Giorgio Bogani
@istitutotumori.mi.it
Fondazione IRCCS Istituto Nazionale dei Tumori di Milano
RESEARCH INTERESTS
Gynecologic oncology
Scopus Publications
Scopus Publications
Andrea Giannini, Ilaria Cuccu, Tullio Golia D'Auge, Emanuele De Angelis, Antonio Simone Laganà, Vito Chiantera, Donatella Caserta, Salvatore Giovanni Vitale, Ludovico Muzii, Ottavia D'Oria,et al.
Elsevier BV
Antonino Ditto, Mariangela Longo, Giulia Chiarello, Luigi Mariani, Biagio Paolini, Umberto Leone Roberti Maggiore, Fabio Martinelli, Giorgio Bogani, and Francesco Raspagliesi
Elsevier BV
C. Taliento, G. Scutiero, M. Arcieri, G. Pellecchia, V. Tius, G. Bogani, M. Petrillo, M. Pavone, N. Bizzarri, L. Driul,et al.
Elsevier BV
Ilaria Cuccu, Francesco Raspagliesi, Mario Malzoni, Enrico Vizza, Andrea Papadia, Violante Di Donato, Andrea Giannini, Pierandrea De Iaco, Anna Myriam Perrone, Francesco Plotti,et al.
Elsevier BV
Giorgio Bogani, Francesco Sopracordevole, Andrea Ciavattini, Alessandro Ghelardi, Enrico Vizza, Paolo Vercellini, Jvan Casarin, Ciro Pinelli, Fabio Ghezzi, Rosa De Vincenzo,et al.
SAGE Publications
Objective: To date, no data supports the execution of vaccination after hysterectomy for high-grade cervical intraepithelial neoplasia (CIN2+) and early-stage cervical cancer. We aim to evaluate the potential effect of vaccination after hysterectomy for high-grade cervical intraepithelial neoplasia and early-stage cervical cancer. Methods: This is a multi-center retrospective study evaluating data of women who develop lower genital tract dysplasia (including anal, vulvar and vaginal intra-epithelial neoplasia) after having hysterectomy for CIN2+ and FIGO stage IA1- IB1 cervical cancer. Results: Overall, charts for 77 patients who developed lower genital tract dysplasia were collected. The study population included 62 (80.5%) and 15 (19.5%) patients with CIN2+ and early-stage cervical cancer, respectively. The median (range) time between hysterectomy and diagnosis of develop lower genital tract dysplasia was 38 (range, 14-62) months. HPV types covered by the nonavalent HPV vaccination would potentially cover 94.8% of the development of lower genital tract dysplasia. Restricting the analysis to the 18 patients with available HPV data at the time of hysterectomy, the beneficial effect of nonvalent vaccination was 89%. However, considering that patients with persistent HPV types (with the same HPV types at the time of hysterectomy and who developed lower genital tract dysplasia) would not benefit from vaccination, we estimated the potential protective effect of vaccination to be 67% (12 out of 18 patients; four patients had a persistent infection for the same HPV type(s)). Conclusions: Our retrospective analysis supported the adoption of HPV vaccination in patients having treatment for HPV-related disease. Even in the absence of the uterine cervix, HPV vaccination would protect against develop lower genital tract dysplasia. Further prospective studies have to confirm our preliminary research.
Luca Giannella, Giovanni Delli Carpini, Jacopo Di Giuseppe, Camilla Grelloni, Giorgio Bogani, Marco Dri, Francesco Sopracordevole, Nicolò Clemente, Giorgio Giorda, Rosa De Vincenzo,et al.
MDPI AG
Objective: The present study aimed to assess long-term follow-up outcomes in women with in situ/microinvasive adenocarcinoma (AC) of the uterine cervix treated conservatively. Methods: Retrospective multi-institutional study including women with early glandular lesions and 5-year follow-up undergoing fertility-sparing treatment. Independent variables associated with recurrence were evaluated. Logistic regression analysis and Kaplan–Meier survival analysis with Logrank test were performed. Results: Of 269 women diagnosed with in situ/microinvasive AC, 127 participants underwent conservative treatment. During follow-up, recurrences were found in nine women (7.1%). The only factor associated with recurrence during follow-up was positive high-risk Human Papillomavirus (hr-HPV) testing (odds ratio 6.21, confidence interval 1.47–26.08, p = 0.012). HPV positivity in follow-up showed a recurrence rate of 21.7% against 3.8% in patients who were HPV-negative (p = 0.002, Logrank test). Among women with negative high-risk HPV tests in follow-up, recurrences occurred in 20.0% of non-usual-type histology vs. 2.1% of usual-type cases (p = 0.005). Conclusion: HPV testing in follow-up is of pivotal importance in women with early glandular lesions undergoing conservative treatment, given its recurrence predictive value. However, women who are high-risk HPV-negative in follow-up with non-usual-type histopathology may represent a sub-population at increased risk of recurrences. Further studies should confirm these findings.
I. Cuccu, T. Golia D’Augè, C. Di Dio, A. Giannini, A.S. Laganà, V. Chiantera, G. Bogani, A. Pernazza, L. Manganaro, V. Miceli,et al.
Edra SpA
Vito Andrea Capozzi, Luciano Monfardini, Giuseppe Maglietta, Giuseppe Barresi, Alessandra De Finis, Andrea Rosati, Virginia Vargiu, Francesco Cosentino, Giulio Sozzi, Vito Chiantera,et al.
Elsevier BV
Umberto Leone Roberti Maggiore, Ludovica Spanò Bascio, Carlo Alboni, Giulia Chiarello, Luca Savelli, Giorgio Bogani, Fabio Martinelli, Valentina Chiappa, Antonino Ditto, and Francesco Raspagliesi
Elsevier BV
Jvan Casarin, Fabio Ghezzi, Antonio Lembo, Valeria Artuso, Gabriella Schivardi, Emanuele Filippo Galati, Andrea Luigi Ambrosoli, Giorgio Bogani, Francesco Multinu, and Antonella Cromi
Wiley
AbstractBackground and MethodsUterine leiomyosarcomas (uLMS) are rare malignant tumors, often incidentally discovered, with an estimated annual incidence of five cases per one million women in the United States. This study aimed to compare the oncological outcomes of two groups of patients: those with uLMS incidentally found during surgery and those who underwent surgery due to suspected or confirmed uLMS before the procedure. The study assessed patients who had undergone hysterectomy and were diagnosed with stage I uLMS at a tertiary gynecologic oncology referral center in Italy between January 2000 and December 2019. Data on patients' baseline characteristics, surgical procedures, and oncological outcomes were collected. The patients were classified into two groups based on whether uLMS was unexpectedly discovered or suspected before the surgery. Survival rates and factors influencing recurrence were analyzed.ResultsThe study included 36 patients meeting the inclusion criteria, with 12 having preoperatively suspected or proven uLMS and 24 having incidentally discovered uLMS. No significant differences were observed between the two groups regarding disease‐free survival (23.7 vs. 27.3 months, log rank = 0.28), disease‐specific survival (median not reached, log rank = 0.78), or sites of relapse. Notably, among patients who underwent laparoscopic hysterectomy (compared to open surgery), a significantly higher rate of locoregional recurrence was found (78% vs. 33.3%, p = 0.04). Nevertheless, no significant differences in survival were observed based on the surgical approach.ConclusionsPreoperative suspicion for uLMS did not seem to impact survival outcomes or the pattern of recurrence. Furthermore, although patients who underwent laparoscopic hysterectomy showed a higher rate of locoregional relapse, this did not affect their overall survival.
Andrea Giannini, Ottavia D’Oria, Giacomo Corrado, Valentina Bruno, Isabella Sperduti, Giorgio Bogani, Antonio Simone Laganà, Vito Chiantera, Donatella Caserta, and Enrico Vizza
Springer Science and Business Media LLC
Giusi Santangelo, Antonio Simone Lagana, Andrea Giannini, Filippo Murina, Camilla Di Dio, Gianfilippo Ruggiero, Violante Di Donato, Giorgia Perniola, Margherita Fischetti, Assunta Casorelli,et al.
S. Karger AG
<b><i>Background:</i></b> The role of hormonal replacement therapy in menopause is under debate. The premature closure of the Women’s Health Initiative (WHI) study in 2002 is still a source of concern among treating physicians. <b><i>Objectives:</i></b> The interest in alternatives to conventional hormone therapy has significantly increased. The adoption of personalized steroid hormone galenic preparations, formulated by compounding pharmacies, has recently spread. <b><i>Methods:</i></b> In June 2023, an extensive literature search was conducted by different authors to identify relevant studies in various databases (MEDLINE, Embase, PubMed, and Cochrane). The studies that met the inclusion and exclusion criteria were further analyzed, and relevant data were extracted and analyzed for each paper. Any discrepancies between the investigators were resolved through a consensus approach. <b><i>Outcomes:</i></b> The primary outcomes observed included the clinical utility of CBHT. This study reviewed the current evidence on the utility of compounded bioidentical hormones, concluding that improving knowledge and awareness of bioidentical hormones is necessary to consider their use in clinical practice. <b><i>Conclusion and Outlook:</i></b> These formulations might provide effective options to best tailor therapies to each patient.
Camilla Turetta, Andrea Colizza, Andrea Giannini, Massimo Ralli, Giorgio Bogani, Antonio Simone Laganà, Francesco Pecorini, Ludovico Muzii, Antonio Paoli, Violante Di Donato,et al.
S. Karger AG
<b><i>Introduction:</i></b> Polycystic ovary syndrome (PCOS) is a common hormonal disorder among young women, correlated with hyperandrogenism. Among the symptoms of PCOS, vocal alterations are quite unknown. Dysphonia may be related to hyperandrogenism, and there is no consensus about its prevalence and the severity of vocal disorders, which can cause noticeable discomfort. <b><i>Methods:</i></b> A systematic review of the literature was conducted. Four studies on PCOS that evaluated the phonatory system were included for a total of 174 patients (96 PCOS, 78 controls), and a meta-analysis on comparable data was performed. <b><i>Results:</i></b> Four studies evaluated parameters related to vocal symptomatology, altered audiometric examination, and findings at the laryngoscopy in patients affected by PCOS versus controls. Although the individual studies showed increased incidence of alterations and a tendency to develop speech fatigue in women with PCOS, when the results of studies were pulled in meta-analysis, the overall difference was not statistically significant. The studies themselves were very different from each other; therefore, it is hard to draw any firm conclusions. <b><i>Discussion:</i></b> The aim of this study was to assess the prevalence of vocal alterations, the correlation with hyperandrogenism, the quality of life, and the voice changes after starting a therapy for PCOS. The present meta-analysis failed to find any difference in terms of PCOS and control cohort. However, the lack of high-quality studies makes it difficult to draw firm conclusions. New and larger studies or big population program data are therefore warranted.
Umberto Leone Roberti Maggiore, G Bogani, Biagio Paolini, Fabio Martinelli, Giulia Chiarello, Ludovica Spanò Bascio, Valentina Chiappa, Simone Ferrero, Antonino Ditto, and Francesco Raspagliesi
BMJ
ObjectiveTo compare survival outcomes and patterns of recurrence between endometriosis-associated ovarian cancer patients and non-endometriosis-associated ovarian cancer patients.MethodsThis retrospective study included data of consecutive patients with endometrioid or clear cell ovarian cancer treated at the Fondazione IRCCS Istituto Nazionale dei Tumori di Milano between January 2010 and June 2021. Patients were assigned to one of two groups according to the absence or presence of endometriosis together with ovarian cancer at final histological examination. Survival outcomes were assessed using Kaplan-Meier and Cox hazard models. Proportions in recurrence rate and pattern of recurrence were evaluated using the Fisher exact test.ResultsOverall, 83 women were included in the endometriosis-associated ovarian cancer group and 144 in the non-endometriosis-associated ovarian cancer group, respectively. Patients included in the non- endometriosis-associated ovarian cancer group had a shorter disease-free survival than those in the endometriosis-associated ovarian cancer group (23.4 (range 2.0–168.9) vs 60.9 (range 4.0–287.8) months; p<0.001). Univariable and multivariable analyses showed that the association with endometriosis, previous hormonal treatment, early stage at presentation, and endometrioid histology were related to better disease-free survival in the entire study population. Similarly, patients in the non-endometriosis-associated ovarian cancer group had a shorter median (range) overall survival than those in the endometriosis-associated ovarian cancer group (54.4 (range 0.7–190.6) vs 77.6 (range 4.5–317.8) months; p<0.001). Univariable and multivariable analyses showed that younger age at diagnosis, association with endometriosis, and early stage at presentation were related to better overall survival. The recurrence rate was higher in the non-endometriosis-associated ovarian cancer group (63/144 women, 43.8%) than in the endometriosis-associated ovarian cancer group (17/83 women, 20.5%; p<0.001).ConclusionsEndometriosis-associated ovarian cancer patients had significantly longer disease-free survival and overall survival than non-endometriosis-associated ovarian cancer patients, while the recurrence rate was higher in non-endometriosis-associated ovarian cancer patients.
Luca Giannella, Francesco Piva, Giovanni Delli Carpini, Jacopo Di Giuseppe, Camilla Grelloni, Matteo Giulietti, Francesco Sopracordevole, Giorgio Giorda, Anna Del Fabro, Nicolò Clemente,et al.
MDPI AG
Background: The rate of concurrent endometrial cancer (EC) in atypical endometrial hyperplasia (AEH) can be as high as 40%. Some patient characteristics showed associations with this occurrence. However, their real predictive power with related validation has yet to be discovered. The present study aimed to assess the performance of various models based on patient characteristics in predicting EC in women with AEH. Methods: This is a retrospective multi-institutional study including women with AEH undergoing definitive surgery. The women were divided according to the final histology (EC vs. no-EC). The available cases were divided into a training and validation set. Using k-fold cross-validation, we built many predictive models, including regressions and artificial neural networks (ANN). Results: A total of 193/629 women (30.7%) showed EC at hysterectomy. A total of 26/193 (13.4%) women showed high-risk EC. Regression and ANN models showed a prediction performance with a mean area under the curve of 0.65 and 0.75 on the validation set, respectively. Among the best prediction models, the most recurrent patient characteristics were age, body mass index, Lynch syndrome, diabetes, and previous breast cancer. None of these independent variables showed associations with high-risk diseases in women with EC. Conclusions: Patient characteristics did not show satisfactory performance in predicting EC in AEH. Risk stratification in AEH based mainly on patient characteristics may be clinically unsuitable.
Ottavia D’Oria, Giorgio Bogani, Ilaria Cuccu, Tullio Golia D’Auge, Violante Di Donato, Donatella Caserta, and Andrea Giannini
Informa UK Limited
INTRODUCTION
Cervical cancer is the fourth most common cause of cancer-related death worldwide. High-risk locally advanced or recurrent/metastatic cervical cancers have a poor prognosis with routine treatments. The objective of this study is to analyze the data available in the literature on therapies and molecules currently in use to improve the prognosis of recurrent cervical cancer.
AREAS COVERED
An extensive literature search was conducted by authors to identify relevant trials on various databases. Articles in English published until September 2023 that investigate different pharmacotherapy strategies for the treatment of recurrent cervical cancer, were included. Results of various pharmacological regimens including different combinations of chemotherapy, immune checkpoint inhibitors, DNA damage repair inhibitors and antibody-drug conjugates were analyzed.
EXPERT OPINION
In recent years, there have been significant improvements in the outcomes of recurrent/metastatic cervical cancer. However, these improvements do not address the unmet need in terms of oncological outcomes. The introduction of immunotherapy and targeted therapies showed advantages in cervical cancer patients. New therapies and combination strategies must be implemented. Centralization of care and enrollment in clinical trials are of paramount importance. Primary and secondary prevention remains the fundamental goal to reduce the burden of cervical cancer.
Giorgio Bogani, Andrea Giannini, Enrico Vizza, Violante Di Donato, and Francesco Raspagliesi
XMLink
Nodal status is one of the most important prognostic factors for patients with apparent early stage endometrial cancer. The role of retroperitoneal staging in endometrial cancer is controversial. Nodal status provides useful prognostic data, and allows to tailor the need of postoperative treatments. However, two independent randomized trials showed that the execution of (pelvic) lymphadenectomy increases the risk of having surgery-related complication without improving patients’ outcomes. Sentinel node mapping aims to achieve data regarding nodal status without increasing morbidity. Sentinel node mapping is the removal of first (clinically negative) lymph nodes draining the uterus. Several studies suggested that sentinel node mapping is not inferior to lymphadenectomy in identifying patients with nodal disease. More importantly, thorough ultrastaging sentinel node mapping allows the detection of low volume disease (micrometastases and isolated tumor cells), that are not always detectable via conventional pathological examination. Therefore, the adoption of sentinel node mapping guarantees a higher identification of patients with nodal disease than lymphadenectomy. Further evidence is needed to assess the value of various adjuvant strategies in patients with low volume disease and to tailor those treatments also on the basis of the molecular and genomic characterization of endometrial tumors.
Tullio Golia D’Augè, Ilaria Cuccu, Emanuele De Angelis, Giovanni Buzzaccarini, Ottavia D’Oria, Aris Raad Besharat, Donatella Caserta, Ludovico Muzii, Giorgio Bogani, Violante Di Donato,et al.
Walter de Gruyter GmbH
Abstract This literature review aims to analyze available data on minimally invasive surgery (MIS) for the surgical treatment of endometrial cancer (EC) in obese patients and compare the surgical outcomes of patients with EC, treated with robotic and laparoscopic hysterectomy. An extensive literature search was conducted about studies on obese EC women who underwent robotic or laparoscopic hysterectomy. MIS reduces the impact of common adverse effects in obese patients. The robotic approach can ensure many advantages: reduction in blood loss, operative time, and hospital stay; indeed, robotic surgery seems to add other benefits when lymphadenectomy is required. Robotic surgery is more expensive compared to other approaches but considering global cost, this is less expensive than abdominal hysterectomy and its cost decreases with increasing procedural volume. Intra, peri and post-operative outcomes of obese patients with endometrial carcinoma treated with mininvasive surgery have been analyzed, highlighting the advantages and disadvantages of this approach. However, the gold standard between classical laparoscopy and robotic laparoscopy has not been defined. Robotic surgery shows better surgical outcomes, but its potential is limited due to its costs and long operating times. However, oncologic outcomes remain the most important aspects and are still to be defined.
Francesco Raspagliesi, William Creasman, Giorgio Bogani, and Sergio Pecorelli
Wiley
Giorgio Bogani, Ilaria Betella, Francesco Multinu, Jvan Casarin, Fabio GhezzI, Flavia Sorbi, Giuseppe VizziellI, Marco Petrillo, Stefano Cianci, Roberto Berretta,et al.
Elsevier BV
Giorgio Bogani, Robert L Coleman, Ignace Vergote, Toon van Gorp, Isabelle Ray-Coquard, Ana Oaknin, Ursula Matulonis, David O’Malley, Francesco Raspagliesi, Giovanni Scambia,et al.
BMJ
Mirvetuximab soravtansine-gynx (MIRV) is a conjugate of a folate receptor alpha (FRα)-directed antibody and the maytansinoid microtubule inhibitor, DM4. Accumulating pre-clinical and clinical data supported the safety and anti-tumor activity of MIRV in tumors expressing FRα. In 2017, a phase I expansion study reported the first experience of MIRV in FRα-positive platinum-resistant ovarian cancer with promising results. However, the phase III FORWARD I study failed to demonstrate a significant benefit of MIRV in FRα-positive tumors. On the basis of the data reported from this latter study, MIRV was then explored in the FRα-high population only and using a different folate receptor assay. The phase II SORAYA trial supported the adoption of MIRV in this setting. Hence, the US Food and Drug Administration granted accelerated approval of MIRV for patients with FRα-positive platinum-resistant epithelial ovarian, fallopian tube, or primary peritoneal cancer who have received 1–3 prior systemic treatment regimens. Moreover, the results of the MIRASOL trial showed a significant reduction in the risk of tumor progression or death among patients treated with MIRV versus chemotherapy. VENTANA FOLR1 (FOLR-2.1) was approved as a companion diagnostic test to identify FRα patients. MIRV appears to be a significant asset in managing advanced or recurrent ovarian cancer. Further trials are needed to confirm these promising results, even in the neoadjuvant, adjuvant, and maintenance settings.
Daniele Morelli, Anna Cantarutti, Camilla Valsecchi, Federica Sabia, Luigi Rolli, Giovanni Leuzzi, Giorgio Bogani, and Ugo Pastorino
Springer Science and Business Media LLC
AbstractThere is growing evidence that inflammatory, immunologic, and metabolic status is associated with cancer patients survival. Here, we built a simple algorithm to predict lung cancer outcome. Perioperative routine blood tests (RBT) of a cohort of patients with resectable primary lung cancer (LC) were analysed. Inflammatory, immunologic, and metabolic profiles were used to create a single algorithm (RBT index) predicting LC survival. A concurrent cohort of patients with resectable lung metastases (LM) was used to validate the RBT index. Charts of 2088 consecutive LC and 1129 LM patients undergoing lung resection were evaluated. Among RBT parameters, C-reactive protein (CRP), lymphocytes, neutrophils, hemoglobin, albumin and glycemia independently correlated with survival, and were used to build the RBT index. Patients with a high RBT index had a higher 5-year mortality than low RBT patients (adjusted HR 1.93, 95% CI 1.62–2.31). High RBT patients also showed a fourfold higher risk of 30-day postoperative mortality (2.3% vs. 0.5%, p 0.0019). The LM analysis validated the results of the LC cohort. We developed a simple and easily available multifunctional tool predicting short-term and long-term survival of curatively resected LC and LM. Prospective external validation of RBT index is warranted.
Giorgio Bogani, Bradley J Monk, Robert L Coleman, Ignace Vergote, Ana Oakin, Isabelle Ray-Coquard, Andrea Mariani, Giovanni Scambia, Francesco Raspagliesi, and Bruno Bolognese
Elsevier BV
Giorgio Bogani, Francesco Sopracordevole, Andrea Ciavattini, Enrico Vizza, Paolo Vercellini, Andrea Giannini, Fabio Ghezzi, Giovanni Scambia, Francesco Raspagliesi, Violante Di Donato,et al.
Ovid Technologies (Wolters Kluwer Health)
Objective To evaluate how the duration of human papillomavirus (HPV) persistence influences the risk of developing recurrent high-grade cervical dysplasia (CIN2+). Methods Data of patients with persistent HPV infection (at least at 6 months) after primary conization were extracted from a multi-institutional Italian database, retrospectively. Kaplan–Meier and Cox proportional hazards models were used to evaluate associations between duration of HPV persistence with the 5-year risk of developing recurrent CIN2+. Results Overall, 545 patients met the inclusion criteria. Positive margins were detected in 160 (29.3%) patients. Overall, 247 (45.3%) and 123 (22.6%) patients had a documented infection from HPV16/18, and other high-risk HPV types. 187 (34.3%), 73 (13.4%), and 40 (7.3%) were diagnosed with persistent HPV infection at 12, 18, and 24 months, respectively. Patients with HPV persistence at 6 months experienced a risk of recurrence of 7.46%. Twelve-month HPV persistence strongly correlates with the risk of developing the recurrent disease (risk of recurrence: 13.1%). While, having HPV persistence >12 months did not correlate with an increased risk of recurrence (hazard ratio: 1.34 (95% confidence interval: 0.78–2.32); P = 0.336, log-rank test). Conclusion HPV persistence is one of the most important factors predicting the risk of CIN2+ recurrence. The risk of CIN2+ recurrence increased with the increase of HPV persistence for up to 1 year. The persistence of HPV after the first year does not appear as a risk factor.
Ludovica Spanò Bascio, Valentina Chiappa, Biagio Paolini, Giulia Chiarello, Umberto Leone Roberti Maggiore, Giorgio Bogani, and Francesco Raspagliesi
Wiley
The authors discuss a rare case of cervical asymptomatic metastasis of a primary high‐grade poorly differentiated urothelial bladder carcinoma, diagnosed by cervical cytology test.