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Militello in Val di Catania, Italy

Campiglio M.,Molecular Targeting Unit | Bufalino R.,Molecular Targeting Unit | Sasso M.,Molecular Targeting Unit | Ferri E.,Molecular Targeting Unit | And 15 more authors.
Breast Cancer Research and Treatment | Year: 2013

Clinical trials have shown the efficacy of trastuzumab-based adjuvant therapy in HER2-positive breast cancers, but routine clinical use awaits evaluation of compliance, safety, and effectiveness. Adjuvant trastuzumab-based therapy in routine clinical use was evaluated in the retrospective study GHEA, recording 1,002 patients treated according to the HERA protocol between March 2005 and December 2009 in 42 Italian oncology departments; 874 (87.23 %) patients completed 1-year trastuzumab treatment. In 128 patients (12.77 %), trastuzumab was withdrawn due to cardiac or non-cardiac toxicity (28 and 29 patients, respectively), disease progression (5 patients) or the clinician's decision (66 patients). In addition, 156 patients experienced minor non-cardiac toxicities; 10 and 44 patients showed CHF and decreased LVEF, respectively, at the end of treatment. Compliance and safety of adjuvant trastuzumab-based therapy in Italian hospitals were high and close to those reported in the HERA trial. With a median follow-up of 32 months, 107 breast cancer relapses were recorded (overall frequency, 10.67 %), and lymph node involvement, estrogen receptor negativity, lymphoid infiltration, and vascular invasion were identified as independent prognostic factors for tumor recurrence, indicating that relapses were associated with advanced tumor stage. Analysis of site and frequency of distant metastases showed that bone metastases were significantly more frequent during or immediately after trastuzumab (<18 months from the start of treatment) compared to recurrences in bone after the end of treatment and wash-out of the drug (>18 months from the start of treatment) (35.89 vs. 14.28 %, p = 0.0240); no significant differences were observed in recurrences in the other recorded body sites, raising the possibility that the protection exerted by trastuzumab is lower in bone metastases. © 2013 The Author(s).

Scilletta R.,University of Catania | Pagano D.,University of Palermo | Spada M.,University of Palermo | Mongiovi S.,Humanitas Centro Catanese Of Oncologia | And 5 more authors.
Journal of Surgical Research | Year: 2014

Background The aim of this study was to identify the incidence of surgical site infections (SSIs) and postoperative complications, as defined by the Clavien-Dindo classification, after hepatic resection for metastatic colorectal cancer in patients with and without associated neoadjuvant chemotherapy. Methods A total of 181 patients were studied retrospectively. Patients were divided into two groups: The first group comprised patients with associated neoadjuvant chemotherapeutic treatment for liver metastases with a latency time <8 wk and the second group comprised patients without associated neoadjuvant chemotherapy. Results Variables of duration of liver surgery, length of total hospital stay, and length of postoperative hospital stay seem to be correlated with SSIs and postoperative complications, P < 0.005 and P < 0.0001, respectively. Duration of surgery is a risk factor for SSIs, with an odds ratio of 1.15, and for complications according to the Clavien-Dindo classification, with an odds ratio of 1.35. Conclusions Neoadjuvant chemotherapy was not a significant risk factor for SSIs, whereas the total length of hospital stay, length of postoperative hospital stay, and duration of surgery were independent predictors of SSIs and complications according to the Clavien-Dindo classification. © 2014 Elsevier Inc. All rights reserved.

Gallo G.,University of Catania | Guarnera G.C.,University of Catania | Catanuto G.,Humanitas Centro Catanese Of Oncologia
BIOSIGNALS 2010 - Proceedings of the 3rd International Conference on Bio-inpsired Systems and Signal Processing, Proceedings | Year: 2010

This paper introduces a parametric space to describe the shape of human breasts. The parameter space has been obtained from a sample of about 40 patient's MRI taken in prone position. The data have been cleaned from noise and disturbances and has been dimensionally reduced using Principal Component Analysis. If two references relative to extremal shapes (one of a reconstructed breast and one of a severely aged breast) are taken, all the other shapes span a continuum space that provides an objective way to classify and describe the variability observed in the common clinical practice.

Campiglio M.,Fondazione IRCCS | Bufalino R.,Fondazione IRCCS | Sandri M.,Fondazione IRCCS | Ferri E.,Fondazione IRCCS | And 18 more authors.
Breast Cancer Research and Treatment | Year: 2011

Recent studies have reported the potential clinical utility for metastatic breast cancer (MBC) patients of continuing trastuzumab beyond progression. Based on those results, here the authors have examined the benefits of trastuzumab-continuation by specifically evaluating RECIST responses upon first line trastuzumab-treatment as a potential predictive marker for therapeutic effect of trastuzumab-continuation beyond metastatic disease progression. The authors carried out a retrospective analysis of 272 HER2 positive MBC patients under trastuzumab treatment at 22 different oncology Italian centers during the years of 2000 and 2001 who progressed under first line trastuzumab-treatment. The primary end point of the study was the survival from the date of first documented progression upon first line trastuzumab treatment of disease. Data analysis involved the use of matching on propensity score to balance variables between treated and untreated subjects and to reduce bias. Of the 272 HER2-positive MBC patients, 154 (56.6%) continued treatment. 79 (51.3%) of those 154 patients showed responses based on RECIST criteria during first-line trastuzumab-treatment. Of the 118 patients that suspended trastuzumab, RECIST responses had been observed in 44 (37.3%). Cox proportional hazards analysis of progressed patients, matched using propensity score, showed that discontinuation of trastuzumab at metastatic disease progression was a risk factor for significantly reduced overall survival in both responder (HR = 2.23; 95% CI = 1.03-4.82) and non-responder groups (HR = 3.53, 95% CI = 1.73-7.21), with no significant differences in the two estimated HRs (P-value of the likelihood-ratio test = 0.690). Continued trastuzumab treatment after disease progression has clinically and statistically significant effects in both RECIST responder and non-responder MBC patients. © 2011 Springer Science+Business Media, LLC.

Clemente S.,Centro Of Riferimento Oncologico Della Basilicata | Nigro R.,Azienda Sanitaria Locale Rieti | Oliviero C.,Centro Of Riferimento Oncologico Della Basilicata | Marchioni C.,Azienda Sanitaria Locale Rieti | And 9 more authors.
International Journal of Radiation Oncology Biology Physics | Year: 2015

The increasing use of moderate (<35 fractions) and extreme (<5 fractions) hypofractionated radiation therapy in prostate cancer is yielding favorable results, both in terms of maintained biochemical response and toxicity. Several hypofractionation (HF) schemes for the treatment of prostate cancer are available, although there is considerable variability in the techniques used to manage intra-/interfraction motion and deliver radiation doses. We performed a review of the published studies on HF regimens as a topic of interest for the Stereotactic Ablative Radiotherapy working group, which is part of the Italian Association of Medical Physics. Aspects of organ motion management (imaging for contouring, target volume definition, and rectum/bladder preparation) and treatment delivery (prostate localization, image guided radiation therapy strategy and frequency) were evaluated and categorized to assess outcome relative to disease control and toxicity. Despite the heterogeneity of the data, some interesting trends that emerged from the review might be useful in identifying an optimum HF strategy. © 2015 Elsevier Inc.

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