Publications by authors named "Camilla Panico"

11 Publications

  • Page 1 of 1

Prognostic role of sarcopenia in metastatic colorectal cancer patients during first-line chemotherapy: A retrospective study.

World J Clin Oncol 2021 May;12(5):355-366

Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples 80131, Italy.

Background: Sarcopenia is a condition characterized by decreased skeletal muscle mass due to physiological ageing or to a concomitant disease such as neoplasia. In cancer patients, a low lean body mass is suggested to be a negative prognostic factor for survival and for the development of dose-limiting chemotherapy toxicities irrespective of disease stage.

Aim: To evaluate the prognostic role of sarcopenia in patients with metastatic colorectal cancer (mCRC) undergoing first-line chemotherapy.

Methods: Our retrospective analysis included 56 mCRC patients who received first-line chemotherapy from 2014 to 2017 at the Medical Oncology Unit of our hospital. Computerized scans were performed before starting chemotherapy and at the first disease reassessment. Sarcopenia was assessed using the skeletal mass index = muscle area in cm/(height in m) calculated at the L3 vertebra. Overall survival and objective response rate were evaluated. Toxicities were analyzed during the first four cycles of therapy and graded according to Common Terminology Criteria for Adverse Events version 4.0. A loss of skeletal muscle mass ≥ 5% was considered indicative of deterioration in muscle condition.

Results: Median age was 67 years and 35.7% of patients were ≥ 70 years old. Fourteen patients (25%) were sarcopenic at baseline computed tomography (CT) scan (7/33 men; 7/23 women); 5/14 sarcopenic patients were ≥ 70 years old. Median follow-up was 26.8 mo (3.8-66.8 mo) and median overall survival was 27.2 mo (95%CI: 23.3-37.3). Sarcopenia was not correlated to overall survival ( = 0.362), to higher toxicities reported during the first 4 cycles of chemotherapy ( = 1.0) or to response to treatment ( = 0.221). At the first disease reassessment, a skeletal muscle loss (SML) ≥ 5% was found in 17 patients (30.3%) 3 of whom were already sarcopenic at baseline CT scan, while 7 patients became sarcopenic. SML was not correlated to overall survival ( = 0.961). No statistically significant correlation was found between baseline sarcopenia and age ( = 1.0), body mass index ( = 0.728), stage at diagnosis ( = 0.355) or neutrophil/lymphocyte ratio ( = 0.751).

Conclusion: Neither baseline sarcopenia nor SML affected survival. In addition, baseline sarcopenia was not related to worse treatment toxicity. However, these results must be interpreted with caution due to the limited sample size.
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May 2021

The role of MRI in cervical cancer > 2 cm (FIGO stage IB2-IIA1) conservatively treated with neoadjuvant chemotherapy followed by conization: a pilot study.

Radiol Med 2021 Aug 31;126(8):1055-1063. Epub 2021 May 31.

UOC Radiologia Generale ed Interventistica generale, Area Diagnostica per Immagini, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

Introduction: MRI is very accurate in selecting young women with cervical cancer for fertility-sparing surgery (FSS), in particular radical hysterectomy (RH). In order to improve obstetrical outcomes, neoadjuvant chemotherapy (NACT) followed by cold knife conization (CKC) has been proposed as alternative technique.

Objective: To investigate the role of MRI in evaluation of response to treatment after neoadjuvant chemotherapy (NACT), followed by CKC, in patients with cervical cancer FIGO stage IB2-IIA1 with tumor size 2 - 4 cm, desiring to preserve their fertility.

Methods: 13 young women (23-36 years old) with cervical cancer stage IB2-IIA1 desiring to preserve their fertility were included. Tumor diameter at baseline and after treatment was detected on 1.5 T MRI. Treatment response was assessed according to Response Evaluation Criteria in Solid Tumors (RECIST 1.1) and then compared to histopathology result.

Results: MRI correctly assessed 11 out of 13 cases, according to RECIST 1.1, compared to histopathology. Among these 7 patients with partial response (PR), 2 cases of CR, 1 SD and 1 PD with persistence or enlargement of primary tumor.

Conclusion: Our pilot study supports the usefulness of MRI in assessment of treatment response after NACT, followed by CKC.

Trial Registration Number: NCT02323841.
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August 2021

Non-contrast MRI can accurately characterize adnexal masses: a retrospective study.

Eur Radiol 2021 Sep 16;31(9):6962-6973. Epub 2021 Mar 16.

Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, UK.

Objective: To determine the accuracy of interpretation of a non-contrast MRI protocol in characterizing adnexal masses.

Methods And Materials: Two hundred ninety-one patients (350 adnexal masses) who underwent gynecological MRI at our institution between the 1 of January 2008 and the 31 of December 2018 were reviewed. A random subset (102 patients with 121 masses) was chosen to evaluate the reproducibility and repeatability of readers' assessments. Readers evaluated non-contrast MRI scans retrospectively, assigned a 5-point score for the risk of malignancy and gave a specific diagnosis. The reference standard for the diagnosis was histopathology or at least one-year imaging follow-up. Diagnostic accuracy of the non-contrast MRI score was calculated. Inter- and intra-reader agreement was analyzed with Cohen's kappa statistics.

Results: There were 53/350 (15.1%) malignant lesions in the whole cohort and 20/121 (16.5%) malignant lesions in the random subset. Good agreement between readers was found for the non-contrast MRI score (к = 0.73, 95% confidence interval [CI] 0.58-0.86) whilst the intra-reader agreement was excellent (к = 0.81, 95% CI 0.70-0.88). The non-contrast MRI score value of ≥ 4 was associated with malignancy with a sensitivity of 84.9%, a specificity of 95.9%, an accuracy of 94.2% and a positive likelihood ratio of 21 (area under the receiver operating curve 0.93, 95% CI 0.90-0.96).

Conclusion: Adnexal mass characterization on MRI without the administration of contrast medium has a high accuracy and excellent inter- and intra-reader agreement. Our results suggest that non-contrast studies may offer a reasonable diagnostic alternative when the administration of intravenous contrast medium is not possible.

Key Points: • A non-contrast pelvic MRI protocol may allow the characterization of adnexal masses with high accuracy. • The non-contrast MRI score may be used in clinical practice for differentiating benign from malignant adnexal lesions when the lack of intravenous contrast medium precludes analysis with the O-RADS MRI score.
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September 2021

Depiction of periprostatic nerve fibers by means of 1.5 T diffusion tensor imaging.

Abdom Radiol (NY) 2021 06 31;46(6):2760-2769. Epub 2020 Jul 31.

Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, UOC Radiologia, Fondazione Policlinico Universitario A. Gemelli IRCSS, Università Cattolica del Sacro Cuore, Roma, Italy.

Purpose: The knowledge of periprostatic nerve fiber (pNF) is still incomplete by means of conventional MRI. The purpose of our study was to demonstrate if DTI imaging is able to depict anatomical features of pNF.

Methods: For this retrospective study, fifty-six patients (mean age 63.5 years), who underwent 1.5-T prostate MRI, including 32 directions DTI, were enrolled between October 2014 and December 2018. ANOVA test and Student's t-test were performed between the mean values of the number, FA values, and fiber length of pNF between base and mid-gland, mid-gland and apex, base and apex, right and left side, and anterior and posterior face of the prostate. A qualitative analysis was performed to detect the main orientation of pNF through a colorimetric 3D tractographic reconstruction.

Results: The number of pNF showed a decrease from the base (322) to mid-gland (248) and apex (75) (p < 0.05). The FA values were higher at base and mid-gland (0.435 and 0.456) compared to the apex (0.313) (p < 0.05). The length of pNF was higher at apex (13.4 mm) compared to base (11.5 mm) and mid-gland (11.7 mm) (p < 0.05). The number of pNF was higher on the posterior face compared to the anterior face at base (186 vs 137), (p < 0.001). The FA values were higher on the posterior face compared to the anterior face at base (0.452 vs 0.417), mid-gland (0.483 vs 0.429), and apex (0.42 vs 0.382), (p < 0.05). The length of the pNF was higher in the posterior (14.7 mm) than in the anterior face (12 mm) at apex (p < 0.001). The main orientation of pNF was longitudinal in all patients (56/56, 100%).

Conclusions: DTI imaging has been demonstrated able to depict anatomical features of pNF.
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June 2021

Association between Very Low-Density Lipoprotein Cholesterol (VLDL-C) and Carotid Intima-Media Thickness in Postmenopausal Women Without Overt Cardiovascular Disease and on LDL-C Target Levels.

J Clin Med 2020 May 11;9(5). Epub 2020 May 11.

Department of Clinical Medicine and Surgery, "Federico II" University, 80131 Naples, Italy.

Background: atherosclerotic process inexorably advances in patients reaching low-density lipoprotein cholesterol (LDL-C) targets. An attractive hypothesis is that lipoprotein particles (very low-density lipoprotein (VLDL), intermediate-density lipoprotein (IDL)), could contribute to residual risk. The present study aims to investigate the relationship between carotid intima-media thickness (IMT) and different lipoprotein subfractions in a cohort of healthy postmenopausal women.

Methods: 75 postmenopausal women, at LDL-C target levels without overt cardiovascular disease, underwent biochemical analyses (including subfraction assay of plasma lipoproteins) and carotid ultrasound examination.

Results: a statistically significant correlation between VLDL and carotid IMT ( < 0.001) was found. No significant correlation was found between carotid IMT and LDL-C ( = 0.179), IDL-C ( = 0.815), high-density lipoprotein (HDL) ( = 0.855), and LDL score ( = 0.240). Moreover, IMT is significantly correlated to LDL particle diameter ( = 0.044). After adjusting for age, systolic blood pressure, body mass index, smoking habits, glucose plasma concentration, and Lipoprotein(a) (Lpa) levels, multivariate analysis showed that women in the third tertile of VLDL-C, compared with those in the first tertile, were significantly associated to the highest IMT ( = 0.04).

Conclusions: in this cohort of postmenopausal women, VLDL-C was significantly associated to carotid IMT, independent of main cardiovascular risk factors. These findings pave the way for targeting circulating concentrations of VLDL-C to reduce cardiovascular events in patients with target LDL-C levels.
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May 2020

Porto-mesenteric venous gas as a sign of gastric mucosal damage remitted after surgery: a case report.

Acta Radiol Open 2020 Apr 6;9(4):2058460120911586. Epub 2020 Apr 6.

ASL Napoli 2 NORD, Santa Maria delle Grazie, Italy.

Porto-mesenteric venous gas (PMVG) is a severe sign of abdominal organs damage. Imaging diagnostic criteria allow the detection of PMVG and should be applied in the presence of severe symptoms and signs of abdominal organs damage. Our case had clinical signs of epigastric pain and abdominal tenderness and ultrasonography and computed tomography evidence of PMVG and gastric cancer. The subsequent surgery, without complications, induced PMVG to disappear and the patient to be dismissed from hospital.
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April 2020

Multiple intra-hepatic and abdominal splenosis: an easy call if you know about it.

Acta Radiol Open 2018 May 11;7(5):2058460118772324. Epub 2018 May 11.

Department of Advanced Biomedical Sciences, University Federico II, Naples Italy.

Hepatic splenosis represents the heterotopic implantation of splenic tissue caused by the spillage of cells from the spleen usually after splenectomy or splenic trauma. This condition is usually an incidental finding during surgery and its real incidence is unknown. Splenic implants, which can be placed anywhere in the abdominal cavity, are usually multiple and may be confused with different benign and malignant conditions such as renal tumors, abdominal lymphomas, and endometriosis. We hereby report an unusual case of multiple abdominal splenosis, with a particular intra-hepatic location, that could be misinterpreted as an hepato-cellular carcinoma.
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May 2018

Atherogenic Lipoprotein Subfractions and Carotid Atherosclerosis in Menopausal Women.

Angiology 2018 Sep 27;69(8):666-671. Epub 2017 Nov 27.

2 Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy.

The aim of the study was to evaluate the relationship between cholesterol contained in very-low-density lipoproteins (VLDL-C), intermediate-density lipoproteins (IDL-C), low-density lipoproteins, high-density lipoproteins, and carotid intima-media thickness (cIMT) and carotid plaques in 228 postmenopausal women (63.1 ± 8.2 years) who participated in the ATENA Project and underwent clinical, biochemical (including the assay of lipoproteins using the Lipoprint system), and carotid ultrasound tests. Very-low-density lipoprotein cholesterol had a statistically significant linear association with cIMT ( P < .001), which remained significant after adjustment for age, smoking, systolic blood pressure, glucose, and body mass index ( r = .20, P < .05). Higher concentrations of IDL-C and cholesterol contained in triglyceride-rich lipoproteins (TRL-C, ie, VLDL-C + IDL-C) were associated with plaques in the common carotid (tertile III/tertile I: odds ratio [OR] = 2.52, 95% confidence interval [CI] = 1.21-5.32, P < .02; OR = 2.30, 95% CI = 1.05-5.01, P < .05, respectively), after adjustment for main cardiovascular risk factors. In conclusion, high concentrations of VLDL-C and TRL-C are independently associated with the presence of carotid plaques. Their assay represents a useful tool for improving our knowledge on the role of different classes of lipoproteins in atherosclerosis.
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September 2018

Presymptomatic Diagnosis of Celiac Disease in Predisposed Children: The Role of Gene Expression Profile.

J Pediatr Gastroenterol Nutr 2017 09;65(3):314-320

*Department of Translational Medical Science, University of Naples Federico II, Naples, Italy †European Laboratory for Food-Induced Disease (ELFID), University of Naples Federico II, Naples, Italy ‡Pediatric Unit, University Hospital of Salerno, Cava de' Tirreni §Institute of Protein Biochemistry-CNR, Naples, Italy.

Objective: The prevalence of celiac disease (CD) has increased significantly in recent years, and risk prediction and early diagnosis have become imperative especially in at-risk families. In a previous study, we identified individuals with CD based on the expression profile of a set of candidate genes in peripheral blood monocytes. Here we evaluated the expression of a panel of CD candidate genes in peripheral blood mononuclear cells from at-risk infants long time before any symptom or production of antibodies.

Methods: We analyzed the gene expression of a set of 9 candidate genes, associated with CD, in 22 human leukocyte antigen predisposed children from at-risk families for CD, studied from birth to 6 years of age. Nine of them developed CD (patients) and 13 did not (controls). We analyzed gene expression at 3 different time points (age matched in the 2 groups): 4-19 months before diagnosis, at the time of CD diagnosis, and after at least 1 year of a gluten-free diet. At similar age points, controls were also evaluated.

Results: Three genes (KIAA, TAGAP [T-cell Activation GTPase Activating Protein], and SH2B3 [SH2B Adaptor Protein 3]) were overexpressed in patients, compared with controls, at least 9 months before CD diagnosis. At a stepwise discriminant analysis, 4 genes (RGS1 [Regulator of G-protein signaling 1], TAGAP, TNFSF14 [Tumor Necrosis Factor (Ligand) Superfamily member 14], and SH2B3) differentiate patients from controls before serum antibodies production and clinical symptoms. Multivariate equation correctly classified CD from non-CD children in 95.5% of patients.

Conclusions: The expression of a small set of candidate genes in peripheral blood mononuclear cells can predict CD at least 9 months before the appearance of any clinical and serological signs of the disease.
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September 2017

Dietary glycemic load and risk of cognitive impairment in women: findings from the EPIC-Naples cohort.

Eur J Epidemiol 2015 May 15;30(5):425-33. Epub 2015 Mar 15.

Laboratory of Pre-Clinical and Translational Research, IRCCS CROB - Referral Cancer Center of Basilicata, Via Padre Pio no 1, Rionero in Vulture, Italy,

Cognitive impairment is a common cause of morbidity in the elderly. The relationship between dietary habits and cognitive impairment in a female population living in the metropolitan area of Naples, in the Mediterranean part of Italy, has been evaluated in the Naples EPIC prospective cohort study. The study cohort, enrolled between 1993 and 1997, is composed of 5062 women aged 30-69 years. At time of enrolment anthropometric measures were performed and information about socio-demographic details, clinical data, lifestyle and dietary habits were collected. During 2008 and 2009, women 65 years of age or older received a telephone interview to evaluate cognitive status (TICS); the derived score was used as proxy of cognitive impairment. Analyses were carried out on 1514 participants. Linear regression model showed negative association between TICS score and, respectively, age at baseline (β = -.31, 95% CI -.34, -.24), body mass index (BMI) (β = -.08, 95% CI -.16, -.01), and glycemic load (GL) (β = -.02, 95% CI -.03, -.01), whereas education level (β = 0.62, 95% CI .56, .69) showed positive association. A logistic regression model, used to evaluate determinants of the low cognitive score (TICS score ≤ 15, 1st tertile), confirmed association for previous variables [age (OR 1.1, 95% CI 1.08, 1.15); BMI (OR 1.03, 95% CI 1.001, 1.07); GL (OR 1.005, 95% CI 1.001, 1.011); education level (OR .82, 95% CI .79, .84)] with, in addition, type II diabetes (OR 1.85, 95% CI 1.014, 3.4). This study indicates that GL may play a role in determining risk of cognitive impairment, besides age, BMI, education and diabetes.
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May 2015

Mediterranean dietary pattern and chronic diseases.

Cancer Treat Res 2014 ;159:69-81

Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy,

The study of the relationship between the Mediterranean way of eating and the occurrence of diseases typical of the economically developed countries has been considered the starting point of nutritional epidemiology. From the Seven Countries Study in the 1950s to the recent European EPIC collaboration, the evaluation of the components of diet-affecting chronic diseases such as cardiovascular disease and cancer has been crucially based on the analysis of foods and nutrients characterizing the Mediterranean dietary habits. This long research history has been marked by a consistency of data over time when either single nutrients/food groups or more complex dietary patterns have been analyzed: The Mediterranean way of eating is a protective tool from cardiovascular diseases and many cancers. Italy has been a natural point of observation, starting from cardiovascular disease in the mid-1950s and continuing with major cancers. In spite of unfavorable lifestyle changes in the Italian population mostly due to globalization of unhealthy habits (richer diet and lower levels of physical activity), those individuals still close to the Mediterranean style are significantly protected. The very recent Italian data derived from the observation of about 50,000 individuals, participating in the Italian cohorts of the EPIC study, confirm these findings and are consistent with results from other European populations and in some cases also from North American populations. Moreover, several dietary trials suggest that such a way of eating improves both the metabolic risk condition for chronic disease and the occurrence of those diseases. In conclusion, a way of eating inspired by a Mediterranean dietary pattern is not only based on evidence but is also a palatable style that has contributed to protection from the epidemic of chronic diseases.
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April 2014