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Martinelli F, Ditto A, Bogani G, Signorelli M, Raspagliesi F. SLN in Endometrial Cancer by Hysteroscopic Injection of ICG and Laparoscopic-NIR Mapping. J Minim Invasive Gynecol 2016. [DOI: 10.1016/j.jmig.2016.08.556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Kusamura S, Raspagliesi F, Baratti D, Gronchi A, Casali P, Deraco M. Uterine Sarcoma Treated by Cytoreductive Surgery and Intraperitoneal Hyperthermic Perfusion: a Feasiblity Study. J Chemother 2016; 16 Suppl 5:19-22. [PMID: 15675470 DOI: 10.1080/1120009x.2004.11782376] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The purpose of this study was to evaluate the feasibility and the outcome impact of cytoreductive surgery (CRS) followed by intraperitoneal hyperthermic perfusion (IPHP) in patients affected by uterine sarcoma (US). Ten US patients were treated with CRS+IPHP (closed technique, cisplatin+mitomycin C or cisplatin+doxorubicin). Median follow-up was 25 months (range: 2-61). Five patients received preoperative chemotherapy. Nine cases underwent optimal CRS. Five-year overall and progression-free survivals were 65% and 30%, respectively. There was no operative morbidity, nor mortality and nor toxicity. Six patients presented disease progression. CRS+IPHP proved feasible and safe, with encouraging outcome results, warranting confirmation by further prospective controlled trials.
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Cecere S, Arenare L, Signoriello S, Bologna A, Vergote I, Kurzeder C, Scambia G, Lorusso D, Murgia V, Lombardi D, Sacco C, Breda E, Pisano C, Salutari V, Raspagliesi F, Bryce J, Daniele G, Piccirillo M, Gallo C, Perrone F, Pignata S. Quality of life (QOL) analysis of the MITO8 phase 3 trial, a collaboration of MITO, Mango, AGO Study Group, BGOG, ENGOT, and GCIG. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw338.04] [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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Piccirillo M, Scambia G, Bologna A, Vergote I, Baumann K, Raspagliesi F, Murgia V, Pisano C, Salutari V, Sorio R, Ferrandina G, Sacco C, Cormio G, Breda E, Cinieri S, Cecere S, Daniele G, Gallo C, Perrone F, Pignata S. The MITO8 phase 3 international multicenter randomized study testing the effect on survival of prolonging platinum-free interval (PFI) in patients with ovarian cancer (OC) recurring between 6 and 12 months after previous platinum based chemotherapy. A collaboration of MITO, Mango, AGO Study Group, BGOG, ENGOT, and GCIG. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw331.04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Lindemann K, Kristensen G, Mirza M, Davies L, Hilpert F, Romero I, Ayhan A, Burges A, Rubio M, Raspagliesi F, Huizing M, Creemers GJ, Lykka M, Lee C, Gebski V, Pujade-Lauraine E. Poor concordance between CA-125 and RECIST at the time of disease progression in patients with platinum-resistant ovarian cancer: analysis of the AURELIA trial. Ann Oncol 2016; 27:1505-1510. [DOI: 10.1093/annonc/mdw238] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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Martinelli F, Signorelli M, Bogani G, Ditto A, Chiappa V, Perotto S, Scaffa C, Lorusso D, Raspagliesi F. Is aortic lymphadenectomy indicated in locally advanced cervical cancer after neoadjuvant chemotherapy followed by radical surgery? A retrospective study on 261 women. Eur J Surg Oncol 2016; 42:1512-8. [PMID: 27378160 DOI: 10.1016/j.ejso.2016.06.004] [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: 12/06/2015] [Revised: 05/02/2016] [Accepted: 06/09/2016] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES The aim of this study was to estimate the rate of aortic lymph nodes (LN) metastases/recurrences among patients affected by locally advanced stage cancer patients (LACC), treated with neoadjuvant chemotherapy (NACT) and radical surgery. METHODS Retrospective evaluation of consecutive 261 patients affected by LACC (stage IB2-IIB), treated with NACT followed by radical surgery at National Cancer Institute, Milan, Italy, between 1990 and 2011. RESULTS Stage at presentation included stage IB2, IIA and IIB in 100 (38.3%), 50 (19.2%) and 111 (42.5%) patients, respectively. Squamous cell carcinoma accounted for more than 80%, followed by adenocarcinoma or adenosquamous cancers (20%). Overall, 56 women (21.5%) had LN metastases. Four out of 83 women (5%) who underwent both pelvic and aortic LN dissection had aortic LN metastases, and all women had concomitant pelvic and aortic LN metastases. Only one woman out of 178 (0.5%) who underwent pelvic lymphadenectomy only, had an aortic LN recurrence. Overall 2% of women (5/261) had aortic LN metastases/recurrence. CONCLUSIONS Our data suggest that aortic lymphadenectomy at the time of surgery is not routinely indicated in LACC after NACT, but should reserved in case of bulky LN in both pelvic and/or aortic area. The risk of isolated aortic LN relapse is negligible. Further prospective studies are warranted.
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Lorusso D, Scambia G, Pignata S, Sorio R, Amadio G, Lepori S, Mosconi A, Pisano C, Mangili G, Maltese G, Sabbatini R, Artioli G, Gamucci T, Di Napoli M, Capoluongo E, Ludovini V, Raspagliesi F, Ferrandina G. Prospective phase II trial of trabectedin in BRCA-mutated and/or BRCAness phenotype recurrent ovarian cancer patients: the MITO 15 trial. Ann Oncol 2015; 27:487-93. [PMID: 26681678 DOI: 10.1093/annonc/mdv608] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Accepted: 12/09/2015] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Current evidence suggest that trabectedin is particularly effective in cells lacking functional homologous recombination repair mechanisms. A prospective phase II trial was designed to evaluate the activity of trabectedin in the treatment of recurrent ovarian cancer patients presenting BRCA mutation and/or BRCAness phenotype. PATIENTS AND METHODS A total of 100 patients with recurrent BRCA-mutated ovarian cancer and/or BRCAness phenotype (≥2 previous responses to platinum) were treated with trabectedin 1.3 mg/mq i.v. q 3 weeks. The activity of the drug with respect to BRCA mutational status and to a series of polymorphisms [single-nucleotide polymorphisms (SNPs)] involved in DNA gene repair was analyzed. RESULTS Ninety-four were evaluable for response; in the whole population, 4 complete and 33 partial responses were registered for an overall response rate (ORR) of 39.4. In the platinum-resistant (PR) and -sensitive (PS) population, an ORR of 31.2% and 47.8%, and an overall clinical benefit of 54.2% and 73.9%, respectively, were registered. In the whole series, the median progression-free survival (PFS) was 18 weeks and the median overall survival (OS) was 72 weeks; PS patients showed a more favorable PFS and OS compared with PR patients. BRCA gene mutational status was available in 69 patients. There was no difference in ORR, PFS and OS according to BRCA 1-2 status nor any association between SNPs of genes involved in DNA repair and NER machinery and response to trabectedin was reported. CONCLUSIONS Our data prospectively confirmed that the signature of 'repeated platinum sensitivity' identifies patients highly responsive to trabectedin. In this setting, the activity of trabectedin seems comparable to what could be obtained using platinum compounds and the drug may represent a valuable alternative option in patients who present contraindication to receive platinum. EUDRACT NUMBER 2011-001298-17.
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Martinelli F, Ditto A, Bogani G, Chiappa V, Lorusso D, Raspagliesi F. Sentinel Node Mapping in Endometrial Cancer By Using Hysteroscopic Injection of Indocyanine Green and Laparoscopic Near-Infrared Fluorescence Imaging: A Preliminary Experience. J Minim Invasive Gynecol 2015; 22:S4. [DOI: 10.1016/j.jmig.2015.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Cecere S, Daniele G, Lorusso D, Scambia G, Nicoletto M, Breda E, Colombo N, Artioli G, Daniele B, Lo Re G, Raspagliesi F, Chiappa V, Salutari V, Ferrandina G, Greggi S, Baldoni A, Piccirillo M, Fossati R, Perrone F, Pignata S. Feasibility and outcome of interval debulking surgery (IDS) after carboplatin-paclitaxel-bevacizumab (CPB): results from a subgroup of patient from the MITO-16A-MANGO OV2A phase 4 trial. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv339.02] [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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Martinelli F, Bogani G, Ditto A, Carcangiu M, Papadia A, Lecce F, Chiappa V, Lorusso D, Raspagliesi F. How often parametrial involvement leads to post-operative adjuvant treatment in locally advanced cervical cancer after neoadjuvant chemotherapy and type C radical hysterectomy? Eur J Surg Oncol 2015; 41:1089-96. [DOI: 10.1016/j.ejso.2015.03.228] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 03/04/2015] [Accepted: 03/18/2015] [Indexed: 01/22/2023] Open
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Lorusso D, Ferrandina G, Pignata S, Sorio R, Amadio G, Mosconi A, Pisano C, Mangili G, Masini C, Artioli G, Narducci F, Di Napoli M, Rigamonti C, Raspagliesi F, Scambia G. Trabectedin in Patients with Brca Mutated and Brcaness Phenotype Advanced Ovarian Cancer (Aoc): Phase Ii Prospective Mito-15 Study. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu338.12] [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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Orsini P, De Cecco L, Cecchin E, Carcangiu M, Raspagliesi F, Lo Russo D, Toffoli G, Mezzanzanica D, Canevari S, Bagnoli M. 433: An integrated multi level ‘-omics’ approach to decipher disease recurrence in epithelial ovarian cancer. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)50387-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Ferrero A, Ditto A, Giorda G, Gadducci A, Greggi S, Daniele A, Fuso L, Panuccio E, Scaffa C, Raspagliesi F, Sismondi P, Biglia N. Secondary cytoreductive surgery for isolated lymph node recurrence of epithelial ovarian cancer: A multicenter study. Eur J Surg Oncol 2014; 40:891-8. [DOI: 10.1016/j.ejso.2013.11.026] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Revised: 11/25/2013] [Accepted: 11/29/2013] [Indexed: 11/17/2022] Open
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Ditto A, Martinelli F, Ramondino S, Vullo S, Carcangiu M, Haeusler E, Mariani L, Lorusso D, Raspagliesi F. Class II versus Class III radical hysterectomy in early cervical cancer: An observational study in a tertiary center. Eur J Surg Oncol 2014; 40:883-90. [DOI: 10.1016/j.ejso.2014.02.229] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Revised: 02/10/2014] [Accepted: 02/14/2014] [Indexed: 12/31/2022] Open
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Lorusso D, Cirillo F, Mancini M, Spatti G, Grijuela B, Ditto A, Raspagliesi F. The Different Impact ofBRCAMutations on the Survival of Epithelial Ovarian Cancer Patients: A Retrospective Single-Center Experience. Oncology 2013; 85:122-7. [DOI: 10.1159/000353786] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Accepted: 06/10/2013] [Indexed: 11/19/2022]
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Mancini M, Ramondino S, Di Rocco R, Ratti M, Lorusso D, Raspagliesi F. Case Control Study on Two Different Chemotherapy Regimens in Advanced Mixed Mullerian Tumours. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33562-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Lorusso D, Mancini M, Di Rocco R, Fontanelli R, Raspagliesi F. The role of secondary surgery in recurrent ovarian cancer. Int J Surg Oncol 2012; 2012:613980. [PMID: 22919475 PMCID: PMC3420128 DOI: 10.1155/2012/613980] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2012] [Accepted: 05/30/2012] [Indexed: 12/28/2022] Open
Abstract
Despite optimal treatment (complete cytoreduction and adjuvant chemotherapy), 5-year survival for advanced ovarian cancer is approximately 30% and most patients succumb to their disease. Cytoreductive surgery is accepted as a major treatment of primary ovarian cancer but its role in recurrent disease is controversial and remains a field of discussion mainly owing to missing data from prospective randomized trials. A critical review of literature evidence on secondary surgery in recurrent ovarian cancer will be described.
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Brunner C, Müller-Holzner E, Gitsch G, Tamussino K, Raspagliesi F, Marth C. Eine Multicenter Studie über die prognostische Bedeutung des extranodalen Tumorwachstums beim Zervixkarzinom. Geburtshilfe Frauenheilkd 2012. [DOI: 10.1055/s-0032-1309232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Cibula D, Abu-Rustum N, Benedetti-Panici P, Köhler C, Raspagliesi F, Querleu D, Morrow C. New classification system of radical hysterectomy: Emphasis on a three-dimensional anatomic template for parametrial resection. Gynecol Oncol 2011; 122:264-8. [PMID: 21592548 DOI: 10.1016/j.ygyno.2011.04.029] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2011] [Revised: 04/17/2011] [Accepted: 04/19/2011] [Indexed: 11/25/2022]
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Solima E, Martinelli F, Hanozet F, Ditto A, Carcangiu M, Raspagliesi F. Sentinel Node Detection in Endometrial Cancer. Diagnostic Accuracy Evaluation. J Minim Invasive Gynecol 2010. [DOI: 10.1016/j.jmig.2010.08.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Di Donato P, Giulini NA, Bacchi Modena A, Cicchetti G, Comitini G, Gentile G, Cristiani P, Careccia A, Esposito E, Gualdi F, Golinelli S, Bergamini E, Masellis G, Rastelli S, Gigli C, Elia A, Marchesoni D, Sticotti F, Del Frate G, Zompicchiatti C, Marino L, Costa MR, Pinto P, Dodero D, Storace A, Spinelli G, Quaranta S, Bossi CM, Ollago A, Omodei U, Vaccari M, Luerti M, Repetti F, Zandonini G, Raspagliesi F, Dolci F, Gambarino G, De Pasquale B, Polizzotti G, Borsellino G, Alpinelli P, Natale N, Colombo D, Belloni C, Viani A, Cecchini G, Vinci GW, Samaja BA, Pasinetti E, Penotti M, Ognissanti F, Pesando P, Malanetto C, Gallo M, Dolfin G, Tartaglino P, Mossotto D, Pistoni A, Tarani A, Rattazzi PD, Rossaro D, Campanella M, Arisi E, Gamper M, Salvatores D, Bocchin E, Stellin G, Meli G, Azzini V, Tirozzi F, Buoso G, Fraioli R, Marsoni V, Cetera C, Sposetti R, Candiotto E, Pignalosa R, Del Pup L, Bellati U, Angeloni C, Buonerba M, Garzarelli S, Santilli C, Mucci M, Di Nisio Q, Cappa F, Pierangeli I, Cordone A, Falasca L, Ferrante D, Serra GB, Cirese E, Todaro PA, Romanini C, Spagnuolo L, Lanzone A, Donadio C, Fabiani M, Baldaccini E, Votano S, Bellardini P, Favale W, Monti V, Bonomo A, Boninfante CE, Pietrobattista P, Massacesi L, Donini G, Del Savio F, Palombi L, Procaccioli P, Romani A, Romagnoli G, Genazzani AR, Gambacciani M, Scarselli G, Curiel P, De Leo V, Melani A, Levi D'Ancona V, Giarrè G, Di Gioia E, Ceccarelli P, Massi GB, Cosci S, Gacci G, Cascianini A, Donati Sarti C, Bircolotti S, Pupita P, Mincigrucci M, Spadafora A, Santeufemia G, Marongiu G, Lai GR, Lai R, Dessole S, D'Andrea SA, Chiantera A, Arienzo R, Pastore AR, Tamburrino A, Cardone A, Colacurci N, Izzo S, Tesauro R, Pascarella A, De Silvio MG, Di Prisco L, Lauda N, Sirimarco F, Agrimi C, Casarella G, Senatore G, Ronzini S, Ruccia G, De Carlo G, Pisaturo G, Carlomagno F, Fasolino A, Fiorillo F, Sorrentino R, Ercolano VB, Panariello S, Brun A, Tropea P, Stigliano CM, Amoroso A, Vadalà P, Coco A, Galati G, Barese G, Masciari G, Pirillo P, Gioffrè T, Mastrantonio P, Cardamone A, D'Angelo N, Valentino G, Barretta R, Ferraro G, Ferruccio C, Agostinelli D, Corrado G, Scopelliti A, Schonauer S, Trojano V, Bongiovanni F, Tinelli F, Poddi ER, Scarpello F, Colonna L, Fischetti G, Doria R, Trombetta G, Cocca EB, D'Amore A, Di Masi M, Liguori R, Dimaggio A, Laneve MR, Maolo MC, Gravina G, Nacci G, Nocera F, Lupo A, Giannola C, Graziano R, Mezzatesta M, Vegna G, Giannone G, Palumbo G, Cancellieri F, Mondo A, Cordopatri A, Carrubba M, Mazzola V, Cincotta L, D'Asta S, Bono A, Li Calsi L, Cavallaro Nigro S, Schilirò S, Repici A, Gullo D, Orlando A, Specchiale F, Papotto A, Giulia FV, Adige TA, D'Aosta V, Massacesi A, Chiantera A, Donati Sarti C, De Aloysio P, Omodei U, Ognissanti F, Campagnoli C, Penotti M, Gambacciani A, Graziottin A, Baldi C, Colacurci N, Corrado Tonti G, Parazzini F, Chatenoud L. Risk factors for type 2 diabetes in women attending menopause clinics in Italy: a cross-sectional study. Climacteric 2009; 8:287-93. [PMID: 16397927 DOI: 10.1080/13697130500196866] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To analyze risk factors for type 2 diabetes among women attending menopause clinics in Italy for counselling about the menopause. SUBJECTS Women attending a network of first-level outpatient menopause clinics in Italy for general counselling about menopause or treatment of menopausal symptoms. METHODS Cross-sectional study with no exclusion criteria. Type 2 diabetes was defined according to National Diabetes Data Groups Indications and the fasting blood glucose at an oral glucose tolerance test within the previous year. RESULTS Out of the 44 694 considered in this analysis, 808 had a diagnosis of diabetes type 2 (1.8%). In comparison with women aged < 50 years, the multivariate odds ratios (OR) of type 2 diabetes were 1.31 (95% confidence interval (CI), 0.99-1.74) for women aged 50-52 years, 1.66 (95% CI, 1.27-2.17) at 53-56 years and 2.84 (95% CI, 2.20-3.67) in women aged > or = 57 years. Type 2 diabetes was less frequently reported in more educated women (OR high school/university vs. primary school = 0.44 (95% CI, 0.36-0.55)). Being overweight was associated with an increased risk of type 2 diabetes. In comparison with women reporting a low level of physical activity, the multivariate OR of type 2 diabetes was 0.67 (95% CI, 0.54-0.84) for women reporting regular physical activity. In comparison with premenopausal women, the multivariate OR of type 2 diabetes was 1.38 (95% CI, 1.03-1.84) in women with natural menopause. This finding was present also after allowing for the potential confounding effect of age. The multivariate OR of diabetes for users of hormonal replacement therapy was 0.58 (95% CI, 0.46-0.73). CONCLUSIONS This large cross-sectional study suggests that postmenopausal women are at higher risk of type 2 diabetes after allowance for the effect of age. Other main determinants of risk of type 2 diabetes in women around menopause were low socioeconomic status and being overweight. Diabetes was found less frequently in those taking hormone replacement therapy.
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Grosso F, Sanfilippo R, Jones RL, Collini P, Morosi C, Raspagliesi F, Tercero JC, D'Incalci M, Judson IR, Casali PG. Role of trabectedin (T) in the management of advanced uterine leiomyosarcoma (U-LM). J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.10530] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
10530 Background: To explore the clinical impact of T in U-LM. T has been approved in Europe for second line treatment of advanced soft tissue sarcomas (STS). Efficacy is well established in liposarcoma and leiomyosarcoma. U-LMs display peculiar clinical and genetic features compared to other STS. These differences may be responsible for the sensitivity of this subtype to therapy, thus justifying an evaluation of the activity of T in a relatively homogeneous series of U-LM patients. Methods: From April 2000, 56 patients (pts) with advanced disease, previously exposed to a median of 3 chemotherapy lines (range 1–5), received T within an expanded access programme at two European referral institutions for sarcoma. The clinical records were reviewed focusing on response and treatment outcome. Two pts were excluded from the analysis having received only 1 course of T. Median age was 56 yrs (range 29–73), median number of metastatic sites was 2 (range 1–4), the most frequent metastatic site was lung (88%), 24 patients had a local relapse. Results: A total of 252 courses were delivered (median 3, IQR2–6) and 36% of patients received more than 5 courses of T. Fifty-two patients were evaluable for response. A partial response was observed in 11 patients and stable disease in 15, for a PR rate of 21% and a tumor control rate of 50%. The median progression-free survival was 3.6 months (CI95% 2.6–6.7), with 41% of patients free from progression at 6 months. Conclusions: These results compare favourably with other systemic treatments in advanced U-LMS and support their sensitivity to T. This should prompt further studies to prospectively evaluate the efficacy of T in U-LMS and elucidate possible biological predictive factors (e.g. DNA repair protein expression). [Table: see text]
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Zanaboni F, Grijuela MD B, Kusamura S, Ditto A, Hanozet F, Fontanelli R, Solima E, Martinelli F, Bomè A, Raspagliesi F. Weekly topotecan and cisplatin (TOPOCIS) as neoajuvant chemotherapy for locally-advanced squamous cervical carcinoma: results of a phase II study. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.16500] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Lorusso D, Zanaboni F, Scalone S, Secomandi R, Ferrandina G, Scambia G, Jannuzzo MG, Petroccione A, Comis S, Raspagliesi F. Phase II exploratory study of brostallicin in patients with ovarian cancer resistant/refractory to platinum-based chemotherapy. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.16520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Zola P, Fuso L, Mazzola S, Piovano E, Perotto S, Gadducci A, Galletto L, Landoni F, Maggino T, Raspagliesi F, Sartori E, Scambia G. Could follow-up different modalities play a role in asymptomatic cervical cancer relapses diagnosis? Gynecol Oncol 2007; 107:S150-4. [PMID: 17868785 DOI: 10.1016/j.ygyno.2007.07.028] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2007] [Accepted: 07/06/2007] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate how much clinical surveillance performed by follow-up scheduled appointments may correctly identify asymptomatic recurrences and describe the pattern of relapse detected by procedures. METHODS The records of 327 consecutive women with recurrent cervical cancer treated from 1980 to 2005 were retrospectively collected in 8 Italian Institutions. Primary disease and recurrence data were picked up: diagnosis, type of treatment, FIGO stage, tumour grade, histology, clinical lesion size, number of localizations and site of relapse, presence of symptoms and primary method of detection, the type of treatment of recurrence and follow-up data, such as appointment date, clinical status and procedure performed. A multivariate analysis was carried out using the Cox proportional hazards regression model. Survival curves were calculated using the Kaplan-Meier technique. Survival differences were evaluated by the log-rank test. RESULTS Sixty-seven out of 327 patients (20.5%) had a local recurrence on vaginal vault, 120 (36.7%) in central pelvis, 31 (9.5%) in pelvic wall, 16 cases (4.9%) in lymph nodes. Seventy-nine patients (24.2%) showed a distant relapse while 14 (4.3%) developed both a distant and local relapse. Among patients with distant relapses 39 (49.4%) had lung metastasis, 41 (51.9%) an hepatic recurrence, 4 (5.1%) a bone relapse. Among distant sites 32 out of 79 patients (40.5%) had single relapse and 46 (58.2%) had multiple localizations. The site of relapse influenced survival since patients with vaginal vault recurrences lived significantly longer than patients with recurrences in other sites. Ninety-seven (29.7%) patients were symptomatic and anticipated the scheduled visit, 66 (20.2%) reported their symptoms during the follow-up visit and 164 (50.1%) were asymptomatic and the diagnostic path was introduced by a planned visit or exam. Between asymptomatic patients the first procedure was clinical visit for 85 patients out of 164 patients (51.8%), imaging for 60 patients (36.6%), both clinical visit and imaging for 14 (8.5%) and cytology for 5 (3%, Pap smear test). The median OS of symptomatic patients was 37 months versus 109 months of asymptomatic patients (Log rank, p=0.00001). The median survival since recurrence was 9 months for symptomatic patients and median was not reached for asymptomatic patients (p<0.0001). The median disease-free interval was 24 months for asymptomatic patients vs. 36 months for symptomatic patients (p=0.03). CONCLUSIONS Our study helps demonstrate the great need of prospective cost-effectiveness studies which are lacking at the present time.
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