Giovanni Scambia

Université René Descartes - Paris 5, Lutetia Parisorum, Île-de-France, France

Are you Giovanni Scambia?

Claim your profile

Publications (982)3660.26 Total impact

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To analyze the feasibility of total mesometrial resection by laparoscopy (L-TMMR) in a multicentric series of early stage cervical cancer. We prospectively evaluated a consecutive series of cervical cancer patients with pre-operative FIGO stage IA2- IB1 at the Catholic University in Rome and in Campobasso and the Charitè University in Berlin. All cases were assessed at pre-operative MRI scan and clinically confirmed by investigation under anesthesia, adhering strictly to the FIGO criteria. The surgical and post-surgical data were collected. 104 women with cervical cancer were admitted between July 2013 and August 2014 and among them 71 patients with pre-operative FIGO stage IA2-IB1 were treated with L-TMMR. One laparotomic conversion was registered. The median operative time was 260min (120 - 670min), estimated blood loss was 100cc (25-900cc), and the median length of hospital stay was 6days (2-26 days). We observed 8 intra-operative complications including a vascular injury of the left internal iliac vein that caused conversion, 6 vesical injuries and 1 uretheral injury managed laparoscopically. Two vescico-vaginal fistula and one hemoperitoenum were observed as major post-operative complications (4.2%). L-TMMR can be safely performed in selected cervical cancer patients. Further larger prospective trials are needed to evaluate the oncological outcome of patients undergoing this surgical procedure. Copyright © 2015. Published by Elsevier Inc.
    Gynecologic Oncology 07/2015; DOI:10.1016/j.ygyno.2015.07.010 · 3.69 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Prolactin (PRL) is a hormone, mainly secreted by lactotroph cells of the anterior pituitary gland. Recent studies have shown it may also be produced by many extrapituitary cells. Its well-recognized PRL plays an important role in lactation during pregnancy, but it is involved in other biological functions such as angiogenesis, immunoregulation and osmoregulation. Hyperprolactinemia is a typical condition producing reproductive dysfunction in both sexes, resulting in hypogonadism, infertility and galactorrhea. It may be also asymptomatic. Lactotroph adenomas (prolactinoma) is one of the most common cause of PRL excess, representing approximately 40% of all pituitary tumors. Several other conditions should be excluded before a clear diagnosis of hyperprolactinemia is made. Hyperprolactinemia may be secondary to pharmacological or pathological interruption of hypothalamic–pituitary dopaminergic pathways or idiopathic. Stress, renal failure or hypothyroidism are other frequent conditions to exclude in patients with hyperprolactinemia. We will review biochemical characteristics and physiological functions of that hormone. Clinical and pharmacological approach to hyperprolactinemia will also be discussed.
    Gynecological Endocrinology 07/2015; DOI:10.3109/09513590.2015.1017810 · 1.14 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Pelvic organ prolapse occurs in 50% of parous women. Laparoscopic sacrocolpopexy (LSCP) is a common surgical procedure for restoring pelvic anatomy and function. The aim of this study is to evaluate surgical anatomy and anatomical modifications induced by standardized LSCP. Ten fresh female cadavers underwent LSCP, six subsequently underwent standard anatomical dissection, and four had sagittal anatomical dissection. Four cadavers were used as control subjects; two of them underwent standard anatomical dissection, and two had sagittal anatomical dissection. Vesicovaginal space dissection resulted in an arrow-shaped space limited by the trigone and vesical branches of the uterine artery. Rectovaginal space dissection resulted in an inverted V-shaped space marked by the utero-sacral and rectovaginal ligaments, the cranial end of the perineal body and the levator ani muscle. Exposing the longitudinal vertebral ligament through a peritoneal and presacral fascia incision along the medial border of the right common iliac artery allowed the identification and the preservation of the right hypogastric nerve. The anterior mesh stretched across the proximal half of the anterior vaginal wall, and the cervix towards the sacral promontory provided excellent cervix suspension and anterior-vaginal wall support with a concomitant stretch of the pubocervical fascia. The median angle formed by the axis of the infra-levatorial vagina with the axis of the supra-levatorial vagina changed from 142° to 171° and determined the linearization-ventralization of the vaginal canal. LSCP can be performed in a nerve-sparing, standardized fashion, providing excellent apical suspension and anterior vaginal wall support. Neurourol. Urodynam. 9999:1-6, 2015. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.
    Neurourology and Urodynamics 07/2015; DOI:10.1002/nau.22806 · 2.46 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The study analyses the performances of FRAX algorithm and quantitative ultrasound (QUS) tool in relationship to the dual-energy X-ray absorptiometry (DXA) categorization to identify patients at risk of osteoporosis during menopause and to reach new thresholds for recommending the first DXA examination. Retrospective cohort study. Two hundred eighty-two postmenopausal patients filled out a questionnaire which determined their FRAX index and performed a bone evaluation by QUS of the calcaneus to determine their stiffness index (SI). Thereafter, they underwent assessments by the gold-standard DXA bone examination. Statistically significant correlations were observed between FRAX (calculated without BMD) and both QUS and DXA diagnosis. FRAX mean indices of risk corresponding to the diagnosis of osteoporosis by QUS and DXA were similar. Receiver operating characteristic (ROC) curve analysis showed that both FRAX and QUS tests were sufficiently accurate in predicting the alteration of bone mineral composition. The ROC curves of QUS allowed us to identify, in our population, SI cutoff for normal patients (SI > 90.5) and for patients having osteoporosis (SI < 78.5). We selected a cutoff screening value from FRAX ROC curve for major clinical fracture (2.94). The following diagnostic algorithm demonstrated that the use of FRAX test alone has a sensitivity of 85.3 % and a specificity of 33.8 % while the use of QUS exam alone showed a sensitivity of 81.3 % and a specificity of 45.1 %. When considering the capacity of QUS exam in combination with FRAX test, the final algorithm showed a sensitivity of 69.4 % and a specificity of 57.7 %. The use of QUS test with adjusted cutoffs offers a similar performance to the FRAX test alone in terms of sensitivity. The combined use of the tests reduces the sensibility but increases the specificity and adds clinical information related to the bone status of the patient.
    Journal of endocrinological investigation 07/2015; DOI:10.1007/s40618-015-0341-4 · 1.55 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Male gender is a risk factor for medulloblastoma (MB), being also a negative predictor for clinical outcome. This study sought to assess sex differences in tumor biological features and hormone receptor profiles in a cohort of MB patients. Sixty-four MBs and 5 normal cerebella were included in the study. Cell proliferation (Ki67), apoptosis (cleaved caspase-3) and microvessel density (CD31) were evaluated in tumors by immunohistochemistry. Tissues were analyzed for Estrogen Receptor α (ERα), ERβ1, ERβ2, ERβ5 and Androgen Receptor (AR) expression. Results demonstrated sex-specific features in MBs, with tumors from females exhibiting a higher apoptosis/proliferation ratio along with a decreased tumor vascularization compared to males. MBs were negative for ERα and AR, while expressing ERβ isoforms at similar levels between sexes. Altogether these findings indicate that signaling mechanisms that control cell turnover and angiogenesis are more efficiently operating in females compared to males. The lack of sex differences in the hormone receptor profiles suggests that circulating estrogens could be the major determinants of the sexual dimorphism observed in MB features. Here we give molecular support to epidemiological data showing gender differences in MB incidence and outcome, completely defining the hormone receptor profile of the tumors. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Histopathology 07/2015; DOI:10.1111/his.12770 · 3.30 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To assess the learning curve associated with tele-assisted surgery. We performed a training box-based study, describing speed and accuracy in volunteers performing basic and complex laparoscopic tasks, to assess performance and in the skill acquisition of inexperienced users, using the Telelap Alf X system. Ten surgeons in gynaecology who had never received formal instruction on this new surgical device, completed four modules during a consecutive 3 day training programme. All the participants completed the training programme with a good learning curve. Use of the TELELAP Alf X advanced surgical robotic system is associated with a rapid learning curve among experienced surgeons. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.
    International Journal of Medical Robotics and Computer Assisted Surgery 06/2015; DOI:10.1002/rcs.1672 · 1.53 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Mutations in the KCNQ2 gene, encoding for voltage-gated Kv7.2K(+) channel subunits, are responsible for early-onset epileptic diseases with widely-diverging phenotypic presentation, ranging from Benign Familial Neonatal Seizures (BFNS) to epileptic encephalopathy. In the present study, Kv7.2 BFNS-causing mutations (W344R, L351F, L351V, Y362C, and R553Q) have been investigated for their ability to interfere with calmodulin (CaM) binding and CaM-induced channel regulation. To this aim, semi-quantitative (Far-Western blotting) and quantitative (Surface Plasmon Resonance and dansylated CaM fluorescence) biochemical assays have been performed to investigate the interaction of CaM with wild-type or mutant Kv7.2 C-terminal fragments encompassing the CaM-binding domain; in parallel, mutation-induced changes in CaM-dependent Kv7.2 or Kv7.2/Kv7.3 current regulation were investigated by patch-clamp recordings in CHO cells co-expressing Kv7.2 or Kv7.2/Kv7.3 channels and CaM or CaM1234 (a CaM isoform unable to bind Ca(2+)). The results obtained suggest that each BFNS-causing mutation prompts specific biochemical and/or functional consequences; these range from slight alterations in CaM affinity which did not translate into functional changes (L351V), to a significant reduction in the affinity and functional modulation by CaM (L351F, Y362C or R553Q), to a complete functional loss without significant alteration in CaM affinity (W344R). CaM overexpression increased Kv7.2 an Kv7.2/Kv7.3 current levels, and partially (R553Q) or fully (L351F) restored normal channel function, providing a rationale pathogenetic mechanism for mutation-induced channel dysfunction in BFNS, and highlighting the potentiation of CaM-dependent Kv7.2 modulation as a potential therapeutic approach for Kv7.2-related epilepsies. Copyright © 2015. Published by Elsevier B.V.
    Biochimica et Biophysica Acta 06/2015; DOI:10.1016/j.bbadis.2015.06.012 · 4.66 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this study was to compare the toxicity, perioperative outcomes of interval debulking surgery (IDS), and duration of progression-free survival (PFS) in women with unresectable high-grade serous advanced ovarian cancer (AOC) receiving neoadjuvant chemotherapy (NACT) with or without bevacizumab. Twenty-five patients with high-grade serous AOC treated with bevacizumab-based NACT (cases) were matched according to initial disease extension assessed by laparoscopy, and age, in a 1:2 ratio, with 50 high-grade serous AOC patients treated with standard NACT without bevacizumab (controls). Both groups received a median of four NACT cycles before IDS (p = 0.867), and the median time interval between NACT and IDS was 27 days in both groups (p = 0.547). Twenty-two cases (88.0 %) showed complete/partial radiologic response compared with 36 controls (72.3 %; p = 0.054). A higher percentage of cases showed complete serological response (48 vs. 35.1 %; p = 0.041). At IDS, complete cytoreduction was achieved in 20 cases (80.0 %) and 36 controls (72.3 %) [p = 0.260]. No differences were observed between groups in terms of surgical complexity score, perioperative outcomes, surgical complications, and chemotherapy-related adverse events. One death due to gastrointestinal perforation was observed among cases. Cases showed a longer median PFS compared with controls (18 months vs. 10 months; p = 0.001), and the administration of bevacizumab (hazard ratio 3.786; p = 0.001) retained a prognostic role for longer PFS at multivariate analysis. The incorporation of bevacizumab in NACT prolongs PFS without affecting the safety of IDS. The risk of gastrointestinal perforation should be considered prior to attempting bevacizumab-based NACT in women with diffuse bowel involvement at initial laparoscopic evaluation.
    Annals of Surgical Oncology 06/2015; DOI:10.1245/s10434-015-4651-8 · 3.94 Impact Factor
  • S. Lello, A. Capozzi, G. Scambia
    [Show abstract] [Hide abstract]
    ABSTRACT: Osteoporosis (OP) and cardiovascular diseases (CVD) are the most important causes of mortality and morbility in the elderly. Lots of studies showed a correlation between bone loss and cardiovascular risk mediated by the vascular calcification. The relationship between OP and CVD could be firstly explained by their common risk factors such as age, smoking, alcohol consumption, physical activity and menopause. However, other different hypotheses were proposed to clarify this link. Multiple factors, for example bone morphogenetic proteins, osteoprotegerin, receptor activator of nuclear factor κB ligand, parathyroid hormone, phosphate, oxidized lipids and vitamins D and K seemed to be involved in both conditions, indicating a possible common pathophysiologic mechanism. We review and discuss the available data describing this association. Further studies are necessary to better investigate similarities between OP and CVD.
    Gynecological Endocrinology 06/2015; DOI:10.3109/09513590.2015.1041908 · 1.14 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To explore the effects of intraperitoneal (i.p.) infusion of catumaxomab, a bispecific monoclonal antibody (anti-EpCAM x anti-CD3), on T cells, NK cells and macrophages in ascites of cancer patients and to understand how ascitic immune cells can be activated despite the pervasive immunosuppressive ability of ascites microenvironment. Six patients with malignant ascites received i.p. catumaxomab infusion. Ascitic immune cells were profiled by flow cytometry and gene expression at baseline and after i.p. catumaxomab infusion. In vitro experiments enabled investigations on the adverse effect of ascites microenvironment on catumaxomab-stimulated immune cells. I.p. catumaxomab infusion enhanced the expression of the CD69 and CD38 activation molecules in CD4(+) and CD8(+) T cells, NK cells and macrophages, and favoured CD8(+)T cell accumulation into the peritoneal cavity. An analogous immune cell activation as well as IFN-γ and IL-2 production was induced by catumaxomab in vitro. In vitro experiments showed that the immunosuppressive milieu of ascites abrogated all the immunostimulatory activities of catumaxomab. Adding EpCAM(+) tumour cells to the culture permitted both catumaxomab Fab regions to engage cognate antigens and restored immunostimulatory catumaxomab activity. This is the first demonstration in a clinical setting that i.p. catumaxomab infusion activates NK cells and macrophages in addition to T cells in ascites and favours CD8(+)T cell accumulation into the peritoneal cavity. Moreover, our findings indicate that the concomitant binding of both catumaxomab Fab regions delivers an activation signal that is strong enough to activate immune cells despite the prevailing immunosuppressive environment of malignant ascites. Copyright © 2015. Published by Elsevier Inc.
    Gynecologic Oncology 06/2015; DOI:10.1016/j.ygyno.2015.06.003 · 3.69 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: From the whole plant of Euphorbia cyparissias, two new diterpenes based on jatrophane skeleton, named cyparissins A and B (1 and 2) were isolated. Their chemical structures were established through a combination of nuclear magnetic resonance spectroscopy and mass spectrometric methods. The new compounds cyparissins A and B were tested to evaluate their ability to inhibit P-glycoprotein-mediated multidrug resistance and their cytotoxic activity against A2780 human ovarian cancer cells, both WT and ADR. Compounds 1 and 2 showed moderate inhibitory effects on P-glycoprotein while showing a significant concentration-depending cytotoxic activity for both cancer cell lines. These isolated compounds are based on a new chemical structure that expands the knowledge base for this class of bioactive metabolites. Copyright © 2015. Published by Elsevier B.V.
    Fitoterapia 05/2015; 104. DOI:10.1016/j.fitote.2015.05.012 · 2.22 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: This prospective single-institutional clinical trial sought to assess the safety and feasibility of laparoscopic benign ovarian cyst enucleation with a novel robot-assisted laparoscopic system. In this study, we report a series of 10 cases treated using Telelap ALF-X in the first clinical application on patients at the Division of Gynaecologic Oncology, Catholic University of the Sacred Heart of Rome. The primary inclusion criterion was the presence of monolateral ovarian cyst without a preoperative assessment suspicious for malignancy. Intra-operative data such as docking time, operative time, estimated blood loss, intra and peri-operative complications, and conversion to either standard laparoscopy or laparotomy were collected. The cysts were removed using the ovary sparing technique with respect to conservative surgical principles. The median operative time was 46,3 min, and patients without post-operative complications were discharged either 1 or 2 days after the procedure. Telelap Alf-X laparoscopic enucleation of benign ovarian cysts with ovary sparing techniques is feasible, safe and effective. However, more clinical data are needed to assess whether this approach would offer any other benefits compared to other minimally invasive surgical techniques. Copyright © 2015 AAGL. Published by Elsevier Inc. All rights reserved.
    Journal of Minimally Invasive Gynecology 05/2015; DOI:10.1016/j.jmig.2015.05.007 · 1.58 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: ZEB2 is a key factor in epithelial-mesenchymal transition (EMT), a program controlling cell migration in embryonic development and adult tissue homeostasis. We demonstrated a role of ZEB2 in migration and anchorage-independent cell growth in ovarian cancer, as shown by ZEB2 silencing. We found that the RNA-binding protein HuR bound the 3'UTR of ZEB2 mRNA, acting as a positive regulator of ZEB2 protein expression. In Hey ovarian cell line, HuR silencing decreased ZEB2 and ZEB1 nuclear expression and impaired migration. In hypoglycemic conditions ZEB2 expression decreased, along with ZEB1, vimentin and cytoplasmic HuR, and a reduced cellular migration ability was observed. Analysis of ZEB2 and HuR expression in ovarian cancers revealed that nuclear ZEB2 is localized in tumor leading edge and co-localizes with cytoplasmic HuR. In a series of 143 ovarian cancer patients high expression of ZEB2 mRNA significantly correlated with a poor prognosis in term of both overall survival and progression- free survival. Moreover, at immunohistochemical evaluation, we found that prognostic significance of ZEB2 protein relies on its nuclear expression and co-localization with cytoplasmic HuR. In conclusion our findings indicated that nuclear ZEB2 may enhance progression of EMT transition and acquisition of an aggressive phenotype in ovarian cancer.
    Oncotarget 05/2015; · 6.63 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Phase II study on total TELELAP ALF-X hysterectomy. safety, feasibility and perioperative outcomes analysis. Phase II study. Canadian Task Force II-2. Catholic University of the Sacred Heart, Rome, Italy. From October 2013 to May 2014, 80 women underwent total TELELAP ALF X hysterectomy. The study population was divided in two groups according to surgical procedures: total hysterectomy ± bilateral salpingo-oophorectomy (Group 1), and endometrial cancer patients staged also with pelvic lymphadenectomy (Group 2). Total TELELAP ALF-X hysterectomy ± bilateral salpingo-oophorectomy with or without pelvic lymphadenectomy. Median age was 51 years (range 48-79), and median BMI was 24 kg/m2 (range 17.3 - 34.2). Forty-five patients (56.2%) had previous surgery. Median operative time was 140 minutes (range 58-320) in the Group 1 and 197 minutes (range 129-290) in the Group 2 (p < .001). Median docking time was 8 minutes (range 3-25). During the study period, a significant trend in the operative time reduction was observed. Procedures were successfully performed without conversion in 93.7% of cases. We observed 2 (2.5%) intraoperative complications, 3 (3.7%) conversions to standard laparoscopy and 2 (2.5%) to laparotomy. Median time to discharge was 2 days (range 1-5). One patient (1.2%) was readmitted the early post-operative period. As new technology evolves, critical appraisal of patient-related outcomes, utilization, cost, and access to minimally invasive hysterectomy must remain a priority. Despite the relative small number of our series, we showed the feasibility and safety of total TELELAP ALF-X hysterectomy for benig and malignant disease. Copyright © 2015 AAGL. Published by Elsevier Inc. All rights reserved.
    Journal of Minimally Invasive Gynecology 05/2015; DOI:10.1016/j.jmig.2015.05.004 · 1.58 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: In post-menopausal period vulvo-vaginal atrophy (VVA)-related symptoms may seriously affect women's quality of life. Hormonal replacement therapy effectively relieves these symptoms but it is not always safe or accepted, and a non-hormonal treatment is often needed instead. Over a period of 12 weeks, we tested the effect of a twice-a-week vulvo-vaginal application of a hyaluronic acid, AC collagen, isoflavones and vitamins-based cream (Perilei Pausa®) on 35 women in post-menopausal period, reporting VVA-related symptoms. After 12 weeks of treatment with Perilei Pausa® a significant improvement in vaginal dryness, vulvo-vaginal itching, dyspareunia (P < 0.001), dysuria (P = 0.02), nocturia (P = 0.009) and pollakiuria (P = 0.005) was reported by the women. Colposcopical score assessing the intensity of atrophic colpitis, cervico-vaginal paleness and petechiae was also reduced (P = 0.037, P = 0.016 and P = 0.032, respectively). No significant difference in terms of maturation value of cervico-vaginal epithelium was observed. In conclusion, Perilei Pausa® may represent an effective and safe alternative treatment of symptomatic VVA in post-menopausal women.
    Journal of Obstetrics and Gynaecology 05/2015; DOI:10.3109/01443615.2015.1014326 · 0.60 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Alternatives to the use of fetal bovine serum (FBS) have been investigated to ensure xeno-free growth condition. In this study we evaluated the efficacy of human platelet lysate (PL) as a substitute of FBS for the in vitro culture of some human cell lines. PL was obtained by pools of pathogen inactivated human donor platelet (PLT) concentrates. Human leukemia cell lines (KG-1, K562, JURKAT, HL-60) and epithelial tumor cell lines (HeLa and MCF-7) were cultured with either FBS or PL. Changes in cell proliferation, viability, morphology, surface markers and cell cycle were evaluated for each cell line. Functional characteristics were analysed by drug sensitivity test and cytotoxicity assay. Our results demonstrated that PL can support growth and expansion of all cell lines, although the cells cultured in presence of PL experienced a less massive proliferation compared to those grown with FBS. We found a comparable percentage of viable specific marker-expressing cells in both conditions, confirming lineage fidelity in all cultures. Functionality assays showed that cells in both FBS- and PL-supported cultures maintained their normal responsiveness to adriamycin and NK cell-mediated lysis. Our findings indicate that PL is a feasible serum substitute for supporting growth and propagation of haematopoietic and epithelial cell lines with many advantages from a perspective of process standardization, ethicality and product safety.
    Cytotechnology 05/2015; DOI:10.1007/s10616-015-9878-5 · 1.45 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Recurrence of disease represents a clinical challenge in cervical cancer patients, especially when all available treatment modalities have been used in the primary setting. The aim of this study was to analyse the patterns of recurrence and their association with clinical outcome in locally advanced cervical cancer (LACC) patients submitted to primary chemoradiation (CTRT) followed by radical surgery (RS). This study was conducted on 364 LACC patients treated with CTRT plus RS since January 1996 to July 2012. For each relapse, information on date of clinical/pathological recurrence, and pattern of disease presentation were retrieved. Post-relapse survival (PRS) was recorded from the date of recurrence to the date of death for disease or last seen. Survival probabilities were compared by the log rank test. Cox's regression model with stepwise variable selection was used for multivariate prognostic analysis for PRS. Within a median follow-up of 42 months, 75 recurrences (20.6%) and 54 disease-associated deaths (14.8%) were recorded. By analysing the pattern of relapse, most of the recurrences were outside the irradiated field (n=43, 57.3%) and the most frequently observed site was visceral (n=16, 21.3%). Among the parameters of the recurrence associated with PRS including the pattern of recurrence, the size of recurrence, SCC-Ag serum levels at recurrence, and secondary radical surgery, only the last one retained an independent predictive role in reducing the risk of death (p=0.037). The feasibility of secondary radical resection positively impacts on PRS of LACC patients submitted to multimodality primary treatments. Copyright © 2015. Published by Elsevier Inc.
    Gynecologic Oncology 05/2015; DOI:10.1016/j.ygyno.2015.04.035 · 3.69 Impact Factor
  • Gynecologic Oncology 05/2015; 138:1-2. DOI:10.1016/j.ygyno.2015.04.017 · 3.69 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To compare prognosis of advanced epithelial ovarian cancer (AEOC) patients based on where the first surgical assessment was performed. Retrospective analysis of primary AEOC patients was performed and three groups were formed based on where the decision of primary treatment was taken: Internal, if the decision was carried out at our Institution (PDS (Primary Debulking Surgery), I-IDS (Internal-Interval Debulking Surgery)) and Referred in case women were referred after neoadjuvant chemotherapy (NACT) from other Centers (R-IDS (Referred-Interval Debulking Surgery)). Among 573 AEOC, 279 (48.7%) were PDS and 294 (51.3%) IDS. In particular, 134 of 294 (45.6%) were R-IDS and 160 (54.4%) were I-IDS. Median progression-free survival (PFS) was 26 months in PDS, 14 months in I-IDS and 17 months in R-IDS. The difference was statistically significant (p<0.05) among all groups. IDS can represent a suitable approach only when the first complete debulking is not achievable in a tertiary referral hospital. Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.
    Anticancer research 05/2015; 35(5):3027-32. · 1.87 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of this multicenter, open label, randomized phase III study was to determine whether ixabepilone resulted in improved overall survival (OS) compared with commonly used single-agent chemotherapy (doxorubicin or paclitaxel) in women with locally advanced, recurrent, or metastatic endometrial cancer with at least one failed prior platinum-based chemotherapeutic regimen. Patients were randomized 1:1 to ixabepilone (40 mg/m(2)), or either paclitaxel (175 mg/m(2)) or doxorubicin (60 mg/m(2)), every 21 days. Patients that had previously received an anthracycline were randomized to ixabepilone or paclitaxel; all other patients were randomized to ixabepilone or doxorubicin. An interim analysis of futility for OS was planned. At the time of database lock, 496 patients were randomized to receive ixabepilone (n = 248) or control (n = 248); nine patients in the control arm were not treated. The interim analysis of futility for OS (219 events) favored the control chemotherapy arm (hazard ratio = 1.3 [95% confidence interval: 1.0-1.7], stratified log rank test P = 0.0397), indicating that the study would not meet its primary objective. The study was discontinued based on the interim OS results. The frequency of adverse events was comparable between the treatment arms. The study did not meet its primary objective of improving OS in the ixabepilone arm compared to the control chemotherapy arm. A favorable risk/benefit ratio was not observed for ixabepilone versus control at the time of the interim analysis. The safety results were consistent with the known safety profiles of ixabepilone and control. Copyright © 2015. Published by Elsevier Inc.
    Gynecologic Oncology 04/2015; 138(1). DOI:10.1016/j.ygyno.2015.04.026 · 3.69 Impact Factor

Publication Stats

18k Citations
3,660.26 Total Impact Points

Institutions

  • 2015
    • Université René Descartes - Paris 5
      Lutetia Parisorum, Île-de-France, France
  • 1996–2015
    • Policlinico Universitario Agostino Gemelli
      Roma, Latium, Italy
  • 1984–2015
    • The Catholic University of America
      Washington, Washington, D.C., United States
  • 1981–2015
    • Catholic University of the Sacred Heart
      • • School of Obstetrics and Gynecology
      • • School of Oncology
      • • Institute of Clinical Obstetrics and Gynecology
      • • Institute of Histology and General Ebryology
      • • Institute of Clinical Otorhinolaryngology
      • • Institute of Pathological Anatomy
      • • Laboratory for Molecular Oncology
      Milano, Lombardy, Italy
  • 2003–2014
    • Sacred Heart University
      Феърфилд, Connecticut, United States
  • 2009–2013
    • Columbus-Gemelli University Hospital
      Roma, Latium, Italy
    • Ospedale Sacro Cuore di Gesù
      Benevento, Campania, Italy
    • Università degli studi di Cassino e del Lazio Meridionale
      • Department of Sports Science and Health
      Cassino, Latium, Italy
  • 2008–2010
    • Università degli Studi di Torino
      Torino, Piedmont, Italy
  • 2002–2010
    • Sapienza University of Rome
      • • Department of Gynecology-Obstetrics & Urology
      • • Department of Experimental Medicine
      Roma, Latium, Italy
    • University of California, Santa Barbara
      • Department of Molecular, Cellular, and Developmental Biology
      Santa Barbara, CA, United States
  • 2007
    • The American University of Rome
      Roma, Latium, Italy
  • 2006
    • Gynecologic Oncology Group
      Buffalo, New York, United States
  • 2005
    • Temple University
      • Department of Biology
      Philadelphia, PA, United States
  • 2001
    • Università degli Studi dell'Insubria
      Varese, Lombardy, Italy
    • Azienda Ospedaliera San Camillo Forlanini
      Roma, Latium, Italy
    • Thomas Jefferson University
      • Department of Pathology, Anatomy & Cell Biology
      Filadelfia, Pennsylvania, United States
    • Johns Hopkins Medicine
      • Department of Gynecology & Obstetrics
      Baltimore, Maryland, United States
  • 1994–2001
    • Istituto Superiore di Sanità
      Roma, Latium, Italy
  • 1990
    • Università Cattolica del Sacro Cuore
      Milano, Lombardy, Italy
  • 1988
    • Università degli Studi G. d'Annunzio Chieti e Pescara
      Chieta, Abruzzo, Italy
    • West Georgia Obstetrics and Gynecology
      Georgetown, Georgia, United States
  • 1985–1988
    • University of Ferrara
      • Department of Audiology
      Ferrare, Emilia-Romagna, Italy
  • 1986–1987
    • Università degli studi di Cagliari
      Cagliari, Sardinia, Italy