0000000000179734

AUTHOR

Salvatore Gueli Alletti

showing 14 related works from this author

Sentinel Lymph Node in Aged Endometrial Cancer Patients “The SAGE Study”: A Multicenter Experience

2021

ObjectiveThe incidence of endometrial cancer is increasing in elderly people. Considering that aging progressively affects lymphatic draining function, we aimed to define its impact on IGC uptake during SLN mapping.MethodsA multicenter retrospective cohort of endometrial cancer patients with apparently early-stage endometrial cancer undergoing complete surgical staging with SLN dissection was identified in four referral cancer centers from May 2015 to March 2021. Patients were classified in Group 1 (<65 years old) and Group 2 (≥65 years old). The primary endpoint was the assessment of the overall, bilateral, and unsuccessful SLN mapping in the two groups. Secondary outcomes were the …

aged populationCancer Researchmedicine.medical_specialtyindocyanine greenSentinel lymph nodesentinel lymph node (SLN)Logistic regressionelderlylymphatic anatomyInternal medicineClinical endpointMedicineRisk factorRC254-282Original Researchbusiness.industryIncidence (epidemiology)Endometrial cancerCancerNeoplasms. Tumors. Oncology. Including cancer and carcinogensRetrospective cohort studymedicine.diseaseSettore MED/40 - GINECOLOGIA E OSTETRICIAaged population; elderly; endometrial cancer; indocyanine green; lymphatic anatomy; sentinel lymph node (SLN)Oncologyendometrial cancerbusiness
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Indocyanine Green to Assess Vascularity of Ileal Conduit Anastomosis During Pelvic Exenteration for Recurrent/Persistent Gynecological Cancer: A Pilo…

2021

IntroductionPelvic exenteration performed for recurrent/persistent gynecological malignancies has been associated with urological short- and long-term morbidity due to altered vascularization of tissues for previous radiotherapy. The aims of the present study were to describe the use of intravenous indocyanine green (ICG) to assess vascularity of urinary diversion (UD) after pelvic exenteration for gynecologic cancers, to evaluate the feasibility and safety of this technique, and to assess the postoperative complications.MethodsProspective, observational, single-center, pilot study including consecutive patients undergoing anterior or total pelvic exenteration due to persistent/recurrent gy…

Cancer Researchmajor postoperative complicationsNeoplasms. Tumors. Oncology. Including cancer and carcinogensanastomosisgynecological canceranastomosimajor postoperative complicationeye diseasespelvic exenteration (PE)body regionsileal conduit diversionSettore MED/40 - GINECOLOGIA E OSTETRICIAOncologyindocyanine green (ICG)anastomosis; gynecological cancer; ileal conduit diversion; indocyanine green (ICG); major postoperative complications; pelvic exenteration (PE)RC254-282Original ResearchFrontiers in Oncology
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Minimally invasive interval debulking surgery in ovarian neoplasm (MISSION trial–NCT02324595): a feasibility study

2016

Background Laparoscopy has acquired an increasing role in the management of ovarian cancer. Laparoscopic cytoreduction could represent a new frontier for selected patients after neoadjuvant chemotherapy (NACT). Objective We sought to assess feasibility and early complication rate of minimally invasive (MI) interval debulking surgery (IDS) in stage III-IV epithelial ovarian cancer (EOC) patients after NACT. Study Design This is a phase II multicentric study in advanced EOC cases with clinical complete response after NACT, according to Gynecologic Cancer Intergroup and Response Evaluation Criteria In Solid Tumors criteria. Institutional review board approval was obtained and all patients sign…

Neoplasm Residualmedicine.medical_treatmentchemotherapyresidual0302 clinical medicine80 and overMedicineminimally invasive surgeryAged 80 and overOvarian Neoplasms030219 obstetrics & reproductive medicineadvanced ovarian cancerMedicine (all)Obstetrics and GynecologyCytoreduction Surgical ProceduresBowel resectionMiddle AgedDebulkinglaparoscopic cytoreductionNeoadjuvant TherapyIntestinesChemotherapy AdjuvantResponse Evaluation Criteria in Solid Tumors030220 oncology & carcinogenesisinterval debulking surgeryFemaleMedian bodyPeritoneumOmentumneoadjuvant chemotherapyAdultmedicine.medical_specialtyOvariectomyadvanced ovarian cancer; interval debulking surgery; laparoscopic cytoreduction; minimally invasive surgery; neoadjuvant chemotherapy; quality of life; Adult; Aged; Aged 80 and over; Appendectomy; Chemotherapy Adjuvant; Fallopian Tubes; Feasibility Studies; Female; Humans; Hysterectomy; Intestines; Middle Aged; Neoadjuvant Therapy; Neoplasm Recurrence Local; Neoplasm Residual; Omentum; Ovarian Neoplasms; Ovariectomy; Peritoneum; Cytoreduction Surgical Procedures; Laparoscopy; Medicine (all); Obstetrics and GynecologyHysterectomy03 medical and health sciencesadjuvantlocalAppendectomyHumansSurvival rateFallopian TubesAgedHysterectomybusiness.industryAdvanced ovarian cancer interval debulking surgery laparoscopic cytoreduction minimally invasive surgery neoadjuvant chemotherapy quality of life adult aged 80 and over appendectomy chemotherapy adjuvant fallopian tubes feasibility studies female humans hysterectomy intestines middle aged neoadjuvant therapy neoplasm recurrence local neoplasm residual omentum ovarian neoplasms ovariectomy peritoneum cytoreduction surgical procedures laparoscopyPerioperativeneoplasm recurrenceSurgerySettore MED/40 - GINECOLOGIA E OSTETRICIAquality of lifeFeasibility StudiesLaparoscopyLymphadenectomyNeoplasm Recurrence LocalbusinessneoplasmAmerican Journal of Obstetrics and Gynecology
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Laparoscopic surgical management of localized recurrent ovarian cancer: a single-institution experience

2014

Background: Optimally, secondary cytoreduction is acknowledged as a valid option in terms of oncologic outcome for patients with platinum-sensitive recurrent ovarian cancer. In cases of localized relapse, a laparoscopic approach has been attempted at various institutions, but studies on its role for this subset of patients still are limited. This report describes the authors' experience using laparoscopic secondary cytoreduction for patients with localized recurrent ovarian cancer. The results from a retrospective analysis of a prospective case series are reported. Methods: Between October 2011 and May 2013, 29 patients with localized recurrent ovarian cancer were selected for a laparoscopi…

Secondary cytoreductionmedicine.medical_treatmentTissue AdhesionsPostoperative ComplicationsLaparotomyLaparoscopyOvarian Neoplasmsmedicine.diagnostic_testMedicine (all)Middle Agedovarian cancerChemotherapy AdjuvantLymphatic MetastasisFemaleAdult; Aged; Antineoplastic Agents; Carcinoma; Chemotherapy; Adjuvant; Disease-Free Survival; Female; Follow-Up Studies; Humans; Laparoscopy; Laparotomy; Length of Stay; Lymph Node Excision; Lymphatic Metastasis; Middle Aged; Monitoring; Intraoperative; Neoplasm Recurrence; Local; Neoplasm Staging; Operative Time; Ovarian Neoplasms; Postoperative Complications; Retrospective Studies; Tissue AdhesionsAdultmedicine.medical_specialtyRecurrent ovarian cancer; Laparoscopy; Secondary cytoreductionOperative TimeAntineoplastic AgentsDisease-Free SurvivalLaparoscopicMonitoring IntraoperativeInternal medicineCarcinomamedicineHumansAgedNeoplasm StagingRetrospective StudiesLaparotomybusiness.industryGeneral surgeryCarcinomaRetrospective cohort studyLength of StayHepatologymedicine.diseaseSurgerySettore MED/40 - GINECOLOGIA E OSTETRICIARecurrent Ovarian CancerLymph Node ExcisionSurgeryLaparoscopyNeoplasm Recurrence LocalRecurrent ovarian cancerOvarian cancerbusinessFollow-Up StudiesAbdominal surgery
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Phase III randomised clinical trial comparing primary surgery versus neoadjuvant chemotherapy in advanced epithelial ovarian cancer with high tumour …

2016

Abstract Objective To establishing whether neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS) is superior primary debulking surgery (PDS) in terms of clinical outcome as well as peri-operative morbidity in advanced epithelial ovarian cancer (AEOC) endowed with high tumour load (HTL). Material and methods This is a single-Institution, superiority, randomised phase III trial enrolling supposed AEOC women. Patients considered pre-operatively eligible were triaged to staging laparoscopy to assess the predictive index (PI) of tumour load. All AEOC women with PI ≥ 8 or ≤ 12 (considered as HTL) were included. They were randomly assigned (1:1 ratio) to undergo either PDS f…

Cancer ResearchCarcinoma Ovarian EpithelialRandomised clinical trialCarboplatinCytoreductionchemistry.chemical_compoundPostoperative Complications0302 clinical medicineQuality of lifeAntineoplastic Combined Chemotherapy ProtocolsNeoplasms Glandular and EpithelialOvarian Neoplasms030219 obstetrics & reproductive medicineCytoreduction Surgical ProceduresMiddle AgedDebulkingOncologyChemotherapy Adjuvant030220 oncology & carcinogenesisFemalemedicine.symptomAdultQuality of lifemedicine.medical_specialtyAdolescentPaclitaxelNauseaOperative TimeYoung Adult03 medical and health sciencesOvarian cancerBody ImagemedicineHumansProgression-free survivalAgedAnalysis of VarianceAdvanced ovarian cancer; Cytoreduction; Laparoscopy; Peri-operative complications; Quality of life; Randomised clinical trialbusiness.industryPeri-operative complicationsPerioperativeLength of StayCarboplatinSurgeryClinical trialSettore MED/40 - GINECOLOGIA E OSTETRICIAchemistryAdvanced ovarian cancerLaparoscopyPeri-operative complicationComplicationbusiness
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Peritoneal HPV‐DNA test in cervical cancer (PIONEER study): A proof of concept

2020

The aim of this study was to investigate the prevalence of peritoneal human papillomavirus (HPV) infection in different clinical cervical cancer (CC) settings, and its association with potential clinical and/or histological factors. This is a single-center, prospective, observational study. Consecutive patients with newly diagnosed or recurrent/persistent CC, between March 2019 and April 2020, were included. A group of patients undergoing surgery for benign gynecological conditions was included as control group. All patients underwent HPV-DNA test in the cervix and in the peritoneal cavity simultaneously at time of surgery. Two-hundred seventy-two patients had cervical and peritoneal HPV te…

AdultHPVCancer Researchmedicine.medical_specialtyMultivariate analysiscervical cancergenotypemedicine.medical_treatmentUterine Cervical Neoplasmsprognostic factors.GastroenterologyHuman Papillomavirus DNA Tests03 medical and health sciencesPeritoneal cavity0302 clinical medicinegenotypesInternal medicineGenotypemedicineHumansProspective StudiesStage (cooking)Peritoneal CavityCervixAgedNeoplasm StagingAged 80 and overCervical cancerHuman papillomavirus 16Human papillomavirus 18business.industryHPV infectionprognostic factorsMiddle Agedperitoneummedicine.diseaseCervical conizationinfectionSettore MED/40 - GINECOLOGIA E OSTETRICIAmedicine.anatomical_structureOncology030220 oncology & carcinogenesisFemalebusinessInternational Journal of Cancer
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Laparoscopic Radical Hysterectomy After Concomitant Chemoradiation in Locally Advanced Cervical Cancer: A Prospective Phase II Study

2015

Abstract Study Objective To assess the feasibility of total robotic radical surgery (TRRS) in patients with locally advanced cervical cancer (LACC) who receive chemoradiation therapy (CT/RT). Design A prospective (preplanned) study of a nonrandomized controlled trial (Canadian Task Force classification level 2). Setting Catholic University of the Sacred Hearth, Rome, Italy. Patients Between September 2013 and January 2016, a total of 40 patients with LACC (Federation Internationale de Gynecologie et d'Obstetrique stage IB2–III) were enrolled in the study. Interventions Robotic radical hysterectomy (RRH) plus pelvic and/or aortic lymphadenectomy was attempted within 6 weeks after CT/RT. The …

AdultUterine Cervical Neoplasmmedicine.medical_specialtymedicine.medical_treatmentUterine Cervical NeoplasmsHysterectomyPostoperative ComplicationsmedicineRadical hysterectomyHumansProspective StudiesCervical cancer; Laparoscopy; Neoadiuvant chemoradiation; Radical hysterectomy; Adult; Aged; Carcinoma; Squamous Cell; Chemoradiotherapy; Adjuvant; Cisplatin; Feasibility Studies; Female; Humans; Italy; Middle Aged; Neoadjuvant Therapy; Neoplasm Recurrence; Local; Postoperative Complications; Prospective Studies; Uterine Cervical Neoplasms; Hysterectomy; Laparoscopy; Lymph Node ExcisionRadical surgeryRadical HysterectomyProspective cohort studyNeoadjuvant therapyAgedCervical cancerHysterectomybusiness.industryMedicine (all)Obstetrics and GynecologyLaparoscopic Radical HysterectomyPerioperativeChemoradiotherapy AdjuvantMiddle Agedmedicine.diseaseNeoadjuvant TherapySurgeryFeasibility StudieProspective StudieSettore MED/40 - GINECOLOGIA E OSTETRICIAItalyCervical cancerNeoadiuvant chemoradiationCarcinoma Squamous CellFeasibility StudiesLymph Node ExcisionLymphadenectomyFemaleLaparoscopyPostoperative ComplicationCisplatinNeoplasm Recurrence LocalbusinessHuman
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Sentinel lymph node mapping with indocyanine green in cervical cancer patients undergoing open radical hysterectomy: a single-institution series

2020

Abstract Purpose To assess the rate of bilateral sentinel lymph node (SLN) detection with indocyanine green (ICG), to evaluate the sensitivity and the negative predictive value of cervical cancer patients undergoing open radical hysterectomy; to compare open versus minimally invasive SLN biopsy performance and to assess factors related to no/unilateral SLN mapping. Methods We retrospectively reviewed consecutive patients with FIGO 2018 stage IA1 with lymph-vascular space involvement to IIB and IIIC1p cervical carcinoma who underwent SLN mapping with ICG followed by systematic pelvic lymphadenectomy between 05/2017 and 06/2020. Patients were divided according to surgical approach for statist…

Cancer ResearchUterine Cervical Neoplasmmedicine.medical_treatmentUterine Cervical NeoplasmsCohort Studieschemistry.chemical_compound0302 clinical medicineRetrospective StudieLaparotomyStage (cooking)Coloring AgentsColoring AgentCervical cancerAged 80 and over030219 obstetrics & reproductive medicinemedicine.diagnostic_testGeneral MedicineMiddle AgedSentinel lymph node mappingOncology030220 oncology & carcinogenesisLymphatic MetastasisFemaleRadiologySentinel Lymph NodeAdultIndocyanine Greenmedicine.medical_specialtySentinel lymph nodeHysterectomy03 medical and health sciencesMinimally invasive surgeryBiopsymedicineHumansRadical HysterectomyAgedRetrospective StudiesNeoplasm StagingLaparotomybusiness.industrySentinel Lymph Node BiopsyDetection rateLymphatic Metastasimedicine.diseasechemistryCervical cancerLymph Node ExcisionLymph NodesCohort StudiebusinessOriginal Article – Cancer ResearchIndocyanine green
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Survival analyses from a randomized trial of primary debulking surgery versus neoadjuvant chemotherapy for advanced epithelial ovarian cancer with hi…

2018

5516Background: Previous randomized multicenter trials determined that neoadjuvant chemotherapy (NACT) was non-inferior to primary debulking surgery (PDS) for both progression-free (PFS) and overal...

0301 basic medicineCancer ResearchChemotherapymedicine.medical_specialtybusiness.industrymedicine.medical_treatmentfood and beveragesDebulkinglaw.inventionSurgery03 medical and health sciences030104 developmental biology0302 clinical medicineOncologyRandomized controlled triallaw030220 oncology & carcinogenesisMedicineEpithelial ovarian cancerbusinessTumor LoadJournal of Clinical Oncology
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Mesenteric Lymph Node Involvement in Advanced Ovarian Cancer Patients Undergoing Rectosigmoid Resection: Prognostic Role and Clinical Considerations

2014

Background: The aim of this retrospective study was to investigate the incidence of mesenteric lymph node (MLN) involvement, and its prognostic role in advanced ovarian cancer (OC). Methods: OC patients undergoing rectosigmoid resection during primary debulking surgery or interval debulking surgery were recorded. Progression-free survival (PFS) and overall survival were calculated from the date of diagnosis to the date of relapse/progression, death of disease, or the date of last follow-up. Results: MLNs were detected in 102/148 cases (68.9 %); the rate of MLN involvement was 47.0 %. The percentage of metastatic MLNs was higher in cases with >5 MLNs removed compared with cases with ≤5 MLNs …

OncologySettore MED/18 - CHIRURGIA GENERALEGastroenterologyClear CellSurgical oncology80 and overMucinousMesenteryCystadenocarcinomaLymph nodeAged 80 and overOvarian NeoplasmsMedicine (all)Middle AgedDebulkingPrognosisAdenocarcinoma MucinousOVARIAN CANCERSurvival Ratemedicine.anatomical_structureOncologyLymphatic MetastasisAdenocarcinomaFemaleAdultmedicine.medical_specialtyCystadenocarcinomaAdenocarcinomaAdenocarcinoma Clear Cell; Adenocarcinoma Mucinous; Adult; Aged; Aged 80 and over; Cystadenocarcinoma Serous; Endometrial Neoplasms; Female; Follow-Up Studies; Humans; Lymph Node Excision; Lymph Nodes; Lymphatic Metastasis; Mesentery; Middle Aged; Neoplasm Grading; Ovarian Neoplasms; Prognosis; Rectum; Retrospective Studies; Sigmoid Neoplasms; Survival Rate; Surgery; OncologyInternal medicinemedicineHumansSurvival rateAgedRetrospective Studiesbusiness.industryRectumSerousRetrospective cohort studymedicine.diseaseCystadenocarcinoma SerousEndometrial NeoplasmsSigmoid NeoplasmsSettore MED/40 - GINECOLOGIA E OSTETRICIALymph Node ExcisionSurgeryLymph NodesNeoplasm GradingOvarian cancerbusinessAdenocarcinoma Clear CellFollow-Up Studies
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A Multicentric Randomized Trial to Evaluate the ROle of Uterine MANipulator on Laparoscopic/Robotic HYsterectomy for the Treatment of Early-Stage End…

2021

ObjectiveThis prospective randomized trial aimed to assess the impact of the uterine manipulator in terms of lymph vascular space invasion (LVSI) in patients undergoing minimally invasive staging for early-stage endometrial cancer.MethodsIn this multicentric randomized trial, enrolled patients were randomly allocated in two groups according to the no use (arm A) or the use (arm B) of the uterine manipulator. Inclusion criteria were G1-G2 early-stage endometrial cancer at preoperative evaluation. The variables collected included baseline demographic characteristics, perioperative data, final pathology report, adjuvant treatment, and follow-up.ResultsIn the study, 154 patients (76 in arm A an…

Cancer Researchmedicine.medical_specialtyuterine manipulatormedicine.medical_treatmentUrologylaw.inventionRandomized controlled trialminimally invasive hysterectomylawmedicinehysterectomyStage (cooking)RC254-282Original ResearchHysterectomybusiness.industryEndometrial cancerrobotic hysterectomyNeoplasms. Tumors. Oncology. Including cancer and carcinogensPerioperativemedicine.diseaseendometrial cancer; hysterectomy; laparoscopic hysterectomy; minimally invasive hysterectomy; robotic hysterectomy; uterine manipulatorUterine manipulatorRobotic hysterectomyClinical trialSettore MED/40 - GINECOLOGIA E OSTETRICIAOncologyendometrial cancerlaparoscopic hysterectomybusinessFrontiers in Oncology
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Robotic versus laparoscopic radical hysterectomy in early cervical cancer: A case matched control study

2018

Abstract Background This study aims at evaluating the feasibility, surgical outcome and oncological results observed after robotic radical hysterectomy (RH) compared to laparoscopy for patients with early stage cervical cancer (ECC) patients. Methods Between January 2010 and October 2016, 210 patients underwent RH for treatment of ECC: 70 underwent robotic approach (Cases), and 140 underwent laparoscopic approach (Controls). Results There was no statistically significant difference between the two approaches with regard to clinical patient characteristics and in terms of extent of RH and rate of pelvic and aortic lymphadenectomy. Operative time was significantly longer in the robotic versus…

Uterine Cervical NeoplasmTime Factorsmedicine.medical_treatmentEarly stage cervical cancerUterine Cervical Neoplasms0302 clinical medicinePostoperative ComplicationsRetrospective StudieLaparotomy80 and overMedicineEarly Detection of CancerEarly stage cervical cancer; Laparoscopy; Robotic surgery; Adult; Aged; Aged 80 and over; Female; Humans; Hysterectomy; Incidence; Italy; Laparoscopy; Middle Aged; Postoperative Complications; Retrospective Studies; Robotics; Survival Rate; Time Factors; Uterine Cervical Neoplasms; Young Adult; Early Detection of Cancer; Neoplasm Staging; Surgery; OncologyAged 80 and over030219 obstetrics & reproductive medicineIncidenceGeneral MedicineRoboticsMiddle AgedSurvival RateOncologyItaly030220 oncology & carcinogenesisFemaleHumanAdultmedicine.medical_specialtyTime FactorHysterectomy03 medical and health sciencesYoung AdultHumansRobotic surgeryRadical surgeryRadical HysterectomySurvival rateRetrospective StudiesAgedNeoplasm StagingHysterectomybusiness.industryRobotic surgeryPerioperativeSurgeryRoboticSettore MED/40 - GINECOLOGIA E OSTETRICIASurgeryLymphadenectomyLaparoscopyPostoperative Complicationbusiness
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Subcutaneous Vulvar Flap Viability Evaluation With Near-Infrared Probe and Indocyanine Green for Vulvar Cancer Reconstructive Surgery: A Feasible Tec…

2021

Introduction: Vulvar cancer is a rare condition affecting older women and accounts for 3–5% of all gynecological cancers. Primary surgical treatment involves the removal of a large amount of tissue for which reconstructive surgery is often necessary with a high rate of postoperative complications. Despite several techniques for the evaluation of vulvar flap viability have been proposed, many methods cannot be performed during surgery and require expensive devices often missing in a gynecological clinic. This study aims to verify the feasibility and the safety of the vulvar flap viability evaluation through a near-infrared endoscopic probe and Indocyanine green (ICG) tracer in a small group …

medicine.medical_specialtySurgical marginReconstructive surgeryindocyanine greenRD1-811Dehiscencechemistry.chemical_compoundflap viability; indocyanine green; laparoscopic near-infrared probe; vulvar cancer; vulvar flapmedicineSurgical FlapsProspective cohort studyOriginal Researchvulvar flapvulvar cancerintegumentary systembusiness.industryVulvar cancermedicine.diseaseflap viabilitySurgerychemistrylaparoscopic near-infrared probeRadical VulvectomySurgerybusinessIndocyanine greenFrontiers in Surgery
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Surgical Neuropelveology: Lateral Femoral Cutaneous Nerve Endometriosis. Laparoscopic Resection and Nerve Transplantation

2021

ABSTRACT Study Objective To demonstrate the application of surgical neuroanatomic principles for the diagnosis and treatment of deep infiltrating endometriosis involving the lateral femoral cutaneous nerve. Design Video demonstration of laparoscopic lateral femoral cutaneous endometriosis resection with nerve transplant. Setting Endometriosis infiltrating somatic nerves is a poorly known condition, which can cause severe neuropathic symptoms [1] and is often unrecognized with a subsequent treatment delay [1] . Intimate knowledge of pelvic neuroanatomy and expertise in minimally invasive surgery are essential to manage this challenging surgical scenario 2 , 3 , 4 . Interventions Thirty-six y…

Adultmedicine.medical_specialtyEndometriosisEndometriosisPeripheral nerveAnimalsHumansMedicineEndometriosiLaparoscopyNerve reconstructionCutaneous endometriosisPelvic surgerymedicine.diagnostic_testbusiness.industryPelvic painObstetrics and GynecologyHypoesthesiamedicine.diseaseSurgeryTransplantationmedicine.anatomical_structureAllodyniaDermatomeGynecologyCattleLaparoscopymedicine.symptombusinessConstipation
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