Publications by authors named "Zanagnolo V"
Objective: No biomarkers are available to predict treatment response in patients with endometrial cancers who undergo fertility-sparing treatment. Therefore, we aimed to evaluate the prognostic role of molecular classification.
Methods: Patients with endometrial cancer who underwent fertility-sparing treatment with progestins between 2005 and 2021 were retrospectively identified.
Article Synopsis
- The study aimed to determine the recurrence rate of para-aortic lymph nodes in patients with early-stage cervical cancer who did not have surgical staging for these nodes while undergoing radical surgery.
- A total of 432 patients were included, with a focus on various stages of cervical cancer and the follow-up revealed that only 0.5% of patients experienced recurrence in the para-aortic lymph nodes.
- The overall 5-year recurrence-free survival rate for the cohort was found to be 90%, suggesting that para-aortic lymphadenectomy may not be necessary in all early-stage cases.
SENECA study: staging endometrial cancer based on molecular classification.
Int J Gynecol Cancer
September 2024
Objective: Management of endometrial cancer is advancing, with accurate staging crucial for guiding treatment decisions. Understanding sentinel lymph node (SLN) involvement rates across molecular subgroups is essential. To evaluate SLN involvement in early-stage (International Federation of Gynecology and Obstetrics 2009 I-II) endometrial cancer, considering molecular subtypes and new European Society of Gynaecological Oncology (ESGO) risk classification.
View Article and Find Full Text PDFObjective: To assess the distribution of molecular classes and their impact on the risk of recurrence in endometrial cancer patients with lymph node metastasis at the time of primary surgery.
Methods: Endometrial cancer patients with lymph node micrometastasis or macrometastasis (International Federation of Gynecology and Obstetrics (FIGO) 2009 stage IIIC) after surgical staging at five referral centers worldwide from October 2013 to September 2022 who underwent molecular classification were identified. Endometrial cancers were categorized into four molecular classes: POLE mutated, mismatch repair deficient, p53 abnormal, and no specific molecular profile.
Article Synopsis
- - Cancer-associated thrombosis is a significant issue for cancer patients, ranking as the second leading cause of death, prompting a survey among MITO-MaNGO members to assess thromboembolic prophylaxis practices.
- - The survey revealed that 82% of respondents recognize the importance of prophylaxis in gynecologic oncology, with most centers employing standardized protocols for patients undergoing surgery or chemotherapy.
- - Despite this awareness, only 26% of respondents utilized a thromboembolic risk assessment scale, suggesting a gap in the application of preventative measures, particularly for outpatient settings.
The prevention and appropriate management of venous thromboembolism in cancer patients is of paramount importance. However, the literature data report an underestimation of this major problem in patients with gynecological cancers, with an inconsistent venous thromboembolism risk assessment and prophylaxis in this patient setting. This narrative review provides a comprehensive overview of the available evidence regarding the management of venous thromboembolism in cancer patients, focusing on the specific context of gynecological tumors, exploring the literature discussing risk factors, risk assessment, and pharmacological prophylaxis.
View Article and Find Full Text PDFObjective: Ultrastaging is accurate in detecting nodal metastases, but increases costs and may not be necessary in certain low-risk subgroups. In this study we examined the risk of nodal involvement detected by sentinel lymph node (SLN) biopsy in a large population of apparent early-stage endometrial cancer and stratified by histopathologic characteristics. Furthermore, we aimed to identify a subgroup in which ultrastaging may be omitted.
View Article and Find Full Text PDFBackground: Endometrial cancers with more than one molecular feature- mutations (POLEmut), mismatch repair protein deficiency (MMRd), p53 abnormality (p53abn)-are called 'multiple classifiers'.
Objective: To describe our cohort of multiple classifiers and to report the results of a review on their incidence and the techniques used to identify them.
Methods: Multiple classifiers identified at the European Institute of Oncology, Milan, between April 2019 and Decmber 2022, were included.
Article Synopsis
- The study aims to evaluate the prognostic impact of isolated tumor cells in sentinel lymph nodes (SLNs) of low-risk endometrial cancer patients who did not receive additional therapy.
- A total of 494 patients were analyzed, finding that recurrence rates were higher in those with SLN-isolated tumor cells, with significant differences in recurrence-free survival between this group and node-negative patients.
- Although isolated tumor cells were associated with poorer recurrence-free outcomes, no significant differences in overall survival between the two groups were observed.
Objective: To evaluate the role of dose-dense neoadjuvant chemotherapy followed by radical hysterectomy in reducing adjuvant radiotherapy in International Federation of Gynecology and Obstetrics (FIGO) 2018 stage IB1-IB2/IIA1 cervical cancer with disrupted stromal ring and as an alternative to concurrent chemoradiotherapy in FIGO 2018 stages IB3/IIA2.
Methods: This was a retrospective cohort study including patients with FIGO 2018 stage IB1-IIA2 cervical cancer undergoing dose-dense neoadjuvant chemotherapy at the European Institute of Oncology in Milan, Italy between July 2014 and December 2022. Weekly carboplatin (AUC2 or AUC2.
Non-metastatic neuroendocrine carcinoma of the cervix (NECC) is a rare and aggressive disease. Lacking prospective studies, the optimal multimodal treatment approach has not yet been clearly defined. This study aims to assess the clinical outcomes of patients with non-metastatic NECC treated with surgery and (neo)adjuvant chemotherapy, according to pathologic prognostic factors and multimodal treatments received.
View Article and Find Full Text PDFObjective: To evaluate whether compliance with European Society of Gynaecological Oncology (ESGO) surgery quality indicators impacts disease-free survival in patients undergoing radical hysterectomy for cervical cancer.
Methods: In this retrospective cohort study, 15 ESGO quality indicators were assessed in the SUCCOR database (patients who underwent radical hysterectomy for International Federation of Gynecology and Obstetrics (FIGO) stage 2009 IB1, FIGO 2018 IB1, and IB2 cervical cancer between January 2013 and December 2014), and the final score ranged between 0 and 16 points. Centers with more than 13 points were classified as high-quality indicator compliance centers.
Simple Summary: Low-grade serous ovarian cancer (LGSOC) represents an uncommon histotype of serous ovarian cancer (accounting for approximately 5% of all ovarian cancer) with a distinct behavior compared to its high-grade serous counterpart, characterized by a better prognosis and low response rate to chemotherapeutic agents. Similar to high-grade serous ovarian cancer, cytoreductive surgery is considered crucial for patient survival. This retrospective study aimed to analyze the outcomes of women affected by advanced stages (III-IV FIGO) of LGSOC from two high-volume oncological centers for ovarian neoplasm.
View Article and Find Full Text PDFObjective: Optimal management of the contralateral groin in patients with early-stage vulvar squamous cell carcinoma (VSCC) and a metastatic unilateral inguinal sentinel lymph node (SN) is unclear. We analyzed patients who participated in GROINSS-V I or II to determine whether treatment of the contralateral groin can safely be omitted in patients with a unilateral metastatic SN.
Methods: We selected the patients with a unilateral metastatic SN from the GROINSS-V I and II databases.
Assessing the role of minimally invasive radical hysterectomy for early-stage cervical cancer.
Eur J Obstet Gynecol Reprod Biol
August 2022
Article Synopsis
- - Surgery is the primary treatment for early-stage cervical cancer, with minimally invasive radical hysterectomy being the standard until the LACC trial raised concerns about its effectiveness.
- - The LACC trial found that minimally invasive surgery led to worse disease-free and cancer-specific survival compared to traditional open surgery, reinforcing similar findings from other retrospective studies.
- - The review aims to evaluate the current evidence on minimally invasive radical hysterectomy's role in cervical cancer and address unresolved questions about its use in early-stage patients.
Objective: To compare the risk class attribution with to those with according to the European Society of Gynaecological Oncology/European Society for Radiotherapy and Oncology/European Society of Pathology (ESGO/ESTRO/ESP) 2020 guidelines on endometrial cancer, with a focus on risk group migration. Additionally, to evaluate the capability of a novel molecular analysis algorithm to reduce the number of required tests.
Methods: We conducted a retrospective study including all consecutive patients with endometrial cancer undergoing surgery and comprehensive molecular analyses between April 2019 and December 2021.
Objective: To evaluate disease-free survival of cervical conization prior to radical hysterectomy in patients with stage IB1 cervical cancer (International Federation of Gynecology and Obstetrics (FIGO) 2009).
Methods: A multicenter retrospective observational cohort study was conducted including patients from the Surgery in Cervical Cancer Comparing Different Surgical Aproaches in Stage IB1 Cervical Cancer (SUCCOR) database with FIGO 2009 IB1 cervical carcinoma treated with radical hysterectomy between January 1, 2013, and December 31, 2014. We used propensity score matching to minimize the potential allocation biases arising from the retrospective design.
Article Synopsis
- 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.
Introduction: Comprehensive updated information on cervical cancer surgical treatment in Europe is scarce.
Objective: To evaluate baseline characteristics of women with early cervical cancer and to analyze the outcomes of the ESGO quality indicators after radical hysterectomy in the SUCCOR database.
Methods: The SUCCOR database consisted of 1272 patients who underwent radical hysterectomy for stage IB1 cervical cancer (FIGO 2009) between January 2013 and December 2014.
Objective: To assess oncologic outcomes in endometrial cancer patients with low-volume metastasis (LVM) in the sentinel lymph nodes (SLNs).
Methods: Patients with endometrial cancer and SLN-LVM (≤2 mm) from December 3, 2009, to December 31, 2018, were retrospectively identified from 22 centers worldwide. Patients with International Federation of Gynecology and Obstetrics (FIGO) stage IV, adnexal involvement, or unknown adjuvant therapy (ATx) were excluded.
Objectives: To evaluate the role of cervical re-injection of indocyanine green (ICG) to increase the detection rate of sentinel lymph node (SLN) in patients with endometrial cancer (EC) who underwent robotic-assisted surgical staging.
Methods: We retrospectively identified consecutive EC patients undergoing robotic-assisted staging with SLN biopsy at our Institution between June 2016 and April 2020. Patients were excluded if they had open abdominal surgical approach, neoadjuvant chemotherapy, and advanced stage [International Federation of Gynecology and Obstetrics (FIGO) stage III-IV] at diagnosis.
Ovarian transposition aims to minimize ovarian exposure and damage during pelvic radiotherapy. One or both ovaries are separated from the uterus and mobilized away from the area where the radiation will be administered. A review of the available literature was conducted to evaluate the efficacy and safety of ovarian transposition among pre-menopausal women diagnosed with cervical cancer and eligible for pelvic radiotherapy.
View Article and Find Full Text PDFSame-day discharge protocol for laparoscopic treatment of adnexal disease: management and acceptance.
Minim Invasive Ther Allied Technol
March 2022
Objective: Develop a 'same-day discharge' setting for laparoscopic treatment of adnexal disease.
Setting: Preventive Gynecology, European Institute of Oncology, Milan, Italy.
Population: Two hundred patients undergoing laparoscopic procedures.