Riccardo Vizza

Sentinel lymph node biopsy in apparently early-stage epithelial ovarian cancer: a systematic review and meta-analysis

To evaluate the detection rate, sensitivity, and negative predictive value (NPV) of sentinel lymph node (SLN) biopsy in patients with apparently early-stage epithelial ovarian cancer (EOC). A systematic search of multiple electronic databases was conducted from inception to October 31, 2025. Studies reporting detection rate, sensitivity, and NPV of SLN biopsy in apparently early-stage EOC, with completion pelvic and para-aortic lymphadenectomy as reference standard, were included. Study selection, risk-of-bias assessment, and data extraction were independently performed by four reviewers. Pooled estimates with 95 % confidence intervals (CI) were calculated using random-effects models on a per-patient basis and by anatomical site. Heterogeneity was assessed using the I Fourteen studies comprising 365 patients were included. Most studies used indocyanine green injected into the infundibulopelvic ligament for para-aortic mapping and the utero-ovarian ligament for pelvic mapping. The pooled para-aortic detection rate was 79.9 % (95 %CI 66.1-91.4 %; I In apparently early-stage EOC, SLN biopsy shows acceptable para-aortic detection but limited pelvic detection. Nonetheless, sensitivity and NPV indicate high diagnostic accuracy. Further studies are needed to optimize pelvic mapping strategies and confirm these findings. At present, sentinel lymph node mapping in apparently early-stage epithelial ovarian cancer should be regarded as investigational and not as standard of care.

Robotic Single‐Port Versus Robotic Single‐Site Hysterectomy in Early Endometrial Cancer: A Case Control Study

ABSTRACT Objective To compare surgical outcomes of robotic single‐port (RSPH) versus single‐site (RSSH) hysterectomy in early‐stage endometrial cancer. Methods This is a retrospective case‐control study, comparing surgical outcomes of RSPH (Cases) and RSSH (Controls) in early‐stage endometrial cancer. Results Twenty‐five women who underwent RSPH from June 2024 to November 2024 were matched with 50 historical RSSH controls treated at the same institution by the same surgical team between December 2011 and September 2014. Operation time was similar: 110 min in RSPH and 99 min in RSSH ( p  = 0.76). Blood loss was 50 mL in RSPH and 60 mL in RSSH ( p  = 0.14). Hospital stay was shorter in RSSH (3.5 days in RSPH and 3 days in RSSH, p  = 0.001). Conclusions Our study confirms the safety and feasibility of RSPH for endometrial cancer without major differences from the RSSH in terms of surgical outcomes.

Feasibility, safety, and efficacy of robotic single-port hysterectomy (R-SPH) using the da Vinci SP system in low-risk endometrial cancer: a pilot study

The purpose of this study was to evaluate the feasibility, safety, and efficacy of robotic single-port hysterectomy (R-SPH) with the da Vinci SP in low-risk endometrial cancer. Patients with clinically confirmed endometrioid endometrial cancer, FIGO stages IA-IB, were enrolled for R-SPH. All surgical procedures were performed through a single 2.5 cm umbilical incision. An Intuitive Access Port of small size was placed into the incision, and pneumoperitoneum was established. Robotic instruments were inserted as described below through the Intuitive Access Port, which has four different channel ports: in the superior channel, a three-dimensional 8.5 mm optics; in channel 1, Cadiere Forceps; in channel 2, a Maryland Bipolar; and in channel 3, monopolar scissors. From June 24 to November 13, 2024, a total of 25 patients were included in the study. The median age was 61 years, and median BMI was 25.9 kg/m R-SPH seems safe and feasible in endometrial cancer. The true benefit of the technique should be sought in larger comparative studies. ClinicalTrials.gov Protocol Record: NCT06681831.

Dissecting endometrial cancer complexity in response to standard and targeted therapies

Abstract Endometrial cancer (EC) is one of the most common gynecologic malignancies amongst women worldwide. Its incidence and mortality rates have been increasing in the last decade. In the present work, we built a patient EC-derived organoid (PDOs) platform that faithfully recapitulated tumor phenotype, genomic alterations, and expression profiles of matched-primary cancer tissues. Interestingly, we found that the response of EC-derived PDOs to both standard therapy and a wide range of targeted drugs accordingly to their specific druggable genetic alterations was congruent with that of the originating patients. We also isolated and genomically characterized matched-PDO stromal cells, specifically cancer-associated fibroblasts (CAFs). Unlike PDOs matched CAFs were poorly responsive and underwent to pro-inflammatory senescence upon treatment with standard therapy. Collectively, our findings established a EC-PDOs preclinical platform which allows assessing the therapeutic response of tumor and surrounding tumor microenvironment cellular landscape.

Robotic-assisted single-port and multi-port surgical staging in early-stage endometrial cancer: a propensity matched comparison.

Robotic-assisted surgery has emerged as an effective method for managing endometrial cancer. Recently, the new Da Vinci Single-Port (SP) was developed with the aim of minimizing surgery-related morbidity, using a single-port approach. The present research evaluated outcomes of apparent early-stage endometrial cancer patients undergoing single- and multi-port robotic-assisted surgery. This is a retrospective study. Data of consecutive patients affected by early-stage endometrial cancer who had robotic-assisted staging (including hysterectomy, bilateral salpingo-oophorectomy and nodal staging) with Da Vinci SP were matched 1:1 with a cohort of patients undergoing robotic-assisted surgery with the multi-port Da Vinci Xi. The matching was conducted by a propensity-score comparison. Fifty patient pairs (50 undergoing single-port surgical staging vs. 50 undergoing multiple-port surgical staging) were included. Demographic and baseline characteristics were balanced between groups. Median (skin to skin) operative time (minutes) was similar between groups (120 (range, 70-229) in the single-port vs. 115 (range, 60-205) in the multi-port group; p = 0.367). Estimated blood loss was comparable between groups (p = 0.317). No intra-operative complications or intra-operative blood transfusions were recorded. The median length of hospital stay was similar between groups (p = 0.269). Overall, 10 (10 %) patients developed 90-day surgery-related complications: six (12 %) and four (8 %) in the single- and multi-port group, respectively (p = 0.740). One (2 %) and two (4 %) patients experienced severe (grade 3 or more) 90-day complications after single- and multi-port robotic-assisted staging (p = 1.00). Introducing Da Vinci SP appears to be safe and feasible. The single-port approach does not increase operative time and complication rates in comparison to the multi-port robotic-assisted system.

Single-Port Hysterectomy (R-SPH) Using the Da Vinci SP System in Low-Risk Endometrial Cancer

Patients with clinically confirmed endometrioid endometrial cancer at FIGO stage IA-IB were eligible for robotic single-port hysterectomy (R-SPH). Criteria included: well or moderately differentiated tumor grade (G1 or G2), sufficient vaginal access, uterine size under 12 weeks' gestation, adequate bone marrow, kidney, liver, and heart function, and an ECOG performance status of 2 or below. Exclusions applied to patients with significant cardiopulmonary disease, previous pelvic or abdominal radiation, or severe hip disease affecting positioning. Prior abdominal surgeries did not exclude patients from robotic surgery. Surgeries were performed using the Vinci Single-Site® system by a specialized team. Clinical data collected included age, BMI, FIGO stage, tumor grade, surgical margin status, and hospital stay duration. Operation times were divided into docking, console (surgical), and total operation times. Intraoperative assessments included complications, blood loss, hemoglobin changes, and transfusions if hemoglobin was ≤7 g/L. Postoperative complications were evaluated short- and long-term, including surgical, cardiac, and respiratory events.