1.Minimally invasive surgery improves short-term outcomes of nerve-sparing radical hysterectomy in patients with cervical cancer: a propensity-matched analysis with open abdominal surgery
Giorgio BOGANI ; Diego ROSSETTI ; Antonino DITTO ; Fabio MARTINELLI ; Valentina CHIAPPA ; Chiara LEONE ; Umberto LEONE ROBERTI MAGGIORE ; Domenica LORUSSO ; Francesco RASPAGLIESI
Journal of Gynecologic Oncology 2019;30(2):e27-
OBJECTIVES: Nerve-sparing radical hysterectomy has been implemented in order to reduce pelvic floor dysfunctions in women undergoing radical surgery for cervical cancer. Here, we aimed to investigate if the adoption of laparoscopic surgery impacts on patients' outcomes. METHODS: Data of consecutive patients affected by cervical cancer who had laparoscopic nerve-sparing radical hysterectomy were matched 1:1 with an historical cohort of patients undergoing open procedure. A propensity-score matched algorithm was applied. RESULTS: Thirty-five patients' pairs (70 patients: 35 undergoing laparoscopic vs. 35 undergoing open abdominal nerve-sparing radical hysterectomy) were included. Demographic and baseline oncologic characteristics were balanced between groups. Patients undergoing laparoscopic surgery had similar operative time than patients undergoing open abdominal procedures (249 [±91.5] vs. 223 [±65.0] minutes; p=0.066). Laparoscopic approach correlated with lower blood loss (30.5 [±11.0] vs. 190 [90.4] mL; p < 0.001) and shorter hospital stay (3.2 [±1.2] vs. 5.4 [2.0] days; p=0.023). Patients undergoing laparoscopy experienced a lower 30-day pelvic floor dysfunction rate than patients having open surgery. Moreover, they experienced shorter recovery of bladder function than patients having open procedures (median, 7 vs. 9 days; p=0.004, log-rank test). CONCLUSIONS: Laparoscopic approach resulted in a faster recovery of bladder function in comparison to open surgery for patients undergoing nerve-sparing radical hysterectomy.
Cohort Studies
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Female
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Humans
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Hysterectomy
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Laparoscopy
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Length of Stay
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Minimally Invasive Surgical Procedures
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Operative Time
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Pelvic Floor
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Urinary Bladder
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Urination Disorders
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Uterine Cervical Neoplasms
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.