Publications by authors named "Nicolo Bizzarri"

Introduction: There is a demand for intraoperative diagnostic support and image guidance in oncological surgery. Novel techniques can provide images similar to histopathological slides within a few minutes. Optical coherence tomography (OCT) and full-field OCT (FF-OCT) provide images with resolution greater than a hundred micrometers without the need for exogenous contrast agents or specimen staining.

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Objective: We assessed reproductive, obstetrical, and oncological outcomes in patients who underwent fertility-sparing treatment by including studies that adhere to the FIGO 2018 staging system.

Methods: Data on recurrence, mortality, pregnancy rate, live birth rate, and preterm delivery rate were collected.

Results: In patients with stages IA1, IA2, and IB1, the recurrence rate was 4.

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Article Synopsis
  • Sentinel lymph node (SLN) mapping in epithelial ovarian cancer may lower risks from lymphadenectomy while still providing reliable diagnostic results; ongoing research aims to evaluate its effectiveness.
  • A systematic review of four studies involving 239 patients found SLN detection rates of 59.5% for pelvic and 64.4% for para-aortic regions, with technetium-99 showing better detection rates compared to indocyanine green.
  • Diagnostic accuracy for identifying lymph node metastasis was high, reaching 100% in the pelvic field and 98.1% for the para-aortic field, suggesting SLN mapping could be a valuable tool in this context.
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  • This study aims to explore how not following the Enhanced Recovery After Surgery (ERAS) protocol affects post-operative complications in women who have had open surgery for gynecological cancers.
  • It focuses on patients with various types of gynecological cancers undergoing elective surgeries and examines the relationship between compliance to ERAS guidelines and complication rates on the second day after surgery.
  • The trial will include around 600 participants, with results expected to be reported by the end of 2025.
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This is a protocol for a Cochrane Review (prognosis). The objectives are as follows: To evaluate the predictive value of the prognostic factor HRD status, as determined by various clinically validated HRD assays at the time of staging laparotomy, compared to BRCA1/2 mutation status for progression-free survival and overall survival in patients with tubo-ovarian high-grade serous carcinoma treated in the first-line setting with a combination of surgery and platinum-based chemotherapy and/or maintenance with PARP inhibitors.

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Aim: The aim of this study was to assess whether the use of sentinel lymph node (SLN) in addition to lymphadenectomy was associated with survival benefit in patients with early-stage cervical cancer.

Methods: International, multicenter, retrospective study.

Inclusion Criteria: cervical cancer treated between 01/2007 and 12/2016 by surgery only; squamous cell carcinoma, adenocarcinoma, adenosquamous carcinoma, FIGO 2009 stage IB1-IIA2, negative surgical margins, and laparotomy approach.

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  • The study examines the prevalence of peritoneal metastasis in patients with locally advanced cervical cancer (LACC) and how it affects treatment and prognosis.
  • It found that 13.2% of the 251 patients had peritoneal metastasis, significantly impacting treatment plans for many of them.
  • The research also revealed that standard imaging techniques like PET/CT and MRI have low sensitivity in detecting peritoneal disease, emphasizing the need for routine diagnostic laparoscopy in high-risk patients.
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After the publication of the Laparoscopic Approach to Cervical Cancer (LACC) trial, open surgery has become the standard approach for radical hysterectomy in early stage cervical cancer. Recent studies assessed the role of a non-radical approach in low risk cervical cancer and showed no survival difference compared with radical hysterectomy. However, there is a gap in knowledge regarding the oncologic outcomes of minimally invasive simple hysterectomy in low risk cervical cancer.

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In March 2024, 12 European Network of Young Gynae Oncologists- (ENYGO-IJGC) Editorial Fellows conducted 10 interviews with senior opinion leaders on original and controversial topics in the field of gynecologic oncology presented during the 25th European Society of Gynaecological Oncology (ESGO) Congress in Barcelona, Spain. This article provides a summary and overview of the content of these discussions summarizing key points presented at the meeting. These selected interviews were chosen by consensus by the ENYGO-IJGC Editorial Fellows based on novelty and relevance to the field of gynecologic oncology.

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Preservation of fertility without compromising oncological outcomes is a major objective in young patients at the time of cancer treatment (Azaïs et al., 2018, Bizzarri et al., 2022).

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The 'Best of ESGO 2024' article includes a selection of the most highly rated original research presented during the 25th Annual Congress of the European Society of Gynaecologic Oncology (ESGO), held in Barcelona, Spain, March 7-10, 2024. Of 1218 asbtracts submitted, 35 studies presented during the best oral sessions, mini oral sessions, best three minute presentations session, and young investigator session were selected by the ESGO abstract committee and the authors of the European Network of Young Gynae Oncologists (ENYGO). There was a strong focus on the surgical treatment of early stage cervical cancer and the management of advanced or recurrent gynecological cancers using induction therapy, immunotherapy, and maintenance therapy.

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Purpose Of Review: The rationale on the use of sentinel lymph node (SLN) biopsy in the surgical staging of apparent early-stage ovarian cancer (OC) is supported by the fact that diagnostic and prognostic role of systematic staging lymphadenectomy has been determined but its therapeutic significance is still matter of controversy. Moreover, SLN biopsy represents an option to decrease intra- and postoperative morbidity. The present review aims to provide an overview on the current and future role of SLN in OC.

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Objective: To investigate the prevalence and patterns of social media use among gynecologic oncologists for professional and academic purposes.

Methods: A prospective online survey between November and December 2022 targeted gynecologic oncology practitioners (gynecologic oncologists, surgical oncologists, medical oncologists, radiation/clinical oncologists, and onco-pathologists/pathologists). The survey, distributed via various social media platforms, included 40 questions to capture qualitative and quantitative data on social media use.

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Background: PIPAC is a recent approach for intraperitoneal chemotherapy with promising results for patients with peritoneal carcinomatosis. A systematic review was conducted to assess current evidence on the efficacy and outcomes of PIPAC in patients affected by ovarian cancer.

Methods: The study adhered to the PRISMA guidelines.

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Background: Radio(chemo)therapy is often required in pelvic malignancies (cancer of the anus, rectum, cervix). Direct irradiation adversely affects ovarian and endometrial function, compromising the fertility of women. While ovarian transposition is an established method to move the ovaries away from the radiation field, surgical procedures to displace the uterus are investigational.

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Article Synopsis
  • This study looked at whether being obese (having a BMI over 30) affects how well women with certain cancers (like cervical, ovarian, and endometrial) survive compared to those who are not obese.
  • Researchers analyzed data from 21 different studies with over 14,000 patients.
  • The results showed no clear survival benefits for obese women with these cancers and even found that obese women with endometrial cancer had a lower survival rate by 44%.
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  • - This study assessed whether radiomic features from pretreatment [F]FDG PET scans could better predict tumor response and survival in patients with locally advanced cervical cancer after chemoradiotherapy and surgery compared to traditional PET measurements and histopathologic data.
  • - Out of 195 patients analyzed, 67.2% showed no or minimal residual tumors after treatment, while 32.8% had larger residual tumors; further follow-ups indicated a 31.3% recurrence or progression rate, with 20% mortality due to the disease.
  • - Although some conventional and radiomic features were found to differ between responders and nonresponders, the predictive power for survival and response was generally low, with most metrics yielding areas under the curve
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Platinum and taxane chemotherapy is associated with the risk of hypersensitivity reactions (HSRs), which may require switching to less effective treatments. Desensitization to platinum and taxane HSRs can be used to complete chemotherapy according to the standard regimen. Therefore, we aimed to investigate the current management of HSRs to platinum and/or taxane chemotherapy in patients with gynecologic cancers.

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Introduction: Ultrasound has been nicknamed "the surgeon's stethoscope". The advantages of laparoscopic ultrasound beyond a substitute for the sense of touch are considerable, especially for robotic surgery. Being able to see through parenchyma and into vascular structures enables to avoid unnecessary dissection by providing a thorough assessment at every stage without the need for contrast media or ionising radiation.

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Article Synopsis
  • The study aimed to analyze the effectiveness of operative hysteroscopy in preserving fertility for patients with endometrial cancer and premalignancies, as well as to assess related medical therapies and pregnancy outcomes.
  • A semi-systematic literature review of 15 studies involving 458 patients was conducted, showing a pregnancy rate of 31.9% with 66.4% of those resulting in live births, while complications from the procedure were reported infrequently.
  • The authors suggest future research should integrate molecular classification to enhance personalized fertility-preserving strategies for treating endometrial malignancies.
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Indocyanine green (ICG), a well-known molecule employed in medicine for over five decades, has emerged as a versatile dye widely embraced across various surgical disciplines. In gynecologic oncology, its prevalent use revolves around the detection of sentinel lymph nodes. However, the true potential of ICG extends beyond this singular application, owing to its pragmatic utility, cost-effectiveness, and safety profile.

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