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RISS 인기검색어
- 검색키워드
- 저자 : Alessandro Gioè (검색결과 2 건)
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Emanuele Perrone,Ilaria Capasso,Tina Pasciuto,Alessandro Gioè,Salvatore Gueli Alletti,Stefano Restaino,Giovanni Scambia,Francesco Fanfani 대한부인종양학회 2021 Journal of Gynecologic Oncology Vol.32 No.3
Objective: The aim of this study is to analyze and draw the potential differences between therobotic-assisted surgery (RS) and the laparoscopy (LPS) in endometrial cancer staging. Methods: In this single-institution retrospective study we enrolled 1,221 consecutive clinicalstage I–III endometrial cancer patients undergone minimally invasive surgical staging. Wecompared patients treated by LPS and by RS, on the basis of perioperative and oncologicaloutcomes (disease-free survival [DFS] and overall survival [OS]). A sub-analysis of the high risk endometrial cancer population was performed in the 2 cohorts. Results: The 2 cohorts (766 treated by LPS and 455 by RS) were homogeneous in termsof perioperative and pathological data. We recorded differences in number of relapse/progression (11.7% in LPS vs. 7% in RS, p=0.008) and in number of deaths (9.8% in LPSvs. 4.8% in RS, p=0.002). Whereas, univariate and multivariate analyses according to DFSand OS confirmed that the surgical approach did not influence the DFS or the OS. In themultivariable analysis the association of the age and grading was significant for DFS and OS. In the sub-analysis of the 426 high risk EC patients (280 in LPS and 146 in RS) the univariateand the multivariate confirmed the influence of the age in DFS and OS, independently of theminimally invasive approach. Conclusions: In our large retrospective analysis, we confirmed that the RS and LPS havesimilar efficacy and safety for endometrial cancer staging also for the high-risk endometrialcancer patients.
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Lucia Tortorella,Stefano Restaino,Gianfranco Zannoni,Giuseppe Vizzielli,Vito Chiantera,Serena Cappuccio,Alessandro Gioè,Eleonora La Fera,Giorgia Dinoi,Giuseppe Angelico,Giovanni Scambia,Francesco Fanf 대한부인종양학회 2021 Journal of Gynecologic Oncology Vol.32 No.2
Objective: The aim of this study is to analyze the prognostic role of lymph-vascular spaceinvasion (LVSI), evaluated in a semi-quantitative fashion on prognosis of early stage, low riskendometrial cancer (EC). Methods: We enrolled patients who underwent surgery for endometrial cancer between2003 and 2018 in two referral cancer center. All patients had endometrioid EC, G1–G2, withmyometrial invasion <50%, and no lymph-node involvement. LVSI was analyzed in a semi quantitative way, according to a 3-tiered scoring system in absent, focal and substantial. Results: Among 524 patients, any positive LVSI was found in 57 patients (10.9%) with focalLVSI (n=35, 6.7%) and substantial LVSI (n=22, 4.2%). Substantial LVSI was associated tohigher rate of G2 (p<0.001), myometrial infiltration (p=0.002) and greater tumor dimensions(p=0.014). Patients with substantial LVSI were more likely to receive adjuvant treatment(6.6% vs. 52.6%, p<0.001). The 5-year OS was 99.5% in patients with absent LVSI and 70.6%in those with substantial LVSI (p<0.001). The 5-year disease free survival (DFS) was 93.6%in patients with absent LVSI and 56.5% in those with substantial LVSI (p<0.001). The rate ofdistant failures increased from 1.8% for absent LVSI to 22.7% for substantial LVSI (p=0.002). In univariate analysis substantial LVSI was the strongest predictor of poor overall survival(hazard ratio [HR]=11.9, p=0.001). Multivariate analysis showed that substantial LVSI wasan independent predictive factor of both recurrence (HR=5.88, p=0.001) and distant failure(HR=10.6, p=0.006). Conclusions: Substantial LVSI represents the strongest independent risk factor for decreasedsurvival and distant relapse, indicating a role for potential hematogenous dissemination.
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