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Padilla-Iserte P, Iváñez M, Muruzabal JC, Navarro R, Díaz-Feijoo B, Iacoponi S, García-Pineda V, Díaz C, Utrilla-Layna J, Gil-Moreno A, Serra A, Gilabert-Estellés J, Martínez Canto C, Tejerizo Á, Lago V, Cárdenas-Rebollo JM, Domingo S. Oncological outcomes of intraperitoneal chemotherapy in advanced ovarian cancer: BRCA mutation role. Eur J Surg Oncol 2024; 50:108263. [PMID: 38492526 DOI: 10.1016/j.ejso.2024.108263] [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: 10/18/2023] [Revised: 03/04/2024] [Accepted: 03/08/2024] [Indexed: 03/18/2024]
Abstract
INTRODUCTION The knowledge of BRCA status offers a chance to evaluate the role of the intraperitoneal route in patients selected by biomolecular profiles after primary cytoreduction surgery in advanced ovarian cancer. MATERIALS AND METHODS We performed a retrospective, multicenter study to assess oncological outcomes depending on adjuvant treatment (intraperitoneal [IP] vs intravenous [IV]) and BRCA status (BRCA1/2 mutated vs. BRCA wild type [WT]). The primary endpoint was to determine progression-free survival. The secondary objectives were overall survival and toxicity. RESULTS A total of 288 women from eight centers were included: 177 in the IP arm and 111 in the IV arm, grouped into four arms according to BRCA1/2 status. Significantly better PFS was observed in BRCA1/2-mutated patients with IP chemotherapy (HR: 0.35; 95% CI, 0.16-0.75, p = 0.007), which was not present in BRCA1/2-mutated patients with IV chemotherapy (HR: 0.65; 95% CI, 0.37-1.12, p = 0.14). Significantly better OS was also observed in IP chemotherapy (HR: 0.17; 95% CI, 0.06-043, p < 0.0001), but was not present in IV chemotherapy in relation with BRCA mutation (HR: 0.52; 95% CI, 0.22-1.27, p = 0.15). For BRCA WT patients, worse survival was observed regardless of the adjuvant route used. The IP route was more toxic compared to the IV route, but toxicity was equivalent at the long-term follow-up. CONCLUSION This retrospective study suggests that BRCA status can help to offer an individualized, systematic treatment after optimal primary surgery for advanced ovarian cancer, but is limited by the small sample size. Prospective trials are essential to confirm these results.
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Affiliation(s)
- Pablo Padilla-Iserte
- Department of Gynecologic Oncology, La Fe University and Polytechnic Hospital, Valencia, Spain.
| | - Maria Iváñez
- Department of Gynaecologic Oncology, La Fe University and Polytechnic Hospital, Valencia, Spain
| | | | - Rafael Navarro
- Department of Gynecologic Oncology, MD Anderson Cancer Center Madrid, Spain
| | - Berta Díaz-Feijoo
- Institute Clinic of Gynecology, Obstetrics and Neonatology, Hospital Clinic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Spain
| | - Sara Iacoponi
- Department of Obstetrics and Gynaecology, University Quirónsalud Madrid Hospital, Spain
| | | | - Cristina Díaz
- Department of Gynecology, Valencian Institute of Oncology (IVO), Spain
| | | | - Antonio Gil-Moreno
- Gynecologic Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Institut de Recerca Biomèdica en Ginecologia-VHIR, CIBERONC, Barcelona, Spain
| | - Anna Serra
- Department of Obstetrics and Gynecology, Multidisciplinary Unit of Abdominal Pelvic Oncology Surgery (MUAPOS), University General Hospital of Castellón, Spain
| | - Juan Gilabert-Estellés
- Department of Obstetrics and Gynecology, University General Hospital of Valencia Spain, Spain
| | | | - Álvaro Tejerizo
- Department of Obstetrics and Gynecology, Gynecologic Oncology Unit, Hospital Universitario 12 de Octubre, Madrid, Spain; Instituto de Investigación i+12, Universidad Complutense de Madrid, Spain
| | - Víctor Lago
- Department of Gynaecologic Oncology, La Fe University and Polytechnic Hospital, Valencia, Spain
| | | | - Santiago Domingo
- Department of Gynaecologic Oncology, La Fe University and Polytechnic Hospital, Valencia, Spain
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Zapardiel I, Gracia Segovia M, Macuks R, Mancari R, Achimas-Cadariu P, Corrado G, Bartusevicius A, Sukhin V, Muruzabal JC, Coronado Martín PJ, Gardella B, Piek JM, Concin N, Arab C, Papatheodorou D, Polterauer S, Iacoponi S, Nieto T, Lopez-Sanclemente MC, Trukhan H, Gil MM, Bakinovskaya I, Dalamanava A, Cucurull M, Rovski D, Baquedano L, Chiva L, Mardas M, Mavrichev SA, Klat J, Lopez de la Manzanara CA, Yildirim Y. Prognostic factors in patients with uterine sarcoma: the SARCUT study. Int J Gynecol Cancer 2023:ijgc-2022-004204. [PMID: 37192761 DOI: 10.1136/ijgc-2022-004204] [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] [Indexed: 05/18/2023] Open
Abstract
OBJECTIVE Uterine sarcomas are a rare and heterogeneous group of malignancies that include different histological sub-types. The aim of this study was to identify and evaluate the impact of the different prognostic factors on overall survival and disease-free survival of patients with uterine sarcoma. METHODS This international multicenter retrospective study included 683 patients diagnosed with uterine sarcoma at 46 different institutions between January 2001 and December 2007. RESULTS The 5-year overall survival for leiomyosarcoma, endometrial stromal sarcoma, undifferentiated sarcoma, and adenosarcoma was 65.3%, 78.3%, 52.4%, and 89.5%, respectively, and the 5-year disease-free survival was 54.3%, 68.1%, 40.3%, and 85.3%, respectively. The 10-year overall survival for leiomyosarcoma, endometrial stromal sarcoma, undifferentiated sarcoma and adenosarcoma was 52.6%, 64.8%, 52.4%, and 79.5%, respectively, and the 10-year disease-free survival was 44.7%, 53.3%, 40.3%, and 77.5%, respectively. The most significant factor associated with overall survival in all types of sarcoma except for adenosarcoma was the presence of residual disease after primary treatment. In adenosarcoma, disease stage at diagnosis was the most important factor (hazard ratio 17.7; 95% CI 2.86 to 109.93). CONCLUSION Incomplete cytoreduction, tumor persistence, advanced stage, extra-uterine and tumor margin involvement, and the presence of necrosis were relevant prognostic factors significantly affecting overall survival in uterine sarcoma. The presence of lymph vascular space involvement and administration of adjuvant chemotherapy were significantly associated with a higher risk of relapse.
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Affiliation(s)
- Ignacio Zapardiel
- Gynecologic Oncology Unit, La Paz University Hospital, Madrid, Spain
| | | | - Ronalds Macuks
- Riga East Clinical University Hospital Latvian Oncology Center, Riga, Latvia
| | - Rosanna Mancari
- Gynecologic Oncology Department, IRCCS, Milan, Italy
- Gynecologic Oncology Department, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Patriciu Achimas-Cadariu
- Gynecologic Oncology Department, The Oncology Institute 'Prof Dr Ion Chiricuta' Cluj-Napoca, Cluj-Napoca, Romania
| | - Giacomo Corrado
- Policlinico Universitario Agostino Gemelli Dipartimento Scienze della Salute della Donna e del Bambino, Roma, Italy
| | - Arnoldas Bartusevicius
- Department of Obstetrics and Gynaecology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Vladyslav Sukhin
- Oncology, Radiology and Radiation Medicine, V N Karazin Kharkiv National University, Harkiv, Ukraine
- Oncogynecology, Grigoriev Institute for Medical Radiology NAMS of Ukraine, Harkiv, Ukraine
| | - Juan C Muruzabal
- Gynecologic Oncology Unit, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
| | | | - Barbara Gardella
- Gynecologic Oncology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Jurgen M Piek
- Gynecologic Oncology Department, Catharina Hospital and Catharina Cancer Institute, Eindhoven, Netherlands
| | - Nicole Concin
- Department of Gynecology and Obstetrics, Innsbruck Medical Univeristy, Innsbruck, Austria
- Division of General Gynecology and Gynecologic Oncology, Department of Obstetrics and Gynecology, Gynecologic Cancer Unit, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Clemente Arab
- Gynecologic Oncology Department, Hospital Luis Tisné. Universidad de Chile, Santiago, Chile
| | | | - Stephan Polterauer
- Karl Landsteiner Institute for General Gynecology and Experimental Gynecologic Oncology, Vienna, Austria
| | - Sara Iacoponi
- Gynecologic Oncology Unit, La Paz University Hospital, Madrid, Spain
| | - Teresa Nieto
- Gynecologic Oncology Department, Hospital Universitario Santa Cristina, Madrid, Spain
| | - Martha C Lopez-Sanclemente
- Gynecologic Oncology Department, Torrecárdenas Hospital Complex, Almeria, Andalucía, Spain
- Gynecologic Oncology Department, Clinica Diatros, Barcelona, Spain
| | - Hanna Trukhan
- Gynecologic Oncology Department, N N Alexandrov National Cancer Center, Minsk, Belarus
| | - Maria M Gil
- Gynecologic Oncology Unit, La Paz University Hospital, Madrid, Spain
| | - Irina Bakinovskaya
- Gynecologic Oncology Department, N N Alexandrov National Cancer Center, Minsk, Belarus
| | - Alena Dalamanava
- Gynecologic Oncology Department, N N Alexandrov National Cancer Center, Minsk, Belarus
| | - Marc Cucurull
- Catalan Institute of Oncology, L'Hospitalet de Llobregat, Catalunya, Spain
| | - Dzmitry Rovski
- Gynecologic Oncology Department, N N Alexandrov National Cancer Center, Minsk, Belarus
| | - Laura Baquedano
- Gynecologic Oncology Department, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Luis Chiva
- Obstetrics and Gynecology, Clinica Universidad de Navarra, Madrid, Spain
| | - Marcin Mardas
- Department of Gynecological Oncology, Poznan University of Medical Sciences, Poznan, Wielkopolskie, Poland
| | | | - Jaroslav Klat
- Obstetrics and Gynecology Department, University Hospital Ostrava, Ostrava, Moravskoslezský, Czech Republic
| | | | - Yusuf Yildirim
- Gynecologic Oncology Department, Tepecik Training and Research Hospital Clinics, Konak, Izmir, Turkey
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Lago V, Marina T, Laseca Modrego M, Gil-Ibañez B, Rodriguez JR, Domingo J, Minig L, Padilla-Iserte P, Arencibia Sánchez O, Sala Ferichola M, Munmanny M, Martín Salamanca B, Iacoponi S, Cabrera S, Coronado P, Utrilla-Layna J, Bataller Á, Fiol G, Corbalán S, Espinosa E, Gil-Moreno A, Domingo S. Fertility sparing treatment in patients with endometrial cancer (FERT-ENC): a multicentric retrospective study from the Spanish Investigational Network Gynecologic Oncology Group (SPAIN-GOG). Arch Gynecol Obstet 2022; 306:821-828. [PMID: 35122158 DOI: 10.1007/s00404-021-06375-2] [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: 05/03/2021] [Accepted: 12/20/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The primary objective was to evaluate the response rate of conservative treatment for endometrial cancer, and the secondary objective was to assess oncological, fertility and obstetric outcomes in patients who underwent fertility preservation treatment. MATERIAL AND METHODS This multicentre, observational, retrospective study evaluated endometrial cancer patients who underwent fertility-sparing treatment in Spanish centres between January 2010 and January 2020. Seventy-three patients with stage IA endometrioid adenocarcinoma of the uterus were included in the study. RESULTS The levonorgestrel intrauterine device (LNG-IUD) was the most common fertility-sparing treatment (53.4%), followed by megestrol acetate (20.5%) and medroxyprogesterone acetate (16.4%). During the 24-month follow-up period, the rate of complete response to fertility-sparing management was 74% (n = 54), and 8.2% (n = 6) of patients presented a partial response. Additionally, 13 (17.8%) patients presented with persistent disease and six (8.2%) relapsed after response. The LNG-IUD was associated with a higher complete response rate than the other methods (87.2 vs. 58.8%; p = 0.01). Surgical treatment (at least hysterectomy) was performed in 44 (60.3%) patients as the end of fertility-sparing treatment. Four (5.5%) patients presented relapse after surgery, associated with final FIGO stage III (p = 0.036), myometrial invasion > 50% (p = 0.018) and final tumour grade 2-3 (p = 0.018). The mean follow-up period was 57.8 (range 6-159) months. The 5-year relapse-free survival and overall survival rates were 92.6% [95% CI (81.3, 97.2)] and 93.5% [95% CI (80.7, 97.9)], respectively. During follow-up, three patients (4.1%) died of the disease after completion of surgical treatment. Up to 50.7% of patients included in the study attempted to get pregnant. Of these, the rate of pregnancy was 81.1% (n = 30/37), and reproductive techniques were used for this purpose in 78.4% of cases. CONCLUSIONS Fertility-sparing management presented a high response rate in patients with endometrial cancer. LNG-IUD was associated with a better response rate compared to the other treatment options. Moreover, in patients using this management method, pregnancy could be achieved using reproductive techniques.
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Affiliation(s)
- Víctor Lago
- Gynecologic Oncology Department, University Hospital La Fe, Valencia, Spain.
| | - Tiermes Marina
- Gynecologic Oncology Department, University Hospital La Fe, Valencia, Spain.,Obstetrics and Gynecology Department, Clinic University Hospital, Barcelona, Spain
| | - María Laseca Modrego
- Gynecologic Oncology Department, Maternal and Child University Hospital of the Canarias, Canari Island, Spain
| | - Blanca Gil-Ibañez
- Gynecologic Oncology Department, University Hospital, 12 de Octubre, Madrid, Spain
| | - José Ramón Rodriguez
- Obstetrics and Gynecology Department, Clinic and University Hospital Virgen de la Arrixaca, Murcia, Spain
| | | | - Lucas Minig
- Department of Gynecology, CEU Cardenal Herrera University, Valencia, Spain
| | | | - Octavio Arencibia Sánchez
- Gynecologic Oncology Department, Maternal and Child University Hospital of the Canarias, Canari Island, Spain
| | - Manuela Sala Ferichola
- Obstetrics and Gynecology Department, General University Hospital of Alicante, Alicante, Spain
| | - Merixell Munmanny
- Obstetrics and Gynecology Department, Clinic University Hospital, Barcelona, Spain
| | | | - Sara Iacoponi
- Gynecologic Oncology Department, Hospital Quironsalud Madrid, Madrid, Spain
| | - Silvia Cabrera
- Gynecologic Oncology Department, University Hospital Vall d´Hebron, Barcelona, Spain
| | - Pluvio Coronado
- Obstetrics and Gynecology Department, Clinic University Hospital San Carlos, Madrid, Spain
| | | | - Águeda Bataller
- Obstetrics and Gynecology Department, University Hospital of La Rivera, Alzira, Spain
| | - Gabriel Fiol
- Gynecologic Oncology Department, University Hospital Torrecárdenas, Almeria, Spain
| | - Shiana Corbalán
- Obstetrics and Gynecology Department, University Hospital Los Arcos, Murcia, Spain
| | | | - Antonio Gil-Moreno
- Gynecologic Oncology Department, University Hospital Vall d´Hebron, Barcelona, Spain
| | - Santiago Domingo
- Gynecologic Oncology Department, University Hospital La Fe, Valencia, Spain
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Affiliation(s)
- M. Picchio
- Department of Surgery, Civil Hospital of Acquapendente, Roma, Italy
| | - A. Paioletti
- Department of Surgery, Civil Hospital of Acquapendente, Roma, Italy
| | - E. Santini
- Department of Surgery, Civil Hospital of Acquapendente, Roma, Italy
| | - S. Iacoponi
- Department of Surgery, Civil Hospital of Acquapendente, Roma, Italy
| | - M. Cordahi
- Department of Surgery, Civil Hospital of Acquapendente, Roma, Italy
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Zapardiel I, Iacoponi S, Coronado PJ, Zalewski K, Chen F, Fotopoulou C, Dursun P, Kotsopoulos IC, Jach R, Buda A, Martinez-Serrano MJ, Grimm C, Fruscio R, Garcia E, Sznurkowski JJ, Ruiz C, Noya MC, Barazi D, Diez J, Diaz De la Noval B, Bartusevicius A, De Iaco P, Otero M, Diaz M, Haidopoulos D, Franco S, Blecharz P, Zuñiga MA, Rubio P, Gardella B, Papatheodorou DC, Yildirim Y, Fargas F, Macuks R. Prognostic factors in patients with vulvar cancer: the VULCAN study. Int J Gynecol Cancer 2020; 30:1285-1291. [PMID: 32571891 DOI: 10.1136/ijgc-2019-000526] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [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: 04/09/2019] [Accepted: 04/29/2019] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE This study aimed to analyze the prognostic factors for overall and progression-free survival in patients with vulvar cancer. METHODS This international, multicenter, retrospective study included 2453 patients diagnosed with vulvar cancer at 100 different institutions. Inclusion criteria were institutional review board approval from each collaborating center, pathologic diagnosis of invasive carcinoma of the vulva, and primary treatment performed at the participating center. Patients with intraepithelial neoplasia or primary treatment at non-participating centers were excluded. Global survival analysis and squamous cell histology subanalysis was performed. RESULTS After excluding patients due to incomplete data entry, 1727 patients treated for vulvar cancer between January 2001 and December 2005 were registered for analysis (1535 squamous, 42 melanomas, 38 Paget's disease and 112 other histologic types). Melanomas had the worse prognosis (p=0.02). In squamous vulvar tumors, independent factors for increase in local recurrence of vulvar cancer were: no prior radiotherapy (p<0.001) or chemotherapy (p=0.006), and for distant recurrence were the number of positive inguinal nodes (p=0.025), and not having undergone lymphadenectomy (p=0.03) or radiotherapy (p<0.001), with a HR of 1.1 (95% CI 1.2 to 1.21), 2.9 (95% CI 1.4 to 6.1), and 3.1 (95% CI 1.7 to 5.7), respectively. Number of positive nodes (p=0.008), FIGO stage (p<0.001), adjuvant chemotherapy (p=0.001), tumor resection margins (p=0.045), and stromal invasion >5 mm (p=0.001) were correlated with poor overall survival, and large case volume (≥9 vs <9 cases per year) correlated with more favorable overall survival (p=0.05). CONCLUSIONS Advanced patient age, number of positive inguinal lymph nodes, and lack of adjuvant treatment are significantly associated with a higher risk of relapse in patients with squamous cell vulvar cancer. Case volume per treating institution, FIGO stage, and stromal invasion appear to impact overall survival significantly. Future prospective trials are warranted to establish these prognostic factors for vulvar cancer.
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Affiliation(s)
- Ignacio Zapardiel
- Gynecologic Oncology Unit, La Paz University Hospital - IdiPAZ, Madrid, Spain
| | - Sara Iacoponi
- Gynecologic Oncology Unit, La Paz University Hospital - IdiPAZ, Madrid, Spain
| | - Pluvio J Coronado
- Gynecology Department, Hospital Clinico Universitario San Carlos - IdISSC, Madrid, Spain
| | - Kamil Zalewski
- Gynecologic Oncology Department, Maria Sklodowska-Curie Memorial Cancer Center - Institute of Oncology, Warsaw, Poland
| | - Frank Chen
- Department of Gynecology, Campus Virchow-Klinikum, Charite Universitatsmedizin Berlin, Berlin, Germany
| | - Christina Fotopoulou
- Department of Gynecology, Campus Virchow-Klinikum, Charite Universitatsmedizin Berlin, Berlin, Germany
| | - Polat Dursun
- Department of Obstetrics and Gynecology Division of Gynecologic Oncology, Baskent University School of Medicine, Ankara, Turkey
| | | | - Robert Jach
- Gynecology Department, University Hospital, Jagiellonian University, Krakow, Poland
| | - Alessandro Buda
- Gynecologic Oncology Department, Hospital San Gerardo, Monza, Lombardia, Italy
| | | | - Christoph Grimm
- Division of General Gynaecology and Gynaecological Oncology, Medical University of Vienna - Vienna General Hospital, Vienna, Austria
| | - Robert Fruscio
- Gynecologic Oncology Department, Hospital San Gerardo, Monza, Lombardia, Italy
| | - Enrique Garcia
- Gynecologic Oncology Department, Fundacion Instituto Valenciano de Oncologia, Valencia, Spain
| | | | - Cristina Ruiz
- Gynecologic Oncology Department, Hospital Universitario Virgen del Rocio, Sevilla, Spain
| | - Maria C Noya
- Gynecology Department, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Galicia, Spain
| | - Dib Barazi
- Gynecologic Oncology Department, Ciudad Sanitaria de Bellvitge, Barcelona, Spain
| | - Javier Diez
- Gynecologic Oncology Department, Hospital de Cruces, Vizcaya, Spain
| | | | - Arnoldas Bartusevicius
- Gynecologic Oncology Department, Hospital of Lithuanian University of Health Sciences Kauno Klinikos, Kaunas, Lithuania
| | | | - Maria Otero
- Gynecology Department, Complejo Hospitalario de Leon, Leon, Spain
| | - Maria Diaz
- Gynecology Department, Complejo Hospitalario Universitario Juan Canalejo, La Coruña, Spain
| | | | - Silvia Franco
- Gynecology Department, Hospital Vall D'Hebron, Barcelona, Spain
| | - Pawel Blecharz
- Gynecologic Oncology Department, Maria Sklodowska-Curie Memorial Cancer Center, Krakow, Poland
| | - Miguel A Zuñiga
- Gynecology Department, Complejo Hospitalario Torrecardenas, Almeria, Spain
| | - Patricia Rubio
- Gynecology Department, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Barbara Gardella
- Gynecologic Oncology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Yusuf Yildirim
- Gynecologic Oncology Department, Ege Gynaecology Training and Research Hospital, Izmir, Turkey
| | - Francesc Fargas
- Gynecology Department, Instituto Universitario Dexeus, Barcelona, Spain
| | - Ronalds Macuks
- Gynecologic Oncology Department, Riga East Clinical University Hospital Latvian Oncology Center, Riga, Latvia
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Picardi G, Chellapurath M, Iacoponi S, Stefanni S, Laschi C, Calisti M. Bioinspired underwater legged robot for seabed exploration with low environmental disturbance. Sci Robot 2020; 5:5/42/eaaz1012. [DOI: 10.1126/scirobotics.aaz1012] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 04/06/2020] [Indexed: 12/12/2022]
Abstract
Robots have the potential to assist and complement humans in the study and exploration of extreme and hostile environments. For example, valuable scientific data have been collected with the aid of propeller-driven autonomous and remotely operated vehicles in underwater operations. However, because of their nature as swimmers, such robots are limited when closer interaction with the environment is required. Here, we report a bioinspired underwater legged robot, called SILVER2, that implements locomotion modalities inspired by benthic animals (organisms that harness the interaction with the seabed to move; for example, octopi and crabs). Our robot can traverse irregular terrains, interact delicately with the environment, approach targets safely and precisely, and hold position passively and silently. The capabilities of our robot were validated through a series of field missions in real sea conditions in a depth range between 0.5 and 12 meters.
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Affiliation(s)
- G. Picardi
- The BioRobotics Institute, Scuola Superiore Sant’Anna, Pisa, Italy
- Department of Excellence in Robotics & AI, Scuola Superiore Sant’Anna, Pisa, Italy
| | - M. Chellapurath
- The BioRobotics Institute, Scuola Superiore Sant’Anna, Pisa, Italy
- Department of Excellence in Robotics & AI, Scuola Superiore Sant’Anna, Pisa, Italy
- Stazione Zoologica Anton Dohrn, Napoli, Italy
| | - S. Iacoponi
- The BioRobotics Institute, Scuola Superiore Sant’Anna, Pisa, Italy
- Department of Excellence in Robotics & AI, Scuola Superiore Sant’Anna, Pisa, Italy
| | - S. Stefanni
- Stazione Zoologica Anton Dohrn, Napoli, Italy
| | - C. Laschi
- The BioRobotics Institute, Scuola Superiore Sant’Anna, Pisa, Italy
- Department of Excellence in Robotics & AI, Scuola Superiore Sant’Anna, Pisa, Italy
| | - M. Calisti
- The BioRobotics Institute, Scuola Superiore Sant’Anna, Pisa, Italy
- Department of Excellence in Robotics & AI, Scuola Superiore Sant’Anna, Pisa, Italy
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Iacoponi S, Massaroni C, Lo Presti D, Saccomandi P, Caponero MA, DrAmato R, Schena E. Polymer-coated fiber optic probe for the monitoring of breathing pattern and respiratory rate. Annu Int Conf IEEE Eng Med Biol Soc 2019; 2018:1616-1619. [PMID: 30440702 DOI: 10.1109/embc.2018.8512566] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
In recent years, no-invasive and small size systems are meeting the demand of the new healthcare system, in which the vital signs monitoring is gaining in importance. In this context, Fiber Bragg grating (FBG) sensors are becoming very popular and FBG-based systems could be used for monitoring vital signs. At the same time, FBG could be able to sense chemical parameters by the polymer functionalization. The aim of our study was investigating the ability of a polymer-coated FBG-based probe for monitoring breathing patterns and respiratory rates. We tested the proposed FBG-based probe on 9 healthy volunteers during spirometry, the most common pulmonary function test. Results showed the high accuracy of the proposed probe to detect respiratory rate. The comparison between the respiratory rates estimated by the probe with the ones by the spirometer showed the absolute value of the percentage errors lower than 2.07% (in the 78% of cases <.91%). Lastly, a Bland Altman analysis was performed to compare the instantaneous respiratory rate values gathered by the spirometer and the FBG probe showing the feasibility of breath-by-breath monitoring by the proposed probe. Results showed a bias of 0.06± 2.90 $\mathrm{breaths}\square {\mathrm {min}}^{-1}$. Additionally, our system was able to follow the breathing activities and monitoring the breathing patterns.
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Minig L, Cabrera S, Oliver R, Couso A, Rubio MJ, Iacoponi S, Martin-Salamanca MB, Carballo-Rastrilla S, Cádenas-Rebollo JM, García-Garcia A, Gil-Ibáñez B, Juan-Fita MJ, Patrono MG. Pathology findings and clinical outcomes after risk reduction salpingo-oophorectomy in BRCA mutation carriers: a multicenter Spanish study. Clin Transl Oncol 2018; 20:1337-1344. [DOI: 10.1007/s12094-018-1865-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 03/22/2018] [Indexed: 12/24/2022]
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9
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Polterauer S, Schwameis R, Grimm C, Macuks R, Iacoponi S, Zalewski K, Zapardiel I. Prognostic value of lymph node ratio and number of positive inguinal nodes in patients with vulvar cancer. Gynecol Oncol 2017; 147:92-97. [PMID: 28797698 DOI: 10.1016/j.ygyno.2017.07.142] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 07/24/2017] [Accepted: 07/30/2017] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To estimate the prognostic significance of lymph node ratio and number of positive nodes in vulvar cancer patients. METHODS This international multicenter retrospective study included patients diagnosed with vulvar cancer treated with inguinal lymphadenectomy. Lymph node ratio (LNR) is the ratio of the number of positive lymph nodes (LN) to the number of removed LN. Patients were stratified into risk groups according to LNR. LNR was correlated with clinical-pathological parameters. Survival analyses were performed. RESULTS This analysis included 745 patients. In total, 292 (39.2%) patients had positive inguinal LN. The mean (SD) number of resected and positive LN was 14.1 (7.6) and 3.0 (2.9), respectively. High LNR was associated with larger tumor size and higher tumor grade. Patients with LNRs 0% (N0), >0<20%, and >20% had 5-year overall survival (OS) rates of 90.9%, 70.7%, and 61.8%, respectively (P<0.001). LNR was associated with both local and distant recurrence-free survival (P<0.001). Patients with 0, 1, 2, 3 or >3 positive lymph nodes had 5-year OS rates of 90.9%, 70.8%, 67.8%, 70.8% and 63.4% respectively (P<0.001). In multivariate analysis, LNR (P=0.01) and FIGO stage (P<0.001), were associated with OS, whereas the number of positive nodes (P=0.8), age (P=0.2), and tumor grade (P=0.7), were not. In high-risk patients, adjuvant radiotherapy was associated with improved survival. CONCLUSIONS LNR provides useful prognostic information in vulvar cancer patients with inguinal LN resection in vulvar cancer. LNR allows for more accurate prognostic stratification of patients than number of positive nodes. LNR seems useful to select appropriate candidates for adjuvant radiation.
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Affiliation(s)
- Stephan Polterauer
- Department of General Gynaecology and Gynaecological Oncology, Gynecologic Cancer Unit - Comprehensive Cancer Center, Medical University of Vienna, Vienna, 1090, Austria; Karl Landsteiner Institute for General Gynecology and Experimental Gynecologic Oncology, Vienna, 1090, Austria.
| | - Richard Schwameis
- Department of General Gynaecology and Gynaecological Oncology, Gynecologic Cancer Unit - Comprehensive Cancer Center, Medical University of Vienna, Vienna, 1090, Austria
| | - Christoph Grimm
- Department of General Gynaecology and Gynaecological Oncology, Gynecologic Cancer Unit - Comprehensive Cancer Center, Medical University of Vienna, Vienna, 1090, Austria
| | - Ronalds Macuks
- Latvian Oncology Center of Riga - Eastern Clinical University Hospital, Riga, Latvia
| | - Sara Iacoponi
- Gynecologic Oncology Unit, La Paz University Hospital - IdiPAZ, Madrid, Spain
| | - Kamil Zalewski
- Department of Gynecologic Oncology, Holycross Cancer Center, Kielce, Poland; Department of Molecular and Translational Oncology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
| | - Ignacio Zapardiel
- Gynecologic Oncology Unit, La Paz University Hospital - IdiPAZ, Madrid, Spain
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Iacoponi S, Zapardiel I. European Nationality Influence in the Management of Squamous Cell Vulvar Cancer. Gynecol Obstet Invest 2016; 82:349-354. [DOI: 10.1159/000452097] [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: 12/08/2015] [Accepted: 09/26/2016] [Indexed: 11/19/2022]
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11
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Brunel I, Iacoponi S, Hernandez A, Diestro MD, Santiago JD, Zapardiel I. Intravascular leiomyomatosis: an exceptional entity. CLIN EXP OBSTET GYN 2016. [DOI: 10.12891/ceog2141.2016] [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: 11/01/2022]
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12
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Iacoponi S, Calleja J, Hernandez G, Sainz de la Cuesta R. Primary breast angiosarcoma in a young woman. Int J Surg Case Rep 2016; 24:101-3. [PMID: 27232295 PMCID: PMC4885116 DOI: 10.1016/j.ijscr.2016.05.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 05/03/2016] [Accepted: 05/09/2016] [Indexed: 11/30/2022] Open
Abstract
Angiosarcomas are rare malignant vascular tumors of the breast. They frequently are associated with previous breast radiotherapy. Total mastectomy without axillary lymphadenectomy appears to be the only treatment. Chemotherapy and radiotherapy have not proven any benefit in terms of survival.
Introduction Angiosarcomas of the breast are a rare subtype of sarcomas that frequently are diagnosed after radiation therapy for primary breast cancer. Primary angiosarcomas are rare entities accounting 0.05% of all malignant breast neoplasm. Presentation of Case We report a case of primary angiosarcoma of the breast in a 25 years woman, with no previous radiotherapy, treated with a total mastectomy followed by radio-chemotherapy. Discussion Total mastectomy appears to be the only treatment known that has proven to benefit these patients. Adjuvant treatment has not proven value up until today. The 5-year disease free survival for grade 1 tumors can be as high as 76%, and up to 15% for grade 3. Conclusion Due to the rarity of these tumors there is no standard therapies approach.
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Affiliation(s)
- Sara Iacoponi
- Gynecologic Oncology Unit. Quiron university hospital Madrid, Spain.
| | - Jackie Calleja
- Gynecologic Oncology Unit. Quiron university hospital Madrid, Spain
| | - Gines Hernandez
- Gynecologic Oncology Unit. Quiron university hospital Madrid, Spain
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Brunel I, Iacoponi S, Hernandez A, Diestro MD, De Santiago J, Zapardiel I. Intravascular leiomyomatosis: an exceptional entity. CLIN EXP OBSTET GYN 2016; 43:443-445. [PMID: 27328511] [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
Intravenous leiomyomatosis (IVL) is a rare benign condition characterized by the proliferation of smooth muscle cells originating from either the uterine venous wall or a uterine myoma. This leiomyomatosis extends most frequently to pelvic vessels, but also occasionally into the inferior vena cava and right cardiac chambers. Preoperative diagnosis is difficult and it should be suspected in the presence of cardiac or pelvic masses in women who have undergone hysterectomy or myomectomy previously. The treatment is hysterectomy, normally associated with a bilateral oophorectomy and removing the mass or metastasis if any. The post-surgical follow-up should be performed at long-term and include exploration and imaging, either ultrasound or MRI. The association of antiestrogenic drugs can be useful for disease control, especially in cases where oophorectomy is not performed and the tumor cannot be removed completely.
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Iacoponi S, Zalewski K, Fruscio R, Diaz-De la Noval B, De Iaco P, Ceccaroni M, Barazi D, Chen F, Zapardiel I. Prognostic factors for recurrence and survival among patients with invasive vulvar Paget disease included in the VULCAN study. Int J Gynaecol Obstet 2015; 133:76-9. [DOI: 10.1016/j.ijgo.2015.08.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Revised: 07/25/2015] [Accepted: 12/07/2015] [Indexed: 11/27/2022]
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15
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Iacoponi S, Calleja J, Hernandez G, de la Cuesta RS. Asymptomatic peritoneal carcinomatosis originating from benign cystic peritoneal mesothelioma. Ecancermedicalscience 2015; 9:605. [PMID: 26715942 PMCID: PMC4679213 DOI: 10.3332/ecancer.2015.605] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Indexed: 11/13/2022] Open
Abstract
Benign multicystic mesothelioma is a rare tumour that originates from the abdominal peritoneum with a predisposition to the pelvic peritoneum. It typically affects women of reproductive age. There have been less than 200 cases of this rare neoplasia reported to date. We present the case of a 35-year-old woman who was referred to our centre because of the detection of a peritoneal carcinomatosis during a gynaecological exam. A diagnostic laparoscopy was performed. The findings included multiple cysts appearing as ‘a bunch of grapes’ occupying the omentum. Biopsies were taken during the surgery and the results showed benign multicystic peritoneal mesothelioma. Benign multicystic mesothelioma can simulate other conditions, such as malignant ovarian tumours or cystic lymphangioma. It is often diagnosed accidentally during surgery performed for another reason. The diagnosis is interoperative, observing multicystic structures grouped as a ‘bunch of grapes’ containing clear fluid with thin walls made of connective tissue. Immunohistochemistry confirmed mesothelial origin. Surgery is considered the treatment of choice and is based on the removal of the cysts from the abdominal cavity. Hyperthermic intraperitoneal chemotherapy can be considered as a primary treatment in patients with recurrences or even as a part of primary treatment associated with surgery. Survival at 5 years is 100% and invasive or malignant progression is extraordinary. The treatment approach should be multidisciplinary, and the patient should be referred to a referral centre.
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Affiliation(s)
- S Iacoponi
- Gynecologic Oncology Unit, Quiron University Hospital, Calle Diego de Velasquez 1, Madrid, Spain
| | - J Calleja
- Gynecologic Oncology Unit, Quiron University Hospital, Calle Diego de Velasquez 1, Madrid, Spain
| | - G Hernandez
- Gynecologic Oncology Unit, Quiron University Hospital, Calle Diego de Velasquez 1, Madrid, Spain
| | - R Sainz de la Cuesta
- Gynecologic Oncology Unit, Quiron University Hospital, Calle Diego de Velasquez 1, Madrid, Spain
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16
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Iacoponi S, Diestro MD, Zapardiel I, Serrano M, Santiago JD. Vaginal laparoscopically assisted radical trachelectomy in cervical clear cell adenocarcinoma. Ecancermedicalscience 2013; 7:373. [PMID: 24244219 PMCID: PMC3826807 DOI: 10.3332/ecancer.2013.373] [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: 03/29/2013] [Indexed: 12/02/2022] Open
Abstract
Adenocarcinoma of the cervix is a rare condition that has shown an increase in incidence, especially in the 20- to 34-year-old group. Adenocarcinoma represents about 5–10% of all tumours in this area, and, among these, the clear cell type accounts for 4–9%. This type of tumour affects mainly postmenopausal women but also occurs in young women with a history of prenatal exposure to diethylstilbestrol (DES). The prognosis for adenocarcinoma of the cervix is poor overall and worse for the clear cell variety. This article discusses a case of clear cell adenocarcinoma of the cervix, unrelated to intrauterine exposure to DES, in a woman of childbearing age who wished to preserve her fertility and was therefore treated by radical vaginal trachelectomy and pelvic lymphadenectomy.
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Affiliation(s)
- Sara Iacoponi
- Gynaecological Oncology Unit, La Paz University Hospital, Madrid, Spain
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Iacoponi S, Zapardiel I, Diestro MD, Hernandez A, De Santiago J. Prognostic factors associated with local recurrence in squamous cell carcinoma of the vulva. J Gynecol Oncol 2013; 24:242-8. [PMID: 23875074 PMCID: PMC3714462 DOI: 10.3802/jgo.2013.24.3.242] [Citation(s) in RCA: 28] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Revised: 12/27/2012] [Accepted: 01/09/2013] [Indexed: 11/30/2022] Open
Abstract
Objective To analyze the prognostic factors related to the recurrence rate of vulvar cancer. Methods Retrospective study of 87 patients diagnosed of vulvar squamous cell carcinoma diagnosed at a tertiary hospital in Madrid between January 2000 and December 2010. Results The pathological mean tumor size was 35.1±22.8 mm, with stromal invasion of 7.7±6.6 mm. The mean free margin after surgery was 16.8±10.5 mm. Among all patients, 31 (35.6%) presented local recurrence (mean time 10 months; range, 1 to 114 months) and 7 (8%) had distant metastases (mean time, 5 months; range, 1 to 114 months). We found significant differences in the mean tumor size between patients who presented a relapse and those who did not (37.6±21.3 mm vs. 28.9±12.1 mm; p=0.05). Patients with free margins equal or less than 8 mm presented a relapse rate of 52.6% vs. 43.5% of those with free margin greater than 8 mm (p=0.50). However, with a cut-off of 15 mm, we observed a local recurrence rate of 55.6% vs. 34.5%, respectively (p=0.09). When the stromal invasion cut-off was >4 mm, local recurrence rate increased up to 52.9% compared to 37.5% when the stromal invasion was ≤4 mm (p=0.20). Conclusion Tumor size, pathologic margin distance and stromal invasion seem to be the most important predictors of local vulvar recurrence. We consider the cut-off of 35 mm of tumor size, 15 mm tumor-free surgical margin and stromal invasion >4 mm, high risk predictors of local recurrence rate.
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Affiliation(s)
- Sara Iacoponi
- Gynecologic Oncology Unit, La Paz University Hospital, Madrid, Spain
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Cuerva González MJ, Herrero Ruiz B, Gil Mira MDM, Iacoponi S, Rodríguez González R, González González A. [Congenital cystic adenomatoid malformation. Consequences of prenatal diagnosis]. Ginecol Obstet Mex 2013; 81:29-33. [PMID: 23513401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Advances in technology and the specialized training of gynecologists in ultrasound have led to an increase in fetal diagnoses. Congenital cystic adenomatoid malformation (CCAM) is of particular interest because of its difficulty in predicting the disease evolution. OBJECTIVE To review the cases of prenatal diagnosis of CCAM during the last five years in our hospital, and to analyze their evolution as a consequence of its diagnosis. PATIENTS AND METHODS Retrospective study that reviewed the cases of CCAM between 2005 and 2010 treated in our hospital. We evaluated gestational age, type of CCAM and evolution in at least the first 12 months. RESULTS Twenty-one cases were diagnosed (1 for every 2,660 deliveries in our hospital of reference), 3 of them with CCAM type 1 (14.3%), 8 with type 2 (38.1%) and 10 with type 3 (47.6%). Two patients proceeded with a medical interruption of pregnancy; in 11 patients lesions were stable, in eight they disappeared and one fetus suffered severe mediastinal shift with little healthy lung, and died during the first postpartum week. Four of eight cases in which the image disappeared were considered free of disease after birth. Of the 19 cases in which pregnancy was not interrupt, 15 had mediastinal shift and 6 did not; in five of them (83.3%), the image disappeared and only one remained stable. The lesion disappeared in only three cases of the 13 who had mediastinal shift (p < 0.01). Lobectomies were necessary in 8 of 19 cases, four are considered free of the disease and seven are still in follow-up. CONCLUSION Congenital cystic adenomatoid malformation is a condition in which the council is extremely complex, but most cases evolved favorably. Severe complications such as hydrops are described in up to 25% of all CCAM.
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Picchio M, Paioletti A, Santini E, Iacoponi S, Cordahi M. Gastric metastasis from renal cell carcinoma fourteen years after radical nephrectomy. Acta Chir Belg 2000; 100:228-30. [PMID: 11143327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
We report one case of solitary gastric metastasis from renal cell carcinoma following radical excision of the primary tumour 14 years previously. During evaluation for a severe anaemia with melaena, a patient underwent upper gastrointestinal endoscopy that evidenced the presence of a small polypoid lesion in the body of the stomach. Endoscopic biopsy revealed renal cell carcinoma. There was no evidence of further metastatic disease. A subtotal gastric resection with Roux-en-Y gastrojejunal reconstruction was performed. After 6 months follow-up, the patient was disease-free. This case confirms the potential of renal cell carcinoma for late and solitary metastasis with circumscribed local invasiveness and suggests that endoscopic resection may be feasible.
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Affiliation(s)
- M Picchio
- Department of Surgery, Civil Hospital of Acquapendente, Roma, Italy
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