Potential role of epicardial adipose tissue as a biomarker of anthracycline cardiotoxicity.

Background: We investigated the radiodensity of epicardial (EAT), subcutaneous (SAT), and visceral adipose tissue (VAT) before and after treatment with anthracyclines in a population of breast cancer (BC) patients, and in controls not treated with anthracyclines, to detect a potential role of EAT density as a biomarker of changes related to chemotherapy cardiotoxicity.

Methods: We reviewed BC patients treated with anthracyclines who underwent CT before (CT-t) and after (CT-t) chemotherapy, and age- and sex-matched controls who underwent two CT examinations at comparable intervals. On non-contrast scans, EAT was segmented contouring the pericardium and thresholding between -190 and -30 Hounsfield units (HU), and SAT and VAT were segmented with two 15-mm diameter regions of interest thresholded between -195 and -45 HU.

Delayed presentation of inflammatory breast carcinoma during the COVID-19 pandemic.

Background: Breast cancer may present with distinct cutaneous manifestations that may be paraneoplastic or secondary to direct skin infiltration, distant skin metastases, or dermal lymphatic tumor embolization (inflammatory breast carcinoma).

Case Report: A 51-year-old Asian woman visited the emergency care department during the outbreak of COVID-19 in Northern Italy. About 6 months before, she had noted the onset of right breast swelling accompanied by skin redness and itching.

Computed tomography-derived myocardial extracellular volume: an early biomarker of cardiotoxicity in esophageal cancer patients undergoing radiation therapy.

Objectives: We aimed to assess extracellular volume (ECV) through non-gated, contrast-enhanced computed tomography (CT) before and after radiation therapy (RT) in patients with esophageal cancer (EC).

Materials And Methods: EC patients who had undergone CT before and after RT were retrospectively assessed. Patients with preexisting cardiovascular disease or with heavily artifacted CT were excluded.

Assessment of myocardial extracellular volume on body computed tomography in breast cancer patients treated with anthracyclines.

Background: Cancer treatment with anthracyclines may lead to an increased incidence of cardiac disease due to cardiotoxicity, as they may cause irreversible myocardial fibrosis. So far, the proposed methods for screening patients for cardiotoxicity have led to only limited success, while the analysis of myocardial extracellular volume (mECV) at cardiac magnetic resonance (CMR) has shown promising results, albeit requiring a dedicated exam. Recent studies have found strong correlations between mECV values obtained through computed tomography (CT), and those derived from CMR.

Assessment of Ramucirumab plus paclitaxel as switch maintenance versus continuation of first-line chemotherapy in patients with advanced HER-2 negative gastric or gastroesophageal junction cancers: the ARMANI phase III trial.

Background: Platinum/fluoropyrimidine regimens are the backbone of first-line chemotherapy for advanced gastric cancer (AGC). However response rates to first line chemotherapy range from 30 to 50% and disease progression occurs after 4-6 cycles. The optimal duration of first-line therapy is still unknown and its continuation until disease progression represents the standard.

Outcome of Trimodal Therapy in Elderly Patients with Esophageal Cancer: Prognostic Value of the Charlson Comorbidity Index.

Background: In the real-world setting outside clinical trials, neoadjuvant chemoradiation therapy followed by esophagectomy may represent overtreatment in some elderly individuals with multiple comorbidities.

Patients And Methods: Through an observational cohort study, consecutive patients with esophageal cancer treated with the protocol of the Chemoradiotherapy for Oesophageal Cancer Followed by Surgery Study (CROSS) were compared to patients of similar age who underwent upfront surgery during the same study period.

Results: Fifty consecutive patients treated between 2010 and 2017 were enrolled.

Surgery for esophageal carcinoma and the role of neoadjuvant therapy.

Esophagectomy is a major surgical procedure. Due to the related morbidity and mortality, this operation should be carried out in high-volume referral centers by expert surgeons. Only patients in whom a complete resection is predictable at preoperative staging can consistently benefit from the operation.