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3. Image-Guided Robotic Surgery for Sentinel Lymph Node Status Assessment in Uterine Cancers Using Ultrasound Drop-in Probe: Surgical Technique in 10 Steps

Author

Pavone, Matteo, Teodorico, Elena, Bizzarri, Nicolò, Innocenzi, Chiara, Rosati, Andrea, Zorzi, Michela, Cantarini, Chiara, Ciancia, Marianna, Moro, Francesca, Gallotta, Valerio, Marescaux, Jacques, Lecointre, Lise, Fagotti, Anna, Scambia, Giovanni, Fanfani, Francesco, Testa, Antonia, and Querleu, Denis

Published
2025
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4. ASO Author Reflections: Tailored Strategies to Prevent Anastomotic Leakage After Colorectal Resections: The Importance of Understanding Risks in Different Patient Subtypes

Author

Santullo, Francesco, Vargiu, Virginia, Rosati, Andrea, Costantini, Barbara, Gallotta, Valerio, Lodoli, Claudio, Abatini, Carlo, Attalla El Halabieh, Miriam, Ghirardi, Valentina, Ferracci, Federica, Quagliozzi, Lorena, Naldini, Angelica, Pacelli, Fabio, Scambia, Giovanni, and Fagotti, Anna

Published
2025
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10. Robotic approach for the treatment of gynecological cancers recurrences: A ten-year single-institution experience

Author

Certelli, Camilla, Palmieri, Luca, Federico, Alex, Oliva, Riccardo, Conte, Carmine, Rosati, Andrea, Vargiu, Virginia, Tortorella, Lucia, Chiantera, Vito, Foschi, Nazario, Ardito, Francesco, Lodoli, Claudio, Bruno, Matteo, Santullo, Francesco, De Rose, Agostino M., Fagotti, Anna, Fanfani, Francesco, Scambia, Giovanni, and Gallotta, Valerio

Published
2024
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13. Robotic surgery in ovarian cancer

Author

Gallotta, Valerio, Certelli, Camilla, Oliva, Riccardo, Rosati, Andrea, Federico, Alex, Loverro, Matteo, Lodoli, Claudio, Foschi, Nazario, Lathouras, Konstantinos, Fagotti, Anna, and Scambia, Giovanni

Published
2023
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14. Lung-protective ventilation during Trendelenburg pneumoperitoneum surgery: A randomized clinical trial

Author

Grieco, Domenico Luca, Russo, Andrea, Anzellotti, Gian Marco, Romanò, Bruno, Bongiovanni, Filippo, Dell’Anna, Antonio M., Mauti, Luigi, Cascarano, Laura, Gallotta, Valerio, Rosà, Tommaso, Varone, Francesco, Menga, Luca S., Polidori, Lorenzo, D’Indinosante, Marco, Cappuccio, Serena, Galletta, Claudia, Tortorella, Lucia, Costantini, Barbara, Gueli Alletti, Salvatore, Sollazzi, Liliana, Scambia, Giovanni, and Antonelli, Massimo

Published
2023
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18. Clinical Impact of Pathologic Residual Tumor in Locally Advanced Cervical Cancer Patients Managed by Chemoradiotherapy Followed by Radical Surgery: A Large, Multicenter, Retrospective Study

Author

Federico, Alex, Anchora, Luigi Pedone, Gallotta, Valerio, Fanfani, Francesco, Cosentino, Francesco, Turco, Luigi Carlo, Bizzarri, Nicolo’, Legge, Francesco, Teodorico, Elena, Macchia, Gabriella, Valentini, Vincenzo, Scambia, Giovanni, and Ferrandina, Gabriella

Published
2022
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21. The Role of the Endometrial Microbiota in Endometrial Cancer: A Systematic Review of the Literature.

Author

Stabile, Guglielmo, Doria, Alessandra, Bruno, Matteo, D'Indinosante, Marco, Gallotta, Valerio, Fanfani, Francesco, Scambia, Giovanni, Restaino, Stefano, Vizzielli, Giuseppe, Carlucci, Stefania, and Nappi, Luigi

Subjects
ENDOMETRIAL cancer, ANAEROBIC bacteria, MICROBIAL diversity, CANCER patients, GRAM-negative bacteria
Abstract

Background: Endometrial cancer is currently the sixth most frequent cancer in women, and scientific research is focusing on the search for particular features of the endometrium that may explain a further predisposition to the onset of endometrial cancer, aimed at improving knowledge of the pathogenetic factors of this disease. The aim of our review is to analyze in detail the results of the literature on the endometrial microbiota in patients with endometrial cancer and to investigate its role. Methods: We performed our research on the Pubmed, Web of Science, and Scopus databases. We searched up to December 2023 and considered manuscripts published from 2000. Only articles in English were included in the search. We excluded studies in which the endometrial microbiota were collected through the vagina or cervical canal. Results: We included in our review a total of five manuscripts at the end of the screening process, and the total number of patients involved was 190. Four studies considered only post-menopausal patients, while one study considered both pre- and post-menopausal patients. In all studies, the microbiota analysis was derived from a post-hysterectomy biopsy. From our review, it emerged that Bacteroidetes, Actinobacteria, Firmicutes, and Proteobacteria are the most represented bacteria in patients with endometrial cancer. These are both Gram-positive and Gram-negative, but predominantly anaerobic bacteria. Conclusions: The reduced microbial diversity and the presence of specific bacteria is often associated with endometrial cancer. Further work on larger population samples, and on healthy women and those affected by endometrial carcinoma, is needed to understand how the endometrial microbiota changes and influences the development of the tumor and whether intervening in the changes in the microbiota will have a therapeutic impact on endometrial carcinoma. [ABSTRACT FROM AUTHOR]

Published
2024
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26. Robotic Rectosigmoid Resection with Totally Intracorporeal Colorectal Anastomosis (TICA) for Recurrent Ovarian Cancer: A Case Series and Description of the Technique.

Author

Gallotta, Valerio, Palmieri, Luca, Santullo, Francesco, Certelli, Camilla, Lodoli, Claudio, Abatini, Carlo, El Halabieh, Miriam Attalla, D'Indinosante, Marco, Federico, Alex, Rosati, Andrea, Conte, Carmine, Oliva, Riccardo, Fagotti, Anna, and Scambia, Giovanni

Subjects
*MINIMALLY invasive procedures, *BLOOD loss estimation, *ARTERIAL catheterization, *SURGICAL complications, *CANCER relapse
Abstract

Background: Most patients with ovarian cancer relapse within 2 years. Prospective randomized trials, such as DESKTOP III and SOC-I, have shown the role of secondary cytoreduction in improving oncological outcomes in selected patients, when complete tumor resection is achieved. Recent retrospective series suggest that minimally invasive surgery is a feasible option in oligometastatic recurrences, such as rectal ones. Methods: Five patients with an isolated rectal recurrence infiltrating the bowel wall underwent a robotic rectosigmoid resection with totally intracorporeal colorectal anastomosis. The procedure began with retroperitoneal access to manage the vascular structures, followed by visceral resection with a minimally invasive approach. The standard steps of an en-bloc pelvic resection, including intracorporeal end-to-end anastomosis, were performed. The treatment data were evaluated. Results: The mean age of the patients was 54 years, and their mean body mass index was 30. All patients had at least one previous abdominal surgery and 60% had high-grade serous ovarian cancer at their initial diagnosis. Their mean platinum-free interval was 17.4 months. Complete secondary cytoreduction was achieved in all cases, with histopathology confirming bowel infiltration. The mean procedure duration was 294 min, with an estimated blood loss of 180 mL. No intraoperative complications occurred. The mean hospital stay was 8 days. One patient had a grade 2 postoperative complication. The mean follow-up period was 14 months, with only one patient experiencing a recurrence at the level of the abdominal wall. Conclusions: Robotic rectosigmoid resection is a viable option for complete cytoreduction in isolated recurrent ovarian cancer. [ABSTRACT FROM AUTHOR]

Published
2024
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33. Neoadjuvant Chemoradiotherapy Treatment With Intensity-Modulated Technique (VMAT/IMRT), Simultaneous Integrated Boost (SIB), And Image-Guided Radiotherapy (IGRT) Followed By Radical Surgery In Locally Advanced Cervical Cancer: Prospective Phase II Study (LARA 4.0)

Author

Certelli, Camilla, Anchora, Luigi Pedone, Macchia, Gabriella, Autorino, Rosa, Restaino, Stefano, Titone, Francesca, Cosentino, Francesco, Vizzielli, Giuseppe, Legge, Francesco, Surgo, Alessia, De Luca, Viola, Di Stefano, Aida, Bizzarri, Nicolò, Fedele, Camilla, Carbone, Vittoria, Arciuolo, Damiano, Gallotta, Valerio, Fanfani, Francesco, Scambia, Giovanni, and Ferrandina, Gabriella

Published
2025
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46. Predictive factors of surgical complications after pelvic exenteration for gynecological malignancies: a large single-institution experience

Author

Tortorella, Lucia, Cintoni, Marco, Loverro, Matteo, Conte, Carmine, Persichetti, Eleonora, Bizzarri, Nicolò, Costantini, Barbara, Santullo, Francesco, Foschi, Nazario, Gallotta, Valerio, Avesani, Giacomo, Chiantera, Vito, Ercoli, Alfredo, Fanfani, Francesco, Fagotti, Anna, Mele, Maria Cristina, Restaino, Stefano, Gueli Alletti, Salvatore, Scambia, Giovanni, Vizzielli, Giuseppe, Marco, Cintoni (ORCID:0000-0002-9610-0748), Carmine, Conte, Barbara, Costantini, Francesco, Santullo, Fanfani, Francesco (ORCID:0000-0003-1991-7284), Fagotti, Anna (ORCID:0000-0001-5579-335X), Mele, Maria Cristina (ORCID:0000-0003-0153-5819), Scambia, Giovanni (ORCID:0000-0003-2758-1063), Tortorella, Lucia, Cintoni, Marco, Loverro, Matteo, Conte, Carmine, Persichetti, Eleonora, Bizzarri, Nicolò, Costantini, Barbara, Santullo, Francesco, Foschi, Nazario, Gallotta, Valerio, Avesani, Giacomo, Chiantera, Vito, Ercoli, Alfredo, Fanfani, Francesco, Fagotti, Anna, Mele, Maria Cristina, Restaino, Stefano, Gueli Alletti, Salvatore, Scambia, Giovanni, Vizzielli, Giuseppe, Marco, Cintoni (ORCID:0000-0002-9610-0748), Carmine, Conte, Barbara, Costantini, Francesco, Santullo, Fanfani, Francesco (ORCID:0000-0003-1991-7284), Fagotti, Anna (ORCID:0000-0001-5579-335X), Mele, Maria Cristina (ORCID:0000-0003-0153-5819), and Scambia, Giovanni (ORCID:0000-0003-2758-1063)

Abstract

Objective: To evaluate pre-operative predictors of early (<30 days) severe complications (grade Dindo 3+) in patients with gynecological malignancy submitted to pelvic exenteration (PE). Methods: We retrospectively analyzed 129 patients submitted to surgery at Fondazione Policlinico Gemelli between 2010 and 2019. We included patients affected by primary or recurrent/persistent cervical, endometrial, or vulvar/vaginal cancers. Post-operative complications were graded according to the Dindo classification. Logistic regression was used to analyze potential predictors of complications. Results: We performed 63 anterior PE, 10 posterior PE, and 56 total PE. The incidence of early severe post-operative complications was 27.9% (n=36), and the early mortality rate was 2.3% (n=3). More frequent complications were related to the urinary diversion and intestinal surgery. In univariable analysis, hemoglobin <= 10 g/dL (odds ratio [OR]=4.2; 95% confidence interval [CI]=1.65-10.7; p=0.003), low albumin levels (OR=3.9; 95% CI=1.27-12.11; p=0.025), diabetes (OR=4.15; 95% CI=1.22-14.1; p=0.022), 2+ comorbidities at presentation (OR=5.18; 95% CI=1.49-17.93; p=0.012) were predictors of early severe complications. In multivariable analysis, only low hemoglobin and comorbidities at presentation were independent predictors of complications. Conclusion: Pelvic exenteration is an aggressive surgery characterized by a high rate of post-operative complications. Pre-operative assessment of comorbidities and patient health status are crucial to better select the right candidate for this type of surgery.

Published
2024

47. The potential role of systemic inflammatory markers in predicting recurrence in early-stage cervical cancer

Author

Bruno, Matteo, Bizzarri, Nicolò, Teodorico, Elena, Certelli, Camilla, Gallotta, Valerio, Pedone Anchora, Luigi, Fagotti, Anna, Fanfani, Francesco, Scambia, Giovanni, Ferrandina, Maria Gabriella, Fagotti, Anna (ORCID:0000-0001-5579-335X), Fanfani, Francesco (ORCID:0000-0003-1991-7284), Scambia, Giovanni (ORCID:0000-0003-2758-1063), Ferrandina, Gabriella (ORCID:0000-0003-4672-4197), Bruno, Matteo, Bizzarri, Nicolò, Teodorico, Elena, Certelli, Camilla, Gallotta, Valerio, Pedone Anchora, Luigi, Fagotti, Anna, Fanfani, Francesco, Scambia, Giovanni, Ferrandina, Maria Gabriella, Fagotti, Anna (ORCID:0000-0001-5579-335X), Fanfani, Francesco (ORCID:0000-0003-1991-7284), Scambia, Giovanni (ORCID:0000-0003-2758-1063), and Ferrandina, Gabriella (ORCID:0000-0003-4672-4197)

Abstract

Introduction: The influence of systemic inflammatory markers on early-stage cervical cancer (ECC) patients is contradictory. No previous study analyzed whether these markers may be suggestive of recurrence. The aim of this study was to assess whether the inflammatory markers level of patients with recurrence during surveillance was different from those of patients without recurrence representing a risk factor for recurrence. Methods: Retrospective, single-center, observational study. Patients with 2009 FIGO EEC surgically treated between 2012 and 2019 were included. Baseline inflammatory markers were evaluated on the results of the complete blood count (CBC) and coagulation tests. Inflammatory markers of relapsed patients were evaluated on the last CBC performed before the relapse diagnosis. Inflammatory markers of patients with no recurrence were evaluated on the available CBC taken at the same median follow-up time as the one from relapsed patients. Results: 174 patients were included. Baseline Systemic immune inflammation index (SII) > 663 and Systemic inflammation response index (SIRI) > 0.98 were associated with significant risk of recurrence. SII>663 and Neutrophil to lymphocyte ratio (NLR) > 2.41 were associated with increased risk of death. Significant changes between relapsed (n = 23) and non-relapsed (n = 151) patients in median values of SII (615 versus 490, p-value = 0.001), SIRI (0.74 versus 1.05, p-value = 0.005), NRL (2.95 versus 2.15, p-value = 0.0035), and MLR (0.26 versus 0.22 p-value = 0.020), showed that different levels of inflammatory markers could help identifying recurrent disease during surveillance. Conclusion: Baseline SII>663 and SIRI>0.98 were associated with increased risk of recurrence. Higher median values of SII, SIRI, NLR and MLR in relapsed patients highlight their potential association with recurrence.

Published
2024

50. ASO Visual Abstract: Clinical Impact of Pathological Residual Tumor in Locally Advanced Cervical Cancer Patients Managed by Chemoradiotherapy Followed by Radical Surgery: A Large, Multicenter, Retrospective Study

Author

Federico, Alex, Anchora, Luigi Pedone, Gallotta, Valerio, Fanfani, Francesco, Cosentino, Francesco, Turco, Luigi Carlo, Bizzarri, Nicolo’, Legge, Francesco, Teodorico, Elena, Macchia, Gabriella, Valentini, Vincenzo, Scambia, Giovanni, and Ferrandina, Gabriella

Published
2022
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