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Dell'Amore A, Monteverde M, Martucci N, Davoli F, Caroli G, Pipitone E, Bini A, Stella F, Dell'Amore D, Casadio C, Rocco G. Surgery for non-small cell lung cancer in younger patients: what are the differences? Heart Lung Circ 2014; 24:62-8. [PMID: 25130384 DOI: 10.1016/j.hlc.2014.07.054] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2014] [Revised: 06/04/2014] [Accepted: 07/02/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Non-small cell lung cancer (NSCLC) in young adults is uncommon. The objective of this study was to evaluate the clinicopathological characteristics, outcomes and prognosis of people younger than 50 years old treated surgically for NSCLC. METHODS A retrospective study was conducted using the institutional database of four thoracic surgery units to collect patients with NSCLC younger than 50 years who had undergone surgery. These patients were compared with older patients (>75-years) operated in the same institutions and in the same period. RESULTS We identified 113 young patients and 347 older patients. Younger patients were more likely to be female, non-smokers, with fewer comorbidities. Younger patients were more likely to be symptomatic at the time of diagnosis. Risk factors for poor prognosis in younger patients were T-stage, and disease-free-interval less than 548 days. Kaplan-Meier analysis showed a lower five-year survival in older patients compared with the younger ones (66% vs 38%, p=0.001). CONCLUSIONS In conclusion NSCLC in younger patients has some distinct clinicopathological characteristics. The overall-survival of young patients is better than in older patients. Young patients receive more complete and aggressive treatment that could explain better survival. Further prospective studies with larger patient populations are required, to clarify the biological and genetic variance of NSCLC in younger patients.
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Davoli F, Stella F, Valente G, Vasuri F, Rena O, Massera F, Caroli G, Bini A, Casadio C. F-076 * PROGNOSTIC ROLE OF MICROVESSEL DENSITY IN PT1AN0M0 NON-SMALL-CELL LUNG CANCER. Interact Cardiovasc Thorac Surg 2014. [DOI: 10.1093/icvts/ivu167.76] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Rena O, Santos Pereira P, Boldorini R, Baietto G, Roncon A, Papalia E, Massera F, Turello D, Davoli F, Casadio C. P-166 * PROGNOSTIC VALUE OF THE IASLC/ATS/ERS CLASSIFICATION OF LUNG ADENOCARCINOMA IN RESECTED STAGE I DISEASE IN PURE CAUCASIAN PATIENTS. Interact Cardiovasc Thorac Surg 2014. [DOI: 10.1093/icvts/ivu167.166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Rena O, Massera F, Boldorini R, Papalia E, Turello D, Davoli F, Baietto G, Roncon A, Robustellini M, Casadio C. Non-small cell lung cancer in surgically treated women. TUMORI JOURNAL 2014. [PMID: 24503788 DOI: 10.1700/1390.15453] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM AND BACKGROUND To determine whether female patients operated on for non-small cell lung cancer (NSCLC) have a survival advantage compared to male patients. METHODS AND STUDY DESIGN We analyzed data from 1,426 prospectively collected patients submitted to lung resection for NSCLC between 1999 and 2008. RESULTS Two groups, including 1,014 male and 412 female patients, were compared. Female patients were significantly younger, were more frequently asymptomatic, were less likely to be smokers, had better preoperative respiratory function, had a lower frequency of COPD, and were less commonly affected by cardiovascular comorbidity than men. Adenocarcinoma was more frequently present and early pathological stage (stage IA) more frequently detected in women at diagnosis. The operative mortality was significantly lower among women (1.6% vs 4.6%) (P = 0.012), and women underwent significantly more segmentectomies and fewer pneumonectomies (P = 0.001). The disease-related 5-year survival rate was significantly higher in women (66% vs 51%) (P = 0.0008). At univariate analysis the absence of symptoms at presentation, lower pathological stage, squamous cell type, and female gender were positive factors influencing long-term survival. At multivariate analysis low pathological stage, squamous cell type and female gender were confirmed as independent positive prognostic predictors. Women had a significant survival advantage irrespective of the histological subtype at pathological stage IA, IB, IIB and IIIA disease (P <0.05). CONCLUSIONS Female gender was confirmed to be a particular subset amongst patients affected by NSCLC and exerted a positive effect on disease-related survival of patients submitted to surgical resection. This important effect of gender should be cautiously kept in mind in analyzing the results of current and future trials for lung cancer therapy.
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Rena O, Boldorini R, Papalia E, Turello D, Massera F, Davoli F, Roncon A, Baietto G, Casadio C. Metastasis to Subsegmental and Segmental Lymph Nodes in Patients Resected for Non-Small Cell Lung Cancer: Prognostic Impact. Ann Thorac Surg 2014; 97:987-92. [DOI: 10.1016/j.athoracsur.2013.11.051] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 11/12/2013] [Accepted: 11/19/2013] [Indexed: 11/27/2022]
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Filosso PL, Guerrera F, Rendina AE, Bora G, Ruffini E, Novero D, Ruco L, Vitolo D, Anile M, Ibrahim M, Casadio C, Rena O, Terzi A, Lyberis P, Oliaro A, Venuta F. Outcome of surgically resected thymic carcinoma: A multicenter experience. Lung Cancer 2014; 83:205-10. [DOI: 10.1016/j.lungcan.2013.11.015] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2013] [Revised: 10/19/2013] [Accepted: 11/18/2013] [Indexed: 10/26/2022]
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Gentilli S, Davoli F, Portigliotti L, Boldorini R, Casadio C, Garavoglia M. Double-stapling technique for transhiatal distal esophageal resection: feasibility test in a cadaver model. Int J Surg 2014; 12:353-6. [PMID: 24463144 DOI: 10.1016/j.ijsu.2014.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Revised: 10/25/2013] [Accepted: 01/16/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To assess the feasibility of a new surgical technique for the resection of the distal third of the esophagus and/or cardias for neoplasm. METHODS This surgical technique consists of two steps: For this purpose we built a stainless steel support bar for the anvil that is thinner than the freespace of a standard linear suturing stapler (TATM). The support bar holds up a push rod that can be adapted to the hooking-unhooking of the anvil. RESULTS We performed our new technique on five cadavers. We did not encounter any difficulty during the procedures. We tested the anastomosis with hydropneumatic assessment without recording any leaks. The esophago-enteric anastomosis was then opened without finding any mechanical defects related to the procedure. CONCLUSION It can often be very difficult to fashion a safe hand-sewn pouch or a purse string around the anvil of an EEATM during the resection of the distal third of the esophagus or the cardias by a trans-hiatal approach. Moreover, there is no standardized procedure to minimize anastomotic leak. To avoid these mechanical problems we designed this innovative procedure, which is considered to be reproducible without significant training.
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Filosso PL, Venuta F, Oliaro A, Ruffini E, Rendina EA, Margaritora S, Casadio C, Terzi A, Rena O, Lococo F, Guerrera F. Thymoma and inter-relationships between clinical variables: a multicentre study in 537 patients. Eur J Cardiothorac Surg 2014; 45:1020-7. [DOI: 10.1093/ejcts/ezt567] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Kiehlmann S, Savolainen T, Jorstad SG, Sokolovsky KV, Schinzel FK, Agudo I, Arkharov AA, Benítez E, Berdyugin A, Blinov DA, Bochkarev NG, Borman GA, Burenkov AN, Casadio C, Doroshenko VT, Efimova NV, Fukazawa Y, Gómez JL, Hagen-Thorn VA, Heidt J, Hiriart D, Itoh R, Joshi M, Kimeridze GN, Konstantinova TS, Kopatskaya EN, Korobtsev IV, Kovalev YY, Krajci T, Kurtanidze O, Kurtanidze SO, Larionov VM, Larionova EG, Larionova LV, Lindfors E, López E, Marscher AP, McHardy IM, Molina SN, Morozova DA, Nazarov S, Nikolashvili MG, Nilsson K, Pulatova NG, Reinthal R, Sadun A, Sergeev SG, Sigua LA, Sorcia M, Spiridonova OI, Takalo LO, Taylor B, Troitsky IS, Ugolkova LS, Zensus JA, Zhdanova VE. Analyzing polarization swings in 3C 279. EPJ WEB OF CONFERENCES 2013. [DOI: 10.1051/epjconf/20136106003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Rena O, Massera F, Boldorini R, Papalia E, Turello D, Davoli F, Baietto G, Roncon A, Robustellini M, Casadio C. Non-small cell lung cancer in surgically treated women. TUMORI JOURNAL 2013; 99:661-6. [DOI: 10.1177/030089161309900604] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aim and background To determine whether female patients operated on for non-small cell lung cancer (NSCLC) have a survival advantage compared to male patients. Methods and study design We analyzed data from 1,426 prospectively collected patients submitted to lung resection for NSCLC between 1999 and 2008. Results Two groups, including 1,014 male and 412 female patients, were compared. Female patients were significantly younger, were more frequently asymptomatic, were less likely to be smokers, had better preoperative respiratory function, had a lower frequency of COPD, and were less commonly affected by cardiovascular comorbidity than men. Adenocarcinoma was more frequently present and early pathological stage (stage IA) more frequently detected in women at diagnosis. The operative mortality was significantly lower among women (1.6% vs 4.6%) (P = 0.012), and women underwent significantly more segmentectomies and fewer pneumonectomies (P = 0.001). The disease-related 5-year survival rate was significantly higher in women (66% vs 51%) (P= 0.0008). At univariate analysis the absence of symptoms at presentation, lower pathological stage, squamous cell type, and female gender were positive factors influencing long-term survival. At multivariate analysis low pathological stage, squamous cell type and female gender were confirmed as independent positive prognostic predictors. Women had a significant survival advantage irrespective of the histological subtype at pathological stage IA, IB, IIB and IIIA disease (P <0.05). Conclusions Female gender was confirmed to be a particular subset amongst patients affected by NSCLC and exerted a positive effect on disease-related survival of patients submitted to surgical resection. This important effect of gender should be cautiously kept in mind in analyzing the results of current and future trials for lung cancer therapy.
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Rena O, Ferretti G, Roncon A, Baietto G, Papalia E, Turello D, Massera F, Davoli F, Casadio C. P-183PERSISTENT LUNG EXPANSION AFTER PLEURAL TALC POUDRAGE IN MALIGNANT PLEURAL MESOTHELIOMA NOT ELIGIBLE FOR SURGICAL RESECTION: AN INDEPENDENT PROGNOSTIC FACTOR. Interact Cardiovasc Thorac Surg 2013. [DOI: 10.1093/icvts/ivt288.183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Filosso PL, Rendina A, Guerrera F, Ruffini E, Margaritora S, Casadio C, Terzi A, Lococo F, Rena O, Venuta F. BTOG-115THYMOMA AND INTER-RELATIONSHIPS BETWEEN CLINICAL VARIABLES: A MULTICENTRE STUDY IN 537 PATIENTS. Interact Cardiovasc Thorac Surg 2013. [DOI: 10.1093/icvts/ivt288.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Rena O, Baietto G, Roncon A, Papalia E, Turello D, Massera F, Davoli F, Casadio C. O-013PROGNOSTIC SIGNIFICANCE OF METASTASIS TO SEGMENTAL OR SUBSEGMENTAL LYMPH NODES IN PATIENTS SUBMITTED TO SURGICAL RESECTION OF NON-SMALL CELL LUNG CANCER WITH PATHOLOGIC N1 LYMPH NODE STATUS. Interact Cardiovasc Thorac Surg 2013. [DOI: 10.1093/icvts/ivt288.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Matullo G, Guarrera S, Betti M, Fiorito G, Ferrante D, Voglino F, Cadby G, Di Gaetano C, Rosa F, Russo A, Hirvonen A, Casalone E, Tunesi S, Padoan M, Giordano M, Aspesi A, Casadio C, Ardissone F, Ruffini E, Betta PG, Libener R, Guaschino R, Piccolini E, Neri M, Musk AWB, de Klerk NH, Hui J, Beilby J, James AL, Creaney J, Robinson BW, Mukherjee S, Palmer LJ, Mirabelli D, Ugolini D, Bonassi S, Magnani C, Dianzani I. Genetic variants associated with increased risk of malignant pleural mesothelioma: a genome-wide association study. PLoS One 2013; 8:e61253. [PMID: 23626673 PMCID: PMC3634031 DOI: 10.1371/journal.pone.0061253] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Accepted: 03/06/2013] [Indexed: 12/19/2022] Open
Abstract
Asbestos exposure is the main risk factor for malignant pleural mesothelioma (MPM), a rare aggressive tumor. Nevertheless, only 5-17% of those exposed to asbestos develop MPM, suggesting the involvement of other environmental and genetic risk factors. To identify the genetic risk factors that may contribute to the development of MPM, we conducted a genome-wide association study (GWAS; 370,000 genotyped SNPs, 5 million imputed SNPs) in Italy, among 407 MPM cases and 389 controls with a complete history of asbestos exposure. A replication study was also undertaken and included 428 MPM cases and 1269 controls from Australia. Although no single marker reached the genome-wide significance threshold, several associations were supported by haplotype-, chromosomal region-, gene- and gene-ontology process-based analyses. Most of these SNPs were located in regions reported to harbor aberrant alterations in mesothelioma (SLC7A14, THRB, CEBP350, ADAMTS2, ETV1, PVT1 and MMP14 genes), causing at most a 2-3-fold increase in MPM risk. The Australian replication study showed significant associations in five of these chromosomal regions (3q26.2, 4q32.1, 7p22.2, 14q11.2, 15q14). Multivariate analysis suggested an independent contribution of 10 genetic variants, with an Area Under the ROC Curve (AUC) of 0.76 when only exposure and covariates were included in the model, and of 0.86 when the genetic component was also included, with a substantial increase of asbestos exposure risk estimation (odds ratio, OR: 45.28, 95% confidence interval, CI: 21.52-95.28). These results showed that genetic risk factors may play an additional role in the development of MPM, and that these should be taken into account to better estimate individual MPM risk in individuals who have been exposed to asbestos.
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Davoli F, Rena O, Pirondini E, Casadio C. Giant functioning mediastinal parathyroid cyst: an unusual cause of exertional dyspnea and mild dysphagia. Arch Bronconeumol 2013; 49:408-9. [PMID: 23542045 DOI: 10.1016/j.arbres.2013.01.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Revised: 01/25/2013] [Accepted: 01/29/2013] [Indexed: 10/27/2022]
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Filosso PL, Galassi C, Ruffini E, Margaritora S, Bertolaccini L, Casadio C, Anile M, Venuta F. Thymoma and the increased risk of developing extrathymic malignancies: a multicentre study†. Eur J Cardiothorac Surg 2013; 44:219-24; discussion 224. [DOI: 10.1093/ejcts/ezs663] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
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Lico R, Casadio C, Gómez J, Giroletti M, Orienti M, Giovannini G, Blasi M, Cotton W, Edwards PG, Fuhrmann L, Jorstad S, Kino M, Kovalev Y, Krichbaum T, Marscher A, Paneque D, Perez-Torres M, Piner G, Sokolovsky K. Very Long Baseline Polarimetric monitoring at 15 GHz of the TeV blazar Markarian 421. EPJ WEB OF CONFERENCES 2013. [DOI: 10.1051/epjconf/20136107004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Giovannini G, Liuzzo E, Giroletti M, Boccardi B, Tamburri S, Casadio C, Taylor G, Kadler M, Tosti G, Mignano AA. Exploring the bulk of the BL Lac object population: parsec scale radio properties and gamma ray emission. EPJ WEB OF CONFERENCES 2013. [DOI: 10.1051/epjconf/20136108006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Mendola C, Cammarota G, Netto R, Cecci G, Pisterna A, Ferrante D, Casadio C, Della Corte F. S(+)-ketamine for control of perioperative pain and prevention of post thoracotomy pain syndrome: a randomized, double-blind study. Minerva Anestesiol 2012; 78:757-766. [PMID: 22441361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Post-thoracotomy pain syndrome (PTPS) often complicates the long term outcome of patients; its appearance has been related to perioperative acute pain. The main goal of this study was to evaluate a possible role of S(+)-ketamine in the prevention of PTPS up to 6 months and secondarily its efficacy in the control of perioperative pain when added to thoracic epidural analgesia (TEA) and adjuvants. METHODS Sixty-six patients underwent thoracotomy under general anesthesia. A thoracic epidural catheter was placed for levobupivacaine and sufentanil administration. Thirty-three patients received an i.v. infusion of S(+)-ketamine (Group S(+)K) for 60 hours and 33 patients received i.v. placebo (Group PLAC). Pain was evaluated by Numeric Rating Scale (NRS) during the whole study. All patients had supplementary doses of analgesics, as needed, to have NRS targeted to a value of ≤3 in the 1st and <3 in the following days. Neuropathic Pain Symptom Inventory (NPSI) was evaluated at 1, 3 and 6 months. RESULTS All patients had NRS ≤3 in the early postoperative period and NPSI was less or equal to 1 in the follow-up control for each group with no significant difference at three (P=0.67, OR 0.8 [IC95% 0.3-2.2]) and at six months (P=0.23, OR 1.9 [0.7-5.4]). Incidence of moderate PTPS was 24.6% at 3 and 21.1% at six months while severe PTPS was 6.6% at 3 and 1.8% at six months. No difference was detected in NRS and NPSI at 3 and 6 months between groups. CONCLUSION S(+)-ketamine had no effects in respect to placebo in the prevention of PTPS at 3 and 6 months but had a significant role in maintaining a NRS≤3 in the early postoperative period. A tight control of perioperative pain seems to be associated with a low incidence of moderate and severe PTPS.
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Rena O, Ramponi A, Roncon A, Casadio C. Thymomaptysis: unusual presentation of invasive thymoma. Interact Cardiovasc Thorac Surg 2012; 14:658-9. [PMID: 22290246 PMCID: PMC3329316 DOI: 10.1093/icvts/ivr156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2011] [Revised: 11/29/2011] [Accepted: 12/01/2011] [Indexed: 11/12/2022] Open
Abstract
Symptomatic thymomas are characterized by non-specific thoracic symptoms or symptoms related to associated para-thymic syndromes. We report the case of a 56-year old Caucasian male who was affected by invasive (Masaoka IVA) WHO mixed AB-B2 thymoma after the elimination through the sputum of a fragment of tumour vegetating in the left upper lobar bronchus. The patient received multimodal treatment consisting of neoadjuvant cisplatinum-based polychemiotherapy, radical surgical resection ('en bloc' thymectomy, thymomectomy and pulmonary left upper lobe exeresis and pleural implants resection) and subsequent mediastinal radiation therapy. At 18-month follow-up, the patient is alive and disease-free.
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Rena O, Mineo TC, Casadio C. Multimodal treatment for stage IVA thymoma: A proposable strategy. Lung Cancer 2012; 76:89-92. [DOI: 10.1016/j.lungcan.2011.10.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2011] [Revised: 09/27/2011] [Accepted: 10/01/2011] [Indexed: 10/16/2022]
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Rena O, Sacchetti GM, Ramponi A, Roncon A, Baietto G, Casadio C. Single thymic gland metastasis from resected non-small-cell lung cancer. Arch Bronconeumol 2012; 48:423-4. [PMID: 22341302 DOI: 10.1016/j.arbres.2011.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Accepted: 12/01/2011] [Indexed: 11/19/2022]
Abstract
Primary thymic tumors are rare, but secondary ones are exceptionally uncommon. We report the case of a single metastasis within the thymic gland from a lung adenocarcinoma that had been completely resected 3 years before. There was high diagnostic doubt because the thymic lesion was not associated with the recurrence of the paraneoplastic syndrome or the increased CEA levels described at the moment of the treatment of the primary tumor. The lesion was diagnosed and treated at the same time by transcervical thymectomy. At the one-year follow-up, the patient is alive and disease-free.
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Rena O, Casadio C. Extrapleural pneumonectomy for early stage malignant pleural mesothelioma: a harmful procedure. Lung Cancer 2012; 77:151-5. [PMID: 22244608 DOI: 10.1016/j.lungcan.2011.12.009] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Revised: 11/04/2011] [Accepted: 12/15/2011] [Indexed: 11/15/2022]
Abstract
The effects on long-term post-operative quality of life (QoL) and disease-control in malignant pleural mesothelioma (MPM) of extrapleural pneumonectomy (EPP) and pleurectomy/decortication (P/D) are compared. Seventy-seven patients affected by early-stage MPM received EPP (40) or P/D (37) associated with multimodal treatment between 1998 and 2009 at our institution. The last consecutive 39 (19 EPP and 20 P/D) were asked to answer the EORTC-QLQ-C30 questionnaire at baseline and at 6- and 12-months after treatment completion to evaluate the impact on QoL of both procedures. QoL evaluation was stopped at recurrence demonstration. Twenty-five (62%) EPP vs 9 (24%) P/D patients (p = 0.002) had in-hospital major complications, and 2/40 (5%) EPP vs no one P/D patients died after surgery. Both procedures caused a significant impairment of all the considered variables of the EORTC-QLQ-C30 questionnaire after treatment completion; only P/D patients returned at baseline levels after 12 months. EPP patients had a worse long-term post-operative QoL when compared with P/D. Median post-operative disease-free period was longer for EPP patients (14 vs 11 months) whereas the residual life to death period after recurrence detection was significantly longer for P/D patients (13 vs 9 months) (p = 0.01). Median long-term survival was longer, even not significant, for P/D patients (25 vs 20 months). MPM patients submitted to EPP had a higher post-operative complication rate, a worse long-term QoL, a shorter residual life time after recurrent disease, despite a similar long-term survival when compared to P/D.
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Sandri MT, Salvatici M, Botteri E, Passerini R, Zorzino L, Rotmensz N, Luini A, Mauro C, Bagnardi V, Cassatella MC, Bottari F, Casadio C, Colleoni M. Prognostic role of CA15.3 in 7942 patients with operable breast cancer. Breast Cancer Res Treat 2011; 132:317-26. [DOI: 10.1007/s10549-011-1863-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2011] [Accepted: 10/25/2011] [Indexed: 11/24/2022]
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