F. Raspagliesi - Academia.edu (original) (raw)

Papers by F. Raspagliesi

British Journal of Surgery, 2020

European journal of gynaecological oncology, 2017

This paper reviews the surgical approach experiences in endometrial cancer recurrence and present... more This paper reviews the surgical approach experiences in endometrial cancer recurrence and presents for the first time data on the surgical management of endometrial cancer patients at the time of their second recurrence. Surgery could represent a pivotal role in selected cases of recurrent endometrial cancer, offering long-term complete remissions and a survival advantage.

Ultrasound in Obstetrics & Gynecology, 2019

Doppler assessment during their routine 20 weeks anomaly scan. UtA Doppler was considered abnorma... more Doppler assessment during their routine 20 weeks anomaly scan. UtA Doppler was considered abnormal if sum of pulsatility index (PI) of both uterine arteries was ≥ 2.5. Women were assigned to 4 risk group categories according with presence of SGA maternal risk factors and UtA results: A. low risk: no risk factors and normal UtA; B. intermediate-low risk: no risk factors and abnormal UtA; C. intermediate-high risk: risk factors present and normal UtA; D. high risk: risk factors present and abnormal UtA. The primary outcome was SGA, defined as a baby with birth weight < 10 th centile according with INTERGROWTH-21st standards. Sensitivity and specificity were calculated. Results: UtA Doppler assessment and birth weight were available in 864 women. Amongst those women, neonatal SGA occurred in 51 (5.90%), UtA was abnormal in 91% of all cases. The overall sensitivity, specificity, positive and negative predictive value were, 33, 88, 16, and 95%, respectively. In the low and intermediate-low risk group sensitivity and negative predictive value were similar to the all population (33, and 96%, respectively) (group A and B). SGA rate detection in the intermediate-low risk group doubled (from 8 to 16 cases). In the intermediate-high and high risk groups (C, D), sensitivity was higher (58%); with a lower negative predictive value (91%). Conclusions: UtA Doppler assessment in the second trimester, as a part of a multiparamenter test for screening for SGA, improves detection rate, especially in the subgroup of patients with risk factors for SGA. Negative predictive value in low-risk women can justify its use routinely.

Tumori Journal, 1998

Aims and background: Adult granulosa cell tumor has a low malignant potential but requires an ext... more Aims and background: Adult granulosa cell tumor has a low malignant potential but requires an extensive follow-up of more than 5 years to accurately assess tumor activity. The aim of the present study was to evaluate the clinical characteristics, the treatment and the outcome of this rare ovarian tumor. Study design: A retrospective review of 35 cases treated at pri•

Annals of Oncology, 1992

... Correspondence to: Dr. Rosanna Fontanelli Istituto Nazionale Tumori Via Venezian 1 20133 Mila... more ... Correspondence to: Dr. Rosanna Fontanelli Istituto Nazionale Tumori Via Venezian 1 20133 Milan, Italy ... of Preventive and Societal Medicine, University of Nebraska Medial Center Omaha;Sara T. Fry, School of Nursing, University of Baltimore, MD; John Golenski, SJ Bioethics ...

Geburtshilfe und Frauenheilkunde, 2012

British Journal of Cancer, 1994

No published data are available concerning the activity and tolerability of intramuscularly admin... more No published data are available concerning the activity and tolerability of intramuscularly administered granulocyte colony-stimulating factor (G-CSF) in humans. To fill this gap, 19 patients with advanced ovarian cancer previously treated with at least one first-line chemotherapy cycle received the following myelosuppressive regimen: mitoxantrone (DHAD) 12 mg m-2 i.v. on day 1; ifosfamide (IFO) 4 g m-2 i.v. on days 1 and 2; mesna 800 mg m-2 i.v. t.i.d. on days I and 2. G-CSF (Filgrastim) was given at a dose of 5 gLg/kg/day i.m. from day 6 to day 19, its pharmacokinetics being assessed in five patients. The neutrophil nadir was observed after a mean period of 8 days, and the neutrophil count was <1.0 x I03 mm-3 for a mean of 6 days during the cycle of chemotherapy. The neutrophil count fell after the withdrawal of G-CSF on the 19th day of treatment. The difference in absolute neutrophil count between day 19 and day 21 was statistically significant (P = 0.0001); nevertheless, at day 21 no WHO grade 3-4 neutropenia was reported. DHAD and IFO were respectively given at 95% and 93% of the planned dose. The pharmacokinetics of G-CSF i.m. seems to be similar to that of the drug given subcutaneously. No evidence of cumulative myelosuppression was observed. G-CSF was well tolerated and no complications were observed at the injection sites. In conclusion, if the results obtained in this pilot study regarding the activity of i.m. G-CSF are confirmed by a randomised trial, the intramuscular administration of G-CSF could become a valid alternative for patients who dislike the subcutaneous route and who are being treated with chemotherapy that does not induce profound thrombocytopenia.

European journal of gynaecological oncology, 2002

This study included patients with inoperable primary or recurrent cervical cancer whose treatment... more This study included patients with inoperable primary or recurrent cervical cancer whose treatment plan called for exclusive radiotherapy. The endopoints of the study were to confirm the feasibility of concurrent radiotherapy and paclitaxel in relation to potential acute toxicity and to evaluate if an increase of complete local control might be obtained with the association of paclitaxel to radiotherapy as a radiosensitizer. Twenty patients (13 new cases, stage IIB-III, and 7 with pelvic recurrences) were enrolled and, with exclusion of one recurrence, 19 were evaluable for acute toxicity and response. In new cases, radiotherapy was conventionally administered: 50.4 Gy/28 fractions by external beam (whole pelvis) followed by intracavitary cesium or reduced transcutaneous field. In recurrences, radiotherapy was performed with external beam only through individualized fields. Paclitaxel was administered weekly at the dose of 40 mg/m2 or 60 mg/m2 during the entire course of external rad...

† Introduction † Methods † Malignancies and thrombosis † Ovarian stimulation and thrombosis † Ova... more † Introduction † Methods † Malignancies and thrombosis † Ovarian stimulation and thrombosis † Ovarian hyperstimulation syndrome † Discussion background: Compared with the general population, cancer patients have a higher risk of venous thromboembolism as well as arterial thrombotic events such as stroke, myocardial infarction and peripheral arterial embolism. Therefore a possible concern for women with malignancies undergoing ovarian stimulation for fertility preservation is the increased risk of venous or arterial thrombosis. methods: In this article, we revised current available literature on the risk of thrombosis in patients with cancer and in women undergoing ovarian stimulation, with the ultimate aim of drawing some indications for preventive measures. results: Unfortunately, there are no specific data on the risk of thrombosis in women with cancer undergoing ovarian stimulation for fertility preservation. However, the literature suggests that the cancer type and stage, surgery, and chemotherapy all influence the risk of venous and, possibly, arterial thrombosis. Reports of cases of ovarian stimulation in women without malignancies have shown that venous thrombosis rarely occurs unless a pregnancy is achieved, while arterial thrombosis can occur in the absence of pregnancy but is usually only associated with ovarian hyperstimulation syndrome (OHSS). OHSS increases the risk of thrombotic events, but only the early form of the syndrome is relevant for women undergoing fertility preservation. conclusions: The available evidence on the risks of thrombosis for women undergoing ovarian stimulation for fertility preservation due to a malignancy is reassuring. However the avoidance of the early form of OHSS in women preserving oocytes/embryos due to malignancy is crucial. For these cycles, we advocate the use of a regimen of ovarian stimulation with gonadotrophin releasing hormone (GnRH) antagonists using GnRH agonists to trigger ovulation, an approach that has been shown to markedly reduce the risk of OHSS. Antithrombotic prophylaxis should be administered only to selected subgroups of women such as those with other risk factors or those who do develop early OHSS.

The Lancet Oncology, 2014

Oncology, 2013

Objectives: The objective of this study was to examine whether the oncologic outcomes of BRCA1-as... more Objectives: The objective of this study was to examine whether the oncologic outcomes of BRCA1-associated and BRCA2-associated ovarian cancers correlate differently. Methods: Genetic data and clinical characteristics were correlated with progression-free survival (PFS) and overall survival (OS). Results: Data from 147 BRCA-mutated patients (119 BRCA1-positive and 28 BRCA2-positive) were analyzed. At a median follow-up of 69 months, the median PFS was 27.2 and 45.46 months for BRCA1 and BRCA2 patients, respectively (p = 0.03). Median OS was 77.23 and 111.47 months for BRCA1 and BRCA2 patients, respectively (p = 0.08). Conclusion:BRCA2 mutations confer PFS and a trend to OS advantage compared with the BRCA1 mutation in BRCA-mutated epithelial ovarian cancer patients.

Journal of the American College of Surgeons, 1997

Background: In epithelial ovarian cancer, conservative surgery has mainly been adopted for stage ... more Background: In epithelial ovarian cancer, conservative surgery has mainly been adopted for stage Ia disease. The aim of this study is to report on a conservative surgieai approach used in selected young patients with ovarian cancer who would usually undergo radical operations.

International Journal of Gynecology & Obstetrics, 2000

Objectives: The study was done to frame ultrasonographic & sonosalpingographic guidelines for... more Objectives: The study was done to frame ultrasonographic & sonosalpingographic guidelines for therapeutic trial of ATT in female infertility. Study Methods: This open, prospective & non-comparative study was done with150 infertile women. After routine clinical exam, they were subjected to thorough abdominal, vaginal sonographic and sonosalpingographic (SSG) examinations on 10thday of menstruation. On the basis of positive findings, 9 parameters were laid out. 50 patients having 4 or >4 positive parameters were selected for therapeutic trial of ATT. For an initial 12 weeks (base line phase) patients were treated for infertility on the lines of individual merits. For the next 12 weeks, antitubercular therapy was added to these patients (study period). Results: The efficacy parameters evaluated during the study period compared to baseline included improvement in menstrual function (cycle & flow); pelvic pain & vag. discharge; ovulation and conception rate. Efficacy parameters were analyzed and compared. Improvement in all the parameters in study period (after adding ATT) was significant compared to baseline phase (p<O.OOl, Wilcoxon Rank Sum Test). Conclusion: Sonoand sono-salpingographic parameters laid down in this study may form a promising, valuable and basic tool to screen and treat genital tuberculosis in female infertility.

International Journal of Gynecologic Cancer, 1994

Fifty-two intestinal operations were performed during 45 laparatomies in 43 non-obstructed ovaria... more Fifty-two intestinal operations were performed during 45 laparatomies in 43 non-obstructed ovarian cancer patients. The histology of the tumor was serous in 29/43 cases (67.5%). The gross postoperative morbidity rate was 15.5% and postoperative mortality rate 6.9%. The 5-year survival was 28.3%, and was not affected by the time of intestinal surgery (during the first or following laparotomies). As a result, intestinal surgery in advanced ovarian cancer patients is feasible without an undue increase in morbidity. However, it must be carefully tailored because, though contributing to the quality of life of these patients, it does not seem to affect their survival, at least in this retrospective series.

International Journal of Gynecological Cancer, 2005

We examined tumor-related pathologic factors and cone-related characteristics to identify paramet... more We examined tumor-related pathologic factors and cone-related characteristics to identify parameters related to recurrence in microinvasive squamous cell carcinoma of the cervix treated with conization. This is a retrospective study on 67 consecutive cases of microinvasive carcinoma of the cervix [depth of invasion (DI) < 3 mm] treated with conization. The mean follow-up was 121 months (range 72-276 months). Four (6%) invasive recurrences were observed. Presence of lymphvascular space involvement (LVSI) was significantly related with recurrences (P < 0.05). The mean distance between tumor margin and apex of the cone (apical clearance) was 10.6 mm (range 5-22 mm), and the mean distance between lateral border of the cone and tumor margin (lateral clearance) was 6.5 mm (range 1.7-15 mm). We adopted cut-off values of 10 and 8 mm for apical and lateral clearances, respectively. We found a statistically significant difference between apical clearance and recurrence rate (P < 0.02). The LVSI was, other than DI, an important prognostic factor. Apical clearance was significantly correlated with recurrence. The cone-related characteristics, other than tumor-related pathologic factors, could help the decision concerning the definitive therapy for microinvasive carcinoma of the cervix.

International Journal of Gynecological Cancer, 1994

From January 1975 to December 1991, 34 patients with a diagnosis of epithelial ovarian tumors of ... more From January 1975 to December 1991, 34 patients with a diagnosis of epithelial ovarian tumors of low malignant potential (LMP) were admitted to the Istituto Nazionale Tumori of Milan. Eighteen of them (group 1) underwent complete staging laparotomy and retroperitoneal para-aortic and pelvic lymphadenectomy, as for ovarian cancer. In the remaining 16 cases (group 2), the surgical treatment ranged from unilateral oophorectomy to incomplete staging procedure. In group 1, nine patients (50%) were found to have retroperitoneal nodal involvement. In group 2, all patients had stage I disease. Patients were followed up for 20–222 months (mean 108, median 86). There were two recurrences in group 2 (after 5 years) and none in group 1 (NS). Currently all patients are alive and disease free. Nine of 18 group 1 patients were upstaged to stage III on the basis of lymph node involvement only. However, at least in this retrospective series, lymph node metastases did not affect prognosis or survival.

International Journal of Gynecological Cancer, 2003

Evidence from recent studies indicates that the technique of sentinel node biopsy might be a usef... more Evidence from recent studies indicates that the technique of sentinel node biopsy might be a useful solution for detecting lymph node status for primary vulvar cancer without having to perform radical inguinal lymphadenectomy. The patient in this report underwent sentinel node biopsy, then bilateral inguino-femoral node dissection, and, lastly, radical vulvectomy. The histologic analysis showed a well differentiated squamous cell carcinoma with metastases in one right inguinal node and one left inguinal node and a false-negative right sentinel node. Technically the biopsy of groin sentinel nodes should be quite easy to perform. The use of preoperative lymphoscintigraphy and the intraoperative use of the gamma probe combined with blue dye helps considerably in identifying lymphatic drainage and the sentinel node for vulvar cancer. Further results are needed to confirm the value of sentinel node dissection in the treatment of early stage vulvar cancer.

Gynecologic Oncology, 2003

Gynecologic Oncology, 1992

To assess the role of appendectomy in the surgical procedures for ovarian cancer, we evaluated re... more To assess the role of appendectomy in the surgical procedures for ovarian cancer, we evaluated retrospectively the clinical charts of 435 patients who underwent surgery after diagnosis of ovarian cancer. The appendix was removed in 160 cases and pathological examination revealed 37 with metastatic implants (23%). All the patients with appendiceal metastases showed advanced disease (stages III-IV) with an incidence of 43%. Ninety-one percent (31/34) of the tumors with appendiceal involvement at the staging operation were of the serous cell type and grade II or III. No case with early stage, right ovary carcinoma showed appendiceal metastatic foci, denying the existence of a preferential lymphatic pathway. Microscopic involvement was found only in 4 patients with advanced disease (11.7%). No intra- or postoperative complication directly related to the appendectomy was recorded. We conclude, with these results, that appendectomy should be part of the cytoreductive operation for ovarian cancer.