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Dal Maso L, Toffolutti F, De Paoli A, Giudici F, Francisci S, Bucchi L, Zorzi M, Fusco M, Caldarella A, Rossi S, De Angelis R, Botta L, Ravaioli A, Casella C, Musolino A, Vitale MF, Mangone L, Fanetti AC, Carpin E, Burgio Lo Monaco MG, Migliore E, Gambino ML, Ferrante M, Stracci F, Gasparotti C, Carrozzi G, Cavallo R, Mazzucco W, Ballotari P, Ferretti S, Sampietro G, Rizzello RV, Boschetti L, Cascone G, Mian M, Pesce MT, Piras D, Galasso R, Bella F, Seghini P, Pinna P, Crocetti E, Serraino D, Guzzinati S. Cure indicators and prevalence by stage at diagnosis for breast and colorectal cancer patients: A population-based study in Italy. Int J Cancer 2024; 155:270-281. [PMID: 38520231 DOI: 10.1002/ijc.34923] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 01/15/2024] [Accepted: 02/20/2024] [Indexed: 03/25/2024]
Abstract
People alive many years after breast (BC) or colorectal cancer (CRC) diagnoses are increasing. This paper aimed to estimate the indicators of cancer cure and complete prevalence for Italian patients with BC and CRC by stage and age. A total of 31 Italian Cancer Registries (47% of the population) data until 2017 were included. Mixture cure models allowed estimation of net survival (NS); cure fraction (CF); time to cure (TTC, 5-year conditional NS >95%); cure prevalence (who will not die of cancer); and already cured (prevalent patients living longer than TTC). 2.6% of all Italian women (806,410) were alive in 2018 after BC and 88% will not die of BC. For those diagnosed in 2010, CF was 73%, 99% when diagnosed at stage I, 81% at stage II, and 36% at stages III-IV. For all stages combined, TTC was >10 years under 45 and over 65 years and for women with advanced stages, but ≤1 year for all BC patients at stage I. The proportion of already cured prevalent BC women was 75% (94% at stage I). Prevalent CRC cases were 422,407 (0.7% of the Italian population), 90% will not die of CRC. For CRC patients, CF was 56%, 92% at stage I, 71% at stage II, and 35% at stages III-IV. TTC was ≤10 years for all age groups and stages. Already cured were 59% of all prevalent CRC patients (93% at stage I). Cancer cure indicators by stage may contribute to appropriate follow-up in the years after diagnosis, thus avoiding patients' discrimination.
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Affiliation(s)
- Luigino Dal Maso
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Federica Toffolutti
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | | | - Fabiola Giudici
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Silvia Francisci
- National Centre for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
| | - Lauro Bucchi
- Emilia-Romagna Cancer Registry, Romagna Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì, Italy
| | - Manuel Zorzi
- Epidemiological Department, Azienda Zero, Padua, Italy
| | - Mario Fusco
- Registro Tumori ASL Napoli 3 Sud, Napoli, Italy
| | - Adele Caldarella
- Tuscany Cancer Registry, Institute for Cancer Research, Prevention and Clinical Network, Florence, Italy
| | - Silvia Rossi
- Department of Oncology and Molecular Medicine, National Institute of Health, Rome, Italy
| | - Roberta De Angelis
- Department of Oncology and Molecular Medicine, National Institute of Health, Rome, Italy
| | - Laura Botta
- Evaluative Epidemiology Unit, Department of Epidemiology and Data Science, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Alessandra Ravaioli
- Emilia-Romagna Cancer Registry, Romagna Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì, Italy
| | - Claudia Casella
- Liguria Cancer Registry, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Antonino Musolino
- Emilia-Romagna Cancer Registry, Parma Unit, Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | | | - Lucia Mangone
- Emilia-Romagna Cancer Registry, Reggio Emilia Unit, Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Anna Clara Fanetti
- Sondrio Cancer Registry, Agenzia di Tutela della Salute della Montagna, Sondrio, Italy
| | - Eva Carpin
- Epidemiological Department, Azienda Zero, Padua, Italy
| | - Maria Giovanna Burgio Lo Monaco
- Coordination Centre of the Cancer Registry of Puglia-Strategic Regional Agency for Health and Social Care (AReSS), Bari, Italy
| | - Enrica Migliore
- Piedmont Cancer Registry, Centro di Riferimento per l'Epidemiologia e la Prevenzione Oncologica (CPO) Piemonte and University of Turin, Turin, Italy
| | - Maria Letizia Gambino
- Registro tumori ATS Insubria (Provincia di Como e Varese) S.S. Epidemiologia Registri Specializzati e Reti di Patologia, Varese, Italy
| | - Margherita Ferrante
- Registro Tumori Integrato di Catania-Messina-Enna, Igiene Ospedaliera, Azienda Ospedaliero-Universitaria Policlinico G. Rodolico-San Marco, Catania, Italy
| | - Fabrizio Stracci
- Umbria Cancer Registry, Public Health Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Cinzia Gasparotti
- Registro tumori ATS Brescia, Struttura Semplice Epidemiologia, ATS, Brescia, Italy
| | - Giuliano Carrozzi
- Emilia-Romagna Cancer Registry, Modena Unit, Public Health Department, Local Health Authority, Modena, Italy
| | - Rossella Cavallo
- Cancer Registry Azienda Sanitaria Locale (ASL) Salerno, Dipartimento di Prevenzione, Salerno, Italy
| | - Walter Mazzucco
- Clinical Epidemiology and Cancer Registry Unit, Azienda Ospedaliera Universitaria Policlinico (AOUP) di Palermo, Palermo, Italy
| | | | - Stefano Ferretti
- Emilia-Romagna Cancer Registry, Ferrara Unit, Local Health Authority, Ferrara, University of Ferrara, Ferrara, Italy
| | - Giuseppe Sampietro
- Bergamo Cancer Registry, Epidemiological Service, Agenzia di Tutela della Salute, Bergamo, Italy
| | | | | | - Giuseppe Cascone
- Azienda Sanitaria Provinciale (ASP) Ragusa-Dipartimento di Prevenzione-Registro Tumori, Ragusa, Italy
| | - Michael Mian
- Innovation, Research and Teaching Service (SABES-ASDAA), Lehrkrankenhaus der Paracelsus Medizinischen Privatuniversität, Bolzano-Bozen, Italy
| | - Maria Teresa Pesce
- Monitoraggio Rischio Ambientale e Registro Tumori ASL Caserta, Caserta, Italy
| | | | - Rocco Galasso
- Unit of Regional Cancer Registry, Clinical Epidemiology and Biostatistics, IRCCS Centro di Riferimento Oncologico di Basilicata (CROB), Rionero in Vulture, Italy
| | - Francesca Bella
- Siracusa Cancer Registry, Provincial Health Authority of Siracusa, Siracusa, Italy
| | - Pietro Seghini
- Emilia-Romagna Cancer Registry, Piacenza Unit, Public Health Department, AUSL Piacenza, Piacenza, Italy
| | - Pasquala Pinna
- Nuoro Cancer Registry, RT Nuoro, Servizio Igiene e Sanità Pubblica, ASL Nuoro, Nuoro, Italy
| | - Emanuele Crocetti
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Diego Serraino
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
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Pierannunzio D, Maraschini A, Lopez T, Donati S, Amodio R, Bianconi F, Bruni R, Castaing M, Cirilli C, Fantaci G, Guarda L, Iacovacci S, Mangone L, Mazzoleni G, Mazzucco W, Melcarne A, Merlo E, Parazzini F, Peccatori FA, Rugge M, Sampietro G, Scambia G, Scarfone G, Sferrazza A, Stracci F, Torrisi A, Vitale MF, Francisci S. Cancer and Pregnancy: Estimates in Italy from Record-Linkage Procedures between Cancer Registries and the Hospital Discharge Database. Cancers (Basel) 2023; 15:4305. [PMID: 37686581 PMCID: PMC10486505 DOI: 10.3390/cancers15174305] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 08/21/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
The aim of this study is to describe the frequency and trend of pregnancy-associated cancer (PAC) in Italy, an increasingly relevant phenomenon due to postponing age at childbirth. To this purpose, a population-based retrospective longitudinal study design based on cohorts of women aged 15-49 diagnosed with cancer and concomitant pregnancy is proposed. The study uses 19 population-based Cancer Registries, covering about 22% of Italy, and linked at an individual level with Hospital Discharge Records. A total of 2,861,437 pregnancies and 3559 PAC are identified from 74,165 women of the cohort with a rate of 1.24 PAC per 1000 pregnancies. The most frequent cancer site is breast (24.3%), followed by thyroid (23.9%) and melanoma (14.3%). The most frequent outcome is delivery (53.1%), followed by voluntary termination of pregnancy and spontaneous abortion (both 12.0%). The trend of PAC increased from 2003 to 2015, especially when the outcome is delivery, thus confirming a new attitude of clinicians to manage cancer throughout pregnancy. This represents the first attempt in Italy to describe PAC from Cancer Registries data; the methodology is applicable to other areas with the same data availability. Evidence from this study is addressed to clinicians for improving clinical management of women with PAC.
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Affiliation(s)
- Daniela Pierannunzio
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, 00162 Rome, Italy
| | - Alice Maraschini
- Technical-Scientific Statistical Service, Italian National Institute of Health, 00162 Rome, Italy
| | - Tania Lopez
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, 00162 Rome, Italy
| | - Serena Donati
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, 00162 Rome, Italy
| | - Rosalba Amodio
- Clinical Epidemiology and Cancer Registry Unit, Azienda Ospedaliera Universitaria Policlinico (AOUP), 90127 Palermo, Italy
| | | | | | - Marine Castaing
- Siracusa Cancer Registry, Health Unit of Siracusa, 96100 Siracusa, Italy
| | - Claudia Cirilli
- Dipartimento di Epidemiologia e Comunicazione del Rischio, AUSL di Modena, 41126 Modena, Italy
| | | | - Linda Guarda
- SC Osservatorio Epidemiologico ATS Valpadana, 46100 Mantova, Italy
| | - Silvia Iacovacci
- RT LT, Dipartimento di Prevenzione ASL Latina, 04100 Latina, Italy
| | - Lucia Mangone
- European Epidemiology Unit, Gynecologic Oncology Department, AUSL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy
| | | | - Walter Mazzucco
- Clinical Epidemiology and Cancer Registry Unit, Azienda Ospedaliera Universitaria Policlinico (AOUP), 90127 Palermo, Italy
| | | | - Elisabetta Merlo
- UOC Epidemiologia, Agenzia per la Tutela della Salute (ATS) della Brianza, 20900 Monza, Italy
| | - Fabio Parazzini
- Dipartimento di Scienze Cliniche e di Comunità, Università degli Studi di Milano, 20122 Milano, Italy
| | | | - Massimo Rugge
- Surgical Pathology & Cytopathology Unit, Department of Medicine (DIMED), University of Padova, 35128 Padova, Italy
- Veneto Tumor Registry (RTV), Veneto Regional Authority, 35132 Padova, Italy
| | | | - Giovanni Scambia
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica Roma, 00168 Roma, Italy
| | - Giovanna Scarfone
- Gynecologic Oncology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy
| | - Ausilia Sferrazza
- ASP Ragusa-Dipartimento Medico di Prevenzione, UOSD Registro Tumori, 97100 Ragusa, Italy
| | - Fabrizio Stracci
- Associazione Nazionale dei Registri Tumori—AIRTUM—Public Health Section, Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy
| | - Antonina Torrisi
- Registro Tumori Integrato, Azienda Ospedaliero Universitaria Policlinico “G. Rodolico—San Marco”, 95123 Catania, Italy
| | | | - Silvia Francisci
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, 00162 Rome, Italy
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Toffolutti F, Guzzinati S, De Paoli A, Francisci S, De Angelis R, Crocetti E, Botta L, Rossi S, Mallone S, Zorzi M, Manneschi G, Bidoli E, Ravaioli A, Cuccaro F, Migliore E, Puppo A, Ferrante M, Gasparotti C, Gambino M, Carrozzi G, Stracci F, Michiara M, Cavallo R, Mazzucco W, Fusco M, Ballotari P, Sampietro G, Ferretti S, Mangone L, Rizzello RV, Mian M, Cascone G, Boschetti L, Galasso R, Piras D, Pesce MT, Bella F, Seghini P, Fanetti AC, Pinna P, Serraino D, Dal Maso L. Complete prevalence and indicators of cancer cure: enhanced methods and validation in Italian population-based cancer registries. Front Oncol 2023; 13:1168325. [PMID: 37346072 PMCID: PMC10280813 DOI: 10.3389/fonc.2023.1168325] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 05/09/2023] [Indexed: 06/23/2023] Open
Abstract
Objectives To describe the procedures to derive complete prevalence and several indicators of cancer cure from population-based cancer registries. Materials and methods Cancer registry data (47% of the Italian population) were used to calculate limited duration prevalence for 62 cancer types by sex and registry. The incidence and survival models, needed to calculate the completeness index (R) and complete prevalence, were evaluated by likelihood ratio tests and by visual comparison. A sensitivity analysis was conducted to explore the effect on the complete prevalence of using different R indexes. Mixture cure models were used to estimate net survival (NS); life expectancy of fatal (LEF) cases; cure fraction (CF); time to cure (TTC); cure prevalence, prevalent patients who were not at risk of dying as a result of cancer; and already cured patients, those living longer than TTC at a specific point in time. CF was also compared with long-term NS since, for patients diagnosed after a certain age, CF (representing asymptotical values of NS) is reached far beyond the patient's life expectancy. Results For the most frequent cancer types, the Weibull survival model stratified by sex and age showed a very good fit with observed survival. For men diagnosed with any cancer type at age 65-74 years, CF was 41%, while the NS was 49% until age 100 and 50% until age 90. In women, similar differences emerged for patients with any cancer type or with breast cancer. Among patients alive in 2018 with colorectal cancer at age 55-64 years, 48% were already cured (had reached their specific TTC), while the cure prevalence (lifelong probability to be cured from cancer) was 89%. Cure prevalence became 97.5% (2.5% will die because of their neoplasm) for patients alive >5 years after diagnosis. Conclusions This study represents an addition to the current knowledge on the topic providing a detailed description of available indicators of prevalence and cancer cure, highlighting the links among them, and illustrating their interpretation. Indicators may be relevant for patients and clinical practice; they are unambiguously defined, measurable, and reproducible in different countries where population-based cancer registries are active.
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Affiliation(s)
- Federica Toffolutti
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Aviano, Italy
| | | | | | - Silvia Francisci
- National Centre for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
| | - Roberta De Angelis
- Department of Oncology and Molecular Medicine, National Institute of Health, Rome, Italy
| | - Emanuele Crocetti
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Aviano, Italy
| | - Laura Botta
- Evaluative Epidemiology Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Silvia Rossi
- Department of Oncology and Molecular Medicine, National Institute of Health, Rome, Italy
| | - Sandra Mallone
- National Centre for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
| | - Manuel Zorzi
- Epidemiological Department, Azienda Zero, Padua, Italy
| | - Gianfranco Manneschi
- Tuscany Cancer Registry, Clinical Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Ettore Bidoli
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Aviano, Italy
| | - Alessandra Ravaioli
- Emilia-Romagna Cancer Registry, Romagna Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Forlì, Italy
| | - Francesco Cuccaro
- Registro Tumori Puglia - Sezione Azienda Sanitaria Locale (ASL) Barletta-Andria-Trani, Epidemiologia e Statistica, Barletta, Italy
| | - Enrica Migliore
- Piedmont Cancer Registry, Centro di Riferimento per l'Epidemiologia e la Prevenzione Oncologica (CPO) Piemonte and University of Turin, Turin, Italy
| | - Antonella Puppo
- Liguria Cancer Registry, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Margherita Ferrante
- Registro tumori integrato di Catania-Messina-Enna, Igiene Ospedaliera, Azienda Ospedaliero-Universitaria Policlinico G. Rodolico-San Marco, Catania, Italy
| | - Cinzia Gasparotti
- Struttura Semplice Epidemiologia, Agenzia di Tutela della Salute (ATS) Brescia, Brescia, Italy
| | - Maria Gambino
- Registro tumori ATS Insubria (Provincia di Como e Varese) Responsabile S.S. Epidemiologia Registri Specializzati e Reti di Patologia, Varese, Italy
| | - Giuliano Carrozzi
- Emilia-Romagna Cancer Registry, Modena Unit, Public Health Department, Local Health Authority, Modena, Italy
| | - Fabrizio Stracci
- Umbria Cancer Registry, Public Health Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Maria Michiara
- Emilia-Romagna Cancer Registry, Parma Unit, Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - Rossella Cavallo
- Cancer Registry Azienda Sanitaria Locale (ASL) Salerno- Dipartimento di Prevenzione, Salerno, Italy
| | - Walter Mazzucco
- Clinical Epidemiology and Cancer Registry Unit, Azienda Ospedaliera Universitaria Policlinico (AOUP) di Palermo, Palermo, Italy
| | - Mario Fusco
- Registro Tumori ASL Napoli 3 Sud, Napoli, Italy
| | | | | | - Stefano Ferretti
- Emilia-Romagna Cancer Registry, Ferrara Unit, Local Health Authority, Ferrara, and University of Ferrara, Ferrara, Italy
| | - Lucia Mangone
- Emilia-Romagna Cancer Registry, Reggio Emilia Unit, Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Michael Mian
- Innovation, Research and Teaching Service (SABES-ASDAA), Lehrkrankenhaus der Paracelsus Medizinischen Privatuniversität, Bolzano-Bozen, Italy
| | - Giuseppe Cascone
- Azienda Sanitaria Provinciale (ASP) Ragusa - Dipartimento di Prevenzione -Registro Tumori, Ragusa, Italy
| | | | - Rocco Galasso
- Unit of Regional Cancer Registry, Clinical Epidemiology and Biostatistics, IRCCS Centro di Riferimento Oncologico di Basilicata (CROB), Rionero in Vulture, Italy
| | | | - Maria Teresa Pesce
- Monitoraggio rischio ambientale e Registro Tumori ASL Caserta, Caserta, Italy
| | - Francesca Bella
- Siracusa Cancer Registry, Provincial Health Authority of Siracusa, Siracusa, Italy
| | - Pietro Seghini
- Emilia-Romagna Cancer Registry, Piacenza Unit, Public Health Department, AUSL Piacenza, Piacenza, Italy
| | - Anna Clara Fanetti
- Sondrio Cancer Registry, Agenzia di Tutela della Salute della Montagna, Sondrio, Italy
| | - Pasquala Pinna
- Nuoro Cancer Registry, RT Nuoro, Servizio Igiene e Sanità Pubblica, ASL Nuoro, Nuoro, Italy
| | - Diego Serraino
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Aviano, Italy
| | - Luigino Dal Maso
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Aviano, Italy
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Girardi F, Matz M, Stiller C, You H, Marcos Gragera R, Valkov MY, Bulliard JL, De P, Morrison D, Wanner M, O'Brian DK, Saint-Jacques N, Coleman MP, Allemani C, Hamdi-Chérif M, Kara L, Meguenni K, Regagba D, Bayo S, Cheick Bougadari T, Manraj SS, Bendahhou K, Ladipo A, Ogunbiyi OJ, Somdyala NIM, Chaplin MA, Moreno F, Calabrano GH, Espinola SB, Carballo Quintero B, Fita R, Laspada WD, Ibañez SG, Lima CA, Da Costa AM, De Souza PCF, Chaves J, Laporte CA, Curado MP, de Oliveira JC, Veneziano CLA, Veneziano DB, Almeida ABM, Latorre MRDO, Rebelo MS, Santos MO, Azevedo e Silva G, Galaz JC, Aparicio Aravena M, Sanhueza Monsalve J, Herrmann DA, Vargas S, Herrera VM, Uribe CJ, Bravo LE, Garcia LS, Arias-Ortiz NE, Morantes D, Jurado DM, Yépez Chamorro MC, Delgado S, Ramirez M, Galán Alvarez YH, Torres P, Martínez-Reyes F, Jaramillo L, Quinto R, Castillo J, Mendoza M, Cueva P, Yépez JG, Bhakkan B, Deloumeaux J, Joachim C, Macni J, Carrillo R, Shalkow Klincovstein J, Rivera Gomez R, Perez P, Poquioma E, Tortolero-Luna G, Zavala D, Alonso R, Barrios E, Eckstrand A, Nikiforuk C, Woods RR, Noonan G, Turner D, Kumar E, Zhang B, Dowden JJ, Doyle GP, Saint-Jacques N, Walsh G, Anam A, De P, McClure CA, Vriends KA, Bertrand C, Ramanakumar AV, Davis L, Kozie S, Freeman T, George JT, Avila RM, O’Brien DK, Holt A, Almon L, Kwong S, Morris C, Rycroft R, Mueller L, Phillips CE, Brown H, Cromartie B, Ruterbusch J, Schwartz AG, Levin GM, Wohler B, Bayakly R, Ward KC, Gomez SL, McKinley M, Cress R, Davis J, Hernandez B, Johnson CJ, Morawski BM, Ruppert LP, Bentler S, Charlton ME, Huang B, Tucker TC, Deapen D, Liu L, Hsieh MC, Wu XC, Schwenn M, Stern K, Gershman ST, Knowlton RC, Alverson G, Weaver T, Desai J, Rogers DB, Jackson-Thompson J, Lemons D, Zimmerman HJ, Hood M, Roberts-Johnson J, Hammond W, Rees JR, Pawlish KS, Stroup A, Key C, Wiggins C, Kahn AR, Schymura MJ, Radhakrishnan S, Rao C, Giljahn LK, Slocumb RM, Dabbs C, Espinoza RE, Aird KG, Beran T, Rubertone JJ, Slack SJ, Oh J, Janes TA, Schwartz SM, Chiodini SC, Hurley DM, Whiteside MA, Rai S, Williams MA, Herget K, Sweeney C, Kachajian J, Keitheri Cheteri MB, Migliore Santiago P, Blankenship SE, Conaway JL, Borchers R, Malicki R, Espinoza J, Grandpre J, Weir HK, Wilson R, Edwards BK, Mariotto A, Rodriguez-Galindo C, Wang N, Yang L, Chen JS, Zhou Y, He YT, Song GH, Gu XP, Mei D, Mu HJ, Ge HM, Wu TH, Li YY, Zhao DL, Jin F, Zhang JH, Zhu FD, Junhua Q, Yang YL, Jiang CX, Biao W, Wang J, Li QL, Yi H, Zhou X, Dong J, Li W, Fu FX, Liu SZ, Chen JG, Zhu J, Li YH, Lu YQ, Fan M, Huang SQ, Guo GP, Zhaolai H, Wei K, Chen WQ, Wei W, Zeng H, Demetriou AV, Mang WK, Ngan KC, Kataki AC, Krishnatreya M, Jayalekshmi PA, Sebastian P, George PS, Mathew A, Nandakumar A, Malekzadeh R, Roshandel G, Keinan-Boker L, Silverman BG, Ito H, Koyanagi Y, Sato M, Tobori F, Nakata I, Teramoto N, Hattori M, Kaizaki Y, Moki F, Sugiyama H, Utada M, Nishimura M, Yoshida K, Kurosawa K, Nemoto Y, Narimatsu H, Sakaguchi M, Kanemura S, Naito M, Narisawa R, Miyashiro I, Nakata K, Mori D, Yoshitake M, Oki I, Fukushima N, Shibata A, Iwasa K, Ono C, Matsuda T, Nimri O, Jung KW, Won YJ, Alawadhi E, Elbasmi A, Ab Manan A, Adam F, Nansalmaa E, Tudev U, Ochir C, Al Khater AM, El Mistiri MM, Lim GH, Teo YY, Chiang CJ, Lee WC, Buasom R, Sangrajrang S, Suwanrungruang K, Vatanasapt P, Daoprasert K, Pongnikorn D, Leklob A, Sangkitipaiboon S, Geater SL, Sriplung H, Ceylan O, Kög I, Dirican O, Köse T, Gurbuz T, Karaşahin FE, Turhan D, Aktaş U, Halat Y, Eser S, Yakut CI, Altinisik M, Cavusoglu Y, Türkköylü A, Üçüncü N, Hackl M, Zborovskaya AA, Aleinikova OV, Henau K, Van Eycken L, Atanasov TY, Valerianova Z, Šekerija M, Dušek L, Zvolský M, Steinrud Mørch L, Storm H, Wessel Skovlund C, Innos K, Mägi M, Malila N, Seppä K, Jégu J, Velten M, Cornet E, Troussard X, Bouvier AM, Guizard AV, Bouvier V, Launoy G, Dabakuyo Yonli S, Poillot ML, Maynadié M, Mounier M, Vaconnet L, Woronoff AS, Daoulas M, Robaszkiewicz M, Clavel J, Poulalhon C, Desandes E, Lacour B, Baldi I, Amadeo B, Coureau G, Monnereau A, Orazio S, Audoin M, D’Almeida TC, Boyer S, Hammas K, Trétarre B, Colonna M, Delafosse P, Plouvier S, Cowppli-Bony A, Molinié F, Bara S, Ganry O, Lapôtre-Ledoux B, Daubisse-Marliac L, Bossard N, Uhry Z, Estève J, Stabenow R, Wilsdorf-Köhler H, Eberle A, Luttmann S, Löhden I, Nennecke AL, Kieschke J, Sirri E, Justenhoven C, Reinwald F, Holleczek B, Eisemann N, Katalinic A, Asquez RA, Kumar V, Petridou E, Ólafsdóttir EJ, Tryggvadóttir L, Murray DE, Walsh PM, Sundseth H, Harney M, Mazzoleni G, Vittadello F, Coviello E, Cuccaro F, Galasso R, Sampietro G, Giacomin A, Magoni M, Ardizzone A, D’Argenzio A, Di Prima AA, Ippolito A, Lavecchia AM, Sutera Sardo A, Gola G, Ballotari P, Giacomazzi E, Ferretti S, Dal Maso L, Serraino D, Celesia MV, Filiberti RA, Pannozzo F, Melcarne A, Quarta F, Andreano A, Russo AG, Carrozzi G, Cirilli C, Cavalieri d’Oro L, Rognoni M, Fusco M, Vitale MF, Usala M, Cusimano R, Mazzucco W, Michiara M, Sgargi P, Boschetti L, Marguati S, Chiaranda G, Seghini P, Maule MM, Merletti F, Spata E, Tumino R, Mancuso P, Cassetti T, Sassatelli R, Falcini F, Giorgetti S, Caiazzo AL, Cavallo R, Piras D, Bella F, Madeddu A, Fanetti AC, Maspero S, Carone S, Mincuzzi A, Candela G, Scuderi T, Gentilini MA, Rizzello R, Rosso S, Caldarella A, Intrieri T, Bianconi F, Contiero P, Tagliabue G, Rugge M, Zorzi M, Beggiato S, Brustolin A, Gatta G, De Angelis R, Vicentini M, Zanetti R, Stracci F, Maurina A, Oniščuka M, Mousavi M, Steponaviciene L, Vincerževskienė I, Azzopardi MJ, Calleja N, Siesling S, Visser O, Johannesen TB, Larønningen S, Trojanowski M, Macek P, Mierzwa T, Rachtan J, Rosińska A, Kępska K, Kościańska B, Barna K, Sulkowska U, Gebauer T, Łapińska JB, Wójcik-Tomaszewska J, Motnyk M, Patro A, Gos A, Sikorska K, Bielska-Lasota M, Didkowska JA, Wojciechowska U, Forjaz de Lacerda G, Rego RA, Carrito B, Pais A, Bento MJ, Rodrigues J, Lourenço A, Mayer-da-Silva A, Coza D, Todescu AI, Valkov MY, Gusenkova L, Lazarevich O, Prudnikova O, Vjushkov DM, Egorova A, Orlov A, Pikalova LV, Zhuikova LD, Adamcik J, Safaei Diba C, Zadnik V, Žagar T, De-La-Cruz M, Lopez-de-Munain A, Aleman A, Rojas D, Chillarón RJ, Navarro AIM, Marcos-Gragera R, Puigdemont M, Rodríguez-Barranco M, Sánchez Perez MJ, Franch Sureda P, Ramos Montserrat M, Chirlaque López MD, Sánchez Gil A, Ardanaz E, Guevara M, Cañete-Nieto A, Peris-Bonet R, Carulla M, Galceran J, Almela F, Sabater C, Khan S, Pettersson D, Dickman P, Staehelin K, Struchen B, Egger Hayoz C, Rapiti E, Schaffar R, Went P, Mousavi SM, Bulliard JL, Maspoli-Conconi M, Kuehni CE, Redmond SM, Bordoni A, Ortelli L, Chiolero A, Konzelmann I, Rohrmann S, Wanner M, Broggio J, Rashbass J, Stiller C, Fitzpatrick D, Gavin A, Morrison DS, Thomson CS, Greene G, Huws DW, Grayson M, Rawcliffe H, Allemani C, Coleman MP, Di Carlo V, Girardi F, Matz M, Minicozzi P, Sanz N, Ssenyonga N, James D, Stephens R, Chalker E, Smith M, Gugusheff J, You H, Qin Li S, Dugdale S, Moore J, Philpot S, Pfeiffer R, Thomas H, Silva Ragaini B, Venn AJ, Evans SM, Te Marvelde L, Savietto V, Trevithick R, Aitken J, Currow D, Fowler C, Lewis C. Global survival trends for brain tumors, by histology: analysis of individual records for 556,237 adults diagnosed in 59 countries during 2000-2014 (CONCORD-3). Neuro Oncol 2023; 25:580-592. [PMID: 36355361 PMCID: PMC10013649 DOI: 10.1093/neuonc/noac217] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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: 11/12/2022] Open
Abstract
BACKGROUND Survival is a key metric of the effectiveness of a health system in managing cancer. We set out to provide a comprehensive examination of worldwide variation and trends in survival from brain tumors in adults, by histology. METHODS We analyzed individual data for adults (15-99 years) diagnosed with a brain tumor (ICD-O-3 topography code C71) during 2000-2014, regardless of tumor behavior. Data underwent a 3-phase quality control as part of CONCORD-3. We estimated net survival for 11 histology groups, using the unbiased nonparametric Pohar Perme estimator. RESULTS The study included 556,237 adults. In 2010-2014, the global range in age-standardized 5-year net survival for the most common sub-types was broad: in the range 20%-38% for diffuse and anaplastic astrocytoma, from 4% to 17% for glioblastoma, and between 32% and 69% for oligodendroglioma. For patients with glioblastoma, the largest gains in survival occurred between 2000-2004 and 2005-2009. These improvements were more noticeable among adults diagnosed aged 40-70 years than among younger adults. CONCLUSIONS To the best of our knowledge, this study provides the largest account to date of global trends in population-based survival for brain tumors by histology in adults. We have highlighted remarkable gains in 5-year survival from glioblastoma since 2005, providing large-scale empirical evidence on the uptake of chemoradiation at population level. Worldwide, survival improvements have been extensive, but some countries still lag behind. Our findings may help clinicians involved in national and international tumor pathway boards to promote initiatives aimed at more extensive implementation of clinical guidelines.
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Affiliation(s)
- Fabio Girardi
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK.,Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK.,Division of Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Melissa Matz
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK
| | - Charles Stiller
- National Cancer Registration and Analysis Service, Public Health England, London, UK
| | - Hui You
- Cancer Information Analysis Unit, Cancer Institute NSW, St Leonards, New South Wales, Australia
| | - Rafael Marcos Gragera
- Epidemiology Unit and Girona Cancer Registry, Catalan Institute of Oncology, Girona, Spain
| | - Mikhail Y Valkov
- Department of Radiology, Radiotherapy and Oncology, Northern State Medical University, Arkhangelsk, Russia
| | - Jean-Luc Bulliard
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.,Neuchâtel and Jura Tumour Registry, Neuchâtel, Switzerland
| | - Prithwish De
- Surveillance and Cancer Registry, and Research Office, Clinical Institutes and Quality Programs, Ontario Health, Toronto, Ontario, Canada
| | - David Morrison
- Scottish Cancer Registry, Public Health Scotland, Edinburgh, UK
| | - Miriam Wanner
- Cancer Registry Zürich, Zug, Schaffhausen and Schwyz, University Hospital Zürich, Zürich, Switzerland
| | - David K O'Brian
- Alaska Cancer Registry, Alaska Department of Health and Social Services, Anchorage, Alaska, USA
| | - Nathalie Saint-Jacques
- Department of Medicine and Community Health and Epidemiology, Centre for Clinical Research, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Michel P Coleman
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK.,Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK
| | - Claudia Allemani
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK
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5
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Mancini S, Bucchi L, Zamagni F, Baldacchini F, Crocetti E, Giuliani O, Ravaioli A, Vattiato R, Preti M, Tumino R, Ferretti S, Biggeri A, Ballotari P, Boschetti L, Brustolin A, Caldarella A, Cavallo R, Cirilli C, Citarella A, Contrino ML, Dal Maso L, Filiberti RA, Fusco M, Galasso R, Lotti FL, Magoni M, Mangone L, Masanotti G, Mazzoleni G, Mazzucco W, Melcarne A, Michiara M, Pesce P, Pinto A, Piras D, Rizzello RV, Rognoni M, Rosso S, Rugge M, Sampietro G, Scalzi S, Scuderi T, Tagliabue G, Toffolutti F, Vitarelli S, Falcini F. Trends in Net Survival from Vulvar Squamous Cell Carcinoma in Italy (1990–2015). J Clin Med 2023; 12:jcm12062172. [PMID: 36983173 PMCID: PMC10054662 DOI: 10.3390/jcm12062172] [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] [Received: 01/17/2023] [Revised: 02/27/2023] [Accepted: 03/06/2023] [Indexed: 03/14/2023] Open
Abstract
(1) Objective: In many Western countries, survival from vulvar squamous cell carcinoma (VSCC) has been stagnating for decades or has increased insufficiently from a clinical perspective. In Italy, previous studies on cancer survival have not taken vulvar cancer into consideration or have pooled patients with vulvar and vaginal cancer. To bridge this knowledge gap, we report the trend in survival from vulvar cancer between 1990 and 2015. (2) Methods: Thirty-eight local cancer registries covering 49% of the national female population contributed the records of 6274 patients. Study endpoints included 1- and 2-year net survival (NS) calculated using the Pohar-Perme estimator and 5-year NS conditional on having survived two years (5|2-year CNS). The significance of survival trends was assessed with the Wald test on the coefficient of the period of diagnosis, entered as a continuous regressor in a Poisson regression model. (3) Results: The median patient age was stable at 76 years. One-year NS decreased from 83.9% in 1990–2001 to 81.9% in 2009–2015 and 2-year NS from 72.2% to 70.5%. Five|2-year CNS increased from 85.7% to 86.7%. These trends were not significant. In the age stratum 70–79 years, a weakly significant decrease in 2-year NS from 71.4% to 65.7% occurred. Multivariate analysis adjusting for age group at diagnosis and geographic area showed an excess risk of death at 5|2-years, of borderline significance, in 2003–2015 versus 1990–2002. (4) Conclusions: One- and 2-year NS and 5|2-year CNS showed no improvements. Current strategies for VSCC control need to be revised both in Italy and at the global level.
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Affiliation(s)
- Silvia Mancini
- Romagna Cancer Registry, Romagna Cancer Institute (IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori), 47014 Meldola, Italy; (S.M.); (L.B.); (F.B.); (E.C.); (O.G.); (A.R.); (R.V.); (F.F.)
| | - Lauro Bucchi
- Romagna Cancer Registry, Romagna Cancer Institute (IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori), 47014 Meldola, Italy; (S.M.); (L.B.); (F.B.); (E.C.); (O.G.); (A.R.); (R.V.); (F.F.)
| | - Federica Zamagni
- Romagna Cancer Registry, Romagna Cancer Institute (IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori), 47014 Meldola, Italy; (S.M.); (L.B.); (F.B.); (E.C.); (O.G.); (A.R.); (R.V.); (F.F.)
- Correspondence:
| | - Flavia Baldacchini
- Romagna Cancer Registry, Romagna Cancer Institute (IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori), 47014 Meldola, Italy; (S.M.); (L.B.); (F.B.); (E.C.); (O.G.); (A.R.); (R.V.); (F.F.)
| | - Emanuele Crocetti
- Romagna Cancer Registry, Romagna Cancer Institute (IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori), 47014 Meldola, Italy; (S.M.); (L.B.); (F.B.); (E.C.); (O.G.); (A.R.); (R.V.); (F.F.)
| | - Orietta Giuliani
- Romagna Cancer Registry, Romagna Cancer Institute (IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori), 47014 Meldola, Italy; (S.M.); (L.B.); (F.B.); (E.C.); (O.G.); (A.R.); (R.V.); (F.F.)
| | - Alessandra Ravaioli
- Romagna Cancer Registry, Romagna Cancer Institute (IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori), 47014 Meldola, Italy; (S.M.); (L.B.); (F.B.); (E.C.); (O.G.); (A.R.); (R.V.); (F.F.)
| | - Rosa Vattiato
- Romagna Cancer Registry, Romagna Cancer Institute (IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori), 47014 Meldola, Italy; (S.M.); (L.B.); (F.B.); (E.C.); (O.G.); (A.R.); (R.V.); (F.F.)
| | - Mario Preti
- Department of Obstetrics and Gynaecology, University of Torino, 10124 Torino, Italy;
| | - Rosario Tumino
- Cancer Registry and Histopathology Department, Provincial Health Authority (ASP), 97100 Ragusa, Italy;
| | - Stefano Ferretti
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Local Health Authority, 44121 Ferrara, Italy;
| | - Annibale Biggeri
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35128 Padua, Italy;
| | - Paola Ballotari
- Mantova & Cremona Cancer Registry, Epidemiology Unit, Val Padana Health Protection Agency, 46100 Mantova, Italy;
| | - Lorenza Boschetti
- Pavia Cancer Registry, Public Health Agency of Pavia, 27100 Pavia, Italy;
| | - Angelita Brustolin
- Unit of Epidemiology and Cancer Registry, Local Health Authority, 01100 Viterbo, Italy
| | - Adele Caldarella
- Tuscany Cancer Registry, Clinical and Descriptive Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50139 Florence, Italy;
| | - Rossella Cavallo
- Cancer Registry of Local Health Authority Salerno, 84124 Salerno, Italy;
| | - Claudia Cirilli
- Modena Cancer Registry, Public Health Department, Local Health Authority, 41126 Modena, Italy;
| | - Annarita Citarella
- Cancer Registry, Department of Prevention, Unit of Epidemiology, Local Health Authority, 82100 Benevento, Italy;
| | | | - Luigino Dal Maso
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy; (L.D.M.); (F.T.)
| | - Rosa A. Filiberti
- Liguria Cancer Registry, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy;
| | - Mario Fusco
- Napoli 3 Sud Cancer Registry, 80031 Napoli, Italy;
| | - Rocco Galasso
- Unit of Regional Cancer Registry, Clinical Epidemiology and Biostatistics, IRCCS-CROB, Basilicata, 85028 Rionero in Vulture, Italy;
| | - Fernanda L. Lotti
- Brindisi Cancer Registry, Local Health Authority, 72100 Brindisi, Italy;
| | - Michele Magoni
- Cancer Registry of Brescia Province, Epidemiology Unit, Brescia Health Protection Agency, 25124 Brescia, Italy;
| | - Lucia Mangone
- Epidemiology Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, Via Amendola 2, 42122 Reggio Emilia, Italy;
| | - Giuseppe Masanotti
- Section of Public Health and RTUP Register, Department of Experimental Medicine, University of Perugia, 06123 Perugia, Italy;
| | | | - Walter Mazzucco
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90131 Palermo, Italy;
| | | | - Maria Michiara
- Parma Cancer Registry, Medical Oncology Unit, University Hospital of Parma, 43126 Parma, Italy;
| | - Paola Pesce
- Catania, Messina and Enna Cancer Registry, 95123 Catania, Italy;
| | - Angela Pinto
- Barletta, Andria, Trani Cancer Registry, BAT Province, 76121 Barletta, Italy;
| | - Daniela Piras
- Sassari Cancer Registry, Azienda Regionale per la Tutela della Salute-ATS, 7100 Sassari, Italy;
| | - Roberto V. Rizzello
- Trento Province Cancer Registry, Unit of Clinical Epidemiology, Azienda Provinciale per i Servizi Sanitari (APSS), 38123 Trento, Italy;
| | - Magda Rognoni
- Epidemiology Unit, Cancer Registry of ATS Brianza, Health Protection Agency, 20900 Monza, Italy;
| | - Stefano Rosso
- Piedmont Cancer Registry, A.O.U. Città della Salute e della Scienza di Torino, 10123 Turin, Italy;
| | - Massimo Rugge
- Veneto Tumour Registry, Azienda Zero, University of Padova-DIMED, 35132 Padova, Italy;
| | | | - Santo Scalzi
- Catanzaro ASP Cancer Registry, 88100 Catanzaro, Italy;
| | - Tiziana Scuderi
- Trapani and Agrigento Cancer Registry, 91100 Trapani, Italy;
| | - Giovanna Tagliabue
- Lombardy Cancer Registry-Varese Province, Cancer Registry Unit, Department of Research, Fondazione IRCCS Istituto Nazionale Tumori, 20133 Milan, Italy;
| | - Federica Toffolutti
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy; (L.D.M.); (F.T.)
| | - Susanna Vitarelli
- Macerata Province Cancer Registry, University of Camerino, 62032 Camerino, Italy;
| | - Fabio Falcini
- Romagna Cancer Registry, Romagna Cancer Institute (IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori), 47014 Meldola, Italy; (S.M.); (L.B.); (F.B.); (E.C.); (O.G.); (A.R.); (R.V.); (F.F.)
- Cancer Prevention Unit, Local Health Authority, 47121 Forlì, Italy
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6
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Botta L, Gatta G, Capocaccia R, Stiller C, Cañete A, Dal Maso L, Innos K, Mihor A, Erdmann F, Spix C, Lacour B, Marcos-Gragera R, Murray D, Rossi S, Hackl M, Van Eycken E, Van Damme N, Valerianova Z, Sekerija M, Scoutellas V, Demetriou A, Dušek L, Krejci D, Storm H, Mägi M, Innos K, Paapsi K, Malila N, Pitkäniemi J, Jooste V, Clavel J, Poulalhon C, Lacour B, Desandes E, Monnereau A, Erdmann F, Spix C, Katalinic A, Petridou E, Markozannes G, Garami M, Birgisson H, Murray D, Walsh PM, Mazzoleni G, Vittadello F, Cuccaro F, Galasso R, Sampietro G, Rosso S, Gasparotto C, Maifredi G, Ferrante M, Torrisi A, Sutera Sardo A, Gambino ML, Lanzoni M, Ballotari P, Giacomazzi E, Ferretti S, Caldarella A, Manneschi G, Gatta G, Sant M, Baili P, Berrino F, Botta L, Trama A, Lillini R, Bernasconi A, Bonfarnuzzo S, Vener C, Didonè F, Lasalvia P, Del Monego G, Buratti L, Serraino D, Taborelli M, Capocaccia R, De Angelis R, Demuru E, Di Benedetto C, Rossi S, Santaquilani M, Venanzi S, Tallon M, Boni L, Iacovacci S, Russo AG, Gervasi F, Spagnoli G, Cavalieri d'Oro L, Fusco M, Vitale MF, Usala M, Vitale F, Michiara M, Chiranda G, Sacerdote C, Maule M, Cascone G, Spata E, Mangone L, Falcini F, Cavallo R, Piras D, Dinaro Y, Castaing M, Fanetti AC, Minerba S, Candela G, Scuderi T, Rizzello RV, Stracci F, Tagliabue G, Rugge M, Brustolin A, Pildava S, Smailyte G, Azzopardi M, Johannesen TB, Didkowska J, Wojciechowska U, Bielska-Lasota M, Pais A, Ferreira AM, Bento MJ, Miranda A, Safaei Diba C, Zadnik V, Zagar T, Sánchez-Contador Escudero C, Franch Sureda P, Lopez de Munain A, De-La-Cruz M, Rojas MD, Aleman A, Vizcaino A, Almela F, Marcos-Gragera R, Sanvisens A, Sanchez MJ, Chirlaque MD, Sanchez-Gil A, Guevara M, Ardanaz E, Cañete-Nieto A, Peris-Bonet R, Galceran J, Carulla M, Kuehni C, Redmond S, Visser O, Karim-Kos H, Stevens S, Stiller C, Gavin A, Morrison D, Huws DW. Long-term survival and cure fraction estimates for childhood cancer in Europe (EUROCARE-6): results from a population-based study. Lancet Oncol 2022; 23:1525-1536. [DOI: 10.1016/s1470-2045(22)00637-4] [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] [Received: 08/04/2022] [Revised: 10/04/2022] [Accepted: 10/05/2022] [Indexed: 11/17/2022]
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Gamba S, Marchetti M, Russo L, Giaccherini C, Bolognini S, Tartari C, Verzeroli C, Ticozzi C, Vignoli A, Schieppati F, Sampietro G, Malighetti P, Spinelli D, Falanga A. OC-06: Identification of predictive hemostatic biomarkers for cancer diagnosis: results from the HYPERCAN study. Thromb Res 2022. [DOI: 10.1016/s0049-3848(22)00178-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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8
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Trama A, Tittarelli A, Barigelletti G, Botta L, Gatta G, Tagliabue G, Contiero P, Guzzinati S, Andreano A, Manneschi G, Falcini F, Castaing M, Filiberti RA, Gasparotti C, Cirilli C, Mazzucco W, Mangone L, Iacovacci S, Vitale MF, Stracci F, Piffer S, Tumino R, Carone S, Sampietro G, Melcarne A, Ballotari P, Boschetti L, Pisani S, Cavalieri D'Oro L, Cuccaro F, D'Argenzio A, D'Orsi G, Fanetti AC, Ardizzone A, Candela G, Savoia F, Pascucci C, Castelli M, Storchi C, Bernasconi A. Excess risk of subsequent malignant neoplasms in adolescent and young adult cancer survivors: Results from the first Italian population-based cohort. Cancer 2021; 128:364-372. [PMID: 34582036 DOI: 10.1002/cncr.33931] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 07/15/2021] [Accepted: 08/03/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Evidence about late effects in adolescent and young adult (AYA) cancer survivors is scarce. This study assessed the risk of subsequent malignant neoplasms (SMNs) to identify the most common SMNs to be considered in follow-up care. METHODS Population-based cancer registries retrospectively identified first primary tumors (between 1976 and 2013) and SMNs in AYAs (15-39 years old at their cancer diagnosis). AYA cancer survivors were those alive at least 5 years after their first cancer diagnosis. The excess risk of SMNs was measured as standardized incidence ratios (SIRs) and absolute excess risk together with the cumulative incidence of SMNs. RESULTS The cohort included 67,692 AYA cancer survivors. The excess risk of developing any SMN (SIR, 1.6; 95% confidence interval, 1.5-1.7) was 60%. The excess risk of SMNs was significantly high for survivors of lymphomas; cancers of the breast, thyroid, female genital tract, digestive organs, gonads, and urinary tract; and melanomas. The cumulative incidence of all SMNs in AYA cancer survivors within 25 years of their first cancer diagnosis was approximately 10%. Subsequent tumors contributing to approximately 60% of all SMNs were breast cancer, colorectal cancer, corpus uteri cancer, and ovarian cancer in females and colorectal cancer, bladder cancer, prostate cancer, lung cancer, and lymphomas in males. CONCLUSIONS These results highlight the need to personalize follow-up strategies for AYA cancer survivors.
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Affiliation(s)
- Annalisa Trama
- Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Andrea Tittarelli
- Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Giulio Barigelletti
- Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Laura Botta
- Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Gemma Gatta
- Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Giovanna Tagliabue
- Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Paolo Contiero
- Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | | | - Anita Andreano
- Epidemiology Unit, Agency for Health Protection of Milan, Milano, Italy
| | - Gianfranco Manneschi
- Clinical Epidemiology Unit, Istituto per lo Studio, la Prevenzione e la Rete Oncologica, Firenze, Italy
| | - Fabio Falcini
- Department of Clinical and Experimental Oncology and Ematology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
| | - Marine Castaing
- Department of Hygiene and Public Health, Integrated Cancer Registry of Catania-Messina-Siracusa-Enna, Università di Catania, Catania, Italy
| | - Rosa A Filiberti
- Liguria Cancer Registry, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Cinzia Gasparotti
- Epidemiology Unit, Agency for Health Protection of Brescia, Brescia, Italy
| | - Claudia Cirilli
- Modena Cancer Registry, Azienda Unità Sanitaria Locale Modena, Modena, Italy
| | - Walter Mazzucco
- Department of Medicine and Surgery, Università degli Studi di Palermo, Palermo, Italy
| | - Lucia Mangone
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Silvia Iacovacci
- Active Prevention Unit, Azienda Sanitaria Locale Latina, Latina, Italy
| | | | - Fabrizio Stracci
- Department of Experimental Medicine, Università degli Studi di Perugia, Perugia, Italy
| | - Silvano Piffer
- Evaluative and Clinical Epidemiological Service, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
| | - Rosario Tumino
- Cancer Registry and Histopathology Unit, Azienda Sanitaria Provinciale di Ragusa, Ragusa, Italy
| | - Simona Carone
- Taranto Cancer Registry, Azienda Sanitaria Locale di Taranto, Taranto, Italy
| | - Giuseppe Sampietro
- Epidemiological Service, Agenzia di Tutela della Salute di Bergamo, Bergamo, Italy
| | - Anna Melcarne
- Cancer Registry Epidemiology Unit, Azienda Sanitaria Locale di Lecce, Lecce, Italy
| | - Paola Ballotari
- Epidemiologic Observatory, Azienda di Tutela della Salute della Val Padana, Mantova, Italy
| | - Lorenza Boschetti
- Epidemiologic Observatory, Cancer Registry, Agenzia di Tutela della Salute di Pavia, Pavia, Italy
| | - Salvatore Pisani
- Epidemiology Unit, Agenzia di Tutela della Salute dell'Insubria, Varese, Italy
| | - Luca Cavalieri D'Oro
- Epidemiology Unit, Agenzia per la Tutela della Salute della Brianza, Monza, Italy
| | - Francesco Cuccaro
- Epidemiology Unit - Cancer Registry, Azienda Sanitaria Locale di Barletta-Andria-Trani, Barletta, Italy
| | - Angelo D'Argenzio
- Epidemiology Unit, Azienda Sanitaria Locale Caserta 2, Caserta, Italy
| | - Giancarlo D'Orsi
- Department of Prevention, Azienda Sanitaria Locale Napoli 2, Napoli, Italy
| | - Anna C Fanetti
- Epidemiology Unit, Azienda di Tutela della Salute della Montagna, Sondrio, Italy
| | - Antonino Ardizzone
- Statistic and Epidemiology Unit - Cancer Registry, Azienda Sanitaria Locale di Brindisi, Brindisi, Italy
| | - Giuseppa Candela
- Cancer Registry Unit, Azienda Sanitaria Provinciale di Trapani, Trapani, Italy
| | - Fabio Savoia
- Childhood Cancer Registry of Campania Region, AORN Santobono Pausilipon, Napoli, Italy
| | - Cristiana Pascucci
- Department of Experimental Medicine and Public Health, Università di Camerino, Camerino, Italy
| | - Maurizio Castelli
- Prevention Unit, Azienda Unità Sanitaria Locale della Valle d'Aosta, Aosta, Italy
| | - Cinzia Storchi
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Alice Bernasconi
- Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
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Frontali A, Cohen L, Bridoux V, Myrelid P, Sica G, Poggioli G, Espin E, Beyer-Berjot L, Laharie D, Spinelli A, Zerbib P, Sampietro G, Frasson M, Louis E, Danese S, Fumery M, Denost Q, Altwegg R, Nancey S, Michelassi F, Treton X, Panis Y. Segmental Colectomy for Ulcerative Colitis: Is There a Place in Selected Patients Without Active Colitis? An International Multicentric Retrospective Study in 72 Patients. J Crohns Colitis 2020; 14:1687-1692. [PMID: 32498084 DOI: 10.1093/ecco-jcc/jjaa107] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [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] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND AIMS The aim of this study was to report a multicentric experience of segmental colectomy [SC] in ulcerative colitis [UC] patients without active colitis, in order to assess if SC can or cannot represent an alternative to ileal pouch-anal anastomosis [IPAA]. METHODS All UC patients undergoing SC were included. Postoperative complications according to ClavienDindo's classification, long term results, and risk factors for postoperative colitis and reoperation for colitis on the remnant colon, were assessed. RESULTS: A TOTAL OF 72 UC patients underwent: sigmoidectomy [n = 28], right colectomy [n = 24], proctectomy [n = 11], or left colectomy [n = 9] for colonic cancer [n = 27], 'diverticulitis' [n = 17], colonic stenosis [n = 5], dysplasia or polyps [n = 8], and miscellaneous [n = 15]. Three patients died postoperatively and 5/69 patients [7%] developed early flare of UC within 3 months after SC. After a median followup of 40 months, 24/69 patients [35%] were reoperated after a median delay after SC of 19 months [range, 2-158 months]: 22/24 [92%] underwent total colectomy and ileorectal anastomosis [n = 9] or total coloproctectomy [TCP] [n = 13] and 2/24 [8%] an additional SC. Reasons for reoperation were: colitis [n = 14; 20%], cancer [n = 3] or dysplasia [n = 3], colonic stenosis [n = 1], and unknown reasons [n = 3]. Endoscopic score of colitis before SC was Mayo 23 in 5/5 [100%] patients with early flare vs 15/42 without early flare [36%; p = 0.0101] and in 9/12 [75%] patients with reoperation for colitis vs 11/35 without reoperation [31%; p = 0.016]. CONCLUSIONS After segmental colectomy in UC patients, postoperative early colitis is rare [7%]. Segmental colectomy could possibly represent an alternative to IPAA in selected UC patients without active colitis.
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Affiliation(s)
- A Frontali
- Department of Colorectal Surgery, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, Clichy and Université de Paris, France
| | - L Cohen
- Department of Gastroenterology, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris VII, Clichy, France
| | - V Bridoux
- CHU Rouen, Digestive Surgery, Rouen, France
| | - P Myrelid
- Department of Biomedical and Clinical Sciences, Linköping University and Department of Surgery, Linköping University Hospital, Linköping Sweden
| | - G Sica
- Policlinico Tor Vergata, Digestive Surgery, Roma, Italy
| | | | - E Espin
- Hospital Universitari Val d'Hebron, Digestive Surgery, Barcelona, Spain
| | | | - D Laharie
- Department of Gastroenterology, CHU Bordeaux, Bordeaux, France
| | - A Spinelli
- Department of Colorectal Surgery, Humanitas Clinical and Research Center - IRCCS, via Manzoni 56, 20089 Rozzano, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy
| | - P Zerbib
- CHU Lille, Digestive Surgery, Lille, France
| | - G Sampietro
- Department of Surgery, IBD Unit, Luigi Sacco University Hospital, Milano, Italy
| | - M Frasson
- University Hospital La Fe, Digestive Surgery, Valencia, Spain
| | - E Louis
- CHU Liege, Gastroenterology, Liege, France
| | - S Danese
- Department of Biomedical Sciences, Humanitas University, via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy.,IBD center, Department of Gastroenterology, Humanitas Clinical and Research Center - IRCCS, via Manzoni 56, 20089 Rozzano, Milan, Italy
| | - M Fumery
- Department of Gastroenterology, CHU Amiens Picardie, Amiens, France
| | - Q Denost
- Department of Colorectal Surgery, CHU Bordeaux, Bordeaux, France
| | - R Altwegg
- Department of Gastroenterology, CHU Montpellier, Montpellier, France
| | - S Nancey
- Department of Gastroenterology, CHU Lyon, Lyon, France
| | - F Michelassi
- Department of Surgery, New York Presbyterian Hospital Weill Cornell Medical Centre, New York, NY, USA
| | - X Treton
- Department of Gastroenterology, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris VII, Clichy, France
| | - Y Panis
- Department of Colorectal Surgery, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, Clichy and Université de Paris, France
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10
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Conti S, Ferrara P, Mazzaglia G, D'Orso MI, Ciampichini R, Fornari C, Madotto F, Magoni M, Sampietro G, Silenzi A, Sileo CV, Zucchi A, Cesana G, Manzoli L, Mantovani LG. Magnitude and time-course of excess mortality during COVID-19 outbreak: population-based empirical evidence from highly impacted provinces in northern Italy. ERJ Open Res 2020; 6:00458-2020. [PMID: 33015145 PMCID: PMC7520169 DOI: 10.1183/23120541.00458-2020] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 07/10/2020] [Indexed: 01/01/2023] Open
Abstract
Background The real impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on overall mortality remains uncertain as surveillance reports have attributed a limited number of deaths to novel coronavirus disease 2019 (COVID-19) during the outbreak. The aim of this study was to assess the excess mortality during the COVID-19 outbreak in highly impacted areas of northern Italy. Methods We analysed data on deaths that occurred in the first 4 months of 2020 provided by the health protection agencies (HPAs) of Bergamo and Brescia (Lombardy), building a time-series of daily number of deaths and predicting the daily standardised mortality ratio (SMR) and cumulative number of excess deaths through a Poisson generalised additive model of the observed counts in 2020, using 2019 data as a reference. Results We estimated that there were 5740 (95% credible set (CS) 5552–5936) excess deaths in the HPA of Bergamo and 3703 (95% CS 3535–3877) in Brescia, corresponding to a 2.55-fold (95% CS 2.50–2.61) and 1.93 (95% CS 1.89–1.98) increase in the number of deaths. The excess death wave started a few days later in Brescia, but the daily estimated SMR peaked at the end of March in both HPAs, roughly 2 weeks after the introduction of lockdown measures, with significantly higher estimates in Bergamo (9.4, 95% CI 9.1–9.7). Conclusion Excess mortality was significantly higher than that officially attributed to COVID-19, disclosing its hidden burden likely due to indirect effects on the health system. Time-series analyses highlighted the impact of lockdown restrictions, with a lower excess mortality in the HPA where there was a smaller delay between the epidemic outbreak and their enforcement. This study identifies another important element to research on #SARSCoV2 and provides actionable strategies to quantify the excess mortality due to #COVID19 spread, which has public health and research implications to minimise the disease impacthttps://bit.ly/3jbKXAW
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Affiliation(s)
- Sara Conti
- Center for Public Health Research, University of Milano - Bicocca, Monza, Italy
| | - Pietro Ferrara
- Center for Public Health Research, University of Milano - Bicocca, Monza, Italy
| | - Giampiero Mazzaglia
- Center for Public Health Research, University of Milano - Bicocca, Monza, Italy
| | - Marco I D'Orso
- Center for Public Health Research, University of Milano - Bicocca, Monza, Italy
| | | | - Carla Fornari
- Center for Public Health Research, University of Milano - Bicocca, Monza, Italy
| | - Fabiana Madotto
- Center for Public Health Research, University of Milano - Bicocca, Monza, Italy.,Value-based Healthcare Unit, IRCCS Multimedica, Sesto San Giovanni, Italy
| | - Michele Magoni
- Health Protection Agency of Brescia (ATS Brescia), Brescia, Italy
| | | | - Andrea Silenzi
- Health Protection Agency of Brescia (ATS Brescia), Brescia, Italy.,Center for Leadership in Medicine Research and Studies, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Claudio V Sileo
- Health Protection Agency of Brescia (ATS Brescia), Brescia, Italy
| | - Alberto Zucchi
- Health Protection Agency of Bergamo (ATS Bergamo), Bergamo, Italy
| | - Giancarlo Cesana
- Center for Public Health Research, University of Milano - Bicocca, Monza, Italy
| | | | - Lorenzo G Mantovani
- Center for Public Health Research, University of Milano - Bicocca, Monza, Italy.,Value-based Healthcare Unit, IRCCS Multimedica, Sesto San Giovanni, Italy
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11
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Pezzolo E, Ciampichini R, Cazzaniga S, Sampietro G, Zucchi A, Naldi L. Psoriasis severity matters when dealing with all-cause mortality in psoriasis patients: a record linkage analysis in Northern Italy. Arch Dermatol Res 2020; 313:255-261. [PMID: 32627048 DOI: 10.1007/s00403-020-02101-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 06/19/2020] [Accepted: 06/30/2020] [Indexed: 10/23/2022]
Abstract
Psoriasis has been linked with several comorbidities and increased all-cause mortality compared with the general population. Data are still limited concerning mortality especially from Southern European countries. Between January 2012 and December 2018, we conducted a retrospective cohort study on psoriasis patients and population controls in Northern Italy. Through record linkage of health-care databases, psoriasis cases were identified, and their morbidity and mortality were compared with the general population. The Charlson index was used as an index of comorbidities. Standardized mortality ratios (SMR) were estimated for overall psoriasis cases and for patients with mild vs moderate-to-severe disease, separately. We identified 12,693 psoriasis patients (mean age: 60.8 ± 16.3 years). They had a significantly higher Charlson index compared with the general population (p < 0.001). In spite of the higher rate of comorbidities, age-specific SMR was not increased in the psoriasis population as a whole (1.04 (95% CI 0.89-1.20)) or in people with mild psoriasis. However, a 40% higher than the expected risk of all-cause mortality was documented in individuals with moderate-to-severe psoriasis (SMR: 1.41; 95% CI 1.12-1.75). Notably, an excess mortality in these patients occurred as early as age 40-49 years. The proportion of deaths from malignancies and cardiovascular diseases was remarkably high. Our results support the notion that psoriasis severity influences mortality and indicate that patients with psoriasis, especially those with severe disease, should receive appropriate screening and health education.
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Affiliation(s)
- Elena Pezzolo
- Department of Epidemiology, Erasmus MC University of Rotterdam, Rotterdam, The Netherlands.,Study Center of the Italian Group for Epidemiologic Research in Dermatology (GISED), Via Clara Maffei 4, 24121, Bergamo, Italy.,Department of Dermatology, San Bortolo Hospital, Vicenza, Italy
| | - Roberta Ciampichini
- Department of Epidemiology, Health Protection Agency of Bergamo, Bergamo, Italy
| | - Simone Cazzaniga
- Study Center of the Italian Group for Epidemiologic Research in Dermatology (GISED), Via Clara Maffei 4, 24121, Bergamo, Italy.,Department of Dermatology, Inselspital University Hospital of Bern, Bern, Switzerland
| | - Giuseppe Sampietro
- Department of Epidemiology, Health Protection Agency of Bergamo, Bergamo, Italy
| | - Alberto Zucchi
- Department of Epidemiology, Health Protection Agency of Bergamo, Bergamo, Italy
| | - Luigi Naldi
- Study Center of the Italian Group for Epidemiologic Research in Dermatology (GISED), Via Clara Maffei 4, 24121, Bergamo, Italy. .,Department of Dermatology, San Bortolo Hospital, Vicenza, Italy.
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12
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Bernasconi A, Barigelletti G, Tittarelli A, Botta L, Gatta G, Tagliabue G, Contiero P, Guzzinati S, Andreano A, Manneschi G, Falcini F, Castaing M, Filiberti RA, Gasparotti C, Cirilli C, Mazzucco W, Mangone L, Iacovacci S, Vitale MF, Stracci F, Piffer S, Tumino R, Carone S, Sampietro G, Melcarne A, Ballotari P, Boschetti L, Pisani S, Cavalieri D'Oro L, Cuccaro F, D'Argenzio A, D'Orsi G, Fanetti AC, Ardizzone A, Candela G, Savoia F, Pascucci C, Castelli M, Storchi C, Trama A. Adolescent and Young Adult Cancer Survivors: Design and Characteristics of the First Nationwide Population-Based Cohort in Italy. J Adolesc Young Adult Oncol 2020; 9:586-593. [PMID: 32283044 DOI: 10.1089/jayao.2019.0170] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 11/12/2022] Open
Abstract
Purpose: Adolescent and young adult (AYA, 15-39 years) cancer survivors (alive at least 5 years after cancer diagnosis) are less studied than younger and older cancer survivors and research on their late effects is limited. To facilitate research on long-term outcomes of AYA cancer survivors, we established, in Italy, a population-based AYA cancer survivors' cohort. This article describes the study design and main characteristics of this cohort. Methods: The cohort derives from population-based cancer registries (CRs). Each CR identified AYA cancer patients retrospectively. Treatment for first primary cancer and all health events from diagnosis to death can be traced through linkage with available health databases, such as hospital discharge records (HDRs), mortality files, and outpatient and pharmaceutical databases. Results: Thirty-four CRs participated to the cohort which overall includes 93,291 AYAs with cancer and 67,692 cancer survivors. First primary cancer distribution in AYA cancer survivors differs by sex and age groups because of the different cancer types diagnosed in AYAs. Almost 78% of AYA cancer survivors have HDRs and 14.8% also pharmaceutical and outpatient databases. Conclusion: This cohort will be used to study, for the first time in Italy, the pattern and excess risk of late effects in AYA cancer survivors. HDRs, outpatient and pharmaceutical databases will be used to define primary treatment to assess its impact on AYA cancer survivors' late effects. This cohort exploiting data sources already available at CRs, minimize the data collection effort and it will contribute to assess the feasibility of using administrative database to study cancer survivors' late effects.
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Affiliation(s)
- Alice Bernasconi
- Department of Research, Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Giulio Barigelletti
- Department of Research, Cancer Registry Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Andrea Tittarelli
- Department of Research, Cancer Registry Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Laura Botta
- Department of Research, Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Gemma Gatta
- Department of Research, Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Giovanna Tagliabue
- Department of Research, Cancer Registry Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Paolo Contiero
- Department of Research, Environmental Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | | | - Anita Andreano
- Epidemiology Unit, Agency for Health Protection (ATS) of Milan, Milan, Italy
| | - Gianfranco Manneschi
- Clinical Epidemiology Unit, Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO), Firenze, Italy
| | - Fabio Falcini
- Department of Clinical and Experimental Oncology and Ematology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Marine Castaing
- Integrated Cancer Registry of Catania-Messina-Siracusa-Enna, Department of Hygiene and Public Health, Università di Catania, Catania, Italy
| | | | | | | | - Walter Mazzucco
- Department of Medicine and Surgery, Università degli Studi di Palermo, Palermo, Italy
| | - Lucia Mangone
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | | | - Fabrizio Stracci
- Department of Experimental Medicine, Università degli studi di Perugia, Perugia, Italy
| | - Silvano Piffer
- Evaluative and Clinical Epidemiological Service, Azienda provinciale per i servizi sanitari Trento, Italy
| | - Rosario Tumino
- Cancer Registry and Histopathology Unit, ASP Ragusa, Ragusa, Italy
| | - Simona Carone
- Taranto Cancer Registry, ASL Taranto, Taranto, Italy
| | | | - Anna Melcarne
- Cancer Registry Epidemiology Unit, ASL Lecce, Lecce, Italy
| | | | - Lorenza Boschetti
- Epidemiologic Observatory, Cancer Registry, ATS di Pavia, Pavia, Italy
| | | | - Luca Cavalieri D'Oro
- Epidemiology Unit, Agenzia per la Tutela della Salute della Brianza, Monza, Italy
| | | | | | | | | | - Antonino Ardizzone
- Statistic and Epidemiology Unit, Cancer Registry, ASL Brindisi, Brindisi, Italy
| | | | - Fabio Savoia
- Childhood Cancer Registry of Campania Region, AORN Santobono Pausilipon, Napoli, Italy
| | - Cristiana Pascucci
- Department of Experimental Medicine and Public Health, Università di Camerino, Camerino, Italy
| | | | - Cinzia Storchi
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Annalisa Trama
- Department of Research, Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
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13
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Mancini S, Bucchi L, Baldacchini F, Giuliani O, Ravaioli A, Vattiato R, Preti M, Tumino R, Ferretti S, Biggeri A, Brustolin A, Boschetti L, Caiazzo AL, Caldarella A, Cesaraccio R, Cirilli C, Citarella A, Filiberti RA, Fusco M, Galasso R, Gatti L, Lotti FL, Magoni M, Mangone L, Masanotti G, Mazzoleni G, Mazzucco W, Melcarne A, Michiara M, Pesce P, Piffer S, Pinto A, Rognoni M, Rosso S, Rugge M, Sampietro G, Scalzi S, Scuderi T, Tagliabue G, Tisano F, Toffolutti F, Vitarelli S, Falcini F. Incidence trends of vulvar squamous cell carcinoma in Italy from 1990 to 2015. Gynecol Oncol 2020; 157:656-663. [PMID: 32273199 DOI: 10.1016/j.ygyno.2020.03.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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: 12/16/2019] [Accepted: 03/08/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The incidence of vulvar squamous cell carcinoma has increased for decades in most Western countries - a trend virtually restricted to women aged <50 or 60 years. In southern Europe, conversely, the trends have been insufficiently studied. This article reports a study from Italy. METHOD Thirty-eight local cancer registries, currently covering 15,274,070 women, equivalent to 49.2% of the Italian national female population, participated. Invasive cancers registered between 1990 and 2015 with an International Classification of Diseases for Oncology, 3rd revision, topography code C51 and morphology codes compatible with vulvar squamous cell carcinoma (n = 6294) were eligible. Incidence trends were analysed using joinpoint regression models, with calculation of the estimated annual percent change (EAPC), and age-period-cohort models. RESULTS Total incidence showed a regular and significant decreasing trend (EAPC, -0.96; 95% confidence interval (CI), -1.43 to -0.48). This was entirely accounted for by women aged ≥60 years (EAPC, -1.34; 95% CI, -1.86 to -0.81). For younger women, the EAPC between 1990 and 2012 was 1.20 (95% CI, 0.34 to 2.06) with a non-significant acceleration thereafter. This pattern did not vary substantially in a sensitivity analysis for the effect of geographic area and duration of the registry. The age-period-cohort analysis revealed a risk decrease in cohorts born between 1905 and 1940 and a new increase in cohorts born since 1945. CONCLUSIONS The decreasing trend observed among older women and the resulting decrease in total rate are at variance with reports from most Western countries. Age-period-cohort analysis confirmed a decreasing trend for earliest birth cohorts and an opposite one for recent ones.
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Affiliation(s)
- Silvia Mancini
- Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy
| | - Lauro Bucchi
- Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy
| | - Flavia Baldacchini
- Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy
| | - Orietta Giuliani
- Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy
| | - Alessandra Ravaioli
- Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy.
| | - Rosa Vattiato
- Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy
| | - Mario Preti
- Department of Obstetrics and Gynaecology, University of Torino, Torino, Italy
| | - Rosario Tumino
- Cancer Registry and Histopathology Department, Provincial Health Authority (ASP), Ragusa, Italy
| | | | - Annibale Biggeri
- Department of Statistics, Computer Science, Applications G. Parenti, University of Florence, Florence, Italy
| | - Angelita Brustolin
- Unit of Epidemiology and Cancer Registry, Local Health Authority, Viterbo, Italy
| | | | - Anna L Caiazzo
- Cancer Registry of Local Health Authority Salerno, Salerno, Italy
| | - Adele Caldarella
- Tuscany Cancer Registry, Clinical and Descriptive Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Rosaria Cesaraccio
- Sassari Cancer Registry, Azienda Regionale per la Tutela della Salute - ATS, Sassari, Italy
| | - Claudia Cirilli
- Modena Cancer Registry, Public Health Department, Local Health Authority, Modena, Italy
| | - Annarita Citarella
- Cancer Registry, Department of Prevention, Unit of Epidemiology, Local Health Authority, Benevento, Italy
| | - Rosa A Filiberti
- Liguria Cancer Registry, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | | | - Rocco Galasso
- Unit of Regional Cancer Registry, Clinical Epidemiology and Biostatistics, IRCCS-CROB, Basilicata, Rionero in Vulture, Italy
| | - Luciana Gatti
- Mantova Cancer Registry, Epidemiology Unit, Agenzia di Tutela della Salute (ATS) della Val Padana, Mantova, Italy
| | - Fernanda L Lotti
- Brindisi Cancer Registry, Local Health Authority, Brindisi, Italy
| | - Michele Magoni
- Cancer Registry of Brescia Province, Epidemiology Unit, Brescia Health Protection Agency, Brescia, Italy
| | - Lucia Mangone
- Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Amendola 2, 42122 Reggio Emilia, Italy
| | - Giuseppe Masanotti
- Section of Public Health and RTUP Register, Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | | | - Walter Mazzucco
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | | | - Maria Michiara
- Parma Cancer Registry, Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - Paola Pesce
- Catania, Messina, and Enna Cancer Registry, Catania, Italy
| | - Silvano Piffer
- Trento Province Cancer Registry, Unit of Clinical Epidemiology, Trento, Italy
| | - Angela Pinto
- Barletta, Andria, Trani Cancer Registry, BAT Province, Barletta, Italy
| | - Magda Rognoni
- Epidemiology Unit, Cancer Registry of ATS Brianza, Health Protection Agency, Monza, Italy
| | - Stefano Rosso
- Piedmont Cancer Registry, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
| | - Massimo Rugge
- Veneto Tumour Registry, Azienda Zero, University of Padova-DIMED, Padova, Italy
| | | | | | | | - Giovanna Tagliabue
- Lombardy Cancer Registry-Varese Province, Cancer Registry Unit, Department of Research, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | | | - Federica Toffolutti
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Susanna Vitarelli
- Macerata Province Cancer Registry, University of Camerino, Camerino, Italy
| | - Fabio Falcini
- Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy; Cancer Prevention Unit, Local Health Authority, Forlì, Italy
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Mege D, Colombo F, Stellingwerf ME, Germain A, Maggiori L, Foschi D, Buskens CJ, de Buck van Overstraeten A, Sampietro G, D'Hoore A, Bemelman W, Panis Y. Risk Factors for Small Bowel Obstruction After Laparoscopic Ileal Pouch-Anal Anastomosis for Inflammatory Bowel Disease: A Multivariate Analysis in Four Expert Centres in Europe. J Crohns Colitis 2019; 13:294-301. [PMID: 30312385 DOI: 10.1093/ecco-jcc/jjy160] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS Although laparoscopy is associated with a reduction in adhesions, no data are available about the risk factors for small bowel obstruction [SBO] after laparoscopic ileal pouch-anal anastomosis [IPAA]. Our aims here were to identify the risk factors for SBO after laparoscopic IPAA for inflammatory bowel disease [IBD]. METHODS All consecutive patients undergoing laparoscopic IPAA for IBD in four European expert centres were included and divided into Groups A [SBO during follow-up] and B [no SBO]. RESULTS From 2005 to 2015, SBO occurred in 41/521 patients [Group A; 8%]. Two-stage IPAA was more frequently complicated by SBO than 3- and modified 2-stage IPAA [12% vs 7% and 4%, p = 0.04]. After multivariate analysis, postoperative morbidity (odds ratio [OR] = 3, 95% confidence interval [CI] = 1.5-7, p = 0.002), stoma-related complications [OR = 3, 95% CI = 1-6, p = 0.03] and long-term incisional hernia [OR = 6, 95% CI = 2-18, p = 0.003] were predictive factors for SBO, while subtotal colectomy as first surgery was an independent protective factor [OR = 0.4, 95% CI = 0.2-0.8, p = 0.002]. In the subgroup of patients receiving restorative proctocolectomy as first operation, stoma-related or other surgical complications and long-term incisional hernia were predictive of SBO. In the patient subgroup of subtotal colectomy as first operation, postoperative morbidity and long-term incisional hernia were predictive of SBO, whereas ulcerative colitis and a laparoscopic approach during the second surgical stage were protective factors. CONCLUSIONS We found that SBO occurred in less than 10% of patients after laparoscopic IPAA. The study also suggested that modified 2-stage IPAA could potentially be safer than procedures with temporary ileostomy [2- and 3-stage IPAA] in terms of SBO occurrence.
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Affiliation(s)
- D Mege
- Department of Colorectal Surgery, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris VII, Clichy, France
| | - F Colombo
- Department of Surgery, Luigi Sacco University Hospital, Milan, Italy
| | - M E Stellingwerf
- Department of Surgery, Academic Medical Center, Amsterdam, the Netherlands
| | - A Germain
- Department of Abdominal Surgery, University Hospitals Leuven, Leuven, Belgium
| | - L Maggiori
- Department of Colorectal Surgery, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris VII, Clichy, France
| | - D Foschi
- Department of Surgery, Luigi Sacco University Hospital, Milan, Italy
| | - C J Buskens
- Department of Surgery, Academic Medical Center, Amsterdam, the Netherlands
| | | | - G Sampietro
- Department of Surgery, Luigi Sacco University Hospital, Milan, Italy
| | - A D'Hoore
- Department of Abdominal Surgery, University Hospitals Leuven, Leuven, Belgium
| | - W Bemelman
- Department of Surgery, Academic Medical Center, Amsterdam, the Netherlands
| | - Y Panis
- Department of Colorectal Surgery, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris VII, Clichy, France
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15
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Carugno M, Imbrogno P, Zucchi A, Ciampichini R, Tereanu C, Sampietro G, Barbaglio G, Pesenti B, Barretta F, Bertazzi PA, Pesatori AC, Consonni D. Effects of aircraft noise on annoyance, sleep disorders, and blood pressure among adult residents near the Orio al Serio International Airport (BGY), Italy. Med Lav 2018. [PMID: 30168498 DOI: 10.23749/mdl.vl09i4.7271] [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] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
BACKGROUND Aircraft noise may cause several non-auditory health effects, including annoyance, sleep disorders, hypertension, cardiovascular diseases, and impaired cognitive skills in children. OBJECTIVES To perform a cross-sectional study among adult residents near the Orio al Serio International Airport (BGY), Italy to investigate the association between aircraft noise, annoyance, sleep disorders, blood pressure levels, and prevalence of hypertension. METHODS Residential addresses of subjects aged 45-70 years were geocoded and classified in three groups according to noise levels: <60 (Reference), 60-65 (Zone A), and 65-75 dBA (Zone B). A sample of subjects was invited to undergo a personal interview and blood pressure measurements. Multiple linear and robust Poisson regression models were used to analyze quantitative and categorical variables, respectively. RESULTS Between June and September 2013, we enrolled 400 subjects (166 in the Reference Zone, 164 in Zone A, and 70 in Zone B). Compared to the Reference Zone, we found elevated adjusted annoyance scores (day and night) in Zone A (+2.7) and Zone B (+4.0) (p<0.001) and about doubled proportions of severely annoyed subjects (p<0.001). Reported sleep disorders in the previous month were also more frequent in Zones A and B. Sleep disorders in general were 19.9% in the Reference Zone, 29.9% in Zone A, and 35.7% in Zone B (p<0.001). CONCLUSIONS We found a strong association between aircraft noise levels, annoyance, and sleep disorders among adult residents near the Orio al Serio International Airport. We found no relationship with blood pressure levels and prevalence of hypertension.
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Affiliation(s)
- Michele Carugno
- Dipartimento di Scienze Cliniche e di Comunità, Università degli Studi di Milano.
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16
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Carugno M, Imbrogno P, Zucchi A, Ciampichini R, Tereanu C, Sampietro G, Barbaglio G, Pesenti B, Barretta F, Bertazzi PA, Pesatori AC, Consonni D. Effects of aircraft noise on annoyance, sleep disorders, and blood pressure among adult residents near the Orio al Serio International Airport (BGY), Italy. Med Lav 2018; 109:253-263. [PMID: 30168498 PMCID: PMC7682165 DOI: 10.23749/mdl.v109i4.7271] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 07/12/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND Aircraft noise may cause several non-auditory health effects, including annoyance, sleep disorders, hypertension, cardiovascular diseases, and impaired cognitive skills in children. OBJECTIVES To perform a cross-sectional study among adult residents near the Orio al Serio International Airport (BGY), Italy to investigate the association between aircraft noise, annoyance, sleep disorders, blood pressure levels, and prevalence of hypertension. METHODS Residential addresses of subjects aged 45-70 years were geocoded and classified in three groups according to noise levels: <60 (Reference), 60-65 (Zone A), and 65-75 dBA (Zone B). A sample of subjects was invited to undergo a personal interview and blood pressure measurements. Multiple linear and robust Poisson regression models were used to analyze quantitative and categorical variables, respectively. RESULTS Between June and September 2013, we enrolled 400 subjects (166 in the Reference Zone, 164 in Zone A, and 70 in Zone B). Compared to the Reference Zone, we found elevated adjusted annoyance scores (day and night) in Zone A (+2.7) and Zone B (+4.0) (p<0.001) and about doubled proportions of severely annoyed subjects (p<0.001). Reported sleep disorders in the previous month were also more frequent in Zones A and B. Sleep disorders in general were 19.9% in the Reference Zone, 29.9% in Zone A, and 35.7% in Zone B (p<0.001). CONCLUSIONS We found a strong association between aircraft noise levels, annoyance, and sleep disorders among adult residents near the Orio al Serio International Airport. We found no relationship with blood pressure levels and prevalence of hypertension.
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Affiliation(s)
- Michele Carugno
- Dipartimento di Scienze Cliniche e di Comunità, Università degli Studi di Milano.
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Gamba S, Raffaeli D, Marchetti M, Russo L, Tartari C, Giaccherini C, Verzeroli C, Milesi V, Brevi S, Sampietro G, Malighetti P, Spinelli D, Falanga A. Hypercoagulable State as innovative tool for risk assessment and early cancer diagnosis: Data from HYPERCAN Prospective Study. Thromb Res 2018. [DOI: 10.1016/j.thromres.2018.02.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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18
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Tereanu C, Smith SA, Ghelase MS, Sampietro G, Molnar A, Dragoescu A, Furtunescu FL, Stanescu C, Gavrila OA, Patrascu A, Golli AL, Dragomir M. Psychometric Properties of the Romanian Version of the Hospital Survey on Patient Safety Culture (HSOPS). Maedica (Bucur) 2018; 13:34-43. [PMID: 29868138 PMCID: PMC5972785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To explore psychometrics of the Romanian version of the Hospital Survey on Patient Safety Culture (HSOPS) released by the US Agency for Healthcare Research and Quality in 2004. MATERIAL AND METHODS The original US survey with 12 composites and 42 items was translated (back translation method), pre-tested on a few staff and then minimally adjusted. A qualitative cross-sectional study was carried out in units from six hospitals in four Romanian regions, based on the census of medical and non-medical staff (n. 969). Participants completed a paper-based self-administered questionnaire. The main outcome measures were: descriptive statistics, confirmatory factor analysis (CFA), internal reliability and intercorrelations among survey composites. RESULTS Nurses accounted for 67% of respondents, and doctors for 23%. Most work units were surgery (24%) and medical specialties (22%). After individual-level CFA on half of the sample, Staffing and Overall perceptions of patient safety composites were dropped and Feedback & communication about error and Communication openness composite items were aggregated to a single Communication composite. Subsequent CFA on the second half of the sample indicated that the novel composite structure adequately fitted the data: comparative fit index=0.90; root mean square error of approximation=0.06; standardized root mean square residual=0.06. Internal consistency was .0.70 for most composites. Spearman intercorrelations among the patient safety composites at the individual level averaged 0.28. CONCLUSION Psychometrics of the Romanian version of the HSOPS tested in Romania was acceptable for nine composites with 31 items. Integration of this survey with items more pertinent for Romania is suggested.
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Affiliation(s)
- Carmen Tereanu
- Department of Hygiene and Prevention, Agenzia di Tutela della Salute, Bergamo, Italy
| | | | - Mugurel Stefan Ghelase
- Department of Public Health and Healthcare Management, University of Medicine and Pharmacy of Craiova, Romania
| | | | - Adrian Molnar
- Management, "Niculae Stancioiu" Heart Institute, Cluj-Napoca, Romania
| | - Antoaneta Dragoescu
- Department of Public Health and Healthcare Management, University of Medicine and Pharmacy of Bucharest, Romania
| | - Florentina Ligia Furtunescu
- Department of Public Health and Healthcare Management, University of Medicine and Pharmacy of Bucharest, Romania
| | - Camelia Stanescu
- System Engineer, "Niculae Stancioiu" Heart Institute, Cluj-Napoca, Romania
| | | | - Anca Patrascu
- Head Obstetrics and Gynaecologic Unit, Filantropia Hospital, Craiova, Romania
| | - Andreea Loredana Golli
- Department of Public Health and Healthcare Management, University of Medicine and Pharmacy of Craiova, Romania
| | - Manuela Dragomir
- Department of Public Health and Healthcare Management, University of Medicine and Pharmacy of Craiova, Romania
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Tereanu C, Sampietro G, Sarnataro F, Siscanu D, Palaria R, Savin V, Cliscovscaia T, Pislaru V, Oglinda V, Capmare L, Ghelase MS, Turcanu T. Survey on patient safety culture in the Republic of Moldova: a baseline study in three healthcare settings. Clujul Med 2018; 91:65-74. [PMID: 29456450 PMCID: PMC5808270 DOI: 10.15386/cjmed-869] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 10/20/2017] [Accepted: 11/06/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND AIMS The Republic of Moldova is a small ex-soviet country in the Central Eastern European group of states, whose official language is Romanian. In countries with limited resources, quality improvement in healthcare and patient safety are very challenging. This study aims to identify which areas of the patient safety culture (PSC) need prompt intervention. METHODS A cross-sectional study was conducted in three Moldovan healthcare settings, using the Romanian translation of the US Hospital Survey on Patient Safety Culture HSOPSC. Descriptive statistics were carried out, based on the responses from n. 929 staff. Percentages of positive responses (PPRs) by item (41 items) and composite (12 PSC areas) were computed. RESULTS Most respondents were nurses (53%), followed by doctors (35%). The main work areas were: primary care (27%), medical specialties (20%), gynecology and obstetrics (16%), and general surgery (11%). The highest composite PPRs were for: teamwork within units (80%), feedback & communication about error, organizational learning-continuous improvement and supervisor/manager expectations & actions promoting patient safety (78%), and management support for patient safety (75%). The lowest composites were for: frequency of events reported (57%), non-punitive response to errors (53%), communication openness (51%) and staffing (37%). CONCLUSION Our results suggest that staffing issues should be tackled to provide safe care. Staff avoid to openly report adverse events and/or discuss errors, likely because a poor understanding of the potential of these events for learning and because of fear of blame or punitive actions. Future research should check psychometrics of the Romanian version of the HSOPSC applied to Moldovan staff.
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Affiliation(s)
- Carmen Tereanu
- Department of Hygiene and Prevention, Agenzia di Tutela della Salute, Bergamo, Italy
| | | | - Francesco Sarnataro
- Department of Hygiene and Prevention, Agenzia di Tutela della Salute, Bergamo, Italy
| | - Dumitru Siscanu
- Consultative Unit of the Perinatology Center, Municipal Clinical Hospital 1, Chisinau, Republic of Moldova
| | - Rodica Palaria
- Quality Management, Municipal Clinical Hospital 1, Chisinau, Republic of Moldova
| | - Victor Savin
- Municipal Clinical Hospital 1, Chisinau, Republic of Moldova
| | | | | | | | | | - Mugurel Stefan Ghelase
- Department of Public Health and Healthcare Management, University of Medicine and Pharmacy of Craiova, Romania
| | - Tamara Turcanu
- Department of Pediatrics, Nicolae Testemitanu University of Medicine and Pharmacy of Chisinau, Republic of Moldova
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20
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Gamba S, Raffaeli D, Marchetti M, Russo L, Tartari C, Giaccherini C, Verzeroli C, Milesi V, Brevi S, Diani E, Vignoli A, Sampietro G, Malighetti P, Spinelli D, Falanga A. Hypercoagulable state as marker of occult cancer in healthy blood donors: data from HYPERCAN Prospective Study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx433.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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21
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Tereanu C, Sampietro G, Sarnataro F, Mazzoleni G, Pesenti B, Sala L, Cecchetti R, Arvati M, Brioschi D, Viscardi M, Prati C, Sala G, Barbaglio G. Exploring patient safety culture in preventive medicine settings: an experience from Northern Italy. J Prev Med Hyg 2017; 58:E121-E129. [PMID: 28900352 PMCID: PMC5584081] [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] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Patient safety and quality in healthcare are inseparable. Examining patient safety culture in staff members contributes to further develop quality in healthcare. In Italy there has been some experience in assessing patient safety culture in staff working in hospital. In this pilot study we explored patient safety culture in public health staff working in Italian Local Health Authorities. METHODS We carried out a descriptive cross sectional study in four Italian territorial Prevention facilities in Northern Italy. We administrated an adapted Italian version of the US Hospital Survey of Patient Safety Culture to all the staff within these facilities. The survey consisted of 10 dimensions based on 33 items, according to the results of a previous psychometric validation. RESULTS Seventy per cent of the staff responded to the survey (N = 479). Overall, six out of the 10 dimensions exhibited composite scores of positive response frequency for patient safety culture below 50%. While "communication openness" (65%) was the most developed factor, "teamwork across Units" (37%) was the least developed. The work areas with the highest composite scores were Management and the Public Health Laboratory, while in terms of professional categories, Physicians had the highest scores. Patient safety culture in the staff participating in this study was lower than in hospital staff. DISCUSSION Our descriptive cross sectional study is the first to be carried out in Preventive medicine settings in Italy. It has clearly indicated the need of improvement. Consequently, several interventions with this aim have been implemented.
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Affiliation(s)
- C. Tereanu
- Department of Hygiene and Prevention, Agenzia di Tutela della Salute Bergamo, Italy;,Correspondence: Carmen Tereanu, Department of Hygiene and Prevention, Agenzia di Tutela della Salute Bergamo, via Borgo Palazzo 130, 24125 Bergamo, Italy - E-mail:
| | - G. Sampietro
- Epidemiology Service, Agenzia di Tutela della Salute Bergamo, Italy
| | - F. Sarnataro
- Department of Hygiene and Prevention, Agenzia di Tutela della Salute Bergamo, Italy
| | - G. Mazzoleni
- Azienda Socio-Sanitaria Territoriale, Bergamo Est, Italy
| | - B. Pesenti
- Department of Hygiene and Prevention, Agenzia di Tutela della Salute Bergamo, Italy
| | - L.C. Sala
- Department of Prevention, Local Health Authority of Biella, Italy
| | - R. Cecchetti
- Department of Medical Prevention, Agenzia di Tutela della Salute Brianza, Italy
| | - M. Arvati
- Department of Medical Prevention, Agenzia di Tutela della Salute Val Padana, Italy
| | - D. Brioschi
- Department of Teaching and Communication, Local Health Authority of Biella, Italy
| | - M. Viscardi
- Department of Medical Prevention, Agenzia di Tutela della Salute Brianza, Italy
| | - C. Prati
- Department of Medical Prevention, Agenzia di Tutela della Salute Val Padana, Italy
| | - G. Sala
- Research and Evaluation Officer, COOPI - Cooperazione Internazionale, Niamey, Niger
| | - G.G. Barbaglio
- MD, Medical Management, Agenzia di Tutela della Salute Bergamo, Italy
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Tereanu C, Smith SA, Sampietro G, Sarnataro F, Mazzoleni G, Pesenti B, Sala LC, Cecchetti R, Arvati M, Brioschi D, Viscardi M, Prati C, Barbaglio GG. Experimenting the hospital survey on patient safety culture in prevention facilities in Italy: psychometric properties. Int J Qual Health Care 2017; 29:269-275. [PMID: 28453829 DOI: 10.1093/intqhc/mzx014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 01/30/2017] [Indexed: 11/13/2022] Open
Abstract
Objective The Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture (HSOPS) was designed to assess staff views on patient safety culture in hospital. This study examines psychometrics of the Italian translation of the HSOPS for use in territorial prevention facilities. Design After minimal adjustments and pre-test of the Italian version, a qualitative cross-sectional study was carried out. Setting Departments of Prevention (DPs) of four Local Health Authorities in Northern Italy. Participants Census of medical and non-medical staff (n. 479). Intervention Web-based self-administered questionnaire. Main outcome measures Descriptive statistics, internal reliability, Confirmatory Factor Analysis (CFA) and intercorrelations among survey composites. Results Initial CFA of the 12 patient safety culture composites and 42 items included in the original version of the questionnaire revealed that two dimensions (Staffing and Overall Perception of Patient Safety) and nine individual items did not perform well among Italian territorial Prevention staff. After dropping those composites and items, psychometric properties were acceptable (comparative fit index = 0.94; root mean square error of approximation = 0.04; standardized root mean square residual = 0.04). Internal consistency for each remaining composite met or exceeded the criterion 0.70. Intercorrelations were all statistically significant. Conclusions Psychometric analyses provided overall support for 10 of the 12 initial patient safety culture composites and 33 of the 42 initial composite items. Although the original instrument was intended for US Hospitals, the Italian translation of the HSOPS adapted for use in territorial prevention facilities performed adequately in Italian DPs.
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Affiliation(s)
- Carmen Tereanu
- Department of Hygiene and Prevention, Agenzia di Tutela della Salute, Via Borgo Palazzo n. 130, 24125 Bergamo, Italy
| | - Scott A Smith
- Westat, Rockville, 1600 Research Blvd., RB 1194 Rockville, MD 20850, USA
| | - Giuseppe Sampietro
- Epidemiology Service, Agenzia di Tutela della Salute, Via Francesco Gallicciolli 4, 24121 Bergamo, Italy
| | - Francesco Sarnataro
- Department of Hygiene and Prevention, Agenzia di Tutela della Salute, Via Borgo Palazzo n. 130, 24125 Bergamo, Italy
| | - Giuliana Mazzoleni
- Azienda Socio-Sanitaria Territoriale, Bergamo Est, Via Paderno 21, 24068 Seriate, Italy
| | - Bruno Pesenti
- Department of Hygiene and Prevention, Agenzia di Tutela della Salute, Via Borgo Palazzo n. 130, 24125 Bergamo, Italy
| | - Luca C Sala
- Department of Prevention, Local Health Authority, Via don Sturzo 20, 13900 Biella, Italy
| | - Roberto Cecchetti
- Department of Medical Prevention, Agenzia di Tutela della Salute della Brianza, Viale Elvetia 2, 20900 Monza, Italy
| | - Massimo Arvati
- Department of Medical Prevention, Agenzia di Tutela della Salute della Val Padana, Via dei Toscani 1, 46100 Mantova, Italy
| | - Dania Brioschi
- Department of Teaching and Communication, Local Health Authority, Via don Sturzo 20, 13900 Biella, Italy
| | - Michela Viscardi
- Department of Medical Prevention, Agenzia di Tutela della Salute della Brianza, Viale Elvetia 2, 20900 Monza, Italy
| | - Chiara Prati
- Department of Medical Prevention, Agenzia di Tutela della Salute della Val Padana, Via dei Toscani 1, 46100 Mantova, Italy
| | - Giorgio G Barbaglio
- Medical Management, Agenzia di Tutela della Salute, Via Francesco Gallicciolli 4, 24121 Bergamo, Italy
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Andreano A, Anghinoni E, Autelitano M, Bellini A, Bersani M, Bizzoco S, Cavalieri d'Oro L, Decarli A, Lucchi S, Mannino S, Panciroli E, Rebora P, Rognoni M, Sampietro G, Villa M, Zocchetti C, Zucchi A, Valsecchi MG, Russo AG. Indicators based on registers and administrative data for breast cancer: routine evaluation of oncologic care pathway can be implemented. J Eval Clin Pract 2016; 22:62-70. [PMID: 26290172 DOI: 10.1111/jep.12436] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [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] [Accepted: 07/15/2015] [Indexed: 01/16/2023]
Abstract
RATIONALE, AIMS AND OBJECTIVES Assuring the best standards of care - in a sustainable way - in chronic diseases as breast cancer is nowadays an important challenge for any health system. The aim of this study was to present the methodology used to define a set of quality indicators, computable from administrative data for the pathway of care of breast cancer, and its application at a population level. METHOD The cohort of 2007-2009 incident cases of breast cancer was identified through a network of six cancer registers in Northern Italy. Cases of sarcoma and lymphoma, patients with multiple primary cancers and those metastatic at diagnosis were excluded; 9614 women were retained for the analysis. For each indicator, the sub-cohort of women eligible for the diagnostic/therapeutic procedures was identified and calculations were performed through record linkage between the cohort and sources of health information. Data on potential available confounders or prognostic factors were also collected. RESULTS For a few indicators, such as cyto-histological assessment before surgery (62%) and intensive follow-up (79%), deviation from recommendations was evident. Younger patients (≤50 years) more frequently needed a short term re-intervention, while older patients less frequently underwent reconstructive surgery and received palliative care. Several indicators had a great variability across hospitals. In some cases, this heterogeneity appeared to be related to the hospital size, with high-volume hospitals being more compliant to guidelines. CONCLUSION It is possible to evaluate the quality of cancer care delivered in clinical practice in recent years, in order to implement interventions aimed to improve adherence to international standards of care.
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Affiliation(s)
- Anita Andreano
- Osservatorio Epidemiologico, ASL Milano 1, Magenta, Italy.,Centro di Biostatistica per l'Epidemiologia Clinica, Dipartimento di Scienze della Salute, Università di Milano Bicocca, Monza, Italy
| | - Emanuela Anghinoni
- Servizio di Epidemiologia e Registri di Popolazione, ASL Cremona, Cremona, Italy
| | | | - Aldo Bellini
- Dipartimento PAC, ASL Milano 2, Melegnano, Italy
| | | | - Sabrina Bizzoco
- Servizio di Epidemiologia e Registri di Popolazione, ASL Cremona, Cremona, Italy
| | | | - Adriano Decarli
- Dipartimento di Scienze Cliniche e di Comunità, Università di Milano, Milano, Italy
| | - Silvia Lucchi
- Analisi Statistiche e Progetti di Ricerca, ASL Cremona, Cremona, Italy
| | - Salvatore Mannino
- Servizio di Epidemiologia e Registri di Popolazione, ASL Cremona, Cremona, Italy
| | | | - Paola Rebora
- Centro di Biostatistica per l'Epidemiologia Clinica, Dipartimento di Scienze della Salute, Università di Milano Bicocca, Monza, Italy
| | - Magda Rognoni
- U.O. Epidemiologia, ASL Monza e Brianza, Monza, Italy
| | | | - Marco Villa
- Analisi Statistiche e Progetti di Ricerca, ASL Cremona, Cremona, Italy
| | | | - Alberto Zucchi
- Servizio Epidemiologico Aziendale, ASL Bergamo, Bergamo, Italy
| | - Maria Grazia Valsecchi
- Centro di Biostatistica per l'Epidemiologia Clinica, Dipartimento di Scienze della Salute, Università di Milano Bicocca, Monza, Italy
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24
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Russo A, Andreano A, Anghinoni E, Autelitano M, Bellini A, Bersani M, Bizzoco S, Cavalieri d'Oro L, Decarli A, Lucchi S, Mannino S, Panciroli E, Rognoni M, Sampietro G, Valsecchi MG, Villa M, Zocchetti C, Zucchi A. [A set of indicators to monitor the adherence to the guidelines for the diagnosis and treatment of breast cancer]. Epidemiol Prev 2014; 38:16-28. [PMID: 24736958] [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] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVES to present a set of indicators developed from six Local Health Authorities of the Lombardy Region to monitor the diagnostic and therapeutic pathway of breast cancer patients, applied to 2007-2009 incident cases. DESIGN retrospective cohort study. SETTING AND PARTICIPANTS all subjects with primary breast cancer, incident in the period 2007-2009, and collected by cancer registries of Milano 1, Bergamo, Cremona, Milano, Milano 2 and Monza-Brianza (5,320,272 inhabitants) were included. MAIN OUTCOME MEASURES through the use of combined current health databases (health registry, hospitalizations, outpatient, pharmaceutical prescription and specific database for anticancer drugs), for each incident case 34 different indicators have been developed to measure the appropriateness of the procedures provided for diagnosis, treatment (surgical and medical) and follow-up. For each indicator, we analyzed the relationship with age, stage, deprivation index, type of treatment, volume of the specific procedure of the hospital where primary surgery was performed. Estimates were adjusted using multilevel regression models. RESULTS 12,988 incident cases, without metastatic diseases and other cancers, were included in the cohort: 62% were localized to the breast, 33% to the axillary lymph-nodes, 3% metastatic ab initio, and 2% with unknown stage. Deviations from the expected value of different magnitude depending on the type of indicator were observed: the most important differences were detected for the follow-up indicators. There was, in fact, an excess of several procedures in the first year of follow-up: 75% of the cases performed a dosage of a tumor marker, 67% an ecography or a CT scan or an MR, and 37% a bone scan. On the other hand, the access to neoadjuvant and adjuvant treatments in older women was far below the expected values. CONCLUSIONS the study presents data derived from a large cohort of population cases; the set of indicators was validated by a board of oncologists. The use of indicators calculated by linking the cancer registries (that provide staging) and administrative databases allows the assessment of compliance to the guidelines for diagnosis and treatment of tumours. This experience shows that it is possible to develop a methodology, shared with clinicians, to define indicators that measure the distance between guidelines and current clinical practice in order to decrease variability, to limit inappropriateness, and to reduce unnecessary diagnostic tests for patients (and, consequently, hospitals organizational overload). In order to be sustainable and equitable, a health care system must be able to ensure implementation of protocols/procedures based exclusively on the best available scientific evidences.
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Affiliation(s)
- Antonio Russo
- Osservatorio epidemiologico e registri specializzati, ASL Milano 1
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25
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Pesatori AC, Grillo P, Consonni D, Caironi M, Sampietro G, Olivari L, Ghisleni S, Bertazzi PA. Update of the mortality study of workers exposed to polychlorinated biphenyls (Pcbs) in two Italian capacitor manufacturing plants. Med Lav 2013; 104:107-114. [PMID: 23789517] [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] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND PCB carcinogenicity to humans is still controversial. Cohort mortality studies in PCB-exposed workers reported elevated risks for the following causes of death: liver, stomach, digestive, brain, prostate cancers and non-Hodgkin lymphoma. OBJECTIVES The purpose of this study was to update as of December 2006 the mortality experience of two Italian cohorts of workers employed in the manufacture of capacitors impregnated with PCBs. METHODS Age-gender-and calendar period adjusted Standardized Mortality Ratios (SMRs) and 95% Confidence Intervals (CI) were calculated using regional rates. Analyses by duration of employment and time since first employment were performed Results: Vital status was ascertained for 98.9% of the study subjects. Mortality from biliary tract cancer among males (SMR 3.91; 95%CI 1.47-10.41), digestive cancer "not otherwise specified" in the whole cohort (SMR 2.54; 95%CI 1.21-5.34), and brain cancer in Plant I (SMR 2.13; 95%CI 1.02-4.48), were significantly increased. Increased risks were also observed for Hodgkin's and non-Hodgkin lymphoma. No linear associations between mortality and duration of employment or latency were observed for these cancers. Mortality from stomach cancer did not differ from expectation in the whole cohort, however an increasing risk with increasing duration of employment was detected (p for trend=0.02). CONCLUSIONS The current update suggests possibly increased cancer risks in PCB-exposed workers, affecting in particular the digestive system, brain, and lymphohemopoietic tissue. However the limited sample size, the lack of clear trends with duration of employment or with latency period, preclude to derive definite conclusions about PCB exposure and the increased cancer risks.
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Affiliation(s)
- Angela Cecilia Pesatori
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.
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26
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Ruggenenti P, Porrini E, Motterlini N, Perna A, Ilieva AP, Iliev IP, Dodesini AR, Trevisan R, Bossi A, Sampietro G, Capitoni E, Gaspari F, Rubis N, Ene-Iordache B, Remuzzi G. Measurable urinary albumin predicts cardiovascular risk among normoalbuminuric patients with type 2 diabetes. J Am Soc Nephrol 2012; 23:1717-24. [PMID: 22935482 DOI: 10.1681/asn.2012030252] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Micro- or macroalbuminuria is associated with increased cardiovascular risk factors among patients with type 2 diabetes, but whether albuminuria within the normal range predicts long-term cardiovascular risk is unknown. We evaluated the relationships between albuminuria and cardiovascular events in 1208 hypertensive, normoalbuminuric patients with type 2 diabetes from the BErgamo NEphrologic Diabetes Complication Trial (BENEDICT), all of whom received angiotensin-converting enzyme inhibitor (ACEI) therapy at the end of the trial and were followed for a median of 9.2 years. The main outcome was time to the first of fatal or nonfatal myocardial infarction; stroke; coronary, carotid, or peripheral artery revascularization; or hospitalization for heart failure. Overall, 189 (15.6%) of the patients experienced a main outcome event (2.14 events/100 patient-years); 24 events were fatal. Albuminuria independently predicted events (hazard ratio [HR], 1.05; 95% confidence interval [CI], 1.02-1.08). Second-degree polynomial multivariable analysis showed a continuous nonlinear relationship between albuminuria and events without thresholds. Considering the entire study population, even albuminuria at 1-2 μg/min was significantly associated with increased risk compared with albuminuria <1 μg/min (HR, 1.04; 95% CI, 1.02-1.07). This relationship was similar in the subgroup originally randomly assigned to non-ACEI therapy. Among those originally receiving ACEI therapy, however, the event rate was uniformly low and was not significantly associated with albuminuria. Taken together, among normoalbuminuric patients with type 2 diabetes, any degree of measurable albuminuria bears significant cardiovascular risk. The association with risk is continuous but is lost with early ACEI therapy.
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Affiliation(s)
- Piero Ruggenenti
- Mario Negri Institute for Pharmacological Research, Centro Anna Maria Astori Science and Technology Park, Kilometro Rosso Via Stezzano 87, Bergamo, Italy
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27
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Konoshita T, Ichikawa M, Kimura T, Sato S, Fujii M, Makino Y, Wakahara S, Miyamori I, Svensson M, Cederholm J, Eliasson B, Zethelius B, Gudbjornsdottir S, Porrini E, Ruggenenti P, Motterlini N, Perna A, Parvanova Ilieva A, Petrov Iliev I, Dodesini AR, Bossi A, Sampietro G, Capitoni E, Gaspari F, Rubis N, Gherardi G, Ene-Iordache B, Remuzzi G, Tsuda A, Ishimura E, Ohno Y, Ichii M, Nakatani S, Mori K, Inaba M, Ge Y, Xie H, LI S, Jin B, Hou J, Zhang H, Shi M, Liu Z, Simone S, Cariello M, Vavallo A, Loverre A, Ranieri E, Battaglia M, Ditonno P, Gesualdo L, Grandaliano G, Pertosa G. Diabetes clinical studies. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Abstract
BACKGROUND AND AIM Mucosal healing (MH) after short-term medical treatment is being considered as an important step in the therapeutic work-up of inflammatory bowel disorder (IBD) patients due to the potential prognostic role of MH in predicting disease outcome. However, IBD patients are reluctant to be re-endoscoped during follow-up; therefore, there is a need for non-invasive alternative index of MH which can replace endoscopy in clinical practice. We evaluated bowel ultrasound (US) as a surrogate of colonoscopy in a series of consecutive patients with active ulcerative colitis (UC). PATIENTS AND METHODS 83 patients with moderate to severe UC requiring high-dose steroids were initially recruited; endoscopic severity of UC was graded 0-3 according to Baron score, and US severity was also graded 0-3 according to the colonic wall thickening and the presence of vascular signal at power Doppler. 74 patients responsive to steroids and then maintained on 5-ASA compounds were followed up with repeated colonoscopy and bowel US at 3, 9 and 15 months from entry. Concordance between clinical, endoscopic and US scores at various visits was determined by kappa statistics. Multiple unconditional logistic regression models were used to assess the predictivity of Truelove, Baron and US scores measured at 3 and 9 months on the development of a UC relapse (Baron score 2-3) at 15 months. RESULTS An inconsistent concordance was found over time between 0 and I Baron scores and Truelove score (weighted kappa between 0.38 and 0.94), with high and consistent concordance between 0 and I Baron scores and US scores (weighted kappa between 0.76 and 0.90). On logistic regression analysis, a moderate/severe Baron score, regardless of their Truelove score, at 3 months was associated with a high risk of endoscopic activity at 15 months (OR 5.2; 95% CI: 1.6-17.6); similarly, patients with severe US scores (2-3) at 3 months had a high risk of severe endoscopic activity at 15 months (OR 9.1; 95% CI: 2.5-33.5). DISCUSSION In expert hands bowel US may be used as a surrogate of colonoscopy in evaluating the response to high-dose steroids in severe forms of UC. US score after 3 months of steroid therapy accurately predicts clinical outcome of disease at 15 months.
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Affiliation(s)
- F Parente
- Gastrointestinal Unit, A. Manzoni Hospital, IT-23900 Lecco, Italy.
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29
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Caironi M, Olivari L, Sampietro G, Mandelli G, Mosconi G. [Introductional results of a mortality study in 471 ex-exposed workers to PCBs]. G Ital Med Lav Ergon 2005; 27:279-81. [PMID: 16240573] [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] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
This study concerned a group of ex-workers (372 males and 99 females) from a firm situated in Bergamo (Italy) that ceased its activity at the beginning of the Nineties. From an introductory analysis of the results, we found out that there isn't excess in the death-rate for liver and bile ducts cancers among the males of this group. Among them, for what concerns the other tumoral pathologies, such as leukaemia and stomach tumors, the information allowed to verify an excess of mortality. However, this increase hasn't result statistically significant. On the contrary, it came out that there is an excess of risk for intestine tumors: standardized death-rate of 2.58. In accordance with the information collected, for the future it will be necessary to carefully examine the research in order to verify the existence of a direct connection to the exposure at PCB and study the incidence (not only for mortality) of these neoplasms.
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Affiliation(s)
- M Caironi
- Servizio Prevenzione e Sicurezza Ambienti di Lavoro, ASL Provincia di Bergamo, Bergamo
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30
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Collini P, Sampietro G, Pilotti S. Extensive vascular invasion is a marker of risk of relapse in encapsulated non-Hurthle cell follicular carcinoma of the thyroid gland: a clinicopathological study of 18 consecutive cases from a single institution with a 11-year median follow-up. Histopathology 2004; 44:35-9. [PMID: 14717667 DOI: 10.1111/j.1365-2559.2004.01729.x] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIMS To determine the prognostic value of certain clinicopathological features in a series of 18 consecutive cases of encapsulated follicular carcinoma (EFC) of the thyroid gland with long follow-up. METHODS AND RESULTS Eighteen consecutive cases of EFC were retrieved from 1975 to 1993. Gender, age at onset, type of surgery, presence of capsular and/or vascular invasion, number of involved vessels, tumour size, and TNM/pTNM classification were evaluated and correlated with disease outcome. None of the cases presented with distant metastases. Extensive vascular invasion (defined as more than four capsular vessels involved) was present in two cases. After a median follow-up of 133 months, all patients were alive. Three cases had relapsed in lung and bone. In two out of these three cases, extensive vascular invasion was present. Radioiodine therapy was curative in two of three of the relapsed cases. CONCLUSIONS EFC is a low-risk carcinoma, with no patients' deaths after a median follow-up of 11 years. Extensive vascular invasion should be considered as a risk factor for relapse. A conservative surgical approach is recommended. Since relapses may occur up to 14 years after the initial surgery, life-long follow-up is advisable.
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Affiliation(s)
- P Collini
- Department of Pathology, Istituto Nazionale Tumori, Milan, Italy.
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31
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Collini P, Sampietro G, Rosai J, Pilotti S. Minimally invasive (encapsulated) follicular carcinoma of the thyroid gland is the low-risk counterpart of widely invasive follicular carcinoma but not of insular carcinoma. Virchows Arch 2003; 442:71-6. [PMID: 12536317 DOI: 10.1007/s00428-002-0701-2] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2002] [Accepted: 07/05/2002] [Indexed: 10/25/2022]
Abstract
Minimally invasive (encapsulated) follicular carcinoma (MIFC), widely invasive follicular carcinoma (WIFC), and insular carcinoma (IC) are three distinct types of thyroid carcinomas composed of follicular cells, IC representing the poorly differentiated counterpart. Our aim was to test whether there is a time-dependent relationship among these three entities, in particular whether MIFC is the low-risk form of the entire group. We used overall survival analysis and multiple correspondence analysis (MCA), the latter exploring the clinicopathological characteristics at onset (sex, age, TNM/pTNM classification). The study included 18 MIFCs, 29 WIFCs, and 27 ICs. On the basis of both overall survival and MCA, WIFC emerged as the high-risk counterpart of MIFC, occurring in older age, with a larger size, a widespread growth into the thyroid parenchyma, and presenting with distant metastases. In both types of follicular carcinoma distant metastases involved only lung and bone, and there was no tendency for local spread beyond the thyroid capsule or nodal metastases. By contrast, IC confirmed to be a distinct high-risk lesion, showing both follicular and papillary-related biological behavior characteristics.
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Affiliation(s)
- Paola Collini
- Department of Pathology, Istituto Nazionale Tumori, Via G. Venezian 1, 20133 Milan, Italy.
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32
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Parente F, Maconi G, Bollani S, Anderloni A, Sampietro G, Cristaldi M, Franceschelli N, Bianco R, Taschieri AM, Bianchi Porro G. Bowel ultrasound in assessment of Crohn's disease and detection of related small bowel strictures: a prospective comparative study versus x ray and intraoperative findings. Gut 2002; 50:490-5. [PMID: 11889068 PMCID: PMC1773178 DOI: 10.1136/gut.50.4.490] [Citation(s) in RCA: 144] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND AIM Despite the fact that bowel ultrasound (US) has recently been proved to be useful in the assessment of bowel diseases, uncertainty persists as to its diagnostic role in patients with complicated Crohn's disease (CD). Therefore, we have prospectively investigated the accuracy of US compared with x ray procedures and intraoperative findings in detecting small bowel strictures complicating CD as well as its reliability in assessing disease extent and location within the bowel. METHODS A series of 296 consecutive patients with proven CD admitted to L Sacco University Hospital between 1997 and 1999, having undergone complete radiographic evaluation (including small bowel x ray, colonoscopy, or double contrast barium enema), were enrolled in the study. Bowel US was performed in each patient by two experienced operators unaware of the results of other diagnostic procedures. The accuracy of US in detecting strictures compared with x ray studies was determined separately in two different groups of patients: 211 patients treated conservatively (non-operative CD) and 85 patients who were candidates for surgery for CD complications or unresponsiveness to medical therapy (operative CD). RESULTS Overall sensitivity and specificity of US in assessing the anatomical distribution of CD were 93% and 97%, respectively. The extent of ileal disease measured at US correlated well with that determined by x ray (r=0.52, p<0.001) in medically treated patients as well as with that measured intraoperatively in surgical patients (r=0.64, p<0.001). One or more stenoses were detected in 75 patients (35.5%) at small bowel enteroclysis in the non-operative CD group compared with 70 (82%) in the operative CD series. Sensitivity, specificity, and positive predictive values of bowel US in the detection of strictures were 79%, 98%, and 95% in non-operative CD patients and 90%, 100%, and 100% in operative CD cases, respectively. CONCLUSIONS In experienced hands, bowel US is an accurate technique for assessing CD extent and location and is very helpful in detecting small bowel strictures, especially in very severe cases that are candidates for surgery. The use of bowel US is therefore justified as a primary investigation in CD patients in whom complications are suspected.
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Affiliation(s)
- F Parente
- Department of Gastroenterology, L Sacco University Hospital, Milan, Italy.
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33
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Andreola S, Leo E, Belli F, Gallino G, Sirizzotti G, Sampietro G. Adenocarcinoma of the lower third of the rectum: metastases in lymph nodes smaller than 5 mm and occult micrometastases; preliminary results on early tumor recurrence. Ann Surg Oncol 2001; 8:413-7. [PMID: 11407515 DOI: 10.1007/s10434-001-0413-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND The number of examined lymph nodes and metastases in lymph nodes smaller than 5 mm (small lymph nodes) are a determining factor in the stage of rectal cancer although the clinical significance of occult micrometastases is controversial. We are reporting our preliminary results on the identification and prognostic utility of metastases in small lymph nodes and occult micrometastases. METHODS We searched small metastatic lymph nodes in 101 cases of adenocarcinoma of the lower third of the rectum. We used the manual technique to dissect mesorectal fat and occult micrometastases in the lymph nodes of 52 Dukes' A and B patients, using a pool of anticytokeratin antibodies. RESULTS Forty-five percent of the metastatic lymph nodes were smaller than 5 mm in diameter and determined the Dukes' stage in 15 (30.6%) of 49 Dukes' C patients. Occult micrometastases were found in 21 (40.4%) patients: five recurred but vascular invasion, positive distal margin of the rectum, and positive circumferential margin of the mesorectum were present. CONCLUSIONS Small metastatic lymph nodes, vascular invasion, positive distal margin of the rectum, and positive circumferential margin of the mesorectum were found to be more important than occult micrometastases in predicting early recurrence of rectal cancer.
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Affiliation(s)
- S Andreola
- Department of Anatomical Pathology and Cytology, National Cancer Institute, Milan, Italy
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Collini P, Sampietro G, Bertulli R, Casali PG, Luksch R, Mezzelani A, Sozzi G, Pilotti S. Cytokeratin immunoreactivity in 41 cases of ES/PNET confirmed by molecular diagnostic studies. Am J Surg Pathol 2001; 25:273-4. [PMID: 11176079 DOI: 10.1097/00000478-200102000-00022] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
MESH Headings
- Adult
- Biomarkers, Tumor/analysis
- DNA, Neoplasm/analysis
- Female
- Humans
- Immunohistochemistry
- Keratins/analysis
- Keratins/biosynthesis
- Keratins/immunology
- Male
- Neoplasm Proteins/analysis
- Neoplasms, Multiple Primary/chemistry
- Neoplasms, Multiple Primary/genetics
- Neoplasms, Multiple Primary/immunology
- Neoplasms, Multiple Primary/pathology
- Neuroectodermal Tumors, Primitive/chemistry
- Neuroectodermal Tumors, Primitive/genetics
- Neuroectodermal Tumors, Primitive/immunology
- Neuroectodermal Tumors, Primitive/pathology
- Oncogene Proteins, Fusion/analysis
- Proto-Oncogene Protein c-fli-1
- RNA-Binding Protein EWS
- Reverse Transcriptase Polymerase Chain Reaction
- Sarcoma, Ewing/chemistry
- Sarcoma, Ewing/genetics
- Sarcoma, Ewing/immunology
- Sarcoma, Ewing/pathology
- Transcription Factors/analysis
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35
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Mancuso T, Mezzelani A, Riva C, Fabbri A, Dal Bo L, Sampietro G, Perego P, Casali P, Zunino F, Sozzi G, Pierotti MA, Pilotti S. Analysis of SYT-SSX fusion transcripts and bcl-2 expression and phosphorylation status in synovial sarcoma. J Transl Med 2000; 80:805-13. [PMID: 10879732 DOI: 10.1038/labinvest.3780085] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Synovial sarcomas (SS) are characterized by a chromosomal translocation t(X;18)(p11.2;q11.2) which usually fuses the SYT gene from chromosome 18 to SSX1 or SSX2 genes on chromosome X. Also, a variant SYT-SSX4 fusion gene has recently been shown in a single SS case. In addition to these cytogenetic changes, bcl-2 expression, as assessed by immunohistochemistry, has been reported to be an almost general constitutive alteration of SS. In the present work, we analyze a series of 36 SS surgical samples (from 34 patients) by RT-PCR for the presence of the SYT-SSX1 or the SYT-SSX2 fusion transcript. The analysis was extended to SYT-SSX4 on SYT-SSX1-negative and SYT-SSX2-negative cases only. Our results showed a significant correlation between the SYT-SSX2 fusion and the monophasic SS histologic subtype. SYT-SSX1 fusion transcripts were present in both monophasic and biphasic tumors. The SYT-SSX4 fusion type was detected in a single monophasic SS. In the same series of SS cases, we also confirmed and extended the previously reported constitutive expression of bcl-2 protein, by using both immunohistochemical and western blot analysis. Moreover, we demonstrated that the BCL-2 gene is not rearranged or amplified at genomic level, indicating that the high levels of bcl-2 expression observed in SS might result from transcriptional activation of the gene and/or protein stabilization. Finally, we show that bcl-2 is not phosphorylated in tumors from patients who had been preoperatively treated with radio/chemotherapy, in tumors from untreated patients, or in an SS cell line (CME-1) after in vitro treatment with cytotoxic concentrations of DNA-damaging agents or taxanes. These data indicate that SS cells are unable to activate an apoptosis pathway involving bcl-2 phosphorylation/inactivation and may provide a possible explanation for the limited effectiveness of conventional pharmacological treatments of this tumor type.
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MESH Headings
- Adolescent
- Adult
- Aged
- Biomarkers, Tumor/analysis
- Biomarkers, Tumor/genetics
- Chromosomes, Human, Pair 18
- Female
- Gene Rearrangement
- Genes, bcl-2
- Humans
- Male
- Middle Aged
- Neoplasm Recurrence, Local/genetics
- Neoplasm Recurrence, Local/surgery
- Oncogene Proteins, Fusion/analysis
- Oncogene Proteins, Fusion/genetics
- Phosphorylation
- Proto-Oncogene Proteins c-bcl-2/metabolism
- Reverse Transcriptase Polymerase Chain Reaction
- Sarcoma/genetics
- Sarcoma/pathology
- Sarcoma/surgery
- Synovial Membrane
- Transcription, Genetic
- X Chromosome
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Affiliation(s)
- T Mancuso
- Division of Anatomic Pathology and Cytology, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milano, Italy
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36
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Sampietro G, Tomasic G, Collini P, Biganzoli E, Boracchi P, Bidoli P, Pilotti S. Gene product immunophenotyping of neuroendocrine lung tumors. No linking evidence between carcinoids and small-cell lung carcinomas suggested by multivariate statistical analysis. Appl Immunohistochem Mol Morphol 2000; 8:49-56. [PMID: 10937049] [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: 02/17/2023]
Abstract
Fifty-three neuroendocrine lung tumors (24 carcinoids, one atypical carcinoid, five large-cell neuroendocrine carcinomas, and 23 small-cell lung carcinomas) were investigated for immunocytochemical expression of several gene products, i.e., p53, Rb, bcl-2, c-kit, mdm-2, cdk-4, p21 proteins, and proliferation index as assessed by MIB-1. The goal of the study was to explore the relationships between histotypes in light of their own gene product-based immunophenotypical profiles. To this aim we applied the multiple correspondence analysis, which is an exploratory statistical multivariate technique that converts a data matrix into a particular type of graphic display in which the rows and columns are depicted as points. Such statistical analysis displayed that some categories of the gene product-based immunophenotyping variables are grouped in the plot identifying three groups: the first group related to carcinoids, the second to small-cell carcinomas, and the third to large-cell neuroendocrine carcinomas. These data support the evidence that carcinoids and small-cell carcinomas are two distinct, apparently immunogenotypically unrelated entities among neuroendocrine lung tumors and that atypical carcinoids and large-cell neuroendocrine carcinomas seem not to represent intermediate steps between them.
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MESH Headings
- Antigens, Nuclear
- Biomarkers, Tumor/genetics
- Biomarkers, Tumor/metabolism
- Carcinoid Tumor/genetics
- Carcinoid Tumor/metabolism
- Carcinoid Tumor/pathology
- Carcinoma, Neuroendocrine/genetics
- Carcinoma, Neuroendocrine/metabolism
- Carcinoma, Neuroendocrine/pathology
- Carcinoma, Non-Small-Cell Lung/genetics
- Carcinoma, Non-Small-Cell Lung/metabolism
- Carcinoma, Non-Small-Cell Lung/pathology
- Carcinoma, Small Cell/genetics
- Carcinoma, Small Cell/metabolism
- Carcinoma, Small Cell/pathology
- Cyclin-Dependent Kinase 4
- Cyclin-Dependent Kinases/genetics
- Cyclin-Dependent Kinases/metabolism
- Gene Expression
- Humans
- Immunohistochemistry
- Immunophenotyping
- Ki-67 Antigen
- Lung Neoplasms/genetics
- Lung Neoplasms/metabolism
- Lung Neoplasms/pathology
- Multivariate Analysis
- Nuclear Proteins/genetics
- Nuclear Proteins/metabolism
- Proto-Oncogene Proteins
- Proto-Oncogene Proteins c-bcl-2/genetics
- Proto-Oncogene Proteins c-bcl-2/metabolism
- Proto-Oncogene Proteins c-kit/genetics
- Proto-Oncogene Proteins c-kit/metabolism
- Retinoblastoma Protein/genetics
- Retinoblastoma Protein/metabolism
- Tumor Suppressor Protein p53/genetics
- Tumor Suppressor Protein p53/metabolism
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Affiliation(s)
- G Sampietro
- Division of Anatomical Pathology, Istituto Nazionale Tumori, Milan, Italy
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37
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Luksch R, Sampietro G, Collini P, Boracchi P, Massimino M, Lombardi F, Gandola L, Giardini R, Fossati-Bellani F, Migliorini L, Pilotti S, Scopsi L. Prognostic value of clinicopathologic characteristics including neuroectodermal differentiation in osseous Ewing's sarcoma family of tumors in children. Tumori 1999; 85:101-7. [PMID: 10363075] [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: 02/12/2023]
Abstract
AIMS AND BACKGROUND The aim of the present study was to determine the relationship between clinico-pathologic parameters, including neuroectodermal differentiation, and their impact on survival in a series of pediatric patients with osseous tumors of the Ewing's sarcoma family admitted to the Pediatric Department of the Istituto Nazionale Tumori of Milan. METHODS Seventy-three patients were enrolled. The variables analyzed were sex, age, site of primary tumor, serum lactate dehydrogenase (LDH) level at diagnosis, involvement of periosseous soft tissues by primary tumor, presence of metastatic disease, status of disease after the treatment plan, as well as the presence of mitoses, morphologic and immunocytochemical neural markers, and neuroendocrine markers in the primary tumor. RESULTS Neural and neuroendocrine markers were not significantly associated with any of the other parameters. In the univariate analysis, significant risk factors related to unfavorable outcome were elevated LDH, metastatic disease, lack of complete remission after treatment, presence of mitoses and of morphological neural markers; immunocytochemical neural and neuroendocrine markers lacked prognostic value. In the multivariate analysis, only LDH levels and the status of disease following the treatment were retained. CONCLUSIONS LDH level at diagnosis might be a useful marker to identify different risk levels; neuroectodermal differentiation might have no clear-cut impact on the clinical management of osseous Ewing's sarcoma family of tumors.
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Affiliation(s)
- R Luksch
- Divisione di Oncologia Pediatrica, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan.
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38
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Collini P, Sampietro G, Luksch R, Migliorini L, Boracchi P, Scopsi L. Differentiation in paediatric peripheral primitive neuroectodermal tumours of bone. A critical contribution to its assessment. Virchows Arch 1998; 432:505-13. [PMID: 9672191 DOI: 10.1007/s004280050198] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Differentiation was studied in 73 paediatric peripheral primitive neurorectodermal tumours (pPNETs) of bone observed during 1974 through 1992. The presence of rosettes, pseudorosettes, and/or a rosette-like arrangement of tumour cells (the morphological neural marker, MNM) occurred in 29% of these cases. NSE and N-CAM were expressed by nearly all tumours; synaptophysin was present in 30% of cases, not significantly associated with the MNM status. Neuroendocrine (NE) markers were present in 25% (chromogranin B, secretogranin II) to 40% (chromogranin A, 7B2 protein) of cases. Focal expression of cytokeratins, S100 protein and/or desmin was also noted in a minority of cases. In univariate statistical analysis, only the presence of MNM conferred a significantly higher (about twofold) risk of death than its absence. This study demonstrates the occurrence of at least one immunocytochemical N and/or NE differentiation marker in all pPNETs of bone and a focal expression of cytokeratins, S100 protein and/or desmin in a minority of cases. Synaptophysin and MNM were present each in less than 1/3 of the cases, and no association was noted between them. Statistical analyses highlighted the prognostic role of MNM per se and discourage the sole use of immunocytochemistry in the assessment of neuroectodermal differentiation for prognostic purposes in paediatric pPNETs of bone.
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Affiliation(s)
- P Collini
- Division of Anatomical Pathology and Cytopathology, Istituto Nazionale Tumori, Milan, Italy.
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40
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Scopsi L, Sampietro G, Boracchi P, Collini P. Argyrophilia and chromogranin A and B immunostaining in patients with sporadic medullary thyroid carcinoma. A critical appraisal of their prognostic utility. J Pathol 1998; 184:414-9. [PMID: 9664908 DOI: 10.1002/(sici)1096-9896(199804)184:4<414::aid-path1229>3.0.co;2-u] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The purpose of the present study was to evaluate the prognostic utility of tumour argyrophilia and chromogranin A (CgA) and B (CgB) immunocytochemical expression in patients with sporadic medullary thyroid carcinoma. To this end, the histo-immunocytochemical data on a consecutive series of 99 such tumours were submitted to statistical analysis. In univariate analysis, a significantly increased risk of disease progression and death was present in patients with CgA-poor and CgB-poor tumours, respectively. Multivariate analyses were performed by adding the histo-immunocytochemical variables to the final (reference) models obtained in earlier work on the same case series, in which 18 clinicopathological variables had been taken into account. This addition did not change the prognostic impact of the variables considered in the two reference models; it did, however, increase the prognostic information for overall survival, since the adjunctive contribution of CgB immunocytochemical expression (as assessed by the likelihood ratio test) was statistically significant. It is concluded that the chromogranin B immunostaining pattern of the primary tumour allows the distinction of patients with an increased risk of death. Argyrophilia and expression of chromogranin A seem instead to be of no prognostic value in patients with sporadic medullary thyroid carcinoma.
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Affiliation(s)
- L Scopsi
- Endocrinology Unit, Istituto Nazionale Tumori, Milan, Italy.
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41
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42
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Catalano M, Schioppa S, Sampietro G, Contini P, Ninno D. Skin blood flow during vasoconstrictive and vasodilative stimuli in essential hypertension patients: a laser Doppler flowmetry study. Int J Microcirc Clin Exp 1997; 17:80-5. [PMID: 9253685 DOI: 10.1159/000179211] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
In order to compare the extent of the elicited vasoconstrictive and vasodilative response at the microcirculatory level in essential hypertension (EH), we measured the skin blood flow by means of a laser Doppler flowmeter (LDF). Thirty-four mild-to-moderate EH patients were enrolled. Twenty-two sex- and age-matched healthy subjects were selected as a control group. The LDF measurements were carried out with the probe over the fingertip of the distal phalanx at baseline conditions (Rest flow, RF), after an ischaemic test (post-ischaemic peak flow) and during an arithmetic stress test (AT). The flow was expressed in arbitrary units. The data were processed using the Perisoft computer program. The relative flows after the ischaemic test (Rel F1) and during the AT (Rel F2) were expressed as a percentage of the previous RF values (RF1 and RF2, respectively). During the AT, the lag time was calculated (in seconds). As compared to the control subjects, RF was significantly lower in the EH group (p < 0.01). During the AT, the EH patients showed a statistically lower mean Rel F2 decrease compared to the control subjects (p < 0.01). No statistically significant difference occurred in the Rel F1 and lag time. These data suggest that the vasoconstrictive capacity of the precapillary vessels is impaired in patients with hypertension.
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Affiliation(s)
- M Catalano
- Research Centre on Vascular Diseases, L. Sacco Hospital, University of Milan, Italy
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43
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Abstract
A retrospective search for lymphocytic infiltration of the thyroid was performed on archival paraffin specimens from 95 cases of thyroid medullary carcinoma observed at a single institution during a 30-year period. A mild lymphocytic infiltration of the nonneoplastic thyroid tissue, mainly concentrated at the edge of the tumor mass, was observed in 33 cases, while in a further 24 cases a moderate to marked lymphocytic infiltration, resembling that seen in chronic lymphocytic thyroiditis, was homogeneously distributed all over the gland, with no apparent relationship to the site of the primary tumor. Virtually no lymphocytic infiltration was detected inside of any of the tumors. The presence of chronic lymphocytic thyroiditis seemed to be a characteristic of the host rather than a tumor-induced event. Statistical univariate analysis of relapse-free survival and overall survival showed that lack of chronic lymphocytic thyroiditis marked those patients with an increased risk of disease recurrence and death. However, the observed risk for survival was statistically nonsignificant, whereas that for disease recurrence was significant and remained in a multivariate model of statistical analysis.
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Affiliation(s)
- L Scopsi
- Endocrinology Unit, Division of Pathological Anatomy, Istituto Nazionale Tumori, Milan, Italy
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44
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Scopsi L, Sampietro G, Boracchi P, Del Bo R, Gullo M, Placucci M, Pilotti S. Multivariate analysis of prognostic factors in sporadic medullary carcinoma of the thyroid. A retrospective study of 109 consecutive patients. Cancer 1996; 78:2173-83. [PMID: 8918412] [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: 02/03/2023]
Abstract
BACKGROUND Because of the rarity of medullary thyroid carcinoma, adequate information for determination of the prognostic characteristics and clinical course of this disease can be obtained only from a database that serves a large population. METHODS A retrospective review of 109 patients with sporadic medullary thyroid carcinoma was conducted; all were diagnosed and treated at a single institution over a 30-year period. The series included 57 males and 52 females with a median follow-up of 5.3 years. Statistical univariate analysis of relapse free survival and overall survival was done for 18 clinicopathologic variables, including sex, age, TNM staging, completeness of surgical resection, postoperative calcitoninemia, histologic subtype, tumor size, thyroid capsule invasion, amyloid, katacalcin, calcitonin, and calcitonin gene-related peptide immunostaining patterns of the primary tumor. RESULTS Risk factors for unfavorable outcome were male sex, age > 60 years, incomplete tumor resection, mixed cell subtype, tumor size > 4 cm, extrathyroid tumor invasion, lack of amyloid, N1 and M1 categories, and heterogeneous calcitonin and katacalcin immunostaining pattern. In the multivariate analysis, only capsule status, M category, and age at diagnosis remained in the final model for overall survival. In the final model for relapse free survival, capsule status remained, together with sex and amyloid status. CONCLUSIONS Extrathyroid tumor invasion, the presence of distant metastases, and age > 60 years are characteristic of patients at high risk of death from disease sooner, whereas extrathyroid invasion, male sex, and the absence of amyloid characterize patients who are at high risk for recurrence. Extrathyroid tumor invasion appears to be the worst prognostic factor and may allow for the breakdown of patients into two categories, amenable to different therapeutic regimens.
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Affiliation(s)
- L Scopsi
- Endocrinology Unit, Istituto Nazionale Tumori, Milan, Italy
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Scopsi L, Sampietro G, Boracchi P, Del Bo R, Gullo M, Placucci M, Pilotti S. Multivariate analysis of prognostic factors in sporadic medullary carcinoma of the thyroid: A retrospective study of 109 consecutive patients. Cancer 1996. [DOI: 10.1002/(sici)1097-0142(19961115)78:10<2173::aid-cncr20>3.0.co;2-v] [Citation(s) in RCA: 75] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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46
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Pilotti S, D'Amato L, Della Torre G, Donghi R, Longoni A, Giarola M, Sampietro G, De Palo G, Pierotti MA, Rilke F. Papillomavirus, p53 alteration, and primary carcinoma of the vulva. Diagn Mol Pathol 1995; 4:239-48. [PMID: 8634779 DOI: 10.1097/00019606-199512000-00003] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Twenty-nine samples from 28 cases of vulvar squamous cell carcinoma, of which 13 fulfilled the criteria of the bowenoid subtype (mean age 45 years, range 31-68) and 16 of the usual subtype of invasive squamous cell carcinoma (ISCC) (mean age 67.5 years, range 34-83) were investigated for human papillomavirus (HPV) DNA, TP53 alterations, and mdm2 and bcl-2 gene product deregulation. Microscopically all the bowenoid subtype cases (group I) showed a high-grade intraepithelial (VIN 3, carcinoma in situ) lesion associated with early invasive carcinoma in six cases and overt invasive carcinoma in one. By contrast, no evidence of early carcinoma was present in the ISCCs (group II). By in situ hybridization and/or Southern blot hybridization or polymerase chain reaction (PCR), HPV DNA was detected in all cases of group I and in four of 16 cases (25%) of group II, two only by Southern blot after PCR. By single-strand conformation polymorphism and immunocytochemistry only wild-type TP53 and absence of detectable p53 product, respectively, were found in all cases of group I, i.e., in high-risk HPV-positive carcinomas, whereas mutations and/or p53 overexpression accounted for 75% in group II, i.e., in mainly HPV-negative carcinomas. The TP53 gene mutations observed in invasive carcinomas were significantly related to node-positive cases (p = 0.04). Taken together and in agreement with in vitro data, these results support the view that an alteration of TP53, gained either by interaction with viral oncoproteins or by somatic mutations, is a crucial event in the pathogenesis of vulvar carcinomas, but that TP53 mutations are mainly associated with disease progression. Finally, a preliminary immunocytochemical analysis seems to speak against the possible involvement of both MDM2 and BCL-2 gene products in the development of vulvar carcinoma.
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Affiliation(s)
- S Pilotti
- Division of Anatomical Pathology and Cytology, Istituto Nazionale Tumori, Milan, Italy
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Guerrissi J, Klersfeld D, Sampietro G, Valdivieso J. Limitation of thigh function by a giant lipoma. Plast Reconstr Surg 1994; 94:410-1. [PMID: 8041841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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48
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Saba GM, Sampietro G, Salvatori R. [Emergencies in ambulatory dentistry]. G Anest Stomatol 1986; 15:25-8. [PMID: 3460931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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49
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Goracci G, Sampietro G. [The problem of resuscitation in the dental office]. Dent Cadmos 1982; 50:39-44. [PMID: 6964334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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50
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Sampietro G, Faraglia V, Tomiselli G, Di Salvo R, Stirati G. [Induced hypotension test in the study of nephrovascular hypertension. Comparison of renographic findings with separate renal function tests]. Nunt Radiol 1968; 34:1689-95. [PMID: 5758208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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