Positive p16 Immunostaining Is an Independent Prognostic Variable for Disease-free Survival and Overall Survival in Patients With Squamous Cell Carcinoma of the Vulva Treated With Radical Surgery and Inguinofemoral Lymphadenectomy: An Italian Single Center Retrospective Study.

BACKGROUND/AIM: The expression of the cyclin-dependent kinase inhibitor p16 correlates with the presence of human papillomavirus. The purpose of this investigation was to assess the prognostic relevance of p16 expression in patients with vulvar squamous cell carcinoma (VSCC) treated with radical surgery followed by adjuvant (chemo) radiation in selected cases. PATIENTS AND METHODS: Seventy-eight patients were analyzed retrospectively. RESULTS: Positive p16 immunostaining was detected in 19 (24.4%) patients. Five-year disease-free survival (DFS) and 5-year overall survival (OS) were better in p16-positive compared to p16-negative patients (83.9% versus 37.3% p=0.002 and 91.7% versus 57.6%, p=0.003, respectively). p16 expression retained prognostic relevance at multivariate analysis for both DFS and OS. CONCLUSION: p16 expression was detected in 24.4% of patients with VSCC and was found to be an independent prognostic variable for both DFS and OS.

Computed Tomography-assessed Skeletal Muscle Index and Skeletal Muscle Radiation Attenuation in Patients With Ovarian Cancer Treated With Primary Surgery Followed by Platinum-based Chemotherapy: A Single-center Italian Study.

AIM: To assess the prognostic relevance of baseline and post-treatment skeletal muscle index (SMI) and skeletal muscle radiation attenuation (SMRA) at the level of third lumbar vertebra in patients with ovarian cancer who underwent primary surgery and platinum-based chemotherapy. PATIENTS AND METHODS: This retrospective investigation analyzed 134 patients who underwent staging computed tomography, surgery, chemotherapy and post-treatment computed tomography. RESULTS: At univariate analysis, stage (p<0.0001), histotype (p=0.01), residual disease (p<0.0001) and treatment response (p<0.0001) correlated with progression-free survival (PFS), whereas age (p=0.004), stage (p=0.006), residual disease (p<0.0001) and treatment response (p<0.0001) were associated with overall survival (OS). Neither baseline nor post-treatment SMI and SMRA had prognostic relevance. At multivariate analysis, residual disease and treatment response correlated with PFS (p<0.0001 and p<0.0001) and OS (p=0.007 and p<0.0001), whilst age was an independent prognostic variable for OS (p=0.02). CONCLUSION: Baseline and post-treatment SMI and SMRA did not correlate with patient outcome in this clinical setting.

Have Volume-based Parameters of Positron Emission Tomography/Computed Tomography Prognostic Relevance for Patients With Potentially Platinum-responsive Recurrent Ovarian Cancer? A Single Center Italian Study.

BACKGROUND/AIM: To assess the prognostic relevance of volume-based parameters [whole body (wb)-metabolic tumor volume (MTV) and wb-total lesion glycolysis (TLG)] of pretreatment PET/CT in patients with potentially platinum-responsive recurrent ovarian cancer. PATIENTS AND METHODS: This retrospective investigation analyzed 67 patients at first relapse. RESULTS: At univariate analysis, post-relapse survival and overall survival correlated with residual disease after primary surgery (RD) (p=0.015 and 0.049, respectively), time to recurrence (p=0.005 and p=0.0003), number of recurrence sites (p=0.001 and p=0.0005), treatment at recurrence (p=0.044 and 0.043) and wb-MTV (p=0.023 and 0.021) but not with wb-TLG. RD, time to recurrence and number of recurrence sites, but not wb-MTV, were independent prognostic variables for post-relapse survival, and time to recurrence and number of recurrence sites, but not wb-MTV, were independent prognostic factors for overall survival. CONCLUSION: Volume-based parameters of PET/CT are not independent predictors of clinical outcome in potentially platinum-responsive recurrent ovarian cancer.

Plant functional traits are correlated with species persistence in the herb layer of old-growth beech forests.

This paper explores which traits are correlated with fine-scale (0.25 m2) species persistence patterns in the herb layer of old-growth forests. Four old-growth beech forests representing different climatic contexts (presence or absence of summer drought period) were selected along a north-south gradient in Italy. Eight surveys were conducted in each of the sites during the period spanning 1999-2011. We found that fine-scale species persistence was correlated with different sets of plant functional traits, depending on local ecological context. Seed mass was found to be as important for the fine-scale species persistence in the northern sites, while clonal and bud-bank traits were markedly correlated with the southern sites characterised by summer drought. Leaf traits appeared to correlate with species persistence in the drier and wetter sites. However, we found that different attributes, i.e. helomorphic vs scleromorphic leaves, were correlated to species persistence in the northernmost and southernmost sites, respectively. These differences appear to be dependent on local trait adaptation rather than plant phylogenetic history. Our findings suggest that the persistent species in the old-growth forests might adopt an acquisitive resource-use strategy (i.e. helomorphic leaves with high SLA) with higher seed mass in sites without summer drought, while under water-stressed conditions persistent species have a conservative resource-use strategy (i.e. scleromorphic leaves with low SLA) with an increased importance of clonal and resprouting ability.

Positron Emission Tomography/Computed Tomography in Platinum-sensitive Recurrent Ovarian Cancer: A Single-center Italian Study.

AIM: To assess the correlation between contrast-enhanced computed tomography (CE-CT) and positron-emission tomography (PET)/CT results and surgical and pathological findings in patients with recurrent platinum-sensitive ovarian cancer who underwent secondary cytoreduction. PATIENTS AND METHODS: 18F-fluorodeoxyglucose (18F-FDG) PET/CT with/without CE-CT were performed before 56 cytoreductive surgeries in 49 patients with suspicious recurrent ovarian cancer. RESULTS: 18F-FDG PET/CT showed higher sensitivity and diagnostic accuracy compared with CE-CT for both the whole series (100% versus 90.6%, respectively, and 97.8% versus 85.3%), and the 24 cases in which both examinations were performed (100% versus 87.0% and, respectively, 95.8% versus 83.3%). The addition of CE-CT to 18F-FDG PET/CT did not improve its diagnostic reliability. CONCLUSION: 18F-FDG PET/CT appears to be the more reliable imaging technique for the evaluation of patients with suspicious recurrent ovarian cancer, and for the selection of those more suitable for secondary cytoreductive surgery.

Enhancing the WorldClim data set for national and regional applications.

Climatic change in the last few decades has had a widespread impact on both natural and human systems, observable on all continents. Ecological and environmental models using climatic data often rely on gridded data, such as WorldClim. The main aim of this study was to devise and evaluate a computationally efficient approach to produce new high resolution (100m) estimates of current and future climatic variables to be used at the national and regional scale. The test area was Great Britain, where local data are available and of good quality. Present and future climate surfaces were produced. For the present, the approach involved the integration, via spatial interpolation, of local climate information and WorldClim to reduce bias. For future climate scenarios the approach involved spatially downscaling of WorldClim (1km) to a finer resolution of 100m. The main advantages of the proposed approach are: 1. finer resolution, 2. locally adapted to the study area with use of higher number of meteorological stations and improved accuracy and bias, and 3. computationally efficient while making use of the existing resources provided by WorldClim. Two applications were presented to illustrate the practical consequences of improvements obtained with this method. The first is a measure of rainfall intensity, i.e. the R-factor, widely applied in erosion and catchment-scale studies. The second is an application to species distribution modelling, involving a range of bioclimatic variables. The results highlighted the importance of considering the spatial variability and structure of the data integrated in the modelling, and using data adapted to the geographical extent of the analysis, whenever possible. The results of the applications showed the advantage of using enhanced climatic data in applications such as the estimation of soil erosion, species range shift, carbon stocks and the provision of ecosystem services.