Alessandro Gronchi

Alessandro Gronchi
Fondazione IRCCS Istituto Nazionale dei Tumori di Milano | Istituto Tumori di Milano · Dipartimento di Chirurgia

MD

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733
Publications
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30,234
Citations
Citations since 2017
375 Research Items
19208 Citations
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201720182019202020212022202301,0002,0003,0004,000

Publications

Publications (733)
Article
Aims: Soft tissue tumours are rare and both accurate diagnosis and proper treatment represent a global challenge. Current treatment guidelines also recommend review by specialized pathologists. Here we report on international consensus-based datasets for the pathology reporting of biopsy and resection specimens of soft tissue sarcomas. The dataset...
Article
Full-text available
Sarcomas represent a large group of rare to very rare diseases, requiring complex management with a transdisciplinary approach. Overall progress has been hampered because of discipline, institution and network fragmentation, and there is no global data harmonization or quality standards. To report on and improve quality, a common definition of qual...
Article
Purpose: Inflammatory biomarkers and neutrophil-to-lymphocyte ratio (NLR) are associated with prognosis in several tumors. Data on sarcomas are limited, and insufficient on retroperitoneal sarcoma (RPS). Experimental design: Patients with primary RPS operated between 2002 and 2016 were included. Hemoglobin, monocytes, NLR, platelet-to-lymphocyte...
Article
Full-text available
Tenosynovial giant cell tumour (TGCT) is a rare, locally aggressive, mesenchymal tumor arising from the joints, bursa and tendon sheaths. TGCT comprises a nodular- and a diffuse-type, with the former exhibiting mostly indolent course and the latter a locally aggressive behavior. Although usually not life-threatening, TGCT may cause chronic pain and...
Article
Introduction: limb-sparing surgery is the mainstream treatment for primary extremity soft tissue sarcoma (ESTS) at referral centers, following advances in surgical reconstructions and multimodal management. However, amputation is still needed in selected patients and has not yet been described for a ESTS cohort in a contemporary scenario. Materia...
Article
Introduction: Primary malignancies of the inferior vena cava comprise a heterogeneous group of histologic types that generally have a poor prognosis. Their rarity limits the data available in literature. There is no doubt that surgery is the mainstay treatment, but several questions about the best surgical strategy and multidisciplinary approach r...
Article
Background We retrospectively investigated the role of (neo)adjuvant chemotherapy in patients with primary, localized angiosarcoma. Methods We selected all patients with primary, localized angiosarcoma, who had received radical surgery between January 2005 and December 2019 at 33 European sarcoma reference centers. The primary objective was to com...
Article
Background In ultrarare sarcomas (URS) the conduction of prospective, randomized trials is challenging. Data from retrospective observational studies (ROS) may represent the best evidence available. ROS implicit limitations led to poor acceptance by the scientific community and regulatory authorities. In this context, an expert panel from the Conne...
Article
Objective: The Transatlantic Australasian Retroperitoneal Sarcoma Working Group (TARPSWG) conducted a retrospective study on the disease course and clinical management of ganglioneuromas. Background: Ganglioneuromas are rare tumors derived from neural crest cells. Data on these tumors remain limited to case reports and single-institution case se...
Article
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Background: The Complexity INdex in SARComas (CINSARC) is a transcriptional signature derived from the expression of 67 genes involved in mitosis control and chromosome integrity. This study aims to assess CINSARC value of in an independent series of high-risk patients with localized soft tissue sarcoma (STS) treated with preoperative chemotherapy...
Article
Objective: The aim of the present study was to compare the effect of radiotherapy (RT) on abdominal recurrence-free survival (ARFS) in patients with primary retroperitoneal sarcoma treated in the EORTC-STBSG-62092 (STRASS) phase 3 randomized controlled trial (STRASS cohort) and off-trial (STREXIT cohort) and to pool STRASS and STREXIT data to test...
Article
Purpose of review: To review current knowledge and recent advances in retroperitoneal sarcoma management. Recent findings: Surgery, radiotherapy, and medical treatments of retroperitoneal sarcomas should take into account the peculiarities of each histotype and the unique anatomical site. Surgery remains the mainstay of treatment and the only ch...
Article
PURPOSE XXXX(Anonymized) demonstrated that the first-in-class radioenhancer NBTXR3, activated by preoperative radiotherapy, doubled the rate of pathological complete response after resection compared with preoperative radiotherapy alone in adult patients with locally advanced soft tissue sarcoma of the extremity or trunk wall (16.1% versus 7.9%, P=...
Article
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Bone sarcoma are infrequent diseases, representing < 0.2% of all adult neoplasms. A multidisciplinary management within reference centers for sarcoma, with discussion of the diagnostic and therapeutic strategies within an expert multidisciplinary tumour board, is essential for these patients, given its heterogeneity and low frequency. This approach...
Article
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Constitutional BRCA1/BRCA2 pathogenic or likely pathogenic variants (PVs) are associated with an increased risk for developing breast and ovarian cancers. Current evidence indicates that BRCA1/2 PVs are also associated with pancreatic cancer, and that BRCA2 PVs are associated with prostate cancer risk. The identification of carriers of constitution...
Article
11566 Background: EHE is an ultra-rare sarcoma marked by two specific fusions, WWTR1-CAMTA1 (̃90%) and YAP1-TFE3 (̃10%). The clinical course of EHE ranges from indolent to highly aggressive, often associated with systemic paraneoplastic symptoms. Molecular predictors of clinical outcome are unknown. While surgery is the mainstay of treatment in the...
Article
11508 Background: An ISG, GEIS, FSG and PSG randomized trial on 3 cycles of neoadjuvant epirubicine+ifosfamide (EI) versus a histology-tailored (HT) regimen in selected localized high-risk STS showed some superiority of EI in all histologies with the exception of Myxoid Liposarcoma (MLPS) where EI and HT regimens seemed equivalent (J Clin Oncol 202...
Article
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Background: Surgery is the mainstay of treatment for retroperitoneal sarcoma (RPS), but local recurrence is common. Biologic behavior and recurrence patterns differ significantly among histologic types of RPS, with implications for management. The Transatlantic Australasian RPS Working Group (TARPSWG) published a consensus approach to primary RPS,...
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AIM: The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. METHODS: This was an international prospective cohort study of consecutive colorectal cancer patients...
Article
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Background: Well-differentiated (WD)/dedifferentiated (DD) liposarcoma (LPS) accounts for ~60% of retroperitoneal sarcomas. WDLPS and DDLPS divergently evolve from a common precursor and are both marked by the amplification of the 12q13-q15 region, leading to the abnormal expression of MDM2, CDK4, and HMGA2 genes. DDLPS is a non-lipogenic disease...
Preprint
Background Complex surgical resection and reconstruction for rare thoracic cancers (RTCs) represent a major challenge, given their very low frequency, extreme variability of presentation, multi-modality treatment options and inadequate outcome prediction. We reported the experience of a tertiary referral centre on a consecutive series of RTC patien...
Article
Background: The European Organization for Research and Treatment of Cancer 22092-62092 STRASS trial failed to demonstrate the superiority of neoadjuvant radiotherapy (RT) over surgery alone in patients with retroperitoneal sarcoma. Therefore, an RT quality-assurance program was added to the study protocol to detect and correct RT deviations. The a...
Article
Almost half of retroperitoneal (RP) sarcomas are liposarcomas (LPS). The large majority of RP LPS are either well-differentiated LPS (WDLPS) or dedifferentiated LPS (DDLPS), these latter further classified according to grading in G2 and G3 DDLPS. Surgery is the only potentially curative treatment to achieve local control and possibly cure in primar...
Article
Background: No prospective trial with anthracycline-based chemotherapy has individually assessed response in a well-differentiated (WD)/dedifferentiated (DD) liposarcoma patient cohort. We conducted a retrospective analysis of first-line chemotherapy in liposarcoma of intra-abdominal origin (IA-LPS) in patients who had entered the European Organis...
Article
Until recently, the recommendation for primary retroperitoneal sarcomas (RPS) was to perform a complete en-bloc gross excision, (neo) adjuvant treatments being options which were not validated by randomized studies, with a large discrepancy of use between centers. The heterogeneity of RPS, with their different biological behaviour, renders a homoge...
Article
Introduction: In the last few years steps forward in the knowledge of the biology of soft tissue sarcomas (STS) has led to the development of new therapeutic strategies, including immunotherapy. Areas covered: This review outlines the recent findings on immunological features and provides a synopsis of the results of clinical trials with differe...
Article
Full-text available
The cornerstone of therapy for primary retroperitoneal sarcomas (RPS) is complete surgical resection, best achieved by resecting the tumor en bloc with adherent structures even if not overtly infiltrated. Until recently, trials designed to elucidate the role of neoadjuvant radiation or chemotherapy for RPS have been unable to achieve sufficient enr...
Article
Introduction This study analyzes the outcomes of patients with hepatic EHE (HEHE) in the United States stratified by their most definitive treatment. Methods The National Cancer Data Base was used to identify patients with HEHE between 2004 and 2018. Patients were divided in four groups: no surgical treatment, ablation, liver resection or liver tr...
Article
Full-text available
Introduction: Primary abdominal wall sarcomas are rare, heterogeneous tumours. The mainstay of management is surgery, although local recurrences (LR) and distant metastases (DM) are common. Objectives: Overall survival (OS) and disease-free survival (DFS) were primary outcomes; factors associated with prognosis secondary outcomes. Materials and...
Article
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Background Retroperitoneal sarcoma (RPS) is a rare tumour that can reach exceptionally large size at diagnosis and affects body weight with its volume. We investigated the risk of nutritional status misclassification based on the Global Leadership Initiative on Malnutrition (GLIM) criteria in RPS patients. Methods We retrospectively analyzed the b...
Article
Background: Sarculator is an online validated nomogram that predicts overall survival of patients with resected, primary extremity sarcomas. However, its ability to accurately predict outcomes in US patients with sarcoma is unknown. Patients and methods: Patients from the National Cancer Data Base (NCDB) (2006-2016) with resected stage I-III pri...
Article
Background: The purpose of this article is to summarize the opinions of the surgical oncology leaders from the Global Forum of Cancer Surgeons (GFCS) about the global impact of COVID-19 pandemic on cancer surgery. Methods: A panel session (virtual) was held at the annual Society of Surgical Oncology 2021 International Conference on Surgical Canc...
Article
Purpose: To prospectively assess the behaviour of primary sporadic (not FAP associated) desmoid fibromatosis (DF) managed by active surveillance (AS). Experimental design: This is an Italian prospective, multicenter, observational study (NCT02547831) including patients {greater than or equal to}16 years with primary sporadic DF at any site. Pati...
Article
Importance: The risk of developing adrenal insufficiency (AI) following adrenalectomy has been insufficiently studied in the context of multivisceral resection (MVR). Objective: To evaluate the incidence of AI in patients undergoing MVR with en bloc adrenalectomy. Design, setting, and participants: Prospective observational longitudinal study...
Article
Background this study analysed primary myxofibrosarcoma (MFS) to investigate patient outcomes focusing on histopathologic margins and perioperative treatments. Patients and methods data from consecutive patients affected by primary and localized MFS of the extremities or trunk wall who underwent surgery (2002–2017) were analysed. Local recurrence...
Article
IntroductionDelayed gastric emptying (DGE) is a common complication in surgery, but incidence and relevance following multivisceral resection are unknown.Methods Data from 100 consecutive patients treated for primary retroperitoneal sarcoma (RPS) were analyzed from our institutional prospectively maintained database from January 2019 to April 2020....
Article
Background Retroperitoneal sarcoma (RPS)-specific nomograms provide estimates of survival and recurrence risk following resection in the individual patient. The effect of preoperative treatment on nomogram performance has not been previously examined. Our aim was to evaluate the predictive accuracy of existing RPS-specific nomograms in patients man...
Article
Background The improved outcome of extremity soft tissue sarcoma patients surgically treated until 2007 at the authors’ institution was previously reported. This study updates the analysis at a later follow-up and extends the patients’ cohort to assess changes in outcomes over time for extremity and superficial trunk soft tissue sarcoma (ESTSTS) tr...
Article
Full-text available
Soft-tissue sarcomas are rare tumors arising from mesenchymal tissues. As a heterogeneous group comprising more than 50 types, the development of clinical trials remains challenging. Decision-making for neoadjuvant or adjuvant chemotherapy and radiation therapy is based on the available evidence of contemporary trials and multidisciplinary clinical...
Chapter
Desmoid tumors (DT) are a rare disease with no metastatic potential, characterized by a local aggressive monoclonal fibroblastic proliferation. DT are characterized by a mutually exclusive CTNNB1 or APC mutation: CTNNB1 mutations are somatic and occur only in the sporadic form, while APC mutations are generally germline and associated with the fami...
Article
Full-text available
There is little evidence around the potentially protective role of previous Bacillus Calmette-Guerin (BCG) vaccination on postoperative mortality in patients with perioperative SARS-CoV-2 vaccination. Prior BCG vaccination did not protect SARS-CoV-2 infected patients against postoperative pulmonary complications and 30-day mortality.
Article
Purpose: The aim of this study was to create and validate dynamic nomograms to predict overall survival (OS) and disease-free survival (DFS) at different time points during follow-up in patients who had undergone resection of primary retroperitoneal sarcoma (RPS). Methods: Patients with primary RPS operated upon between 2002 and 2017 at four and...
Conference Paper
Objectives Perivascular epitheliod cell tumors (PEComas) are rare mesenchymal neoplasms. Uterine PEComa is extremely rare and only limited evidence is still available. Methods Charts of consecutive patients who had treatment (between 01/01/2010 and 12/31/2020) for newly diagnosed uterine PEComas were retrieved. Five-year outcomes were assessed usi...
Article
Background Desmoid fibromatosis (DF) is a locally aggressive rare tumor with high recurrence rate after surgery and unpredictable clinical course. Standard of care for DF patients is active surveillance; however, 30% of patients will progress and need active treatments. Biomarkers discriminating aggressive forms of DF are not available and predicti...
Article
Introduction The standard of care for localized primary retroperitoneal sarcomas (RPS) is a macroscopically complete resection (R0/R1 resection). It has been established that more extensive resection is associated with increasing morbidity. In particular, resection of more than three organs is associated with a significantly increased risk of morbi...
Article
Background: The value of neoadjuvant chemotherapy in soft tissue sarcoma (STS) is not completely understood. This study investigated the benefit of neoadjuvant chemotherapy according to prognostic stratification based on the Sarculator nomogram for STS. Methods: This study analyzed data from ISG-STS 1001, a randomized study that tested 3 cycles...
Article
Full-text available
Purpose: The effect of high-dose imatinib (800 mg/d) on survival in the adjuvant treatment of patients with resected KIT exon-9 mutated gastrointestinal stromal tumors (GIST) is not established. Here, the association of dose and other clinicopathological variables with survival was evaluated in a large multi-institutional European cohort. Methods...
Article
Full-text available
Background Myxofibrosarcoma (MFS) is a rare soft tissue sarcoma with a high recurrence rate and a low risk of distant metastasis. It occurs mainly in the extremities of elderly men. Head and neck MFS is extremely rare. Surgery is the cornerstone of treatment. The role of radiotherapy (RT) and chemotherapy (CHT) on MFS is still debated. Case presen...
Chapter
Gastrointestinal stromal tumors (GISTs) are a group of tumors that, over the past 15 years, has emerged from a poorly understood neoplasm to a well-defined tumor entity. GISTs are highly resistant to conventional chemotherapy and, in the past, were typically managed surgically. Prior to the advent of the tyrosine kinase inhibitors (TKIs) like imati...
Conference Paper
Introduction/Background* Perivascular epitheliod cell tumors (PEComas) are rare mesenchymal neoplasms. Uterine PEComa is extremely rare and only limited evidence is still available. Methodology This is a single-center retrospective study. Charts of consecutive patients who had treatment (from 01/01/2010 to 12/31/2020) for newly diagnosed uterine P...
Article
Fat-containing tumors are very commonly found in daily practice with benign lipoma accounting for the majority of superficial tumors. Overlap in imaging findings between benign and intermediate or malignant fat-containing tumor is common. Guidelines recommend a core needle biopsy (CNB) for all deep tumors, and superficial tumors over 3 cm. However,...
Article
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Background: Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction. Methods: This internati...
Article
MRP-1 is implicated in multidrug resistance and was described as prognostic in high-risk soft-tissue sarcoma (STS) patients in a previous study. The current research aimed to validate MRP-1 prognostic/predictive value in localized sarcomas treated with anthracyclines plus ifosfamide within the ISG-1001 phase III study. Additionally, the inhibitory...
Article
Full-text available
This Clinical Practice Guideline provides key recommendations on the management of bone sarcomas. // Recommendations have been agreed following a consensus meeting of representatives from ESMO, EURACAN, GENTURIS and ERNPaedCan. // Authorship includes a multidisciplinary group of experts from different institutions and countries worldwide.
Article
Gastrointestinal stromal tumours (GISTs) are malignant mesenchymal tumours with a variable clinical behaviour, marked by differentiation towards the interstitial cells of Cajal. GISTs belong to the family of soft tissue sarcomas (STSs) but are treated separately due to their peculiar histogenesis, clinical behaviour and specific therapy. This Europ...
Article
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Purpose Head and neck soft tissues sarcomas (HNSTS) are a heterogeneous group of rare tumours. The 8th edition of the TNM staging system (8TNM) considered these lesions separately for the first time. The aim of this study is to assess its effectiveness and identify the most significant prognostic factors for HNSTS. Methods A retrospective survival...
Article
Full-text available
Background In extremity or trunk liposarcoma, the implications of a dedifferentiated (DD) component within a well-differentiated (WD) tumor are unclear. We evaluated outcomes after surgery and identified potential predictors of survival in these patients compared to those with an entirely WD tumor. Methods Retrospective data were collected for pat...
Article
Full-text available
To support the global restart of elective surgery, data from an international prospective cohort study of 8492 patients (69 countries) was analysed using artificial intelligence (machine learning techniques) to develop a predictive score for mortality in surgical patients with SARS-CoV-2. We found that patient rather than operation factors were the...
Article
Background The surgical management of retroperitoneal sarcomas frequently involves complex multivisceral resections, however retroperitoneal liposarcoma (LPS) rarely invade major abdominal vessels. The aim of the study was to assess association of major vascular resections with outcome of primary LPS. Methods All consecutive patients who underwent...
Article
Full-text available
Soft tissue sarcomas (STSs) comprise ∼80 entities defined by the World Health Organization (WHO) classification based on a combination of distinctive morphological, immunohistochemical and molecular features.1 These ESMO–EURACAN–GENTURIS (European Society for Medical Oncology; European Reference Network for Rare Adult Solid Cancers; European Refere...
Article
Full-text available
Background Desmoid fibromatosis (DF) is a rare and locally infiltrative monoclonal fibroblastic proliferation arising from connective tissues, with lack of metastatic potential. About 10% of all DF cases are intra-abdominally sited. Complications in this site, due to the locally infiltrative nature of the disease, may be severe and potentially life...
Article
Full-text available
Surgery is the primary treatment for localized, clinically resectable soft tissue sarcoma (STS). Chemotherapy and radiotherapy, administered in the pre- or post-operative settings, have important ancillary roles in the multimodal management of primary STS. Some sarcoma centers also employ locoregional therapies such as isolated limb perfusion and d...