Publications by authors named "F Mastrilli"

13 Publications

Coping With Oral Tongue Cancer and COVID-19 Infection.

Front Psychiatry 2021 16;12:562502. Epub 2021 Jun 16.

Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy.

To date, April 19, 2021, the coronavirus disease 2019 (COVID-19) caused about 140,886,773 confirmed cases and more than 3,000,000 deaths worldwide since the beginning of the pandemic. Oncology patients are usually frail due to the fear of prognosis, recurrence, and outcomes of treatments. Thus, coping with cancer is a complicated process that is necessary to overcome oncological challenge, even more in case of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) disease. This is a brief case report on a middle-aged man affected by advanced oral tongue cancer and COVID-19, describing his experience of cancer diagnosis, surgical treatment, and rehabilitation during the hospital quarantine for COVID-19. Besides the traumatic experience due to the functional alteration in breathing, eating, and speaking caused by major surgery and the concurrent facial disfigurement, our patient had to face a COVID-19 diagnosis, which implied hospital and social isolation. The aim of this perspective work is to focus on the role of the psychological support in the management of hospital distress related to COVID-19 psychophysical loneliness or alienation. In our experience, such support should anticipate patients' oncological surgery or treatment and should be implemented through telemedicine in case of isolation or after hospital discharge.
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http://dx.doi.org/10.3389/fpsyt.2021.562502DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8241927PMC
June 2021

Breast Adjuvant Radiotherapy Amid the COVID-19 Crisis in a Hub Cancer Center, Lombardy, Italy.

Breast Care (Basel) 2020 Dec 16;5:1-7. Epub 2020 Dec 16.

Division of Radiation Oncology, IEO, European Institute of Oncology, IRCCS, Milan, Italy.

Introduction: During the COVID-19 pandemic, Lombardy (Northern Italy) Regional Health Council created hubs for cancer care, meant to be SARS-CoV-2-free pathways for cancer patients. The workflow of breast cancer (BC) radiotherapy (RT) in one of the hubs is presented here.

Methods: Candidates to adjuvant RT during the pandemic peak of March-April 2020 were compared to those treated in the same period of 2019, and patient volume, deferral rate, and type of RT were analyzed. Statistics were calculated with χ or Fisher exact tests for categorical variables, and the Wilcoxon rank test for continuous variables.

Results: In March-April 2020 the BC patient volume increased by 28% compared to the same period in 2019 (scheduled patients: 175 vs. 137) and amid travel restrictions it was kept high (treated patients: 136 vs. 133), mainly due to an influx from across Lombardy. RT schemes basically did not change, being already centered on hypofractionation. The increase of median time (67 vs. 74.5 days in 2019 and 2020, respectively) to the commencement of RT for low-risk patients was clinically negligible yet statistically significant ( = 0.03), and in line with the pertinent recommendations. No significant difference was found in the time interval between treatments and RT for high-risk patients. Concomitant chemoradiotherapy was avoided throughout the pandemic peak. Twenty-one women (13.6%) delayed either computed tomography simulation or RT commencement mainly because of COVID-19-related concerns and mobility restrictions.

Conclusion: The workload for BC was high during the pandemic peak. Hubs allowed the continuation of oncologic treatments, while mitigating the strain on frontline COVID-19 hospitals.
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http://dx.doi.org/10.1159/000513227DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7801963PMC
December 2020

Management of breast cancer patients during the peak of the COVID 19 pandemic.

Eur J Surg Oncol 2021 10 25;47(10):2694-2695. Epub 2021 May 25.

Division of Senology, IEO, European Institute of Oncology IRCCS, Milan, Italy; University of Milan School of Medicine, Milan, Italy.

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http://dx.doi.org/10.1016/j.ejso.2021.05.037DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8143908PMC
October 2021

Outcomes of head and neck cancer management from two cancer centres in Southern and Northern Europe during the first wave of COVID-19.

Tumori 2021 Apr 12:3008916211007927. Epub 2021 Apr 12.

Medical Administration, CMO, IEO, European Institute of Oncology, IRCCS, Milan, Italy.

Objective: To describe the approach and outcomes from two cancer centres in Southern and Northern Europe during the first wave of coronavirus disease 2019 (COVID-19) of patients with head and neck cancer (HNC).

Methods: Data collection was performed on a retrospective cohort of patients surgically treated for primary HNC between March and May 2020, using data from two tertiary hospitals: the European Institute of Oncology (Milan) and Guy's & St Thomas' NHS Foundation Trust (London).

Results: We included 77 patients with HNC. More patients with COVID-19 were taking angiotensin-converting enzyme (ACE) inhibitors and had Clavien-Dindo Classification grade I compared to negative patients, respectively (60% vs 22% [ = 0.058] and 40% vs 8% [ = 0.025]). Multivariate logistic regression analyses confirmed our data ( = 0.05 and 0.03, respectively). Sex and age were statistically significantly different ( = 0.05 and <0.001 respectively), showing more male patients (75% vs 53.66%, respectively) and more elderly patients in Italy than in the United Kingdom (patients aged >63 years: 69.44% vs 29.27%).

Conclusions: This study presents a large cohort of patients with HNC with nasopharyngeal swab during the first peak of the COVID-19 pandemic in Europe. Patients with HNC with COVID-19 appeared more likely to develop postsurgical complications and to be taking ACE inhibitors. The preventive measures adopted guaranteed the continuation of therapeutic surgical intervention.
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http://dx.doi.org/10.1177/03008916211007927DOI Listing
April 2021

Continuity of Cancer Care: The Surgical Experience of Two Large Cancer Hubs in London and Milan.

Cancers (Basel) 2021 03 30;13(7). Epub 2021 Mar 30.

Department of Medical Oncology, Guy's and St Thomas' NHS Foundation Trust, London SE1 9RT, UK.

The SARS-CoV-2 (COVID-19) pandemic is having a large effect on the management of cancer patients. This study reports on the approach and outcomes of cancer patients receiving radical surgery with curative intent between March and September 2020 (in comparison to 2019) in the European Institute of Oncology, IRCCS (IEO) in Milan and the South East London Cancer Alliance (SELCA). Both institutions implemented a COVID-19 minimal pathway where patients were required to self-isolate prior to admission and were swabbed for COVID-19 within 72 h of surgery. Positive patients had surgery deferred until a negative swab. At IEO, radical surgeries declined by 6% as compared to the same period in 2019 ( = 1477 vs. 1560, respectively). Readmissions were required for 3% ( = 41), and <1% ( = 9) developed COVID-19, of which only one had severe disease and died. At SELCA, radical surgeries declined by 34% ( = 1553 vs. 2336). Readmissions were required for 11% ( = 36), <1% ( = 7) developed COVID-19, and none died from it. Whilst a decline in number of surgeries was observed in both centres, the implemented COVID-19 minimal pathways have shown to be safe for cancer patients requiring radical treatment, with limited complications and almost no COVID-19 infections.
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http://dx.doi.org/10.3390/cancers13071597DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8036608PMC
March 2021
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