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Filbert AL, Kremer L, Ladenstein R, Chronaki C, Degelsegger-Márquez A, van der Pal H, Bardi E, Uyttebroeck A, Langer T, Muraca M, Nieto AC, Rascon J, Bagnasco F, Beyer S, Te Dorsthorst J, Essiaf S, Galan AO, Kienesberger A, O'Brien K, Palau MC, Pluijm SMF, di Profio S, Saraceno D, Schneider C, Schreier G, Trinkūnas J, Zamberlan I, Grabow D, Haupt R. Scaling up and implementing the digital Survivorship Passport tool in routine clinical care - The European multidisciplinary PanCareSurPass project. Eur J Cancer 2024; 202:114029. [PMID: 38513384 DOI: 10.1016/j.ejca.2024.114029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 03/11/2024] [Accepted: 03/14/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND Childhood cancer survivors (CCS), of whom there are about 500,000 living in Europe, are at an increased risk of developing health problems [1-6] and require lifelong Survivorship Care. There are information and knowledge gaps among CCS and healthcare providers (HCPs) about requirements for Survivorship Care [7-9] that can be addressed by the Survivorship Passport (SurPass), a digital tool providing CCS and HCPs with a comprehensive summary of past treatment and tailored recommendations for Survivorship Care. The potential of the SurPass to improve person-centred Survivorship Care has been demonstrated previously [10,11]. METHODS The EU-funded PanCareSurPass project will develop an updated version (v2.0) of the SurPass allowing for semi-automated data entry and implement it in six European countries (Austria, Belgium, Germany, Italy, Lithuania and Spain), representative of three infrastructure healthcare scenarios typically found in Europe. The implementation study will investigate the impact on person-centred care, as well as costs and processes of scaling up the SurPass. Interoperability between electronic health record systems and SurPass v2.0 will be addressed using the Health Level Seven (HL7) International interoperability standards. RESULTS PanCareSurPass will deliver an interoperable digital SurPass with comprehensive evidence on person-centred outcomes, technical feasibility and health economics impacts. An Implementation Toolkit will be developed and freely shared to promote and support the future implementation of SurPass across Europe. CONCLUSIONS PanCareSurPass is a novel European collaboration that will improve person-centred Survivorship Care for CCS across Europe through a robust assessment of the implementation of SurPass v2.0 in different healthcare settings.
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Affiliation(s)
- Anna-Liesa Filbert
- Division of Childhood Cancer Epidemiology, German Childhood Cancer Registry, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Leontien Kremer
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Ruth Ladenstein
- St. Anna Children's Cancer Research Institute, Vienna, Austria; St Anna Children's Hospital, Vienna, Austria
| | | | | | | | - Edit Bardi
- St Anna Children's Hospital, Vienna, Austria; Department of Paediatrics and Adolescent Medicine, Johannes Kepler University Linz, Kepler University Hospital, Linz, Austria
| | | | - Thorsten Langer
- Universitatsklinikum Schleswig-Holstein, Campus Lubeck, Germany
| | | | | | - Jelena Rascon
- Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania; Clinics for Children's Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Lithuania
| | | | - Stefan Beyer
- AIT Austrian Institute of Technology, Graz, Austria
| | | | | | | | | | | | | | - Saskia M F Pluijm
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Sonia di Profio
- Clinical Psychology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | | | | | | | - Justas Trinkūnas
- Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | | | - Desiree Grabow
- Division of Childhood Cancer Epidemiology, German Childhood Cancer Registry, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
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Grabow D, Filbert AL, Saraceno D, Kremer L, Skinner R, Hjorth L, Ladenstein R, Scheinemann K, Kepak T, Kepakova K, Muraca M, Haupt R. European Cancer Summit 2022 submission for Digital Health NetworkThe Survivorship Passport: a digital tool for better and homogeneous long-term care for childhood cancer survivors. J Cancer Policy 2023. [DOI: 10.1016/j.jcpo.2023.100394] [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: 03/07/2023]
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Haeberle B, Rangaswami A, Krailo M, Czauderna P, Hiyama E, Maibach R, Lopez-Terrada D, Aronson DC, Alaggio R, Ansari M, Malogolowkin MH, Perilongo G, O'Neill AF, Trobaugh-Lotrario AD, Watanabe K, Schmid I, von Schweinitz D, Ranganathan S, Yoshimura K, Hishiki T, Tanaka Y, Piao J, Feng Y, Rinaldi E, Saraceno D, Derosa M, Meyers RL. The importance of age as prognostic factor for the outcome of patients with hepatoblastoma: Analysis from the Children's Hepatic tumors International Collaboration (CHIC) database. Pediatr Blood Cancer 2020; 67:e28350. [PMID: 32383794 DOI: 10.1002/pbc.28350] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [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: 07/06/2019] [Revised: 03/24/2020] [Accepted: 03/30/2020] [Indexed: 12/27/2022]
Abstract
PURPOSE Treatment outcomes for hepatoblastoma have improved markedly in the contemporary treatment era, principally due to therapy intensification, with overall survival increasing from 35% in the 1970s to 90% at present. Unfortunately, these advancements are accompanied by an increased incidence of toxicities. A detailed analysis of age as a prognostic factor may support individualized risk-based therapy stratification. METHODS We evaluated 1605 patients with hepatoblastoma included in the CHIC database to assess the relationship between event-free survival (EFS) and age at diagnosis. Further analysis included the age distribution of additional risk factors and the interaction of age with other known prognostic factors. RESULTS Risk for an event increases progressively with increasing age at diagnosis. This pattern could not be attributed to the differential distribution of other known risk factors across age. Newborns and infants are not at increased risk of treatment failure. The interaction between age and other adverse risk factors demonstrates an attenuation of prognostic relevance with increasing age in the following categories: metastatic disease, AFP < 100 ng/mL, and tumor rupture. CONCLUSION Risk for an event increased with advancing age at diagnosis. Increased age attenuates the prognostic influence of metastatic disease, low AFP, and tumor rupture. Age could be used to modify recommended chemotherapy intensity.
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Affiliation(s)
- Beate Haeberle
- Division of Pediatric Surgery, University of Munich, Munich, Germany
| | - Arun Rangaswami
- Division of Pediatric Hematology and Oncology, University of California San Francisco, San Francisco, California
| | - Mark Krailo
- Department of Preventive Medicine, University of Southern California, California, Los Angeles
| | - Piotr Czauderna
- Department of Surgery for Children and Adolescents, Medical University of Gdansk, Gdansk, Poland
| | - Eiso Hiyama
- Department of Pediatric Surgery, Hiroshima University, Hiroshima, Japan
| | | | | | - Daniel C Aronson
- Department of Pediatric Surgery, University Children's Hospital Zurich, Zurich, Switzerland
| | - Rita Alaggio
- Department of Pathology, Bambino Gesu Pediatric Hospital, Roma, Italy
| | - Marc Ansari
- Pediatric Department, Onco-Hematology Unit, Geneva University Hospital, Geneva, Switzerland
| | - Marcio H Malogolowkin
- Division of Pediatric Hematology Oncology, University of California Davis Comprehensive Cancer Center, California, Sacramento
| | | | - Allison F O'Neill
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Angela D Trobaugh-Lotrario
- Department of Pediatric Hematology/Oncology, Providence Sacred Heart Children's Hospital Spokane, Washington
| | - Kenichiro Watanabe
- Department of Hematology and Oncology, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Irene Schmid
- Department of Pediatric Hematology and Oncology, University of Munich, Munich, Germany
| | | | - Sarangarajan Ranganathan
- Division of Pathology and Laboratory Medicine, Cincinnati Children's Hospital Mediacla Center, Cincinnati, Ohio
| | - Kenichi Yoshimura
- Innovative Clinical Research Center (iCREK), Kanazawa University Hospital, Japan
| | - Tomoro Hishiki
- Department of Pediatric Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yukichi Tanaka
- Department of Pathology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Jin Piao
- Department of Preventive Medicine, University of Southern California, California, Los Angeles
| | - Yurong Feng
- Children's Oncology Group, Los Angeles, California
| | | | | | | | - Rebecka L Meyers
- Division of Pediatric Surgery, University of Utah School of Medicine, Utah, Salt Lake City
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Haupt R, Essiaf S, Dellacasa C, Ronckers CM, Caruso S, Sugden E, Zadravec Zaletel L, Muraca M, Morsellino V, Kienesberger A, Blondeel A, Saraceno D, Ortali M, Kremer LCM, Skinner R, Roganovic J, Bagnasco F, Levitt GA, De Rosa M, Schrappe M, Hjorth L, Ladenstein R. The 'Survivorship Passport' for childhood cancer survivors. Eur J Cancer 2018; 102:69-81. [PMID: 30138773 DOI: 10.1016/j.ejca.2018.07.006] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [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: 03/13/2018] [Revised: 06/15/2018] [Accepted: 07/12/2018] [Indexed: 01/13/2023]
Abstract
BACKGROUND Currently, there are between 300,000 and 500,000 childhood cancer survivors (CCSs) in Europe. A significant proportion is at high risk, and at least 60% of them develop adverse health-related outcomes that can appear several years after treatment completion. Many survivors are unaware of their personal risk, and there seems to be a general lack of information among healthcare providers about pathophysiology and natural history of treatment-related complications. This can generate incorrect or delayed diagnosis and treatments. METHOD The Survivorship Passport (SurPass) consists of electronic documents, which summarise the clinical history of the childhood or adolescent cancer survivor. It was developed by paediatric oncologists of the PanCare and SIOPE networks and IT experts of Cineca, together with parents, patients, and survivors' organisations within the European Union-funded European Network for Cancer research in Children and Adolescents. It consists of a template of a web-based, simply written document, translatable in all European languages, to be given to each CCS. The SurPass provides a summary of each survivor's clinical history, with detailed information about the original cancer and of treatments received, together with personalised follow-up and screening recommendations based on guidelines published by the International Guidelines Harmonization Group and PanCareSurFup. RESULTS The SurPass data schema contains a maximum of 168 variables and uses internationally approved nomenclature, except for radiotherapy fields, where a new classification was defined by radiotherapy experts. The survivor-specific screening recommendations are mainly based on treatment received and are automatically suggested, thanks to built-in algorithms. These may be adapted and further individualised by the treating physician in case of special disease and survivor circumstances. The SurPass was tested at the Istituto Giannina Gaslini, Italy, and received positive feedback. It is now being integrated at the institutional, regional and national level. CONCLUSIONS The SurPass is potentially an essential tool for improved and more harmonised follow-up of CCS. It also has the potential to be a useful tool for empowering CCSs to be responsible for their own well-being and preventing adverse events whenever possible. With sufficient commitment on the European level, this solution should increase the capacity to respond more effectively to the needs of European CCS.
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Affiliation(s)
- Riccardo Haupt
- Epidemiology and Biostatistics Unit, IRCCS Istituto Giannina Gaslini, Genova, Italy.
| | - Samira Essiaf
- The European Society for Paediatric Oncology (SIOPE), Brussels, Belgium
| | - Chiara Dellacasa
- Inter-University Consortium Cineca, Casalecchio di Reno (BO), Italy
| | - Cecile M Ronckers
- Department of Paediatric Oncology, Emma Children's Hospital, Academic Medical Center, Amsterdam, Netherlands; Princess Maxima Center for Pediatric Oncology, Utrecht, Netherlands
| | - Silvia Caruso
- Epidemiology and Biostatistics Unit, IRCCS Istituto Giannina Gaslini, Genova, Italy
| | | | | | - Monica Muraca
- Epidemiology and Biostatistics Unit, IRCCS Istituto Giannina Gaslini, Genova, Italy
| | - Vera Morsellino
- Department of Hematology and Oncology, Istituto Giannina Gaslini, Genova, Italy
| | - Anita Kienesberger
- Austrian Childhood Cancer Organisation on behalf of CCI (Childhood Cancer International), Vienna, Austria
| | - Anne Blondeel
- The European Society for Paediatric Oncology (SIOPE), Brussels, Belgium
| | - Davide Saraceno
- Inter-University Consortium Cineca, Casalecchio di Reno (BO), Italy
| | - Maurizio Ortali
- Inter-University Consortium Cineca, Casalecchio di Reno (BO), Italy
| | - Leontien C M Kremer
- Department of Paediatric Oncology, Emma Children's Hospital, Academic Medical Center, Amsterdam, Netherlands; Princess Maxima Center for Pediatric Oncology, Utrecht, Netherlands
| | - Roderick Skinner
- Department of Paediatric and Adolescent Haematology and Oncology, Children's BMT Unit, Great North Children's Hospital, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - Jelena Roganovic
- Department of Pediatrics, Division of Hematology and Oncology, Clinical Hospital Centre Rijeka, Rijeka, Croatia
| | - Francesca Bagnasco
- Epidemiology and Biostatistics Unit, IRCCS Istituto Giannina Gaslini, Genova, Italy
| | - Gill A Levitt
- Department of Haematology/Oncology, Great Ormond Street Hospital for Children NHS Trust, Great Ormond Street, London, UK
| | - Marisa De Rosa
- Inter-University Consortium Cineca, Casalecchio di Reno (BO), Italy
| | - Martin Schrappe
- Department of Paediatrics, Christian-Albrechts-University Kiel and University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Lars Hjorth
- Lund University, Skane University Hospital, Department of Clinical Sciences Lund, Paediatrics, Lund, Sweden
| | - Ruth Ladenstein
- St. Anna Children's Cancer Research Institute, Vienna, Austria
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Meyers RL, Maibach R, Hiyama E, Häberle B, Krailo M, Rangaswami A, Aronson DC, Malogolowkin MH, Perilongo G, von Schweinitz D, Ansari M, Lopez-Terrada D, Tanaka Y, Alaggio R, Leuschner I, Hishiki T, Schmid I, Watanabe K, Yoshimura K, Feng Y, Rinaldi E, Saraceno D, Derosa M, Czauderna P. Risk-stratified staging in paediatric hepatoblastoma: a unified analysis from the Children's Hepatic tumors International Collaboration. Lancet Oncol 2017; 18:122-131. [PMID: 27884679 PMCID: PMC5650231 DOI: 10.1016/s1470-2045(16)30598-8] [Citation(s) in RCA: 220] [Impact Index Per Article: 31.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 10/06/2016] [Accepted: 10/12/2016] [Indexed: 01/26/2023]
Abstract
BACKGROUND Comparative assessment of treatment results in paediatric hepatoblastoma trials has been hampered by small patient numbers and the use of multiple disparate staging systems by the four major trial groups. To address this challenge, we formed a global coalition, the Children's Hepatic tumors International Collaboration (CHIC), with the aim of creating a common approach to staging and risk stratification in this rare cancer. METHODS The CHIC steering committee-consisting of leadership from the four major cooperative trial groups (the International Childhood Liver Tumours Strategy Group, Children's Oncology Group, the German Society for Paediatric Oncology and Haematology, and the Japanese Study Group for Paediatric Liver Tumours)-created a shared international database that includes comprehensive data from 1605 children treated in eight multicentre hepatoblastoma trials over 25 years. Diagnostic factors found to be most prognostic on initial analysis were PRETreatment EXTent of disease (PRETEXT) group; age younger than 3 years, 3-7 years, and 8 years or older; α fetoprotein (AFP) concentration of 100 ng/mL or lower and 101-1000 ng/mL; and the PRETEXT annotation factors metastatic disease (M), macrovascular involvement of all hepatic veins (V) or portal bifurcation (P), contiguous extrahepatic tumour (E), multifocal tumour (F), and spontaneous rupture (R). We defined five clinically relevant backbone groups on the basis of established prognostic factors: PRETEXT I/II, PRETEXT III, PRETEXT IV, metastatic disease, and AFP concentration of 100 ng/mL or lower at diagnosis. We then carried the additional factors into a hierarchical backwards elimination multivariable analysis and used the results to create a new international staging system. RESULTS Within each backbone group, we identified constellations of factors that were most predictive of outcome in that group. The robustness of candidate models was then interrogated using the bootstrapping procedure. Using the clinically established PRETEXT groups I, II, III, and IV as our stems, we created risk stratification trees based on 5 year event-free survival and clinical applicability. We defined and adopted four risk groups: very low, low, intermediate, and high. INTERPRETATION We have created a unified global approach to risk stratification in children with hepatoblastoma on the basis of rigorous statistical interrogation of what is, to the best of our knowledge, the largest dataset ever assembled for this rare paediatric tumour. This achievement provides the structural framework for further collaboration and prospective international cooperative study, such as the Paediatric Hepatic International Tumour Trial (PHITT). FUNDING European Network for Cancer Research in Children and Adolescents, funded through the Framework Program 7 of the European Commission (grant number 261474); Children's Oncology Group CureSearch grant contributed by the Hepatoblastoma Foundation; Practical Research for Innovative Cancer Control and Project Promoting Clinical Trials for Development of New Drugs and Medical Devices, Japan Agency for Medical Research; and Swiss Cancer Research grant.
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Affiliation(s)
| | - Rudolf Maibach
- International Breast Cancer Study Group Coordinating Center, Bern, Switzerland
| | | | | | - Mark Krailo
- Children's Oncology Group, Monrovia, CA, USA
| | | | - Daniel C Aronson
- Department of Paediatric Surgery, Noah's Ark Childrens' Hospital for Wales, University Hospital of Wales, Cardiff, UK
| | | | | | | | - Marc Ansari
- Geneva University Hospital, Geneva, Switzerland
| | | | | | | | | | - Tomoro Hishiki
- Department of Pediatric Surgery, Chiba University Hospital, Chiba, Japan
| | | | | | - Kenichi Yoshimura
- Innovative Clinical Research Center (iCREK), Kanazawa University Hospital, Kanazawa, Japan
| | - Yurong Feng
- Children's Oncology Group, Monrovia, CA, USA
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Hochedlinger N, Nitzlnader M, Falgenhauer M, Welte S, Hayn D, Koumakis L, Potamias G, Tsiknakis M, Saraceno D, Rinaldi E, Ladenstein R, Schreier G. Standardized data sharing in a paediatric oncology research network--a proof-of-concept study. Stud Health Technol Inform 2015; 212:27-34. [PMID: 26063254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Data that has been collected in the course of clinical trials are potentially valuable for additional scientific research questions in so called secondary use scenarios. This is of particular importance in rare disease areas like paediatric oncology. If data from several research projects need to be connected, so called Core Datasets can be used to define which information needs to be extracted from every involved source system. In this work, the utility of the Clinical Data Interchange Standards Consortium (CDISC) Operational Data Model (ODM) as a format for Core Datasets was evaluated and a web tool was developed which received Source ODM XML files and--via Extensible Stylesheet Language Transformation (XSLT)--generated standardized Core Dataset ODM XML files. Using this tool, data from different source systems were extracted and pooled for joined analysis in a proof-of-concept study, facilitating both, basic syntactic and semantic interoperability.
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Affiliation(s)
| | | | | | | | - Dieter Hayn
- AIT Austrian Institute of Technology, Austria
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Abstract
The carcinoma of the penis is a rare neoplasia which tends to remain localized for long because of the patient's embarrassment; thus the diagnosis is often late. The treatment modality is a critical issue due to the controversies existing with regard to the role of linfoadenectomy. However, in cases of no lymphonodal involvement, the surgical treatment with the penis amputation proves certainly to be curative and leads to a favourable outcome.
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Affiliation(s)
- G. Zumbo
- UO di Urologia, Ospedale Giovanni XXIII di Gioia Tauro, ASL n. 10, Palmi, Reggio Calabria
| | - D. Saraceno
- UO di Urologia, Ospedale Giovanni XXIII di Gioia Tauro, ASL n. 10, Palmi, Reggio Calabria
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8
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Zumbo G, Saraceno D. Ricostruzione dei genitali maschili per gangrena di Fournier. Presentazione di un caso: Reconstruction of male genitals due to Fournier's gangrene. Case presentation. Urologia 1998. [DOI: 10.1177/039156039806500227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A recent case of Fournier's gangrene is reported, which had a dramatic onset and progression. The highly satisfactory reconstruction of the scrotum and covering of the penile shaft are described.
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Affiliation(s)
- G. Zumbo
- Unità Operativa Aggregata di Urologia - P.O. di Gioia Tauro ASL 10 - Palmi (Reggio Calabria)
- Unità Operativa Aggregata di Urologia, P.O. di Gioia Tauro, ASL n. 10 Palmi - Via Madame Curie - 89013 Gioia Tauro (Reggio Calabria) - Italy
| | - D. Saraceno
- Unità Operativa Aggregata di Urologia - P.O. di Gioia Tauro ASL 10 - Palmi (Reggio Calabria)
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