1.Immunonutrition in ovarian cancer: clinical and immunological impact?
Annamaria FERRERO ; Daniela VASSALLO ; Massimo GEUNA ; Luca FUSO ; Michela VILLA ; Enrico BADELLINO ; Martina BARBONI ; Paola COATA ; Nathalie SANTORO ; Roberto C. Delgado BOLTON ; Nicoletta BIGLIA
Journal of Gynecologic Oncology 2022;33(6):e77-
Objective:
Malnutrition is frequent in ovarian cancer (OC) patients and may compromise post-operative outcomes. The aim of this study is to evaluate the impact of pre-operative immunonutrition on the surgical outcome of OC patients, and on their nutritional, inflammatory and peripheral blood immune status.
Methods:
A prospective study was performed between September 2016 and April 2020. Immune-enhancing enteral nutrition was administered to 42 patients before surgery according to their nutritional status assessed by the Malnutritional Universal Screening Tool. Biochemical and hematological monitoring was performed before and after immunonutrition. Post-operative outcomes were assessed and compared with those of a similar group of patients treated without nutritional support.
Results:
Of the 42 immune-nourished patients, 23 (54.8%) had a low, 11 (26.2%) an intermediate and 8 (19%) a high risk of malnutrition. After the immunonutritional intake, significant variations of prealbumin, creatinine and white blood cells were detected. All T cell populations had an increasing trend, in particular CD3+ T lymphocytes (p=0.020), CD3+CD8+ cytotoxic T lymphocytes (p=0.046) and lymphocyte with HLA-DR expression (p=0.012). The rate of grade II–III post-operative complications was lower (21.4% vs. 42.9%, p=0.035) and the time of hospitalization was shorter (7.5 vs. 9.2, p=0.009) in the immune-nourished group.
Conclusion
Pre-operative immunonutrition improves the surgical outcome of OC patients. After immunonutrition, an increase of CD3+CD8+ cytotoxic T lymphocytes was observed.
2.Characteristics and patterns of care of endometrial cancer before and during COVID-19 pandemic
Giorgio BOGANI ; Giovanni SCAMBIA ; Chiara CIMMINO ; Francesco FANFANI ; Barbara COSTANTINI ; Matteo LOVERRO ; Gabriella FERRANDINA ; Fabio LANDONI ; Luca BAZZURINI ; Tommaso GRASSI ; Domenico VITOBELLO ; Gabriele SIESTO ; Anna Myriam PERRONE ; Vanna ZANAGNOLO ; Pierandrea DE IACO ; Francesco MULTINU ; Fabio GHEZZI ; Jvan CASARIN ; Roberto BERRETTA ; Vito A CAPOZZI ; Errico ZUPI ; Gabriele CENTINI ; Antonio PELLEGRINO ; Silvia CORSO ; Guido STEVENAZZI ; Serena MONTOLI ; Anna Chiara BOSCHI ; Giuseppe COMERCI ; Pantaleo GRECO ; Ruby MARTINELLO ; Francesco SOPRACORDEVOLE ; Giorgio GIORDA ; Tommaso SIMONCINI ; Marta CARETTO ; Enrico SARTORI ; Federico FERRARI ; Antonio CIANCI ; Giuseppe SARPIETRO ; Maria Grazia MATARAZZO ; Fulvio ZULLO ; Giuseppe BIFULCO ; Michele MORELLI ; Annamaria FERRERO ; Nicoletta BIGLIA ; Fabio BARRA ; Simone FERRERO ; Umberto Leone Roberti MAGGIORE ; Stefano CIANCI ; Vito CHIANTERA ; Alfredo ERCOLI ; Giulio SOZZI ; Angela MARTOCCIA ; Sergio SCHETTINI ; Teresa ORLANDO ; Francesco G CANNONE ; Giuseppe ETTORE ; Andrea PUPPO ; Martina BORGHESE ; Canio MARTINELLI ; Ludovico MUZII ; Violante Di DONATO ; Lorenza DRIUL ; Stefano RESTAINO ; Alice BERGAMINI ; Giorgio CANDOTTI ; Luca BOCCIOLONE ; Francesco PLOTTI ; Roberto ANGIOLI ; Giulia MANTOVANI ; Marcello CECCARONI ; Chiara CASSANI ; Mattia DOMINONI ; Laura GIAMBANCO ; Silvia AMODEO ; Livio LEO ; Raphael THOMASSET ; Diego RAIMONDO ; Renato SERACCHIOLI ; Mario MALZONI ; Franco GORLERO ; Martina Di LUCA ; Enrico BUSATO ; Sami KILZIE ; Andrea DELL'ACQUA ; Giovanna SCARFONE ; Paolo VERCELLINI ; Marco PETRILLO ; Salvatore DESSOLE ; Giampiero CAPOBIANCO ; Andrea CIAVATTINI ; Giovanni Delli CARPINI
Journal of Gynecologic Oncology 2022;33(1):e10-
Objective:
Coronavirus disease 2019 (COVID-19) outbreak has correlated with the disruption of screening activities and diagnostic assessments. Endometrial cancer (EC) is one of the most common gynecological malignancies and it is often detected at an early stage, because it frequently produces symptoms. Here, we aim to investigate the impact of COVID-19 outbreak on patterns of presentation and treatment of EC patients.
Methods:
This is a retrospective study involving 54 centers in Italy. We evaluated patterns of presentation and treatment of EC patients before (period 1: March 1, 2019 to February 29, 2020) and during (period 2: April 1, 2020 to March 31, 2021) the COVID-19 outbreak.
Results:
Medical records of 5,164 EC patients have been retrieved: 2,718 and 2,446 women treated in period 1 and period 2, respectively. Surgery was the mainstay of treatment in both periods (p=0.356). Nodal assessment was omitted in 689 (27.3%) and 484 (21.2%) patients treated in period 1 and 2, respectively (p<0.001). While, the prevalence of patients undergoing sentinel node mapping (with or without backup lymphadenectomy) has increased during the COVID-19 pandemic (46.7% in period 1 vs. 52.8% in period 2; p<0.001). Overall, 1,280 (50.4%) and 1,021 (44.7%) patients had no adjuvant therapy in period 1 and 2, respectively (p<0.001). Adjuvant therapy use has increased during COVID-19 pandemic (p<0.001).
Conclusion
Our data suggest that the COVID-19 pandemic had a significant impact on the characteristics and patterns of care of EC patients. These findings highlight the need to implement healthcare services during the pandemic.