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Cordova A, Rossi M, Roggio T, Cammarata E, Cipolla C, Vieni S, Toia F. The wide base bipedicled (WIBB) flap in nipple-sparing skin-reducing mastectomy. Sci Rep 2024; 14:9226. [PMID: 38649704 PMCID: PMC11035620 DOI: 10.1038/s41598-024-52396-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 01/18/2024] [Indexed: 04/25/2024] Open
Abstract
In this article, we present a modification of the NS/SRM technique in which the mastopexy design for skin reduction is undertaken with a wide-base bipedicled (WIBB) flap. The WIBB flap can be applied in both autologous and implant-based breast reconstruction. Our reconstructive algorithm is also presented. The clinical data of patients operated on from June 2017 to November 2022 were collected: 51 patients for a total of 71 breasts. Personal data, BMI, type and volume of implants used, and major and minor complications were analyzed by descriptive statistics. The mean age was 48.3 years. BMI ranged between 21.5 and 30.9 kg/m2. Thirty-one patients underwent unilateral mastectomy, while twenty patients underwent bilateral surgery. In 25 breasts, immediate reconstruction was performed with implants and ADM. In 40 breasts, reconstruction was performed with a subpectoral tissue expander, and in 6 breasts, reconstruction was performed with a DIEP flap. We observed only one case (1.4%) of periprosthetic infection requiring implant removal under general anesthesia. Minor complications occurred in 14.1% of patients. The use of both the WIBB flap and our algorithm maintained a low complication rate in our series, ensuring oncological radicality and a good aesthetic result at the same time.
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Affiliation(s)
- Adriana Cordova
- Plastic and Reconstructive Surgery, Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - Matteo Rossi
- Plastic and Reconstructive Surgery, Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - Tiziana Roggio
- Plastic and Reconstructive Surgery, Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
- St Andrew's Centre for Plastic Surgery and Burns, Broomfield Hospital, Mid Essex Hospital Services NHS Trust, Chelmsford, Essex, UK
| | - Emanuele Cammarata
- Plastic and Reconstructive Surgery, Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), University of Palermo, Via del Vespro 129, 90127, Palermo, Italy.
| | - Calogero Cipolla
- Oncological Surgery Unit, Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - Salvatore Vieni
- Oncological Surgery Unit, Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - Francesca Toia
- Plastic and Reconstructive Surgery, Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
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Cipolla C, Vieni S, D'Agati E, Grassi N, Genova P, Graceffa G, Vigneri P, Gebbia V, Valerio MR. Outcomes of Sentinel Lymph Node Biopsy for Patients With Node-positive Breast Cancer Treated With Neoadjuvant Chemotherapy. Anticancer Res 2023; 43:4643-4649. [PMID: 37772556 DOI: 10.21873/anticanres.16659] [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: 07/17/2023] [Revised: 08/18/2023] [Accepted: 08/30/2023] [Indexed: 09/30/2023]
Abstract
BACKGROUND/AIM Clinical trials have shown that the sentinel lymph node biopsy (SLNB) is feasible for patients with cN1 breast carcinoma treated with neoadjuvant chemotherapy (NAC). This study aimed to evaluate the technical outcomes of SLNB by assessing the volume of residual nodal disease. PATIENTS AND METHODS All patients with cT1-3 cN1 breast cancer undergoing NAC from January 2018 to December 2021 were retrospectively identified from our institutional database. We assessed the outcomes of preoperative clinical examination, ultrasonography, and other imaging to predict the axillary nodal status after NAC for patients converted to cN0 and undergoing SLNB; both adequate mapping and false-negative rate (FNR) at intraoperative evaluation of SLN were assessed. RESULTS Overall 160 patients were included in the study; 98 were converted to cN0 and underwent SLNB. No difference was found in the adequate mapping rate nor in the mean number of SLNs retrieved compared to the residual LN burden. The intraoperative SLN FNR was 38.2%, with smaller nodal volume being associated with lower FNR (p<0.01). The positive predictive values of physical examination and imaging-based nodal assessment post-NAC were 87.1% and 68.2%, respectively. CONCLUSION In a significant percentage of patients with cN1 disease converted to cN0 after NAC, it was possible to recover three or more SLNs. The residual volume of LN disease did not impact the SLN mapping rate. However, we found a high FNR for intraoperative SLN evaluation, particularly for patients with small residual nodal disease. It seems that only a small proportion of patients eligible for SLNB after NAC can be spared ALND.
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Affiliation(s)
- Calogero Cipolla
- Department of Surgical Oncological and Oral Sciences, Università degli Studi of Palermo Policlinico Paolo Giaccone, Palermo, Italy
| | - Salvatore Vieni
- Department of Surgical Oncological and Oral Sciences, Università degli Studi of Palermo Policlinico Paolo Giaccone, Palermo, Italy
| | - Eleonora D'Agati
- Department of Surgical Oncological and Oral Sciences, Università degli Studi of Palermo Policlinico Paolo Giaccone, Palermo, Italy
| | - Nello Grassi
- Department of Surgical Oncological and Oral Sciences, Università degli Studi of Palermo Policlinico Paolo Giaccone, Palermo, Italy
| | - Pietro Genova
- Department of Digestive, Oncological and Metabolic Surgery, Ambroise Paré University Hospital, University of Paris-Saclay, Boulogne-Billancourt, France
| | - Giuseppa Graceffa
- Department of Surgical Oncological and Oral Sciences, Università degli Studi of Palermo Policlinico Paolo Giaccone, Palermo, Italy
| | - Paolo Vigneri
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
- Humanitas Istituto Clinico Catanese, University Oncology Department, Catania, Italy
| | - Vittorio Gebbia
- Humanitas Istituto Clinico Catanese, University Oncology Department, Catania, Italy;
- Medical Oncology, University of Enna Kore, Plesso I - Polo Scientifico e Tecnologico di Santa Panasia, Enna, Italy
- Medical Oncology Unit, Casa di Cura Torina, Palermo, Italy
| | - Maria Rosaria Valerio
- Department of Surgical Oncological and Oral Sciences, Università degli Studi of Palermo Policlinico Paolo Giaccone, Palermo, Italy
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Cammarata E, Toia F, Rossi M, Cipolla C, Vieni S, Speciale A, Cordova A. Implant-Based Breast Reconstruction after Risk-Reducing Mastectomy in BRCA Mutation Carriers: A Single-Center Retrospective Study. Healthcare (Basel) 2023; 11:1741. [PMID: 37372859 DOI: 10.3390/healthcare11121741] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 06/09/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
Women with BRCA gene mutations have a higher lifetime risk of developing breast cancer. Furthermore, cancer is usually diagnosed at a younger age compared to the wild-type counterpart. Strategies for risk management include intensive surveillance or risk-reducing mastectomy. The latter provides a significant reduction of the risk of developing breast cancer, simultaneously ensuring a natural breast appearance due to the preservation of the skin envelope and the nipple-areola complex. Implant-based breast reconstruction is the most common technique after risk-reducing surgery and can be achieved with either a submuscular or a prepectoral approach, in one or multiple stages. This study analyzes the outcomes of the different reconstructive techniques through a retrospective review on 46 breasts of a consecutive, single-center case series. Data analysis was carried out with EpiInfo version 7.2. Results of this study show no significant differences in postoperative complications between two-stage tissue expander/implant reconstruction and direct-to-implant (DTI) reconstruction, with DTI having superior aesthetic outcomes, especially in the prepectoral subgroup. In our experience, the DTI prepectoral approach has proven to be a safe and less time-consuming alternative to the submuscular two-stage technique, providing a pleasant reconstructed breast and overcoming the drawbacks of subpectoral implant placement.
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Affiliation(s)
- Emanuele Cammarata
- Plastic and Reconstructive Surgery Unit, Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
| | - Francesca Toia
- Plastic and Reconstructive Surgery Unit, Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
| | - Matteo Rossi
- Plastic and Reconstructive Surgery Unit, Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
| | - Calogero Cipolla
- Oncological Surgery Unit, Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
| | - Salvatore Vieni
- Oncological Surgery Unit, Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
| | - Antonino Speciale
- Plastic and Reconstructive Surgery Unit, Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
| | - Adriana Cordova
- Plastic and Reconstructive Surgery Unit, Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
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Fanale D, Brando C, Corsini LR, Cutaia S, Di Donna MC, Randazzo U, Filorizzo C, Lisanti C, Magrin L, Gurrera V, Romano R, Dimino A, Bazan Russo TD, Olive D, Vieni S, Pantuso G, Giordano A, Chiantera V, Russo A, Bazan V, Iovanna JL. Low plasma PD-L1 levels, early tumor onset and absence of peritoneal carcinomatosis improve prognosis of women with advanced high-grade serous ovarian cancer. BMC Cancer 2023; 23:437. [PMID: 37179293 PMCID: PMC10183131 DOI: 10.1186/s12885-023-10911-5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 05/03/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND The most common subtype of ovarian cancer (OC) showing immunogenic potential is represented by the high-grade serous ovarian cancer (HGSOC), which is characterized by the presence of tumor-infiltrating immune cells able to modulate immune response. Because several studies showed a close correlation between OC patient's clinical outcome and expression of programmed cell death protein-1 or its ligand (PD-1/PD-L1), the aim of our study was to investigate if plasma levels of immunomodulatory proteins may predict prognosis of advanced HGSOC women. PATIENTS AND METHODS Through specific ELISA tests, we analyzed plasma concentrations of PD-L1, PD-1, butyrophilin sub-family 3A/CD277 receptor (BTN3A1), pan-BTN3As, butyrophilin sub-family 2 member A1 (BTN2A1), and B- and T-lymphocyte attenuator (BTLA) in one hundred patients affected by advanced HGSOC, before surgery and therapy. The Kaplan-Meier method was used to generate the survival curves, while univariate and multivariate analysis were performed using Cox proportional hazard regression models. RESULTS For each analyzed circulating biomarker, advanced HGSOC women were discriminated based on long (≥ 30 months) versus short progression-free survival (PFS < 30 months). The concentration cut-offs, obtained by receiver operating characteristic (ROC) analysis, allowed to observe that poor clinical outcome and median PFS ranging between 6 and 16 months were associated with higher baseline levels of PD-L1 (> 0.42 ng/mL), PD-1 (> 2.48 ng/mL), BTN3A1 (> 4.75 ng/mL), pan-BTN3As (> 13.06 ng/mL), BTN2A1 (> 5.59 ng/mL) and BTLA (> 2.78 ng/mL). Furthermore, a lower median PFS was associated with peritoneal carcinomatosis, age at diagnosis > 60 years or Body Mass Index (BMI) > 25. A multivariate analysis also suggested that plasma concentrations of PD-L1 ≤ 0.42 ng/mL (HR: 2.23; 95% CI: 1.34 to 3.73; p = 0.002), age at diagnosis ≤ 60 years (HR: 1.70; 95% CI: 1.07 to 2.70; p = 0.024) and absence of peritoneal carcinomatosis (HR: 1.87; 95% CI: 1.23 to 2.85; p = 0.003) were significant prognostic marker for a longer PFS in advanced HGSOC patients. CONCLUSIONS The identification of high-risk HGSOC women could be improved through determination of the plasma PD-L1, PD-1, BTN3A1, pan-BTN3As, BTN2A1 and BTLA levels.
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Affiliation(s)
- Daniele Fanale
- Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, Palermo, 90127, Italy.
| | - Chiara Brando
- Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, Palermo, 90127, Italy
| | - Lidia Rita Corsini
- Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, Palermo, 90127, Italy
| | - Sofia Cutaia
- Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, Palermo, 90127, Italy
| | | | - Ugo Randazzo
- Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, Palermo, 90127, Italy
| | - Clarissa Filorizzo
- Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, Palermo, 90127, Italy
| | - Chiara Lisanti
- Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, Palermo, 90127, Italy
| | - Luigi Magrin
- Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, Palermo, 90127, Italy
| | - Vittorio Gurrera
- Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, Palermo, 90127, Italy
| | - Raffaella Romano
- Department of Gynecologic Oncology, University of Palermo, Palermo, 90127, Italy
| | - Alessandra Dimino
- Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, Palermo, 90127, Italy
| | | | - Daniel Olive
- Team Immunity and Cancer, Centre de Recherche en Cancérologie de Marseille (CRCM), INSERM U1068, CNRS UMR 7258, Aix-Marseille Université and Institut Paoli-Calmettes, Marseille, France
| | - Salvatore Vieni
- Division of General and Oncological Surgery, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, 90127, Italy
| | - Gianni Pantuso
- Division of General and Oncological Surgery, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, 90127, Italy
| | - Antonio Giordano
- Sbarro Institute for Cancer Research and Molecular Medicine and Center of Biotechnology, College of Science and Technology, Temple University, PA, Philadelphia, 19122, USA
| | - Vito Chiantera
- Department of Gynecologic Oncology, University of Palermo, Palermo, 90127, Italy
| | - Antonio Russo
- Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, Palermo, 90127, Italy.
- Sbarro Institute for Cancer Research and Molecular Medicine and Center of Biotechnology, College of Science and Technology, Temple University, PA, Philadelphia, 19122, USA.
| | - Viviana Bazan
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, 90127, Italy
| | - Juan Lucio Iovanna
- Centre de Recherche en Cancérologie de Marseille (CRCM), INSERM U1068, CNRS UMR 7258, Aix-Marseille Université and Institut Paoli-Calmettes, Parc Scientifique Et Technologique de Luminy, Marseille, 13288, France
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Giammanco A, Anzalone R, Serra N, Graceffa G, Vieni S, Scibetta N, Rea T, Capra G, Fasciana T. Helicobacter pylori and Epstein-Barr Virus Co-Infection in Gastric Disease: What Is the Correlation with p53 Mutation, Genes Methylation and Microsatellite Instability in a Cohort of Sicilian Population? Int J Mol Sci 2023; 24:ijms24098104. [PMID: 37175810 PMCID: PMC10179236 DOI: 10.3390/ijms24098104] [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: 03/01/2023] [Revised: 04/06/2023] [Accepted: 04/10/2023] [Indexed: 05/15/2023] Open
Abstract
Genetic predisposition, environmental factors, and infectious agents interact in the development of gastric diseases. Helicobacter pylori (Hp) and Epstein-Barr virus (EBV) infection has recently been shown to be correlated with these diseases. A cross-sectional study was performed on 100 hospitalized Italian patients with and without gastric diseases. The patients were stratified into four groups. Significant methylation status differences among CDH1, DAPK, COX2, hMLH1 and CDKN2A were observed for coinfected (Hp-EBV group) patients; particularly, a significant presence of COX2 (p = 0.0179) was observed. For microsatellite instability, minor stability was described in the Hp-HBV group (69.23%, p = 0.0456). Finally, for p53 mutation in the EBV group, exon 6 was, significantly, most frequent in comparison to others (p = 0.0124), and in the Hp-EBV group exon 8 was, significantly, most frequent in comparison to others (p < 0.0001). A significant positive relationship was found between patients with infection (Hp, EBV or both) and p53 mutation (rho = 0.383, p = 0.0001), methylation status (rho = 0.432, p < 0.0001) and microsatellite instability (rho = 0.285, p = 0.004). Finally, we observed among infection and methylation status, microsatellite instability, and p53 mutation a significant positive relationship only between infection and methylation status (OR = 3.78, p = 0.0075) and infection and p53 mutation (OR = 6.21, p = 0.0082). According to our analysis, gastric disease in the Sicilian population has different pathways depending on the presence of various factors, including infectious agents such as Hp and EBV and genetic factors of the subject.
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Affiliation(s)
- Anna Giammanco
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy
| | - Rita Anzalone
- Department of Surgical Oncological and Oral Sciences, University of Palermo, 90133 Palermo, Italy
| | - Nicola Serra
- Department of Public Health, University Federico II of Naples, 80138 Napoli, Italy
| | - Giuseppa Graceffa
- Department of Surgical Oncological and Oral Sciences, University of Palermo, 90133 Palermo, Italy
| | - Salvatore Vieni
- Department of Surgical Oncological and Oral Sciences, University of Palermo, 90133 Palermo, Italy
| | - Nunzia Scibetta
- Anatomopathology Unit, Arnas Civico Di Cristina Benfratelli Hospital, 90127 Palermo, Italy
| | - Teresa Rea
- Public Health Department, Federico II University Hospital, 80131 Naples, Italy
| | - Giuseppina Capra
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy
| | - Teresa Fasciana
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy
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Gristina V, La Mantia M, Peri M, Iacono F, Barraco N, Perez A, Viscardi G, Cutaia S, Russo TDB, Anwar Z, Incorvaia L, Fulfaro F, Vieni S, Pantuso G, Graceffa G, Russo A, Galvano A, Bazan V. Navigating the liquid biopsy Minimal Residual Disease (MRD) in non-small cell lung cancer: Making the invisible visible. Crit Rev Oncol Hematol 2023; 182:103899. [PMID: 36596401 DOI: 10.1016/j.critrevonc.2022.103899] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 06/21/2022] [Revised: 12/16/2022] [Accepted: 12/19/2022] [Indexed: 01/02/2023] Open
Abstract
Liquid biopsy has gained increasing interest in the growing era of precision medicine as minimally invasive technique. Recent findings demonstrated that detecting minimal or molecular residual disease (MRD) in NSCLC is a challenging matter of debate that need multidisciplinary competencies, avoiding the overtreatment risk along with achieving a significant survival improvement. This review aims to provide practical consideration for solving data interpretation questions about MRD in NSCLC thanks to the close cooperation between biologists and oncology clinicians. We discussed with a translational approach the critical point of view from benchside, bedside and bunchside to facilitate the future applicability of liquid biopsy in this setting. Herein, we defined the clinical significance of MRD, focusing on relevant practical consideration about advantages and disadvantages, speculating on future clinical trial design and standardization of MRD technology.
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Affiliation(s)
- Valerio Gristina
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
| | - Maria La Mantia
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
| | - Marta Peri
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
| | - Federica Iacono
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
| | - Nadia Barraco
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
| | - Alessandro Perez
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
| | - Giuseppe Viscardi
- Medical Oncology, Department of Pneumology and Oncology, AORN Ospedali dei Colli, Via Leonardo Bianchi, 80131 Naples, Italy
| | - Sofia Cutaia
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
| | - Tancredi Didier Bazan Russo
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
| | - Zubair Anwar
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
| | - Lorena Incorvaia
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
| | - Fabio Fulfaro
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
| | - Salvatore Vieni
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
| | - Gianni Pantuso
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
| | - Giuseppa Graceffa
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
| | - Antonio Russo
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, 90127 Palermo, Italy.
| | - Antonio Galvano
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
| | - Viviana Bazan
- Department of Experimental Biomedicine and Clinical Neurosciences, School of Medicine, University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
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7
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Galvano A, Castellana L, Gristina V, La Mantia M, Insalaco L, Barraco N, Perez A, Cutaia S, Calò V, Bazan Russo TD, Francini E, Incorvaia L, Mirisola MG, Vieni S, Rolfo C, Bazan V, Russo A. The diagnostic accuracy of PIK3CA mutations by circulating tumor DNA in breast cancer: an individual patient data meta-analysis. Ther Adv Med Oncol 2022; 14:17588359221110162. [PMID: 36188485 PMCID: PMC9516428 DOI: 10.1177/17588359221110162] [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: 03/24/2022] [Accepted: 06/09/2022] [Indexed: 11/17/2022] Open
Abstract
Background: The circulating tumor DNA (ctDNA) diagnostic accuracy for detecting phosphatidylinositol 4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA) mutations in breast cancer (BC) is under discussion. We aimed to compare plasma and tissue PIK3CA alterations, encompassing factors that could affect the results. Methods: Two reviewers selected studies from different databases until December 2020. We considered BC patients with matched tumor tissue and plasma ctDNA. We performed meta-regression and subgroup analyses to explore sources of heterogeneity concerning tumor burden, diagnostic technique, sample size, sampling time, biological subtype, and hotspot mutation. Pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and the related area under the curve (AUC) were elaborated for the overall population and each subgroup. Results: The pooled analysis was carried out on 25 cohorts for a total of 1966 patients. The overall ctDNA sensitivity and specificity were 0.73 (95% CI: 0.70–0.77) and 0.87 (95% CI: 0.85–0.89). The AUC was 0.93. Pooled concordance, negative predictive value and positive predictive value values were 0.87 (95% CI: 0.82–0.92), 0.86 (95% CI: 0.81–0.90), and 0.89 (95% CI: 0.81–0.95) with pooled PLR, NLR, and DOR of 7.94 (95% CI: 4.90–12.86), 0.33 (95% CI: 0.25–0.45), and 33.41 (95% CI: 17.23–64.79), respectively. The pooled results consistently favored next-generation sequencing (NGS)- over polymerase chain reaction-based methodologies. The best ctDNA performance in terms of sensitivity, specificity, and AUC (0.85, 0.99, and 0.94, respectively) was observed in the low-time sampling subgroup (⩽18 days between tissue and plasma collection). Meta-regression and subgroup analyses highlighted sampling time as a possible major cause of heterogeneity. Conclusions: These findings reliably estimate the high ctDNA accuracy for the detection of PIK3CA mutations. A ctDNA-first approach for the assessment of PIK3CA mutational status by NGS may accurately replace tissue tumor sampling, representing the preferable strategy at diagnosis of metastatic BC in patients who present with visceral involvement and at least two metastatic lesions, primarily given low clinical compliance or inaccessible metastatic sites.
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Affiliation(s)
- Antonio Galvano
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Luisa Castellana
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Valerio Gristina
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Maria La Mantia
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Lavinia Insalaco
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Nadia Barraco
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Alessandro Perez
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Sofia Cutaia
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Valentina Calò
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | | | - Edoardo Francini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Lorena Incorvaia
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Mario Giuseppe Mirisola
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Salvatore Vieni
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Christian Rolfo
- Center for Thoracic Oncology, Tisch Cancer Institute, Mount Sinai Medical System & Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Viviana Bazan
- Department of Experimental Biomedicine and Clinical Neurosciences, School of Medicine, University of Palermo, Palermo, Italy
| | - Antonio Russo
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, Palermo 90127, Italy
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8
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Fanale D, Corsini LR, Brando C, Cutaia S, Di Donna MC, Filorizzo C, Lisanti MC, Randazzo U, Magrin L, Romano R, Bazan Russo TD, Olive D, Vieni S, Pantuso G, Chiantera V, Russo A, Bazan V, Iovanna JL. Can circulating PD-1, PD-L1, BTN3A1, pan-BTN3As, BTN2A1 and BTLA levels enhance prognostic power of CA125 in patients with advanced high-grade serous ovarian cancer? Front Oncol 2022; 12:946319. [PMID: 36212445 PMCID: PMC9532861 DOI: 10.3389/fonc.2022.946319] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 08/29/2022] [Indexed: 11/13/2022] Open
Abstract
The most common subtype of ovarian cancer (OC) is the high-grade serous ovarian carcinoma (HGSOC), accounting for 70%–80% of all OC deaths. Although HGSOC is a potentially immunogenic tumor, clinical studies assessing the effectiveness of inhibitors of programmed death protein and its ligand (PD-1/PD-L1) in OC patients so far showed only response rates <15%. However, recent studies revealed an interesting prognostic role of plasma PD-1/PD-L1 and other circulating immunoregulatory molecules, such as the B- and T-lymphocyte attenuator (BTLA), butyrophilin sub-family 3A/CD277 receptors (BTN3A), and butyrophilin sub-family 2 member A1 (BTN2A1), in several solid tumors. Since evidence showed the prognostic relevance of pretreatment serum CA125 levels in OC, the aim of our study was to investigate if soluble forms of inhibitory immune checkpoints can enhance prognostic power of CA125 in advanced HGSOC women. Using specific ELISA tests, we examined the circulating PD-1, PD-L1, pan-BTN3As, BTN3A1, BTN2A1, and BTLA levels in 100 advanced HGSOC patients before treatment, correlating them with baseline serum CA125, age at diagnosis, body mass index (BMI), and peritoneal carcinomatosis. A multivariate analysis revealed that plasma BTN3A1 ≤4.75 ng/ml (HR, 1.94; 95% CI, 1.23–3.07; p=0.004), age at diagnosis ≤60 years (HR, 1.65; 95% CI, 1.05–2.59; p=0.03) and absence of peritoneal carcinomatosis (HR, 2.65; 95% CI, 1.66–4.22; p<0.0001) were independent prognostic factors for a longer progression-free survival (PFS) (≥30 months) in advanced HGSOC women. However, further two-factor multivariate analyses highlighted that baseline serum CA125 levels >401 U/ml and each soluble protein above respective concentration cutoff were covariates associated with shorter PFS (<30 months) and unfavorable clinical outcome, suggesting that contemporary measurement of both biomarkers than CA125 only could strengthen prognostic power of serum CA125 in predicting PFS of advanced HGSOC women. Plasma PD-L1, PD-1, BTN3A1, pan-sBTN3As, BTN2A1, or BTLA levels could be helpful biomarkers to increase prognostic value of CA125.
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Affiliation(s)
- Daniele Fanale
- Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Lidia Rita Corsini
- Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Chiara Brando
- Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Sofia Cutaia
- Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | | | - Clarissa Filorizzo
- Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Maria Chiara Lisanti
- Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Ugo Randazzo
- Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Luigi Magrin
- Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Raffaella Romano
- Department of Gynecologic Oncology, University of Palermo, Palermo, Italy
| | - Tancredi Didier Bazan Russo
- Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Daniel Olive
- Team Immunity and Cancer, Centre de Recherche en Cancérologie de Marseille (CRCM), Institut National de la Santé et de la Recherche Médicale (INSERM) U1068, Centre National de la Recherche Scientifique Unité Mixte de Recherche (CNRS UMR) 7258 Aix-Marseille Université and Institut Paoli-Calmettes, Marseille, France
| | - Salvatore Vieni
- Division of General and Oncological Surgery, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Gianni Pantuso
- Division of General and Oncological Surgery, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Vito Chiantera
- Department of Gynecologic Oncology, University of Palermo, Palermo, Italy
| | - Antonio Russo
- Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
- *Correspondence: Viviana Bazan, ; Antonio Russo,
| | - Viviana Bazan
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy
- *Correspondence: Viviana Bazan, ; Antonio Russo,
| | - Juan Lucio Iovanna
- Centre de Recherche en Cancérologie de Marseille (CRCM), Institut National de la Santé et de la Recherche Médicale (INSERM) U1068, Centre National de la Recherche Scientifique Unité Mixte de Recherche (CNRS UMR) 7258, Aix-Marseille Université and Institut Paoli-Calmettes, Parc Scientifique et Technologique de Luminy, Marseille, France
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9
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Bartolotta TV, Orlando AAM, Dimarco M, Zarcaro C, Ferraro F, Cirino A, Matranga D, Vieni S, Cabibi D. Diagnostic performance of 2D-shear wave elastography in the diagnosis of breast cancer: a clinical appraisal of cutoff values. Radiol Med 2022; 127:1209-1220. [DOI: 10.1007/s11547-022-01546-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 08/17/2022] [Indexed: 11/29/2022]
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Gristina V, Barraco N, Galvano A, La Mantia M, Cutaia S, Iacono F, Lisanti C, Inguglia S, Sardo D, Perez A, Cusenza S, Castellana L, Bazan Russo T, Vieni S, Fulfaro F, Incorvaia L, Badalamenti G, Bazan V, Russo A. 1094P The clinical potential of circulating-free DNA (cfDNA) for real-time longitudinally monitoring clinical outcomes in a real-world first-line non-small cell lung cancer (NSCLC) prospective study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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11
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La Mantia M, Gristina V, Galvano A, Barraco N, Perez A, Cutaia S, Sardo D, Inguglia S, Busuito G, Spinnato V, Iacono F, Insalaco L, Castellana L, Calò V, cusenza S, Fulfaro F, Incorvaia L, Badalamenti G, Russo TB, Vieni S, Russo A, Bazan V. EP16.01-013 The Diagnostic Accuracy of Tumor Mutational Burden in Advanced NSCLC: An Individual Patient Data Meta-Analysis. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.1013] [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: 10/14/2022]
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12
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Fanale D, Pivetti A, Cancelliere D, Spera A, Bono M, Fiorino A, Pedone E, Barraco N, Brando C, Perez A, Guarneri MF, Russo TDB, Vieni S, Guarneri G, Russo A, Bazan V. BRCA1/2 variants of unknown significance in hereditary breast and ovarian cancer (HBOC) syndrome: looking for the hidden meaning. Crit Rev Oncol Hematol 2022; 172:103626. [PMID: 35150867 DOI: 10.1016/j.critrevonc.2022.103626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 12/23/2021] [Revised: 01/28/2022] [Accepted: 02/07/2022] [Indexed: 01/04/2023] Open
Abstract
Hereditary breast and ovarian cancer syndrome is caused by germline mutations in BRCA1/2 genes. These genes are very large and their mutations are heterogeneous and scattered throughout the coding sequence. In addition to the above-mentioned mutations, variants of uncertain/unknown significance (VUSs) have been identified in BRCA genes, which make more difficult the clinical management of the patient and risk assessment. In the last decades, several laboratories have developed different databases that contain more than 2000 variants for the two genes and integrated strategies which include multifactorial prediction models based on direct and indirect genetic evidence, to classify the VUS and attribute them a clinical significance associated with a deleterious, high-low or neutral risk. This review provides a comprehensive overview of literature studies concerning the VUSs, in order to assess their impact on the population and provide new insight for the appropriate patient management in clinical practice.
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Affiliation(s)
- Daniele Fanale
- Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, 90127 Palermo, Italy
| | - Alessia Pivetti
- Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, 90127 Palermo, Italy
| | - Daniela Cancelliere
- Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, 90127 Palermo, Italy
| | - Antonio Spera
- Department of Radiotherapy, San Giovanni di Dio Hospital, ASP of Agrigento, Agrigento, Italy
| | - Marco Bono
- Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, 90127 Palermo, Italy
| | - Alessia Fiorino
- Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, 90127 Palermo, Italy
| | - Erika Pedone
- Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, 90127 Palermo, Italy
| | - Nadia Barraco
- Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, 90127 Palermo, Italy
| | - Chiara Brando
- Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, 90127 Palermo, Italy
| | - Alessandro Perez
- Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, 90127 Palermo, Italy
| | | | - Tancredi Didier Bazan Russo
- Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, 90127 Palermo, Italy
| | - Salvatore Vieni
- Division of General and Oncological Surgery, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Italy
| | - Girolamo Guarneri
- Gynecology Section, Mother - Child Department, University of Palermo, 90127 Palermo, Italy
| | - Antonio Russo
- Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, 90127 Palermo, Italy.
| | - Viviana Bazan
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy
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Cipolla C, Galvano A, Vieni S, Saputo F, Lupo S, Latteri M, Graceffa G, Valerio MR. Effects of the number of removed lymph nodes on survival outcome in patients with sentinel node-negative breast cancer. World J Surg Oncol 2021; 19:306. [PMID: 34666764 PMCID: PMC8524859 DOI: 10.1186/s12957-021-02418-9] [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: 05/26/2021] [Accepted: 10/04/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sentinel lymph node biopsy is the gold standard surgical technique for axillary staging in patients with clinically node-negative. However, it is still uncertain what is the optimal number of sentinel lymph nodes (SLNs) to be removed to reduce the false-negative rate. The aim of this study was to investigate whether patients with a single negative SLN have a worse prognosis than those with two or more negative SLNs. METHODS A retrospective review was conducted on a large series of SLN-negative breast cancer patients. Survival outcomes and regional recurrence rate were evaluated according to the number of removed SLNs. Secondly, the contribution of different adjuvant therapies on disease-free survival was explored. Statistical analysis included the chi-square, Wilcoxon-Mann-Whitney test, and Kaplan-Meier survival analysis. RESULTS A total of 1080 patients were included in the study. A first group consisted of 328 patients in whom a single SLN was retrieved, and a second group consisted of 752 patients in whom two or more SLNs were retrieved. There was no relevant difference in median DFS (64.9 vs 41.4) for SLN = 1 vs SLN > 1 groups (HR 0.76, CI 95% 0.39-1.46; p = 0.38). A statistically significant difference in mDFS was showed only for HT-treated patients who were SLN = 1 if compared to SLN > 1 (100.6 months versus 35.3 months). CONCLUSIONS There is likely a relationship between the number of resected SNL and mDFS. Our results, however, showed no relevant difference in median DFS for SLN = 1 vs SLN > 1 group, except for a subset of the patients treated with hormone therapy.
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Affiliation(s)
- Calogero Cipolla
- Department of Surgical, Oncological and Oral Sciences, University of Palermo (Italy), A.O.U.P. "P. Giaccone" University Hospital, Via del Vespro 129, 90127, Palermo, Italy.
| | - Antonio Galvano
- Department of Surgical, Oncological and Oral Sciences, University of Palermo (Italy), A.O.U.P. "P. Giaccone" University Hospital, Via del Vespro 129, 90127, Palermo, Italy
| | - Salvatore Vieni
- Department of Surgical, Oncological and Oral Sciences, University of Palermo (Italy), A.O.U.P. "P. Giaccone" University Hospital, Via del Vespro 129, 90127, Palermo, Italy
| | - Federica Saputo
- Department of Surgical, Oncological and Oral Sciences, University of Palermo (Italy), A.O.U.P. "P. Giaccone" University Hospital, Via del Vespro 129, 90127, Palermo, Italy
| | - Simona Lupo
- Department of Surgical, Oncological and Oral Sciences, University of Palermo (Italy), A.O.U.P. "P. Giaccone" University Hospital, Via del Vespro 129, 90127, Palermo, Italy
| | - Mario Latteri
- Department of Surgical, Oncological and Oral Sciences, University of Palermo (Italy), A.O.U.P. "P. Giaccone" University Hospital, Via del Vespro 129, 90127, Palermo, Italy
| | - Giuseppa Graceffa
- Department of Surgical, Oncological and Oral Sciences, University of Palermo (Italy), A.O.U.P. "P. Giaccone" University Hospital, Via del Vespro 129, 90127, Palermo, Italy
| | - Maria Rosaria Valerio
- Department of Surgical, Oncological and Oral Sciences, University of Palermo (Italy), A.O.U.P. "P. Giaccone" University Hospital, Via del Vespro 129, 90127, Palermo, Italy
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14
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Graceffa G, Vieni S, Mannino V, Gennari V, Genova P, Cipolla C. Effectiveness of early administration of a single dose of steroids and escin after loss of signal on electromyographic signal recovery during neuromonitored thyroidectomy. Am J Surg 2021; 223:923-926. [PMID: 34663501 DOI: 10.1016/j.amjsurg.2021.10.016] [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: 07/13/2021] [Revised: 09/08/2021] [Accepted: 10/11/2021] [Indexed: 11/01/2022]
Abstract
BACKGROUND The aim of this study was to evaluate the effect of a single early administration of dexamethasone and escin after loss of signal (LOS) during a neuromonitored total thyroidectomy. METHODS A retrospective analysis of results concerning consecutive patients undergoing total thyroidectomy was performed. Patients included in the study were divided into two groups: Group 1 for which a "wait and see" strategy was used; Group 2, receiving dexamethasone and escin immediately after LOS detection. RESULTS Overall 37 patients were included in Group 1 and 35 in Group 2. LOS recovery occurring in 29.7% of cases (n. 11) versus 65.7% (n. 23) respectively (p < 0.001). Postoperative fibrolayngoscopy for patients without LOS recovery showed normal cord function in 4 out of 26 cases (15.4%) in Group 1 and in 7 out of 12 (58.3%) in Group 2 (p < 0.001). CONCLUSIONS The early administration of dexamethasone and escin after LOS detection may achieve greater EMG signal recovery than a "wait and see" strategy.
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Affiliation(s)
- Giuseppa Graceffa
- Department of Surgical Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - Salvatore Vieni
- Department of Surgical Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - Valeria Mannino
- Department of Surgical Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - Valeria Gennari
- Department of Surgical Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - Pietro Genova
- Department of Surgical Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - Calogero Cipolla
- Department of Surgical Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy.
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Cipolla C, Vieni S, Genova P, Contino S, Latteri M, Graceffa G. Value of Neurostimulation Plus Laryngeal Palpation to Predict Postoperative Vocal Fold Motility. J Surg Res 2021; 267:506-511. [PMID: 34252792 DOI: 10.1016/j.jss.2021.06.003] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 04/28/2021] [Accepted: 06/08/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND The aim of this study was to evaluate the reliability of intraoperative neuromonitoring through recurrent laryngeal nerve stimulation and simultaneous laryngeal palpation (NSLP) in predicting postoperative vocal cord palsy and in providing useful information in the decision to perform a staged surgery in initially planned total thyroidectomy. MATERIALS AND METHODS A retrospective review was performed involving 552 patients for whom a total thyroidectomy was planned. In all patients, preoperative and postoperative laryngoscopy was performed. The incidence of vocal cord palsy was calculated on 1104 nerves at risk. RESULTS Sensitivity and specificity of NSLP were 0.9411 and 0.9925 respectively. The positive predictive value was 0.7804, the negative predictive value was 0.9981, the false positive rate was 0.8%. In 41 patients (7.4%) the initial surgical strategy was changed into a staged procedure. Nine patients (21.9%) were false positive, 32 patients (78.1%) were true positive. Finally, a two-stage thyroidectomy was performed in 27 of 41 patients. CONCLUSIONS High sensitivity and specificity confirm the validity of NSLP in predicting postoperative vocal cord palsy and in driving a possible staged thyroidectomy, both in benign thyroid disease and in differentiated thyroid carcinoma.
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Affiliation(s)
- Calogero Cipolla
- Department of Surgical Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, 90127 Palermo, Italy.
| | - Salvatore Vieni
- Department of Surgical Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
| | - Pietro Genova
- Department of Surgical Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
| | - Silvia Contino
- Department of Surgical Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
| | - Mario Latteri
- Department of Surgical Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
| | - Giuseppa Graceffa
- Department of Surgical Oncological and Oral Sciences, University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
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Macaione I, Galvano A, Graceffa G, Lupo S, Latteri M, Russo A, Vieni S, Cipolla C. Impact of BMI on Preoperative Axillary Ultrasound Assessment in Patients With Early Breast Cancer. Anticancer Res 2020; 40:7083-7088. [PMID: 33288606 DOI: 10.21873/anticanres.14736] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 08/20/2020] [Revised: 10/13/2020] [Accepted: 10/15/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND The accuracy of axillary ultrasound (AUS) with fine-needle aspiration with varying patient body mass index (BMI) is still unclear. The aim of our study was to evaluate whether the US features of axillary lymph nodes changes with BMI of patients. PATIENTS AND METHODS A retrospective review was performed involving 144 out of 270 patients with early breast cancer who underwent breast surgery with sentinel lymph node biopsy. Diagnostic efficacy of AUS in preoperative axillary nodal staging was assessed in relation to BMI. RESULTS Negative predictive values of AUS for the overweight and obese groups were statistically significantly lower compared to the normal/underweight group (p=0.02 and p=0.003, respectively). Additionally, Spearman's correlation coefficient R between BMI and positive sentinel lymph node biopsy was 0.257, suggesting a significantly positive linear relationship between the two variables in the cohort overall. CONCLUSION Our results demonstrate how in our cohort the negative predictive value of AUS was significantly influenced by adipose tissue and that the selection of the most suitable instrumental diagnostic technique might contribute to improving heterogeneous results.
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Affiliation(s)
- Ina Macaione
- Department of Surgical, Oncological and Oral Sciences, Surgical Oncology Unit University of Palermo, Palermo, Italy
| | - Antonio Galvano
- Department of Surgical, Oncological and Oral Sciences, Medical Oncology Unit, University of Palermo, Palermo, Italy
| | - Giuseppa Graceffa
- Department of Surgical, Oncological and Oral Sciences, Surgical Oncology Unit University of Palermo, Palermo, Italy
| | - Simona Lupo
- Department of Surgical, Oncological and Oral Sciences, Surgical Oncology Unit University of Palermo, Palermo, Italy
| | - Mario Latteri
- Department of Surgical, Oncological and Oral Sciences, Surgical Oncology Unit University of Palermo, Palermo, Italy
| | - Antonio Russo
- Department of Surgical, Oncological and Oral Sciences, Medical Oncology Unit, University of Palermo, Palermo, Italy
| | - Salvatore Vieni
- Department of Surgical, Oncological and Oral Sciences, Surgical Oncology Unit University of Palermo, Palermo, Italy
| | - Calogero Cipolla
- Department of Surgical, Oncological and Oral Sciences, Surgical Oncology Unit University of Palermo, Palermo, Italy;
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Cipolla C, Valerio MR, Grassi N, Calamia S, Latteri S, Latteri M, Graceffa G, Vieni S. Axillary Nodal Burden in Breast Cancer Patients With Pre-operative Fine Needle Aspiration-proven Positive Lymph Nodes Compared to Those With Positive Sentinel Nodes. In Vivo 2020; 34:729-734. [PMID: 32111777 DOI: 10.21873/invivo.11831] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 11/11/2019] [Revised: 11/26/2019] [Accepted: 12/02/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND/AIM Recent years have seen a considerable shift to a more conservative management of the axilla in patients with positive axillary sentinel lymph nodes. The aim of this study was to determine whether some breast cancer patients with a preoperative ultrasound-guided needle aspiration biopsy proven positive node could potentially be spared an axillary lymph node dissection according to the ACOSOG Z0011 trial criteria. PATIENTS AND METHODS A retrospective review was performed involving 623 breast cancer patients who underwent axillary lymph node dissection after either ultrasound-guided needle aspiration biopsy proven positive node or sentinel lymph node biopsy. RESULTS Patients with fine needle aspiration biopsy-proven positive node had worse prognosis and a higher nodal burden (6.7 vs 1.9 nodes, p<0.001), compared to those with positive sentinel lymph nodes. CONCLUSION Patients with an ultrasound guided needle aspiration biopsy proven positive node are more likely to have tumor with more aggressive pathological characteristics and a higher nodal burden than those with a positive sentinel lymph node biopsy.
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Affiliation(s)
- Calogero Cipolla
- University of Palermo, Department of Surgical Oncological and Oral Sciences, Palermo, Italy
| | - Maria Rosaria Valerio
- University of Palermo, Department of Surgical Oncological and Oral Sciences, Palermo, Italy
| | - Nello Grassi
- University of Palermo, Department of Surgical Oncological and Oral Sciences, Palermo, Italy
| | - Sergio Calamia
- University of Palermo, Department of Surgical Oncological and Oral Sciences, Palermo, Italy
| | - Stefania Latteri
- University of Palermo, Department of Surgical Oncological and Oral Sciences, Palermo, Italy
| | - Mario Latteri
- University of Palermo, Department of Surgical Oncological and Oral Sciences, Palermo, Italy
| | - Giuseppa Graceffa
- University of Palermo, Department of Surgical Oncological and Oral Sciences, Palermo, Italy
| | - Salvatore Vieni
- University of Palermo, Department of Surgical Oncological and Oral Sciences, Palermo, Italy
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Cipolla C, Graceffa G, Cabibi D, Gangi G, Latteri M, Valerio MR, Vieni S. Current Role of Intraoperative Frozen Section Examination of Sentinel Lymph Node in Early Breast Cancer. Anticancer Res 2020; 40:1711-1717. [PMID: 32132079 DOI: 10.21873/anticanres.14124] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 01/14/2020] [Revised: 02/02/2020] [Accepted: 02/04/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM The aim of this study was to evaluate the current role of frozen section in identifying patients who could benefit from an immediate axillary lymph node dissection (ALND), following the criteria of the ASOCOG Z0011 and IBCSG 23-10 trials. PATIENTS AND METHODS A retrospective review was performed involving 2,079 patients with early breast cancer who underwent conservative surgery or total mastectomy with sentinel lymph node biopsy. RESULTS Sensitivity and diagnostic accuracy were 63.8% and 90.3%, respectively. Sensitivity was significantly higher (p<0.001) in finding macrometastases (81.8%) compared to micrometastases (11.9%). Frozen section was useful only in 7.7% of the patients who met the criteria of the IBCSG 23-01 and ACOSOG Z0011 trials. CONCLUSION Frozen section continues to be very useful in the intraoperative assessment of the SLN, offering a high sensitivity and diagnostic accuracy. Omission of ALND in 24.4% of patients who met the ACOSOG Z0011 criteria would have resulted in their undertreatment.
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Affiliation(s)
- Calogero Cipolla
- Department of Surgical Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Giuseppa Graceffa
- Department of Surgical Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Daniela Cabibi
- Department of Sciences for the Promotion of Health and Mother and Child Care, University of Palermo, Palermo, Italy
| | - Giuseppe Gangi
- Department of Surgical Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Mario Latteri
- Department of Surgical Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Maria Rosaria Valerio
- Department of Surgical Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Salvatore Vieni
- Department of Surgical Oncological and Oral Sciences, University of Palermo, Palermo, Italy
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Lo Presti E, Mocciaro F, Mitri RD, Corsale AM, Di Simone M, Vieni S, Scibetta N, Unti E, Dieli F, Meraviglia S. Analysis of colon-infiltrating γδ T cells in chronic inflammatory bowel disease and in colitis-associated cancer. J Leukoc Biol 2020; 108:749-760. [PMID: 32202356 DOI: 10.1002/jlb.5ma0320-201rr] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 07/24/2019] [Revised: 02/28/2020] [Accepted: 03/04/2020] [Indexed: 12/12/2022] Open
Abstract
Inflammatory bowel disease (IBD) remains a global health problem with a significant percentage of patients progressing to chronic inflammation and colitis-associated cancer (CAC). Whether or not γδ T cells contribute to initiation and maintenance of inflammation in IBD and in the development of CAC is not known. We have evaluated the frequency, phenotype, and functions of γδ T cells among tissue-infiltrating lymphocytes in healthy donors and IBD and CAC patients. Results show that Vδ1 T cells are the dominant γδ T-cell population in healthy tissue, whereas Vδ2 T significantly abound in chronic IBD. Vδ2 T cells produce more IFN-γ, TNF-α, and IL-17 than Vδ1 T cells in chronic inflamed IBD. In CAC patients no significant cytokine production was detected in tissue-resident Vδ1 T cells, but Vδ2 T cells produced remarkable amounts of IFN-γ and TNF-α; these data were confirmed by the analysis of an independent cohort of IBD transcriptomes. Moreover, transcriptomes of IBD patients revealed a clear-cut clusterization of genes related with the maintenance of the inflammatory status. In conclusion, our results demonstrating that Vδ2 T cells have a proinflammatory profile in chronic IBD are suggestive of their participation in IBD and CAC pathogenesis.
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Affiliation(s)
- Elena Lo Presti
- Central Laboratory of Advanced Diagnosis and Biomedical Research (CLADIBIOR), University of Palermo, Palermo, Italy.,Department of Biomedicine, Neurosciences and Advanced Diagnosis (BIND), University of Palermo, Palermo, Italy
| | - Filippo Mocciaro
- Gastroenterology and Endoscopy Unit, Arnas Civico Di Cristina Benfratelli Hospital, Palermo, Italy
| | - Roberto Di Mitri
- Gastroenterology and Endoscopy Unit, Arnas Civico Di Cristina Benfratelli Hospital, Palermo, Italy
| | - Anna Maria Corsale
- Central Laboratory of Advanced Diagnosis and Biomedical Research (CLADIBIOR), University of Palermo, Palermo, Italy.,Department of Biomedicine, Neurosciences and Advanced Diagnosis (BIND), University of Palermo, Palermo, Italy
| | - Marta Di Simone
- Central Laboratory of Advanced Diagnosis and Biomedical Research (CLADIBIOR), University of Palermo, Palermo, Italy.,Department of Biomedicine, Neurosciences and Advanced Diagnosis (BIND), University of Palermo, Palermo, Italy
| | - Salvatore Vieni
- Department of Surgical, Oncological and Stomatological Sciences, University of Palermo, Palermo, Italy
| | - Nunzia Scibetta
- Anatomopathology Unit, Arnas Civico Di Cristina Benfratelli Hospital, Palermo, Italy
| | - Elettra Unti
- Anatomopathology Unit, Arnas Civico Di Cristina Benfratelli Hospital, Palermo, Italy
| | - Francesco Dieli
- Central Laboratory of Advanced Diagnosis and Biomedical Research (CLADIBIOR), University of Palermo, Palermo, Italy.,Department of Biomedicine, Neurosciences and Advanced Diagnosis (BIND), University of Palermo, Palermo, Italy
| | - Serena Meraviglia
- Central Laboratory of Advanced Diagnosis and Biomedical Research (CLADIBIOR), University of Palermo, Palermo, Italy.,Department of Biomedicine, Neurosciences and Advanced Diagnosis (BIND), University of Palermo, Palermo, Italy
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20
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Murugaiah V, Agostinis C, Varghese PM, Belmonte B, Vieni S, Alaql FA, Alrokayan SH, Khan HA, Kaur A, Roberts T, Madan T, Bulla R, Kishore U. Hyaluronic Acid Present in the Tumor Microenvironment Can Negate the Pro-apototic Effect of a Recombinant Fragment of Human Surfactant Protein D on Breast Cancer Cells. Front Immunol 2020; 11:1171. [PMID: 32733438 PMCID: PMC7360846 DOI: 10.3389/fimmu.2020.01171] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 05/12/2020] [Indexed: 02/05/2023] Open
Abstract
Human surfactant protein D (SP-D) belongs to the family of collectins that is composed of a characteristic amino-terminal collagenous region and a carboxy-terminal C-type lectin domain. Being present at the mucosal surfaces, SP-D acts as a potent innate immune molecule and offers protection against non-self and altered self, such as pathogens, allergens, and tumor. Here, we examined the effect of a recombinant fragment of human SP-D (rfhSP-D) on a range of breast cancer lines. Breast cancer has four molecular subtypes characterized by varied expressions of estrogen (ER), progesterone (PR), and epidermal growth factor (EGF) receptors (HER2). The cell viability of HER2-overexpressing (SKBR3) and triple-positive (BT474) breast cancer cell lines [but not of a triple-negative cell line (BT20)] was reduced following rfhSP-D treatment at 24 h. Upregulation of p21/p27 cell cycle inhibitors and p53 phosphorylation (Ser15) in rfhSP-D-treated BT474 and SKBR3 cell lines signified G2/M cell cycle arrest. Cleaved caspases 9 and 3 were detected in rfhSP-D-treated BT474 and SKBR3 cells, suggesting an involvement of the intrinsic apoptosis pathway. However, rfhSP-D-induced apoptosis was nullified in the presence of hyaluronic acid (HA) whose increased level in breast tumor microenvironment is associated with malignant tumor progression and invasion. rfhSP-D bound to solid-phase HA and promoted tumor cell proliferation. rfhSP-D-treated SKBR3 cells in the presence of HA showed decreased transcriptional levels of p53 when compared to cells treated with rfhSP-D only. Thus, HA appears to negate the anti-tumorigenic properties of rfhSP-D against HER2-overexpressing and triple-positive breast cancer cells.
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Affiliation(s)
- Valarmathy Murugaiah
- Biosciences, College of Health and Life Sciences, Brunel University London, Uxbridge, United Kingdom
| | - Chiara Agostinis
- Institute for Maternal and Child Health, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Burlo Garofolo, Trieste, Italy
| | - Praveen M. Varghese
- Biosciences, College of Health and Life Sciences, Brunel University London, Uxbridge, United Kingdom
- School of Biosciences and Technology, Vellore Institute of Technology, Vellore, India
| | - Beatrice Belmonte
- Tumor Immunology Unit, Human Pathology Section, Department of Health Sciences, University of Palermo, Palermo, Italy
| | - Salvatore Vieni
- Division of General and Oncological Surgery, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Fanan A. Alaql
- Biosciences, College of Health and Life Sciences, Brunel University London, Uxbridge, United Kingdom
| | - Salman H. Alrokayan
- Department of Biochemistry, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Haseeb A. Khan
- Department of Biochemistry, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Anuvinder Kaur
- Biosciences, College of Health and Life Sciences, Brunel University London, Uxbridge, United Kingdom
| | - Terry Roberts
- Biosciences, College of Health and Life Sciences, Brunel University London, Uxbridge, United Kingdom
| | - Taruna Madan
- Department of Innate Immunity, ICMR—National Institute for Research in Reproductive Health, Mumbai, India
| | - Roberta Bulla
- Department of Life Sciences, University of Trieste, Trieste, Italy
- *Correspondence: Roberta Bulla
| | - Uday Kishore
- Biosciences, College of Health and Life Sciences, Brunel University London, Uxbridge, United Kingdom
- Uday Kishore ;
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21
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Incorvaia L, Fanale D, Badalamenti G, Barraco N, Bono M, Corsini LR, Galvano A, Gristina V, Listì A, Vieni S, Gori S, Bazan V, Russo A. Programmed Death Ligand 1 (PD-L1) as a Predictive Biomarker for Pembrolizumab Therapy in Patients with Advanced Non-Small-Cell Lung Cancer (NSCLC). Adv Ther 2019; 36:2600-2617. [PMID: 31432460 PMCID: PMC6822831 DOI: 10.1007/s12325-019-01057-7] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Indexed: 12/11/2022]
Abstract
Recently, immunotherapy has been shown to be an effective and helpful therapeutic option for the treatment of advanced non-small-cell lung cancer (NSCLC). The activity of antitumor T cells may be restored through the checkpoint blockade using anti-programmed death 1 or anti-programmed death ligand 1 (PD-L1) antibodies, showing, in several cancer patients, an increased progression-free survival and overall survival compared with classical chemotherapy. As recently shown by several studies, the PD-L1 expression levels in tumors may offer a selection criterion for patients to predict their immunotherapy response. In particular, NSCLC patients with high tumor PD-L1 levels (proportional score ≥ 50% for first-line therapy and ≥ 1% for second-line treatment, respectively) showed better response rates to immunotherapy and longer survival in first-line therapy compared with conventional chemotherapy. PD-L1, whose expression is evaluated by using immunohistochemistry analysis, is currently the only biomarker approved for clinical use in the first- and second-line monotherapy setting and therefore plays a central role in treatment decision-making for patients with advanced NSCLC. In this review we will discuss the key role of PD-L1 as a predictive biomarker of response to pembrolizumab therapy in NSCLC patients by describing the appropriate techniques and methodologies for immunohistochemical evaluation of PD-L1 expression and providing an overview of the clinical studies supporting its predictive significance.
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Affiliation(s)
- Lorena Incorvaia
- Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Daniele Fanale
- Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Giuseppe Badalamenti
- Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Nadia Barraco
- Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Marco Bono
- Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Lidia Rita Corsini
- Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Antonio Galvano
- Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Valerio Gristina
- Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Angela Listì
- Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Salvatore Vieni
- Division of General and Oncological Surgery, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Stefania Gori
- Department of Oncology, IRCCS Ospedale Sacro Cuore-Don Calabria, Negrar, Verona, Italy
- Italian Association of Medical Oncology (AIOM), Bergamo, Italy
| | - Viviana Bazan
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Antonio Russo
- Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy.
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D'Arpa S, Pignatti M, Vieni S, Muradov M, Blondeel P, Cordova A. The Thin bilateral and bipedicled DIEAP flap for axillary reconstruction in hidradenitis suppurativa. HANDCHIR MIKROCHIR P 2019; 51:469-476. [PMID: 31307106 DOI: 10.1055/a-0881-9646] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
INTRODUCTION Reconstruction after resection of advanced stage hidradenitis suppurativa is currently performed with pedicled perforator flaps, that allow functional reconstruction and preservation of shoulder function. Skin availability is limited by the possibility of closing the donor site primarily. Bilateral cases need to be treated in two stages, since the operation is carried out in the lateral decubitus. In this manuscript the application of bilateral and bipedicled DIEAP flaps to bilateral and extensive cases is presented. PATIENTS AND METHODS Between October 2008 and October 2018, 39 patients were treated for axillary hidradenitis suppurativa. Of these, 11 patients had bilateral reconstruction with bilateral DIEAP flaps (22 flaps) and one patient had unilateral reconstruction with a bipedicled DIEAP flap. 23 flaps were used. Twelve flaps were raised above Scarpa's fascia, 6 flaps werethinned after dissection. Three flaps were not thinned in the first stage. Average flap size was 14 × 17cm for the bilateral flaps, while the bipedicled flap was 15 × 32cm. RESULTS Average operative time was 324 minutes. No flap necrosis was observed. Two patients had wound dehiscences in the axilla and one in the abdomen, all treated conservatively. One patient had a pyoderma gangrenosum at both surgical sites that healed after cortisone therapy. No revisions were needed for the flaps that were thinned during the primary operation. The three patients whose flaps where not thinned needed liposuction after three months for thinning. There was one disease recurrence, unilateral and treated surgically. Mean follow up was 64 months. CONCLUSIONS Axillary reconstruction with the DIEAP flap allows reconstruction of large and bilateral defect in a single operation closing the donor site primarily. If the flap is thinned during the operation, no thinning seems to be needed postoperatively. Otherwise the flap shall be thinned by liposuction three months after the initial procedure. We believe that the benefits of this technique outweigh the added complexity of a microsurgical procedure when bilateral resections are needed, the defects are too wide to close the donor site of a pedicled flap primarily and the lower abdomen is free of disease.
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Affiliation(s)
- Salvatore D'Arpa
- Gent University Hospital, Department of Plastic and Reconstructive Surgery, Gent, Belgium Università degli Studi di Palermo, Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), Plastic and Reconstructive Surgery, Palermo, Italy
| | - Marco Pignatti
- Azienda Ospedaliera Universitaria Policlinico di Modena, Chirurgia Plastica, Modena, Italy
| | - Salvatore Vieni
- Università degli Studi di Palermo, Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), Plastic and Reconstructive Surgery, Palermo, Italy
| | - Mismil Muradov
- Syzganov National Scientific Center of Surgery, Plastic Surgery, Almaty, Kazakhstan
| | - Phillip Blondeel
- Gent University Hospital, Department of Plastic and Reconstructive Surgery, Gent, Belgium
| | - Adriana Cordova
- Università degli Studi di Palermo, Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), Plastic and Reconstructive Surgery, Palermo, Italy
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Taormina G, Ferrante F, Vieni S, Grassi N, Russo A, Mirisola MG. Longevity: Lesson from Model Organisms. Genes (Basel) 2019; 10:genes10070518. [PMID: 31324014 PMCID: PMC6678192 DOI: 10.3390/genes10070518] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 07/01/2019] [Accepted: 07/02/2019] [Indexed: 12/31/2022] Open
Abstract
Research on longevity and healthy aging promises to increase our lifespan and decrease the burden of degenerative diseases with important social and economic effects. Many aging theories have been proposed, and important aging pathways have been discovered. Model organisms have had a crucial role in this process because of their short lifespan, cheap maintenance, and manipulation possibilities. Yeasts, worms, fruit flies, or mammalian models such as mice, monkeys, and recently, dogs, have helped shed light on aging processes. Genes and molecular mechanisms that were found to be critical in simple eukaryotic cells and species have been confirmed in humans mainly by the functional analysis of mammalian orthologues. Here, we review conserved aging mechanisms discovered in different model systems that are implicated in human longevity as well and that could be the target of anti-aging interventions in human.
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Affiliation(s)
- Giusi Taormina
- Dipartimento di Discipline Chirurgiche, Oncologiche e Stomatologiche, Università di Palermo, Via del Vespro 129, 90100 Palermo, Italy
| | - Federica Ferrante
- Dipartimento di Discipline Chirurgiche, Oncologiche e Stomatologiche, Università di Palermo, Via del Vespro 129, 90100 Palermo, Italy
| | - Salvatore Vieni
- Dipartimento di Discipline Chirurgiche, Oncologiche e Stomatologiche, Università di Palermo, Via del Vespro 129, 90100 Palermo, Italy
| | - Nello Grassi
- Dipartimento di Discipline Chirurgiche, Oncologiche e Stomatologiche, Università di Palermo, Via del Vespro 129, 90100 Palermo, Italy
| | - Antonio Russo
- Dipartimento di Discipline Chirurgiche, Oncologiche e Stomatologiche, Università di Palermo, Via del Vespro 129, 90100 Palermo, Italy
| | - Mario G Mirisola
- Dipartimento di Discipline Chirurgiche, Oncologiche e Stomatologiche, Università di Palermo, Via del Vespro 129, 90100 Palermo, Italy.
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Vernuccio F, Bruno A, Costanzo V, Bartolotta TV, Vieni S, Midiri M, Salvaggio G, Brancatelli G. Comparison of the Enhancement Pattern of Hepatic Hemangioma on Magnetic Resonance Imaging Performed With Gd-EOB-DTPA Versus Gd-BOPTA. Curr Probl Diagn Radiol 2019; 49:398-403. [PMID: 31253462 DOI: 10.1067/j.cpradiol.2019.06.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 05/21/2019] [Accepted: 06/03/2019] [Indexed: 12/13/2022]
Abstract
PURPOSE To compare magnetic resonance imaging (MRI) findings with gadoxetic acid and gadobenate dimeglumine for the diagnosis of hepatic hemangiomas. MATERIALS AND METHODS In this retrospective study, we included 26 hemangiomas (mean size was 14 mm ± 10 mm) in 19 patients (mean age 60 ± 14 years) scanned with both gadobenate dimeglumine MRI and gadoxetic acid MRI. For each patient, we collected multiple lesion variables including location, number, size and enhancement pattern on arterial, portal venous, 3-minute and hepatobiliary phases with both gadoxetic acid and gadobenate dimeglumine. The enhancement pattern with the two contrast agents was then compared. RESULTS The typical enhancement pattern of hepatic hemangiomas was more common-though not statistically significant-with gadobenate dimeglumine compared to gadoxetic acid (57% [15 of 26] vs 42% [11 of 26], respectively; P = 0.4057 for both peripheral globular discontinuous enhancement in the arterial phase and centripetal fill-in in the portal venous phase). A significantly higher number of hemangiomas showed centripetal fill-in or hyperintensity in the 3-minute phase with gadobenate dimeglumine compared to gadoxetic acid (88% [23 of 26) vs 58% [15 of 26]; P = 0.0266). A pseudo washout sign in the 3-minute phase was detected in one of the 5 flash-filling hemangiomas with gadoxetic acid, but not gadobenate dimeglumine. All hemangiomas were hypointense in the hepatobiliary phase with both gadobenate dimeglumine and gadoxetic acid. CONCLUSIONS The enhancement pattern of hepatic hemangiomas may vary depending on the hepatobiliary agent, with more frequent lack of the typical pattern with gadoxetic acid compared to gadobenate dimeglumine.
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Affiliation(s)
- Federica Vernuccio
- Dipartimento Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro", University Hospital of Palermo, Palermo, Italy; University Paris Diderot, Sorbonne Paris Cité, Paris, France; I.R.C.C.S. Centro Neurolesi Bonino Pulejo, Messina, Italy.
| | - Alberto Bruno
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica avanzata (BIND), University Hospital of Palermo, Palermo, Italy
| | - Vincenzo Costanzo
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica avanzata (BIND), University Hospital of Palermo, Palermo, Italy
| | - Tommaso Vincenzo Bartolotta
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica avanzata (BIND), University Hospital of Palermo, Palermo, Italy
| | - Salvatore Vieni
- Dipartimento di Discipline Chirurgiche, Oncologiche e Stomatologiche, University Hospital of Palermo, Palermo, Italy
| | - Massimo Midiri
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica avanzata (BIND), University Hospital of Palermo, Palermo, Italy
| | - Giuseppe Salvaggio
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica avanzata (BIND), University Hospital of Palermo, Palermo, Italy
| | - Giuseppe Brancatelli
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica avanzata (BIND), University Hospital of Palermo, Palermo, Italy
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Genova P, Cipolla C, Genova G, Graceffa G, Vieni S. What Is the Meaning of an Early Anastomotic Recurrence after Curative Right Hemicolectomy? A Synchronous, Metachronous, or What Else? Am Surg 2019; 85:e300-e302. [PMID: 31267920] [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: 06/09/2023]
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Cipolla C, Graceffa G, Calamia S, Fiorentino E, Pantuso G, Vieni S, Latteri M. The value of total thyroidectomy as the definitive treatment for Graves' disease: A single centre experience of 594 cases. J Clin Transl Endocrinol 2019; 16:100183. [PMID: 30815364 PMCID: PMC6377402 DOI: 10.1016/j.jcte.2019.100183] [Citation(s) in RCA: 5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 01/30/2019] [Accepted: 02/07/2019] [Indexed: 02/06/2023] Open
Abstract
PURPOSE Thyroidectomy is the preferred approach as the definitive treatment for Graves' disease. The outcomes for total thyroidectomy in a large series of 594 patients, who were observed in the last decade, will be presented in this study. METHODS The study concerned a retrospective review of 594 patients, undergoing a total thyroidectomy for Graves' disease. The incidence of complications and outcomes on hyperthyroidism and correlated symptoms resolution were also evaluated. RESULTS The mean age of the patients was of 44.7 ± 12.7 years and 456 patients (76.7%) were females. The mean gland weight was 67.3 ± 10.8 g (range: 20-350 g) and, in 397 patients (66.8%), the gland weighed >40 g. The mean operative time was 125 ± 23.1 min (range: 65-212 min). Temporary and permanent hypocalcaemia developed in 241 (40.6%) and 3 patients (0.5%), respectively. Temporary and permanent recurrent laryngeal nerve palsy were recorded in 31 (5.2%) and 1 patients (0.16%) respectively. No patient developed a thyroid storm. On multivariate analysis, patient age ≤50 years (Odds ratio: 1; 95% Confidence Interval: 0.843-0.901) and thyroid weight >40 g (Odds ratio: 1; 95%, Confidence Interval: 0.852-0.974), were mainly associated with the occurrence of complications. CONCLUSION This high-volume surgeon experience demonstrates that total thyroidectomy is a safe and effective treatment for Graves' disease. It is associated with a very low incidence rate of post-operative complications, most of which are transitory; therefore, it offers a rapid and definitive control of hyperthyroidism and its related symptoms.
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Affiliation(s)
- Calogero Cipolla
- University of Palermo, Department of Surgical Oncological and Oral Sciences, Division of General and Oncological Surgery, Palermo, Italy
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27
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Genova P, Cipolla C, Genova G, Graceffa G, Vieni S. What is the Meaning of an Early Anastomotic Recurrence after Curative Right Hemicolectomy? A Synchronous, Metachronous, or What Else? Am Surg 2019. [DOI: 10.1177/000313481908500611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Pietro Genova
- Department of Surgical Oncological and Oral Sciences University of Palermo Palermo, Italy
| | - Calogero Cipolla
- Department of Surgical Oncological and Oral Sciences University of Palermo Palermo, Italy
| | - Gaspare Genova
- Department of Surgical Oncological and Oral Sciences University of Palermo Palermo, Italy
| | - Giuseppa Graceffa
- Department of Surgical Oncological and Oral Sciences University of Palermo Palermo, Italy
| | - Salvatore Vieni
- Department of Surgical Oncological and Oral Sciences University of Palermo Palermo, Italy
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Graceffa G, Patrone R, Vieni S, Campanella S, Calamia S, Laise I, Conzo G, Latteri M, Cipolla C. Association between Hashimoto's thyroiditis and papillary thyroid carcinoma: a retrospective analysis of 305 patients. BMC Endocr Disord 2019; 19:26. [PMID: 31142293 PMCID: PMC6541562 DOI: 10.1186/s12902-019-0351-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Accepted: 02/15/2019] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND The association between Hashimoto's thyroiditis (HT) and papillary thyroid carcinoma (PTC) is a controversial question that is still under debate, its pathological significance and the eventual clinical implications of this association remaining unclear. METHODS The data regarding 305 patients were retrospectively analyzed. The patients were divided in two different groups. A first group made up of 142 patients undergoing surgery for differentiated thyroid carcinoma was compared to a control group of 142 analogous subjects operated for normofunctioning goiter. A second group was made up of 163 patients who had undergone total thyroidectomy (TT) with pre-operative diagnosis of HT. RESULTS In the first group of patients an association with HT was found in 28,6% of the patients with final histopathological diagnosis of PTC versus 7,7% of the patients with histopathological diagnosis of multinodular goiter, which was a significant difference (p < 0.001). In the second group, the association with PTC was found in 43 (40,2%) cases of HT nodular variant and in 3 cases (8,1%) of HT diffuse variant (p < 0.001). CONCLUSIONS The relationship between HT and PTC is still far from clear and represents an unresolved issue. Our own study has underlined the frequent coexistence of these two pathologies, an aspect not to be neglected in clinical practice. Patients receiving HT diagnosis should undergo careful follow-up and, especially those with the nodular variant, should undergo a frequent both clinical and cytological evaluation of the nodular lesions, taking always into great consideration the surgical approach of total thyroidectomy.
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Affiliation(s)
- Giuseppa Graceffa
- Department of Surgical Oncological and Oral Sciences, University of Palermo, Via del Vespro, 129 90127 Palermo, Italy
| | - Renato Patrone
- Division of General and Oncologic Surgery - Department of Cardiothoracic Sciences, University of Campania “Luigi Vanvitelli”, Via Pansini 5, 80131 Naples, Italy
| | - Salvatore Vieni
- Department of Surgical Oncological and Oral Sciences, University of Palermo, Via del Vespro, 129 90127 Palermo, Italy
| | - Silvia Campanella
- Department of Surgical Oncological and Oral Sciences, University of Palermo, Via del Vespro, 129 90127 Palermo, Italy
| | - Sergio Calamia
- Department of Surgical Oncological and Oral Sciences, University of Palermo, Via del Vespro, 129 90127 Palermo, Italy
| | - Iole Laise
- Department of Surgical Oncological and Oral Sciences, University of Palermo, Via del Vespro, 129 90127 Palermo, Italy
| | - Giovanni Conzo
- Division of General and Oncologic Surgery - Department of Cardiothoracic Sciences, University of Campania “Luigi Vanvitelli”, Via Pansini 5, 80131 Naples, Italy
| | - Mario Latteri
- Department of Surgical Oncological and Oral Sciences, University of Palermo, Via del Vespro, 129 90127 Palermo, Italy
| | - Calogero Cipolla
- Department of Surgical Oncological and Oral Sciences, University of Palermo, Via del Vespro, 129 90127 Palermo, Italy
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Vieni S, Graceffa G, Rizzo GEM, Latteri F, Latteri MA, Cipolla C. An evaluation score of the difficulty of thyroidectomy considering operating time and preservation of recurrent laryngeal nerve. Updates Surg 2018; 71:569-577. [DOI: 10.1007/s13304-018-0604-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 11/08/2018] [Indexed: 12/20/2022]
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30
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Vieni S, Graceffa G, Priola R, Fricano M, Latteri S, Latteri MA, Cipolla C. Ultrasound-Guided Breast-Conservative Surgery Decreases the Rate of Reoperations for Palpable Breast Cancer. Am Surg 2018. [DOI: 10.1177/000313481808400663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this study is to verify whether the performance of ultrasound-guided quadrantectomy (USGQ) versus palpation-guided quadrantectomy (PGQ) can reduce the incidence of positive margins and if it can change the attitude of the surgeon. A retrospective study was conducted on 842 patients underwent quadrantectomy for breast cancer, 332 of them underwent USGQ, whereas 550 underwent PGQ. The histological type of the tumors and the margin status obtained with the histological examination were compared. The histological examination of the surgical specimen showed involvement of the margins in 24/842 patients (2.85%), 22 (2.61%) of them belonged to the PGQ group, and two to the USGQ group (P = 0.0011). The highest rate of microscopically positive margins was, statistically significant, for carcinoma in situ, when compared with patients with invasive carcinoma (0.0001). USGQ technique showed several advantages compared with PGQ. In fact, the former notes a lower positive margin rate and, consequently, a lower rate of reintervention. In addition, it may change the surgeon's attitude by causing him to remove another slice of margin to ensure more histological negativity. It should be the gold standard technique for breast-conservative surgery of palpable tumors.
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Affiliation(s)
- Salvatore Vieni
- From the Department of Surgical Oncological and Oral Sciences, Division of General and Oncological Surgery, University of Palermo, Palermo, Italy
| | - Giuseppa Graceffa
- From the Department of Surgical Oncological and Oral Sciences, Division of General and Oncological Surgery, University of Palermo, Palermo, Italy
| | - Roberta Priola
- From the Department of Surgical Oncological and Oral Sciences, Division of General and Oncological Surgery, University of Palermo, Palermo, Italy
| | - Martina Fricano
- From the Department of Surgical Oncological and Oral Sciences, Division of General and Oncological Surgery, University of Palermo, Palermo, Italy
| | - Stefania Latteri
- From the Department of Surgical Oncological and Oral Sciences, Division of General and Oncological Surgery, University of Palermo, Palermo, Italy
| | - Mario A. Latteri
- From the Department of Surgical Oncological and Oral Sciences, Division of General and Oncological Surgery, University of Palermo, Palermo, Italy
| | - Calogero Cipolla
- From the Department of Surgical Oncological and Oral Sciences, Division of General and Oncological Surgery, University of Palermo, Palermo, Italy
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Vieni S, Graceffa G, Priola R, Fricano M, Latteri S, Latteri MA, Cipolla C. Ultrasound-Guided Breast-Conservative Surgery Decreases the Rate of Reoperations for Palpable Breast Cancer. Am Surg 2018; 84:1043-1048. [PMID: 29981646] [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: 06/08/2023]
Abstract
The purpose of this study is to verify whether the performance of ultrasound-guided quadrantectomy (USGQ) versus palpation-guided quadrantectomy (PGQ) can reduce the incidence of positive margins and if it can change the attitude of the surgeon. A retrospective study was conducted on 842 patients underwent quadrantectomy for breast cancer, 332 of them underwent USGQ, whereas 550 underwent PGQ. The histological type of the tumors and the margin status obtained with the histological examination were compared. The histological examination of the surgical specimen showed involvement of the margins in 24/842 patients (2.85%), 22 (2.61%) of them belonged to the PGQ group, and two to the USGQ group (P = 0.0011). The highest rate of microscopically positive margins was, statistically significant, for carcinoma in situ, when compared with patients with invasive carcinoma (0.0001). USGQ technique showed several advantages compared with PGQ. In fact, the former notes a lower positive margin rate and, consequently, a lower rate of reintervention. In addition, it may change the surgeon's attitude by causing him to remove another slice of margin to ensure more histological negativity. It should be the gold standard technique for breast-conservative surgery of palpable tumors.
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Cipolla C, Fulfaro F, Sandonato L, Fricano S, Pantuso G, Grassi N, Vieni S, Valerio MR, Lo Dico R, Gebbia N, Latteri MA. Clinical Presentation and Treatment of Gastrointestinal Stromal Tumors. Tumori 2018; 92:279-84. [PMID: 17036516 DOI: 10.1177/030089160609200403] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Aims and background Gastrointestinal stromal tumors (GISTs), although rare, are the most common mesenchymal neoplasms affecting the gastrointestinal tract. We present our experience in the treatment of localized and metastatic disease and a review of literature. Patients and methods Nine patients were observed from April 2002 to July 2004. Eight tumors were in the gastric area and J was in the small bowel. In 5 cases, complete surgical removal was performed, and none of these patients underwent adjuvant therapy. The remaining 4 cases, with locally advanced or recurrent disease, were treated with imatinib. Results The patients with localized disease treated only by surgery did not relapse. In the patients with locally advanced or metastatic disease treated by imatinib, we observed 3 partial responses, and one case was not assessable because he had no measurable disease. In 2 of 3 responders, it was possible to perform a new radical surgery. Conclusions Our series is too small to draw any conclusion. According to our review of the literature, surgery remains the standard treatment for non-metastatic GISTs. Imatinib mesylate represents a major breakthrough in the treatment of advanced GISTs and is the first effective systemic therapy for the disease.
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Affiliation(s)
- Calogero Cipolla
- University of Palermo, Department of Oncology, Division of General and Oncological Surgery, Italy.
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Cipolla C, Graceffa G, Calamia S, Latteri S, Marino MV, Latteri M, Vieni S. Completion axillary lymph node dissection can be avoid in patients with invasive breast cancer and sentinel lymph node micrometastases. Ann Ital Chir 2017; 6:S0003469X17027804. [PMID: 29134954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND The prognostic value of sentinel lymph node (SLN) micrometastases in invasive breast cancer patients is still widely debated. Even if, in the absence of unequivocal guidelines, the axillary lynphadenectomy is not still performed in the routine clinical care of these patients. MATERIALS AND METHOD We have retrospectively analyzed 897 patients with operable invasive breast cancer and clinically negative axillary lymph nodes underwent conservative surgery or total mastectomy with SLN biopsy. Two groups of patients with SLN micrometastases and isolated tumor cells (ITC) were considered, the first one treated with completion axillary dissection, the second one not followed by further surgical axillary procedure. The incidence of axillary recurrences has BEEN evaluated in both groups and only in the first group of patients the involvement of the remaining lymph nodes was analyzed. RESULTS Micrometastases were found in 67 (7.4%) patients and ITC in 8 (0,9%) patients. 14 (20.9%) patients with micrometastases and 1 (12.5%) patient with ITC underwent completion axillary dissection. 53 (79.1%) patients with micrometastases and 7 (87.5%) with ITC didn't receive further surgical axillary procedure. No axillary recurrences were found during a median follow up of 65.7±8.69 months in both groups of patients. CONCLUSIONS Based on the results and according to some recent randomized trials we can say that completion axillary dissection can be safely avoided when micrometastases are found in sentinel lymph nodes. It should be performed anyway, depending on the analysis of the biomedical profile of the tumor. KEY WORDS Breast Carcinoma, Micrometastases Axillary Lymphonode Dissection, Sentinel Lymphonode.
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34
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Meraviglia S, Lo Presti E, Tosolini M, La Mendola C, Orlando V, Todaro M, Catalano V, Stassi G, Cicero G, Vieni S, Fourniè JJ, Dieli F. Distinctive features of tumor-infiltrating γδ T lymphocytes in human colorectal cancer. Oncoimmunology 2017; 6:e1347742. [PMID: 29123962 DOI: 10.1080/2162402x.2017.1347742] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 06/14/2017] [Accepted: 06/22/2017] [Indexed: 12/31/2022] Open
Abstract
γδ T cells usually infiltrate many different types of cancer, but it is unclear whether they inhibit or promote tumor progression. Moreover, properties of tumor-infiltrating γδ T cells and those in the corresponding normal tissue remain largely unknown. Here we have studied features of γδ T cells in colorectal cancer, normal colon tissue and peripheral blood, and correlated their levels with clinicopathologic hallmarks. Flow cytometry and transcriptome analyses showed that the tumor comprised a highly variable rate of TILs (5-90%) and 4% γδ T cells on average, with the majority expressing Vδ1. Most Vδ1 and Vδ2 T cells showed a predominant effector memory phenotype and had reduced production of IFN- γ which was likely due to yet unidentified inhibitory molecules present in cancer stem cell secretome. Transcriptome analyses revealed that patients containing abundant γδ T cells had significantly longer 5-year disease free survival rate, suggesting their efficacy in controlling tumor at very early stage.
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Affiliation(s)
- S Meraviglia
- Central Laboratory of Advanced Diagnosis and Biomedical Research (CLADIBIOR), University of Palermo, Palermo, Italy.,Department of Biopathology and Medical Biotechnologies (DIBIMED), University of Palermo, Palermo, Italy
| | - E Lo Presti
- Central Laboratory of Advanced Diagnosis and Biomedical Research (CLADIBIOR), University of Palermo, Palermo, Italy.,Department of Biopathology and Medical Biotechnologies (DIBIMED), University of Palermo, Palermo, Italy
| | - M Tosolini
- Centre de Recherches en Cancérologie de Toulouse (CRCT), Toulouse, France
| | - C La Mendola
- Central Laboratory of Advanced Diagnosis and Biomedical Research (CLADIBIOR), University of Palermo, Palermo, Italy.,Department of Biopathology and Medical Biotechnologies (DIBIMED), University of Palermo, Palermo, Italy
| | - V Orlando
- Central Laboratory of Advanced Diagnosis and Biomedical Research (CLADIBIOR), University of Palermo, Palermo, Italy.,Department of Biopathology and Medical Biotechnologies (DIBIMED), University of Palermo, Palermo, Italy
| | - M Todaro
- Central Laboratory of Advanced Diagnosis and Biomedical Research (CLADIBIOR), University of Palermo, Palermo, Italy.,Department of Medicine, University of Palermo, Palermo, Italy
| | - V Catalano
- Central Laboratory of Advanced Diagnosis and Biomedical Research (CLADIBIOR), University of Palermo, Palermo, Italy
| | - G Stassi
- Department of Surgical and Oncological Sciences, University of Palermo, Palermo, Italy
| | - G Cicero
- Department of Surgical and Oncological Sciences, University of Palermo, Palermo, Italy
| | - S Vieni
- Department of Surgical and Oncological Sciences, University of Palermo, Palermo, Italy
| | - J J Fourniè
- Centre de Recherches en Cancérologie de Toulouse (CRCT), Toulouse, France
| | - F Dieli
- Central Laboratory of Advanced Diagnosis and Biomedical Research (CLADIBIOR), University of Palermo, Palermo, Italy.,Department of Biopathology and Medical Biotechnologies (DIBIMED), University of Palermo, Palermo, Italy
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Gaggianesi M, Turdo A, Chinnici A, Lipari E, Apuzzo T, Benfante A, Sperduti I, Di Franco S, Meraviglia S, Lo Presti E, Dieli F, Caputo V, Militello G, Vieni S, Stassi G, Todaro M. IL4 Primes the Dynamics of Breast Cancer Progression via DUSP4 Inhibition. Cancer Res 2017; 77:3268-3279. [PMID: 28400477 DOI: 10.1158/0008-5472.can-16-3126] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 03/02/2017] [Accepted: 04/07/2017] [Indexed: 11/16/2022]
Abstract
The tumor microenvironment supplies proinflammatory cytokines favoring a permissive milieu for cancer cell growth and invasive behavior. Here we show how breast cancer progression is facilitated by IL4 secreted by adipose tissue and estrogen receptor-positive and triple-negative breast cancer cell types. Blocking autocrine and paracrine IL4 signaling with the IL4Rα antagonist IL4DM compromised breast cancer cell proliferation, invasion, and tumor growth by downregulating MAPK pathway activity. IL4DM reduced numbers of CD44+/CD24- cancer stem-like cells and elevated expression of the dual specificity phosphatase DUSP4 by inhibiting NF-κB. Enforced expression of DUSP4 drove conversion of metastatic cells to nonmetastatic cells. Mechanistically, RNAi-mediated attenuation of DUSP4 activated the ERK and p38 MAPK pathways, increased stem-like properties, and spawned metastatic capacity. Targeting IL4 signaling sensitized breast cancer cells to anticancer therapy and strengthened immune responses by enhancing the number of IFNγ-positive CTLs. Our results showed the role of IL4 in promoting breast cancer aggressiveness and how its targeting may improve the efficacy of current therapies. Cancer Res; 77(12); 3268-79. ©2017 AACR.
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Affiliation(s)
- Miriam Gaggianesi
- Department of Surgical, Oncological and Stomatological Sciences, University of Palermo, Palermo, Italy
| | - Alice Turdo
- Department of Surgical, Oncological and Stomatological Sciences, University of Palermo, Palermo, Italy
| | - Aurora Chinnici
- Department of Surgical, Oncological and Stomatological Sciences, University of Palermo, Palermo, Italy
| | - Elisa Lipari
- Department of Surgical, Oncological and Stomatological Sciences, University of Palermo, Palermo, Italy
| | - Tiziana Apuzzo
- Department of Surgical, Oncological and Stomatological Sciences, University of Palermo, Palermo, Italy
| | - Antonina Benfante
- Department of Surgical, Oncological and Stomatological Sciences, University of Palermo, Palermo, Italy
| | | | - Simone Di Franco
- Department of Surgical, Oncological and Stomatological Sciences, University of Palermo, Palermo, Italy
| | - Serena Meraviglia
- Central Laboratory of Advanced Diagnosis and Biomedical Research (CLADIBIOR), University of Palermo, Palermo, Italy
- Department of Biopathology and Biomedical Methodologies, University of Palermo, Palermo, Italy
| | - Elena Lo Presti
- Central Laboratory of Advanced Diagnosis and Biomedical Research (CLADIBIOR), University of Palermo, Palermo, Italy
| | - Francesco Dieli
- Central Laboratory of Advanced Diagnosis and Biomedical Research (CLADIBIOR), University of Palermo, Palermo, Italy
- Department of Biopathology and Biomedical Methodologies, University of Palermo, Palermo, Italy
| | | | - Gabriella Militello
- Department of Emergency, General Surgery and Organ Transplants, University of Palermo, Palermo, Italy
| | - Salvatore Vieni
- Department of Surgical, Oncological and Stomatological Sciences, University of Palermo, Palermo, Italy
| | - Giorgio Stassi
- Department of Surgical, Oncological and Stomatological Sciences, University of Palermo, Palermo, Italy
| | - Matilde Todaro
- Central Laboratory of Advanced Diagnosis and Biomedical Research (CLADIBIOR), University of Palermo, Palermo, Italy.
- Department of DIBIMIS, University of Palermo, Palermo, Italy
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Locurto P, Antona AD, Grillo A, Ciulla A, Martorana S, Cipolla C, Graceffa G, Vieni S. Primary neuroendocrine carcinoma of the breast A single Center experience and review of the literature. Ann Ital Chir 2016; 87:S2239253X1602658X. [PMID: 27905324] [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: 06/06/2023]
Abstract
UNLABELLED Neuroendocrine carcinoma of the breast is an extremely rare tumor. A standard treatment has yet to be established because only a few cases have been reported in literature. The authors report five cases observed from January 2007 to December 2014 and a review of literature. Four patients underwent quadrantectomy and in two cases axillary nodal dissection and only one to mastectomy with axillary nodal dissection. Tumor size was from T1 to T2 with N0 to N1, according TNM classification. Pathological specimens were stained with hematoxylin and eosin and an immunohistochemical panel of antibodies (Neuron-specific enolase, Chromogranin, Synaptophysin, Estrogen and Progesterone receptors, c-erb and Ki-67). All cases showed markers positivity to Neuron-specific enolase, Chromogranin, Synaptophysin and Estrogen and Progesterone receptors were found. Ki-67 was higher than 40% in four patients. Adjuvant chemotherapy was administrated in patients with Ki-67>10%; every patients were treated with radiotherapy and with hormonal therapy too. Although Neuroendocrine breast tumor is considered a distinct entity, the best treatment seems to be correlate to the size of tumor and to the lymph node status and to Ki-67 index like the common breast cancer. KEY WORDS Diagnosis, Neuroendocrine breast carcinoma.
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MESH Headings
- Aged
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biomarkers, Tumor/analysis
- Breast Neoplasms/chemistry
- Breast Neoplasms/diagnosis
- Breast Neoplasms/epidemiology
- Breast Neoplasms/therapy
- Carcinoma, Neuroendocrine/chemistry
- Carcinoma, Neuroendocrine/diagnosis
- Carcinoma, Neuroendocrine/epidemiology
- Carcinoma, Neuroendocrine/therapy
- Chemotherapy, Adjuvant
- Cisplatin/administration & dosage
- Combined Modality Therapy
- Estrogens
- Etoposide/administration & dosage
- Female
- Humans
- Mastectomy/methods
- Middle Aged
- Neoplasm Proteins/analysis
- Neoplasms, Hormone-Dependent/chemistry
- Neoplasms, Hormone-Dependent/diagnosis
- Neoplasms, Hormone-Dependent/epidemiology
- Neoplasms, Hormone-Dependent/therapy
- Progesterone
- Radiotherapy, Adjuvant
- Radiotherapy, High-Energy
- Receptors, Steroid/analysis
- Retrospective Studies
- Sentinel Lymph Node Biopsy
- Tamoxifen/administration & dosage
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Vieni S, Graceffa G, La Mendola R, Latteri S, Cordova A, Latteri MA, Cipolla C. Application of a predictive model of axillary lymph node status in patients with sentinel node metastasis from breast cancer. A retrospective cohort study. Int J Surg 2016; 35:58-63. [DOI: 10.1016/j.ijsu.2016.09.015] [Citation(s) in RCA: 3] [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] [Received: 06/07/2016] [Revised: 09/08/2016] [Accepted: 09/11/2016] [Indexed: 10/21/2022]
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Perez A, Castiglia M, Passiglia F, Barraco N, Cangemi A, Fanale D, Listì A, Maragliano R, Massihnia D, Di Piazza F, Vieni S, Calò V, Rizzo S, Incorvaia L, Bazan V, Russo A. The role of microRNAs in driving EGFR-TKI resistance in NSCLC cell lines. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw332.19] [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: 11/12/2022] Open
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Massihnia D, Bronte G, Castiglia M, Barraco N, Cangemi A, Perez A, Fanale D, Pantuso G, Vieni S, Calò V, Rolfo CD, Bazan V, Russo A. Abstract 1855: Role of mTOR inhibition in triple-negative breast cancer. Cancer Res 2016. [DOI: 10.1158/1538-7445.am2016-1855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
BACKGROUND:
Triple-negative breast cancers (TNBC) represent the 10-17% of all diagnosed breast cancers (BC) and are characterized by the absence of ER/PgR expression, HER2 amplification and often show a basal-like phenotype. TNBC are often diagnosed in patients with BRCA1 germline mutation and unfortunately treatment options are still limited. The mTOR (Mammalian Target Of Rapamycin) pathway seems to play an important role in BC pathogenesis and it is possible to target this pathway by inhibitors such as rapamycin. In human BC cross talk between ER/PgR receptors signaling and the mTOR pathway is believed to be responsible for resistance to hormone therapy probably due to a down regulation of hormone receptors. Based on these evidences we have hypothesized that the inhibitors of mTOR pathway may lead to the up-regulation of ER, PgR and HER2 in TNBC cell lines.
METHODS:
For this study we used TNBC cells (MDA-MB-231 and BT20) cultured in DMEM:F12 (Dulbecco's Modified Eagle's Medium) with 10% bovine serum (FBS), 100 U/mL penicillin (1%) and 50 mg/mL of streptomycin under standard conditions (37°C in an atmosphere composed of 16% O2, 79% N2 and 5% CO2).
Cells were initially treated with Rapamycin (1, 5, 10, 15 microM) for 24, 48, and 72h in order to verify if the drug determines a blockade of cell proliferation. Before drug administration, the cells were subjected to serum starvation by eliminating serum from culture medium. The evaluation of cell viability following the administration of the drug was carried out using the MTT assay. Real time PCR analyses were carried out in order to evaluate gene expression modifications of ER, PgR and HER2 receptors, through Taqman probe chemistry.
RESULTS:
The preliminary cell viability experiments conducted on different TNBC cell lines (MDA-MB-231 and BT20), showed no significant cytotoxic effects by increasing Rapamycin concentrations (1, 5 and 10 microM) after 72h treatment, except for the higher concentration (15 microM) for which a cytotoxic effect was observed.
The following qPCR approach highlighted significant variations in estrogen and progesterone receptor gene expression for the TNBC cell lines after 24, 48, 72h with 1, 5, 10 microM Rapamycin. In particular their expression level resulted up-regulated. Unlikely no association between mTOR inhibition and HER2 expression level were identified, suggesting no effects of mTOR inhibition on HER2 expression.
CONCLUSION AND FUTURE PERSPECTIVES:
To these preliminary results suggest that the mTOR inhibition leads to re-expression of hormone receptors. This finding supports a potential clinical application of mTOR inhibition in TNBC. The perspective of phenotype change upon rapamycin treatment prompts new therapeutic scenarios. However, further investigations are needed to explain the biological mechanisms driving these changes.
Citation Format: Daniela Massihnia, Giuseppe Bronte, Marta Castiglia, Nadia Barraco, Antonina Cangemi, Alessandro Perez, Daniele Fanale, Gianni Pantuso, Salvatore Vieni, Valentina Calò, Christian D. Rolfo, Viviana Bazan, Antonio Russo. Role of mTOR inhibition in triple-negative breast cancer. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 1855.
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Passiglia F, Bronte G, Galvano A, Rizzo S, Listì A, Barraco N, Insalaco L, Maragliano R, Bronte E, Musso E, Guarini A, Castellana L, Castiglia M, Calò V, Vieni S, Cicero G, Rolfo CD, Bazan V, Russo A. KRAS and BRAF as prognostic biomarkers in patients undergoing surgical resection of colorectal cancer liver metastasis: A systematic review and meta-analysis. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.3565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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)
- Francesco Passiglia
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
| | - Giuseppe Bronte
- 1.Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
| | - Antonio Galvano
- 1.Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
| | - Sergio Rizzo
- 1.Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
| | - Angela Listì
- 1.Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
| | - Nadia Barraco
- 1.Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
| | - Lavinia Insalaco
- 1.Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
| | - Rossella Maragliano
- 1. Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
| | - Enrico Bronte
- 1.Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
| | - Emmanuela Musso
- 1.Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
| | - Aurelia Guarini
- 1.Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
| | - Luisa Castellana
- 1.Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
| | - Marta Castiglia
- 1.Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
| | - Valentina Calò
- 1.Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
| | - Salvatore Vieni
- 1.Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
| | - Giuseppe Cicero
- 1.Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
| | - Christian Diego Rolfo
- Phase I – Early Clinical Trials Unit, Oncology Department, Antwerp University Hospital, Edegem, Belgium
| | - Viviana Bazan
- 1.Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
| | - Antonio Russo
- 1.Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
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Cangemi A, Fanale D, Rinaldi G, Bazan V, Galvano A, Perez A, Barraco N, Massihnia D, Castiglia M, Vieni S, Bronte G, Mirisola M, Russo A. Dietary restriction: could it be considered as speed bump on tumor progression road? Tumour Biol 2016; 37:7109-18. [PMID: 27043958 DOI: 10.1007/s13277-016-5044-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 03/28/2016] [Indexed: 02/06/2023] Open
Abstract
Dietary restrictions, including fasting (or long-term starvation), calorie restriction (CR), and short-term starvation (STS), are considered a strong rationale that may protect against various diseases, including age-related diseases and cancer. Among dietary approaches, STS, in which food is not consumed during designed fasting periods but is typically not restricted during designated feeding periods, seems to be more suitable, because other dietary regimens involving prolonged fasting periods could worsen the health conditions of cancer patients, being they already naturally prone to weight loss. Until now, the limited amount of available data does not point to a single gene, pathway, or molecular mechanism underlying the benefits to the different dietary approaches. It is well known that the healthy effect is mediated in part by the reduction of nutrient-related pathways. The calorie restriction and starvation (long- and short-term) also suppress the inflammatory response reducing the expression, for example, of IL-10 and TNF-α, mitigating pro-inflammatory gene expression and increasing anti-inflammatory gene expression. The dietary restriction may regulate both genes involved in cellular proliferation and factors associated to apoptosis in normal and cancer cells. Finally, dietary restriction is an important tool that may influence the response to chemotherapy in preclinical models. However, further data are needed to correlate dietary approaches with chemotherapeutic treatments in human models. The aim of this review is to discuss the effects of various dietary approaches on the cancer progression and therapy response, mainly in preclinical models, describing some signaling pathways involved in these processes.
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Affiliation(s)
- Antonina Cangemi
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - Daniele Fanale
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - Gaetana Rinaldi
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - Viviana Bazan
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - Antonio Galvano
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - Alessandro Perez
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - Nadia Barraco
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - Daniela Massihnia
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - Marta Castiglia
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - Salvatore Vieni
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - Giuseppe Bronte
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - Mario Mirisola
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy
| | - Antonio Russo
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy.
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Cipolla C, Ferro G, Graceffa G, Morini L, Guercio G, Vieni S, Pantuso G. Transanal endoscopic video-assisted (TEVA) resection of early rectal lesions using a SILS port A single center experience. Ann Ital Chir 2016; 87:36-40. [PMID: 27025396] [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: 06/05/2023]
Abstract
UNLABELLED represents a safe and complete technique to remove benign lesions of the rectum not treatable by endoscopy and malignant rectal lesions at early stage. It is a valid alternative to transanal endoscopic microsurgery (TEM), to conventional transanal surgery and to transabdominal resection. METHODS In our operating Unit we performed a resection of 8 voluminous adenoma in the rectal ampulla with SILSTM-Port. RESULTS The mean age of the patients was of 51.1 years, the mean BMI was 23. There were not intra or post-operative complications nor conversions to conventional transanal excision or major resective surgery. The postoperative course was normal. The average time of hospitalization was 3 days. CONCLUSIONS TEVA is easier to perform than TEM and does not require a long training and specific and expensive material as the TEM does. TEVA might go to replace completely TEM. KEY WORDS Rectal tumours, SILS, TEVA.
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Cipolla C, Graceffa G, La Mendola R, Fricano S, Fricano M, Vieni S. The prognostic value of sentinel lymph node micrometastases in patients with invasive breast carcinoma. Ann Ital Chir 2015; 86:497-502. [PMID: 26898168] [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: 06/05/2023]
Abstract
AIM The prognostic value of sentinel lymph node micrometastases in invasive breast cancer patients is still widely debated. Even if, in the absence of unequivocal guidelines, the axillary lynphadenectomy is not still performed in the routine clinical care of these patients. METHOD We have retrospectively analyzed 746 patients with operable invasive breast cancer and clinically negative axillary lymph nodes. These patients underwent conservative surgery or total mastectomy with sentinel lymph node biopsy. Patients with micrometastases in the sentinel lymph node treated with axillary dissection has been checked and the involvement of the remaining lymph nodes analyzed. Patients with micrometastases in the SLN not followed by axillary dissection have been checked as well and the incidence of recurrences has been evaluated in both groups. RESULTS Micrometastases were found in 51 (6.83%) patients and isolated tumor cells in 8 (1.07%) patients at frozen section and confirmed at the final hystopathologic examination. Fifteen of these patients underwent complete axillary dissection: two of them (13.33%) had metastatic involvement of other axillary lymph nodes. The other 44 patients didn't receive further surgical axillary procedure. No axillary recurrences in these patients were found during a median follow up of 65.3±9.65 months (range 42-78 months). CONCLUSION Based on the results and according to some recent randomized trials we can say that axillary lynphadenectomy can be avoided when micrometastases are found in sentinel lynph nodes. It should be performed anyway, depending on the analysis of the biomedical profile of the tumor. KEY WORDS Breast carcinoma, Micrometases, Sentinel lymph node.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Axilla
- Biopsy, Fine-Needle
- Breast Neoplasms/diagnostic imaging
- Breast Neoplasms/pathology
- Breast Neoplasms/surgery
- Breast Neoplasms/therapy
- Carcinoma, Ductal, Breast/diagnostic imaging
- Carcinoma, Ductal, Breast/secondary
- Carcinoma, Ductal, Breast/surgery
- Carcinoma, Ductal, Breast/therapy
- Carcinoma, Lobular/diagnostic imaging
- Carcinoma, Lobular/secondary
- Carcinoma, Lobular/surgery
- Carcinoma, Lobular/therapy
- Combined Modality Therapy
- Female
- Humans
- Lymph Node Excision/statistics & numerical data
- Lymphatic Metastasis/diagnosis
- Lymphatic Metastasis/diagnostic imaging
- Mastectomy/methods
- Middle Aged
- Neoplasm Micrometastasis/diagnosis
- Neoplasm Micrometastasis/diagnostic imaging
- Neoplasm Recurrence, Local/epidemiology
- Neoplasm Recurrence, Local/prevention & control
- Neoplasms, Hormone-Dependent/diagnostic imaging
- Neoplasms, Hormone-Dependent/secondary
- Neoplasms, Hormone-Dependent/surgery
- Neoplasms, Hormone-Dependent/therapy
- Prognosis
- Radionuclide Imaging
- Radiopharmaceuticals
- Retrospective Studies
- Sentinel Lymph Node/diagnostic imaging
- Sentinel Lymph Node/pathology
- Sentinel Lymph Node Biopsy/statistics & numerical data
- Technetium Tc 99m Aggregated Albumin
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Russo A, De Luca R, Cicero G, Civilleri A, Bronte G, Dispenza J, Vieni S, Guarneri R, Cascio VL, Guadagna FP, Foddai E, Pace F. Well-being among Italian medical oncologists: an exploratory study. Oncology 2014; 86:72-8. [PMID: 24401657 DOI: 10.1159/000354642] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Accepted: 07/16/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND Recently, attention has been focused on physicians' stress and quality-of-life improvement. Due to their relationship with patients, oncologists in particular are overloaded physically, emotionally and psychologically. Previous studies showed that training of communication skills improves the satisfaction and well-being of physicians and patients. AIMS Our research investigates the relationship between work stress and engagement and personal well-being in physicians working in Italian hospitals. MATERIALS AND METHODS 176 physicians were included. Doctors filled out self-report questionnaires to evaluate work stress and coping strategies, personal well-being, work engagement and two purpose-built scales to measure the degree of perceived organizational support and the level of specific training of social and relational skills. Descriptive statistics were used to analyze data, as well as correlation analysis (Pearson's r), hierarchical regression analysis (enter step) and analysis of variance (one-way ANOVA). RESULT Positive and significant correlations were found between variables. Moreover, physicians who obtained higher levels of specific training on social and relational skills reported lower levels of stress. Oncologists experienced greater stress than other physicians in terms of maladaptive coping and lack of additional training. CONCLUSIONS The study suggests that physicians' well-being is mediated by professional aspects, such as social skills in relationships with patients.
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Affiliation(s)
- Antonio Russo
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
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Cipolla C, Fricano S, Vieni S, Graceffa G, Licari G, Torcivia A, Latteri MA. Does the use of fibrin glue prevent seroma formation after axillary lymphadenectomy for breast cancer? A prospective randomized trial in 159 patients. J Surg Oncol 2010; 101:600-3. [PMID: 20461767 DOI: 10.1002/jso.21531] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Seroma formation frequently occurs in patients who have undergone axillary lymphadenectomy. The aim of the study was to evaluate the effect of fibrin glue in the prevention of seroma formation after axillary lymphadenectomy. MATERIALS AND METHODS Hundred fifty-nine breast cancer patients about to undergo quadrantectomy or mastectomy plus axillary lymphadenectomy were enrolled in the study and randomized into two groups. Fibrin glue spray applied to the axillary fossa plus placement of closed suction drainage were used in 80 patients (group A); placement of closed suction drainage was only used in 79 patients (group B). RESULTS Group A patients showed a slight advantage with regard to the mean duration of axillary drainage placement (4.5 +/- 1.3 days in group A vs. 5.1 +/- 1.6 days in group B) and number of seroma aspirations (6.3 +/- 1.1 in group A vs. 6.7 +/- 1.2 in group B). No statistically significant differences were observed between the two groups of patients regarding the mean volume of total axillary drainage and of total seroma volume. CONCLUSIONS The use of fibrin glue does not prevent seroma formation and does not reduce seroma magnitude and duration. The costs of the product involved do not justify its routine use in patients undergoing axillary dissection.
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Affiliation(s)
- Calogero Cipolla
- Division of General and Oncological Surgery, Department of Oncology, University of Palermo, Palermo, Italy.
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Bazan V, Agnese V, Corsale S, Calò V, Valerio MR, Latteri MA, Vieni S, Grassi N, Cicero G, Dardanoni G, Tomasino RM, Colucci G, Gebbia N, Russo A. Specific TP53 and/or Ki-ras mutations as independent predictors of clinical outcome in sporadic colorectal adenocarcinomas: results of a 5-year Gruppo Oncologico dell'Italia Meridionale (GOIM) prospective study. Ann Oncol 2008; 16 Suppl 4:iv50-55. [PMID: 15923430 DOI: 10.1093/annonc/mdi908] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Although Ki-ras and TP53 mutations have probably been the genetic abnormalities most exhaustively implicated and studied in colorectal cancer (CRC) progression, their significance in terms of disease relapse and overall survival has not yet clearly been established. PATIENTS AND METHODS A prospective study was carried out on paired tumor and normal colon tissue samples from a consecutive series of 160 previously-untreated patients, undergoing resective surgery for primary operable sporadic CRC. Mutations within the TP53 (exons 5-8) and Ki-ras (exon 2) genes were detected by PCR-SSCP analyses following sequencing. RESULTS Mutation analyses of exons 5 to 8 of the TP53 gene showed mutations in 43% (68/160) of the cases, while mutation analyses of exon 2 of the Ki-ras gene showed mutations in 46% (74/160) of the cases. Multivariate analyses showed that clinical outcome were strongly associated with the presence of specific TP53 mutations in L3 domain alone (only in DFS) or in combination with specific Ki-ras mutations at codon 13. CONCLUSION Specific TP53 mutations in L3 domain alone (only in DFS) or in combination with specific Ki-ras mutations at codon 13 are associated with a worse prognosis in sporadic CRC.
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Affiliation(s)
- V Bazan
- Department of Oncology-Regional Reference Center for the Biomolecular Characterization of Neoplasms and Genetic Screening of Hereditary Tumors, Institute of Experimental Medicine, Institute of Pathology, Università di Palermo, Palermo, Italy
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Vieni S, Cabibi D, Cipolla C, Fricano S, Graceffa G, Latteri MA. Secretory breast carcinoma with metastatic sentinel lymph node. World J Surg Oncol 2006; 4:88. [PMID: 17150092 PMCID: PMC1764883 DOI: 10.1186/1477-7819-4-88] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2006] [Accepted: 12/06/2006] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Secretory mammary carcinoma is a rare breast neoplasia originally described in children but sometimes also found in adults. It presents a more favourable outcome than more common histological types of breast carcinoma; published literature in fact reports only a few cases with axillary lymph node metastases and only four cases with distant metastases. CLINICAL PRESENTATION In this paper we report a rare case of secretory breast carcinoma with axillary lymph node metastases in a 33-year-old woman. To our knowledge, this is the first case of secretory carcinoma involving biopsy of the sentinel lymph node and investigation of the e-cadherin expression. We found positivity for e-cadherin, which would support the hypothesis that this type of tumour is a variant of the infiltrating ductal carcinoma. CONCLUSION After a careful analysis of reported data, we have come to the conclusion that the treatment of choice for patients with secretory breast carcinoma should be conservative surgery with sentinel lymph node biopsy, followed by accurate follow-up. We are of the opinion that while post-operative radiotherapy is indicated in adult patients who have undergone quadrantectomy, it should not be used in children. Although several cases of secretory carcinoma have been treated with adjuvant chemotherapy, there are still no reliable data regarding the real value of such a choice.
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Affiliation(s)
- Salvatore Vieni
- Department of Oncology, Division of General and Oncological Surgery, University of Palermo, Palermo, Italy
| | - Daniela Cabibi
- Institute of Pathology, University of Palermo, Palermo, Italy
| | - Calogero Cipolla
- Department of Oncology, Division of General and Oncological Surgery, University of Palermo, Palermo, Italy
| | - Salvatore Fricano
- Department of Oncology, Division of General and Oncological Surgery, University of Palermo, Palermo, Italy
| | - Giuseppa Graceffa
- Department of Oncology, Division of General and Oncological Surgery, University of Palermo, Palermo, Italy
| | - Mario Adelfio Latteri
- Department of Oncology, Division of General and Oncological Surgery, University of Palermo, Palermo, Italy
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Russo A, Corsale S, Agnese V, Macaluso M, Cascio S, Bruno L, Surmacz E, Dardanoni G, Valerio MR, Vieni S, Restivo S, Fulfaro F, Tomasino RM, Gebbia N, Bazan V. TP53 mutations and S-phase fraction but not DNA-ploidy are independent prognostic indicators in laryngeal squamous cell carcinoma. J Cell Physiol 2006; 206:181-8. [PMID: 15965904 DOI: 10.1002/jcp.20447] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
To prospectively evaluate the prognostic significance of TP53, H-, K-, and N-Ras mutations, DNA-ploidy and S-phase fraction (SPF) in patients affected by locally advanced laryngeal squamous cell carcinoma (LSCC). Eight-one patients (median follow-up was 71 months) who underwent resective surgery for primary operable locally advanced LSCC were analyzed. Tumor DNA was screened for mutational analysis by PCR/SSCP and sequencing. DNA-ploidy and SPF were performed by flow cytometric analyses. Thirty-six patients (44%) had, at least, a mutation in the TP53 gene. Of them, 22% (8/36) had double mutations and 3% (1/36) had triple mutations. In total, 46 TP53 mutations were observed. The majority (41%) of these occur in exon 5 (19/46), while the mutations in exons 6, 7, and 8 were represented in 14, 7, and 6 patients, respectively (31%, 15%, and 16%). Five LSCC patients (6%) showed a mutation in H-Ras gene. Sixty-three percent of the cases (51/81) were DNA aneuploidy, 14% of these (7/51) were multiclonal. Thirty-nine patients (48%) had an high SPF value. At Univariate analysis, the DNA aneuploidy, high SPF (>15.1%), TP53 mutations and, in particular, the mutations that occur in exons 5 and 8 were significantly related to quicker disease relapse and short OS. At Multivariate analysis, the major significant predictors for both disease relapse and death were high SPF and any TP53 mutations. While histological grade G3 was an independent factor only for relapse. In conclusions, any TP53 mutations and high SPF are important biological indicators to predict the outcome of LSCC patients.
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Affiliation(s)
- Antonio Russo
- Section and Oncology, Department of Oncology, Università di Palermo, Palermo, Italy.
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Cipolla C, Fricano S, Vieni S, Amato C, Napoli L, Graceffa G, Latteri S, Latteri MA. Validity of needle core biopsy in the histological characterisation of mammary lesions. Breast 2006; 15:76-80. [PMID: 16473738 DOI: 10.1016/j.breast.2005.01.007] [Citation(s) in RCA: 9] [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] [Received: 07/17/2004] [Accepted: 01/06/2005] [Indexed: 11/15/2022] Open
Abstract
Over the last few years, there has been an enormous increase in the use of needle core biopsy (CB) for the histopathological characterisation of suspect lesions of the breast. The aim of this study was to verify the diagnostic reliability of CB by comparing the histological results obtained with the use of this technique with those obtained from the whole of the surgically resected specimen. We studied 198 out of 426 patients with clinically and/or radiologically suspect breast lesions. We found correspondence between the histological examination of the whole of the excised specimen and that of the CB in 94.9% of the cases of infiltrating carcinoma and in 71.4% of those involving ductal carcinomas in situ. The predictive value of CB was 98.9%, sensitivity was 96.1% and specificity 93.3%. These results confirmed that CB is an extremely reliable diagnostic tool in the definition of breast lesions.
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MESH Headings
- Biopsy, Needle
- Breast Neoplasms/diagnosis
- Breast Neoplasms/pathology
- Breast Neoplasms/surgery
- Carcinoma, Ductal, Breast/diagnosis
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/surgery
- Carcinoma, Intraductal, Noninfiltrating/diagnosis
- Carcinoma, Intraductal, Noninfiltrating/pathology
- Carcinoma, Intraductal, Noninfiltrating/surgery
- Female
- Humans
- Reproducibility of Results
- Retrospective Studies
- Sensitivity and Specificity
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Affiliation(s)
- Calogero Cipolla
- Division of General and Oncological Surgery, Department of Oncology, University of Palermo, Palermo, Italy.
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Cipolla C, Sandonato L, Graceffa G, Fricano S, Torcivia A, Vieni S, Latteri S, Latteri MA. Hashimoto Thyroiditis Coexistent with Papillary Thyroid Carcinoma. Am Surg 2005. [DOI: 10.1177/000313480507101018] [Citation(s) in RCA: 89] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Several studies report a higher rate of papillary thyroid carcinomas (PTC) in patients with Hashimoto thyroiditis (HT), indicating a possible correlation between the two diseases. We studied a group of 89 subjects undergoing surgery for thyroid carcinomas compared with a control group of 89 subjects operated on for normofunctioning goiter, and a second group of 47 patients undergoing total thyroidectomy for HT. Association with HT was found in 19 of the 71 PTC subjects (26.7%) and in 8 goiter patients (8.9%), which was a significant difference ( P < 0.02). Thirteen of the HT patients, mostly with the nodular form, showed coexistent PTC (27.6%). HT and PTC coexisted in several morphological, immunohistochemical, and biomolecular aspects; increased incidence of PTC in HT patients might therefore indicate that HT is a precursor of thyroid cancer. Further studies are required, however, in order to confirm this hypothesis; until then, HT patients should undergo careful clinical and technical follow-up.
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Affiliation(s)
- Calogero Cipolla
- University of Palermo, Department of Oncology, Division of General and Oncological Surgery Policlinico “P. Giaccone” Palermo, Italy
| | - Luigi Sandonato
- University of Palermo, Department of Oncology, Division of General and Oncological Surgery Policlinico “P. Giaccone” Palermo, Italy
| | - Giuseppa Graceffa
- University of Palermo, Department of Oncology, Division of General and Oncological Surgery Policlinico “P. Giaccone” Palermo, Italy
| | - Salvatore Fricano
- University of Palermo, Department of Oncology, Division of General and Oncological Surgery Policlinico “P. Giaccone” Palermo, Italy
| | - Adriana Torcivia
- University of Palermo, Department of Oncology, Division of General and Oncological Surgery Policlinico “P. Giaccone” Palermo, Italy
| | - Salvatore Vieni
- University of Palermo, Department of Oncology, Division of General and Oncological Surgery Policlinico “P. Giaccone” Palermo, Italy
| | - Stefania Latteri
- University of Palermo, Department of Oncology, Division of General and Oncological Surgery Policlinico “P. Giaccone” Palermo, Italy
| | - Mario Adelfio Latteri
- University of Palermo, Department of Oncology, Division of General and Oncological Surgery Policlinico “P. Giaccone” Palermo, Italy
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