Elisa Scarpelli - Academia.edu (original) (raw)

Papers by Elisa Scarpelli

Research paper thumbnail of Atypical Endometriosis: A Comprehensive Systematic Review of Pathological Patterns and Diagnostic Challenges

Biomedicines, May 29, 2024

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Research paper thumbnail of Exploring the Relationship between Ovarian Cancer and Genital Microbiota: A Systematic Review and Meta-Analysis

Journal of personalized medicine, Mar 27, 2024

Research paper thumbnail of Infectious Complications in Laparoscopic Gynecologic Oncology Surgery within an ERAS-Compliant Setting

Journal of personalized medicine, Jan 29, 2024

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Research paper thumbnail of Update of Laparoscopic Surgery in Borderline Ovarian Tumor: Systematic Review

Clinical and Experimental Obstetrics & Gynecology, Dec 28, 2023

Background: Borderline ovarian tumor (BOT) predominantly affects young women and is often diagnos... more Background: Borderline ovarian tumor (BOT) predominantly affects young women and is often diagnosed at an early stage. BOT accounts for 15% of all epithelial tumors. In this regard, a minimally invasive surgical approach and the ability to preserve fertility, without increasing the incidence of recurrences or worsening the prognosis, are crucial. This review aims to provide an update on the role and indications of laparoscopic surgery in BOTs. Methods: The electronic research was performed on Pubmed, Medline, and Embase. Articles published in the last 20 years (2004-2023) were included, and the following keywords were used: 'borderline ovarian tumor' and 'laparoscopic surgery', 'borderline ovarian tumor' and 'minimally invasive surgery', 'borderline ovarian tumor' and 'fertility sparing', 'borderline ovarian tumor' and 'recurrence' and 'Borderline ovarian tumor' and 'relapse'. The agreement about potential relevance was reached by consensus of the researchers and according to PRISMA statement guidelines. We thoroughly reviewed all bibliographies to assess the inclusion of any further eligible studies. We excluded studies that did not align with the study's objectives. Results: The electronic database search yielded 767 total studies. Of whom, 188 were published before 2004, 84 were case reports, and 45 were not in the English language. Of the remaining 450 studies, 148 were considered eligible for the study. We included 20 studies in this review. Conclusions: Despite the latest guidelines recommending an open approach for the treatment of BOT, the laparoscopic approach has gained popularity as a feasible and safe alternative. The use of an endo-bag, along with advanced laparoscopic skills, has made the minimally invasive approach increasingly safe, with oncological outcomes almost comparable to those of reference. Moreover, in the context of fertility-sparing surgery (FSS), laparoscopy seems to be associated with improved obstetrical outcomes, without detrimental effects on overall survival and disease-free survival. Therefore, the laparoscopic approach in the treatment of BOT appears to be a safe and effective option, especially in the case of FSS.

Research paper thumbnail of Optimal Management for Stage IVB Endometrial Cancer: A Systematic Review

Research paper thumbnail of #454 Proposition of a tailored perioperative-care algorithm for patients with advanced-stage ovarian cancer, based on the surgical complexity score (aletti score)

TriNetX healthcare organization (HCO) networks in the US (TNX-US) and EMEA (TNX-EMEA) to analyze ... more TriNetX healthcare organization (HCO) networks in the US (TNX-US) and EMEA (TNX-EMEA) to analyze the impact of endometriosis as a risk factor for the development of EC. Methodology Using TriNetX Platform, we defined a cohort of 284,287 patients with endometriosis and at least 6 months of follow up at the HCO, 254,726 from TNX-US and 29,561 TNX-EMEA. Propensity score matching between these cohorts and the female control cohorts in each regional network was used to remove the possible confounding effects of age, body mass index (BMI), previous diagnosis of pelvic inflammatory disease, breast cancer, other cancer of female genital organs or genetic susceptibility to cancer. Hazard ratio (HR) was used to compare the incidence of EC between the matched cohorts. Kaplan Meier analysis was used to compare the overall survival (OS) of EC patients with previous endometriosis vs those without endometriosis patients after propensity score matching. The time window of observation in both analyses was 10 years.

Research paper thumbnail of Minimally invasive surgery in gynecological cancers: update and systematic review

Clinical and Experimental Obstetrics & Gynecology, Apr 8, 2022

Introduction: In the last decades, the introduction of laparoscopy and, more recently, of robotic... more Introduction: In the last decades, the introduction of laparoscopy and, more recently, of robotic surgery, offered new options for surgical treatment also in gynecological malignancies, as an alternative to open surgery. When considering the best surgical treatment option for gynecological malignancies, evidence about safety, feasibility, and oncological outcomes must be taken into account, to offer the best treatment to the patient. The present review aims to provide an updated scenario over the available evidence in the use of minimally invasive surgery (MIS) in gynecological malignancies. Material and methods: An electronic search was performed using the following keywords: 'minimally invasive surgery' and 'gynecology', 'minimally invasive surgery' and 'endometrial cancer', 'minimally invasive surgery' and 'ovarian cancer', 'minimally invasive surgery' and 'cervical cancer'. The agreement about potential relevance was reached by consensus of the researchers and according to PRISMA statement guidelines. Systematic reviews, meta-analyses, clinical trials, and original articles were included in the present review. Results: Fifty-eight studies were considered eligible for the study, 23 studies regarding MIS in endometrial cancer (EC), 19 studies on MIS in ovarian cancer (OC), and 16 studies regarding MIS in cervical cancer (CC). The total of patients enrolled was 180,057, 131,430 in the EC group, 23,774 in the OC groups, and 24,853 in the CC group. Conclusions: According to the available evidence and current clinical practice, MIS is undoubtedly the gold standard for early-stage EC treatment and may represent an acceptable option even in high-risk EC patients. Concerning OC, MIS is a safe and useful tool for staging purposes in advanced-stage disease, and a treatment option only in high volume centres with expert oncologic surgeons. On the contrary, MIS should be abandoned in the context of CC, exception made for well-selected patients, who received adequate counselling about current evidence.

Research paper thumbnail of 2022-VA-864-ESGO Rectovaginal fistula repair by Martius flap after exclusive chemo-radiation in advanced cervical cancer patient. A case report

Cervical cancer, Oct 1, 2022

methods were comparable in detecting tumor extension and equally good at detecting lymph node met... more methods were comparable in detecting tumor extension and equally good at detecting lymph node metastases and distant metastases. The radiologists experienced more certainty in analysing malignant lesions with the additional information of PET, however, the lesions were more easily defined on MRI.

Research paper thumbnail of Rectovaginal fistula repair by Martius flap after exclusive chemoradiation in a patient with advanced cervical cancer

International Journal of Gynecological Cancer, Mar 23, 2023

Research paper thumbnail of Urologic Complication after Laparoscopic Hysterectomy in Gynecology Oncology: A Single-Center Analysis and Narrative Review of the Literature

Medicina-lithuania, Dec 18, 2022

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Research paper thumbnail of Update of Robotic Surgery in Benign Gynecological Pathology: Systematic Review

Medicina-lithuania, Apr 17, 2022

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Research paper thumbnail of Do Exophytic and Endophytic Patterns in Borderline Ovarian Tumors Have Different Prognostic Implications? A Large Multicentric Experience

Journal of Clinical Medicine, May 18, 2023

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Research paper thumbnail of 2022-RA-1521-ESGO Do exophytic and endophytic patterns in borderline ovarian tumors have different prognostic implications? A large multicentric experience

Ovarian cancer, Oct 1, 2022

Introduction/Background With the approval of the first poly-(adenosine diphosphate-ribose) polyme... more Introduction/Background With the approval of the first poly-(adenosine diphosphate-ribose) polymerase inhibitor (PARPi), olaparib therapy has demonstrated efficacy in first-line (1L) maintenance for Breast Cancer gene mutated (BRCAm) advanced ovarian cancer (AOC) patients in 2018 and in combination with bevacizumab for Homologous Recombination Deficient (HRD+) AOC patients in 2020. This study describes biomarker testing and treatment patterns in a representative AOC patient sample. Methodology A retrospective observational study utilizing the electronic health record-derived de-identified US-based Flatiron Health database was performed including women aged 18 years at AOC diagnosis between July 2018 and December 2021 with 2 clinical visits. Patients were followed from diagnosis until 31 December 2021, cessation of dataset coverage, or death, whichever occurred first. Biomarker testing was defined as evidence of a test for BRCA or HRD.

Research paper thumbnail of Peripherally Inserted Central Venous Catheters (PICC) versus totally implantable venous access device (PORT) for chemotherapy administration: a meta-analysis on gynecological cancer patients

PubMed, Nov 3, 2021

Background and aim: Ninety-four thousand gynecological cancer diagnoses are performed each year i... more Background and aim: Ninety-four thousand gynecological cancer diagnoses are performed each year in the United States. The majority of these tumors require systemic adjuvant therapy. Sustained venous access was overcome by indwelling long-term central venous catheter (CVC). The best choice of which CVC to use is often arbitrary or dependent on physician confidence. This meta-analysis aims to compare PORT and peripherally inserted central catheter (PICC) outcomes during adjuvant treatment for gynecological cancer. Methods: Meta-analysis Of Observational Studies in Epidemiology (MOOSE) and the preferred reporting items for systematic reviews and meta-analyses statement (PRISMA)were used to conduct the meta-analysis. Results: 1320 patients were included, 794 belonging to the PORT group and 526 to the PICC group. Total complication rates were fewer in the PORT group, p = 0.05. CVC malfunction was less frequent in the PORT group than in the PICC group, p <0.01. Finally, thrombotic events were less expressed in the PORT group than in the PICC group, p = 0.02. No difference was found in operative complication, migration, malposition, extravasation, infection, and complication requiring catheter removal. Conclusions: PORT had fewer thrombotic complications and fewer malfunction problems than PICC devices. Unless specific contraindications, PORTs can be preferred for systemic treatment in gynecological cancer patients.

Research paper thumbnail of Response to: Correspondence on 'Long-term survival outcomes in high-risk endometrial cancer patients undergoing sentinel lymph node biopsy alone versus lymphadenectomy' by Buda et al

International Journal of Gynecologic Cancer

Research paper thumbnail of #444 Verification of the association of the surgical complexity score (aletti score) with postoperative complications in a cohort of patients operated for advanced ovarian cancer

Research paper thumbnail of Hysteroscopic endometrial tumor localization and sentinel lymph node mapping. An upgrade of the hysteroscopic role in endometrial cancer patients

European Journal of Surgical Oncology

Research paper thumbnail of Do Exophytic and Endophytic Patterns in Borderline Ovarian Tumors Have Different Prognostic Implications? A Large Multicentric Experience

Journal of Clinical Medicine

Borderline ovarian tumor (BOT) accounts for 15–20% of all epithelial ovarian tumors. Concerns hav... more Borderline ovarian tumor (BOT) accounts for 15–20% of all epithelial ovarian tumors. Concerns have arisen about the clinical and prognostic implications of BOT with exophytic growth patterns. We retrospectively reviewed all cases of BOT patients surgically treated from 2015 to 2020. Patients were divided into an endophytic pattern (with intracystic tumor growth and intact ovarian capsule) and an exophytic pattern (with tumor growth outside the ovarian capsule) group. Among the 254 patients recruited, 229 met the inclusion criteria, and of these, 169 (73.8%) belonged to the endophytic group. The endophytic group showed more commonly an early FIGO stage than the exophytic group (100.0% vs. 66.7%, p < 0.001). Furthermore, tumor cells in peritoneal washing (20.0% vs. 0.6%, p < 0.001), elevated Ca125 levels (51.7% vs. 31.4%, p = 0.003), peritoneal implants (0 vs. 18.3%, p < 0.001), and invasive peritoneal implants (0 vs. 5%, p = 0.003) were more frequently observed in the exophy...

Research paper thumbnail of Rectovaginal fistula repair by Martius flap after exclusive chemoradiation in a patient with advanced cervical cancer

International Journal of Gynecological Cancer, Mar 23, 2023

Research paper thumbnail of 2022-RA-1521-ESGO Do exophytic and endophytic patterns in borderline ovarian tumors have different prognostic implications? A large multicentric experience

Ovarian cancer

Introduction/Background With the approval of the first poly-(adenosine diphosphate-ribose) polyme... more Introduction/Background With the approval of the first poly-(adenosine diphosphate-ribose) polymerase inhibitor (PARPi), olaparib therapy has demonstrated efficacy in first-line (1L) maintenance for Breast Cancer gene mutated (BRCAm) advanced ovarian cancer (AOC) patients in 2018 and in combination with bevacizumab for Homologous Recombination Deficient (HRD+) AOC patients in 2020. This study describes biomarker testing and treatment patterns in a representative AOC patient sample. Methodology A retrospective observational study utilizing the electronic health record-derived de-identified US-based Flatiron Health database was performed including women aged 18 years at AOC diagnosis between July 2018 and December 2021 with 2 clinical visits. Patients were followed from diagnosis until 31 December 2021, cessation of dataset coverage, or death, whichever occurred first. Biomarker testing was defined as evidence of a test for BRCA or HRD.

Research paper thumbnail of Atypical Endometriosis: A Comprehensive Systematic Review of Pathological Patterns and Diagnostic Challenges

Biomedicines, May 29, 2024

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Research paper thumbnail of Exploring the Relationship between Ovarian Cancer and Genital Microbiota: A Systematic Review and Meta-Analysis

Journal of personalized medicine, Mar 27, 2024

Research paper thumbnail of Infectious Complications in Laparoscopic Gynecologic Oncology Surgery within an ERAS-Compliant Setting

Journal of personalized medicine, Jan 29, 2024

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Research paper thumbnail of Update of Laparoscopic Surgery in Borderline Ovarian Tumor: Systematic Review

Clinical and Experimental Obstetrics & Gynecology, Dec 28, 2023

Background: Borderline ovarian tumor (BOT) predominantly affects young women and is often diagnos... more Background: Borderline ovarian tumor (BOT) predominantly affects young women and is often diagnosed at an early stage. BOT accounts for 15% of all epithelial tumors. In this regard, a minimally invasive surgical approach and the ability to preserve fertility, without increasing the incidence of recurrences or worsening the prognosis, are crucial. This review aims to provide an update on the role and indications of laparoscopic surgery in BOTs. Methods: The electronic research was performed on Pubmed, Medline, and Embase. Articles published in the last 20 years (2004-2023) were included, and the following keywords were used: 'borderline ovarian tumor' and 'laparoscopic surgery', 'borderline ovarian tumor' and 'minimally invasive surgery', 'borderline ovarian tumor' and 'fertility sparing', 'borderline ovarian tumor' and 'recurrence' and 'Borderline ovarian tumor' and 'relapse'. The agreement about potential relevance was reached by consensus of the researchers and according to PRISMA statement guidelines. We thoroughly reviewed all bibliographies to assess the inclusion of any further eligible studies. We excluded studies that did not align with the study's objectives. Results: The electronic database search yielded 767 total studies. Of whom, 188 were published before 2004, 84 were case reports, and 45 were not in the English language. Of the remaining 450 studies, 148 were considered eligible for the study. We included 20 studies in this review. Conclusions: Despite the latest guidelines recommending an open approach for the treatment of BOT, the laparoscopic approach has gained popularity as a feasible and safe alternative. The use of an endo-bag, along with advanced laparoscopic skills, has made the minimally invasive approach increasingly safe, with oncological outcomes almost comparable to those of reference. Moreover, in the context of fertility-sparing surgery (FSS), laparoscopy seems to be associated with improved obstetrical outcomes, without detrimental effects on overall survival and disease-free survival. Therefore, the laparoscopic approach in the treatment of BOT appears to be a safe and effective option, especially in the case of FSS.

Research paper thumbnail of Optimal Management for Stage IVB Endometrial Cancer: A Systematic Review

Research paper thumbnail of #454 Proposition of a tailored perioperative-care algorithm for patients with advanced-stage ovarian cancer, based on the surgical complexity score (aletti score)

TriNetX healthcare organization (HCO) networks in the US (TNX-US) and EMEA (TNX-EMEA) to analyze ... more TriNetX healthcare organization (HCO) networks in the US (TNX-US) and EMEA (TNX-EMEA) to analyze the impact of endometriosis as a risk factor for the development of EC. Methodology Using TriNetX Platform, we defined a cohort of 284,287 patients with endometriosis and at least 6 months of follow up at the HCO, 254,726 from TNX-US and 29,561 TNX-EMEA. Propensity score matching between these cohorts and the female control cohorts in each regional network was used to remove the possible confounding effects of age, body mass index (BMI), previous diagnosis of pelvic inflammatory disease, breast cancer, other cancer of female genital organs or genetic susceptibility to cancer. Hazard ratio (HR) was used to compare the incidence of EC between the matched cohorts. Kaplan Meier analysis was used to compare the overall survival (OS) of EC patients with previous endometriosis vs those without endometriosis patients after propensity score matching. The time window of observation in both analyses was 10 years.

Research paper thumbnail of Minimally invasive surgery in gynecological cancers: update and systematic review

Clinical and Experimental Obstetrics & Gynecology, Apr 8, 2022

Introduction: In the last decades, the introduction of laparoscopy and, more recently, of robotic... more Introduction: In the last decades, the introduction of laparoscopy and, more recently, of robotic surgery, offered new options for surgical treatment also in gynecological malignancies, as an alternative to open surgery. When considering the best surgical treatment option for gynecological malignancies, evidence about safety, feasibility, and oncological outcomes must be taken into account, to offer the best treatment to the patient. The present review aims to provide an updated scenario over the available evidence in the use of minimally invasive surgery (MIS) in gynecological malignancies. Material and methods: An electronic search was performed using the following keywords: 'minimally invasive surgery' and 'gynecology', 'minimally invasive surgery' and 'endometrial cancer', 'minimally invasive surgery' and 'ovarian cancer', 'minimally invasive surgery' and 'cervical cancer'. The agreement about potential relevance was reached by consensus of the researchers and according to PRISMA statement guidelines. Systematic reviews, meta-analyses, clinical trials, and original articles were included in the present review. Results: Fifty-eight studies were considered eligible for the study, 23 studies regarding MIS in endometrial cancer (EC), 19 studies on MIS in ovarian cancer (OC), and 16 studies regarding MIS in cervical cancer (CC). The total of patients enrolled was 180,057, 131,430 in the EC group, 23,774 in the OC groups, and 24,853 in the CC group. Conclusions: According to the available evidence and current clinical practice, MIS is undoubtedly the gold standard for early-stage EC treatment and may represent an acceptable option even in high-risk EC patients. Concerning OC, MIS is a safe and useful tool for staging purposes in advanced-stage disease, and a treatment option only in high volume centres with expert oncologic surgeons. On the contrary, MIS should be abandoned in the context of CC, exception made for well-selected patients, who received adequate counselling about current evidence.

Research paper thumbnail of 2022-VA-864-ESGO Rectovaginal fistula repair by Martius flap after exclusive chemo-radiation in advanced cervical cancer patient. A case report

Cervical cancer, Oct 1, 2022

methods were comparable in detecting tumor extension and equally good at detecting lymph node met... more methods were comparable in detecting tumor extension and equally good at detecting lymph node metastases and distant metastases. The radiologists experienced more certainty in analysing malignant lesions with the additional information of PET, however, the lesions were more easily defined on MRI.

Research paper thumbnail of Rectovaginal fistula repair by Martius flap after exclusive chemoradiation in a patient with advanced cervical cancer

International Journal of Gynecological Cancer, Mar 23, 2023

Research paper thumbnail of Urologic Complication after Laparoscopic Hysterectomy in Gynecology Oncology: A Single-Center Analysis and Narrative Review of the Literature

Medicina-lithuania, Dec 18, 2022

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Research paper thumbnail of Update of Robotic Surgery in Benign Gynecological Pathology: Systematic Review

Medicina-lithuania, Apr 17, 2022

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Research paper thumbnail of Do Exophytic and Endophytic Patterns in Borderline Ovarian Tumors Have Different Prognostic Implications? A Large Multicentric Experience

Journal of Clinical Medicine, May 18, 2023

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Research paper thumbnail of 2022-RA-1521-ESGO Do exophytic and endophytic patterns in borderline ovarian tumors have different prognostic implications? A large multicentric experience

Ovarian cancer, Oct 1, 2022

Introduction/Background With the approval of the first poly-(adenosine diphosphate-ribose) polyme... more Introduction/Background With the approval of the first poly-(adenosine diphosphate-ribose) polymerase inhibitor (PARPi), olaparib therapy has demonstrated efficacy in first-line (1L) maintenance for Breast Cancer gene mutated (BRCAm) advanced ovarian cancer (AOC) patients in 2018 and in combination with bevacizumab for Homologous Recombination Deficient (HRD+) AOC patients in 2020. This study describes biomarker testing and treatment patterns in a representative AOC patient sample. Methodology A retrospective observational study utilizing the electronic health record-derived de-identified US-based Flatiron Health database was performed including women aged 18 years at AOC diagnosis between July 2018 and December 2021 with 2 clinical visits. Patients were followed from diagnosis until 31 December 2021, cessation of dataset coverage, or death, whichever occurred first. Biomarker testing was defined as evidence of a test for BRCA or HRD.

Research paper thumbnail of Peripherally Inserted Central Venous Catheters (PICC) versus totally implantable venous access device (PORT) for chemotherapy administration: a meta-analysis on gynecological cancer patients

PubMed, Nov 3, 2021

Background and aim: Ninety-four thousand gynecological cancer diagnoses are performed each year i... more Background and aim: Ninety-four thousand gynecological cancer diagnoses are performed each year in the United States. The majority of these tumors require systemic adjuvant therapy. Sustained venous access was overcome by indwelling long-term central venous catheter (CVC). The best choice of which CVC to use is often arbitrary or dependent on physician confidence. This meta-analysis aims to compare PORT and peripherally inserted central catheter (PICC) outcomes during adjuvant treatment for gynecological cancer. Methods: Meta-analysis Of Observational Studies in Epidemiology (MOOSE) and the preferred reporting items for systematic reviews and meta-analyses statement (PRISMA)were used to conduct the meta-analysis. Results: 1320 patients were included, 794 belonging to the PORT group and 526 to the PICC group. Total complication rates were fewer in the PORT group, p = 0.05. CVC malfunction was less frequent in the PORT group than in the PICC group, p <0.01. Finally, thrombotic events were less expressed in the PORT group than in the PICC group, p = 0.02. No difference was found in operative complication, migration, malposition, extravasation, infection, and complication requiring catheter removal. Conclusions: PORT had fewer thrombotic complications and fewer malfunction problems than PICC devices. Unless specific contraindications, PORTs can be preferred for systemic treatment in gynecological cancer patients.

Research paper thumbnail of Response to: Correspondence on 'Long-term survival outcomes in high-risk endometrial cancer patients undergoing sentinel lymph node biopsy alone versus lymphadenectomy' by Buda et al

International Journal of Gynecologic Cancer

Research paper thumbnail of #444 Verification of the association of the surgical complexity score (aletti score) with postoperative complications in a cohort of patients operated for advanced ovarian cancer

Research paper thumbnail of Hysteroscopic endometrial tumor localization and sentinel lymph node mapping. An upgrade of the hysteroscopic role in endometrial cancer patients

European Journal of Surgical Oncology

Research paper thumbnail of Do Exophytic and Endophytic Patterns in Borderline Ovarian Tumors Have Different Prognostic Implications? A Large Multicentric Experience

Journal of Clinical Medicine

Borderline ovarian tumor (BOT) accounts for 15–20% of all epithelial ovarian tumors. Concerns hav... more Borderline ovarian tumor (BOT) accounts for 15–20% of all epithelial ovarian tumors. Concerns have arisen about the clinical and prognostic implications of BOT with exophytic growth patterns. We retrospectively reviewed all cases of BOT patients surgically treated from 2015 to 2020. Patients were divided into an endophytic pattern (with intracystic tumor growth and intact ovarian capsule) and an exophytic pattern (with tumor growth outside the ovarian capsule) group. Among the 254 patients recruited, 229 met the inclusion criteria, and of these, 169 (73.8%) belonged to the endophytic group. The endophytic group showed more commonly an early FIGO stage than the exophytic group (100.0% vs. 66.7%, p < 0.001). Furthermore, tumor cells in peritoneal washing (20.0% vs. 0.6%, p < 0.001), elevated Ca125 levels (51.7% vs. 31.4%, p = 0.003), peritoneal implants (0 vs. 18.3%, p < 0.001), and invasive peritoneal implants (0 vs. 5%, p = 0.003) were more frequently observed in the exophy...

Research paper thumbnail of Rectovaginal fistula repair by Martius flap after exclusive chemoradiation in a patient with advanced cervical cancer

International Journal of Gynecological Cancer, Mar 23, 2023

Research paper thumbnail of 2022-RA-1521-ESGO Do exophytic and endophytic patterns in borderline ovarian tumors have different prognostic implications? A large multicentric experience

Ovarian cancer

Introduction/Background With the approval of the first poly-(adenosine diphosphate-ribose) polyme... more Introduction/Background With the approval of the first poly-(adenosine diphosphate-ribose) polymerase inhibitor (PARPi), olaparib therapy has demonstrated efficacy in first-line (1L) maintenance for Breast Cancer gene mutated (BRCAm) advanced ovarian cancer (AOC) patients in 2018 and in combination with bevacizumab for Homologous Recombination Deficient (HRD+) AOC patients in 2020. This study describes biomarker testing and treatment patterns in a representative AOC patient sample. Methodology A retrospective observational study utilizing the electronic health record-derived de-identified US-based Flatiron Health database was performed including women aged 18 years at AOC diagnosis between July 2018 and December 2021 with 2 clinical visits. Patients were followed from diagnosis until 31 December 2021, cessation of dataset coverage, or death, whichever occurred first. Biomarker testing was defined as evidence of a test for BRCA or HRD.