http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
Francesco Raspagliesi,Flavia Zanaboni,Fabio Martinelli,Santiago Scasso,Joel Laufer,Antonino Ditto 대한부인종양학회 2014 Journal of Gynecologic Oncology Vol.25 No.1
Objective: The therapeutic outcomes of patients with advanced vulvar cancer are poor. Multi-modality treatments including concurrent chemoradiation or different regimens of neoadjuvant chemotherapy (NACT), and surgery have been explored to reduce the extent of surgery and morbidity. The present single-institution trial aimed to evaluate the efficacy and toxicity of paclitaxel and cisplatin in locally advanced vulvar cancer. Methods: From 2002 to 2009, 10 patients with stage III-IV locally advanced squamous cell carcinoma of the vulva were prospectively treated with 3 courses of paclitaxel-ifosfamide-cisplatin or paclitaxel-cisplatin. Nine of them subsequently underwent radical local excision or radical partial vulvectomy and bilateral inguino-femoral lymphadenectomy. Results: The clinical response rate of all enrolled patients was 80%, whereas the pathological responses included 1 case with complete remission, 2 with persistent carcinoma in situ, and 6 invasive cancer cases with tumor shrinkage of more than 50%. Four patients had positive nodes. Forty percent of patients experienced grade 3-4 bone marrow toxicity, which was successfully managed with granulocyte-colony stimulating factor, even in cases of elderly patients. Median progression-free survival after surgery was 14 months (range, 5 to 44 months). Six of the 7 recurrent cases were local, and 3 of them were treated with salvage surgery while the other 3 received radiation with or without chemotherapy. After a median follow-up period of 40 months (range, 5 to 112 months), 55.5% of patients remained alive with no evidence of disease, including 2 long-term survivors after recurrence at 5 and 9 years. Conclusion: Based on the high response rate and manageable toxicity, NACT with paclitaxel and cisplatin with or without ifosfamide followed by surgery could be considered as a therapeutic option for locally advanced vulvar cancer.
Current landscape and future perspective of sentinel node mapping in endometrial cancer
Giorgio Bogani,Francesco Raspagliesi,Umberto Leone Roberti Maggiore,Andrea Mariani 대한부인종양학회 2018 Journal of Gynecologic Oncology Vol.29 No.6
Endometrial cancer (EC) represents the most common gynecological neoplasm in developed countries. Surgery is the mainstay of treatment for EC. Although EC is characterized by a high prevalence several features regarding its management are still unclear. In particular the execution of lymphadenectomy is controversial. The recent introduction of sentinel node mapping represents the mid-way between the execution and omission of node dissection in EC patients. In the present review we discuss the emerging role of sentinel node mapping in EC. In addition, we discussed how type of tracers utilized and site of injection impacted on sentinel node detection rates. Future perspective regarding EC management are also discussed.
Sentinel node mapping in endometrial cancer
Giorgio Bogani,Andrea Giannini,Enrico Vizza,Francesco Raspagliesi,Violante Di Donato 대한부인종양학회 2024 Journal of Gynecologic Oncology Vol.35 No.1
Nodal status is one of the most important prognostic factors for patients with apparentearly stage endometrial cancer. The role of retroperitoneal staging in endometrial cancer iscontroversial. Nodal status provides useful prognostic data, and allows to tailor the needof postoperative treatments. However, two independent randomized trials showed thatthe execution of (pelvic) lymphadenectomy increases the risk of having surger y-relatedcomplication without improving patients’ outcomes. Sentinel node mapping aims toachieve data regarding nodal status without increasing morbidity. Sentinel node mappingis the removal of first (clinically negative) lymph nodes draining the uterus. Several studiessuggested that sentinel node mapping is not inferior to lymphadenectomy in identif yingpatients with nodal disease. More importantly, thorough ultrastaging sentinel node mappingallows the detection of low volume disease (micrometastases and isolated tumor cells), thatare not always detectable via conventional pathological examination. Therefore, the adoptionof sentinel node mapping guarantees a higher identification of patients with nodal diseasethan lymphadenectomy. Further evidence is needed to assess the value of various adjuvantstrategies in patients with low volume disease and to tailor those treatments also on the basisof the molecular and genomic characterization of endometrial tumors.
A critical assessment on the role of sentinel node mapping in endometrial cancer
Giorgio Bogani,Antonino Ditto,Fabio Martinelli,Mauro Signorelli,Stefania Perotto,Domenica Lorusso,Francesco Raspagliesi 대한부인종양학회 2015 Journal of Gynecologic Oncology Vol.26 No.4
Endometrial cancer is the most common gynecologic malignancy in the developed countries. Although the high incidence of this occurrence no consensus, about the role of retroperitoneal staging, still exists. Growing evidence support the safety and efficacy of sentinel lymph node mapping. This technique is emerging as a new standard for endometrial cancer staging procedures. In the present paper, we discuss the role of sentinel lymph node mapping in endometrial cancer, highlighting the most controversies features.
Fertility sparing surgery in early stage epithelial ovarian cancer
Antonino Ditto,Fabio Martinelli,Domenica Lorusso,Edward Haeusler,Marialuisa Carcangiu,Francesco Raspagliesi 대한부인종양학회 2014 Journal of Gynecologic Oncology Vol.25 No.4
Objective: Fertility sparing surgery (FSS) is a strategy often considered in young patients with early epithelial ovarian cancer. We investigated the role and the outcomes of FSS in eEOC patients who underwent comprehensive surgery. Methods: From January 2003 to January 2011, 24 patients underwent fertility sparing surgery. Eighteen were one-to-one matched and balanced for stage, histologic type and grading with a group of patients who underwent radical comprehensive staging (n=18). Demographics, surgical procedures, morbidities, pathologic findings, recurrence-rate, pregnancy-rate and correlations with disease-free survival were assessed. Results: A total of 36 patients had a complete surgical staging including lymphadenectomy and were therefore analyzed. Seven patients experienced a recurrence: four (22%) in the fertility sparing surgery group and three (16%) in the control group (p=not significant). Sites of recurrence were: residual ovary (two), abdominal wall and peritoneal carcinomatosis in the fertility sparing surgery group; pelvic (two) and abdominal wall in the control group. Recurrences in the fertility sparing surgery group appeared earlier (mean, 10.3 months) than in radical comprehensive staging group (mean, 53.3 months) p<0.001. Disease-free survival were comparable between the two groups (p=0.422). No deaths were reported. All the patients in fertility sparing surgery group recovered a regular period. Thirteen out of 18 (72.2%) attempted to have a pregnancy. Five (38%) achieved a spontaneous pregnancy with a full term delivery. Conclusion: Fertility sparing surgery in early epithelial ovarian cancer submitted to a comprehensive surgical staging could be considered safe with oncological results comparable to radical surgery group.
Giorgio Bogani,Ciro Pinelli,Valentina Chiappa,Fabio Martinelli,Salvatore Lopez,Antonino Ditto,Francesco Raspagliesi 대한부인종양학회 2020 Journal of Gynecologic Oncology Vol.31 No.5
Objective: This study aimed to identify predictors of recurrence/persistence of cervicalintraepithelial neoplasia grade 2+ (CIN2+) lesion (r-CIN2+) after primary conization. Methods: Retrospective analysis involving all consecutive women having conization for CIN2+between 1998 and 2018. The risk of r-CIN2+ was assessed using Kaplan-Meier and Cox models. Results: Data of 3,212 women were retrospectively identified. After a mean follow-up of 47(±22.2) months, 112 (3.5%) patients developed r-CIN2+. Mean time interval between priorconization and diagnosis of r-CIN2+ was 26.2 (±13.2) months. Via multivariate analysis,presence of high-risk human papillomavirus (HPV) types at the time of CIN2+ diagnosis,hazard ratio (HR)=3.40 (95% confidence interval [CI]=1.66–6.95) for HPV16/18 and HR=2.59(95% CI=1.21–5.55) for HPV types other than 16/18, positive margins at primary conization,HR=4.11 (95% CI=2.04–8.26) and HPV persistence after conization, HR=16.69 (95%CI=8.20–33.9), correlated with r-CIN2+, independently. Considering age-specific HPV typesdistribution, we observed that HPV16/18 infection correlated to an increased risk of r-CIN2+only in young women (aged ≤25 years; p=0.031, log-rank test); while in the older population(>25 years) HPV type(s) involved had not impact on r-CIN2+ risk (p>0.200, log-rank test). Conclusion: HPV persistence is the main factor predicting r-CIN2+. Infection from HPV16/18has a detrimental effect in young women, thus highlighting the need of implementingvaccination against HPV in this population. Further prospective studies are warranted fortailoring clinical decision-making for post-conization follow-up on the basis of risk factors.