External validation of a <em>red cell-based</em> blood prognostic score in patients with metastatic renal cell carcinoma treated with first-line immunotherapy combinations

\ua9 The Author(s) 2024. Immunotherapy combinations with tyrosine-kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs) had significantly improved outcomes of patients with mRCC. Predictive and prognostic factors are crucial to improve patients’ counseling and management. The present study aimed to externally validate the prognostic value of a previously developed red cell-based score, including hemoglobin (Hb), mean corpuscular volume (MCV) and red cell distribution width (RDW), in patients with mRCC treated with first-line immunotherapy combinations (TKI plus ICI or ICI plus ICI). We performed a sub-analysis of a multicentre retrospective observational study (ARON-1 project) involving patients with mRCC treated with first-line immunotherapy combinations. Uni- and multivariable Cox regression models were used to assess the correlation between the red cell-based score and progression-free survival (PFS), and overall survival (OS). Logistic regression were used to estimate the correlation between the score and the objective response rate (ORR). The prognostic impact of the red cell-based score on PFS and OS was confirmed in the whole population regardless of the immunotherapy combination used [median PFS (mPFS): 17.4 vs 8.2 months, HR 0.66, 95% CI 0.47–0.94; median OS (mOS): 42.0 vs 17.3 months, HR 0.60, 95% CI 0.39–0.92; p &lt; 0.001 for both]. We validated the prognostic significance of the red cell-based score in patients with mRCC treated with first-line immunotherapy combinations. The score is easy to use in daily clinical practice and it might improve patient counselling

Evolution and time trends of nipple-sparing mastectomy: a single-center experience

Nipple Sparing Mastectomy (NSM) requires the entire breast tissue to be removed, maintaining the nipple-areola complex, and represents nowadays the gold standard of the demolitive breast surgery. Although it represents the evolution of conservative breast surgery, NSM presents some limitations in the selection of women candidates for treatment, and still there are no real guidelines regarding its indications, but simply objective data to address the choice. How the breast surgery approach to demolitive and conservative surgery has changed over time? We evaluated throughout the years (from 2009 up to 2018) the time trend of NSM at our institution and analysed the main differences between patients undergone NSM and other mastectomies and/or breast conserving surgery in terms of cancer size, multicentricity and biological profile. We found 781 NSMs, 1261 other mastectomies and 5621 breast conservative surgeries. Among NSMs, 39.6% were reconstructed with tissue expander and 58.1% with definitive prosthesis. From 2009 to 2018 we found a general increase of NSM rate (from 21.3% of all mastectomies in 2009 to 67.3% in 2018) and a decrease of total mastectomies (from 78.7% of all mastectomies in 2009 to 32.7% in 2018). In line with the literature data, our data confirm that in the recent years NSM represents the gold standard for radical breast surgery. Undisputed in prophylaxis, NSM is continuously acquiring more support in being used as first line treatment for locally advanced disease

DUPLICE INTUSSUSCEZIONE PER METASTASI VISCERALE DA HCC: UNA CAUSA RARA DI INTERVENTO CHIRURGICO PER OCCLUSIONE INTESTINALE

Il carcinoma epatocellulare rappresenta approssimativamente il 4% dei nuovi tumori diagnosticati nel mondo, ed il tumore che più frequentemente insorge nel fegato (approssimativamente per il 75%); Si manifesta più frequentemente negli uomini che nelle donne in un range di età compreso fra approssimativamente fra i 50 e i 60 anni. E’ un tumore altamente invasivo che tende alla metastatizzazione per via ematica e linfatica ad altri organi come i polmoni, linfonodi regionali, le ossa e le ghiandole surrenali.L a meta statizzazione al tratto gastrointestinale è una condizione piuttosto rara, dove lo stomaco è l’organo più frequentemente coinvolto; la via di metastatizzazione è stata descritta sempre come una via diretta, per contiguità, e la modamità con cui più frequentemente si presenta un secondarismo gastrointestinale di HCC è il sanguinamento (16-17). Le metastasi al piccolo intestino sono estremamente rare, ed in particolar modo il tipo di meta statizzazione per via ematica che segue un flusso epatofugo; ma ancor più rara è la presentazione clinica di tale metastasi con una intussuscezione intestinale. Altresì l’intussuscezione è una condizione che molto di rado si osserva nella popolazione adulta, contrariamente a quanto avviene nel bambino, e la causa molto spesso è dovuta ad una neoplasia intraluminale, ad un polipo infiammatorio, adenocarcinoma, linfoma(19-20) o metastasi intestinali, in particolar modo i secondarismi da melanoma sono la malignità che più frequentemente si manifesta con intussuscezione