Incidence and spatial distribution of adult-onset primary malignant and other central nervous system tumors in Southern Sardinia, Italy.

PURPOSE: To study for the first time the incidence of adult-onset CNS tumors in Southern Sardinia, Italy. METHODS: Clinical records of patients > 18 years old who were diagnosed with primary CNS tumors during 2016-2019 in the study area were reviewed. Meningiomas, cranial/paraspinal nerve tumors, lymphomas, and pituitary tumors were excluded. Cases were classified according to the 2016 WHO classification of CNS tumors and to the morphology codes from the International Classification of Diseases-Oncology, third edition. Age-adjusted incidence rates were calculated by the direct method to the 2011-2020 European standard population. Kulldorff's spatial scan statistic was used to identify geographic clusters of patients who shared increased/decreased tendency to develop CNS tumors. RESULTS: CNS tumors were diagnosed in 234 incident patients, but histological diagnosis was available in 222/234 patients (95%) aged 64.3 ± 13.5 years at diagnosis. Crude incidence rate was 7.1 per 100,000 persons-year (95% CI, 6.2-8.1), 6.2 per 100,000 persons-year (95% CI, 5.4-7.0) when age-adjusted. CNS tumors were more frequent in men and after age 40. Glioblastoma accounted for 76% of the total (adjusted rate, 4.7 per 100,000 persons-year; 95% CI, 4.0-5.4). Spatial analysis revealed geographic variations of glioblastoma incidence within the study area. CONCLUSION: Although the distribution of tumor diagnoses in Sardinia reflects expected age and gender-related patterns in western populations, our findings would indicate a slightly higher incidence of glial tumors, glioblastoma in particular, in Sardinia than in other European countries. The identification of spatial clusters of high/low risk will serve as a resource for etiological research.

Prolonged disease stability with trabectedin in two monorenal patients with retroperitoneal sarcoma.

Soft tissue sarcomas constitute a heterogeneous group of tumors of mesenchymal origin: at present, more than 50 separate histological subtypes of soft tissue sarcoma have been listed. Although there have been advances in the understanding of these tumors and their treatment over the past few years, there is still a lack of consensus on the standard of care, and new therapeutic options are eagerly awaited. Trabectedin has been approved for the treatment of patients with advanced soft tissue sarcomas after failure of anthracyclines and ifosfamide. However, the effectiveness and tolerability of this agent in retroperitoneal soft tissue sarcomas have been poorly characterized. Here we report the cases of two monorenal patients with a retroperitoneal sarcoma who achieved prolonged stabilization of disease with trabectedin. Trabectedin-associated toxicities were generally mild and were successfully managed by supportive care. Of note, the patients did not experience clinically relevant myelosuppression, which is currently considered the limiting toxicity of trabectedin.