Ampollini, L. (Luca)

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    Prognostic impact of lung adenocarcinoma second predominant pattern from a large European database
    (Willey, 2020) Aprile, V. (Vittorio); Lococo, F. (Filippo); Bertoglio, P. (Pietro); Franzi, F. (Francesca); Guerrera, F. (Francesco); Cattoni, M. A. (Maria Angela); Femia, F. (Federico); Ampollini, L. (Luca); Nachira, D. (Dania); Viti, A. (Andrea); Bacchin, D. (Diana); Imperatori, A. S. (Andrea Selenito); Margaritora, S. (Stefano); Terzi, A. C. (Alberto Claudio); Ruffini, E. (Enrico); Rodríguez-Pérez, M.C. (María C.); Bellafiore, S. (Salvatore); Minervini, F. (Fabrizio); Bogina, G. S. (Giuseppe Salvatore); Lucchi, M. (Marco); Paci, M. (Massimiliano); Gnetti, L. (Letizia); Querzoli, G. (Giulia); Ventura, L. (Luigi); Rindi, G. (Guido); Kestenholz, P. (Peter)
    Background and Objectives: Adenocarcinoma patterns could be grouped based on clinical behaviors: low‐ (lepidic), intermediate‐ (papillary or acinar), and high‐grade (micropapillary and solid). We analyzed the impact of the second predominant pattern (SPP) on disease‐free survival (DFS). Methods: We retrospectively collected data of surgically resected stage I and II adenocarcinoma. Selection criteria: anatomical resection with lymphadenectomy and pathological N0. Pure adenocarcinomas and mucinous subtypes were excluded. Recurrence rate and factors affecting DFS were analyzed according to the SPP focusing on intermediate‐grade predominant pattern adenocarcinomas. Results: Among 270 patients, 55% were male. The mean age was 68.3 years. SPP pattern appeared as follows: lepidic 43.0%, papillary 23.0%, solid 14.4%, acinar 11.9%, and micropapillary 7.8%. The recurrence rate was 21.5% and 5‐year DFS was 71.1%. No difference in DFS was found according to SPP (p = .522). In patients with high‐grade SPP, the percentage of SPP, age, and tumor size significantly influenced DFS (p = .016). In patients with lepidic SPP, size, male gender, and lymph‐node sampling (p = .005; p = .014; p = .038, respectively) significantly influenced DFS. Conclusions: The impact of SPP on DFS is not homogeneous in a subset of patients with the intermediate‐grade predominant patterns. The influence of high‐grade SPP on DFS is related to its proportion in the tumor.
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    Pathological and clinical features of multiple cancers and lung adenocarcinoma: a multicentre study
    (2022) Aprile, V. (Vittorio); Lococo, F. (Filippo); Bertoglio, P. (Pietro); Franzi, F. (Francesca); Guerrera, F. (Francesco); Cattoni, M. A. (Maria Angela); Femia, F. (Federico); Ampollini, L. (Luca); Nachira, D. (Dania); Bacchin, D. (Diana); Imperatori, A. S. (Andrea Selenito); Margaritora, S. (Stefano); Terzi, A. C. (Alberto Claudio); Ruffini, E. (Enrico); Rodríguez-Pérez, M.C. (María C.); Bellafiore, S. (Salvatore); Minervini, F. (Fabrizio); Bogina, G. S. (Giuseppe Salvatore); Lucchi, M. (Marco); Paci, M. (Massimiliano); Lenzini, A. (Alessandra); Gnetti, L. (Letizia); Querzoli, G. (Giulia); Ventura, L. (Luigi); Rindi, G. (Guido); Kestenholz, P. (Peter)
    OBJECTIVES Lung cancer is increasingly diagnosed as a second cancer. Our goal was to analyse the characteristics and outcomes of early-stage resected lung adenocarcinomas in patients with previous cancers (PC) and correlations with adenocarcinoma subtypes. METHODS We retrospectively reviewed data of patients radically operated on for stage I–II lung adenocarcinoma in 9 thoracic surgery departments between 2014 and 2017. Overall survival (OS) and time to disease relapse were evaluated between subgroups. RESULTS We included 700 consecutive patients. PC were present in 260 (37.1%). Breast adenocarcinoma, lung cancer and prostate cancer were the most frequent (21.5%, 11.5% and 11.2%, respectively). No significant differences in OS were observed between the PC and non-PC groups (P = 0.378), with 31 and 75 deaths, respectively. Patients with PC had smaller tumours and were more likely to receive sublobar resection and to be operated on with a minimally invasive approach. Previous gastric cancer (P = 0.042) and synchronous PC (when diagnosed up to 6 months before lung adenocarcinoma; P = 0.044) were related, with a worse OS. Colon and breast adenocarcinomas and melanomas were significantly related to a lower incidence of high grade (solid or micropapillary, P = 0.0039, P = 0.005 and P = 0.028 respectively), whereas patients affected by a previous lymphoma had a higher incidence of a micropapillary pattern (P = 0.008). CONCLUSIONS In patients with PC, we found smaller tumours more frequently treated with minimally invasive techniques and sublobar resection, probably due to a more careful follow-up. The impact on survival is not uniform and predictable; however, breast and colon cancers and melanoma showed a lower incidence of solid or micropapillary patterns whereas patients with lymphomas had a higher incidence of a micropapillary pattern.