The Impact of Routine Molecular Screening for SARS-CoV-2 in Patients Receiving Anticancer Therapy: An Interim Analysis of the Observational COICA Study.

Introduction: Cancer aggravates COVID-19 prognosis. Nosocomial transmission of SARS-CoV-2 is particularly frequent in cancer patients, who need to attend hospitals regularly. Since March 2020, all cancer patients having access to the Oncology Unit at the "Andrea Tortora" Hospital (Pagani, Salerno - referred to as "the Hospital") as inpatients or outpatients receiving intravenous therapy have been screened for SARS-CoV-2 using RT-PCR nasal swab. The ongoing COICA (COVID-19 infection in cancer patients) study is an ambispective, multicenter, observational study designed to assess the prognosis of SARS-CoV-2 infection in cancer patients. The aim of the study presented here was to explore potential differences in COVID-19-related outcomes among screening-detected versus nonscreening-detected SARS-CoV-2-infected patients. Methods: The COICA study enrolled cancer patients who had received any anticancer systemic therapy within 3 months since the day they tested positive for SARS-CoV-2 on RT-PCR. The target accrual is 128 patients, and the study was approved by the competent Ethics Committee. Only the subgroup of patients enrolled at the Hospital was considered in this unplanned interim analysis. Logistic regression analysis was used to evaluate the association of screening-based versus nonscreening-based diagnosis. Results: Since March 15, 2020, until August 15, 2021, a total of 931 outpatients and 230 inpatients were repeatedly screened for SARS-CoV-2 using RT-PCR nasal swab at the Hospital. Among these, 71 asymptomatic patients were positive on routine screening and 5 patients were positive for SARS-CoV-2 outside the institutional screening. Seven patients died because of COVID-19. At univariate analysis, nonscreening- versus screening-detected SARS-CoV-2 infection was associated with significantly higher odds of O2 therapy (OR = 16.2; 95% CI = 2.2-117.1; p = 0.006), hospital admission (OR = 31.5; 95% CI = 3.1-317.8; p = 0.003), admission to ICU (OR = 23.0; 95% CI = 2.4-223.8; p = 0.007), and death (OR = 8.8; 95% CI = 1.2-65.5; p = 0.034). Conclusion: Routine screening with RT-PCR may represent a feasible and effective strategy in reducing viral circulation and possibly COVID-19 mortality in patients with active cancer having repeated access to hospital facilities.

[Extension of lymphatic resection in the colon cancer]. / Estensione della linfectomia nel cancro del colon.

It is commonly believed that treatment of colon cancer by surgical resection is a standardised approach. A review of the literature, however, shows differences in the extent of colon resection among the various different centres. Reported results are provided almost entirely by retrospective studies. In the absence of prospective randomised studies the ideal extent of colon and lymphatic resection in the curative treatment of colon cancer has not yet to be defined. The aim of this review was to examine the anatomical, physiological and clinical assumptions on which colon resections are habitually based.

[Lymphoplasmacytic sclerosing pancreatitis: a case report]. / Pancreatite linfoplasmacellulare sclerosante. A proposito di un caso clinico.

The Authors report a case of a 57 years old woman with a pancreatic cystic mass detected by abdominal ultrasonography performed for abdominal pain. Abdominal computed tomography revealed a cystic mass in the pancreatic head. Left segmental intrahepatic biliary tract dilatation without dilatation of the common bile duct and dilatation of the main pancreatic duct distal to the pancreatic mass were also present at cholangio-pancreatography. The patient underwent pancreaticoduodenectomy (Whipple procedure). The histological diagnosis was lymphoplasmacytic pancreatitis. The diagnosis of this disease is challenging. It should be suspected in patients with known autoimmune diseases. Accepted diagnostic criteria are diffuse swelling of the pancreas and diffuse or focal narrowing of the main pancreatic duct, but they are not always present. In the absence of the above-mentioned characteristics, when the disease presents as a solid or, less frequently, cystic mass it is almost impossible to distinguish it from pancreatic neoplasms. Awareness of this pathological condition in the differential diagnosis of pancreatic masses is necessary, especially in view of reports of complete recovery after medical therapy in the literature.