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Quagliariello V, Passariello M, Bisceglia I, Paccone A, Inno A, Maurea C, Rapuano Lembo R, Manna L, Iovine M, Canale ML, Scherillo M, Ascierto PA, Gabrielli D, De Lorenzo C, Maurea N. Combinatorial immune checkpoint blockade increases myocardial expression of NLRP-3 and secretion of H-FABP, NT-Pro-BNP, interleukin-1β and interleukin-6: biochemical implications in cardio-immuno-oncology. Front Cardiovasc Med 2024; 11:1232269. [PMID: 38322766 PMCID: PMC10844473 DOI: 10.3389/fcvm.2024.1232269] [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: 05/31/2023] [Accepted: 01/10/2024] [Indexed: 02/08/2024] Open
Abstract
Background Immune checkpoint blockade in monotherapy or combinatorial regimens with chemotherapy or radiotherapy have become an integral part of oncology in recent years. Monoclonal antibodies against CTLA-4 or PD-1 or PDL-1 are the most studied ICIs in randomized clinical trials, however, more recently, an anti-LAG3 (Lymphocyte activation gene-3) antibody, Relatlimab, has been approved by FDA in combination with Nivolumab for metastatic melanoma therapy. Moreover, Atezolizumab is actually under study in association with Ipilimumab for therapy of metastatic lung cancer. Myocarditis, vasculitis and endothelitis are rarely observed in these patients on monotherapy, however new combination therapies could expose patients to more adverse cardiovascular events. Methods Human cardiomyocytes co-cultured with human peripheral blood lymphocytes (hPBMCs) were exposed to monotherapy and combinatorial ICIs (PD-L1 and CTLA-4 or PD-1 and LAG-3 blocking agents, at 100 nM) for 48 h. After treatments, cardiac cell lysis and secretion of biomarkers of cardiotoxicity (H-FABP, troponin-T, BNP, NT-Pro-BNP), NLRP3-inflammasome and Interleukin 1 and 6 were determined through colorimetric and enzymatic assays. Mitochondrial functions were studied in cardiomyocyte cell lysates through quantification of intracellular Ca++, ATP content and NADH:ubiquinone oxidoreductase core subunit S1 (Ndufs1) levels. Histone deacetylases type 4 (HDAC-4) protein levels were also determined in cardiomyocyte cell lysates to study potential epigenetic changes induced by immunotherapy regimens. Results Both combinations of immune checkpoint inhibitors exert more potent cardiotoxic side effects compared to monotherapies against human cardiac cells co-cultured with human lymphocytes. LDH release from cardiac cells was 43% higher in PD-L1/CTLA-4 blocking agents, and 35.7% higher in PD-1/LAG-3 blocking agents compared to monotherapies. HDAC4 and intracellular Ca++ levels were increased, instead ATP content and Ndufs1 were reduced in myocardial cell lysates (p < 0.001 vs. untreated cells). Troponin-T, BNP, NT-Pro-BNP and H-FABP, were also strongly increased in combination therapy compared to monotherapy regimen. NLRP3 expression, IL-6 and IL-1β levels were also increased by PDL-1/CTLA-4 and PD-1/LAG-3 combined blocking agents compared to untreated cells and monotherapies. Conclusions Data of the present study, although in vitro, indicate that combinatorial immune checkpoint blockade, induce a pro- inflammatory phenotype, thus indicating that these therapies should be closely monitored by the multidisciplinary team consisting of oncologists, cardiologists and immunologists.
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Affiliation(s)
- V. Quagliariello
- Division of Cardiology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Naples, Italy
| | - M. Passariello
- Department of Molecular Medicine and Medical Biotechnology, University of Naples “Federico II”, Naples, Italy
| | - I. Bisceglia
- Servizi Cardiologici Integrati, Dipartimento Cardio-Toraco-Vascolare, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy
| | - A. Paccone
- Division of Cardiology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Naples, Italy
| | - A. Inno
- Medical Oncology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ospedale Sacro Cuore Don Calabria, Negrar, Italy
| | - C. Maurea
- Medical Oncology, Ospedale del Mare, Naples, Italy
| | - R. Rapuano Lembo
- Department of Molecular Medicine, Ceinge-Biotecnologie Avanzate s.c.a.r.l., Naples, Italy
| | - L. Manna
- Department of Molecular Medicine and Medical Biotechnology, University of Naples “Federico II”, Naples, Italy
| | - M. Iovine
- Division of Cardiology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Naples, Italy
| | - M. L. Canale
- U.O.C. Cardiologia, Ospedale Versilia, Lido di Camaiore (LU), Camaiore, Italy
| | - M. Scherillo
- Cardiologia Interventistica e UTIC, A.O. San Pio, Presidio Ospedaliero Gaetano Rummo, Benevento, Italy
| | - P. A. Ascierto
- Melanoma Cancer Immunotherapy and Innovative Therapy Unit, Istituto Nazionale Tumori IRCCS Fondazione "G. Pascale", Naples, Italy
| | - D. Gabrielli
- U.O.C. Cardiologia, Dipartimento Cardio-Toraco-Vascolare, Azienda Ospedaliera San Camillo Forlanini, Roma – Fondazione per il Tuo Cuore – Heart Care Foundation, Firenze, Italy
| | - C. De Lorenzo
- Department of Molecular Medicine and Medical Biotechnology, University of Naples “Federico II”, Naples, Italy
- Department of Molecular Medicine, Ceinge-Biotecnologie Avanzate s.c.a.r.l., Naples, Italy
| | - N. Maurea
- Division of Cardiology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Naples, Italy
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Mangone L, Marinelli F, Bisceglia I, Braghiroli MB, Mastrofilippo V, Pezzarossi A, Morabito F, Aguzzoli L, Mandato VD. Optimizing Outcomes through a Multidisciplinary Team Approach in Endometrial Cancer. Healthcare (Basel) 2023; 12:64. [PMID: 38200970 PMCID: PMC10778853 DOI: 10.3390/healthcare12010064] [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: 11/22/2023] [Revised: 12/20/2023] [Accepted: 12/22/2023] [Indexed: 01/12/2024] Open
Abstract
This study aimed to assess the impact of a multidisciplinary team (MDT) approach on outcomes with endometrial cancer (EC) patients, utilizing 2013-2020 data from the Reggio Emilia Cancer Registry. Recurrence rate, treatments, and outcome indicators were compared between the MDT (319 cases) and non-MDT (324 cases) groups. Among 643 cases, 52.4% were over 65 years old, 98% had microscopic confirmation, and 73% were in stage I. Surgery was performed in 89%, with 41% receiving adjuvant therapies. Recurrence rates (10%) were similar between the two groups, but MDT patients who were older and predominantly in stage I exhibited 79% recurrence within one year (21% in the non-MDT group). Disease-free survival (DFS) showed no significant difference [HR 1.1; 95% CI 0.7-1.6], while differences in overall survival (OS) were notable [HR 1.5; 95% CI 1.0-2.4]. The 5-year OS rates were 87% and 79% in the MDT and non-MDT groups. Comparing the 2013-2015 to 2016-2020 study periods, a shift towards caring for older women, more advanced-stage patients, and those residing outside the metropolitan area, along with a greater number of relapsed cases (from 16% to 76%), were accounted for. These findings underscore the impact of an MDT on EC outcomes, highlighting the evolving patient demographics over time.
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Affiliation(s)
- Lucia Mangone
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (F.M.); (I.B.); (M.B.B.); (A.P.)
| | - Francesco Marinelli
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (F.M.); (I.B.); (M.B.B.); (A.P.)
| | - Isabella Bisceglia
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (F.M.); (I.B.); (M.B.B.); (A.P.)
| | - Maria Barbara Braghiroli
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (F.M.); (I.B.); (M.B.B.); (A.P.)
| | - Valentina Mastrofilippo
- Unit of Obstetrics and Gynaecology, Azienda USL—IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (V.M.); (L.A.); (V.D.M.)
| | - Annamaria Pezzarossi
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (F.M.); (I.B.); (M.B.B.); (A.P.)
| | | | - Lorenzo Aguzzoli
- Unit of Obstetrics and Gynaecology, Azienda USL—IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (V.M.); (L.A.); (V.D.M.)
| | - Vincenzo Dario Mandato
- Unit of Obstetrics and Gynaecology, Azienda USL—IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (V.M.); (L.A.); (V.D.M.)
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Mangone L, Marinelli F, Bisceglia I, Masini C, Palicelli A, Morabito F, Di Girolamo S, Neri A, Pinto C. Incidence and Survival of Testicular Cancers in a Province in Northern Italy and Their Association with Second Tumors. Biology (Basel) 2023; 12:1409. [PMID: 37998008 PMCID: PMC10669588 DOI: 10.3390/biology12111409] [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] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 11/07/2023] [Accepted: 11/07/2023] [Indexed: 11/25/2023]
Abstract
This study investigated the incidence, mortality, and 5-year survival rates of testicular cancers diagnosed in a northern Italian province, which were eventually associated with previous or subsequent extratesticular neoplasms. Cases from 1996 to 2020 were examined by age and histotype (seminoma vs. non-seminoma). The standardized incidence rate was calculated using the European population, and the annual percent change (APC) was reported. The five-year relative survival was estimated using the Pohar Perme method. The association with the second neoplasm was also evaluated. In our study, 385 patients with testicular cancer were included, most of whom were aged between 30 and 40 years. The non-seminoma and seminoma groups accounted for 44% and 18% of younger adults, respectively. The incidence rate increased during the study period (APC 1.6*); however, it increased in seminomas (APC 2.3*) but not in non-seminomas (APC -0.1). Conversely, the mortality rate remained constantly low either overall or in each of the two groups. The overall 5-year survival rate of testicular cancer patients was 95% (99% and 88% for seminomas and non-seminomas, respectively). Primary extratesticular tumors were documented in 37 cases, 18 after and 19 before the testicular cancer diagnosis. Our study confirms that the increased incidence and excellent survival rate are the prerogative of seminomas.
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Affiliation(s)
- Lucia Mangone
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (F.M.); (I.B.)
| | - Francesco Marinelli
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (F.M.); (I.B.)
| | - Isabella Bisceglia
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (F.M.); (I.B.)
| | - Cristina Masini
- Medical Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (C.M.); (S.D.G.); (C.P.)
| | - Andrea Palicelli
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy;
| | | | - Stefania Di Girolamo
- Medical Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (C.M.); (S.D.G.); (C.P.)
| | - Antonino Neri
- Scientific Directorate, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy;
| | - Carmine Pinto
- Medical Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (C.M.); (S.D.G.); (C.P.)
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Mangone L, Giorgi Rossi P, Taborelli M, Toffolutti F, Mancuso P, Dal Maso L, Gobbato M, Clagnan E, Del Zotto S, Ottone M, Bisceglia I, Neri A, Serraino D. SARS-CoV-2 Infection, Vaccination and Risk of Death in People with An Oncological Disease in Northeast Italy. J Pers Med 2023; 13:1333. [PMID: 37763101 PMCID: PMC10532764 DOI: 10.3390/jpm13091333] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 08/28/2023] [Accepted: 08/28/2023] [Indexed: 09/29/2023] Open
Abstract
People with a history of cancer have a higher risk of death when infected with SARS-CoV-2. COVID-19 vaccines in cancer patients proved safe and effective, even if efficacy may be lower than in the general population. In this population-based study, we compare the risk of dying of cancer patients diagnosed with COVID-19 in 2021, vaccinated or non-vaccinated against SARS-CoV-2 and residing in Friuli Venezia Giulia or in the province of Reggio Emilia. An amount of 800 deaths occurred among 6583 patients; the risk of death was more than three times higher among unvaccinated compared to vaccinated ones [HR 3.4; 95% CI 2.9-4.1]. The excess risk of death was stronger in those aged 70-79 years [HR 4.6; 95% CI 3.2-6.8], in patients with diagnosis made <1 year [HR 8.5; 95% CI 7.3-10.5] and in all cancer sites, including hematological malignancies. The study results indicate that vaccination against SARS-CoV-2 infection is a necessary tool to be included in the complex of oncological therapies aimed at reducing the risk of death.
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Affiliation(s)
- Lucia Mangone
- Epidemiology Unit, AUSL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (L.M.); (P.M.); (I.B.)
| | - Paolo Giorgi Rossi
- Epidemiology Unit, AUSL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (L.M.); (P.M.); (I.B.)
| | - Martina Taborelli
- Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy; (M.T.); (F.T.); (L.D.M.); (D.S.)
| | - Federica Toffolutti
- Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy; (M.T.); (F.T.); (L.D.M.); (D.S.)
| | - Pamela Mancuso
- Epidemiology Unit, AUSL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (L.M.); (P.M.); (I.B.)
| | - Luigino Dal Maso
- Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy; (M.T.); (F.T.); (L.D.M.); (D.S.)
| | - Michele Gobbato
- Agenzia Regionale di Coordinamento per la Salute Udine, 33100 Udine, Italy; (M.G.); (E.C.); (S.D.Z.)
| | - Elena Clagnan
- Agenzia Regionale di Coordinamento per la Salute Udine, 33100 Udine, Italy; (M.G.); (E.C.); (S.D.Z.)
| | - Stefania Del Zotto
- Agenzia Regionale di Coordinamento per la Salute Udine, 33100 Udine, Italy; (M.G.); (E.C.); (S.D.Z.)
| | - Marta Ottone
- Epidemiology Unit, AUSL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (L.M.); (P.M.); (I.B.)
| | - Isabella Bisceglia
- Epidemiology Unit, AUSL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (L.M.); (P.M.); (I.B.)
| | - Antonino Neri
- Scientific Directorate, AUSL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy;
| | - Diego Serraino
- Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy; (M.T.); (F.T.); (L.D.M.); (D.S.)
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Mangone L, Penna D, Marinelli F, Roncaglia F, Bisceglia I, Merli F, Ruffini A, Gamberi B, Tieghi A, Valli R, Albertazzi L, Iori M, Giorgi Rossi P, Vener C, Morabito F, Neri A, Luminari S. Incidence, mortality, and survival of hematological malignancies in Northern Italian patients: an update to 2020. Front Oncol 2023; 13:1182971. [PMID: 37534259 PMCID: PMC10391155 DOI: 10.3389/fonc.2023.1182971] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 06/15/2023] [Indexed: 08/04/2023] Open
Abstract
Background Hematological malignancies (HMs) represent a heterogeneous group of diseases with diverse etiology, pathogenesis, and prognosis. HMs' accurate registration by Cancer Registries (CRs) is hampered by the progressive de-hospitalization of patients and the transition to molecular rather than microscopic diagnosis. Material and methods A dedicated software capable of automatically identifying suspected HMs cases by combining several databases was adopted by Reggio Emilia Province CR (RE-CR). Besides pathological reports, hospital discharge archives, and mortality records, RE-CR retrieved information from general and biomolecular laboratories. Incidence, mortality, and 5-year relative survival (RS) reported according to age, sex, and 4 HMs' main categories, were noted. Results Overall, 7,578 HM cases were diagnosed from 1996 to 2020 by RE-CR. HMs were more common in males and older patients, except for Hodgkin Lymphoma and Follicular Lymphoma (FL). Incidence showed a significant increase for FL (annual percent change (APC)=3.0), Myeloproliferative Neoplasms (MPN) in the first period (APC=6.0) followed by a significant decrease (APC=-7.4), and Myelodysplastic Syndromes (APC=16.4) only in the first period. Over the years, a significant increase was observed in 5-year RS for Hodgkin -, Marginal Zone -, Follicular - and Diffuse Large B-cell-Lymphomas, MPN, and Acute Myeloid Leukemia. The availability of dedicated software made it possible to recover 80% of cases automatically: the remaining 20% required direct consultation of medical records. Conclusions The study emphasizes that HM registration needs to collect information from multiple sources. The digitalization of CRs is necessary to increase their efficiency.
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Affiliation(s)
- Lucia Mangone
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Domenico Penna
- PhD Program in Clinical and Experimental Medicine, University of Modena and, Reggio Emilia, Italy
| | | | | | - Isabella Bisceglia
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Francesco Merli
- Hematology Unit, Azienda USL- IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Alessia Ruffini
- Gruppo Amici Dell’Ematologia Foundation-GrADE, Reggio Emilia, Italy
| | - Barbara Gamberi
- Hematology Unit, Azienda USL- IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Alessia Tieghi
- Hematology Unit, Azienda USL- IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Riccardo Valli
- Pathology Unit, Azienda USL- IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Laura Albertazzi
- Laboratory of Clinical Chemistry, Azienda USL- IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Mauro Iori
- Medical Physics Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Paolo Giorgi Rossi
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Claudia Vener
- Department of Oncology and Hemato-oncology, Università di Milano, Milano, Italy
| | | | - Antonino Neri
- Scientific Directorate, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Stefano Luminari
- Hematology Unit, Azienda USL- IRCCS di Reggio Emilia, Reggio Emilia, Italy
- Chimomo Department, University of Modena and Reggio Emilia, Reggio Emilia, Italy
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Mangone L, Marinelli F, Bisceglia I, Zambelli A, Zanelli F, Pagano M, Alberti G, Morabito F, Pinto C. Changes in the Histology of Lung Cancer in Northern Italy: Impact on Incidence and Mortality. Cancers (Basel) 2023; 15:3187. [PMID: 37370797 DOI: 10.3390/cancers15123187] [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: 04/28/2023] [Revised: 06/06/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
This study assessed the incidence, mortality, and survival of lung cancer subtypes of NSCSLC (non-small-cell lung cancer), SCLC (small-cell lung cancer), and other morphologies. It is an observational epidemiological study using 7197 cases from the Reggio Emilia Cancer Registry recorded between 2001 and 2020 in males and females. The incidence of NSCLC in 5104 males indicates a significant 3% annual increase until 2013 and then a decline of -3.2% that is not statistically significant; until 2014, mortality increased significantly (3.2%), but it then decreased non-significantly (-12.1%), especially squamous cell cancer. In 2093 females, the incidence and mortality trends continued to rise significantly through 2012, and then they began to slightly decline (not statistically significant). The two-year relative survival of NSCLC increased from 32% to 38% in males and from 42% to 56% in females. SCLC in males decreased significantly both in incidence and mortality, while in women, it showed a slight increase (significantly for incidence but not for mortality). This study is important because it analyzes the decrease in lung cancer in males and the increase in females in relation to the different histotypes. Our study's findings confirmed a decline in male incidence and death beginning in 2013. We were unable to determine if the drop in cigarette smoking and the introduction of new drugs such as EGFR in first-line therapy were responsible for the lower incidence.
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Affiliation(s)
- Lucia Mangone
- Epidemiology Unit, Azienda Unità Sanitaria Locale, IRCCS di Reggio Emilia, 42122 Reggio Emilia, RE, Italy
| | - Francesco Marinelli
- Epidemiology Unit, Azienda Unità Sanitaria Locale, IRCCS di Reggio Emilia, 42122 Reggio Emilia, RE, Italy
| | - Isabella Bisceglia
- Epidemiology Unit, Azienda Unità Sanitaria Locale, IRCCS di Reggio Emilia, 42122 Reggio Emilia, RE, Italy
| | - Alessandro Zambelli
- Epidemiology Unit, Azienda Unità Sanitaria Locale, IRCCS di Reggio Emilia, 42122 Reggio Emilia, RE, Italy
| | - Francesca Zanelli
- Medical Oncology Unit, Azienda Unità Sanitaria Locale, IRCCS di Reggio Emilia, 42122 Reggio Emilia, RE, Italy
| | - Maria Pagano
- Medical Oncology Unit, Azienda Unità Sanitaria Locale, IRCCS di Reggio Emilia, 42122 Reggio Emilia, RE, Italy
| | - Giulia Alberti
- Medical Oncology Unit, Azienda Unità Sanitaria Locale, IRCCS di Reggio Emilia, 42122 Reggio Emilia, RE, Italy
| | - Fortunato Morabito
- Biotechnology Research Unit, Azienda Sanitaria Provinciale di Cosenza, 87051 Aprigliano, CS, Italy
| | - Carmine Pinto
- Medical Oncology Unit, Azienda Unità Sanitaria Locale, IRCCS di Reggio Emilia, 42122 Reggio Emilia, RE, Italy
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Mangone L, Marinelli F, Bonfante G, Bisceglia I, Morabito F, Masini C, Bergamaschi FAM, Pinto C. The Impact of COVID-19 on New Kidney Cancer Diagnosis: Stage and Treatment in Northern Italy. Int J Environ Res Public Health 2023; 20:4755. [PMID: 36981664 PMCID: PMC10048571 DOI: 10.3390/ijerph20064755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/27/2023] [Accepted: 03/04/2023] [Indexed: 06/18/2023]
Abstract
This study aims to evaluate the impact of COVID-19 on new renal carcinoma (RC) diagnoses using data from the Reggio Emilia Cancer Registry in 2018-2020. A total of 293 RCs were registered, with roughly 100 cases yearly. The distribution by age shows a significant decrease in the 30-59 age group (33.7% in 2018, 24.8% in 2019, and 19.8% in 2020). The incidence of Stage I was 59.4%, 46.5%, and 58.2% in 2018, 2019, and 2020, respectively, whereas the Stage II rate had values of 6.9%, 7.9%, and 2.2% in the years 2018, 2019, and 2020, respectively. Slight non-significant variations were observed in Stages III and IV. Surgery was performed in 83.2% of cases in 2018, 78.2% in 2019, and 82.4% in 2020; the surgery distribution by stage showed no significant differences. Chemotherapy showed an increase in 2020, which was statistically significant only for Stage IV. The gender incidence trends over the last 25 years showed an increase in the male sex in the first period; then, a decline was documented, likely due to a decrease in cigarette consumption. In females, the trend was constant. The RC mortality trend significantly dropped in both genders over the entire study period.
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Affiliation(s)
- Lucia Mangone
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Francesco Marinelli
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Giulia Bonfante
- Unit of Urology, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Isabella Bisceglia
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | | | - Cristina Masini
- Medical Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | | | - Carmine Pinto
- Medical Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
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Mangone L, Marinelli F, Bisceglia I, Filice A, De Leonibus L, Rapicetta C, Paci M. The Influence of COVID-19 on New Lung Cancer Diagnoses, by Stage and Treatment, in Northern Italy. Biology 2023; 12:biology12030390. [PMID: 36979081 PMCID: PMC10045495 DOI: 10.3390/biology12030390] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 02/20/2023] [Accepted: 02/24/2023] [Indexed: 03/05/2023]
Abstract
The COVID-19 pandemic has had a significant impact on new cancer diagnoses. This study aims to evaluate the implications of the lockdown period on new lung cancer diagnoses in northern Italy. We compared 2020 with 2019 cancer registry data, reporting the variations by age, stage, and treatments. In 2020, 303 lung cancer cases were registered, 21 fewer than in 2019. Cases fell in men (−31 patients, 9.6%) but not in women (+10 patients, +3.1%). A significant drop in stage I from 19.8% to 12.9% (p < 0.05) and an increase in stage III (12.7% vs. 19.1%; p < 0.05) was observed. Histological confirmation dropped (70.1% vs. 60.1%; p < 0.05) while cytology increased (12% vs. 20.8%; p < 0.01). Surgery declined (28.7% vs. 21.5%; p < 0.05) but increased in stage III (19.5% vs. 25.9%; p = 0.46), while chemotherapy increased (17.6% vs. 34.3%; p < 0.01) for all stages. During the pandemic, new lung cancer diagnoses dropped only in men. The reorganization of health services has ensured a decrease in surgical interventions (due to the unavailability of operating rooms) counterbalanced by an increase in chemotherapy.
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Affiliation(s)
- Lucia Mangone
- Epidemiology Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy
- Correspondence:
| | - Francesco Marinelli
- Epidemiology Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy
| | - Isabella Bisceglia
- Epidemiology Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy
| | - Angelina Filice
- Nuclear Medicine Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy
| | - Lisa De Leonibus
- Thoracic Surgery Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy
| | - Cristian Rapicetta
- Thoracic Surgery Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy
| | - Massimiliano Paci
- Thoracic Surgery Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy
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Mangone L, Marinelli F, Bisceglia I, Braghiroli MB, Damato A, Pinto C. Five-year relative survival by stage of breast and colon cancers in northern Italy. Front Oncol 2022; 12:982461. [PMID: 36387150 PMCID: PMC9659859 DOI: 10.3389/fonc.2022.982461] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 10/13/2022] [Indexed: 11/30/2022] Open
Abstract
The aim of this study is to present the 5-year relative survival by stage of breast and colorectal cancer patients in a northern Italian province. For the period 2013-2015, cases were selected from the Reggio Emilia Cancer Registry. Breast cancer patients were divided into 3 age groups: <45, 45-74 (the target screening population) and 74+. Colorectal cancers patients were classified into <50, 50-69 (the target screening population), and over 69 years. Carcinomas in situ and unknown stage were both excluded from the survival analyses. The five-year relative survival was estimated using the Pohar Perme method. During the period examined, 1,450 breast cancers and 992 colorectal cancer cases were registered. Analyzing in detail the patients with breast cancer for the entire 2013-2015 period, we noted that 50.4% were in stage I, 33.6% in stage II, 10.8% in stage III and 3.8% in stage IV. The stage was unknown in only 1.3% of patients (19 cases). The stage data of patients with colorectal cancer showed 24.5% were in stage I, 26.1% in stage II, 23.4% in stage III, and 24.6% in stage IV, and 1.4% unknown. Breast cancer 5-year survival was 100%, 89.7%, 71.4%, and 29.1% for stages I, II, III and IV, respectively and for colon cancer 96.7%, 83.4%, 70.8% and 16.2%, respectively.The presence of cancer screening, associated with effective treatments, account for the high survival rate of early-stage breast and colon cancers.
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Affiliation(s)
- Lucia Mangone
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, Reggio Emilia, Italy
- *Correspondence: Lucia Mangone,
| | - Francesco Marinelli
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, Reggio Emilia, Italy
| | - Isabella Bisceglia
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, Reggio Emilia, Italy
| | - Maria Barbara Braghiroli
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, Reggio Emilia, Italy
| | - Angela Damato
- Medical Oncology Unit, Comprehensive Cancer Center, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Viale Risorgimento 80, Reggio Emilia, Italy
- Department of Biotechnologies, University of Siena, Siena, Italy
| | - Carmine Pinto
- Medical Oncology Unit, Comprehensive Cancer Center, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Viale Risorgimento 80, Reggio Emilia, Italy
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Mangone L, Storchi C, Pinto C, Giorgi Rossi P, Bisceglia I, Romanelli A. Incidence of malignant mesothelioma and asbestos exposure in the Emilia-Romagna region, Italy. Med Lav 2022; 113:e2022047. [PMID: 36282034 PMCID: PMC9632668 DOI: 10.23749/mdl.v113i5.13312] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 09/12/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The aim of this study is to describe the incidence of malignant mesothelioma (MM) and asbestos exposure in an Italian region in the period 1996-June 2021. METHODS The study included cases with microscopic confirmation and those with instrumental confirmation. For each case, information on sex, age, tumour site, morphology and date of diagnosis was collected, along with details of exposure to asbestos. RESULTS 3,097 cases of MM (2,233 males and 864 females) were registered: 90.8% with microscopic confirmation. A total of 2,840 cases involved the pleura (92%), 230 cases the peritoneum (7%), and a small number of cases the pericardium and testis (9 and 18, respectively). Most cases (78.0%) occurred after 65 years of age, while only 1.5% concerned individuals with age < 45 years. The standardized incidence rate for the entire period (adjusted to the 2000 Italian standard population and calculated per 100,000 person-years) was equal to 3.9 in males and 1.4 in females, and the trend showed an increase with age in both sexes. Concerning asbestos exposure, 79.7% of cases were exposed (86.7% males and 60.1% females). In 70.3%, exposure was occupational (83.4% males and 33.2% females), while 20.7% of females and 0.8% of males had familial exposure. Building construction, rolling stock manufacture/repair and metalworking were the most prevalent economic activities associated with occupational exposure. CONCLUSIONS This study offers an overview of MM in an Italian region characterized by high incidence and high exposure due to its particular production activities.
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Affiliation(s)
- Lucia Mangone
- Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Italy.
| | - Cinzia Storchi
- COR Emilia-Romagna, Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Italy.
| | - Carmine Pinto
- Medical Oncology Unit, Comprehensive Cancer Centre, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
| | - Paolo Giorgi Rossi
- Reggio Emilia Cancer Registry, Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Italy.
| | - Isabella Bisceglia
- Reggio Emilia Cancer Registry, Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Italy.
| | - Antonio Romanelli
- COR Emilia-Romagna, Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Italy.
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Mangone L, Mancuso P, Bisceglia I, Setti G, Malaguti G, Giorgi Rossi P. The epidemiology of oral cancer during the COVID-19 pandemic in Northern Italy: Incidence, survival, prevalence. Front Oral Health 2022; 3:982584. [PMID: 36186539 PMCID: PMC9523507 DOI: 10.3389/froh.2022.982584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 08/24/2022] [Indexed: 11/26/2022] Open
Abstract
Despite novel treatment approaches, oral cancer survival has not improved significantly and the disease often presents a disabling path for patients. The aim of this work was to describe the epidemiological data of oral cancers in a province of northern Italy. Incident cases in the period 1996–2020 and EU population standardized rates were reported for Oral Cavity cancer (OC) and OroPharyngeal cancer (OP). Annual percent changes (APC) were estimated with joint point analysis. The 5-year survival was calculated in three different periods: 1996–2000, 2001–2010 and 2011–2015. From 1996 to 2020, 771 cases of oral cancers (442 OC and 329 OP) were recorded with the age-standardized incidence rate 7.28 (10.74 in males and 3.97 in females): 3.82 for OC and 3.47 for OP. In males there is a significant increase in the incidence of OP up to 2017 (APC 11; 95% CI, 4.9–17.5), which then decreases; in females the rates are constant. In 2020 (the era of Covid-19), we did not see a decline in incidence compared to 2019. The 5-year survival (for cases diagnosed in 2011–2015) was 55.6%, 56.5% and 56% for OC, OP and OC + OP, respectively; it was somewhat higher in females and was undergoing some changes over the course of years. The number of prevalent cases as of 1 January 2021 is 314 (175 OC, 139 OP). The study showed a decline in cancers in men, particularly for OP; survival shows improvement in the long-term examined; Covid-19 had no negative impact on 2020 diagnoses.
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Affiliation(s)
- Lucia Mangone
- Epidemiology Unit, Azienda Unità Sanitaria Locale – IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Pamela Mancuso
- Epidemiology Unit, Azienda Unità Sanitaria Locale – IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Isabella Bisceglia
- Epidemiology Unit, Azienda Unità Sanitaria Locale – IRCCS di Reggio Emilia, Reggio Emilia, Italy
- Correspondence: Isabella Bisceglia
| | - Giacomo Setti
- Centro Universitario Odontoiatria, University of Parma, Parma, Italy
| | - Giuliano Malaguti
- Department of Specialist Surgeries Head-Neck, Modena and Reggio Emilia University, Modena, Italy
| | - Paolo Giorgi Rossi
- Epidemiology Unit, Azienda Unità Sanitaria Locale – IRCCS di Reggio Emilia, Reggio Emilia, Italy
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Di Girolamo S, Masini C, Mangone L, Marinelli F, Bisceglia I, Tarantini L, Navazio A, Pinto C. Trends in incidence and mortality in kidney cancer patients over the last 25 years in Reggio Emilia Province of the North Italy. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.e22511] [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: 11/20/2022] Open
Abstract
e22511 Background: In the last years, the incidence of renal cell carcinoma (RCC) has rapidly increased in Western countries. From the first decade of this century the new drugs (tyrosine kinase inhibitors, immune checkpoint inhibitors) have markedly improved the clinical outcomes of these patients (pts). The increase in survival has allowed to observe the emergence of other illness including cardiovascular disease (CVD). The aim of our study is to examine the trend in incidence and mortality for tumors and for CVD in RCC pts of Reggio Emilia Province. Methods: All cases of RCC recorded from 1996 to 2020 in Reggio Emilia Cancer Registry (RE-CR) were included. The RE-CR covers a population of 529,609 inhabitants. It is considered a high-quality CR thanks high histological confirmation and data updated to 2020. Kidney cancer cases were defined based on the ICD-O-3 as topography C64.9. The causes of death were classified as kidney cancer, other cancers, CVD (ICD-10 I00-I99). Mortality data were selected based on classification C64 used in the ICD-O-10. Descriptive analyses of patient characteristics with kidney cancer were performed by number of deaths for all causes, for CVD, for kidney cancer and for other cancer. For difference within these groups, we performed one-way Anova test. Analyses were performed using STATA 16.1 software. Trends over time were analyzed by calculating the annual percent change (APC) in age-standardized rates using Joinpoint regression. Results: 2,331 pts with RCC were identified, mainly males (1,504 cases) and aged 60-79 years (1,240 cases). There were 1,257 deaths, with no differences by sex but with a significant gradient according to age (12.1% among young people and 80.4% among over 80 years). The standardized incidence rate showed an increase in males between 1996 and 2011 (APC = 2.3) and then decreased. In females the trend appeared stable. Mortality dropped significantly among those who received diagnosis in the recent years (79.4% in 1996-2000 vs 25.2% in 2016-2020). The standardized mortality rate decreased both in males (APC = -3.3%) and in females (APC = -4.5%). Comparing the same periods, kidney cancer specific mortality decreased from 81.8% to 43.7% (p < 0.01). The opposite occurred for CVD mortality with an increasing not-statistically significant trend. The risk of CVD mortality increased as we move away from the diagnosis (from 6.2% to 27.5%, p < 0.01). The same trend was observed for other causes of death (from 12.6% to 32.1%, p < 0.01). Conclusions: The percentage of mortality from RCC has decreased over the years, while that from CVD has slightly increased starting from 2009. These data may be related to the introduction of new active therapies with a significantly reduction in mortality in the first two years from diagnosis and a longer survival. Dedicated studies are required to define the impact of cancer treatment on CVD risk in long-term cancer survivors.
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Affiliation(s)
| | - Cristina Masini
- Medical Oncology Unit, AUSL-IRCCS of Reggio Emilia, Reggio Emilia, Italy
| | - Lucia Mangone
- Reggio Emilia Cancer Registry, Epidemiology Unit, AUSL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Francesco Marinelli
- Reggio Emilia Cancer Registry, Epidemiology Unit, AUSL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Isabella Bisceglia
- Reggio Emilia Cancer Registry, Epidemiology Unit, AUSL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Luigi Tarantini
- Cardiology Unit, AUSL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Carmine Pinto
- Medical Oncology Unit, Azienda USL-IRCCS Reggio Emilia, Reggio Emilia, Italy
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Bisceglia I, Camilli M, Mistrulli R, Cartoni D, Matera S, Canale M, Battistini R, Rigacci L, Petrolati S. P140 EFFICACY AND SAFETY OF CHEMOTHERAPY CONTAINING NON–PEGYLATED LIPOSOMAL DOXORUBICIN IN PATIENTS AT HIGH CARDIOVASCULAR RISK: A SINGLE–CENTER EXPERIENCE. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.135] [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: 11/13/2022]
Abstract
Abstract
Anthracyclines represent the most effective chemotherapeutic agent in the treatment of non–Hodgkin‘s lymphoma (NHL), although their use is limited due to the risk of cardiac toxicity. This occurs mainly in elderly patients, those with a history of cardiovascular (CV) disease and/or multiple concomitant risk factors. Liposomal doxorubicin has been shown to reduce this toxicity. The aim of this retrospective study is to investigate the use of non–pegylated liposomal doxorubicin in high–risk patients in terms of haematological response rate and CV events. In a single centre, 15 patients undergoing R–COMP regimen (Rituximab, Prednisone, Cyclophosphamide, Vincristine, Myocet liposomal doxorubicin) were consecutively collected from January 2020 to December 2021. The mean age of patients was 73.9 years and 60% were male. The baseline mean left ventricular ejection fraction (LVEF) was 55.9%; four patients had a baseline FE of < 50%, two of them had a severe reduction in LVEF. Among all patients, 86.7% had systemic hypertension, 40% diabetes mellitus, 46.7% dyslipidaemia and 20% a family history of CV disease. Moreover, 46.7% of patients had at least two concomitant risk factors and 20% at least three. 20% had a history of ischemic heart disease, 13.3% had previous exposure to anthracyclines and 20% with mediastinal radiotherapy; 26.7% had moderate to severe aortic valvulopathy. According to the joint Cardio–Oncology evaluation, 100% of patients had been considered unsuitable for conventional doxorubicin.. More than 85% of the cases were already on cardioactive therapy at baseline evaluation and 66.7% required titration or modification during chemotherapy. With R–COMP, the whole population was able to finish treatment achieved complete haematological remission. The mean LVEF at the end of treatment was 55.8% (p = 0.814).
Conclusions
Our results support the efficacy and safety of R–COMP in a population at high risk for cardiac events, otherwise excluded from anthracycline–containing therapy. Liposomal formulatio reduces doxorubicin cardiomyocyte accumulation and thus toxicity, providing the best possible treatment for the majority of the onco–haematological population.
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Affiliation(s)
- I Bisceglia
- OSPEDALE SAN CAMILLO, ROMA; FONDAZIONE POLICLINICO UNIV. A. GEMELLI, ROMA; OSPEDALE SANT‘ANDREA DI ROMA, ROMA; OSPEDALE S. MARIA GORETTI, LATINA; NUOVO OSPEDALE VERSILIA, LIDO DI CAMAIORE; HEMATOLOGY, AZIENDA OSPEDALIERA SAN CAMILLO– FORLANINI, ROMA
| | - M Camilli
- OSPEDALE SAN CAMILLO, ROMA; FONDAZIONE POLICLINICO UNIV. A. GEMELLI, ROMA; OSPEDALE SANT‘ANDREA DI ROMA, ROMA; OSPEDALE S. MARIA GORETTI, LATINA; NUOVO OSPEDALE VERSILIA, LIDO DI CAMAIORE; HEMATOLOGY, AZIENDA OSPEDALIERA SAN CAMILLO– FORLANINI, ROMA
| | - R Mistrulli
- OSPEDALE SAN CAMILLO, ROMA; FONDAZIONE POLICLINICO UNIV. A. GEMELLI, ROMA; OSPEDALE SANT‘ANDREA DI ROMA, ROMA; OSPEDALE S. MARIA GORETTI, LATINA; NUOVO OSPEDALE VERSILIA, LIDO DI CAMAIORE; HEMATOLOGY, AZIENDA OSPEDALIERA SAN CAMILLO– FORLANINI, ROMA
| | - D Cartoni
- OSPEDALE SAN CAMILLO, ROMA; FONDAZIONE POLICLINICO UNIV. A. GEMELLI, ROMA; OSPEDALE SANT‘ANDREA DI ROMA, ROMA; OSPEDALE S. MARIA GORETTI, LATINA; NUOVO OSPEDALE VERSILIA, LIDO DI CAMAIORE; HEMATOLOGY, AZIENDA OSPEDALIERA SAN CAMILLO– FORLANINI, ROMA
| | - S Matera
- OSPEDALE SAN CAMILLO, ROMA; FONDAZIONE POLICLINICO UNIV. A. GEMELLI, ROMA; OSPEDALE SANT‘ANDREA DI ROMA, ROMA; OSPEDALE S. MARIA GORETTI, LATINA; NUOVO OSPEDALE VERSILIA, LIDO DI CAMAIORE; HEMATOLOGY, AZIENDA OSPEDALIERA SAN CAMILLO– FORLANINI, ROMA
| | - M Canale
- OSPEDALE SAN CAMILLO, ROMA; FONDAZIONE POLICLINICO UNIV. A. GEMELLI, ROMA; OSPEDALE SANT‘ANDREA DI ROMA, ROMA; OSPEDALE S. MARIA GORETTI, LATINA; NUOVO OSPEDALE VERSILIA, LIDO DI CAMAIORE; HEMATOLOGY, AZIENDA OSPEDALIERA SAN CAMILLO– FORLANINI, ROMA
| | - R Battistini
- OSPEDALE SAN CAMILLO, ROMA; FONDAZIONE POLICLINICO UNIV. A. GEMELLI, ROMA; OSPEDALE SANT‘ANDREA DI ROMA, ROMA; OSPEDALE S. MARIA GORETTI, LATINA; NUOVO OSPEDALE VERSILIA, LIDO DI CAMAIORE; HEMATOLOGY, AZIENDA OSPEDALIERA SAN CAMILLO– FORLANINI, ROMA
| | - L Rigacci
- OSPEDALE SAN CAMILLO, ROMA; FONDAZIONE POLICLINICO UNIV. A. GEMELLI, ROMA; OSPEDALE SANT‘ANDREA DI ROMA, ROMA; OSPEDALE S. MARIA GORETTI, LATINA; NUOVO OSPEDALE VERSILIA, LIDO DI CAMAIORE; HEMATOLOGY, AZIENDA OSPEDALIERA SAN CAMILLO– FORLANINI, ROMA
| | - S Petrolati
- OSPEDALE SAN CAMILLO, ROMA; FONDAZIONE POLICLINICO UNIV. A. GEMELLI, ROMA; OSPEDALE SANT‘ANDREA DI ROMA, ROMA; OSPEDALE S. MARIA GORETTI, LATINA; NUOVO OSPEDALE VERSILIA, LIDO DI CAMAIORE; HEMATOLOGY, AZIENDA OSPEDALIERA SAN CAMILLO– FORLANINI, ROMA
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14
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Canale M, Coviello K, Solarino G, Del Meglio J, Simonetti F, Venturini E, Camerini A, Maurea N, Bisceglia I, Tessa C, Casolo G. P147 RECOVERY OF CHEMOTHERAPY RELATED ACUTE HEART FAILURE BY THE COMBINED USE OF SACUBITRIL VALSARTAN AND WEARABLE CARDIOVERTER DEFIBRILLATOR. A NOVEL WINNING COMBINATION IN CARDIO–ONCOLOGY. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.142] [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: 11/12/2022]
Abstract
Abstract
Effective anticancer treatments have dramatically improved the outcome of cancer patients but cardiac toxicity reduces their clinical efficacy in a non–negligible percentage of patients. Sacubitril/valsartan is a new paradigm in the treatment of chronic heart failure with reduced ejection fraction due to the enhancement of natriuretic peptides’ properties when coupled with a blocking effect on the AT1 angiotensin receptors. As with other clinical conditions of heart failure with potentially reversible declines in cardiac function, the wearable cardioverter defibrillator is a valid tool for protection against sudden death until recovery occurs. We report a case series of four patients with chemotherapy–related acute cardiac failure with severely reduced cardiac function. They were successfully treated with sacubitril/valsartan while being protected from malignant arrhythmias by the use of a wearable cardioverter defibrillator until the recovery of cardiac function. Sacubitril/valsartan was confirmed to be effective in anthracycline–related cardiac toxicity and the wearable cardioverter defibrillator should be considered as a support tool even in the oncology patient.
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Affiliation(s)
- M Canale
- CARDIOLOGIA OSPEDALE VERSILIA, LIDO DI CAMAIORE; EMATOLOGIA OSPEDALE VERSILIA, LIDO DI CAMAIORE; CARDIOLOGIA OSPEDALE CIVILE, CECINA; ONCOLOGIA OSPEDALE VERSILIA, LIDO DI CAMAIORE; CARDIOLOGIA ISTITUTO NAZIONALE TUMORI, IRCCS FONDAZIONE PASCALE, NAPOLI; SERVIZI CARDIOLOGICI INTEGRATI, AZIENDA OSPEDALIERA SAN CAMILLO FORLANINI, ROMA; RADIOLOGIA, NUOVO OSPEDALE APUANO, MASSA
| | - K Coviello
- CARDIOLOGIA OSPEDALE VERSILIA, LIDO DI CAMAIORE; EMATOLOGIA OSPEDALE VERSILIA, LIDO DI CAMAIORE; CARDIOLOGIA OSPEDALE CIVILE, CECINA; ONCOLOGIA OSPEDALE VERSILIA, LIDO DI CAMAIORE; CARDIOLOGIA ISTITUTO NAZIONALE TUMORI, IRCCS FONDAZIONE PASCALE, NAPOLI; SERVIZI CARDIOLOGICI INTEGRATI, AZIENDA OSPEDALIERA SAN CAMILLO FORLANINI, ROMA; RADIOLOGIA, NUOVO OSPEDALE APUANO, MASSA
| | - G Solarino
- CARDIOLOGIA OSPEDALE VERSILIA, LIDO DI CAMAIORE; EMATOLOGIA OSPEDALE VERSILIA, LIDO DI CAMAIORE; CARDIOLOGIA OSPEDALE CIVILE, CECINA; ONCOLOGIA OSPEDALE VERSILIA, LIDO DI CAMAIORE; CARDIOLOGIA ISTITUTO NAZIONALE TUMORI, IRCCS FONDAZIONE PASCALE, NAPOLI; SERVIZI CARDIOLOGICI INTEGRATI, AZIENDA OSPEDALIERA SAN CAMILLO FORLANINI, ROMA; RADIOLOGIA, NUOVO OSPEDALE APUANO, MASSA
| | - J Del Meglio
- CARDIOLOGIA OSPEDALE VERSILIA, LIDO DI CAMAIORE; EMATOLOGIA OSPEDALE VERSILIA, LIDO DI CAMAIORE; CARDIOLOGIA OSPEDALE CIVILE, CECINA; ONCOLOGIA OSPEDALE VERSILIA, LIDO DI CAMAIORE; CARDIOLOGIA ISTITUTO NAZIONALE TUMORI, IRCCS FONDAZIONE PASCALE, NAPOLI; SERVIZI CARDIOLOGICI INTEGRATI, AZIENDA OSPEDALIERA SAN CAMILLO FORLANINI, ROMA; RADIOLOGIA, NUOVO OSPEDALE APUANO, MASSA
| | - F Simonetti
- CARDIOLOGIA OSPEDALE VERSILIA, LIDO DI CAMAIORE; EMATOLOGIA OSPEDALE VERSILIA, LIDO DI CAMAIORE; CARDIOLOGIA OSPEDALE CIVILE, CECINA; ONCOLOGIA OSPEDALE VERSILIA, LIDO DI CAMAIORE; CARDIOLOGIA ISTITUTO NAZIONALE TUMORI, IRCCS FONDAZIONE PASCALE, NAPOLI; SERVIZI CARDIOLOGICI INTEGRATI, AZIENDA OSPEDALIERA SAN CAMILLO FORLANINI, ROMA; RADIOLOGIA, NUOVO OSPEDALE APUANO, MASSA
| | - E Venturini
- CARDIOLOGIA OSPEDALE VERSILIA, LIDO DI CAMAIORE; EMATOLOGIA OSPEDALE VERSILIA, LIDO DI CAMAIORE; CARDIOLOGIA OSPEDALE CIVILE, CECINA; ONCOLOGIA OSPEDALE VERSILIA, LIDO DI CAMAIORE; CARDIOLOGIA ISTITUTO NAZIONALE TUMORI, IRCCS FONDAZIONE PASCALE, NAPOLI; SERVIZI CARDIOLOGICI INTEGRATI, AZIENDA OSPEDALIERA SAN CAMILLO FORLANINI, ROMA; RADIOLOGIA, NUOVO OSPEDALE APUANO, MASSA
| | - A Camerini
- CARDIOLOGIA OSPEDALE VERSILIA, LIDO DI CAMAIORE; EMATOLOGIA OSPEDALE VERSILIA, LIDO DI CAMAIORE; CARDIOLOGIA OSPEDALE CIVILE, CECINA; ONCOLOGIA OSPEDALE VERSILIA, LIDO DI CAMAIORE; CARDIOLOGIA ISTITUTO NAZIONALE TUMORI, IRCCS FONDAZIONE PASCALE, NAPOLI; SERVIZI CARDIOLOGICI INTEGRATI, AZIENDA OSPEDALIERA SAN CAMILLO FORLANINI, ROMA; RADIOLOGIA, NUOVO OSPEDALE APUANO, MASSA
| | - N Maurea
- CARDIOLOGIA OSPEDALE VERSILIA, LIDO DI CAMAIORE; EMATOLOGIA OSPEDALE VERSILIA, LIDO DI CAMAIORE; CARDIOLOGIA OSPEDALE CIVILE, CECINA; ONCOLOGIA OSPEDALE VERSILIA, LIDO DI CAMAIORE; CARDIOLOGIA ISTITUTO NAZIONALE TUMORI, IRCCS FONDAZIONE PASCALE, NAPOLI; SERVIZI CARDIOLOGICI INTEGRATI, AZIENDA OSPEDALIERA SAN CAMILLO FORLANINI, ROMA; RADIOLOGIA, NUOVO OSPEDALE APUANO, MASSA
| | - I Bisceglia
- CARDIOLOGIA OSPEDALE VERSILIA, LIDO DI CAMAIORE; EMATOLOGIA OSPEDALE VERSILIA, LIDO DI CAMAIORE; CARDIOLOGIA OSPEDALE CIVILE, CECINA; ONCOLOGIA OSPEDALE VERSILIA, LIDO DI CAMAIORE; CARDIOLOGIA ISTITUTO NAZIONALE TUMORI, IRCCS FONDAZIONE PASCALE, NAPOLI; SERVIZI CARDIOLOGICI INTEGRATI, AZIENDA OSPEDALIERA SAN CAMILLO FORLANINI, ROMA; RADIOLOGIA, NUOVO OSPEDALE APUANO, MASSA
| | - C Tessa
- CARDIOLOGIA OSPEDALE VERSILIA, LIDO DI CAMAIORE; EMATOLOGIA OSPEDALE VERSILIA, LIDO DI CAMAIORE; CARDIOLOGIA OSPEDALE CIVILE, CECINA; ONCOLOGIA OSPEDALE VERSILIA, LIDO DI CAMAIORE; CARDIOLOGIA ISTITUTO NAZIONALE TUMORI, IRCCS FONDAZIONE PASCALE, NAPOLI; SERVIZI CARDIOLOGICI INTEGRATI, AZIENDA OSPEDALIERA SAN CAMILLO FORLANINI, ROMA; RADIOLOGIA, NUOVO OSPEDALE APUANO, MASSA
| | - G Casolo
- CARDIOLOGIA OSPEDALE VERSILIA, LIDO DI CAMAIORE; EMATOLOGIA OSPEDALE VERSILIA, LIDO DI CAMAIORE; CARDIOLOGIA OSPEDALE CIVILE, CECINA; ONCOLOGIA OSPEDALE VERSILIA, LIDO DI CAMAIORE; CARDIOLOGIA ISTITUTO NAZIONALE TUMORI, IRCCS FONDAZIONE PASCALE, NAPOLI; SERVIZI CARDIOLOGICI INTEGRATI, AZIENDA OSPEDALIERA SAN CAMILLO FORLANINI, ROMA; RADIOLOGIA, NUOVO OSPEDALE APUANO, MASSA
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Bisceglia I, Mistrulli R, Cartoni D, Buffa V, Battistini R, Proia A, Rigacci L, Petrolati S. C50 CARDIO–ONCO–HAEMATOLOGY IN CLINICAL PRACTICE. A “CHANGELING” CASE: MORE THAN PARADOXICAL BUBBLES. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac011.049] [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: 11/13/2022]
Abstract
Abstract
39–year–old female, without cardiovascular risk factors. At the end of pregnancy she complained of progressive dyspnoea and so she was admitted to the emergency room. Blood tests showed elevated D–dimer and LDH values. A chest CT scan was performed showing a mediastinal mass of about 15 cm encompassing the ascending aorta, the left brachiocephalic trunk and the superior vena cava, both of which appeared thrombosed. Therapy with low molecular weight heparin was started. The patient underwent a mediastinal biopsy, which documented a primary mediastinal non–Hodgkin‘s lymphoma. The baseline cardiological evaluation showed a preserved ejection fraction (60%) at echocardiogram (ECHO). The first cycle of chemotherapy with R–CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine) was started. After an episode of hypoesthesia of the left upper limb, that regressed spontaneously within a few hours, she performed MRI that showed multiple areolas compatible with ischemic disease. Following these results the patient was submitted to an ECHO with saline solution injected through the right brachial vein that documented evidence of early opacification of the left atrium and subsequent opacification of the right sections (after 3 cardiac cycles) (Fig. 1–2). This finding suggested a right–to–left shunting, via the bronchial lower district to the left atrium (pulmonary veins). This suspicion was confirmed by CT angiography, which showed occlusion of the superior vena cava with passage of contrast into azygos and early opacification of peribronchial venous circles (Fig. 3). A patency of foramen ovale was ruled out by injection of saline solution through the femoral vein. After the second cycle of chemotherapy, ECHO showed diffuse hypokinesia and reduced EF to 50%. It was then decided to proceed with the third cycle according to the intensified R–DAEPOCH scheme, except for doxorubicin, because of the cardiotoxicity developed by the patient. A cardioprotective therapy was also started with bisoprolol and ramipril with rapid titration. At subsequent radiological controls, a progressive reduction of the mediastinal mass was found and after just one month, the echocardiogram showed a complete recovery of the EF. Contrast injection confirmed presence of a veno–venous shunt. Cardio–oncology is an intriguing and complex discipline that requires the development of local multidisciplinary teams for challenging situations that patients with cancer may ask us to address.
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Affiliation(s)
- I Bisceglia
- OSPEDALE SAN CAMILLO, ROMA; OSPEDALE SANT‘ANDREA ROMA; HEMATOLOGY, AZIENDA OSPEDALIERA SAN CAMILLO–FORLANINI, ROMA
| | - R Mistrulli
- OSPEDALE SAN CAMILLO, ROMA; OSPEDALE SANT‘ANDREA ROMA; HEMATOLOGY, AZIENDA OSPEDALIERA SAN CAMILLO–FORLANINI, ROMA
| | - D Cartoni
- OSPEDALE SAN CAMILLO, ROMA; OSPEDALE SANT‘ANDREA ROMA; HEMATOLOGY, AZIENDA OSPEDALIERA SAN CAMILLO–FORLANINI, ROMA
| | - V Buffa
- OSPEDALE SAN CAMILLO, ROMA; OSPEDALE SANT‘ANDREA ROMA; HEMATOLOGY, AZIENDA OSPEDALIERA SAN CAMILLO–FORLANINI, ROMA
| | - R Battistini
- OSPEDALE SAN CAMILLO, ROMA; OSPEDALE SANT‘ANDREA ROMA; HEMATOLOGY, AZIENDA OSPEDALIERA SAN CAMILLO–FORLANINI, ROMA
| | - A Proia
- OSPEDALE SAN CAMILLO, ROMA; OSPEDALE SANT‘ANDREA ROMA; HEMATOLOGY, AZIENDA OSPEDALIERA SAN CAMILLO–FORLANINI, ROMA
| | - L Rigacci
- OSPEDALE SAN CAMILLO, ROMA; OSPEDALE SANT‘ANDREA ROMA; HEMATOLOGY, AZIENDA OSPEDALIERA SAN CAMILLO–FORLANINI, ROMA
| | - S Petrolati
- OSPEDALE SAN CAMILLO, ROMA; OSPEDALE SANT‘ANDREA ROMA; HEMATOLOGY, AZIENDA OSPEDALIERA SAN CAMILLO–FORLANINI, ROMA
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16
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Mangone L, Bisceglia I, Michiara M, Musolino A, Mazzoleni G, Caldarella A, Minerba S, Cascone G, Bella F, Dinaro Y, Pau L, Pinto C. Breast Cancer in Italy: Stage and Region Distribution. BCTT 2022; 14:125-131. [PMID: 35515355 PMCID: PMC9064450 DOI: 10.2147/bctt.s360244] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 04/06/2022] [Indexed: 12/18/2022]
Abstract
Purpose Describe breast cancer in Italy by age, geographical area, stage and sites of metastases. In addition, incident and prevalent cases by region are provided. Patients and Methods This population-based study included all female patients with histologically confirmed breast cancer diagnosed in Italy between 2013 and 2019 in the eight participating Cancer Registries. Cases were described by geographic area (north, center, south), age group (<50, 50–69 and 70+) and site of metastases. In addition, the study also provided an estimate of the cases of metastatic breast cancer per single region. Results Of the total 5731 cases, the number of unknown stage cases (eliminated from our analyses) was 545 (10.5% of cases); therefore, the study was conducted on 5186 cases. Overall, 333 (6.5%) of tumors were metastatic at diagnosis but the distribution by geographical area was different: 5.1% in the north, 7.4% in the center and 7.8% in the south. Related to age, 5.6% were diagnosed before the age of 50 and 5.6% within the screening target group (50–69 years), while in elderly women the percentage rose to 8.1%. As regards the site of the metastases, 27.1% developed metastasis to the bone, 12.4% to the liver, 8.6% to the lung and 2.6% to the brain; in 34.9%, multiple sites were already present at the beginning of the cancer. Overall, 3520 cases of incident mBC are estimated in Italia every year (520 in Lombardy in northern Italy, 350 in Lazio in the center, followed by 330 in Campania in the south), and finally they are out of 52,000 prevalent cases. Conclusion A greater possibility of treating and living with the disease for a long time now requires careful monitoring of these tumors.
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Affiliation(s)
- Lucia Mangone
- Epidemiology Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Isabella Bisceglia
- Epidemiology Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, Reggio Emilia, Italy
- Correspondence: Isabella Bisceglia, Via Giovanni Amendola 2, Tel +39 0522/35075, Email
| | - Maria Michiara
- Medical Oncology and Breast Unit, University Hospital of Parma, Parma, Italy
| | - Antonino Musolino
- Medical Oncology and Breast Unit, University Hospital of Parma, Parma, Italy
| | - Guido Mazzoleni
- Pathology Service South Tyrol Local Health Authority, Bolzano, 39100, Italy
| | - Adele Caldarella
- Tuscany Cancer Registry, Clinical and Descriptive Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | | | | | - Francesca Bella
- Siracusa Cancer Registry, Azienda Sanitaria Provinciale Di Siracusa, Siracusa, Italy
| | - Ylenia Dinaro
- Siracusa Cancer Registry, Azienda Sanitaria Provinciale Di Siracusa, Siracusa, Italy
| | | | - Carmine Pinto
- Medical Oncology Unit, Comprehensive Cancer Centre, Azienda Unità Sanitaria Locale -IRCCS Di Reggio Emilia, Reggio Emilia, Italy
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Mangone L, Mancuso P, Bisceglia I, Giorgi Rossi P, Chellini E, Negro C, Benfatto L, Migliore E, Casotto V, Mensi C, Romanelli A, Tumino R, Grappasonni I, Cavone D, Mazzoleni G, Tallarigo F, Marinaccio A. The impact of COVID-19 on new mesothelioma diagnoses in Italy. Thorac Cancer 2022; 13:702-707. [PMID: 35076994 PMCID: PMC8888152 DOI: 10.1111/1759-7714.14296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/09/2021] [Accepted: 12/11/2021] [Indexed: 12/02/2022] Open
Abstract
Background The aim of this work was to evaluate the impact of the restrictions put in place to control the COVID‐19 pandemic on new diagnoses of malignant mesothelioma (MM) in Italy. Methods Twelve of the 21 Italian malignant mesothelioma CORs (regional operating centres) participated. The study included all cases of MM with microscopic confirmation; cases without microscopic confirmation and death certificate only (DCO) were excluded. For each case, information on sex, date of birth, tumor site, morphology, and date of diagnosis was retrieved. We compared the number of incident cases in 2020 with 2019, looking at the overall picture and for four periods: pre‐pandemic (January–February), first wave (March–May), low incidence (June–September), and second wave (October–December). Results A total of 604 cases were registered: 307 in 2019 and 297 in 2020. In the 2020 pre‐pandemic period, the incidence was higher than in the same months in 2019 (+45%); there was no significant change during the first wave (+1%) or in the low‐incidence period (−3%), while a decrease was observed during the second wave (−32%). However, the data were not homogeneous across the country: the increase in the pre‐pandemic period concerned mostly the regions of northern (+61.5%) and central Italy (+43.5%); during the first wave, MM diagnoses increased in the northern (+38.5%) and central (+11.4%) regions but decreased in the southern regions (−52.9%). All these differences are compatible with random fluctuations. Conclusion The COVID‐19 pandemic had little or no impact on new MM diagnoses, and variations were not homogeneous throughout the country.
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Affiliation(s)
- Lucia Mangone
- Reggio Emilia Cancer Registry, Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy.,COR Emilia-Romagna, Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Pamela Mancuso
- Reggio Emilia Cancer Registry, Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Isabella Bisceglia
- Reggio Emilia Cancer Registry, Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Paolo Giorgi Rossi
- Reggio Emilia Cancer Registry, Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Elisabetta Chellini
- COR Toscana, Unit of Occupational & Environmental Epidemiology, Institute for Cancer Research, Prevention and Clinical Network, Firenze, Italy
| | - Corrado Negro
- COR Friuli Venezia Giulia, Azienda Ospedaliero-Universitaria "Ospedali Riuniti di Trieste" Struttura Complessa Medicina del Lavoro, Trieste, Italy
| | - Lucia Benfatto
- COR Liguria, Epidemiologia Clinica, Istituto Nazionale per la Ricerca sul Cancro (IST-Nord), Dipartimento Terapie Oncologiche Integrate e IRCCS Azienda Ospedaliera Universitaria San Martino, Genoa, Italy
| | - Enrica Migliore
- COR Piemonte, Unità di Epidemiologia dei Tumori Città della salute e della scienza di Torino, Torino, Italy
| | - Veronica Casotto
- COR Veneto, Epidemiological Department, Azienda Zero, Veneto Region, Padova, Italy
| | - Carolina Mensi
- COR Lombardia, Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Antonio Romanelli
- COR Emilia-Romagna, Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Rosario Tumino
- COR Sicilia, Cancer Registry and Histopathology Department, Provincial Health Authority (ASP 7), Ragusa, Italy
| | - Iolanda Grappasonni
- COR Marche, School of Medicinal and Health Products Sciences, University of Camerino, Camerino, Italy
| | - Domenica Cavone
- COR Puglia, Interdisciplinary Department of Medicine, Section Occupational Medicine B. Ramazzini, School of Medicine, University Aldo Moro Bari, Bari, Italy
| | - Guido Mazzoleni
- COR Alto-Adige, Health Trust South Tyrol, South Tyrol, Italy
| | - Federico Tallarigo
- COR Calabria, c/o UOC Anatomia Patologica PO San Giovanni di Dio, ASP, Crotone, Italy
| | - Alessandro Marinaccio
- RENAM, INAIL (Italian Workers' Compensation Authority), Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Occupational and Environmental Epidemiology Unit, Rome, Italy
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Mangone L, Pinto C, Mancuso P, Ottone M, Bisceglia I, Chiaranda G, Michiara M, Vicentini M, Carrozzi G, Ferretti S, Falcini F, Hassan C, Rossi PG. Colon cancer survival differs from right side to left side and lymph node harvest number matter. BMC Public Health 2021; 21:906. [PMID: 33980174 PMCID: PMC8117551 DOI: 10.1186/s12889-021-10746-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 02/19/2021] [Indexed: 12/11/2022] Open
Abstract
Background Right-sided colorectal cancer (CRC) has worse survival than does left-sided CRC. The objective of this study was to further assess the impact of right-side location on survival and the role of the extent of lymphadenectomy. Methods All CRCs diagnosed between 2000 and 2012 in Emilia-Romagna Region, Italy, were included. Data for stage, grade, histology, screening history, and number of removed lymph nodes (LN) were collected. Multivariable Cox regression models were used to estimate hazard ratios (HR), with relative 95% confidence intervals (95%CI), of right vs. left colon and of removing < 12, 12–21 or > 21 lymph nodes by cancer site. Results During the study period, 29,358 patients were registered (8828 right colon, 18,852 left colon, 1678 transverse). Patients with right cancer were more often older, females, with advanced stage and high grade, and higher number of removed LNs. Five-year survival was lower in the right than in the left colon (55.2% vs 59.7%). In multivariable analysis, right colon showed a lower survival when adjusting for age, sex, and screening status (HR 1.12, 95%CI 1.04–1.21). Stratification by number of lymph nodes removed (12–21 or > 21) was associated with better survival in right colon (HR 0.54, 95%CI 0.40–0.72 and HR 0.40, 95%CI 0.30–0.55, respectively) compared to left colon (HR 0.89, 95%CI 0.76–1.06 and HR 0.83, 95%CI 0.69–1.01, respectively). Conclusions This study confirms that right CRC has worse survival; the association is not due to screening status. An adequate removal of lymph nodes is associated with better survival, although the direction of the association in terms of causal links is not clear. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10746-4.
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Affiliation(s)
- Lucia Mangone
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, 42122, Reggio Emilia, MD, Italy.
| | - Carmine Pinto
- Medical Oncology, AUSL-IRCCS di Reggio Emilia, Reggio Emilia, MD, Italy
| | - Pamela Mancuso
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, 42122, Reggio Emilia, MD, Italy
| | - Marta Ottone
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, 42122, Reggio Emilia, MD, Italy
| | - Isabella Bisceglia
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, 42122, Reggio Emilia, MD, Italy
| | | | - Maria Michiara
- Medical Oncology Unit, University Hospital of Parma, Parma, MD, Italy
| | - Massimo Vicentini
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, 42122, Reggio Emilia, MD, Italy
| | - Giuliano Carrozzi
- Epidemiology Unit, Azienda Unità Sanitaria Locale, Via Martiniana 21, Baggiovara, 41126, Modena, MD, Italy
| | - Stefano Ferretti
- Romagna Cancer Registry - Section of Ferrara. Local Health Unit, University of Ferrara, Ferrara, MD, Italy
| | - Fabio Falcini
- Romagna Cancer Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola (Forlì), Italy-Azienda Usl della Romagna, Forlì, MD, Italy
| | - Cesare Hassan
- Endoscopy Unit, Nuovo Regina Margherita Hospital, Rome, MD, Italy
| | - Paolo Giorgi Rossi
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, 42122, Reggio Emilia, MD, Italy
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Mangone L, Gioia F, Mancuso P, Bisceglia I, Ottone M, Vicentini M, Pinto C, Giorgi Rossi P. Cumulative COVID-19 incidence, mortality and prognosis in cancer survivors: A population-based study in Reggio Emilia, Northern Italy. Int J Cancer 2021; 149:820-826. [PMID: 33861870 PMCID: PMC8250826 DOI: 10.1002/ijc.33601] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 04/02/2021] [Accepted: 04/09/2021] [Indexed: 12/30/2022]
Abstract
The aim of this population-based study was to evaluate the impact of being a cancer survivor (CS) on COVID-19 risk and prognosis during the first wave of the pandemic (27 February 2020 to 13 May 2020) in Reggio Emilia Province. Prevalent cancer cases diagnosed between 1996 and 2019 were linked with the provincial COVID-19 surveillance system. We compared CS' cumulative incidence of being tested, testing positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), being hospitalized and dying of COVID-19 with that of the general population; we compared COVID-19 prognosis in CS and in patients without cancer. During the study period, 15 391 people (1527 CS) underwent real-time polymerase chain reaction for SARS-CoV-2, of whom 4541 (447 CS) tested positive; 541 (113 CS) died of COVID-19. CS had higher age- and sex-adjusted incidence rate ratios (IRR) of testing (1.28 [95% confidence interval, CI = 1.21-1.35]), of positive test (IRR 1.06 [95% CI = 0.96-1.18]) and of hospitalization and death (IRR 1.27 [95% CI = 1.09-1.48] and 1.39 [95%CI = 1.12-1.71], respectively). CS had worse prognosis when diagnosed with COVID-19, particularly those below age 70 (adjusted odds ratio [OR] of death 5.03; [95% CI = 2.59-9.75]), while the OR decreased after age 70. The OR of death was higher for CS with a recent diagnosis, that is, <2 years (OR = 2.92; 95% CI = 1.64-5.21), or metastases (OR = 2.09; 95% CI = 0.88-4.93). CS showed the same probability of being infected, despite a slightly higher probability of being tested than the general population. Nevertheless, CS were at higher risk of death once infected.
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Affiliation(s)
- Lucia Mangone
- Epidemiology UnitAzienda USL‐IRCCS di Reggio EmiliaReggio EmiliaItaly
| | - Francesco Gioia
- Epidemiology UnitAzienda USL‐IRCCS di Reggio EmiliaReggio EmiliaItaly
| | - Pamela Mancuso
- Epidemiology UnitAzienda USL‐IRCCS di Reggio EmiliaReggio EmiliaItaly
| | | | - Marta Ottone
- Epidemiology UnitAzienda USL‐IRCCS di Reggio EmiliaReggio EmiliaItaly
| | - Massimo Vicentini
- Epidemiology UnitAzienda USL‐IRCCS di Reggio EmiliaReggio EmiliaItaly
| | - Carmine Pinto
- Medical Oncology UnitAzienda USL‐IRCCS di Reggio EmiliaReggio EmiliaItaly
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Mangone L, Mancuso P, Bisceglia I, Braghiroli B, Ferrari F, Vicentini M, Giorgi Rossi P. Five-year relative survival by stage of breast and colon cancers in Italy. Tumori 2020; 107:318-324. [PMID: 33153410 DOI: 10.1177/0300891620964565] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To present the changes in 5-year relative survival of patients with breast and colorectal cancer in a northern Italian province in the 2000-2012 period. Changes are presented in relation to stage, period, and age in the screening population. METHODS A total of 5073 breast cancer and 4093 colorectal cancer cases were registered. Breast cancer was divided into 5 age groups: <45, 45-49, 50-69, 70-74 (the target screening population is ages 45-74), and >74 years. Colorectal cancers were classified into 3 age groups: <50, 50-69 (screening target population), and >69 years. Survival was analysed by stage, period, and screening program. RESULTS Five-year breast cancer relative survival was 92.9% overall, with 100%, 91.9%, 78.8%, 34.2%, and 76.4% for stages I, II, III, IV, and unknown, respectively. Survival increased from 89.7%, 91.8%, and 93.4%, respectively, in the periods 2000-2005, 2006-2009, and 2010-2012. Breast cancer survival was stable in early stages (although already high); a slight improvement was seen for stages III and IV. Five-year colorectal cancer relative survival was 63.6% overall, with 93.3%, 78.6%, 69.8%, 13.2%, and 55.8% for stages I, II, III, IV, and unknown, respectively. No improvement in survival was seen in the periods analysed, although the introduction of screening in 2005 did lead to a sharp decrease in incidence and mortality. CONCLUSIONS For breast cancer, extending the screening target age led to an improvement in survival; for colorectal cancer, the best impact was on incidence and mortality rate.
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Affiliation(s)
- Lucia Mangone
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Pamela Mancuso
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Isabella Bisceglia
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Barbara Braghiroli
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Francesca Ferrari
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Massimo Vicentini
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Paolo Giorgi Rossi
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
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Bisceglia I, Tanzi P, Menichelli M. [Dilated cardiomyopathies: prognosis-determining factors]. G Ital Cardiol 1999; 29:1184-9. [PMID: 10546131] [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] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Affiliation(s)
- I Bisceglia
- I Divisione Cardiologica, Azienda Ospedaliera S. Camillo, Forlanini, Roma
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Bisceglia I, Ceci V, Giovannini E, Santoboni A, Sebastiani F, Masini V. [Clinical aspects and diagnostic criteria in non-obstructive symmetric hypertrophic myocardiopathy]. G Ital Cardiol 1983; 13:192-9. [PMID: 6229442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
We describe the clinical data, the standard and Holter electrocardiographic observations, the carotid pulse tracings, the M-mode and B-mode echocardiographic findings and the left ventriculographic aspects of 21 patients with non-obstructive symmetric hypertrophic cardiomyopathy (NOSHCM). NOSHCM was diagnosed when there was echocardiographic and/or left ventriculographic evidence of septal and posterior wall hypertrophy without signs of left ventricular outflow destruction (LVOTO). Compared to the asymmetric hypertrophic obstructive cardiomyopathy (AHOCM), NOSHCM reveals reduced excursion of the posterior wall of the left ventricle, whereas patients with AHOCM have more frequently systolic murmurs and carotid pulse changes suggestive of LVOTO. Proper classification and treatment of NOSHCM are discussed.
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