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Ansarin M, Pietrobon G, Tagliabue M, Mossinelli C, Ruju F, Maffini F, Rocca MC, Alterio D, Simon C, Zorzi SF. Salvage transoral robotic surgery in recurrent oropharyngeal carcinoma: a single-center retrospective study. Eur Arch Otorhinolaryngol 2024; 281:3167-3177. [PMID: 38546850 DOI: 10.1007/s00405-024-08590-4] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 02/29/2024] [Indexed: 05/03/2024]
Abstract
PURPOSE Salvage surgery is still the best therapeutic option for resectable recurrent oropharyngeal squamous cell carcinoma (rOPSCC). Transoral robotic surgery may potentially reduce the morbidity of standard open approaches. The aim of the study is to present oncological and functional outcomes of a monocentric experience in salvage transoral robotic surgery. METHODS We performed a single-center retrospective analysis of patients submitted to transoral robotic salvage surgery with or without neck dissection for cT1-3 rOPSCC. We investigated complication rate, survival outcomes (Overall Survival, Disease Specific Survival, Loco-Regional Recurrence Free Survival) and functional outcomes (tracheal tube and/or gastrostomy dependence). RESULTS Sixty-one patients were included in the analysis. No major complications or perioperative deaths were recorded. The estimated 2-year OS was 76.7%, DSS 81.8% and LRRFS 50.5%. In multivariable analysis rpT, PNI (perineural infiltration) and HPV-positivity were significantly associated with LRRFS (Hazard Ratios: T3 vs T1 6.43, PNI yes vs no 4.19, HPV+ yes vs no 2.63). At last follow up, 97% of patients were tracheal tube-free, while 93% were gastrostomy-free. CONCLUSION Transoral robotic salvage surgery is a successful treatment in selected patients affected by rOPSCC because it grants good oncologic and functional outcomes.
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Affiliation(s)
- Mohssen Ansarin
- Division of Otolaryngology and Head and Neck Surgery, IEO European Institute of Oncology, IRCCS, Via Giuseppe Ripamonti 435, 20141, Milan, Italy
| | - Giacomo Pietrobon
- Division of Otolaryngology and Head and Neck Surgery, IEO European Institute of Oncology, IRCCS, Via Giuseppe Ripamonti 435, 20141, Milan, Italy.
| | - Marta Tagliabue
- Division of Otolaryngology and Head and Neck Surgery, IEO European Institute of Oncology, IRCCS, Via Giuseppe Ripamonti 435, 20141, Milan, Italy
| | - Chiara Mossinelli
- Division of Otolaryngology and Head and Neck Surgery, IEO European Institute of Oncology, IRCCS, Via Giuseppe Ripamonti 435, 20141, Milan, Italy
| | - Francesca Ruju
- Division of Radiology, IEO European Institute of Oncology, IRCCS, Milan, Italy
| | - Fausto Maffini
- Division of Pathology, IEO European Institute of Oncology, IRCCS, Milan, Italy
| | - Maria Cossu Rocca
- Division of Medical Oncology, IEO European Institute of Oncology, IRCCS, Milan, Italy
| | - Daniela Alterio
- Division of Radiotherapy, IEO European Institute of Oncology, IRCCS, Milan, Italy
| | - Christian Simon
- Department of Otolaryngology, Head and Neck Surgery, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Stefano Filippo Zorzi
- Division of Otolaryngology and Head and Neck Surgery, IEO European Institute of Oncology, IRCCS, Via Giuseppe Ripamonti 435, 20141, Milan, Italy
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2
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Canini V, Eccher A, d’Amati G, Fusco N, Maffini F, Lepanto D, Martini M, Cazzaniga G, Paliogiannis P, Lobrano R, L’Imperio V, Pagni F. Digital Pathology Applications for PD-L1 Scoring in Head and Neck Squamous Cell Carcinoma: A Challenging Series. J Clin Med 2024; 13:1240. [PMID: 38592086 PMCID: PMC10932078 DOI: 10.3390/jcm13051240] [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: 12/12/2023] [Revised: 01/29/2024] [Accepted: 02/20/2024] [Indexed: 04/10/2024] Open
Abstract
The assessment of programmed death-ligand 1 (PD-L1) combined positive scoring (CPS) in head and neck squamous cell carcinoma (HNSCC) is challenged by pre-analytical and inter-observer variabilities. An educational program to compare the diagnostic performances between local pathologists and a board of pathologists on 11 challenging cases from different Italian pathology centers stained with PD-L1 immunohistochemistry on a digital pathology platform is reported. A laboratory-developed test (LDT) using both 22C3 (Dako) and SP263 (Ventana) clones on Dako or Ventana platforms was compared with the companion diagnostic (CDx) Dako 22C3 pharm Dx assay. A computational approach was performed to assess possible correlations between stain features and pathologists' visual assessments. Technical discordances were noted in five cases (LDT vs. CDx, 45%), due to an abnormal nuclear/cytoplasmic diaminobenzidine (DAB) stain in LDT (n = 2, 18%) and due to variation in terms of intensity, dirty background, and DAB droplets (n = 3, 27%). Interpretative discordances were noted in six cases (LDT vs. CDx, 54%). CPS remained unchanged, increased, or decreased from LDT to CDx in three (27%) cases, two (18%) cases, and one (9%) case, respectively, around relevant cutoffs (1 and 20, k = 0.63). Differences noted in DAB intensity/distribution using computational pathology partly explained the LDT vs. CDx differences in two cases (18%). Digital pathology may help in PD-L1 scoring, serving as a second opinion consultation platform in challenging cases. Computational and artificial intelligence tools will improve clinical decision-making and patient outcomes.
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Affiliation(s)
- Valentina Canini
- Department of Medicine and Surgery, Pathology, IRCCS Fondazione San Gerardo dei Tintori, University of Milano-Bicocca, 20126 Milan, Italy; (V.C.); (G.C.); (V.L.); (F.P.)
| | - Albino Eccher
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, University Hospital of Modena, 41124 Modena, Italy
| | - Giulia d’Amati
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Roma, 00185 Rome, Italy;
| | - Nicola Fusco
- Division of Pathology, European Institute of Oncology IRCCS, 20141 Milan, Italy; (N.F.); (F.M.); (D.L.)
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy
| | - Fausto Maffini
- Division of Pathology, European Institute of Oncology IRCCS, 20141 Milan, Italy; (N.F.); (F.M.); (D.L.)
| | - Daniela Lepanto
- Division of Pathology, European Institute of Oncology IRCCS, 20141 Milan, Italy; (N.F.); (F.M.); (D.L.)
| | - Maurizio Martini
- Department of Pathology, University of Messina, 98122 Messina, Italy;
| | - Giorgio Cazzaniga
- Department of Medicine and Surgery, Pathology, IRCCS Fondazione San Gerardo dei Tintori, University of Milano-Bicocca, 20126 Milan, Italy; (V.C.); (G.C.); (V.L.); (F.P.)
| | - Panagiotis Paliogiannis
- Anatomic Pathology and Histology, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy; (P.P.); (R.L.)
| | - Renato Lobrano
- Anatomic Pathology and Histology, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy; (P.P.); (R.L.)
| | - Vincenzo L’Imperio
- Department of Medicine and Surgery, Pathology, IRCCS Fondazione San Gerardo dei Tintori, University of Milano-Bicocca, 20126 Milan, Italy; (V.C.); (G.C.); (V.L.); (F.P.)
| | - Fabio Pagni
- Department of Medicine and Surgery, Pathology, IRCCS Fondazione San Gerardo dei Tintori, University of Milano-Bicocca, 20126 Milan, Italy; (V.C.); (G.C.); (V.L.); (F.P.)
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3
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Mossinelli C, Tagliabue M, Ruju F, Cammarata G, Volpe S, Raimondi S, Zaffaroni M, Isaksson JL, Garibaldi C, Cremonesi M, Corso F, Gaeta A, Emili I, Zorzi S, Alterio D, Marvaso G, Pepa M, De Fiori E, Maffini F, Preda L, Benazzo M, Jereczek-Fossa BA, Ansarin M. The role of radiomics in tongue cancer: A new tool for prognosis prediction. Head Neck 2023; 45:849-861. [PMID: 36779382 DOI: 10.1002/hed.27299] [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: 07/01/2022] [Revised: 11/08/2022] [Accepted: 12/27/2022] [Indexed: 02/14/2023] Open
Abstract
BACKGROUND Radiomics represents an emerging field of precision-medicine. Its application in head and neck is still at the beginning. METHODS Retrospective study about magnetic resonance imaging (MRI) based radiomics in oral tongue squamous cell carcinoma (OTSCC) surgically treated (2010-2019; 79 patients). All preoperative MRIs include different sequences (T1, T2, DWI, ADC). Tumor volume was manually segmented and exported to radiomic-software, to perform feature extraction. Statistically significant variables were included in multivariable analysis and related to survival endpoints. Predictive models were elaborated (clinical, radiomic, clinical-radiomic models) and compared using C-index. RESULTS In almost all clinical-radiomic models radiomic-score maintained statistical significance. In all cases C-index was higher in clinical-radiomic models than in clinical ones. ADC provided the best fit to the models (C-index 0.98, 0.86, 0.84 in loco-regional recurrence, cause-specific mortality, overall survival, respectively). CONCLUSION MRI-based radiomics in OTSCC represents a promising noninvasive method of precision medicine, improving prognosis prediction before surgery.
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Affiliation(s)
- Chiara Mossinelli
- Department of Otorhinolaryngology and Head and Neck Surgery, European Institute of Oncology, IRCCS, Milan, Italy
| | - Marta Tagliabue
- Department of Otorhinolaryngology and Head and Neck Surgery, European Institute of Oncology, IRCCS, Milan, Italy.,Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Francesca Ruju
- Division of Radiology, IEO, European Institute of Oncology, IRCCS, Milan, Italy
| | - Giulio Cammarata
- Department of Experimental Oncology, IEO European Institute of Experimental Oncology IRCCS, Milan, Italy
| | - Stefania Volpe
- Division of Radiation Oncology, European Institute of Oncology, IRCCS, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Sara Raimondi
- Department of Experimental Oncology, IEO European Institute of Experimental Oncology IRCCS, Milan, Italy
| | - Mattia Zaffaroni
- Division of Radiation Oncology, European Institute of Oncology, IRCCS, Milan, Italy
| | | | - Cristina Garibaldi
- Unit of Radiation Research, IEO European Institute of Oncology, IRCCS, Milan, Italy
| | - Marta Cremonesi
- Unit of Radiation Research, IEO European Institute of Oncology, IRCCS, Milan, Italy
| | - Federica Corso
- Department of Experimental Oncology, IEO European Institute of Experimental Oncology IRCCS, Milan, Italy.,Department of Mathematics (DMAT), Politecnico di Milano, Milan, Italy.,Centre for Health Data Science (CHDS), Human Techonopole
| | - Aurora Gaeta
- Department of Experimental Oncology, IEO European Institute of Experimental Oncology IRCCS, Milan, Italy
| | - Ilaria Emili
- Division of Radiology, IEO, European Institute of Oncology, IRCCS, Milan, Italy.,ASST Centro Specialistico Ortopedico Traumatologico G. Pini/C.T.O, Milan, Italy
| | - Stefano Zorzi
- Department of Otorhinolaryngology and Head and Neck Surgery, European Institute of Oncology, IRCCS, Milan, Italy
| | - Daniela Alterio
- Division of Radiation Oncology, European Institute of Oncology, IRCCS, Milan, Italy
| | - Giulia Marvaso
- Division of Radiation Oncology, European Institute of Oncology, IRCCS, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Matteo Pepa
- Division of Radiation Oncology, European Institute of Oncology, IRCCS, Milan, Italy
| | - Elvio De Fiori
- Division of Radiology, IEO, European Institute of Oncology, IRCCS, Milan, Italy
| | - Fausto Maffini
- Division of Pathology, IEO, European Institute of Oncology, IRCCS, Milan, Italy
| | - Lorenzo Preda
- Department of Clinical, Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, Pavia, Italy.,Division of Radiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Marco Benazzo
- Department of Clinical, Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, Pavia, Italy.,Department of Otorhinolaryngology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Barbara Alicja Jereczek-Fossa
- Division of Radiation Oncology, European Institute of Oncology, IRCCS, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Mohssen Ansarin
- Department of Otorhinolaryngology and Head and Neck Surgery, European Institute of Oncology, IRCCS, Milan, Italy
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Chu F, Maffini F, Lepanto D, Vacirca D, Taormina SV, De Berardinis R, Gandini S, Vignati S, Ranghiero A, Rappa A, Chiocca S, Barberis M, Tagliabue M, Ansarin M. The Genetic and Immunologic Landscape Underlying the Risk of Malignant Progression in Laryngeal Dysplasia. Cancers (Basel) 2023; 15:cancers15041117. [PMID: 36831458 PMCID: PMC9954731 DOI: 10.3390/cancers15041117] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 01/27/2023] [Accepted: 02/08/2023] [Indexed: 02/12/2023] Open
Abstract
(1) Background: The development of laryngeal cancer is a multistep process involving structural alterations of the epithelial mucosa, from dysplasia (LDy) to invasive carcinoma. In this study, we define new biomarkers, prognostic for malignant transformation, in patients affected by LDy. (2) Methods: We used targeted next-generation sequencing and immunohistochemical analysis to define the mutational and immunological landscape of 15 laryngeal dysplasia progressing to invasive cancer (progressing dysplasia), as well as 31 cases of laryngeal dysplasia that did not progress to carcinoma (non-progressing dysplasia). Two pathologists independently analyzed the presence of tumor-infiltrating lymphocytes in LDy pre-embedded paraffin-fixed specimens. The RNA-based next-generation sequencing panel OIRRA was used to evaluate the expression of 395 genes related to immune system activation. (3) Results: High TILs are significantly correlated with a higher risk of malignant transformation. The non-brisk pattern was significantly associated with an 86% reduced risk of malignant progression (OR = 0.16, 95% CI: 0.03-0.5, p = 0.008). TILs showed a highly positive correlation with CCR6, CD83, HLA-DPB1, MX1 and SNAI1, and they were inversely correlated with CD48, CIITA, CXCR4, FCER1G, IL1B, LST1 and TLR8. (4) Conclusions: TILs have a great potential to identify high-risk progression dysplasia and thus to define surveillance protocols and prevention programs.
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Affiliation(s)
- Francesco Chu
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, 20141 Milan, Italy
| | - Fausto Maffini
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, 20141 Milan, Italy
| | - Daniela Lepanto
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, 20141 Milan, Italy
| | - Davide Vacirca
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, 20141 Milan, Italy
| | - Sergio Vincenzo Taormina
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, 20141 Milan, Italy
| | - Rita De Berardinis
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, 20141 Milan, Italy
- Correspondence: (R.D.B.); (M.T.); Tel.: +39-02-57489380 (R.D.B. & M.T.)
| | - Sara Gandini
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Via Adamello 16, 20139 Milan, Italy
| | - Silvano Vignati
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Via Adamello 16, 20139 Milan, Italy
| | - Alberto Ranghiero
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Via Adamello 16, 20139 Milan, Italy
| | - Alessandra Rappa
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Via Adamello 16, 20139 Milan, Italy
| | - Susanna Chiocca
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Via Adamello 16, 20139 Milan, Italy
| | - Massimo Barberis
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, 20141 Milan, Italy
| | - Marta Tagliabue
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, 20141 Milan, Italy
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy
- Correspondence: (R.D.B.); (M.T.); Tel.: +39-02-57489380 (R.D.B. & M.T.)
| | - Mohssen Ansarin
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, 20141 Milan, Italy
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5
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Tagliabue M, D’Ecclesiis O, De Berardinis R, Gaeta A, Martinoli C, Piana AF, Maffini F, Gandini S, Ansarin M, Chiocca S. The prognostic role of sex and hemoglobin levels in patients with oral tongue squamous cell carcinoma. Front Oncol 2022; 12:1018886. [PMID: 36457509 PMCID: PMC9706199 DOI: 10.3389/fonc.2022.1018886] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 10/27/2022] [Indexed: 10/31/2023] Open
Abstract
BACKGROUND Women and men differ genetically, biologically (sex) and by social construct (gender), possibly impacting on prognostic factors in predicting cancer survival. Hemoglobin levels and immune system activation are players acting in this scenario which could play a role in partly determining prognosis between patients of different sex/gender (S/G). Here, we investigate these factors in patients affected by tongue squamous cell carcinoma. METHODS This is an observational retrospective cohort study. We collected tongue cancer patients' clinical data, including hemoglobin levels and neutrophil lymphocyte ratio (NLR). Overall survival (OS) and disease-free survival (DFS) were compared between women and men considering confounding and prognostic factors in multivariate Cox proportional hazard models. Stratified analyses were also conducted by sex and tumor stage. RESULT 576 patients, 39.9% women and 60.1% men, were found eligible for the analysis. Men were more often smokers (p<0.001), alcohol consumers (p<0.001), overweight or obese (p<0.001) and undergoing radiotherapy (p=0.002). In multivariate models for stage I-II, men showed half risk of death and relapse compared to women (HR=0.44; 95%CI 0.24-0.81, p=0.009; HR=0.55; 95%CI 0.34-0.87, p=0.01, for OS and DFS respectively). Moreover, low hemoglobin levels appeared to be an independent prognostic factor for women but not for men in terms of both OS and DFS. Specifically, women with low hemoglobin levels showed a worse tumor outcome (HR=2.66; 95%CI 1.50-4.70; HR=2.09; 95%CI 1.24-3.53, for OS and DFS respectively). Low hemoglobin levels appeared to be a poor OS prognostic factor for women at stage I-II (p<0.004) but not for men (p=0.10). Women with advanced stage tumors, NLR>2.37, who did not performed Radiotherapy and with depth of invasion (DOI)> 10 were associated with a significant increase in relapse and death (all p<0.05). CONCLUSION In our cohort of patients with oral tongue squamous cell carcinoma, men present better OS and DFS than women with early stages tumors. Low hemoglobin level was an independent prognostic factor for women, especially at early-stage tumors. For advanced stages (III-IV), sex is not a significant factor related to patients' prognosis.
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Affiliation(s)
- Marta Tagliabue
- Department of Otolaryngology Head and Neck Surgery, European Institute of Oncology (IEO) Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Oriana D’Ecclesiis
- Department of Experimental Oncology, European Institute of Oncology (IEO) Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Rita De Berardinis
- Department of Otolaryngology Head and Neck Surgery, European Institute of Oncology (IEO) Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Aurora Gaeta
- Department of Experimental Oncology, European Institute of Oncology (IEO) Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Chiara Martinoli
- Department of Experimental Oncology, European Institute of Oncology (IEO) Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Andrea Fausto Piana
- Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
| | - Fausto Maffini
- Division of Pathology, European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Sara Gandini
- Department of Experimental Oncology, European Institute of Oncology (IEO) Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Mohssen Ansarin
- Department of Otolaryngology Head and Neck Surgery, European Institute of Oncology (IEO) Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Susanna Chiocca
- Department of Experimental Oncology, European Institute of Oncology (IEO) Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
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Sabatini ME, Compagnoni M, Maffini F, Miccolo C, Pagni F, Lombardi M, Brambilla V, Lepanto D, Tagliabue M, Ansarin M, Citro S, Chiocca S. The UBC9/SUMO pathway affects E-cadherin cleavage in HPV-positive head and neck cancer. Front Mol Biosci 2022; 9:940449. [PMID: 36032664 PMCID: PMC9411811 DOI: 10.3389/fmolb.2022.940449] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 06/30/2022] [Indexed: 12/24/2022] Open
Abstract
Functional loss of E-cadherin is frequent during tumor progression and occurs through a variety of mechanisms, including proteolytic cleavage. E-cadherin downregulation leads to the conversion of a more malignant phenotype promoting Epithelial to Mesenchymal Transition (EMT). The UBC9/SUMO pathway has been also shown to be involved in the regulation of EMT in different cancers. Here we found an increased expression of UBC9 in the progression of Head and Neck Cancer (HNC) and uncovered a role for UBC9/SUMO in hampering the HPV-mediated E-cadherin cleavage in HNC.
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Affiliation(s)
- Maria Elisa Sabatini
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, IEO Campus, Milan, Italy
| | - Micaela Compagnoni
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, IEO Campus, Milan, Italy
| | - Fausto Maffini
- Division of Pathology, IEO, European Institute of Oncology, IRCCS, Milan, Italy
| | - Claudia Miccolo
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, IEO Campus, Milan, Italy
| | - Fabio Pagni
- Department of Medicine and Surgery, Pathology, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy
| | - Mariano Lombardi
- Division of Pathology, IEO, European Institute of Oncology, IRCCS, Milan, Italy
| | - Virginia Brambilla
- Department of Medicine and Surgery, Pathology, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy
| | - Daniela Lepanto
- Division of Pathology, IEO, European Institute of Oncology, IRCCS, Milan, Italy
| | - Marta Tagliabue
- Division of Otolaryngology Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Mohssen Ansarin
- Division of Otolaryngology Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Simona Citro
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, IEO Campus, Milan, Italy
- *Correspondence: Simona Citro, ; Susanna Chiocca,
| | - Susanna Chiocca
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, IEO Campus, Milan, Italy
- *Correspondence: Simona Citro, ; Susanna Chiocca,
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7
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Simoens C, Gheit T, Ridder R, Gorbaslieva I, Holzinger D, Lucas E, Rehm S, Vermeulen P, Lammens M, Vanderveken OM, Kumar RV, Gangane N, Caniglia A, Maffini F, Rubio MBL, Anantharaman D, Chiocca S, Brennan P, Pillai MR, Sankaranarayanan R, Bogers J, Pawlita M, Tommasino M, Arbyn M. Accuracy of high-risk HPV DNA PCR, p16 (INK4a) immunohistochemistry or the combination of both to diagnose HPV-driven oropharyngeal cancer. BMC Infect Dis 2022; 22:676. [PMID: 35933382 PMCID: PMC9357318 DOI: 10.1186/s12879-022-07654-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 07/08/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The incidence of high-risk human papillomavirus (hrHPV)-driven head and neck squamous cell carcinoma, in particular oropharyngeal cancers (OPC), is increasing in high-resource countries. Patients with HPV-induced cancer respond better to treatment and consequently have lower case-fatality rates than patients with HPV-unrelated OPC. These considerations highlight the importance of reliable and accurate markers to diagnose truly HPV-induced OPC. METHODS The accuracy of three possible test strategies, i.e. (a) hrHPV DNA PCR (DNA), (b) p16(INK4a) immunohistochemistry (IHC) (p16), and (c) the combination of both tests (considering joint DNA and p16 positivity as positivity criterion), was analysed in tissue samples from 99 Belgian OPC patients enrolled in the HPV-AHEAD study. Presence of HPV E6*I mRNA (mRNA) was considered as the reference, indicating HPV etiology. RESULTS Ninety-nine OPC patients were included, for which the positivity rates were 36.4%, 34.0% and 28.9% for DNA, p16 and mRNA, respectively. Ninety-five OPC patients had valid test results for all three tests (DNA, p16 and mRNA). Using mRNA status as the reference, DNA testing showed 100% (28/28) sensitivity, and 92.5% (62/67) specificity for the detection of HPV-driven cancer. p16 was 96.4% (27/28) sensitive and equally specific (92.5%; 62/67). The sensitivity and specificity of combined p16 + DNA testing was 96.4% (27/28) and 97.0% (65/67), respectively. In this series, p16 alone and combined p16 + DNA missed 1 in 28 HPV driven cancers, but p16 alone misclassified 5 in 67 non-HPV driven as positive, whereas combined testing would misclassify only 2 in 67. CONCLUSIONS Single hrHPV DNA PCR and p16(INK4a) IHC are highly sensitive but less specific than using combined testing to diagnose HPV-driven OPC patients. Disease prognostication can be encouraged based on this combined test result.
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Affiliation(s)
- Cindy Simoens
- Unit of Cancer Epidemiology, Belgian Cancer Centre, Sciensano, Juliette Wytsmanstraat 14, 1050, Brussels, Belgium.
- AMBIOR, Laboratory for Cell Biology & Histology, University of Antwerp, Antwerp, Belgium.
| | - Tarik Gheit
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer (IARC), Lyon, France
| | - Ruediger Ridder
- Roche Diagnostics GmbH, Mannheim, Germany
- Ventana Medical Systems, Inc. (Roche Diagnostics Solutions), Tucson, AZ, USA
| | - Ivana Gorbaslieva
- AMBIOR, Laboratory for Cell Biology & Histology, University of Antwerp, Antwerp, Belgium
| | - Dana Holzinger
- Infections and Cancer Epidemiology, Research Program Infection, Inflammation and Cancer, Deutsches Krebsforschungszentrum, Heidelberg, Germany
| | - Eric Lucas
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer (IARC), Lyon, France
| | | | - Peter Vermeulen
- Laboratory for Pathological Anatomy, Sint Augustinus Hospital, GZA, Antwerp, Belgium
| | - Martin Lammens
- Department of Pathology, Antwerp University Hospital, Edegem, Belgium
- Center for Oncological Research, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Olivier M Vanderveken
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Rekha Vijay Kumar
- Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, 560029, India
| | - Nitin Gangane
- Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha, Maharashtra State, 442102, India
| | | | - Fausto Maffini
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | | | - Devasena Anantharaman
- Rajiv Gandhi Centre for Biotechnology, Poojappura, Thiruvananthapuram, Kerala, 695014, India
| | - Susanna Chiocca
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Paul Brennan
- Genomic Epidemiology Branch, International Agency for Research On Cancer (IARC), Lyon, France
| | | | | | - Johannes Bogers
- AMBIOR, Laboratory for Cell Biology & Histology, University of Antwerp, Antwerp, Belgium
| | - Michael Pawlita
- Infections and Cancer Epidemiology, Research Program Infection, Inflammation and Cancer, Deutsches Krebsforschungszentrum, Heidelberg, Germany
| | - Massimo Tommasino
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer (IARC), Lyon, France
| | - Marc Arbyn
- Unit of Cancer Epidemiology, Belgian Cancer Centre, Sciensano, Juliette Wytsmanstraat 14, 1050, Brussels, Belgium.
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Tagliabue M, De Berardinis R, Belloni P, Gandini S, Scaglione D, Maffini F, Mirabella RA, Riccio S, Gioacchino G, Bruschini R, Chu F, Ansarin M. Oral tongue carcinoma: prognostic changes according to the updated 2020 version of the AJCC/UICC TNM staging system. Acta Otorhinolaryngol Ital 2022; 42:140-149. [PMID: 35612505 PMCID: PMC9131996 DOI: 10.14639/0392-100x-n2055] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 03/01/2022] [Indexed: 04/24/2023]
Abstract
BACKGROUND This study aimed to evaluate the performance of the 2017 8th TNM edition and the latest update in 2020 compared to the 7th in a large cohort of patients affected by oral tongue squamous cell carcinoma (OTSCC), considering all stages. MATERIALS AND METHODS The cohort involved 300 patients affected by OTSCC treated with surgery. All cases were classified according to the 7th, 8th (2017), and the latest updated TNM edition (October 2020),. Patients were grouped based on the shift in tumour (T) category, lymph nodal (N) category and final pathological stage. Overall survival (OS) and disease-free survival (DFS) were calculated with the Kaplan-Meier method. Univariate and multivariate analyses were carried out. RESULTS According to the 7th edition, multivariate analysis OS revealed that stage IV patients had an almost 4-fold risk of death compared to stage I (HR = 3.81 95% CI: 2.32-6.25; p < 0.001). Regarding DFS, stage IV patients had a 2-fold greater risk of relapses, or second primary, than patients in stage I (HR = 2.51 95% CI: 1.68-3.74; p < 0.001). According to 2017 8th edition for OS, stage IV patients presented a 5-fold higher risk of death compared to patients in stage I (HR = 5.18 95% CI: 2.96-9.08; p < 0.001) and almost 4-old greater risk of relapses or second primary compared to patients in stage I considering DFS (HR = 3.61 95% CI: 2.28-5.71; p < 0.001). Regarding the recent edition of 8th TNM (2020), stage IV patients had an almost 5-fold greater risk of death compared to patients in stage I considering OS (HR = 4.84 95% CI: 2.74-8.55; p < 0.001), while for DFS they had 3-fold greater risk of relapse or second primary compared to patients in stage I (HR = 3.13 95% CI: 1.99-4.91; p < 0.001). CONCLUSIONS This study confirmed that the recent update of the 8th edition of the TNM (2020) improves stratification and identification of advanced tumours, reducing the number of T3 compared to the 2017 edition and increasing the number of patients with pT4. This improvement made by the updated edition may reduce the risk of skipping adjuvant therapy.
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Affiliation(s)
- Marta Tagliabue
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Rita De Berardinis
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Correspondence Rita De Berardinis Department of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, via Ripamonti 435, 20141 Milano, Italy E-mail:
| | - Pietro Belloni
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Statistical Sciences, University of Padua, Padua, Italy
| | - Sara Gandini
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Donatella Scaglione
- Division of Data Management, European Institute of Oncology IRCCS, Milan, Italy
| | - Fausto Maffini
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | | | - Stefano Riccio
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Giugliano Gioacchino
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Roberto Bruschini
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Francesco Chu
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Mohssen Ansarin
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
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De Berardinis R, Tagliabue M, Belloni P, Gandini S, Scaglione D, Maffini F, Margherini S, Riccio S, Giugliano G, Bruschini R, Chu F, Ansarin M. Tongue cancer treatment and oncological outcomes: The role of glossectomy classification. Surg Oncol 2022; 42:101751. [DOI: 10.1016/j.suronc.2022.101751] [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] [Received: 01/27/2022] [Revised: 03/18/2022] [Accepted: 03/22/2022] [Indexed: 11/25/2022]
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10
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Salvatori R, Manzoni M, Lepanto D, Stufano V, Pessina S, Zanetti C, Bassi F, Mazzarol G, Montagna E, Maffini F. A molecular reappraisal of matrix-producing breast metaplastic carcinoma highlighted by PLAG1 and MYC rearrangements. Tumori 2022; 109:197-202. [PMID: 35361013 PMCID: PMC10070549 DOI: 10.1177/03008916221080190] [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] [Indexed: 11/16/2022]
Abstract
Background: Very little is currently known about molecular alteration of matrix-producing carcinoma of the breast. However, the morphological similarity with other neoplasm with a myxo-chondroid component is remarkable. In this pilot study we evaluated the molecular alterations involving PLAG1 and MYC genes in 12 cases of matrix producing carcinoma. Methods: We evaluated PLAG1 rearrangements as Break-Apart and Gene Copy Gain, and MYC as amplification and polysomy in 12 cases of matrix producing carcinoma using a FISH method. Results: Among the 12 cases of matrix producing carcinomas we found that the three cases harboring MYC amplification were all negative for PLAG1 break-apart; four cases with MYC polysomy were associated to PLAG1 break-apart and high Gene Copy Number; among four cases wild type for MYC, three showed a PLAG1- break-apart signal and of them two died with disease. One of the deceased patients showed an amplification of MYC with PLAG1- wild-type and the other showed a PLAG1 break-apart (6%) and a MYC wild-type. Conclusion: This is the first report to the best of our knowledge that shows a possible correlation between a matrix producing carcinoma with PLAG1 and MYC involvement in the development and progression of this kind of tumor. We can suppose that MYC amplification behaves in an aggressive way together with PLAG1- break-apart in the cases of matrix producing carcinoma presented here. The gene copy gain is a useful diagnostic tool in the case of difficult diagnosis because an increase was observed in more than 50% of cases.
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Affiliation(s)
- Rebecca Salvatori
- Department of Surgical Pathology, European Institute of Oncology, IRCCS, Milan, Italy
- University “Statale” of Milan, School of Medicine, Milan, Italy
| | - Marco Manzoni
- Department of Surgical Pathology, European Institute of Oncology, IRCCS, Milan, Italy
| | - Daniela Lepanto
- Department of Surgical Pathology, European Institute of Oncology, IRCCS, Milan, Italy
| | - Viviana Stufano
- Department of Surgical Pathology, European Institute of Oncology, IRCCS, Milan, Italy
| | - Simona Pessina
- Department of Surgical Pathology, European Institute of Oncology, IRCCS, Milan, Italy
| | - Chiara Zanetti
- Department of Surgical Pathology, European Institute of Oncology, IRCCS, Milan, Italy
| | - Fabio Bassi
- Department of Breast Surgery, European Institute of Oncology, IRCCS, Milan, Italy
| | - Giovanni Mazzarol
- Department of Surgical Pathology, European Institute of Oncology, IRCCS, Milan, Italy
| | - Emilia Montagna
- Department of Breast Medical Oncology, European Institute of Oncology, IRCCS, Milan, Italy
| | - Fausto Maffini
- Department of Surgical Pathology, European Institute of Oncology, IRCCS, Milan, Italy
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Pirola S, Fiori S, Maffini F, Mostardini G, Mastroiacovo G, Polvani G. A Malignant Lymphoma Growing Inside a Cardiac Mixoma: A Case Report. Braz J Cardiovasc Surg 2022; 37. [PMID: 35072410 PMCID: PMC9162416 DOI: 10.21470/1678-9741-2021-0081] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Introduction Lymphomas arising from cardiac myxomas represent a particularly rare pathology, with only few cases reported in the literature. Case presentation: We report a complete excision of a malignant lymphoma arising from a cardiac myxoma in a 44-year-old female patient. The myxoma presented like a floating mass within the left atrium with a maximum diameter of 3.5 cm. The clinical post-operative period was uneventful and the patient was dismissed on the 6th post-operative day. Conclusion This case reinforces the concept of radical excision of cardiac neoplasms.
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12
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Alterio D, De Berardinis R, Augugliaro M, D’Urso P, Volpe S, Maffini F, Bruschini R, Marvaso G, Riccio S, Tagliabue M, Turturici I, Farneti A, Calabrese L, Starzynska A, Ferrari A, Zaffaroni M, Jereczek-Fossa BA, Sanguineti G, Ansarin M. Indication to postoperative radiotherapy for oral cavity squamous cell carcinoma: what’s new in the Depth of Infiltration (DOI) era? Br J Radiol 2021; 95:20210705. [DOI: 10.1259/bjr.20210705] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objectives: The last edition of the American Joint Committee on Cancer (AJCC eighth) has introduced the depth of infiltration (DOI) as a new prognostic parameter in oral cavity squamous cell carcinomas (OCSCCs). Aim of this study is to analyze the impact of stage migration on the indication to postoperative radiotherapy (PORT). Methods: OCSCCs treated at two Institutions between 2014 and 2019 were retrieved. Per the AJCC eighth, only pT3 primarily OCSCCs were considered; availability of the pathologic specimen was a further inclusion criterion. Risk factors considered for PORT were: pT3-pT4, nodal involvement, positive/close surgical margins, perineural and lymph vascular invasion. Results: One-hundred forty-nine patients staged as pT3 AJCC eighth were included. A four-fold increase in the number of patients staged as pT3 from the seventh to the eighth AJCC was found. Stage migration to pT3 was equally due to the downstaging from former pT4 (38%) and upstaging of former pT1-pT2 (35%). Considering the former pT1-pT2 53 patients, 13 (25%) had no risk factors for PORT other than DOI. Among 25 cases with former pT1-pT2 and negative lymph nodes no additional risk factors were found in 11 (44%). Conclusion: Ninety percent of patients had at least one risk factor besides DOI and would have received PORT also according to the AJCC seventh; notably, of former pT1-pT2N0, half of them have been upstaged to pT3 in the current TNM classification. The role of PORT in this cohort of patients has not been clarified yet. Advances in knowledge: Other-than-DOI risk factors leading to PORT indication are highly prevalent in OCSSC patients classified as pT3 per the latest AJCC TNM staging system and should therefore be considered for a comprehensive oncological assessment.
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Affiliation(s)
- Daniela Alterio
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Rita De Berardinis
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Matteo Augugliaro
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Pasqualina D’Urso
- Radiotherapy Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Stefania Volpe
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Fausto Maffini
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Roberto Bruschini
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Giulia Marvaso
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Stefano Riccio
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Marta Tagliabue
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Irene Turturici
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Alessia Farneti
- Radiotherapy Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Luca Calabrese
- Division of Otorhinolaryngology, "San Maurizio" Hospital, Bolzano, Italy
| | - Anna Starzynska
- Department of Oral Surgery, Medical University of Gdansk, Gdansk, Poland
| | - Annamaria Ferrari
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Mattia Zaffaroni
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Barbara Alicja Jereczek-Fossa
- Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Giuseppe Sanguineti
- Radiotherapy Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Mohssen Ansarin
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
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Bruschini R, Maffini F, Chiesa F, Lepanto D, De Berardinis R, Chu F, Tagliabue M, Giugliano G, Ansarin M. Oral cancer: changing the aim of the biopsy in the age of precision medicine. A review. ACTA ACUST UNITED AC 2021; 41:108-119. [PMID: 34028455 PMCID: PMC8142729 DOI: 10.14639/0392-100x-n1056] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 02/03/2021] [Indexed: 01/15/2023]
Abstract
Oral cancer is a heterogeneous disease that develops through a complex, multi-step process. Precision medicine should help to better understand its molecular basis, integrate traditional classifications and have a positive impact on cancer management. To apply this information in clinical practice, we need to define its histology and identify biomarkers expressed by the tumour that provide useful information for planning tailored treatment. The most reliable information currently derives from evaluation of biomarkers on post-operative samples. To plan personalised treatment, oncologists need to assess these markers on biopsy samples. We reviewed the recent literature and identified 6 of 184 publications that compared markers measured on biopsy and post-operative samples or assessed their predictivity for the development of lymph node metastases. Data from these studies suggest that markers measured on biopsy samples can provide useful indications for tailoring treatments. However, due to their heterogeneity and low level of evidence, these results need to be confirmed by clinical studies on a large population to standardise and validate biomarkers in biopsies and to assess their reliability in other diagnostic mini-invasive procedures such as radiomics and liquid biopsy.
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Affiliation(s)
- Roberto Bruschini
- Division of Otolaryngology and Head & Neck Surgery, European Institute of Oncology IRCCS, Milan, Italy
| | - Fausto Maffini
- Division of Pathology, European Institute of Oncology IRCCS, Milan, Italy
| | - Fausto Chiesa
- Division of Otolaryngology and Head & Neck Surgery, European Institute of Oncology IRCCS, Milan, Italy
| | - Daniela Lepanto
- Division of Pathology, European Institute of Oncology IRCCS, Milan, Italy
| | - Rita De Berardinis
- Division of Otolaryngology and Head & Neck Surgery, European Institute of Oncology IRCCS, Milan, Italy
| | - Francesco Chu
- Division of Otolaryngology and Head & Neck Surgery, European Institute of Oncology IRCCS, Milan, Italy
| | - Marta Tagliabue
- Division of Otolaryngology and Head & Neck Surgery, European Institute of Oncology IRCCS, Milan, Italy
| | - Gioacchino Giugliano
- Division of Otolaryngology and Head & Neck Surgery, European Institute of Oncology IRCCS, Milan, Italy
| | - Mohssen Ansarin
- Division of Otolaryngology and Head & Neck Surgery, European Institute of Oncology IRCCS, Milan, Italy
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14
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Simoens C, Gorbaslieva I, Gheit T, Holzinger D, Lucas E, Ridder R, Rehm S, Vermeulen P, Lammens M, Vanderveken OM, Kumar RV, Gangane N, Caniglia A, Maffini F, Rubio MBL, Anantharaman D, Chiocca S, Brennan P, Pillai MR, Sankaranarayanan R, Bogers J, Pawlita M, Tommasino M, Arbyn M. HPV DNA genotyping, HPV E6*I mRNA detection, and p16 INK4a/Ki-67 staining in Belgian head and neck cancer patient specimens, collected within the HPV-AHEAD study. Cancer Epidemiol 2021; 72:101925. [PMID: 33839457 DOI: 10.1016/j.canep.2021.101925] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 02/26/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND The main risk factors for head and neck cancer (HNC) are tobacco and alcohol use. However, an important fraction of oropharyngeal cancer (OPC) is caused by human papillomaviruses (HPV), a subgroup with increasing incidence in several western countries. METHODS As part of the HPV-AHEAD study, we assessed the role of HPV infection in 772 archived tissue specimens of Belgian HNC patients: 455 laryngeal (LC), 106 oral cavity (OCC), 99 OPC, 76 hypopharyngeal (HC), and 36 unspecified parts of the head and neck. All specimens were tested for HPV DNA (21 genotypes); whereof all HPV DNA-positives, all HPV DNA-negative OPCs and a random subset of HPV DNA-negatives of the other HNC-sites were tested for the presence of type-specific HPV RNA and p16INK4a over-expression. RESULTS The highest HPV DNA prevalence was observed in OPC (36.4 %), and was significantly lower (p < 0.001) in the other HNCs (OCC:7.5 %, LC:6.6 %). HPV16 was the most common HPV-genotype in all HNCs. Approximately 83.0 % of the HPV DNA-positive OPCs tested HPV RNA or p16-positive, compared to about 37.5 % and 44.0 % in OCC and LC, respectively. Estimation of the attributable fraction of an HPV infection in HNC was very similar for HPV RNA or p16 in addition to DNA-positivity; with 30 % for OPC, and 3 % for OCC and LC. CONCLUSION Our study confirms the heterogeneity of HPV DNA prevalence across anatomical sites in HNC, with a predominance of HPV16 in all sites. The estimated proportion of HPV-driven HNC in Belgium, during the period 1980-2014, was 10 times higher in OPC compared to OCC and LC.
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Affiliation(s)
- Cindy Simoens
- Unit of Cancer Epidemiology, Cancer Centre, Sciensano, Brussels, Belgium; AMBIOR, Laboratory for Cell Biology & Histology, University of Antwerp, Antwerp, Belgium.
| | - Ivana Gorbaslieva
- AMBIOR, Laboratory for Cell Biology & Histology, University of Antwerp, Antwerp, Belgium
| | - Tarik Gheit
- Infections and Cancer Biology Group, International Agency for Research on Cancer (IARC), Lyon, France
| | - Dana Holzinger
- Infections and Cancer Epidemiology, Research Program Infection, Inflammation and Cancer, Deutsches Krebsforschungszentrum, Heidelberg, Germany
| | - Eric Lucas
- Infections and Cancer Biology Group, International Agency for Research on Cancer (IARC), Lyon, France
| | - Ruediger Ridder
- Roche Mtm Laboratories, Mannheim, Germany; Ventana Medical Systems, Inc. (Roche Tissue Diagnostics), Tucson, AZ, USA
| | | | - Peter Vermeulen
- Laboratory for Pathological Anatomy, Sint Augustinus Hospital, GZA, Antwerp, Belgium
| | - Martin Lammens
- Department of Pathology, Antwerp University Hospital, Edegem, Belgium; Center for Oncological Research, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Olivier M Vanderveken
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium; Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Rekha Vijay Kumar
- Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, 560029, India
| | - Nitin Gangane
- Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha, Maharashtra State, 442102, India
| | | | - Fausto Maffini
- Division of Pathology, Instituto Europeo di Oncologia (IEO), Milan, Italy
| | | | - Devasena Anantharaman
- Rajiv Gandhi Centre for Biotechnology, Poojappura, Thiruvananthapuram, Kerala, 695014, India
| | - Susanna Chiocca
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Paul Brennan
- Section of Genetics, International Agency for Research on Cancer (IARC), Lyon, France
| | | | | | - Johannes Bogers
- AMBIOR, Laboratory for Cell Biology & Histology, University of Antwerp, Antwerp, Belgium
| | - Michael Pawlita
- Infections and Cancer Epidemiology, Research Program Infection, Inflammation and Cancer, Deutsches Krebsforschungszentrum, Heidelberg, Germany
| | - Massimo Tommasino
- Infections and Cancer Biology Group, International Agency for Research on Cancer (IARC), Lyon, France
| | - Marc Arbyn
- Unit of Cancer Epidemiology, Cancer Centre, Sciensano, Brussels, Belgium.
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15
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Ansarin M, De Berardinis R, Corso F, Giugliano G, Bruschini R, De Benedetto L, Zorzi S, Maffini F, Sovardi F, Pigni C, Scaglione D, Alterio D, Cossu Rocca M, Chiocca S, Gandini S, Tagliabue M. Survival Outcomes in Oral Tongue Cancer: A Mono-Institutional Experience Focusing on Age. Front Oncol 2021; 11:616653. [PMID: 33912446 PMCID: PMC8075362 DOI: 10.3389/fonc.2021.616653] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 10/12/2020] [Accepted: 01/11/2021] [Indexed: 11/13/2022] Open
Abstract
Objective The prognostic role of age among patients affected by Oral Tongue Squamous Cell Carcinoma (OTSCC) is a topic of debate. Recent cohort studies have found that patients diagnosed at 40 years of age or younger have a better prognosis. The aim of this cohort study was to clarify whether age is an independent prognostic factor and discuss heterogeneity of outcomes by stage and treatments in different age groups. Methods We performed a study on 577 consecutive patients affected by primary tongue cancer and treated with surgery and adjuvant therapy according to stage, at European Institute of Oncology, IRCCS. Patients with age at diagnosis below 40 years totaled 109 (19%). Overall survival (OS), disease-free survival (DFS), tongue specific free survival (TSFS) and cause-specific survival (CSS) were compared by age groups. Multivariate Cox proportional hazards models were used to assess the independent role of age. Results The median follow-up time was 5.01 years (range 0–18.68) years with follow-up recorded up to February 2020. After adjustment for all the significant confounding and prognostic factors, age remained independently associated with OS and DSF (respectively, p = 0.002 and p = 0.02). In CSS and TSFS curves, the role of age seems less evident (respectively, p = 0.14 and p = 0.0.37). In the advanced stage sub-group (stages III–IV), age was significantly associated with OS and CSS with almost double increased risk of dying (OS) and dying from tongue cancer (CSS) in elderly compared to younger groups (OS: HR = 2.16 95%, CI: 1.33–3.51, p= 0.001; CSS: HR = 1.76 95%, CI: 1.03–3.01, p = 0.02, respectively). In our study, young patients were more likely to be treated with intensified therapies (glossectomies types III–V and adjuvant radio-chemotherapy). Age was found as a prognostic factor, independently of other significant factors and treatment. Also the T–N tract involved by disease and neutrophil-to-lymphocyte ratio ≥3 were independent prognostic factors. Conclusions Young age at diagnosis is associated with a better overall survival. Fewer younger people than older people died from tongue cancer in advanced stages.
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Affiliation(s)
- Mohssen Ansarin
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Rita De Berardinis
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Federica Corso
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy.,Department of Mathematics, DMAT, Politecnico di Milano, Milan, Italy.,Center for Analysis Decisions and Society, CADS, Human Technopole, Milan, Italy
| | - Gioacchino Giugliano
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Roberto Bruschini
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Luigi De Benedetto
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Stefano Zorzi
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Fausto Maffini
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Fabio Sovardi
- Department of Otorhinolaryngology, Policlinico San Matteo, IRCCS, Pavia, Italy
| | - Carolina Pigni
- Department of Otorhinolaryngology, ASST Ovest Milanese, Legnano, Italy
| | - Donatella Scaglione
- Division of Data Manager, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Daniela Alterio
- Division of Radiotherapy, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Maria Cossu Rocca
- Department of Medical Oncology, Urogenital and Head and Neck Tumors Medical Treatment, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Susanna Chiocca
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Sara Gandini
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Marta Tagliabue
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy.,Department of Biomedical Sciences, University of Sassari, Sassari, Italy
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16
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Chu F, De Santi S, Tagliabue M, De Benedetto L, Zorzi S, Pietrobon G, Herman I, Maffini F, Chiocca S, Corso F, Gandini S, Ansarin M. Laryngeal dysplasia: Oncological outcomes in a large cohort of patients treated in a tertiary comprehensive cancer centre. Am J Otolaryngol 2021; 42:102861. [PMID: 33445041 DOI: 10.1016/j.amjoto.2020.102861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 12/20/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE Laryngeal dysplasia represents a series of precancerous lesions, observed as laryngeal leukoplakia. General agreement has been lacking for their management and treatment ranging from simple biopsy to complete excision with cold blade/laser. In this work, we aim at providing the oncological outcomes of patients affected by laryngeal dysplasia, treated with a single modality, and at identifying clinical parameters predictive of malignant transformation. MATERIALS AND METHODS We performed a retrospective analysis of patients treated with transoral laser microsurgery between January 2005 and December 2015 in a tertiary comprehensive cancer centre. Data were collected about smoke and alcohol habits, site of the laryngeal lesion, surgical outcomes and progression to invasive squamous cell carcinoma. RESULTS The grade of dysplasia, margins' status and smoke habit were not associated with a significantly worse DFS and a higher risk of invasive SCC. We identified three parameters (supraglottic involvement, multifocality and history of more than one recurrence of dysplasia) that have a significant prognostic value. CONCLUSIONS On the base of these clinical parameters, a more intensive follow-up might be warranted for high-risk patients.
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17
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Tagliabue M, Mena M, Maffini F, Gheit T, Quirós Blasco B, Holzinger D, Tous S, Scelsi D, Riva D, Grosso E, Chu F, Lucas E, Ridder R, Rrehm S, Bogers JP, Lepanto D, Lloveras Rubio B, Vijay Kumar R, Gangane N, Clavero O, Pawlita M, Anantharaman D, Radhakrishna Pillai M, Brennan P, Sankaranarayanan R, Arbyn M, Lombardi F, Taberna M, Gandini S, Chiesa F, Ansarin M, Alemany L, Tommasino M, Chiocca S. Role of Human Papillomavirus Infection in Head and Neck Cancer in Italy: The HPV-AHEAD Study. Cancers (Basel) 2020; 12:E3567. [PMID: 33260360 PMCID: PMC7760748 DOI: 10.3390/cancers12123567] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [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: 10/28/2020] [Revised: 11/20/2020] [Accepted: 11/24/2020] [Indexed: 02/07/2023] Open
Abstract
Literature on the role of human papillomavirus (HPV) in head and neck cancer (HNC) in Italy is limited, especially for non-oropharyngeal tumours. Within the context of the HPV-AHEAD study, we aimed to assess the prognostic value of different tests or test algorithms judging HPV carcinogenicity in HNC and factors related to HPV positivity at the European Institute of Oncology. We conducted a retrospective cohort study (2000-2010) on a total of 696 primary HNC patients. Formalin-fixed, paraffin-embedded cancer tissues were studied. All HPV-DNA-positive and a random sample of HPV-DNA-negative cases were subjected to HPV-E6*I mRNA detection and p16INK4a staining. Multivariate models were used to assess for factors associated with HPV positivity and proportional hazards for survival and recurrence. The percentage of HPV-driven cases (considering HPV-E6*I mRNA positivity) was 1.8, 2.2, and 40.4% for oral cavity (OC), laryngeal (LC), and oropharyngeal (OPC) cases, respectively. The estimates were similar for HPV-DNA/p16INK4a double positivity. Being a non-smoker or former smoker or diagnosed at more recent calendar periods were associated with HPV-E6*I mRNA positivity only in OPC. Being younger was associated with HPV-E6*I mRNA positivity in LC. HPV-driven OPC, but not HPV-driven OC and LC, showed better 5 year overall and disease-free survival. Our data show that HPV prevalence in OPC was much higher than in OC and LC and observed to increase in most recent years. Moreover, HPV positivity conferred better prognosis only in OPC. Novel insights on the role of HPV in HNC in Italy are provided, with possible implications in the clinical management of these patients.
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Affiliation(s)
- Marta Tagliabue
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (M.T.); (D.S.); (D.R.); (E.G.); (F.C.); (F.C.); (M.A.)
| | - Marisa Mena
- Cancer Epidemiology Research Program, Catalan Institute of Oncology-Bellvitge Biomedical Research Institute (ICO-IDIBELL), L’Hospitalet de Llobregat, 08908 Barcenola, Spain; (M.M.); (B.Q.B.); (S.T.); (O.C.); (L.A.)
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Fausto Maffini
- Division of Pathology, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (F.M.); (D.L.)
| | - Tarik Gheit
- Infections and Cancer Biology Group, International Agency for Research on Cancer (IARC), 69372 Lyon, France; (T.G.); (E.L.)
| | - Beatriz Quirós Blasco
- Cancer Epidemiology Research Program, Catalan Institute of Oncology-Bellvitge Biomedical Research Institute (ICO-IDIBELL), L’Hospitalet de Llobregat, 08908 Barcenola, Spain; (M.M.); (B.Q.B.); (S.T.); (O.C.); (L.A.)
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Dana Holzinger
- Deutsches Krebsforschungszentrum (DKFZ), 69120 Heidelberg, Germany; (D.H.); (M.P.)
| | - Sara Tous
- Cancer Epidemiology Research Program, Catalan Institute of Oncology-Bellvitge Biomedical Research Institute (ICO-IDIBELL), L’Hospitalet de Llobregat, 08908 Barcenola, Spain; (M.M.); (B.Q.B.); (S.T.); (O.C.); (L.A.)
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Daniele Scelsi
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (M.T.); (D.S.); (D.R.); (E.G.); (F.C.); (F.C.); (M.A.)
| | - Debora Riva
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (M.T.); (D.S.); (D.R.); (E.G.); (F.C.); (F.C.); (M.A.)
| | - Enrica Grosso
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (M.T.); (D.S.); (D.R.); (E.G.); (F.C.); (F.C.); (M.A.)
| | - Francesco Chu
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (M.T.); (D.S.); (D.R.); (E.G.); (F.C.); (F.C.); (M.A.)
| | - Eric Lucas
- Infections and Cancer Biology Group, International Agency for Research on Cancer (IARC), 69372 Lyon, France; (T.G.); (E.L.)
| | - Ruediger Ridder
- Roche mtm laboratories, 69117 Mannheim, Germany; (R.R.); (S.R.)
- Ventana Medical Systems Inc./Roche Tissue Diagnostics, Tucson, AZ 85755, USA
| | - Susanne Rrehm
- Roche mtm laboratories, 69117 Mannheim, Germany; (R.R.); (S.R.)
| | - Johannes Paul Bogers
- Laboratory for Cell Biology and Histology, University of Antwerp, 2610 Antwerp, Belgium;
| | - Daniela Lepanto
- Division of Pathology, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (F.M.); (D.L.)
| | | | - Rekha Vijay Kumar
- Kidwai Memorial Institute of Oncology, Bangalore, Karnataka 560029, India;
| | - Nitin Gangane
- Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha, Maharashtra State 442102, India;
| | - Omar Clavero
- Cancer Epidemiology Research Program, Catalan Institute of Oncology-Bellvitge Biomedical Research Institute (ICO-IDIBELL), L’Hospitalet de Llobregat, 08908 Barcenola, Spain; (M.M.); (B.Q.B.); (S.T.); (O.C.); (L.A.)
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Michael Pawlita
- Deutsches Krebsforschungszentrum (DKFZ), 69120 Heidelberg, Germany; (D.H.); (M.P.)
| | - Devasena Anantharaman
- Rajiv Gandhi Centre for Biotechnology, Poojappura, Thiruvananthapuram, Kerala 695012, India; (D.A.); (M.R.P.)
| | | | - Paul Brennan
- Section of Genetics, International Agency for Research on Cancer (IARC), 69372 Lyon, France;
| | | | - Marc Arbyn
- Unit of Cancer Epidemiology/Belgian Cancer Centre, Sciensano, 1050 Brussels, Belgium;
| | - Francesca Lombardi
- Data Management, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy;
| | - Miren Taberna
- Medical Oncology Department, Catalan Institute of Oncology (ICO), ONCOBELL, IDIBELL, L’Hospitalet de Llobregat, 08035 Barcelona, Spain;
| | - Sara Gandini
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy;
| | - Fausto Chiesa
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (M.T.); (D.S.); (D.R.); (E.G.); (F.C.); (F.C.); (M.A.)
| | - Mohssen Ansarin
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (M.T.); (D.S.); (D.R.); (E.G.); (F.C.); (F.C.); (M.A.)
| | - Laia Alemany
- Cancer Epidemiology Research Program, Catalan Institute of Oncology-Bellvitge Biomedical Research Institute (ICO-IDIBELL), L’Hospitalet de Llobregat, 08908 Barcenola, Spain; (M.M.); (B.Q.B.); (S.T.); (O.C.); (L.A.)
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Massimo Tommasino
- Infections and Cancer Biology Group, International Agency for Research on Cancer (IARC), 69372 Lyon, France; (T.G.); (E.L.)
| | - Susanna Chiocca
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy;
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18
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Guerini-Rocco E, Taormina SV, Vacirca D, Ranghiero A, Rappa A, Fumagalli C, Maffini F, Rampinelli C, Galetta D, Tagliabue M, Ansarin M, Barberis M. SARS-CoV-2 detection in formalin-fixed paraffin-embedded tissue specimens from surgical resection of tongue squamous cell carcinoma. J Clin Pathol 2020; 73:754-757. [PMID: 32366599 PMCID: PMC7431818 DOI: 10.1136/jclinpath-2020-206635] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [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: 04/15/2020] [Revised: 04/17/2020] [Accepted: 04/17/2020] [Indexed: 12/12/2022]
Abstract
In the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, pathologists can be exposed to infection handling surgical specimens. Guidelines related to safety procedures in the laboratory have been released. However, there is a lack of studies performed on biopsy and surgical resection specimens. Here we report the detection of SARS-CoV-2 in formalin-fixed paraffin-embedded samples from surgical resection of tongue squamous cell carcinoma of a patient who developed COVID-19 postsurgery. RNA of SARS-CoV-2 strain was detected in the tumour and the normal submandibular gland samples using real-time PCR-based assay. No viral RNA was found in metastatic and reactive lymph nodes. We demonstrated that SARS-CoV-2 RNA can be detected in routine histopathological samples even before COVID-19 disease development. These findings may give important information on the possible sites of infection or virus reservoir, and highlight the necessity of proper handling and fixation before sample processing.
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Affiliation(s)
- Elena Guerini-Rocco
- Division of Pathology and Laboratory Medicine, IEO, European Institute of Oncology, IRCCS, Milano, Italy
- Department of Oncology and Hemato-Oncology, University of Milano, Milano, Italy
| | - Sergio Vincenzo Taormina
- Division of Pathology and Laboratory Medicine, IEO, European Institute of Oncology, IRCCS, Milano, Italy
| | - Davide Vacirca
- Division of Pathology and Laboratory Medicine, IEO, European Institute of Oncology, IRCCS, Milano, Italy
| | - Alberto Ranghiero
- Division of Pathology and Laboratory Medicine, IEO, European Institute of Oncology, IRCCS, Milano, Italy
| | - Alessandra Rappa
- Division of Pathology and Laboratory Medicine, IEO, European Institute of Oncology, IRCCS, Milano, Italy
| | - Caterina Fumagalli
- Division of Pathology and Laboratory Medicine, IEO, European Institute of Oncology, IRCCS, Milano, Italy
| | - Fausto Maffini
- Division of Pathology and Laboratory Medicine, IEO, European Institute of Oncology, IRCCS, Milano, Italy
| | - Cristiano Rampinelli
- Division of Radiology, IEO, European Institute of Oncology, IRCCS, Milano, Italy
| | - Domenico Galetta
- Division of Thoracic Surgery, IEO, European Institute of Oncology, IRCCS, Milano, Italy
| | - Marta Tagliabue
- Division of Otolaryngology and Head-Neck Surgery, IEO, European Institute of Oncology, IRCCS, Milano, Italy
| | - Mohssen Ansarin
- Division of Otolaryngology and Head-Neck Surgery, IEO, European Institute of Oncology, IRCCS, Milano, Italy
| | - Massimo Barberis
- Division of Pathology and Laboratory Medicine, IEO, European Institute of Oncology, IRCCS, Milano, Italy
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19
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Maffini F, Lorenzini D, Lepanto D, De Fiori E, Fumagalli C, Rappa A, Tagliabue M, Barberis M. A case of Warthin-like papillary thyroid carcinoma with diffuse sclerosing stroma and a novel RET mutation: a new entity or a combined tumour? Ecancermedicalscience 2019; 13:965. [PMID: 31921336 PMCID: PMC6834387 DOI: 10.3332/ecancer.2019.965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 05/09/2019] [Indexed: 01/11/2023] Open
Abstract
Activating mutations of the RET gene have been described for both papillary (chromosomal rearrangement) and medullary (missense mutations) thyroid carcinomas. Here, we describe a case of a Warthin-like variant of papillary thyroid carcinoma displaying some morphological aspects that mimic the diffuse sclerosing variant. The tumour harboured BRAF V600E mutation and a novel germline point mutation in the RET gene, with unknown clinical and pathological meaning.
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Affiliation(s)
- Fausto Maffini
- Department of Pathology, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy.,These authors contributed equally to writing this article
| | - Daniele Lorenzini
- University of Milan School of Medicine, Via Ripamonti 435, 20141 Milan, Italy.,These authors contributed equally to writing this article
| | - Daniela Lepanto
- Department of Pathology, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy
| | - Elvio De Fiori
- Department of Radiology, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy
| | - Caterina Fumagalli
- Department of Pathology, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy
| | - Alessandra Rappa
- Department of Pathology, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy
| | - Marta Tagliabue
- Division of Otolaryngology and Head and Neck Surgery, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy
| | - Massimo Barberis
- Department of Pathology, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy
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20
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Tagliabue M, Gandini S, Maffini F, Navach V, Bruschini R, Giugliano G, Lombardi F, Chiocca S, Rebecchi E, Sica E, Tommasino M, Calabrese L, Ansarin M. The role of the T-N tract in advanced stage tongue cancer. Head Neck 2019; 41:2756-2767. [PMID: 30942940 DOI: 10.1002/hed.25761] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 03/11/2019] [Accepted: 03/18/2019] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND We investigated the role of the soft tissue tract between the primary tumor and the neck lymph nodes, the "T-N tract," in patients with tongue squamous cell carcinoma at an advanced stage. METHODS We performed a compartmental tongue surgery in 233 patients. Cumulative incidence of relapses and overall survival curves were compared by T-N tract involvement. Multivariate Cox proportional hazards models were used to assess the independent role of T-N tract. RESULTS At 4 years of follow-up, patients with disease in the T-N tract experienced a significantly more distant recurrence (40%) than did patients without T-N tract involvement (22%; P = .02). Multivariate Cox models indicate a significant almost triple risk of distant metastases (hazard ratio [HR], 2.70; 95% CI, 1.01-7.19; P = .05) and double risk of death (HR, 2.09; 95%CI, 1.13-3.85; P = .02) in patients with "T-N tract involvement." CONCLUSIONS Our data show that the T-N tract plays an important role in prognosis and survival in patients with tongue cancer.
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Affiliation(s)
- Marta Tagliabue
- Division of Otolaryngology and Head and Neck Surgery, European Institute of Oncology IRCCS, Milan, Italy
| | - Sara Gandini
- Department of Experimental Oncology, European Institute of Oncology IRCCS, Milan, Italy
| | - Fausto Maffini
- Division of Pathology, European Institute of Oncology IRCCS, Milan, Italy
| | - Valeria Navach
- Division of Otolaryngology and Head and Neck Surgery, European Institute of Oncology IRCCS, Milan, Italy
| | - Roberto Bruschini
- Division of Otolaryngology and Head and Neck Surgery, European Institute of Oncology IRCCS, Milan, Italy
| | - Gioacchino Giugliano
- Division of Otolaryngology and Head and Neck Surgery, European Institute of Oncology IRCCS, Milan, Italy
| | - Francesca Lombardi
- Division of Data Manager, European Institute of Oncology IRCCS, Milan, Italy
| | - Susanna Chiocca
- Department of Experimental Oncology, European Institute of Oncology IRCCS, Milan, Italy
| | - Elisabetta Rebecchi
- Department of Otolaryngology Head Neck Surgery, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Eleonora Sica
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, ASST Sette Laghi, Ospedale di circolo Fondazione Macchi, Varese, Italy
| | - Massimo Tommasino
- Infections and Cancer Biology Group, International Agency for Research on Cancer, Course Albert Thomas 150, Lyon, France
| | - Luca Calabrese
- Division of Otolaryngology and Head and Neck Surgery, European Institute of Oncology IRCCS, Milan, Italy
| | - Mohssen Ansarin
- Division of Otolaryngology and Head and Neck Surgery, European Institute of Oncology IRCCS, Milan, Italy
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21
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Tagliabue M, Gandini S, Navach V, Maffini F, Bruschini R, Giugliano G, Tommasino M, Calabrese L, Ansarin M. PO-097 The role of T-N tract in advanced stage tongue cancer. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30263-4] [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: 10/27/2022]
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22
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Capodiferro S, Calabrese L, Maffini F, Cascardi E, Favia G, Maiorano E. Dentinogenic ghost cell tumour in a 20-year-old male with previous squamous cell carcinoma of the tongue. J BIOL REG HOMEOS AG 2019; 33:269-273. [PMID: 30654855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- S Capodiferro
- Department of Interdisciplinary Medicine, "Aldo Moro" University of Bari, Bari, Italy
| | - L Calabrese
- Division of Otolaryngology, Bolzano Hospital, Bolzano, Italy
| | - F Maffini
- Division of Pathology, European Institute of Oncology, Milan, Italy
| | - E Cascardi
- Department of Emergency and Organ Transplantation, Aldo Moro University, Bari
| | - G Favia
- Department of Interdisciplinary Medicine, "Aldo Moro" University of Bari, Bari, Italy
| | - E Maiorano
- Department of Emergency and Organ Transplantation, Aldo Moro University, Bari, Italy
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23
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Ursu RG, Danciu M, Spiridon IA, Ridder R, Rehm S, Maffini F, McKay-Chopin S, Carreira C, Lucas E, Costan VV, Popescu E, Cobzeanu B, Ghetu N, Iancu LS, Tommasino M, Pawlita M, Holzinger D, Gheit T. Role of mucosal high-risk human papillomavirus types in head and neck cancers in Romania. PLoS One 2018; 13:e0199663. [PMID: 29940024 PMCID: PMC6016945 DOI: 10.1371/journal.pone.0199663] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 06/12/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Limited information is available about the involvement of human papillomavirus (HPV) in head and neck squamous cell carcinomas (HNSCCs) in Romanian patients. OBJECTIVE To evaluate the HPV-attributable fraction in HNSCCs collected in Northeastern Romania. MATERIALS AND METHODS In total, 189 formalin-fixed paraffin-embedded tissue samples (99 oral cavity tumors, 28 oropharynx, 48 pharynx, and 14 larynx/hypopharynx) were analyzed for HPV DNA and RNA using Luminex-based assays, and for overexpression of p16INK4a (p16) by immunohistochemistry. RESULTS Of the 189 cases, 23 (12.2%) were HPV DNA-positive, comprising half of the oropharyngeal cases (14/28, 50.0%) and 9/161 (5.6%) of the non-oropharyngeal cases. HPV16 was the most prevalent HPV type (20/23, 86.9%), followed by HPV18 (5/23, 21.7%) and HPV39 (1/23, 4.3%). Only two (2/189, 1.1%) HNSCC cases were HPV-driven, i.e. positive for both HPV DNA and RNA. CONCLUSION A very small subset of HNSCC cases within this cohort from Northeastern Romania appeared to be HPV-driven.
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Affiliation(s)
- Ramona Gabriela Ursu
- University of Medicine and Pharmacy “Grigore T. Popa”, Discipline of Microbiology, Iași, Romania
| | - Mihai Danciu
- University of Medicine and Pharmacy “Grigore T. Popa”, Department of Pathology, Iași, Romania
| | | | - Ruediger Ridder
- Roche MTM Laboratories, Mannheim, Germany
- Ventana Medical Systems, Inc., Tucson, Arizona, United States of America
| | - Susanne Rehm
- Roche MTM Laboratories, Mannheim, Germany
- Ventana Medical Systems, Inc., Tucson, Arizona, United States of America
| | - Fausto Maffini
- Department of Pathology, European Institute of Oncology, Milan, Italy
| | - Sandrine McKay-Chopin
- Infections and Cancer Biology Group, International Agency for Research on Cancer, Lyon, France
| | - Christine Carreira
- Infections and Cancer Biology Group, International Agency for Research on Cancer, Lyon, France
| | - Eric Lucas
- Infections and Cancer Biology Group, International Agency for Research on Cancer, Lyon, France
| | - Victor-Vlad Costan
- University of Medicine and Pharmacy “Grigore T. Popa”, Department of Oral and Maxillofacial Surgery, Iași, Romania
| | - Eugenia Popescu
- University of Medicine and Pharmacy “Grigore T. Popa”, Department of Oral and Maxillofacial Surgery, Iași, Romania
| | - Bogdan Cobzeanu
- University of Medicine and Pharmacy “Grigore T. Popa”, Department of Otorhinolaryngology, Iași, Romania
| | - Nicolae Ghetu
- University of Medicine and Pharmacy “Grigore T. Popa”, Department of Plastic surgery, Iași, Romania
| | - Luminita Smaranda Iancu
- University of Medicine and Pharmacy “Grigore T. Popa”, Discipline of Microbiology, Iași, Romania
| | - Massimo Tommasino
- Infections and Cancer Biology Group, International Agency for Research on Cancer, Lyon, France
| | - Michael Pawlita
- German Cancer Research Center (DKFZ), Division of Molecular Diagnostics of Oncogenic Infections, Heidelberg, Germany
| | - Dana Holzinger
- German Cancer Research Center (DKFZ), Division of Molecular Diagnostics of Oncogenic Infections, Heidelberg, Germany
| | - Tarik Gheit
- Infections and Cancer Biology Group, International Agency for Research on Cancer, Lyon, France
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Mena M, Lloveras B, Tous S, Bogers J, Maffini F, Gangane N, Kumar RV, Somanathan T, Lucas E, Anantharaman D, Gheit T, Castellsagué X, Pawlita M, de Sanjosé S, Alemany L, Tommasino M. Development and validation of a protocol for optimizing the use of paraffin blocks in molecular epidemiological studies: The example from the HPV-AHEAD study. PLoS One 2017; 12:e0184520. [PMID: 29036167 PMCID: PMC5642890 DOI: 10.1371/journal.pone.0184520] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Accepted: 08/27/2017] [Indexed: 12/11/2022] Open
Abstract
Worldwide use of formalin-fixed paraffin-embedded blocks (FFPE) is extensive in diagnosis and research. Yet, there is a lack of optimized/standardized protocols to process the blocks and verify the quality and presence of the targeted tissue. In the context of an international study on head and neck cancer (HNC)-HPV-AHEAD, a standardized protocol for optimizing the use of FFPEs in molecular epidemiology was developed and validated. First, a protocol for sectioning the FFPE was developed to prevent cross-contamination and distributed between participating centers. Before processing blocks, all sectioning centers underwent a quality control to guarantee a satisfactory training process. The first and last sections of the FFPEs were used for histopathological assessment. A consensus histopathology evaluation form was developed by an international panel of pathologists and evaluated for four indicators in a pilot analysis in order to validate it: 1) presence/type of tumor tissue, 2) identification of other tissue components that could affect the molecular diagnosis and 3) quality of the tissue. No HPV DNA was found in sections from empty FFPE generated in any histology laboratories of HPV-AHEAD consortium and all centers passed quality assurance for processing after quality control. The pilot analysis to validate the histopathology form included 355 HNC cases. The form was filled by six pathologists and each case was randomly assigned to two of them. Most samples (86%) were considered satisfactory. Presence of >50% of invasive carcinoma was observed in all sections of 66% of cases. Substantial necrosis (>50%) was present in <2% of samples. The concordance for the indicators targeted to validate the histopathology form was very high (kappa > 0.85) between first and last sections and fair to high between pathologists (kappa/pabak 0.21-0.72). The protocol allowed to correctly process without signs of contamination all FFPE of the study. The histopathology evaluation of the cases assured the presence of the targeted tissue, identified the presence of other tissues that could disturb the molecular diagnosis and allowed the assessment of tissue quality.
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Affiliation(s)
- Marisa Mena
- Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO)-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- CIBER in primary and secondary prevention of viral induced cancers (CIBERONC), Madrid, Spain
| | - Belen Lloveras
- Department of Pathology. Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
| | - Sara Tous
- Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO)-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- CIBER in primary and secondary prevention of viral induced cancers (CIBERONC), Madrid, Spain
| | - Johannes Bogers
- Laboratory of cell biology and histology, University of Antwerp, Antwerp, Belgium
| | - Fausto Maffini
- Division of Pathology, European Institute of Oncology, Milan, Italy
| | - Nitin Gangane
- Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha, India
| | | | | | - Eric Lucas
- International Agency for Research on Cancer, Lyon, France
| | - Devasena Anantharaman
- International Agency for Research on Cancer, Lyon, France
- Cancer Research Program, Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram, India
| | - Tarik Gheit
- International Agency for Research on Cancer, Lyon, France
| | - Xavier Castellsagué
- Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO)-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Michael Pawlita
- Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Germany
| | - Silvia de Sanjosé
- Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO)-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Laia Alemany
- Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO)-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain
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Gheit T, Anantharaman D, Holzinger D, Alemany L, Tous S, Lucas E, Prabhu PR, Pawlita M, Ridder R, Rehm S, Bogers J, Maffini F, Chiocca S, Lloveras B, Kumar RV, Somanathan T, de Sanjosé S, Castellsagué X, Arbyn M, Brennan P, Sankaranarayanan R, Pillai MR, Gangane N, Tommasino M. Role of mucosal high-risk human papillomavirus types in head and neck cancers in central India. Int J Cancer 2017; 141:143-151. [PMID: 28369859 DOI: 10.1002/ijc.30712] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 02/17/2017] [Accepted: 03/07/2017] [Indexed: 01/21/2023]
Abstract
Mucosal high-risk (HR) human papillomaviruses (HPV) cause a subset of head and neck cancers (HNC). The HPV-attributable fraction of HNC varies substantially between countries. Although HNC has a very high incidence in the Indian subcontinent, information on the contribution of HPV infection is limited. Here, we evaluated the HPV-attributable fraction in HNC (N = 364) collected in a central region of India. HNC from three different anatomical subsites were included, namely, oral cavity (n = 252), oropharynx (n = 53) and hypopharynx/larynx (n = 59). In this retrospective study, HPV-driven HNC were defined by presence of both viral DNA and RNA. Overexpression of p16INK4a was also evaluated. HR-HPV DNA was detected in 13.7% of the cases; however, only 2.7% were positive for both HPV DNA and RNA. The highest percentage of HPV DNA/RNA double positivity was found in oropharynx (9.4%), followed by larynx (1.7%) and oral cavity (1.6%) (p = 0.02). More than half of HPV DNA/RNA-positive cases were p16INK4a -negative, while a considerable number of HPV RNA-negative cases were p16INK4a -positive (17.9%). HPV16 was the major type associated with HNC (60.0%), although cases positive for HPV18, 35 and 56 were also detected. Our data indicate that the proportion and types of mucosal HR-HPV associated with HNC in this central Indian region differ from those in other (developed) parts of the world. This may be explained by differences in smoking and/or sexual behaviour compared with North America and northern Europe. Moreover, we show that p16INK4a staining appeared not to be a good surrogate marker of HPV transformation in the Indian HNC cases.
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Affiliation(s)
- Tarik Gheit
- International Agency for Research on Cancer, Lyon, 69008, France
| | - Devasena Anantharaman
- International Agency for Research on Cancer, Lyon, 69008, France
- Cancer Research Program, Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram, 695014, India
| | - Dana Holzinger
- Deutsches Krebsforschungszentrum (DKFZ), 69120, Heidelberg, Germany
| | - Laia Alemany
- L'Hospitalet de Llobregat, Barcelona, Catalonia, Spain & CIBER Epidemiologia y Salud Publica, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO)-IDIBELL, Barcelona, Spain
| | - Sara Tous
- L'Hospitalet de Llobregat, Barcelona, Catalonia, Spain & CIBER Epidemiologia y Salud Publica, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO)-IDIBELL, Barcelona, Spain
| | - Eric Lucas
- International Agency for Research on Cancer, Lyon, 69008, France
| | - Priya Ramesh Prabhu
- Rajiv Gandhi Centre for Biotechnology, Poojappura, Thiruvananthapuram, Kerala, 695014, India
| | - Michael Pawlita
- Deutsches Krebsforschungszentrum (DKFZ), 69120, Heidelberg, Germany
| | - Ruediger Ridder
- Roche MTM laboratories, Mannheim, Germany
- Ventana Medical Systems Inc, Tucson, AZ
| | | | | | | | | | - Belén Lloveras
- Hospital del Mar, Parc de Salut Mar, Pg/Marítim 25-29, Barcelona, 08003, Spain
| | - Rekha Vijay Kumar
- Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, 560029, India
| | | | - Silvia de Sanjosé
- L'Hospitalet de Llobregat, Barcelona, Catalonia, Spain & CIBER Epidemiologia y Salud Publica, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO)-IDIBELL, Barcelona, Spain
| | - Xavier Castellsagué
- L'Hospitalet de Llobregat, Barcelona, Catalonia, Spain & CIBER Epidemiologia y Salud Publica, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO)-IDIBELL, Barcelona, Spain
| | - Marc Arbyn
- Unit of Cancer Epidemiology/Belgian Cancer Centre, Scientific Institute of Public Health, Brussels, B1050, Belgium
| | - Paul Brennan
- International Agency for Research on Cancer, Lyon, 69008, France
| | | | | | - Nitin Gangane
- Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha, Maharashtra State, 442102, India
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Preda L, Conte G, Bonello L, Giannitto C, Tagliabue E, Raimondi S, Ansarin M, De Benedetto L, Cattaneo A, Maffini F, Bellomi M. Diagnostic accuracy of surface coil MRI in assessing cartilaginous invasion in laryngeal tumours: Do we need contrast-agent administration? Eur Radiol 2017; 27:4690-4698. [PMID: 28477165 DOI: 10.1007/s00330-017-4840-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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: 10/10/2016] [Revised: 03/20/2017] [Accepted: 04/03/2017] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To assess the diagnostic accuracy of MRI performed using surface coils, with and without contrast medium, in predicting thyroid and cricoid cartilage infiltration in laryngeal tumours, and to investigate whether the radiologist's experience influences diagnostic accuracy. METHODS We retrospectively enrolled patients with biopsy-proven laryngeal cancer who had undergone preoperative staging MRI and open surgery. Two radiologists with different experience (senior vs. junior) reviewed the MR images without (session A1) and with contrast medium (session A2) separately. We calculated the accuracy of MRI with and without contrast medium in detecting infiltration of the thyroid and cricoid cartilages. Interobserver agreement was calculated by Cohen's Kappa (k). RESULTS Forty-two patients were enrolled, for a total of 62 cartilages. In session A1 the senior and junior radiologists showed an accuracy of 85% and 71%, respectively, with k = 0.53 (0.33-0.72). In session A2 the senior and junior radiologists showed an accuracy of 84% and 77%, respectively, with k = 0.68 (0.49-0.86). CONCLUSIONS Staging of laryngeal tumours with surface coil MRI showed good diagnostic accuracy in assessing cartilaginous infiltration. We observed similar values of diagnostic accuracy for the analysis performed with and without contrast medium for the senior radiologist. KEY POINTS • Surface coil MRI demonstrated good accuracy in assessing laryngeal cartilage invasion. • The radiologist's experience can influence the diagnostic accuracy. • Gadolinium administration may increase interobserver concordance.
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Affiliation(s)
- Lorenzo Preda
- Department of Clinical-Surgical Diagnostic and Pediatric Sciences, Università degli Studi di Pavia, Pavia, Italy
- Division of Radiology, National Center of Oncological Hadrontherapy (CNAO Foundation), Pavia, Italy
| | - Giorgio Conte
- Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono 7, 20122, Milan, Italy.
| | - Luke Bonello
- Division of Radiology, Poliambulanza Hospital, Brescia, Italy
| | | | - Elena Tagliabue
- Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy
| | - Sara Raimondi
- Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy
| | - Mohssen Ansarin
- Division of Head and Neck Surgery, European Institute of Oncology, Milan, Italy
| | - Luigi De Benedetto
- Division of Head and Neck Surgery, European Institute of Oncology, Milan, Italy
| | - Augusto Cattaneo
- Division of Head and Neck Surgery, European Institute of Oncology, Milan, Italy
| | - Fausto Maffini
- Division of Pathology, European Institute of Oncology, Milan, Italy
| | - Massimo Bellomi
- Division of Radiology, European Institute of Oncology, Milan, Italy
- Oncology and Haematology/Oncology Department, Università degli Studi di Milano, Milan, Italy
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Mattoscio D, Casadio C, Miccolo C, Maffini F, Raimondi A, Tacchetti C, Gheit T, Tagliabue M, Galimberti VE, De Lorenzi F, Pawlita M, Chiesa F, Ansarin M, Tommasino M, Chiocca S. Autophagy regulates UBC9 levels during viral-mediated tumorigenesis. PLoS Pathog 2017; 13:e1006262. [PMID: 28253371 PMCID: PMC5349695 DOI: 10.1371/journal.ppat.1006262] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 03/14/2017] [Accepted: 02/26/2017] [Indexed: 02/06/2023] Open
Abstract
UBC9, the sole E2-conjugating enzyme required for SUMOylation, is a key regulator of essential cellular functions and, as such, is frequently altered in cancers. Along these lines, we recently reported that its expression gradually increases during early stages of human papillomavirus (HPV)-mediated cervical lesions transformation. However, a better understanding of how UBC9 is exploited by transforming viral oncoproteins is still needed. In the present study, we show that in human samples HPV drives UBC9 up-regulation also in very early steps of head and neck tumorigenesis, pointing to the important role for UBC9 in the HPV-mediated carcinogenic program. Moreover, using HPV-infected pre-cancerous tissues and primary human keratinocytes as the natural host of the virus, we investigate the pathological meaning and the cellular mechanisms responsible for UBC9 de-regulation in an oncoviral context. Our results show that UBC9 overexpression is promoted by transforming viral proteins to increase host cells' resistance to apoptosis. In addition, ultrastuctural, pharmacological and genetic approaches crucially unveil that UBC9 is physiologically targeted by autophagy in human cells. However, the presence of HPV E6/E7 oncoproteins negatively impacts the autophagic process through selective inhibition of autophagosome-lysosome fusion, finally leading to p53 dependent UBC9 accumulation during viral-induced cellular transformation. Therefore, our study elucidates how UBC9 is manipulated by HPV oncoproteins, details the physiological mechanism by which UBC9 is degraded in cells, and identifies how HPV E6/E7 impact on autophagy. These findings point to UBC9 and autophagy as novel hallmarks of HPV oncogenesis, and open innovative avenues towards the treatment of HPV-related malignancies.
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Affiliation(s)
- Domenico Mattoscio
- European Institute of Oncology, Department of Experimental Oncology, Milan, Italy
| | - Chiara Casadio
- European Institute of Oncology, Department of Pathology, Milan, Italy
| | - Claudia Miccolo
- European Institute of Oncology, Department of Experimental Oncology, Milan, Italy
| | - Fausto Maffini
- European Institute of Oncology, Department of Pathology, Milan, Italy
| | - Andrea Raimondi
- Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Carlo Tacchetti
- Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Department of Experimental Medicine, University of Genova, Genova, Italy
| | - Tarik Gheit
- Infections and Cancer Biology Group, International Agency for Research on Cancer, Lyon, France
| | - Marta Tagliabue
- European Institute of Oncology, Division of Otolaryngology and Head and Neck Surgery, Milan, Italy
| | | | | | - Michael Pawlita
- Division of Molecular Diagnostics of Oncogenic Infections, Research Program Infection, Inflammation and Cancer, German Cancer Research Center, Heidelberg, Germany
| | - Fausto Chiesa
- European Institute of Oncology, Division of Otolaryngology and Head and Neck Surgery, Milan, Italy
| | - Mohssen Ansarin
- European Institute of Oncology, Division of Otolaryngology and Head and Neck Surgery, Milan, Italy
| | - Massimo Tommasino
- Infections and Cancer Biology Group, International Agency for Research on Cancer, Lyon, France
| | - Susanna Chiocca
- European Institute of Oncology, Department of Experimental Oncology, Milan, Italy
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Alterio D, Marvaso G, Zorzi S, Preda L, Ferrari A, Rappa A, Giugliano G, Maffini F, Sibio D, Francia C, Cossu Rocca M, Jereczek-Fossa B, Ansarin M. PO-133: Occult lymphnode metastasis in early stage OPC treated with TORS without neck lymphnodes dissection. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)30267-0] [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: 10/19/2022]
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Bonello L, Preda L, Conte G, Giannitto C, Raimondi S, Ansarin M, Maffini F, Summers P, Bellomi M. Squamous cell carcinoma of the oral cavity and oropharynx: what does the apparent diffusion coefficient tell us about its histology? Acta Radiol 2016; 57:1344-1351. [PMID: 26013024 DOI: 10.1177/0284185115587734] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [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: 11/17/2022]
Abstract
Background Diffusion-weighted imaging obtained with magnetic resonance (DW-MRI) is a non-invasive imaging tool potentially able to provide information about microstructural tumor characteristics. Purpose To prospectively analyze the correlation between the apparent diffusion coefficient (ADC) and clinical-histologic characteristics of squamous cell carcinoma (SCCA) of the oral cavity and oropharynx. Material and Methods Sixty-seven patients with untreated, histologically proven SCCA of the oral cavity and oropharynx underwent conventional and diffusion-weighted (b-values 0, 50, 250, 500, and 900 s/mm2) MRI. Tumor ADC was calculated from regions of interest drawn manually on the highest b-value images using ImageJ (ImageJ, NIH) and fsl (fsl 4, University of Oxford) image processing packages. ADC was calculated in two ways: standard ADC using all b-values; and ADCHigh using only b-values ≥ 250 s/mm2. We assessed the correlations between both ADC and ADCHigh and the clinical-histological characteristics of SCCA. Results Fifty-two patients (36 men, 16 women; mean age, 55 ± 13 years) were suitable for ADC calculation. Mean ADC was 1136.0 ± 108.5 × 10-6 mm2/s. Mean tumor ADCHigh was 991.2 ± 152.1 × 10-6 mm2/s. Mean tumor size was 32.3 ± 13.4 mm (range, 14.0-69.0 mm). We observed no correlation of either ADC or ADCHigh values with any of the clinical-histological tumor characteristics. Undifferentiated tumors (G3) showed lower apparent diffusion coefficient values compared to differentiated ones (G1-G2), without reaching statistical significance. Conclusion We did not observe any statistically significant correlation between ADC values and clinical-histological characteristics of SCCA of the oral cavity and oropharynx.
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Affiliation(s)
- Luke Bonello
- Specialisation School of Radiology, University of Milan, Milan, Italy
| | - Lorenzo Preda
- Department of Radiology, European Institute of Oncology, Milan, Italy
| | - Giorgio Conte
- Specialisation School of Radiology, University of Milan, Milan, Italy
| | | | - Sara Raimondi
- Department of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy
| | - Mohssen Ansarin
- Department of Head and Neck Surgery, European Institute of Oncology, Milan, Italy
| | - Fausto Maffini
- Department of Pathology, European Institute of Oncology, Milan, Italy
| | - Paul Summers
- Department of Radiology, European Institute of Oncology, Milan, Italy
| | - Massimo Bellomi
- Specialisation School of Radiology, University of Milan, Milan, Italy
- Department of Radiology, European Institute of Oncology, Milan, Italy
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Alterio D, Ferrari A, Maffini F, Marvaso G, Santoro L, Fodor C, Cossu Rocca M, Ansarin M, Dicuonzo S, Muto M, Zerini D, Chiocca S, Orecchia R, Jereczek-Fossal B. EP-1085: EGFR expression in head and neck cancer : does it have a role as prognostic factor in radiotherapy? Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32335-0] [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: 11/28/2022]
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De Fiori E, Conte G, Ansarin M, De Benedetto L, Bonello L, Alterio D, Maffini F, Bellomi M, Preda L. The role of ultrasound-guided transcutaneous tru-cut biopsy in diagnosing untreated and recurrent laryngo-hypopharyngeal masses. Eur J Radiol 2015; 85:158-163. [PMID: 26724661 DOI: 10.1016/j.ejrad.2015.10.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [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: 05/26/2015] [Revised: 09/13/2015] [Accepted: 10/25/2015] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To evaluate the diagnostic performance of Ultrasound-guided Transcutaneous Tru-Cut biopsy (USGTCB) of laryngo-hypopharyngeal masses suspicious for malignancy. Furthermore we investigated whether USGTCB is accurate for both untreated masses and suspected recurrences. MATERIALS AND METHODS From August 2004 to July 2014 we prospectively enrolled 66 patients for a total of 68 USGTCBs: 38 USGTCB were performed for a suspicious untreated mass and in 30 for a suspected recurrence. We calculated the sensitivity, specificity, positive predictive value and negative predictive value for all procedures and separately for untreated masses and suspected recurrences. RESULTS USGTCB diagnosed 57 malignancies (51 squamous cell carcinomas, 6 other tumors) and 11 benign lesions. There were no false positives reported, whereas five false negatives were observed: two in patients with an untreated mass, three in patients with a suspected recurrence. Overall, the sensitivity of the technique was 91.9% (95% confidence interval [CI]: 82.2-97.3%); the specificity was 100% (95% CI: 54.1-100%); positive and negative predictive values were 100% (95% CI: 93.7-100%) and 54.5% (95% CI: 23.5-83.1%) respectively, with similar performances in untreated masses and suspected recurrences of SCC. CONCLUSION USGTCB is an effective procedure for the histological diagnosis of laryngo-hypopharyngeal masses suspicious for malignancy in patients showing contraindications to biopsy via microlaryngoscopy under general, with similar performances for untreated masses and suspected recurrences.
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Affiliation(s)
- Elvio De Fiori
- Division of Radiology, European Institute of Oncology, Milan, Italy.
| | - Giorgio Conte
- Department of Health Sciences, University of Milan, Milan, Italy.
| | - Mohssen Ansarin
- Department of Head and Neck Surgery, European Institute of Oncology, Milan, Italy.
| | - Luigi De Benedetto
- Department of Head and Neck Surgery, European Institute of Oncology, Milan, Italy.
| | - Luke Bonello
- Department of Health Sciences, University of Milan, Milan, Italy.
| | - Daniela Alterio
- Division of Radiotherapy, European Institute of Oncology, Milan, Italy.
| | - Fausto Maffini
- Division of Pathology, European Institute of Oncology, Milan, Italy.
| | - Massimo Bellomi
- Division of Radiology, European Institute of Oncology, Milan, Italy; Department of Health Sciences, University of Milan, Milan, Italy.
| | - Lorenzo Preda
- Division of Radiology, European Institute of Oncology, Milan, Italy.
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Cossu Rocca M, Maffini F, Chiocca S, Massaro M, Santoro L, Cattaneo A, Verri E, Chiesa F, Preda L, Nole F, Ansarin M. Induction chemotherapy followed by transoral laser microsurgery: A mutimodal approach to improve outcomes for locally advanced laryngeal cancer patients? J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e17039] [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: 11/20/2022] Open
Affiliation(s)
- Maria Cossu Rocca
- Medical Oncology Unit of Urogenital and Head and Neck Tumors, Milano, Italy
| | - Fausto Maffini
- Division of Pathology and Laboratory Medicineeuropean institute of oncology, Milan, Italy
| | - Susanna Chiocca
- Department of Experimental Oncology at IFOM-IEO Campuseuropean Institute of Oncology, Milan, Italy
| | | | - Luigi Santoro
- Epidemiology and Biostatistics Division, Milan, Italy
| | - Augusto Cattaneo
- Division of Otolaryngology Head and Neck surgery, European Institute of Oncology, Milan, Italy
| | - Elena Verri
- Medical Oncology Unit of Urogenital and Head and Neck Tumors- European Institute of Oncology, Milano, Italy
| | - Fausto Chiesa
- Division of Otolaryngology Head and Neck surgery, European Institute of Oncology, Milan, Italy
| | - Lorenzo Preda
- Division of Radiology, European Institute of Oncology,, Milan, Italy
| | | | - Mohssen Ansarin
- Division of Otolaryngology Head and Neck surgery, European Institute of Oncology, Milan, Italy
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Cossu Rocca M, Maffini F, Santoro L, Chiocca S, Massaro M, Preda L, Cattaneo A, Verri E, Alterio D, Ansarin M. PO-058: Primary chemotherapy followed by Transoral Laser Microsurgery and early laryngeal squamous cell carcinoma. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)34818-0] [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: 10/23/2022]
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Chiappa A, Bertani E, Ferrari C, Della Vigna P, Monfardini L, Venturino M, Maffini F, Andreoni B. 358. Echoguided hepatic resection for “ghost” colorectal metastases. Eur J Surg Oncol 2014. [DOI: 10.1016/j.ejso.2014.08.347] [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: 10/24/2022] Open
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Lepanto D, Maffini F, Petrella F, Colandrea M, Putzu C, Barberis M, Paganelli G, Viale G. Atypical primary pulmonary meningioma: a report of a case suspected of being a lung metastasis. Ecancermedicalscience 2014; 8:414. [PMID: 24761155 PMCID: PMC3971872 DOI: 10.3332/ecancer.2014.414] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [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: 12/17/2013] [Indexed: 02/05/2023] Open
Abstract
Primary extracranial and extraspinal meningiomas are very rare tumours, and primary pulmonary ones are even more uncommon. They present as a solitary pulmonary nodule, and most of them are benign, except for three cases. We describe a primitive atypical pulmonary meningioma first suspected of being a metastasis in a patient during follow-up ten years after therapy for breast cancer.
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Affiliation(s)
- Daniela Lepanto
- Division of Pathology, European Institute of Oncology, 20141 Milan, Italy
| | - Fausto Maffini
- Division of Pathology, European Institute of Oncology, 20141 Milan, Italy
| | - Francesco Petrella
- Division of Thoracic Surgery, European Institute of Oncology, 20141 Milan, Italy
| | - Marzia Colandrea
- Division of Nuclear Medicine, European Institute of Oncology, 20141 Milan, Italy
| | - Carlo Putzu
- Division of Medical Oncology, University of Sassari, 07100 Sassari, Italy
| | - Massimo Barberis
- Division of Pathology, European Institute of Oncology, 20141 Milan, Italy
| | - Giovanni Paganelli
- Division of Nuclear Medicine, European Institute of Oncology, 20141 Milan, Italy
| | - Giuseppe Viale
- Division of Pathology, European Institute of Oncology, 20141 Milan, Italy ; University of Milan School of Medicine, 20122 Milan, Italy
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36
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Maffini F, French CA, Cameron MJ, Stufano V, Barberis M, Pisa E, Manzotti M, Cattaneo A, De Fiori E, Viale G. A case of NUT midline carcinoma with no HPV infection, slight EWSR1 rearrangement and strong expression of EGFR. Tumori 2014. [PMID: 24326851 DOI: 10.1700/1361.15114] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
NUT midline carcinoma (NMC) is a rare neoplasm with a poor prognosis and involving mostly young patients. Here we describe a classic NMC with a BRD4-NUT fusion gene in a middle-aged woman. We also analyzed some biological features that could potentially influence its clinical behavior such as HPV infection, EWSR1 rearrangement, and the status of the EGFR gene.
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Maffini F, Cocorocchio E, Pruneri G, Bonomo G, Peccatori F, Chiapparini L, Vincenzo SD, Martinelli G, Viale G. Locked-in syndrome after basilary artery thrombosis by mucormycosis masquerading as meningoencephalitis in a lymphoma patient. Ecancermedicalscience 2014; 7:382. [PMID: 24386011 PMCID: PMC3869474 DOI: 10.3332/ecancer.2013.382] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 08/20/2013] [Indexed: 11/13/2022] Open
Abstract
Locked-in syndrome is a rare clinical syndrome due to basilary artery thrombosis generally associated with trauma, vascular, or cardiac malformation. It can present as various types of clinical evolution and occasionally masquerades as other pathological conditions, such as infective meningoencephalitis. These complications are the cause of diagnostic delay, if not promptly recognised, followed by patient death. We report the case of a 42-year-old female with a systemic B and cutaneous T-cell non-Hodgkin’s lymphoma, with a severe neutropenia lasting over a year, who eventually developed a rapid and fatal fungal mucormycosis sepsis following a skin infection on her right arm, associated with locked-in syndrome and meningoencephalitis.
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Affiliation(s)
- Fausto Maffini
- Division of Pathology, European Institute of Oncology, Milan 20141, Italy
| | - Emilia Cocorocchio
- Division of Haematoncology, European Institute of Oncology, Milan 20141, Italy
| | - Giancarlo Pruneri
- Division of Pathology, European Institute of Oncology, Milan 20141, Italy
| | - Guido Bonomo
- Division of Radiology, European Institute of Oncology, Milan 20141, Italy
| | - Fedro Peccatori
- Division of Haematoncology, European Institute of Oncology, Milan 20141, Italy
| | - Laura Chiapparini
- Division of Pathology, European Institute of Oncology, Milan 20141, Italy
| | - Silvia Di Vincenzo
- Division of Pathology, European Institute of Oncology, Milan 20141, Italy
| | - Giovanni Martinelli
- Division of Haematoncology, European Institute of Oncology, Milan 20141, Italy
| | - Giuseppe Viale
- Division of Pathology, European Institute of Oncology, Milan 20141, Italy ; University of Milan School of Medicine, Milan 20141, Italy
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38
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Maffini F, Renne G, Olivadese R, Solli P, Locatelli M, Pruneri G, Barberis M, Viale G. A rare case of lung metastasis from a malignant adenomyoepithelioma of the breast: histological features and therapeutic implications. Ecancermedicalscience 2013; 7:372. [PMID: 24244218 PMCID: PMC3826808 DOI: 10.3332/ecancer.2013.372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 08/20/2013] [Indexed: 12/26/2022] Open
Abstract
We present a rare case of lung metastasis from a malignant adenomyoepithelioma of the breast. A 44-year-old woman was surgically treated in 2008 for a malignant adenomyoepithelioma of the breast. Shortly after, two lung nodules were detected through a CT scan, and a diagnosis of malignant adenomyoepithelioma was rendered.
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Affiliation(s)
- Fausto Maffini
- Division of Pathology, European Institute of Oncology, Milan 20141, Italy
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Maffini F, French CA, Cameron MJ, Stufano V, Barberis M, Pisa E, Manzotti M, Cattaneo A, De Fiori E, Viale G. A case of NUT midline carcinoma with no HPV infection, slight EWSR1rearrangement and strong expression of EGFR. Tumori 2013; 99:e152-5. [DOI: 10.1177/030089161309900423] [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] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
NUT midline carcinoma (NMC) is a rare neoplasm with a poor prognosis and involving mostly young patients. Here we describe a classic NMC with a BRD4-NUT fusion gene in a middle-aged woman. We also analyzed some biological features that could potentially influence its clinical behavior such as HPV infection, EWSR1 rearrangement, and the status of the EGFR gene.
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Affiliation(s)
- Fausto Maffini
- Division of Pathology, European Institute of Oncology, Milan, Italy
| | | | - Michael James Cameron
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Viviana Stufano
- Division of Pathology, European Institute of Oncology, Milan, Italy
| | - Massimo Barberis
- Division of Pathology, European Institute of Oncology, Milan, Italy
| | - Eleonora Pisa
- Division of Pathology, European Institute of Oncology, Milan, Italy
| | - Michela Manzotti
- Division of Pathology, European Institute of Oncology, Milan, Italy
| | - Augusto Cattaneo
- Division of Head and Neck Surgery, European Institute of Oncology, Milan
| | - Elvio De Fiori
- Division of Radiology, European Institute of Oncology, Milan
| | - Giuseppe Viale
- Division of Pathology, European Institute of Oncology, Milan, Italy
- University of Milan School of Medicine, Milan, Italy
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40
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Calabrese L, Ostuni A, Ansarin M, Giugliano G, Maffini F, Alterio D, Rocca MC, Petralia G, Bruschini R, Chiesa F. Future challenges in head and neck cancer: From the bench to the bedside? Crit Rev Oncol Hematol 2012; 84 Suppl 1:e90-6. [DOI: 10.1016/j.critrevonc.2010.11.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2010] [Revised: 10/29/2010] [Accepted: 11/03/2010] [Indexed: 01/23/2023] Open
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Affiliation(s)
- F Maffini
- Division of Pathology and Laboratory Medicine, European Institute of Oncology, Milan, Italy.
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Maffini F, Bozzini A, Casadio C, Carinelli S, Pisa E, Possanzini P, Viale G. Ovarian serous papillary carcinoma, metastatic to intramammary lymph-node mimic a primary breast carcinoma on RX mammography. Breast J 2012; 18:484-5. [PMID: 22882656 DOI: 10.1111/j.1524-4741.2012.01286.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Fausto Maffini
- Division of Pathology and Laboratory Medicine Radiological Senology Unit, European Institute of Oncology, Milan, Italy.
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Corbellini C, Vingiani A, Maffini F, Chiappa A, Bertani E, Andreoni B. Retroperitoneal pararenal isolated neurofibroma: report of a case and review of literature. Ecancermedicalscience 2012; 6:253. [PMID: 22654960 PMCID: PMC3357181 DOI: 10.3332/ecancer.2012.253] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 02/28/2012] [Indexed: 11/17/2022] Open
Abstract
The neurofibroma is a tumour of neural origin. This kind of neoplasm, though, is generally skin located. Rare cases in deep organs or in the peritoneal cavity are also reported in the literature. There are two types of neurofibromas, localized and diffuse; the latter is associated with von Recklinghausen disease and always occurs together with skin neurofibromas. Here we report the case of a 47-year-old man affected by retroperitoneal neurofibroma, but not associated with von Recklinghausen disease. A computed tomography (CT) scan described a retroperitoneal pararenal lesion with no clear involvement of adjacent viscera. We describe the diagnostic modality, treatment planning and the timing of treatment of this neoplasm, reviewing also the literature.
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Affiliation(s)
- C Corbellini
- Division of General and Laparoscopic Surgery, European Institute of Oncology, University of Milan, 435 Ripamonti St., Milan 20141, Italy
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44
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Calabrese L, Bruschini R, Giugliano G, Ostuni A, Maffini F, Massaro MA, Santoro L, Navach V, Preda L, Alterio D, Ansarin M, Chiesa F. Compartmental tongue surgery: Long term oncologic results in the treatment of tongue cancer. Oral Oncol 2011; 47:174-9. [PMID: 21257337 DOI: 10.1016/j.oraloncology.2010.12.006] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2010] [Revised: 12/17/2010] [Accepted: 12/21/2010] [Indexed: 12/27/2022]
Abstract
Compartmental tongue surgery (CTS) is a surgical technique that removes the compartments (anatomo-functional units) containing the primary tumor, eliminating the disease and potential muscular, vascular, glandular and lymphatic pathways of spread and recurrence. Compartment boundaries are defined as each hemi-tongue bounded by the lingual septum, the stylohyoid ligament and muscle, and the mylohyoid muscle. In this non-randomized retrospective study we evaluated the oncologic efficacy of CTS in patients with squamous cell carcinoma (SCCA) of the tongue treated from 1995 to 2008. We evaluated 193 patients with primary, previously untreated cT2-4a, cN0, cN+, M0 SCCA with no contraindication to anesthesia and able to give informed consent. Fifty patients treated between October 1995 and July 1999 received standard surgery (resection margin >1cm); 143 patients treated between July 1999 and January 2008 received CTS. Study endpoints were: 5-year local disease-free, locoregional disease-free and overall survival. After 5years, local disease control was achieved in 88.4% of CTS patients (16.8% improvement on standard surgery); locoregional disease control in 83.5% (24.4% improvement) and overall survival was 70.7% (27.3% improvement). The markedly improved outcomes in CTS patients, compared to those treated by standard surgery, suggest CTS as an important new approach in the surgical management of tongue cancer.
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Affiliation(s)
- Luca Calabrese
- Division of Head and Neck Surgery, European Institute of Oncology, Milan, Italy.
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46
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Preda L, De Fiori E, Rampinelli C, Ansarin M, Petralia G, Maffini F, Alterio D, Bonello L, Chiesa F, Bellomi M. US-guided transcutaneous tru-cut biopsy of laryngo-hypopharyngeal lesions. Eur Radiol 2009; 20:1450-5. [PMID: 20016904 DOI: 10.1007/s00330-009-1682-1] [Citation(s) in RCA: 7] [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: 07/21/2009] [Revised: 10/15/2009] [Accepted: 10/29/2009] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To evaluate the feasibility and performance of ultrasound-guided transcutaneous tru-cut biopsy (USGTCB) in selected patients (with stenosis of airways or difficult intubation or contraindication to general anaesthesia) with untreated or previously treated suspicious laryngo-hypopharyngeal masses. METHODS Biopsies were performed with a free-hand technique by a single radiologist. Thirty-six USGTCBs were scheduled in 34 patients (24 males, 10 females; age range 47-95 years). Two USGTCBs were not performed, as lesions were not detectable: therefore, 16 USGTCBs were performed for an untreated mass suspicious for malignancy and 18 were performed for a mass suspicious for recurrence after radiotherapy alone, or associated with endoscopic laser surgery or chemotherapy. RESULTS USGTCB diagnosed 25 squamous cell carcinomas (73.5%) and nine benign lesions (26.5%); no false positives and two false negatives were reported, both in patients previously treated with radiotherapy. The sensitivity, specificity, positive and negative predictive value of the technique was 92.5%, 100%, 100% and 77.7% respectively, with no major complications. CONCLUSION Although biopsy under microlaryngoscopy remains the "gold-standard" technique, USGTCB is feasible, carries the advantages of avoiding general anaesthesia, is suitable for outpatients and is cost-effective. If applied to selected patients, it could be considered for the histological diagnosis of both primary and recurrent laryngo-hypopharyngeal masses.
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Affiliation(s)
- Lorenzo Preda
- Department of Radiology, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy.
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47
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Affiliation(s)
- G De Roberto
- Endoscopy Division, European Institute of Oncology, Milan, Italy.
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48
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Maffini F, Baldini F, Bassi F, Luini A, Viale G. Systemic therapy as a first choice treatment for idiopathic granulomatous mastitis. J Cutan Pathol 2009; 36:689-91. [DOI: 10.1111/j.1600-0560.2008.01102.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ansarin M, Santoro L, Cattaneo A, Massaro MA, Calabrese L, Giugliano G, Maffini F, Ostuni A, Chiesa F. Laser surgery for early glottic cancer: impact of margin status on local control and organ preservation. ACTA ACUST UNITED AC 2009; 135:385-90. [PMID: 19380362 DOI: 10.1001/archoto.2009.10] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To assess the impact of margin status on disease-free survival, overall survival, and organ preservation in early glottic cancer treated by endoscopic laser surgery. DESIGN Prospective nonrandomized study. SETTING Tertiary referral center. PATIENTS A total of 274 patients with untreated (possibly biopsied) cTis, cT1a/b, cT2, cN0 glottic cancer; adequate exposure of the glottic region; no contraindications to general anesthesia; and the ability to give informed consent. INTERVENTIONS European Laryngological Society laser cordectomy. Patients with negative margins (>1 mm) were followed, patients with close margins (< or =1 mm) or 1 positive margin (tumor on margin) had another operation, and patients with more than 1 positive margin had postoperative radiotherapy. Median follow-up was 58 months. MAIN OUTCOME MEASURES Eight-year disease-free survival, 5-year overall survival, and organ preservation rate. RESULTS Margins were negative in 180 patients, close in 40, and positive in 54. A second laser resection was performed in 36 of 94 patients with close or positive margins. Radiotherapy was administered to 36 patients. Patients with close or positive margins who did not undergo further treatment had a greater recurrence risk (hazard ratio, 2.53; 95% confidence interval, 0.97-6.59, P = .06) than did those with negative margins, mainly owing to relapses in 5 of the 8 protocol breakers with positive margins not treated further. Eight-year relapse-free survival was 88.2%, 5-year overall survival was 90.9%, and the larynx was preserved in 97.1%. CONCLUSIONS Laser removal of early glottic cancer is oncologically adequate with margins greater than 1 mm from the tumor edge. Positive margins require further treatment; close margins may require further treatment depending on tumor characteristics.
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Affiliation(s)
- Mohssen Ansarin
- Division of Head and Neck Surgery, European Institute of Oncology, Via Ripamonti 435, 20141 Milano, Italy.
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50
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Ravaioli A, Monti F, Regan MM, Maffini F, Mastropasqua MG, Spataro V, Castiglione-Gertsch M, Panzini I, Gianni L, Goldhirsch A, Coates A, Price KN, Gusterson BA, Viale G. p27 and Skp2 immunoreactivity and its clinical significance with endocrine and chemo-endocrine treatments in node-negative early breast cancer. Ann Oncol 2008; 19:660-8. [PMID: 18272916 DOI: 10.1093/annonc/mdm547] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Low p27 and high Skp2 immunoreactivity are associated with a poor prognosis and other poor prognostic features including resistant phenotypes and antiestrogen drug resistance. We investigated these proteins in two International Breast Cancer Study Group trials studying node-negative early breast cancer. PATIENTS AND METHODS Trial VIII compared chemotherapy followed by goserelin with either modality alone in premenopausal patients. Trial IX compared chemotherapy followed by tamoxifen with tamoxifen alone in postmenopausal patients. Central Pathology Office assessed p27 and Skp2 expression in the primary tumor by immunohistochemistry among 1631 (60%) trial patients. RESULTS p27 and Skp2 were inversely related; 13% of tumors expressed low p27 and high Skp2. Low p27 and high Skp2 were associated with unfavorable prognostic factors including larger size and higher grade tumors, absence of estrogen receptor and progesterone receptor, human epidermal growth factor receptor 2 overexpression and high Ki-67 (each P < 0.05). Low p27 and high Skp2 were not associated with disease-free survival (P = 0.42 and P = 0.48, respectively). The relative effects of chemo-endocrine versus endocrine therapy were similar regardless of p27 or Skp2. CONCLUSIONS We confirm the association of low p27 and high Skp2 with other poor prognostic features, but found no predictive or prognostic value, and therefore do not recommend routine determination of p27 and Skp2 for node-negative breast cancer.
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Affiliation(s)
- A Ravaioli
- Department of Oncology, Ospedale Infermi, Rimini and Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola (FC) Italy.
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