti
- Department of Biomedical and Dental Science and Morphofunctional Imaging, Unit of Neurosurgery, University of Messina, Messina, Italy
| | - A Curcio
- Department of Biomedical and Dental Science and Morphofunctional Imaging, Unit of Neurosurgery, University of Messina, Messina, Italy
| | - Antonino Francesco Germanò
- Department of Biomedical and Dental Science and Morphofunctional Imaging, Unit of Neurosurgery, University of Messina, Messina, Italy.
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9
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Curcio A, Angileri FF, Zaccaria R, Germanò AF. Avoiding the Blinded Funnel: A Combined Single Piece Fronto-Temporo-Orbito-Zygomatic Craniotomy Endoscopic-Assisted Approach with Multimodal Assistance for an Epidermoid Tumor of Meckel's Cave-Case Report. Acta Neurochir Suppl 2023; 135:109-114. [PMID: 38153457 DOI: 10.1007/978-3-031-36084-8_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
A Meckel's cave tumor poses a great challenge because of the peculiar neurovascular structure of the area and the deep location. Multiple surgical approaches have been designed for this area. In this report, we describe a case treated with a combined one step single piece fronto-temporo-orbito-zygomatic craniotomy (FTOZ) endoscopic-assisted approach for the treatment of an epidermoid tumor of Meckel's cave. A 51-year-old woman presented with a clinical history of left trigeminal neuralgia and paresthesia. CT imaging revealed a left basal temporal tumor. MR showed a tumor located in Meckel's cave near the cavernous sinus, with a good enhancement after gadolinium administration. The tumor was resected through a lateral basal subtemporal extradural approach followed by an intradural approach using intraoperative neuronavigation, endoscopic assistance, neurophysiological monitoring, and an intraoperative ultrasound probe. The lesion was completely removed. No new onset neurological damage has occurred. The symptoms improved following surgery. The aesthetic appearance of the patient was respected. The combined approach with a single piece fronto-temporo-orbito-zygomatic craniotomy has enabled us to work on a wider operating field to completely remove the lesion avoiding blind spots.
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Affiliation(s)
- A Curcio
- Department of Biomedical and Dental Science and Morphofunctional Imaging, Unit of Neurosurgery, University of Messina, Messina, Italy
| | - F F Angileri
- Department of Biomedical and Dental Science and Morphofunctional Imaging, Unit of Neurosurgery, University of Messina, Messina, Italy
| | - R Zaccaria
- Department of Biomedical and Dental Science and Morphofunctional Imaging, Unit of Neurosurgery, University of Messina, Messina, Italy
| | - Antonino Francesco Germanò
- Department of Biomedical and Dental Science and Morphofunctional Imaging, Unit of Neurosurgery, University of Messina, Messina, Italy.
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10
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Zaccaria R, Cacciola F, Caruso G, Ferri S, Caffo M, Curcio A, Ghetti I, Germanò A. Correlation Between Cervical Spine Sagittal Alignment and Clinical Outcome After Standalone Intersomatic Titanium Cage CeSPACE for Cervical Anterior Discectomy and Fusion in Cervical Degenerative Disk Diseases. Acta Neurochir Suppl 2023; 135:361-366. [PMID: 38153494 DOI: 10.1007/978-3-031-36084-8_55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
The aim of this study was to determine the relationship between cervical spine sagittal alignment and clinical outcomes after using a standalone intersomatic titanium cage CeSPACE for anterior cervical discectomy and arthrodesis. We present our clinical experience in a group of 180 patients with a mean follow-up for at least 2 years. Patients were evaluated by clinical and radiological assessment preoperatively, immediately after surgery and at regular follow-up. There were 97 male and 83 female patients (average age: 56.6 years) who were preoperatively affected by cervical radiculomyelopathy that was due to spondylosis or cervical disk herniation and who underwent surgical treatment. All patients underwent an anterior discectomy and interbody fusion through the positioning of one or more levels of the CeSPACE device. Compared with the preoperative scores, improvement was seen in postoperative visual analog scale (VAS) scores and Neck Disability Index (NDI) values. The standalone intersomatic titanium cage CeSPACE for anterior cervical discectomy and arthrodesis improved radiculomyelopathy and increased the probability of cervical kyphotic alignment. However, cervical sagittal alignment after surgery was not significantly associated with clinical outcomes in terms of postoperative improvement in VAS scores and NDI values. Similarly, the change in cervical sagittal alignment was not related to visual analog scale scores or Neck Disability Index values.
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Affiliation(s)
- R Zaccaria
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Unit of Neurosurgery, University of Messina, Messina, Italy
| | - F Cacciola
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Unit of Neurosurgery, University of Messina, Messina, Italy
| | - G Caruso
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Unit of Neurosurgery, University of Messina, Messina, Italy
| | - S Ferri
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Unit of Neurosurgery, University of Messina, Messina, Italy
| | - M Caffo
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Unit of Neurosurgery, University of Messina, Messina, Italy
| | - A Curcio
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Unit of Neurosurgery, University of Messina, Messina, Italy
| | - I Ghetti
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Unit of Neurosurgery, University of Messina, Messina, Italy
| | - A Germanò
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Unit of Neurosurgery, University of Messina, Messina, Italy.
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11
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Merloni F, Palleschi M, Casadei C, Romeo A, Curcio A, Casadei R, Stella F, Ercolani G, Gianni C, Sirico M, Cima S, Sarti S, Cecconetto L, Di Menna G, De Giorgi U. Oligometastatic breast cancer and metastasis-directed treatment: an aggressive multimodal approach to reach the cure. Ther Adv Med Oncol 2023; 15:17588359231161412. [PMID: 36950272 PMCID: PMC10026139 DOI: 10.1177/17588359231161412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 02/16/2023] [Indexed: 03/20/2023] Open
Abstract
Metastatic breast cancer (BC) is considered an incurable disease and is usually treated with palliative intent. However, about 50% of metastatic BCs present with only a few metastatic lesions and are characterized by longer overall survival. These patients, defined as oligometastatic, could benefit from a multimodal approach, which combines systemic therapy with metastasis-directed treatment (stereotactic ablative therapy or surgery). The current definition of oligometastatic seems incomplete since it is based only on imaging findings and does not include biological features, and the majority of relevant data supporting this strategy comes from retrospective or non-randomized studies. However, the chance of reaching long-term complete remission or even a cure has led to the development of randomized trials investigating the impact of combined treatment in oligometastatic BC (OMBC). The SABR-COMET trial, the first randomized study to include BC patients, showed promising results from a combination of stereotactic ablative radiotherapy and systemic therapy. Considering the randomized trial's results, multidisciplinary teams should be set up to select OMBC patients who could achieve long-term survival with aggressive multimodal treatment.
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Affiliation(s)
| | - Michela Palleschi
- Department of Medical Oncology, IRCCS Istituto
Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola,
Italy
| | - Chiara Casadei
- Department of Medical Oncology, IRCCS Istituto
Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola,
Italy
| | - Antonino Romeo
- Radiotherapy Unit, IRCCS Istituto Romagnolo per
lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Annalisa Curcio
- Breast Surgery Unit, Pierantoni-Morgagni
Hospital Forlì and Santa Maria delle Croci Hospital, Ravenna, Italy
| | - Roberto Casadei
- Orthopedic Unit, Morgagni-Pierantoni Hospital,
Ausl Romagna, Forlì, Italy
| | - Franco Stella
- Division of Thoracic Surgery, Department of
Experimental, Diagnostic and Specialty Medicine—DIMES of the Alma Mater
Studiorum, University of Bologna, Forlì, Italy
| | - Giorgio Ercolani
- Department of Medical and Surgical
Sciences-DIMEC, Alma Mater Studiorum – University of Bologna, Bologna,
Italy
- General and Oncology Surgery,
Morgagni-Pierantoni Hospital, Ausl Romagna, Forlì, Italy
| | - Caterina Gianni
- Department of Medical Oncology, IRCCS Istituto
Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola,
Italy
| | - Marianna Sirico
- Department of Medical Oncology, IRCCS Istituto
Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola,
Italy
| | - Simona Cima
- Radiotherapy Unit, IRCCS Istituto Romagnolo
per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
| | - Samanta Sarti
- Department of Medical Oncology, IRCCS Istituto
Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola,
Italy
| | - Lorenzo Cecconetto
- Department of Medical Oncology, IRCCS Istituto
Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola,
Italy
| | - Giandomenico Di Menna
- Department of Medical Oncology, IRCCS Istituto
Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola,
Italy
| | - Ugo De Giorgi
- Department of Medical Oncology, IRCCS Istituto
Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola,
Italy
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12
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Nadarajah R, Ludman P, Appelman Y, Brugaletta S, Budaj A, Bueno H, Huber K, Kunadian V, Leonardi S, Lettino M, Milasinovic D, Gale CP, Budaj A, Dagres N, Danchin N, Delgado V, Emberson J, Friberg O, Gale CP, Heyndrickx G, Iung B, James S, Kappetein AP, Maggioni AP, Maniadakis N, Nagy KV, Parati G, Petronio AS, Pietila M, Prescott E, Ruschitzka F, Van de Werf F, Weidinger F, Zeymer U, Gale CP, Beleslin B, Budaj A, Chioncel O, Dagres N, Danchin N, Emberson J, Erlinge D, Glikson M, Gray A, Kayikcioglu M, Maggioni AP, Nagy KV, Nedoshivin A, Petronio AP, Roos-Hesselink JW, Wallentin L, Zeymer U, Popescu BA, Adlam D, Caforio ALP, Capodanno D, Dweck M, Erlinge D, Glikson M, Hausleiter J, Iung B, Kayikcioglu M, Ludman P, Lund L, Maggioni AP, Matskeplishvili S, Meder B, Nagy KV, Nedoshivin A, Neglia D, Pasquet AA, Roos-Hesselink JW, Rossello FJ, Shaheen SM, Torbica A, Gale CP, Ludman PF, Lettino M, Bueno H, Huber K, Leonardi S, Budaj A, Milasinovic (Serbia) D, Brugaletta S, Appelman Y, Kunadian V, Al Mahmeed WAR, Kzhdryan H, Dumont C, Geppert A, Bajramovic NS, Cader FA, Beauloye C, Quesada D, Hlinomaz O, Liebetrau C, Marandi T, Shokry K, Bueno H, Kovacevic M, Crnomarkovic B, Cankovic M, Dabovic D, Jarakovic M, Pantic T, Trajkovic M, Pupic L, Ruzicic D, Cvetanovic D, Mansourati J, Obradovic I, Stankovic M, Loh PH, Kong W, Poh KK, Sia CH, Saw K, Liška D, Brozmannová D, Gbur M, Gale CP, Maxian R, Kovacic D, Poznic NG, Keric T, Kotnik G, Cercek M, Steblovnik K, Sustersic M, Cercek AC, Djokic I, Maisuradze D, Drnovsek B, Lipar L, Mocilnik M, Pleskovic A, Lainscak M, Crncic D, Nikojajevic I, Tibaut M, Cigut M, Leskovar B, Sinanis T, Furlan T, Grilj V, Rezun M, Mateo VM, Anguita MJF, Bustinza ICM, Quintana RB, Cimadevilla OCF, Fuertes J, Lopez F, Dharma S, Martin MD, Martinez L, Barrabes JA, Bañeras J, Belahnech Y, Ferreira-Gonzalez I, Jordan P, Lidon RM, Mila L, Sambola A, Orvin K, Sionis A, Bragagnini W, Cambra AD, Simon C, Burdeus MV, Ariza-Solé A, Alegre O, Alsina M, Ferrando 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Potpara T, Marinkovic M, Mihajlovic M, Mujovic N, Kocijancic A, Mijatovic Z, Radovanovic M, Matic D, Milosevic A, Savic L, Subotic I, Uscumlic A, Zlatic N, Antonijevic J, Vesic O, Vucic R, Martinovic SS, Kostic T, Atanaskovic V, Mitic V, Stanojevic D, Petrovic M. Cohort profile: the ESC EURObservational Research Programme Non-ST-segment elevation myocardial infraction (NSTEMI) Registry. Eur Heart J Qual Care Clin Outcomes 2022; 9:8-15. [PMID: 36259751 DOI: 10.1093/ehjqcco/qcac067] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 10/11/2022] [Indexed: 11/12/2022]
Abstract
AIMS The European Society of Cardiology (ESC) EURObservational Research Programme (EORP) Non-ST-segment elevation myocardial infarction (NSTEMI) Registry aims to identify international patterns in NSTEMI management in clinical practice and outcomes against the 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without ST-segment-elevation. METHODS AND RESULTS Consecutively hospitalised adult NSTEMI patients (n = 3620) were enrolled between 11 March 2019 and 6 March 2021, and individual patient data prospectively collected at 287 centres in 59 participating countries during a two-week enrolment period per centre. The registry collected data relating to baseline characteristics, major outcomes (in-hospital death, acute heart failure, cardiogenic shock, bleeding, stroke/transient ischaemic attack, and 30-day mortality) and guideline-recommended NSTEMI care interventions: electrocardiogram pre- or in-hospital, pre-hospitalization receipt of aspirin, echocardiography, coronary angiography, referral to cardiac rehabilitation, smoking cessation advice, dietary advice, and prescription on discharge of aspirin, P2Y12 inhibition, angiotensin converting enzyme inhibitor (ACEi)/angiotensin receptor blocker (ARB), beta-blocker, and statin. CONCLUSION The EORP NSTEMI Registry is an international, prospective registry of care and outcomes of patients treated for NSTEMI, which will provide unique insights into the contemporary management of hospitalised NSTEMI patients, compliance with ESC 2015 NSTEMI Guidelines, and identify potential barriers to optimal management of this common clinical presentation associated with significant morbidity and mortality.
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Affiliation(s)
- Ramesh Nadarajah
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, LS2 9JT Leeds, UK.,Leeds Institute of Data Analytics, University of Leeds, LS2 9JT Leeds, UK.,Department of Cardiology, Leeds Teaching Hospitals NHS Trust, LS1 3EX Leeds, UK
| | - Peter Ludman
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK
| | - Yolande Appelman
- Department of Cardiology, Amsterdam UMC-Vrije Universiteit, Amsterdam Cardiovascular Sciences, Amsterdam, Netherlands
| | - Salvatore Brugaletta
- Hospital Clinic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Andrzej Budaj
- Department of Cardiology, Center of Postgraduate Medical Education, Grochowski Hospital, Warsaw, Poland
| | - Hector Bueno
- Cardiology Department, Hospital Universitario 12 de Octubre and Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain.,Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain.,Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Kurt Huber
- 3rd Medical Department, Cardiology and Intensive Care Medicine, Clinic Ottakring (Wilhelminenhospital), Vienna, Austria.,Medical Faculty, Sigmund Freud University, Vienna, Austria
| | - Vijay Kunadian
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Sergio Leonardi
- University of Pavia, Pavia, Italy.,Fondazione IRCCS Policlinico S.Matteo, Pavia, Italy
| | - Maddalena Lettino
- Cardio-Thoracic and Vascular Department, San Gerardo Hospital, ASST-Monza, Monza, Italy
| | - Dejan Milasinovic
- Department of Cardiology, University Clinical Center of Serbia and Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Chris P Gale
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, LS2 9JT Leeds, UK.,Leeds Institute of Data Analytics, University of Leeds, LS2 9JT Leeds, UK.,Department of Cardiology, Leeds Teaching Hospitals NHS Trust, LS1 3EX Leeds, UK
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Sibilio A, Bucchi E, Alfieri C, Marongiu F, Curcio A. Successful retrieval of a needle point from the breast through a vacuum-assisted breast biopsy system. Acta Radiol Open 2022; 11:20584601221143499. [PMID: 36507313 PMCID: PMC9732792 DOI: 10.1177/20584601221143499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 11/18/2022] [Indexed: 12/12/2022] Open
Abstract
Stereotactic vacuum-assisted breast biopsy (VABB) system is generally used to perform breast biopsies after identifying suspicious lesions that are occult on ultrasound. In this case, we used an 8-Gauge VABB to retrieve a needle point retained in the outer-lower quadrant of the right breast of a patient previously treated with lumpectomy. The use of stereotactic VABB system in this specific clinical setting has been never described before and resulted minimally invasive and perfectly suitable for correct localisation and retrieval of the 3-mm needle point; moreover, it may be easily reproduced elsewhere.
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Affiliation(s)
- Andrea Sibilio
- UOC - Chirurgia Senologica
Forlì-Ravenna, Ravenna (RA),
Italy,Andrea Sibilio, U.O.C, Chirurgia Senologica
Forlì-Ravenna, P.O. Ravenna, Viale Randi, 5 - 48121, Ravenna, Italy.
| | - Elisa Bucchi
- Centro di Prevenzione
Oncologica, Lugo (RA), Italy
| | | | | | - Annalisa Curcio
- UOC - Chirurgia Senologica
Forlì-Ravenna, Ravenna (RA),
Italy
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14
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Sibilio A, Curcio A, Toesca A, Rossi EMC, Corso G. Local treatment in patients with hereditary breast cancer: decision-making process in low-, moderate-, high-penetrance pathogenic germline mutation carriers. Curr Opin Oncol 2022; 34:614-622. [PMID: 36170166 DOI: 10.1097/cco.0000000000000872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW We summarize recent evidence regarding commonly tested breast cancer susceptibility genes and review indications derived from recently published guidelines regarding management of carriers affected by early breast cancer (BC). RECENT FINDINGS Management of affected women with a known genetic predisposition to BC was matter of debate at the most relevant international conferences, such as St. Gallen International Consensus Conference and San Antonio Breast Cancer Symposium held both in 2021. At the same time, a joint Experts Panel from American Society of Clinical Oncology/American Society for Radiation Oncology/Society of Surgical Oncology (ASCO/ASTRO/SSO) convened to develop recommendations to support clinical decision-making in this specific setting and results about administration of new systemic therapies such as poly adenosine diphosphate-ribose polymerase (PARP) inhibitors became available. SUMMARY Population of patients affected by BC and carriers of mutations in susceptibility genes is progressively increasing, but new mutations identified do not always have a clear clinical impact.To date, we have data to support consideration of different local management choices for affected patients carrying specific mutations, but some issues especially relating to breast-conserving surgery or administration of radiotherapy in these patients, still need to be better addressed. Opinions about the best way to treat these patients are still heterogeneous and information deriving from different sources seems to be conflicting at times. Our purpose is to offer a synopsis of the different evidence available that may be helpful in clinical decision making.
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Affiliation(s)
- Andrea Sibilio
- UOC Chirurgia Senologica Forlì-Ravenna, AUSL Romagna, Forlì, Italy
| | - Annalisa Curcio
- UOC Chirurgia Senologica Forlì-Ravenna, AUSL Romagna, Forlì, Italy
| | - Antonio Toesca
- Division of Breast Surgery, Candiolo Cancer Institute, IRCCS, Candiolo, Italy
| | | | - Giovanni Corso
- Division of Breast Surgery, IEO, European Institute of Oncology, IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- European Cancer Prevention Organization (ECP), Milan, Italy
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15
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Tinterri C, Gentile D, Gatzemeier W, Sagona A, Barbieri E, Testori A, Errico V, Bottini A, Marrazzo E, Dani C, Dozin B, Boni L, Bruzzi P, Fernandes B, Franceschini D, Spoto R, Torrisi R, Scorsetti M, Santoro A, Canavese G, Custodero O, Troilo VL, Taffurelli M, Cucchi MC, Galluzzo V, Cabula C, Cabula R, Lazzaretti MG, Caruso F, Castiglione G, Grossi S, Tavoletta MS, Rossi C, Curcio A, Friedman D, Fregatti P, Magni C, Tazzioli G, Papi S, Giovanazzi R, Chifu C, Bettini R, Pezzella M, Michieletto S, Saibene T, Roncella M, Ghilli M, Sibilio A, Cariello A, Coiro S, Falco G, Meli EZ, Fortunato L, Ciuffreda L, Murgo R, Battaglia C, Rubino L, Biglia N, Bounous V, Rovera FA, Chiappa C, Pollini G, Mirandola S, Meneghini G, Di Bartolo F. ASO Visual Abstract: Preservation of Axillary Lymph Nodes Compared with Complete Dissection in T1-2 Breast Cancer Patients Presenting 1-2 Metastatic Sentinel Lymph Nodes: The Multicenter Randomized Clinical Trial SINODAR-ONE. Ann Surg Oncol 2022. [DOI: 10.1245/s10434-022-11908-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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16
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Giliberti A, Curcio A, Marchitto N, Di Lullo L, Paolozzi F, Nano F, Pironti M, Raimondi G. Comparison of Ferric Sodium EDTA in Combination with Vitamin C, Folic Acid, Copper Gluconate, Zinc Gluconate, and Selenomethionine as Therapeutic Option for Chronic Kidney Disease Patients with Improvement in Inflammatory Status. Nutrients 2022; 14:nu14102116. [PMID: 35631257 PMCID: PMC9145680 DOI: 10.3390/nu14102116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 05/14/2022] [Accepted: 05/15/2022] [Indexed: 01/23/2023] Open
Abstract
Anemia is one of the most frequent and earliest complications of chronic kidney disease (CKD), which impacts a patient’s quality of life and increases the risk of adverse clinical outcomes. Patients’ inflammatory status is strictly related to the occurrence of functional iron deficiency anemia (IDA) because this causes an increase in hepcidin levels with the consequent inhibition of iron absorption and release from cellular stores into blood circulation. The aim of this study was to evaluate the use of the new oral formulation based on ferric sodium EDTA in combination with vitamin C, folic acid, copper gluconate, zinc gluconate, and selenomethionine (Ferachel Forte®) in patients with moderate CKD and functional IDA, analyzing the inflammatory status in addition to iron blood parameters, in comparison with oral ferrous sulfate and liposomal iron therapies. Sixty-two elderly patients were randomly allocated to one of the following oral treatments for 6 months: ferrous sulfate (Group 1; N = 20), ferric sodium EDTA in combination (Group 2; N = 22), and ferric liposomal formulation (Group 3; N = 20). The evaluated parameters included iron profile parameters of hemoglobin (Hb), sideremia, ferritin, transferrin saturation, C-reactive protein (CRP), and hepcidin. The results showed that in Group 1, there were no improvements. In Group 2, there were statistically significant (p < 0.001) improvements in all evaluated parameters. Finally, in Group 3, there were significant improvements in all evaluated parameters except for hepcidin, which was less than that of Group 2 patients. In conclusion, the findings showed the superior efficacy of the formulation based on ferric sodium EDTA over the other oral iron sources, and that this formulation can contribute to reducing the systemic inflammatory status in patients with CKD.
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Affiliation(s)
- Antonella Giliberti
- Department of Nephrology and Dialysis, “Santa Maria delle Grazie” Hospital Pozzuoli, 80078 Naples, Italy;
| | - Annalisa Curcio
- Medical Department, Aqma Italia S.p.A., 80138 Naples, Italy; (F.N.); (M.P.)
- Correspondence: ; Tel.: +39-3482322796
| | - Nicola Marchitto
- Department of Internal Medicine, “San Giovanni di Dio” Hospital, 04022 Fondi, Italy;
| | - Luca Di Lullo
- Department of Nephrology and Dialysis, “L. Parodi-Delfino” Hospital, 00034 Colleferro, Italy;
| | - Fulvia Paolozzi
- Department of Pharmacy, Pellegrini Hospital, 80134 Naples, Italy;
| | - Fabiana Nano
- Medical Department, Aqma Italia S.p.A., 80138 Naples, Italy; (F.N.); (M.P.)
| | - Michele Pironti
- Medical Department, Aqma Italia S.p.A., 80138 Naples, Italy; (F.N.); (M.P.)
| | - Gianfranco Raimondi
- Department of Medico-Surgical Sciences and Biotechnologies, Faculty of Internal Medicine, “Sapienza” University of Rome, 04100 Latina, Italy;
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Curcio A, Gatti G. Time-domain study of the synchrotron radiation emitted from electron beams in plasma focusing channels. Phys Rev E 2022; 105:025201. [PMID: 35291175 DOI: 10.1103/physreve.105.025201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 01/12/2022] [Indexed: 06/14/2023]
Abstract
This paper sheds light on the time structure of betatron radiation, emitted by electrons that undergo betatron oscillations as they accelerate under the action of plasma wakefields. It is a common practice to assume that the betatron pulses are as short as the electron bunch length, however we show that this is not a general rule. Indeed, the betatron pulse length is affected by the betatron motion, which stretches and modulates the radiation pulses already at the source level. Propagation in a vacuum, therefore, can greatly lengthen the betatron pulses by orders of magnitude. In the wake of the above, the coherent emission of betatron radiation is studied. Coherent betatron radiation has been found to propagate in an underdense region created by ponderomotive forces, thus not suppressed by the overdense plasma absorption. This could be observed experimentally, revealing information on the acceleration process and on key beam parameters.
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Affiliation(s)
- A Curcio
- Centro de Laseres Pulsados (CLPU), Edificio M5. Parque Científico. C/ Adaja, 8. 37185 Villamayor, Salamanca, Spain
| | - G Gatti
- Centro de Laseres Pulsados (CLPU), Edificio M5. Parque Científico. C/ Adaja, 8. 37185 Villamayor, Salamanca, Spain
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18
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Marongiu F, Bertozzi N, Sibilio A, Curcio A. The First Use of Autologous Dermal Patch in DTI Pre-Pectoral Breast Reconstruction After Skin Reducing Mastectomy: A New Useful and Cheap Reconstruction Option. Aesthetic Plast Surg 2022; 46:590-592. [PMID: 33825071 DOI: 10.1007/s00266-021-02246-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 03/15/2021] [Indexed: 10/21/2022]
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19
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Corsi F, Albasini S, Sorrentino L, Armatura G, Carolla C, Chiappa C, Combi F, Curcio A, Della Valle A, Ferrari G, Gasparri ML, Gentilini O, Ghilli M, Listorti C, Mancini S, Marinello P, Meani F, Mele S, Pertusati A, Roncella M, Rovera F, Sgarella A, Tazzioli G, Tognali D, Folli S. Development of a novel nomogram-based online tool to predict axillary status after neoadjuvant chemotherapy in cN+ breast cancer: A multicentre study on 1,950 patients. Breast 2021; 60:131-137. [PMID: 34624755 PMCID: PMC8503563 DOI: 10.1016/j.breast.2021.09.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 09/30/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Type of axillary surgery in breast cancer (BC) patients who convert from cN + to ycN0 after neoadjuvant chemotherapy (NAC) is still debated. The aim of the present study was to develop and validate a preoperative predictive nomogram to select those patients with a low risk of residual axillary disease after NAC, in whom axillary surgery could be minimized. PATIENTS AND METHODS 1950 clinically node-positive BC patients from 11 Breast Units, treated by NAC and subsequent surgery, were included from 2005 to 2020. Patients were divided in two groups: those who achieved nodal pCR vs. those with residual nodal disease after NAC. The cohort was divided into training and validation set with a geographic separation criterion. The outcome was to identify independent predictors of axillary pathologic complete response (pCR). RESULTS Independent predictive factors associated to nodal pCR were axillary clinical complete response (cCR) after NAC (OR 3.11, p < 0.0001), ER-/HER2+ (OR 3.26, p < 0.0001) or ER+/HER2+ (OR 2.26, p = 0.0002) or ER-/HER2- (OR 1.89, p = 0.009) BC, breast cCR (OR 2.48, p < 0.0001), Ki67 > 14% (OR 0.52, p = 0.0005), and tumor grading G2 (OR 0.35, p = 0.002) or G3 (OR 0.29, p = 0.0003). The nomogram showed a sensitivity of 71% and a specificity of 73% (AUC 0.77, 95%CI 0.75-0.80). After external validation the accuracy of the nomogram was confirmed. CONCLUSION The accuracy makes this freely-available, nomogram-based online tool useful to predict nodal pCR after NAC, translating the concept of tailored axillary surgery also in this setting of patients.
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Affiliation(s)
- Fabio Corsi
- Breast Unit, Department of Surgery, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy; Department of Biomedical and Clinical Sciences "Luigi Sacco", Università di Milano, Milan, Italy.
| | - Sara Albasini
- Breast Unit, Department of Surgery, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Luca Sorrentino
- Department of Biomedical and Clinical Sciences "Luigi Sacco", Università di Milano, Milan, Italy
| | - Giulia Armatura
- Chirurgia Generale, Ospedale Centrale di Bolzano, Azienda Sanitaria dell'Alto Adige, Italy
| | - Claudia Carolla
- Breast Unit, Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Francesca Combi
- Breast Unit Azienda Ospedaliero-Universitaria Policlinico Modena, Italy
| | - Annalisa Curcio
- Chirurgia Senologica, Ospedale Morgagni Pierantoni, Ausl Romagna, Forlì, Italy
| | - Angelica Della Valle
- Breast Surgery, Department of Surgery, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Guglielmo Ferrari
- Breast Surgery Unit, AUSL-IRCCS Reggio Emilia, Via Amendola 2, 42122, Reggio Emilia, Italy
| | - Maria Luisa Gasparri
- Service of Gynecology and Obstetrics, Department of Gynecology and Obstetrics, Ospedale Regionale di Lugano EOC, Lugano, Switzerland; Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Oreste Gentilini
- Breast Surgery, San Raffaele University and Research Hospital, Milano, Italy
| | - Matteo Ghilli
- Breast Cancer Centre, University Hospital of Pisa, Italy
| | - Chiara Listorti
- Breast Unit, Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Stefano Mancini
- Breast Surgery, Department of Surgery, ASST Fatebenefratelli Sacco, Milano, Italy
| | - Peter Marinello
- Chirurgia Generale, Ospedale Centrale di Bolzano, Azienda Sanitaria dell'Alto Adige, Italy
| | - Francesco Meani
- Service of Gynecology and Obstetrics, Department of Gynecology and Obstetrics, Ospedale Regionale di Lugano EOC, Lugano, Switzerland
| | - Simone Mele
- Breast Surgery Unit, AUSL-IRCCS Reggio Emilia, Via Amendola 2, 42122, Reggio Emilia, Italy
| | - Anna Pertusati
- General Surgery I, Department of Surgery, ASST Fatebenefratelli Sacco, Milano, Italy
| | | | | | - Adele Sgarella
- Breast Surgery, Department of Surgery, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Università degli Studi di Pavia, Pavia, Italy
| | - Giovanni Tazzioli
- Breast Unit Azienda Ospedaliero-Universitaria Policlinico Modena, Italy
| | - Daniela Tognali
- Chirurgia Senologica, Ospedale Morgagni Pierantoni, Ausl Romagna, Forlì, Italy
| | - Secondo Folli
- Breast Unit, Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Marongiu F, Bertozzi N, Sibilio A, Tognali D, Mingozzi M, Curcio A. The First Use of Human-Derived ADM in Prepectoral Direct-to-Implant Breast Reconstruction after Skin-Reducing Mastectomy. Aesthetic Plast Surg 2021; 45:2048-2057. [PMID: 33782725 DOI: 10.1007/s00266-021-02231-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 03/11/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Large and ptotic breasts always represented a great reconstructive challenge for plastic surgeons. In order to deal with these patients, we started performing Wise-pattern skin-reducing mastectomies (SRM) followed by direct-to-implant breast reconstructions (DTI-BR) in the prepectoral space where the implants were covered with the autologous adipo-dermal flap and a human acellular dermal matrix called MODA. MATERIALS AND METHOD We retrospectively reviewed all patients that underwent Wise-pattern SRM followed by MODA-assisted, prepectoral, DTI-BR between January 2017 and November 2019 at our Institution. Inclusion criteria were large ptotic breast and pinch test >2cm, while exclusion criteria were smoking >10 cigarettes/day, history of prior radiotherapy, patients supposedly requiring breast implants bigger than 550cc or post-mastectomy radiotherapy. Patients' data were collected through their electronic medical records. Both short- and long-term outcomes were reported. RESULTS Seventeen patients underwent Wise-pattern SRM followed by MODA-assisted, prepectoral, DTI-BR for a total of twenty-one breast reconstruction and fourteen matching procedures. Mean follow-up was 13.4 months (SD= ±3.67). No major complication was reported. Three (14.3%) reconstructed breasts had minor complications: 2 (9.5%) minimal (<1cm2) wound dehiscence and 1 (4.8%) de-epithelization of the skin at the T junction that were treated conservatively. Drainages gave mean output of 410.59 ml (SD= ±214.83) and were kept in place on average for 8.59 days (SD= ±3.45). CONCLUSION Few are the reports in the literature regarding DTI-BR following SRM and even fewer are those where BR was performed in the prepectoral space. Our work demonstrated the safety of prepectoral DTI-BR following SRM in selected patients in accordance with the "conservative reconstruction" principles. Furthermore, we confirmed the reliability of MODA in accordance with previously published works. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Marongiu F, Bertozzi N, Sibilio A, Tognali D, Mingozzi M, Curcio A. Invited Response on: Comment on "The First use of Human-Derived ADM in Prepectoral Direct-to-Implant Breast Reconstruction after Skin Reducing Mastectomy.". Aesthetic Plast Surg 2021; 45:1934-1935. [PMID: 33948719 DOI: 10.1007/s00266-021-02329-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 04/19/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Francesco Marongiu
- O.U. Breast Surgery Unit, Morgagni-Pierantoni Hospital, Ausl Romagna, Via Carlo Forlanini 34, 47100, Forli (FC), Italy.
| | - Nicolò Bertozzi
- O.U. Breast Surgery Unit, Morgagni-Pierantoni Hospital, Ausl Romagna, Via Carlo Forlanini 34, 47100, Forli (FC), Italy
| | - Andrea Sibilio
- O.U. Breast Surgery Unit, Morgagni-Pierantoni Hospital, Ausl Romagna, Via Carlo Forlanini 34, 47100, Forli (FC), Italy
| | - Daniela Tognali
- O.U. Breast Surgery Unit, Morgagni-Pierantoni Hospital, Ausl Romagna, Via Carlo Forlanini 34, 47100, Forli (FC), Italy
| | - Matteo Mingozzi
- O.U. Breast Surgery Unit, Morgagni-Pierantoni Hospital, Ausl Romagna, Via Carlo Forlanini 34, 47100, Forli (FC), Italy
| | - Annalisa Curcio
- O.U. Breast Surgery Unit, Morgagni-Pierantoni Hospital, Ausl Romagna, Via Carlo Forlanini 34, 47100, Forli (FC), Italy
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Pompili R, Chiadroni E, Cianchi A, Curcio A, Del Dotto A, Ferrario M, Galletti M, Romeo S, Scifo J, Shpakov V, Villa F, Zigler A. Time-resolved study of nonlinear photoemission in radio-frequency photoinjectors. Opt Lett 2021; 46:2844-2847. [PMID: 34129555 DOI: 10.1364/ol.423880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 05/16/2021] [Indexed: 06/12/2023]
Abstract
Photoemission is one of the fundamental processes that describes the generation of charged particles from materials irradiated by photons. The continuous progress in the development of ultrashort lasers allows investigation into the dynamics of the process at the femtosecond timescale. Here we report about experimental measurements using two ultrashort ultraviolet laser pulses to temporally probe the electrons release from a copper cathode in a radio-frequency photoinjector. By changing their relative delay, we studied how the release mechanism is affected by two-photon photoemission when tens of GW/cm2 intensities are employed. We evaluated the limits it poses on the achievable beam brightness and analyzed the resulting emission yield in terms of the electronic temperature by modeling the cathode as a two-temperature system.
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Marongiu F, Bertozzi N, Sibilio A, Gasperoni M, Curcio A. "Bifidus pedicle", The Use of Bilobed Superomedial Pedicle for Breast Reshaping Following Upper Outer Quadrantectomy: A New Oncoplastic Breast Surgery Technique. Aesthetic Plast Surg 2021; 45:866-874. [PMID: 32978658 DOI: 10.1007/s00266-020-01982-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 09/12/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The aim of this work was to describe our technique, the "Bifidus pedicle", which is a modification of the superomedial pedicle, for managing large breast cancers (BCs) in the upper outer quadrant (UOQ) in patients with medium/large breasts and associated ptosis. Observed complications, cosmetic outcome and oncologic safety were also reported. MATERIALS AND METHODS Thirty patients underwent our modification of the superomedial pedicle combined with a Wise skin resection pattern for large BCs in the UOQ. All patients underwent contralateral Wise pattern breast reduction/mastopexy for symmetry. RESULTS The average weight of the quadrantectomy specimen was 235 grams (range: 36-400 grams). Mean free tumour margin was 19.4 mm (range: 16-30). Mean operative time was 165 minutes (range: 150-220). Eight (13.2%) breasts had minor complications: two partial NAC necrosis, and six minimal wound dehiscences. Mean follow-up was 22 months (range: 12-30). Overall satisfaction rate was 91%; patients reported to be satisfied the most with the shape (92%) of the breasts, the achieved symmetry (94%), and the volume (85%), focusing on the fullness in the UOQ. CONCLUSIONS Our Bifidus pedicle allowed to fill even wide defects in the UOQ, because we selectively employed it in patients with medium to large ptotic breasts where the lower pole had enough tissue to be displaced. Satisfactory cosmetic and oncologic outcomes were achieved with low complication rate. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Francesco Marongiu
- O.U. Breast Surgical Unit, Morgagni-Pierantoni Hospital, Ausl Romagna, Via Carlo Forlanini 34, 47100, Forli, FC, Italy.
| | - Nicolò Bertozzi
- Plastic and Reconstructive Surgery Unit, San Martino Hospital, Division of Plastic Surgery, Diagnostic and Surgical Sciences Department (DISC), University of Genoa, San Martino Institute for Research and Care, University of Genoa, L.go R. Benzi 10, Genoa, 16132, GE, Italy
| | - Andrea Sibilio
- O.U. Breast Surgical Unit, Morgagni-Pierantoni Hospital, Ausl Romagna, Via Carlo Forlanini 34, 47100, Forli, FC, Italy
| | - Marco Gasperoni
- O.U. Breast Surgical Unit, Morgagni-Pierantoni Hospital, Ausl Romagna, Via Carlo Forlanini 34, 47100, Forli, FC, Italy
| | - Annalisa Curcio
- O.U. Breast Surgical Unit, Morgagni-Pierantoni Hospital, Ausl Romagna, Via Carlo Forlanini 34, 47100, Forli, FC, Italy
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Curcio A, Mou S, Palumbo L, Lupi S, Petrarca M. Selection rules for the orbital angular momentum of optically produced THz radiation. Opt Lett 2021; 46:1514-1517. [PMID: 33793468 DOI: 10.1364/ol.416814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 02/22/2021] [Indexed: 06/12/2023]
Abstract
In this work, we theoretically study the transduction of orbital angular momentum (OAM) l for infrared pump lasers into the THz domain. In the case of optical rectification, the transduction of OAM occurs only through a spin-orbit interaction, with the selection rule on the OAM l=0 valid for any kind of polarization of the pump, which means that there is no transfer of OAM along the propagation axis. In difference frequency generation, the selection rule for the difference Δl between the OAM of the pump fields with linear or circular polarization is l=Δl, whereas l ranges from Δl-2 to Δl+2 in cases of both radial and azimuthal polarization. Moreover, for THz generation in the latter case, the high diffraction obtained with tightly focused pumps yields l tending to Δl±2, while l tends to zero in the opposite case of large pump beams.
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Sgarzani R, Pasquali S, Buggi F, Tognali D, Marongiu F, Mingozzi M, Melandri D, Morselli PG, Curcio A. Sub-muscular Reconstruction after NAC Sparing Mastectomy: Direct to Implant Breast Reconstruction with Human ADM Versus Tissue Expander. Aesthetic Plast Surg 2021; 45:413-420. [PMID: 33078212 DOI: 10.1007/s00266-020-02007-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 10/04/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Nipple areola complex (NAC) sparing mastectomy allows good oncological and aesthetic results. The study compares the results, in terms of self-evaluated satisfaction and symmetry, of direct to implant (DTI) sub-muscular breast reconstruction, with the aid of human acellular dermal matrix (ADM) versus two-stage reconstruction with sub-muscular tissue expander, followed by implant. MATERIALS AND METHODS This is a retrospective, observational, single-center, non-randomized, case-control study. Inclusion criteria were: unilateral NAC sparing mastectomy at Forlì Hospital between 2014 and 2018; sub-muscular reconstruction; minimum follow-up of 12 months from the reconstructive stage; no history of radiotherapy. Patients were divided into two groups: group A included patients who underwent DTI breast reconstruction with the aid of human ADM; group B were those who underwent a two-stage reconstruction with tissue expander then implant. We collected data on: (1) Self-evaluated satisfaction by Breast Q questionnaire (scores from 0 to 100). (2) Observer-evaluated symmetry. Bi-dimensional photographs were collected and evaluated by 11 breast surgeons blinded to each other, who assigned a score for symmetry (from 0 to 10). (3) Symmetry of anthropometric measures collected by hand and volume estimated by Breast V application. RESULTS Group A included 28 patients; group included B 26 patients. Breast-Q questionnaires reported the following results: satisfaction with breasts in group A 65 ± 12 versus group B 68 ± 14; satisfaction with outcome in group A 88 ± 16 versus group B 93 ± 11; psychosocial well-being in group A 71 ± 20 versus group B 76 ± 17; sexual well-being in group A 63 ± 26 versus group B 60 ± 13; physical well-being in group A 68 ± 15 versus group B 60 ± 12. The average symmetry breast score assigned to group A was 6.9, versus group B 7.2. Regarding the anthropometric measures in group A, the differences between right and left were major to those in group B. Regarding breast volume, the mean difference between right and left in group A was 31.89 cc ± 24.97, whereas in group B was 25.46 cc ± 23.59. CONCLUSION Our data show better symmetry and better psychosocial well-being in the two-stage reconstruction, and higher satisfaction with sexual and physical well-being in DTI reconstructions. These aspects should be discussed with the patient while collecting the informed consent. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Rocca A, Cortesi P, Cortesi L, Gianni L, Matteucci F, Fantini L, Maestri A, Giunchi DC, Cavanna L, Ciani R, Falcini F, Bagni A, Meldoli E, Dall’Agata M, Volpi R, Andreis D, Nanni O, Curcio A, Lucchi L, Amadori D, Fedeli A. Phase II study of liposomal doxorubicin, docetaxel and trastuzumab in combination with metformin as neoadjuvant therapy for HER2-positive breast cancer. Ther Adv Med Oncol 2021; 13:1758835920985632. [PMID: 33613693 PMCID: PMC7876584 DOI: 10.1177/1758835920985632] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 12/11/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The aim of this study was to improve activity over single human epidermal growth factor receptor 2 (HER2)-blockade sequential neaodjuvant regimens for HER2-positive breast cancer, by exploiting the concomitant administration of trastuzumab, taxane and anthracycline, while restraining cardiac toxicity with use of liposomal doxorubicin, and by adding metformin, based on preliminary evidence of antitumor activity. PATIENTS AND METHODS This multi-center, single-arm, two-stage phase II trial, assessed the safety and the activity of a new treatment regimen for HER2-positive, early or locally advanced breast cancer. Patients received six 21-day cycles of non-pegylated liposomal doxorubicin, 50 mg/m2 intravenously (i.v.) on day 1, docetaxel, 30 mg/m2 i.v. on days 2 and 9, trastuzumab, 2 mg/kg/week i.v. on days 2, 9, and 16 (with 4 mg/kg loading dose), in association with metformin 1000 mg orally twice daily. The primary endpoint was the rate of pathological complete response (pCR) in the breast and axilla (ypT0/is ypN0). A subgroup of patients performed a 3-deoxy-3-18F-fluorothymidine positron emission tomography (FLT-PET) at baseline and after one cycle. RESULTS Among 47 evaluable patients, there were 18 pCR [38.3%, 95% confidence interval (CI) 24.5-53.6%]. A negative estrogen-receptor status, high Ki67, and histological grade 3 were related with pCR, although only grade reached statistical significance. FLT-PET maximum standardized uptake value after one cycle was inversely related to pCR in the breast (odds ratio 0.29, 95% CI 0.06-1.30, p = 0.11). Toxicity included grade 3-4 neutropenia in 70% and febrile neutropenia in 4% of patients, grade 1-2 nausea/vomiting in 60%/38%, and grade 3 in 4%/2%, respectively, grade 1-2 diarrhea in 72%, and grade 3 in 6%. There were two cases of reversible grade 2 left-ventricular ejection-fraction decrease, and one case of sharp troponin-T increase. CONCLUSIONS The concomitant administration of trastuzumab, liposomal doxorubicin, docetaxel, and metformin is safe and shows good activity, but does not appear to improve activity over conventional sequential regimens.
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Affiliation(s)
- Andrea Rocca
- Department of Clinical and Experimental Oncology and Hematology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Via Maroncelli 40, Meldola 47014, Italy
| | - Pietro Cortesi
- Department of Clinical and Experimental Oncology and Hematology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Laura Cortesi
- Department of Oncology and Hematology, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
| | - Lorenzo Gianni
- Department of Medical Oncology, Infermi Hospital, Rimini, Italy
| | - Federica Matteucci
- Nuclear Medicine Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Lorenzo Fantini
- Nuclear Medicine Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Antonio Maestri
- Department of Medical Oncology, Santa Maria della Scaletta Hospital, Imola, Italy
| | - Donata Casadei Giunchi
- Department of Clinical and Experimental Oncology and Hematology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Luigi Cavanna
- Department of Onco-Hematology, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Rosa Ciani
- Cancer Prevention Unit, Azienda Usl della Romagna, Forlì, Italy
| | - Fabio Falcini
- Cancer Prevention Unit, Azienda Usl della Romagna, Forlì, Italy Romagna Cancer Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Antonella Bagni
- Breast Diagnostic Unit, Maurizio Bufalini Hospital, Cesena, Italy
| | - Elena Meldoli
- Breast Diagnostic Unit, Maurizio Bufalini Hospital, Cesena, Italy
| | - Monia Dall’Agata
- Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Roberta Volpi
- Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Daniele Andreis
- Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Oriana Nanni
- Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Annalisa Curcio
- Breast Surgery Unit, Morgagni-Pierantoni Hospital, Forlì, Italy
| | - Leonardo Lucchi
- Breast Surgery Unit, Maurizio Bufalini Hospital, Forlì, Italy
| | - Dino Amadori
- Department of Clinical and Experimental Oncology and Hematology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Anna Fedeli
- Department of Clinical and Experimental Oncology and Hematology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
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Curcio A, Temperoni G, Tramontano M, De Angelis S, Iosa M, Mommo F, Cochi G, Formisano R. The effects of aquatic therapy during post-acute neurorehabilitation in patients with severe traumatic brain injury: a preliminary randomized controlled trial. Brain Inj 2020; 34:1630-1635. [PMID: 32991207 DOI: 10.1080/02699052.2020.1825809] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The primary aim is to verify the effectiveness of an aquatic training (AT) in inpatients with severe Traumatic Brain Injury (sTBI) on balance. The secondary aims are to explore the effects on gait, activities of daily living, and quality of life, comparing to a land-based conventional protocol. METHODS Two-arm, randomized controlled trial. Twenty inpatients with sTBI, Glasgow Coma Scale score ≤8, and Level of Cognitive Functioning ≥7 were recruited and randomly assigned to the aquatic therapy group (ATG) or to the Conventional Training Group (CTG). Patients underwent 12 individual rehabilitation sessions (3 days/week, 4 weeks), in a rehabilitation pool during the post-acute intensive neurorehabilitation. The primary outcome measure was the Berg Balance Scale (BBS). Secondary outcome measures were the Modified Barthel Index (MBI), Disability Rating Scale (DRS), Tinetti Gait Balance Scale (TBG) and Quality of Life After Brain Injury (QOLIBRI). All the evaluations were performed at the baseline and after 4 weeks of training. RESULTS The within-subjects analysis showed a significant improvement both in ATG and CTG in MBI, BBS, TBG, and QOLIBRI. CONCLUSION Our results may support the use of AT during post-acute phase to improve motor functions and quality of life in patients with sTBI.
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Affiliation(s)
- A Curcio
- Fondazione Santa Lucia IRCCS , Rome, Italy
| | | | - Marco Tramontano
- Fondazione Santa Lucia IRCCS , Rome, Italy.,Department of Movement, Human and Health Sciences, University of Rome "Foro Italico," Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System , Rome, Italy
| | | | - M Iosa
- Fondazione Santa Lucia IRCCS , Rome, Italy
| | - F Mommo
- Fondazione Santa Lucia IRCCS , Rome, Italy
| | - G Cochi
- Fondazione Santa Lucia IRCCS , Rome, Italy
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Marongiu F, de Tullio D, Tognali D, Nensor P, Pasquali S, Sibilio A, Sgarzani R, Mingozzi M, Buggi F, Curcio A. A human-derived acellular dermal matrix for breast reconstruction: The first European experience. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)30634-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Farolfi A, Petracci E, Serra L, Ravaioli A, Bravaccini S, Ravaioli S, Tumedei MM, Ulivi P, Canale M, Puccetti M, Falcini F, Folli S, Curcio A, Rocca A. Tumor-Infiltrating Lymphocytes (TILs) and Risk of a Second Breast Event After a Ductal Carcinoma in situ. Front Oncol 2020; 10:1486. [PMID: 32974178 PMCID: PMC7466557 DOI: 10.3389/fonc.2020.01486] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 07/13/2020] [Indexed: 01/21/2023] Open
Abstract
Women with a diagnosis of ductal carcinoma in situ (DCIS) have a high risk of developing a second breast event (SBE). The immune system might play a role in trying to prevent a SBE. Patients diagnosed with DCIS were identified in the population-based cancer registry of Area Vasta Romagna from 1997 to 2010. Median follow-up is 8.5 years. Tumor-infiltrating lymphocytes (TILs) were evaluated both in index DCIS and in SBE. The main endpoint was to assess the association between TILs' levels in index DCIS and risk of a SBE. Out of 496 DCIS patients, 100 SBEs (20.2%) were identified: 55 ipsilateral (11.1%) and 43 contralateral (8.7%). The distribution of TILs was heterogeneous, but significantly associated with grade, necrosis, screen detection and type of surgery. Patients stratified according to TILs percentage (≤5% and >5%) did not show a statistically significant difference in the 5-year cumulative incidence of SBEs: 14.9% (95% CI 11.3–19.1) and 11.0% (95% CI, 6.9–16.2), respectively (p = 0.147). In the subgroup of patients who did not receive radiotherapy, TILs >5% were associated with a reduced risk of SBE (HR 0.34, 95% CI 0.14–0.82, p = 0.016). Although we did not find any significant association between TILs and SBE, further studies evaluating their role according to radiotherapy are warranted.
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Affiliation(s)
- Alberto Farolfi
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Elisabetta Petracci
- Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Luigi Serra
- Pathology Unit, Morgagni-Pierantoni Hospital, Forlì, Italy
| | - Alessandra Ravaioli
- Romagna Cancer Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Sara Bravaccini
- Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Sara Ravaioli
- Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Maria Maddalena Tumedei
- Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Paola Ulivi
- Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Matteo Canale
- Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | | | - Fabio Falcini
- Romagna Cancer Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Secondo Folli
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Andrea Rocca
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
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Palleschi M, Maltoni R, Ravaioli S, Vagheggini A, Mannozzi F, Fanini F, Pirini F, Tumedei MM, Barzotti E, Cecconetto L, Sarti S, Manunta S, Possanzini P, Fedeli A, Curcio A, Altini M, De Giorgi U, Rocca A, Bravaccini S. Ki67 and PR in Patients Treated with CDK4/6 Inhibitors: A Real-World Experience. Diagnostics (Basel) 2020; 10:diagnostics10080573. [PMID: 32784518 PMCID: PMC7460222 DOI: 10.3390/diagnostics10080573] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 08/06/2020] [Accepted: 08/08/2020] [Indexed: 01/20/2023] Open
Abstract
CDK4/6 inhibitors (CDK4/6i) are recommended in patients with estrogen receptor (ER)-positive, HER2-negative advanced breast cancer (ABC). Up to now, no prognostic biomarkers have been identified in this setting. We retrospectively analyzed the expression of progesterone receptor (PR) and Ki67, assessed by immunohistochemistry, in 71 ABC patients treated with CDK4/6i and analyzed the impact of these markers on progression-free survival (PFS). The majority of patients 63/71 (88.7%) received palbociclib, 4 (5.6%) received ribociclib, and 4 (5.6%) received abemaciclib. A higher median value of Ki67 was observed in cases undergoing second-line treatment (p = 0.047), whereas the luminal B subtype was more prevalent (p = 0.005). In the univariate analysis of the first-line setting, luminal A subtype showed a trend towards a correlation with a longer PFS (p = 0.053). A higher continuous Ki67 value led to a significantly shorter PFS. When the interaction between pathological characteristics and line of treatment was considered, luminal B subtype showed a significantly (p = 0.043) worse outcome (Hazard Ratio (HR) 2.84; 1.03–7.82 95% Confidence Interval (CI)). PFS in patients undergoing endocrine therapy plus CDK4/6i was inversely correlated with Ki67 expression but not with PR, suggesting that tumor proliferation has a greater impact on cell cycle inhibitors combined with endocrine therapy than PR expression.
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Affiliation(s)
- Michela Palleschi
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (M.P.); (R.M.); (A.V.); (F.M.); (F.F.); (F.P.); (M.M.T.); (E.B.); (L.C.); (S.S.); (S.M.); (A.F.); (M.A.); (U.D.G.); (A.R.); (S.B.)
| | - Roberta Maltoni
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (M.P.); (R.M.); (A.V.); (F.M.); (F.F.); (F.P.); (M.M.T.); (E.B.); (L.C.); (S.S.); (S.M.); (A.F.); (M.A.); (U.D.G.); (A.R.); (S.B.)
| | - Sara Ravaioli
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (M.P.); (R.M.); (A.V.); (F.M.); (F.F.); (F.P.); (M.M.T.); (E.B.); (L.C.); (S.S.); (S.M.); (A.F.); (M.A.); (U.D.G.); (A.R.); (S.B.)
- Correspondence: ; Tel.: +39-054-373-9978; Fax: +39-054-373-9221
| | - Alessandro Vagheggini
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (M.P.); (R.M.); (A.V.); (F.M.); (F.F.); (F.P.); (M.M.T.); (E.B.); (L.C.); (S.S.); (S.M.); (A.F.); (M.A.); (U.D.G.); (A.R.); (S.B.)
| | - Francesca Mannozzi
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (M.P.); (R.M.); (A.V.); (F.M.); (F.F.); (F.P.); (M.M.T.); (E.B.); (L.C.); (S.S.); (S.M.); (A.F.); (M.A.); (U.D.G.); (A.R.); (S.B.)
| | - Francesca Fanini
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (M.P.); (R.M.); (A.V.); (F.M.); (F.F.); (F.P.); (M.M.T.); (E.B.); (L.C.); (S.S.); (S.M.); (A.F.); (M.A.); (U.D.G.); (A.R.); (S.B.)
| | - Francesca Pirini
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (M.P.); (R.M.); (A.V.); (F.M.); (F.F.); (F.P.); (M.M.T.); (E.B.); (L.C.); (S.S.); (S.M.); (A.F.); (M.A.); (U.D.G.); (A.R.); (S.B.)
| | - Maria Maddalena Tumedei
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (M.P.); (R.M.); (A.V.); (F.M.); (F.F.); (F.P.); (M.M.T.); (E.B.); (L.C.); (S.S.); (S.M.); (A.F.); (M.A.); (U.D.G.); (A.R.); (S.B.)
| | - Eleonora Barzotti
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (M.P.); (R.M.); (A.V.); (F.M.); (F.F.); (F.P.); (M.M.T.); (E.B.); (L.C.); (S.S.); (S.M.); (A.F.); (M.A.); (U.D.G.); (A.R.); (S.B.)
| | - Lorenzo Cecconetto
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (M.P.); (R.M.); (A.V.); (F.M.); (F.F.); (F.P.); (M.M.T.); (E.B.); (L.C.); (S.S.); (S.M.); (A.F.); (M.A.); (U.D.G.); (A.R.); (S.B.)
| | - Samanta Sarti
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (M.P.); (R.M.); (A.V.); (F.M.); (F.F.); (F.P.); (M.M.T.); (E.B.); (L.C.); (S.S.); (S.M.); (A.F.); (M.A.); (U.D.G.); (A.R.); (S.B.)
| | - Silvia Manunta
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (M.P.); (R.M.); (A.V.); (F.M.); (F.F.); (F.P.); (M.M.T.); (E.B.); (L.C.); (S.S.); (S.M.); (A.F.); (M.A.); (U.D.G.); (A.R.); (S.B.)
| | - Paola Possanzini
- Pathology Unit, Morgagni-Pierantoni Hospital, 47121 Forlì, Italy;
| | - Anna Fedeli
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (M.P.); (R.M.); (A.V.); (F.M.); (F.F.); (F.P.); (M.M.T.); (E.B.); (L.C.); (S.S.); (S.M.); (A.F.); (M.A.); (U.D.G.); (A.R.); (S.B.)
| | - Annalisa Curcio
- Breast Surgery Unit, Morgagni-Pierantoni Hospital, 47121 Forlì, Italy;
| | - Mattia Altini
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (M.P.); (R.M.); (A.V.); (F.M.); (F.F.); (F.P.); (M.M.T.); (E.B.); (L.C.); (S.S.); (S.M.); (A.F.); (M.A.); (U.D.G.); (A.R.); (S.B.)
| | - Ugo De Giorgi
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (M.P.); (R.M.); (A.V.); (F.M.); (F.F.); (F.P.); (M.M.T.); (E.B.); (L.C.); (S.S.); (S.M.); (A.F.); (M.A.); (U.D.G.); (A.R.); (S.B.)
| | - Andrea Rocca
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (M.P.); (R.M.); (A.V.); (F.M.); (F.F.); (F.P.); (M.M.T.); (E.B.); (L.C.); (S.S.); (S.M.); (A.F.); (M.A.); (U.D.G.); (A.R.); (S.B.)
| | - Sara Bravaccini
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (M.P.); (R.M.); (A.V.); (F.M.); (F.F.); (F.P.); (M.M.T.); (E.B.); (L.C.); (S.S.); (S.M.); (A.F.); (M.A.); (U.D.G.); (A.R.); (S.B.)
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Marchitto N, Curcio A, Iannarelli N, Petrucci A, Romano A, Pironti M, Paparello PT, Raimondi G. A pilot study on secondary anemia in "frailty" patients treated with Ferric Sodium EDTA in combination with vitamin C, folic acid, copper gluconate, zinc gluconate and selenomethionine: safety of treatment explored by HRV non-linear analysis as predictive factor of cardiovascular tolerability. Eur Rev Med Pharmacol Sci 2020; 24:7776-7783. [PMID: 32744704 DOI: 10.26355/eurrev_202007_22280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Iron deficiency anemia (IDA) in patients with heart disease is correlated with decreased exercise capacity and poor health-related quality of life, and predicts worse cardiovascular outcomes, especially for elderly patients. IDA can worsen cardiac function that can be monitored with Heart Rate Variability (HRV) analysis, providing important information about cardiac health. In a recent study we explored the effect and the tolerability of the administration of Ferric Sodium EDTA in combination with vitamin C, folic acid, copper gluconate, zinc gluconate and selenomethionine (Ferachel Forte®) in "frailty" patients with secondary anemia and low kidney failure, by analysing the HRV frequency domain. The aim of the present study is the further confirmation of the safety of the already evaluated intervention, by analysing non-linear domain of HRV. PATIENTS AND METHODS In this pilot study we enrolled 52 "frailty" elderly patients, with a recent diagnosis of secondary anemia due to iron deficiency, with Class II New York Heart Association (NYHA) hypertensive heart disease, low kidney failure, and atherosclerosis. The patients were divided in 2 groups: Group A (N=23 patients) received oral administration of Ferric Sodium EDTA in combination with vitamin C, folic acid, copper gluconate, zinc gluconate and selenomethionine (Ferachel Forte®) 2 tabs/day, containing 60 mg of Fe3+, for 24 days; Group B (N=29 patients) received intravenous administration of ferrous gluconate 63 mg/day added to saline solution, while they were hospitalized (15±5 days). We evaluated laboratory values of hemoglobin (Hb) and sideremia levels. Furthermore, we measured ECG signals before and after treatment, using non-linear analysis techniques. RESULTS Both intravenous and oral treatments evaluated in this study, were effective and safe about the cardiovascular risk in "frailty" elderly patients, as resulted from non-linear HRV analysis. Efficacy results showed that hemoglobin and sideremia levels after treatments are significantly increased. The HRV non-linear analysis showed that all parameters evaluated, except for the SD1 values in the Group A, were not affected by treatments, confirming the absence of cardiovascular risk of the therapy. CONCLUSIONS Non-linear HRV evaluation confirmed that oral administration of Ferric Sodium EDTA, in combination with vitamin C, folic acid, copper gluconate, zinc gluconate and selenomethionine (Ferachel forte®) did not impact the cardiovascular risk, without causing adverse events typically reported with other iron supplementation therapies, both oral and intravenous.
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Affiliation(s)
- N Marchitto
- Alfredo Fiorini Hospital, Terracina, (Latina), Italy.
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Curcio A, Petrarca M. Saturation regime of THz generation in nonlinear crystals by pumps with arbitrary spectral modulations. Opt Lett 2020; 45:1619-1622. [PMID: 32235957 DOI: 10.1364/ol.386341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 02/24/2020] [Indexed: 06/11/2023]
Abstract
A self-consistent analytic formalism of the description of saturation effects in optical rectification is provided. It is shown that a nonlinear absorption term arises from this process that is dominant over two-photon absorption, deriving instead from the nonlinear susceptibility of the third order. An analytical expression for the saturation intensity is provided and compared to experiments in literature. Moreover, it is shown how the saturation effects modify the transfer of the pump spectral phase and amplitude into the terahertz domain.
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Romano A, Curcio A, Marchitto N, Paparello PT, Pironti M, Raimondi G. A topical combination of blackberry, Centella asiatica, sodium hyaluronate, vitamin E and Melilotus to relieve legs symptoms of venous insufficiency. Veins and Lymphatics 2020. [DOI: 10.4081/vl.2020.8465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Chronic Venous Insufficiency (CVI) is a clinical condition characterized by several legs symptoms: telangiectasias, reticular veins, varicose veins, edema, pigmentation, eczema, lipodermatosclerosis, white atrophy and ulcers. These symptoms are often associated with tired and heavy legs, leg pain, itching, legs and ankles swelling. This report analyzes the usefulness of a cream based on blackberry, Centella asiatica, sodium hyaluronate, vitamin E and Melilotus (Flavofort 1500® legs cream) to relieve leg symptoms in CVI. A group of 35 subjects (7 men and 28 women) with legs symptoms applied Flavofort 1500® legs cream on the legs, twice a day for 10 days. The symptoms were evaluated with a patient questionnaire at 4 steps: T0 (before cream application), T1 (just after first application), T2 (5 days after first application) and T3 (10 days after first application). A reduction of subjects (%) with legs symptoms was observed both after 5 day and after 10 days.
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Palleschi M, Maltoni R, Barzotti E, Melegari E, Curcio A, Cecconetto L, Sarti S, Manunta S, Rocca A. Can cyclin-dependent kinase 4/6 inhibitors convert inoperable breast cancer relapse to operability? A case report. World J Clin Cases 2020; 8:517-521. [PMID: 32110660 PMCID: PMC7031833 DOI: 10.12998/wjcc.v8.i3.517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 01/09/2020] [Accepted: 01/14/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Pathological complete response (pCR) is rare in hormone receptor-positive (HR+) HER2-negative breast cancer (BC) treated with either endocrine therapy (ET) or chemotherapy. Radical resection of locoregional relapse, although potentially curative in some cases, is challenging when the tumor invades critical structures. The oral cyclin-dependent kinase 4/6 inhibitor palbociclib in combination with ET has obtained a significant increase in objective response rates and progression-free survival in patients with advanced BC and is now being evaluated in the neoadjuvant setting. We present a clinical case of a patient with an inoperable locoregional relapse of HR+ HER2-negative BC who experienced pCR after treatment with palbociclib.
CASE SUMMARY We report the clinical case of a 60-year-old patient who presented with an inoperable locoregional relapse of HR+, HER2-negative BC 10 years after the diagnosis of the primary tumor. During a routine follow-up visit, breast magnetic resonance imaging and positron emission tomography/computed tomography revealed a 4-cm lesion in the right subclavicular region, infiltrating the chest wall and extending to the subclavian vessels, but without bone or visceral involvement. Treatment was begun with palbociclib plus letrozole, converting the disease to operability over a period of 6 mo. Surgery was performed and a pCR achieved. Of note, during treatment the patient experienced a very uncommon toxicity characterized by burning tongue and glossodynia associated with dysgeusia, paresthesia, dysesthesia, and xerostomia. A reduction in the dose of palbociclib did not provide relief and treatment with the inhibitor was thus discontinued, resolving the tongue symptoms. Laboratory exams were unremarkable. Given that this was a late relapse, the tumor was classified as endocrine-sensitive, a condition associated with high sensitivity to palbociclib.
CONCLUSION This case highlights the potential of the cyclin-dependent kinase 4/6 inhibitor plus ET combination to achieve pCR in locoregional relapse of BC, enabling surgical resection of a lesion initially considered inoperable.
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Affiliation(s)
- Michela Palleschi
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola 47014, Italy
| | - Roberta Maltoni
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola 47014, Italy
| | - Eleonora Barzotti
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola 47014, Italy
| | - Elisabetta Melegari
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola 47014, Italy
| | - Annalisa Curcio
- Breast Surgery Unit, Ospedale Morgagni-Pierantoni, Forlì 47121, Italy
| | - Lorenzo Cecconetto
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola 47014, Italy
| | - Samanta Sarti
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola 47014, Italy
| | - Silvia Manunta
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola 47014, Italy
| | - Andrea Rocca
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola 47014, Italy
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Curcio A, Bisesto F, Costa G, Biagioni A, Anania MP, Pompili R, Ferrario M, Petrarca M. Modeling and diagnostics for plasma discharge capillaries. Phys Rev E 2019; 100:053202. [PMID: 31869917 DOI: 10.1103/physreve.100.053202] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Indexed: 11/07/2022]
Abstract
In this paper, we show how plasma discharge capillaries can be numerically modeled as resistors within an RLC-series discharge circuit, allowing for a simple description of these systems, while taking into account heat and radiation losses. An analytic radial model is also provided and compared to the numerical model for plasma discharge capillaries at thermal equilibrium, with corrections due to radiation losses. Finally, diagnostic techniques based on visible spectroscopy of plasma emission lines are discussed both for atomic and molecular gases, comparing experimental results with numerical simulations and theoretical calculations.
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Affiliation(s)
| | | | - G Costa
- INFN LNF, Frascati (Rome), Italy
| | | | | | | | | | - M Petrarca
- S.B.A.I. Department of the Roma University "La Sapienza," Rome, Italy and INFN Roma1, Rome, Italy
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Mazzanti A, Tenuta E, Marino M, Pagan E, Morini M, Memmi M, Curcio A, Monteforte N, Bloise R, Napolitano C, Bagnardi V, Priori SG. 6081Efficacy and limitations of quinidine therapy in patients with Brugada Syndrome. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Quinidine at high-dose is used in patients with Brugada Syndrome (BrS), but its efficacy to prevent life-threatening arrhythmic events (LAE) in BrS is unproven and its use is limited by side effects.
Objective
We assessed whether low-dose quinidine in BrS patients reduces: 1) the occurrence of a first LAE; 2) the arrhythmic burden in the high-risk group of cardiac arrest survivors.
Methods
We first compared the clinical course of 53 BrS patients treated with quinidine to that of 441 untreated controls, matched by sex, age, and symptoms. Furthermore, we calculated the annual incidence of LAEs off- and on-quinidine in 123 BrS patients who had survived a cardiac arrest.
Results
First, we compared the clinical course of 53 BrS patients treated with quinidine (i.e. “cases”: 89% males, median age 40 years) to that of 441 untreated, clinically-matched BrS patients (i.e. “controls”: 91% males, median age 41 years) present in our database of patients with inherited arrhythmias. Cases received quinidine (median dose of 450 mg per day) for 5.0±3.7 years. Quinidine was interrupted in only 3/53 cases (6%) for side effects and it conferred a nonsignificant reduction of the risk of a first LAE in cases versus controls (HR 0.74, 95% CI 0.22–2.48, P=0.62).
Secondly, we calculated the annual recurrence of LAE off- and on-quinidine in 123 BrS cardiac arrest survivors, 27 of whom were treated with quinidine for 7.0±3.5 years. The annual rate of recurrent LAEs decreased significantly from 14.7% while off-quinidine to 3.9% while on-quinidine (P=0.03). Notably, recurrent life-threatening arrhythmic events were recorded in 4/27 (15%) symptomatic patients while on-quinidine.
Conclusion
We demonstrated for the first time in the long-term that low-dose quinidine reduces the recurrence of life-threatening arrhythmias in symptomatic BrS patients, with few side effects. Remarkably, about one-fifth of symptomatic patients experience life-threatening arrhythmias while on-treatment, suggesting that quinidine cannot replace implantable defibrillators in high-risk subjects.
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Affiliation(s)
| | - E Tenuta
- ICS Maugeri - IRCCS, Pavia, Italy
| | - M Marino
- ICS Maugeri - IRCCS, Pavia, Italy
| | - E Pagan
- University of Milan-Bicocca, Department of Statistics and Quantitative Methods, Milan, Italy
| | - M Morini
- ICS Maugeri - IRCCS, Pavia, Italy
| | - M Memmi
- ICS Maugeri - IRCCS, Pavia, Italy
| | - A Curcio
- ICS Maugeri - IRCCS, Pavia, Italy
| | | | - R Bloise
- ICS Maugeri - IRCCS, Pavia, Italy
| | | | - V Bagnardi
- University of Milan-Bicocca, Department of Statistics and Quantitative Methods, Milan, Italy
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Curcio A, Petrarca M. Diagnosing plasmas with wideband THz pulses: errata. Opt Lett 2019; 44:4427. [PMID: 31465419 DOI: 10.1364/ol.44.004427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Indexed: 06/10/2023]
Abstract
In this erratum Fig. 3 of Opt. Lett.44, 1011 (2019)OPLEDP0146-959210.1364/OL.44.001011 has been updated. A diagnostic method for the electron plasma density and temperature based on the exploitation of wide-band THz pulses is presented. The model accompanying the diagnostic method is described and it is shown useful to characterize the plasma density and temperature profile along a symmetry axis. This diagnostic is particularly interesting for plasma-acceleration schemes or laser-produced plasma channels.
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Gennaro M, Meneghini E, Baili P, Bravaccini S, Curcio A, De Santis MC, Lozza L, Listorti C, Di Cosimo S, Sant M, Folli S. High consistency between characteristics of primary intraductal breast cancer and subtype of subsequent ipsilateral invasive cancer. Tumori 2019; 106:64-69. [PMID: 31446852 DOI: 10.1177/0300891619867845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Ductal carcinoma in situ (DCIS) is considered a morphologic precursor of invasive cancer and is often treated with adjuvant whole-breast irradiation and endocrine therapy, as if it were an invasive cancer. Our aim was to provide further support for treatment de-escalation or enrollment of such patients in active surveillance trials. METHODS We retrospectively analyzed data on patients with conservatively treated primary DCIS subsequently diagnosed with ipsilateral invasive breast cancer (IBC) at 2 comprehensive breast cancer centers. From their merged databases, we identified 50 cases with full details on tumor grade, hormone receptor expression, and HER2 amplification, for both the primary DCIS and the corresponding IBC, and we assessed the similarities and differences between the two. RESULTS Distributions of hormone receptors were similar in primary DCIS and IBC, while high-grade and HER2-positive status was less common in IBC than in primary DCIS. The positivity for estrogen receptors (ER) and well-differentiated or moderately differentiated morphology in the primary DCIS persisted in 90% of the matching IBC. Changes in progesterone receptor expression were slightly more common than those in ER expression. Overall consistency for the luminal-like receptors subtype was found in 90% of cases. CONCLUSION The high consistency between the features of primary DCIS and those of subsequent IBC (in the rare but not negligible cases of local failure) should be borne in mind when considering the therapeutic options. Treatment de-escalation and accrual of patients for active surveillance trials could be appropriate for luminal-like precursors.
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Affiliation(s)
| | - Elisabetta Meneghini
- Analytical Epidemiology and Health Impact Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milano, Italy
| | - Paolo Baili
- Analytical Epidemiology and Health Impact Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milano, Italy
| | - Sara Bravaccini
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola FC, Italy
| | - Annalisa Curcio
- Breast Unit, Ospedale GB Morgagni, Forlì, AUSL Romagna, Italy
| | | | - Laura Lozza
- Radiotherapy Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milano, Italy
| | - Chiara Listorti
- Breast Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milano, Italy
| | - Serena Di Cosimo
- Department of Applied Research and Technological Development (DRAST), Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy
| | - Milena Sant
- Analytical Epidemiology and Health Impact Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milano, Italy
| | - Secondo Folli
- Breast Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milano, Italy
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Belkahla H, Boudjemaa R, Caorsi V, Pineau D, Curcio A, Lomas JS, Decorse P, Chevillot-Biraud A, Azaïs T, Wilhelm C, Randriamahazaka H, Hémadi M. Carbon dots, a powerful non-toxic support for bioimaging by fluorescence nanoscopy and eradication of bacteria by photothermia. Nanoscale Adv 2019; 1:2571-2579. [PMID: 36132715 PMCID: PMC9418816 DOI: 10.1039/c9na00140a] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 05/17/2019] [Indexed: 05/02/2023]
Abstract
Carbon Dots (CDs) are innovative materials which have potential applications in many fields, including nanomedicine, energy and catalysis. Here CDs were produced by the alkali-assisted ultrasonic route and characterized by several techniques to determine their composition and properties. Fluorescence nanoscopy using single-molecule localization microscopy shows that they have very good photophysical properties and a remarkable blinking behaviour at 405 nm. Moreover, these CDs are a safe material, non-toxic towards different cell lines (cancer and non-cancer cells) even at very high concentration, reflecting an excellent biocompatibility. Photothermia, i.e. their heating capacity under laser irradiation, was evaluated at two wavelengths and at several power densities. The resulting temperature increment was high (5 < ΔT < 45 °C) and appropriate for biomedical applications. Bioimaging and photothermia were then performed on E. coli, a Gram(-) bacterium, incubated with CDs. Remarkably, by photothermia at 680 nm (0.3, 1 and 1.9 W cm-2) or 808 nm (1.9 W cm-2), CDs are able to eradicate bacteria in their exponential and stationary phases. Images obtained by 3D super-resolution microscopy clearly show the different CD distributions in surviving bacteria after mild photothermal treatment. These results confirm that CDs are multifunctional materials with a wide range of biomedical applications.
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Affiliation(s)
- H Belkahla
- Interfaces, Traitements, Organisation et Dynamique des Systèmes, Université Paris Diderot, Sorbonne Paris Cité CNRS-UMR 7086, 15 rue Jean-Antoine de Baïf 75205 Paris Cedex 13 France
| | - R Boudjemaa
- Abbelight 6 rue Jean Calvin 75005 Paris France
| | - V Caorsi
- Abbelight 6 rue Jean Calvin 75005 Paris France
| | - D Pineau
- Interfaces, Traitements, Organisation et Dynamique des Systèmes, Université Paris Diderot, Sorbonne Paris Cité CNRS-UMR 7086, 15 rue Jean-Antoine de Baïf 75205 Paris Cedex 13 France
| | - A Curcio
- Laboratoire Matières et Systèmes Complexes, Université Paris Diderot, Sorbonne Paris Cité CNRS-UMR 7057, 10 rue Alice Domon et Léonie Duquet 75205 Paris Cedex 13 France
| | - J S Lomas
- Interfaces, Traitements, Organisation et Dynamique des Systèmes, Université Paris Diderot, Sorbonne Paris Cité CNRS-UMR 7086, 15 rue Jean-Antoine de Baïf 75205 Paris Cedex 13 France
| | - P Decorse
- Interfaces, Traitements, Organisation et Dynamique des Systèmes, Université Paris Diderot, Sorbonne Paris Cité CNRS-UMR 7086, 15 rue Jean-Antoine de Baïf 75205 Paris Cedex 13 France
| | - A Chevillot-Biraud
- Interfaces, Traitements, Organisation et Dynamique des Systèmes, Université Paris Diderot, Sorbonne Paris Cité CNRS-UMR 7086, 15 rue Jean-Antoine de Baïf 75205 Paris Cedex 13 France
| | - T Azaïs
- Laboratoire de Chimie de la Matière Condensée de Paris, Sorbonne Université, CNRS-UMR 7574, Collège de France 4 place Jussieu 75005 Paris France
| | - C Wilhelm
- Laboratoire Matières et Systèmes Complexes, Université Paris Diderot, Sorbonne Paris Cité CNRS-UMR 7057, 10 rue Alice Domon et Léonie Duquet 75205 Paris Cedex 13 France
| | - H Randriamahazaka
- Interfaces, Traitements, Organisation et Dynamique des Systèmes, Université Paris Diderot, Sorbonne Paris Cité CNRS-UMR 7086, 15 rue Jean-Antoine de Baïf 75205 Paris Cedex 13 France
| | - M Hémadi
- Interfaces, Traitements, Organisation et Dynamique des Systèmes, Université Paris Diderot, Sorbonne Paris Cité CNRS-UMR 7086, 15 rue Jean-Antoine de Baïf 75205 Paris Cedex 13 France
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Curcio A, Petrarca M. Diagnosing plasmas with wideband terahertz pulses. Opt Lett 2019; 44:1011-1014. [PMID: 30768036 DOI: 10.1364/ol.44.001011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 01/17/2019] [Indexed: 06/09/2023]
Abstract
A diagnostic method for the electron plasma density and temperature based on the exploitation of wideband THz pulses is presented. The model accompanying the diagnostic method is described, and it is shown useful to characterize the plasma density and temperature profile along a symmetry axis. This diagnostic is particularly interesting for plasma-acceleration schemes or laser-produced plasma channels.
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Zarba Meli E, Cattin F, Curcio A, Manna E, Samorani D, Tognali D, Gennaro M, Loreti A, Folli S, Fortunato L. Surgical delay may extend the indications for nipple-sparing mastectomy: A multicentric study. Eur J Surg Oncol 2019; 45:1373-1377. [PMID: 30826199 DOI: 10.1016/j.ejso.2019.02.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 02/05/2019] [Accepted: 02/12/2019] [Indexed: 10/27/2022] Open
Abstract
INTRODUCTION Nipple-sparing mastectomy (NSM) is considered an oncologically sound procedure but necrosis of the nipple-areola complex (NAC) or skin flaps is a concern, particularly in the presence of risk factors. To increase the indications for NSM and decrease such complications, different procedures of "surgical delay" (SD) have been described. MATERIALS AND METHODS A retrospective analysis of patients who underwent SD for NSM at four Italian Breast Centers from 2014 to 2017 was performed. SD generally consisted of a periareolar or "hemi-batwing" incision, dissecting the skin and the NAC from the underlying breast tissue. NSM was scheduled after 2-3 weeks. RESULTS Eighty-eight procedures were analyzed. Mild complications of SD were registered in 7.9% of cases. NSM was performed in 85 cases, whereas in three cases (3.4%) a "skin-sparing" mastectomy was necessary due to positivity of the retroareolar biopsy for cancer at SD. A direct-to- implant (DTI) reconstruction was performed in 42 cases (49.4%), while in 43 (50.6%) a tissue-expander (TE) was inserted. After NSM, eight complications (9.4%) were recorded: one total necrosis (1.2%), one partial necrosis (1.2%) and four minimal ischemia (4.7%) of NAC, one skin flap necrosis (1.2%), one haematoma (1.2%). In only two cases (2.3%) prosthesis removal was needed. Aesthetic outcome was evaluated excellent or good in 92.9% of cases. At a median follow-up of 24 months no local recurrences were seen. CONCLUSION This is the largest series of SD with NSM presented so far in the literature. In our experience, SD extends indications for NSM in high-risk women.
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Affiliation(s)
- Emanuele Zarba Meli
- Department of Surgery, San Giovanni-Addolorata Hospital, Via dell'Amba Aradam 9, 00199, Rome, Italy.
| | - Federico Cattin
- Department of Surgery, Stabilimento Franchini, Santarcangelo di Romagna, Presidio Ospedaliero di Rimini, AUSL Romagna, Via Pedrignone 3, 47822, Santarcangelo di Romagna (RN), Italy
| | - Annalisa Curcio
- Department of Surgery, Morgagni-Pierantoni Hospital, AUSL Romagna, Via Carlo Forlanini 34, 47121, Forlì, Italy
| | - Elena Manna
- Department of Surgery, San Giovanni-Addolorata Hospital, Via dell'Amba Aradam 9, 00199, Rome, Italy
| | - Domenico Samorani
- Department of Surgery, Stabilimento Franchini, Santarcangelo di Romagna, Presidio Ospedaliero di Rimini, AUSL Romagna, Via Pedrignone 3, 47822, Santarcangelo di Romagna (RN), Italy
| | - Daniela Tognali
- Department of Surgery, Morgagni-Pierantoni Hospital, AUSL Romagna, Via Carlo Forlanini 34, 47121, Forlì, Italy
| | - Massimiliano Gennaro
- Department of Surgery, Istituto Nazionale Tumori, Via Giacomo Venezian 1, 20133, Milano, Italy
| | - Andrea Loreti
- Department of Surgery, San Giovanni-Addolorata Hospital, Via dell'Amba Aradam 9, 00199, Rome, Italy
| | - Secondo Folli
- Department of Surgery, Istituto Nazionale Tumori, Via Giacomo Venezian 1, 20133, Milano, Italy
| | - Lucio Fortunato
- Department of Surgery, San Giovanni-Addolorata Hospital, Via dell'Amba Aradam 9, 00199, Rome, Italy
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Abstract
One hundred and one patients with histologically proved non-small cell lung cancer underwent whole body gallium-67 (TB Ga-67) scintigraphy as a part of their routine pretreatment evaluation. Twenty-eight of these patients were subsequently operated and pathologically staged for hilar and mediastinal disease. Two other patients underwent mediastinoscopy, but were judged unresectable at that time. All had computed tomography (CT) of the thorax, as well as radionuclide or CT scans of suspicious metastatic areas, and were carefully followed-up. When possible, a biopsy was performed of each suspected metastasis. Primary lung tumors concentrated Ga-67 in 94 patients. Sensitivity, specificity, and accuracy for hilar and mediastinal node metastases were 58%, 89%, and 77%, respectively. There were no false-negative gallium scans as regards secondary involvement of both liver and bone, whereas only 1 of the 4 brain metastases was detected by the technique. Sensitivity, specificity, and accuracy for all metastatic sites were 82%, 38%, and 56%, respectively. Fifty-five patients were classified as having a more advanced stage of disease by TB Ga-67 scintigraphy than at the initial clinical evaluation. However, 42 gallium-staged patients were ultimately re-classified differently according to all available clinical data. Using TB Ga-67 scintigraphy, 21 patients were found to have occult metastases which would not otherwise have been recognized; for the above reason, an unnecessary intervention was avoided in 6 of them.
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Affiliation(s)
- G Buccheri
- Medical Departments, A. Carle Hospital of Chest Diseases, Cuneo, Italy
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Zarba Meli E, Curcio A, Samorani D, Manna E, Pallara T, Tognali D, Marongiu F, Fabiocchi L, Frisoni G, Cattin F, Fortunato L, Folli S, Gennaro M. Surgical delay in nipple-sparing mastectomy: A multicenter study. Eur J Cancer 2018. [DOI: 10.1016/s0959-8049(18)30492-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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De Luca S, Curcio A, Calabro' G, Passafaro F, Ruggiero AR, Calvelli P, Santarpia G, Indolfi C. P788Short-coupled ventricular ectopic beats in a cohort of young patients with major cardiac events and early repolarization pattern. Europace 2018. [DOI: 10.1093/europace/euy015.392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- S De Luca
- Magna Graecia University of Catanzaro, Div of Cardiology, Dept of Medical and Surgical Sciences, Catanzaro, Italy
| | - A Curcio
- Magna Graecia University of Catanzaro, Div of Cardiology, Dept of Medical and Surgical Sciences, Catanzaro, Italy
| | - G Calabro'
- Magna Graecia University of Catanzaro, Div of Cardiology, Dept of Medical and Surgical Sciences, Catanzaro, Italy
| | - F Passafaro
- Magna Graecia University of Catanzaro, Div of Cardiology, Dept of Medical and Surgical Sciences, Catanzaro, Italy
| | - A R Ruggiero
- Magna Graecia University of Catanzaro, Div of Cardiology, Dept of Medical and Surgical Sciences, Catanzaro, Italy
| | - P Calvelli
- Magna Graecia University of Catanzaro, Div of Cardiology, Dept of Medical and Surgical Sciences, Catanzaro, Italy
| | - G Santarpia
- Magna Graecia University of Catanzaro, Div of Cardiology, Dept of Medical and Surgical Sciences, Catanzaro, Italy
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Gareri C, Curcio A, Pezone A, Sorrentino S, Iaconetti C, Mastroroberto P, Avvedimento VE, Indolfi C. P450HDACs drive increased expression of beta-catenin and reduced levels of potassium channels in atrial fibrillation. Europace 2018. [DOI: 10.1093/europace/euy015.259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- C Gareri
- Duke University Medical Center, Department of Medicine, Durham, United States of America
| | - A Curcio
- Magna Graecia University of Catanzaro, Div of Cardiology, Dept of Medical and Surgical Sciences, Catanzaro, Italy
| | - A Pezone
- Federico II University of Naples, Department of Molecular Medicine and Medical Biotechnology, Naples, Italy
| | - S Sorrentino
- Mount Sinai School of Medicine, Department of Cardiology, New York, United States of America
| | - C Iaconetti
- Magna Graecia University of Catanzaro, Div of Cardiology, Dept of Medical and Surgical Sciences, Catanzaro, Italy
| | - P Mastroroberto
- Magna Graecia University of Catanzaro, Division of Cardiac Surgery, Catanzaro, Italy
| | - V E Avvedimento
- Federico II University of Naples, Department of Molecular Medicine and Medical Biotechnology, Naples, Italy
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Curcio A, Dolci V, Lupi S, Petrarca M. Terahertz-based retrieval of the spectral phase and amplitude of ultrashort laser pulses. Opt Lett 2018; 43:783-786. [PMID: 29443993 DOI: 10.1364/ol.43.000783] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 01/11/2018] [Indexed: 06/08/2023]
Abstract
Terahertz (THz) radiation is of great interest for a variety of applications, e.g., particle accelerations, spectroscopy investigations of quantum systems, and high-field study of materials. One of the most common laser-based processes to produce THz pulses is optical rectification, which transduces an infrared pump laser to the THz domain (0.1-20 THz). In this work, we propose and theoretically describe a method to characterize the amplitude and phase of the electric field of the pump laser pulse relying on THz generation and detection. We demonstrate with a numerical example how THz radiation can be used as diagnostics to characterize laser pulses with temporal length at the femtosecond level.
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Labate A, Mumoli L, Curcio A, Tripepi G, D'Arrigo G, Ferlazzo E, Aguglia U, Indolfi C, Quattrone A, Gambardella A. Value of clinical features to differentiate refractory epilepsy from mimics: a prospective longitudinal cohort study. Eur J Neurol 2018; 25:711-717. [PMID: 29359374 DOI: 10.1111/ene.13579] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 01/11/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND PURPOSE Misdiagnosis of refractory epilepsy (rE) is common and such patients experience a long diagnostic delay. Our aim was to identify key clinical/laboratory factors in order to obtain an alternative diagnosis in patients referred for rE. METHODS Between January 2010 and December 2015, 125 consecutive patients with a diagnosis of rE were prospectively enrolled. All patients underwent a comprehensive neurological, neuropsychiatric and cardiological evaluation, and had an observation time of at least 1 year after the study entry. RESULTS Diagnosis of rE was confirmed in 104/125 (83.2%) patients (55 women, mean age 38.8 ± 14.3 years). Thirteen/125 patients (10.4%, seven women, mean age 50.8 ± 20.9) were diagnosed with syncope, which was cardiac/cardio inhibitory in 9/13 (69%). The remaining 8/125 patients (6.4%, six women, mean age 41.2 ± 14.6 years) were diagnosed with psychogenic non-epileptic seizures. Age at onset had a high accuracy in differentiating patients with syncope from others, with the best cut-off age at 35 years and above. Abnormal brain magnetic resonance imaging (MRI) had a significant yield of about 70% in rE. A diagnostic model including age at onset and brain MRI was highly accurate in differentiating patients with syncope from others. In patients with cardiac/cardio inhibitory syncope, the point score of historical features was ≥1 and falsely favoured the diagnosis of epileptic seizures. CONCLUSIONS This prospective cohort study identifies rE mimics who are at high risk of morbidity and mortality. rE starting in adulthood should raise a high suspicion of cardiac syncope. Brain MRI is accurate in differentiating rE from other conditions.
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Affiliation(s)
- A Labate
- Institute of Neurology, University Magna Graecia, Catanzaro, Italy.,Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
| | - L Mumoli
- Institute of Neurology, University Magna Graecia, Catanzaro, Italy
| | - A Curcio
- Institute of Cardiology, University Magna Graecia, Catanzaro, Italy
| | - G Tripepi
- Institute of Clinical Physiology, National Research Council, Reggio Calabria, Italy
| | - G D'Arrigo
- Institute of Clinical Physiology, National Research Council, Reggio Calabria, Italy
| | - E Ferlazzo
- Institute of Neurology, University Magna Graecia, Catanzaro, Italy
| | - U Aguglia
- Institute of Neurology, University Magna Graecia, Catanzaro, Italy
| | - C Indolfi
- Institute of Cardiology, University Magna Graecia, Catanzaro, Italy
| | - A Quattrone
- Institute of Neurology, University Magna Graecia, Catanzaro, Italy.,Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
| | - A Gambardella
- Institute of Neurology, University Magna Graecia, Catanzaro, Italy.,Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
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Abstract
In this paper, an alternative perspective for the generation of millimetric high-gradient resonant plasma waves is discussed. This method is based on the plasma-wave excitation by energetic single-cycle THz pulses whose temporal length is comparable to the plasma wavelength. The excitation regime discussed in this paper is the quasi-nonlinear regime that can be achieved when the normalized vector potential of the driving THz pulse is on the order of unity. To investigate this regime and determine the strength of the excited electric fields, a Particle-In-Cell (PIC) code has been used. It has been found that by exploiting THz pulses with characteristics currently available in laboratory, longitudinal electron plasma waves with electric gradients up to hundreds MV/m can be obtained. The mm-size nature of the resonant plasma wave can be of great utility for an acceleration scheme in which high-brightness electron bunches are injected into the wave to undergo a strong acceleration. The long-size nature of the acceleration bucket with respect to the short length of the electron bunches can be handled in a more robust manner in comparison with the case when micrometric waves are employed.
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Affiliation(s)
- A Curcio
- Department of Basic and Applied Sciences for Engineering (SBAI), "Sapienza" University of Rome, Via A. Scarpa 14, 00161, Rome, Italy.,INFN-LNF, via Enrico Fermi 40, 00044, Frascati, Italy
| | - A Marocchino
- Department of Basic and Applied Sciences for Engineering (SBAI), "Sapienza" University of Rome, Via A. Scarpa 14, 00161, Rome, Italy.,INFN-LNF, via Enrico Fermi 40, 00044, Frascati, Italy
| | - V Dolci
- Department of Basic and Applied Sciences for Engineering (SBAI), "Sapienza" University of Rome, Via A. Scarpa 14, 00161, Rome, Italy.,Roma1-INFN, P.le Aldo Moro, 2, 00185, Rome, Italy
| | - S Lupi
- Roma1-INFN, P.le Aldo Moro, 2, 00185, Rome, Italy.,Department of Physics, "Sapienza" University of Rome, Piazzale A. Moro 2, I-00185, Rome, Italy
| | - M Petrarca
- Department of Basic and Applied Sciences for Engineering (SBAI), "Sapienza" University of Rome, Via A. Scarpa 14, 00161, Rome, Italy. .,Roma1-INFN, P.le Aldo Moro, 2, 00185, Rome, Italy.
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Weijs B, Field T, Curcio A, Giustozzi M, Sudikas S, Katholing A, Weitz J, Cohen A, Martinez C. P4624New onset dementia in incident atrial fibrillation. A large cohort study. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Affiliation(s)
- Annalisa Curcio
- Breast Surgical Unit, Morgagni-Pierantoni Hospital Forlì, Forlì-Cesena, Italy
| | - Francesco Marongiu
- Breast Surgical Unit, Morgagni-Pierantoni Hospital Forlì, Forlì-Cesena, Italy -
| | - Federico Buggi
- Breast Surgical Unit, Morgagni-Pierantoni Hospital Forlì, Forlì-Cesena, Italy
| | - Giuseppe Falco
- Breast Surgery Unit, IRCCS-Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
| | - Matteo Mingozzi
- Breast Surgical Unit, Morgagni-Pierantoni Hospital Forlì, Forlì-Cesena, Italy
| | - Secondo Folli
- Department of Breast Surgery, Plastic and Reconstructive Surgery Unit, Fondazione IRCCS Istituto Nazionale Tumori Milano, Milan, Italy
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