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- 저자 : Mario Malzoni (검색결과 2 건)
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Marcello Ceccaroni,Giovanni Roviglione,Mario Malzoni,Francesco Cosentino,Emanuela Spagnolo,Roberto Clarizia,Paolo Casadio,Renato Seracchioli,Fabio Ghezzi,Daniele Mautone,Francesco Bruni,Stefano Uccell 대한부인종양학회 2021 Journal of Gynecologic Oncology Vol.32 No.1
Objective: Total laparoscopic nerve-sparing radical hysterectomy (TL-NSRH) has beenconsidered a promising approach, however, surgical, clinical, oncological and functionaloutcomes have not been systematically addressed. We present a large retrospective multi center experience comparing TL-NSRH vs. open abdominal NSRH (OA-NSRH) for early andlocally-advanced cervical cancer, with particular emphasis on post-surgical pelvic function. Methods: All consecutive patients who underwent class C1-NSRH plus bilateral pelvic + para aortic lymphadenectomy for stage IA2–IIB cervical cancer at 4 Italian gynecologic oncologiccenters (Negrar, Varese, Bologna, Avellino) were enrolled. Patients were divided into TL NSRH and OA-NSRH groups and were investigated with preoperative questionnaires onurinary, rectal and sexual function. Postoperatively, patients filled a questionnaire assessingquality of life, taking into account sexual function and psychological status. Oncologicaloutcomes were analyzed using Kaplan-Meyer method. Results: 301 consecutive patients were included in this study: 170 in the TL-NSRH group and131 in the OA-NSRH group. Patients in the OA-NSRH group were more likely to experienceurinary incontinence and (after 12-months follow-up) urinary retention. No patient in theTL-NSRH group vs. 5 (5.5%) in the OA-NSRH group had complete urinary retention (at the>24-month follow-up [p=0.02]). A total of 20 (11.8%) in the TL-NSRH and 11 (8.4%) patientsin the OA-NSRH had recurrence of disease (p=0.44) and 14 (8.2%) and 9 (6.9%) died ofdisease during follow-up, respectively (p=0.83). Conclusion: Our study shows that TL-NSRH is feasible, safe and effective and conjugatesadequate radicality and improvement in post-operative functional outcomes. Oncologicaloutcomes of laparoscopic procedures deserve further investigation.
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Francesca Falcone,Umberto Leone Roberti Maggiore,Violante Di Donato,Anna Myriam Perrone,Luigi Frigerio,Giuseppe Bifulco,Stephan Polterauer,Paolo Casadio,Gennaro Cormio,Valeria Masciullo,Mario Malzoni 대한부인종양학회 2020 Journal of Gynecologic Oncology Vol.31 No.5
Objective: ‘The Endometrial Cancer Conservative Treatment (E.C.Co.). A multicentre archive’is a worldwide project endorsed by the Gynecologic Cancer Inter-Group, aimed at registeringconservatively treated endometrial cancer (EC) patients. This paper reports the oncologicaland reproductive outcomes of intramucous, G2, endometrioid EC patients from this archive. Methods: Twenty-three patients (Stage IA, G2, endometrioid EC) were enrolled betweenJanuary 2004 and March 2019. Primary and secondary endpoints were, respectively, completeregression (CR) and recurrence rates, and pregnancy and live birth rates. Results: A median follow-up of 35 months (9–148) was achieved. Hysteroscopic resection(HR) plus progestin was adopted in 74% (17/23) of cases. Seventeen patients showed CR(median time to CR, 6 months; 3-13). Among the 6 non-responders, one showed persistenceand 5 progressed, all submitted to definitive surgery, with an unfavorauble outcome in one. The recurrence rate was 41.1%. Ten (58.8%) complete responders attempted to conceive, ofwhom 3 achieved at least one pregnancy with a live-birth. Two out of the 11 candidate patientsunderwent definitive surgery, while the remaining 9 have so far refused. To date, 22 patientsshow no evidence of disease, and one is still alive with disease. Conclusions: Fertility-sparing treatment seems to be feasible even in G2 EC, although cautionshould be kept considering the potential pathological undergrading or non-endometrioid histology misdiagnosis. The low rate of attempt to conceive and of compliance to definitivesurgery underline the need for a ‘global’ counselling extended to the follow-up period.
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