44 results on '"Morgagni, P."'
Search Results
2. Clinical outcomes of patients with complicated post-operative course after gastrectomy for cancer: a GIRCG study using the GASTRODATA registry
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Baiocchi, Gian Luca, Giacopuzzi, Simone, Vittimberga, Giovanni, De Pascale, Stefano, Pastorelli, Elisabetta, Gelmini, Roberta, Viganò, Jacopo, Graziosi, Luigina, Vagliasindi, Alessio, Rosa, Fausto, Steccanella, Francesca, Demartini, Paolo, Reddavid, Rossella, Berselli, Mattia, Elmore, Ugo, Romario, Uberto Fumagalli, Degiuli, Maurizio, Morgagni, Paolo, Marrelli, Daniele, D’Ugo, Domenico, Rosati, Riccardo, and De Manzoni, Giovanni more...
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- 2023
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Catalog
3. Looking for a strategy in treating peritoneal gastric cancer carcinomatosis: an Italian multicenter Gastric Cancer Research group’s analysis
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Graziosi, Luigina, Marino, Elisabetta, Bencivenga, Maria, D’Ignazio, Alessia, Solaini, Leonardo, Ministrini, Silvia, Caprioli, Michela, Sacco, Michele, Marrelli, Daniele, Mura, Gianni, Degiuli, Maurizio, Morgagni, Paolo, Tiberio, Guido Alberto Massimo, De Manzoni, Giovanni, Roviello, Franco, and Donini, Annibale more...
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- 2021
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4. International consensus on a complications list after gastrectomy for cancer
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Baiocchi, Gian Luca, Giacopuzzi, Simone, Marrelli, Daniele, Reim, Daniel, Piessen, Guillaume, Matos da Costa, Paulo, Reynolds, John V., Meyer, Hans-Joachim, Morgagni, Paolo, Gockel, Ines, Lara Santos, Lucio, Jensen, Lone Susanne, Murphy, Thomas, Preston, Shaun R., Ter-Ovanesov, Mikhail, Fumagalli Romario, Uberto, Degiuli, Maurizio, Kielan, Wojciech, Mönig, Stefan, Kołodziejczyk, Piotr, Polkowski, Wojciech, Hardwick, Richard, Pera, Manuel, Johansson, Jan, Schneider, Paul M., de Steur, Wobbe O., Gisbertz, Suzanne S., Hartgrink, Henk, van Sandick, Joanna W., Portolani, Nazario, Hölscher, Arnulf H., Botticini, Maristella, Roviello, Franco, Mariette, Christophe, Allum, William, and De Manzoni, Giovanni more...
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- 2019
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5. Resection line involvement after gastric cancer treatment: handle with care
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Morgagni, Paolo, La Barba, Giuliano, Colciago, Eleonora, Vittimberga, Giovanni, and Ercolani, Giorgio
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- 2018
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6. Complications after gastrectomy for cancer: Italian perspective
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Baiocchi, Gian Luca, Giacopuzzi, Simone, Marrelli, Daniele, Bencivenga, Maria, Morgagni, Paolo, Rosa, Fausto, Berselli, Mattia, Orsenigo, Elena, Cananzi, Ferdinando, Tiberio, Guido, Rausei, Stefano, Cozzaglio, Luca, Degiuli, Maurizio, Di Leo, Alberto, Fumagalli, Uberto, Portolani, Nazario, Rosati, Riccardo, Roviello, Franco, De Manzoni, Giovanni, and On behalf of the Italian Research Group for Gastric Cancer (GIRCG) more...
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- 2017
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7. Textbook Oncological Outcome in European GASTRODATA.
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Sędłak, Katarzyna, Rawicz-Pruszyński, Karol, Mlak, Radosław, Van Sandick, Johanna, Gisbertz, Suzanne, Pera, Manuel, Cero, Mariagiulia Dal, Baiocchi, Gian Luca, Celotti, Andrea, Morgagni, Paolo, Vittimberga, Giovani, Hoelscher, Arnulf, Moenig, Stefan, Kołodziejczyk, Piotr, and Richter, Piotr more...
- Abstract
Objective: To assess the rate of textbook outcome (TO) and textbook oncological outcome (TOO) in the European population based on the GASTRODATA registry. Background: TO is a composite parameter assessing surgical quality and strongly correlates with improved overall survival. Following the standard of treatment for locally advanced gastric cancer, TOO was proposed as a quality and optimal multimodal treatment parameter. Methods: TO was achieved when all the following criteria were met: no intraoperative complications, radical resection according to the surgeon, pR0 resection, retrieval of at least 15 lymph nodes, no severe postoperative complications, no reintervention, no admission to the intensive care unit, no prolonged length of stay, no postoperative mortality and no hospital readmission. TOO was defined as TO with the addition of perioperative chemotherapy compliance. Results: Of the 2558 patients, 1700 were included in the analysis. TO was achieved in 1164 (68.5%) patients. The use of neoadjuvant chemotherapy [odds ratio (OR) = 1.33, 95% CI: 1.04--1.70] and D2 or D2+ lymphadenectomy (OR = 1.55, 95% CI: 1.15--2.10) had a positive impact on TO achievement. Older age (OR = 0.73, 95% CI: 0.54--0.94), pT3/4 (OR = 0.79, 95% CI: 0.63--0.99), ASA 3/4 (OR = 0.68, 95% CI: 0.54--0.86) and total gastrectomy (OR = 0.56, 95% CI: 0.45--0.70), had a negative impact on TO achievement. TOO was achieved in 388 (22.8%) patients. Older age (OR = 0.37, 95% CI: 0.27--0.53), pT3 or pT4 (OR = 0.52, 95% CI: 0.39--0.69), and ASA 3 or 4 (OR = 0.58, 95% CI: 0.43--0.79) had a negative impact on TOO achievement. Conclusions: Despite successively improved surgical outcomes, stageappropriate chemotherapy in adherence to the current guidelines for multimodal treatment of gastric cancer remains poor. Further implementation of oncologic quality metrics should include greater emphasis on perioperative chemotherapy and adequate lymphadenectomy. [ABSTRACT FROM AUTHOR] more...
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- 2023
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8. The Italian Research Group for Gastric Cancer (GIRCG) guidelines for gastric cancer staging and treatment: 2015
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De Manzoni, Giovanni, Marrelli, Daniele, Baiocchi, Gian Luca, Morgagni, Paolo, Saragoni, Luca, Degiuli, Maurizio, Donini, Annibale, Fumagalli, Uberto, Mazzei, Maria Antonietta, Pacelli, Fabio, Tomezzoli, Anna, Berselli, Mattia, Catalano, Filippo, Di Leo, Alberto, Framarini, Massimo, Giacopuzzi, Simone, Graziosi, Luigina, Marchet, Alberto, Marini, Mario, Milandri, Carlo, Mura, Gianni, Orsenigo, Elena, Quagliuolo, Vittorio, Rausei, Stefano, Ricci, Riccardo, Rosa, Fausto, Roviello, Giandomenico, Sansonetti, Andrea, Sgroi, Giovanni, Tiberio, Guido Alberto Massimo, Verlato, Giuseppe, Vindigni, Carla, Rosati, Riccardo, and Roviello, Franco more...
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- 2017
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9. Follow-up after gastrectomy for cancer: the Charter Scaligero Consensus Conference
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Baiocchi, Gian Luca, D’Ugo, Domenico, Coit, Daniel, Hardwick, Richard, Kassab, Paulo, Nashimoto, Atsushi, Marrelli, Daniele, Allum, William, Berruti, Alfredo, Chandramohan, Servarayan Murugesan, Coburn, Natalie, Gonzàlez-Moreno, Santiago, Hoelscher, Arnulf, Jansen, Edwin, Leja, Marcis, Mariette, Christophe, Meyer, Hans-Joachim, Mönig, Stefan, Morgagni, Paolo, Ott, Katia, Preston, Shaun, Rha, Sun Young, Roviello, Franco, Sano, Takeshi, Sasako, Mitsuru, Shimada, Hideaki, Schuhmacher, Cristoph, So Bok-yan, Jimmy, Strong, Vivian, Yoshikawa, Takaki, Terashima, Masanori, Ter-Ovanesov, Michail, Van der Velde, Cornelis, Memo, Maurizio, Castelli, Francesco, Pecorelli, Sergio, Detogni, Claudio, Kodera, Yasuhiro, and de Manzoni, Giovanni more...
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- 2016
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10. Is a clear benefit in survival enough to modify patient access to the surgery service? A retrospective analysis in a cohort of gastric cancer patients
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Altini, Mattia, Carretta, Elisa, Morgagni, Paolo, Carradori, Tiziano, Ciotti, Emanuele, Prati, Elena, Garcea, Domenico, Dino, Amadori, Falcini, Fabio, and Nanni, Oriana
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- 2015
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11. A new way to experience the International Gastric Cancer Association Congress: the Web Round Tables
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Morgagni, Paolo, Verlato, Giuseppe, Marrelli, Daniele, Roviello, Franco, and de Manzoni, Giovanni
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- 2014
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12. Naso-gastric or naso-jejunal decompression after partial distal gastrectomy for gastric cancer. Final results of a multicenter prospective randomized trial
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Pacelli, Fabio, Rosa, Fausto, Marrelli, Daniele, Morgagni, Paolo, Framarini, Massimo, Cristadoro, Luigi, Pedrazzani, Corrado, Casadei, Riccardo, Cozzaglio, Luca, Covino, Marcello, Donini, Annibale, Roviello, Franco, de Manzoni, Giovanni, and Doglietto, Giovanni Battista more...
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- 2014
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13. The SIC-GIRCG 2013 Consensus Conference on Gastric Cancer
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De Manzoni, Giovanni, Baiocchi, Gian Luca, Framarini, Massimo, De Giuli, Maurizio, D’Ugo, Domenico, Marchet, Alberto, Nitti, Donato, Marrelli, Daniele, Morgagni, Paolo, Rinnovati, Andrea, Rosati, Riccardo, Roviello, Franco, Allieta, Rosaldo, Berti, Stefano, Bracale, Umberto, Capelli, Patrizio, Cavicchi, Angelo, Di Martino, Natale, Donini, Annibale, Filippini, Angelo, Francioni, Gianfranco, Frascio, Marco, Garofalo, Alfredo, Giulini, Stefano Maria, Grassi, Giovanni Battista, Innocenti, Paolo, Martino, Antonio, Mazzocconi, Gualtiero, Mazzola, Lorenzo, Montemurro, Severino, Palasciano, Nicola, Pantuso, Gianni, Pernthaler, Heinrich, Petri, Roberto, Piazza, Diego, Sacco, Rosario, Sgroi, Giovanni, Staudacher, Carlo, Testa, Michele, Vallicelli, Carlo, Vettoretto, Nereo, Zingaretti, Costantino, Capussotti, Lorenzo, Morino, Mario, and Verdecchia, Giorgio Maria more...
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- 2014
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14. Core Outcome Set for Surgical Trials in Gastric Cancer (GASTROS Study):International patient and healthcare professional consensus
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Alkhaffaf, B, Metryka, A, Blazeby, J M, Glenny, A-M, Adeyeye, A, Costa, P M, Diez Del Val, I, Gisbertz, S S, Guner, A, Law, S, Lee, H-J, Li, Z, Nakada, K, Reim, D, Vorwald, P, Baiocchi, G L, Allum, W, Chaudry, M A, Griffiths, E A, Williamson, P R, Bruce, I A, Li, S., He, Yl, Xu, Z., Xue, Y., Liang, H., Li, G., Zhao, E., Neumann, P., O’Neill, L., Guinan, E., Zanotti, D., de Manzoni, G., Hagens, Erc., van Berge Henegouwen, Mi., Lages, P., Onofre, S., Restrepo Nunez, Rm., Salcedo Cabanas, G., Posada Gonzalez, M., Marin Campos, C., Candas, B., Emre Baki, B., Selim Bodur, M., Yildirim, R., Burak Cekic, A., Brown, J., Hayes, K., Daher, I., Gianchandani Moorjani, Rh., Adetoyese Adeyeye, A., Sulaiman Olayide, A., Mitsuo Leon-Takahashi, A., Pueyo Rabanal, A., Peri, A., Boddy, A., Novotny, A., Charalabopoulos, A., Alemdar, A., Souadka, A., Rodrigues Gomes, Am., Lazaro, A., Maciel Da Silva, A., do Rosario da Conceicao Silva e Santos, A., Guidi, A., Silva Bernardes, Aj., Quinn, A., Isik, A., A Slipek, A., Candas Altinbas, B., Johnson Alegbeleye, B., Wool Eom, B., Frittoli, B., Lonsdale, B., Rogers, B., Ammori, Bj., Rau, B., Molteni, B., Byrne, Be., Villacıs- Bermeo, Ba., Villacıs Gallardo, Be., Kose, B., Sampedro Nogueira, Cj., Loureiro, C., Oliveira de Sousa, Cm., Collins, Cg., Nonso Ekwunife, C., Chukwunwendu Osuagwu, C., Wong, Cly., Winkler, C., Reim, D., Kjær, Dw., Cooper, D., Horner, D., Irvine, D., Bowrey, Dj., Chuter, Dj., Elliot, D., Mcghee, D., Toth, D., Ofner, D., Manatakis, Dk., Silveira Martins, Dr., Belt, Ejt., Cattaneo, E., Samadov, E., Colak, E., Treppiedi, E., Guglielmi, E., Redondo- Villahoz, E., Ciferri, E., Tiemens-de Graaf, E., Cocozza, E., Pape, E., Drozdov, Es., Enrico, F., Rashid, F., Sandri, Marco, Rosa, F., Mingol Navarro, F., Simionato Perrotta, F., Chan, Fsy., Saavedra Tomasich, Fd., Takeda, Fr., Farrell, F., Olanike Wuraola, F., Rosero, G., Bevilacqua, G., Baronio, G., Mura, G., D’Eugenio, G., Ortega-Perez, G., Tilt, G., Sutcliffe, G., Mureddu, G., Guerra Jacob, G., Daneri, H., Olufemi Gbenga, H., Okabe, H., Kingsford Smith, I., Olawale Lateef, I., Garosio, I., Hatipoglu, I., Gockel, I., Negoi, I., Min, Ish., Mesquita, Imm., Diez del Val, I., Leemhuis, Jhf., Gossage, Ja., Weindelmayer, J., Izbicki, Jr., McKenzie Manson, J., Kelly, J., Stoot, Jhmb., Haveman, Jw., Brown, Jd., Sultan, J., Hassall, J., van Sandick, J., Saunders, Jh., Clarke, Jk., Heisterkamp, J., Vargas, Ji., Couselo Villanueva, Jm., Ingmire, J., Mcewen, J., Galindo Alvarez, J., Turner, J., Peng, J., Roberts, K., Brandon, Kg., Mitchell, K., Mccarthy, K., Akhtar, K., Mikhailovich, Kn., Corbelli, L., Medeiros Milhomem, L., Solaini, L., Fengyuan, L., Xinchun, L., Timmermans, L., Porritt, L., Taglietti, L., Bonavina, L., F. Pinheiro L., de los Angeles Mayo Ossorio, M., Schiavo, M., Marchesiello, M., das Dores Vieira Leite, M., Demois, M., Di Felice, Mt., de Sousa, Md., Takahashi, M., Forshaw, M., Berselli, M., Paro, M., Usta, Ma., Yan, Mh., Pinchin, M., Caprioli, M., Rubbini, M., Cowen, M., Herrera Servin, Ma., Li, Mz., Sasako, M., Shukri Jahit, M., Ngonyoku Muhinga, M., Tareen, Ma., Ahmad, Mf., Bodur, Ms., Kaban, M., Farooq, N., Coburn, N., Cooper, N., Blencowe, Ns., Loria, N., de Vries, N., Adami Andreollo, N., Koksal, N., Zanini, N., Kreuser, N., Okkabaz, N., Damiana, O., Afuwape, O., Kayode Fasiku, O., Comensoli, O., F. Koroye O., Capener, P., Morgagni, P., Pernadas Lages, Pm., Wilkerson, Pm., Turner, P., Dutton, P., Hayes, P., Vorwald, P., Singh, P., Gan, Q., Kottayasamy Seenivasagam, R., Ayloor Seshadri, R., Guevara Castro, R., Douglas, R., Koshy, Rm., Yıldırım, R., Skipworth, Rje., Gould, Ra., Wetherill, Rc., Shaw, R., Burley, Ra., Palatucci, R., Racalbuto, R., Correia Casaca, Rm., Lagarde, Sm., Gana, S., Marietti, S., Qureshi, S., Morales-Conde, S., Molfino, S., Barreto, Sg., Turkyilmaz, S., Turan-Trabzon, S., Frisch, S., Castoldi, S., Belloni, S., Flisi, S., Galloway, S., Maria, Sr., Royston, S., Boyle, T., Sezer, T., Mengardo, V., Concepcion Martın, V., Lee Wills, V., Owen-Holt, V., Casagrande, V., Al-Khyatt, W., Jansen, W., Wang, W., Eshuis, W., Polkowski, Wp., Huang, X., Wang, X., Chen, Xz., Gonzalez Dominguez, Y., Wang, Y., Viswanath, Yks., He, Yl., Demir, Z., Na, Z., Surgery, CCA - Cancer Treatment and Quality of Life, CCA - Cancer biology and immunology, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, CCA - Imaging and biomarkers, Experimental Immunology, Clinical Immunology and Rheumatology, CCA -Cancer Center Amsterdam, and CCA - Cancer Treatment and quality of life more...
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medicine.medical_specialty ,Manchester Cancer Research Centre ,business.industry ,gastric cancer ,ResearchInstitutes_Networks_Beacons/mcrc ,Delphi method ,MEDLINE ,Cancer ,medicine.disease ,Outcome (game theory) ,03 medical and health sciences ,0302 clinical medicine ,Quality of life (healthcare) ,030220 oncology & carcinogenesis ,Family medicine ,gastros ,Medicine ,Surgery ,030212 general & internal medicine ,Stage (cooking) ,Adverse effect ,business ,Set (psychology) - Abstract
Background Surgery is the primary treatment that can offer potential cure for gastric cancer, but is associated with significant risks. Identifying optimal surgical approaches should be based on comparing outcomes from well designed trials. Currently, trials report different outcomes, making synthesis of evidence difficult. To address this, the aim of this study was to develop a core outcome set (COS)—a standardized group of outcomes important to key international stakeholders—that should be reported by future trials in this field. Methods Stage 1 of the study involved identifying potentially important outcomes from previous trials and a series of patient interviews. Stage 2 involved patients and healthcare professionals prioritizing outcomes using a multilanguage international Delphi survey that informed an international consensus meeting at which the COS was finalized. Results Some 498 outcomes were identified from previously reported trials and patient interviews, and rationalized into 56 items presented in the Delphi survey. A total of 952 patients, surgeons, and nurses enrolled in round 1 of the survey, and 662 (70 per cent) completed round 2. Following the consensus meeting, eight outcomes were included in the COS: disease-free survival, disease-specific survival, surgery-related death, recurrence, completeness of tumour removal, overall quality of life, nutritional effects, and ‘serious’ adverse events. Conclusion A COS for surgical trials in gastric cancer has been developed with international patients and healthcare professionals. This is a minimum set of outcomes that is recommended to be used in all future trials in this field to improve trial design and synthesis of evidence. more...
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- 2021
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15. Does Resection Line Involvement Affect Prognosis in Early Gastric Cancer Patients? An Italian Multicentric Study
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Morgagni, Paolo, Garcea, Domenico, Marrelli, Daniele, de Manzoni, Giovanni, Natalini, Giovanni, Kurihara, Hayato, Marchet, Alberto, Vittimberga, Giovanni, Saragoni, Luca, Roviello, Franco, Leo, Alberto Di, De Santis, Francesco, Panizza, Valerio, and Nitti, Donato more...
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- 2006
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16. Survival benefit of extended D2 lymphadenectomy in gastric cancer with involvement of second level lymph nodes: A longitudinal multicenter study
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Roviello, Franco, Marrelli, Daniele, Morgagni, Paolo, de Manzoni, Giovanni, di Leo, Alberto, Vindigni, Carla, Saragoni, Luca, Tomezzoli, Anna, and Kurihara, Hayato
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- 2002
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17. Which gastric cancer patients could benefit from staging laparoscopy? A GIRCG multicenter cohort study.
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Solaini, Leonardo, Bencivenga, Maria, D'ignazio, Alessia, Milone, Marco, Marino, Elisabetta, De Pascale, Stefano, Rosa, Fausto, Sacco, Michele, Fumagalli Romario, Uberto, Graziosi, Luigina, De Palma, Giovanni, Marrelli, Daniele, Morgagni, Paolo, and Ercolani, Giorgio more...
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STOMACH cancer ,CANCER patients ,LAPAROSCOPY ,PERITONEAL cancer ,COHORT analysis ,INTESTINAL tumors - Abstract
This study aimed to investigate which gastric cancer patients could benefit the most from staging laparoscopy. A retrospective cohort study was carried out, including 316 (216 cM- and 100 cM+) gastric cancer patients who had undergone staging laparoscopy between 2010 and 2020 in seven GIRCG centers. A model including easily-accessible clinical, biochemical and pathological markers was constructed to predict the risk of carcinomatosis. ROC curve and decision curve analyses were used to verify its accuracy and net benefit. In the cM-population staging laparoscopy could detect 67 cases who had peritoneal carcinomatosis or positive cytology, for a yield of 30.5%. In cM-patients, intestinal type tumors (0.25, 0.12–0.51; p = 0.002), cT4 tumors (2.18, 1.11–4.28; p = 0.023) and cancers of the lower third (0.31, 0.14–0.70; p = 0.004) were associated with the presence of peritoneal carcinomatosis and/or positive cytology. The ROC curve analysis of the model including the three variables showed an AUC of 0.75 (0.68–0.81, p < 0.001). The decision curve analyses showed that the model had a higher net benefit than the treating all strategy between threshold probabilities of 15 and 50%. Staging laparoscopy is a useful tool to address the patient with gastric cancer to the most adequate treatment. In cM-patients the assessment of the location of the tumor, the Lauren's histotype and the cT status may help in providing additional elements in indicating or not the use of staging laparoscopy. [ABSTRACT FROM AUTHOR] more...
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- 2022
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18. Incidence and Grading of Complications After Gastrectomy for Cancer Using the GASTRODATA Registry: A European Retrospective Observational Study.
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Baiocchi, Gian Luca, Giacopuzzi, Simone, Reim, Daniel, Piessen, Guillaume, da Costa, Paulo Matos, Reynolds, John V., Meyer, Hans-Joachim, Morgagni, Paolo, Gockel, Ines, Santos, Lucio Lara, Jensen, Lone Susanne, Murphy, Thomas, D’Ugo, Domenico, Rosati, Riccardo, Romario, Uberto Fumagalli, Degiuli, Maurizio, Kielan, Wojciech, Mönig, Stefan, Kołodziejczyk, Piotr, and Polkowski, Wojciech more...
- Abstract
Objective: Utilizing a standardized dataset based on a newly developed list of 27 univocally defined complications, this study analyzed data to assess the incidence and grading of complications and evaluate outcomes associated with gastrectomy for cancer in Europe. Summary Background Data: The absence of a standardized system for recording gastrectomy-associated complications makes it difficult to compare results from different hospitals and countries. Methods: Using a secure online platform (www.gastrodata.org), referral centers for gastric cancer in 11 European countries belonging to the Gastrectomy Complications Consensus Group recorded clinical, oncological, and surgical data, and outcome measures at hospital discharge and at 30 and 90 days postoperatively. This retrospective observational study included all consecutive resections over a 2-year period. Results: A total of 1349 gastrectomies performed between January 2017 and December 2018 were entered into the database. Neoadjuvant chemotherapy was administered to 577 patients (42.8%). Total (46.1%) and subtotal (46.4%) gastrectomy were the predominant resections. D2 or D2+ lymphadenectomy was performed in almost 80% of operations. The overall complications’ incidence was 29.8%; 402 patients developed 625 complications, with the most frequent being nonsurgical infections (23%), anastomotic leak (9.8%), other postoperative abnormal fluid from drainage and/or abdominal collections (9.3%), pleural effusion (8.3%), postoperative bleeding (5.6%), and other major complications requiring invasive treatment (5.6%). The median Clavien-Dindo score and Comprehensive Complications Index were IIIa and 26.2, respectively. In-hospital, 30-day, and 90-day mortality were 3.2%, 3.6%, and 4.5%, respectively. Conclusions: The use of a standardized platform to collect European data on perioperative complications revealed that gastrectomy for gastric cancer is still associated with heavy morbidity and mortality. Actions are needed to limit the incidence of, and to effectively treat, the most frequent and most lethal complications. [ABSTRACT FROM AUTHOR] more...
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- 2020
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19. VEGF-A clinical significance in gastric cancers: immunohistochemical analysis of a wide Italian cohort
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Lastraioli, E, Boni, L, Romoli, Mr, Crescioli, S, Taddei, A, Beghelli, Stefania, Tomezzoli, Anna, Vindigni, C, Saragoni, L, Messerini, L, Bernini, M, Bencini, L, Giommoni, E, Freschi, G, Di Costanzo, F, Scarpa, Aldo, Morgagni, P, Farsi, M, Roviello, F, DE MANZONI, Giovanni, Bechi, P, Arcangeli, A, and Gruppo Italiano di Ricerca Cancro Gastrico more...
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Oncology ,Adult ,Male ,Vascular Endothelial Growth Factor A ,Pathology ,medicine.medical_specialty ,VEGF-A, Gastric cancer, Immunohistochemistry, Prognostic markers ,Multivariate analysis ,VEGF receptors ,Gastric carcinoma ,VEGF ,Adenocarcinoma ,VEGF-A ,Cohort Studies ,Prognostic markers ,Stomach Neoplasms ,Gastric cancer ,Immunohistochemistry ,Internal medicine ,medicine ,Humans ,Clinical significance ,Pathological ,Aged ,biology ,business.industry ,Univariate ,Cancer ,General Medicine ,Middle Aged ,medicine.disease ,Prognosis ,Logistic Models ,Italy ,Cohort ,biology.protein ,Surgery ,Female ,business - Abstract
Purpose The clinical significance of VEGF-A expression in gastric cancer (GC) has been reported with contradicting results. We analyzed the expression and clinical significance of VEGF-A in a wide Italian cohort of GC specimens. Methods VEGF-A expression was tested by immunohistochemistry in 507 patients with GC of all clinical stages. The impact of VEGF-A on overall survival (OS) was evaluated in conjunction with clinical and pathological parameters. Results In the Italian cohort we studied VEGF-A was not an independent prognostic factor neither at the univariate nor at multivariate analysis. Conclusions Although frequently expressed, in our study VEGF-A was not able to discriminate between groups of patients with different risk. more...
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- 2014
20. Herg-1 channels and VEGF-A clinical significance in gastric cancer
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Arcangeli, A., Boni, L., Lastraioli, E., Romoli, Mr, Taddei, A., Bernini, M., Bencini, L., Farsi, M., Giani, I., Beghelli, S., Scarpa, Aldo, Tomezzoli, Anna, Vimdigni, C., Morgagni, P., Di Costamzo, F., Giommoni, E., Roviello, F., de Manzoni, G., and Bechi, R. Moretti P. more...
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gastric cancer - Published
- 2013
21. Changing clinical and pathological features of gastric cancer over time
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Marrelli, D, Pedrazzani, C, Morgagni, P, De Manzoni, G, Pacelli, F, Coniglio, Arianna, Marchet, A, Saragoni, L, Giacopuzzi, S, Roviello, F, Vindigni, C, Tomezzoli, A, Vittimberga, G, Rosa, F, Tiberio, Guido Alberto Massimo, Baiocchi, Gian Luca, Rossi, Gm, and Nitti, D. more...
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Adult ,Male ,medicine.medical_specialty ,PROGNOSIS ,Epidemiology ,medicine.medical_treatment ,Settore MED/18 - CHIRURGIA GENERALE ,Gastric Cancer ,Surgery ,Gastrectomy ,Stomach Neoplasms ,80 and over ,medicine ,Humans ,Sex Distribution ,Survival rate ,Pathological ,GASTRIC CANCER ,LAUREN HISTOTYPE ,SURGERY ,LYMPHADENECTOMY ,Aged ,Aged, 80 and over ,business.industry ,Hazard ratio ,Cancer ,Middle Aged ,medicine.disease ,Confidence interval ,Neoplasm Recurrence ,Treatment Outcome ,Local ,Italy ,Lymphatic Metastasis ,Lymph Node Excision ,Observational study ,Female ,Adult, Aged, Aged ,80 and over, Epidemiologic Methods, Female, Gastrectomy, Humans, Italy, Lymph Node Excision, Lymphatic Metastasis, Male, Middle Aged, Neoplasm Recurrence ,Local, Sex Distribution, Stomach Neoplasms, Treatment Outcome ,Neoplasm Recurrence, Local ,business ,Epidemiologic Methods - Abstract
Background The aim of the present multicentre observational study was to evaluate potential changes in clinical and pathological features of patients with gastric cancer (GC) treated in a 15-year interval. Methods A centralized prospective database including clinical, surgical, pathological and follow-up data from 2822 patients who had resection of a primary GC was analysed. The analysis focused on three periods: 1991–1995 (period 1), 1996–2000 (period 2) and 2001–2005 (period 3). Surgical procedure, pathological classification and follow-up were standardized among centres. Results The number of resections decreased from 1024 in period 1 to 955 and 843 in periods 2 and 3 respectively. More advanced stages and a smaller number of intestinal-type tumours of the distal third were observed over time. Five-year survival rates after R0 resection (2320 patients) did not change over time (overall: 56·6 and 51·2 per cent in periods 1 and 3; disease-free: 66·8 and 61·1 per cent respectively). Decreases in survival in more recent years were related particularly to more advanced stage, distal tumours and tumours in women. Multivariable analysis showed a lower probability of overall and disease-free survival in the most recent interval: hazard ratio 1·22 (95 per cent confidence interval 1·06 to 1·40) and 1·29 (1·06 to 1·58) respectively compared with period 1. Recurrent tumours were more frequently peritoneal rather than locoregional. Conclusion Overall and disease-free survival rates after R0 resection of GC were unchanged over time. more...
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- 2011
22. Multicentric Western analysis of prognostic factors in advanced , node-negative gastric cancer patients
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Baiocchi, Gl, Tiberio, Ga, Minicozzi, Am, Morgagni, P, Marrelli, D, Bruno, L, Rosa, F, Marchet, A, Coniglio, A, Saragoni, L, Veltri, M, Pacelli, F, Roviello, F, Nitti, D, Giulini, Sm, and DE MANZONI, Giovanni more...
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Node metastasis ,Gastric Cancer ,Prognosis - Published
- 2010
23. Prediction of recurrence aftre radical surgery for gastric cancer. A scoring system obtained from a prospective multicentre study
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Marrelli, D., Roviello, F., DE MANZONI, Giovanni, Morgagni, P., Di Leo, A., De Stefano, A., and Pinto, E.
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radical surgery ,gastric cancer ,recurrence - Published
- 2005
24. [Benefits of extended lymphadenectomy in patients with gastric carcinoma with metastasis to second level lymph nodes. An Italian multicenter study]
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Roviello, Franco, Marrelli, Daniele, Morgagni, P, De Manzoni, G, Di Leo, A, Vindigni, C, Nastri, G, Saragoni, L, Tomezzoli, A, Kurihara, H, and DE STEFANO, Alfonso
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Adult ,Aged, 80 and over ,Male ,Surgical treatment ,Gastric cancer ,Lymphadenectomy ,Prognosis ,Infant ,Middle Aged ,Survival Rate ,Stomach Neoplasms ,Lymphatic Metastasis ,Humans ,Lymph Node Excision ,Prospective Studies ,Aged ,Neoplasm Staging - Abstract
The actual benefit of extended lymphadenectomy in terms of survival in the surgical treatment of gastric cancer is still a debated issue. The aim of this non-randomized prospective multicentre study was to evaluate long-term survival in a group of patients with involvement of the second level lymph nodes, which would not have been removed with a limited lymphadenectomy. From 1991 to 1997, 451 patients with primary gastric cancer underwent curative resection with extended lymphadenectomy in three italian surgical departments. Lymph node stations were removed and classified according to the rules of the Japanese Research Society for Gastric Cancer; in all cases, retrieval of the lymph nodes was performed by the surgeon on the fresh specimen. Metastases to lymph node stations 7-12 were found in 126 patients out of 451 (27.9%). A mean number of 13 +/- 9 positive lymph nodes (range: 1-42) was found in these cases. Lymph node stations 7 and 8 showed the highest incidence of metastases (61.1% and 44.4%, respectively). Morbidity and mortality rates were 17.1% and 2% in 451 cases treated by extended lymphadenectomy, and 21.4% and 3.2%, respectively, in 126 cases with involvement of second level lymph nodes. In this group of patients, the five-year survival rate was 32 +/- 4%. Multivariate analysis, identified depth of invasion (P0.0001, relative risk (RR) 2.4) and the number of positive lymph nodes (P0.001, RR 1.6) as significant predictors of a poor prognosis. Japanese-type extended lymphadenectomy is associated with low morbidity and mortality rates if performed in specialised centres. The incidence of metastases in lymph node stations removed with this technique is by no means negligible. This procedure could be beneficial as regards long-term survival even in patients with involvement of regional lymph nodes. more...
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- 2003
25. Different patterns of recurrence in gastric cancer depending on Lauren's histological type: longitudinal study
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Marrelli, Daniele, Roviello, Franco, DE MANZONI, G, Morgagni, P, DI LEO, A, Saragoni, L, DE STEFANO, Alfonso, Folli, S, Cordiano, C, Pinto, Enrico, and ITALIAN RESEARCH GROUP FOR GASTRIC CANCER
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Adult ,Male ,medicine.medical_specialty ,Prognostic variable ,recurrence ,medicine.medical_treatment ,surgical treatment ,Gastroenterology ,Group B ,Disease-Free Survival ,Stomach Neoplasms ,Internal medicine ,medicine ,Humans ,Neoplasm Invasiveness ,Prospective Studies ,Prospective cohort study ,Lymph node ,Peritoneal Neoplasms ,Aged ,Aged, 80 and over ,business.industry ,Stomach ,gastric cancer ,Cancer ,Lauren histotype ,Middle Aged ,medicine.disease ,Prognosis ,Surgery ,medicine.anatomical_structure ,lymphadenectomy ,Lymph Node Excision ,Lymphadenectomy ,Female ,Lymph ,Neoplasm Recurrence, Local ,business - Abstract
The aim of this multicenter longitudinal study was to evaluate the pattern of recurrence in patients submitted to potentially curative surgery for intestinal-type and diffuse-type gastric cancer. The study included 412 patients surgically treated at three Italian surgical departments, subdivided into 273 intestinal-type cases (group A) and 139 diffuse-type cases (group B). Recurrence of disease was found in 41% of group A cases and 65% of group B cases (p < 0.0001). The incidence of locoregional, hematogenous, and peritoneal recurrence was 20%, 19%, and 9% in group A, and 27%, 16%, and 34% in group B, respectively; the difference between the two groups was statistically significant for peritoneal recurrence (p < 0.0001). Multivariate analysis identified as prognostic variables lymph node status, depth of invasion, extent of lymphadenectomy, advanced age, and male gender in group A; depth of invasion, extent of lymphadenectomy, tumor size, and lymph node status, in group B. Whereas in group A the incidence of peritoneal recurrence was limited in all subgroups examined, in group B very high rates were observed in cases with infiltration of the serosa, involvement of second-level lymph nodes, or large tumor size. The notable difference in the risk of peritoneal recurrence between the intestinal and diffuse types should be taken into consideration in the therapeutic approach to gastric cancer. more...
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- 2002
26. [Influence of histologic type on prognosis of patients undergoing curative intervention for gastric adenocarcinoma. Italian multicenter study]
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de Manzoni, G, Roviello, Franco, Marrelli, Daniele, Morgagni, P, Di Leo, A, Saragoni, L, DE STEFANO, Alfonso, Bazzocchi, F, and Pinto, Enrico
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Adult ,Aged, 80 and over ,Male ,gastric cancer ,Lauren histotype ,Adenocarcinoma ,Middle Aged ,Prognosis ,survival ,Italy ,prognosis ,Stomach Neoplasms ,Multivariate Analysis ,Humans ,Female ,Prospective Studies ,Neoplasm Recurrence, Local ,Aged - Abstract
The prognostic significance of the histological type in gastric cancer is still debated. The correlation between intestinal-diffuse type and tumor recurrence was investigated in a prospective multicentric study which collects the cases from three surgical Departments of Italy.Four-hundred and twelve patients who underwent a potentially curative resection between 1988 and 1995 were considered; 273 cases were classified as intestinal type (group A), and 139 cases as diffuse type (group B). Mixed cases were excluded from the study. All patients were included in a complete follow-up program for the early diagnosis of recurrence. Clinical, histopathological and surgical factors were examined for their influence on tumor recurrence by univariate and multivariate analysis.Recurrence rate was 41.4% in intestinal type, and 65.5% in diffuse type cases (p0.0001). In group A, multivariate analysis identified nodal status (p0.0001), depth of invasion (p0.005), lymph node dissection (D1 vs. D2-D4, p0.01), advanced age (p0.01) and male sex (p0.05) as significant prognostic factors. In group B, depth of invasion (p0.0005), lymph node dissection (p0.005), tumor size (p0.01) and nodal status (p0.05) resulted as significant variables; no preventive effect on tumor recurrence was found for D2 vs. D1 lymphadenectomy. Multivariate analysis performed on the totality of the cases demonstrated diffuse type as an independent predictor of poor prognosis (relative risk: 1.67, p0.001).Diffuse type of gastric cancer is an independent risk factor for tumor recurrence as compared with intestinal type; clinical and pathological variables play a different role as prognostic factors in the two histotypes. more...
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- 2001
27. Extended lymphadenectomy in elderly and/or highly co-morbid gastric cancer patients: A retrospective multicenter study.
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Rausei, S., Ruspi, L., Rosa, F., Morgagni, P., Marrelli, D., Cossu, A., Cananzi, F.C.M., Lomonaco, R., Coniglio, A., Biondi, A., Cipollari, C., Graziosi, L., Fumagalli, U., Casella, F., Bertoli, P., di Leo, A., Alfieri, S., Vittimberga, G., Roviello, F., and Orsenigo, E. more...
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GASTRECTOMY ,LYMPHADENECTOMY ,CANCER patients ,LYMPH node surgery ,INPATIENT care - Abstract
Background Gastrectomy with extended lymphadenectomy is considered the gold standard treatment for advanced gastric cancer, with no age- or comorbidity-related limitations. We evaluated the safety and efficacy of curative gastrectomy with extended nodal dissection, verifying survival in elderly and highly co-morbid patients. Methods In a retrospective multicenter study, we examined 1322 non-metastatic gastric-cancer patients that underwent curative gastrectomy with D2 versus D1 lymphadenectomy from January 2000 to December 2009. Postoperative complications, overall survival (OS), and disease-specific survival (DSS) according to age and the Charlson Comorbidity Score were analyzed in relation to the extent of lymphadenectomy. Results Postoperative morbidity was 30.4%. Complications were more frequent in highly co-morbid elderly patients, and, although general morbidity rates after D2 and D1 lymphadenectomy were similar (29.9% and 33.2%, respectively), they increased following D2 in highly co-morbid elderly patients (39.6%). D2-lymphadenectomy significantly improved 5-year OS and DSS (48.0% vs. 37.6% in D1, p < 0.001 and 72.6% vs. 58.1% in D1, p < 0.001, respectively) in all patients. In elderly patients, this benefit was present only in 5-year DSS. D2 nodal dissection induced better 5-year OS and DSS rates in elderly patients with positive nodes (29.7% vs. 21.2% in D1, p = 0.008 and 47.5% vs. 30.6% in D1, p = 0.001, respectively), although it was present only in DSS when highly co-morbid elderly patients were considered. Conclusion Extended lymphadenectomy confirmed better survival rates in gastric cancer patients. Due to high postoperative complication rate and no significant improvement of the OS, D1 lymphadenectomy should be considered in elderly and/or highly co-morbid gastric cancer patients. [ABSTRACT FROM AUTHOR] more...
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- 2016
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28. VEGF-A clinical significance in gastric cancers: Immunohistochemical analysis of a wide Italian cohort.
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Lastraioli, E., Boni, L., Romoli, M.R., Crescioli, S., Taddei, A., Beghelli, S., Tomezzoli, A., Vindigni, C., Saragoni, L., Messerini, L., Bernini, M., Bencini, L., Giommoni, E., Freschi, G., Di Costanzo, F., Scarpa, A., Morgagni, P., Farsi, M., Roviello, F., and De Manzoni, G. more...
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VASCULAR endothelial growth factors ,STOMACH cancer patients ,ITALIANS ,PROTEIN expression ,IMMUNOHISTOCHEMISTRY ,MULTIVARIATE analysis ,TUMOR markers ,DISEASES - Abstract
Purpose The clinical significance of VEGF-A expression in gastric cancer (GC) has been reported with contradicting results. We analyzed the expression and clinical significance of VEGF-A in a wide Italian cohort of GC specimens. Methods VEGF-A expression was tested by immunohistochemistry in 507 patients with GC of all clinical stages. The impact of VEGF-A on overall survival (OS) was evaluated in conjunction with clinical and pathological parameters. Results In the Italian cohort we studied VEGF-A was not an independent prognostic factor neither at the univariate nor at multivariate analysis. Conclusions Although frequently expressed, in our study VEGF-A was not able to discriminate between groups of patients with different risk. [ABSTRACT FROM AUTHOR] more...
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- 2014
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29. Validation of the new AJCC TNM staging system for gastric cancer in a large cohort of patients (n = 2,155): Focus on the T category.
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Marchet, A., Mocellin, S., Ambrosi, A., Morgagni, P., Vittimberga, G., Roviello, F., Marrelli, D., de Manzoni, G., Minicozzi, A., Coniglio, A., Tiberio, G., Pacelli, F., Rosa, F., and Nitti, D.
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STOMACH cancer ,COHORT analysis ,DISEASE progression ,MULTIVARIATE analysis ,SURVIVAL analysis (Biometry) ,LYMPH nodes ,ONCOLOGIC surgery ,CANCER patients - Abstract
Abstract: Background: The prognostic value of T subclassification in patients with gastric carcinoma has been just implemented in the new AJCC TNM staging system, which has reclassified T2a and T2b into T2 and T3 tumors, respectively. The aim of the present study was to validate the prognostic significance of the new T categorization within the frame of the latest TNM staging system. Methods: We retrospectively reviewed the records of 686 T2/T3 patients among 2155 subjects who underwent radical resection for gastric carcinoma at six Italian centers from 1988 through 2006. Results: Upon multivariate analysis, the new T categories, extent of lymph node dissection (D) and patient’s age were retained by the survival model as independent prognostic factors. In particular, the death risk for patients with T3 tumors was higher than that of patients with T2 tumors (HR: 1.42, P = 0.005). Among the 686 patients previously classified as having T2 tumors, patients with T2 and T3 disease were 270 (39.4%) and 416 (60.6%), respectively. After a median follow-up of 55 months, the 5-year overall survival rates were 67.3% and 52.3% for patients with T2 and T3 tumors, respectively (P < 0.001). The survival advantage for the T2 as compared to T3 category was maintained even when N0 and N+ patients were separately considered (P = 0.0154 and P < 0.001, respectively). Conclusions: Our data confirm the prognostic difference between the newly proposed T2 and T3 categories, which should be implemented in the routine clinical practice to improve risk stratification of patients with gastric cancer. [Copyright &y& Elsevier] more...
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- 2011
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30. The prognostic value of N-ratio in patients with gastric cancer: Validation in a large, multicenter series.
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Marchet, A., Mocellin, S., Ambrosi, A., de Manzoni, G., Di Leo, A., Marrelli, D., Roviello, F., Morgagni, P., Saragoni, L., Natalini, G., De Santis, F., Baiocchi, L., Coniglio, A., and Nitti, D.
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STOMACH ,CANCER ,PROGNOSIS ,MULTIVARIATE analysis - Abstract
Abstract: Aims: The proportion between metastatic and examined lymph nodes (N-ratio) has been proposed as an independent prognostic factor in patients with gastric cancer. In the present work we validated the reliability of N-ratio in a large, multicenter series. Patients and methods: We retrospectively reviewed the data of 1853 patients who underwent radical resection for gastric carcinoma. Survival of patients with >15 (Group-1, n =1421) and those with ≤15 (Group-2, n =432) lymph nodes examined was separately analyzed in order to evaluate the influence of lymph node dissection on disease staging. N-ratio categories (N-ratio 0, 0%; N-ratio 1, 1–9%; N-ratio 2, 10–25%; N-ratio 3, >25%) were determined by the best cut-off approach. Results: At multivariate analysis, N-ratio (but not TNM N-category) was retained as an independent prognostic factor both in Group-1 and Group-2 (HR for N-ratio 1, N-ratio 2 and N-ratio 3=1.67, 2.96 and 6.59, and 1.56, 2.68 and 4.28, respectively). After a median follow-up of 45.5months, the 5-year overall survival rates of TNM N0, N1 and N2 patients were significantly different in Group-1 vs Group-2. This was not the case when adopting the N-ratio classification, suggesting that a low number of excised lymph nodes can lead to patients being understaged using the N-category, but not N-ratio. Moreover, N-ratio identified subsets of patients with significantly different survival rates within TNM N1 and N2 categories in both groups. Conclusions: N-ratio is a simple and reproducible prognostic tool that can stratify patients with gastric cancer, including those cases with limited lymph node dissection. These data support the rationale to propose the implementation of N-ratio into the current TNM staging system. [Copyright &y& Elsevier] more...
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- 2008
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31. Gastric cancer in young patients with no alarm symptoms: focus on delay in diagnosis, stage of neoplasm and survival.
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Maconi, G., Kurihara, H., Panizzo, V., Russo, A., Cristaldi, M., Marrelli, D., Roviello, F., de Manzoni, G., Di Leo, A., Morgagni, P., Bechi, P., Porro, G. Bianchi, and Taschieri, A.M.
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STOMACH cancer ,TUMORS in children ,CANCER diagnosis ,INDIGESTION in children ,GASTROINTESTINAL cancer ,SYMPTOMS - Abstract
Background: The test and treat strategy for Helicobacter pylori infection has raised some concern since young gastric cancer patients may have no alarm symptoms. In this study the frequency of alarm symptoms was assessed in a series of young gastric cancer patients, as well as the impact of absence of alarm symptoms on delay in diagnosis and stage of gastric cancer at diagnosis and survival. Methods: A retrospective study was carried out on 92 gastric cancer patients ≤ 45 years of age identified from databases in four hospitals between January 1985 and December 2001. Characteristics analysed included duration and features of dyspeptic symptoms, presence of alarm symptoms, time interval from the onset of symptoms to diagnosis, pTNM stage and survival. Results: Of the 92 patients, 54 (58.7%) presented uncomplicated dyspepsia and 38 (41.3%) alarm symptoms. In those with uncomplicated dyspepsia, epigastric pain was the most common complaint (64.1%) followed by vomiting (30.4%), heartburn and nausea. Weight loss was the most common alarm symptom (30.4%), followed by anorexia (10.9%), dysphagia or anaemia (7.6%). The mean delay from first symptoms to final diagnosis was 16.8 ± 13.9 weeks in patients with alarm symptoms and 29.3 ± 39.9 weeks in patients without alarm symptoms ( P :ns). Patients without alarm symptoms showed significantly less aggressive gastric cancer compared to patients with alarm symptoms in relation to TNM stage and survival (cumulative 5-year survival rate: 76% versus 49% P : 0.01). The survival rate, at 5 years, of patients without alarm symptoms, and with a history of dyspepsia of more than 24 weeks, was higher than that in patients with early diagnosis (93.4% versus 66.5%; P : 0.05). Conclusions : A large proportion of young gastric cancer patients present without alarm symptoms. Despite the delay in diagnosis, these patients have a better outcome than those with alarm symptoms. Thus the delay in diagnosis of patients without alarm symptoms does not affect survival. [ABSTRACT FROM AUTHOR] more...
- Published
- 2003
32. The SIC-GIRCG 2013 Consensus Conference on Gastric Cancer
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Andrea Rinnovati, Franco Roviello, Carlo Staudacher, Riccardo Rosati, Paolo Innocenti, Natale Di Martino, Angelo Filippini, Giovanni Sgroi, Gualtiero Mazzocconi, Gianni Pantuso, Mario Morino, Lorenzo Capussotti, Carlo Vallicelli, Gian Luca Baiocchi, Antonio Martino, Umberto Bracale, Diego Piazza, Giorgio Maria Verdecchia, Maurizio De Giuli, Stefano Maria Giulini, Nicola Palasciano, Gianfranco Francioni, Patrizio Capelli, Severino Montemurro, Nereo Vettoretto, Giovanni Battista Grassi, Roberto Petri, Lorenzo Mazzola, Marco Frascio, S. Berti, Heinrich Pernthaler, Daniele Marrelli, Paolo Morgagni, Domenico D'Ugo, Annibale Donini, Donato Nitti, Alfredo Garofalo, Massimo Framarini, Alberto Marchet, Costantino Zingaretti, Michele Testa, Rosario Sacco, Rosaldo Allieta, Giovanni de Manzoni, Angelo Cavicchi, De Manzoni, G, Baiocchi, Gl, Framarini, M, De Giuli, M, D'Ugo, D, Marchet, A, Nitti, D, Marrelli, D, Morgagni, P, Rinnovati, A, Rosati, R, Roviello, F, Allieta, R, Berti, S, Bracale, Umberto, Capelli, P, Cavicchi, A, Di Martino, N, Donini, A, Filippini, A, Francioni, G, Frascio, M, Garofalo, A, Giulini, Sm, Grassi, Gb, Innocenti, P, Martino, A, Mazzocconi, G, Mazzola, L, Montemurro, S, Palasciano, N, Pantuso, G, Pernthaler, H, Petri, R, Piazza, D, Sacco, R, Sgroi, G, Staudacher, C, Testa, M, Vallicelli, C, Vettoretto, N, Zingaretti, C, Capussotti, L, Morino, M, Verdecchia, Gm, De Manzoni, G., Baiocchi, G., Framarini, M., De Giuli, M., D'Ugo, D., Marchet, A., Nitti, D., Marrelli, D., Morgagni, P., Rinnovati, A., Rosati, R., Roviello, F., Allieta, R., Berti, S., Bracale, U., Capelli, P., Cavicchi, A., Di Martino, N., Donini, A., Filippini, A., Francioni, G., Frascio, M., Garofalo, A., Giulini, S., Grassi, G., Innocenti, P., Martino, A., Mazzocconi, G., Mazzola, L., Montemurro, S., Palasciano, N., Pantuso, G., Pernthaler, H., Petri, R., Piazza, D., Sacco, R., Sgroi, G., Staudacher, C., Testa, M., Vallicelli, C., Vettoretto, N., Zingaretti, C., Capussotti, L., Morino, M., Verdecchia, G, De Manzoni, G1, Bracale, U, DI MARTINO, Natale, and Verdecchia, G. M. more...
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Male ,medicine.medical_specialty ,Gastric cancer, Surgery, Chemotherapy, Staging, Endoscopy, Laparoscopy ,Staging ,Delphi Technique ,MEDLINE ,Delphi method ,chemotherapy ,Endosonography ,Female ,Humans ,Italy ,Lymph Node Excision ,Neoplasm Staging ,Societies, Medical ,Stomach Neoplasms ,Stomach Neoplasm ,Medical ,medicine ,lapaoscopy ,guidelines ,gastric cancer ,staging endoscopy ,Settore MED/06 - ONCOLOGIA MEDICA ,treatment ,business.industry ,Consensus conference ,Cancer ,Endoscopy ,medicine.disease ,Plenary session ,Surgery ,Settore MED/18 - Chirurgia Generale ,Gastric Cancer ,Neoplasm staging ,Laparoscopy ,business ,Societies ,Human - Abstract
The topic chosen by the Board of the Italian Society of Surgery for the 2013 annual Consensus Conference was gastric cancer. With this purpose, under the direction of 2 chairmen, 36 experts nominated by the Regional Societies of Surgery and by the Italian Research Group for Gastric Cancer (GIRCG) participated in an experts consensus exercise, preceded by a questionnaire and mainly held by telematic vote, in accordance with the rules of the Delphi method. The results of this Consensus Conference, presented to the 115th National Congress of the Italian Society of Surgery, and approved in plenary session, are reported in the present paper. more...
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- 2014
33. Conversion Surgery in Gastric Cancer Carcinomatosis
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Paolo, Morgagni, Leonardo, Solaini, Luca, Saragoni, Manlio, Monti, Martina, Valgiusti, Giovanni, Vittimberga, Giovanni Luca, Frassineti, Massimo, Framarini, Giorgio, Ercolani, Morgagni P., Solaini L., Saragoni L., Monti M., Valgiusti M., Vittimberga G., Frassineti G.L., Framarini M., and Ercolani G. more...
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Cancer Research ,HIPEC ,Oncology ,conversion surgery ,gastric cancer ,metastatic disease ,positive peritoneal cytology - Abstract
BackgroundAfter the REGATTA trial, patients with stage IV gastric cancer could only benefit from chemotherapy (CHT). However, some of these patients may respond extraordinarily to palliative chemotherapy, converting their disease to a radically operable stage. We present a single centre experience in treating peritoneal carcinomatosis from gastric cancer.MethodsAll patients with stage IV gastric cancer with peritoneal metastases as a single metastatic site operated at a single centre between 2005 and 2020 were included. Cases were grouped according to the treatment received.ResultsA total of 118 patients were considered, 46 were submitted to palliative gastrectomy (11 were considered M1 because of an unsuspected positive peritoneal cytology), and 20 were submitted to Hyperthermic Intraperitoneal Chemotherapy (HIPEC) because of a p = 0.742).ConclusionsConversion surgery for peritoneal carcinomatosis from gastric cancer was associated with long survival and it should always be taken into consideration in this group of patients. more...
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- 2022
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34. Current practice on the use of prophylactic drain after gastrectomy in Italy: the Abdominal Drain in Gastrectomy ({ADiGe}) survey
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Mengardo, Valentina, Weindelmayer, Jacopo, Veltri, Alessandro, Giacopuzzi, Simone, Torroni, Lorena, DE MANZONI, Giovanni, Ferdinando, Agresta, Rita, Alfieri, Sergio, Alfieri, Nicola, Antonacci, Gian Luca Baiocchi, Lapo, Bencini, Bencivenga, Maria, Benedetti, Michele, Mattia, Berselli, Alberto, Biondi, Gabriella Teresa Capolupo, Fabio, Carboni, Riccardo, Casadei, Casella, Francesco, Catarci, Marco, Paolo, Cerri, Damiano, Chiari, Eugenio, Cocozza, Giovanni, Colombo, Luca, Cozzaglio, Giorgio, Dalmonte, Maurizio, Degiuli, Maurizio De Luca, Raffaele De Luca, Nicol(`(o)) De Manzini, DE PASQUAL, CARLO ALBERTO, Stefano De Pascale, Nicola De Ruvo, DI COSMO, Mariantonietta, DI LEO, Alberto, Massimiliano Di Paola, Amedeo, Elio, Francesco, Ferrara, Giovanni, Ferrari, Valentino, Fiscon, Uberto, Fumagalli, Gianluca, Garulli, Andrea, Gennai, Irene, Gentile, Paola, Germani, Monica, Gualtierotti, Guerini, Francesca, Angela, Gurrado, Inama, Marco, Filippo La Torre, Ernesto, Laterza, Pasquale, Losurdo, Antonio, Macr(`(i)), Alessandra, Marano, Luigi, Marano, Federico, Marchesi, Fabio, Marino, Marco, Massani, Roberta, Menghi, Marco, Milone, Sarah, Molfino, Mauro, Montuori, Moretto, Gianluigi, Paolo, Morgagni, Emilio, Morpurgo, Moukchar, Abdallah, Luca, Nespoli, Stefano, Olmi, Raffaele, Palaia, Giovanni, Pallabazer, Parise, Paolo, Alessandro, Pasculli, Marco Pericoli Ridolfini, Antonio, Pesce, Enrico, Pinotti, Michele, Pisano, Elia, Poiasina, Vittorio, Postiglione, Stefano, Rausei, Antonio, Rella, Fausto, Rosa, Riccardo, Rosati, Gianmaria, Rossi, Luca, Rossit, Massimo, Rovatti, Laura, Ruspi, DAL SACCO, Luca, Saladino, Edoardo, Andrea, Sansonetti, Sartori, Alberto, Donatella, Scaglione, Stefano, Scaringi, Christian, Schoenthaler, Giuseppe, Sena, Michele, Simone, Leonardo, Solaini, Paolo, Strignano, Nicola, Tartaglia, Silvio, Testa, Mario, Testini, Guido Alberto Massimo Tiberio, Treppiedi, Elio, Alessio, Vagliasindi, Michele, Valmasoni, Jacopo, Vigan(`(o)), Gianpietro, Zanchettin, Andrea, Zanoni, Zardini, Claudio, Antonio Zerbinati and, Mengardo, V, Weindelmayer, J, Veltri, A, Giacopuzzi, S, Torroni, L, de Manzoni, G, Agresta, F, Alfieri, R, Alfieri, S, Antonacci, N, Baiocchi, G, Bencini, L, Bencivenga, M, Benedetti, M, Berselli, M, Biondi, A, Capolupo, G, Carboni, F, Casadei, R, Casella, F, Catarci, M, Cerri, P, Chiari, D, Cocozza, E, Colombo, G, Cozzaglio, L, Dalmonte, G, Degiuli, M, De Luca, M, De Luca, R, De Manzini, N, De Pasqual, C, De Pascale, S, De Ruvo, N, Di Cosmo, M, Di Leo, A, Di Paola, M, Elio, A, Ferrara, F, Ferrari, G, Fiscon, V, Fumagalli, U, Garulli, G, Gennai, A, Gentile, I, Germani, P, Gualtierotti, M, Guerini, F, Gurrado, A, Inama, M, La Torre, F, Laterza, E, Losurdo, P, Macri, A, Marano, A, Marano, L, Marchesi, F, Marino, F, Massani, M, Menghi, R, Milone, M, Molfino, S, Montuori, M, Moretto, G, Morgagni, P, Morpurgo, E, Abdallah, M, Nespoli, L, Olmi, S, Palaia, R, Pallabazer, G, Parise, P, Pasculli, A, Pericoli Ridolfini, M, Pesce, A, Pinotti, E, Pisano, M, Poiasina, E, Postiglione, V, Rausei, S, Rella, A, Rosa, F, Rosati, R, Rossi, G, Rossit, L, Rovatti, M, Ruspi, L, Sacco, L, Saladino, E, Sansonetti, A, Sartori, A, Scaglione, D, Scaringi, S, Schoenthaler, C, Sena, G, Simone, M, Solaini, L, Strignano, P, Tartaglia, N, Testa, S, Testini, M, Tiberio, G, Treppiedi, E, Vagliasindi, A, Valmasoni, M, Vigano, J, Zanchettin, G, Zanoni, A, Zardini, C, Zerbinati, A, Mengardo, Valentina, Weindelmayer, Jacopo, Veltri, Alessandro, Giacopuzzi, Simone, Torroni, Lorena, de Manzoni, Giovanni, and de Manzini, Nicolo more...
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Surgeons ,Postoperative Complications ,Gastrectomy ,Stomach Neoplasms ,Surveys and Questionnaires ,Drain ,Drainage ,Gastric cancer ,Survey ,Humans ,Surgery - Abstract
Evidence against the use of prophylactic drain after gastrectomy are increasing and ERAS guidelines suggest the benefit of drain avoidance. Nevertheless, it is unclear whether this practice is still widespread. We conducted a survey among Italian surgeons through the Italian Gastric Cancer Research Group and the Polispecialistic Society of Young Surgeons, aiming to understand the current use of prophylactic drain. A 28-item questionnaire-based survey was developed to analyze the current practice and the individual opinion about the use of prophylactic drain after gastrectomy. Groups based on age, experience and unit volume were separately analyzed. Response of 104 surgeons from 73 surgical units were collected. A standardized ERAS protocol for gastrectomy was applied by 42% of the respondents. Most of the surgeons, regardless of age, experience, or unit volume, declared to routinely place one or more drain after gastrectomy. Only 2 (1.9%) and 7 surgeons (6.7%) belonging to high volume units, do not routinely place drains after total and subtotal gastrectomy, respectively. More than 60% of the participants remove the drain on postoperative day 4–6 after performing an assessment of the anastomosis integrity. Interestingly, less than half of the surgeons believe that drain is the main tool for leak management, and this percentage further drops among younger surgeons. On the other hand, drain’s role seems to be more defined for duodenal stump leak treatment, with almost 50% of the surgeons recognizing its importance. Routine use of prophylactic drain after gastrectomy is still a widespread practice even if younger surgeons are more persuaded that it could not be advantageous. more...
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- 2022
35. Development and Multicenter Validation of a Novel Immune-Inflammation-Based Nomogram to Predict Survival in Western Resectable Gastric and Gastroesophageal Junction Adenocarcinoma (GEA): The NOMOGAST
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Massimiliano Salati, Nicola De Ruvo, Mariano Cesare Giglio, Lorena Sorrentino, Giuseppe Esposito, Sara Fenocchi, Giovanni Cucciarrè, Francesco Serra, Elena Giulia Rossi, Giovanni Vittimberga, Giorgia Radi, Leonardo Solaini, Paolo Morgagni, Giulia Grizzi, Margherita Ratti, Fabio Gelsomino, Andrea Spallanzani, Michele Ghidini, Giorgio Ercolani, Massimo Dominici, Roberta Gelmini, Salati M., De Ruvo N., Giglio M.C., Sorrentino L., Esposito G., Fenocchi S., Cucciarre G., Serra F., Rossi E.G., Vittimberga G., Radi G., Solaini L., Morgagni P., Grizzi G., Ratti M., Gelsomino F., Spallanzani A., Ghidini M., Ercolani G., Dominici M., and Gelmini R. more...
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nomogram ,gastric cancer ,prognosis ,General Medicine - Abstract
Background. More than 50% of operable GEA relapse after curative-intent resection. We aimed at externally validating a nomogram to enable a more accurate estimate of individualized risk in resected GEA. Methods. Medical records of a training cohort (TC) and a validation cohort (VC) of patients undergoing radical surgery for c/uT2-T4 and/or node-positive GEA were retrieved, and potentially interesting variables were collected. Cox proportional hazards in univariate and multivariate regressions were used to assess the effects of the prognostic factors on OS. A graphical nomogram was constructed using R software’s package Regression Modeling Strategies (ver. 5.0-1). The performance of the prognostic model was evaluated and validated. Results. The TC and VC consisted of 185 and 151 patients. ECOG:PS > 0 (p < 0.001), angioinvasion (p < 0.001), log (Neutrophil/Lymphocyte ratio) (p < 0.001), and nodal status (p = 0.016) were independent prognostic values in the TC. They were used for the construction of a nomogram estimating 3- and 5-year OS. The discriminatory ability of the model was evaluated with the c-Harrell index. A 3-tier scoring system was developed through a linear predictor grouped by 25 and 75 percentiles, strengthening the model’s good discrimination (p < 0.001). A calibration plot demonstrated a concordance between the predicted and actual survival in the TC and VC. A decision curve analysis was plotted that depicted the nomogram’s clinical utility. Conclusions. We externally validated a prognostic nomogram to predict OS in a joint independent cohort of resectable GEA; the NOMOGAST could represent a valuable tool in assisting decision-making. This tool incorporates readily available and inexpensive patient and disease characteristics as well as immune-inflammatory determinants. It is accurate, generalizable, and clinically effectivex. more...
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- 2022
36. Looking for a strategy in treating peritoneal gastric cancer carcinomatosis: an Italian multicenter Gastric Cancer Research group’s analysis
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Guido A. M. Tiberio, Michela Caprioli, Elisabetta Marino, Paolo Morgagni, Luigina Graziosi, Alessia D'Ignazio, Gianni Mura, Daniele Marrelli, Silvia Ministrini, Maria Bencivenga, Franco Roviello, Maurizio Degiuli, Michele Sacco, Annibale Donini, Giovanni de Manzoni, Leonardo Solaini, Graziosi L., Marino E., Bencivenga M., D'Ignazio A., Solaini L., Ministrini S., Caprioli M., Sacco M., Marrelli D., Mura G., Degiuli M., Morgagni P., Tiberio G.A.M., De Manzoni G., Roviello F., and Donini A. more...
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medicine.medical_specialty ,RD1-811 ,Prognosi ,Surgical oncology ,Retrospective Studie ,Stomach Neoplasms ,medicine ,Humans ,Hyperthermia ,Prospective Studies ,Pathological ,RC254-282 ,Peritoneal Neoplasms ,Retrospective Studies ,Surgical approach ,business.industry ,General surgery ,Research ,Induced ,Cancer ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Retrospective cohort study ,Hyperthermia, Induced ,medicine.disease ,Prognosis ,Peritoneal carcinomatosis ,Peritoneal carcinomatosi ,Prospective Studie ,Oncology ,Italy ,Homogeneous ,Cohort ,Surgery ,business ,Gastric cancer ,Peritoneal Neoplasm ,Human - Abstract
Background The present study provides a snapshot of Italian patients with peritoneal metastasis from gastric cancer treated by surgery in Italian centers belonging to the Italian Research Group on Gastric Cancer. Prognostic factors affecting survival in such cohort of patients were evaluated with the final aim to identify patients who may benefit from radical intent surgery. Methods It is a multicentric retrospective study based on a prospectively collected database including demographics, clinical, surgical, pathological, and follow-up data of patients with gastric cancer and synchronous macroscopic peritoneal metastases. Patients were surgically treated from January 2005 to January 2017. We focused on patients with macroscopic peritoneal carcinomatosis (PC) treated with upfront surgery in order to provide homogeneous evidences. Results Our results show that patients with peritoneal carcinomatosis cannot be considered all lost. Strictly selected cases (R0/R1 and P1 patients) could benefit from an aggressive surgical approach performing an extended lymphadenectomy and HIPEC treatment. Conclusion The main result of the study is that GC patients with limited peritoneal involvement can have a survival benefit from a surgery with “radical oncological intent”, that means extended lymphadenectomy and R0 resection. The retrospective nature of this study is an important bias, and for this reason, we have started a prospective multicentric study including Italian stage IV patients that hopefully will give us more answers. more...
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- 2021
37. Genetic and Epigenetic Alterations of CDH1 Regulatory Regions in Hereditary and Sporadic Gastric Cancer
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Celina São José, Francesca Rebuzzi, Chiara Molinari, Matteo Canale, Daniele Calistri, Elisa Ferracci, Paola Ulivi, Ana André, Gianluca Tedaldi, Paolo Morgagni, Valentina Arcangeli, Sara Pignatta, Luca Saragoni, Rita Barbosa-Matos, Carla Oliveira, Guglielmina Nadia Ranzani, Mila Ravegnani, Rita Danesi, Giovanni Martinelli, Tedaldi G., Molinari C., Jose C.S., Barbosa-Matos R., Andre A., Danesi R., Arcangeli V., Ravegnani M., Saragoni L., Morgagni P., Rebuzzi F., Canale M., Pignatta S., Ferracci E., Martinelli G., Ranzani G.N., Oliveira C., Calistri D., and Ulivi P. more...
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Next-Generation Sequencing ,Pharmaceutical Science ,Biology ,Pharmacy and materia medica ,Drug Discovery ,Genetic predisposition ,medicine ,Epigenetics ,Gene ,CDH1 gene ,Regulation of gene expression ,Genetics ,DNA methylation ,gastric cancer ,Methylation ,medicine.disease ,RS1-441 ,Regulatory sequence ,Molecular Medicine ,Medicine ,Hereditary diffuse gastric cancer ,regulatory regions ,genetic predisposition - Abstract
E-cadherin is a key player in gastric cancer (GC) and germline alterations of CDH1, its encoding gene, are responsible for Hereditary Diffuse Gastric Cancer (HDGC) syndrome. This study aimed at elucidating the role of genetic variants and DNA methylation of CDH1 promoter and enhancers in the regulation of gene expression. For this purpose, we analyzed genetic variants of the CDH1 gene through Next-Generation Sequencing (NGS) in a series of GC cell lines (NCI-N87, KATO-III, SNU-1, SNU-5, GK2, AKG, KKP) and the corresponding CDH1 expression levels. By bisulfite genomic sequencing, we analyzed the methylation status of CDH1 regulatory regions in 8 GC cell lines, in a series of 13 sporadic GC tissues and in a group of 20 HDGC CDH1-negative patients and 6 healthy controls. The NGS analysis on CDH1 coding and regulatory regions detected genetic alterations in 3 out of 5 GC cell lines lacking functional E-cadherin. CDH1 regulatory regions showed different methylation patterns in patients and controls, GC cell lines and GC tissues, expressing different E-cadherin levels. Our results showed that alterations in terms of genetic variants and DNA methylation patterns of both promoter and enhancers are associated with CDH1 expression levels and have a role in its regulation. more...
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- 2021
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38. The effect of learning curve on perioperative outcomes of robotic gastrectomy in two western high-volume centers
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Leonardo Solaini, Daniele Marrelli, Giorgio Ercolani, Luigi Marano, Franco Roviello, Andrea Avanzolini, Alessia D'Ignazio, Paolo Morgagni, Solaini L., D'Ignazio A., Marrelli D., Marano L., Avanzolini A., Morgagni P., Roviello F., and Ercolani G. more...
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medicine.medical_specialty ,medicine.medical_treatment ,Operative Time ,Biophysics ,Conversion to open surgery ,03 medical and health sciences ,0302 clinical medicine ,Primary outcome ,gastrectomy ,gastric cancer ,learning curve ,robotic gastrectomy ,robotic surgery ,training ,Robotic Surgical Procedures ,Stomach Neoplasms ,Medicine ,Humans ,Robotic surgery ,Retrospective Studies ,business.industry ,Retrospective cohort study ,Perioperative ,Odds ratio ,Confidence interval ,Computer Science Applications ,Surgery ,Treatment Outcome ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Gastrectomy ,Laparoscopy ,business - Abstract
Introduction: To compare outcomes of robotic gastrectomy (RG) performed during the learning curve (P1) with those after its completion (P2). Methods: In this retrospective study, all consecutive RG patients (n=92) performed between 2008 and 2018 were included. Primary outcome was conversion rate. Results: D2 lymphadenectomies were more common in P2 (41, 97.6%) than P1 (41, 82.0%) (p=0.019). Conversions were 11 (22%) in P1 versus 2 (4.8%) in P2 (p=0.006). Postoperative morbidity was comparable between the groups. Median hospital stay was significantly shorter in P2. The only factor significantly associated with conversion was P2 (odds ratio = 0.18; 95% confidence interval, 0.04–0.85; p=0.039). The 5-year overall survival in P1 was 79.6% versus 79.7% in P2 (p=0.373). Conclusions: The learning curve affected operative and postoperative outcomes: during the learning curve, conversion to open surgery was significantly more frequent, the number of D2 was higher and patients were discharged earlier. more...
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- 2021
39. Preoperative or Perioperative Docetaxel, Oxaliplatin, and Capecitabine (GASTRODOC Regimen) in Patients with Locally-Advanced Resectable Gastric Cancer: A Randomized Phase-II Trial
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Luigina Graziosi, Uberto Fumagalli Romario, Maria Bencivenga, Franco Roviello, Oriana Nanni, Daniele Marrelli, Giovanni de Manzoni, Silvia Bozzarelli, Francesca Steccanella, Stefano Rausei, Massimo Framarini, Giovanni Sgroi, Annibale Donini, Stefano Santi, Luca Saragoni, Andrea Rinnovati, Giorgio Ercolani, Lorenza Rimassa, Flavia Foca, Paolo Morgagni, Ilaria Proserpio, Valentina Mengardo, Giovanni Luca Frassineti, Carlo Milandri, Manlio Monti, Sarah Molfino, Emilio Parma, Roberto Petrioli, Gian Luca Baiocchi, Gianni Mura, Dino Amadori, Linda Valmorri, Alessandra Signorini, Verena De Angelis, J. Viganò, Silvia Brugnatelli, Monti M., Morgagni P., Nanni O., Framarini M., Saragoni L., Marrelli D., Roviello F., Petrioli R., Romario U.F., Rimassa L., Bozzarelli S., Donini A., Graziosi L., De Angelis V., De Manzoni G., Bencivenga M., Mengardo V., Parma E., Milandri C., Mura G., Signorini A., Baiocchi G., Molfino S., Sgroi G., Steccanella F., Rausei S., Proserpio I., Vigano J., Brugnatelli S., Rinnovati A., Santi S., Ercolani G., Foca F., Valmorri L., Amadori D., and Frassineti G.L. more...
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0301 basic medicine ,Cancer Research ,medicine.medical_specialty ,medicine.medical_treatment ,lcsh:RC254-282 ,Gastroenterology ,Article ,Capecitabine ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Chemotherapy ,Medicine ,Perioperative ,Progression-free survival ,Preoperative ,Gastric cancer ,business.industry ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,medicine.disease ,Oxaliplatin ,Regimen ,030104 developmental biology ,Oncology ,Docetaxel ,030220 oncology & carcinogenesis ,business ,Febrile neutropenia ,medicine.drug - Abstract
Docetaxel associated with oxaliplatin and 5-fluorouracil (FLOT) has been reported as the best perioperative treatment for gastric cancer. However, there is still some debate about the most appropriate number and timing of chemotherapy cycles. In this randomized multicenter phase II study, patients with resectable gastric cancer were staged through laparoscopy and peritoneal lavage cytology, and randomly assigned (1:1) to either four cycles of neoadjuvant chemotherapy (arm A) or two preoperative + two postoperative cycles of docetaxel, oxaliplatin, and capecitabine (DOC) chemotherapy (arm B). The primary endpoint was to assess the percentage of patients receiving all the planned preoperative or perioperative chemotherapeutic cycles. Ninety-one patients were enrolled between September 2010 and August 2016. The treatment was well tolerated in both arms. Thirty-three (71.7%) and 24 (53.3%) patients completed the planned cycles in arms A and B, respectively (p = 0.066), reporting an odds ratio for early interruption of treatment of 0.45 (95% confidence interval (CI): 0.18&ndash, 1.07). Resection was curative in 39 (88.6%) arm A patients and 35 (83.3%) arm B patients. Five-year progression-free survival (PFS) was 51.2% (95% CI: 34.2&ndash, 65.8) in arm A and 40.3% (95% CI: 28.9&ndash, 55.2) in arm B (p = 0.300). Five-year survival was 58.5% (95% CI: 41.3&ndash, 72.2) and 53.9% (95% CI: 35.5&ndash, 69.3) (p = 0.883) in arms A and B, respectively. The planned treatment was more frequently completed and was more active, albeit not significantly, in the neoadjuvant arm than in the perioperative group. more...
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- 2020
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40. Validation of the new AJCC TNM staging system for gastric cancer in a large cohort of patients (n = 2,155): Focus on the T category
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Franco Roviello, Arianna Coniglio, Donato Nitti, Alessandro Ambrosi, Daniele Marrelli, Fausto Rosa, G. De Manzoni, Annamaria Minicozzi, Simone Mocellin, Guido A. M. Tiberio, Alberto Marchet, Giovanni Vittimberga, Paolo Morgagni, Fabio Pacelli, Marchet, A, Mocellin, S, Ambrosi, Alessandro, Morgagni, P, Vittimberga, G, Roviello, F, Marrelli, D, de Manzoni, G, Minicozzi, A, Coniglio, A, Tiberio, G, Pacelli, F, Rosa, F, Nitti, D., Universita Vita Salute San Raffaele = Vita-Salute San Raffaele University [Milan, Italie] (UniSR), Department of General Surgery, Morgagni-Pierantoni Hospital, University of Siena, First Division of General surgery, University of Verona (UNIVR), University of Brescia, Department of Chirurgia Digestiva, and Cattolica University of Rome more...
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Male ,Oncology ,Multivariate analysis ,Settore MED/18 - CHIRURGIA GENERALE ,Disease ,030230 surgery ,0302 clinical medicine ,TNM staging system ,Lymph node ,Aged, 80 and over ,Prognostic factor ,T2 ,SEROSAL INVASION ,General Medicine ,Middle Aged ,Prognosis ,3. Good health ,Dissection ,medicine.anatomical_structure ,Lymphatic Metastasis ,030220 oncology & carcinogenesis ,PROGNOSTIC-FACTORS [Survival analysis KeyWords Plus] ,Female ,Gastric Cancer ,TNM Staging System ,Adult ,medicine.medical_specialty ,CARCINOMA ,Prognostic factors ,SUBCLASSIFICATION ,03 medical and health sciences ,Stomach Neoplasms ,Internal medicine ,medicine ,Humans ,MUSCULARIS ,Survival analysis ,Gastric cancer, TNM staging system, Prognostic factors, Survival analysis ,Aged ,Neoplasm Staging ,business.industry ,Cancer ,ADENOCARCINOMA ,medicine.disease ,digestive system diseases ,Large cohort ,Surgery ,Gastric cancer ,business - Abstract
Background: The prognostic value of T subclassification in patients with gastric carcinoma has been just implemented in the new AJCC TNM staging system, which has reclassified T2a and T2b into T2 and T3 tumors, respectively. The aim of the present study was to validate the prognostic significance of the new T categorization within the frame of the latest TNM staging system. Methods: We retrospectively reviewed the records of 686 T2/T3 patients among 2155 subjects who underwent radical resection for gastric carcinoma at six Italian centers from 1988 through 2006. Results: Upon multivariate analysis, the new T categories, extent of lymph node dissection (D) and patient's age were retained by the survival model as independent prognostic factors. In particular, the death risk for patients with T3 tumors was higher than that of patients with T2 tumors (HR: 1.42, P = 0.005). Among the 686 patients previously classified as having T2 tumors, patients with T2 and T3 disease were 270 (39.4%) and 416 (60.6%), respectively. After a median follow-up of 55 months, the 5-year overall survival rates were 67.3% and 52.3% for patients with T2 and T3 tumors, respectively (P < 0.001). The survival advantage for the T2 as compared to T3 category was maintained even when N0 and N+ patients were separately considered (P = 0.0154 and P < 0.001, respectively). Conclusions: Our data confirm the prognostic difference between the newly proposed T2 and T3 categories, which should be implemented in the routine clinical practice to improve risk stratification of patients with gastric cancer. more...
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- 2011
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41. Extended lymphadenectomy in elderly and/or highly co-morbid gastric cancer patients: A retrospective multicenter study
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P. Bertoli, Luca Ansaloni, F. Roviello, Chiara Cipollari, Stefano Rausei, Andrea Sansonetti, Paolo Morgagni, Alberto Biondi, Andrea Cossu, Laura Ruspi, Fausto Rosa, Gianlorenzo Dionigi, Uberto Fumagalli, Ferdinando Carlo Maria Cananzi, A. Di Leo, Daniele Marrelli, Luigina Graziosi, Sergio Alfieri, Federica Galli, Francesco Casella, Giovanni Vittimberga, Andrea Zanoni, R. Lomonaco, Riccardo Rosati, Vittorio Quagliuolo, Mattia Bencivenga, Severino Montemurro, Elena Orsenigo, Annibale Donini, Arianna Coniglio, Gian Luca Baiocchi, Roberto Persiani, Rausei, S., Ruspi, L., Rosa, F., Morgagni, P., Marrelli, D., Cossu, A., Cananzi, F. C. M., Lomonaco, R., Coniglio, A., Biondi, A., Cipollari, C., Graziosi, L., Fumagalli, U., Casella, F., Bertoli, P., di Leo, A., Alfieri, S., Vittimberga, G., Roviello, F., Orsenigo, E., Quagliuolo, V., Montemurro, S., Baiocchi, G., Persiani, R., Bencivenga, M., Donini, A., Rosati, R., Sansonetti, A., Ansaloni, L., Zanoni, A., Galli, F., and Dionigi, G. more...
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Male ,Settore MED/18 - CHIRURGIA GENERALE ,medicine.medical_treatment ,Elderly ,Gastric cancer ,High morbidity ,Lymphadenectomy ,Tailored treatment ,Adenocarcinoma ,Adult ,Age Factors ,Aged ,Aged, 80 and over ,Cardiovascular Diseases ,Comorbidity ,Dementia ,Diabetes Mellitus ,Disease-Free Survival ,Female ,Gastrectomy ,Humans ,Liver Diseases ,Lymph Node Excision ,Middle Aged ,Postoperative Complications ,Pulmonary Disease, Chronic Obstructive ,Retrospective Studies ,Stomach Neoplasms ,Survival Rate ,030230 surgery ,0302 clinical medicine ,80 and over ,Pulmonary Disease ,Chronic Obstructive ,Surgery ,Oncology ,Retrospective Studie ,Cardiovascular Disease ,Age Factor ,Liver Disease ,Diabetes Mellitu ,General Medicine ,Dissection ,030220 oncology & carcinogenesis ,Human ,medicine.medical_specialty ,03 medical and health sciences ,Stomach Neoplasm ,medicine ,Survival rate ,business.industry ,Cancer ,Postoperative complication ,Retrospective cohort study ,medicine.disease ,Postoperative Complication ,business - Abstract
Background Gastrectomy with extended lymphadenectomy is considered the gold standard treatment for advanced gastric cancer, with no age- or comorbidity-related limitations. We evaluated the safety and efficacy of curative gastrectomy with extended nodal dissection, verifying survival in elderly and highly co-morbid patients. Methods In a retrospective multicenter study, we examined 1322 non-metastatic gastric-cancer patients that underwent curative gastrectomy with D2 versus D1 lymphadenectomy from January 2000 to December 2009. Postoperative complications, overall survival (OS), and disease-specific survival (DSS) according to age and the Charlson Comorbidity Score were analyzed in relation to the extent of lymphadenectomy. Results Postoperative morbidity was 30.4%. Complications were more frequent in highly co-morbid elderly patients, and, although general morbidity rates after D2 and D1 lymphadenectomy were similar (29.9% and 33.2%, respectively), they increased following D2 in highly co-morbid elderly patients (39.6%). D2-lymphadenectomy significantly improved 5-year OS and DSS (48.0% vs. 37.6% in D1, p more...
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- 2016
42. Duodenal fistula after elective gastrectomy for malignant disease : an italian retrospective multicenter study
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Paolo Morgagni, Roberto Biffi, Luca Gianotti, Riccardo Rosati, Vittorio Corso, Massimiliano Coladonato, Roberto Doci, Paolo Dionigi, F. Roviello, Luca Cozzaglio, Fausto Rosa, Vincenzo Mazzaferro, Arianna Coniglio, L., Cozzaglio, M., Coladonato, R., Biffi, A., Coniglio, V., Corso, P., Dionigi, L., Gianotti, V., Mazzaferro, P., Morgagni, F., Rosa, Rosati, Riccardo, F., Rovello, R., Doci, Cozzaglio, L, Coladonato, M, Biffi, R, Coniglio, A, Corso, V, Dionigi, P, Gianotti, L, Mazzaferro, V, Morgagni, P, Rosa, F, Rosati, R, Roviello, F, and Doci, R more...
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Male ,Gastric cancer, Gastrectomy, Complications, Duodenalfistula ,Complications ,medicine.medical_treatment ,Settore MED/18 - CHIRURGIA GENERALE ,Kaplan-Meier Estimate ,Postoperative Complications ,Surgical ,Medicine ,Mortality rate ,Incidence ,Hazard ratio ,Anastomosis, Surgical ,Statistics ,Gastroenterology ,Treatment Outcome ,Italy ,Elective Surgical Procedures ,Duodenal Fistula ,gastrectomia, neoplasia, chirurgia ,Female ,Elective Surgical Procedure ,Reoperation ,medicine.medical_specialty ,Anastomosis ,Risk Assessment ,Statistics, Nonparametric ,Gastrectomy ,Stomach Neoplasms ,Duodenal fistula ,Intestinal Fistula ,Humans ,Nonparametric ,Duodenal Diseases ,Proportional Hazards Models ,Retrospective Studies ,Chi-Square Distribution ,Proportional hazards model ,business.industry ,Retrospective cohort study ,Survival Analysis ,Surgery ,Duodenalfistula ,Gastric cancer ,business ,Follow-Up Studies - Abstract
BACKGROUND: Duodenal fistula (DF) after gastrectomy continues to be a life-threatening problem. We performed a retrospective multicenter study analyzing the characteristics of DF after elective gastrectomy for malignant disease. METHODS: Three thousand seven hundred eighty-five patients who had undergone gastrectomy with duodenal stump in 11 Italian surgical units were analyzed. RESULTS: Sixty-eight DFs occurred, with a median frequency of 1.6% and a mortality rate of 16%. Complications were mainly septic but fistulas or bleeding of surrounding organs accounted for about 30%. Reoperation was performed in 40% of patients. We observed a correlation between mortality and age (hazard ratio 1.09; 95% CI 1.00-1.20) and serum albumin (hazard ratio 0.90; 95% CI 0.83-0.99). The appearance of further complications was associated with reoperation (P < 0.001) and death (P = 0.054), while the preservation of oral feeding was related to DF healing (P < 0.001). CONCLUSIONS: This paper represents the largest series ever published on DF and shows that its features have changed in the last 20 years. DF alone no longer leads to death and some complications observed in the past have disappeared, while new ones are emerging. Nowadays, medical therapy is preferred and surgery is indicated only in cases of abdominal sepsis or bleeding. more...
- Published
- 2010
43. The prognostic value of N-ratio in patients with gastric cancer: validation in a large, multicenter series
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Luca Baiocchi, Donato Nitti, A. Di Leo, G. De Manzoni, Simone Mocellin, Alberto Marchet, Luca Saragoni, Paolo Morgagni, G. Natalini, Alessandro Ambrosi, Daniele Marrelli, Arianna Coniglio, Franco Roviello, F. De Santis, Marchet, A, Mocellin, S, Ambrosi, Alessandro, de Manzoni, G, Di Leo, A, Marrelli, D, Roviello, F, Morgagni, P, Saragoni, L, Natalini, G, De Santis, F, Baiocchi, L, Coniglio, A, and Nitti, D. more...
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Oncology ,STAGE MIGRATION ,Male ,Metastasis ,Gastric cancer ,Prognosis ,TNM staging system ,N-ratio ,STOMACH ,Multicenter Studies as Topic ,Gastric Cancer ,Nodal Metastasis ,nodal Staging ,Lymph node ,Aged, 80 and over ,Stomach ,General Medicine ,TNM CLASSIFICATION ,Middle Aged ,Immunohistochemistry ,Dissection ,medicine.anatomical_structure ,Lymphatic Metastasis ,SURVIVAL ,TRIAL ,Female ,Lymph ,prognosi ,medicine.medical_specialty ,RESECTION ,CARCINOMA ,Adenocarcinoma ,Risk Assessment ,Sensitivity and Specificity ,Gastrectomy ,Predictive Value of Tests ,Stomach Neoplasms ,Internal medicine ,medicine ,Carcinoma ,Humans ,RECURRENCE ,Aged ,Neoplasm Staging ,Probability ,Proportional Hazards Models ,Retrospective Studies ,Analysis of Variance ,business.industry ,gastric cancer ,Cancer ,medicine.disease ,Survival Analysis ,Gastric cancer, Prognosis, TNM staging system, N-ratio ,LYMPH-NODE DISSECTION ,LYMPH-NODE DISSECTION, STAGE MIGRATION, TNM CLASSIFICATION, SURVIVAL, CARCINOMA, METASTASIS, RECURRENCE, RESECTION, STOMACH, TRIAL ,METASTASIS ,Multivariate Analysis ,Lymph Node Excision ,Surgery ,Lymph Nodes ,business - Abstract
Aims The proportion between metastatic and examined lymph nodes (N-ratio) has been proposed as an independent prognostic factor in patients with gastric cancer. In the present work we validated the reliability of N-ratio in a large, multicenter series. Patients and methods We retrospectively reviewed the data of 1853 patients who underwent radical resection for gastric carcinoma. Survival of patients with >15 (Group-1, n = 1421) and those with ≤15 (Group-2, n = 432) lymph nodes examined was separately analyzed in order to evaluate the influence of lymph node dissection on disease staging. N-ratio categories (N-ratio 0, 0%; N-ratio 1, 1–9%; N-ratio 2, 10–25%; N-ratio 3, >25%) were determined by the best cut-off approach. Results At multivariate analysis, N-ratio (but not TNM N-category) was retained as an independent prognostic factor both in Group-1 and Group-2 (HR for N-ratio 1, N-ratio 2 and N-ratio 3 = 1.67, 2.96 and 6.59, and 1.56, 2.68 and 4.28, respectively). After a median follow-up of 45.5 months, the 5-year overall survival rates of TNM N0, N1 and N2 patients were significantly different in Group-1 vs Group-2. This was not the case when adopting the N-ratio classification, suggesting that a low number of excised lymph nodes can lead to patients being understaged using the N-category, but not N-ratio. Moreover, N-ratio identified subsets of patients with significantly different survival rates within TNM N1 and N2 categories in both groups. Conclusions N-ratio is a simple and reproducible prognostic tool that can stratify patients with gastric cancer, including those cases with limited lymph node dissection. These data support the rationale to propose the implementation of N-ratio into the current TNM staging system. more...
- Published
- 2008
44. The ratio between metastatic and examined lymph nodes (N ratio) is an independent prognostic factor in gastric cancer regardless of the type of lymphadenectomy: results from an Italian multicentric study in 1853 patients
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Luca Baiocchi, Franco Roviello, Donato Nitti, Alessandro Ambrosi, Domenico Garcea, Francesco De Santis, Giovanni de Manzoni, Arianna Coniglio, Paolo Morgagni, G. Natalini, Simone Mocellin, Annamaria Minicozzi, Daniele Marrelli, Alberto Marchet, Marchet, A, Mocellin, S, Ambrosi, Alessandro, Morgagni, P, Garcea, D, Marrelli, D, Roviello, F, de Manzoni, G, Minicozzi, A, Natalini, G, De Santis, F, Baiocchi, L, Coniglio, A, and Nitti, D. more...
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STAGE MIGRATION ,Male ,medicine.medical_specialty ,RESECTION ,CARCINOMA ,medicine.medical_treatment ,MODELS ,TNM staging system ,Gastroenterology ,TNM ,Metastasis ,surgery ,Stomach Neoplasms ,STOMACH ,Internal medicine ,N-ratio ,Gastric cancer ,Prognosis ,medicine ,Humans ,RECURRENCE ,Stomach cancer ,DISSECTION ,Lymph node ,Aged ,Neoplasm Staging ,Proportional Hazards Models ,Retrospective Studies ,business.industry ,Cancer ,RESIDUALS ,Retrospective cohort study ,TNM CLASSIFICATION ,Original Articles ,medicine.disease ,Surgery ,prognosis ,lymphadenectomy ,medicine.anatomical_structure ,Italy ,Lymphatic Metastasis ,Multivariate Analysis ,SURVIVAL ,Lymph Node Excision ,Lymphadenectomy ,Female ,Lymph ,business - Abstract
Purpose: To investigate whether the ratio between metastatic and examined lymph nodes (N ratio) is a better prognostic factor as compared with traditional staging systems in patients with gastric cancer regardless of the extension of lymph node dissection. Patients & Methods: We retrospectively reviewed the data of 1853 patients who underwent radical resection for gastric carcinoma at 6 Italian centers. Patients with >15 (group 1, n = 1421) and those with 25%) were determined by the best cut-off approach. Results: After a median follow-up of 45.5 months (range, 4-182 months), the 5-year overall survival of N0, N1, and N2 patients of group 1 versus group 2 was 83.4% versus 74.2% (P = 0.0026), 54.3% versus 44.3% (P = 0.018), and 32.7% versus 14.7% (P = 0.004), respectively, suggesting that a low number of excised lymph nodes can lead to the understaging of patients. N ratio identified subsets of patients with significantly different survival rates within NI and N2 stages in both groups. At multivariate analysis, the N ratio (but not N stage) was retained as an independent prognostic factor both in group I and group 2 (HR for N ratio 1, N ratio 2, and N ratio 3 = 1.67, 2.96, and 6.59, and 1.56, 2.68, and 4.28, respectively). In our series, the implementation of N ratio led to the identification of subgroups of patients prognostically more homogeneous than those classified by the TNM system. Conclusion: N ratio is a simple and reproducible prognostic tool that can stratify patients with gastric cancer also in case of limited lymph node dissection. These data may represent the rational for improving the prognostic power of current UICC TNM staging system and ultimately the selection of patients who may most benefit from adjuvant treatments. more...
- Published
- 2007
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