244 results on '"F. Ardito"'
Search Results
2. Detection of hepatocellular carcinoma's microvascular invasion at the preoperative CT scan: Artificial intelligence meets radiomics
- Author
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S. Famularo, M. Donadon, C. Penzo, M. Bortolotto, C. Maino, J. Marescaux, M. Diana, F. Romano, F. Giuliante, F. Ardito, G.L. Grazi, D. Bernasconi, and G. Torzilli
- Subjects
Hepatology ,Gastroenterology - Published
- 2023
3. P-83 The impact of the multidisciplinary team (MDT) in the management of colorectal cancer (CRC)
- Author
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F. Schietroma, M. Bensi, B. Barbaro, M. Calegari, C. Cina, R. Menghi, L. Lorenzon, C. Pozzo, M. Basso, A. Anghelone, G. Valente, F. Lococo, F. Ardito, F. Cellini, G. Caira, G. Trovato, D. D'Ugo, F. Giuliante, G. Tortora, and L. Salvatore
- Subjects
Oncology ,Hematology - Published
- 2022
4. Conversion Therapy With Encorafenib and Cetuximab for Chemo-Refractory BRAF V600E-Mutated Liver-Limited Colorectal Cancer Metastasis: The First Case Report
- Author
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Carmelo Pozzo, Floriana Camarda, Brunella Di Stefano, Giampaolo Tortora, Maria Alessandra Calegari, Maurizio Martini, F. Ardito, Annunziato Anghelone, Carmine Carbone, Felice Giuliante, Raffaella Vivolo, Maria Vellone, Maria Bensi, Lisa Salvatore, Michele Basso, and M. Ribelli
- Subjects
Oncology ,Proto-Oncogene Proteins B-raf ,medicine.medical_specialty ,Colorectal cancer ,medicine.medical_treatment ,Settore MED/18 - CHIRURGIA GENERALE ,Cetuximab ,Target therapy ,Metastasis ,Refractory ,Encorafenib ,Internal medicine ,medicine ,Humans ,Liver surgery ,neoplasms ,Chemotherapy ,Sulfonamides ,business.industry ,Gastroenterology ,Precision oncology ,medicine.disease ,digestive system diseases ,CRC ,Regimen ,BRAF mutation ,Liver ,Biomarker (medicine) ,Carbamates ,business ,Colorectal Neoplasms ,medicine.drug - Abstract
Clinical Practice Points • Standard chemotherapy plus surgery yields to unsatisfying results in BRAF-mutated colorectal liver metastases (CLM). Combination of targeted agents (encorafenib, a BRAF inhibitor, and cetuximab, an anti-EGFR) is the new standard of care for BRAF V600E-mutated mCRC refractory to a first-line standard chemotherapy. Up to now no evidence is available concerning the activity of this novel treatment as conversion therapy in CLM setting. • Our case provides evidence, for the first time to our knowledge, of the activity of encorafenib plus cetuximab as conversion regimen for BRAF V600E-mutated CLM. Additional observations in this case report concern mechanisms underlying rapid occurrence of acquired resistance and the role of CEA serum levels as biomarker to monitor treatment activity and occurrence of resistance, allowing to optimize the timing of surgery. • Further evidence on the role of doublet targeted regimen (encorafenib plus cetuximab) as conversion treatment in the setting of BRAF-mutant CLM is warranted.
- Published
- 2021
5. Survival after Resection of Colorectal Liver Metastases: Results from a Single Institution over Three Decades
- Author
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E. Panettieri, F. Ardito, A. De Rose, M. Vellone, C. Mele, A. Frascarelli, F. Razionale, G. Nuzzo, and F. Giuliante
- Subjects
Hepatology ,Gastroenterology - Published
- 2022
6. Multicentre evaluation of case volume in minimally invasive hepatectomy
- Author
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L Viganò, M Cimino, L Aldrighetti, A Ferrero, U Cillo, A Guglielmi, G M Ettorre, F Giuliante, R Dalla Valle, V Mazzaferro, E Jovine, L De Carlis, F Calise, G Torzilli, F Ratti, E Gringeri, N Russolillo, G B Levi Sandri, F Ardito, U Boggi, S Gruttadauria, F Di Benedetto, G E Rossi, S Berti, G Ceccarelli, L Vincenti, G Belli, F Zamboni, A Coratti, P Mezzatesta, R Santambrogio, G Navarra, A Giuliani, A D Pinna, A Parisi, M Colledan, A Slim, A Antonucci, G L Grazi, A Frena, G Sgroi, A Brolese, L Morelli, A Floridi, A Patriti, L Veneroni, L Boni, P Maida, G Griseri, M Filauro, S Guerriero, G Tisone, R Romito, U Tedeschi, G Zimmitti, Vigano L., Cimino M., Aldrighetti L., Ferrero A., Cillo U., Guglielmi A., Ettorre G.M., Giuliante F., Dalla Valle R., Mazzaferro V., Jovine E., De Carlis L., Calise F., Torzilli G., Ratti F., Gringeri E., Russolillo N., Levi Sandri G.B., Ardito F., Boggi U., Gruttadauria S., Di Benedetto F., Rossi G.E., Berti S., Ceccarelli G., Vincenti L., Belli G., Zamboni F., Coratti A., Mezzatesta P., Santambrogio R., Navarra G., Giuliani A., Pinna A.D., Parisi A., Colledan M., Slim A., Antonucci A., Grazi G.L., Frena A., Sgroi G., Brolese A., Morelli L., Floridi A., Patriti A., Veneroni L., Boni L., Maida P., Griseri G., Filauro M., Guerriero S., Tisone G., Romito R., Tedeschi U., Zimmitti G., Vigano, L, Cimino, M, Aldrighetti, L, Ferrero, A, Cillo, U, Guglielmi, A, Ettorre, G, Giuliante, F, Dalla Valle, R, Mazzaferro, V, Jovine, E, De Carlis, L, Calise, F, Torzilli, G, Ratti, F, Gringeri, E, Russolillo, N, Levi Sandri, G, Ardito, F, Boggi, U, Gruttadauria, S, Di Benedetto, F, Rossi, G, Berti, S, Ceccarelli, G, Vincenti, L, Belli, G, Zamboni, F, Coratti, A, Mezzatesta, P, Santambrogio, R, Navarra, G, Giuliani, A, Pinna, A, Parisi, A, Colledan, M, Slim, A, Antonucci, A, Grazi, G, Frena, A, Sgroi, G, Brolese, A, Morelli, L, Floridi, A, Patriti, A, Veneroni, L, Boni, L, Maida, P, Griseri, G, Filauro, M, Guerriero, S, Tisone, G, Romito, R, Tedeschi, U, Zimmitti, G, Vigano, L., Cimino, M., Aldrighetti, L., Ferrero, A., Cillo, U., Guglielmi, A., Ettorre, G. M., Giuliante, F., Dalla Valle, R., Mazzaferro, V., Jovine, E., De Carlis, L., Calise, F., Torzilli, G., Ratti, F., Gringeri, E., Russolillo, N., Levi Sandri, G. B., Ardito, F., Boggi, U., Gruttadauria, S., Di Benedetto, F., Rossi, G. E., Berti, S., Ceccarelli, G., Vincenti, L., Belli, G., Zamboni, F., Coratti, A., Mezzatesta, P., Santambrogio, R., Navarra, G., Giuliani, A., Pinna, A. D., Parisi, A., Colledan, M., Slim, A., Antonucci, A., Grazi, G. L., Frena, A., Sgroi, G., Brolese, A., Morelli, L., Floridi, A., Patriti, A., Veneroni, L., Boni, L., Maida, P., Griseri, G., Filauro, M., Guerriero, S., Tisone, G., Romito, R., Tedeschi, U., and Zimmitti, G.
- Subjects
Aged ,Female ,Hepatectomy ,Humans ,Italy ,Liver Neoplasms ,Male ,Minimally Invasive Surgical Procedures ,Registries ,Retrospective Studies ,Treatment Outcome ,Liver surgery ,Hepatic resection ,Settore MED/18 - CHIRURGIA GENERALE ,medicine.medical_treatment ,Proposal ,laparoscopy ,Metastases ,Liver resections ,0302 clinical medicine ,minimally invasive liver surgery ,case volume ,Case volume ,Laparascopic Liver Resection ,minimally invasive hepatectomy ,liver resections ,030220 oncology & carcinogenesis ,high-volume centres ,030211 gastroenterology & hepatology ,hepatectomy, laparoscopy, liver resections ,Hepatocellular-Carcinome ,medicine.medical_specialty ,Outcomes ,NO ,03 medical and health sciences ,Hospital volume ,medicine ,minimally invasive, hepatectomy ,LS7_4 ,business.industry ,Retrospective cohort study ,Laparascopic Liver Resection, Hepatocellular-Carcinome, Surgery, Outcomes, Metastases, Difficulty, Proposal ,hepatectomy ,Surgery ,Severe morbidity ,business ,Difficulty - Abstract
Surgical outcomes may be associated with hospital volume and the influence of volume on minimally invasive liver surgery (MILS) is not known.Patients entered into the prospective registry of the Italian Group of MILS from 2014 to 2018 were considered. Only centres with an accrual period of at least 12 months and stable MILS activity during the enrolment period were included. Case volume was defined by the mean number of minimally invasive liver resections performed per month (MILS/month).A total of 2225 MILS operations were undertaken by 46 centres; nine centres performed more than two MILS/month (1376 patients) and 37 centres carried out two or fewer MILS/month (849 patients). The proportion of resections of anterolateral segments decreased with case volume, whereas that of major hepatectomies increased. Left lateral sectionectomies and resections of anterolateral segments had similar outcome in the two groups. Resections of posterosuperior segments and major hepatectomies had higher overall and severe morbidity rates in centres performing two or fewer MILS/month than in those undertaking a larger number (posterosuperior segments resections: overall morbidity 30·4 versus 18·7 per cent respectively, and severe morbidity 9·9 versus 4·0 per cent; left hepatectomy: 46 versus 22 per cent, and 19 versus 5 per cent; right hepatectomy: 42 versus 34 per cent, and 25 versus 15 per cent).A volume-outcome association existed for minimally invasive hepatectomy. Complex and major resections may be best managed in high-volume centres.Los resultados quirúrgicos pueden estar relacionados con el volumen de casos del hospital, pero no se conoce la influencia en la cirugía mínimamente invasiva del hígado (minimally‐invasive liver surgery, MILS). MÉTODOS: Se incluyeron los pacientes registrados en el registro prospectivo del grupo italiano de MILS desde 2014 a 2018. Solo se consideraron centros con extensión de ≥ 12 meses y actividad estable de MILS durante el periodo de reclutamiento. El volumen de casos se definió como el número de MILS efectuado por mes.Se llevaron a cabo un total de 2.225 MILS en 46 centros, 9 de ellos con 2 MILS/mes (n = 1.376 pacientes) y 37 centros con ≤ 2 MILS/mes (n = 849). La proporción de resecciones de segmentos anterolaterales disminuyó con el volumen de casos, mientras que la proporción de hepatectomías mayores aumentó. Los resultados para ambos grupos fueron similares en las seccionectomías lateral izquierda y en las resecciones del segmento anterolateral. Las resecciones del segmento posterosuperior y las hepatectomías mayores presentaron tasas más altas de morbilidad global y morbilidad grave en centros que realizaban ≤ 2 MILS/mes que en los que realizaban 2 MILS/mes (resecciones del segmento posterosuperior, morbilidad global 30,4 versus 18,7%, morbilidad grave 9,9 versus 4,0%; hepatectomía izquierda, 46,2 versus 22,0%, 19,2 versus 5,5%; hepatectomía derecha, 41,7 versus 33,8%, 25,0 versus 14.9%). CONCLUSIÓN: Se observó una asociación volumen‐resultado para la resección hepática mínimamente invasiva. Las resecciones complejas y mayores se pueden manejar mejor en centros de gran volumen.
- Published
- 2020
7. Laparoscopic left hepatectomy for primary intrahepatic lithiasis: surgical technique
- Author
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Felice Giuliante, Caterina Mele, F. Ardito, and Maria Vellone
- Subjects
medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Settore MED/18 - CHIRURGIA GENERALE ,left hepatectomy ,intraoperative ultrasound ,Laparoscopic liver resection ,Surgery ,medicine ,Radiology, Nuclear Medicine and imaging ,Hepatectomy ,primary intrahepatic lithiasis ,business ,cholangiocarcinoma - Published
- 2020
8. Critical analysis of major and ancillary features of LI-RADS v2018 in the differentiation of small (≤ 2 cm) hepatocellular carcinoma from dysplastic nodules with gadobenate dimeglumine-enhanced magnetic resonance imaging
- Author
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A M, De Gaetano, M, Catalano, M, Pompili, M G, Marini, P, Rodríguez Carnero, C, Gullì, A, Infante, R, Iezzi, F R, Ponziani, L, Cerrito, G, Marrone, F, Giuliante, F, Ardito, G L, Rapaccini, F M, Vecchio, L, Giraldi, and R, Manfredi
- Subjects
Male ,Carcinoma, Hepatocellular ,Consensus ,Liver Neoplasms ,Cell Differentiation ,Middle Aged ,Magnetic Resonance Imaging ,Sensitivity and Specificity ,Meglumine ,Predictive Value of Tests ,Radiologists ,Organometallic Compounds ,Humans ,Female ,Radionuclide Imaging ,Aged ,Retrospective Studies - Abstract
To evaluate the performance of major features, ancillary features, and categories of Liver Imaging Reporting and Data System (LI-RADS) version 2018 at magnetic resonance (MR) imaging in the differentiation of small hepatocellular carcinoma (HCC) from dysplastic nodules (DNs).This retrospective study included cirrhotic patients with pathologically proven untreated HCCs and DNs (≤ 2 cm) and liver MR imaging performed with gadobenate dimeglumine contrast agent within 3 months before pathological analysis, between 2015 and 2018. 37 patients with 43 observations (17 HCCs and 26 DNs) met the inclusion criteria. Two radiologists assessed major and ancillary imaging features for each liver observation and assigned a LI-RADS v2018 category in consensus. Estimates of diagnostic performance of major features, ancillary features, and LI-RADS categories were assessed based on their sensitivity, specificity, positive (PPV), and negative predictive values (NPV).Major features (nonrim arterial phase hyperenhancement, nonperipheral "washout", and enhancing "capsule") had a sensitivity of 94.1%, 88.2%, and 41.2%, and a specificity of 57.7%, 42.3%, and 88.5% for HCC, respectively. Ancillary features (hepatobiliary phase hypointensity, mild-moderate T2 hyperintensity, restricted diffusion, and fat in the lesion more than adjacent liver) had a sensitivity of 94.1%, 64.7%, 58.8%, and 11.8%, and a specificity of 26.9%, 61.5%, 65.4%, and 76.9% for HCC, respectively. The LR-5 category (determined by using major features only vs. the combination of major and ancillary features) had a sensitivity of 88.2% at both evaluations and a specificity of 76.9% and 80.8% for HCC, respectively. The combination of LR-4, LR-5 categories (determined by using major features only vs. the combination of major and ancillary features) had a sensitivity of 94.1% at both interpretations and a specificity of 65.4% and 26.9% for HCC, respectively. The use of ancillary features modified LI-RADS category in 25.6% of observations (11/43), predominantly upgraded from LR-3 to LR4 (10/11), increasing the proportion of low-grade DNs and high-grade DNs categorized as LR-4 (from 15.4% to 61.5% and from 7.7% to 46.1%, respectively).The added value of ancillary features in combination with major features is limited for the non-invasive diagnosis of small HCC; however, their use modifies the final category in a substantial proportion of observations from LR-3 to LR-4, thus allowing possible changes in the management of patients at risk for HCC.
- Published
- 2019
9. The best potential treatment for recurrent hepatocellular carcinoma after surgery: a machine learning predictive model for treatment allocation based on an Italian multicentric database
- Author
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S. Famularo, M. Donadon, F. Cipriani, F. Fazio, F. Ardito, F. Carissimi, M. Iaria, P. Perri, S. Conci, N. Pontarolo, Q. Lai, G. La Barba, S. Patauner, S. Molfino, P. Germani, A. Manzoni, E. Pinotti, M. Zanello, L. Fumagalli, C. Ferrari, M. Romano, A. Delvecchio, D.P. Bernasconi, M.G. Valsecchi, A. Antonucci, R. Memeo, G. Zanus, G. Griseri, M. Chiarelli, E. Jovine, M. Zago, G. Zimmitti, P. Tarchi, G.L. Baiocchi, A. Frena, G. Ercolani, M. Rossi, M. Maestri, A. Ruzzenente, G.L. Grazi, R. Dalla Valle, F. Romano, F. Giuliante, A. Ferrero, L. Aldrighetti, G. Torzilli, and HE.RC.O.LE.S. Group
- Subjects
medicine.medical_specialty ,Hepatology ,business.industry ,General surgery ,Gastroenterology ,Medicine ,business ,Recurrent Hepatocellular Carcinoma - Published
- 2021
10. P-73 The role of site of metastatic resection in metastatic colorectal cancer patients: A mono-institutional cohort study
- Author
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Carmelo Pozzo, F. Schietroma, Floriana Camarda, Michele Basso, Maria Bensi, Filippo Lococo, Lisa Salvatore, Annunziato Anghelone, Maria Vellone, C. Mele, Marco Chiappetta, Felice Giuliante, Giampaolo Tortora, Maria Alessandra Calegari, M. Ribelli, G. Valente, F. Ardito, B. Di Stefano, Stefano Margaritora, and D. Tabacco
- Subjects
Oncology ,medicine.medical_specialty ,Colorectal cancer ,business.industry ,Internal medicine ,medicine ,Hematology ,medicine.disease ,business ,Resection ,Cohort study - Published
- 2021
11. Care or palliation for recurrent hepatocarcinoma: a multicentric national analysis of survival
- Author
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G.L. Grazi, T. Dominioni, Marcello Maestri, Giorgio Ercolani, M. Garatti, Matteo Donadon, A. Troci, Felice Giuliante, Davide Paolo Bernasconi, Luca Aldrighetti, A. Del Vecchio, Andrea Ruzzenente, Alessandro Floridi, F. Carissimi, G. Zimmitti, G. Griseri, A. Frena, M. De Angelis, A. Percivale, R. DallaValle, Luigi Boccia, F. Ardito, Simone Conci, A. Antonucci, M. Iaria, F. Romano, E. Lodo, Elio Jovine, G. LaBarba, Maurizio Cosimelli, Giacomo Zanus, S. Patauner, Simone Famularo, Sarah Molfino, L. Fumagalli, Gian Luca Baiocchi, Federica Cipriani, Guido Torzilli, Christophe Ferrari, Michele Crespi, Marco Chiarelli, Riccardo Memeo, and Matteo Zanello
- Subjects
medicine.medical_specialty ,Hepatology ,business.industry ,General surgery ,Gastroenterology ,Medicine ,business - Published
- 2020
12. Impact of primary tumor location on survival following colorectal liver metastases resection
- Author
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F. Ardito, Edoardo Rosso, C. Mele, Giuseppe Zimmitti, Elena Panettieri, and Felice Giuliante
- Subjects
medicine.medical_specialty ,Hepatology ,business.industry ,Gastroenterology ,Medicine ,Radiology ,business ,medicine.disease ,Primary tumor ,Resection - Published
- 2020
13. Colorectal Liver Metastases and Concomitant Extrahepatic Disease: is Resection Justified? Single Center Survival Analysis on 84 Patients
- Author
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Felice Giuliante, Maria Vellone, A.M. De Rose, Alessandro Coppola, Elena Panettieri, and F. Ardito
- Subjects
medicine.medical_specialty ,Hepatology ,business.industry ,Concomitant ,Gastroenterology ,Medicine ,Disease ,business ,Single Center ,Survival analysis ,Resection ,Surgery - Published
- 2019
14. Exceptional long-term survivor (12 years) with metastatic gallbladder cancer
- Author
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Franco Sacchetti, F M Vecchio, Felice Giuliante, and F. Ardito
- Subjects
medicine.medical_specialty ,business.industry ,General surgery ,medicine ,Long Term Survivor ,Gallbladder cancer ,medicine.disease ,business - Published
- 2019
15. Impact of R1 resection for colorectal liver metastases on local recurrence in the era of modern chemotherapy. Analysis of 1428 resection areas
- Author
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N. Silvestrini, Alessandro Coppola, F. Ardito, M. Ferrucci, Maria Vellone, Felice Giuliante, and Elena Panettieri
- Subjects
medicine.medical_specialty ,Chemotherapy ,Hepatology ,R1 resection ,business.industry ,medicine.medical_treatment ,medicine ,Gastroenterology ,business ,Surgery ,Resection - Published
- 2019
16. Survival Outcome of Two or More Resections of Recurrence with or without Extrahepatic Disease After First Curative Resection for Colorectal Liver Metastases
- Author
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J.N. Vauthey, Timothy E. Newhook, C. Mele, F. Guilante, J.D. Velasco, F. Ardito, Bradford J. Kim, Yoshikuni Kawaguchi, and Elena Panettieri
- Subjects
Curative resection ,medicine.medical_specialty ,Hepatology ,business.industry ,Gastroenterology ,medicine ,Disease ,business ,Survival outcome ,Surgery - Published
- 2021
17. Short-term Outcomes after Minimally-invasive Liver Resection for Single Small Hepatocellular Carcinoma: An Analysis from the IGoMILS (Italian Group of Minimally Invasive Liver Surgery) Registry
- Author
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F. Ardito, Francesca Ratti, L. Aldrighetti, Felice Giuliante, Annamaria Ferrero, Giuseppe Maria Ettorre, Alfredo Guglielmi, and Elena Panettieri
- Subjects
Liver surgery ,medicine.medical_specialty ,Hepatology ,business.industry ,Hepatocellular carcinoma ,Gastroenterology ,medicine ,medicine.disease ,business ,Surgery ,Resection - Published
- 2021
18. P-103 The role of primary tumor site as a prognostic factor after resection of colorectal liver metastases: A mono-institutional cohort study
- Author
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B. Di Stefano, F. Ardito, Carmelo Pozzo, Maria Vellone, M. Ribelli, Raffaella Vivolo, Floriana Camarda, G. Tortora, Felice Giuliante, Michele Basso, Maria Bensi, C. Mele, Lisa Salvatore, A. Frascarelli, E. Panettieri, and Maria Alessandra Calegari
- Subjects
Oncology ,medicine.medical_specialty ,Prognostic factor ,business.industry ,Internal medicine ,Medicine ,Hematology ,business ,medicine.disease ,Primary tumor ,Resection ,Cohort study - Published
- 2020
19. Staging surgical resected peri-hilar cholangiocarcinoma: comparison of the 7th and 8th ed. of the American Joint Committee on Cancer staging systems
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I. Scoleri, Tommaso Campagnaro, Andrea Ruzzenente, Fabio Bagante, Francesca Bertuzzo, Simone Conci, Alfredo Guglielmi, F. Ardito, Calogero Iacono, and Felice Giuliante
- Subjects
medicine.medical_specialty ,Hepatology ,business.industry ,General surgery ,Peri ,Gastroenterology ,medicine ,business ,Cancer staging - Published
- 2019
20. Prognostic role of KRAS mutational status and response to preoperative chemotherapy in patients undergoing hepatectomy for colorectal liver metastases
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F. Ardito, Giuseppe Zimmitti, Elena Panettieri, I. Scoleri, C. Mele, Edoardo Rosso, and Felice Giuliante
- Subjects
Oncology ,medicine.medical_specialty ,Hepatology ,business.industry ,medicine.medical_treatment ,Gastroenterology ,medicine.disease_cause ,Internal medicine ,medicine ,Mutational status ,Preoperative chemotherapy ,In patient ,KRAS ,Hepatectomy ,business - Published
- 2019
21. Surgical repair for bile duct injuries after cholecistectomy in a tertiary referral center: long term results
- Author
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A.M. De Rose, F. Ardito, Felice Giuliante, Elena Panettieri, Gennaro Nuzzo, and Alessandro Coppola
- Subjects
Surgical repair ,medicine.medical_specialty ,medicine.anatomical_structure ,Hepatology ,business.industry ,Bile duct ,Gastroenterology ,Medicine ,Referral center ,Long term results ,business ,Surgery - Published
- 2019
22. Video of laparoscopic hepatic segmentectomy 5 with an 80-degree articulating advanced bipolar device
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F. Ardito, Fabio Longo, Felice Giuliante, and Alessandro Coppola
- Subjects
medicine.medical_specialty ,business.industry ,Materials Chemistry ,Medicine ,Radiology ,business ,Degree (temperature) - Published
- 2018
23. Laparoscopic liver resection with an 80-degree articulating advanced bipolar device
- Author
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Fabio Longo, Felice Giuliante, F. Ardito, and Alessandro Coppola
- Subjects
Surgical margin ,Cirrhotic liver ,medicine.medical_specialty ,business.industry ,medicine.disease ,Resection ,Surgery ,Male patient ,Hepatocellular carcinoma ,medicine ,Portal hypertension ,Radiology, Nuclear Medicine and imaging ,Laparoscopic resection ,business - Abstract
The video shows the case of a 68-year-old male patient, affected by hemochromatosis, with 3-cm hepatocellular carcinoma in segment 5 on cirrhotic liver. The patient was classified as Child A5, MELD 7, with portal hypertension. An ultrasound-guided laparoscopic resection of segment 5 was planned. Liver resection was carried out by the 80-degree articulating vessel sealer (Aesculap Caiman; B. Braun, Tuttlingen, Germany). The embedded video shows how this device is safe and efficient for laparoscopic liver resection and how its 80-degree articulation jaw may be useful in case of deep or posterior transection planes in order to obtain an adequate oncologic surgical margin.
- Published
- 2018
24. Impact of the evolution of surgical approach on radicality of resection for colorectal liver metastases: experience of a high volume hepatobiliary surgery center
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F. Ardito, Felice Giuliante, A.M. De Rose, Maria Vellone, and Elena Panettieri
- Subjects
Hepatobiliary surgery ,medicine.medical_specialty ,Surgical approach ,Hepatology ,business.industry ,Gastroenterology ,medicine ,Center (algebra and category theory) ,Radiology ,business ,Volume (compression) ,Resection - Published
- 2018
25. Résections hépatiques pour lithiase sur dilatations congénitales des voies biliaires intrahépatiques
- Author
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Felice Giuliante, Gennaro Clemente, Ivo Giovannini, F. Ardito, Gennaro Nuzzo, and A.M. De Rose
- Subjects
Liver resection ,Settore MED/18 - CHIRURGIA GENERALE ,Intrahepatic lithiasis ,Results ,Surgery - Abstract
Resume Objectif Cette etude rapporte une experience clinique relative aux resections hepatiques pour dilatations congenitales des voies biliaires et lithiase intrahepatique associee pour evaluer les resultats et definir les indications du traitement. Patients et methodes Nous avons etudie les donnees cliniques des patients soumis a une resection hepatique de janvier 1992 a decembre 2008 et evalue les resultats immediats et cela a distance des interventions. Resultats Sur 49 patients traites, 47 ont eu une resection hepatique. Dans la majorite des cas la maladie etait limitee au foie gauche et l’hepatectomie gauche a ete l’intervention chirurgicale la plus frequente. La mortalite operatoire a ete nulle et la morbidite de 24,5 %. Un cholangiocarcinome a ete diagnostique dans six cas (12,2 %) . Dans 91,6 % de cas, les resultats a distance ont ete bons ou satisfaisants. Conclusion Les objectifs du traitement doivent etre dans tous les cas l’elimination des calculs, la prevention des recidives ainsi que celle du cholangiocarcinome. La chirurgie d’exerese represente le meilleur traitement possible pour les patients symptomatiques avec une maladie localisee et atrophie du foie touche.
- Published
- 2010
26. Clinical applicability of Quantiferon-TB-Gold testing in psoriasis patients during long-term anti-TNF-alpha treatment: a prospective, observational study
- Author
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S, Garcovich, A, Ruggeri, M, D'Agostino, F, Ardito, C, De Simone, G, Delogu, and G, Fadda
- Subjects
Adult ,Male ,Reverse Transcriptase Polymerase Chain Reaction ,Tumor Necrosis Factor-alpha ,Enzyme-Linked Immunosorbent Assay ,tbc ,Hepacivirus ,anti-TNF ,Middle Aged ,Hepatitis C ,Settore MED/07 - MICROBIOLOGIA E MICROBIOLOGIA CLINICA ,tuberculusis ,Italy ,Prevalence ,Humans ,Psoriasis ,Female ,Prospective Studies ,Settore MED/35 - MALATTIE CUTANEE E VENEREE ,Aged - Abstract
Psoriasis patients who are treated with tumour necrosis factor (TNF)-alpha antagonists are at increased risk of reactivation of latent tuberculosis infection (LTBI) and should be adequately screened and monitored during active treatment.To evaluate in a prospective study, the performance of Quantiferon-TB-Gold in tube (QFT) in vitro assay compared to the conventional tuberculin skin test (TST) in detecting LTBI among a cohort of non-BCG-vaccinated patients with moderate-to-severe psoriasis during long-term treatment (12 months) with TNF-alpha antagonists.A total of 50 patients underwent QFT and TST testing at baseline and after 6 and 12 months of continuous anti-TNF-alpha treatment. Diagnosis of LTBI was made on the basis of a positive QFT result and negative chest-radiographic and microbiological assays. Patients with LTBI were subjected to standard isoniazid chemoprophylaxis and after 1 month, they resumed anti-TNF-alpha treatment with subsequent QFT and TST testing after 6 months. In all the cases, a follow-up period of 12 months was observed.During the 12-month-study period, 14% of patients presented a QFT conversion. During active anti-TNF-alpha treatment, a QFT conversion was observed in 10% of patients (five cases). Agreement between QFT and TST was moderate (κ=0.408) at screening, good (κ=0.734) after 6 months and fair (κ=0.328) after 12 months of treatment. A total of 18% of patients presented a positive, discordant TST during the study period.A single-test QFT-based screening strategy for LTBI in psoriasis patients receiving long-term anti-TNF-alpha treatment could reduce the incidence of false-positive LTBI cases, preventing unnecessary TB chemoprophylaxis.
- Published
- 2011
27. Acute toxicity in 14 patients with locally advanced head and neck squamous cell carcinoma treated with concurrent cetuximab and radiotherapy
- Author
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Giuseppe Minniti, Mattia Falchetto Osti, Roberta Muni, F. Ardito, V. De Sanctis, Maurizio Valeriani, and R. Maurizi Enrici
- Subjects
Oncology ,Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Locally advanced ,Cetuximab ,Antineoplastic Agents ,adult ,adverse effects ,aged ,antibodies ,antineoplastic agents ,carcinoma ,combined modality therapy ,dose-response relationship ,drug therapy/radiotherapy ,epidemiology ,female ,head and neck neoplasms ,humans ,italy ,male ,middle aged ,monoclonal ,prospective studies ,radiation ,radiodermatitis ,squamous cell ,survival rate ,therapeutic use ,treatment outcome ,Head and neck tumours ,Radiotherapy ,Toxicity ,Antibodies, Monoclonal, Humanized ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,neoplasms ,Neuroradiology ,Aged ,medicine.diagnostic_test ,business.industry ,Antibodies, Monoclonal ,Interventional radiology ,Dose-Response Relationship, Radiation ,General Medicine ,Middle Aged ,medicine.disease ,Head and neck squamous-cell carcinoma ,Combined Modality Therapy ,digestive system diseases ,Acute toxicity ,Radiation therapy ,Survival Rate ,Treatment Outcome ,Italy ,Head and Neck Neoplasms ,Carcinoma, Squamous Cell ,Female ,Radiodermatitis ,business ,medicine.drug - Abstract
The authors report acute toxicity in 14 patients with locally advanced head and neck squamous cell carcinoma treated with radiotherapy and cetuximab.Data collection was performed prospectively on patients treated from September 2007 to March 2009. Treatment consisted of 64.8-70 Gy radiotherapy in conventional fractions and cetuximab.Two out of 14 patients did not complete the planned combined treatment; radiotherapy was temporarily suspended in six other patients. Seven of 12 patients received cetuximab until the end of radiotherapy. Treatment breaks were principally due to severe acute cutaneous or mucous toxicity. Any grade acneiform rash occurred in all patients. In-field G3-4 cutaneous toxicity occurred in five (36%) patients and G3-4 mucous toxicity in seven (50%). One patient died of sepsis.In our experience, severe acute toxic reactions are common in patients treated with radiotherapy and concurrent cetuximab, resulting in frequent breaks or incomplete treatment with potential reduction in disease control.
- Published
- 2010
28. Biofilm formation by Haemophilus influenzae isolated from adeno-tonsil tissue samples, and its role in recurrent adenotonsillitis
- Author
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J, Galli, L, Calò, F, Ardito, M, Imperiali, E, Bassotti, G, Fadda, and G, Paludetti
- Subjects
Male ,Tonsillitis ,Recurrence ,Biofilms ,Adenoids ,Palatine Tonsil ,Humans ,Female ,Child ,Infection ,Haemophilus influenzae - Abstract
Aim of the present study was to identify bacterial biofilms in tissue samples obtained from paediatric patients undergoing surgical treatment, for chronic and recurrent adeno-tonsillitis, not responding to repeated cycles of selective medical antibiotic and anti-inflammatory treatment and to assay the ability of Haemophilus influenzae strains, most frequently identified in the culture examinations, to grow as biofilm in vitro. Overall, 25 surgical specimens (15 adenoids, 10 tonsils) were examined from the upper respiratory tract, from 15 paediatric patients (mean age 6 years). All patients were affected by recurrent and/or chronic adenoiditis and adenotonsillitis unresponsive to selective antibiotic and anti-inflammatory therapy. Tissues were cultured using conventional methods and subjected to scanning electron microscopy for detection of biofilm. Haemophilus influenzae strains, were cultured on 96-sterile well polystyrene microtitre plates (CELLSTAR-greiner bio-one) and stained with 1% crystal violet to quantify biofilm production. Bacterial cocci attached to the tissue surface and organized in colonies, with a morphology consistent with bacterial coccoid biofilms, were observed in all adenoid (15/15) and in 6/10 tonsil samples. Haemophilus influenzae isolates from 12/25 (48%) of our tissue samples scored a percent transmittance (%Tbloc) > 50, displaying a high capacity to form biofilms (level 4). In conclusion identification of bacterial biofilms in chronic and/or recurrent paediatric upper airway inflammatory processes and the capacity to produce biofilm in vitro, demonstrated by Haemophilus influenzae (the most frequently identified bacteria in our samples), could be related to the aetiopathogenic role of biofilms in chronic inflammatory mucosal reactions and to the resistance of these infections to selective antibiotic therapy.
- Published
- 2007
29. Modified radical neck dissection via extra-thyroideal space (MRND vets) in papillary thyroid carcinoma
- Author
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G, Ardito, L, Revelli, F, Ardito, F, Moschella, E M, Centritto, V, Lo Schiavo, and F, Rulli
- Subjects
Adult ,Male ,Lymphatic Metastasis ,Humans ,Neck Dissection ,Female ,Lymph Nodes ,Thyroid Neoplasms ,Carcinoma, Papillary - Abstract
The purpose of this study was to describe an alternative lateral neck access to perform lymph nodes sampling and/or neck dissection via extra-thyroideal space (MRND vets) in papillary thyroid carcinoma with lymph nodes involvment. Twenty-four consecutive patients with papillary thyroid carcinoma were included. Lymph nodes sampling and modified radical neck dissection, unilateral or bilateral, were performed acceding via a lateral dissection through a traditional Kocher incision, running along the medial fascia of the neck, posteriorly to the sterno-cleido-mastoideus muscle (SCM). Mean age was 39.04 +/- 13.69 years. Twenty patients were women, and 4 were men. Mean tumor size was 2.5 +/- 1 cm.. Total thyroidectomy with lymph nodes dissection of the central compartment associated to modified radical neck dissection was performed in 17 patients: among these, nine patients had a preoperative diagnosis of the latero-cervical lymph nodes metastases, and eight had a perioperative diagnosis of metastases of the extensive sampling of the lower third of the jugular chain. Metastatic lymph nodes were found in 107 out of 615 lymph nodes dissected. The MNRD vets access for modified lateral neck dissection seems to carry a lower risk in terms of specific morbility and allows a quicker recovery and a better cosmetic result. This access has to be considered as a less invasive procedure compared to other surgical accesses for the radical modified lateral neck dissection.
- Published
- 2004
30. Follicular adenoma of the thyroid gland with extensive bone metaplasia
- Author
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G, Ardito, G, Fadda, L, Revelli, P, Modugno, C, Lucci, F, Ardito, A, Pontecorvi, and V A, LiVolsi
- Subjects
Adenoma ,Adult ,Metaplasia ,Thyroidectomy ,Humans ,Female ,Thyroid Neoplasms ,Bone and Bones - Abstract
Follicular adenomas of the thyroid account for over 90% of benign neoplasms of the gland. They exhibit a wide range of morphological structures, from the classical follicular pattern to the peculiar hyalinizing trabecular pattern. Although follicular adenomas grow slowly, they are nonetheless subject to degenerative, most often hemorrhagic changes in their central portion. These hemorrhagic areas undergo further regressive changes such as sclerosis and calcification. However, the detection of a true bone formation with a trabecular structure and the presence of marrow is a very rare occurrence. A follicular adenoma with central cartilaginous metaplasia has been reported in literature but, to our knowledge, a follicular adenoma with bone metaplasia has never been described.
- Published
- 2001
31. Comparison of the mycobacteria growth indicator tube with radiometric and solid culture for isolation of mycobacteria from clinical specimens and susceptibility testing of Mycobacterium tuberculosis
- Author
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F, Ardito, M, Sanguinetti, L, Sechi, B, Posteraro, L, Masucci, G, Fadda, and S, Zanetti
- Subjects
Bacteriological Techniques ,Humans ,Microbial Sensitivity Tests ,Reagent Kits, Diagnostic ,Tuberculosis, Pulmonary ,Anti-Bacterial Agents ,Culture Media ,Mycobacterium - Abstract
We compared the mycobacteria growth indicator tube (MGIT) system with the BACTEC 460 TB and Loewenstein-Jensen (LJ) systems for the recovery of mycobacteria (acid-fast bacilli [AFB]) from 600 clinical specimens. A total of 50 AFB (32 Mycobacterium tuberculosis complex, 10 M. avium complex, 3 M. gordonae, 3 M. xenopi, 1 M. terrae and 1 M. fortuitum) were detected. MGIT recovered 50 isolates of AFB (100% sensitivity), and BACTEC 460 TB and LJ recovered 49 (98% sensitivity) and 19 (38% sensitivity) AFB isolates, respectively. The mean times to detect mycobacteria were 10, 10 and 25 days for MGIT, BACTEC 460, and LJ slants. All isolates of M. tuberculosis complex were tested for susceptibility to streptomycin, isoniazid, rifampin, and ethambutol with the MGIT and BACTEC 460 TB. Both systems yielded identical susceptibility data with different mean times to report (5.38 days for MGIT versus 7.33 days for BACTEC 460 TB, P0.05). The results suggest that MGIT is equivalent to BACTEC 460 TB in its ability to support the growth of mycobacteria, but significantly more efficient than LJ. MGIT may also be used for susceptibility testing of primary antituberculosis drugs.
- Published
- 2000
32. [Follow-up of residual renal function in patients with serious forms of posterior urethral valves]
- Author
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V A, Mei, A, Corsini, F P, Di Lorenzo, P, Minelli, M, Rossi-Doria, V, Venturoli, F, Vigoriti, R, De Castro, F, Ardito, and R P, Di Turi
- Subjects
Adult ,Male ,Adolescent ,Water-Electrolyte Balance ,Kidney Function Tests ,Severity of Illness Index ,Urethra ,Child, Preschool ,Creatinine ,Urethral Diseases ,Humans ,Child ,Follow-Up Studies ,Glomerular Filtration Rate - Abstract
We report the results of the trend of the residual renal function (RRF) of 15 patients with serious forms of hind urethral valves (HUV) which agreed to be long term regularly controlled after surgical correction at the Children's Surgical Hospital of Bologna University. The nephrological follow-up started in 1985 is based on a periodical control at least once a year, of some indicatives parameters of the glomerulars activity (creatinine clearance according Schwartz and creatinine reciprocal), of the tubular activity (urinary flux ml/kg/h, per cent fraction of Na excretion) and the dynamical test of the RRF started in 1991. The results although the low cases studies, are not statistically significant, the Authors underline the validity of the adopted method. Although of the simplified and/or indirect type, this is able to give clinically reliable informations of the renal functionality evolution avoiding particularly complex or invasive analysis.
- Published
- 1997
33. Liver resection for primarily ?unresectable? colorectal metastases downstaged by chemotherapy
- Author
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G NUZZO, F GIULIANTE, M VELLONE, F ARDITO, C POZZO, A CASSANO, and C BARONE
- Subjects
Gastroenterology ,Surgery - Published
- 2005
34. N-ACETIL-CYSTEINE PRE-TREATMENT AND TISSUE CULTURE INDICATIONS-BASED APPROACH FOR THE ERADICATION OF SEVERAL THERAPIES-RESISTANT HELICOBACTER PYLORI
- Author
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G. Fadda, R. Torelli, Anna Chiara Piscaglia, Alessia Cazzato, Gianluca Ianiro, F. Barbaro, F. Ardito, Giovanni Gigante, F. Fiore, Giovanni Cammarota, Giovanna Branca, C. Lauritano, G. Gasbarrini, and Alessandro Gasbarrini
- Subjects
Pre treatment ,Tissue culture ,Hepatology ,biology ,business.industry ,Gastroenterology ,Medicine ,Helicobacter pylori ,biology.organism_classification ,business ,Cysteine ,Microbiology - Published
- 2009
35. Evaluation of hilar biliary strictures using a newly developed forward viewing therapeutic echoendoscope: preliminary results of an ongoing experience
- Author
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A. Larghi, P.G. Lecca, C. Spada, F. Ardito, E.D. Rossi, G. Fadda, G. Nuzzo, and G. Costamagna
- Subjects
Gastroenterology ,Radiology, Nuclear Medicine and imaging - Published
- 2009
36. Incidence of genital tuberculosis in infertile patients submitted to diagnostic laparoscopy: recent experience in an Italian university hospital
- Author
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R, Marana, L, Muzii, A, Lucisano, F, Ardito, P, Muscatello, E, Bilancioni, E, Maniccia, and S, Dell'Acqua
- Subjects
Adult ,Hospitals, University ,Italy ,Incidence ,Humans ,Female ,Laparoscopy ,Infertility, Female ,Tuberculosis, Female Genital - Abstract
The incidence of genital tuberculosis is decreasing in industrialized countries. The authors report their experience in 254 patients with primary or secondary infertility. Out of 101 patients with a tubal factor of infertility, two patients were diagnosed as having tuberculosis by both endometrial biopsy and endometrial culture. In a third patient, even in the presence of laparoscopic findings suggesting genital tuberculosis Mycobacterium tuberculosis was isolated only from the urine.
- Published
- 1991
37. PA.202 EVALUATION OF HILAR BILIARY STRICTURES USING A NEWLY DEVELOPED FORWARD VIEWING THERAPEUTIC ECHOENDOSCOPE: PRELIMINARY RESULTS OF AN ONGOING EXPERIENCE
- Author
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Alberto Larghi, Guido Costamagna, F. Ardito, E.D. Rossi, G. Fadda, Gennaro Nuzzo, and Piera Giuseppina Lecca
- Subjects
medicine.medical_specialty ,Hepatology ,business.industry ,Gastroenterology ,medicine ,Radiology ,business - Published
- 2008
38. Recurrent upper airway infections and bacterial biofilms.
- Author
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J Galli, F Ardito, L Calò, L Mancinelli, M Imperiali, C Parrilla, P M Picciotti, and G Fadda
- Subjects
- *
MICROBIAL ecology , *MICROBIAL aggregation , *PRESERVATION of organs, tissues, etc. , *LYMPHOID tissue - Abstract
Background: Bacterial biofilms identified in various medical devices used in otorhinolaryngology, including tympanostomy tubes, voice prostheses, and cochlear implants, can directly colonise mucosal tissues. The upper airways seem to be at high risk for this type of colonisation. Chronic and/or recurrent upper airway infections may be related to the complex structural and biochemical (quorum sensing) organisation of the biofilm which interferes with the activity of antibiotics (including those with proven in vitro efficacy), thus promoting the establishment of a chronic infection eradicable only by surgical treatment. Biofilm formation plays a role in upper respiratory infections: it not only explains the resistance of these infections to antibiotic therapy but it also represents an important element that contributes to the maintenance of a chronic inflammatory reaction.Objectives: To document the presence of biofilms in surgical tissue specimens from patients with recurrent infection diseases, and identify their possible role in the chronicity of these infectious processes.Method: We examined 32 surgical specimens from the upper respiratory tract (tonsils, adenoids, mucosa from the ethmoid and maxillary sinuses) of 28 patients (20 adults, eight children) with upper airway infections that had persisted despite repeated treatment with anti-inflammatory agents and antibiotics with demonstrated in vitro efficacy. Tissues were cultured using conventional methods and subjected to scanning electron microscopy for detection of biofilm formation.Results: Over 80 per cent (26/32; 81.3 per cent) of the tissue specimens were culture-positive. Bacterial biofilms (associated in most cases with coccoid bacteria) were observed in 65.6 per cent of the tissue samples. [ABSTRACT FROM AUTHOR]
- Published
- 2007
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39. Robotic approach for the treatment of gynecological cancers recurrences: A ten-year single-institution experience.
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Certelli C, Palmieri L, Federico A, Oliva R, Conte C, Rosati A, Vargiu V, Tortorella L, Chiantera V, Foschi N, Ardito F, Lodoli C, Bruno M, Santullo F, De Rose AM, Fagotti A, Fanfani F, Scambia G, and Gallotta V
- Subjects
- Humans, Female, Middle Aged, Retrospective Studies, Aged, Adult, Operative Time, Endometrial Neoplasms surgery, Endometrial Neoplasms pathology, Postoperative Complications epidemiology, Peritoneal Neoplasms secondary, Peritoneal Neoplasms surgery, Ovarian Neoplasms surgery, Ovarian Neoplasms pathology, Blood Loss, Surgical statistics & numerical data, Lymphatic Metastasis, Obesity complications, Aged, 80 and over, Robotic Surgical Procedures methods, Neoplasm Recurrence, Local, Genital Neoplasms, Female surgery, Genital Neoplasms, Female pathology, Cytoreduction Surgical Procedures methods
- Abstract
Introduction: Although the management of gynecological cancers recurrences may be challenging, due to the heterogeneity of recurrent disease, the aim of this work is to present a descriptive analysis of gynecological malignancies recurrences in our institution treated by robotic approach., Materials and Methods: We performed a retrospective review and analysis of data of patients who underwent robotic surgery for recurrent gynecological malignancies at Catholic University of the Sacred Hearth, Rome, from January 2013 to January 2024., Results: A total of 54 patients underwent successful robotic cytoreductive surgery. The median age was 63 years; the median BMI was 33 kg/m
2 and most of the patients (59 %) were obese. In 12 cases (22 %) the relapse presented was the second or third relapse. The most frequent patterns of recurrence were represented by lymph nodes (41 %), followed by peritoneal (26 %), pelvic (22 %) and parenchymal (11 %). In all patients complete cytoreduction was achieved. In 29 patients (54 %) the surgical field was previous treated. The median operative time and estimated blood loss were, respectively, 270 min and 100 ml. There were 2 intraoperative complications, managed endoscopically; 10 early postoperative complications, and 3 late postoperative complications. The 2-year progression-free-survival and overall survival were, respectively, 39.8 % and 72.3 %., Conclusion: Robotic approach in the treatment of recurrent gynecological cancers should be considered in selected patients with oligometastatic disease, in high-volume centers with expert surgeons, particularly in obese patients., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)- Published
- 2024
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40. Radiomics of Intrahepatic Cholangiocarcinoma and Peritumoral Tissue Predicts Postoperative Survival: Development of a CT-Based Clinical-Radiomic Model.
- Author
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Fiz F, Rossi N, Langella S, Conci S, Serenari M, Ardito F, Cucchetti A, Gallo T, Zamboni GA, Mosconi C, Boldrini L, Mirarchi M, Cirillo S, Ruzzenente A, Pecorella I, Russolillo N, Borzi M, Vara G, Mele C, Ercolani G, Giuliante F, Cescon M, Guglielmi A, Ferrero A, Sollini M, Chiti A, Torzilli G, Ieva F, and Viganò L
- Subjects
- Adult, Aged, Female, Humans, Male, Middle Aged, Follow-Up Studies, Prognosis, Retrospective Studies, Survival Rate, Bile Duct Neoplasms surgery, Bile Duct Neoplasms pathology, Bile Duct Neoplasms diagnostic imaging, Bile Duct Neoplasms mortality, Cholangiocarcinoma surgery, Cholangiocarcinoma pathology, Cholangiocarcinoma diagnostic imaging, Cholangiocarcinoma mortality, Hepatectomy mortality, Radiomics, Tomography, X-Ray Computed methods
- Abstract
Background: For many tumors, radiomics provided a relevant prognostic contribution. This study tested whether the computed tomography (CT)-based textural features of intrahepatic cholangiocarcinoma (ICC) and peritumoral tissue improve the prediction of survival after resection compared with the standard clinical indices., Methods: All consecutive patients affected by ICC who underwent hepatectomy at six high-volume centers (2009-2019) were considered for the study. The arterial and portal phases of CT performed fewer than 60 days before surgery were analyzed. A manual segmentation of the tumor was performed (Tumor-VOI). A 5-mm volume expansion then was applied to identify the peritumoral tissue (Margin-VOI)., Results: The study enrolled 215 patients. After a median follow-up period of 28 months, the overall survival (OS) rate was 57.0%, and the progression-free survival (PFS) rate was 34.9% at 3 years. The clinical predictive model of OS had a C-index of 0.681. The addition of radiomic features led to a progressive improvement of performances (C-index of 0.71, including the portal Tumor-VOI, C-index of 0.752 including the portal Tumor- and Margin-VOI, C-index of 0.764, including all VOIs of the portal and arterial phases). The latter model combined clinical variables (CA19-9 and tumor pattern), tumor indices (density, homogeneity), margin data (kurtosis, compacity, shape), and GLRLM indices. The model had performance equivalent to that of the postoperative clinical model including the pathology data (C-index of 0.765). The same results were observed for PFS., Conclusions: The radiomics of ICC and peritumoral tissue extracted from preoperative CT improves the prediction of survival. Both the portal and arterial phases should be considered. Radiomic and clinical data are complementary and achieve a preoperative estimation of prognosis equivalent to that achieved in the postoperative setting., (© 2024. Society of Surgical Oncology.)
- Published
- 2024
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41. Single large hepatocellular carcinoma > 5 cm with surgical indication: is it mandatory a major hepatectomy? a propensity-score weighted analysis.
- Author
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Garancini M, Serenari M, Famularo S, Cipriani F, Ardito F, Russolillo N, Conci S, Nicolini D, Perri P, Zanello M, Iaria M, Lai Q, Romano M, La Barba G, Molfino S, Germani P, Dominioni T, Zimmiti G, Conticchio M, Fumagalli L, Zago M, Troci A, Sciannamea I, Ferrari C, Scotti MA, Griseri G, Antonucci A, Crespi M, Pinotti E, Chiarelli M, Memeo R, Hilal MA, Maestri M, Tarchi P, Baiocchi G, Ercolani G, Zanus G, Rossi M, Valle RD, Jovine E, Frena A, Patauner S, Grazi GL, Vivarelli M, Ruzzenente A, Ferrero A, Giuliante F, Aldrighetti L, Torzilli G, Cescon M, Bernasconi D, and Romano F
- Subjects
- Humans, Male, Female, Retrospective Studies, Middle Aged, Aged, Postoperative Complications etiology, Treatment Outcome, Survival Rate, Adult, Hepatectomy methods, Carcinoma, Hepatocellular surgery, Carcinoma, Hepatocellular pathology, Carcinoma, Hepatocellular mortality, Liver Neoplasms surgery, Liver Neoplasms pathology, Liver Neoplasms mortality, Propensity Score
- Abstract
Purpose: Single large hepatocellular carcinoma >5cm (SLHCC) traditionally requires a major liver resection. Minor resections are often performed with the goal to reduce morbidity and mortality. Aim of the study was to establish if a major resection should be considered the best treatment for SLHCC or a more limited resection should be preferred., Methods: A multicenter retrospective analysis of the HE.RC.O.LE.S. Group register was performed. All collected patients with surgically treated SLHCC were divided in 5 groups of treatment (major hepatectomy, sectorectomy, left lateral sectionectomy, segmentectomy, non-anatomical resection) and compared for baseline characteristics, short and long-term results. A propensity-score weighted analysis was performed., Results: 535 patients were enrolled in the study. Major resection was associated with significantly increased major complications compared to left lateral sectionanectomy, segmentectomy and non-anatomical resection (all p<0.05) and borderline significant increased major complications compared to sectorectomy (p=0.08). Left lateral sectionectomy showed better overall survival compared to major resection (p=0.02), while other groups of treatment resulted similar to major hepatectomy group for the same item. Absence of oncological benefit after major resection and similar outcomes among the 5 groups of treatment was confirmed even in the sub-population excluding patients with macrovascular invasion., Conclusion: Major resection was associated to increased major post-operative morbidity without long-term survival benefit; when technically feasible and oncologically adequate, minor resections should be preferred for the surgical treatment of SLHCC., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
- Published
- 2024
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42. Liver Resection vs Nonsurgical Treatments for Patients With Early Multinodular Hepatocellular Carcinoma.
- Author
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Vitale A, Romano P, Cillo U, Lauterio A, Sangiovanni A, Cabibbo G, Missale G, Marseglia M, Trevisani F, Foschi FG, Cipriani F, Famularo S, Marra F, Saitta C, Serenari M, Vidili G, Morisco F, Caturelli E, Mega A, Pelizzaro F, Nicolini D, Ardito F, Garancini M, Masotto A, Baroni GS, Azzaroli F, Giannini E, Perri P, Scarinci A, Fontana AP, Brunetto MR, Iaria M, Di Marco M, Nardone G, Dominioni T, Lai Q, Ferrari C, Rapaccini GL, Rodolfo S, Romano M, Conci S, Zoli M, Conticchio M, Zanello M, Zimmitti G, Fumagalli L, Troci A, Germani P, Gasbarrini A, La Barba G, De Angelis M, Patauner S, Molfino S, Zago M, Pinotti E, Frigo AC, Baiocchi GL, Frena A, Boccia L, Ercolani G, Tarchi P, Crespi M, Chiarelli M, Abu Hilal M, Cescon M, Memeo R, Ruzzenente A, Zanus G, Griseri G, Rossi M, Maestri M, Della Valle R, Ferrero A, Grazi GL, Romano F, Giuliante F, Vivarelli M, Jovine E, Torzilli G, Aldrighetti L, and De Carlis L
- Subjects
- Humans, Male, Female, Middle Aged, Retrospective Studies, Aged, Survival Rate, Radiofrequency Ablation, Treatment Outcome, Carcinoma, Hepatocellular therapy, Carcinoma, Hepatocellular mortality, Carcinoma, Hepatocellular pathology, Carcinoma, Hepatocellular surgery, Liver Neoplasms therapy, Liver Neoplasms mortality, Liver Neoplasms pathology, Hepatectomy, Chemoembolization, Therapeutic
- Abstract
Importance: The 2022 Barcelona Clinic Liver Cancer algorithm currently discourages liver resection (LR) for patients with multinodular hepatocellular carcinoma (HCC) presenting with 2 or 3 nodules that are each 3 cm or smaller., Objective: To compare the efficacy of liver resection (LR), percutaneous radiofrequency ablation (PRFA), and transarterial chemoembolization (TACE) in patients with multinodular HCC., Design, Setting, and Participants: This cohort study is a retrospective analysis conducted using data from the HE.RC.O.LE.S register (n = 5331) for LR patients and the ITA.LI.CA database (n = 7056) for PRFA and TACE patients. A matching-adjusted indirect comparison (MAIC) method was applied to balance data and potential confounding factors between the 3 groups. Included were patients from multiple centers from 2008 to 2020; data were analyzed from January to December 2023., Interventions: LR, PRFA, or TACE., Main Outcomes and Measures: Survival rates at 1, 3, and 5 years were calculated. Cox MAIC-weighted multivariable analysis and competing risk analysis were used to assess outcomes., Results: A total of 720 patients with early multinodular HCC were included, 543 males (75.4%), 177 females (24.6%), and 350 individuals older than 70 years (48.6%). There were 296 patients in the LR group, 240 who underwent PRFA, and 184 who underwent TACE. After MAIC, LR exhibited 1-, 3-, and 5-year survival rates of 89.11%, 70.98%, and 56.44%, respectively. PRFA showed rates of 94.01%, 65.20%, and 39.93%, while TACE displayed rates of 90.88%, 48.95%, and 29.24%. Multivariable Cox survival analysis in the weighted population showed a survival benefit over alternative treatments (PRFA vs LR: hazard ratio [HR], 1.41; 95% CI, 1.07-1.86; P = .01; TACE vs LR: HR, 1.86; 95% CI, 1.29-2.68; P = .001). Competing risk analysis confirmed a lower risk of cancer-related death in LR compared with PRFA and TACE., Conclusions and Relevance: For patients with early multinodular HCC who are ineligible for transplant, LR should be prioritized as the primary therapeutic option, followed by PRFA and TACE when LR is not feasible. These findings provide valuable insights for clinical decision-making in this patient population.
- Published
- 2024
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43. Feasibility and operative outcomes of surgery in the liver area in advanced ovarian cancer.
- Author
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Rosati A, De Rose AM, Gallotta V, Giannarelli D, Ghirardi V, Pavone M, De Palma A, Conte C, Marchetti C, Gallucci V, Ardito F, Giuliante F, Querleu D, Scambia G, and Fagotti A
- Subjects
- Humans, Female, Middle Aged, Retrospective Studies, Aged, Adult, Intraoperative Complications epidemiology, Intraoperative Complications etiology, Treatment Outcome, Aged, 80 and over, Hepatectomy methods, Hepatectomy adverse effects, Ovarian Neoplasms surgery, Ovarian Neoplasms pathology, Liver Neoplasms surgery, Liver Neoplasms secondary, Liver Neoplasms pathology, Feasibility Studies, Postoperative Complications epidemiology, Postoperative Complications etiology
- Abstract
Objective: The study aimed to characterize intra-and postoperative complications according to a standardized anatomo-surgical classification for ovarian cancer metastases in the liver area., Methods: Data from all patients with advanced ovarian cancer undergoing primary or secondary surgery with perihepatic liver involvement (May-2016 to May-2022), were retrospectively retrieved and classified according to a standardized anatomo-surgical classification, and clustered into four Classes: Class I "Peritoneal", Class II "Hepatoceliac-lymph-nodes", Class III "Parenchymal" and Class IV Mixed (≥ 2 classes)., Results: Data from 615 patients were collected. Intraoperative complications were observed in 15%, and severe postoperative complications in 17.6% of cases. While surgical complexity scores were similar, Class IV had longer operative times, higher blood loss, and a 30.4% intraoperative transfusion rate. Class II showed a higher prevalence of vascular injuries (8%). Classes II and IV were significantly associated with severe postoperative complications. Specific complications varied among classes, such as perihepatic collection and intrahepatic hematoma/abscess in Class III (p = 0.003, p < 0.001, respectively), and pleuric effusion, sepsis, anemia, and "other complications" in Class IV (p = 0.002, p = 0.004, p = 0.03, p = 0.03, respectively). Multivariable analysis identified Class II and IV (Class II: OR 4.991, p = 0.045; Class IV: OR 5.331, p = 0.030), Surgical Complexity Score group 3 (OR:3.922, p = 0.003), and the presence of residual tumor (OR:1.748, p = 0.048) as independent risk factors for severe postoperative complications., Conclusions: Liver procedures during advanced ovarian cancer surgery are feasible with acceptable complication rates According to the anatomo-surgical classification, metastatic patterns are related to both different surgical outcomes and postoperative complication profiles., Competing Interests: Declaration of competing interest The authors report no conflict of interest., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
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- 2024
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44. Protective Effect of Minimally Invasive Approach on Postoperative Peak Transaminase Following Liver Resection: A Single-Center Propensity Score-Based Analysis.
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Ardito F, Ingallinella S, Lai Q, Razionale F, De Sio D, Mele C, Vani S, Vellone M, and Giuliante F
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Background: Postoperative serum ALT levels are one of the most frequently used marker to detect liver tissue damage following liver resection. The aim of this study was to evaluate if minimally invasive liver surgery (MILS) may result in less hepatic injury than open hepatectomy by assessing the differences of postoperative ALT levels., Methods: Patients who underwent MILS between 2009 and 2019 at our unit were included and compared with open liver resections. Median ALT levels was measured on postoperative day (POD) 1, 3 and 5. Postoperative peak transaminase (PPT) of ALT was determined on POD 1. The stabilized inverse probability treatment weighing (SIPTW) process was used to balance the two groups. A multivariable logistic regression analysis was used to analyze factors associated with high PPT., Results: After SIPTW, 292 MILS were compared with 159 open resections. Median ALT levels on POD 1, 3 and 5 were significantly higher in the open group than in the MILS group (301 vs. 187, p = 0.002; 180 vs. 121, p < 0.0001; 104 vs. 60, p < 0.0001; respectively). At the multivariable logistic regression analysis, MILS showed a protective effect for high PPT., Conclusions: MILS was associated with significantly lower postoperative ALT levels compared with open liver resections. MILS showed a protective effect for high PPT.
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- 2024
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45. Emerging Prognostic Markers in Patients Undergoing Liver Resection for Hepatocellular Carcinoma: A Narrative Review.
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Panettieri E, Campisi A, De Rose AM, Mele C, Giuliante F, Vauthey JN, and Ardito F
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In patients with hepatocellular carcinoma (HCC), liver resection is potentially curative. Nevertheless, post-operative recurrence is common, occurring in up to 70% of patients. Factors traditionally recognized to predict recurrence and survival after liver resection for HCC include pathologic factors (i.e., microvascular and capsular invasion) and an increase in alpha-fetoprotein level. During the past decade, many new markers have been reported to correlate with prognosis after resection of HCC: liquid biopsy markers, gene signatures, inflammation markers, and other biomarkers, including PIVKA-II, immune checkpoint molecules, and proteins in urinary exosomes. However, not all of these new markers are readily available in clinical practice, and their reproducibility is unclear. Liquid biopsy is a powerful and established tool for predicting long-term outcomes after resection of HCC; the main limitation of liquid biopsy is represented by the cost related to its technical implementation. Numerous patterns of genetic expression capable of predicting survival after curative-intent hepatectomy for HCC have been identified, but published findings regarding these markers are heterogenous. Inflammation markers in the form of prognostic nutritional index and different blood cell ratios seem more easily reproducible and more affordable on a large scale than other emerging markers. To select the most effective treatment for patients with HCC, it is crucial that the scientific community validate new predictive markers for recurrence and survival after resection that are reliable and widely reproducible. More reports from Western countries are necessary to corroborate the evidence.
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- 2024
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46. Treatment of oligo-metastatic pancreatic ductal adenocarcinoma to the liver: is there a role for surgery? A narrative review.
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Giuliante F, Panettieri E, Campisi A, Coppola A, Vellone M, De Rose AM, and Ardito F
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Pancreatic ductal adenocarcinoma (PDAC) is a prognostically unfavorable malignancy that presents with distant metastases at the time of diagnosis in half of patients. Even if patients with metastatic PDAC have not been traditionally considered candidates for surgery, an increasing number of researchers have been investigating the efficacy of surgical treatment for patients with liver-only oligometastases from PDAC, showing promising results in extremely selected patients, mainly with metachronous metastases after perioperative chemotherapy. Nevertheless, a standardized definition of oligometastatic disease should be adopted and additional investigations focusing on the role of perioperative chemotherapy and tumor biology are warranted to reliably assess the role of resection for PDAC metastatic to the liver., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)
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- 2024
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47. Laparoscopic hepatic segmentectomy 4a for HCC with cirrhosis: The cranio-ventral approach to the middle hepatic vein.
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Ardito F, Razionale F, and Giuliante F
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- Humans, Treatment Outcome, Carcinoma, Hepatocellular surgery, Carcinoma, Hepatocellular complications, Hepatectomy methods, Hepatic Veins surgery, Hepatic Veins diagnostic imaging, Laparoscopy methods, Liver Cirrhosis complications, Liver Cirrhosis surgery, Liver Neoplasms surgery, Liver Neoplasms complications
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- 2024
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48. Evaluation of the economic impact of the robotic approach in major and postero-superior segment liver resections: a multicenter retrospective analysis.
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Ingallinella S, Ardito F, Ratti F, Marino R, Catena M, De Rose AM, Razionale F, Rumi F, Cicchetti A, Giuliante F, and Aldrighetti L
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Background: Economic impact of robotic liver surgery (RLS) is still a debated issue due to the heterogeneity of liver resections considered and the lack of a rigorous methodology. Therefore, the aim of this study is to perform a time-driven activity-based costing (TD-ABC) comparing the costs of RLS, laparoscopic liver surgery (LLS) and open liver surgery (OLS) in the context of complex liver resections and to compare short term perioperative outcomes., Methods: The institutional databases of two Italian high volume hepatobiliary centres were retrospectively reviewed from February 2021 to April 2022. Patients submitted to major hepatectomies or postero-superior liver resections were selected and divided into three groups according to the approach scheduled (RLS, LLS and OLS) and compared. Major contributors of perioperative expenses were calculated using the TD-ABC model and accurately quantifying each unit resource consumed per patient and the time spent performing each activity. A primary intention-to-treat analysis (ITT-A) including conversions in the RLS and LLS groups was performed., Results: Forty-seven RLS, 101 LLS and 124 OLS were collected. LLS and RLS showed reduced blood loss, morbidity, mortality and hospital stay compared with open. A trend towards reduced conversion rate in RLS compared to LLS was registered. Total costs associated with RLS were estimated at €10,637 vs. €9,543 for LLS and vs. €13,960 for OLS. The higher intraoperative costs associated with RLS (+153.3% vs. OLS and +148.2% vs. LLS, P<0.001), primarily related to surgical equipment expenses, were slightly offset by the postoperative savings (-56.0% vs. OLS and -29.4% vs. LLS, P<0.001) resulting from significantly reduced hospital stays., Conclusions: RLS offers economic advantages over OLS, as initial higher costs are offset by better perioperative outcomes. The evolving robotic marketplace is expected to drive down RLS costs, promoting widespread adoption in minimally invasive procedures. Despite its higher costs than LLS, RLS's ability to enhance minimally invasive feasibility makes it a preferred choice for complex cases, reducing the need for conversions., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://hbsn.amegroups.com/article/view/10.21037/hbsn-23-407/coif). L.A. serves as an unpaid editorial board member of Hepatobiliary Surgery and Nutrition. The other authors have no conflicts of interest to declare., (2024 Hepatobiliary Surgery and Nutrition. All rights reserved.)
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- 2024
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49. Preoperative detection of hepatocellular carcinoma's microvascular invasion on CT-scan by machine learning and radiomics: A preliminary analysis.
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Famularo S, Penzo C, Maino C, Milana F, Oliva R, Marescaux J, Diana M, Romano F, Giuliante F, Ardito F, Grazi GL, Donadon M, and Torzilli G
- Abstract
Introduction: Microvascular invasion (MVI) is the main risk factor for overall mortality and recurrence after surgery for hepatocellular carcinoma (HCC).The aim was to train machine-learning models to predict MVI on preoperative CT scan., Methods: 3-phases CT scans were retrospectively collected among 4 Italian centers. DICOM files were manually segmented to detect the liver and the tumor(s). Radiomics features were extracted from the tumoral, peritumoral and healthy liver areas in each phase. Principal component analysis (PCA) was performed to reduce the dimensions of the dataset. Data were divided between training (70%) and test (30%) sets. Random-Forest (RF), fully connected MLP Artificial neural network (neuralnet) and extreme gradient boosting (XGB) models were fitted to predict MVI. Prediction accuracy was estimated in the test set., Results: Between 2008 and 2022, 218 preoperative CT scans were collected. At the histological specimen, 72(33.02%) patients had MVI. First and second order radiomics features were extracted, obtaining 672 variables. PCA selected 58 dimensions explaining >95% of the variance.In the test set, the XGB model obtained Accuracy = 68.7% (Sens: 38.1%, Spec: 83.7%, PPV: 53.3% and NPV: 73.4%). The neuralnet showed an Accuracy = 50% (Sens: 52.3%, Spec: 48.8%, PPV: 33.3%, NPV: 67.7%). RF was the best performer (Acc = 96.8%, 95%CI: 0.91-0.99, Sens: 95.2%, Spec: 97.6%, PPV: 95.2% and NPV: 97.6%)., Conclusion: Our model allowed a high prediction accuracy of the presence of MVI at the time of HCC diagnosis. This could lead to change the treatment allocation, the surgical extension and the follow-up strategy for those patients., Competing Interests: Declaration of competing interest No conflict of interest has to be reported for the present manuscript from each of the authors., (© 2024 Published by Elsevier Ltd.)
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- 2024
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50. Liver transplantation vs liver resection in HCC: promoting extensive collaborative research through a survival meta-analysis of meta-analyses.
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Martinino A, Bucaro A, Cardella F, Wazir I, Frongillo F, Ardito F, and Giovinazzo F
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Background: HCC is a major global health concern, necessitating effective treatment strategies. This study conducts a meta-analysis of meta-analyses comparing liver resection (LR) and liver transplantation (LT) for HCC., Methods: The systematic review included meta-analyses comparing liver resection vs. liver transplantation in HCC, following PRISMA guidelines. Primary outcomes included 5-year overall survival (OS) and disease-free survival (DFS). AMSTAR-2 assessed study quality. Citation matrix and hierarchical clustering validated the consistency of the included studies., Results: A search identified 10 meta-analyses for inclusion. The median Pearson correlation coefficient for citations was 0.59 (IQR 0.41-0.65). LT showed better 5-year survival and disease-free survival in all HCC (OR): 0.79; 95% CI: 0.67-0.93, I^2:57% and OR: 0.44; 95% CI: 0.25-0.75, I^2:96%). Five-year survival in early HCC and ITT was 0.63 (95% CI: 0.50-0.78, I^2:0%) and 0.60 (95% CI: 0.39-0.92, I^2:0%). Salvage LT vs. Primary LT did not differ between 5-year survival and disease-free survival (OR: 0.62; 95% CI: 0.33-1.15, I^2:0% and 0.93; 95% CI: 0.82-1.04, I^2:0%)., Conclusion: Overall, the study underscores the superior survival outcomes associated with LT over LR in HCC treatment, supported by comprehensive meta-analysis and clustering analysis. There was no difference in survival or recurrence rate between salvage LT and primary LT. Therefore, considering the organ shortage, HCC can be resected and transplanted in case of recurrence., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Martinino, Bucaro, Cardella, Wazir, Frongillo, Ardito and Giovinazzo.)
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- 2024
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