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Haas RL, Walraven I, Lecointe-Artzner E, van Houdt WJ, Scholten AN, Strauss D, Schrage Y, Hayes AJ, Raut CP, Fairweather M, Baldini EH, Gronchi A, De Rosa L, Griffin AM, Ferguson PC, Wunder J, van de Sande MAJ, Krol ADG, Skoczylas J, Brandsma D, Doglietto F, Sangalli C, Stacchiotti S. Management of meningeal solitary fibrous tumors/hemangiopericytoma; surgery alone or surgery plus postoperative radiotherapy? Acta Oncol 2021; 60:35-41. [PMID: 32988268 DOI: 10.1080/0284186x.2020.1826574] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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: 02/07/2023]
Abstract
INTRODUCTION A meningeal solitary fibrous tumor (SFT), also called hemangiopericytoma, is a rare mesenchymal malignancy. Due to anatomic constrains, even after macroscopic complete surgery with curative intent, the local relapse risk is still relatively high, thus increasing the risk of dedifferentiation and metastatic spread. This study aims to better define the role of postoperative radiotherapy (RT) in meningeal SFTs. PATIENTS AND METHODS A retrospective study was performed across seven sarcoma centers. Clinical information was retrieved from all adult patients with meningeal primary localized SFT treated between 1990 and 2018 with surgery alone (S) compared to those that also received postoperative RT (S + RT). Differences in treatment characteristics between subgroups were tested using independent samples t-test for continuous variables and chi-square tests for proportions. Local control (LC) and overall survival (OS) rates were calculated as time from start of treatment until progression or death from any cause. LC and OS in groups receiving S or S + RT were compared using Kaplan-Meier survival curves. RESULTS Among a total of 48 patients, 7 (15%) underwent S and 41 (85%) underwent S + RT. Median FU was 65 months. LC was significantly associated with treatment. LC after S at 60 months was 60% versus 90% after S + RT (p = 0.052). Furthermore, R1 resection status was significantly associated with worse LC (HR 4.08, p = 0.038). OS was predominantly associated with the mitotic count (HR 3.10, p = 0.011). CONCLUSION This retrospective study, investigating postoperative RT in primary localized meningeal SFT patients, suggests that combining RT to surgery in the management of this patient population may reduce the risk for local failures.
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Affiliation(s)
- R. L. Haas
- Department of Radiotherapy, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of Radiation Oncology, The Leiden University Medical Center, Leiden, The Netherlands
| | - I. Walraven
- Department of Radiotherapy, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | - W. J. van Houdt
- Department of Surgical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - A. N. Scholten
- Department of Radiotherapy, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - D. Strauss
- Sarcoma Unit, Department of Surgery, The Royal Marsden Hospital, London, UK
| | - Y. Schrage
- Department of Surgical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Sarcoma Unit, Department of Surgery, The Royal Marsden Hospital, London, UK
- Department of Surgical Oncology, The Leiden University Medical Center, Leiden, The Netherlands
| | - A. J. Hayes
- Sarcoma Unit, Department of Surgery, The Royal Marsden Hospital, London, UK
| | - C. P. Raut
- Division of Surgical Oncology, Department of Surgery, Brigham and Women’s Hospital, Boston, MA, USA
| | - M. Fairweather
- Division of Surgical Oncology, Department of Surgery, Brigham and Women’s Hospital, Boston, MA, USA
| | - E. H. Baldini
- Department of Radiation Oncology, Brigham and Women’s Hospital, Boston, MA, USA
- Center for Sarcoma and Bone Oncology, Dana-Farber Cancer Institute, Brigham and Women’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - A. Gronchi
- Department of Surgical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - L. De Rosa
- Department of Surgical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - A. M. Griffin
- Department of Orthopedic Surgery, Sarcoma Unit, Mount Sinai Hospital, Toronto, ON, Canada
| | - P. C. Ferguson
- Department of Orthopedic Surgery, Sarcoma Unit, Mount Sinai Hospital, Toronto, ON, Canada
| | - J. Wunder
- Department of Orthopedic Surgery, Sarcoma Unit, Mount Sinai Hospital, Toronto, ON, Canada
| | - M. A. J. van de Sande
- Department of Orthopedic Oncology, The Leiden University Medical Center, Leiden, The Netherlands
| | - A. D. G. Krol
- Department of Radiation Oncology, The Leiden University Medical Center, Leiden, The Netherlands
| | - J. Skoczylas
- Department of Surgical Oncology, The Maria Sklodowska-Curie Institute – Oncology Center, Warsaw, Poland
| | - D. Brandsma
- Department of Neuro-Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - F. Doglietto
- Neurosurgery Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - C. Sangalli
- Department of Radiation Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - S. Stacchiotti
- Adult Mesenchymal and Rare Tumor Unit, Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Mattavelli D, Doglietto F, Ferrari M, Fiorentino A, Agnelli S, Rodella L, Maroldi R, Nicolai P. PO-167 3D printing of biocompatible polymers for personalized skull-base reconstruction: proof of concept. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30333-0] [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: 11/16/2022]
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Stacchiotti S, Gronchi A, Fossati P, Akiyama T, Alapetite C, Baumann M, Blay JY, Bolle S, Boriani S, Bruzzi P, Capanna R, Caraceni A, Casadei R, Colia V, Debus J, Delaney T, Desai A, Dileo P, Dijkstra S, Doglietto F, Flanagan A, Froelich S, Gardner PA, Gelderblom H, Gokaslan ZL, Haas R, Heery C, Hindi N, Hohenberger P, Hornicek F, Imai R, Jeys L, Jones RL, Kasper B, Kawai A, Krengli M, Leithner A, Logowska I, Martin Broto J, Mazzatenta D, Morosi C, Nicolai P, Norum OJ, Patel S, Penel N, Picci P, Pilotti S, Radaelli S, Ricchini F, Rutkowski P, Scheipl S, Sen C, Tamborini E, Thornton KA, Timmermann B, Torri V, Tunn PU, Uhl M, Yamada Y, Weber DC, Vanel D, Varga PP, Vleggeert-Lankamp CLA, Casali PG, Sommer J. Best practices for the management of local-regional recurrent chordoma: a position paper by the Chordoma Global Consensus Group. Ann Oncol 2018; 28:1230-1242. [PMID: 28184416 PMCID: PMC5452071 DOI: 10.1093/annonc/mdx054] [Citation(s) in RCA: 138] [Impact Index Per Article: 23.0] [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] [Indexed: 12/16/2022] Open
Abstract
Chordomas are rare, malignant bone tumors of the skull-base and axial skeleton. Until recently, there was no consensus among experts regarding appropriate clinical management of chordoma, resulting in inconsistent care and suboptimal outcomes for many patients. To address this shortcoming, the European Society of Medical Oncology (ESMO) and the Chordoma Foundation, the global chordoma patient advocacy group, convened a multi-disciplinary group of chordoma specialists to define by consensus evidence-based best practices for the optimal approach to chordoma. In January 2015, the first recommendations of this group were published, covering the management of primary and metastatic chordomas. Additional evidence and further discussion were needed to develop recommendations about the management of local-regional failures. Thus, ESMO and CF convened a second consensus group meeting in November 2015 to address the treatment of locally relapsed chordoma. This meeting involved over 60 specialists from Europe, the United States and Japan with expertise in treatment of patients with chordoma. The consensus achieved during that meeting is the subject of the present publication and complements the recommendations of the first position paper.
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Affiliation(s)
| | - A Gronchi
- Surgery, Fondazione IRCCS Istituto Nazionale Tumori, Milan
| | - P Fossati
- CNAO National Center for Oncological Hadrontherapy, Pavia.,Department of Radiotherapy, IEO-European Institute of Oncology, Milan, Italy
| | - T Akiyama
- Department of Orthopaedic Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - C Alapetite
- Department of Radiotherapy, Institut Curie, Paris.,Institut Curie-Centre de Protonthérapie d'Orsay (ICPO), Orsay, France
| | - M Baumann
- Department of Radiation Oncology, Medical Faculty and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - J Y Blay
- Cancer Medicine Department, Centre Léon Bérard, Lyon
| | - S Bolle
- Department of Radiotherapy, Gustave Roussy, Villejuif Cedex, France
| | - S Boriani
- Department of Degenerative and Oncological Spine Surgery, Rizzoli Institute Bologna, Bologna
| | - P Bruzzi
- Department of Epidemiology, IRCCS Azienda Ospedaliera Universitaria San Martino, IST Istituto Nazionale per la Ricerca sul Cancro, Genova
| | - R Capanna
- University Clinic of Orthopedics and Traumatology AO Pisa, Pisa
| | - A Caraceni
- Palliative Care Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan
| | - R Casadei
- Orthopedic Department, Rizzoli Institute Bologna, Bologna, Italy
| | - V Colia
- Departments of Cancer Medicine
| | - J Debus
- Department of Radiation Oncology, University of Heidelberg, Heidelberg, Germany
| | - T Delaney
- Department of Radiation Oncology, Francis H. Burr Proton Therapy Center, Massachusetts General Hospital, Boston, USA
| | - A Desai
- Midlands Abdominal and Retroperitoneal Sarcoma Unit (MARSU), Queen Elizabeth Hospital, Birmingham
| | - P Dileo
- Department of Oncology, University College London Hospitals (UCLH), London, UK
| | - S Dijkstra
- Department of Orthopaedic Surgery, Leiden University Medical Centre, Leiden, The Netherlands
| | - F Doglietto
- Institute of Neurosurgery, University of Brescia, Brescia, Italy
| | - A Flanagan
- University College London Cancer Institute, London.,Histopathology Department, Royal National Orthopaedic Hospital NHS Trust, Stanmore, UK
| | - S Froelich
- Department of Neurosurgery, Paris Diderot University, Hôpital Lariboisière, Paris, France
| | - P A Gardner
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, USA
| | - H Gelderblom
- Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - Z L Gokaslan
- Department of Neurosurgery, Brown University School of Medicine, Providence, USA
| | - R Haas
- Department of Radiotherapy, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - C Heery
- Laboratory of Tumor Immunology and Biology, Center for Cancer Research, National Cancer Institute, Bethesda, USA
| | - N Hindi
- Department of Cancer Medicine, Hospital Universitario Virgen del Rocio, Sevilla, Spain
| | - P Hohenberger
- Sarcoma Unit, Interdisciplinary Tumor Center, Mannheim University Medical Center, University of Heidelberg, Mannheim, Germany
| | - F Hornicek
- Department of Orthopedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - R Imai
- National Institute of Radiological Sciences, Research Center Hospital for Charged Particle Therapy, Chiba, Japan
| | - L Jeys
- Department of Orthopaedics, Royal Orthopaedic Hospital Birmingham, Birmingham
| | - R L Jones
- Sarcoma Unit, Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London, UK
| | - B Kasper
- Sarcoma Unit, Interdisciplinary Tumor Center, Mannheim University Medical Center, University of Heidelberg, Mannheim, Germany
| | - A Kawai
- Musculoskeletal Oncology and Rehabilitation Medicine, National Cancer Center, Tokio, Japan
| | - M Krengli
- Radiotherapy Department, University of Piemonte Orientale, Novara, Italy
| | - A Leithner
- Department of Orthopaedics and Orthopaedic Surgery, Medical University Graz, Graz, Austria
| | - I Logowska
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
| | - J Martin Broto
- Department of Cancer Medicine, Hospital Universitario Virgen del Rocio, Sevilla, Spain
| | - D Mazzatenta
- Department of Neurosurgery, IRCCS Istituto delle Scienze Neurologiche, Bologna
| | - C Morosi
- Department of Radiology, Fondazione IRCCS Istituto Nazionale Tumori, Milan
| | - P Nicolai
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Brescia, Brescia, Italy
| | - O J Norum
- Department of Tumor Orthopedic Surgery, The Norwegian Radium Hospital, Oslo, Norway
| | - S Patel
- Department of Sarcoma Medical Oncology, MD Anderson Cancer Center, Houston, USA
| | - N Penel
- Cencer Medicine Department, Oscar Lambret Cancer Centre, Lille, France
| | - P Picci
- Laboratory of Oncologic Research, Istituto Ortopedico Rizzoli, Bologna
| | - S Pilotti
- Laboratory of Molecular Pathology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - S Radaelli
- Surgery, Fondazione IRCCS Istituto Nazionale Tumori, Milan
| | - F Ricchini
- Palliative Care Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan
| | - P Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
| | - S Scheipl
- Department of Orthopaedics and Orthopaedic Surgery, Medical University Graz, Graz, Austria
| | - C Sen
- Department of Neurosurgery, NYU Langone Medical Center, New York
| | - E Tamborini
- Laboratory of Molecular Pathology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - K A Thornton
- Center for Bone and Soft Tissue Sarcoma, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA
| | - B Timmermann
- Particle Therapy Department, West German Proton Therapy Centre Essen, University Hospital Essen, Essen, Germany
| | - V Torri
- Oncology Unit, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - P U Tunn
- Department of Orthopaedic Oncology, HELIOS Klinikum Berlin-Buch, Berlin, Germany
| | - M Uhl
- Department of Radiation Oncology, University of Heidelberg, Heidelberg, Germany
| | - Y Yamada
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, USA
| | - D C Weber
- Paul Scherrer Institut PSI, Villigen, Switzerland
| | - D Vanel
- Department of Radiology, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - P P Varga
- National Center for Spinal Disorders, Budapest, Hungary
| | | | | | - J Sommer
- Chordoma Foundation, Durham, USA
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Iacovazzo D, Bianchi A, Lugli F, Milardi D, Giampietro A, Lucci-Cordisco E, Doglietto F, Lauriola L, De Marinis L. Double pituitary adenomas. Endocrine 2013; 43:452-7. [PMID: 23325364 DOI: 10.1007/s12020-013-9876-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Accepted: 01/07/2013] [Indexed: 10/27/2022]
Abstract
Double pituitary adenomas represent up to 2.6 % of pituitary adenomas in large surgical series and up to 3.3 % of patients with Cushing's disease have been found to have double or multiple pituitary adenomas. We report the case of a 60-year-old male patient whose medical history began in 2002 with erectile dysfunction; hyperprolactinemia was found and MRI showed a 6-mm area of delayed enhancement in the lateral portion of the right pituitary lobe. Treatment with cabergoline was started with normalization of prolactin levels; the following MRI, performed in 2005 and 2008, showed shrinkage of the pituitary lesion. In 2005, the patient began to manifest weight gain, hypertension, and facial plethora, but no further evaluations were done. In January 2010, the patient came to our attention and underwent multiple tests that suggested Cushing's disease. A new MRI was negative. Bilateral inferior petrosal sinus sampling showed significant pituitary-to-peripheral ratio and, in May 2010, the patient underwent exploratory pituitary surgery with evidence of a 1-2-mm white-coloured midline area compatible with pituitary adenoma that was surgically removed. Post-operatively, the patient's clinical conditions improved with onset of secondary hypoadrenalism. The histologic examination confirmed a pituitary adenoma (immunostaining was found to be positive for ACTH and negative for prolactin). We report the case of an ACTH-producing microadenoma metachronous to a prolactin secreting microadenoma although not confirmed histologically, shrunk by medical treatment. A review of data in the literature regarding double or multiple pituitary adenomas has also been done.
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Affiliation(s)
- D Iacovazzo
- Department of Endocrinology, Catholic University, Policlinico A. Gemelli, Largo A. Gemelli, 8, 00168, Rome, Italy.
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Fernandez E, Lauretti L, Tufo T, D’Ercole M, Ciampini A, Doglietto F. End-to-side nerve neurorrhaphy: critical appraisal of experimental and clinical data. How to Improve the Results of Peripheral Nerve Surgery 2011; 100:77-84. [DOI: 10.1007/978-3-211-72958-8_17] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Kim CY, Tate M, Chang E, Polley MY, Berger M, Mercier L, Del Maestro RF, Petrecca K, Collins DL, Doglietto F, Salehi F, Ridout R, Gentili F, Zadeh G, Shrivastava RK, Ghesani M, Sen C, Shrivastava RK, Tabaee A, Lee KD, DePowell JJ, Air E, Dwivedi AK, McPherson CM, Mishra MV, Andrews D, Evans J, Glass J, Dicker AP, Lawrence YR, Kirsch M, Juratli T, Meyer K, Schackert G, Cho JM, Kim EH, Oh MC, Chang JH, Kim SH, Lee KS, Cho JM, Kim EH, Oh MC, Chang JH, Kim SH, Lee KS, Adams H, Avendano J, Raza SM, Olivi A, Quinones-Hinojosa A, Del Maestro RF, Siu V, Seyed sadr M, Alshami J, Sabau C, Seyed sadr E, Anan M, Guiot MC, Samani A, Del Maestro P, Galameau A, Greaves K, Pouliot JF, Mangano F, Pruitt D, Hummel T. Surgical Therapies. Neuro Oncol 2010. [DOI: 10.1093/neuonc/noq116.s19] [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: 11/14/2022] Open
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Montano N, Signorelli F, Tufo T, Sioletic S, Lauretti L, Pallini R, Maira G, Doglietto F. Teaching NeuroImages: extralesional bleeding of conus medullaris cavernoma. Neurology 2010; 75:e1. [PMID: 20603476 DOI: 10.1212/wnl.0b013e3181e6209b] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- N Montano
- Institute of Neurosurgery, Catholic University, Largo Agostino Gemelli, 8, 00168 Rome, Italy.
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Montano N, Nucci CG, Doglietto F, Cianfoni A, Lucantoni C, De Bonis P, Tamburrini G, Visocchi M. Teaching NeuroImage: Spontaneous idiopathic spinal subdural hematoma. Neurology 2008; 71:e27. [DOI: 10.1212/01.wnl.0000324930.79807.4f] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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De Bonis P, Lucantoni C, D'Angelo L, Doglietto F, Romano D, Visocchi M. Teaching NeuroImage: spinal extradural arachnoid cyst: a rare cause of back pain. Neurology 2008; 71:e24. [PMID: 18725585 DOI: 10.1212/01.wnl.0000324614.63378.f0] [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: 11/15/2022] Open
Affiliation(s)
- P De Bonis
- Institute of Neurosurgery, Catholic University School of Medicine, L.go A. Gemelli 8, 00168 Rome, Italy.
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Fusco A, Zatelli MC, Bianchi A, Cimino V, Tilaro L, Veltri F, Angelini F, Lauriola L, Vellone V, Doglietto F, Ambrosio MR, Maira G, Giustina A, degli Uberti EC, Pontecorvi A, De Marinis L. Prognostic significance of the Ki-67 labeling index in growth hormone-secreting pituitary adenomas. J Clin Endocrinol Metab 2008; 93:2746-50. [PMID: 18460561 DOI: 10.1210/jc.2008-0126] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Ki-67 is a marker of proliferation activity associated with invasiveness and prognosis in human tumors. OBJECTIVE The aim of the study was to evaluate the Ki-67 index prognostic relevance in a group of acromegalic patients who underwent transsphenoidal surgery for a GH-secreting pituitary adenoma. MATERIAL AND METHODS We selected 68 consecutive acromegalic patients referred to our hospital during a 5-yr period. The Ki-67 index was determined by immunohistochemistry on tissue samples obtained from each adenoma after surgery. Those patients who were not completely cured after surgery began medical therapy with somatostatin analogs (SSAs). Periodical pituitary magnetic resonance imaging and hormonal evaluation were performed during the follow-up. RESULTS Twenty-eight of 68 patients were cured after surgery (41%). Among the 40 patients treated with SSAs, 13 were considered uncontrolled. Pituitary magnetic resonance imaging showed residual/recurrent disease in 25 of 68 patients after 6 months. No correlation was found between Ki-67 index and age, tumor size, GH, or IGF-I plasma levels. Tumors described as having cavernous sinus invasion had a higher mean Ki-67 index as compared with noninvasive tumors (P < 0.01). The Ki-67 index was significantly lower in tumors in patients cured after surgery as compared with patients considered not cured (P < 0.01) and in tumors in patients controlled by SSA therapy as compared with patients considered as uncontrolled (P < 0.05). CONCLUSION The Ki-67 labeling index may predict clinical outcome in postsurgical management of acromegalic patients. We suggest routine Ki-67 evaluation in GH-secreting pituitary adenomas.
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Affiliation(s)
- A Fusco
- Section of Endocrinology, Department of Internal Medicine, Università Cattolica del Sacro Cuore, Via Cassia 901, Rome, Italy
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Montano N, De Bonis P, Doglietto F, Cianfoni A, Pallini R, Lauriola L, Maira G. Teaching NeuroImage: hemorrhagic ependymoma in the elderly: a rare cause of headache and gait imbalance. Neurology 2008; 70:e95. [PMID: 18519865 DOI: 10.1212/01.wnl.0000313841.63392.70] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- N Montano
- Institute of Neurosurgery, Catholic University School of Medicine, Largo Agostino Gemelli, 8, 00168 Rome, Italy
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Albanese A, Marchese MR, Sabatino G, Doglietto F, Anile C, Mangiola A, Galli J. Hearing loss after cerebrospinal fluid shunt and its resolution following programmable valve adjustment. Eur J Neurol 2007; 14:e47-8. [PMID: 17222097 DOI: 10.1111/j.1468-1331.2006.01546.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Doglietto F, Massimi L, Dickmann A, Tamburrini G, Caldarelli M, Di Rocco C. Microphthalmia and colobomatous cyst of the orbit. Acta Neurochir (Wien) 2006; 148:1123-5. [PMID: 16944051 DOI: 10.1007/s00701-006-0879-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2005] [Accepted: 07/20/2006] [Indexed: 10/24/2022]
Affiliation(s)
- F Doglietto
- Institute of Pediatric Neurosurgery, Catholic University Medical School, Rome, Italy.
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Doglietto F, Sabatino G, Policicchio D, Tirpakova B, Albanese A. Transcranial cerebral herniation after chronic subdural hematoma treatment with no dura closure. Neurology 2006; 67:493. [PMID: 16894113 DOI: 10.1212/01.wnl.0000218283.98647.d4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- F Doglietto
- Institute of Neurosurgery, Catholic University School of Medicine, L.go A. Gemelli, 8 00168 Rome, Italy
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Doglietto F, Sabatino G, Albanese A, Mangiola A, Anile C, Maira G. Late perforation of the bowel in patients with a ventriculoperitoneal shunt. Eur J Neurol 2006; 13:e5. [PMID: 16879282 DOI: 10.1111/j.1468-1331.2006.01303.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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16
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Doglietto F, Lauretti L, Tartaglione T, Gessi M, Fernandez E, Maira G. Diffuse craniospinal choroid plexus papilloma with involvement of both cerebellopontine angles. Neurology 2005; 65:842. [PMID: 16186520 DOI: 10.1212/01.wnl.0000167136.64675.9e] [Citation(s) in RCA: 13] [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] [Indexed: 11/15/2022] Open
Affiliation(s)
- F Doglietto
- Institute of Neurosurgery, Catholic University School of Medicine, 00168 Rome, Italy.
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Abstract
PURPOSE To describe repetitive movements of the right arm possibly originating from the ipsilateral SMA area in two drug-resistant epileptic patients. METHODS Two epileptic patients (one female, one male, 35 and 36 years old, respectively) were submitted to pre-surgical evaluation including history, neurological examination, long-term video-EEG monitoring, interictal and ictal SPET, MRI and fMRI, neuropsychological assessment. Invasive recordings (stereoelectroencephalography) were also performed. RESULTS In both patients ictal semiology was characterized by very stereotyped repetitive right arm movements, i.e. tapping towards the thorax (movement rate of 6-7 Hz and 3-4 Hz for the two subjects, respectively). Seizures in the first patient, whose epilepsy was cryptogenetic, originated from the right pre-SMA area, which was surgically removed. She is seizure free 2 years after the operation. In the second patient, in whom a right pre-frontal post-abscess porencephaly was disclosed, the epileptogenic zone included the lesion and surrounding areas, while the SMA area was involved less consistently. CONCLUSIONS Even if, according to literature, SMA epilepsy is predominantly characterized by postural manifestations, ipsilateral repetitive movements could be a relevant sign in this kind of epilepsy, as showed in our first patient. The presence of similar semiology in the second patient, might suggest that the symptomatogenic zone involved SMA area.
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Affiliation(s)
- C Barba
- Post-Coma Unit, Fondazione Santa Lucia, IRCCS, via Ardeatina 306, 00179 Rome, Italy.
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Barba C, Doglietto F, De Luca L, Faraca G, Marra C, Meglio M, Rossi GF, Colicchio G. Retrospective analysis of variables favouring good surgical outcome in posterior epilepsies. J Neurol 2005; 252:465-72. [PMID: 15726256 DOI: 10.1007/s00415-005-0676-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [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: 06/10/2004] [Revised: 09/23/2004] [Accepted: 10/08/2004] [Indexed: 10/25/2022]
Abstract
AIM to determine variables favouring good surgical outcome in posterior epilepsies. METHODS Fourteen patients submitted to epilepsy surgery were included in the study. The epileptogenic zone was located in temporo-parieto-occipital areas as assessed by both invasive and non-invasive pre-surgical evaluation. Several variables (age at first seizure; age at surgery; disease duration; type, frequency and clinical semiology of seizures; presence of lesion; scalp ictal and interictal EEG; localization and extension of epileptogenic zone; completeness of surgical resection) were compared (Fisher's exact test) with freedom from seizures to determine whether surgical outcome (Engel's classification) could be related to any of them. RESULTS Seven patients were seizure free (Ia) and very satisfying results were obtained for 3 patients (2 Ib, 1 Ic). New post-surgical visual deficits occurred only in 3 patients. Surgical outcome was related significantly to two variables: scalp ictal EEG (focal versus non-focal; p: 0.014) and completeness of surgical resection of epileptogenic zone (p: 0.0023). A significant trend towards a better outcome for focal interictal intracranial activity versus a non-focal one (p: 0.07) was found. CONCLUSIONS The correlation between completeness of epileptogenic zone resection and surgical outcome suggests that a presurgical protocol, allowing a precise definition of the area of resection, could help in obtaining more satisfying results in posterior epilepsies.
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Affiliation(s)
- Carmen Barba
- Fondazione Santa Lucia, IRCCS, Via Ardeatina, 306, 00179 Rome, Italy.
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Barba C, Policicchio D, Doglietto F, Papacci F, Colicchio G. Seizure suppression after left anterior temporal lobectomy in a patient with an ipsilateral parietal lesion. Eur J Neurol 2004; 12:75-6. [PMID: 15613153 DOI: 10.1111/j.1468-1331.2004.00962.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Colicchio G, Barba C, D’Abramo G, Doglietto F, Faraca G, Papacci F, Meglio M. Vagal Stimulation for Drug Resistent Epileptic Patients: a Long-Term Follow-up Evaluation. Neuromodulation 2003. [DOI: 10.1046/j.1525-1403.2003.03027_18.x] [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: 11/20/2022]
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Cioni B, Doglietto F, Mannino S, Meglio M, Romani R, Tirpakova B. Spinal Cord Stimulation (SCS) Versus Intrathecal Drug Infusion (IDI) for the Treatment of Spinal Spasticity. Neuromodulation 2003. [DOI: 10.1046/j.1525-1403.2003.03027_14.x] [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: 11/20/2022]
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