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Background: Patients with high-grade serous ovarian carcinoma (HGSOC) often have a personal and/or family history of breast cancers. However, the clinical association and underlying molecular interaction between breast cancer and HGSOC is not well understood. In this study, the clinical characteristics and outcomes of HGSOC patients with or without breast cancer were compared.

Methods: Eligible patient information was extracted from the Surveillance, Epidemiology, and End Results database. Kaplan-Meier and Cox proportional hazards regression models were used to determine survival outcomes and prognostic factors.

Results: A total of 3065 HGSOC (ICD-O-3 code 8461/3) patients were identified from 1975 to 2020, among whom 239 (9.56%) had co-existing breast cancers. HGSOC with breast cancers tended to have more stage I-II ovarian cancer (20.92% vs 13.79%), less metastatic diseases (25.1% vs 32.13%) and had a higher probability of undergoing surgery (94.1% vs 87.9%). The overall survival of HGSOC patients with breast cancer was better than that of patients without breast cancer (HR = 0.77, 95% CI 0.65 to 0.91; P = 0.0015). Further, patients who developed ovarian cancer before breast cancer had better overall survival than those who developed breast cancer before or simultaneously with ovarian cancer (HR = 0.35, 95% CI 0.23 to 0.52; P < 0.001).

Conclusion: HGSOC combined with breast cancer is a common phenomenon. HGSOC patients with breast cancer, especially those diagnosed with ovarian cancer before breast cancer have a better prognosis. Further validation is warranted and more genetic and mechanistical study is needed.

Background and aims: Vascular endothelial growth factor (VEGF) gene polymorphisms are associated with the response to pharmaceutical therapy in many cancers. This study aimed to investigate the effects of VEGF gene polymorphisms in esophageal squamous cell carcinoma patients receiving pharmaceutical therapy.

Methods: This literature-based meta-analysis was performed with keywords related to VEGF gene polymorphisms and clinical response in esophageal squamous carcinoma patients receiving pharmaceutical therapy (including 5-FU, cisplatin, oxaliplatin, and calcium folinate). After a series of bias grading analyses and DerSimonian-Laird method analysis, odds ratios and 95% confidence intervals were calculated to examine the potential relationships. Sensitivity and subgroup analyses were subsequently performed to determine the major causes of heterogeneity.

Results: Heterogeneity was dramatically reduced after the removal of one study from the analysis (I² = 37%, P = 0.19). The remaining studies involved 5-FU-based treatment. The presence of VEGF G-1154A and VEGF-634C/G was found to be correlated with patient response to 5-FU/CDDP-based treatment, whereas VEGF-2549I/D was correlated with response to 5-FU/oxaliplatin-based treatment, and VEGF-936C/T was associated with both 5-FU/CDDP- and 5-FU/oxaliplatin-based treatment response.

Conclusion: VEGF gene polymorphisms affect the response of esophageal squamous carcinoma patients receiving pharmaceutical therapy, especially 5-FU-based treatments.

Background: The increasing incidence, rapidly evolving classification, rarity and heterogeneity of neuroendocrine neoplasms (NENs) pose challenges to NEN registration including difficulty in distinguishing neuroendocrine carcinoma (NEC) and neuroendocrine tumours (NETs). Thus, in Italy a higher NEC incidence was reported. Focusing on gastroenteropancreatic (GEP) NEN, we aimed to review GEP NEN, and in particular cases of neuroendocrine carcinoma, not otherwise specified (NOS) and estimate the incidence of NEN, NET and NEC of the GEP.

Methods: We launched a pilot study examining cases of neuroendocrine carcinomas NOS (ICD-O3 code 8246) of GEP incidents in the years 2012-2020. Cancer registries (CRs) reviewed information included in the pathology report regarding differentiation and tumour cells proliferation to decide whether to confirm the case as neuroendocrine carcinoma NOS or register it as NET or NEC. After the review, we estimated the GEP NEN, NET and NEC incidence.

Results: Nine CRs contributed to the pilot study. After review, in all CRs, only 31% of GEP NOS neuroendocrine carcinomas were confirmed; 50% were recoded as NETs, and approximately 17% of cases were non-NENs. The IR of GEP NENs was 2.99/100,000, and the incidence of NETs was higher than that of NECs.

Conclusion: After the review, the incidence of GEP NEN, NET and NEC in the eight Italian CRs involved was comparable to that reported in other European countries.

Impact: Our results confirmed that heterogeneity of cancer registries in the registration of NEN requires collaborative work to define and promote a standard definition to be extended to all Italian registries.

Background: Establishment of sister chromatid cohesion N-acetyltransferase 1 (ESCO1) plays an important role in mitosis and is involved in tumor progression of human bladder and prostate cancer. However, its pathological effects on renal cell cancer (RCC) remain unknown. Here, we aimed to assess the impact of ESCO1 down-regulation in RCC cells and explore its role as potential prognosis biomarker for RCC.

Methods: This is a retrospective study. Tumor samples from 263 RCC patients were collected, and survival data were analyzed to detect the relationship between ESCO1 expression and patient survival. For mechanistic exploration, the impact of silence ESCO1 on proliferation, migration and apoptosis were studied in ESCO1-knockdown RCC cells.

Results: Significantly over-expression of ESCO1 was observed in renal tumor tissues. ESCO1 expression was related to the malignant degree and a high expression was associated with unfavorable prognosis in RCC patients. Moreover, down-regulation of ESCO1 attenuated cell proliferation and migration. The flow cytometry assay revealed that the knockdown of ESCO1 inhibited RCC cells from entering the G1 phase.

Conclusions: The increased ESCO1 expression in renal tumor tissues might be a useful biomarker for prognosis of RCC patients. Knockdown of ESCO1 undermined proliferation, migration of renal cancer cells, and induced the apoptosis of renal cancer cells.

Purpose: Professional quality of life (QoL) is crucial for healthcare workers as it affects performance at work and interaction with patients, but little is known about stressors influencing radiation oncology professionals. The present study aims to explore the professional QoL of radiation oncologists (ROs) and radiation therapists (RTTs) in an Italian radiotherapy department and to report data about the possible impact of personality factors, such as alexithymia and empathy.

Material and methods: Participants filled out three validated questionnaires measuring the professional QoL, alexithymia, and empathy: (i) Professional Quality of Life Scale (ProQOL); (ii) Toronto Alexithymia Scale (TAS-20); (iii) Interpersonal Reactivity Index (IRI). Correlation, regression analyses and non-parametric tests were run.

Results: A total of 48 professionals completed the survey (66.7% ROs, 33.3% RTTs). Considering the ProQOL dimensions, moderate levels of risk for burnout (BO) and secondary traumatic stress (STS) were found. BO was found to be predictive by TAS-20 total score (β=.37, p=.010), while STS resulted to be predictive by TAS-20 total score (β=.54, p <.001) and IRI Empathic Concern subscale (β=.45, p <.001). No significant differences were found between ROs and RTTs for all the considered variables, except for TAS-20 total score (p=.032), higher for RTTs.

Conclusions: Results showed no evidence of high risk of burnout and no intrinsic differences regarding the professional QoL between ROs and RTTs. Findings suggest a significant role of alexithymia and empathy predicting professional QoL. These results underscore the importance of promoting a positive work environment and emotional competencies to prevent high stress levels.

Purpose: This study aimed to validate a CT-based radiomics signature for predicting Kirsten rat sarcoma (KRAS) mutation status in lung adenocarcinoma (LADC).

Materials and methods: A total of 815 LADC patients were included. Radiomics features were extracted from non-contrast-enhanced CT (NECT) and contrast-enhanced CT (CECT) images using Pyradiomics. CT-based radiomics were combined with clinical features to distinguish KRAS mutation status. Four feature selection methods and four deep learning classifiers were employed. Data was split into 70% training and 30% test sets, with SMOTE addressing imbalance in the training set. Model performance was evaluated using AUC, accuracy, precision, F1 score, and recall.

Results: The analysis revealed that 10.4% of patients showed KRAS mutations. The study extracted 1061 radiomics features and combined them with 17 clinical features. After feature selection, two signatures were constructed using top 10, 20, and 50 features. The best performance was achieved using Multilayer Perceptron with 20 features. CECT, it showed 66% precision, 76% recall, 69% F1-score, 84% accuracy, and AUC of 93.3% and 87.4% for train and test sets, respectively. For NECT, accuracy was 85% and 82%, with AUC of 90.7% and 87.6% for train and test sets, respectively.

Conclusions: CT-based radiomics signature is a noninvasive method that can predict KRAS mutation status of LADC when mutational profiling is unavailable.

Introduction: In the literature, the data about the factors related to the choice of the setting at patient's first palliative care admission visit are scanty. In fact it seems that the choice between home or hospice care is mainly based on the opinions and needs of patients, families and physicians. This study aims to address the association between the clinical factors detected at the first palliative visit in advanced cancer patients and the choice of palliative care setting (i.e., hospice or home care).

Methods: This is a monocentric, prospective cohort study. A total of 1811 consecutive patients with advanced cancer, admitted to the VIDAS Palliative Care service (hospice/ home care), Milan, Italy in 2018-2020 were included.

Results: In the univariate analysis, several clinical comorbidities and physiological deficits were associated with hospice admittance; while patients with more severe symptoms of anxiety, asthenia, depression, and pain were associated with home care admittance. In the multivariate logistic analysis, six clinical factors were associated with the risk of hospice admission: anxiety (OR 0.16), brain metastases (OR 1.67), severe sleep-wake rhythm upset (OR 1.79), bone/vertebral fractures (OR 2.12), intestinal occlusion or sub-occlusion (OR 2.16), and cachexia (OR 2.25). The multivariate cluster analysis confirmed the link observed with the previous statistical analyses.

Conclusion: The results of this analysis showed that some clinical factors were closely related to the chosen palliative care setting and should be taken into consideration a priori to deciding the most appropriate place of care.

Objectives: Concurrence of pregnancy and cancer diagnosis is increasingly frequent in Italy. The study aimed to compare women with pregnancy-associated cancers (PACs) to those of childbearing age, focusing on fertility, induced abortion, and miscarriage.

Methods: The population-based study included women aged 15-49 years, both with and without PAC, who were residents in the area covered by the 19 participating Cancer Registries between 2003 and 2015 and identified by individual deterministic linkage with the Hospital Discharge Database.

Results: Overall, 2,218,139 obstetrics hospitalizations occurred, covering delivery (75%), induced abortion (14%), and miscarriage (11%). Among 2409 women with PAC, 69% gave birth, 16% had an induced abortion and 15% a miscarriage. Compared with the reference population, the fertility rate in women with PACs was steadily lower (mean values 25.7/1000 vs 37.7/1000), while induced abortion (from 359/1000 - SRR 1.99, 95%CI 1.32-3.00 - in 2003 to 147/1000 - SRR 1.11, 95%CI 0.59-2.09 - in 2015) and miscarriage ratios exhibited a decreasing trend.

Conclusion: These results are consistent with international literature and are probably due to advancements in diagnostic and therapeutic opportunities. This is the first Italian population-based study analysing fertility and pregnancy outcomes among women with PAC based on a reliable information on cancer diagnosis.

This article analyses the integration of artificial intelligence (AI) in health pastoral care, emphasizing the synergy between technology and spirituality. This paper discusses possible AI applications, highlighting the importance of ethical implementation that respects human interactions. Ethical issues like privacy and empathy are examined, as well as the potential of AI in facilitating collaboration between healthcare professionals and pastoral workers. Finally, it calls for a debate on the responsible use of AI in care contexts.

The Gruppo Oncologico Italiano di Ricerca Clinica (GOIRC) is Italy's first cooperative oncology research group, evolving to conduct academic clinical trials since 1985. With 167 publications and collaborations with national and international partners, GOIRC has significantly impacted clinical practices. The group emphasizes training and has developed robust internal standard operative procedures (SOPs) to enhance data quality. GOIRC is poised to tackle future challenges in translational research, focusing on innovative trial designs, precision medicine, and leveraging different laboratory resources across its 42 units.