Marco Petrillo

@uniss.it

Department of Medicine, Surgery and Pharmacy
University of Sassari

I dedidcated my research activity to Gynecologic oncology with a particular focus on molecular biology and characterization of ovarian cancer

EDUCATION

Catholic University of the Sacred Heart

138

Scopus Publications

Scopus Publications

  • Simple hysterectomy versus radical hysterectomy in early-stage cervical cancer: A systematic review and meta-analysis
    C. Taliento, G. Scutiero, M. Arcieri, G. Pellecchia, V. Tius, G. Bogani, M. Petrillo, M. Pavone, N. Bizzarri, L. Driul,et al.

    Elsevier BV

  • Sentinel node mapping in high-intermediate and high-risk endometrial cancer: Analysis of 5-year oncologic outcomes
    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




  • Characteristics and outcomes of surgically staged multiple classifier endometrial cancer
    Giorgio Bogani, Ilaria Betella, Francesco Multinu, Jvan Casarin, Fabio GhezzI, Flavia Sorbi, Giuseppe VizziellI, Marco Petrillo, Stefano Cianci, Roberto Berretta,et al.

    Elsevier BV

  • Ten-year outcomes following laparoscopic and open abdominal radical hysterectomy for “low-risk” early-stage cervical cancer: A propensity-score based analysis
    Violante Di Donato, Giorgio Bogani, Jvan Casarin, Fabio Ghezzi, Mario Malzoni, Francesca Falcone, Marco Petrillo, Giampiero Capobianco, Filippo Calò, Tullio Golia D’Augè,et al.

    Elsevier BV

  • Hysterectomy alone vs. hysterectomy plus sentinel node mapping in endometrial cancer: Perioperative and long-term results from a propensity-score based study
    Giorgio Bogani, Violante Di Donato, Andrea Papadia, Alessandro Buda, Jvan Casarin, Francesco Multinu, Francesco Plotti, Maria Luisa Gasparri, Ciro Pinelli, Anna Myriam Perrone,et al.

    Elsevier BV

  • Mammary-like adenocarcinoma of the vulva: a rare case report with next generation sequencing
    Renato Lobrano, Alessandra Manca, Maria Cristina Sini, Giuseppe Palmieri, Marco Petrillo, Antonio Cossu, and Panagiotis Paliogiannis

    Siapec Servizi Srl
    Vulvar adenocarcinomas are rare tumors, representing approximately 5% of vulvar cancers. Mammary-like adenocarcinomas of the vulva (MLAV) are extremely rare, and their molecular features are poorly described in the scientific literature. We report a case of an 88-year-old woman affected by MLAV with comedo-like features, with a detailed description of the pathological, immunohistochemical and molecular features. Immunohistochemistry (IHC) showed strong staining for cytokeratin 7, GATA3, androgen receptor, GCFPD15, and weak staining for mammaglobin; no staining for Her-2 was found. The proliferation index (Ki-67) was 15%. Molecular testing detected a pathogenic mutation of the AKT1 gene, a likely pathogenic frameshift insertion of the JAK1 gene, and two likely pathogenic frameshift deletions of the KMT2C gene; in addition, two variants of unknown significance (VUS) involving the ARID1A and OR2T4 genes were detected. Finally, two CNVs of the BRCA1 gene were identified.

  • Outcomes of High-Grade Cervical Dysplasia with Positive Margins and HPV Persistence after Cervical Conization
    Andrea Giannini, Violante Di Donato, Francesco Sopracordevole, Andrea Ciavattini, Alessandro Ghelardi, Enrico Vizza, Ottavia D’Oria, Tommaso Simoncini, Francesco Plotti, Jvan Casarin,et al.

    MDPI AG
    The objective of this work is to assess the 5-year outcomes of patients undergoing conization for high-grade cervical lesions that simultaneously present as risk factors in the persistence of HPV infection and the positivity of surgical resection margins. This is a retrospective study evaluating patients undergoing conization for high-grade cervical lesions. All patients included had both positive surgical margins and experienced HPV persistence at 6 months. Associations were evaluated with Cox proportional hazard regression and summarized using hazard ratio (HR). The charts of 2966 patients undergoing conization were reviewed. Among the whole population, 163 (5.5%) patients met the inclusion criteria, being at high risk due to the presence of positive surgical margins and experiencing HPV persistence. Of 163 patients included, 17 (10.4%) patients developed a CIN2+ recurrence during the 5-year follow-up. Via univariate analyses, diagnosis of CIN3 instead of CIN2 (HR: 4.88 (95%CI: 1.10, 12.41); p = 0.035) and positive endocervical instead of ectocervical margins (HR: 6.44 (95%CI: 2.80, 9.65); p < 0.001) were associated with increased risk of persistence/recurrence. Via multivariate analyses, only positive endocervical instead of ectocervical margins (HR: 4.56 (95%CI: 1.23, 7.95); p = 0.021) were associated with worse outcomes. In this high-risk group, positive endocervical margins is the main risk factor predicting 5-year recurrence.

  • Management of Patients Diagnosed with Endometrial Cancer: Comparison of Guidelines
    Stefano Restaino, Chiara Paglietti, Martina Arcieri, Anna Biasioli, Monica Della Martina, Laura Mariuzzi, Claudia Andreetta, Francesca Titone, Giorgio Bogani, Diego Raimondo,et al.

    MDPI AG
    Endometrial cancer is the most common gynecological malignancy in Europe and its management involves a variety of health professionals. In recent years, big discoveries were made concerning the management of patients diagnosed with endometrial cancer, particularly in the field of molecular biology and minimally invasive surgery. This requires the continuous updating of guidelines and protocols over the years. In this paper, we aim to summarize and compare common points and disparities among protocols for management of patients diagnosed with endometrial cancer by leading international gynecological oncological societies. We therefore systematically report the parallel among the guidelines based on the various steps patients with endometrial cancer usually undergo. The comparison between American and European protocols revealed some relevant disparities, in particular regarding surgical staging, molecular biology application as a prognostic tool and follow up regimens. This could possibly cause differences in interpreting and applying protocols in clinical practice in small centers, leading to a lack of adherence to guidelines or even prompting a confusing mix of them.

  • Restructuring surgical training after COVID-19 pandemic: A nationwide survey on the Italian scenario on behalf of the Italian polyspecialistic young surgeons society (SPIGC)
    Gaetano Gallo, Eleonora Guaitoli, Fabio Barra, Arcangelo Picciariello, Alessandro Pasculli, Alessandro Coppola, Davide Pertile, Roberto Luca Meniconi, and

    Frontiers Media SA
    IntroductionThe COVID-19 pandemic has led to the disruption of surgical training. Lack of communication, guidelines for managing clinical activity as well as concerns for safety in the workplace appeared to be relevant issues. This study aims to investigate how surgical training has been reorganized in Italy, almost 2 years after the outbreak of COVID-19 pandemic.Materials and methodsA 16-item-electronic anonymous questionnaire was designed through SurveyMonkey© web application. This survey was composed of different sections concerning demographic characteristics and impacts of the second COVID-19 pandemic wave on surgical and research/didactic activities. Changes applied in the training programme and activities carried out were also investigated. The survey was carried out in the period between June and October 2021.ResultsFour hundred and thirty responses were collected, and 399 were considered eligible to be included in the study analysis. Three hundred and thirty-five respondents continued working in Surgical Units, with a significant reduction (less than one surgical session per week) of surgical sessions in 49.6% of them. With concern to didactic and research activities, 140 residents maintained their usual activity, while 116 reported a reduction. A sub-group analysis on resident moved to COVID-19 departments showed a reduction of research activities in 35% of them. During the period considered in this survey, the surgical training program was not substantially modified for most of participants (74.6%).ConclusionOur survey demonstrated that surgical residency programs haven't improved 2 years after the beginning of the pandemic. Further improvements are needed to guarantee completeness of surgical training, even in emergency conditions.

  • HPV-related lesions after hysterectomy for high-grade cervical intraepithelial neoplasia and early-stage cervical cancer: A focus on the potential role of vaccination
    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.

  • Native tissue repair (NTR) versus transvaginal mesh interventions for the treatment of anterior vaginal prolapse: Systematic review and meta-analysis
    Giampiero Capobianco, Illari Sechi, Narcisa Muresu, Laura Saderi, Andrea Piana, Mario Farina, Francesco Dessole, Giuseppe Virdis, Davide De Vita, Massimo Madonia,et al.

    Elsevier BV

  • Practice patterns and 90-day treatment-related morbidity in early-stage cervical cancer
    Giorgio Bogani, Violante Di Donato, Giovanni Scambia, Fabio Landoni, Fabio Ghezzi, Ludovico Muzii, Pierluigi Benedetti Panici, Francesco Raspagliesi, Giorgio Bogani, Violante Di Donato,et al.

    Elsevier BV

  • Fetal Growth and Neonatal Outcomes in Pregestational Diabetes Mellitus in a Population with a High Prevalence of Diabetes
    Giampiero Capobianco, Alessandra Gulotta, Giulio Tupponi, Francesco Dessole, Giuseppe Virdis, Claudio Cherchi, Davide De Vita, Marco Petrillo, Giorgio Olzai, Roberto Antonucci,et al.

    MDPI AG
    The aim of this retrospective study, conducted in an Italian tertiary care hospital, was to evaluate maternal-fetal and neonatal clinical outcomes in a group of patients with pregestational diabetes mellitus (PGDM), such as diabetes mellitus type 1 (DM1), diabetes mellitus type 2 (DM2), and maturity onset diabetes of the young (MODY). Overall, 174 pregnant women, nulliparous and multiparous, with a single pregnancy were enrolled. Data on pregnancy, childbirth, and newborns were collected from medical records. The selected patients were divided into two groups: the PGDM group (42 with DM1, 14 with DM2, and 2 with MODY), and the control group (116 patients with a negative pathological history of diabetes mellitus). We reported an incidence of preterm delivery of 55.2% in the PGDM group, including 59.5% of those with DM1 and 42.9% of those with DM2, vs. 6% in the controls. Fetal growth disorders, such as intrauterine growth retardation, small for gestational age, and fetal macrosomia were found in 19% and 3.6% in the case and control groups, respectively. A relationship between DM2 and gestational hypertension was found.

  • Reproductive and pregnancy outcomes of fertility-sparing treatments for early-stage endometrial cancer or atypical hyperplasia: A systematic review and meta-analysis
    Silvia De Rocco, Danilo Buca, Ludovica Oronzii, Marco Petrillo, Francesco Fanfani, Luigi Nappi, Marco Liberati, Francesco D'Antonio, Giovanni Scambia, Martina Leombroni,et al.

    Elsevier BV

  • Development of a Nomogram Predicting the Risk of Persistence/Recurrence of Cervical Dysplasia
    Giorgio Bogani, Luca Lalli, Francesco Sopracordevole, Andrea Ciavattini, Alessandro Ghelardi, Tommaso Simoncini, Francesco Plotti, Jvan Casarin, Maurizio Serati, Ciro Pinelli,et al.

    MDPI AG
    Background: Cervical dysplasia persistence/recurrence has a great impact on women’s health and quality of life. In this study, we investigated whether a prognostic nomogram may improve risk assessment after primary conization. Methods: This is a retrospective multi-institutional study based on charts of consecutive patients undergoing conization between 1 January 2010 and 31 December 2014. A nomogram assessing the importance of different variables was built. A cohort of patients treated between 1 January 2015 and 30 June 2016 was used to validate the nomogram. Results: A total of 2966 patients undergoing primary conization were analyzed. The median (range) patient age was 40 (18–89) years. At 5-year of follow-up, 6% of patients (175/2966) had developed a persistent/recurrent cervical dysplasia. Median (range) recurrence-free survival was 18 (5–52) months. Diagnosis of CIN3, presence of HR-HPV types, positive endocervical margins, HPV persistence, and the omission of HPV vaccination after conization increased significantly and independently of the risk of developing cervical dysplasia persistence/recurrence. A nomogram weighting the impact of all variables was built with a C-Index of 0.809. A dataset of 549 patients was used to validate the nomogram, with a C-index of 0.809. Conclusions: The present nomogram represents a useful tool for counseling women about their risk of persistence/recurrence after primary conization. HPV vaccination after conization is associated with a reduced risk of CIN2+.

  • Endoscopic inguinal sentinel node biopsy using indocyanine green in early-stage vulvar cancer: an innovative technique
    M. Petrillo, G. Sozzi, G. Paci, M. Dessole, G. Scambia, and V. Chiantera

    Edra SpA

  • Sentinel Lymph Node Biopsy in Surgical Staging for High-Risk Groups of Endometrial Carcinoma Patients
    Antonio Raffone, Diego Raimondo, Antonio Travaglino, Giulia Rovero, Manuela Maletta, Ivano Raimondo, Marco Petrillo, Giampiero Capobianco, Paolo Casadio, Renato Seracchioli,et al.

    MDPI AG
    Background: In endometrial carcinoma (EC) patients, sentinel lymph node (SLN) biopsy has shown the potential to reduce post-operative morbidity and long-term complications, and to improve the detection of low-volume metastasis through ultrastaging. However, while it has shown high sensitivity and feasibility in low-risk EC patient groups, its role in high-risk groups is still unclear. Aim: To assess the role of SLN biopsy through the cervical injection of indocyanine green (ICG) in high-risk groups of early-stage EC patients. Materials and methods: Seven electronic databases were searched from their inception to February 2021 for studies that allowed data extraction about detection rate and accuracy of SLN biopsy through the cervical injection of ICG in high-risk groups of early-stage EC patients. We calculated pooled sensitivity, false negative (FN) rate, detection rate of SLN per hemipelvis (DRh), detection rate of SLN per patients (DRp), and bilateral detection rate of SLN (DRb), with 95% confidence interval (CI). Results: Five observational cohort studies (three prospective and two retrospective) assessing 578 high risk EC patients were included. SLN biopsy sensitivity in detecting EC metastasis was 0.90 (95% CI: 0.03–0.95). FN rate was 2.8% (95% CI: 0.6–11.6%). DRh was 88.4% (95% CI: 86–90.5%), DRp was 96.6% (95% CI: 94.7–97.8%), and DRb was 80% (95% CI: 75.4–83.9). Conclusion: SLN biopsy through ICG cervical injection may be routinely adopted instead of systematic pelvic and para-aortic lymphadenectomy in surgical staging for high-risk groups of early-stage EC patients, as well as in low-risk groups.

  • Prevalence of HPV Infection and p16<sup>INK4a</sup> Overexpression in Surgically Treated Laryngeal Squamous Cell Carcinoma
    Roberto Gallus, Tarik Gheit, Dana Holzinger, Marco Petrillo, Davide Rizzo, Gianluigi Petrone, Francesco Miccichè, Gian Carlo Mattiucci, Damiano Arciuolo, Giampiero Capobianco,et al.

    MDPI AG
    Background: The mucosal high-risk (HR) human papillomavirus (HPV) is associated with oropharyngeal carcinogenesis. Aims of this study were to evaluate the prevalence of HR-HPV infection in laryngeal squamous cell carcinoma (LSCC) from different subsites, and the clinico-biological meaning of p16 overexpression. Methods: Ninety-seven LSCCs submitted to primary surgery (n = 75) or to post-irradiation salvage laryngectomy (n = 22) were evaluated for HR-HPV DNA and RNA using Luminex-based assays. p16 immunohistochemistry was performed. Results: HR-HPV DNA from HPV16 was detected in seven cases (8.75%), without significant differences between supraglottic and glottic lesions. HPV RNA was never detected. p16 overexpression correlated with HR-HPV DNA, but the kappa agreement score was poor. HPV DNA showed no impact on prognosis. p16 overexpression was associated with a better survival (OS, RFS) in primarily operated cases, while an inverse association with OS was observed in the salvage surgery group. Conclusions: HR-HPV infection appears to have a marginal role in LSCC independent of the anatomical subsite. p16 expression is deregulated in LSCC independent of HPV but displays a prognostic role in patients submitted to primary surgery. The negative predictive role of p16 overexpression in patients undergoing salvage surgery deserves more investigations for validation and elucidation of its clinical relevance.

  • Thyroid Function in Pregnancy
    Alessandro Delitala, Margherita Maioli, Francesco Dessole, Marco Petrillo, and Giampiero Capobianco

    Springer International Publishing

  • 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,et al.

    Asian Society of Gynecologic Oncology; Korean Society of Gynecologic Oncology and Colposcopy
    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.

  • Correlation of Leptin, Proinflammatory Cytokines and Oxidative Stress with Tumor Size and Disease Stage of Endometrioid (Type I) Endometrial Cancer and Review of the Underlying Mechanisms
    Clelia Madeddu, Elisabetta Sanna, Giulia Gramignano, Luciana Tanca, Maria Cristina Cherchi, Brunella Mola, Marco Petrillo, and Antonio Macciò

    MDPI AG
    Endometrioid endometrial cancer is associated with increased BMI and obesity through multiple pathogenetic mechanisms involving hyperestrogenism, hyperinsulinemia, altered adipokine secretion, inflammation, and oxidative stress. In the present study, we aimed to investigate the correlation between BMI, leptin, the proinflammatory cytokines IL-6 and TNFα, reactive oxygen species (ROS), and the traditional prognostic factors T, G, N and M status among type I endometrioid and type II endometrial cancer patients. We enrolled 305 consecutive endometrial cancer patients prospectively. We found that BMI, leptin, and IL-6 significantly correlated with T status, N status, and M status among endometrioid type I endometrial cancer patients. Among type II endometrial cancer patients, BMI and leptin did not correlate with any of the prognostic parameters, whereas there was a positive correlation between IL-6 and the presence of distant metastases. In the multivariate regression analysis, BMI, leptin, and IL-6 were independent predictive variables of T, N, and M status in endometrioid type I endometrial cancer patients. Our study demonstrates that weight gain, adiposity-related adipokines, inflammation, and oxidative stress correlate with the prognostic factors of endometrioid endometrial cancer. Knowledge of the role of obesity-related biological pathways and mediators in the pathogenesis and prognosis of endometrioid endometrial malignancies may offer new perspectives on combined therapeutic strategies that have not been explored to date, both in the advanced disease and in the adjuvant setting.

  • Laparoscopic splenectomy both for primary cytoreductive surgery for advanced ovarian cancer and for secondary surgery for isolated spleen recurrence: feasibility and technique
    Antonio Macciò, Elisabetta Sanna, Fabrizio Lavra, Giacomo Chiappe, Marco Petrillo, and Clelia Madeddu

    Springer Science and Business Media LLC
    Abstract Background This study investigated the feasibility and safety of laparoscopic splenectomy conducted in the contexts of both laparoscopic secondary surgery for isolated recurrence in the spleen and primary laparoscopic cytoreductive surgery for advanced ovarian cancer. Methods We performed a perspective observational study including all consecutive patients with ovarian cancer who underwent laparoscopic splenectomy as part of primary cytoreductive procedures for advanced stage ovarian cancer or secondary surgery for isolated splenic recurrence between January 2016 and May 2020. Results We enrolled 13 consecutive patients, candidate to laparoscopic splenectomy as part of primary cytoreductive procedures for advanced stage ovarian cancer (6 patients) or secondary surgery for isolated splenic recurrence of platinum-sensitive ovarian cancer (7 patients). Median operative time (509 min [range, 200–845]) for primary cytoreductive surgery varied according to surgical complexity depending on the extensiveness of the disease. Median operative time for secondary surgery for isolated splenic metastasis was 253 min (90–380). Only 1 patient with isolated splenic recurrence required conversion to an open approach. No intraoperative complication occurred, and no intraoperative blood transfusions were required. Median hospital stay was 3 days (range, 2–5) for isolated recurrence and 9 days (7–18) for primary cytoreductive surgery. Complete tumor resection was achieved in all patients. Median time from surgery to adjuvant chemotherapy was 16 days (7–24). All six patients who underwent laparoscopic splenectomy during primary cytoreductive surgery remain alive, four of whom exhibit no evidence of disease (median follow-up 25 months [4–36]). Among patients who underwent laparoscopic splenectomy during secondary surgery for isolated splenic relapse, all patients are alive and only one had a central diaphragmatic relapse 2 years after surgery (median follow-up 17 months ([5–48 months]). Conclusions The laparoscopic approach to splenectomy is feasible and safe both in patients undergoing primary cytoreductive surgery for advanced stage disease and those with isolated recurrence of ovarian cancer, without compromising survival and allowing early initiation of postoperative systemic chemotherapy.

  • The role of surgery in platinum-resistant ovarian cancer: A call to the scientific community
    Marco Petrillo, Giulio Sozzi, Margherita Dessole, Giampiero Capobianco, Salvatore Dessole, Massimo Madonia, Pier Luigi Cherchi, Anna Maria Paoletti, Giovanni Scambia, and Vito Chiantera

    Elsevier BV

  • SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study
    GlobalSurg Collaborative Covidsurg Collaborative, Ergin Erginöz, Juan J. Segura-Sampedro and Fardis Vosoughi

    Oxford University Press (OUP)
    Abstract Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18–49, 50–69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population.