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Dell'Aquila E, Cremolini C, Zeppola T, Lonardi S, Bergamo F, Masi G, Stellato M, Marmorino F, Schirripa M, Urbano F, Ronzoni M, Tomasello G, Zaniboni A, Racca P, Buonadonna A, Allegrini G, Fea E, Di Donato S, Chiara S, Tonini G, Tomcikova D, Boni L, Falcone A, Santini D. Prognostic and predictive role of neutrophil/lymphocytes ratio in metastatic colorectal cancer: a retrospective analysis of the TRIBE study by GONO. Ann Oncol 2019; 29:924-930. [PMID: 29324972 DOI: 10.1093/annonc/mdy004] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background Neutrophil/lymphocyte ratio (NLR), defined as absolute neutrophils count divided by absolute lymphocytes count, has been reported as poor prognostic factor in several neoplastic diseases but only a few data are available about unresectable metastatic colorectal cancer (mCRC) patients (pts). The aim of our study was to evaluate the prognostic and predictive role of NLR in the TRIBE trial. Patients and methods Pts enrolled in TRIBE trial were included. TRIBE is a multicentre phase III trial randomizing unresectable and previously untreated mCRC pts to receive FOLFOXIRI or FOLFIRI plus bevacizumab. A cut-off value of 3 was adopted to discriminate pts with low (NLR < 3) versus high (NLR ≥ 3) NLR, as primary analysis. As secondary analysis, NLR was treated as an ordinal variable with three levels based on terciles distribution. Results NLR at baseline was available for 413 patients. After multiple imputation at univariate analysis, patients with high NLR had significantly shorter progression-free survival (PFS) [hazard ratio (HR) 1.27 (95% CI 1.05-1.55), P = 0.017] and overall survival (OS) [HR 1.56 (95% CI 1.25-1.95), P < 0.001] than patients with low NLR. In the multivariable model, NLR retained a significant association with OS [HR 1.44 (95% CI 1.14-1.82), P = 0.014] but not with PFS [HR 1.18 (95% CI 0.95-1.46), P = 0.375]. No interaction effect between treatment arm and NLR was evident in terms of PFS (P for interaction = 0.536) or OS (P for interaction = 0.831). Patients with low [HR 0.84 (95% CI 0.64-1.08)] and high [HR 0.73 (95% CI 0.54-0.97)] NLR achieved similar PFS benefit from the triplet and consistent results were obtained in terms of OS [HR 0.83 (95% CI 0.62-1.12) for low NLR; HR 0.82 (95% CI 0.59-1.12) for high NLR]. Conclusion This study confirmed the prognostic role of NLR in mCRC pts treated with bevacizumab plus chemotherapy in the first line, showing the worse prognosis of pts with high NLR. The advantage of the triplet is independent of NLR at baseline.
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Affiliation(s)
- E Dell'Aquila
- Department of Medical Oncology, Università Campus Bio-Medico di Roma, Rome, Italy
| | - C Cremolini
- Department of Translational Research and New Technologies in Medicine and Surge, Unit of Medical Oncology 2, Azienda Ospedaliera Universitaria Pisana, Istituto Toscano Tumori, Pisa, Italy.
| | - T Zeppola
- Department of Medical Oncology, Università Campus Bio-Medico di Roma, Rome, Italy
| | - S Lonardi
- Department of Clinical and Experimental Oncolog, Medical Oncology Unit 1, Istituto Oncologico Veneto Istituto di Ricovero e Cura a Carattere Scientifico, Padova, Italy
| | - F Bergamo
- Department of Clinical and Experimental Oncolog, Medical Oncology Unit 1, Istituto Oncologico Veneto Istituto di Ricovero e Cura a Carattere Scientifico, Padova, Italy
| | - G Masi
- Department of Translational Research and New Technologies in Medicine and Surge, Unit of Medical Oncology 2, Azienda Ospedaliera Universitaria Pisana, Istituto Toscano Tumori, Pisa, Italy
| | - M Stellato
- Department of Medical Oncology, Università Campus Bio-Medico di Roma, Rome, Italy
| | - F Marmorino
- Department of Translational Research and New Technologies in Medicine and Surge, Unit of Medical Oncology 2, Azienda Ospedaliera Universitaria Pisana, Istituto Toscano Tumori, Pisa, Italy
| | - M Schirripa
- Department of Clinical and Experimental Oncolog, Medical Oncology Unit 1, Istituto Oncologico Veneto Istituto di Ricovero e Cura a Carattere Scientifico, Padova, Italy
| | - F Urbano
- Department of Radiologica, Oncological and Pathological Sciences, Umberto I Policlinico di Roma, Rome, Italy
| | - M Ronzoni
- Medical Oncology, IRCCS San Raffaele, Milan, Italy
| | - G Tomasello
- S. C. Oncologia, ASST Ospedale di Cremona, Cremona, Italy
| | - A Zaniboni
- Department of Medical Oncology, Fondazione Poliambulanza, Brescia, Italy
| | - P Racca
- SSD ColoRectal Cancer Unit-A.O.U. Department of Oncology, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - A Buonadonna
- Division of Medical Oncology B, Centro di Riferimento Oncologico, Aviano, Italy
| | - G Allegrini
- Department of Oncology, Ospedale F. Lotti, Pontedera, Italy
| | - E Fea
- Department of Medical Oncology, Azienda Ospedaliera S Croce e Carle, Cuneo, Italy
| | - S Di Donato
- Department of Oncology, AUSL 4 Prato, Prato, Italy
| | - S Chiara
- Medical Oncology 2, Policlinico San Martino Hospital IRCCS per l'Oncologia, Genoa, Italy
| | - G Tonini
- Department of Medical Oncology, Università Campus Bio-Medico di Roma, Rome, Italy
| | - D Tomcikova
- Clinical Trials Coordinating Cente, Istituto Toscano Tumori, University Hospital Careggi, Florence, Italy
| | - L Boni
- Clinical Trials Coordinating Cente, Istituto Toscano Tumori, University Hospital Careggi, Florence, Italy
| | - A Falcone
- Department of Translational Research and New Technologies in Medicine and Surge, Unit of Medical Oncology 2, Azienda Ospedaliera Universitaria Pisana, Istituto Toscano Tumori, Pisa, Italy
| | - D Santini
- Department of Medical Oncology, Università Campus Bio-Medico di Roma, Rome, Italy
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Fuca G, Guarini V, Corallo S, Lonardi S, Raimondi A, Peverelli G, Rimassa L, Antoniotti C, Murialdo R, Zaniboni A, Sartore-Bianchi A, Tomasello G, Racca P, Clavarezza M, Adamo V, Prisciandaro M, Palermo F, Bartolomeo MD, De Braud F, Pietrantonio F. Prognostic role of blood cell count-based immuno-inflammatory parameters in the Valentino trial. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz246.082] [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: 11/13/2022] Open
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Franco P, Arcadipane F, Mistrangelo M, Cassoni P, Martini S, Iorio G, Elisabetta T, Racca P, Morino M, Ricardi U. Comparing simultaneous vs sequential boost strategies during concurrent chemo-radiation for anal cancer: Results of a retrospective observational study. Eur J Surg Oncol 2018. [DOI: 10.1016/j.ejso.2018.07.033] [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: 10/28/2022] Open
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Cremolini C, Antoniotti C, Lonardi S, Bergamo F, Cortesi E, Tomasello G, Moretto R, Ronzoni M, Racca P, Loupakis F, Zaniboni A, Tonini G, Buonadonna A, Marmorino F, Allegrini G, Granetto C, Masi G, Zagonel V, Sensi E, Fontanini G, Boni L, Falcone A. Primary tumor sidedness and benefit from FOLFOXIRI plus bevacizumab as initial therapy for metastatic colorectal cancer. Retrospective analysis of the TRIBE trial by GONO. Ann Oncol 2018; 29:1528-1534. [DOI: 10.1093/annonc/mdy140] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
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Dell'Aquila E, Pantano F, Rossini D, Stellato M, Lonardi S, Masi G, Schirripa M, Marmorino F, Antoniotti C, Murgioni S, Tomasello G, Ronzoni M, Racca P, Vincenzi B, Allegrini G, Urbano F, Buonadonna A, Banzi M, Tonini G, Cremolini C, Falcone A, Santini D. Development of a new clinical nomogram including velocity rate of disease progression to predict outcome in metastatic colorectal cancer patients treated with bevacizumab beyond progression: A subanalysis from tribe trial. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy151.236] [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: 11/12/2022] Open
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Franco P, Arcadipane F, Racca P, Mistrangelo M, Cassoni P, Morino M, Ricardi U. Image-guided SIB-IMRT for the treatment of anal cancer patients. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx422.016] [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: 11/12/2022] Open
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Arcadipane F, Franco P, Martini S, Furfaro G, Ceccarelli M, Mistrangelo M, Rondi N, Cassoni P, Racca P, Ricardi U. EP-1265: Image-guided SIB-IMRT for the treatment of anal cancer patients. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31700-0] [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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Franco P, Arcadipane F, Ragona R, Lesca A, Gallio E, Mistrangelo M, Cassoni P, Baccega M, Racca P, Faletti R, Rondi N, Morino M, Ricardi U. PV-0324: FDG-PET based pelvic bone marrow dose predicts for blood cell nadirs in CT-RT for anal cancer. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)30766-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Ponzetti A, Zaccaria G, Bustreo S, Mecca C, Spadi R, Fanchini L, Ritorto G, Zanini M, Ciuffreda L, Racca P. Monocentric survey about the use of Raltitrexed in the daily clinical practice for patients with metastatic colorectal cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw335.50] [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: 11/12/2022] Open
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Sartore-Bianchi A, Marsoni S, Trusolino L, Martino C, Lonardi S, Leone F, Cottino F, Vurchio V, Valtorta E, Lauricella C, Zagonel V, Racca P, Ciardiello F, Ardizzoni A, Tonini G, Aglietta M, Siena S. Pertuzumab and trastuzumab-emtansine in HER2 positive metastatic colorectal cancer: the HERACLES B TRIAL. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw335.26] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Marsoni S, Siena S, Martino C, Depetris I, Sartore-Bianchi A, Di Fabio F, Ponzetti A, Fioroni I, Lonardi S, Cassoni P, Truini M, Fiorentino M, Crescenzi A, Rugge M, Leone F, Racca P, Zagonel V, Ciardiello F, Sapino A, Aglietta M. The FUNNEL: a precision medicine project for metastatic colorectal cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw335.28] [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: 11/12/2022] Open
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Siena S, Sartore-Bianchi A, Trusolino L, Martino C, Bencardino K, Lonardi S, Zagonel V, Leone F, Martinelli E, Ciardiello F, Racca P, Amatu A, Palmeri L, Valtorta E, Cassingena A, Vanzulli A, Regge D, Veronese S, Bardelli A, Marsoni S. Final Results of the HERACLES trial in HER2 amplified colorectal cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw335.01] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Bardelli A, Montemurro F, Siravegna G, Mussolin B, Milani A, Leone F, Marino D, Spione M, Corso S, De Braud F, Racca P, Pietrantonio F, Ponzetti A, Cristiano C, Tonini G, Zagonel V, Ardizzoni A, Curigliano G, Siena S, Marsoni S. Clonal evolution and drug resistance in the blood of patients with metastatic solid tumors responding to targeted therapies - THE CORNUCOPIA STUDY. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw345.29] [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: 11/12/2022] Open
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Franco P, Arcadipane F, Ragona R, Mistrangelo M, Cassoni P, Di Muzio J, Rondi N, Morino M, Racca P, Ricardi U. OC-0240: Lumbarsacral bone marrow modeling of acute hematological toxicity in chemoradiation for anal cancer. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)31489-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Franco P, Ragona R, Arcadipane F, Mistrangelo M, Cassoni P, Rondi N, Morino M, Racca P, Ricardi U. Dosimetric predictors of acute hematologic toxicity during concurrent intensity-modulated radiotherapy and chemotherapy for anal cancer. Clin Transl Oncol 2016; 19:67-75. [PMID: 27037814 DOI: 10.1007/s12094-016-1504-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 03/15/2016] [Indexed: 11/25/2022]
Abstract
PURPOSE This study aimed at investigating whether the irradiated volume of pelvic bone marrow (PBM) and specific subsites may predict the occurrence of acute hematologic toxicity (HT) in anal cancer patients undergoing concurrent chemo-radiation. METHODS 50 patients, submitted to IMRT and concurrent chemotherapy, were analyzed. Several bony structures were defined on planning-CT: PBM and lumbar-sacral (LSBM), lower pelvis (LPBM) and iliac (IBM) bone marrow. On dose-volume histograms, dosimetric parameters were taken. Endpoints included white blood-cell-count (WBC), absolute-neutrophil-count (ANC), hemoglobin (Hb) and platelet nadirs and acute hematologic toxicity (HT) according to RTOG scoring scale. Generalized linear modeling was used to find correlations between dosimetric variables and blood cell nadirs, while logistic regression analysis was used to test correlation with ≥G3 HT. Receiver Operating Characteristic (ROC) curve analysis was used to evaluate the optimal cut-off points for predictive dosimetric variables with the Youden method. RESULTS Maximum detected acute HT comprised 38 % of ≥G3 leukopenia and 32 % of ≥G3 neutropenia. Grade 2 anemia was observed in 4 % of patients and ≥G3 thrombocytopenia in 10 %. On multivariate analysis a higher PBM-V 20 was associated with lower WBC nadir. Increased LSBM-V 40 was correlated with a higher likelihood to develop ≥G3 HT. A cut-off point at 41 % for LSBM-V 40 was found. Patients with LSBM-V 40 ≥41 % were more likely to develop ≥G3 HT (55.3 vs. 32.4 %; p < 0.01). CONCLUSIONS Increased low-dose to pelvic bony structures significantly predicted for WBC decrease. Medium-high dose to specific osseous subsites was associated with a higher probability of HT. LSBM-V 40 was a strong predictor of ≥G3 HT. A threshold at 41 % for LSBM-V 40 could be used to limit HT.
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Affiliation(s)
- P Franco
- Department of Oncology, Radiation Oncology, University of Turin School of Medicine, Via Genova 3, 10126, Turin, Italy.
| | - R Ragona
- Department of Oncology, Radiation Oncology, University of Turin School of Medicine, Via Genova 3, 10126, Turin, Italy
| | - F Arcadipane
- Department of Oncology, Radiation Oncology, University of Turin School of Medicine, Via Genova 3, 10126, Turin, Italy
| | - M Mistrangelo
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - P Cassoni
- Department of Medical Sciences, Pathology Unit, University of Torino, Turin, Italy
| | - N Rondi
- Department of Medical Imaging and Radiotherapy, Radiation Oncology, AOU Città della Salute e della Scienza, Turin, Italy
| | - M Morino
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - P Racca
- Oncological Centre for Gastrointestinal Neoplasm, Medical Oncology 1, AOU Città della Salute e della Scienza, Turin, Italy
| | - U Ricardi
- Department of Oncology, Radiation Oncology, University of Turin School of Medicine, Via Genova 3, 10126, Turin, Italy
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Tebbe C, Breckheimer B, Racca P, Schorn C, Kleinhenz B, Nauen R. Incidence and spread of knockdown resistance (kdr) in German Colorado potato beetle (Leptinotarsa decemlineataSay) populations. ACTA ACUST UNITED AC 2016. [DOI: 10.1111/epp.12265] [Citation(s) in RCA: 3] [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: 11/28/2022]
Affiliation(s)
- C. Tebbe
- ZEPP - Central Institute for Decision Support Systems in Crop Protection; Ruedesheimer Straße 60-68 55545 Bad Kreuznach (Germany)
| | - B. Breckheimer
- ZEPP - Central Institute for Decision Support Systems in Crop Protection; Ruedesheimer Straße 60-68 55545 Bad Kreuznach (Germany)
| | - P. Racca
- ZEPP - Central Institute for Decision Support Systems in Crop Protection; Ruedesheimer Straße 60-68 55545 Bad Kreuznach (Germany)
| | - C. Schorn
- Bayer CropScience, R&D, Pest Control; Alfred Nobel Street 50 40789 Monheim (Germany)
| | - B. Kleinhenz
- ZEPP - Central Institute for Decision Support Systems in Crop Protection; Ruedesheimer Straße 60-68 55545 Bad Kreuznach (Germany)
| | - R. Nauen
- Bayer CropScience, R&D, Pest Control; Alfred Nobel Street 50 40789 Monheim (Germany)
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Tampellini M, Polverari RS, Ottone A, Alabiso I, Baratelli C, Bitossi R, Brizzi MP, Leone F, Forti L, Bertona E, Racca P, Mecca C, Alabiso O, Aglietta M, Berruti A, Scagliotti GV. Circannual variation of efficacy outcomes in patients with newly diagnosed metastatic colorectal cancer and treated with first-line chemotherapy. Chronobiol Int 2015; 32:1359-66. [PMID: 26540634 DOI: 10.3109/07420528.2015.1093495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 11/13/2022]
Abstract
Seasonal variation of baseline diagnosis (or clinical suspect) of stage I-III colorectal cancer patients has been repeatedly reported as an independent variable influencing overall survival. However, data are conflicting and no information is available about such a rhythm in advanced stage patients. To test whether a circannual rhythm of efficacy outcomes can be detected in this setting, we collected data about response rate (RR), progression-free survival (PFS), and overall survival (OS) to first-line chemotherapy of 1610 newly diagnosed metastatic patients treated at four independent centers. Responses to first-line chemotherapy were available for 1495 patients. A strong circannual rhythm in RR was evident, with the higher proportion of responding patients in the subgroup diagnosed in January (acrophase). At the time of data cutoff, 1322 patients progressed and 986 died, with median PFS and OS of 11 and 25.6 months, respectively. A circannual rhythmicity of the proportion of patients progressing at 6 months and surviving at 1 year was demonstrated, with acrophases located both in winter (February and January, respectively), similar to what reported for RR. Several interpretations about the genesis of this cyclic variation could be claimed: the rhythm in sunlight exposure and, as a consequence, of vitamin D serum levels and folate degradation, the variability in toxic effect intensity of chemotherapy, and the rhythm in the biological behavior of tumor cells. This observation is worth of further investigation both in preclinical and in clinical settings in order to better elucidate the underlying mechanisms.
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Affiliation(s)
- M Tampellini
- a Department of Oncology , Division of Medical Oncology, San Luigi Hospital, University of Torino , Torino , Italy
| | - R S Polverari
- a Department of Oncology , Division of Medical Oncology, San Luigi Hospital, University of Torino , Torino , Italy
| | - A Ottone
- a Department of Oncology , Division of Medical Oncology, San Luigi Hospital, University of Torino , Torino , Italy
| | - I Alabiso
- a Department of Oncology , Division of Medical Oncology, San Luigi Hospital, University of Torino , Torino , Italy
| | - C Baratelli
- a Department of Oncology , Division of Medical Oncology, San Luigi Hospital, University of Torino , Torino , Italy
| | - R Bitossi
- a Department of Oncology , Division of Medical Oncology, San Luigi Hospital, University of Torino , Torino , Italy
| | - M P Brizzi
- a Department of Oncology , Division of Medical Oncology, San Luigi Hospital, University of Torino , Torino , Italy
| | - F Leone
- c Division of Medical Oncology at IRCCS Candiolo , Candiolo , Italy
| | - L Forti
- d Division of Medical Oncology , University of Oriental Piedmont , Novara , Italy , and
| | - E Bertona
- d Division of Medical Oncology , University of Oriental Piedmont , Novara , Italy , and
| | - P Racca
- e ColoRectal Cancer Unit , Oncologia 1, AOU Città della Salute , Torino
| | - C Mecca
- e ColoRectal Cancer Unit , Oncologia 1, AOU Città della Salute , Torino
| | - O Alabiso
- d Division of Medical Oncology , University of Oriental Piedmont , Novara , Italy , and
| | - M Aglietta
- c Division of Medical Oncology at IRCCS Candiolo , Candiolo , Italy
| | - A Berruti
- b Department of Medical and Surgical Specialties , Radiological Sciences and Public Health, Division of Medical Oncology, University of Brescia , Brescia , Italy
| | - G V Scagliotti
- a Department of Oncology , Division of Medical Oncology, San Luigi Hospital, University of Torino , Torino , Italy
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Tampellini M, Ottone A, Alabiso I, Baratelli C, Bitossi R, Brizzi M, Leone F, Forti L, Bertona E, Racca P, Mecca C, Alabiso O, Aglietta M, Berruti A, Scagliotti G. Circannual variation of efficacy outcomes in patients with newly diagnosed metastatic colorectal cancer and treated with first-line chemotherapy. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv340.28] [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: 11/12/2022] Open
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Ponzetti A, Sonetto C, Spadi R, Pinta F, Fanchini L, Zanini M, Ciuffreda L, Racca P. Clinical characteristics of a series of patients with prolonged clinical benefit after anti-EGFR treatment in metastatic colorectal cancer. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv340.24] [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: 11/13/2022] Open
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Filippi A, Guerrera F, Badellino S, Ceccarelli M, Castiglione A, Guarneri A, Spadi R, Racca P, Ciccone G, Ricardi U, Ruffini E. PO-0770: Stereotactic radiotherapy versus surgery: comparison of survival in lung metastases from colo-rectal cancer. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)40762-5] [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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Franco P, Arcadipane F, Segantin M, Munoz F, Migliaccio F, Sciacero P, Mistrangelo M, Angelini V, Racca P, Morino M, Cassoni P, Ricardi U. EP-1217: SIB-IMRT combined with concurrent chemotherapy for anal cancer: 4-year results of a consecutive case series. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)41209-5] [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: 11/30/2022]
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Mistrangelo M, Senetta R, Racca P, Castellano I, Chiusa L, Bellò M, Ricardi U, Morino M, Cassoni P. A novel biomarker-based analysis reliably predicts nodal metastases in anal carcinoma: preliminary evidence of therapeutic impact. Colorectal Dis 2013; 15:1382-91. [PMID: 23692332 DOI: 10.1111/codi.12289] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Accepted: 02/15/2013] [Indexed: 12/26/2022]
Abstract
AIM Routine prophylactic inguinal irradiation in anal cancer may cause significant toxicity associated with overtreatment bias. The aim of this study was to determine the risk of regional node metastases in anal carcinoma by identifying predictive molecular biomarkers. METHOD Clinicohistopathological data from 50 pretreatment anal carcinoma biopsies were collected. Immunohistochemical analyses with antibodies against Ki67, p53, epidermal growth factor receptor (EGFR) and YKL-40 were performed. Statistical correlations between biomarkers and clinicopathological features and outcomes were studied. Sentinel lymph node biopsy was performed in a subset of 36 patients. RESULTS All patients had undergone synchronous radiochemotherapy; tumour recurrence had developed in 26%, and 16% had died. YKL-40 tumour expression correlated with lymph node metastasis, whereas no inguinal node metastases were found in any of the (14%) patients presenting with a YKL-40/EGFR-negative tumour. YKL-40 expression and node metastasis were both significantly associated with shorter overall and disease-free survival. Tumour grade significantly correlated with disease-free survival only. HIV, tumour histological type, Ki67, p53 and EGFR were not associated with outcome. CONCLUSION YKL-40 expression in anal carcinoma is correlated with a poor outcome and can predict lymph node metastases. The combined absence of YKL-40 and EGFR expression in a first biopsy of anal carcinoma reliably selects a subset of patients without inguinal metastases. Such patients could be spared sentinel lymph node biopsy and/or inguinal radiotherapy.
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Affiliation(s)
- M Mistrangelo
- Digestive and Colorectal Surgery, Centre of Minimal Invasive Surgery, University of Turin, Molinette Hospital, Turin, Italy
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Mistrangelo DM, Bellò M, Cassoni P, Milanesi E, Racca P, Munoz F, Fora G, Rondi N, Gilbo N, Senetta R, Ricardi U, Morino M. Value of staging squamous cell carcinoma of the anal margin and canal using the sentinel lymph node procedure: an update of the series and a review of the literature. Br J Cancer 2013; 108:527-32. [PMID: 23329231 PMCID: PMC3593553 DOI: 10.1038/bjc.2012.600] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Inguinal metastases in patients affected by anal cancer are an independent prognostic factor for local failure and overall mortality. Since 2001, sentinel lymph node biopsy was applied in these patients. This original study reports an update of personal and previous published series, which were compared with Literature to value the incidence of inguinal metastases T-stage related and the overall incidence of false negative inguinal metastases at sentinel node. Methods: In all, 63 patients diagnosed with anal cancer submitted to inguinal sentinel node. Furthermore a research in the Pub Med database was performed to find papers regarding this technique. Results: In our series, detection rate was 98.4%. Inguinal metastases were evidentiated in 13 patients (20.6%). Our median follow-up was 35 months. In our series, no false negative nodes were observed. Conclusion: Sentinel node technique in the detection of inguinal metastases in patients affected by anal cancer should be considered as a standard of care. It is indicated for all T stages in order to select patients to be submitted to inguinal radiotherapy, avoiding related morbidity in negative ones. An overall 3.7% rate of false negative must be considered acceptable.
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Affiliation(s)
- D M Mistrangelo
- Digestive and Colorectal Surgical Department, Centre of Minimal Invasive Surgery, University of Turin, Molinette Hospital, Turin, Italy.
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Mistrangelo M, Bellò M, Ricardi U, Cassoni P, Baccega M, Racca P, Lesca A, Munoz F, Morino M. 332. To PET or Not to PET in Anal Cancer. Eur J Surg Oncol 2012. [DOI: 10.1016/j.ejso.2012.06.319] [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] Open
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Veltri A, Guarnieri T, Gazzera C, Busso M, Solitro F, Fora G, Racca P. Long-term outcome of radiofrequency thermal ablation (RFA) of liver metastases from colorectal cancer (CRC): size as the leading prognostic factor for survival. Radiol Med 2012; 117:1139-51. [PMID: 22430677 DOI: 10.1007/s11547-012-0803-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2011] [Accepted: 07/14/2011] [Indexed: 12/14/2022]
Abstract
PURPOSE The aim of this study was to review some prognostic factors for survival after radiofrequency ablation (RFA) of metastases from colorectal cancer (CRC). MATERIALS AND METHODS From 1996 to 2009, 262 patients with metastases from CRC were treated with RFA. Fourteen were lost to follow-up. The following predictors were analysed in the remaining 248: synchronous/metachronous metastases, single/multiple metastases, diameter of largest metastasis and absence/presence of extrahepatic metastases. Survival was measured from the date of metastasis diagnosis and from the date of RFA. RESULTS Survival at 1, 2, 3 and 5 years was 93%, 78%, 62% and 35% from metastasis diagnosis, and 84%, 59%, 43% and 23% from the date of RFA. Median survival was 41 months in patients with largest metastasis ≤3 cm and 21.7 months for those with metastases >3 cm (p=0.0001); survival increased to 45.2 months in patients with largest metastasis ≤2.5 cm and fell to 18.5 months in those with metastasis >3.5 cm. Median survival of patients with extrahepatic metastases was significantly lower than that of patients without extrahepatic disease (23.3 vs. 32.6 months, p=0.018). CONCLUSIONS In light of our long-term results obtained with commonly used equipment, small lesion size (diameter of largest lesion ≤3 or 2.5 cm) proved to be the most favourable prognostic factor for survival in patients with CRC metastases to the liver treated with RFA. This conclusion is probably related to the possibility of obtaining radical ablation and points to the usefulness of devices allowing ablation of larger volumes. In the presence of extrahepatic metastases, RFA has less impact on survival, even though it is potentially useful in patients at a higher risk of death due to hepatic rather than extrahepatic metastases.
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Affiliation(s)
- A Veltri
- Istituto di Radiologia, Università di Torino, Facoltà San Luigi Gonzaga, Regione Gonzole 10, 10043, Orbassano Torino, Italy.
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Räder T, Racca P, Jörg E, Hau B. PUCREC/PUCTRI - a decision support system for the control of leaf rust of winter wheat and winter rye*. ACTA ACUST UNITED AC 2007. [DOI: 10.1111/j.1365-2338.2007.01140.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Bertetto O, Fanchini L, Nigro C, Racca P. [Pre- and post- operative chemotherapy of rectal carcinoma. Indications and results]. MINERVA CHIR 2003; 58:887-91. [PMID: 14663423] [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] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Affiliation(s)
- O Bertetto
- Università degli Studi,Torino, Azienda Ospedaliera, S. Giovanni Battista, Torino Sezione di Scienze Radiologiche, Dipartimento Discipline Medico Chirurgiche, UOADU Radioterapia, Italy
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Piancino G, Racca P, Rayneri W, Piantino P, Cerchier A, Pecchio F. [Tumor-associated markers in malignant lung neoplasms]. Minerva Med 1986; 77:19-25. [PMID: 3945411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The usefulness of assaying tumoral markers in lung cancers is examined. 63 patients (56 men and 7 women) suffering from various types of malignant lung cancers were examined and compared with 44 patients hospitalised for benign lung complaints. The markers used were: CEA, Ferritin, GICA and TPA. Ferritin proved the most sensitive marker with 73% positive results for tumours as opposed to 47.6% for CEA and GICA and only 19% for TPA. The division of tumours into histological types (Adenocarcinomas, squamous cell carcinomas, microcytomas and large cell anaplastic carcinomas) showed that Ferritin is the best marker for lung cancers (70% positive results in adenocarcinomas and squamous cell carcinomas, 62.5% in microcytomas, 87.5% in large cell anaplastic carcinomas). CEA and GICA display almost the same level of sensitivity in the different histological types: the sensitivity of TPA is low in all cases. Specificity was found to be satisfactory for all markers examined. It may be concluded that best results are obtained by combining Ferritin assay with CEA and/or GICA tests.
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Ricci C, Minetto E, Racca P, Cascio G, Rey R, Vitrano G, Uberti M. [Systemic mastocytosis. Clinical and physiopathological study]. Recenti Prog Med 1982; 73:157-78. [PMID: 7146610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Ricci C, Coscia GC, Uberti M, Discalzi G, Racca P. [Reclassification of multiple myeloma and calculation of the myelomatous mass as prognostic and therapeutic indications]. Recenti Prog Med 1982; 72:482-99. [PMID: 7146598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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