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4 results on '"Ferrari, Cecilia"'

1. Biliary Tree Cysts and Surgical Treatment: Outcomes in a Multicentric Study.

Author

Ferrari, Cecilia, Blanco Rodríguez, Manuel, Molina, Víctor, Martín, Belén, Espinet, Marina, Percivale, Andrea, Griseri, Guido, Moral, Antonio, and Sánchez-Cabús, Santiago

Subjects
*BILIARY tract, *CHOLANGITIS, *CHOLANGIOGRAPHY, *TREATMENT effectiveness, *CYSTS (Pathology), *ABDOMINAL pain, *RESEARCH, *BILE duct abnormalities, *RETROSPECTIVE studies, *EVALUATION research, *COMPARATIVE studies, *BILE ducts, *HEPATECTOMY, *DISEASE complications, WESTERN countries, BILE duct tumors
Abstract

Background: Biliary tree cysts (BTCs) represent an either localized or multifocal abnormal dilatation of the biliary tree, which entails an increased risk of acute cholangitis and cholangiocarcinoma (2.5%-16%). Its incidence in Western countries is ∼1/100.000-1/150.000, being more frequent in Asia (1/1.000). These cysts are usually classified according to Todani classification, which is based on site and morphology of cysts. Patients and Methods: This is a retrospective multicentric descriptive study of patients surgically treated for BTCs. From 2005 to 2018, 25 cases were collected between Hospital de la Santa Creu i Sant Pau (Barcelona, Spain) and Ospedale San Paolo (Savona, Italy). Clinical presentation was characterized by abdominal pain, jaundice, fever, and sometimes weight loss. Eight patients presented Todani type I, 1 patient Todani type II, 3 patients Todani III, 1 patient Todani type IV, and 12 patients Todani type V. Results: Among the 25 surgically treated patients, 12 patients underwent liver resection, 7 patients underwent resection of the extrahepatic biliary tree, 3 patients underwent BTC removal through a duodenotomy, 1 patient underwent resection of the extrahepatic biliary tree and liver resection, and 2 patients underwent pancreatoduodenectomy. Overall 30-day morbidity rate was 20%, and 90-day mortality was 0%. Pathologic examination confirmed diagnosis of cholangiocarcinoma in 5 patients (20%). After a median follow-up of 59 months, 20 patients are alive and in good conditions, whereas 50% of patients with cholangiocarcinoma died for disease progression. Conclusions: Surgical treatment for BTCs is associated with acceptable postoperative outcomes, with moderate morbidity and null mortality rates. Moreover, the risk of developing cholangiocarcinoma is still high that prompts surgical treatment once diagnosis is made. [ABSTRACT FROM AUTHOR]

Published
2022
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2. Factors Affecting Local and Intra Hepatic Distant Recurrence After Surgery for Hcc: An Alternative Perspective on Microvascular Invasion and Satellitosis – A Western European Multicentre Study.

Author

Famularo, Simone, Piardi, Tullio, Molfino, Sarah, Di Martino, Marcello, Ferrari, Cecilia, Ielpo, Benedetto, Diago, Maria Victoria, Giani, Alessandro, Griseri, Guido, Terés, Lara Bianco, Gianotti, Luca, Baiocchi, Gian Luca, Sommacale, Daniele, and Romano, Fabrizio

Subjects
LIVER surgery, SURGICAL site, DIAGNOSIS, SURGERY, ACQUISITION of data, LIVER
Abstract

Background: Few studies have focused on risk factors which may predict an intrahepatic local recurrence (LR) on the surgical edge rather than a distant recurrence (DR) in other liver segments after surgery for hepatocarcinoma (HCC). The purpose of this study was to assess the risk factors for both patterns of recurrence. Methods: An international, multicentre, retrospective study was conducted by collecting data on all consecutive patients with a first diagnosis of HCC who were treated between 2010 and 2017. The presence of macrovascular invasion was an exclusion criteria. Results: About 376 patients were enrolled, and, among them, 62 presented LR, while 90 had DR. Baseline characteristics were comparable between the two groups, but the DR group had a much higher rate of HCV infection (48.9% vs 29%, p 0.014) and a higher median nodule size (3.40 cm IQR 2.2–5.5 versus 3.0 cm IQR 2.0–5.0 in the LR group, p 0.025). A positive surgical margin (R1, HR 4.721; 95% CI 1.83–12.17; p 0.001) was the only independent risk factor for LR, while MVI (HR 1.837; 95% CI 1.03–3.77; p 0.039) and satellitosis (HR 2.440, 95% CI 1.43–3.77, p 0.001) were the only predictive factors for DR. Conclusion: MVI and satellitosis are predictive factors of intrahepatic distant recurrence, configuring a probable hallmark of advanced systemic disease, regardless of the treatment. LR has to be considered the expression of surgical failure. [ABSTRACT FROM AUTHOR]

Published
2021
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3. Benchmarking postoperative outcomes after open liver surgery for cirrhotic patients with hepatocellular carcinoma in a national cohort

Author

Simone Famularo, Nadia Russolillo, Matteo Donadon, Federica Cipriani, Francesco Ardito, Pasquale Perri, Alessandro Giani, Francesca De Stefano, Quirino Lai, Sarah Molfino, Matteo Zanello, Maurizio Iaria, Giuliano La Barba, Enrico Pinotti, Paola Germani, Simone Conci, Cecilia Ferrari, Luca Fumagalli, Maurizio Romano, Adelmo Antonucci, Giuseppe Zimmitti, Albert Troci, Antonio Floridi, Valentina Ferraro, Stefan Patauner, Antonio Frena, Riccardo Memeo, Michele Crespi, Mohammed A. Hilal, Giacomo Zanus, Marco Chiarelli, Andrea Percivale, Andrea Ruzzenente, Paola Tarchi, Mauro Zago, Giorgio Ercolani, Raffaele Dalla Valle, Elio Jovine, Gian Luca Baiocchi, Massimo Rossi, Marcello Maestri, Fabrizio Romano, Gian Luca Grazi, Felice Giuliante, Luca Aldrighetti, Alessandro Ferrero, Guido Torzilli, Guido Costa, Flavio Milana, Federico Fazio, Francesca Ratti, Francesco Razionale, Valerio De Peppo, Francesca Carissimi, Giorgio M. Paolo Graziano, Zoe Larghi Laurerio, Mario Giuffrida, Alessandro Cucchetti, Mauro Montuori, Davide Cosola, Pio Corleone, Giovanni Lazzari, Angelo Franceschi, Pietro Calcagno, Luca Salvador, Alberto Manzoni, Luca Pennacchi, Annarita Libia, Francesca Notte, Davide P. Bernasconi, Silvia Mori, Davide Gaudesi, Famularo, Simone, Russolillo, Nadia, Donadon, Matteo, Cipriani, Federica, Ardito, Francesco, Perri, Pasquale, Giani, Alessandro, De Stefano, Francesca, Lai, Quirino, Molfino, Sarah, Zanello, Matteo, Iaria, Maurizio, La Barba, Giuliano, Pinotti, Enrico, Germani, Paola, Conci, Simone, Ferrari, Cecilia, Fumagalli, Luca, Romano, Maurizio, Antonucci, Adelmo, Zimmitti, Giuseppe, Troci, Albert, Floridi, Antonio, Ferraro, Valentina, Patauner, Stefan, Frena, Antonio, Memeo, Riccardo, Crespi, Michele, Hilal, Mohammed A, Zanus, Giacomo, Chiarelli, Marco, Percivale, Andrea, Ruzzenente, Andrea, Tarchi, Paola, Zago, Mauro, Ercolani, Giorgio, Dalla Valle, Raffaele, Jovine, Elio, Baiocchi, Gian Luca, Rossi, Massimo, Maestri, Marcello, Romano, Fabrizio, Grazi, Gian Luca, Giuliante, Felice, Aldrighetti, Luca, Ferrero, Alessandro, and Torzilli, Guido

Subjects
Liver Cirrhosis, Carcinoma, Hepatocellular, Hepatology, Settore MED/18 - CHIRURGIA GENERALE, Carcinoma, Liver Neoplasms, Gastroenterology, Achievable Benchmark of Care, Hepatocellular, hepatocellular carcinoma, NO, Benchmarking, Postoperative Complications, Cirrhosis, Liver, best achievable results, Hepatectomy, Humans, cirrhotic patients, liver surgery, Liver Failure, LS7_4, Retrospective Studies
Abstract

Benchmark analysis for open liver surgery for cirrhotic patients with hepatocellular carcinoma (HCC) is still undefined.Patients were identified from the Italian national registry HE.RC.O.LE.S. The Achievable Benchmark of Care (ABC) method was employed to identify the benchmarks. The outcomes assessed were the rate of complications, major comorbidities, post-operative ascites (POA), post-hepatectomy liver failure (PHLF), 90-day mortality. Benchmarking was stratified for surgical complexity (CP1, CP2 and CP3).A total of 978 of 2698 patients fulfilled the inclusion criteria. 431 (44.1%) patients were treated with CP1 procedures, 239 (24.4%) with CP2 and 308 (31.5%) with CP3 procedures. Patients submitted to CP1 had a worse underlying liver function, while the tumor burden was more severe in CP3 cases. The ABC for complications (13.1%, 19.2% and 28.1% for CP1, CP2 and CP3 respectively), major complications (7.6%, 11.1%, 12.5%) and 90-day mortality (0%, 3.3%, 3.6%) increased with the surgical difficulty, but not POA (4.4%, 3.3% and 2.6% respectively) and PHLF (0% for all groups).We propose benchmarks for open liver resections in HCC cirrhotic patients, stratified for surgical complexity. The difference between the benchmark values and the results obtained during everyday practice reflects the room for potential growth, with the aim to encourage constant improvement among liver surgeons.

Published
2022

4. Curative versus palliative treatments for recurrent hepatocellular carcinoma: a multicentric weighted comparison

Author

Simone Famularo, Matteo Donadon, Federica Cipriani, Davide P. Bernasconi, Giuliano LaBarba, Tommaso Dominioni, Maurizio Iaria, Sarah Molfino, Simone Conci, Cecilia Ferrari, Marco Garatti, Antonella Delvecchio, Albert Troci, Stefan Patauner, Silvia Frassani, Maurizio Cosimelli, Giacomo Zanus, Felice Giuliante, Elio Jovine, Maria G. Valsecchi, GianLuca Grazi, Adelmo Antonucci, Antonio Frena, Michele Crespi, Riccardo Memeo, Giuseppe Zimmitti, Guido Griseri, Andrea Ruzzenente, Gianluca Baiocchi, Raffaele DallaValle, Marcello Maestri, Giorgio Ercolani, Luca Aldrighetti, Guido Torzilli, Fabrizio Romano, Cristina Ciulli, Alessandro Giani, Francesca Carissimi, Guido Costa, Francesca Ratti, Alessandro Cucchetti, Francesco Calabrese, Elena Cremaschi, Giovanni Lazzari, Angelo Franceschi, Valentina Sega, Maria Conticchio, Luca Pennacchi, Michele Ciola, Ivano Sciannamea, Valerio De Peppo, Famularo S., Donadon M., Cipriani F., Bernasconi D.P., LaBarba G., Dominioni T., Iaria M., Molfino S., Conci S., Ferrari C., Garatti M., Delvecchio A., Troci A., Patauner S., Frassani S., Cosimelli M., Zanus G., Giuliante F., Jovine E., Valsecchi M.G., Grazi G., Antonucci A., Frena A., Crespi M., Memeo R., Zimmitti G., Griseri G., Ruzzenente A., Baiocchi G., DallaValle R., Maestri M., Ercolani G., Aldrighetti L., Torzilli G., Romano F., Ciulli C., Giani A., Carissimi F., Costa G., Ratti F., Cucchetti A., Calabrese F., Cremaschi E., Lazzari G., Franceschi A., Sega V., Conticchio M., Pennacchi L., Ciola M., Sciannamea I., De Peppo V., Famularo, Simone, Donadon, Matteo, Cipriani, Federica, Bernasconi, Davide P, Labarba, Giuliano, Dominioni, Tommaso, Iaria, Maurizio, Molfino, Sarah, Conci, Simone, Ferrari, Cecilia, Garatti, Marco, Delvecchio, Antonella, Troci, Albert, Patauner, Stefan, Frassani, Silvia, Cosimelli, Maurizio, Zanus, Giacomo, Giuliante, Felice, Jovine, Elio, Valsecchi, Maria G, Grazi, Gianluca, Antonucci, Adelmo, Frena, Antonio, Crespi, Michele, Memeo, Riccardo, Zimmitti, Giuseppe, Griseri, Guido, Ruzzenente, Andrea, Baiocchi, Gianluca, Dallavalle, Raffaele, Maestri, Marcello, Ercolani, Giorgio, Aldrighetti, Luca, Torzilli, Guido, and Romano, Fabrizio

Subjects
Sorafenib, medicine.medical_specialty, recurrence, Carcinoma, Hepatocellular, Tumor burden, 030230 surgery, liver, Gastroenterology, NO, 03 medical and health sciences, 0302 clinical medicine, hepatectomy, Retrospective Studie, Internal medicine, Humans, Medicine, Chemoembolization, Therapeutic, Liver surgery, Retrospective Studies, LS7_4, Hepatology, business.industry, Palliative Care, Liver Neoplasms, hepatocellular carcinoma, medicine.disease, Recurrent Hepatocellular Carcinoma, multicentric, Treatment Outcome, Time to recurrence, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, Liver function, Neoplasm Recurrence, Local, business, medicine.drug, Human
Abstract

Background Management of recurrence after surgery for hepatocellular carcinoma (rHCC) is still a debate. The aim was to compare the Survival after Recurrence (SAR) of curative (surgery or thermoablation) versus palliative (TACE or Sorafenib) treatments for patients with rHCC. Methods This is a multicentric Italian study, which collected data between 2007 and 2018 from 16 centers. Selected patients were then divided according to treatment allocation in Curative (CUR) or Palliative (PAL) Group. Inverse Probability Weighting (IPW) was used to weight the groups. Results 1,560 patients were evaluated, of which 421 experienced recurrence and were then eligible: 156 in CUR group and 256 in PAL group. Tumor burden and liver function were weighted by IPW, and two pseudo-population were obtained (CUR = 397.5 and PAL = 415.38). SAR rates at 1, 3 and 5 years were respectively 98.3%, 76.7%, 63.8% for CUR and 91.7%, 64.2% and 48.9% for PAL (p = 0.007). Median DFS was 43 months (95%CI = 32-74) for CUR group, while it was 23 months (95%CI = 18-27) for PAL (p = 0.017). Being treated by palliative approach (HR = 1.75; 95%CI = 1.14–2.67; p = 0.01) and having a median size of the recurrent nodule>5 cm (HR = 1.875; 95%CI = 1.22–2.86; p = 0.004) were the only predictors of mortality after recurrence, while time to recurrence was the only protective factor (HR = 0.616; 95%CI = 0.54–0.69; p Conclusion Curative approaches may guarantee long-term survival in case of recurrence.

Published
2021

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