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Baglio SR, Lagerweij T, Pérez-Lanzón M, Ho XD, Léveillé N, Melo SA, Cleton-Jansen AM, Jordanova ES, Roncuzzi L, Greco M, van Eijndhoven MAJ, Grisendi G, Dominici M, Bonafede R, Lougheed SM, de Gruijl TD, Zini N, Cervo S, Steffan A, Canzonieri V, Martson A, Maasalu K, Köks S, Wurdinger T, Baldini N, Pegtel DM. Blocking Tumor-Educated MSC Paracrine Activity Halts Osteosarcoma Progression. Clin Cancer Res 2017; 23:3721-3733. [PMID: 28053020 DOI: 10.1158/1078-0432.ccr-16-2726] [Citation(s) in RCA: 133] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Revised: 12/16/2016] [Accepted: 12/19/2016] [Indexed: 11/16/2022]
Abstract
Purpose: Human osteosarcoma is a genetically heterogeneous bone malignancy with poor prognosis despite the employment of aggressive chemotherapy regimens. Because druggable driver mutations have not been established, dissecting the interactions between osteosarcoma cells and supporting stroma may provide insights into novel therapeutic targets.Experimental Design: By using a bioluminescent orthotopic xenograft mouse model of osteosarcoma, we evaluated the effect of tumor extracellular vesicle (EV)-educated mesenchymal stem cells (TEMSC) on osteosarcoma progression. Characterization and functional studies were designed to assess the mechanisms underlying MSC education. Independent series of tissue specimens were analyzed to corroborate the preclinical findings, and the composition of patient serum EVs was analyzed after isolation with size-exclusion chromatography.Results: We show that EVs secreted by highly malignant osteosarcoma cells selectively incorporate a membrane-associated form of TGFβ, which induces proinflammatory IL6 production by MSCs. TEMSCs promote tumor growth, accompanied with intratumor STAT3 activation and lung metastasis formation, which was not observed with control MSCs. Importantly, intravenous administration of the anti-IL6 receptor antibody tocilizumab abrogated the tumor-promoting effects of TEMSCs. RNA-seq analysis of human osteosarcoma tissues revealed a distinct TGFβ-induced prometastatic gene signature. Tissue microarray immunostaining indicated active STAT3 signaling in human osteosarcoma, consistent with the observations in TEMSC-treated mice. Finally, we isolated pure populations of EVs from serum and demonstrated that circulating levels of EV-associated TGFβ are increased in osteosarcoma patients.Conclusions: Collectively, our findings suggest that TEMSCs promote osteosarcoma progression and provide the basis for testing IL6- and TGFβ-blocking agents as new therapeutic options for osteosarcoma patients. Clin Cancer Res; 23(14); 3721-33. ©2017 AACR.
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Affiliation(s)
- S Rubina Baglio
- Department of Pathology, Cancer Center Amsterdam, VU University Medical Center, Amsterdam, the Netherlands.
| | - Tonny Lagerweij
- Department of Neurosurgery, Cancer Center Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Maria Pérez-Lanzón
- Department of Pathology, Cancer Center Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Xuan Dung Ho
- Department of Pathophysiology, University of Tartu, Tartu, Estonia.,Department of Traumatology and Orthopedics, University of Tartu, Tartu, Estonia.,Department of Oncology, Hue College of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Nicolas Léveillé
- Laboratory for Experimental Oncology and Radiobiology, Center for Experimental Molecular Medicine (CEMM), Academic Medical Center (AMC), Amsterdam, the Netherlands
| | - Sonia A Melo
- Instituto de Investigação e Inovação em Saúde, Universidade do Porto (i3S) and Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), 4200 Porto, Portugal
| | | | - Ekaterina S Jordanova
- Department of Obstetrics and Gynecology, Center for Gynecological Oncology Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Laura Roncuzzi
- Orthopaedic Pathophysiology and Regenerative Medicine Unit, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Michelina Greco
- Orthopaedic Pathophysiology and Regenerative Medicine Unit, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Monique A J van Eijndhoven
- Department of Pathology, Cancer Center Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Giulia Grisendi
- Division of Oncology, Department of Medical and Surgical Sciences for Children and Adults, University-Hospital of Modena and Reggio Emilia, Modena, Italy
| | - Massimo Dominici
- Division of Oncology, Department of Medical and Surgical Sciences for Children and Adults, University-Hospital of Modena and Reggio Emilia, Modena, Italy
| | - Roberta Bonafede
- Department of Pathology, Cancer Center Amsterdam, VU University Medical Center, Amsterdam, the Netherlands.,Department of Neurosciences, Biomedicine and Movement Sciences. University of Verona, Verona, Italy
| | - Sinead M Lougheed
- Department of Medical Oncology, Cancer Center Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Tanja D de Gruijl
- Department of Medical Oncology, Cancer Center Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Nicoletta Zini
- CNR-National Research Council of Italy, Institute of Molecular Genetics, Bologna, Italy.,Laboratory of Musculoskeletal Cell Biology, Rizzoli Orthopaedic Institute, Bologna, Italy
| | - Silvia Cervo
- CRO-Biobank, CRO Aviano National Cancer Institute, Aviano, Italy.,Clinical Cancer Pathology, CRO Aviano National Cancer Institute, Aviano, Italy
| | - Agostino Steffan
- CRO-Biobank, CRO Aviano National Cancer Institute, Aviano, Italy.,Clinical Cancer Pathology, CRO Aviano National Cancer Institute, Aviano, Italy
| | - Vincenzo Canzonieri
- CRO-Biobank, CRO Aviano National Cancer Institute, Aviano, Italy.,Division of Pathology, CRO Aviano National Cancer Institute, Aviano, Italy
| | - Aare Martson
- Department of Traumatology and Orthopedics, University of Tartu, Tartu, Estonia.,Clinic of Traumatology and Orthopaedics, Tartu University Hospital, Tartu, Estonia
| | - Katre Maasalu
- Department of Traumatology and Orthopedics, University of Tartu, Tartu, Estonia.,Clinic of Traumatology and Orthopaedics, Tartu University Hospital, Tartu, Estonia
| | - Sulev Köks
- Department of Pathophysiology, University of Tartu, Tartu, Estonia.,Department of Reproductive Biology, Estonian University of Life Sciences, Tartu, Estonia
| | - Tom Wurdinger
- Department of Neurosurgery, Cancer Center Amsterdam, VU University Medical Center, Amsterdam, the Netherlands.,Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Nicola Baldini
- Orthopaedic Pathophysiology and Regenerative Medicine Unit, Istituto Ortopedico Rizzoli, Bologna, Italy. .,Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - D Michiel Pegtel
- Department of Pathology, Cancer Center Amsterdam, VU University Medical Center, Amsterdam, the Netherlands.
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De Re V, Orzes E, Canzonieri V, Maiero S, Fornasarig M, Alessandrini L, Cervo S, Steffan A, Zanette G, Mazzon C, De Paoli P, Cannizzaro R. Pepsinogens to Distinguish Patients With Gastric Intestinal Metaplasia and Helicobacter pylori Infection Among Populations at Risk for Gastric Cancer. Clin Transl Gastroenterol 2016; 7:e183. [PMID: 27441820 PMCID: PMC5543486 DOI: 10.1038/ctg.2016.42] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 06/08/2016] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES The objectives of this study were to investigate the serum pepsinogen test for the prediction of OLGIM (Operative Link on Gastric Intestinal Metaplasia Assessment) stages in first-degree relatives (FDR-GC) of patients with gastric cancer (GC) and autoimmune chronic atrophic gastritis (ACAG). METHODS In 67 consecutive patients with ACAG, 82 FDR-GC, and 53 controls (CTRL) without gastric disease (confirmed by biopsy), serum levels of pepsinogen 1 (PG1), pepsinogen 2 (PG2), G17, and the PG1/2 ratio were assessed by enzyme-linked immunosorbent assay kit. All ACAG patients had positive antiparietal cell antibody levels, estimated by indirect immunofluorescence. Biopsies taken in duplicate from the antrum, corpus, and fundus were stained with Giemsa for Helicobacter pylori detection. Endoscopic detection of metaplasia was confirmed by histological diagnosis. Histological classification of OLGIM stages was applied by using the criteria of severity and topography of intestinal metaplasia (IM). RESULTS The highest discrimination capacity for distinguishing ACAG from other groups of patients was the gastrin G17 test. The lowest mean for PG1 and PG2 serum levels was found in ACAG. In multivariate analysis by age, PG1 and PG1/PG2 were independent prognostic factors for metaplasia, and PG2 also for the presence of a histological H. pylori infection. The serum PG1 level was significantly lower in individuals with IM at OLGIM stage >2 than in those with IM at OLGIM stage <2, resulting in a useful method for the prediction of OLGIM stage. With the inclusion of patient age at diagnosis in the prediction of ≥2 vs. 0-1 OLGIM stages, the receiver operating characteristic (ROC) curve at 47.9 ng/ml PG1 level reached a significant area under the curve (AUC) value (0.978, P<0.001). We also observed a slight difference in PG2 serum levels between histological H. pylori-positive and H. pylori-negative subjects (ROC AUC: 0.599). CONCLUSIONS This study demonstrated an important increase in gastrin G17 serum level in autoimmune gastritis. PG1 serum level corrected by patient age can be used in the management of patients at risk for GC with a high predicted probability of having an OLGIM stage ≥2. Using a cutoff of 47.9 ng/ml, PG1 testing in FDR-GC and ACAG patients had a sensitivity of 95.83% and a specificity of 93.37. Although these results could be validated in a prospective study, the known importance of higher OLGIM stages in increasing the risk of GC development supports the rationale of proposing PG1 algorithm as a diagnostic tool for the selection of high-risk FDR-GC and ACAG patients at high-risk stages for subsequent detailed endoscopic examination to detect dysplasia and asymptomatic GC. In addition, serum PG1 and PG2 levels could stratify patients based on both H. pylori infection and OLGIM risk in consideration of the increased acknowledge regarding the role of H. pylori in the progression of gastritis to GC.
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Affiliation(s)
- Valli De Re
- Bio-Immunotherapy/Bio-Proteomics, National Cancer Institute, IRCCS, Centro di Riferimento Oncologico, Aviano, Italy
| | - Enrico Orzes
- Division of Oncological Gastroenterology, National Cancer Institute, IRCCS, Centro di Riferimento Oncologico, Aviano, Italy
| | - Vincenzo Canzonieri
- Division of Pathology, National Cancer Institute, IRCCS, Centro di Riferimento Oncologico, Aviano, Italy
| | - Stefania Maiero
- Division of Oncological Gastroenterology, National Cancer Institute, IRCCS, Centro di Riferimento Oncologico, Aviano, Italy
| | - Mara Fornasarig
- Division of Oncological Gastroenterology, National Cancer Institute, IRCCS, Centro di Riferimento Oncologico, Aviano, Italy
| | - Lara Alessandrini
- Division of Pathology, National Cancer Institute, IRCCS, Centro di Riferimento Oncologico, Aviano, Italy
| | - Silvia Cervo
- Clinical Pathology, National Cancer Institute, IRCCS, Centro di Riferimento Oncologico, Aviano, Italy
| | - Agostino Steffan
- Clinical Pathology, National Cancer Institute, IRCCS, Centro di Riferimento Oncologico, Aviano, Italy
| | - Giorgio Zanette
- Division of Diabetology, Pordenone Hospital, Pordenone, Italy
| | - Cinzia Mazzon
- Division of Endocrinology, Pordenone Hospital, Pordenone, Italy
| | - Paolo De Paoli
- Scientific Direction, National Cancer Institute, IRCCS, Centro di Riferimento Oncologico, Aviano, Italy
| | - Renato Cannizzaro
- Division of Oncological Gastroenterology, National Cancer Institute, IRCCS, Centro di Riferimento Oncologico, Aviano, Italy
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Truccolo I, Cipolat Mis C, Cervo S, Dal Maso L, Bongiovanni M, Bearz A, Sartor I, Baldo P, Ferrarin E, Fratino L, Mascarin M, Roncadin M, Annunziata MA, Muzzatti B, De Paoli P. Patient-Centered Cancer Care Programs in Italy: Benchmarking Global Patient Education Initiatives. J Cancer Educ 2016; 31:405-412. [PMID: 25773134 PMCID: PMC4831987 DOI: 10.1007/s13187-015-0805-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [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] [Indexed: 06/04/2023]
Abstract
In Italy, educational programs for cancer patients are currently provided by the national government, scientific societies, and patient advocate organizations. Several gaps limit their effectiveness, including the lack of coordinated efforts, poor involvement of patient feedback in the planning of programs, as well as a lack of resources on innovative cancer-related topics. This process is parallel to a strong shift in the attitude of patients towards health in general and taking charge of their own health conditions in particular. The National Cancer Institute in the USA and the Organization of European Cancer Institutes encourage comprehensive cancer centers in providing educational programs conceived to overcome these gaps. The goal of this paper is to identify and describe the key elements necessary to develop a global patient education program and provide recommendations for strategies with practical examples for implementation in the daily activities of cancer institutes. A multidisciplinary committee was established for patient education, including patient representatives as equal partners, to define, implement, verify, and evaluate the fundamental steps for establishing a comprehensive education program. Six essential topics were identified for the program: appropriate communication of cancer epidemiology, clinical trial information, new therapeutic technologies, support in the use of medicines, psycho-oncological interventions, age-personalized approaches, and training programs for healthcare providers. Integration of these topics along with patient feedback is the key to a successful model for educational programs. An integrated educational program can transform a comprehensive cancer center to an institution that provides research and care for and with patients.
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Affiliation(s)
- Ivana Truccolo
- Scientific Directorate, CRO Aviano National Cancer Institute, via F. Gallini 2, 33081, Aviano, PN, Italy
| | - Chiara Cipolat Mis
- Scientific Directorate, CRO Aviano National Cancer Institute, via F. Gallini 2, 33081, Aviano, PN, Italy
| | - Silvia Cervo
- CRO-Biobank, CRO Aviano National Cancer Institute, via F. Gallini 2, 33081, Aviano, PN, Italy.
- Clinical Cancer Pathology, CRO Aviano National Cancer Institute, via F. Gallini 2, 33081, Aviano, PN, Italy.
| | - Luigino Dal Maso
- Epidemiology and Biostatistics, CRO Aviano National Cancer Institute, via F. Gallini 2, 33081, Aviano, PN, Italy
| | - Marilena Bongiovanni
- Associazione Nazionale Guariti Lungoviventi Oncologici (ANGOLO), CRO Aviano National Cancer Institute, via F. Gallini 2, 33081, Aviano, PN, Italy
| | - Alessandra Bearz
- Medical Oncology, CRO Aviano National Cancer Institute, via F. Gallini 2, 33081, Aviano, PN, Italy
| | - Ivana Sartor
- Scientific Directorate, CRO Aviano National Cancer Institute, via F. Gallini 2, 33081, Aviano, PN, Italy
| | - Paolo Baldo
- Pharmacy, CRO Aviano National Cancer Institute, via F. Gallini 2, 33081, Aviano, PN, Italy
| | - Emanuela Ferrarin
- Pharmacy, CRO Aviano National Cancer Institute, via F. Gallini 2, 33081, Aviano, PN, Italy
| | - Lucia Fratino
- Medical Oncology, CRO Aviano National Cancer Institute, via F. Gallini 2, 33081, Aviano, PN, Italy
| | - Maurizio Mascarin
- Radiotherapy, CRO Aviano National Cancer Institute, via F. Gallini 2, 33081, Aviano, PN, Italy
| | - Mario Roncadin
- Radiotherapy, CRO Aviano National Cancer Institute, via F. Gallini 2, 33081, Aviano, PN, Italy
| | | | - Barbara Muzzatti
- Psychooncology, CRO Aviano National Cancer Institute, via F. Gallini 2, 33081, Aviano, PN, Italy
| | - Paolo De Paoli
- Scientific Directorate, CRO Aviano National Cancer Institute, via F. Gallini 2, 33081, Aviano, PN, Italy
- CRO-Biobank, CRO Aviano National Cancer Institute, via F. Gallini 2, 33081, Aviano, PN, Italy
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Sopracordevole F, Di Giuseppe J, Cervo S, Buttignol M, Giorda G, Ciavattini A, Canzonieri V. Conservative treatment of coexisting microinvasive squamous and adenocarcinoma of the cervix: report of two cases and literature review. Onco Targets Ther 2016; 9:539-44. [PMID: 26869798 PMCID: PMC4734811 DOI: 10.2147/ott.s93899] [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] [Indexed: 12/01/2022] Open
Abstract
Coexistence of microinvasive squamous cell carcinoma (MISCC) and microinvasive adenocarcinoma (MIAC) of the cervix is a rare phenomenon with very few clinically significant cases described in the literature. While a conservative approach has been studied, and may be effective in MISCC, a lower number of studies that recommend conservative treatment are available for MIAC. We report two cases of synchronous cervix lesions in two separate foci, MISCC and MIAC, who underwent fertility-sparing treatment with long-term follow-up. We describe clinical, histological, and immunohistochemical features of the two cases. The first case is a 41-year-old female with a diagnosis of MIAC of endocervical type, grade 1 differentiation, with a stromal invasion, associated with a separate area of squamous cell carcinoma (International Federation of Gynecology and Obstetrics/TNM stage: pT1a1G1). The second case is a 45-year-old female with a diagnosis of plurifocal MISCC, associated with an MIAC of endocervical type with a stromal invasion (International Federation of Gynecology and Obstetrics/TNM stage: pT1a1G1). After multidisciplinary counseling, both patients accepted conization as definitive treatment. Eleven years after the conization, all tests (Papanicolaou smear, colposcopy, cervical curettage, and hybrid capture 2-human papillomavirus test) planned quarterly in the first year and every 6 months in the subsequent years were negative in both patients. In women affected by stage IA1 squamous cervical cancer coexisting with stage IA1 adenocarcinoma endocervical type, with clear margins, and without lymphovascular space invasion, cervical conization may be considered a fertility-preserving, safe, and definitive therapeutic option.
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Affiliation(s)
- Francesco Sopracordevole
- Gynecologic Oncology Unit, Department of Surgical Oncology, CRO Aviano National Cancer Institute, Aviano, Pordenone, Italy
| | - Jacopo Di Giuseppe
- Woman's Health Sciences Department, Gynaecologic Section, Polytechnic University of Marche, Ancona, Italy
| | - Silvia Cervo
- CRO-Biobank, CRO Aviano National Cancer Institute, Aviano, Pordenone, Italy; Clinical Cancer Pathology, CRO Aviano National Cancer Institute, Aviano, Pordenone, Italy
| | - Monica Buttignol
- Gynecologic Oncology Unit, Department of Surgical Oncology, CRO Aviano National Cancer Institute, Aviano, Pordenone, Italy
| | - Giorgio Giorda
- Gynecologic Oncology Unit, Department of Surgical Oncology, CRO Aviano National Cancer Institute, Aviano, Pordenone, Italy
| | - Andrea Ciavattini
- Woman's Health Sciences Department, Gynaecologic Section, Polytechnic University of Marche, Ancona, Italy
| | - Vincenzo Canzonieri
- CRO-Biobank, CRO Aviano National Cancer Institute, Aviano, Pordenone, Italy; Pathology Unit, CRO Aviano National Cancer Institute, Aviano, Pordenone, Italy
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Cervo S, Mansutti E, Del Mistro G, Spizzo R, Colombatti A, Steffan A, Sergo V, Bonifacio A. SERS analysis of serum for detection of early and locally advanced breast cancer. Anal Bioanal Chem 2015; 407:7503-9. [DOI: 10.1007/s00216-015-8923-8] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Revised: 07/14/2015] [Accepted: 07/16/2015] [Indexed: 12/27/2022]
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Miolo G, Ash A, Buonadonna A, Lo Re G, Torrisi E, Cervo S, Santeufemia DA, Tuzi A, Canzonieri V. Grade 4 unclassified renal cell carcinoma with sarcomatoid component expressing S-100 protein. A case report with peculiar diagnostic and therapeutic implications. Cancer Biol Ther 2015; 15:1439-43. [PMID: 25482943 DOI: 10.4161/15384047.2014.956642] [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: 11/19/2022] Open
Abstract
Grade 4 unclassified renal cell carcinoma, with a sarcomatoid component (URCCSC) is a rare high grade tumor presumptively derived from all histological subtypes of renal cell carcinoma (RCC). Even though rare, URCCSC generates a great deal of interest, as it is a particularly aggressive variant of RCC, that is poorly responsive to chemo-immunotherapy. Whether it originates from a separate sarcomatoid cell clone within the tumor or from true cell dedifferentiation from RCC has yet to be established. The diagnosis of URCCSC is usually based on morphological and immunohistochemical characteristics of the neoplastic cells which show transitional epithelial/mesenchymal features. In fact, the frequent loss of epithelial markers and gain of mesenchymal phenotypes, can result in difficulties in interpreting diagnostic data. Consequently assigning the optimal therapeutic treatments can be hindered due to this biological "complexity." Here we present the clinicopathological records of a 51 year-old patient who underwent an excision of a periureteral retroperitoneal mass, and whose first pathological diagnosis was malignant peripheral nerve sheath tumor (MPNST). Eleven months after surgery, a CT-scan revealed a local recurrence of the disease. Later on the patient was admitted to our hospital and a systemic, sarcoma-oriented, treatment was initiated. A partial remission was observed but only with a dacarbazine based regimen administered as a third line therapy, after which a second surgery took place. The removed tumor was diagnosed as URCCSC based on the peculiar morphologic and immunohistochemical characteristics of the cells. Pathological assessment of the first intervention was re-evaluated, resulting in a diagnosis of URCCSC. This case-report therefore highlights the implications that an erroneous pathologic diagnosis can have for the clinical management of this disease. Furthermore, the unexpected response to a dacarbazine based regimen, indicates that this drug should be included among the therapeutic options available against this type of renal carcinoma.
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Key Words
- CT computed tomosarcomatoid component
- EMA, epithelial membrane antigen
- EMT, epithelial mesenchymal transition
- GFAP, glial fibrillary acidic protein
- IORT, intraoperative radiation therapy
- ISUP, international society of urology pathology
- MPNST, malignant peripheral nerve sheath tumor
- NF neurofilament
- NSE, neuron specific enolase
- RCC, renal cell carcinoma
- SMA, smooth muscle actin
- SRCC, sarcomatoid renal cell carcinoma
- URCCSC, unclassified renal cell carcinoma with a sarcomatoid component
- dacarbazine
- diagnosis
- mesenchymal transition
- renal cell carcinoma
- sarcomatoid differentiation
- therapy
- unclassified renal cell carcinoma
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Affiliation(s)
- Gianmaria Miolo
- a Division of Medical Oncology B; Centro di Riferimento Oncologico; National Cancer Institute ; Aviano , Italy
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Corona G, Polesel J, Fratino L, Miolo G, Rizzolio F, Crivellari D, Addobbati R, Cervo S, Toffoli G. Metabolomics Biomarkers of Frailty in Elderly Breast Cancer Patients. J Cell Physiol 2014; 229:898-902. [DOI: 10.1002/jcp.24520] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Accepted: 11/20/2013] [Indexed: 12/21/2022]
Affiliation(s)
- Giuseppe Corona
- Experimental and Clinical Pharmacology Division, Department of Translational Research; IRCCS-National Cancer Institute; Aviano PN Italy
| | - Jerry Polesel
- Epidemiology and Biostatistics; IRCCS-National Cancer Institute; Aviano PN Italy
| | - Lucia Fratino
- Medical Oncology Department; IRCCS-National Cancer Institute; Aviano PN Italy
| | - Gianmaria Miolo
- Medical Oncology Department; IRCCS-National Cancer Institute; Aviano PN Italy
| | - Flavio Rizzolio
- Experimental and Clinical Pharmacology Division, Department of Translational Research; IRCCS-National Cancer Institute; Aviano PN Italy
- Sbarro Institute for Cancer Research and Molecular Medicine; Center for Biotechnology; College of Science and Technology; Temple University; Philadelphia Pennsylvania
| | - Diana Crivellari
- Medical Oncology Department; IRCCS-National Cancer Institute; Aviano PN Italy
| | - Riccardo Addobbati
- Metabolic Disease Laboratory; IRCCS-Burlo Garofolo; Children's Hospital; Trieste TS Italy
| | - Silvia Cervo
- Clinical Pathology Laboratory; IRCCS-National Cancer Institute; Aviano PN Italy
| | - Giuseppe Toffoli
- Experimental and Clinical Pharmacology Division, Department of Translational Research; IRCCS-National Cancer Institute; Aviano PN Italy
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Cervo S, Rovina J, Talamini R, Perin T, Canzonieri V, De Paoli P, Steffan A. An effective multisource informed consent procedure for research and clinical practice: an observational study of patient understanding and awareness of their roles as research stakeholders in a cancer biobank. BMC Med Ethics 2013; 14:30. [PMID: 23899250 PMCID: PMC3734192 DOI: 10.1186/1472-6939-14-30] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2012] [Accepted: 05/17/2013] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Efforts to improve patients' understanding of their own medical treatments or research in which they are involved are progressing, especially with regard to informed consent procedures. We aimed to design a multisource informed consent procedure that is easily adaptable to both clinical and research applications, and to evaluate its effectiveness in terms of understanding and awareness, even in less educated patients. METHODS We designed a multisource informed consent procedure for patients' enrolment in a Cancer Institute Biobank (CRO-Biobank). From October 2009 to July 2011, a total of 550 cancer patients admitted to the Centro di Riferimento Oncologico IRCCS Aviano, who agreed to contribute to its biobank, were consecutively enrolled. Participants were asked to answer a self-administered questionnaire aim at exploring their understanding of biobanks and their needs for information on this topic, before and after study participation. Chi-square tests were performed on the questionnaire answers, according to gender or education. RESULTS Of the 430 patients who returned the questionnaire, only 36.5% knew what a biobank was before participating in the study. Patients with less formal education were less informed by some sources (the Internet, newspapers, magazines, and our Institute). The final assessment test, taken after the multisource informed consent procedure, showed more than 95% correct answers. The information received was judged to be very or fairly understandable in almost all cases. More than 95% of patients were aware of participating in a biobank project, and gave helping cancer research (67.5%), moral obligation, and supporting cancer care as main reasons for their involvement. CONCLUSIONS Our multisource informed consent information system allowed a high rate of understanding and awareness of study participation, even among less-educated participants, and could be an effective and easy-to-apply model for others to consider to contribute to a well-informed decision making process in several fields, from clinical practice to research.Further studies are needed to explore the effects on the study comprehension by each source of information, and by other sources suggested by participants in the questionnaire.
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Affiliation(s)
- Silvia Cervo
- CRO-Biobank, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy
| | - Jane Rovina
- CRO-Biobank, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy
| | - Renato Talamini
- Department of Epidemiology and Biostatistics, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy
| | - Tiziana Perin
- Division of Pathology, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy
| | | | - Paolo De Paoli
- Scientific Directorate, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy
| | - Agostino Steffan
- CRO-Biobank, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy
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