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Milano G, Fresta L, Cerciello S, Cattaneo S, Paderno M, Galante C, Passiatore M, Saccomanno MF. Cross-cultural adaptation and validation of the Italian version of the Western Ontario Rotator Cuff (WORC) index. Musculoskelet Surg 2024:10.1007/s12306-023-00812-y. [PMID: 38285314 DOI: 10.1007/s12306-023-00812-y] [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: 07/04/2023] [Accepted: 12/27/2023] [Indexed: 01/30/2024]
Abstract
The aim of the study was to accomplish translation, cross-cultural adaptation and validation of the Western Ontario Rotator Cuff (WORC) Index questionnaire for its use in Italy. The WORC original version was translated and cross-culturally adapted into Italian. Subsequently, it was administered to a population of 60 patients suffering from rotator cuff disease to evaluate the validity and reliability of the Italian version. The content validity evaluated the correlation between questions and total score of each domain through Pearson's correlation coefficient. The construct validity was similarly assessed through Pearson's correlation coefficient by testing the correlation between the Italian WORC and the Italian version of the Disability of the Arm, Shoulder and Hand (DASH) questionnaire. Reliability was assessed using two methods: internal consistency by calculating the Cronbach's alpha coefficient for each domain; and test-retest by means of the intraclass correlation coefficient (ICC). The translation and cross-cultural adaptation of the Italian version did not reveal any major problems. No significant floor or ceiling effects were found. All the questions were linearly related to the concept expressed by the domain of belonging. Overall correlation with the DASH score was 0.75. Internal consistency was very high overall (α = 0.93) as well as reliability (overall ICC = 0.87). The Italian version of the WORC questionnaire is a valid and reproducible measuring instrument and can be considered a valid tool for the evaluation of the effectiveness of a treatment in terms of quality of life, in Italian patients affected by rotator cuff diseases.Level of evidence Diagnostic study, level II.
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Affiliation(s)
- G Milano
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
- Unit of Orthopaedics, Department of Bone and Joint Surgery, ASST Spedali Civili, Piazzale Spedali Civili, 1, 25123, Brescia, BS, Italy.
| | - L Fresta
- Department of Orthopaedics and Traumatology, San Carlo di Nancy Hospital, Rome, Italy
| | - S Cerciello
- Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - S Cattaneo
- Unit of Orthopaedics, Department of Bone and Joint Surgery, ASST Spedali Civili, Piazzale Spedali Civili, 1, 25123, Brescia, BS, Italy
| | - M Paderno
- Unit of Orthopaedics, Department of Bone and Joint Surgery, ASST Spedali Civili, Piazzale Spedali Civili, 1, 25123, Brescia, BS, Italy
| | - C Galante
- Unit of Orthopaedics, Department of Bone and Joint Surgery, ASST Spedali Civili, Piazzale Spedali Civili, 1, 25123, Brescia, BS, Italy
| | - M Passiatore
- Unit of Orthopaedics, Department of Bone and Joint Surgery, ASST Spedali Civili, Piazzale Spedali Civili, 1, 25123, Brescia, BS, Italy
| | - M F Saccomanno
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
- Unit of Orthopaedics, Department of Bone and Joint Surgery, ASST Spedali Civili, Piazzale Spedali Civili, 1, 25123, Brescia, BS, Italy
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Paderno M, Grassi T, Adorni M, Zambetti B, Di Martino G, Bazzurini L, Landoni F, Lissoni AA. Adjuvant treatment in endometrial cancer: when and what to choose. EUR J GYNAECOL ONCOL 2022. [DOI: 10.31083/j.ejgo4301018] [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: 11/06/2022]
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Paracchini L, Beltrame L, Grassi T, Inglesi A, Fruscio R, Landoni F, Ippolito D, Delle Marchette M, Paderno M, Adorni M, Jaconi M, Romualdi C, D'Incalci M, Siravegna G, Marchini S. Genome-wide Copy-number Alterations in Circulating Tumor DNA as a Novel Biomarker for Patients with High-grade Serous Ovarian Cancer. Clin Cancer Res 2021; 27:2549-2559. [PMID: 33323403 DOI: 10.1158/1078-0432.ccr-20-3345] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [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: 09/01/2020] [Revised: 10/27/2020] [Accepted: 12/11/2020] [Indexed: 02/05/2023]
Abstract
PURPOSE High-grade serous epithelial ovarian cancer (HGS-EOC) is defined by high levels of somatic copy-number alterations (SCNA) with marked spatial and temporal tumor heterogeneity. Biomarkers serving to monitor drug response and detect disease recurrence are lacking, a fact which reflects an unmet clinical need. EXPERIMENTAL DESIGN A total of 185 plasma samples and 109 matched tumor biopsies were collected from 46 patients with HGS-EOC, and analyzed by shallow whole-genome sequencing (sWGS). The percentage of tumor fraction (TF) in the plasma was used to study the biological features of the disease at the time of diagnosis (T0) and correlated with patients' survival. Longitudinal analysis of TF was correlated with CA-125 levels and radiological images to monitor disease recurrence. RESULTS Gain in the clonal regions, 3q26.2 and 8q24.3, was observed in the 87.8% and 78.05% of plasma samples, suggesting that plasma sWGS mirrors solid biopsies. At T0, multivariate analysis revealed that plasma TF levels were an independent prognostic marker of relapse (P < 0.022). After platinum (Pt)-based treatment, circulating tumor DNA (ctDNA) analysis showed a change in the heterogeneous pattern of genomic amplification, including an increased frequency of amplification, compared with before Pt-based treatment in the 19p31.11 and 19q13.42 regions. TF in serially collected ctDNA samples outperformed CA-125 in anticipating clinical and radiological progression by 240 days (range, 37-491). CONCLUSIONS Our results support the notion that sWGS is an inexpensive and useful tool for the genomic analysis of ctDNA in patients with HGS-EOC to monitor disease evolution and to anticipate relapse better than serum CA-125, the routinely used clinical biomarker.See related commentary by Dhani, p. 2372.
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Affiliation(s)
- Lara Paracchini
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Luca Beltrame
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Tommaso Grassi
- Department of Obstetrics and Gynaecology, Università degli Studi Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Alessia Inglesi
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Robert Fruscio
- Department of Obstetrics and Gynaecology, Università degli Studi Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Fabio Landoni
- Department of Obstetrics and Gynaecology, Università degli Studi Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Davide Ippolito
- Department of Obstetrics and Gynaecology, Università degli Studi Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Martina Delle Marchette
- Department of Obstetrics and Gynaecology, Università degli Studi Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Mariachiara Paderno
- Department of Obstetrics and Gynaecology, Università degli Studi Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Marco Adorni
- Department of Obstetrics and Gynaecology, Università degli Studi Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Marta Jaconi
- Department of Pathology, Università degli Studi Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | | | - Maurizio D'Incalci
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy.
| | - Giulia Siravegna
- Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Sergio Marchini
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
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Comerio C, Jaconi M, Zambetti B, Paderno M, Valente MG, Buda A. Recurrence of vulvar squamous cell carcinoma as an undifferentiated sarcomatoid carcinoma. Int J Gynecol Cancer 2021; 31:627-630. [PMID: 33795407 DOI: 10.1136/ijgc-2020-002193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2020] [Indexed: 11/04/2022] Open
Affiliation(s)
- Chiara Comerio
- Department of Obstetrics and Gynecology, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy
| | - Marta Jaconi
- Department of Pathology, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy
| | - Benedetta Zambetti
- Department of Obstetrics and Gynecology, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy
| | - Mariachiara Paderno
- Department of Obstetrics and Gynecology, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy
| | | | - Alessandro Buda
- Department of Obstetrics and Gynecology, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy
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Fanfani F, Pedone Anchora L, Di Martino G, Bizzarri N, Di Meo ML, Carbone V, Paderno M, Fedele C, Paniga C, Fagotti A, Landoni F, Scambia G, Buda A. Oncologic and obstetric outcomes after simple conization for fertility-sparing surgery in FIGO 2018 stage IB1 cervical cancer. Int J Gynecol Cancer 2021; 31:452-456. [PMID: 33649013 DOI: 10.1136/ijgc-2020-001750] [Citation(s) in RCA: 12] [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: 09/16/2020] [Revised: 12/02/2020] [Accepted: 12/04/2020] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE Conization/simple trachelectomy is feasible in patients with early-stage cervical cancer. Retrospective data suggest that conization with negative lymph nodes could be a safe option for these patients. This study aims to provide oncologic and obstetric outcomes of a large series of patients with 2018 International Federation of Gynecology and Obstetrics (FIGO) stage IB1 cervical cancer managed by conization. METHODS Patients with early cervical cancer and a desire to preserve fertility who underwent conization and pelvic lymphadenectomy from January 1993 to December 2019 in two Italian centers were included. Inclusion criteria were: age >18 years and ≤45 years, 2018 FIGO stage IB1, no prior irradiation or chemotherapy, absence of pre-operative radiologic evidence of nodal metastases, a strong desire to preserve fertility, and absence of concomitant malignancies. We excluded patients with confirmed infertility, neuroendocrine tumor, clear cell or mucinous carcinoma. RESULTS A total of 42 patients were included. The median age was 32 years (range 19-44) and median tumor size was 11 mm (range 8-20). Squamous cell carcinoma was found in 27 (64.3%). Grade 3 tumor was present in 7 (16.7%) patients and lymphovascular space involvement was detected in 15 (35.7%). At a median follow-up of 54 months (range 1-185), all patients were alive without evidence of disease. In the entire series three patients experienced recurrence resulting in an overall recurrence rate of 7.1%. All the recurrences occurred in the pelvis (2 in the cervix and 1 in the lymph nodes), resulting in a 3-year disease-free survival of 91.6%. Twenty-two (52%) patients tried to conceive; 18 pregnancies occurred in 17 patients and 12 live births were reported (6 pre-term and 6 term pregnancies). Two miscarriages were recorded, one first trimester and one second trimester fetal loss. CONCLUSIONS Our study showed that conization is feasible for the conservative management of women with stage IB1 cervical cancer desiring fertility. Oncologic outcomes appear favorable in this series of patients. Future prospective studies will hopefully provide further insight into this important question.
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Affiliation(s)
- Francesco Fanfani
- Dipartimento per la Salute della Donna e del Bambino e della Salute Pubblica, UOC Ginecologia Oncologica, Fondazione Policlinico Universitario A Gemelli, IRCCS, Rome, Italy .,Università Cattolica del Sacro Cuore, Istituto di Ginecologia e Ostetricia, Rome, Italy
| | - Luigi Pedone Anchora
- Dipartimento per la Salute della Donna e del Bambino e della Salute Pubblica, UOC Ginecologia Oncologica, Fondazione Policlinico Universitario A Gemelli, IRCCS, Rome, Italy
| | - Giampaolo Di Martino
- Department of Obstetrics and Gynecology, Gynaecologic Oncology Surgical Unit, ASST-Monza, San Gerardo Hospital, Monza, Italy
| | - Nicolò Bizzarri
- Dipartimento per la Salute della Donna e del Bambino e della Salute Pubblica, UOC Ginecologia Oncologica, Fondazione Policlinico Universitario A Gemelli, IRCCS, Rome, Italy
| | | | - Vittoria Carbone
- Dipartimento per la Salute della Donna e del Bambino e della Salute Pubblica, UOC Ginecologia Oncologica, Fondazione Policlinico Universitario A Gemelli, IRCCS, Rome, Italy
| | | | - Camilla Fedele
- Dipartimento per la Salute della Donna e del Bambino e della Salute Pubblica, UOC Ginecologia Oncologica, Fondazione Policlinico Universitario A Gemelli, IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Istituto di Ginecologia e Ostetricia, Rome, Italy
| | | | - Anna Fagotti
- Dipartimento per la Salute della Donna e del Bambino e della Salute Pubblica, UOC Ginecologia Oncologica, Fondazione Policlinico Universitario A Gemelli, IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Istituto di Ginecologia e Ostetricia, Rome, Italy
| | - Fabio Landoni
- Department of Obstetrics and Gynecology, Gynaecologic Oncology Surgical Unit, ASST-Monza, San Gerardo Hospital, Monza, Italy
| | - Giovanni Scambia
- Dipartimento per la Salute della Donna e del Bambino e della Salute Pubblica, UOC Ginecologia Oncologica, Fondazione Policlinico Universitario A Gemelli, IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Istituto di Ginecologia e Ostetricia, Rome, Italy
| | - Alessandro Buda
- Department of Obstetrics and Gynecology, Gynaecologic Oncology Surgical Unit, ASST-Monza, San Gerardo Hospital, Monza, Italy
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Conconi D, Redaelli S, Lissoni AA, Cilibrasi C, Perego P, Gautiero E, Sala E, Paderno M, Dalprà L, Landoni F, Lavitrano M, Roversi G, Bentivegna A. Genomic and Epigenomic Profile of Uterine Smooth Muscle Tumors of Uncertain Malignant Potential (STUMPs) Revealed Similarities and Differences with Leiomyomas and Leiomyosarcomas. Int J Mol Sci 2021; 22:ijms22041580. [PMID: 33557274 PMCID: PMC7914585 DOI: 10.3390/ijms22041580] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/24/2021] [Accepted: 02/01/2021] [Indexed: 01/20/2023] Open
Abstract
Uterine smooth muscle tumors of uncertain malignant potential (STUMPs) represent a heterogeneous group of tumors that cannot be histologically diagnosed as unequivocally benign or malignant. For this reason, many authors are working to obtain a better definition of diagnostic and prognostic criteria. In this work, we analyzed the genomic and epigenomic profile of uterine smooth muscle tumors (USMTs) in order to find similarities and differences between STUMPs, leiomyosarcomas (LMSs) and leiomyomas (LMs), and possibly identify prognostic factors in this group of tumors. Array-CGH data on 23 USMTs demonstrated the presence of a more similar genomic profile between STUMPs and LMSs. Some genes, such as PRKDC and PUM2, with a potential prognostic value, were never previously associated with STUMP. The methylation data appears to be very promising, especially with regards to the divergent profile found in the sample that relapsed, characterized by an overall CGI hypomethylation. Finally, the Gene Ontology analysis highlighted some cancer genes that could play a pivotal role in the unexpected aggressive behavior that can be found in some of these tumors. These genes could prove to be prognostic markers in the future.
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Affiliation(s)
- Donatella Conconi
- School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy; (S.R.); (A.A.L.); (M.P.); (L.D.); (F.L.); (M.L.); (G.R.)
- Correspondence: (D.C.); (A.B.); Tel.: +39-0264488133 (A.B.)
| | - Serena Redaelli
- School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy; (S.R.); (A.A.L.); (M.P.); (L.D.); (F.L.); (M.L.); (G.R.)
| | - Andrea Alberto Lissoni
- School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy; (S.R.); (A.A.L.); (M.P.); (L.D.); (F.L.); (M.L.); (G.R.)
- Clinic of Obstetrics and Gynecology, San Gerardo Hospital, 20900 Monza, Italy
| | - Chiara Cilibrasi
- Department of Biochemistry and Biomedicine, School of Life Sciences, University of Sussex, Falmer, Brighton BN1 9RH, UK;
| | - Patrizia Perego
- Division of Pathology, San Gerardo Hospital, 20900 Monza, Italy;
| | - Eugenio Gautiero
- Medical Genetics Laboratory, San Gerardo Hospital, 20900 Monza, Italy; (E.G.); (E.S.)
| | - Elena Sala
- Medical Genetics Laboratory, San Gerardo Hospital, 20900 Monza, Italy; (E.G.); (E.S.)
| | - Mariachiara Paderno
- School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy; (S.R.); (A.A.L.); (M.P.); (L.D.); (F.L.); (M.L.); (G.R.)
- Clinic of Obstetrics and Gynecology, San Gerardo Hospital, 20900 Monza, Italy
| | - Leda Dalprà
- School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy; (S.R.); (A.A.L.); (M.P.); (L.D.); (F.L.); (M.L.); (G.R.)
| | - Fabio Landoni
- School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy; (S.R.); (A.A.L.); (M.P.); (L.D.); (F.L.); (M.L.); (G.R.)
- Clinic of Obstetrics and Gynecology, San Gerardo Hospital, 20900 Monza, Italy
| | - Marialuisa Lavitrano
- School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy; (S.R.); (A.A.L.); (M.P.); (L.D.); (F.L.); (M.L.); (G.R.)
| | - Gaia Roversi
- School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy; (S.R.); (A.A.L.); (M.P.); (L.D.); (F.L.); (M.L.); (G.R.)
- Medical Genetics Laboratory, San Gerardo Hospital, 20900 Monza, Italy; (E.G.); (E.S.)
| | - Angela Bentivegna
- School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy; (S.R.); (A.A.L.); (M.P.); (L.D.); (F.L.); (M.L.); (G.R.)
- Correspondence: (D.C.); (A.B.); Tel.: +39-0264488133 (A.B.)
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Paracchini L, Pesenti C, Delle Marchette M, Beltrame L, Bianchi T, Grassi T, Buda A, Landoni F, Ceppi L, Bosetti C, Paderno M, Adorni M, Vicini D, Perego P, Leone BE, D’Incalci M, Marchini S, Fruscio R. Detection of TP53 Clonal Variants in Papanicolaou Test Samples Collected up to 6 Years Prior to High-Grade Serous Epithelial Ovarian Cancer Diagnosis. JAMA Netw Open 2020; 3:e207566. [PMID: 32609349 PMCID: PMC7330718 DOI: 10.1001/jamanetworkopen.2020.7566] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
IMPORTANCE The low 5-year survival rate of women with high-grade serous epithelial ovarian cancer (HGS-EOC) is related to its late diagnosis; thus, improvement in diagnosis constitutes a crucial step to increase the curability of this disease. OBJECTIVE To determine whether the presence of the clonal pathogenic TP53 variant detected in matched primary tumor biopsies can be identified in DNA purified from Papanicolaou test samples collected from women with HGS-EOC years before the diagnosis. DESIGN, SETTING, AND PARTICIPANTS This cohort study was conducted among a single-center cohort of women with histologically confirmed diagnosis of HGS-EOC recruited at San Gerardo Hospital, Monza, Italy, from October 15, 2015, to January 4, 2019. Serial dilutions of DNA derived from tumor samples and DNA extracted from healthy women's Papanicolaou test samples were analyzed to define the sensitivity and specificity of droplet digital polymerase chain reaction assays designed to detect the TP53 variants identified in tumors. All available brush-based Papanicolaou test slides performed up to 6 years before diagnosis were investigated at the Mario Negri Institute, Milano, Italy. Data were analyzed from October 2018 to December 2019. MAIN OUTCOMES AND MEASURES The presence of tumor pathogenic TP53 variants was assessed by the droplet digital polymerase chain reaction approach in DNA purified from Papanicolaou test samples obtained from the same patients before diagnosis during cervical cancer screenings. RESULTS Among 17 included patients (median [interquartile range] age at diagnosis, 60 [53-69] years), Papanicolaou tests withdrawn before diagnosis presented tumor-matched TP53 variants in 11 patients (64%). In 2 patients for whom longitudinal Papanicolaou tests were available, including 1 patient with Papanicolaou tests from 25 and 49 months before diagnosis and 1 patient with Papanicolaou tests from 27 and 68 months before diagnosis, the TP53 clonal variant was detected at all time points. CONCLUSIONS AND RELEVANCE These findings suggest that noninvasive early molecular diagnosis of HGS-EOC is potentially achievable through detection of TP53 clonal variants in the DNA purified from Papanicolaou tests performed during cervical cancer screening.
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Affiliation(s)
- Lara Paracchini
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Chiara Pesenti
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Martina Delle Marchette
- Department of Obstetrics and Gynecology, Università degli Studi Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Luca Beltrame
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Tommaso Bianchi
- Department of Obstetrics and Gynecology, Università degli Studi Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Tommaso Grassi
- Department of Obstetrics and Gynecology, Università degli Studi Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Alessandro Buda
- Department of Obstetrics and Gynecology, Università degli Studi Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Fabio Landoni
- Department of Obstetrics and Gynecology, Università degli Studi Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Lorenzo Ceppi
- Department of Obstetrics and Gynecology, Azienda Socio Sanitaria Territoriale -Monza, Desio Hospital, Desio, Italy
| | - Cristina Bosetti
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Mariachiara Paderno
- Department of Obstetrics and Gynecology, Università degli Studi Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Marco Adorni
- Department of Obstetrics and Gynecology, Università degli Studi Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Debora Vicini
- Department of Obstetrics and Gynecology, Università degli Studi Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Patrizia Perego
- Department of Pathology, Università degli Studi Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Biagio Eugenio Leone
- Department of Pathology, Università degli Studi Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Maurizio D’Incalci
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Sergio Marchini
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Robert Fruscio
- Department of Obstetrics and Gynecology, Università degli Studi Milano-Bicocca, San Gerardo Hospital, Monza, Italy
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Grassi T, Dell'Orto F, Jaconi M, Lamanna M, De Ponti E, Paderno M, Landoni F, Leone BE, Fruscio R, Buda A. Two ultrastaging protocols for the detection of lymph node metastases in early-stage cervical and endometrial cancers. Int J Gynecol Cancer 2020; 30:1404-1410. [PMID: 32376740 DOI: 10.1136/ijgc-2020-001298] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 04/14/2020] [Accepted: 04/17/2020] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To date, there is no universal consensus on which is the optimal ultrastaging protocol for sentinel lymph node (SLN) evaluation in gynecologic malignancies. To estimate the impact of different ultrastaging methods of SLNs on the detection of patients with nodal metastases in early-stage cervical and endometrial cancers and to describe the incidence of low-volume metastases between two ultrastaging protocols. METHODS We retrospectively compared two ultrastaging protocols (ultrastaging-A vs ultrastaging-B) in patients with clinical stage I endometrial cancer or FIGO stage IA-IB1 cervical cancer who underwent primary surgery including SLN biopsy from October 2010 to December 2017 in our institution. The histologic subtypes and grades of the tumors were evaluated according to WHO criteria. Only SLNs underwent ultrastaging, while other lymph nodes were sectioned and examined by routine hematoxylin and eosin (H&E). RESULTS Overall 224 patients were reviewed (159 endometrial cancer and 65 cervical cancer). Lymph node involvement was noted in 15% of patients with endometrial cancer (24/159): 24% of patients (9/38) with the ultrastaging protocol A and 12% (15/121) with the ultrastaging protocol B (p=0.08); while for cervical cancer, SLN metastasis was detected in 14% of patients (9/65): 22% (4/18) in ultrastaging-A and 11% (5/47) in ultrastaging-B (p=0.20). Overall, macrometastasis and low-volume metastases were 50% and 50% for endometrial cancer and 78% and 22% for cervical cancer. Median size of nodal metastasis was 2 (range 0.9-8.5) mm for the ultrastaging-A and 1.2 (range 0.4-2.6) mm for the ultrastaging-B protocol in endometrial cancer (p=0.25); 4 (range 2.5-9.8) mm for ultrastaging-A and 4.4 (range 0.3-7.8) mm for ultrastaging-B protocol in cervical cancer (p=0.64). CONCLUSION In endometrial or cervical cancer patients, the incidence of SLN metastasis was not different between the two different types of ultrastaging protocol.
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Affiliation(s)
- Tommaso Grassi
- Obstetrics and Gynecology, Hospital San Gerardo, Monza, Lombardia, Italy
| | - Federica Dell'Orto
- Obstetrics and Gynecology, Hospital San Gerardo, Monza, Lombardia, Italy
| | - Marta Jaconi
- Pathology, Hospital San Gerardo, Monza, Lombardia, Italy
| | - Maria Lamanna
- Obstetrics and Gynecology, Hospital San Gerardo, Monza, Lombardia, Italy
| | - Elena De Ponti
- Physical Medicine, Hospital San Gerardo, Monza, Lombardia, Italy
| | | | - Fabio Landoni
- Obstetrics and Gynecology, University of Milan-Bicocca, Milano, Lombardia, Italy
| | | | - Robert Fruscio
- Obstetrics and Gynecology, University of Milan-Bicocca, Milano, Lombardia, Italy
| | - Alessandro Buda
- Obstetrics and Gynecology, Hospital San Gerardo, Monza, Lombardia, Italy
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9
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Ricciardi E, Plett H, Sangiorgio V, Paderno M, Landoni F, Aletti G, Prader S, du Bois A, Harter P, Colombo N. Adult primary cervical rhabdomyosarcomas: A Multicentric cross-national case series. Int J Gynecol Cancer 2019; 30:21-28. [PMID: 31780571 DOI: 10.1136/ijgc-2019-000821] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 09/04/2019] [Revised: 10/22/2019] [Accepted: 10/28/2019] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVES Adult primary cervical rhabdomyosarcoma is a very rare disease and data regarding treatment are sparce. The goal of this study was to report on our experience with the management of this rare entity, along with an evaluation of the literature. METHODS We conducted a review of the medical records at four centers from January 1990 to December 2017. We reviewed clinical characteristics including age at diagnosis, BMI, medical history and tumor stage, as well as treatment in the primary and recurrent settings and follow-up data. We reclassified tumors according to the Intergroup Rhabdomyosarcoma Study (IRS) clinical group. RESULTS A total of 15 patients were included in the analysis. Median age at diagnosis was 35 years (range 17-55). Median tumor size at presentation was 5 cm (range 3-10). Eleven patients had the embryonal variant, including five showing the botryoid subtype. Four patients had a pleomorphic rhabdomyosarcoma. Eleven patients had disease classified as IRS Clinical Group I, while the remaining four fell into groups II or III. Fertility-sparing treatment was offered to five patients. Primary treatment types were: surgery alone in eight patients, surgery followed by adjuvant chemotherapy in six patients, and neoadjuvant chemotherapy in two patients. The main risk factors for relapse were: IRS clinical group greater than I, tumor size greater than 5 cm, lymph nodal involvement, and non-embryonal histology. At a median follow-up of 35 months (range 3-282), we observed a 5-year overall survival rate of 78.2% and a progression-free survival of 58.2%. No patient in the IRS I group died of the disease. Three out of four patients in the IRS II-III group died of the disease (survival range 5-16 months following treatment). CONCLUSION Our data show that cervical rhabdomyosarcomas account for at least two prognostic groups, demonstrating the existence of low-risk and high-risk patterns. The best predictor of prognosis appearsd to be the IRS clinical group classification system. IRS Group I tumors had an overall good prognosis and rarely recurred; when they did recur they were mainly local, following conservative treatment.
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Affiliation(s)
- Enzo Ricciardi
- Gynecologic Oncology, Kliniken Essen-Mitte Evangelische Huyssens-Stiftung/Knappschaft GmbH, Essen, Germany
| | - Helmut Plett
- Gynecologic Oncology, Kliniken Essen-Mitte Evangelische Huyssens-Stiftung/Knappschaft GmbH, Essen, Germany.,Department of Gynecology, Campus Virchow-Klinikum, Charité Medical University, Berlin, Germany
| | - Valentina Sangiorgio
- Pathology, Istituto Europeo di Oncologia, Milano, Lombardia, Italy.,Pathology, The Royal London Hospital, London, UK
| | | | - Fabio Landoni
- Gynecology, University of Milan-Bicocca, Monza, Lombardia, Italy
| | - Giovanni Aletti
- Gynecology, Istituto Europeo di Oncologia, Milano, Italy.,Universita degli Studi di Milano, Milano, Lombardia, Italy
| | - Sonia Prader
- Gynecologic Oncology, Kliniken Essen-Mitte Evangelische Huyssens-Stiftung/Knappschaft GmbH, Essen, Germany
| | - Andreas du Bois
- Gynecologic Oncology, Kliniken Essen-Mitte Evangelische Huyssens-Stiftung/Knappschaft GmbH, Essen, Germany
| | - Philipp Harter
- Gynecologic Oncology, Kliniken Essen-Mitte Evangelische Huyssens-Stiftung/Knappschaft GmbH, Essen, Germany
| | - Nicoletta Colombo
- Universita degli Studi di Milano, Milano, Lombardia, Italy.,Medical Gynecologic Oncology Unit; University of Milan Bicocca; Milan; Italy, European Institute of Oncology, Milano, Italy
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10
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Buda A, De Bernardi E, Crivellaro C, Elisei F, Marchette MD, Paderno M, Guerra L, Fruscio R. 18F-FDG PET/CT in preoperative nodal staging of endometrial cancer: The role of radiomics to improve sensitivity in detecting nodal metastases. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.04.264] [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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