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270 results on '"Giampalma E."'

1. Pancreatic Organoids establishment from EUS Fine Needle Biopsy in patients affected by Pancreatic Cancer: Preliminary results from the Bile Biopsy study

Author

Binda, C., additional, Giuffrida, P., additional, Zanoni, M., additional, Marisi, G., additional, Coluccio, C., additional, Perini, B., additional, Fabbri, S., additional, Gibiino, G., additional, Limarzi, F., additional, Vizzuso, A., additional, Rapposelli, I. G., additional, Giampalma, E., additional, Cricca, M., additional, Cammà, C., additional, Sambri, V., additional, Ulivi, P., additional, and Fabbri, C., additional

Published
2024
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3. Transient diaphragmatic thinning in patients with interstitial pneumonia due to SARS-CoV-2

Author

Battisti, S., Sanson, G., Paolucci, E., Giampalma, E., Russo, E., Bergamini, C., Agnoletti, V., Di Bella, S., Palermo, A., Scarlata, S., Battisti, S., Sanson, G., Paolucci, E., Giampalma, E., Russo, E., Bergamini, C., Agnoletti, V., Di Bella, S., Palermo, A., and Scarlata, S.

Subjects
Lung Diseases, Pulmonary and Respiratory Medicine, Infectious Diseases, SARS-CoV-2, Humans, COVID-19, Viral, Antibodies, Viral, Lung Diseases, Interstitial, Interstitial, Antibodies, Human
Abstract

NA

Published
2022

4. Sustained oxygenation improvement after first prone positioning is associated with liberation from mechanical ventilation and mortality in critically ill COVID-19 patients: a cohort study

Author

Scaramuzzo G., Gamberini L., Tonetti T., Zani G., Ottaviani I., Mazzoli C. A., Capozzi C., Giampalma E., Bacchi Reggiani M. L., Bertellini E., Castelli A., Cavalli I., Colombo D., Crimaldi F., Damiani F., Fusari M., Gamberini E., Gordini G., Laici C., Lanza M. C., Leo M., Marudi A., Nardi G., Papa R., Potalivo A., Russo E., Taddei S., Consales G., Cappellini I., Ranieri V. M., Volta C. A., Guerin C., Spadaro S., Tartaglione M., Chiarini V., Buldini V., Coniglio C., Moro F., Barbalace C., Citino M., Cilloni N., Giuntoli L., Bellocchio A., Matteo E., Pizzilli G., Siniscalchi A., Tartivita C., Matteo F., Marchio A., Bacchilega I., Bernabe L., Guarino S., Mosconi E., Bissoni L., Viola L., Meconi T., Pavoni V., Pagni A., Pompa Cleta P., Cavagnino M., Malfatto A., Adduci A., Pareschi S., Melegari G., Maccieri J., Marinangeli E., Racca F., Verri M., Falo G., Marangoni E., Boni F., Felloni G., Baccarini F. D., Terzitta M., Maitan S., Becherucci F., Parise M., Masoni F., Imbriani M., Orlandi P., Monetti F., Dalpiaz G., Golfieri R., Ciccarese F., Poerio A., Muratore F., Ferrari F., Mughetti M., Franchini L., Neziri E., Miceli M., Minguzzi M. T., Mellini L., Piciucchi S., Bartolucci M., Scaramuzzo G., Gamberini L., Tonetti T., Zani G., Ottaviani I., Mazzoli C.A., Capozzi C., Giampalma E., Bacchi Reggiani M.L., Bertellini E., Castelli A., Cavalli I., Colombo D., Crimaldi F., Damiani F., Fusari M., Gamberini E., Gordini G., Laici C., Lanza M.C., Leo M., Marudi A., Nardi G., Papa R., Potalivo A., Russo E., Taddei S., Consales G., Cappellini I., Ranieri V.M., Volta C.A., Guerin C., Spadaro S., Tartaglione M., Chiarini V., Buldini V., Coniglio C., Moro F., Barbalace C., Citino M., Cilloni N., Giuntoli L., Bellocchio A., Matteo E., Pizzilli G., Siniscalchi A., Tartivita C., Matteo F., Marchio A., Bacchilega I., Bernabe L., Guarino S., Mosconi E., Bissoni L., Viola L., Meconi T., Pavoni V., Pagni A., Pompa Cleta P., Cavagnino M., Malfatto A., Adduci A., Pareschi S., Melegari G., Maccieri J., Marinangeli E., Racca F., Verri M., Falo G., Marangoni E., Boni F., Felloni G., Baccarini F.D., Terzitta M., Maitan S., Becherucci F., Parise M., Masoni F., Imbriani M., Orlandi P., Monetti F., Dalpiaz G., Golfieri R., Ciccarese F., Poerio A., Muratore F., Ferrari F., Mughetti M., Franchini L., Neziri E., Miceli M., Minguzzi M.T., Mellini L., Piciucchi S., and Bartolucci M.

Subjects
medicine.medical_specialty, Supine position, COVID19, medicine.medical_treatment, Respiratory physiology, Prone positioning, ventilatory free days, Critical Care and Intensive Care Medicine, ICU, COVID19, Prone positioning, ventilatory free days, NO, 03 medical and health sciences, 0302 clinical medicine, Anesthesiology, medicine, 030212 general & internal medicine, Mechanical ventilation, business.industry, RC86-88.9, Research, Medical emergencies. Critical care. Intensive care. First aid, Oxygenation, respiratory system, respiratory tract diseases, Prone position, 030228 respiratory system, Anesthesia, ICU, Complication, business, Cohort study
Abstract

Background Prone positioning (PP) has been used to improve oxygenation in patients affected by the SARS-CoV-2 disease (COVID-19). Several mechanisms, including lung recruitment and better lung ventilation/perfusion matching, make a relevant rational for using PP. However, not all patients maintain the oxygenation improvement after returning to supine position. Nevertheless, no evidence exists that a sustained oxygenation response after PP is associated to outcome in mechanically ventilated COVID-19 patients. We analyzed data from 191 patients affected by COVID-19-related acute respiratory distress syndrome undergoing PP for clinical reasons. Clinical history, severity scores and respiratory mechanics were analyzed. Patients were classified as responders (≥ median PaO2/FiO2 variation) or non-responders (2/FiO2 variation) based on the PaO2/FiO2 percentage change between pre-proning and 1 to 3 h after re-supination in the first prone positioning session. Differences among the groups in physiological variables, complication rates and outcome were evaluated. A competing risk regression analysis was conducted to evaluate if PaO2/FiO2 response after the first pronation cycle was associated to liberation from mechanical ventilation. Results The median PaO2/FiO2 variation after the first PP cycle was 49 [19–100%] and no differences were found in demographics, comorbidities, ventilatory treatment and PaO2/FiO2 before PP between responders (96/191) and non-responders (95/191). Despite no differences in ICU length of stay, non-responders had a higher rate of tracheostomy (70.5% vs 47.9, P = 0.008) and mortality (53.7% vs 33.3%, P = 0.006), as compared to responders. Moreover, oxygenation response after the first PP was independently associated to liberation from mechanical ventilation at 28 days and was increasingly higher being higher the oxygenation response to PP. Conclusions Sustained oxygenation improvement after first PP session is independently associated to improved survival and reduced duration of mechanical ventilation in critically ill COVID-19 patients.

Published
2021

8. Factors influencing liberation from mechanical ventilation in coronavirus disease 2019: multicenter observational study in fifteen Italian ICUs

Author

Gamberini, L., Tonetti, T., Spadaro, S., Zani, G., Mazzoli, C. A., Capozzi, C., Giampalma, E., Bacchi Reggiani, M. L., Bertellini, E., Castelli, A., Cavalli, I., Colombo, D., Crimaldi, F., Damiani, F., Fogagnolo, A., Fusari, M., Gamberini, E., Gordini, G., Laici, C., Lanza, M. C., Leo, M., Marudi, A., Nardi, G., Ottaviani, I., Papa, R., Potalivo, A., Russo, E., Taddei, S., Volta, C. A., Ranieri, V. M., Tartaglione, M., Chiarini, V., Buldini, V., Coniglio, C., Moro, F., Cilloni, N., Giuntoli, L., Bellocchio, A., Matteo, E., Pizzilli, G., Siniscalchi, A., Tartivita, C., Matteo, F., Marchio, A., Bacchilega, I., Bernabe, L., Guarino, S., Mosconi, G., Bissoni, L., Viola, L., Meconi, T., Pavoni, V., Pagni, A., Pompacleta, P., Cavagnino, M., Malfatto, A., Adduci, A., Pareschi, S., Melegari, G., Maccieri, J., Marinangeli, E., Racca, F., Verri, M., Falo, G., Marangoni, E., Boni, F., Felloni, G., Baccarini, F. D., Terzitta, M., Maitan, S., Imbriani, M., Orlandi, P., Dalpiaz, G., Golfieri, R., Ciccarese, F., Poerio, A., Muratore, F., Ferrari, F., Mughetti, M., Franchini, L., Neziri, E., Miceli, M., Minguzzi, M. T., Mellini, L., Piciucchi, S., Gamberini, Lorenzo, Tonetti, Tommaso, Spadaro, Savino, Zani, Gianluca, Mazzoli, Carlo Alberto, Capozzi, Chiara, Giampalma, Emanuela, Bacchi Reggiani, Maria Letizia, Bertellini, Elisabetta, Castelli, Andrea, Cavalli, Irene, Colombo, Davide, Crimaldi, Federico, Damiani, Federica, Fogagnolo, Alberto, Fusari, Maurizio, Gamberini, Emiliano, Gordini, Giovanni, Laici, Cristiana, Lanza, Maria Concetta, Leo, Mirco, Marudi, Andrea, Nardi, Giuseppe, Ottaviani, Irene, Papa, Raffaella, Potalivo, Antonella, Russo, Emanuele, Taddei, Stefania, Volta, Carlo Alberto, and Ranieri, V Marco

Subjects
medicine.medical_specialty, ARDS, medicine.medical_treatment, artificial, Outcomes, Critical Care and Intensive Care Medicine, law.invention, NO, 03 medical and health sciences, 0302 clinical medicine, Mechanical ventilation, law, Coronavirus disease 2019, Intensive care, Outcomes, mortality, Respiration, artificial, medicine, 030212 general & internal medicine, Renal replacement therapy, business.industry, Research, Respiration, Organ dysfunction, lcsh:Medical emergencies. Critical care. Intensive care. First aid, 030208 emergency & critical care medicine, lcsh:RC86-88.9, medicine.disease, Intensive care unit, mortality, Respiratory failure, Emergency medicine, SOFA score, medicine.symptom, business
Abstract

Background A large proportion of patients with coronavirus disease 2019 (COVID-19) develop severe respiratory failure requiring admission to the intensive care unit (ICU) and about 80% of them need mechanical ventilation (MV). These patients show great complexity due to multiple organ involvement and a dynamic evolution over time; moreover, few information is available about the risk factors that may contribute to increase the time course of mechanical ventilation. The primary objective of this study is to investigate the risk factors associated with the inability to liberate COVID-19 patients from mechanical ventilation. Due to the complex evolution of the disease, we analyzed both pulmonary variables and occurrence of non-pulmonary complications during mechanical ventilation. The secondary objective of this study was the evaluation of risk factors for ICU mortality. Methods This multicenter prospective observational study enrolled 391 patients from fifteen COVID-19 dedicated Italian ICUs which underwent invasive mechanical ventilation for COVID-19 pneumonia. Clinical and laboratory data, ventilator parameters, occurrence of organ dysfunction, and outcome were recorded. The primary outcome measure was 28 days ventilator-free days and the liberation from MV at 28 days was studied by performing a competing risks regression model on data, according to the method of Fine and Gray; the event death was considered as a competing risk. Results Liberation from mechanical ventilation was achieved in 53.2% of the patients (208/391). Competing risks analysis, considering death as a competing event, demonstrated a decreased sub-hazard ratio for liberation from mechanical ventilation (MV) with increasing age and SOFA score at ICU admission, low values of PaO2/FiO2 ratio during the first 5 days of MV, respiratory system compliance (CRS) lower than 40 mL/cmH2O during the first 5 days of MV, need for renal replacement therapy (RRT), late-onset ventilator-associated pneumonia (VAP), and cardiovascular complications. ICU mortality during the observation period was 36.1% (141/391). Similar results were obtained by the multivariate logistic regression analysis using mortality as a dependent variable. Conclusions Age, SOFA score at ICU admission, CRS, PaO2/FiO2, renal and cardiovascular complications, and late-onset VAP were all independent risk factors for prolonged mechanical ventilation in patients with COVID-19. Trial registration NCT04411459

Published
2020

18. Clinical patterns of hepatocellular carcinoma in nonalcoholic fatty liver disease: A multicenter prospective study

Author

Piscaglia, Fabio, Svegliati Baroni, Gianluca, Barchetti, Andrea, Pecorelli, Anna, Marinelli, Sara, Tiribelli, Claudio, Bellentani, Stefano, Bernardi M, Biselli M, Bernardi M, Biselli M, Caraceni P, Domenicali M, Garuti F, Gramenzi A, Lenzi B, Magalotti D, Cescon M, Ravaioli M, Del Poggio P, Olmi S, Rapaccini GL, Balsamo C, Di Nolfo MA, Vavassori E, Alberti A, Benvegnù L, Gatta A, Giacomin A, Vanin V, Pozzan C, Maddalo G, Giampalma E, Cappelli A, Golfieri R, Mosconi C, Renzulli M, Roselli P, Dell'Isola S, Ialungo AM, Risso D, Marenco S, Sammito G, Bruzzone L, Bosco G, Grieco A, Pompili M, Rinninella E, Siciliano M, Chiaramonte M, Guarino M, Cammà C, Maida M, Costantino A, Barcellona MR, Schiadà L, Gemini S, Lanzi A, Stefanini GF, Dall'Aglio AC, Cappa FM, Suzzi A, Mussetto A, Treossi O, Missale G, Porro E, Mismas V, Vivaldi C, Bolondi L, Zoli M, Granito A, Malagotti D, Tovoli F, Trevisani F, Venerandi L, Brandi G, Cucchetti A, Bugianesi E, Vanni E, Mezzabotta L, Cabibbo G, Petta S, Fracanzani A, Fargion S, Marra F, Fani B, Biasini E, Sacco R, CAPORASO, NICOLA, Colombo M, D'Ambrosio R, Crocè LS, Patti R, Giannini EG, Loria P, Lonardo A, Baldelli E, Miele L, Farinati F, Borzio M, Dionigi E, Soardo G, Caturelli E, Ciccarese F, Virdone R, Affronti A, Foschi FG, Borzio F., MORISCO, FILOMENA, Piscaglia, Fabio, Svegliati Baroni, Gianluca, Barchetti, Andrea, Pecorelli, Anna, Marinelli, Sara, Tiribelli, Claudio, Bellentani, Stefano, Bernardi M, Biselli M, Bernardi, M, Biselli, M, Caraceni, P, Domenicali, M, Garuti, F, Gramenzi, A, Lenzi, B, Magalotti, D, Cescon, M, Ravaioli, M, Del Poggio, P, Olmi, S, Rapaccini, Gl, Balsamo, C, Di Nolfo, Ma, Vavassori, E, Alberti, A, Benvegnù, L, Gatta, A, Giacomin, A, Vanin, V, Pozzan, C, Maddalo, G, Giampalma, E, Cappelli, A, Golfieri, R, Mosconi, C, Renzulli, M, Roselli, P, Dell'Isola, S, Ialungo, Am, Risso, D, Marenco, S, Sammito, G, Bruzzone, L, Bosco, G, Grieco, A, Pompili, M, Rinninella, E, Siciliano, M, Chiaramonte, M, Guarino, M, Cammà, C, Maida, M, Costantino, A, Barcellona, Mr, Schiadà, L, Gemini, S, Lanzi, A, Stefanini, Gf, Dall'Aglio, Ac, Cappa, Fm, Suzzi, A, Mussetto, A, Treossi, O, Missale, G, Porro, E, Mismas, V, Vivaldi, C, Bolondi, L, Zoli, M, Granito, A, Malagotti, D, Tovoli, F, Trevisani, F, Venerandi, L, Brandi, G, Cucchetti, A, Bugianesi, E, Vanni, E, Mezzabotta, L, Cabibbo, G, Petta, S, Fracanzani, A, Fargion, S, Marra, F, Fani, B, Biasini, E, Sacco, R, Morisco, Filomena, Caporaso, Nicola, Colombo, M, D'Ambrosio, R, Crocè, L, Patti, R, Giannini, Eg, Loria, P, Lonardo, A, Baldelli, E, Miele, L, Farinati, F, Borzio, M, Dionigi, E, Soardo, G, Caturelli, E, Ciccarese, F, Virdone, R, Affronti, A, Foschi, Fg, Borzio, F., Fabio Piscagliaxxx, Gianluca Svegliati-Baroni, Andrea Barchetti, Anna Pecorellixxx, Sara Marinellixxx, Claudio Tiribelli, and, Stefano Bellentani, on behalf of the HCC-NAFLD Italian Study Group [, Mauro Bernardi, Maurizio Biselli, Paolo Caraceni, Marco Domenicali, Francesca Garuti, Annagiulia Gramenzi, Barbara Lenzi, Donatella Magalotti, Matteo Cescon, Matteo Ravaioli, Emanuela Giampalma, Rita Golfieri, Cristina Mosconi, Luigi Bolondi, Marco Zoli, Alessandro Granito, Francesco Tovoli, Franco Trevisani, Laura Venerandi, Giovanni Brandi, Alessandro Cucchetti, ], DIPARTIMENTO DI MEDICINA SPECIALISTICA, DIAGNOSTICA E SPERIMENTALE, DIPARTIMENTO DI SCIENZE MEDICHE E CHIRURGICHE, Facolta' di MEDICINA e CHIRURGIA, AREA MIN. 06 - Scienze mediche, Da definire, Croce', Saveria, and HCC NAFLD Italian Study, Group

Subjects
Male, Cirrhosis, Survival, Chronic liver disease, Gastroenterology, 0302 clinical medicine, Non-alcoholic Fatty Liver Disease, Nonalcoholic fatty liver disease, 80 and over, Prospective Studies, Chronic, Prospective cohort study, Aged, 80 and over, Medicine (all), Liver Neoplasms, hepatocellular carcinoma, Middle Aged, Hepatitis C, Liver Neoplasm, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, Competing risk analysi, 030211 gastroenterology & hepatology, Female, Non Alcoholic SteatoHepatitis=NASH, Human, medicine.medical_specialty, Aged, Carcinoma, Hepatocellular, Hepatitis C, Chronic, Humans, Hepatology, Competing risk analysis, Milan criteria, 03 medical and health sciences, Internal medicine, medicine, Survival rate, business.industry, Settore MED/09 - MEDICINA INTERNA, Carcinoma, nutritional and metabolic diseases, Hepatocellular, medicine.disease, digestive system diseases, Nonalcoholic fatty liver disease, hepatocellular carcinoma, clinical patterns, business, clinical patterns
Abstract

none 31 no Nonalcoholic fatty liver disease (NAFLD) represents the hepatic manifestation of metabolic syndrome and may evolve into hepatocellular carcinoma (HCC). Only scanty clinical information is available on HCC in NAFLD. The aim of this multicenter observational prospective study was to assess the clinical features of patients with NAFLD-related HCC (NAFLD-HCC) and to compare them to those of hepatitis C virus (HCV)-related HCC. A total of 756 patients with either NAFLD (145) or HCV-related chronic liver disease (611) were enrolled in secondary care Italian centers. Survival was modeled according to clinical parameters, lead-time bias, and propensity analysis. Compared to HCV, HCC in NAFLD patients had a larger volume, showed more often an infiltrative pattern, and was detected outside specific surveillance. Cirrhosis was present in only about 50% of NAFLD-HCC patients, in contrast to the near totality of HCV-HCC. Regardless of tumor stage, survival was significantly shorter (P = 0.017) in patients with NAFLD-HCC, 25.5 months (95% confidence interval 21.9-29.1), than in those with HCV-HCC, 33.7 months (95% confidence interval 31.9-35.4). To eliminate possible confounders, a propensity score analysis was performed, which showed no more significant difference between the two groups. Additionally, analysis of patients within Milan criteria submitted to curative treatments did not show any difference in survival between NAFLD-HCC and HCV-HCC (respectively, 38.6 versus 41.0 months, P = nonsignificant) CONCLUSIONS: NAFLD-HCC is more often detected at a later tumor stage and could arise also in the absence of cirrhosis, but after patient matching, it has a similar survival rate compared to HCV infection; a future challenge will be to identify patients with NAFLD who require more stringent surveillance in order to offer the most timely and effective treatment. Fabio Piscagliaxxx; Gianluca Svegliati-Baroni; Andrea Barchetti; Anna Pecorellixxx; Sara Marinellixxx; Claudio Tiribelli; and; Stefano Bellentani; on behalf of the HCC-NAFLD Italian Study Group [;Mauro Bernardi; Maurizio Biselli; Paolo Caraceni; Marco Domenicali; Francesca Garuti; Annagiulia Gramenzi; Barbara Lenzi; Donatella Magalotti; Matteo Cescon; Matteo Ravaioli; Emanuela Giampalma; Rita Golfieri; Cristina Mosconi; Luigi Bolondi; Marco Zoli; Alessandro Granito; Francesco Tovoli; Franco Trevisani; Laura Venerandi; Giovanni Brandi; Alessandro Cucchetti;] Fabio Piscagliaxxx; Gianluca Svegliati-Baroni; Andrea Barchetti; Anna Pecorellixxx; Sara Marinellixxx; Claudio Tiribelli; and; Stefano Bellentani; on behalf of the HCC-NAFLD Italian Study Group [;Mauro Bernardi; Maurizio Biselli; Paolo Caraceni; Marco Domenicali; Francesca Garuti; Annagiulia Gramenzi; Barbara Lenzi; Donatella Magalotti; Matteo Cescon; Matteo Ravaioli; Emanuela Giampalma; Rita Golfieri; Cristina Mosconi; Luigi Bolondi; Marco Zoli; Alessandro Granito; Francesco Tovoli; Franco Trevisani; Laura Venerandi; Giovanni Brandi; Alessandro Cucchetti;]

Published
2016

19. Randomised controlled trial of doxorubicin-eluting beads vs conventional chemoembolisation for hepatocellular carcinoma

Author

Golfieri, R, Giampalma, E, Renzulli, M, Cioni, R, Bargellini, I, Bartolozzi, C, Breatta, A, Gandini, G, Nani, R, Gasparini, D, Cucchetti, A, Bolondi, L, Trevisani, F, Fagiuoli, S, Golfieri R, Giampalma E, Renzulli M, Cioni R, Bargellini I, Bartolozzi C, Breatta AD, Gandini G, Nani R, Gasparini D, Cucchetti A, Bolondi L, Trevisani F, Fagiuoli S, Golfieri, R, Giampalma, E, Renzulli, M, Cioni, R, Bargellini, I, Bartolozzi, C, Breatta, A, Gandini, G, Nani, R, Gasparini, D, Cucchetti, A, Bolondi, L, Trevisani, F, Fagiuoli, S, Golfieri R, Giampalma E, Renzulli M, Cioni R, Bargellini I, Bartolozzi C, Breatta AD, Gandini G, Nani R, Gasparini D, Cucchetti A, Bolondi L, Trevisani F, and Fagiuoli S

Abstract

Background:Transcatheter arterial chemoembolisation (TACE) is the treatment of choice for intermediate stage hepatocellular carcinoma (HCC). Doxorubicin-loaded drug-eluting beads (DEB)-TACE is expected to improve the performance of conventional TACE (cTACE). The aim of this study was to compare DEB-TACE with cTACE in terms of time-to-tumour progression (TTP), adverse events (AEs), and 2-year survival.Methods:Patients were randomised one-to-one to undergo cTACE or DEB-TACE and followed-up for at least 2 years or until death. Transcatheter arterial chemoembolisation was repeated 'on-demand'.Results:We enrolled 177 patients: 89 underwent DEB-TACE and 88 cTACE. The median number of procedures was 2 in each arm, and the in-hospital stay was 3 and 4 days, respectively (P=0.323). No differences were found in local and overall tumour response. The median TTP was 9 months in both arms. The AE incidence and severity did not differ between the arms, except for post-procedural pain, more frequent and severe after cTACE (P<0.001). The 1-and 2-year survival rates were 86.2% and 56.8% after DEB-TACE and 83.5% and 55.4% after cTACE (P=0.949). Eastern Cooperative Oncology Group (ECOG), serum albumin, and tumour number independently predicted survival (P<0.05).Conclusions:The DEB-TACE and the cTACE are equally effective and safe, with the only advantage of DEB-TACE being less post-procedural abdominal pain.

Published
2014

20. Intra-arterial Hepatic Radiotherapy with 90-Ittrium SIR-SPHERES in unresectable colorectal liver metastases refractory to systemic chemotherapy

Author

Cecconi A, Pettinato C, Angelelli B, Di Donna M, Giampalma E, Levorato M, Cappelli A, Golfieri R, Martoni A, Blotta A, Blotta A, Capuccini J, Pettinato C, Angelelli B, Giampalma E, Cappelli A, Gavaruzzi PL, Martoni A, Golfieri R, Mazzarotto R, and Cecconi A, Pettinato C, Angelelli B, Di Donna M, Giampalma E, Levorato M, Cappelli A, Golfieri R, Martoni A, Blotta A

Subjects
Intra-arterial Hepatic Radiotherapy, Sir-sphere, colorectal liver metastase, unresectable colorectal liver metastase, systemic chemotherapy, unresectable, refractory to systemic chemotherapy, 90-Ittrium SIR-SPHERES, 90-Yttrium
Published
2010

21. Yttrium-90 radiotherapy for unresectable intrahepatic cholangiocarcinoma: preliminary results

Author

Svirydenka H, Pettinato C, Monari F, Mosconi C, Sanfilippo S, Ceci F, Tabacchi E, Farina E, Nanni C, Giampalma E, Golfieri R, Fanti S, and Svirydenka H, Pettinato C, Monari F, Mosconi C, Sanfilippo S, Ceci F, Tabacchi E, Farina E, Nanni C, Giampalma E, Golfieri R, Fanti S

Subjects
safety, 90Y radioembolization, intrahepatic cholangiocarcinoma, efficacy, unresectable ICC, CT imaging, mRECIST criteria
Published
2014

23. Age as a possible Independent Prognostic Factor for Overall Survival and Recurrence-Free Survival after Transarterial Chemoembolization in Hepatocellular Carcinoma Patients

Author

Mosconi C, Panzavolta C, Giampalma E, Renzulli M, Bianchi G, Zoli M, Golfieri R, and Mosconi C, Panzavolta C, Giampalma E, Renzulli M, Bianchi G, Zoli M, Golfieri R

Subjects
TACE, age, independent prognostic factor, overall survival, transarterial chemoembolization, hepatocellular carcinoma, recurrence-free survival, elderly patient
Published
2014

25. 99mTc-MAA SPECT vs Y90 PET/CT images: comparison of distribution and dosimetry in SIRT

Author

Pettinato C, Mosconi C, Nanni C, Monari F, Pini P, Castellucci P, Gavaruzzi G, Civollani S, Golfieri R, Giampalma E, Fanti S., Pettinato C, Mosconi C, Nanni C, Monari F, Pini P, and Castellucci P, Gavaruzzi G, Civollani S, Golfieri R,Giampalma E, Fanti, S.

Subjects
SIRTEX, 90Y microsphere, PET/CT, 99mTc‐MAA SPECT
Published
2014

26. Randomised controlled trial of doxorubicin-eluting beads vs conventional chemoembolisation for hepatocellular carcinoma

Author

Golfieri, R., Giampalma, E., Renzulli, M, Cioni, R., Bargellini, I., Bartolozzi, C., Breatta, A. D., Gandini, G., Nani, R., Gasparini, D., Cucchetti, A., Bolondi, L., Trevisani, COLLABORATORS:Mosconi C, F., Cappelli, A, Galaverni, Mc, Pini, P, Piscaglia, F, Benevento, F, Giampaolo, L, Caprara, C, Menichella, R, Lenzi, M, Bernardi, M, Santi, V, Erroi, V, Mazzella, G, Colecchia, A, Montrone, L, Schiumerini, R, Bianchi, G, Zoli, M, Martini, G, Fraticelli, L, Sama, C, Berardi, S, Serra, C, Vignali, C, Bianchi, F, Vallini, V, Carrai, P, Filipponi, F, Moneta, S, Pea, E, Giunta, S, Sacco, R, Ricchiuti, A, di Fluri, G, Coco, B, Rossato, D, Vighetti, C, Battisti, G, Rapellino, A, Carucci, P, Cosso, L, Rizzetto, M, Mirabella, S, Sturniolo, L, Catalano, Giorgia, Salizzoni, M, Agazzi, R, Limonta, S, Fagiuoli, S, Verga, G, Magini, G, Aprile, G, Vit, A., Golfieri, R, Giampalma, E, Renzulli, M, Cioni, R, Bargellini, I, Bartolozzi, C, Breatta, A, Gandini, G, Nani, R, Gasparini, D, Cucchetti, A, Bolondi, L, Trevisani, F, Fagiuoli, S, Golfieri, Rita, Giampalma, Emanuela, Renzulli, Matteo, Cioni, R., Bargellini, I., Bartolozzi, Catia, Breatta, A. D., Gandini, Gualtiero, Nani, R., Gasparini, D., Cucchetti, Alessandro, Bolondi, Luigi, Trevisani, Franco, on behalf of the PRECISION ITALIA STUDY GROUP:, [. . ., Piscaglia, Fabio, Bernardi, Mauro, IBARRA GASPARINI, Daniela, and ], . .

Subjects
Male, medicine.medical_specialty, Abdominal pain, Cancer Research, Carcinoma, Hepatocellular, intra-arterial hepatic therapy, mRECIST, Gastroenterology, survival, law.invention, liver cancer, Randomized controlled trial, law, Antibiotics, Internal medicine, medicine, Carcinoma, Humans, Prospective Studies, HEPATOCELLULAR CARCINOMA, Chemoembolization, Therapeutic, Adverse effect, Prospective cohort study, Survival rate, Aged, Antibiotics, Antineoplastic, business.industry, Liver Neoplasms, Hepatocellular, medicine.disease, Doxorubicin, Female, Survival Rate, Oncology, Antineoplastic, Surgery, Hepatocellular carcinoma, Clinical Study, Chemoembolization, medicine.symptom, Therapeutic, Liver cancer, business
Abstract

Background: Transcatheter arterial chemoembolisation (TACE) is the treatment of choice for intermediate stage hepatocellular carcinoma (HCC). Doxorubicin-loaded drug-eluting beads (DEB)-TACE is expected to improve the performance of conventional TACE (cTACE). The aim of this study was to compare DEB-TACE with cTACE in terms of time-to-tumour progression (TTP), adverse events (AEs), and 2-year survival. Methods: Patients were randomised one-to-one to undergo cTACE or DEB-TACE and followed-up for at least 2 years or until death. Transcatheter arterial chemoembolisation was repeated ‘on-demand'. Results: We enrolled 177 patients: 89 underwent DEB-TACE and 88 cTACE. The median number of procedures was 2 in each arm, and the in-hospital stay was 3 and 4 days, respectively (P=0.323). No differences were found in local and overall tumour response. The median TTP was 9 months in both arms. The AE incidence and severity did not differ between the arms, except for post-procedural pain, more frequent and severe after cTACE (P

Published
2014

28. Estimation of lead-time bias and its impact on the outcome of surveillance for the early diagnosis of hepatocellular carcinoma

Author

Cucchetti A., Trevisani F., Pecorelli A., Erroi V., Farinati F., Ciccarese F., Rapaccini G. L., Di Marco M., Caturelli E., Giannini E. G., Zoli M., Borzio F., Cabibbo G., Felder M., Gasbarrini A., Sacco R., Foschi F. G., Missale G., Morisco F., Baroni G. S., Virdone R., Bernardi M., Pinna A. D., Bolondi L., Biselli M., Caraceni P., Garuti F., Gramenzi A., Lenzi B., Magalotti D., Piscaglia F., Serra C., Ravaioli M., Venerandi L., Del Poggio P., Olmi S., Balsamo C., Di Nolfo M. A., Vavassori E., Alberti A., Benvegnu L., Gatta A., Giacomin A., Vanin V., Pozzan C., Maddalo G., Giampalma E., Cappelli A., Golfieri R., Mosconi C., Renzulli M., Dell'Isola S., Ialungo A. M., Roselli P., Risso D., Marenco S., Sammito G., Bruzzone L., Bosco G., Grieco A., Pompili M., Rinninella E., Siciliano M., Chiaramonte M., Guarino M., Camma C., Maida M., Di Martino A., Barcellona M. R., Schiada L., Gemini S., Biasini E., Porro E., del Ricambio M., Mismas V., Vivaldi C., Cucchetti, A, Trevisani, F, Pecorelli, A, Erroi, V, Farinati, F, Ciccarese, F, Rapaccini, Gl, Di Marco, M, Caturelli, E, Giannini, Eg, Zoli, M, Borzio, F, Cabibbo, G, Felder, M, Gasbarrini, A, Sacco, R, Foschi, Fg, Missale, G, Morisco, Filomena, Baroni, G, Virdone, R, Bernardi, M, Pinna, Ad, Italian Liver Cancer, Group, Alessandro, Cucchetti, Franco, Trevisani, Anna, Pecorelli, Virginia, Erroi, Fabio, Farinati, Francesca, Ciccarese, Gian, Lodovico Rapaccini, Mariella Di, Marco, Eugenio, Caturelli, Edoardo, G. Giannini, Marco, Zoli, Franco, Borzio, Giuseppe, Cabibbo, Martina, Felder, Antonio, Gasbarrini, Rodolfo, Sacco, Francesco, Giuseppe Foschi, Gabriele, Missale, Filomena, Morisco, Gianluca, Svegliati Baroni, Roberto, Virdone, Mauro, Bernardi, Antonio D., Pinna, for the Italian Liver Cancer Group [.., Bolondi, Luigi, Maurizio, Biselli, Piscaglia, Fabio, ]., Cucchetti, A., Trevisani, F., Pecorelli, A., Erroi, V., Farinati, F., Ciccarese, F., Rapaccini, G. L., Di Marco, M., Caturelli, E., Giannini, E. G., Zoli, M., Borzio, F., Cabibbo, G., Felder, M., Gasbarrini, A., Sacco, R., Foschi, F. G., Missale, G., Morisco, F., Baroni, G. S., Virdone, R., Bernardi, M., Pinna, A. D., Bolondi, L., Biselli, M., Caraceni, P., Garuti, F., Gramenzi, A., Lenzi, B., Magalotti, D., Piscaglia, F., Serra, C., Ravaioli, M., Venerandi, L., Del Poggio, P., Olmi, S., Balsamo, C., Di Nolfo, M. A., Vavassori, E., Alberti, A., Benvegnu, L., Gatta, A., Giacomin, A., Vanin, V., Pozzan, C., Maddalo, G., Giampalma, E., Cappelli, A., Golfieri, R., Mosconi, C., Renzulli, M., Dell'Isola, S., Ialungo, A. M., Roselli, P., Risso, D., Marenco, S., Sammito, G., Bruzzone, L., Bosco, G., Grieco, A., Pompili, M., Rinninella, E., Siciliano, M., Chiaramonte, M., Guarino, M., Camma, C., Maida, M., Di Martino, A., Barcellona, M. R., Schiada, L., Gemini, S., Biasini, E., Porro, E., del Ricambio, M., Mismas, V., and Vivaldi, C.

Subjects
Male, medicine.medical_specialty, Pediatrics, Carcinoma, Hepatocellular, Time Factors, Hepatocellular carcinoma, Settore MED/12 - GASTROENTEROLOGIA, Disease, Gastroenterology, Bias, Internal medicine, Overall survival, medicine, Humans, Early Detection of Cancer, Aged, Estimation, Surveillance, Hepatology, business.industry, Liver Neoplasms, medicine.disease, digestive system diseases, Lead time bias, Cirrhosis, Female, business, Lead-time bias, Follow-Up Studies
Abstract

Lead-time is the time by which diagnosis is anticipated by screening/surveillance with respect to the symptomatic detection of a disease. Any screening program, including surveillance for hepatocellular carcinoma (HCC), is subject to lead-time bias. Data regarding lead-time for HCC are lacking. Aims of the present study were to calculate lead-time and to assess its impact on the benefit obtainable from the surveillance of cirrhotic patients. Background & Aims: Lead-time is the time by which diagnosis is anticipated by screening/surveillance with respect to the symptomatic detection of a disease. Any screening program, including surveillance for hepatocellular carcinoma (HCC), is subject to lead-time bias. Data regarding lead-time for HCC are lacking. Aims of the present study were to calculate lead-time and to assess its impact on the benefit obtainable from the surveillance of cirrhotic patients. Methods: One-thousand three-hundred and eighty Child–Pugh class A/B patients from the ITA.LI.CA database, in whom HCC was detected during semiannual surveillance (n = 850), annual surveillance (n = 234) or when patients came when symptomatic (n = 296), were selected. Lead-time was estimated by means of appropriate formulas and Monte Carlo simulation, including 1000 patients for each arm. Results: The 5-year overall survival after HCC diagnosis was 32.7% in semiannually surveilled patients, 25.2% in annually surveilled patients, and 12.2% in symptomatic patients (p

Published
2014

30. Transarterial chemoembolization in downstaging program for hepatocellular carcinoma prior to liver transplantation: the Bologna work-in-progress experience

Author

Cappelli A, Giampalma E, Bazzocchi A, Golfieri R, Cappelli A, Bazzocchi A, Giampalma E, Golfieri R, and Cappelli A, Giampalma E, Bazzocchi A, Golfieri R

Subjects
TACE, liver transplantation, hepatocellular carcinoma, downstaging, long-term survival, Transarterial chemoembolization, downstaging program
Abstract

Purpose: To assess the efficacy and the safety of transarterial chemoembolization (TACE) on long-term survival and tumor recurrence rate in down-staging patients with hepatocellular carcinoma (HCC) listed for liver transplantation (LT): a new allocation policy still under evaluation. Methods and Materials: We prospectively analyzed with an intention-to-treat principle the outcome of 173 patients listed for LT with a diagnosis of HCC. HCCs were divided into three groups: single nodule

Published
2008

31. Unresectable hilar cholangiocarcinoma: multimodality approach with percutaneous treatment associated with radiotherapy and chemotherapy

Author

Golfieri Rita, Giampalma, E., Renzulli, M., Galuppi, A., Vicenzi, L., Galaverni, M. C., Cappelli, A., Golfieri R, Giampalma E, Renzulli M, Galuppi A, Vincenti L, Galaverni MC, Cappelli A, Golfieri, R, Giampalma, E, Renzulli, M, Galuppi, A, Vicenzi, L, Galaverni, M C, and Cappelli, A

Subjects
Brachytherapy, percutaneous treatment, Iridium Radioisotope, Unresectable hilar cholangiocarcinoma, Iridium Radioisotopes, chemotherapy, Combined Modality Therapy, Cholangiocarcinoma, Survival Rate, Bile Ducts, Intrahepatic, Bile Duct Neoplasms, Chemotherapy, Adjuvant, Chemotherapy, Cancer, Regional Perfusion, Humans, Radiotherapy, Adjuvant, Fluorouracil, Bile Duct Neoplasm, radiotherapy, Human
Abstract

Klatskin-type cholangiocarcinoma is a rare tumor, bearing a very poor prognosis: at diagnosis, most patients can only undergo palliation. Evaluation of outcome, mean survival and quality of life was performed in patients with unresectable hilar cholangiocarcinoma treated with multimodality approach in comparison with surgical palliation, biliary stenting or brachytherapy alone. Twenty-six patients with hilar cholangiocarcinoma were studied: 16 patients were enrolled in the multimodality protocol (bilateral biliary drainage; Iridium-192 brachytherapy; plastic endoprosthesis or metallic stent positioning and external radiotherapy plus systemic chemotherapy), 5 patients underwent surgical palliation and 5 percutaneous decompression alone. Nine patients completed the protocol and 7 were treated with brachytherapy followed by biliary stenting alone. The multimodality approach obtained mean survival (10 months) similar to that for surgery and higher than that of the brachytherapy and metallic stenting groups (6 and 2.75 months, respectively). The average hospital stay (15 days) was lower than that of the surgical group (20 days). A multimodality approach is a suitable alternative to palliative surgery of unresectable hilar cholangiocarcinoma.

Published
2007

32. Unresectable perihilar cholangiocarcinoma: multimodal palliative treatment

Author

Mosconi, C., Renzulli, M., Giampalma, E., Andrea Galuppi, Balacchi, C., Brandi, G., Ercolani, G., Bianchi, G., Golfieri, R., Mosconi C, Renzulli M, Giampalma E, Galuppi A, Balacchi C, Brandi G, Ercolani G, Bianchi G, and Golfieri R.

Subjects
Adult, Aged, 80 and over, Male, Brachytherapy, Palliative Care, Middle Aged, Iridium Radioisotopes, Combined Modality Therapy, Disease-Free Survival, Cholangiocarcinoma, Survival Rate, Biliary Tract Surgical Procedures, Bile Ducts, Intrahepatic, Treatment Outcome, Bile Duct Neoplasms, Humans, Female, Stents, Aged
Abstract

Aim: To evaluate the survival of patients with unresectable perihilar cholangiocarcinoma (PHC) treated with multimodal palliative approaches. PATIENTS AND METHODS: thirty-two patients were enrolled in a multimodal protocol including: bilateral biliary drainage; Yridium-192 intraluminal brachytherapy (BT); metal biliary stenting; external-beam radiotherapy (EBRT); systemic chemotherapy (ChT). All patients underwent BT and biliary stenting: this was the only treatment for 14 patients, it was combined with EBRT in 11, and with EBRT and ChT in seven. Mean and median survival, complication rates and duration of hospital stay were calculated for each group. RESULTS: BT with EBRT and ChT obtained the best median (15 months) and one year (71.42%) survival followed by BT with EBRT (14 months and 63.63%, respectively). BT with EBRT in a total dose of 54-60 Gy, with or without ChT, led to a significantly higher median survival rate (14 months) than that for BT alone (seven months). CONCLUSION: BT with EBRT, with or without ChT, improves survival and should be considered as a suitable alternative to palliative surgery for patients with unresectable perihilar cholangiocarcinoma.

Published
2013

36. Radioembolizzazione con 90Y versus sorafenib nei pazienti cirrotici con carcinoma epatocellulare (HCC): studio monocentrico con analisi di propensity

Author

Cappelli A, Mosconi C, Giampalma E, Renzulli M, Galaverni MC, Gramenzi A, Granito A, Cucchetti A, Erroi V, Fiumana S, Marinelli S, Bolondi L, Bernardi M, Trevisani F, Golfieri R, and Cappelli A, Mosconi C, Giampalma E, Renzulli M, Galaverni MC, Gramenzi A, Granito A, Cucchetti A, Erroi V, Fiumana S, Marinelli S, Bolondi L, Bernardi M, Trevisani F, Golfieri R

Subjects
carcinoma epatocellulare, pazienti cirrotici, sorafenib, HCC, 90Y, Radioembolizzazione
Published
2013

37. Survival of ptfe grafts vs. Tunneled cuffed catheters (tccs) for hemodialysis

Author

Donati, G, Scrivo, A, Cianciolo, G, La Manna, G, Panicali, L, Rucci, P, Marchetti, A, Giampalma, E, Galaverni, Mc, Golfieri, R, Stefoni, S, and Donati G, Scrivo A, Cianciolo G, La Manna G, Panicali L, Rucci P, Marchetti A, Giampalma E, Galaverni MC, Golfieri R, Stefoni S

Subjects
TCCs, Hemodialysis, Prosthetic grafts, Vascular acce, hemodialysis patient, survival, PTFE graft
Published
2013

38. Is it possible to perform voxel dosimetry in a simple way in patients treated with Selective Internal Radiotherapy using 90Y microspheres?

Author

Pettinato C, Fracchetti A, Civollani S, Monari F, Gavaruzzi G, Giampalma E, Angelelli B, Mosconi C, Nanni C, Golfieri R, Mazzarotto R, Fanti S, and Pettinato C, Fracchetti A, Civollani S, Monari F, Gavaruzzi G, Giampalma E, Angelelli B, Mosconi C,Nanni C, Golfieri R, Mazzarotto R, Fanti S

Subjects
dosimetry, 99mTc-MAA scan, Dose Volume Histogram, SIRT, HCC, SPECT scan
Published
2013

39. PTFE Grafts Versus Tunneled Cuffed Catheters for Hemodialysis: Which Is the Second Choice When Arteriovenous Fistula Is Not Feasible?

Author

Donati, G, Cianciolo, G, Mauro, R, Rucci, P, Scrivo, A, Marchetti, A, Giampalma, E, Golfieri, R, Panicali, L, Iorio, M, Stella, A, La Manna, G, Stefoni, S, Donati, Gabriele, Cianciolo, Giuseppe, Mauro, Raffaella, Rucci, Paola, Scrivo, Anna, Marchetti, Antonio, Giampalma, Emanuela, Golfieri, Rita, Panicali, Laura, Iorio, Mario, Stella, Andrea, La Manna, Gaetano, and Stefoni, Sergio

Subjects
Aged, 80 and over, Male, Survival, Medicine (all), Biomedical Engineering, Medicine (miscellaneous), Bioengineering, Kaplan-Meier Estimate, Middle Aged, Tunneled cuffed permanent catheter, Biomaterial, Complications, Grafts, Hemodialysis, Tunneled cuffed permanent catheters, Graft, Arteriovenous Shunt, Surgical, Catheters, Indwelling, Renal Dialysis, Renal Dialysi, Humans, Kidney Failure, Chronic, Female, Hemodialysi, Complication, Polytetrafluoroethylene, Aged, Human
Abstract

Vascular access-related complications are still one of the leading causes of morbidity in hemodialysis patients. The aim of this study was to compare polytetrafluoroethylene (PTFE) grafts versus tunneled cuffed permanent catheters (TCCs) in terms of vascular access and patients' survival. An observational study was carried out with a 2-year follow-up. Eighty-seven chronic hemodialysis patients were enrolled: 31 with a PTFE graft as vascular access for hemodialysis versus 56 with a TCC. Patients' mean age was 63.8 ± 14.6 (grafts) versus 73.5 ± 11.3 years (TCCs), P = 0.001. Significantly more patients with TCC had atrial fibrillation than patients with grafts (30.3% versus 6.5%, P = 0.01). In an unadjusted Kaplan-Meier analysis, median TCC survival at 24 months was 5.4 months longer than that of PTFE grafts but not significantly (log-rank test = 1.3, P = ns). In a Cox regression analysis adjusted for age, gender, number of previous vascular accesses, diabetes, atrial fibrillation, smoking, and any complication, this lack of significant difference in survival of the vascular access between TCC and PTFE groups was confirmed and diabetes proved to be an independent risk factor for the survival of both vascular accesses considered (P = 0.02). In an unadjusted Kaplan-Meier analysis, a higher mortality was found in the TCC group than in the PTFE group at 24 months (log-rank test = 10.07, P

Published
2015

40. Hepatocellular carcinoma responding to superselective transarterial chemoembolization: an issue of nodule dimension?

Author

GOLFIERI, RITA, PISCAGLIA, FABIO, TREVISANI, FRANCO, BOLONDI, LUIGI, Renzulli M, Mosconi C, Forlani L, Giampalma E, Bologna Liver Oncology Group, Golfieri R, Renzulli M, Mosconi C, Forlani L, Giampalma E, Piscaglia F, Trevisani F, Bolondi L, and Bologna Liver Oncology Group (BLOG)

Subjects
Adult, Male, medicine.medical_specialty, Carcinoma, Hepatocellular, Time Factors, transarterial chemoembolization, Partial response, On demand, medicine, Humans, Radiology, Nuclear Medicine and imaging, HEPATOCELLULAR CARCINOMA, Chemoembolization, Therapeutic, Complete response, Aged, Retrospective Studies, Aged, 80 and over, Analysis of Variance, Chi-Square Distribution, business.industry, Liver Neoplasms, Nodule (medicine), Middle Aged, medicine.disease, Tumor Burden, Treatment Outcome, Response Evaluation Criteria in Solid Tumors, Hepatocellular carcinoma, Disease Progression, Female, Radiology, medicine.symptom, Neoplasm Recurrence, Local, Cardiology and Cardiovascular Medicine, business, Tomography, X-Ray Computed
Abstract

PURPOSE: To evaluate the per-nodule efficacy of superselective transarterial chemoembolization of hepatocellular carcinomas (HCCs). MATERIALS AND METHODS: From 2006-2009, 271 cirrhotic patients with 635 nodules underwent a first superselective transarterial chemoembolization, repeated "on demand" after local recurrences (LR) or partial responses (PR). Complete response (CR), time to nodule progression (TTnP), and local recurrence rate (LRR), according to three size classes (≤ 2 cm, 2.1-5 cm, and>5 cm) were evaluated. RESULTS: After the first superselective transarterial chemoembolization, the CR was 64%, sustained over time in 77%, higher in small (68%) and intermediate-size (64%) nodules than in large nodules (25%; P5 cm had a CR of 25% after the first superselective transarterial chemoembolization, LR of 50% and PR of 25%, and after the second and third superselective transarterial chemoembolizations, PR of 0%. CONCLUSIONS: Effectiveness of superselective transarterial chemoembolization has a clear cutoff above and below 5-cm nodules, with better results in smaller nodules. In HCCs ≤ 5 cm, the efficacy of the first and second superselective transarterial chemoembolizations performed for LR was higher than the second superselective transarterial chemoembolization for PR and the third superselective transarterial chemoembolization. For HCCs>5 cm, retreatment of PR is of little value, and the third cycle is ineffective.

Published
2012

46. Impact of prior procedures on overall survival following radioembolization in patients with unresectable hepatocellular carcinoma (HCC)

Author

Bilbao JI, Golfieri R, Carpanese L, Cianni R, Paprottka PM, Fiore F, Wilhelm KE, Gasparini D, Sangro B, Saiz-Mendiguren R, Pizzi G, Salvatori R, Giampalma E, Geatti O, Ezzidin S, Bartenstein P, Lastoria, and Bilbao JI, Golfieri R, Carpanese L, Cianni R, Paprottka PM, Fiore F, Wilhelm KE, Gasparini D, Sangro B, Saiz-Mendiguren R, Pizzi G, Salvatori R, Giampalma E, Geatti O, Ezzidin S, Bartenstein P, Lastoria

Subjects
radioembolization, SIR-Sphere, 90Y-resin microsphere, Sirtex Medical, outcome, prior liver-directed procedure, HCC
Published
2012

47. Alpha-fetoprotein has no prognostic role in small hepatocellular carcinoma identified during surveillance in compensated cirrhosis

Author

Giannini, EG, Marenco, S, Borgonovo, G, Savarino, V, Farinati, F, Del Poggio, P, Rapaccini, GL, Di Nolfo, MA, Benvegnu, L, ZOLI, MARCO, Borzio, F, Caturelli, E, Chiaramonte, M, TREVISANI, FRANCO, Italian Liver Canc ITA LI CA Grp [. . ., BERNARDI, MAURO, BISELLI, MAURIZIO, CASSINI, ROMINA, CARACENI, PAOLO, DOMENICALI, MARCO, Erroi V, FRIGERIO, MARTA, GRAMENZI, ANNAGIULIA, Lenzi B, Magalotti D, Balsamo C, Di Marco M, Vavassori E, Gilardoni L, Mattiello M, Alberti A, Gatta A, Gios M, Giacomin A, Vanin V, Pozzan C, Maddalo G, RAVAIOLI, MATTEO, CUCCHETTI, ALESSANDRO, Giampalma E, Golfieri R, MOSCONI, CRISTINA, RENZULLI, MATTEO, Ghittoni G, Roselli P, Bosco G, Giannini, EG, Marenco, S, Borgonovo, G, Savarino, V, Farinati, F, Del Poggio, P, Rapaccini, GL, Di Nolfo, MA, Benvegnu, L, Zoli, M, Borzio, F, Caturelli, E, Chiaramonte, M, Trevisani, F, Italian Liver Canc ITA LI CA Grp [.., Bernardi M, Biselli M, Cassini R, Caraceni P, Domenicali M, Erroi V, Frigerio M, Gramenzi A, Lenzi B, Magalotti D, Balsamo C, Di Marco M, Vavassori E, Gilardoni L, Mattiello M, Alberti A, Gatta A, Gios M, Giacomin A, Vanin V, Pozzan C, Maddalo G, Ravaioli M, Cucchetti A, Giampalma E, Golfieri R, Mosconi C, Renzulli M, Ghittoni G, Roselli P, Bosco G, and ].

Subjects
Liver Cirrhosis, Male, Cirrhosis, IMPACT, medicine.medical_treatment, MULTICENTER, Kaplan-Meier Estimate, Liver transplantation, Gastroenterology, RECOMMENDATIONS, Cohort Studies, Aged, 80 and over, Biopsy, Needle, Liver Neoplasms, ASSOCIATION, Middle Aged, Prognosis, LIVER-TRANSPLANTATION, Immunohistochemistry, Hepatocellular carcinoma, SURVIVAL, Female, alpha-Fetoproteins, Liver cancer, medicine.medical_specialty, Carcinoma, Hepatocellular, RESECTION, Risk Assessment, Sensitivity and Specificity, Statistics, Nonparametric, Internal medicine, Biomarkers, Tumor, medicine, Hepatectomy, Humans, Neoplasm Invasiveness, Aged, Neoplasm Staging, Retrospective Studies, Tumor marker, Hepatology, Performance status, business.industry, CLINICAL-FEATURES, medicine.disease, Survival Analysis, digestive system diseases, ADVANCED HEPATITIS-C, ROC Curve, PERCUTANEOUS ETHANOL INJECTION, Percutaneous ethanol injection, business
Abstract

Alpha-fetoprotein is a tumor marker that has been used for surveillance and diagnosis of hepatocellular carcinoma (HCC) in patients with cirrhosis. The prognostic capability of this marker in patients with HCC has not been clearly defined. In this study our aim was to evaluate the prognostic usefulness of serum alpha-fetoprotein in patients with well-compensated cirrhosis, optimal performance status, and small HCC identified during periodic surveillance ultrasound who were treated with curative intent. Among the 3,027 patients included in the Italian Liver Cancer study group database, we selected 205 Child-Pugh class A and Eastern Cooperative Group Performance Status 0 patients with cirrhosis with a single HCC ≤3 cm of diameter diagnosed during surveillance who were treated with curative intent (hepatic resection, liver transplantation, percutaneous ethanol injection, radiofrequency thermal ablation). Patients were subdivided according to alpha-fetoprotein serum levels (i.e., normal ≤20 ng/mL; mildly elevated 21-200 ng/mL; markedly elevated >200 ng/mL). Patient survival, as assessed by the Kaplan-Meier method, was not significantly different among the three alpha-fetoprotein classes (P = 0.493). The same result was obtained in the subgroup of patients with a single HCC ≤2 cm (P = 0.714). An alpha-fetoprotein serum level of 100 ng/mL identified by receiver operating characteristic curve had inadequate accuracy (area under the curve = 0.536, 95% confidence interval = 0.465-0.606) to discriminate between survivors and deceased patients. Conclusion: Alpha-fetoprotein serum levels have no prognostic meaning in well-compensated cirrhosis patients with single, small HCC treated with curative intent. (HEPATOLOGY 2012)

Published
2012

48. Cost-effectiveness of semi-annual surveillance for hepatocellular carcinoma in cirrhotic patients of the Italian Liver Cancer population

Author

CUCCHETTI, ALESSANDRO, TREVISANI, FRANCO, CESCON, MATTEO, ERCOLANI, GIORGIO, ZOLI, MARCO, PINNA, ANTONIO DANIELE, GRAMENZI, ANNAGIULIA, Farinati F., Poggio P. D., Rapaccini G., Nolfo M. A., Benvegnù L., Borzio F., Giannini E. G., Caturelli E., Chiaramonte M., BERNARDI, MAURO, Buccione D., CARACENI, PAOLO, Domenicali M., Erroi V., Fatti G., Frigerio M., Santi V., Magalotti D., Balsamo C., DI MARCO, MARIACRISTINA, Vavassori E., Gilardoni L., Mattiello M., Alberti A., Gatta A., Gios M., Cazzagon N., Giacomin A., Pozzan C., Sergio A., Vanin V., Giampalma E., Golfieri R., Mosconi C., Renzulli M., Ghittoni G., Roselli P., Bodini G., Corbo M., Savarino V., DOMENICALI, MARCO, Cucchetti A., Trevisani F., Cescon M., Ercolani G., Farinati F., Poggio P.D., Rapaccini G., Nolfo M.A., Benvegnù L., Zoli M., Borzio F., Giannini E.G., Caturelli E., Chiaramonte M., Pinna A.D., Bernardi M., Buccione D., Caraceni P., Domenicali M., Erroi V., Fatti G., Frigerio M., Gramenzi A., Santi V., Magalotti D., Balsamo C., Di Marco M., Vavassori E., Gilardoni L., Mattiello M., Alberti A., Gatta A., Gios M., Cazzagon N., Giacomin A., Pozzan C., Sergio A., Vanin V., Giampalma E., Golfieri R., Mosconi C., Renzulli M., Ghittoni G., Roselli P., Bodini G., Corbo M., and Savarino V.

Subjects
Adult, Liver Cirrhosis, Male, medicine.medical_specialty, Carcinoma, Hepatocellular, Cost effectiveness, Cost-Benefit Analysis, medicine.medical_treatment, Population, COST-EFFECTIVENESS ANALYSIS, Liver transplantation, Risk Factors, Internal medicine, SURVEILLANCE, medicine, Humans, HEPATOCELLULAR CARCINOMA, Intensive care medicine, education, Survival rate, CIRRHOSIS, Aged, Aged, 80 and over, education.field_of_study, Hepatology, Relative survival, business.industry, Incidence, Liver Neoplasms, Odds ratio, Middle Aged, Prognosis, medicine.disease, Markov Chains, Survival Rate, Italy, Population Surveillance, Female, business, Liver cancer, Incremental cost-effectiveness ratio
Abstract

BACKGROUND AND AIMS: It was recently shown that semi-annual surveillance for hepatocellular carcinoma (HCC) in cirrhotic patients provides a prognostic advantage over the annual program; however, its cost-effectiveness (CE) in the general cirrhotic population still needs to be defined. METHODS: A Markov model was built to compare CE of these two strategies, considering literature results and treatment modalities of 918 cirrhotic patients from the Italian Liver Cancer (ITA.LI.CA) database. RESULTS: Results from the Markov model suggest that, compared to annual surveillance, semi-annual surveillance leads to a gain in quality-adjusted life expectancy, in an unselected cirrhotic population, of 1.35 quality-adjusted life-months (QALMs) over 10 years since surveillance start in compensated patients, and of 0.73 QALMs in decompensated patients. Semi-annual surveillance was more cost-effective in compensated than in decompensated cirrhosis, with an incremental CE ratio (ICER) of 1997 and 3814€/QALM, respectively. In compensated cirrhosis, semi-annual surveillance was more cost-effective than the annual program when the annual HCC incidence was ≥3.2% and the relative survival gain after cancer diagnosis was ≥20% with respect to the annual program. In decompensated cirrhosis, semi-annual surveillance was cost-effective in patients amenable to liver transplantation. In both groups, CE of semi-annual surveillance improved with the increase of annual incidence and the survival benefit obtainable with HCC treatment. CONCLUSIONS: Both surveillance strategies for HCC in cirrhotic patients can be recommended, according to the individual risk profile for HCC occurrence and the expected survival gain obtainable after tumor diagnosis and therapy.

Published
2012

49. Survival and tolerability of radioembolization in patients with unresectable advanced-stage hepatocellular carcinoma (HCC)

Author

Bilbao JI, Carpanese L, Cianni R, Golfieri R, Gasparini D, Wilhelm KE, Paprottka PM, Fiore F, Sangro B, Daiz ML, Pizzi G, Salvatori R, Giampalma E, Geatti O, Ezzidin S, Bartenstein P, Lastoria S, and Bilbao JI, Carpanese L, Cianni R, Golfieri R, Gasparini D, Wilhelm KE, Paprottka PM, Fiore F, Sangro B, Daiz ML, Pizzi G, Salvatori R, Giampalma E, Geatti O, Ezzidin S, Bartenstein P, Lastoria S

Subjects
safety, radioembolization, BCLC, Barcelona Clinic Liver Cancer, Stage C, advanced-stage HCC, factors driving prognosi
Published
2012

50. Comparison of the survival and tolerability of radioembolization in elderly versus younger patients with unresectable hepatocellular carcinoma (HCC)

Author

Bilbao JI, Cianni R, Carpanese L, Gasparini D, Fiore F, Wilhelm KE, Paprottka PM, Golfieri R, Sangro B, Diaz ML, Pizzi G, Salvatori R, Giampalma E, Geatti O, Ezzidin S, Bartenstein P, Lastoria S, and Bilbao JI, Cianni R, Carpanese L, Gasparini D, Fiore F, Wilhelm KE, Paprottka PM, Golfieri R, Sangro B, Diaz ML, Pizzi G, Salvatori R, Giampalma E, Geatti O, Ezzidin S, Bartenstein P, Lastoria S

Subjects
radioembolization, tolerance, SIR-Sphere, 90Y-resin microsphere, Sirtex Medical, clinical outcome, HCC
Published
2012

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