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D'Amico R, Nicoli A, Zdoroveac A, Gürke L, Isaak A. Vascular access challenges in hemodialysis patients with superior vena cava syndrome. J Vasc Access 2024:11297298241227549. [PMID: 38316621 DOI: 10.1177/11297298241227549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Superior vena cava syndrome in hemodialysis patients resulting from previous or current use of a tunneled central vein catheter is a rare but potentially severe condition. Two aspects have to be addressed during management and treatment: the restoration of central venous flow and the creation of an alternative vascular access to guarantee hemodialysis. RESEARCH DESIGN Conforming to the current guidelines and literature, we present a stepwise approach and discuss therapeutic options. The removal of the tunneled central vein catheter should be attempted and a native vascular access created whenever feasible. RESULTS First, an upper extremity AVF should be preserved or, as in our case, made functional. Endovascular treatment of CVSO should primarily consist of balloon dilatation. Placement of a stent or stent graft should be considered as a secondary option. HeRO graft placement may be considered in recurrent CVSO and recanalization with a Surfacer. LL-AVF or AVG need to be discussed and may be an alternative for certain HD patients when the risk of lower limb ischemia and infection is considered. CONCLUSION Several therapeutic options are available and the basic principles are well established in the literature, although the level of evidence is not high. Therefore, we propose a stepwise and interdisciplinary approach to guide the challenging decision-making process in SVC.
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Affiliation(s)
- Rosalinda D'Amico
- Vascular and Endovascular Surgery, Cantonal Hospital Aarau, Aarau, Aargau, Switzerland
| | - Andrew Nicoli
- Vascular and Endovascular Surgery, Cantonal Hospital Aarau, Aarau, Aargau, Switzerland
| | - Andrei Zdoroveac
- Vascular and Endovascular Surgery, Cantonal Hospital Aarau, Aarau, Aargau, Switzerland
| | - Lorenz Gürke
- Vascular and Endovascular Surgery, Cantonal Hospital Aarau, Aarau, Aargau, Switzerland
- Vascular and Endovascular Surgery, University Hospital Basel, Basel, Basel-Stadt, Switzerland
| | - Andrej Isaak
- Vascular and Endovascular Surgery, Cantonal Hospital Aarau, Aarau, Aargau, Switzerland
- Vascular and Endovascular Surgery, University Hospital Basel, Basel, Basel-Stadt, Switzerland
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2
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Wuu YR, Gui B, Kokabee M, Stone J, Karten JL, Harshan M, D'Amico R, Vojnic M, Wernicke G. Prioritizing Radiation and Targeted Systemic Therapy in Patients with Resected Brain Metastases from Lung Cancer Primaries with Targetable Mutations: A Report from a Multi-Site Single Institution. Int J Radiat Oncol Biol Phys 2023; 117:e157. [PMID: 37784747 DOI: 10.1016/j.ijrobp.2023.06.983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Brain metastases (BrM) are a common complication of non-small cell lung cancer (NSCLC), present in up to 50% of patients. While treatment of BrM requires a multidisciplinary approach with surgery, radiotherapy (RT), and systemic therapy, advances in sequencing have improved outcomes with targetable alterations in PDL-1, EGFR, ALK, and KRAS mutations. With a push towards molecular characterization of cancers, we sought out to examine outcomes by treatment modalities at our institution with respect to prioritizing RT and targeted therapies. MATERIALS/METHODS After IRB approval, we identified patients treated with a surgical resection of BrM from NSCL primaries between 2011 to 2022 at 5 sites at our institution. Tumor molecular profiles were reviewed and patients with PDL-1, EGFR, ALK, and KRAS mutations were evaluated by a treatment modality: surgery alone or in combination with RT (SRS, WBRT) and/or systemic therapy (TKIs -1st-3rd generations, immunotherapy). The primary endpoints were in-brain freedom from progression (FFP) and overall survival (OS). SAS Studio version 4.4 was used to perform statistical analyses. RESULTS We identified 272 patients with 162/272 (60%) patients with adequate follow-up included in this analysis. The median follow-up was 27.8 months (range, 0.43 - 134.45 months). There were 59.2% females and 40.7% males, with median ages at diagnosis of 67 years for females and 66 for males, respectively. Of the entire cohort, 102/162 (63%) patients received adjuvant combination RT and systemic therapy, and 60/162 (37%) received adjuvant monotherapy (p <0.0001). The use of systemic therapy was associated with 9.89 months median time to progression vs 4.87 months without it (p = 0.077), respectively. Similarly, patients treated with a combination of RT and systemic therapy had a median FFP time of 9.77 months vs 5.28 months (p = 0.064). No significant difference in OS was found with or without systemic therapy. CONCLUSION After resection of BrM from NSCLC with PDL-1, EGFR, ALK, and KRAS mutations, we found that systemic therapy, including TKIs and immunotherapy, may have an increasing role in delaying time to progression. At our institution, as we continue to identify actionable mutations, a statistically significant number of patients continue to be treated with a combination of RT and systemic therapies with a trend toward superior FFP.
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Affiliation(s)
- Y R Wuu
- Department of Radiation Medicine, Northwell Health Cancer Institute, Lake Success, NY; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY
| | - B Gui
- Department of Radiation Medicine, Northwell Health Cancer Institute, Lake Success, NY; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY
| | - M Kokabee
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Department of Pathology and Laboratory Medicine at Lenox Hill Hospital, New York, NY
| | - J Stone
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY
| | - J L Karten
- NYIT College Of Osteopathic Medicine, Old Westbury, NY
| | - M Harshan
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Department of Pathology and Laboratory Medicine at Lenox Hill Hospital, New York, NY
| | - R D'Amico
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Department of Neurosurgery at Lenox Hill Hospital, New York, NY
| | - M Vojnic
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Department of Medical Oncology, Northwell Health Cancer Institute at MEETH, New York, NY
| | - G Wernicke
- Department of Radiation Medicine, Northwell Health Cancer Institute, Lake Success, NY; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Department of Radiation Medicine at Lenox Hill Hospital, New York, NY
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3
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D'Amico R, Wolff T, Richarz S, Gurke L, Isaak A, Mujagic E. A Novel Percutaneous Technique for Aorto-Iliac Thrombectomy without the Risk of Embolization. Bioengineering (Basel) 2023; 10:778. [PMID: 37508805 PMCID: PMC10376630 DOI: 10.3390/bioengineering10070778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 06/20/2023] [Accepted: 06/26/2023] [Indexed: 07/30/2023] Open
Abstract
Classic surgical thrombectomy of the aorta and iliac arteries through an incision in the groin vessels harbors the risk of embolization to the viscero-renal as well as hypogastric arteries, while percutaneous endovascular thrombectomy techniques can lead to peripheral embolization to the lower limbs. Therefore, we describe a novel, percutaneous technique that tackles the above issues. Furthermore, we also present our initial experience using the technique. The principle of the technique is to percutaneously place large-bore sheaths in the iliac arteries that deliberately occlude the latter to protect the lower limbs from embolization. Through one of these sheaths, over wire Fogarty® catheters can be placed and inflated in the ostia of the coeliac trunk, superior mesenteric artery, renal arteries, and hypogastric arteries as needed. A large thrombectomy balloon catheter is then used to bring any aorto-iliac thrombus into the sheaths, whereafter the thrombus is removed from the sheaths by simply deflating their valves. Additional endovascular procedures of the aorto-iliac branches can be performed as needed. We report nine procedures in 8 patients (4 males and 4 females) with a median age of 63 (53-68.5). Additional endovascular procedures were performed in 6 (66.7%) procedures. All but one procedure were technically successful, and all patients had palpable foot pulses on completion of the procedures, while no patient had clinical signs of peripheral embolization. This technique is a very valid addition to the vascular surgeon's armamentarium when treating aorto-iliac thrombotic events because it is minimally invasive while still protecting against embolization and offering the flexibility to perform a wide range of additional endovascular procedures where needed.
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Affiliation(s)
- Rosalinda D'Amico
- University Hospital of Basel, Spitalstrasse 21, 4031 Basel, Switzerland
- Kantonsspital Aarau, Tellstrasse 25, 5001 Aarau, Switzerland
- Faculty of Medicine, University of Basel, Klingelbergstrasse 61, 4056 Basel, Switzerland
| | - Thomas Wolff
- University Hospital of Basel, Spitalstrasse 21, 4031 Basel, Switzerland
- Faculty of Medicine, University of Basel, Klingelbergstrasse 61, 4056 Basel, Switzerland
| | - Sabine Richarz
- University Hospital of Basel, Spitalstrasse 21, 4031 Basel, Switzerland
- Faculty of Medicine, University of Basel, Klingelbergstrasse 61, 4056 Basel, Switzerland
| | - Lorenz Gurke
- University Hospital of Basel, Spitalstrasse 21, 4031 Basel, Switzerland
- Faculty of Medicine, University of Basel, Klingelbergstrasse 61, 4056 Basel, Switzerland
| | - Andrej Isaak
- Kantonsspital Aarau, Tellstrasse 25, 5001 Aarau, Switzerland
| | - Edin Mujagic
- University Hospital of Basel, Spitalstrasse 21, 4031 Basel, Switzerland
- Faculty of Medicine, University of Basel, Klingelbergstrasse 61, 4056 Basel, Switzerland
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Ettorre L, Longchamp J, Longchamp A, Trunfio R, D'Amico R, Wuarin L, Côté E, Deslarzes-Dubuis C, Déglise S. Preliminary experience with the new off-the-shelf 4 inner branches E-nside for the treatment of complex aortic disease. Br J Surg 2022. [DOI: 10.1093/bjs/znac189.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Objective
In case of complex aortic aneurysmal disease, fenestrated or branched EVAR (b/f-EVAR) is considered as a valid and safe alternative to open surgery. However, one the main limitation is the time required for manufacture, limiting its use in emergent situations. The new off-the-shelf 4 inner branches E-nside (Jotec, Hechingen, Germany) has been developed to offer a solution in such circumstances. The aim of this study was to report our preliminary monocentric experience with this new device.
Methods
Retrospective analysis of prospective data retrieved from 1 center between November 2020 and January 2022 was done. Endpoints were technical success, postoperative morbidity, rate of endoleak and any aneurysm-related re-interventions during follow-up.
Results
In this study, 15 patients (mean age 73 years, range 59–90) were identified. There was a majority of male (9/15) and all of them but 3 were asymptomatic. The mean aneurysmal diameter was 60 mm (range 50–100). There were 3 cases of juxtarenal aortic aneurysms (20%), 1 Crawford type I (7%), 4 type II (27%), 4 type III (27%) and 3 type IV (20%) aneurysms. In 7 cases, a 2-steps procedure was done with a TEVAR first followed by Enside implantation. There was a technical success in 93% with 1 open conversion for a mesenterical bypass. There was no death in the post-operative period. During the post-operative period, 33% of patients (5/15) presented complications with 3 complications related to the femoral or iliac access and 2 cases of spinal cord ischemia (13%). One case occurred in an emergent setting of a type III aneurysm rupture. The other case was the open conversion and the patient also developed a colic ischemia and finally died 4 months alter. The mean length of stay was 9 days. During the follow-up, 2 reinterventions were necessary, 1 for a type Ic endoleak with distal prolongation of the stent and 1 renal stent occlusion treated by relining. The overall target vessel patency was 98%.
Conclusion
The use of the off-the-shelf 4 inner branches E-nside appears to be safe with good technical success for the treatment of complex aortic aneurysmal disease. It is associated with an acceptable rate of complications and allows for treatment of a wide variety of diseases in an emergent setting. Further patients and longer follow-up are required to better evaluate the exact role of this new device.
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Affiliation(s)
- L Ettorre
- Department of Vascular Surgery, Lausanne University Hospital , Lausanne, Switzerland
| | - J Longchamp
- Department of Vascular Surgery, Lausanne University Hospital , Lausanne, Switzerland
| | - A Longchamp
- Department of Vascular Surgery, Lausanne University Hospital , Lausanne, Switzerland
| | - R Trunfio
- Department of Vascular Surgery, Lausanne University Hospital , Lausanne, Switzerland
| | - R D'Amico
- Department of Vascular Surgery, Lausanne University Hospital , Lausanne, Switzerland
| | - L Wuarin
- Department of Vascular Surgery, Lausanne University Hospital , Lausanne, Switzerland
| | - E Côté
- Department of Vascular Surgery, Lausanne University Hospital , Lausanne, Switzerland
| | - C Deslarzes-Dubuis
- Department of Vascular Surgery, Lausanne University Hospital , Lausanne, Switzerland
| | - S Déglise
- Department of Vascular Surgery, Lausanne University Hospital , Lausanne, Switzerland
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5
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Menozzi R, Valoriani F, Prampolini F, Banchelli F, Boldrini E, Martelli F, Galetti S, Fari' R, Gabriele S, Palumbo P, Forni D, Pantaleoni M, D'Amico R, Pecchi AR. Impact of sarcopenia in SARS-CoV-2 patients during two different epidemic waves. Clin Nutr ESPEN 2022; 47:252-259. [PMID: 35063210 PMCID: PMC8648616 DOI: 10.1016/j.clnesp.2021.12.001] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 12/01/2021] [Indexed: 01/11/2023]
Abstract
Background Sarcopenia was reported to be associated with poor clinical outcome, higher incidence of community-acquired pneumonia, increased risk of infections and reduced survival in different clinical settings. The aim of our work is to evaluate the prognostic role of sarcopenia in patients with the 2019 novel coronavirus disease (COVID-19). Materials and methods 272 COVID-19 patients admitted to the University Hospital of Modena (Italy) from February 2020 to January 2021 were retrospectively studied. All included patients underwent a chest computed tomography (CT) scan to assess pneumonia during their hospitalization and showed a positive SARS-CoV-2 molecular test. Sarcopenia was defined by skeletal muscle area (SMA) evaluation at the 12th thoracic vertebra (T12). Clinical, laboratory data and adverse clinical outcome (admission to Intensive Care Unit and death) were collected for all patients. Results Prevalence of sarcopenia was high (41.5%) but significantly different in each pandemic wave (57.9% vs 21.6% p < 0.0000). At the multivariate analysis, sarcopenia during the first wave (Hazard Ratio 2.29, 95% confidence intervals 1.17 to 4.49 p = 0.0162) was the only independent prognostic factor for adverse clinical outcome. There were no significant differences in comorbidities and COVID19 severity in terms of pulmonary involvement at lung CT comparing during the first and second wave. Mixed pattern with peripheral and central involvement was found to be dominant in both groups. Conclusion We highlight the prognostic impact of sarcopenia in COVID-19 patients hospitalized during the first wave. T12 SMA could represent a potential tool to identify sarcopenic patients in particular settings. Further studies are needed to better understand the association between sarcopenia and COVID-19.
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Affiliation(s)
- R Menozzi
- Division of Metabolic Diseases and Clinical Nutrition, University Hospital of Modena, Modena, Italy.
| | - F Valoriani
- Division of Metabolic Diseases and Clinical Nutrition, University Hospital of Modena, Modena, Italy
| | - F Prampolini
- Department of Radiology, University Hospital of Modena, Modena, Italy
| | - F Banchelli
- Unit of Clinical Statistics, University Hospital of Modena, Modena, Italy
| | - E Boldrini
- Division of Metabolic Diseases and Clinical Nutrition, University Hospital of Modena, Modena, Italy
| | - F Martelli
- Department of Radiology, University Hospital of Modena, Modena, Italy
| | - S Galetti
- Division of Metabolic Diseases and Clinical Nutrition, University Hospital of Modena, Modena, Italy
| | - R Fari'
- Department of Radiology, University Hospital of Modena, Modena, Italy
| | - S Gabriele
- Division of Metabolic Diseases and Clinical Nutrition, University Hospital of Modena, Modena, Italy
| | - P Palumbo
- Division of Metabolic Diseases and Clinical Nutrition, University Hospital of Modena, Modena, Italy
| | - D Forni
- Department of Radiology, University Hospital of Modena, Modena, Italy
| | - M Pantaleoni
- Division of Metabolic Diseases and Clinical Nutrition, University Hospital of Modena, Modena, Italy
| | - R D'Amico
- Unit of Clinical Statistics, University Hospital of Modena, Modena, Italy
| | - A R Pecchi
- Department of Radiology, University Hospital of Modena, Modena, Italy
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D'Amico R, Malucelli C, Uccelli A, Grosso A, Di Maggio N, Briquez PS, Hubbell JA, Wolff T, Gürke L, Mujagic E, Gianni-Barrera R, Banfi A. Therapeutic arteriogenesis by factor-decorated fibrin matrices promotes wound healing in diabetic mice. J Tissue Eng 2022; 13:20417314221119615. [PMID: 36093431 PMCID: PMC9452813 DOI: 10.1177/20417314221119615] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 07/28/2022] [Indexed: 11/16/2022] Open
Abstract
Chronic wounds in type-2 diabetic patients present areas of severe local skin ischemia despite mostly normal blood flow in deeper large arteries. Therefore, restoration of blood perfusion requires the opening of arterial connections from the deep vessels to the superficial skin layer, that is, arteriogenesis. Arteriogenesis is regulated differently from microvascular angiogenesis and is optimally stimulated by high doses of Vascular Endothelial Growth Factor-A (VEGF) together with Platelet-Derived Growth Factor-BB (PDGF-BB). Here we found that fibrin hydrogels decorated with engineered versions of VEGF and PDGF-BB proteins, to ensure protection from degradation and controlled delivery, efficiently accelerated wound closure in diabetic and obese db/db mice, promoting robust microvascular growth and a marked increase in feeding arterioles. Notably, targeting the arteriogenic factors to the intact arterio-venous networks in the dermis around the wound was more effective than the routine treatment of the inflamed wound bed. This approach is readily translatable to a clinical setting.
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Affiliation(s)
- Rosalinda D'Amico
- Cell and Gene Therapy, Department of Biomedicine, Basel University Hospital and University of Basel, Basel, Switzerland.,Vascular Surgery, Department of Surgery, Basel University Hospital and University of Basel, Basel, Switzerland
| | - Camilla Malucelli
- Cell and Gene Therapy, Department of Biomedicine, Basel University Hospital and University of Basel, Basel, Switzerland
| | - Andrea Uccelli
- Cell and Gene Therapy, Department of Biomedicine, Basel University Hospital and University of Basel, Basel, Switzerland
| | - Andrea Grosso
- Cell and Gene Therapy, Department of Biomedicine, Basel University Hospital and University of Basel, Basel, Switzerland
| | - Nunzia Di Maggio
- Cell and Gene Therapy, Department of Biomedicine, Basel University Hospital and University of Basel, Basel, Switzerland
| | - Priscilla S Briquez
- Pritzker School of Molecular Engineering, University of Chicago, Chicago, IL, USA
| | - Jeffrey A Hubbell
- Pritzker School of Molecular Engineering, University of Chicago, Chicago, IL, USA
| | - Thomas Wolff
- Vascular Surgery, Department of Surgery, Basel University Hospital and University of Basel, Basel, Switzerland
| | - Lorenz Gürke
- Vascular Surgery, Department of Surgery, Basel University Hospital and University of Basel, Basel, Switzerland
| | - Edin Mujagic
- Vascular Surgery, Department of Surgery, Basel University Hospital and University of Basel, Basel, Switzerland
| | - Roberto Gianni-Barrera
- Cell and Gene Therapy, Department of Biomedicine, Basel University Hospital and University of Basel, Basel, Switzerland
| | - Andrea Banfi
- Cell and Gene Therapy, Department of Biomedicine, Basel University Hospital and University of Basel, Basel, Switzerland.,Vascular Surgery, Department of Surgery, Basel University Hospital and University of Basel, Basel, Switzerland
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7
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Khaw P, Do V, Lim K, Cunninghame J, Dixon J, Vassie J, Bailey M, Johnson C, Kahl K, Gordon C, Cook O, Foo K, Fyles A, Powell M, Haie-Meder C, D'Amico R, Bessette P, Mileshkin L, Creutzberg CL, Moore A. Radiotherapy Quality Assurance in the PORTEC-3 (TROG 08.04) Trial. Clin Oncol (R Coll Radiol) 2021; 34:198-204. [PMID: 34903431 DOI: 10.1016/j.clon.2021.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 10/09/2021] [Accepted: 11/18/2021] [Indexed: 11/03/2022]
Abstract
AIMS Quality assurance in radiotherapy (QART) is essential to ensure the scientific integrity of a clinical trial. This paper reports the findings of the retrospective QART assessment for all centres that participated in PORTEC-3; a randomised controlled trial that compared pelvic radiotherapy with concurrent chemoradiotherapy to the pelvis followed by adjuvant chemotherapy. The trial showed an overall survival benefit for the addition of the chemotherapy in the management of women with high-risk endometrial cancer. MATERIALS AND METHODS Clinicians were invited to upload a randomly selected case/s treated at each of the participating sites. Panel reviewers analysed the contours to certify that the target volumes and organ at risk structures were contoured according to guidelines. The results were categorised into acceptable, minor variation, major variation or unevaluable. The radiotherapy plans were dosimetrically evaluated using the well-established Trans-Tasman Radiation Oncology Group (TROG) protocol. RESULTS Between August 2010 and January 2018, data from 146 patients of 686 consecutively treated patients were retrospectively reviewed. All 16 Australia and New Zealand and 71 of 77 international centres uploaded data for evaluation. In total, 3514 dosimetric and contour variables were reviewed. Of these, 3136 variables were deemed acceptable (89.2%), with 335 minor (9.6%) and 43 major variations (1.2%). Major contour variations included the clinical target volume vaginal vault, clinical target volume parametria and differential planning target volume vault expansion. CONCLUSION The results of the QART assessment confirmed high uniformity and low rates of both minor and major deviations in contouring and dosimetry in all sites. This supports the safe introduction of the PORTEC-3 treatment protocol into routine clinical practice.
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Affiliation(s)
- P Khaw
- Division of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; University of Melbourne, Melbourne, Victoria, Australia.
| | - V Do
- Liverpool Cancer Therapy Centre, Liverpool, New South Wales, Australia; South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - K Lim
- Liverpool Cancer Therapy Centre, Liverpool, New South Wales, Australia; South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - J Cunninghame
- Division of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - J Dixon
- Illawarra Cancer Care Centre, Wollongong, New South Wales, Australia
| | - J Vassie
- Division of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - M Bailey
- Illawarra Cancer Care Centre, Wollongong, New South Wales, Australia
| | - C Johnson
- Blood & Cancer Centre, Wellington Hospital, Wellington, New Zealand
| | - K Kahl
- Shoalhaven Cancer Care Centre, Nowra, New South Wales, Australia
| | - C Gordon
- Illawarra Cancer Care Centre, Wollongong, New South Wales, Australia
| | - O Cook
- Trans-Tasman Radiation Oncology Group (TROG), Waratah, New South Wales, Australia
| | - K Foo
- Institute of Medical Physics, School of Physics, University of Sydney, Sydney, New South Wales, Australia
| | - A Fyles
- Canadian Cancer Trials Group, Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - M Powell
- Department of Clinical Oncology, Barts Health NHS Trust, London, UK
| | - C Haie-Meder
- Department of Radiotherapy, Institut Gustave Roussy, Villejuif, France
| | - R D'Amico
- Division of Radiation Oncology, ASST-Lecco, Ospedale A. Manzoni, Lecco, Italy
| | - P Bessette
- Gynaecologic Oncology, University of Sherbrooke, Sherbrooke, Quebec, Canada
| | - L Mileshkin
- Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - C L Creutzberg
- Department of Radiation Oncology, Leiden University Medical Centre, Leiden, the Netherlands
| | - A Moore
- Trans-Tasman Radiation Oncology Group (TROG), Waratah, New South Wales, Australia
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8
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Earl H, Hiller L, Dunn J, Conte P, D'Amico R, Guarneri V, Joensuu H, Huttunen T, Georgoulias V, Abraham J, Cameron D, Miles D, Wardley A, Romieu G, Debled M, Faure-Mercier C, Lindman H, Fraser J, Cox D, Pivot X. LBA11 Individual patient data meta-analysis of 5 non-inferiority RCTs of reduced duration single agent adjuvant trastuzumab in the treatment of HER2 positive early breast cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.2083] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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9
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Certelli A, Valente P, Uccelli A, Grosso A, Di Maggio N, D'Amico R, Briquez PS, Hubbell JA, Wolff T, Gürke L, Mujagic E, Gianni-Barrera R, Banfi A. Robust Angiogenesis and Arteriogenesis in the Skin of Diabetic Mice by Transient Delivery of Engineered VEGF and PDGF-BB Proteins in Fibrin Hydrogels. Front Bioeng Biotechnol 2021; 9:688467. [PMID: 34277588 PMCID: PMC8281302 DOI: 10.3389/fbioe.2021.688467] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 06/02/2021] [Indexed: 12/20/2022] Open
Abstract
Non-healing ulcers are a serious complication of diabetes mellitus and a major unmet medical need. A major cause for the lack of healing is the impairment of spontaneous vascularization in the skin, despite mostly normal blood flow in deeper large vessels. Therefore, pro-angiogenic treatments are needed to increase therapeutic perfusion by recruiting new arterial connections (therapeutic arteriogenesis). Vascular endothelial growth factor (VEGF) is the master regulator of angiogenesis in physiology and disease, but exploitation of its therapeutic potential requires careful control of its dose distribution in tissue. Co-delivery of platelet derived growth factor-BB (PDGF-BB) has been shown to expand the therapeutic window of VEGF and also improve associated arteriogenesis. We used a highly controlled protein delivery system, based on a clinically applicable fibrin-based platform, to investigate the angiogenic and arteriogenic potential of engineered versions (TG-) of VEGF and PDGF-BB proteins in the skin of diabetic and obese db/db mice. Intradermal delivery of therapeutically relevant doses of TG-VEGF and TG-PDGF-BB induced robust growth of new microvascular networks with similar efficacy as in normal littermate control mice. Further, TG-PDGF-BB prevented the formation of aberrant vascular enlargements by high TG-VEGF levels. As fibrin was degraded after the first week, the induced angiogenesis mostly regressed by 4 weeks, but it promoted effective arteriogenesis in the dermal layer. Therefore, controlled co-delivery of TG-VEGF and TG-PDGF-BB recombinant proteins is effective to induce angiogenesis and arteriogenesis in diabetic mouse skin and should be further investigated to promote diabetic wound healing.
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Affiliation(s)
- Alessandro Certelli
- Cell and Gene Therapy, Department of Biomedicine, University Hospital of Basel, University of Basel, Basel, Switzerland
| | - Paolo Valente
- Cell and Gene Therapy, Department of Biomedicine, University Hospital of Basel, University of Basel, Basel, Switzerland.,Vascular Surgery, Department of Surgery, University Hospital of Basel, University of Basel, Basel, Switzerland
| | - Andrea Uccelli
- Cell and Gene Therapy, Department of Biomedicine, University Hospital of Basel, University of Basel, Basel, Switzerland
| | - Andrea Grosso
- Cell and Gene Therapy, Department of Biomedicine, University Hospital of Basel, University of Basel, Basel, Switzerland
| | - Nunzia Di Maggio
- Cell and Gene Therapy, Department of Biomedicine, University Hospital of Basel, University of Basel, Basel, Switzerland
| | - Rosalinda D'Amico
- Cell and Gene Therapy, Department of Biomedicine, University Hospital of Basel, University of Basel, Basel, Switzerland.,Vascular Surgery, Department of Surgery, University Hospital of Basel, University of Basel, Basel, Switzerland
| | - Priscilla S Briquez
- Pritzker School of Molecular Engineering, University of Chicago, Chicago, IL, United States
| | - Jeffrey A Hubbell
- Pritzker School of Molecular Engineering, University of Chicago, Chicago, IL, United States
| | - Thomas Wolff
- Vascular Surgery, Department of Surgery, University Hospital of Basel, University of Basel, Basel, Switzerland
| | - Lorenz Gürke
- Vascular Surgery, Department of Surgery, University Hospital of Basel, University of Basel, Basel, Switzerland
| | - Edin Mujagic
- Vascular Surgery, Department of Surgery, University Hospital of Basel, University of Basel, Basel, Switzerland
| | - Roberto Gianni-Barrera
- Cell and Gene Therapy, Department of Biomedicine, University Hospital of Basel, University of Basel, Basel, Switzerland
| | - Andrea Banfi
- Cell and Gene Therapy, Department of Biomedicine, University Hospital of Basel, University of Basel, Basel, Switzerland.,Vascular Surgery, Department of Surgery, University Hospital of Basel, University of Basel, Basel, Switzerland
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10
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Chiossi G, Facchinetti F, Vergani P, Di Tommaso M, Marozio L, Acaia B, Pignatti L, Locatelli A, Spitaleri M, Benedetto C, Zaina B, D'Amico R. Serial cervical-length measurements after first episode of threatened preterm labor improve prediction of spontaneous delivery prior to 37 weeks' gestation. Ultrasound Obstet Gynecol 2021; 57:298-304. [PMID: 32851714 DOI: 10.1002/uog.22188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 08/10/2020] [Accepted: 08/18/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To assess whether repeat cervical-length (CL) measurement in women discharged from hospital after their first episode of threatened preterm labor can predict their risk of spontaneous preterm birth. METHODS This was a secondary analysis of a randomized controlled trial of maintenance tocolysis, in which CL was measured on transvaginal ultrasound at the time of hospital discharge and after 2, 4, 8 and 12 weeks, in women who remained undelivered after their first episode of threatened preterm labor. After univariate analysis, multivariate logistic regression analysis was used to assess whether CL < 10 mm at the time of hospital discharge or at any follow-up evaluation could predict spontaneous delivery prior to 37 weeks of gestation. RESULTS Of 226 women discharged after a diagnosis of threatened preterm labor, 57 (25.2%) delivered spontaneously prior to 37 weeks' gestation. The risk of spontaneous preterm birth was higher among women with CL < 10 mm at hospital discharge compared to those with CL ≥ 10 mm (adjusted odds ratio (aOR), 3.3; 95% CI, 1.2-9.2). Moreover, spontaneous preterm delivery was more common when CL < 10 mm was detected up to 2 weeks (aOR, 2.9; 95% CI, 1.1-7.3) or up to 4 weeks (aOR, 7.3; 95% CI, 2.3-22.8) post discharge, as compared with when CL was persistently ≥ 10 mm. The association was not significant when considering CL measurements at 8 weeks, and there was insufficient information to assess the effect of measurements obtained at 12 weeks. CONCLUSIONS Women who remain undelivered after their first episode of threatened preterm labor continue to be at high risk of spontaneous preterm birth if their CL is below 10 mm at the time of hospital discharge or at any follow-up visit up to 4 weeks later. CL measurement could be included in the antenatal care of these women in order to stratify their risk of preterm birth, rationalize resource utilization and help clinicians improve pregnancy outcome. © 2020 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- G Chiossi
- Division of Obstetrics, Department of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena and Reggio Emilia, Modena, Italy
| | - F Facchinetti
- Division of Obstetrics, Department of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena and Reggio Emilia, Modena, Italy
| | - P Vergani
- Department of Medicine and Surgery, Obstetrics and Gynecology Branch, University of Milano-Bicocca Health Science, Milan, Italy
| | - M Di Tommaso
- Health Science Department, Obstetrics and Gynecology Branch, University of Florence, Florence, Italy
| | - L Marozio
- Department of Surgical Sciences, Gynecology and Obstetrics 1, University of Turin, Turin, Italy
| | - B Acaia
- Department of Medicine and Surgery, Obstetrics and Gynecology Branch, University of Milano-Bicocca Health Science, Milan, Italy
| | - L Pignatti
- Division of Obstetrics, Department of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena and Reggio Emilia, Modena, Italy
| | - A Locatelli
- Department of Medicine and Surgery, Obstetrics and Gynecology Branch, University of Milano-Bicocca Health Science, Milan, Italy
| | - M Spitaleri
- Health Science Department, Obstetrics and Gynecology Branch, University of Florence, Florence, Italy
| | - C Benedetto
- Department of Surgical Sciences, Gynecology and Obstetrics 1, University of Turin, Turin, Italy
| | - B Zaina
- Department of Medicine and Surgery, Obstetrics and Gynecology Branch, University of Milano-Bicocca Health Science, Milan, Italy
| | - R D'Amico
- Statistics Unit, Department of Diagnostic and Clinical Medicine and Public Health, University of Modena and Reggio Emilia, Modena, Italy
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11
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Pietrantonio F, Alessi E, Pascucci M, Delli Castelli M, D'Amico R, Ronchetti M. Innovation in health care: continuous wireless monitoring to improve management of critically ill atients: LIMS study preliminary results. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3482] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Wireless vital parameter continuous monitoring (WVPCM) is compared to regular nurse monitoring in order to provide data on the clinical and economic impact of critically ill patients (CIPs) in Internal Medicine Units (IMU).
Study Design
Pilot prospective randomized controlled open-label multi-center study with WIN@Hospital wearable wireless system creating alerts on portable devices (ipad). Experimental Arm: CIPs with MEWS (Modified Early Warning Score) ≥3 and/or NEWS (National Early Warning Score) ≥5 at admission underwent WCPCM over the first 72 h. Active Comparator: CIPs with MEWS ≥3 and/or NEWS ≥5 at admission undergoing regular nurse monitoring.
Method
Primary outcomes: Reduction of major complications (MC) from 15% to 5%. Secondary outcomes: One day reduction in length of stay (LOS); reduced nurse monitoring time; accurate patient stratification and definition of end stage disease.
Results
Preliminary results: Enrolled 145 and evaluable 125 patients (51 M/74 F), mean age 80.5 years, Comorbidity: Cumulative Illness Rating Scale CIRS-CI: 4, CIRS SI: 1.8. About 38% scored a BRASS (Blaylock Risk Assessment Screening Score) ≥20 indicating need for discharge planning requiring step-down care. More than 50% of patients present IIA index >3 indicating high dependency from nursing assistance. Nurses saved a minimum of 49,6 minutes to a maximum of 58,1 minutes on time spent monitoring each patient per day. A trend towards reduction of major complications in the experimental group appears to be seen (31% versus 45%). Decrease in re-admissions (7% versus 11%) and mortality (7.3% versus 23.9%) has been observed. Arrhythmic and ischemic complications detection doubled in the experimental arm. More than 30% of the patients meet the criteria defining end stage disease.
Conclusion
WVPCM, detecting early deterioration in CIPs, may facilitate timely response in at-risk patients, increasing safety and reducing costs.
Telemedicine Network
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- F Pietrantonio
- Castelli Hospital Internal Medicine Unit, Internal Medicine Department, Ariccia (Rome), Italy
| | - E Alessi
- Castelli Hospital Internal Medicine Unit, Internal Medicine Department, Ariccia (Rome), Italy
| | - M Pascucci
- Castelli Hospital Internal Medicine Unit, Internal Medicine Department, Ariccia (Rome), Italy
| | - M Delli Castelli
- Castelli Hospital Internal Medicine Unit, Internal Medicine Department, Ariccia (Rome), Italy
| | - R D'Amico
- University of Modena & Reggio Emilia, Department of Medical and Surgical Sciences, Mother and Child and Adult Health, Modena, Italy
| | - M Ronchetti
- ASL Roma 6, Health Management Head Office, Albano Laziale (Rome), Italy
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12
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Post C, De Boer S, Powell M, Mileshkin L, Katsaros D, Bessette P, Haie-Meder C, Ottevanger P, Ledermann J, Khaw P, D'Amico R, Fyles A, Baron M, Kitchener H, Nijman H, Lutgens L, Brooks S, Jürgenliemk-Schulz I, Feeney A, Nout R, Verhoeven-Adema K, Smit V, Putter H, Creutzberg C. OC-0369: Long-Term Quality of Life after (chemo)radiotherapy for high-risk Endometrial Cancer in PORTEC-3. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00393-5] [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: 11/16/2022]
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13
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Dieci MV, Conte P, Bisagni G, Brandes AA, Frassoldati A, Cavanna L, Musolino A, Giotta F, Rimanti A, Garrone O, Bertone E, Cagossi K, Sarti S, Ferro A, Piacentini F, Maiorana A, Orvieto E, Sanders M, Miglietta F, Balduzzi S, D'Amico R, Guarneri V. Association of tumor-infiltrating lymphocytes with distant disease-free survival in the ShortHER randomized adjuvant trial for patients with early HER2+ breast cancer. Ann Oncol 2020; 30:418-423. [PMID: 30657852 PMCID: PMC6442655 DOI: 10.1093/annonc/mdz007] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND There is the need to identify new prognostic markers to refine risk stratification for HER2-positive early breast cancer patients. The aim of this study was to evaluate the association of tumor-infiltrating lymphocytes (TILs) with distant disease-free survival (DDFS) in patients with HER2-positive early breast cancer enrolled in the ShortHER adjuvant trial which compared 9 weeks versus 1-year trastuzumab in addition to chemotherapy, and to test the interaction between TILs and treatment arm. PATIENTS AND METHODS Stromal TILs were assessed for 866 cases on centralized hematoxylin and eosin-stained tumor slides. The association of TILs as 10% increments with DDFS was assessed with Cox models. Kaplan-Meier curves were estimated for patients with TILs ≥20% and TILs <20%. Median follow-up was 6.1 years. RESULTS Median TILs was 5% (Q1-Q3 1%-15%). Increased TILs were independently associated with better DDFS in multivariable model [hazard ratio (HR) 0.73, 95% confidence interval (CI) 0.59-0.89, P = 0.006, for each 10% TILs increment]. Five years DDFS rates were 91.1% for patients with TILs <20% and 95.7% for patients with TILs ≥20% (P = 0.025). The association between 10% TILs increments and DDFS was significant for patients randomized to 9 weeks of trastuzumab (HR 0.60, 95% CI 0.41-0.88) but not for patients treated with 1 year of trastuzumab (HR 0.89, 95% CI 0.71-1.12; test for interaction P = 0.088). For patients with TILs <20%, the HR for the comparison between the short versus the long arm was 1.75 (95% CI 1.09-2.80, P=0.021); whereas, for patients with TILs ≥20% the HR for the comparison of short versus long arm was 0.23 (95% CI 0.05-1.09, P = 0.064), resulting in a significant interaction (P = 0.015). CONCLUSIONS TILs are an independent prognostic factor for HER2-positive early breast cancer patients treated with adjuvant chemotherapy and trastuzumab and may refine the ability to identify patients at low risk of relapse eligible for de-escalated adjuvant therapy.
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Affiliation(s)
- M V Dieci
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova; Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padova
| | - P Conte
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova; Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padova.
| | - G Bisagni
- Oncology Unit, Department of Oncology and Advanced Technologies, Azienda USL-IRCCS, Reggio Emilia
| | - A A Brandes
- Medical Oncology, Azienda Unità Sanitaria Locale di Bologna-IRCCS Istituto delle Scienze Neurologiche, Bologna
| | - A Frassoldati
- Clinical Oncology, Department of Morphology, Surgery and Experimental Medicine, S Anna University Hospital, Ferrara
| | - L Cavanna
- Department of Oncology-Hematology, G. da Saliceto Hospital, Piacenza
| | - A Musolino
- Medical Oncology Unit, University Hospital of Parma, Piacenza
| | - F Giotta
- Division of Medical Oncology, IRCCS, Istituto Tumori "Giovanni Paolo II", Bari
| | - A Rimanti
- Medical Oncology, Azienda Ospedaliera di Mantova, Mantova
| | - O Garrone
- Medical Oncology, A.O. S. Croce and Carle Teaching Hospital, Cuneo
| | - E Bertone
- Medical Oncology, S. Anna Hospital, Torino
| | - K Cagossi
- Breast Unit Ausl Modena, Ramazzini Hospital, Carpi
| | - S Sarti
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola
| | - A Ferro
- Rete Clinica Senologica - Oncologia Medica S. Chiara, Trento
| | - F Piacentini
- Division of Medical Oncology, Department of Medical and Surgical Sciences for Children & Adults, University Hospital of Modena, Modena; Azienda Ospedaliero-Universitaria di Modena, Modena
| | - A Maiorana
- Department of Diagnostic, Clinical Medicine and Public Health, University Hospital of Modena, Modena
| | - E Orvieto
- Pathology Unit, Ulss 5 Polesana, Rovigo, Italy
| | - M Sanders
- Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, USA
| | - F Miglietta
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova
| | - S Balduzzi
- Department of Medical and Surgical Sciences for Children & Adults, University Hospital of Modena, Italy
| | - R D'Amico
- Department of Medical and Surgical Sciences for Children & Adults, University Hospital of Modena, Italy
| | - V Guarneri
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova; Medical Oncology 2, Istituto Oncologico Veneto IRCCS, Padova
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14
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D'Amico R, Malucelli C, Uccelli A, Grosso A, Di Maggio N, Gürke L, Wolff T, Mujagic E, Briquez PS, Hubbell JA, Gianni-Barrera R, Banfi A. Therapeutic Arteriogenesis by Fibrin Based Delivery Of Engineered VEGF and PDGF-BB Accelerates Diabetic Wound Healing in a Mouse Model. EJVES Vasc Forum 2020. [DOI: 10.1016/j.ejvsvf.2020.07.016] [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: 11/16/2022] Open
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15
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Conte P, Frassoldati A, Bisagni G, Brandes AA, Donadio M, Garrone O, Piacentini F, Cavanna L, Giotta F, Aieta M, Gebbia V, Molino A, Musolino A, Ferro A, Maltoni R, Danese S, Zamagni C, Rimanti A, Cagossi K, Russo A, Pronzato P, Giovanardi F, Moretti G, Lombardo L, Schirone A, Beano A, Amaducci L, Bajardi EA, Vicini R, Balduzzi S, D'Amico R, Guarneri V. Nine weeks versus 1 year adjuvant trastuzumab in combination with chemotherapy: final results of the phase III randomized Short-HER study‡. Ann Oncol 2019; 29:2328-2333. [PMID: 30219886 DOI: 10.1093/annonc/mdy414] [Citation(s) in RCA: 100] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Chemotherapy plus 1-year trastuzumab is the standard adjuvant treatment of HER2-positive breast cancer. The efficacy of less extended trastuzumab exposure is under investigation. The short-HER study was aimed to assess the non-inferiority of 9 weeks versus 1 year of adjuvant trastuzumab combined with chemotherapy. Patients and methods HER2-positive breast cancer patients with node-positive or, if node negative, with at least one risk factor (pT>2 cm, G3, lympho-vascular invasion, Ki-67 > 20%, age ≤35 years, or hormone receptor negativity) were randomly assigned to receive sequential anthracycline-taxane combinations plus 1-year trastuzumab (arm A, long) or plus 9 weeks trastuzumab (arm B, short). This study was designed as a non-inferiority trial with disease-free survival (DFS) as primary end point. A DFS hazard ratio (HR) <1.29 was chosen as the non-inferiority margin. Analyses according to the frequentist and Bayesian approach were planned. Secondary end points included 2-year failure rate and cardiac safety. Results A total of 1254 patients from 82 centers were randomized (arm A, long: n = 627; arm B, short: n = 626). Five-year DFS is 88% in the long and 85% in the short arm. The HR is 1.13 (90% CI 0.89-1.42), with the upper limit of the CI crossing the non-inferiority margin. According to the Bayesian analysis, the probability that the short arm is non-inferior to the long one is 80%. The 5-year overall survival (OS) is 95.2% in the long and 95.0% in the short arm (HR 1.07, 90% CI 0.74-1.56). Cardiac events are significantly lower in the short arm (risk-ratio 0.33, 95% CI 0.22-0.50, P < 0.0001). Conclusions This study failed to show the non-inferiority of a shorter trastuzumab administration. One-year trastuzumab remains the standard. However, a 9-week administration decreases the risk of severe cardiac toxicity and can be an option for patients with cardiac events during treatment and for those with a low risk of relapse. Trial Registration EUDRACT number: 2007-004326-25; NCI ClinicalTrials.gov number: NCT00629278.
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Affiliation(s)
- P Conte
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy; Medical Oncology 2, Istituto Oncologico Veneto (IOV), IRCCS, Padova, Italy.
| | - A Frassoldati
- Clinical Oncology, Department of Morphology, Surgery and Experimental Medicine, S Anna University Hospital, Ferrara, Italy
| | - G Bisagni
- Department of Oncology and Advanced Technologies, Oncology Unit, IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
| | - A A Brandes
- Medical Oncology, Azienda Unità Sanitaria Locale di Bologna-IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy
| | - M Donadio
- Department of Medical Oncology 1, Città della Salute e della Scienza Hospital, Turin, Italy
| | - O Garrone
- Medical Oncology, A.O. S. Croce and Carle Teaching Hospital, Cuneo, Italy
| | - F Piacentini
- Division of Medical Oncology, Department of Medical and Surgical Sciences for Children & Adults, University Hospital of Modena, Modena, Italy; Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
| | - L Cavanna
- Department of Oncology-Hematology, G. da Saliceto Hospital, Piacenza, Italy
| | - F Giotta
- Division of Medical Oncology, IRCCS, Giovanni Paolo II Hospital, Bari, Italy
| | - M Aieta
- Division of Medical Oncology, IRCCS-CROB, Referral Cancer Center of Basilicata, Rionero Vulture (PZ), Italy
| | - V Gebbia
- Medical Oncology, Casa di Cura La Maddalena, University of Palermo, Palermo, Italy
| | - A Molino
- Oncology Unit, Verona University Hospital, Verona, Italy
| | - A Musolino
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - A Ferro
- Medical Oncology, Santa Chiara Hospital, Trento, Italy
| | - R Maltoni
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, IRST, IRCCS, Meldola, Italy
| | - S Danese
- Department of Gynecology and Obstetrics, Ospedale S. Anna, Turin, Italy
| | - C Zamagni
- Policlinico S.Orsola-Malpighi, SSD Oncologia Medica Addarii, Bologna, Italy
| | - A Rimanti
- Medical Oncology, Azienda Ospedaliera Carlo Poma, Mantova, Italy
| | - K Cagossi
- Division of Medical Oncology, "B.Ramazzini" Hospital, Carpi, Italy
| | - A Russo
- Section of Medical Oncology, Department of Surgical and Oncological Sciences, University of Palermo, Palermo, Italy
| | - P Pronzato
- Department of Medical Oncology, U.O. Oncologia Medica 2, IRCCS AOU San Martino-IST, Genova, Italy
| | - F Giovanardi
- Department of Oncology and Advanced Technologies, Oncology Unit, IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
| | - G Moretti
- Department of Oncology and Advanced Technologies, Oncology Unit, IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
| | - L Lombardo
- Medical Oncology, Azienda Unità Sanitaria Locale di Bologna-IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy
| | - A Schirone
- Clinical Oncology, Department of Morphology, Surgery and Experimental Medicine, S Anna University Hospital, Ferrara, Italy
| | - A Beano
- Department of Medical Oncology 1, Città della Salute e della Scienza Hospital, Turin, Italy
| | - L Amaducci
- Medical Oncology Unit, Ospedale degli Infermi Faenza, Faenza, Italy
| | - E A Bajardi
- Medical Oncology, Casa di Cura La Maddalena, University of Palermo, Palermo, Italy
| | - R Vicini
- Department of Diagnostic and Clinical Medicine and Public Health, Statistics Unit, University Hospital of Modena and Reggio Emilia, Modena, Italy
| | - S Balduzzi
- Department of Diagnostic and Clinical Medicine and Public Health, Statistics Unit, University Hospital of Modena and Reggio Emilia, Modena, Italy
| | - R D'Amico
- Azienda Ospedaliero-Universitaria di Modena, Modena, Italy; Department of Diagnostic and Clinical Medicine and Public Health, Statistics Unit, University Hospital of Modena and Reggio Emilia, Modena, Italy
| | - V Guarneri
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy; Medical Oncology 2, Istituto Oncologico Veneto (IOV), IRCCS, Padova, Italy
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16
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Manfredi A, Cassone G, Cerri S, Venerito V, Fedele AL, Trevisani M, Furini F, Addimanda O, Pancaldi F, Della Casa G, D'Amico R, Vicini R, Sandri G, Torricelli P, Celentano I, Bortoluzzi A, Malavolta N, Meliconi R, Iannone F, Gremese E, Luppi F, Salvarani C, Sebastiani M. Diagnostic accuracy of a velcro sound detector (VECTOR) for interstitial lung disease in rheumatoid arthritis patients: the InSPIRAtE validation study (INterStitial pneumonia in rheumatoid ArThritis with an electronic device). BMC Pulm Med 2019; 19:111. [PMID: 31221137 PMCID: PMC6587236 DOI: 10.1186/s12890-019-0875-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 06/11/2019] [Indexed: 01/12/2023] Open
Abstract
Background Interstitial lung disease (ILD) is a severe systemic manifestation of rheumatoid arthritis (RA). High-resolution computed tomography (HRCT) represents the gold standard for the diagnosis of ILD, but its routine use for screening programs is not advisable because of both high cost and X-ray exposure. Velcro crackles at lung auscultation occur very early in the course of interstitial pneumonia, and their detection is an indication for HRCT. Recently, we developed an algorithm (VECTOR) to detect the presence of Velcro crackles in pulmonary sounds and showed good results in a small sample of RA patients. The aim of the present investigation was to validate the diagnostic accuracy of VECTOR in a larger population of RA patients, compared with that of the reference standard of HRCT, from a multicentre study. Methods To avoid X-ray exposure, we enrolled 137 consecutive RA patients who had recently undergone HRCT. Lung sounds of all patients were recorded in 4 pulmonary fields bilaterally with a commercial electronic stethoscope (ES); subsequently, all HRCT images were blindly evaluated by a radiologist, and audio data were analysed by means of VECTOR. Results Fifty-nine of 137 patients showed ILD (43.1%). VECTOR correctly classified 115/137 patients, showing a diagnostic accuracy of 83.9% and a sensitivity and specificity of 93.2 and 76.9%, respectively. Conclusions VECTOR may represent the first validated tool for the screening of RA patients who are suspected for ILD and who should be directed to HRCT for the diagnosis. Moreover, early identification of RA-ILD could contribute to the design of prospective studies aimed at elucidating unclear aspects of the disease.
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Affiliation(s)
- A Manfredi
- Rheumatology Unit, Azienda Policlinico di Modena, University of Modena and Reggio Emilia, Via del Pozzo, 71 41121, Modena, Italy.
| | - G Cassone
- Rheumatology Unit, Azienda Policlinico di Modena, University of Modena and Reggio Emilia, Via del Pozzo, 71 41121, Modena, Italy
| | - S Cerri
- Respiratory Disease Unit, Azienda Policlinico di Modena, University of Modena and Reggio Emilia, 41124, Modena, Italy
| | - V Venerito
- Rheumatology Unit, Dipartimento Interdisciplinare di Medicina, University of Bari, 70124, Bari, Italy
| | - A L Fedele
- Rheumatology Unit, Catholic University of the Sacred Heart, 00168, Rome, Italy
| | - M Trevisani
- Rheumatology Unit, Azienda Ospedaliero-Universitaria di Bologna Policlinico Sant'Orsola-Malpighi, 40121, Bologna, Italy
| | - F Furini
- Rheumatology Unit, Clinical and experimental Medicine, Sant'Anna Hospital, 44121, Ferrara, Italy
| | - O Addimanda
- Rheumatology Unit, Department of Biomedical and Neuromotor Sciences, Rizzoli Orthopaedic Institute and University of Bologna, 40136, Bologna, Italy
| | - F Pancaldi
- Department of Sciences and Methods for Engineering, University of Modena and Reggio Emilia, 41124, Modena, Italy
| | - G Della Casa
- Radiology Unit, Azienda Policlinico di Modena, University of Modena and Reggio Emilia, 41124, Modena, Italy
| | - R D'Amico
- Unit of Statistics in Medicine, Department of Oncology and Hematology, University of Modena and Reggio Emilia, 41124, Modena, Italy
| | - R Vicini
- Unit of Statistics in Medicine, Department of Oncology and Hematology, University of Modena and Reggio Emilia, 41124, Modena, Italy
| | - G Sandri
- Rheumatology Unit, Azienda Policlinico di Modena, University of Modena and Reggio Emilia, Via del Pozzo, 71 41121, Modena, Italy
| | - P Torricelli
- Radiology Unit, Azienda Policlinico di Modena, University of Modena and Reggio Emilia, 41124, Modena, Italy
| | - I Celentano
- Radiology Unit, Azienda Policlinico di Modena, University of Modena and Reggio Emilia, 41124, Modena, Italy
| | - A Bortoluzzi
- Rheumatology Unit, Clinical and experimental Medicine, Sant'Anna Hospital, 44121, Ferrara, Italy
| | - N Malavolta
- Rheumatology Unit, Azienda Ospedaliero-Universitaria di Bologna Policlinico Sant'Orsola-Malpighi, 40121, Bologna, Italy
| | - R Meliconi
- Rheumatology Unit, Department of Biomedical and Neuromotor Sciences, Rizzoli Orthopaedic Institute and University of Bologna, 40136, Bologna, Italy
| | - F Iannone
- Rheumatology Unit, Dipartimento Interdisciplinare di Medicina, University of Bari, 70124, Bari, Italy
| | - E Gremese
- Rheumatology Unit, Catholic University of the Sacred Heart, 00168, Rome, Italy
| | - F Luppi
- Respiratory Disease Unit, Azienda Policlinico di Modena, University of Modena and Reggio Emilia, 41124, Modena, Italy
| | - C Salvarani
- Rheumatology Unit, Azienda Policlinico di Modena, University of Modena and Reggio Emilia, Via del Pozzo, 71 41121, Modena, Italy.,Rheumatology Unit, Santa Maria Hospital, IRCCS, 42121, Reggio Emilia, Italy
| | - M Sebastiani
- Rheumatology Unit, Azienda Policlinico di Modena, University of Modena and Reggio Emilia, Via del Pozzo, 71 41121, Modena, Italy
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Delishaj D, Fumagalli I, Cocchi A, Vola A, De Nobili G, Gherardi F, Bonsignore F, Tagliabue F, Arnoffi J, D'Amico R, Declich F, Ardizzoia A, Soatti C. EP-1474 Preoperative RT-CT in locally advanced rectal cancer using different RT doses; our experience. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31894-8] [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: 10/26/2022]
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Delishaj D, Fumagalli I, D'Amico R, Sangalli G, Declich F, Frigerio C, Soatti C. PV-0142 HDR BRT treatment of non-melanoma skin cancer: outcome and feasibility in a retrospective analysis. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30562-6] [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: 11/30/2022]
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D'Angelo A, Rinaldi P, Belli P, D'Amico R, Carlino G, Grippo C, Giuliani M, Orlandi A, Infante A, Manfredi R. Usefulness of automated breast volume scanner (ABVS) for monitoring tumor response to neoadjuvant treatment in breast cancer patients: preliminary results. Eur Rev Med Pharmacol Sci 2019; 23:225-231. [PMID: 30657564 DOI: 10.26355/eurrev_201901_16768] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE We investigated the accuracy of Automated Breast Volume Scanner (ABVS) compared to handheld ultrasound (HHUS) for monitoring tumor response to neoadjuvant treatment (NAT) in breast cancer (BC). PATIENTS AND METHODS All the patients submitted to biopsy in our Institution, from January 2017 to May 2017, proven invasive BC and eligible for NAT, were enrolled in this prospective study. The participants underwent ABVS, HHUS, dynamic contrast-enhanced Magnetic Resonance Imaging (DCE-MRI) and mammography at the beginning of NAT and ABVS, HHUS and DCE-MRI at the halfway point of therapy and before the surgery. DCE-MRI was considered the standard of reference. Two breast radiologists (R1, R2), with fifteen and five years of experience in breast imaging, independently assigned a visibility score (ordinal 5-point scale) to ABVS, HHUS, and DCE-MRI. Diagnostic performance of ABVS and HHUS as measured by sensitivity, specificity, positive and negative predictive values (PPV and NPV) was calculated. Correlations between ABVS and MRI, and between HHUS and MRI were analyzed using Pearson's correlation test. RESULTS A total of 21 patients were enrolled. 189 examinations were performed. The comparison between ABVS and DCE-MRI was similar for the both readers: ABVS had a sensitivity of 63,16%, specificity of 83,58%, PPV of 76,60%, NPV of 72,73%, accuracy of 74,19% (R1) and a sensitivity of 54.54%, specificity of 85.51%, PPV of 75%, NPV of 70,24%, accuracy of 71.77% (R2). The comparison between HHUS and DCE-MRI showed that HHUS had a sensitivity of 63,16 %, specificity of 83,58%, PPV of 76,60%, NPV of 72,73%, accuracy of 74,19% (R1) and a sensitivity of 36.84%, specificity of 85.07%, PPV of 67.74%, NPV of 61.29%, accuracy of 62.90% (R2). The calculated Pearson's correlation coefficient r values were 7.8 for HHUS vs. DCE-MRI and 28.5 for ABVS vs. DCE-MRI (R1) and 7.8 for HHUS vs. DCE-MRI and 22.4 for ABVS vs. DCE-MRI (R2). Statistical significance of ABVS and HHUS was p < 0.0001 and 0.005 < p < 0.01, respectively (R1, R2). CONCLUSIONS DCE-MRI is recommended for the tumor response assessment. ABVS, a product of the biotechnology development, providing reproducible images, in addition to DCE-MRI, can be a potentially useful tool for the monitoring of response to NAT.
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Affiliation(s)
- A D'Angelo
- Dipartimento di Scienze Radiologiche, Istituto di Radiologia, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
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Conte P, Guarneri V, Bisagni G, Piacentini F, Brandes A, Cavanna L, Giotta F, Aieta M, Gebbia V, Frassoldati A, Musolino A, Garrone O, Taverniti C, Rimanti A, Sarti S, Rubino D, Bologna A, Vicini R, Balduzzi S, D'Amico R. 9 weeks versus 1 year adjuvant trastuzumab for HER2+ early breast cancer: Subgroup analysis of the ShortHER trial allows to identify patients for whom a shorter trastuzumab administration may have a favourable risk/benefit ratio. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy424.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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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Dieci M, Conte P, Bisagni G, Brandes A, Frassoldati A, Cavanna L, Musolino A, Giotta F, Rimanti A, Garrone O, Bertone E, Cagossi K, Sarti S, Ferro A, Omarini C, Maiorana A, Orvieto E, Sanders M, D'Amico R, Guarneri V. Tumor-infiltrating lymphocytes (TILs) as an independent prognostic factor for early HER2+ breast cancer patients treated with adjuvant chemotherapy and trastuzumab in the randomized shortHER trial. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy270.183] [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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Guarneri V, Dieci MV, Bisagni G, Brandes AA, Frassoldati A, Cavanna L, Musolino A, Giotta F, Cavazzini G, Garrone O, Bertone E, Cagossi K, Nanni O, Ferro A, Donadio M, Aieta M, Zamagni C, Piacentini F, Maiorana A, Ragazzi M, Cucchi MC, Querzoli P, Orsi N, Curtarello M, Urso L, Amadori A, Orvieto E, Vicini R, Balduzzi S, D'Amico R, Conte P. Abstract P1-13-02: Withdrawn. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p1-13-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
This abstract was withdrawn by the authors.
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Affiliation(s)
- V Guarneri
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - MV Dieci
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - G Bisagni
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - AA Brandes
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - A Frassoldati
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - L Cavanna
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - A Musolino
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - F Giotta
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - G Cavazzini
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - O Garrone
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - E Bertone
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - K Cagossi
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - O Nanni
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - A Ferro
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - M Donadio
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - M Aieta
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - C Zamagni
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - F Piacentini
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - A Maiorana
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - M Ragazzi
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - MC Cucchi
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - P Querzoli
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - N Orsi
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - M Curtarello
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - L Urso
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - A Amadori
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - E Orvieto
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - R Vicini
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - S Balduzzi
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - R D'Amico
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
| | - P Conte
- University of Padova; Medical Oncology 2, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy; IRCCS AO S.Maria Nuova, Reggio Emilia, Italy; UOC Medical Oncology, AUSL Bologna, Bologna, Italy; Ferrara University Hospital, Ferrara, Italy; Guglielmo da Saliceto Hospital, Piacenza, Italy; University Hospital of Parma, Parma, Italy; National Cancer Research Centre Giovanni Paolo II, Bari, Italy; Azienda Ospedaliera Carlo Poma, Mantova, Italy; S. Croce and Carle Teaching Hospital, Cuneo, Italy; S.Anna Hospital, Torino, Italy; Ramazzini Hospital, Carpi, Italy; Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; Santa Chiara Hospital, Trento, Italy; AOU Città della Salute e della Scienza, Torino, Italy; IRCCS-CROB Referral Cancer Center of Basilicata, Rionero in Vulture, Italy; S. Orsola-Malpighi Hospital, Bologna, Italy; Modena University Hospital, Modena, Italy; University of Modena and Reggio Emilia, Modena, Italy; Anatomic Pa
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Cavallini G, Saccarola P, D'Amico R, Gasparin A, Campi L. Impact of Preoperative Testing on Ophthalmologic and Systemic Outcomes in Cataract Surgery. Eur J Ophthalmol 2018. [DOI: 10.1177/112067210401400502] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose To evaluate the incidence of ophthalmologic and systemic complications in patients who undergo cataract surgery without preoperative tests compared to subjects undergoing cataract surgery preceded by preoperative tests. Methods The randomized controlled study included 1276 consecutive patients admitted to the Institute of Ophthalmology of the University of Modena and Reggio Emilia for cataract surgery. The patients were randomly divided into two groups: 638 were assigned not to undergo preoperative evaluation based on routine medical tests and electrocardiograms; the other 638 underwent preoperative evaluation based on said tests. Ophthalmologic and systemic complications were assessed intraoperatively and 1 month after surgery. Results Eleven intraoperative complications occurred in the group without preoperative tests and eight in the group with preoperative tests; at 1 month six complications were recorded in the group without tests and five in the group with tests. Systemic adverse events occurred intraoperatively in four patients, whereas no systemic adverse event was recorded at 1 month in either group. No statistically significant differences were observed between the two groups. Conclusions The findings of this study have broad applicability, because the sample is representative of the population existing in numerous social and healthcare settings; they are of value for administrative purposes, because they may be taken as reference in resource allocation plans; and they have medicolegal implications, as the resulting conduct of healthcare providers is supported by a rigorous scientific study.
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Affiliation(s)
- G.M. Cavallini
- Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena - Italy
| | - P. Saccarola
- Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena - Italy
| | - R. D'Amico
- Institute of Statitics in Medicine, University of Modena and Reggio Emilia, Modena - Italy
| | - A. Gasparin
- Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena - Italy
| | - L. Campi
- Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena - Italy
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Conte P, Conte P, Bisagni G, Frassoldati A, Brandes A, Cavanna L, Giotta F, Aieta M, Gebbia V, Musolino A, Garrone O, Donadio M, Cavazzini G, Turletti A, Zamagni C, Danese S, Ferro A, Piacentini F, Balduzzi S, D'Amico R, Guarneri V. Final analysis of the phase III multicentric Italian study Short-HER: 9 weeks vs 1 year adjuvant trastuzumab for HER2+ early breast cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx421.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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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Affiliation(s)
- G Magliulo
- ENT University "La Sapienza", Rome, Italy
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Praver M, D'Amico R, Arraez C, Zacharia BE, Varma H, Goldman JE, Bruce JN, Canoll P. Atypical pleomorphic neoplasms of the pineal gland: Case report and review of the literature. Surg Neurol Int 2015; 6:129. [PMID: 26257987 PMCID: PMC4524004 DOI: 10.4103/2152-7806.161790] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Accepted: 12/02/2014] [Indexed: 11/23/2022] Open
Abstract
Background: Pineal region tumors are rare and diverse. Among them exist reports of pleomorphic xanthroastrocytoma (PXA) and pleomorphic granular cell astrocytoma (PGCA) of the pineal gland. These related tumors are remarkably similar sharing pleomorphic histologic features with only minor immunohistochemical and ultrastructural differences. Case Description: We present a case of a 42-year old right-handed woman presented with a longstanding history of migraine headaches which had worsened over the two months leading up to her hospitalization. MRI revealed a 1.7 × 1.3 × 1.6 cm intensely enhancing lesion originating in the pineal gland. The tumor closely resembled PGCA but did not strictly fit the diagnostic requirements of either PGCA or PXA. Conclusion: The present case highlights the exotic nature of pineal region tumors with pleomorphic cell histology. Given the diverse range of tumors encountered in the pineal region, pathological confirmation is mandatory. Favorable clinical outcomes demonstrate that surgical resection alone can yield excellent long-term results for tumors falling within the spectrum of pleomorphic lesions of the pineal gland.
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Affiliation(s)
- M Praver
- Department of Neurological Surgery, Columbia University Medical Center, New York, NY, USA
| | - R D'Amico
- Department of Neurological Surgery, Columbia University Medical Center, New York, NY, USA
| | - C Arraez
- Department of Neurological Surgery, Columbia University Medical Center, New York, NY, USA
| | - B E Zacharia
- Department of Neurological Surgery, Columbia University Medical Center, New York, NY, USA
| | - H Varma
- Pathology and Cell Biology, Columbia University Medical Center, New York, NY, USA
| | - J E Goldman
- Pathology and Cell Biology, Columbia University Medical Center, New York, NY, USA
| | - J N Bruce
- Department of Neurological Surgery, Columbia University Medical Center, New York, NY, USA
| | - P Canoll
- Department of Neurological Surgery, Columbia University Medical Center, New York, NY, USA
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Mauro R, Pini R, Faggioli G, Donati G, Facchini MG, D'Amico R, Freyrie A, Gargiulo M, Stella A. Impact of Duplex Ultrasound Surveillance Program on Patency of Prosthetic Arteriovenous Graft for Hemodialysis: A Single-Center Experience. Ann Vasc Surg 2015; 29:1211-7. [DOI: 10.1016/j.avsg.2015.04.059] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 04/02/2015] [Accepted: 04/06/2015] [Indexed: 11/29/2022]
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Praver M, D'Amico R, Canoll P, Bruce J. MS-21 * SUBEPENDYMOMAS DEMONSTRATE LINEAGE MARKERS SUGGESTING AN ORIGIN WITHIN MULTIPOTENTIAL PROGENITORS OF THE SUBVENTRICULAR ZONE. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou260.20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Guarneri V, Bisagni G, Bottini A, Cagossi K, Frassoldati A, Piacentini F, Holford C, Bruey J, D'Amico R, Conte P. Disease-Free Survival According to Pathologic Response and P95-HER2 in the Cher-Lob Neoadjuvant Study of Chemotherapy Plus Trastuzumab, Lapatinib Or Combined Trastuzumab and Lapatinib In HER2+ Operable Breast Cancer. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)32829-5] [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: 11/30/2022] Open
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Colombo A, Frigerio C, Sangalli G, D'Amico R, Sacco S, Declich F, Placa F. PO-185 TWO HDR BRACHYTHERAPY SCHEDULES AS MONOTHERAPY IN PROSTATE CANCER: ANALYSIS OF TOXICITY IN 178 PATIENTS. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)72151-5] [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: 11/16/2022]
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Pellegrini E, Maurantonio M, Giannico IM, Simonini MS, Ganazzi D, Carulli L, D'Amico R, Baldini A, Loria P, Bertolotti M, Carulli N. Risk for cardiovascular events in an Italian population of patients with type 2 diabetes. Nutr Metab Cardiovasc Dis 2011; 21:885-892. [PMID: 20674312 DOI: 10.1016/j.numecd.2010.02.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [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] [Received: 08/12/2009] [Revised: 01/16/2010] [Accepted: 02/15/2010] [Indexed: 10/19/2022]
Abstract
BACKGROUND AND AIM This study aims to analyse the risk of cardiovascular events in a local cohort of patients with type 2 diabetes, and to evaluate the prognostic accuracy of four algorithms used to estimate cardiovascular risk: the Framingham study, United Kingdom Prospective Diabetes Study (UKPDS), Riskard study and Progetto Cuore. METHOD AND RESULTS We analysed clinical charts of the Diabetes Clinics of Modena for the period 1991-95. Patients in the age range of 35-65 with type 2 diabetes and no previous cardiovascular disease were eligible. The incidence of new cardiovascular disease was compared with estimated rates deriving from the different functions. A stratification was obtained in subgroups at different cardiovascular risk, allowing comparison between the algorithms. A total of 1532 patients were eligible; women presented a worse cardiovascular risk profile. An absolute 10-year rate of cardiovascular events of 14.9% was observed. Comparing patients with events with event-free subjects, we found significant differences in systolic blood pressure, age at visit, smoking, high-density lipoprotein (HDL)-cholesterol, duration of diabetes, glycosylated haemoglobin (HbA1c) and co-morbidities. Comparing the estimated risk rate according to the different functions, Italian algorithms were more consistent with observed data; however, Progetto Cuore and Riskard show underestimation of events when applied to females. CONCLUSIONS Estimation of cardiovascular risk is dependent on the algorithm adopted and on the baseline risk of the reference cohort. Functions designed for a specific population, including risk variables peculiar for diabetes, should be adopted to increase the performance of such functions which is clearly unsatisfactory at present.
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Affiliation(s)
- E Pellegrini
- Dipartimento di Medicina, Endocrinologia, Metabolismo e Geriatria, Università degli Studi di Modena e Reggio Emilia, Nuovo Ospedale Civile, via Giardini 1355, 41100 Modena, Italy
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Pavel H, Ajeawung N, Faure R, Poirier D, Kamnasaran D, Ajeawung N, Joshi H, Kamnasaran D, Poirier D, Ajeawung N, Kamnasaran D, Lun X, Zemp F, Sun B, Stechishin O, Luchman A, Kelly JJ, Weiss S, Hamilton MG, Cairncross G, Senger DL, Bell J, McFadden G, Forsyth PA, Tzeng SY, Guerrero-Cazares H, Martinez EE, Young NP, Sunshine JC, Quinones-Hinojosa A, Green JJ, Lei L, D'Amico R, Sisti J, Leung R, Sonabend AM, Guarnieri P, Rosenfeld SS, Bruce JN, Canoll P, Baichwal VR, Reeves L, Chad BL, Zavitz KH, Beelen AP, Mather GG, Carlson RO, Manton C, Chandra J, Keir ST, Reardon DA, Saling JR, Gray LS, Bigner DD, Friedman HS, Zhang J, Brun J, Ogbomo H, Zemp F, Wang Z, Stojdl DJ, Lun X, Forsyth PA, Kong LY, Hatiboglu MA, Wei J, Wang Y, McEnery KA, Fuller GN, Qiao W, Davies MA, Priebe W, Heimberger AB, Amendolara B, Gil O, Lei L, Ivkovic S, Bruce J, Canoll P, Rosenfeld S, Finniss S, Perlstein B, Miller C, Okhrimenko H, Kazimirsky G, Cazacu S, Lemke N, Brodie S, Rempel SA, Rosenblum M, Mikkelsen T, Margel S, Brodie C, Guvenc H, Demir H, Gupta S, Mazumder S, Ray-Chaundhury A, Li T, Li C, Nakano I, Rahman R, Rahman C, Smith S, Macarthur D, Rose F, Shakesheff K, Grundy RG, Brenner AJ, Goins B, Bao A, Miller J, Trevino A, Zuniga R, Phillips WT, Gilg AG, Bowers KG, Toole BP, Maria BL, Leung GK, Sun S, Wong ST, Zhang XQ, Pu JK, Lui WM, Marino AM, Hussaini IM, Amos S, Simpson K, Redpath GT, Lyons C, Dipierro C, Grant GA, Wilson C, Salami S, Macaroni P, Li S, Park JY, Needham D, Bigner D, Dewhirst M, Ohlfest J, Gallardo J, Argawal S, Mittapalli R, Donelson R, Elmquist WF, Nicolaides T, Hariono S, Barkovich K, Hashizume R, Rowitch D, Weiss W, Sheer D, Baker S, Paugh B, Waldman T, Li H, Jones C, Forshew T, James D, Caroline H, Patrick R, Katrin L, Karl F, Ghazaleh T, Michael W, Albrecht V, Thorsteinsdottir J, Wagner E, Tonn JC, Ogris M, Schichor C, Charest G, Paquette B, Sanche L, Mathieu D, Fortin D, Qi X, Cuttitta F, Chu Z, Celerier J, Pakradouni J, Rixe O, Hashizume R, Gragg A, Muller S, Banerjee A, Phillips J, Prados M, Haas-Kogan D, Gupta N, James D, Florence L, Gwendoline VG, Veronique M, Robert K, Agarwal S, Mittapalli RK, Cen L, Carlson BL, Elmquist WF, Sarkaria JN, Sengupta S, Weeraratne SD, Rallapalli S, Amani V, Pierre-Francois J, Teider N, Rotenberg A, Cook J, Pomeroy SL, Jenses F, Cho YJ, Hjouj M, Last D, Guez D, Daniels D, Lavee J, Rubinsky B, Mardor Y, Serwer LP, Noble CO, Michaud K, Drummond DC, Ozawa T, Zhou Y, Marks JD, Bankiewicz K, Park JW, James D, Wang W, Cho H, Weintraub M, Jhaveri N, Torres S, Petasis N, Schonthal AH, Louie SG, Hofman FM, Chen TC, Grada Z, Hegde M, Schaffer DR, Ghazi A, Byrd T, Dotti G, Wels W, Heslop HE, Gottschalk S, Baker M, Ahmed N, Hamblett KJ, Kozlosky CJ, Liu H, Siu S, Arora T, Retter MW, Matsuda K, Hill JS, Fanslow WC, Diaz RJ, Etame A, Meaghan O, Mainprize T, Smith C, Hynynen K, Rutka J, Pradarelli J, Yoo JY, Kaka A, Alvarez-Breckenridge C, Pan Q, Chiocca EA, Teknos T, Kaur B, Lee SY, Slagle-Webb B, Sheehan JM, Connor JR, Cote J, Lepage M, Gobeil F, Fortin D, Kleijn A, Balvers R, Kloezeman J, Dirven C, Lamfers M, Leenstra S, See W, Tan IL, Nicolaides T, Pieper R, Jiang H, White E, Rios-Vicil CI, Yung WKA, Gomez-Manzano C, Fueyo J, Zemp FJ, McKenzie BA, Lun X, McFadden G, Forsyth PA, Mueller S, Yang X, Hashizume R, Gragg A, Smirnov I, Prados M, James DC, Phillips JJ, Berger MS, Rowitch DH, Gupta N, Haas-Kogan DH, D'Amico R, Lei L, Kennedy B, Rosenfeld SS, Canoll P, Bruce JN, Gopalakrishnan V, Das C, Taylor P, Kommagani R, Su X, Aguilera D, Thomas A, Wolff J, Flores E, Kadakia M, Alkins R, Broderson P, Sodhi R, Hynynen K, Chung SA, McDonald KL, Shen H, Day BW, Stringer BW, Johns T, Decollogne S, Teo C, Hogg PJ, Dilda PJ, Patel TR, Zhou J, Piepmeier JM, Saltzman WM, Vogelbaum MA, Agarwal S, Manchanda P, Ohlfest JR, Elmquist WF, Kitange GJ, Mladek AC, Carlson BL, Schroeder MA, Pokorny JL, Sarkaria JN, Ogbomo H, Lun X, Zhang J, McFadden G, Mody C, Forsyth P, Dasgupta T, Yang X, Hashizume R, Gragg A, Prados M, Nicolaides T, James CD, Haas-Kogan D, Madhankumar AB, Webb BS, Park A, Harbaugh K, Sheehan J, Connor JR. PRECLINICAL EXPERIMENTAL THERAPEUTICS AND PHARMACOLOGY. Neuro Oncol 2011. [DOI: 10.1093/neuonc/nor158] [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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Sebastiani M, Manfredi A, Vukatana G, Moscatelli S, Riato L, Bocci M, Iudici M, Principato A, Mazzuca S, Del Medico P, De Angelis R, D'Amico R, Vicini R, Colaci M, Ferri C. Predictive role of capillaroscopic skin ulcer risk index in systemic sclerosis: a multicentre validation study. Ann Rheum Dis 2011; 71:67-70. [DOI: 10.1136/annrheumdis-2011-200022] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
IntroductionThe early detection of systemic sclerosis (SSc) patients at high risk of developing digital ulcers could allow preventive treatment, with a reduction of morbidity and social costs. In 2009, a quantitative score, the capillaroscopic skin ulcer risk index (CSURI), calculated according to the formula ‘D×M/N2’, was proposed, which was highly predictive of the appearance of scleroderma digital ulcers within 3 months of capillaroscopic evaluation.ObjectivesThis multicentre study aims to validate the predictive value and reproducibility of CSURI in a large population of SSc patients.MethodsCSURI was analysed in 229 unselected SSc patients by nailfold videocapillaroscopy (NVC). All patients were re-evaluated 3 months later with regard to the persistence and/or appearance of new digital ulcers.Results57 of 229 patients presented with digital ulcers after 3 months. The receiver operating characteristic curve analysis showed an area under the curve of 0.884 (95% CI 0.835 to 0.922), with specificity and sensitivity of 81.4% (95% CI 74.8 to 86.89) and 92.98% (95% CI 83.0 to 98.0), respectively, at the cut-off value of 2.96. The reproducibility of CSURI was validated on a random sample of 81 patients, with a κ-statistic measure of interrater agreement of 0.8514.ConclusionsThe role of CSURI was confirmed in detecting scleroderma patients with a significantly high risk of developing digital ulcers within the first 3 months from NVC evaluation. CSURI is the only method validated to predict the appearance of digital ulcers and its introduction into routine clinical practice might help optimise the therapeutic strategy of these harmful SSc complications.
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Guarneri V, Frassoldati A, Bottini A, Generali DG, Cagossi K, Artioli F, Bisagni G, Boni C, Ravaioli A, Amadori D, Musolino A, Cavanna L, Untch M, Orlando L, Giardina G, Piacentini F, Tagliafico E, Bagnalasta M, D'Amico R, Conte PF. Final results of a phase II randomized trial of neoadjuvant anthracycline-taxane chemotherapy plus lapatinib, trastuzumab, or both in HER2-positive breast cancer (CHER-LOB trial). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.507] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Conte PF, Guarneri V, Generali DG, Bottini A, Bazzola L, Piacentini F, Artioli F, Cagossi K, Bisagni G, Bagnalasta M, Tagliafico E, Barbieri E, Cavanna L, Ravaioli A, D'Amico R, Vicini R, Frassoldati A. Double-blind, placebo-controlled, multicentric randomized phase IIb neoadjuvant study of letrozole-lapatinib in postmenopausal HER2-negative, hormone receptor-positive operable breast cancer. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.550] [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: 11/20/2022] Open
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Raisi O, Magnani C, Bigiani N, Cianciavicchia E, D'Amico R, Muscatello U, Ghirardini C. The diagnostic reliability of urinary cytology: A retrospective study. Diagn Cytopathol 2011; 40:608-14. [DOI: 10.1002/dc.21716] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2010] [Accepted: 03/15/2011] [Indexed: 11/08/2022]
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Sacco S, D'Amico R, Frigerio C, Sangalli G, Declich F, Colombo A. 697 poster A 7 YEAR EXPERIENCE OF PROSTATE HDR BRACHYTHERAPY AS MONOTHERAPY: ANALYSIS OF OUTCOME AND TOXICITY. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)70819-2] [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: 11/17/2022]
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La Marca A, Nelson SM, Sighinolfi G, Manno M, Baraldi E, Roli L, Xella S, Marsella T, Tagliasacchi D, D'Amico R, Volpe A. Anti-Müllerian hormone-based prediction model for a live birth in assisted reproduction. Reprod Biomed Online 2011; 22:341-9. [PMID: 21317041 DOI: 10.1016/j.rbmo.2010.11.005] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2010] [Revised: 11/02/2010] [Accepted: 11/02/2010] [Indexed: 11/17/2022]
Abstract
Prediction of assisted reproduction treatment outcome has been the focus of clinical research for many years, with a variety of prognostic models describing the probability of an ongoing pregnancy or a live birth. This study assessed whether serum anti-Müllerian hormone (AMH) concentrations may be incorporated into a model to enhance the prediction of a live birth in women undergoing their first IVF cycle, by analysing a database containing clinical and laboratory information on IVF cycles carried out between 2005 and 2008 at the Mother-Infant Department of University Hospital, Modena. Logistic regression was used to examine the association of live birth with baseline patient characteristics. Only AMH and age were demonstrated in regression analysis to predict live birth, so a model solely based on these two criteria was generated. The model permitted the identification of live birth with a sensitivity of 79.2% and a specificity of only 44.2%. In the prediction of a live birth following IVF, a distinction, however moderate, can be made between couples with a good and a poor prognosis. The success of IVF was found to mainly depend on maternal age and serum AMH concentrations, one of the most relevant and valuable markers of ovarian reserve.
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Affiliation(s)
- A La Marca
- Mother-Infant Department, Institute of Obstetrics and Gynecology, University of Modena and Reggio Emilia, 41100 Modena, Italy.
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Blasi I, Fuchs I, D'Amico R, Vinci V, La Sala GB, Mazza V, Henrich W. Intrapartum translabial three-dimensional ultrasound visualization of levator trauma. Ultrasound Obstet Gynecol 2011; 37:88-92. [PMID: 20814872 DOI: 10.1002/uog.8818] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
OBJECTIVES The aim of this study was to visualize levator trauma by three-dimensional (3D) ultrasound performed during labor and soon after the crowning of the fetal head and to determine how often levator trauma occurs. METHODS This was a prospective, observational study of 66 women enrolled during the first stage of labor. The women underwent intrapartum 3D transperineal ultrasound examination during the first and second stages of labor and within 12 h after delivery. Volume datasets were acquired and analyzed to determine the presence of levator trauma. RESULTS Data from 10 of the 66 women were excluded from analysis-nine because they underwent Cesarean section in the first or second stage of labor and one because she underwent hysterectomy and no postpartum volumes were collected. Thus our study group comprised 56 women-35 nulliparous and 21 parous. A total of 504 volumes were collected in the 56 women (three volumes for each stage of labor). One hundred and twenty levator volumes were excluded from analysis, but volumes of acceptable quality were available for all three stages of labor in all women. Eleven (31.4%) of the 35 nulliparae had levator lesions detected postpartum and none of them had levator lesions before delivery. Five (23.8%) of the 21 parous women had a levator tear detected in their postpartum volumes. In two of these five women the levator tear was also present in both volumes taken during labor. CONCLUSIONS Visualization of the levator ani during labor by 3D ultrasound examination is feasible. Comparison of volumes obtained during labor and within the first 2 h after delivery supports the theory that crowning of the head is the immediate cause of avulsion of the levator ani muscle.
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Affiliation(s)
- I Blasi
- Department of Obstetrics and Gynaecology, Modena and Reggio Emilia University, Reggio Emilia, Italy.
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Guarneri V, Frassoldati A, Gebbia V, Bisagni G, Cavanna L, Donadio M, Lelli G, Musolino A, Colucci G, Banna GL, Degli Esposti R, Ferro A, Grasso F, Zamagni C, Amadori D, Aieta M, Molino A, Garrone O, Aitini E, Fornari G, Cascinu S, Rossi G, D'Amico R, Conte PF. Abstract P5-12-05: 9 Weeks vs 1 Year Adjuvant Trastuzumab in Combination with Chemotherapy: Preliminary Cardiac Safety Data of the Phase III Multicentric Italian Study Short-HER. Cancer Res 2010. [DOI: 10.1158/0008-5472.sabcs10-p5-12-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Several large randomized trials have shown the superiority of combining trastuzumab with chemotherapy versus chemotherapy alone as adjuvant treatment for HER2+ breast cancer patients. We are running a large phase III trial comparing two different trastuzumab durations (Short-HER study). We are reporting the preliminary cardiac safety data.
Methods: The Short-HER study is a phase III, multicentric, Italian trial where 2500 HER2+ breast cancer patients will be randomized to: Arm A (Long) 4 courses of anthracycline based chemotherapy (AC or EC) followed by 4 courses of docetaxel in combination with trastuzumab, followed by 14 additional courses of 3-weekly trastuzumab; or Arm B (Short) 3 courses of 3-weekly docetaxel in combination with weekly trastuzumab followed by FEC x3. this is a non-inferiority trial with DFS and OS as primary end points, and 2-yr failure rate and incidence of cardiac events as secondary end points. Left ventricular ejection fraction (LVEF) is measured at baseline, at the end of each sequence of chemotherapy in both arms, and after 9 and 12 months since randomization thereafter. A cardiac event (CE) was defined as the occurrence of any of the followings: 1) LVEF decrease of more than 15 percentage points from baseline ; 2) LVEF decrease of more than 10 percentage points with absolute value below 50%; 3) symptomatic cardiac failure; 4) other cardiac side effects of grade 2 or more.
Results: 510 patients from 69 Italian centers have been randomized so far, 251 in arm A (long) and 259 in Arm B (Short). 146 patients enrolled in arm A and 150 patients enrolled in arm B have received at least 3 months of therapy, and are eligible for the present analysis. In arm A (long), 20 patients (13.7%) experienced a CE: 12 patients experienced a LVEF decline of > 15 percentage points (5 patients with LVEF below 50%, one patient with concomitant atrial fibrillation); 3 patients had a LVEF decline of >10 percentage points with an absolute value below 50%. One patient had symptomatic cardiac failure. Two patients developed Grade 2 hypertension. Two patients developed Grade 2 arrhythmia.
In arm B (short), 11 patients (7.3%) experienced a CE: 7 patients had a LVEF decline of > 15 percentage points; one patient had a LVEF decline of > 10 percentage points with an absolute value below 50%. Three patients developed Grade 2 arrhythmia
Conclusions: This is a non-inferiority study designed on the assumption that a shorter treatment duration is associated with a significantly lower incidence of cardiac events. With 9 clinically relevant CEs (symptomatic cardiac failure or LVEF below 50%) in arm A (Long) and 1 in arm B (Short), these preliminary data support the assumption, and recruitment is ongoing.
Supported by Agenzia Italiana del FArmaco (AIFA).
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P5-12-05.
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Affiliation(s)
- V Guarneri
- Modena University Hospital, Italy; La Maddalena Hospital, Palermo; S Maria Nuova Hospital, Reggio Emilia; Hospital of Piacenza; San Giovanni Battista Hospital, Torino; S. Anna Hospital, Ferrara; Medical Oncology Unit, University Hospital of Parma; Medical and Experimental Oncology Unit, Oncology Institute Giovanni Paolo II, Bari, Italy; Vittorio Emanuele University Hospital, Catania; Bellaria Hospital, University of Bologna; Hospital of Trento; Hospital of Aosta; Medical Oncology Unit, S. Orsola-Malpighi University Hospital, Bologna; Istituto Scientifico Romagnolo perlo Studio e la Cura dei Tumori, Meldola; Hospital of Rionero in Vulture; OCM, Verona University Hospital; Oncology Division, Santa Croce-Carle Hospital, Cuneo; Hospital of Mantova; Ospedale Evangelico Valdese, Torino; Ancona University Hospital; Hospital of Guastalla
| | - A Frassoldati
- Modena University Hospital, Italy; La Maddalena Hospital, Palermo; S Maria Nuova Hospital, Reggio Emilia; Hospital of Piacenza; San Giovanni Battista Hospital, Torino; S. Anna Hospital, Ferrara; Medical Oncology Unit, University Hospital of Parma; Medical and Experimental Oncology Unit, Oncology Institute Giovanni Paolo II, Bari, Italy; Vittorio Emanuele University Hospital, Catania; Bellaria Hospital, University of Bologna; Hospital of Trento; Hospital of Aosta; Medical Oncology Unit, S. Orsola-Malpighi University Hospital, Bologna; Istituto Scientifico Romagnolo perlo Studio e la Cura dei Tumori, Meldola; Hospital of Rionero in Vulture; OCM, Verona University Hospital; Oncology Division, Santa Croce-Carle Hospital, Cuneo; Hospital of Mantova; Ospedale Evangelico Valdese, Torino; Ancona University Hospital; Hospital of Guastalla
| | - V Gebbia
- Modena University Hospital, Italy; La Maddalena Hospital, Palermo; S Maria Nuova Hospital, Reggio Emilia; Hospital of Piacenza; San Giovanni Battista Hospital, Torino; S. Anna Hospital, Ferrara; Medical Oncology Unit, University Hospital of Parma; Medical and Experimental Oncology Unit, Oncology Institute Giovanni Paolo II, Bari, Italy; Vittorio Emanuele University Hospital, Catania; Bellaria Hospital, University of Bologna; Hospital of Trento; Hospital of Aosta; Medical Oncology Unit, S. Orsola-Malpighi University Hospital, Bologna; Istituto Scientifico Romagnolo perlo Studio e la Cura dei Tumori, Meldola; Hospital of Rionero in Vulture; OCM, Verona University Hospital; Oncology Division, Santa Croce-Carle Hospital, Cuneo; Hospital of Mantova; Ospedale Evangelico Valdese, Torino; Ancona University Hospital; Hospital of Guastalla
| | - G Bisagni
- Modena University Hospital, Italy; La Maddalena Hospital, Palermo; S Maria Nuova Hospital, Reggio Emilia; Hospital of Piacenza; San Giovanni Battista Hospital, Torino; S. Anna Hospital, Ferrara; Medical Oncology Unit, University Hospital of Parma; Medical and Experimental Oncology Unit, Oncology Institute Giovanni Paolo II, Bari, Italy; Vittorio Emanuele University Hospital, Catania; Bellaria Hospital, University of Bologna; Hospital of Trento; Hospital of Aosta; Medical Oncology Unit, S. Orsola-Malpighi University Hospital, Bologna; Istituto Scientifico Romagnolo perlo Studio e la Cura dei Tumori, Meldola; Hospital of Rionero in Vulture; OCM, Verona University Hospital; Oncology Division, Santa Croce-Carle Hospital, Cuneo; Hospital of Mantova; Ospedale Evangelico Valdese, Torino; Ancona University Hospital; Hospital of Guastalla
| | - L Cavanna
- Modena University Hospital, Italy; La Maddalena Hospital, Palermo; S Maria Nuova Hospital, Reggio Emilia; Hospital of Piacenza; San Giovanni Battista Hospital, Torino; S. Anna Hospital, Ferrara; Medical Oncology Unit, University Hospital of Parma; Medical and Experimental Oncology Unit, Oncology Institute Giovanni Paolo II, Bari, Italy; Vittorio Emanuele University Hospital, Catania; Bellaria Hospital, University of Bologna; Hospital of Trento; Hospital of Aosta; Medical Oncology Unit, S. Orsola-Malpighi University Hospital, Bologna; Istituto Scientifico Romagnolo perlo Studio e la Cura dei Tumori, Meldola; Hospital of Rionero in Vulture; OCM, Verona University Hospital; Oncology Division, Santa Croce-Carle Hospital, Cuneo; Hospital of Mantova; Ospedale Evangelico Valdese, Torino; Ancona University Hospital; Hospital of Guastalla
| | - M Donadio
- Modena University Hospital, Italy; La Maddalena Hospital, Palermo; S Maria Nuova Hospital, Reggio Emilia; Hospital of Piacenza; San Giovanni Battista Hospital, Torino; S. Anna Hospital, Ferrara; Medical Oncology Unit, University Hospital of Parma; Medical and Experimental Oncology Unit, Oncology Institute Giovanni Paolo II, Bari, Italy; Vittorio Emanuele University Hospital, Catania; Bellaria Hospital, University of Bologna; Hospital of Trento; Hospital of Aosta; Medical Oncology Unit, S. Orsola-Malpighi University Hospital, Bologna; Istituto Scientifico Romagnolo perlo Studio e la Cura dei Tumori, Meldola; Hospital of Rionero in Vulture; OCM, Verona University Hospital; Oncology Division, Santa Croce-Carle Hospital, Cuneo; Hospital of Mantova; Ospedale Evangelico Valdese, Torino; Ancona University Hospital; Hospital of Guastalla
| | - G Lelli
- Modena University Hospital, Italy; La Maddalena Hospital, Palermo; S Maria Nuova Hospital, Reggio Emilia; Hospital of Piacenza; San Giovanni Battista Hospital, Torino; S. Anna Hospital, Ferrara; Medical Oncology Unit, University Hospital of Parma; Medical and Experimental Oncology Unit, Oncology Institute Giovanni Paolo II, Bari, Italy; Vittorio Emanuele University Hospital, Catania; Bellaria Hospital, University of Bologna; Hospital of Trento; Hospital of Aosta; Medical Oncology Unit, S. Orsola-Malpighi University Hospital, Bologna; Istituto Scientifico Romagnolo perlo Studio e la Cura dei Tumori, Meldola; Hospital of Rionero in Vulture; OCM, Verona University Hospital; Oncology Division, Santa Croce-Carle Hospital, Cuneo; Hospital of Mantova; Ospedale Evangelico Valdese, Torino; Ancona University Hospital; Hospital of Guastalla
| | - A Musolino
- Modena University Hospital, Italy; La Maddalena Hospital, Palermo; S Maria Nuova Hospital, Reggio Emilia; Hospital of Piacenza; San Giovanni Battista Hospital, Torino; S. Anna Hospital, Ferrara; Medical Oncology Unit, University Hospital of Parma; Medical and Experimental Oncology Unit, Oncology Institute Giovanni Paolo II, Bari, Italy; Vittorio Emanuele University Hospital, Catania; Bellaria Hospital, University of Bologna; Hospital of Trento; Hospital of Aosta; Medical Oncology Unit, S. Orsola-Malpighi University Hospital, Bologna; Istituto Scientifico Romagnolo perlo Studio e la Cura dei Tumori, Meldola; Hospital of Rionero in Vulture; OCM, Verona University Hospital; Oncology Division, Santa Croce-Carle Hospital, Cuneo; Hospital of Mantova; Ospedale Evangelico Valdese, Torino; Ancona University Hospital; Hospital of Guastalla
| | - G Colucci
- Modena University Hospital, Italy; La Maddalena Hospital, Palermo; S Maria Nuova Hospital, Reggio Emilia; Hospital of Piacenza; San Giovanni Battista Hospital, Torino; S. Anna Hospital, Ferrara; Medical Oncology Unit, University Hospital of Parma; Medical and Experimental Oncology Unit, Oncology Institute Giovanni Paolo II, Bari, Italy; Vittorio Emanuele University Hospital, Catania; Bellaria Hospital, University of Bologna; Hospital of Trento; Hospital of Aosta; Medical Oncology Unit, S. Orsola-Malpighi University Hospital, Bologna; Istituto Scientifico Romagnolo perlo Studio e la Cura dei Tumori, Meldola; Hospital of Rionero in Vulture; OCM, Verona University Hospital; Oncology Division, Santa Croce-Carle Hospital, Cuneo; Hospital of Mantova; Ospedale Evangelico Valdese, Torino; Ancona University Hospital; Hospital of Guastalla
| | - GL Banna
- Modena University Hospital, Italy; La Maddalena Hospital, Palermo; S Maria Nuova Hospital, Reggio Emilia; Hospital of Piacenza; San Giovanni Battista Hospital, Torino; S. Anna Hospital, Ferrara; Medical Oncology Unit, University Hospital of Parma; Medical and Experimental Oncology Unit, Oncology Institute Giovanni Paolo II, Bari, Italy; Vittorio Emanuele University Hospital, Catania; Bellaria Hospital, University of Bologna; Hospital of Trento; Hospital of Aosta; Medical Oncology Unit, S. Orsola-Malpighi University Hospital, Bologna; Istituto Scientifico Romagnolo perlo Studio e la Cura dei Tumori, Meldola; Hospital of Rionero in Vulture; OCM, Verona University Hospital; Oncology Division, Santa Croce-Carle Hospital, Cuneo; Hospital of Mantova; Ospedale Evangelico Valdese, Torino; Ancona University Hospital; Hospital of Guastalla
| | - R Degli Esposti
- Modena University Hospital, Italy; La Maddalena Hospital, Palermo; S Maria Nuova Hospital, Reggio Emilia; Hospital of Piacenza; San Giovanni Battista Hospital, Torino; S. Anna Hospital, Ferrara; Medical Oncology Unit, University Hospital of Parma; Medical and Experimental Oncology Unit, Oncology Institute Giovanni Paolo II, Bari, Italy; Vittorio Emanuele University Hospital, Catania; Bellaria Hospital, University of Bologna; Hospital of Trento; Hospital of Aosta; Medical Oncology Unit, S. Orsola-Malpighi University Hospital, Bologna; Istituto Scientifico Romagnolo perlo Studio e la Cura dei Tumori, Meldola; Hospital of Rionero in Vulture; OCM, Verona University Hospital; Oncology Division, Santa Croce-Carle Hospital, Cuneo; Hospital of Mantova; Ospedale Evangelico Valdese, Torino; Ancona University Hospital; Hospital of Guastalla
| | - A Ferro
- Modena University Hospital, Italy; La Maddalena Hospital, Palermo; S Maria Nuova Hospital, Reggio Emilia; Hospital of Piacenza; San Giovanni Battista Hospital, Torino; S. Anna Hospital, Ferrara; Medical Oncology Unit, University Hospital of Parma; Medical and Experimental Oncology Unit, Oncology Institute Giovanni Paolo II, Bari, Italy; Vittorio Emanuele University Hospital, Catania; Bellaria Hospital, University of Bologna; Hospital of Trento; Hospital of Aosta; Medical Oncology Unit, S. Orsola-Malpighi University Hospital, Bologna; Istituto Scientifico Romagnolo perlo Studio e la Cura dei Tumori, Meldola; Hospital of Rionero in Vulture; OCM, Verona University Hospital; Oncology Division, Santa Croce-Carle Hospital, Cuneo; Hospital of Mantova; Ospedale Evangelico Valdese, Torino; Ancona University Hospital; Hospital of Guastalla
| | - F Grasso
- Modena University Hospital, Italy; La Maddalena Hospital, Palermo; S Maria Nuova Hospital, Reggio Emilia; Hospital of Piacenza; San Giovanni Battista Hospital, Torino; S. Anna Hospital, Ferrara; Medical Oncology Unit, University Hospital of Parma; Medical and Experimental Oncology Unit, Oncology Institute Giovanni Paolo II, Bari, Italy; Vittorio Emanuele University Hospital, Catania; Bellaria Hospital, University of Bologna; Hospital of Trento; Hospital of Aosta; Medical Oncology Unit, S. Orsola-Malpighi University Hospital, Bologna; Istituto Scientifico Romagnolo perlo Studio e la Cura dei Tumori, Meldola; Hospital of Rionero in Vulture; OCM, Verona University Hospital; Oncology Division, Santa Croce-Carle Hospital, Cuneo; Hospital of Mantova; Ospedale Evangelico Valdese, Torino; Ancona University Hospital; Hospital of Guastalla
| | - C Zamagni
- Modena University Hospital, Italy; La Maddalena Hospital, Palermo; S Maria Nuova Hospital, Reggio Emilia; Hospital of Piacenza; San Giovanni Battista Hospital, Torino; S. Anna Hospital, Ferrara; Medical Oncology Unit, University Hospital of Parma; Medical and Experimental Oncology Unit, Oncology Institute Giovanni Paolo II, Bari, Italy; Vittorio Emanuele University Hospital, Catania; Bellaria Hospital, University of Bologna; Hospital of Trento; Hospital of Aosta; Medical Oncology Unit, S. Orsola-Malpighi University Hospital, Bologna; Istituto Scientifico Romagnolo perlo Studio e la Cura dei Tumori, Meldola; Hospital of Rionero in Vulture; OCM, Verona University Hospital; Oncology Division, Santa Croce-Carle Hospital, Cuneo; Hospital of Mantova; Ospedale Evangelico Valdese, Torino; Ancona University Hospital; Hospital of Guastalla
| | - D Amadori
- Modena University Hospital, Italy; La Maddalena Hospital, Palermo; S Maria Nuova Hospital, Reggio Emilia; Hospital of Piacenza; San Giovanni Battista Hospital, Torino; S. Anna Hospital, Ferrara; Medical Oncology Unit, University Hospital of Parma; Medical and Experimental Oncology Unit, Oncology Institute Giovanni Paolo II, Bari, Italy; Vittorio Emanuele University Hospital, Catania; Bellaria Hospital, University of Bologna; Hospital of Trento; Hospital of Aosta; Medical Oncology Unit, S. Orsola-Malpighi University Hospital, Bologna; Istituto Scientifico Romagnolo perlo Studio e la Cura dei Tumori, Meldola; Hospital of Rionero in Vulture; OCM, Verona University Hospital; Oncology Division, Santa Croce-Carle Hospital, Cuneo; Hospital of Mantova; Ospedale Evangelico Valdese, Torino; Ancona University Hospital; Hospital of Guastalla
| | - M Aieta
- Modena University Hospital, Italy; La Maddalena Hospital, Palermo; S Maria Nuova Hospital, Reggio Emilia; Hospital of Piacenza; San Giovanni Battista Hospital, Torino; S. Anna Hospital, Ferrara; Medical Oncology Unit, University Hospital of Parma; Medical and Experimental Oncology Unit, Oncology Institute Giovanni Paolo II, Bari, Italy; Vittorio Emanuele University Hospital, Catania; Bellaria Hospital, University of Bologna; Hospital of Trento; Hospital of Aosta; Medical Oncology Unit, S. Orsola-Malpighi University Hospital, Bologna; Istituto Scientifico Romagnolo perlo Studio e la Cura dei Tumori, Meldola; Hospital of Rionero in Vulture; OCM, Verona University Hospital; Oncology Division, Santa Croce-Carle Hospital, Cuneo; Hospital of Mantova; Ospedale Evangelico Valdese, Torino; Ancona University Hospital; Hospital of Guastalla
| | - A Molino
- Modena University Hospital, Italy; La Maddalena Hospital, Palermo; S Maria Nuova Hospital, Reggio Emilia; Hospital of Piacenza; San Giovanni Battista Hospital, Torino; S. Anna Hospital, Ferrara; Medical Oncology Unit, University Hospital of Parma; Medical and Experimental Oncology Unit, Oncology Institute Giovanni Paolo II, Bari, Italy; Vittorio Emanuele University Hospital, Catania; Bellaria Hospital, University of Bologna; Hospital of Trento; Hospital of Aosta; Medical Oncology Unit, S. Orsola-Malpighi University Hospital, Bologna; Istituto Scientifico Romagnolo perlo Studio e la Cura dei Tumori, Meldola; Hospital of Rionero in Vulture; OCM, Verona University Hospital; Oncology Division, Santa Croce-Carle Hospital, Cuneo; Hospital of Mantova; Ospedale Evangelico Valdese, Torino; Ancona University Hospital; Hospital of Guastalla
| | - O Garrone
- Modena University Hospital, Italy; La Maddalena Hospital, Palermo; S Maria Nuova Hospital, Reggio Emilia; Hospital of Piacenza; San Giovanni Battista Hospital, Torino; S. Anna Hospital, Ferrara; Medical Oncology Unit, University Hospital of Parma; Medical and Experimental Oncology Unit, Oncology Institute Giovanni Paolo II, Bari, Italy; Vittorio Emanuele University Hospital, Catania; Bellaria Hospital, University of Bologna; Hospital of Trento; Hospital of Aosta; Medical Oncology Unit, S. Orsola-Malpighi University Hospital, Bologna; Istituto Scientifico Romagnolo perlo Studio e la Cura dei Tumori, Meldola; Hospital of Rionero in Vulture; OCM, Verona University Hospital; Oncology Division, Santa Croce-Carle Hospital, Cuneo; Hospital of Mantova; Ospedale Evangelico Valdese, Torino; Ancona University Hospital; Hospital of Guastalla
| | - E Aitini
- Modena University Hospital, Italy; La Maddalena Hospital, Palermo; S Maria Nuova Hospital, Reggio Emilia; Hospital of Piacenza; San Giovanni Battista Hospital, Torino; S. Anna Hospital, Ferrara; Medical Oncology Unit, University Hospital of Parma; Medical and Experimental Oncology Unit, Oncology Institute Giovanni Paolo II, Bari, Italy; Vittorio Emanuele University Hospital, Catania; Bellaria Hospital, University of Bologna; Hospital of Trento; Hospital of Aosta; Medical Oncology Unit, S. Orsola-Malpighi University Hospital, Bologna; Istituto Scientifico Romagnolo perlo Studio e la Cura dei Tumori, Meldola; Hospital of Rionero in Vulture; OCM, Verona University Hospital; Oncology Division, Santa Croce-Carle Hospital, Cuneo; Hospital of Mantova; Ospedale Evangelico Valdese, Torino; Ancona University Hospital; Hospital of Guastalla
| | - G Fornari
- Modena University Hospital, Italy; La Maddalena Hospital, Palermo; S Maria Nuova Hospital, Reggio Emilia; Hospital of Piacenza; San Giovanni Battista Hospital, Torino; S. Anna Hospital, Ferrara; Medical Oncology Unit, University Hospital of Parma; Medical and Experimental Oncology Unit, Oncology Institute Giovanni Paolo II, Bari, Italy; Vittorio Emanuele University Hospital, Catania; Bellaria Hospital, University of Bologna; Hospital of Trento; Hospital of Aosta; Medical Oncology Unit, S. Orsola-Malpighi University Hospital, Bologna; Istituto Scientifico Romagnolo perlo Studio e la Cura dei Tumori, Meldola; Hospital of Rionero in Vulture; OCM, Verona University Hospital; Oncology Division, Santa Croce-Carle Hospital, Cuneo; Hospital of Mantova; Ospedale Evangelico Valdese, Torino; Ancona University Hospital; Hospital of Guastalla
| | - S Cascinu
- Modena University Hospital, Italy; La Maddalena Hospital, Palermo; S Maria Nuova Hospital, Reggio Emilia; Hospital of Piacenza; San Giovanni Battista Hospital, Torino; S. Anna Hospital, Ferrara; Medical Oncology Unit, University Hospital of Parma; Medical and Experimental Oncology Unit, Oncology Institute Giovanni Paolo II, Bari, Italy; Vittorio Emanuele University Hospital, Catania; Bellaria Hospital, University of Bologna; Hospital of Trento; Hospital of Aosta; Medical Oncology Unit, S. Orsola-Malpighi University Hospital, Bologna; Istituto Scientifico Romagnolo perlo Studio e la Cura dei Tumori, Meldola; Hospital of Rionero in Vulture; OCM, Verona University Hospital; Oncology Division, Santa Croce-Carle Hospital, Cuneo; Hospital of Mantova; Ospedale Evangelico Valdese, Torino; Ancona University Hospital; Hospital of Guastalla
| | - G Rossi
- Modena University Hospital, Italy; La Maddalena Hospital, Palermo; S Maria Nuova Hospital, Reggio Emilia; Hospital of Piacenza; San Giovanni Battista Hospital, Torino; S. Anna Hospital, Ferrara; Medical Oncology Unit, University Hospital of Parma; Medical and Experimental Oncology Unit, Oncology Institute Giovanni Paolo II, Bari, Italy; Vittorio Emanuele University Hospital, Catania; Bellaria Hospital, University of Bologna; Hospital of Trento; Hospital of Aosta; Medical Oncology Unit, S. Orsola-Malpighi University Hospital, Bologna; Istituto Scientifico Romagnolo perlo Studio e la Cura dei Tumori, Meldola; Hospital of Rionero in Vulture; OCM, Verona University Hospital; Oncology Division, Santa Croce-Carle Hospital, Cuneo; Hospital of Mantova; Ospedale Evangelico Valdese, Torino; Ancona University Hospital; Hospital of Guastalla
| | - R D'Amico
- Modena University Hospital, Italy; La Maddalena Hospital, Palermo; S Maria Nuova Hospital, Reggio Emilia; Hospital of Piacenza; San Giovanni Battista Hospital, Torino; S. Anna Hospital, Ferrara; Medical Oncology Unit, University Hospital of Parma; Medical and Experimental Oncology Unit, Oncology Institute Giovanni Paolo II, Bari, Italy; Vittorio Emanuele University Hospital, Catania; Bellaria Hospital, University of Bologna; Hospital of Trento; Hospital of Aosta; Medical Oncology Unit, S. Orsola-Malpighi University Hospital, Bologna; Istituto Scientifico Romagnolo perlo Studio e la Cura dei Tumori, Meldola; Hospital of Rionero in Vulture; OCM, Verona University Hospital; Oncology Division, Santa Croce-Carle Hospital, Cuneo; Hospital of Mantova; Ospedale Evangelico Valdese, Torino; Ancona University Hospital; Hospital of Guastalla
| | - PF. Conte
- Modena University Hospital, Italy; La Maddalena Hospital, Palermo; S Maria Nuova Hospital, Reggio Emilia; Hospital of Piacenza; San Giovanni Battista Hospital, Torino; S. Anna Hospital, Ferrara; Medical Oncology Unit, University Hospital of Parma; Medical and Experimental Oncology Unit, Oncology Institute Giovanni Paolo II, Bari, Italy; Vittorio Emanuele University Hospital, Catania; Bellaria Hospital, University of Bologna; Hospital of Trento; Hospital of Aosta; Medical Oncology Unit, S. Orsola-Malpighi University Hospital, Bologna; Istituto Scientifico Romagnolo perlo Studio e la Cura dei Tumori, Meldola; Hospital of Rionero in Vulture; OCM, Verona University Hospital; Oncology Division, Santa Croce-Carle Hospital, Cuneo; Hospital of Mantova; Ospedale Evangelico Valdese, Torino; Ancona University Hospital; Hospital of Guastalla
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Liberati A, D'Amico R. Commentary: The debate on non-inferiority trials: 'when meta-analysis alone is not helpful'. Int J Epidemiol 2010; 39:1582-3. [DOI: 10.1093/ije/dyq197] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [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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Blasi I, D'Amico R, Fenu V, Volpe A, Fuchs I, Henrich W, Mazza V. Sonographic assessment of fetal spine and head position during the first and second stages of labor for the diagnosis of persistent occiput posterior position: a pilot study. Ultrasound Obstet Gynecol 2010; 35:210-215. [PMID: 20101635 DOI: 10.1002/uog.7504] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVES The aim of this pilot study was to perform a preliminary investigation into the predictive values of the position of the fetal spine and of the occiput measured during the first and second stages of labor by intrapartum ultrasound for persistent occiput posterior (OP) position. METHODS This was a prospective, cohort study, in which 100 women with singleton pregnancies were enrolled during the first or second stage of labor. The women underwent intrapartum transabdominal sonography and the positions of the fetal head and spine were recorded. The women were followed up until delivery and occiput position at birth was assessed. RESULTS Eighty-four pregnancies were evaluated in the second stage of labor, with 74 of these also evaluated in the first stage. Fifty-one percent of fetuses were found to be in an OP position during the first stage of labor, but the majority of these rotated to an anterior position before delivery. There were six cases of OP at delivery, and all of these were among the 23 fetuses that were found to be in an OP position on ultrasound evaluation during the second stage of labor. All six were also found to have a posterior spine position during the second stage of labor, with this finding observed in only one fetus with occiput anterior position at delivery. CONCLUSIONS The results of this study suggest that the position of the head and spine during the second stage of labor could be useful indicators for predicting the OP position at delivery. The results also suggest that the OP position at delivery results from a failure of rotation from the OP position, rather than a malrotation from the anterior position. Studies with larger sample sizes are needed to confirm these results.
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Affiliation(s)
- I Blasi
- Prenatal Medicine Unit, Department of Obstetrics and Gynaecology, Modena and Reggio Emilia University, Modena, Italy.
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Gambacorta M, van Stiphout R, Barba M, Coco C, Persiani R, Doglietto G, D'Amico R, Balducci M, Lambin P, Valentini V. 6042 Metastases prediction after preoperative radiochemotherapy in cT3M0 rectal cancer patients: an analysis of a large database. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)71137-1] [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: 11/26/2022] Open
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Ferrara G, Losi M, D'Amico R, Cagarelli R, Pezzi A, Meacci M, Meccugni B, Dori IM, Rumpianesi F, Roversi P, Casali L, Fabbri L, Richeldi L. Interferon-γ-Release Assays Detect Recent Tuberculosis Re-Infection in Elderly Contacts. Int J Immunopathol Pharmacol 2009; 22:669-77. [DOI: 10.1177/039463200902200312] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The tuberculin skin test (TST) does not discriminate between recent and remote latent tuberculosis infection (LTBI). This study was carried out to test two interferon-γ (IFN-γ)-based blood assays in recent contacts with high prevalence of remote LTBI. We performed a contact tracing investigation in a nursing home for the elderly, where elderly patients were exposed to a case of pulmonary tuberculosis. TST, QuantiFERON-TB Gold (QFT-G) and T-SPOT.TB (TS.TB) were performed 8 weeks after the end of potential exposure. IFN-γ measurements were recorded and correlation with exposure was evaluated. Twenty-seven (37.5%), 32 (44.4%) and 16 (22.2%) subjects were TST, TS.TB and QFT-G positive, respectively; agreement between TS.TB and QFT-G was good among exposed subjects only (κ=0.915, 0.218 in unexposed, p<0.001). When amounts of IFN-γ were corrected for the number of producing T cells, specific IFN-γ production was significantly different between exposed and unexposed individuals (16.75±5.40 vs 2.33±0.71 IFN-γ IU/1000 SFC, p=0.0001). QFT-G and TS.TB provided discordant results among elderly contacts. Unlike TST, the specific IFN-γ response might discriminate between recent and long-lasting tuberculosis infection.
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Affiliation(s)
- G. Ferrara
- Sections of Respiratory Disease, Hematology and Respiratory Disease, University of Modena and Reggio Emilia
- Section of Respiratory Diseases, Department of Internal Medicine, S. Maria Hospital, University of Perugia, Terni, Italy
| | - M. Losi
- Sections of Respiratory Disease, Hematology and Respiratory Disease, University of Modena and Reggio Emilia
| | - R. D'Amico
- Sections of Statistics, Department of Oncology, Hematology and Respiratory Disease, University of Modena and Reggio Emilia
| | | | | | - M. Meacci
- Laboratory of Microbiology and Virology, Policlinico Hospital of Modena
| | - B. Meccugni
- Laboratory of Microbiology and Virology, Policlinico Hospital of Modena
| | - I. Marchetti Dori
- Laboratory of Microbiology and Virology, Policlinico Hospital of Modena
| | - F. Rumpianesi
- Laboratory of Microbiology and Virology, Policlinico Hospital of Modena
| | - P. Roversi
- Sections of Respiratory Disease, Hematology and Respiratory Disease, University of Modena and Reggio Emilia
| | - L. Casali
- Section of Respiratory Diseases, Department of Internal Medicine, S. Maria Hospital, University of Perugia, Terni, Italy
| | - L.M. Fabbri
- Sections of Respiratory Disease, Hematology and Respiratory Disease, University of Modena and Reggio Emilia
| | - L. Richeldi
- Sections of Respiratory Disease, Hematology and Respiratory Disease, University of Modena and Reggio Emilia
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Guarneri V, Piacentini F, Ficarra G, Frassoldati A, D'Amico R, Giovannelli S, Maiorana A, Jovic G, Conte P. A prognostic model based on nodal status and Ki-67 predicts the risk of recurrence and death in breast cancer patients with residual disease after preoperative chemotherapy. Ann Oncol 2009; 20:1193-8. [DOI: 10.1093/annonc/mdn761] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [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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Luppi F, Losi M, D'Amico R, Fabbri LM, Richeldi L. Endogenous blood maximal interferon-gamma production may predict response to interferon-gamma 1beta treatment in patients with idiopathic pulmonary fibrosis. Sarcoidosis Vasc Diffuse Lung Dis 2009; 26:64-68. [PMID: 19960790] [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: 05/28/2023]
Abstract
BACKGROUND Idiopathic pulmonary fibrosis (IPF) is an untreatable lung disorder with a mean survival of 3 years after diagnosis. Treatment with interferon-gamma (IFN-gamma) 1beta has been reported to significantly improve lung function and arterial oxygen saturation in a first randomized controlled trial; unexpectedly, these findings have not been confirmed in a subsequent large placebo-controlled randomized study. Another larger placebo-controlled randomized trial has been stopped because data analyzed at interim analysis excluded the possibility that treatment with IFN-gamma 1beta would cause a significant reduction in the risk of death. METHODS Seven Italian male patients diagnosed with IPF were treated with IFN-gamma 1beta (200 microg/die subcutaneously three times a week), accordingly to the indications of the Italian Drug Agency. Based on available studies the response to treatment was pre-defined as changes in either lung function (FVC and DLCO) or oxygen arterial saturation. All patients consented to provide a peripheral blood sample for endogenous IFN-gamma production measurement with the ELISpot assay before treatment and 6 months thereafter. RESULTS Four of 7 patients improved or stabilized their lung function after 6 months treatment. Using the ELISpot assay to quantify the maximal production of endogenous IFN-gamma on peripheral blood samples, these 4 patients had a significantly higher endogenous IFN-gamma production before therapy, as compared to the 3 patients who deteriorated (91.3 +/- 49.6 vs. 277.8 +/- 34.2 spot forming cells, p = 0.023). No significant differences were observed after 6 months of treatment. DISCUSSION These preliminary results suggest that some IPF patients might benefit from treatment with IFN-gamma 1beta and may help to interpret the results of large randomized trials, suggesting that individual susceptibility could determine clinical response to treatment.
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Affiliation(s)
- F Luppi
- Center for Rare Lung Disease, University of Modena and Reggio Emilia, Italy.
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Frassoldati A, Guarneri V, Bottini A, Cagossi K, Cavanna L, Bisagni G, D'Amico R, Piacentini F, Oliva C, Conte P. Preplanned first-step analysis of LET-LOB neoadjuvant study: A double-blind randomized phase IIb trial of letrozole (L) plus lapatinib (Lp) or placebo (P) in postmenopausal HER2-ve, HR+ve operable breast cancer. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.570] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
570 Background: In HR+ve BC, the simultaneous blockade of ER and HER-related pathways could prevent the hormone-resistance due to activation of EGFR-family signalling, as shows the high activity of the combination of letrozole and lapatinib in HR+ve/HER2+ve advanced BC. The LET-LOB trial evaluates the clinical and biological effects of the combined inhibitory strategy with letrozole + lapatinib in untreated ER+ve/HER2-ve BC patients suitable for hormonal neoadjuvant therapy. Methods: Postmenopausal women with stage II-IIIa, HR+ve/HER2-ve BC are randomized to L (2.5 mg/d) + Lp (1500 mg/d) or L + P, given continuously for 24 weeks before surgery. Primary end point is the clinical RR (with ultrasonography, US); secondary endpoints are the pathological RR, the safety, and HR/EGFR-related biomarker evaluation. According to the “two step Simon's design” of the study, at least 20 cORs (8 in L+P and 12 in L+Lp) must be observed in the first 43 patients; then, additional 48 patients will be recruited to demonstrate a 40% increase in cOR with L+Lp, assuming a cOR of 50% with L+P. Results: Since April 2007, 39/55 randomized patients completed the preoperative treatment. Median age was 68 yrs. At diagnosis, mean US tumor size was 3 cm. All patients were HER2-ve, and either ER+ve or PR+ve (both +ve: 76%). After 3 and 6 months of therapy, a 29% and 41% reduction from baseline mean US longest tumor diameter was observed. No change in mean LVEF has been reported at the 3- and 6-month evaluations. 5 episodes of G3 toxicity have occured (skin rash, 1; liver function parameters, 4). So far 31 women underwent surgery (conservative in 65 %). The efficacy results according to the first step Simon's analysis will be performed by the IDMC on march 2009, and will be presented at the meeting along with updated clinical and safety data. Conclusions: Preliminary blinded results suggest that the combination of L+Lp in ER+ve/HER2-ve operable BC is feasible, without early cardiac events or other severe toxicities, and associated with clear tumor downstaging. Biological correlative studies will clarify the relationship between the double inhibition strategy and the clinical response. Supported by GlaxoSmithKline. [Table: see text]
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Affiliation(s)
- A. Frassoldati
- Università di Modena e Reggio Emilia, Modena, Italy; Istituti Ospitalieri, Cremona, Italy; Ramazzini Hospital, Carpi, Italy; Hospital of Piacenza, Piacenza, Italy; S.Maria Nuova Hospital, Reggio Emilia, Italy; Glaxo SmithKline, Greenford, United Kingdom
| | - V. Guarneri
- Università di Modena e Reggio Emilia, Modena, Italy; Istituti Ospitalieri, Cremona, Italy; Ramazzini Hospital, Carpi, Italy; Hospital of Piacenza, Piacenza, Italy; S.Maria Nuova Hospital, Reggio Emilia, Italy; Glaxo SmithKline, Greenford, United Kingdom
| | - A. Bottini
- Università di Modena e Reggio Emilia, Modena, Italy; Istituti Ospitalieri, Cremona, Italy; Ramazzini Hospital, Carpi, Italy; Hospital of Piacenza, Piacenza, Italy; S.Maria Nuova Hospital, Reggio Emilia, Italy; Glaxo SmithKline, Greenford, United Kingdom
| | - K. Cagossi
- Università di Modena e Reggio Emilia, Modena, Italy; Istituti Ospitalieri, Cremona, Italy; Ramazzini Hospital, Carpi, Italy; Hospital of Piacenza, Piacenza, Italy; S.Maria Nuova Hospital, Reggio Emilia, Italy; Glaxo SmithKline, Greenford, United Kingdom
| | - L. Cavanna
- Università di Modena e Reggio Emilia, Modena, Italy; Istituti Ospitalieri, Cremona, Italy; Ramazzini Hospital, Carpi, Italy; Hospital of Piacenza, Piacenza, Italy; S.Maria Nuova Hospital, Reggio Emilia, Italy; Glaxo SmithKline, Greenford, United Kingdom
| | - G. Bisagni
- Università di Modena e Reggio Emilia, Modena, Italy; Istituti Ospitalieri, Cremona, Italy; Ramazzini Hospital, Carpi, Italy; Hospital of Piacenza, Piacenza, Italy; S.Maria Nuova Hospital, Reggio Emilia, Italy; Glaxo SmithKline, Greenford, United Kingdom
| | - R. D'Amico
- Università di Modena e Reggio Emilia, Modena, Italy; Istituti Ospitalieri, Cremona, Italy; Ramazzini Hospital, Carpi, Italy; Hospital of Piacenza, Piacenza, Italy; S.Maria Nuova Hospital, Reggio Emilia, Italy; Glaxo SmithKline, Greenford, United Kingdom
| | - F. Piacentini
- Università di Modena e Reggio Emilia, Modena, Italy; Istituti Ospitalieri, Cremona, Italy; Ramazzini Hospital, Carpi, Italy; Hospital of Piacenza, Piacenza, Italy; S.Maria Nuova Hospital, Reggio Emilia, Italy; Glaxo SmithKline, Greenford, United Kingdom
| | - C. Oliva
- Università di Modena e Reggio Emilia, Modena, Italy; Istituti Ospitalieri, Cremona, Italy; Ramazzini Hospital, Carpi, Italy; Hospital of Piacenza, Piacenza, Italy; S.Maria Nuova Hospital, Reggio Emilia, Italy; Glaxo SmithKline, Greenford, United Kingdom
| | - P. Conte
- Università di Modena e Reggio Emilia, Modena, Italy; Istituti Ospitalieri, Cremona, Italy; Ramazzini Hospital, Carpi, Italy; Hospital of Piacenza, Piacenza, Italy; S.Maria Nuova Hospital, Reggio Emilia, Italy; Glaxo SmithKline, Greenford, United Kingdom
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Facchinetti F, Allais G, Nappi RE, D'Amico R, Marozio L, Bertozzi L, Ornati A, Benedetto C. Migraine is a risk factor for hypertensive disorders in pregnancy: a prospective cohort study. Cephalalgia 2009; 29:286-92. [PMID: 19220309 DOI: 10.1111/j.1468-2982.2008.01704.x] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The aim was to assess whether women suffering from migraine are at higher risk of developing hypertensive disorders in pregnancy. In a prospective cohort study, performed at antenatal clinics in three maternity units in Northern Italy, 702 normotensive women with singleton pregnancy at 11-16 weeks' gestation were enrolled. Women with a history of hypertensive disorders in pregnancy or presenting chronic hypertension were excluded. The presence of migraine was investigated according to International Headache Society criteria. The main outcome measure was the onset of hypertension in pregnancy, defined as the occurrence of either gestational hypertension or preeclampsia. Two hundred and seventy women (38.5%) were diagnosed with migraine. The majority (68.1%) suffered from migraine without aura. The risk of developing hypertensive disorders in pregnancy was higher in migraineurs (9.1%) compared with non-migraineurs (3.1%) [odds ratio (OR) adjusted for age, family history of hypertension and smoking 2.85, 95% confidence interval (CI) 1.40, 5.81]. Women with migraine also showed a trend to increased risk for low birth weight infants with respect to women without migraine (OR 1.97, 95% CI 0.98, 3.98). Women with migraine are to be considered at increased risk of developing hypertensive disorders in pregnancy. The diagnosis of primary headaches should be taken into account at antenatal examination.
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Affiliation(s)
- F Facchinetti
- Unit of Psychobiology of Reproduction-UCADH, Mother-Infant Department, University of Modena and Reggio Emilia, Modena, Italy.
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Guarneri V, Pecchi A, Torricelli P, Piacentini F, Frassoldati A, Mauri C, Battista R, Canossi B, D'Amico R, Conte P. Magnetic resonance imaging and ultrasonography in predicting pathologic extent after preoperative chemotherapy in stage II-III breast cancer. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-4024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Abstract #4024
Introduction and aims: the main advantage of preoperative chemotherapy (PCT) is tumor down-staging, that can allow either mastectomy in large, inoperable primaries, or breast conserving surgery (BCS) for patients initially candidate to mastectomy. Therefore, an accurate measurement of residual disease after PCT is critical in the optimal surgical planning. Aim of this study is to evaluate the accuracy of breast magnetic resonance imaging (MRI) and ultrasonography (USG) in predicting the extent of breast residual disease.
 Patients and Methods: patients with stage II-III invasive breast tumor receiving PST and imaged with post-treatment MRI, USG or both were included; deltas were calculated as differences between the longest tumor diameter as measured by MRI and USG and the pathologic size of residual breast tumor. Differences between deltas were tested by using T test for paired data.
 Results: 45 patients treated with PCT in our Institution were eligible. Patients characteristics were as follows: mean age 50 yrs (range 30-70 yrs); stage IIA 31%, IIB 49%, IIIA-B: 20%. Eighty-nine % of the cases had ductal histology, 69% had ER positivity, and 24% had HER2 over-expression. The mean T size at diagnosis was 3.8 cm (range 1.5-8 cm). PCT type was anthracycline-based (24%) or anthracycline-taxane combination (76%). Forty-four patients have been evaluated after PCT by MRI, 41 by USG, 40 patients by both MRI and USG. The mean T size (range) after PCT was 2 cm (0-6.5 cm) and 1.7 cm (0-5 cm) as measured by MRI and USG respectively. The mean interval between breast imaging and surgery was 20 days (range 1-63). Type of surgery was mastectomy in 45% and BCS in 55% of the cases; 6 patients (13%) achieved a pathologic complete response (pCR). The mean pathologic T size was 1.98 cm (range 0-6 cm). The mean of the deltas were 0.04 (SD 1.91) and -0.19 (SD 1.53) for MRI and USG respectively (p=0.22). A complete response by MRI was observed in 9 cases: 3 cases were confirmed as pCRs; 2 cases presented with scattered microscopic residual disease. An USG complete response was observed in 8 cases (4 confirmed pCRs).
 Conclusion: in this series of patients, MRI and USG do not show significant differences in predicting the breast residual tumor after PCT. The major challenge for breast imaging after PCT is represented by scattered residual disease.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 4024.
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Affiliation(s)
- V Guarneri
- 1 Department of Oncology and Hematology, Modena University Hospital, Modena, Italy
| | - A Pecchi
- 2 Department of Radiology, Modena University Hospital, Modena, Italy
| | - P Torricelli
- 2 Department of Radiology, Modena University Hospital, Modena, Italy
| | - F Piacentini
- 1 Department of Oncology and Hematology, Modena University Hospital, Modena, Italy
| | - A Frassoldati
- 1 Department of Oncology and Hematology, Modena University Hospital, Modena, Italy
| | - C Mauri
- 2 Department of Radiology, Modena University Hospital, Modena, Italy
| | - R Battista
- 2 Department of Radiology, Modena University Hospital, Modena, Italy
| | - B Canossi
- 2 Department of Radiology, Modena University Hospital, Modena, Italy
| | - R D'Amico
- 1 Department of Oncology and Hematology, Modena University Hospital, Modena, Italy
| | - P Conte
- 1 Department of Oncology and Hematology, Modena University Hospital, Modena, Italy
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Guarneri V, Piacentini F, Frassoldati A, Ficarra G, D'Amico R, Giovannelli S, Conte P. A prognostic model based on nodal status and Ki 67 predicts the risk of recurrence and death in breast cancer patients with residual disease after preoperative chemotherapy. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-1066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Abstract #1066
Introduction and Aims: The achievement of a pathologic complete response (pCR) after preoperative chemotherapy (PCT) is a validated surrogate end point for long term outcome. On the other side, patients with residual disease in the breast and/or axilla are an heterogeneous group with very different prognosis, including both patients with truly chemo-resistant disease as well as patients with an important tumor downstaging even if not in pCR. Aim of this analysis is to identify, in patients with residual disease, potential markers able to discriminate patients at higher risk of relapse.
 Patients and Methods:. The following parameters were evaluated on the surgical specimen in patients with less than pCR following PCT: residual breast disease, number of involved nodes, proliferation (Ki 67), hormone receptor, HER2, p53, EGFR, VEGFR2. Survival curves were estimated with the Kaplan-Meier method and the log rank test was used to test for differences between groups. Hazard Ratios and their confidence intervals were estimated by using Cox model.
 Results: 195 breast cancer patients were included. Median age 51 yrs (range: 27-73); 71% of the patients had ER+ tumors at diagnosis, 20% were HER2+. After PCT, 55% of the patients received mastectomy, 45% underwent conservative surgery. 57% of the patients had residual breast disease < 2 cm; 38% between 2-5 cm; 35% had no involved nodes, 30% 1-3 nodes, 19% 4-9 nodes, and 16% > 10 nodes; 50% of the patients had Ki 67 >/= 15%. Among the examined parameters, nodal positivity and Ki 67>/=15% were significantly related with a higher risk of relapse (HR 2.5 , p=0.014 and HR 3.4, p <0.0001 respectively). Ki 67 >/=15% was also predictive of a higher risk of death (HR 4.1, p=0.007). On the basis of these two parameters, patients were classified in three groups: 1) low risk (negative nodes and Ki 67<15%): 14.4% of the patients ; 2) intermediate risk (nodal positivity or Ki67 >/= 15%): 54.4% of the patients; 3) high risk (nodal positivity and Ki 67>/= 15%): 31.2% of the patients. Five-year DFS rates were 90%, 72%, and 43% respectively (log rank test p<0.0001); as compared with the low risk group, the HRs for recurrence were 3.1 and 9.3 for the intermediate and high risk group respectively (p=0.0001). Five-year OS rates were 86%, 88%, and 64% respectively (log rank test p=0.035); as compared with the low risk group, the HRs for death were 2.4 and 6.5 for the intermediate and high risk group respectively (p=0.042).
 Conclusions: In this series of patients, Ki 67 and nodal status have been used to generate a simple and easily reproducible prognostic model, able to discriminate patients with worse prognosis among the heterogeneous group of women with residual disease after PCT. In the era of customized treatment strategies, patients at higher risk are the optimal candidates to study the efficacy of additional postoperative treatments.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 1066.
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Affiliation(s)
- V Guarneri
- 1 Department of Oncology and Hematology, University Hospital, Modena, Italy
| | - F Piacentini
- 1 Department of Oncology and Hematology, University Hospital, Modena, Italy
| | - A Frassoldati
- 1 Department of Oncology and Hematology, University Hospital, Modena, Italy
| | - G Ficarra
- 2 Department of Pathology, University Hospital, Modena, Italy
| | - R D'Amico
- 1 Department of Oncology and Hematology, University Hospital, Modena, Italy
| | - S Giovannelli
- 1 Department of Oncology and Hematology, University Hospital, Modena, Italy
| | - P Conte
- 1 Department of Oncology and Hematology, University Hospital, Modena, Italy
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