21 results on '"Diana Bacchin"'
Search Results
2. New Insights in Pleural Mesothelioma Classification Update: Diagnostic Traps and Prognostic Implications
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Maria Giovanna Mastromarino, Alessandra Lenzini, Vittorio Aprile, Greta Alì, Diana Bacchin, Stylianos Korasidis, Marcello Carlo Ambrogi, and Marco Lucchi
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malignant pleural mesothelioma ,tumor grade ,mesothelioma classification ,histological subtypes ,epithelioid mesothelioma ,histology ,Medicine (General) ,R5-920 - Abstract
The 2021 WHO Classification of Tumors of the Pleura has introduced significant changes in mesothelioma codification beyond the three current histological subtypes—epithelioid, sarcomatoid and biphasic. Major advances since the 2015 WHO classification include nuclear grading and the introduction of architectural patterns, cytological and stromal features for epithelioid diffuse mesothelioma. Mesothelioma in situ has been recognized as a diagnostic category. Demonstration of loss of BAP1 or MTAP by immunohistochemistry, or CDKN2A homozygous deletion by FISH, is valuable in establishing the diagnosis of epithelioid mesothelioma. Recent emerging data proved that grading and histological subtypes have prognostic implications and may be helpful to patient risk stratification and clinical management. Nevertheless, the latest mesothelioma classification increases the already non-negligible diagnostic pitfalls, especially concerning differential diagnosis of pre-invasive tumors. In this review, recent changes in histologic classification of mesothelioma and advances in molecular markers are presented and their relation to diagnostic challenges and prognostic implications is discussed.
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- 2022
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3. Intraoperative prevention and conservative management of postoperative prolonged air leak after lung resection: a systematic review
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Vittorio Aprile, Diana Bacchin, Fabrizia Calabrò, Stylianos Korasidis, Maria Giovanna Mastromarino, Marcello Carlo Ambrogi, and Marco Lucchi
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Pulmonary and Respiratory Medicine - Published
- 2023
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4. Cold coagulation in thoracoscopic treatment of primary pneumothorax: a comparison with apicectomy
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Vittorio Aprile, Diana Bacchin, Elena Marrama, Stylianos Korasidis, Maria Giovanna Mastromarino, Gerardo Palmiero, Marcello Carlo Ambrogi, and Marco Lucchi
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OBJECTIVESPrimary spontaneous pneumothorax is a common disease, whose surgical treatment is still enigmatic in terms of timing and technique. Herein, we reported our experience with the parenchymal-sparing technique via cold coagulation (CC), in comparison to stapler apicectomy (SA).METHODSWe retrospectively collected data of all patients with apical blebs or RESULTSOut of 177 patients enrolled, 77 patients (CC group) underwent cold-coagulation of the apex while 100 patients (SA group) were treated with SA. Two groups were comparable in terms of age, surgical indication, intraoperative findings and affected side. CC group had a mean operative time of 43.2 min (standard deviation ± 19.5), shorter than SA group with 49.3 min (standard deviation ± 20.1, P-value: 0.050). Complication rate was significantly different between 2 groups, 5 (7%) and 16 (16%), for the CC and SA groups, respectively (P: 0.048), even if not in terms of prolonged postoperative air leak (P: 0.16). During the follow-up, 13 homolateral recurrences were reported: 2 (3%) in group CC and 11 (11%) in group SA; with a significant difference (P: 0.044). All reinterventions (postoperative prolonged air leak and recurrences) required an SA.CONCLUSIONSParenchymal-sparing technique through CC of apical blebs and bullae is an effective treatment for primary spontaneous pneumothorax and guarantees a good immediate lung sealing, despite stapling still represents the choice treatment in complex cases.
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- 2023
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5. Impact of High-Grade Patterns in Early-Stage Lung Adenocarcinoma: A Multicentric Analysis
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Pietro Bertoglio, Vittorio Aprile, Luigi Ventura, Maria Cattoni, Dania Nachira, Filippo Lococo, Maria Rodriguez Perez, Francesco Guerrera, Fabrizio Minervini, Giulia Querzoli, Giovanni Bocchialini, Diana Bacchin, Francesca Franzi, Guido Rindi, Salvatore Bellafiore, Federico Femia, Giuseppe Salvatore Bogina, Piergiorgio Solli, Peter Kestenholz, Enrico Ruffini, Massimiliano Paci, Stefano Margaritora, Andrea Selenito Imperatori, Marco Lucchi, Letizia Gnetti, and Alberto Claudio Terzi
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Pulmonary and Respiratory Medicine ,Lung adenocarcinoma ,Male ,Lung Neoplasms ,TNM staging ,Adenocarcinoma of Lung ,Adenocarcinoma ,Prognosis ,Lung adenocarcinoma, TNM staging, Lung cancer, Adenocarcinoma subtypes ,Adenocarcinoma subtypes ,Humans ,Female ,Lung cancer ,Neoplasm Recurrence, Local ,Neoplasm Staging ,Retrospective Studies - Abstract
Objective The presence of micropapillary and solid adenocarcinoma patterns leads to a worse survival and a significantly higher tendency to recur. This study aims to assess the impact of pT descriptor combined with the presence of high-grade components on long-term outcomes in early-stage lung adenocarcinomas. Methods We retrospectively collected data of consecutive resected pT1-T3N0 lung adenocarcinoma from nine European Thoracic Centers. All patients who underwent a radical resection with lymph-node dissection between 2014 and 2017 were included. Differences in Overall Survival (OS) and Disease-Free Survival (DFS) and possible prognostic factors associated with outcomes were evaluated also after performing a propensity score matching to compare tumors containing non-high-grade and high-grade patterns. Results Among 607 patients, the majority were male and received a lobectomy. At least one high-grade histological pattern was seen in 230 cases (37.9%), of which 169 solid and 75 micropapillary. T1a-b-c without high-grade pattern had a significant better prognosis compared to T1a-b-c with high-grade pattern (p = 0.020), but the latter had similar OS compared to T2a (p = 0.277). Concurrently, T1a-b-c without micropapillary or solid patterns had a significantly better DFS compared to those with high-grade patterns (p = 0.034), and it was similar to T2a (p = 0.839). Multivariable analysis confirms the role of T descriptor according to high-grade pattern both for OS (p = 0.024; HR 1.285 95% CI 1.033–1.599) and DFS (p = 0.003; HR 1.196, 95% CI 1.054–1.344, respectively). These results were confirmed after the propensity score matching analysis. Conclusions pT1 lung adenocarcinomas with a high-grade component have similar prognosis of pT2a tumors.
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- 2022
6. Unradical Surgery for Locally-Advanced Thymoma: Is it time to evolve Perspectives?
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Maria Giovanna Mastromarino, Diana Bacchin, Vittorio Aprile, Ilaria Ceccarelli, Stylianos Korasidis, Alessandra Lenzini, Marcello Carlo Ambrogi, and Marco Lucchi
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Pulmonary and Respiratory Medicine ,Cancer Research ,Oncology - Published
- 2023
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7. Pathological and clinical features of multiple cancers and lung adenocarcinoma: a multicentre study
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Pietro Bertoglio, Luigi Ventura, Vittorio Aprile, Maria Angela Cattoni, Dania Nachira, Filippo Lococo, Maria Rodriguez Perez, Francesco Guerrera, Fabrizio Minervini, Letizia Gnetti, Alessandra Lenzini, Francesca Franzi, Giulia Querzoli, Guido Rindi, Salvatore Bellafiore, Federico Femia, Giuseppe Salvatore Bogina, Diana Bacchin, Peter Kestenholz, Enrico Ruffini, Massimiliano Paci, Stefano Margaritora, Andrea Selenito Imperatori, Marco Lucchi, Luca Ampollini, and Alberto Claudio Terzi
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Male ,Pulmonary and Respiratory Medicine ,Adenocarcinoma subtype ,Lung adenocarcinoma ,Lung Neoplasms ,Adenocarcinoma of Lung ,Multiple cancers ,Adenocarcinoma ,Prognosis ,Lung cancer ,Thoracic surgery ,Humans ,Surgery ,Cardiology and Cardiovascular Medicine ,Neoplasm Staging ,Retrospective Studies - Abstract
OBJECTIVES Lung cancer is increasingly diagnosed as a second cancer. Our goal was to analyse the characteristics and outcomes of early-stage resected lung adenocarcinomas in patients with previous cancers (PC) and correlations with adenocarcinoma subtypes. METHODS We retrospectively reviewed data of patients radically operated on for stage I–II lung adenocarcinoma in 9 thoracic surgery departments between 2014 and 2017. Overall survival (OS) and time to disease relapse were evaluated between subgroups. RESULTS We included 700 consecutive patients. PC were present in 260 (37.1%). Breast adenocarcinoma, lung cancer and prostate cancer were the most frequent (21.5%, 11.5% and 11.2%, respectively). No significant differences in OS were observed between the PC and non-PC groups (P = 0.378), with 31 and 75 deaths, respectively. Patients with PC had smaller tumours and were more likely to receive sublobar resection and to be operated on with a minimally invasive approach. Previous gastric cancer (P = 0.042) and synchronous PC (when diagnosed up to 6 months before lung adenocarcinoma; P = 0.044) were related, with a worse OS. Colon and breast adenocarcinomas and melanomas were significantly related to a lower incidence of high grade (solid or micropapillary, P = 0.0039, P = 0.005 and P = 0.028 respectively), whereas patients affected by a previous lymphoma had a higher incidence of a micropapillary pattern (P = 0.008). CONCLUSIONS In patients with PC, we found smaller tumours more frequently treated with minimally invasive techniques and sublobar resection, probably due to a more careful follow-up. The impact on survival is not uniform and predictable; however, breast and colon cancers and melanoma showed a lower incidence of solid or micropapillary patterns whereas patients with lymphomas had a higher incidence of a micropapillary pattern.
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- 2022
8. An asymptomatic giant AB thymoma in a patient with Down syndrome: a case report
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Elisa Sicolo, Vittorio Aprile, Tommaso Ferrarello, Diana Bacchin, Maria Giovanna Mastromarino, Greta Alì, Marcello Carlo Ambrogi, Marco Lucchi, and Stylianos Korasidis
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Pulmonary and Respiratory Medicine ,Oncology ,Endocrinology, Diabetes and Metabolism ,Medicine (miscellaneous) ,Radiology, Nuclear Medicine and imaging ,Cardiology and Cardiovascular Medicine - Published
- 2022
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9. Hyperthermic Intrathoracic Chemotherapy for Malignant Pleural Mesothelioma: The Forefront of Surgery-Based Multimodality Treatment
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Filippo Lococo, Marco Lucchi, Giovanni Guglielmi, Diana Bacchin, Alessandra Lenzini, Marcello Carlo Ambrogi, Stylianos Korasidis, Gerardo Palmiero, Maria Giovanna Mastromarino, and Vittorio Aprile
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Chemotherapy ,medicine.medical_specialty ,business.industry ,Pleural mesothelioma ,medicine.medical_treatment ,Multimodality Treatment ,HITHOC ,Hypertermia ,Local treatment ,Mesothelioma ,Review ,General Medicine ,medicine.disease ,chemotherapy ,Surgery ,local treatment ,mesothelioma ,medicine ,Overall survival ,Medicine ,Complication rate ,Cytoreductive surgery ,business ,Radical resection ,hypertermia - Abstract
Introduction: Malignant Pleural Mesothelioma (MPM) is characterized by an aggressive behavior and an inevitably fatal prognosis, whose treatment is still far from being standardized. The role of surgery is questionable since a radical resection is unattainable in most cases. Hyperthermic IntraTHOracic Chemotherapy (HITHOC) combines the advantages of antitumoral effects together with those of high temperature on the exposed tissues with the aim to improve surgical radicality. Material and Methods: this is a narrative review on the role of HITHOC in the management of MPM patients. To provide data on the beginnings and the historical evolution of this technique, we searched the available literature by selecting the more exhaustive papers on this topic. Results: from 1994 to date different authors experimented HITHOC following a cytoreductive surgery in MPM, obtaining in most cases a good local control and a better overall survival associated to very low complication rate. Conclusions: HITHOC may be considered as a safe, feasible and effective procedure although there is a high heterogeneity between different protocols adopted worldwide. More structured studies are needed to reach a unanimous consensus on this technique.
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- 2021
10. Prognostic role of standard uptake value according to pathologic features of lung adenocarcinoma
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Francesca Franzi, Vittorio Aprile, Diana Bacchin, Massimiliano Paci, Peter Kestenholz, Paolo Carbognani, Andrea Viti, Giulia Querzoli, Salvatore Bellafiore, Filippo Lococo, Federico Femia, Letizia Gnetti, Marco Lucchi, Pietro Bertoglio, Dania Nachira, Maria Rodriguez Perez, Fabrizio Minervini, Alberto Terzi, Maria Cattoni, Stefano Margaritora, Luigi Ventura, Guido Rindi, Andrea Imperatori, Francesco Guerrera, and Enrico Ruffini
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Cancer Research ,Pathology ,medicine.medical_specialty ,Lung Neoplasms ,PET-CT ,Standardized uptake value ,Adenocarcinoma of Lung ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Fluorodeoxyglucose F18 ,Positron Emission Tomography Computed Tomography ,medicine ,Humans ,Lung cancer ,Neoplasm Staging ,Retrospective Studies ,Lung ,business.industry ,General Medicine ,medicine.disease ,Prognosis ,lung adenocarcinoma ,SUV ,lung cancer ,medicine.anatomical_structure ,Oncology ,030220 oncology & carcinogenesis ,Positron-Emission Tomography ,Adenocarcinoma ,business - Abstract
Objective: To evaluate the influence of lung adenocarcinoma second predominant pattern on the maximal standard uptake value (SUVmax) and its prognostic effect in different histologic groups. Methods: We retrospectively collected surgically resected pathologic stage I and II lung adenocarcinoma from nine European institutions. Only patients who underwent preoperative PET-CT and with available information regarding SUVmax of T (SUVmaxT) and N1 (SUVmaxN1) component were included. Results: We enrolled 344 patients with lung adenocarcinoma. SUVmaxT did not show any significant relation according to the second predominant pattern ( p = 0.139); this relationship remained nonsignificant in patients with similar predominant pattern. SUVmaxT influenced the disease-free survival in the whole cohort ( p = 0.002) and in low- and intermediate-grade predominant pattern groups ( p = 0.040 and p = 0.008, respectively). In the high-grade predominant pattern cohort and in the pathologic N1 cases, SUVmaxT lost its prognostic power. SUVmaxN1 did not show any significant correlation with predominant and second predominant patterns and did not have any prognostic impact on DFS. Conclusions: SUVmaxT is influenced only by the adenocarcinoma predominant pattern, but not by second predominant pattern. Concurrently, in high-grade predominant pattern and pN1 group the prognostic power of SUVmaxT becomes nonsignificant.
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- 2021
11. Prognostic impact of lung adenocarcinoma second predominant pattern from a large European database
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Andrea Viti, Marco Lucchi, Maria Rodriguez Perez, Diana Bacchin, Filippo Lococo, Stefano Margaritora, Alberto Terzi, Luigi Ventura, Letizia Gnetti, Enrico Ruffini, Guido Rindi, Salvatore Bellafiore, Giulia Querzoli, Massimiliano Paci, Francesca Franzi, Maria Cattoni, Federico Femia, Dania Nachira, Pietro Bertoglio, Fabrizio Minervini, Luca Ampollini, Francesco Guerrera, Giuseppe Bogina, Andrea Imperatori, Peter Kestenholz, and Vittorio Aprile
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Male ,Lung Neoplasms ,Databases, Factual ,medicine.medical_treatment ,Papillary ,Acinar Cell ,Gastroenterology ,0302 clinical medicine ,Settore MED/21 - CHIRURGIA TORACICA ,Lung cancer surgery ,General Medicine ,Prognosis ,Europe ,Survival Rate ,Adenocarcinoma, Papillary ,medicine.anatomical_structure ,lung adenocarcinoma ,lung cancer biology ,lung cancer surgery ,non-small-cell lung cancer ,Adenocarcinoma of Lung ,Aged ,Carcinoma, Acinar Cell ,Female ,Follow-Up Studies ,Humans ,Neoplasm Recurrence, Local ,Retrospective Studies ,Oncology ,Local ,030220 oncology & carcinogenesis ,Adenocarcinoma ,030211 gastroenterology & hepatology ,medicine.medical_specialty ,03 medical and health sciences ,Databases ,Internal medicine ,medicine ,Pathological ,Factual ,Cancer staging ,Lung ,business.industry ,Carcinoma ,Retrospective cohort study ,Histology ,medicine.disease ,Neoplasm Recurrence ,Surgery ,Lymphadenectomy ,business - Abstract
Background and objectives Adenocarcinoma patterns could be grouped based on clinical behaviors: low- (lepidic), intermediate- (papillary or acinar), and high-grade (micropapillary and solid). We analyzed the impact of the second predominant pattern (SPP) on disease-free survival (DFS). Methods We retrospectively collected data of surgically resected stage I and II adenocarcinoma. Selection criteria anatomical resection with lymphadenectomy and pathological N0. Pure adenocarcinomas and mucinous subtypes were excluded. Recurrence rate and factors affecting DFS were analyzed according to the SPP focusing on intermediate-grade predominant pattern adenocarcinomas. Results Among 270 patients, 55% were male. The mean age was 68.3 years. SPP pattern appeared as follows: lepidic 43.0%, papillary 23.0%, solid 14.4%, acinar 11.9%, and micropapillary 7.8%. The recurrence rate was 21.5% and 5-year DFS was 71.1%. No difference in DFS was found according to SPP (p = .522). In patients with high-grade SPP, the percentage of SPP, age, and tumor size significantly influenced DFS (p = .016). In patients with lepidic SPP, size, male gender, and lymph-node sampling (p = .005; p = .014; p = .038, respectively) significantly influenced DFS. Conclusions The impact of SPP on DFS is not homogeneous in a subset of patients with the intermediate-grade predominant patterns. The influence of high-grade SPP on DFS is related to its proportion in the tumor.
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- 2021
12. Hypertermic Intrathoracic Chemotherapy (HITHOC) for thymoma: a narrative review on indications and results
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Vittorio Aprile, Marco Lucchi, Roberta Ricciardi, Stylianos Korasidis, Iacopo Petrini, Marcello Carlo Ambrogi, and Diana Bacchin
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Chemotherapy ,medicine.medical_specialty ,Thymoma ,business.industry ,medicine.medical_treatment ,intracavitary chemotherapy ,Review Article on Hyperthermic Intraoperative Chemotherapy (HITHOC) in Thoracic Surgical Oncology ,General Medicine ,Hypertermic intrathoracic chemotherapy (HITHOC) ,thymoma ,hyperthermia ,redo-surgery ,medicine.disease ,Myasthenia gravis ,Surgery ,Radiation therapy ,Natural history ,Serous fluid ,medicine ,Disseminated disease ,Stage (cooking) ,business - Abstract
OBJECTIVE: With this narrative review, we retraced the history of hypertermic intrathoracic chemotherapy (HITHOC) since the beginning, analyzing literature on operative technique, feasibility and efficacy of this treatment. Moreover, we report the fifteen-year experience of our center in this relatively new technique, for what concerns both early postoperative results and long-term oncological outcomes. BACKGROUND: Thymomas are frequently misdiagnosed and recognized in advanced stage, often with pleural dissemination, especially when not associated to Myasthenia Gravis that allows an early diagnosis during the initial assessment. Moreover, the natural history of locally advanced thymoma is characterized by a high rate of pleural or pericardial relapses. Surgery has always been considered a milestone in thymoma’s treatment, even in case of serous dissemination or relapses, although his role as exclusive therapy does not guarantee an acceptable local disease control. In case of disseminated disease, different multidisciplinary protocols have been experimented, from chemotherapy to radiation therapy, alone or associated to surgery, in order to increase overall and disease-free survival, but the breakthrough happened in the early 90s with the introduction of HITHOC following surgery. Combination of surgery and HITHOC resulted in less toxic than systemic chemotherapy and providing a good local disease control in patients with stage IVa thymomas or thymoma’s pleural recurrences. METHODS: We searched PubMed for relevant literature, up to January 2020, on hypertermic intrapleural chemotherapy for thymomas (TPR or DNT), selecting only those reporting information about HITHOC protocol used, postoperative course and oncological outcomes. CONCLUSIONS: HITHOC is a safe and feasible procedure, with a very low complication rate and negligible systemic effects of chemotherapeutic agents, effective in controlling both TPR and DNT, in particular as regards local disease-free survival. KEYWORDS: Hypertermic intrathoracic chemotherapy (HITHOC); thymoma; intracavitary chemotherapy; hyperthermia; redo-surgery
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- 2021
13. Thymectomy in myasthenic patients with thymoma: killing two birds with one stone
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Diana Bacchin, Giovanni Petralli, Stylianos Korasidis, Marco Lucchi, Vittorio Aprile, Marcello Carlo Ambrogi, Iacopo Petrini, and Roberta Ricciardi
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Adult ,Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Time Factors ,Thymoma ,Adolescent ,medicine.medical_treatment ,Extended thymectomy ,Disease-Free Survival ,Young Adult ,Risk Factors ,Myasthenia Gravis ,medicine ,Overall survival ,Humans ,Neurologic disease ,Stage (cooking) ,Child ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Advanced stage ,Middle Aged ,Thymectomy ,medicine.disease ,Myasthenia gravis ,Surgery ,Female ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
Background Thymoma and myasthenia gravis share several pathogenetic aspects including the role of surgery as a therapeutic option. Extended thymectomy is associated with excellent survival and good local control, especially in early stages, and its role for the neurologic disease has been recently validated. The aim of this study is evaluating oncologic and neurologic outcomes of myasthenic patients with thymoma who underwent extended thymectomy. Methods We retrospectively collected surgical, oncologic, and neurologic data of all myasthenic patients with thymoma who underwent extended thymectomy at our department from January 1994 to December 2016. Clinical and pathologic data, neurologic remission rate, and overall survival and disease-free interval were analyzed. Results In all, 219 patients underwent extended thymectomy. The B2 histotype was the most represented thymoma (24.2%), and the most prevalent pathologic Masaoka stage was IIB (37.9%). The overall survival and disease-free survival were statistically different between early stage and advanced stage. During the surveillance, 33 patients (15.1%) had recurrences, treated in 21 cases with iterative surgery. Regarding neurologic outcomes, 75 patients (34.2%) reached a complete stable remission, 84 (38.4%) a pharmacologic remission, 51 (23.3%) had an improvement of their symptoms, and in 9 patients (4.1%) myasthenia was unchanged or worsened. Conclusions Surgery is a cornerstone in the treatment of patients with both thymoma and myasthenia gravis. Extended thymectomy, as proposed by Masaoka, offers considerable oncologic outcomes with an excellent survival and low recurrence rate of thymoma; moreover, surgery leads to remarkable neurologic results.
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- 2020
14. A narrative review on lymphadenectomy: from open to minimally invasive surgery
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Diana Bacchin, Elisa Sicolo, Stylianos Korasidis, Maria Giovanna Mastromarino, Ilaria Ceccarelli, Marcello Carlo Ambrogi, Marco Lucchi, and Vittorio Aprile
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,thoracotomy (TX) ,business.industry ,General surgery ,medicine.medical_treatment ,Lymphadenectomy ,video-assisted thoracic surgery (VATS) ,Computer Science Applications ,robotic-assisted thoracic surgery (RATS) ,non-small cell lung cancer (NSCLC) ,Invasive surgery ,medicine ,Surgery ,Narrative review ,business - Published
- 2022
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15. OA06.02 High-Grade Patterns Cause the Upstaging of Lung Adenocarcinomas From T1 to T2a: A Multicentric Analysis
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Peter Kestenholz, M. Rodriguez-Perez, Giulia Querzoli, F. Lococo, Alberto Terzi, Diana Bacchin, Vittorio Aprile, G. Bocchialini, Piergiorgio Solli, Francesco Guerrera, Stefano Margaritora, Enrico Ruffini, D. Nachira, Fabrizio Minervini, Federico Femia, Massimiliano Paci, Marco Lucchi, P. Bertoglio, Giuseppe Bogina, Francesca Franzi, Andrea Imperatori, G. Rindi, Salvatore Bellafiore, Maria Cattoni, Luigi Ventura, and Letizia Gnetti
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Pulmonary and Respiratory Medicine ,Pathology ,medicine.medical_specialty ,Lung ,medicine.anatomical_structure ,Oncology ,business.industry ,Medicine ,business - Published
- 2021
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16. Extended surgery of antero-superior mediastinum
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Stylianos Korasidis, Diana Bacchin, Marco Lucchi, Vittorio Aprile, and Marcello Carlo Ambrogi
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Extended surgery ,medicine.medical_specialty ,Treatment plan ,business.industry ,General surgery ,Superior mediastinum ,medicine.medical_treatment ,Extracorporeal circulation ,medicine ,General Medicine ,business ,Prosthesis - Abstract
Surgery of large mediastinal tumors is a great challenge for the surgeons due to wide number of organs that may be involved despite the narrow space. Any treatment plan should be thoroughly planned step-by-step since the diagnosis to assess the features of the tumor and its relationship with the surrounding organs. Radicality is main goal of the surgeons even if this includes the sacrifice of some structure and the reconstruction of others. Cooperation with the anesthesiologist and surgeons of other speciality is often necessary especially in case of infiltrating tumors. Evolution of the surgical technique end of the peri-operative management as well as the availability of new-generation prosthesis and the increasingly widespread of extracorporeal circulation (ECC) have turned this kind of surgery into a feasible, safe and effective procedure. The cornerstones of this surgery are a detailed preoperative assessment, the ability to prevent any potential complication and involve a multidisciplinary equipe.
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- 2019
17. P08.01 Prognostic Impact of Second Predominant Pattern in Lung Adenocarcinoma: Analysis From a Large Multicentric European Database
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Diana Bacchin, M. Rodriguez, Enrico Ruffini, Francesca Franzi, Giulia Querzoli, P. Bertoglio, Guido Rindi, Luca Ampollini, Dania Nachira, Vittorio Aprile, Letizia Gnetti, Federico Femia, Andrea Imperatori, Filippo Lococo, Marco Lucchi, Alberto Terzi, Maria Cattoni, Luigi Ventura, Francesco Guerrera, Massimiliano Paci, Fabrizio Minervini, Andrea Viti, Salvatore Bellafiore, Stefano Margaritora, and Peter Kestenholz
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Pulmonary and Respiratory Medicine ,Oncology ,medicine.medical_specialty ,Lung ,medicine.anatomical_structure ,business.industry ,Internal medicine ,medicine ,Adenocarcinoma ,medicine.disease ,business - Published
- 2021
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18. Expectancy survival of malignant pleural effusion patients treated with thoracoscopic pleurodesis related to histology
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Diana Bacchin, Marcello Carlo Ambrogi, Stylianos Korasidis, Elisa Sicolo, Vittorio Aprile, and Marco Lucchi
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medicine.medical_specialty ,Thoracoscopic pleurodesis ,business.industry ,medicine ,Malignant pleural effusion ,Histology ,General Medicine ,medicine.disease ,business ,Surgery - Published
- 2020
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19. P2.15-02 Primary Salivary Gland-Type Lung Tumours, Surgically Treatable Rare Entity Lung Cancer: A Sixteen-Year Experience of a Single Centre
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Marcello Carlo Ambrogi, F Melfi, Greta Alì, Sara Ricciardi, Diana Bacchin, Marco Lucchi, and Gabriella Fontanini
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Pulmonary and Respiratory Medicine ,Pathology ,medicine.medical_specialty ,Salivary gland ,business.industry ,Rare entity ,medicine.disease ,Single centre ,medicine.anatomical_structure ,Oncology ,medicine ,Lung tumours ,Lung cancer ,business - Published
- 2019
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20. P2.17-29 Impact of Second Predominant Pattern on Recurrence in Early Stage Resected Lung Adenocarcinoma: A Multicentric Study
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Diana Bacchin, M.D. Lozano Escario, Andrea Imperatori, Andrea Viti, Francesca Franzi, M. Rodriguez, Guido Rindi, Federico Femia, Giulia Querzoli, Enrico Ruffini, Marco Lucchi, P. Bertoglio, Massimiliano Paci, L. Garcia Tobar, Dania Nachira, Francesco Guerrera, Salvatore Bellafiore, Filippo Lococo, Maria Cattoni, Alberto Terzi, Stefano Margaritora, and Vittorio Aprile
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Pulmonary and Respiratory Medicine ,Pathology ,medicine.medical_specialty ,Lung ,medicine.anatomical_structure ,Oncology ,business.industry ,medicine ,Adenocarcinoma ,Stage (cooking) ,medicine.disease ,business - Published
- 2019
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21. Mediastinal lymph node metastases in thyroid cancer: surgery without limits
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Diana Bacchin, Elena Marrama, Agnese Nesti, Vittorio Aprile, Marco Lucchi, and Gabriele Materazzi
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medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Extracorporeal circulation ,Medullary thyroid cancer ,Neck dissection ,General Medicine ,Perioperative ,medicine.disease ,Surgery ,Radiation therapy ,Thyroid carcinoma ,Mediastinal lymph node ,medicine ,business ,Thyroid cancer - Abstract
Metastases to lymph nodes of the superior mediastinum have been found in up to 10% of patients with thyroid carcinoma. The treatment of mediastinal lymph node metastases in thyroid cancer is still far from being standardized. However, in selected cases, especially in case of radioiodine ablation and radiation therapy failure, a surgical resection may improve the patients’ survival in addition to the symptomatic benefits. We report our experience in four consecutive patients who underwent extended mediastinal surgery for large lymph node metastases from thyroid cancer during the last year. All patients were pre-operatory evaluated by a multidisciplinary team involving endocrinologist, anaesthesiologist and surgeons. Surgery was carried out in all cases in two steps, firstly through a cervicotomy in order to remove the eventual local recurrence and ensure a radical neck dissection bilaterally and then by sternotomy, in order to dissect all the lymphadenopathies from the mediastinal structures. Two patients (50%) had an extended vascular infiltration and the extracorporeal circulation (ECC) and, at least, one vascular graft, were needed. No intraoperative or perioperative mortality occurred in this series. Two patients (50%) presented a sternal dehiscence that required a second surgery and a prolonged postoperative hospital stay. In all cases the surgery was radical, and the histological report revealed a macroscopic complete resection and, up to date, no recurrences were found. When feasible, surgery is more effective than systemic therapy in the treatment of thyroid cancer recurrences, especially for medullary thyroid cancer in which radioiodine therapy is ineffective and should always be evaluated in case of vascular infiltration or symptomatic patients. Moreover, due to diversity and complexity of the cervical and mediastinal structures that may be involved, a multidisciplinary medical team should always be guaranteed during the surgery.
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- 2019
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