Publications by authors named "Scarfone G"

Endometrial carcinoma (EC) is the most frequent gynecological cancer, with an increasing incidence and mortality in recent times. The last decade has represented a true revolution with the development of the integrated histo-molecular classification of EC, which allows for the stratification of patients with morphologically indistinguishable disease into groups with different prognoses. Particularly, the POLE-mutated subgroup exhibits outstanding survival.

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Background: Pregnancy associated breast cancer is the most common cancer diagnosed during pregnancy. When chemotherapy is indicated, although it is more common to use anthracycline-based chemotherapy as a first treatment, we suggest weekly paclitaxel as a valid alternative both in the adjuvant and neoadjuvant setting, as this allows for weekly assessment of maternal-fetal well-being and a quicker maternal and fetal bone marrow recovery in cases of unexpected preterm delivery.

Patients And Methods: We present a case series of pregnant breast cancer patients treated with weekly paclitaxel between 2016 and 2022.

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Background: Malignant ovarian germ cell tumors usually occur in young women. The standard of care is fertility sparing surgery and comprehensive surgical staging followed by adjuvant chemotherapy with BEP (bleomycin, etoposide, cisplatin) if needed. The aim of this study was to analyze the reproductive outcomes after conservative treatment in patients diagnosed, treated and followed up in MITO (Multicenter Italian Trials in Ovarian Cancer) centers.

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  • The study investigates the safety of using taxane-based chemotherapy for breast cancer during pregnancy, focusing on the risks for both mothers and newborns.
  • It involved 103 patients, primarily treated with paclitaxel and anthracyclines, with a median taxane initiation at 28 weeks of gestation.
  • Results showed a low incidence of severe adverse events, with a high live birth rate and generally favorable obstetric outcomes, supporting the use of taxanes during pregnancy when necessary.
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Background: A diagnosis of cancer during pregnancy or within one year after the end of pregnancy is a major clinical and public health issue. The current study aimed at estimating the incidence of pregnancy-associated cancer (PAC) and assessing whether the risk of abortion is increased in women diagnosed with cancer.

Methods: This population-based cohort study used the regional healthcare utilization (HCU) databases of Lombardy, the largest region in Italy, to identify the women who delivered between 2010 and 2020.

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  • - The study investigates the prevalence and trends of pregnancy-associated cancer (PAC) in Italy, highlighting the growing concern as more women delay childbirth.
  • - Utilizing data from 19 cancer registries covering 22% of the population, the research analyzed over 2.8 million pregnancies, identifying 3,559 cases of PAC with breast, thyroid, and melanoma cancers being the most common types.
  • - Findings indicate a rising trend of PAC from 2003 to 2015, with 53.1% of cases resulting in delivery, emphasizing a shift in clinical practices for managing cancer during pregnancy, providing crucial insights for healthcare providers.
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Background: Breast cancer during pregnancy (PrBC) is a rare condition known for its aggressive clinical behavior. The presence of tumor-infiltrating lymphocytes (TILs) has been shown to have a significant impact on the prognosis of these patients. Despite some biological characteristics of the tumor that may differ depending on the gestational age, little is known about the dynamics of the immune landscape within the tumor microenvironment (TME) in PrBC.

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Breast cancer during pregnancy (PrBC) is a rare tumor with only a little information on its immune landscape. Here, we sought to characterize the cellular composition of the tumor microenvironment (TME) of PrBC and identify its differences from early-onset breast cancer (EOBC) in non-pregnant women. A total of 83 PrBC and 89 EOBC were selected from our Institutional registry and subjected to tumor-infiltrating lymphocytes (TILs) profiling and immunohistochemistry for CD4, CD8, forkhead box P3 (FOXP3), and programmed death-ligand 1 (PD-L1) (clone 22C3).

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  • The study investigates how the COVID-19 outbreak affected the presentation and treatment of endometrial cancer (EC) patients in Italy by comparing data from before and during the pandemic.
  • Researchers analyzed medical records from 5,164 EC patients across 54 centers, noting changes in treatment methods and patient care.
  • The findings indicate a significant shift in treatment patterns, including an increase in the use of sentinel node mapping and adjuvant therapy, highlighting the need for improved healthcare services during such disruptions.
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  • Breast cancer is the most common cancer diagnosed in pregnant women, particularly in early-stage cases during the first trimester.
  • A study evaluated the safety and feasibility of breast-conserving surgery (BCS) followed by radiation therapy after delivery in 30 women diagnosed with early-stage breast cancer during this time, finding no immediate surgical complications or local recurrences for up to five years.
  • Long-term follow-up (14-17 years) showed a small percentage of isolated local recurrences and metastases, with outcomes similar to those who underwent radical surgery, indicating that BCS is a viable option for early-stage breast cancer in pregnant patients.
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  • Chemotherapy during the first trimester of pregnancy is risky due to the potential for congenital malformations, but the safe timing for starting treatment is not well-defined.* -
  • This study analyzed data from 755 pregnant women receiving chemotherapy from 1977 to 2019, focusing on the rates of major and minor congenital malformations in their children.* -
  • The findings revealed a significant increase in major congenital malformations (21.7%) when chemotherapy was given before 12 weeks of gestation, compared to a lower rate (3.0%) when treatment began after 12 weeks, aligning more closely with general population rates.*
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Objective: The aim of this study was to analyze the oncological outcome of stage I malignant ovarian germ cell tumors patients included in the MITO-9 study to identify those who might be recommended routine surveillance alone after complete surgical staging.

Methods: MITO-9 was a prospective observational study analyzing data collected between January 2013 and December 2019. Three groups were identified: group A included 13 patients stage IA dysgerminoma and IAG1 immature teratoma; group B included 29 patients with stage IB-C dysgerminomas, IA-C G2-G3 immature teratomas and stage IA mixed malignant ovarian germ cell tumors and yolk sac tumors; and group C included five patients (two patients with stage IC1 and one patient with stage IC2 yolk sac tumors and two patients with mixed-stage IC2 malignant ovarian germ cell tumors).

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Data on the long-term neurodevelopmental outcomes of children exposed to hematological maternal cancer with or without treatment during pregnancy are lacking. A total of 57 children, of whom 33 males and 24 females, prenatally exposed to hematological malignancies and its treatment, were invited for neuropsychological and physical examinations at 18 months, 36 months, 6, 9, 12, 15 and 18 years of age. Oncological, obstetrical, neonatal and follow-up data of these children were collected.

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Cancer diagnosed during pregnancy is a rare event. The most common type of malignancy diagnosed in pregnant women is breast cancer, whose incidence is expected to raise in the next future due to delayed childbirth, as well as to the increased occurrence of the disease at young age. Pregnant women diagnosed with breast cancer are exposed to multiple sources of stress, which may lead to poorer obstetric outcomes, such as preterm birth and low birth weight.

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  • This case report details a patient with metastatic lung adenocarcinoma who became pregnant while undergoing alectinib treatment, with a specialized team managing her case.
  • The patient chose to continue her medication during pregnancy, resulting in a healthy delivery of a baby girl at 35 weeks and 5 days, with normal fetal development throughout.
  • Post-birth analyses showed alectinib concentrations significantly higher in the mother’s bloodstream compared to the fetus, and both mother and baby remained healthy with no observed developmental issues over the first 20 months.
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Objective: Juvenile type granulosa cell tumor (JGCTs) are extremely rare, mainly diagnosed in young women and pre-pubertal girls at stage I disease. Literature is scanty and guidelines regarding the optimal management are still controversial. The aim of this study is to add on the experience of the MITO group (Multicenter Italian Trials in Ovarian Cancer).

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Background: Pregnancy associated cancer (PAC) may lead to adverse obstetric and neonatal outcomes. This study aims to assess the association between PACs and adverse perinatal outcomes [i.e.

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Background: The role of surveillance after surgery for stage IA-C grade 2 (G2) or grade 3 (G3) immature teratomas (ITs) is controversial with many guidelines advocating adjuvant chemotherapy. Here, we investigate the safety of surveillance in stage IA-C G1-3 ITs.

Methods: Clinicopathological data were analysed on postpubertal patients with stage I pure ITs in Multicenter Italian Trials in Ovarian Cancer centres and at Charing Cross Hospital, UK, between January 1985 and January 2018.

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  • Research on pregnancy-associated cancer (PAC) is inconsistent due to varied study designs, methodologies, and populations.
  • A systematic review of 24 studies revealed that the overall frequency of PAC is approximately 1 in 1000 pregnancies, with 25% diagnosed during pregnancy.
  • To improve accuracy, a unified approach in identifying PAC is necessary to address existing methodological issues.
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  • Breast cancer occurs in about 0.3% of pregnant women, and chemotherapy during pregnancy can lead to complications like preeclampsia and growth issues for the fetus.
  • A study using pregnant mice treated with doxorubicin (a type of chemotherapy) showed significant negative impacts on umbilical blood flow, embryo weight, and placental function, with indications of increased cell death and growth in the placentas.
  • Analysis of human placentas from breast cancer patients treated with epirubicin revealed similar effects, such as increased cell proliferation and death, along with reduced new blood vessel formation, suggesting that chemotherapy can cause harm to the placenta and highlight the need for protective strategies during treatment.
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Objective: To evaluate histological alterations in placentas of women affected by breast cancer and treated with chemotherapy during pregnancy.

Study Design: We retrospectively reviewed histological slides of 23 placentas of patients affected by breast cancer and treated with chemotherapy during pregnancy and 23 control placentas of women without breast cancer and with physiological pregnancies of the same gestational age.

Results: All the patients had breast ductal infiltrating carcinoma, 19 of 23 cases had a G3 cancer.

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Olaparib is the first poly(ADP-ribose) polymerase inhibitor approved as maintenance therapy of recurrent ovarian cancer (OC) patients with a BRCA mutation. To achieve the maximum clinical benefit, adherence to olaparib must be persistent. However, in clinical practice, this is challenged by the frequent suboptimal management of toxicities.

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Objective: Limited data are available on the frequency and time trends of pregnancy-associated cancers, particularly from Southern European countries. The aim of this study was to analyze the frequency and time trends of pregnancy-associated cancer in Italy.

Methods: This was a population-based linkage study using the regional hospital discharge forms database of four Italian regions with more than 17 million inhabitants.

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Objective: Children exposed to chemotherapy in the prenatal period demonstrate normal neurocognitive development at 3 years but concerns regarding fetal brain growth remain high considering its vulnerability to external stimuli. Our aim was to evaluate the impact of in-utero chemotherapy exposure on brain growth and its effects on neurodevelopmental outcome.

Methods: The protocol was approved by the local ethics committee.

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