IEO

The European Institute of Oncology (IEO) stands as one of the most prestigious hospitals globally and holds the distinction of being the fastest growing comprehensive cancer center in Europe. Its scope encompasses a wide range of activities in the battle against cancer, spanning prevention, diagnosis, treatment, training, education, as well as basic and translational research.

Adhering rigorously to Joint Commission International standards has allowed IEO, alongside a select few Italian hospitals, to attain the highest international quality benchmarks. Since December 2002, IEO has been accredited by the JCI and successfully passed their stringent auditing visits, which recur every three years.

In 2015, the International Medical Travel Journal (IM) recognized the European Institute of Oncology as a highly commendable International Patient Centre. This honor was bestowed upon IEO in appreciation of its exceptional outcomes in managing international patients.

Another significant accolade is the Hospital Benchmarking Award, an esteemed recognition granted to the top six hospitals worldwide. IEO stands as the only European institution among the awardees, having been identified as the international “best practice” for caring and treating cancer patients. The centre of healthcare management of the University of Westfalia selected the best facilities on behalf of the Bertelsmann Foundation and meticulously evaluated all aspects, from patient care to management processes, to arrive at this conclusion.

With an unwavering commitment to providing tailored care, IEO established the International Office in September 2013. This office focuses on meeting the diverse medical, language, cultural, and religious needs of patients, making it an truly international reference point in the battle against cancer. It warmly welcomes patients from across the globe, including regions such as the Middle East, Central and Eastern Europe, South America and former Soviet Union countries.

IEO
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The Division of Digestive Surgery specializes in the integrated multidisciplinary treatment of various digestive tumors, encompassing oesophageal, gastric, duodenal, small bowel, colorectal, anal, liver, and pancreatic carcinomas. Additionally, the division’s surgeons have acquired specific expertise in dealing with abdominal sarcomas, gastrointestinal stromal tumors (GIST), neuroendocrine tumors of the digestive tract, peritoneal carcinomatosis, and pelvic recurrences.

Collaboration with other clinical divisions at IEO, such as Gynaecologic Surgery, Thoracic Surgery, Urologic Surgery, and Melanoma, is a regular aspect of their routine clinical activities. This cooperation is essential to offer comprehensive care for oncologic diseases that require diverse skills and medical knowledge from different specialties. Noteworthy examples include advanced ovarian carcinomas, oesophageal neoplasms extending into the abdomen, high-grade male pelvis tumors, and visceral deposits of melanomas.

Minimally invasive approaches, including laparoscopic and robotic techniques, are widely employed in a significant portion of their surgical procedures. These methods are regularly utilized in treating tumors arising from the colon and rectum, stomach, liver, spleen, pancreas, and adrenal glands.

IEO has gained global recognition as a leading center in breast surgery, with an unparalleled volume of breast patients treated each year,having pioneered and validated numerous groundbreaking techniques now adopted worldwide.

The Division of Breast Cancer Surgery works closely with specialists from other divisions within the Breast Program. Extensive clinical studies, both completed and ongoing, consistently demonstrate the effectiveness of this multidisciplinary approach in achieving improved treatment outcomes.

To ensure accuracy and minimize unnecessary tissue removal, IEO physicians employ localization techniques when dealing with non-palpable tumors like microcalcifications or small nodules. Among these techniques, the ROLL (Radioguided Occult Lesion Localization) invented at IEO stands out as the most widely used worldwide, yielding exceptional results.

Breast cancer surgery involves performing a sentinel node biopsy, where the sentinel lymph node, the first node receiving lymph from the cancer-affected breast, is identified and examined. Notably, IEO holds the distinction of being the first center worldwide to validate this technique through a randomized trial.

When mastectomy becomes necessary, immediate reconstruction is usually offered, tailoring the approach to the individual’s needs. Breast surgeons collaborate closely with plastic-reconstructive surgeons to achieve optimal cosmetic results.

IEO developed the Nipple-Sparing Mastectomy in 2002, a surgical technique preserving the outer shell of the breast (skin and nipple) and maintaining the patient’s female shape. Concurrent breast reconstruction is commonly performed using implants (permanent prosthesis or expander). Over time, the technique has been continually refined, resulting in minimal complications, particularly low risks of nipple necrosis, and constant improvements. Intraoperative histological examination of the tissue beneath the nipple ensures maximum oncological radicality. If any tumor presence is detected, the nipple-areola complex is removed.

The Division of Gynecology offers a comprehensive range of services encompassing the diagnosis, treatment, and follow-up care for gynecologic oncology patients. Their surgical activities place particular emphasis on preserving fertility in young patients with borderline ovarian tumors, early-stage ovarian, endometrial, and cervical cancer. Moreover, the Division is fully equipped and experienced in performing major surgeries, including extensive cytoreduction for advanced ovarian cancer and pelvic exenteration with intra-operative radiotherapy (IORT) for recurrent cervical, endometrial, and vulvar cancer cases.

To enhance patient outcomes and recovery, the Division frequently employs minimally-invasive techniques such as robotic and laparoscopic surgery for various gynecological malignancies.

In July 2010, the Gynecology Department was accredited as a European Center in Gynecologic Oncology by prestigious organizations, namely ESGO (European Society of Gynecologic Oncology) and EBCOG (European Board and College of Obstetrics and Gynecology).

Patients diagnosed with soft tissue sarcomas receive a comprehensive array of treatment options that adhere to international standards, including access to innovative treatments through participation in clinical studies.

The management of all clinical aspects takes place within the framework of a multidisciplinary group. This group comprises a diverse team of medical experts, such as surgeons, oncologists, radiotherapists, pathologists, radiologists, interventional radiologists, physiotherapists, cancer psychologists, and may involve collaboration with reconstructive plastic surgeons, thoracic surgeons, neurologists, and gynaecologists.

The therapeutic strategy is adeptly handled, frequently involving a synergistic approach combining surgery, radiotherapy, or chemotherapy. Furthermore, immunotherapy is integrated into treatment plans, encompassing both conventional x-ray therapy and heavy particle therapy, as well as targeted therapy. IEO also makes use of ablative radiotherapy such as radiosurgery and stereotactic radiotherapy.

Preserving the functionality of limbs is a paramount consideration, and IEO employs loco-regional treatments, functional reconstruction techniques, and plastic reconstruction, along with pre- and post-operative treatments.

IEO actively participates in the initiatives of esteemed organizations such as the Italian Sarcoma Group (ISG), CTOS (Connective Tissue Oncology Society), and EORTC. Additionally, the institute is deeply involved in numerous global research programs focused on Next-Generation Sequencing (NGS) and molecular screening in sarcomas, fostering new drug development and therapeutic discoveries.

The Division of Thoracic Oncology at IEO is dedicated to enhancing the survival and quality of life for all lung cancer patients under their care.

Their primary focus lies in conducting phase 2 and phase 3 trials for non-small-cell lung cancer cases with EGFR mutations and ALK translocation across various lines of treatment. Additionally, the Division presently offers diverse clinical trials, evaluating targeted agents against MET, ROS1, HER2, and BRAF in the first-line setting. Moreover, the Institute enrolls patients in multiple and highly promising clinical trials involving advanced, adjuvant and neo-adjuvant therapies utilizing immune checkpoint inhibitors like anti-PD1 and PD-L1 drugs, specifically tailored for squamous and adenocarcinomas of the lung.

Each patient benefits from a comprehensive multidisciplinary approach, ensuring improved treatment outcomes and adherence to proposed therapies. For patients with metastasis, a range of treatments, including chemotherapy, targeted agents, and immune checkpoint inhibitors, are administered by highly experienced physicians.

Beyond non-small-cell lung cancer, the Division of Thoracic Oncology also provides support to patients with neuroendocrine tumors of the lung and mesothelioma. These patients can avail themselves of a comprehensive triple treatment approach involving chemotherapy, radiation therapy, and surgery to maximize their chances of successful outcomes.

The IEO Thoracic Surgery stands as a prominent institution in Italy and Europe, specializing in thoracic surgery.

The Division of Thoracic Surgery covers a comprehensive range of neoplastic diseases affecting the lungs, esophagus, mediastinum, pleura, and chest wall. Their expertise extends to surgical treatments for locally advanced tumors, with a particular focus on parenchymal-sparing procedures and minimally invasive approaches, such as robotic or video-assisted procedures, for early-stage diseases.

An additional area of clinical interest lies in the palliative management of advanced neoplastic tracheo-bronchial obstruction and/or compression, achieved through laser-assisted rigid bronchoscopy. The Division has also made significant progress in optimizing preoperative diagnosis and staging of thoracic neoplasms using endobronchial ultrasound during flexible bronchoscopy, reducing the need for invasive diagnostic procedures.

More than a decade ago, the Division initiated an early-stage lung cancer detection program employing low-dose multi-detector computed tomography. Recently, this program has been further enhanced by incorporating biomarkers and an experimental device, the “electronic nose,” which holds potential for identifying distinct characteristics in the exhaled breath of undiagnosed patients with lung cancer.

The Division has been a pioneer in developing minimally invasive techniques for treating early-stage lung cancers, including the use of robotic and video-thoracoscopic major lung resection. Their research endeavors encompass a range of translational studies, focusing on pharmaco-genomics, molecular biology, lung carcinogenesis, and angiogenesis.

Additionally, the Division has successfully implemented a regenerative medicine program, achieving excellent experimental and clinical outcomes in bronchial tissue restoration through autologous stem cell transplantation.

The Division of Urology specializes in the comprehensive treatment of various urological tumors, encompassing prostate, bladder, kidney, testis and penis cancers.

One of the many notable areas of advancement within the Division is robotic surgery, which has become the predominant surgical approach for prostate cancer cases. The oncological outcomes, with a medium follow-up of 34 months, prove to be comparable to open radical prostatectomy. However, the robotic technique offers several key advantages, including faster recovery of urinary continence and sexual potency, as well as overall better functional outcomes when compared to open surgery.

Additionally, robotic surgery demonstrates superior peri-operative results, including reduced blood loss, shorter catheterization time, and shorter surgical duration.