Giuseppe Scibilia - Academia.edu (original) (raw)

Papers by Giuseppe Scibilia

Italian Journal of Gynaecology and Obstetrics

Objective. To identify any disorder emerging from the psychological and personality assessment in... more Objective. To identify any disorder emerging from the psychological and personality assessment in patients candidates for Uterus Transplantation from deceased donor. Methods. Minnesota Multiphasic Personality Inventory-2 questionnaire was administered to patients affected from Absolute Uterine Factor Infertility candidates for Uterine Transplantation from deceased donor (protocol n. 1438/CNT2018 by National Transplant Center) during the first visit at Gynaecology and Obstetrics Unit of the Cannizzaro Hospital of Catania. The averages of T points for the clinical scales and subscales of the test were calculated. Clinical scale and subscales are significant for T points average equal to or greater than 65. The study was approved by Ethical Committee Catania 1 of the Policlinico-Vittorio Emanuele Hospital of Catania (protocol n. 0026684 on 03/07/2017). Results. 19 patients aged from 18 to 40 returned a valid questionnaire. The median age is 28 years (range 21-38). Eighteen women have MRKH Syndrome, one hysterectomized. Significant elevation has been detected on the clinical scales for the triad: hypochondria, depression, hysteria; and subscales: subjective depression, physical dysfunctions, lassitude-malaise, somatic complaints. Conclusions. The patients candidates for uterine transplantation have alterations in the personality profiles that concern depression, hypochondria and hysteria. SOMMARIO Obiettivo. Identificare qualsiasi disturbo emergente dalla valutazione psicologica e della personalità nelle pazienti candidate al trapianto di utero da donatore deceduto. Metodi. Il questionario Minnesota Multiphasic Personality Inventory-2 è stato somministrato alle pazienti affette da Infertilità assoluta del fattore uterino candidate per il trapianto uterino da donatore deceduto (protocollo n. 1438/CNT2018 del National Transplant Center) durante la prima visita presso l'Unità di Ginecologia e Ostetricia del Cannizzaro Ospedale di Catania. Sono state calcolate le medie dei punti T per le scale cliniche e per le sotto scale del test. La scala clinica e le sotto scale sono significative per punti T medi pari o superiori a 65. Lo studio è stato approvato dal Comitato Etico Catania 1 dell'Ospedale "Policlinico-Vittorio Emanuele" di Catania (protocollo n. 0026684 del 03/07/2017). Risultati. 19 pazienti di età compresa tra 18 e 40 anni hanno consegnato un questionario valido. L'età media è di 28 anni (range 21-38). Diciotto donne hanno la sindrome MRKH, una di queste è isterectomizzata. Una elevazione significativa è stata rilevata sulla scala clinica per la triade: ipocondria, depressione, isteria; e per le sotto scale: depressione soggettiva, disfunzioni fisiche, stanchezza/malessere, disturbi somatici. Conclusioni. Le pazienti candidate al trapianto uterino presentano alterazioni nei profili di personalità che riguardano depressione, ipocondria e isteria.

Clinical and Experimental Obstetrics & Gynecology, 2019

Purpose of Investigation: To investigate the role of CO2 laser in the patients affected by lichen... more Purpose of Investigation: To investigate the role of CO2 laser in the patients affected by lichen sclerosus (LS), analyzing histological changes and relief of feminine discomfort. Materials and Methods: The authors report a case series of ten patients with histologically verified LS, undergoing fractional CO2 laser, from January 2017 to December 2017. The mean age of the participants was 55 (range 40-68) years, and five had been previously treated with the topical corticosteroid clobetasol propionate 0.05% ointment with limited efficacy. The overall sessions varied depending on the lichen extension, from one to three treatments. Results: All the patients tolerated the procedure well with re-epithelialization occurring within 3-4 weeks in all cases. Carbon dioxide laser was successful in achieving remarkable symptoms reduction or remission. There was an improvement in the appearance of the introitus, and in elastic opening and closing. Post-treatment histology revealed trophic epithelium with mild acanthosis and small areas with superficial hyperkeratosis. These results were maintained throughout the three-month post-treatment follow-up period. Conclusion: Laser treatment is relatively simple and effective. The histological changes observed in these patients suggest a more comprehensive healing effect of the fractional CO2 laser, not only symptomatic approach. The authors await the next follow-up to establish the duration of the effects. Content: CO2 laser is a valid treatment option for LS, improving discomfort through histological changes of tissue.

International Journal of Environmental Research and Public Health

Although a surgical approach is one of the key treatments for stages IA1-IIA2, results of the Lap... more Although a surgical approach is one of the key treatments for stages IA1-IIA2, results of the Laparoscopic Approach to Cervical Cancer (LACC) published in 2018 radically changed the field, since minimally invasive surgery was associated with a four-fold higher rate of recurrence and a six-fold higher rate of all-cause death compared to an open approach. We aimed to evaluate surgical outcomes of abdominal radical hysterectomy (ARH) and total laparoscopic radical hysterectomy (TLRH) for cervical cancer, including data collected before the LACC trial. In our retrospective analysis, operative time was significantly longer in TLRH compared to ARH (p < 0.0001), although this disadvantage could be considered balanced by lower intra-operative estimated blood loss in TLRH compared with ARH (p < 0.0001). In addition, we did not find significant differences for intra-operative (p = 0.0874) and post-operative complication rates (p = 0.0727) between ARH and TLRH. This was not likely to be ...

A pregnancy related cancer is defined as a neoplasm diagnosed in a woman during gestation or with... more A pregnancy related cancer is defined as a neoplasm diagnosed in a woman during gestation or within 12 months following childbirth or abortion. Breast, thyroidal, melanoma, cervical and hematological malignancies are those most commonly diagnosed during pregnancy, with a reported incidence considered lower than those estimated of 1 case on 1000 pregnancies. The clinical complexity is generated by the co-presence of mother and fetus, and the consequent conflict represented by the need to identify a therapeutic strategy that is effective for the maternal prognosis and, at the same time, safeguards the fetal well-being. Moreover, the counseling, diagnosis, staging and management of these cases are further complicated because most of the scientific literature consists in case reports or small retrospective studies and lacks in guidelines and prospective clinical trials. On that basis, the Study Group on Cancer in Pregnancy (members of S.I.G.O.-Italian Society of Gynecology and Obstetric...

[ Research paper thumbnail of Corrigendum to “Hysteroscopic versus cervical injection for sentinel node detection in endometrial cancer: A multicenter prospective randomised controlled trial from the Multicenter Italian Trials in Ovarian cancer (MITO) study group” [European Journal of Cancer. Volume 140, November 2020, Pages ...](https://attachments.academia-assets.com/90906589/thumbnails/1.jpg)

European Journal of Cancer, 2021

Gynecological Surgery, 2021

Background Vulvar cancer is a rare gynecological malignancy that primarily affects women of postm... more Background Vulvar cancer is a rare gynecological malignancy that primarily affects women of postmenopausal age. Treatment is mainly surgical, particularly for vulvar squamous cell carcinoma, the most prevalent histotype. In patients with unifocal tumors with a maximum diameter of <4 cm, in the absence of suspected inguinal lymph nodes, sentinel lymph node (SLN) biopsy is recommended. The use of a radioactive tracer is mandatory; the use of the vital blue dye is optional. Results Two patients diagnosed with vulvar squamous cell carcinoma (FIGO IB stage) underwent bilateral radical vulvectomy, SLN search and removal, and bilateral inguinal lymphadenectomy at the Cannizzaro Hospital Operative Unit of Obstetrics and Gynecology Department (Catania, Italy). Three milliliters of indocyanine green (ICG) 0.5 mg/mL was administered in 3 peritumoral injections under general anesthesia to screen the SLN. The images were acquired using an intraoperative infrared camera system, which allowed i...

Oncology Letters, 2016

The aim of the present study was to evaluate the changes in cervical cancer glucose metabolism fo... more The aim of the present study was to evaluate the changes in cervical cancer glucose metabolism for different levels of cellular differentiation. The metabolic activity was measured by standardized uptake value (SUV), SUV normalized to lean body mass, metabolic tumor volume and total lesion glycolysis using fluorine-18 fluorodeoxyglucose positron emission tomography (PET). A correlation study of these values could be used to facilitate therapeutic choice and to improve clinical practice and outcome. This study considered 32 patients with diagnosed cervical cancers, at different International Federation of Gynecology and Obstetrics stages. Glucose metabolism was assessed by PET examination, and histological specimens were examined to determine their initial grade of differentiation. A correlation study of these values was evaluated. Histological examination showed that all cases were of squamous cell carcinoma. Regarding the differentiation of the tumor, 19 well-to moderately-differentiated tumors and 13 poorly-differentiated tumors were determined. Negative findings for correlations between metabolic parameters and initial grade of histological differentiation were found, and considering that histological grade has been shown to have no consistent prognostic value in cervical cancer treatment, PET imaging could play a significant role in cervical cancer prognosis.

Italian journal of gynaecology & obstetrics : official publication of the Societa italiana di ginecologia e ostetricia (SIGO), 2015

Perivascular epithelioid cell tumors (PEComas) represent a rare group of tumours with uncertain m... more Perivascular epithelioid cell tumors (PEComas) represent a rare group of tumours with uncertain malignancy potential exhibiting an immunophenotype characterized by actin and Human Melanoma Black 45 (HMB45) immunoreactivity. Our case concerns about a rare malignant uterine perivascular epithelioid cell tumour diagnosed in a patient underwent to subtotal hysterectomy with unclear diagnosis, 12 years before. Histological diagnosis after colposcopic exam with biopsy revealed a perivascular epithelioid cell tumor, with immunohistochemical profle negative for HMB45. Negativity for HMB45, already described in literature, could be due to important cellular modifcations of tumoral tissue. In our case, tumour was unresectable, progression of disease occurred during medical treatment and the patient died after 6 months. Lack of information about frst surgery doesn't allow to surely categorized the tumor as primitive or relapse. Further studies are necessary to understand some immunohistoch...

Journal of Minimally Invasive Surgical Sciences, Sep 1, 2014

Introduction: Solitary fibrous tumor (SFT) is a rare mesenchymal tumor that is usually located in... more Introduction: Solitary fibrous tumor (SFT) is a rare mesenchymal tumor that is usually located in the pleural cavity, but it can arise in any part of the body. SFTs can develop in the extremities, in the head and neck region, meninges, orbits, thoracic wall, mediastinum, pericardium, peritoneum, retroperitoneum, pelvis, adrenal glands, liver and urogenital system. Case Presentation: A 29-year-old female, was admitted in the gynaecology and obstetrics unit, for suspected pelvic tumor. CT scan showed a mass with hypervascular behavior and adherent to the uterus. The patient underwent laparoscopic resection of the mass. Abdominal exploration revealed a 5 cm mass, rising from the right iliac retroperitoneum above the pelvic space. The tumor was resected totally laparoscopically. The final histological findings were consistent with benign SFT. There were few mitotic cells (2 × 10 HPF) and a positivity for CD34 BCL2 and actin 1A4 and negative for CD117, desmin and CD99; MIb1 was < 5%. Conclusions: This is the first case of SFT of the retroperitoneum removed laparoscopically. The laparoscopic approach is useful for the advantages of minimally invasive surgery especially in case of peduncolate tumor as the case reported.

Gynecologic Oncology, 2010

Conservative surgery followed by platinum-based chemotherapy is considered the standard approach ... more Conservative surgery followed by platinum-based chemotherapy is considered the standard approach for stage I immature ovarian teratoma (IT), except for stage IA G1. Nevertheless the use of chemotherapy in stage IA G2-3 and IB-IC is controversial. The aim of this study was to evaluate the outcome of patients with IT in order to define the role of chemotherapy in stage I disease. Twenty-eight patients with stage I IT treated in MITO centers were retrospectively reviewed. Grade, stage, age, surgical and postoperative treatment were analyzed using χ(2) test and T test looking for association with recurrence. Median age was 25.5. Twenty-four patients underwent fertility-sparing surgery. FIGO stages were 19 IA, 2 IB, and 7 IC. Nine patients had grade 1 tumor, 12 grade 2, and 7 grade 3. Nine patients received adjuvant chemotherapy. Overall recurrence rate was 21.4% (2 in chemotherapy group and 4 in the group without treatment). No patients with G1 had recurrence, whereas 25% of G2 and 42.9% of G3 relapsed. Recurrence rate was not significantly different according to stage, grade or adjuvant chemotherapy, whereas it was greater in the group not operated in a MITO center, not staged and of age lower than 20 years, with statistical significance. At recurrence 4 patients presenting with mature teratoma were treated with surgery alone, whereas 2 recurring with IT were treated with surgery plus chemotherapy. After a median follow-up of 59 months all patients are NED. Our study suggests that chemotherapy may be withheld for primary therapy and utilized only for recurrence.

$Research paper thumbnail of Gemcitabine Combined with Oxaliplatin (GEMOX) as Salvage Treatment in Elderly Patients with Advanced Ovarian Cancer Refractory or Resistant to Platinum: a Single Institution Experience$

Journal of Chemotherapy, 2007

Both oxaliplatin (OXA) and gemcitabine (GEM) have shown single agent activity in patients with re... more Both oxaliplatin (OXA) and gemcitabine (GEM) have shown single agent activity in patients with recurrent ovarian cancer. Response rates to second-line therapies remain low and there is a need to develop more effective regimens. In view of the synergistic effect of using GEM followed by OXA, we studied these agents in elderly patients with recurrent ovarian cancer refractory or resistant to first-line chemotherapy using platinum with or without paclitaxel. The aim of the study was to evaluate the efficacy and toxicity of combination GEM 1000 mg/m(2) Day 1 i.v. and OXA 100 mg/m(2) in 2h infusion Day 2; treatment was repeated every 2 weeks for 6 courses or until progression of disease or intolerable toxicity. The study was monoinstitutional and started in November 2002. 21 patients, median age 68.6 years (range 65-82) have been treated. Median Performance Status was 0-1, all had at least 1 prior platinum based chemotherapy and 11 had received also a taxane. Patients received a median of 6 cycles of treatment (range 4-11). There were 2 patient (9%) with complete response, 3 patients (14%) achieved a partial response. Low profile toxicity (grade 1-2, WHO criteria) was observed: nausea/vomiting 52%, thrombocytopenia 13%, neuropathy 28%. The GEMOX combination is well tolerated and even in this small group of patients, encouraging responses were documented.

Journal of Cancer Therapy, 2015

The aim of this study is to compare morbidity, surgical treatment and post-operative complication... more The aim of this study is to compare morbidity, surgical treatment and post-operative complications in elderly patients underwent surgery for advanced stage ovarian cancer, comparing to younger patients. Data of patients underwent surgery at the Department of Obstetrics and Gynecology of Cannizzaro Hospital (Catania) for advanced stage (IIIC-IV) ovarian cancer were collected from January 2000 to December 2013. Patients were stratified by age in two groups (I > 65 years and II < 65 years old). Following variables were collected: stage of the tumor, associated diseases, previous chemotherapy, the type of surgical procedures, blood transfusions, intraoperative and postoperative morbidity, mortality, and hospital stay. Median values between the two groups were compared using Mann-Whitney test and frequency data using χ 2. Statistical significance was defined as P < 0.05. A total of 179 patients were identified, they were divided into 2 groups: 64 patients were age 65 years or older (group I) and 115 patients were younger than age 65 (group II). In the whole series, 157 patients (87%) did not experience any complication. Overall, postoperative complications occurred in 10 (15%) patients in the group I and in 12 (10%) in the group II (p = NS). In conclusion, elderly patients may tolerate well surgical procedures within acceptable postoperative morbidity, a length of hospital stay and a need for intensive care quite similar to that of younger patients.

Background: Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a congenital disease characterized ... more Background: Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a congenital disease characterized by variable degrees of utero-vaginal agenesis. A diminished ovarian reserve and ectopic ovaries are common in these patients. The objective of this study is to highlight the issues relating to assisted reproduction in patients with MRKH syndrome who are candidates for Uterus Transplantation and to describe alternative methods to the classic transvaginal oocyte retrieval. Methods: In Italy, the Research Project for Uterus Transplantation from brain-dead donor started on 14/06/2018 (n. 1438/CNT2018). The potential recipients underwent to clinical evaluation, laboratory and instrumental tests to achieve eligibility for transplantation, ovarian stimulation and oocytes retrieval at the Obstetrics and Gynecology Unit of the Cannizzaro Hospital of Catania (Italy). A retrospective analysis of all patients affected by MRKH syndrome who are candidates for uterus transplantation was performed in or...