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Rossi C, Fraticelli S, Fanizza M, Ferrari A, Ferraris E, Messina A, Della Valle A, Anghelone CAP, Lasagna A, Rizzo G, Perrone L, Sommaruga MG, Meloni G, Dallavalle S, Bonzano E, Paulli M, Di Giulio G, Sgarella A, Lucioni M. Concordance of immunohistochemistry for predictive and prognostic factors in breast cancer between biopsy and surgical excision: a single-centre experience and review of the literature. Breast Cancer Res Treat 2023; 198:573-582. [PMID: 36802316 PMCID: PMC10036406 DOI: 10.1007/s10549-023-06872-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 01/31/2023] [Indexed: 02/23/2023]
Abstract
PURPOSE Accurate evaluation of breast cancer on bioptic samples is of fundamental importance to guide therapeutic decisions, especially in the neoadjuvant or metastatic setting. We aimed to assess concordance for oestrogen receptor (ER), progesterone receptor (PR), c-erbB2/HER2 and Ki-67. We also reviewed the current literature to evaluate our results in the context of the data available at present. METHODS We included patients who underwent both biopsy and surgical resection for breast cancer at San Matteo Hospital, Pavia, Italy, between January 2014 and December 2020. ER, PR, c-erbB2, and Ki-67 immunohistochemistry concordance between biopsy and surgical specimen was evaluated. ER was further analysed to include the recently defined ER-low-positive in our analysis. RESULTS We evaluated 923 patients. Concordance between biopsy and surgical specimen for ER, ER-low-positive, PR, c-erbB2 and Ki-67 was, respectively, 97.83, 47.8, 94.26, 68 and 86.13%. Cohen's κ for interobserver agreement was very good for ER and good for PR, c-erbB2 and Ki-67. Concordance was especially low (37%) in the c-erbB2 1 + category. CONCLUSION Oestrogen and progesterone receptor status can be safely assessed on preoperative samples. The results of this study advise caution in interpreting biopsy results regarding ER-low-positive, c-erbB2/HER and Ki-67 results due to a still suboptimal concordance. The low concordance for c-erbB2 1 + cases underlines the importance of further training in this area, in the light of the future therapeutic perspectives.
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Affiliation(s)
- Chiara Rossi
- Department of Molecular Medicine, Unit of Anatomic Pathology, University of Pavia, IRCCS San Matteo Hospital Foundation, Pavia, Italy.
| | - Sara Fraticelli
- Department of Molecular Medicine, Unit of Anatomic Pathology, University of Pavia, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Marianna Fanizza
- Unit of Breast Radiology, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Alberta Ferrari
- Department of Surgical Sciences, General Surgery 3-Breast Surgery, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Elisa Ferraris
- Unit of Medical Oncology, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Alessia Messina
- Department of Molecular Medicine, Unit of Anatomic Pathology, University of Pavia, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Angelica Della Valle
- Department of Surgical Sciences, General Surgery 3-Breast Surgery, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | | | - Angioletta Lasagna
- Unit of Medical Oncology, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Gianpiero Rizzo
- Unit of Medical Oncology, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Lorenzo Perrone
- Unit of Medical Oncology, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | | | - Giulia Meloni
- Unit of Breast Radiology, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Silvia Dallavalle
- Unit of Breast Radiology, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Elisabetta Bonzano
- School in Experimental Medicine, Unit of Radiational Oncology, University of Pavia, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Marco Paulli
- Department of Molecular Medicine, Unit of Anatomic Pathology, University of Pavia, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Giuseppe Di Giulio
- Unit of Breast Radiology, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Adele Sgarella
- Department of Surgical Sciences, General Surgery 3-Breast Surgery, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Marco Lucioni
- Department of Molecular Medicine, Unit of Anatomic Pathology, University of Pavia, IRCCS San Matteo Hospital Foundation, Pavia, Italy
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Carroll M, Morello E, Olimpo M, Giacobino D, Buracco P, Ferraris E. Random mucosal rotating flaps for rostral to mid maxillary defect reconstruction: 26 dogs (2000-2019). J Small Anim Pract 2023; 64:149-160. [PMID: 36250216 DOI: 10.1111/jsap.13558] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 08/24/2022] [Accepted: 09/06/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate the feasibility and the complications following single or double random mucosal rotating (transposition or interpolation) flaps for the closure of rostral to mid maxillary defects in dogs. MATERIALS AND METHODS Medical records of dogs treated with single or double random mucosal rotating flaps after maxillectomy for oral lesions or traumatic loss of tissue, were evaluated. Clinical findings, surgery performed, outcome and postoperative complications (major and minor) were extracted. RESULTS Twenty-six client-owned dogs were retrospectively included. Dogs underwent maxillectomy for canine acanthomatous ameloblastomas (9), oral squamous cell carcinomas (4), peripheral odontogenic fibromas (4), oral melanomas (3), oral fibrosarcomas (2), dentigerous cysts (2) and oral osteosarcoma (1) and trauma resulting in an oronasal fistula (1). Twenty-three dogs underwent a single transposition or interpolation flap and three dogs were treated with a double transposition flap. Postoperative complications, including dehiscence or flap necrosis, occurred in six dogs. CLINICAL SIGNIFICANCE Random mucosal rotating (transposition or interpolation) flaps are versatile when used to close rostral maxillary defects in dogs. Postoperative complications appear to be more likely when these flaps are used to close mid maxillary defects.
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Affiliation(s)
- M Carroll
- Department of Veterinary Sciences, University of Torino, Grugliasco, 10095, Italy
| | - E Morello
- Department of Veterinary Sciences, University of Torino, Grugliasco, 10095, Italy
| | - M Olimpo
- Department of Veterinary Sciences, University of Torino, Grugliasco, 10095, Italy
| | - D Giacobino
- Department of Veterinary Sciences, University of Torino, Grugliasco, 10095, Italy
| | - P Buracco
- Department of Veterinary Sciences, University of Torino, Grugliasco, 10095, Italy
| | - E Ferraris
- Department of Veterinary Sciences, University of Torino, Grugliasco, 10095, Italy
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Sottotetti F, Ferraris E, Tagliaferri B, Palumbo R, Quaquarini E, Teragni C, Balletti E, Leli C, Premoli A, Mollica L, Puglisi S, Sardi S, Malovini A, Pedrazzoli P, Bernardo A. The prognostic role of variations in tumour markers (CEA, CA15.3) in patients with metastatic breast cancer treated with CDK4/6 inhibitors. Drugs Context 2022; 11:dic-2022-1-3. [PMID: 36118250 PMCID: PMC9451191 DOI: 10.7573/dic.2022-1-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 07/13/2022] [Indexed: 11/21/2022] Open
Abstract
Tumour markers have no established role in the monitoring of the course of metastatic breast cancer during antineoplastic therapy, yet cancer antigen 15.3 (CA15.3) and carcinoembryonic antigen (CEA) are commonly used in clinical practice to aid in the early detection of progression of disease (PD). In our multicentre, prospective, real-life study, we enrolled 142 consecutive patients with advanced breast cancer receiving endocrine therapy in combination with a CDK4/6 inhibitor from January 2017 to October 2020; 75 patients had PD at the time of database closure. We measured serum marker concentrations at regular 4-month intervals together with radiological tumour response assessments and in cases of clinical suspicion of PD. Appropriate descriptive and inferential statistical methods were used to analyse serum marker level trends amongst prespecified subgroups and at specific time points (baseline, best radiologically documented tumour response and first detection of PD) in the subpopulation of patients with PD at the time of database closure. Notably, the median time from treatment initiation to best tumour response was 4.4 months. We evaluated the presence of an association between baseline CA15.3 and CEA levels and prespecified clinical characteristics but found no clinically meaningful correlation. We assessed marker level variations at the time of best radiologically documented disease response and PD: in the subgroup of patients who responded to treatment before progressing, we detected a statistically significant correlation with tumour marker variation between the time of best response and progression; this finding was not confirmed in the subgroup of patients that did not benefit from treatment. In conclusion, serum tumour marker flares can be useful in the early diagnosis of PD but should not be used as the sole factor prompting a change in treatment strategy without radiological confirmation.
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Lardone E, Sarotti D, Giacobino D, Ferraris E, Franci P. Thoracic epidural anaesthesia vs intrathecal morphine in dogs undergoing major thoracic and abdominal surgery: clinical study. BMC Vet Res 2022; 18:200. [PMID: 35624498 PMCID: PMC9137148 DOI: 10.1186/s12917-022-03296-3] [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: 04/05/2022] [Accepted: 05/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is scant clinical research on neuraxial analgesia in dogs undergoing major surgery. With this study we compared the perioperative analgesic effects of thoracic epidural anaesthesia (TEA) and intrathecal morphine (ITM) in dogs scheduled for thoracic or cranial abdominal surgery. The dogs received methadone and dexmedetomidine, were anaesthetized with propofol maintained with sevoflurane, and randomly assigned to receive either TEA (ropivacaine 0.5% at 0.2 mg/kg and morphine 0.1 mg/kg administered at T12-T13) or ITM (morphine 30 μg/kg administered at L6-L7). Intraoperative rescue analgesia (iRA) was fentanyl 1 μg/kg administered if heart rate or mean arterial pressure increased by 30% above the pre-stimulation level. Glasgow Pain Composite Scale score (GPCS) dictated the use of postoperative rescue analgesia (pRA) with methadone 0.2 mg/kg. RESULTS There was a statistically significant difference in iRA, median time to first fentanyl bolus, median fentanyl dose after surgical opening, and median GPCS score at 30 minutes (min), 1 ,2, 4, 6, and 8 hours (h) between the two groups (p<0.001; p<0.001; p<0.001; p<0.01; p<0.01; p<0.001; p<0.01; p=0.01; p=0.01, respectively). Fewer TEA than ITM group dogs required iRA during surgical opening and pRA: 5% (1/18) and 2/18 (11%), respectively, in the TEA and 83% (16/18) and 10/18 (55%), respectively, in the ITM group. Side effects were urinary retention in 3/18 (16%) TEA group dogs and 2/18 (11%) ITM group dogs and prolonged sedation in 2/18 (11%) in ITM group dogs. TEA and ITM were effective in managing perioperative pain in dogs undergoing thoracic or cranial abdominal surgery.
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Affiliation(s)
- E Lardone
- Department of Veterinary Sciences, School of Veterinary Medicine, University of Turin, 2 Largo Paolo Braccini, 10095, Grugliasco, Italy.
| | - D Sarotti
- Centro Veterinario Fossanese, 29/E Via Cuneo, 12045, Fossano, Italy
| | - D Giacobino
- Department of Veterinary Sciences, School of Veterinary Medicine, University of Turin, 2 Largo Paolo Braccini, 10095, Grugliasco, Italy
| | - E Ferraris
- Department of Veterinary Sciences, School of Veterinary Medicine, University of Turin, 2 Largo Paolo Braccini, 10095, Grugliasco, Italy
| | - P Franci
- Department of Veterinary Sciences, School of Veterinary Medicine, University of Turin, 2 Largo Paolo Braccini, 10095, Grugliasco, Italy
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La Verde N, Damia G, Garrone O, Santini D, Fabi A, Ciccarese M, Generali DG, Nunzi M, Poletto E, Ferraris E, Cretella E, Scandurra G, Meattini I, Bertolini AS, Cavanna L, Collovà E, Romagnoli E, Rulli E, Legramandi L, Guffanti F, Bramati A, Moretti A, Cassano A, Vici P, Torri V, Farina G. Tolerability of Eribulin and correlation between polymorphisms and neuropathy in an unselected population of female patients with metastatic breast cancer: results of the multicenter, single arm, phase IV PAINTER study. Breast Cancer Res 2022; 24:71. [PMID: 36307826 PMCID: PMC9615373 DOI: 10.1186/s13058-022-01560-w] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 09/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Metastatic breast cancer (MBC) is an incurable disease and its treatment focuses on prolonging patients' (pts) overall survival (OS) and improving their quality of life. Eribulin is a microtubule inhibitor that increases OS in pre-treated MBC pts. The most common adverse events (AEs) are asthenia, neutropenia and peripheral neuropathy (PN). METHODS PAINTER is a single arm, phase IV study, aimed at evaluating the tolerability of eribulin in MBC pts. Secondary objectives were the description of treatment efficacy and safety, the assessment of the incidence and severity of PN and its association with genetic polymorphisms. Genomic DNA was isolated from blood samples and 15 Single Nucleotide Polymorphisms (SNPs) were genotyped by Taqman specific assays. The association between PN and SNPs were evaluated by Fisher exact test. RESULTS Starting from May 2014 until June 2018 180 pts were enrolled in this study by 20 Italian centers. 170 of these pts could be evaluated for efficacy and toxicity and 159 for polymorphisms analysis. The median age of pts was 60 years old and the biological subtypes were luminal type (64.7%), Her2 positive (18.3%) and triple negative (17%). Pts were pretreated with a median of 5 lines for MBC. The median follow up of this study was 15.4 months with a median number of 4.5 cycles administered (minimum-maximum 1-23). The median overall survival was 12 months. 48.8% of pts experienced a dose reduction, mainly for neutropenia (23.9%) and liver toxicity (12%). 65 pts (38.2%) reported at least one severe toxicity. Neutropenia and neurotoxicity were the most frequent severe AEs (15.3% and 14.7%, respectively); other reported toxicities were osteo-muscular, abdominal or tumor site pain (19.4%), liver toxicity (6.6%), pulmonary toxicity (6.5%) and dermatological toxicity (3.6%). Among the 15 evaluated SNPs, an association with PN was found for rs2233335 and rs7214723. CONCLUSIONS Eribulin is a well-tolerated treatment option in MBC. Schedule and dosage modifications were common, but toxicity rarely led to treatment discontinuation. SNPs rs2233335 (G/T and T/T) in the NDRG1 gene and rs7214723 (CC and CT) in the CAMKK1 gene were associated with PN. These findings, if validated, could allow a tailored treatment with eribulin in cancer patients. TRIAL REGISTRATION ClinicalTrials.gov ID: NCT02864030.
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Affiliation(s)
- Nicla La Verde
- grid.144767.70000 0004 4682 2907Department of Oncology, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Giovanna Damia
- grid.4527.40000000106678902Laboratory of Molecular Pharmacology, Istituto Di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Ornella Garrone
- grid.414818.00000 0004 1757 8749Medical Oncology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Daniele Santini
- grid.9657.d0000 0004 1757 5329Oncologia Medica Università Campus Biomedico, Rome, Italy ,grid.7841.aUOC Oncologia Universitaria, Sapienza University of Rome Polo Pontino, Latina, Italy
| | - Alessandra Fabi
- grid.414603.4Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Mariangela Ciccarese
- grid.417011.20000 0004 1769 6825Dept of Oncology Vito Fazzi Hospital, Lecce, Italy
| | - Daniele Giulio Generali
- U.O. Multidisciplinare Di Patologia Mammaria E Ricerca, Traslazionale Azienda Socio-Sanitaria Territoriale Di Cremona, Cremona, Italy
| | - Martina Nunzi
- grid.416377.00000 0004 1760 672XDept. of Oncology Medical and Translational Oncology Unit, Azienda Ospedaliera S.Maria, Terni, Italy
| | - Elena Poletto
- ASUFC Presidio Ospedaliero Universitario S.M. Misericordia, Udine, Italy
| | - Elisa Ferraris
- grid.419425.f0000 0004 1760 3027Division of Medical Oncology, IRCCS San Matteo University Hospital Foundation, Pavia, Italy
| | - Elisabetta Cretella
- grid.415844.80000 0004 1759 7181Oncologia Medica Ospedale Di Bolzano, AS Alto Adige, Bolzano, Italy
| | - Giuseppa Scandurra
- grid.413340.10000 0004 1759 8037Medical Oncology Unit, Cannizzaro Hospital, Catania, Italy
| | - Icro Meattini
- grid.24704.350000 0004 1759 9494Radiation Oncology Unit, Oncology Department, Azienda Ospedaliera Universitaria Careggi, Florence, Italy
| | | | - Luigi Cavanna
- Oncology Haematology Department, ASL Piacenza, Piacenza, Italy
| | - Elena Collovà
- ASST Ovest Milanese, Ospedale Di Legnano, Legnano, MI Italy
| | | | - Eliana Rulli
- grid.4527.40000000106678902Laboratory of Methodology for Clinical Research, Istituto Di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Lorenzo Legramandi
- grid.4527.40000000106678902Laboratory of Methodology for Clinical Research, Istituto Di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Federica Guffanti
- grid.4527.40000000106678902Laboratory of Molecular Pharmacology, Istituto Di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Annalisa Bramati
- grid.414759.a0000 0004 1760 170XDepartment of Oncology, Fatebenefratelli Hospital, ASST Fatebenefratelli-Sacco, Piazza Principessa Clotilde 3, 20121 Milan, Italy
| | - Anna Moretti
- grid.414759.a0000 0004 1760 170XDepartment of Oncology, Fatebenefratelli Hospital, ASST Fatebenefratelli-Sacco, Piazza Principessa Clotilde 3, 20121 Milan, Italy
| | - Alessandra Cassano
- Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - Patrizia Vici
- grid.417520.50000 0004 1760 5276Phase IV Clinical Studies Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Valter Torri
- Department of Oncology, Istituto Di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Gabriella Farina
- grid.414759.a0000 0004 1760 170XDepartment of Oncology, Fatebenefratelli Hospital, ASST Fatebenefratelli-Sacco, Piazza Principessa Clotilde 3, 20121 Milan, Italy
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Armani G, Pozzi E, Pagani A, Porta C, Rizzo M, Cicognini D, Rovati B, Moccia F, Pedrazzoli P, Ferraris E. The heterogeneity of cancer endothelium: The relevance of angiogenesis and endothelial progenitor cells in cancer microenvironment. Microvasc Res 2021; 138:104189. [PMID: 34062191 DOI: 10.1016/j.mvr.2021.104189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 05/18/2021] [Accepted: 05/22/2021] [Indexed: 01/02/2023]
Abstract
Tumor-associated vessels constitution is the result of angiogenesis, the hallmark of cancer essential for tumor to develop in dimension and to spread throughout the organism. Tumor endothelium is configured as an active functioning organ capable of determine interaction with the immune response and all the other components of the variegate cancer microenvironment, determining reciprocal influence. Angiogenesis is here analyzed in its molecular and cellular mechanisms, multiple mediators and principal players, represented by Endothelial Cells. It is discussed the striking heterogeneity of cancer endothelium, due to morphological and molecular aberrations that it often presents and its multiple origin. Among the cells that participate to the composition of tumor vasculature, Endothelial Progenitor Cells represent an important source for physical sustain and paracrine signaling in the process of angiogenesis. Treatment options are reviewed, with particular focus on novel therapeutic strategies for overcoming tumor resistance to anti-angiogenic agents.
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Affiliation(s)
- Giovanna Armani
- Division of Medical Oncology, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Italy..
| | - Emma Pozzi
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Anna Pagani
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Camillo Porta
- Division of Translational Oncology, IRCCS Istituti Clinici Scientifici Maugeri, Pavia, Italy
| | - Mimma Rizzo
- Division of Translational Oncology, IRCCS Istituti Clinici Scientifici Maugeri, Pavia, Italy
| | - Daniela Cicognini
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Bianca Rovati
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Francesco Moccia
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Paolo Pedrazzoli
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Elisa Ferraris
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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Affiliation(s)
- Angioletta Lasagna
- Angioletta Lasagna, MD, Elisa Ferraris, MD, Gianpiero Rizzo, MD, Richard J. Tancredi, MD, and Paolo Pedrazzoli, MD, Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy and Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy
| | - Elisa Ferraris
- Angioletta Lasagna, MD, Elisa Ferraris, MD, Gianpiero Rizzo, MD, Richard J. Tancredi, MD, and Paolo Pedrazzoli, MD, Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy and Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy
| | - Gianpiero Rizzo
- Angioletta Lasagna, MD, Elisa Ferraris, MD, Gianpiero Rizzo, MD, Richard J. Tancredi, MD, and Paolo Pedrazzoli, MD, Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy and Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy
| | - Richard J Tancredi
- Angioletta Lasagna, MD, Elisa Ferraris, MD, Gianpiero Rizzo, MD, Richard J. Tancredi, MD, and Paolo Pedrazzoli, MD, Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy and Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy
| | - Paolo Pedrazzoli
- Angioletta Lasagna, MD, Elisa Ferraris, MD, Gianpiero Rizzo, MD, Richard J. Tancredi, MD, and Paolo Pedrazzoli, MD, Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy and Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy
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Affiliation(s)
- Angioletta Lasagna
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Viale Camillo Golgi 19, 27100, Pavia, Italy
| | - Valentina Zuccaro
- Division of Infectious Diseases I, Fondazione IRCCS Policlinico San Matteo, Viale Camillo Golgi 19, 27100, Pavia, Italy
| | - Elisa Ferraris
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Viale Camillo Golgi 19, 27100, Pavia, Italy
| | - Marta Corbella
- Department of Microbiology & Virology, Fondazione IRCCS Policlinico San Matteo, Viale Camillo Golgi 19, 27100, Pavia, Italy
| | - Raffaele Bruno
- Division of Infectious Diseases I, Fondazione IRCCS Policlinico San Matteo, Viale Camillo Golgi 19, 27100, Pavia, Italy.,Department of Clinical Surgical Diagnostic & Pediatric Sciences, University of Pavia, Viale Camillo Golgi 19, 27100, Pavia, Italy
| | - Paolo Pedrazzoli
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Viale Camillo Golgi 19, 27100, Pavia, Italy.,Department of Internal Medicine & Medical Therapy, University of Pavia, Viale Camillo Golgi 19, 27100, Pavia, Italy
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Lasagna A, Zuccaro V, Ferraris E, Rizzo G, Tancredi RJ, Pedrazzoli P. How to Use Prophylactic G-CSF in the Time of COVID-19. JCO Oncol Pract 2020; 16:771-772. [DOI: 10.1200/op.20.00484] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Angioletta Lasagna
- Angioletta Lasagna, MD, Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Valentina Zuccaro, MD, Division of Infectious Diseases I, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Elisa Ferraris, MD; Gianpiero Rizzo, MD; and Richard J. Tancredi, MD, Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; and Paolo Pedrazzoli, MD, Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, and Department of Internal Medicine and Medical Therapy,
| | - Valentina Zuccaro
- Angioletta Lasagna, MD, Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Valentina Zuccaro, MD, Division of Infectious Diseases I, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Elisa Ferraris, MD; Gianpiero Rizzo, MD; and Richard J. Tancredi, MD, Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; and Paolo Pedrazzoli, MD, Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, and Department of Internal Medicine and Medical Therapy,
| | - Elisa Ferraris
- Angioletta Lasagna, MD, Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Valentina Zuccaro, MD, Division of Infectious Diseases I, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Elisa Ferraris, MD; Gianpiero Rizzo, MD; and Richard J. Tancredi, MD, Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; and Paolo Pedrazzoli, MD, Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, and Department of Internal Medicine and Medical Therapy,
| | - Gianpiero Rizzo
- Angioletta Lasagna, MD, Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Valentina Zuccaro, MD, Division of Infectious Diseases I, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Elisa Ferraris, MD; Gianpiero Rizzo, MD; and Richard J. Tancredi, MD, Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; and Paolo Pedrazzoli, MD, Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, and Department of Internal Medicine and Medical Therapy,
| | - Richard J. Tancredi
- Angioletta Lasagna, MD, Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Valentina Zuccaro, MD, Division of Infectious Diseases I, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Elisa Ferraris, MD; Gianpiero Rizzo, MD; and Richard J. Tancredi, MD, Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; and Paolo Pedrazzoli, MD, Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, and Department of Internal Medicine and Medical Therapy,
| | - Paolo Pedrazzoli
- Angioletta Lasagna, MD, Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Valentina Zuccaro, MD, Division of Infectious Diseases I, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Elisa Ferraris, MD; Gianpiero Rizzo, MD; and Richard J. Tancredi, MD, Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; and Paolo Pedrazzoli, MD, Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, and Department of Internal Medicine and Medical Therapy,
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Dionigi F, Martinelli V, Trotti E, Ferrari A, Garcia-Etienne CA, Valle AD, Grasso D, Ferraris E, Rizzo G, Praticò V, Sgarella A. "My Husband Affects Me More Than My Cancer": Reflections on Simultaneous Intimate Partner Violence and Breast Cancer Experience in a 48-Year-Old Woman. J Cancer Educ 2020; 35:1041-1045. [PMID: 31786799 DOI: 10.1007/s13187-019-01661-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
In this paper, we present the case of a 48-year-old woman diagnosed with early breast cancer. As candidate for mastectomy, she refused immediate reconstruction. She was referred to a psycho-oncologist for further evaluation and support. Psychological sessions helped reveal a history of intimate partner violence and helped clarify the reason for her refusal to undergo immediate reconstruction. Experience with this case highlights the importance of a multidisciplinary practice in which collaboration between surgeons, oncologists, and mental health professionals leads to a more in-depth understanding of the apparently paradoxical behaviors of patients, and to better care for their needs.
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Affiliation(s)
- Francesca Dionigi
- Dottorato di Ricerca in Medicina Sperimentale, Università degli Studi di Pavia, 27100, Pavia, Italy.
- Fondazione IRCCS Policlinico "San Matteo", Unità Operativa Complessa di Chirurgia Generale III a indirizzo Senologico e dei tessuti molli, viale Golgi 19, 27100, Pavia, Italy.
| | - Valentina Martinelli
- Fondazione IRCCS Policlinico "San Matteo", Unità Operativa Complessa di Chirurgia Generale II, 27100, Pavia, Italy
| | - Eugenia Trotti
- Department of Biotechnology and Life Sciences, Università degli Studi dell'Insubria, via Ottorino Rossi 9, 21010, Varese, Italy
| | - Alberta Ferrari
- Fondazione IRCCS Policlinico "San Matteo", Unità Operativa Complessa di Chirurgia Generale III a indirizzo Senologico e dei tessuti molli, viale Golgi 19, 27100, Pavia, Italy
- Università degli Studi di Pavia, Pavia, Italy
| | - Carlos Alberto Garcia-Etienne
- Fondazione IRCCS Policlinico "San Matteo", Unità Operativa Complessa di Chirurgia Generale III a indirizzo Senologico e dei tessuti molli, viale Golgi 19, 27100, Pavia, Italy
| | - Angelica Della Valle
- Fondazione IRCCS Policlinico "San Matteo", Unità Operativa Complessa di Chirurgia Generale III a indirizzo Senologico e dei tessuti molli, viale Golgi 19, 27100, Pavia, Italy
| | - Donatella Grasso
- Fondazione IRCCS Policlinico "San Matteo", Unità Operativa Complessa di Oncologia Medica, Pavia, Italy
| | - Elisa Ferraris
- Fondazione IRCCS Policlinico "San Matteo", Unità Operativa Complessa di Oncologia Medica, Pavia, Italy
| | - Gianpiero Rizzo
- Fondazione IRCCS Policlinico "San Matteo", Unità Operativa Complessa di Oncologia Medica, Pavia, Italy
| | - Vincenza Praticò
- Fondazione IRCCS Policlinico "San Matteo", Unità Operativa Complessa di Chirurgia Generale III a indirizzo Senologico e dei tessuti molli, viale Golgi 19, 27100, Pavia, Italy
| | - Adele Sgarella
- Fondazione IRCCS Policlinico "San Matteo", Unità Operativa Complessa di Chirurgia Generale III a indirizzo Senologico e dei tessuti molli, viale Golgi 19, 27100, Pavia, Italy
- Università degli Studi di Pavia, Pavia, Italy
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11
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Lucioni M, Rossi C, Lomoro P, Ballati F, Fanizza M, Ferrari A, Garcia-Etienne CA, Boveri E, Meloni G, Sommaruga MG, Ferraris E, Lasagna A, Bonzano E, Paulli M, Sgarella A, Di Giulio G. Positive predictive value for malignancy of uncertain malignant potential (B3) breast lesions diagnosed on vacuum-assisted biopsy (VAB): is surgical excision still recommended? Eur Radiol 2020; 31:920-927. [PMID: 32816199 DOI: 10.1007/s00330-020-07161-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [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: 05/14/2020] [Revised: 06/20/2020] [Accepted: 08/06/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Breast lesions classified as of "uncertain malignant potential" represent a heterogeneous group of abnormalities with an increased risk of associated malignancy. Clinical management of B3 lesions diagnosed on vacuum-assisted breast biopsy (VABB) is still challenging: surgical excision is no longer the only available treatment and VABB may be sufficient for therapeutic excision. The aim of the present study is to evaluate the positive predictive value (PPV) for malignancy in B3 lesions that underwent surgical excision, identifying possible upgrading predictive factors and characterizing the malignant lesions eventually diagnosed. These results are compared with a subset of patients with B3 lesions who underwent follow-up. METHODS A total of 1250 VABBs were performed between January 2006 and December 2017 at our center. In total, 150 B3 cases were diagnosed and 68 of them underwent surgical excision. VABB findings were correlated with excision histology. A PPV for malignancy for each B3 subtype was derived. RESULTS The overall PPV rate was 28%, with the highest upgrade rate for atypical ductal hyperplasia (41%), followed by classical lobular neoplasia (29%) and flat epithelial atypia (11%). Only two cases of carcinoma were detected in the follow-up cohort, both associated with atypical ductal hyperplasia at VABB. CONCLUSION Open surgery is recommended in case of atypical ductal hyperplasia while, for other B3 lesions, excision with VABB only may be an acceptable alternative if radio-pathological correlation is assessed, if all microcalcifications have been removed by VABB, and if the lesion lacks high-risk cytological features. KEY POINTS • Surgical treatment is strongly recommended in case of ADH, while the upgrade rate in case of pure FEA, especially following complete microcalcification removal by VABB, may be sufficiently low to advice surveillance as a management strategy. • The use of 11-G- or 8-G-needle VABB, resulting in possible complete diagnostic excision of the lesion, can be an acceptable alternative in case of RS, considering open surgery only for selected high-risk patients. • LN management is more controversial: surgical excision may be recommended following classical LN diagnosis on breast biopsy if an additional B3 lesion is concurrently detected while in the presence of isolated LN with adequate radiological-pathological correlation follow-up alone could be an acceptable option.
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Affiliation(s)
- Marco Lucioni
- Anatomic Pathology Section, Department of Human Pathology, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Chiara Rossi
- Anatomic Pathology Section, Department of Human Pathology, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Pascal Lomoro
- Breast Imaging Department, Valduce Hospital, Via Dante Alighieri 11, 22100, Como, Italy.
| | - Francesco Ballati
- Breast Imaging Department, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Marianna Fanizza
- Breast Imaging Department, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Alberta Ferrari
- Breast Surgery Department, Fondazione IRCCS Policlinico San Matteo, Università degli Studi di Pavia, Pavia, Italy
| | - Carlos A Garcia-Etienne
- Breast Surgery Department, Fondazione IRCCS Policlinico San Matteo, Università degli Studi di Pavia, Pavia, Italy
| | - Emanuela Boveri
- Anatomic Pathology Section, Department of Human Pathology, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Giulia Meloni
- Breast Imaging Department, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Maria Grazia Sommaruga
- Breast Imaging Department, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Elisa Ferraris
- Medical Oncology, Fondazione IRCCS Policlinico San Matteo and, Università degli Studi, Pavia, Italy
| | - Angioletta Lasagna
- Medical Oncology, Fondazione IRCCS Policlinico San Matteo and, Università degli Studi, Pavia, Italy
| | - Elisabetta Bonzano
- University of Pavia and Department of Radiation Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Marco Paulli
- Anatomic Pathology Section, Department of Human Pathology, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Adele Sgarella
- Breast Surgery Department, Fondazione IRCCS Policlinico San Matteo, Università degli Studi di Pavia, Pavia, Italy
| | - Giuseppe Di Giulio
- Breast Imaging Department, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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12
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Garcia-Etienne CA, Ferrari A, Della Valle A, Lucioni M, Ferraris E, Di Giulio G, Squillace L, Bonzano E, Lasagna A, Rizzo G, Tancredi R, Scotti Foglieni A, Dionigi F, Grasso M, Arbustini E, Cavenaghi G, Pedrazzoli P, Filippi AR, Dionigi P, Sgarella A. Management of the axilla in patients with breast cancer and positive sentinel lymph node biopsy: An evidence-based update in a European breast center. Eur J Surg Oncol 2019; 46:15-23. [PMID: 31445768 DOI: 10.1016/j.ejso.2019.08.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 06/22/2019] [Accepted: 08/12/2019] [Indexed: 02/07/2023] Open
Abstract
The surgical approach to the axilla in breast cancer has been a controversial issue for more than three decades. Data from recently published trials have provided practice-changing recommendations in this scenario. However, further controversies have been triggered in the surgical community, resulting in heterogeneous diffusion of these recommendations. The development of clinical guidelines for the management of the axilla in patients with breast cancer is a work in progress. A multidisciplinary team discussion was held at the research hospital Policlinico San Matteo from the Università degli Studi di Pavia with the aim to update recommendations for the management of the axilla in patients with breast cancer. An evidence-based approach is presented. Our multidisciplinary panel determined that axillary dissection after a positive sentinel lymph node biopsy may be avoided in cN0 patients with micro/macrometastasis to ≤2 sentinel nodes, with age ≥40y, lesions ≤3 cm, who have not received neoadjuvant chemotherapy and have planned breast conservation (BCS) with whole breast radiotherapy (WBRT). Cases with gross (>2 mm) ECE in SLNs are evaluated on individual basis for completion ALND, axillary radiotherapy or omission of both. Patients fulfilling the criteria listed above who undergo mastectomy, may also avoid axillary dissection after multidisciplinary discussion of individual cases for consideration of axillary irradiation. Women 70 years or older with hormone receptors positive invasive lesions ≤3 cm, clinically negative nodes, and serious or multiple comorbidities who undergo BCS with WBRT, may forgo axillary staging/surgery (if mastectomy or larger tumor, comorbidities and life expectancy are taken into account).
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Affiliation(s)
- Carlos A Garcia-Etienne
- Breast Center, Fondazione IRCCS Policlinico San Matteo, Università degli Studi di Pavia, Pavia, Italy.
| | - Alberta Ferrari
- Breast Center, Fondazione IRCCS Policlinico San Matteo, Università degli Studi di Pavia, Pavia, Italy
| | - Angelica Della Valle
- Breast Center, Fondazione IRCCS Policlinico San Matteo, Università degli Studi di Pavia, Pavia, Italy
| | - Marco Lucioni
- Breast Center, Fondazione IRCCS Policlinico San Matteo, Università degli Studi di Pavia, Pavia, Italy
| | - Elisa Ferraris
- Breast Center, Fondazione IRCCS Policlinico San Matteo, Università degli Studi di Pavia, Pavia, Italy
| | - Giuseppe Di Giulio
- Breast Center, Fondazione IRCCS Policlinico San Matteo, Università degli Studi di Pavia, Pavia, Italy
| | - Luigi Squillace
- Breast Center, Fondazione IRCCS Policlinico San Matteo, Università degli Studi di Pavia, Pavia, Italy
| | - Elisabetta Bonzano
- Breast Center, Fondazione IRCCS Policlinico San Matteo, Università degli Studi di Pavia, Pavia, Italy
| | - Angioletta Lasagna
- Breast Center, Fondazione IRCCS Policlinico San Matteo, Università degli Studi di Pavia, Pavia, Italy
| | - Gianpiero Rizzo
- Breast Center, Fondazione IRCCS Policlinico San Matteo, Università degli Studi di Pavia, Pavia, Italy
| | - Richard Tancredi
- Breast Center, Fondazione IRCCS Policlinico San Matteo, Università degli Studi di Pavia, Pavia, Italy
| | - Andrea Scotti Foglieni
- Breast Center, Fondazione IRCCS Policlinico San Matteo, Università degli Studi di Pavia, Pavia, Italy
| | - Francesca Dionigi
- Breast Center, Fondazione IRCCS Policlinico San Matteo, Università degli Studi di Pavia, Pavia, Italy
| | - Maurizia Grasso
- Breast Center, Fondazione IRCCS Policlinico San Matteo, Università degli Studi di Pavia, Pavia, Italy
| | - Eloisa Arbustini
- Breast Center, Fondazione IRCCS Policlinico San Matteo, Università degli Studi di Pavia, Pavia, Italy
| | - Giorgio Cavenaghi
- Breast Center, Fondazione IRCCS Policlinico San Matteo, Università degli Studi di Pavia, Pavia, Italy
| | - Paolo Pedrazzoli
- Breast Center, Fondazione IRCCS Policlinico San Matteo, Università degli Studi di Pavia, Pavia, Italy
| | - Andrea R Filippi
- Breast Center, Fondazione IRCCS Policlinico San Matteo, Università degli Studi di Pavia, Pavia, Italy
| | - Paolo Dionigi
- Breast Center, Fondazione IRCCS Policlinico San Matteo, Università degli Studi di Pavia, Pavia, Italy
| | - Adele Sgarella
- Breast Center, Fondazione IRCCS Policlinico San Matteo, Università degli Studi di Pavia, Pavia, Italy
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Pedrazzoli P, Cereda E, Cappello S, Arcaini L, Borioli V, Ferraris E, Chiellino S, Stella G, Benazzo M, Ferrari A, Klersy C, Caccialanza R. Effect of whey protein isolate supplementation on body composition, muscle strength, and treatment tolerance in malnourished advanced cancer patients undergoing chemotherapy. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.11598] [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: 11/20/2022] Open
Abstract
11598 Background: Malnutrition is frequent in cancer pts, particularly in advanced disease, which requires appropriate multidisciplinary interventions. We evaluated the benefit of whey protein isolate (WPI) supplementation in addition to nutritional counseling in malnourished cancer pts undergoing chemotherapy (CT). Methods: In a single-center, randomized, pragmatic, parallel-group controlled trial (ClinicalTrials.gov: NCT02065726), 166 malnourished advanced cancer pts undergoing CT were randomly assigned to receive nutritional counseling with (N=82) or without (N=84) WPI supplementation (20 grams/daily) for 3 months. Primary endpoint was the change in phase angle (PhA). Secondary endpoints included changes in standardized PhA (SPA), fat-free mass index (FFMI), body weight, muscle strength, quality of life and CT toxicity. Results: In pts with the primary endpoint assessed (modified intention-to-treat population), counseling plus WPI (N=66) resulted in improved PhA compared to nutritional counseling alone (N=69): mean difference, 0.48° [95%CI, 0.05 to 0.90] (P=0.027). Imputation of missing outcomes yielded consistent findings. WPI supplementation resulted also in improved SPA (P=0.021), FFMI (P=0.041), body weight (P=0.023), muscle strength (P<0.001) and in reduced risk of CT toxicity, particularly of severe (grade ≥3) events (Table). Conclusions: In malnourished advanced cancer patients undergoing CT and receiving nutritional counseling, 3-month supplementation with WPI resulted in improved body composition, muscle strength, body weight and reduced CT toxicity. Further trials in newly diagnosed specific cancer types are warranted. Clinical trial information: NCT02065726. [Table: see text]
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Affiliation(s)
| | | | | | - Luca Arcaini
- Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | | | | | - Giulia Stella
- Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Marco Benazzo
- Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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Ferraris E, Di Cesare P, Lasagna A, Paglino C, Imarisio I, Porta C. Use of Sorafenib in Two Metastatic Renal Cell Cancer Patients with End-Stage Renal Impairment Undergoing Replacement Hemodialysis. Tumori 2018; 95:542-4. [DOI: 10.1177/030089160909500425] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Patients with renal cell carcinoma (RCC) may exhibit renal impairment as a more or less direct consequence of their primary disease. Renal impairment may become a severe complication and alter the normal pharmacokinetic and pharmacodynamic behavior of treatment drugs, thus increasing the risk of side effects. We will discuss the cases of two advanced RCC patients with end-stage renal impairment submitted to dialysis who were treated with sorafenib tosylate in our center. Our experience confirms the scarce literature data available so far that indicate that sorafenib can be used in patients undergoing dialysis. Dialysis cannot be considered per se a contraindication to sorafenib therapy, which can be effective. However, patients must be carefully selected and monitored, since sorafenib administration unquestionably increases the risk of side effects in patients affected by several conditions.
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Affiliation(s)
- Elisa Ferraris
- Oncologia Medica, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Pamela Di Cesare
- Oncologia Medica, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Chiara Paglino
- Oncologia Medica, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Ilaria Imarisio
- Oncologia Medica, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Camillo Porta
- Oncologia Medica, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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Faes M, Ferraris E, Moens D. Influence of Inter-layer Cooling time on the Quasi-static Properties of ABS Components Produced via Fused Deposition Modelling. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.procir.2016.02.313] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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17
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Möhring HC, Kersting P, Carmignato S, Yagüe-Fabra J, Maestro M, Jiménez R, Ferraris E, Tunc L, Bleicher F, Wits W, Walczak K, Hedlind M. A Testpart for Interdisciplinary Analyses in Micro Production Engineering. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.procir.2015.04.018] [Citation(s) in RCA: 3] [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: 10/23/2022]
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18
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Ganini C, Lasagna A, Ferraris E, Gatti P, Paglino C, Imarisio I, Morbini P, Benazzo M, Porta C. Lingual metastasis from renal cell carcinoma: a case report and literature review. Rare Tumors 2012. [DOI: 10.4081/rt.2012.4097] [Citation(s) in RCA: 5] [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: 11/23/2022] Open
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19
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Ganini C, Lasagna A, Ferraris E, Gatti P, Paglino C, Imarisio I, Morbini P, Benazzo M, Porta C. Lingual metastasis from renal cell carcinoma: a case report and literature review. Rare Tumors 2012; 4:e41. [PMID: 23087797 PMCID: PMC3475948 DOI: 10.4081/rt.2012.e41] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [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: 01/07/2012] [Revised: 07/25/2012] [Accepted: 07/26/2012] [Indexed: 11/23/2022] Open
Abstract
Renal cell carcinoma (RCC) accounts for the 3% of all solid tumors. Despite continuous improvement in the therapy regimen, less has been achieved in terms of enabling an earlier diagnosis: the neoplasia usually reveals its presence at an advanced stage, obviously affecting prognosis. The most frequent sites of secondary disease are shown to be lungs (50–60%), bone (30–40%), liver (30–40%) and brain (5%); while the head and neck district seems to account for less than 1% of patients with primary kidney lesion. We report here the case of a 70-year old man who presented with acute renal failure due to abdominal recurrence of RCC 18 years post nephrectomy. After a few months of follow up without any systemic therapy due to the renal impairment, the patient presented a vascularized tongue lesion that was demonstrated to be a secondary localization of the RCC. This lesion has, therefore, been treated with microsphere embolization to stop the frequent bleeding and to lessen the unbearable concomitant symptoms it caused, such as dysphagia and pain. A tongue lesion that appears in a RCC patient should always be considered suspect and a multidisciplinary study should be conducted both to assess whether it is a metastasis or a primary new lesion and to understand which method should be selected, if necessary, to treat it (surgery, radiation or embolization). Lingual metastasis should be examined accurately not only because they seem to implicate a poor prognosis, but also because they carry a burden of symptoms that not only threatens patients' lives but also has a strong impact on their quality of life.
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20
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Rizzo G, Fregoni V, Daprada G, Pavesi L, Gallizzi G, Lorenzetti I, Tancredi R, Ferraris E, Pagani A. Peritumoral Vascular Invasion as Principal Istological Prognostic Factor in TNBC. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)32821-0] [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: 10/25/2022] Open
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21
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Cesare PD, Porta C, Lasagna A, Ferraris E, Imarisio I, Paglino C, Antras L, Chen K, Neary M, Duh M. 7151 Safety and treatment (trx) patterns of multikinase inhibitors (MKI) in patients (pts) with metastatic renal cell carcinoma (mRCC) in Italy. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)71484-3] [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: 10/20/2022] Open
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22
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Porta C, Procopio G, Sabbatini R, Bearz A, Chiappino I, Imarisio I, Guadalupi V, Paglino C, Verzoni E, Ferraris E, Bajetta E. 252 RETROSPECTIVE ANALYSIS OF THE SEQUENTIAL USE OF SORAFENIB AND SUNITINIB IN PATIENTS WITH ADVANCED RENAL CELL CARCINOMA (RCC). ACTA ACUST UNITED AC 2009. [DOI: 10.1016/s1569-9056(09)60257-8] [Citation(s) in RCA: 14] [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] [Indexed: 10/21/2022]
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Porta C, Bonomi L, Lillaz B, Klersy C, Imarisio I, Paglino C, Rovati B, Danova M, Ferraris E, Mensi M, Rovereto B. Immunological stress in kidney cancer patients undergoing either open nephrectomy or nephron-sparing surgery: an immunophenotypic study of lymphocyte subpopulations and circulating dendritic cells. Oncol Rep 2008; 20:1511-1519. [PMID: 19020735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
Immunosuppression is a characteristic hallmark of renal cell carcinoma (RCC), with several complex immune defects, almost solely at the level of cell-mediated immune function, well evident even in patients at first diagnosis. The main circulating lymphocyte subsets and the total number of circulating dendritic cells were quantified in 47 RCC patients at diagnosis (T0), 12 h (T1), 24 h (T2) and 8 days following either radical nephrectomy or nephron-sparing surgery using flow cytometry. RCC patients presented, at baseline, (T0) a profound state of immunosuppression involving naïve T-cells, memory T-cells, CD16+ NK and total circulating dendritic cells, that worsened after 12 (T1) and 24 h (T2) from surgery, involving the majority of the analysed subsets; after 8 days (T3) from surgical removal of tumor, however, there was a return of all the analyzed parameters to the basal state. In conclusion, surgery causes transient but relevant immune suppression in RCC patients; even though, by day +8, this tends to return to baseline, immunostimulatory therapies could be considered in the peri-operative setting with the aim of reducing immunosuppression and, hopefully, also disease recurrence.
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Affiliation(s)
- Camillo Porta
- Medical Oncology, I.R.C.C.S. San Matteo University Hospital Foundation, I-27100 Pavia, Italy.
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25
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Ferrari A, Sternieri E, Ferraris E, Bertolini A. Emerging problems in the pharmacology of migraine: interactions between triptans and drugs for prophylaxis. Pharmacol Res 2003; 48:1-9. [PMID: 12770508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
Patients suffering from migraine take drugs for many years in order either to relieve or to prevent recurrent migraine attacks. When two or more drugs are co-administered, there is always the possibility of drug-drug interaction. Interactions can be either kinetic or dynamic. The former are the most frequent ones. Mechanisms of kinetic interaction can be different, but the most common are represented by the induction or inhibition of enzymes of the cytochromes p450 (CYP) system. This system plays an important role in the disposition of a large number of drugs, including those used for migraine. This review examines the interactions between triptans-the most effective drugs for the therapy of migraine attacks-and drugs for migraine prophylactic treatment.
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Affiliation(s)
- A Ferrari
- Department of Internal Medicine, Centre for the Study of Headache, Largo del Pozzo 71, 41100 Modena, Italy.
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Martelli A, Mattioli F, Carrozzino R, Ferraris E, Marchese M, Angiola M, Brambilla G. Genotoxicity testing of potassium canrenoate in cultured rat and human cells. Mutagenesis 1999; 14:463-72. [PMID: 10473649 DOI: 10.1093/mutage/14.5.463] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Potassium canrenoate (PC), a competitive aldosterone antagonist used as a diuretic and in the treatment of hypertension, was examined for its capacity to produce genotoxic effects in cultured rat and human cells. At subtoxic concentrations (10-90 microM) PC was found to induce a dose-dependent degree of DNA fragmentation, as detected by the Comet assay, and of DNA repair synthesis, as measured by quantitative autoradiography, in primary cultures of hepatocytes from rat and human donors of both genders. In rat hepatocytes both DNA fragmentation and DNA repair were more marked after 3 h than after 20 h exposure and in cultures from females than from males. In human hepatocytes from one male and two female donors, PC caused a similar effect in terms of DNA fragmentation, whereas DNA repair was detected in cultures from only two of the same three donors and was less marked than in rat hepatocytes. A modest but statistically significant increase in micronucleated cells was present in primary cultures of replicating rat hepatocytes exposed to 10 or 30 microM PC for 48 h, the response being, in this case also, more evident in females than in males. In contrast, PC did not induce micronucleus formation in human hepatocytes from two female donors. Any evidence of DNA fragmentation and micronucleus formation was absent in cultured human lymphocytes. Taken as a whole these findings support the hypothesis that hepatocytes activate PC to DNA-damaging reactive species. PC induced the observed genotoxic effects at concentrations close to those produced in humans by the administration of therapeutic doses, but these effects were as a whole more marked in rat than in human hepatocytes. Since PC shares the 17-hydroxy-3-oxopregna-4,6-diene structure with cyproterone acetate, chlormadinone acetate and megestrol acetate, previously found to be genotoxic to both rat and human hepatocytes, the potential carcinogenic hazard of this type of steroids cannot be neglected.
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Affiliation(s)
- A Martelli
- Department of Internal Medicine, Division of Clinical Pharmacology and Toxicology, University of Genoa, Viale Benedetto XV 2, I-16132 Genoa, Italy
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Crovella U, Ferraris E, De Sanso G. [Mastoses. Indications and technic for surgical treatment]. MINERVA CHIR 1980; 35:171-6. [PMID: 7374977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The authors tackle the subject of surgical treatment of benign diseases of breast. They show the importance to get a good result either pathologically or aesthetically. About this consideration they related operating techniques for various kinds of benign disease of breast, that assure the preservation or the aesthetical restoration of this region that is so psychologically important for a woman.
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De Sanso G, Ferraris E, Crovella U. [Mastoses. Etiopathogenetic presuppositions for medical treatment]. MINERVA CHIR 1980; 35:177-82. [PMID: 7374978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The dimensions of breast are genetically determinated and hormones only allow breast (when growth is finished) to reach the definite dimensions. In the development of benign disease of breast, the estro-progestinic lack of balance, for a long period, holds a great importance; while GH, TSH, ACTH, prolactine, and androgens are often favourable elements for the development of the benign disease of breast. It isn't verified how it is due to the hormones activity and how to biometabolic activity of the tissue hormones operate on. Since the opinions about a direct connection between benign disease of breast and Ca. are in contrast, we advise a periodical inspection of breast, and, moreover, the dosage of the receptors for estradiol and 2 OH testosterone; if they are both present, they send to a surgical therpay. Treatment of these patients effected with derivatives of 19-Nor-testosterone and 17-OH-progesteron, must not absolutely base on empiricism but must be documented with hormonal dosages and with dosages of receptors. Failure of this therapy leads to a surgical treatment.
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Ferraris E. [Hyperanalgesia--a new concept in modern anesthesiology. Preliminary communication]. ZFA (Stuttgart) 1977; 53:1243-50. [PMID: 888566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Bocca M, Ferraris E, Boccardo E. Polydactyly: the creation of a functional thumb in cases of mirror hand. Panminerva Med 1968; 10:164-70. [PMID: 5658700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Bottani G, Allaria B, Castelli S, Ferraris E. [Antazoline: the preferred drug for therapy of extra-systolic arrhythmia during anesthesia]. Acta Anaesthesiol 1968; 19:217-30. [PMID: 5757184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Fongo A, Ferraris E, Bocca M. [Skin tension lines and wrinkles. Anatomoclinical observations]. MINERVA CHIR 1966; 21:627-30. [PMID: 5338797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Bocca M, Ferraris E, Fongo A. [Emergency plastic surgery. Considerations and suggestions]. MINERVA CHIR 1966; 21:624-6. [PMID: 5338796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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