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1. Machine Learning Predictive Model for Septic Shock in Acute Pancreatitis with Sepsis

Author

Xia Y, Long H, Lai Q, and Zhou Y

Subjects
machine learning, acute pancreatitis, sepsis, septic shock, Pathology, RB1-214, Therapeutics. Pharmacology, RM1-950
Abstract

Yiqin Xia,1– 3 Hongyu Long,4 Qiang Lai,1– 3 Yiwu Zhou1– 3 1Emergency Department, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 2Laboratory of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 3Disaster Medical Center, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 4Department of Critical Care Medicine, Chengdu First People’s Hospital, Chengdu, Sichuan, People’s Republic of ChinaCorrespondence: Yiwu Zhou, Emergency Department, West China Hospital of Sichuan University, Chengdu, Sichuan, People’s Republic of China, Email 456zyw@163.comObjective: Acute pancreatitis (AP) progresses to septic shock can be fatal. Early identification of high-risk patients and timely intervention can prevent and interrupt septic shock. By analyzing the clinical characteristics of AP with sepsis, this study uses machine learning (ML) to build a model for early prediction of septic shock within 28 days of admission, which guided emergency physicians in resource allocation and medical decision-making.Methods: This retrospective cohort study collected data from the emergency departments (EDs) of three tertiary care hospitals in China. The dataset was randomly divided into a training dataset (70%) and a testing dataset (30%). Ten ML classifiers were utilized to analyze characteristics of AP with sepsis in the training dataset upon admission. Results were evaluated through cross-validation analysis. The optimal model was then tested on the testing dataset without any parameter modifications. The ML model was evaluated using the receiver operating characteristic curve (ROC) and compared to scoring systems through the DeLong test.Results: A total of 604 AP patients with sepsis were included in this study. The auto-encoder (AE) model based on mean normalization, Pearson correlation coefficient (PCC), and recursive feature elimination (RFE) selection, achieved the highest Area Under the Curve (AUC) on the validation dataset (AUC 0.900, accuracy 0.868), with the AUC of 0.879 and accuracy of 0.790 on the testing dataset. Compared to the Sequential Organ Failure Assessment (AUC 0.741), quick Sequential Organ Failure Assessment (AUC 0.727), Acute Physiology and Chronic Health Evaluation II (AUC 0.778), and Bedside Index of Severity in Acute Pancreatitis (AUC 0.691), the AE model showed superior performance.Conclusion: The AE model outperforms traditional scoring systems in predicting septic shock in AP patients with sepsis within 28 days of admission. This assists emergency physicians in identifying high-risk patients early and making timely medical decisions.Keywords: machine learning, acute pancreatitis, sepsis, septic shock

Published
2024

2. Body Mass Index z Scores Correlate with Epidermal Function in Chinese Children

Author

Yang B, Lai Q, Chen A, Ye L, Wang X, Lai Y, Liu D, and Man MQ

Subjects
transepidermal water loss, stratum corneum hydration, skin surface ph, body mass index, bmi z score, Specialties of internal medicine, RC581-951
Abstract

Bin Yang,1,* Qingsong Lai,2,* Aiqi Chen,2 Li Ye,1 Xiaohua Wang,1 Yulin Lai,2 Dan Liu,3 Mao-Qiang Man3 1Department of Dermatology, Dermatology Hospital, Southern Medical University, Guangzhou City, Guangdong, 510091, People’s Republic of China; 2Department of Dermatology, Medical Center for Public Health of Puning, Puning City, Guangdong, 515300, People’s Republic of China; 3Department of Product Development, Dermatology Hospital, Southern Medical University, Guangzhou City, Guangdong, 510091, People’s Republic of China*These authors contributed equally to this workCorrespondence: Mao-Qiang Man, Department of Dermatology, Dermatology Hospital, Southern Medical University, 2 Lujing Road, Guangzhou City, 510091, Guangdong, People’s Republic of China, Tel +86 20 8725 7353, Email mqman@hotmail.comBackground/Objective: Epidermal function is altered in a number of cutaneous and extracutaneous disorders. To determine whether epidermal function is also altered in children with obesity, we assessed the correlation between the body mass index (BMI) z score and epidermal function in children.Participants and Methods: Participants were enrolled from outpatient clinic, schools and kindergartens. Epidermal biophysical properties, including transepidermal water loss rate, stratum corneum hydration and skin surface pH, were measured on the flexor forearm and shin. Correlations between epidermal biophysical properties and BMI were analyzed. In addition, the association of epidermal biophysical properties with BMI z score was also determined.Results: Overall, BMI did not differ significantly between boys and girls among the age groups. BMI z scores correlated negatively with stratum corneum hydration levels and positively with skin surface pH in boys, but not in girls. The negative correlation between TEWL and BMI z score was not significant. Moreover, stratum corneum hydration levels were lower in boys with a BMI z score of ≥ 2 than in those with a BMI z score of − 2 to 0.99.Conclusion: Both stratum corneum hydration levels and skin surface pH are significantly correlated with BMI z scores in boys, but not in girls. Whether epidermal function influences BMI or vice versa remains to be determined.Keywords: transepidermal water loss, stratum corneum hydration, skin surface pH, body mass index, BMI z score

Published
2023

3. Development and Validation of a Rapid and Efficient Prognostic Scoring System for Sepsis Based on Oxygenation Index, Lactate and Glasgow Coma Scale

Author

Lai Q, Xia Y, Yang W, and Zhou Y

Subjects
sepsis, gcs, lactic acid, oxygenation index, pao2/fio2, prognosis, Pathology, RB1-214, Therapeutics. Pharmacology, RM1-950
Abstract

Qiang Lai,1– 3 Yiqin Xia,1– 3 Wentao Yang,1– 3 Yiwu Zhou1– 3 1Emergency Department, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 2Laboratory of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 3Disaster Medical Center, Sichuan University, Chengdu, Sichuan, People’s Republic of ChinaCorrespondence: Yiwu Zhou, Emergency Department, West China Hospital of Sichuan University, Chengdu, Sichuan, People’s Republic of China, Email 456zyw@163.comObjective: To develop a concise scoring system for efficient and rapid assessment of sepsis prognosis applicable to emergency departments.Methods: This was a single-center retrospective cohort study of patients with sepsis. In this study, a new scoring system (oxygenation index, lactate, and Glasgow coma scale: GOL) was developed through a derivation group, and then the GOL was validated using a validation group. Multivariate logistic regression analysis was performed to investigate the relationship between GOL and 28-day adverse outcomes. The GOL was compared with the previous scoring system using receiver operating characteristic curves (ROC) and decision analysis curves. The endpoints of this study were mortality, mechanical ventilation (MV), and admission to the intensive care unit (AICU).Results: 608 patients were included in the derivation group and 213 patients in the validation group, with 131 and 42 deaths, respectively. In the validation group, lactate (Lac), oxygenation index (PaO2/FiO2), and Glasgow coma scale score (GCS), the three best performers in predicting 28-day mortality from receiver operating characteristic curves, were used to construct the GOL. The higher the GOL score, the higher the incidence of death, MV and AICU within 28 days. Multifactorial logistic regression analysis showed that when the GOL was greater than 1, it was an independent risk factor for 28-day mortality, MV, and AICU. In predicting 28-day mortality, GOL was superior to the quick Sequential Organ Failure Assessment (qSOFA), Mortality in Emergency Department Sepsis Score (MEDS), Systemic Inflammatory Response Syndrome Score (SIRS), and Modified Early Warning Score (MEWS), and was comparable to the Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA).Conclusion: The GOL is a simple, rapid, and accurate method for early identification of patients at increased risk of in-hospital death from sepsis.Keywords: sepsis, GCS, lactic acid, oxygenation index, PaO2/FiO2, prognosis

Published
2023

5. A Rapid Prognostic Score Based on Bedside Arterial Blood Gas Analysis (ABG) Established for Predicting 60-Day Adverse Outcomes in Patients with Acute Pancreatitis in the Emergency Department

Author

Lai Q, Wei W, He Y, Cheng T, Han T, and Cao Y

Subjects
acute pancreatitis, prognosis, emergency department, arterial blood gas analysis, abg, Pathology, RB1-214, Therapeutics. Pharmacology, RM1-950
Abstract

Qiang Lai,1– 3 Wei Wei,1– 3 Yarong He,1– 3 Tao Cheng,1– 3 Tianyong Han,1– 3 Yu Cao1– 3 1Emergency Department, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 2Laboratory of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 3Disaster Medical Center, Sichuan University, Chengdu, Sichuan, People’s Republic of ChinaCorrespondence: Yu Cao, Emergency Department, West China Hospital of Sichuan University, 37 Guoxue Lane, Wuhou District, Chengdu, 610041, Sichuan, People’s Republic of China, Email yuyuer@126.comObjective: To establish a rapid and concise prognosis scoring system for pancreatitis in the emergency department based on bedside arterial blood gas analysis (ABG).Methods: A single-center, retrospective cohort study was used to establish the new scoring system, and a validation group was used to verify it. The primary endpoint was 60-day death, and secondary endpoints were 28-day death, admission to the intensive care unit (AICU), requirement for mechanical ventilation (MV) and persistent organ failure (POF). Receiver operating characteristic (ROC) curves was drawn to validate the predictive value of the new scoring system. The performance of the new scoring system was compared with that of conventional predictive scoring.Results: 443 patients were in the derivation group and 217 patients in the validation group, of which 27 and 25 died during follow-up. A total of 443 patients in the derivation group, 27 of whom died during the follow-up period. Multivariate regression analysis showed that mental status, hematocrit (HCT), base excess (BE) and Serum ionic calcium (Ca2+) were independent risk factors for 60-day mortality of pancreatitis, and they were used to create a new scoring system (MHBC). In the derivation and validation, the ability of MHBC (AUC= 0.922, 0.773, respectively) to predict 60-day mortality from pancreatitis was no less than that of APACHE II (AUC= 0.838, 0.748, respectively) and BISAP (AUC= 0.791, 0.750, respectively), while, MHBC is more quickly and concisely than APACHE II and BISAP. Compared with MHBC less than or equal to 2, when MHBC is greater than 2, the 28-day mortality, 60-day mortality and the incidence of AICU, MV and POF increased significantly (P < 0.001).Conclusion: The MHBC can quickly and concisely evaluate the 60-day mortality, 28-day mortality, and the incidence of AICU, MV and POF of patients with acute pancreatitis in the emergency department.Keywords: acute pancreatitis, prognosis, emergency department, arterial blood gas analysis, ABG

Published
2022

6. Thrombo-Inflammatory Prognostic Scores Improve BISAP-Based Risk Stratification in Acute Pancreatitis Patients: A Retrospective Cohort Study

Author

Han T, Cheng T, Liao Y, Lai Q, Tang S, Liu B, He Y, Lei C, and Cao Y

Subjects
acute pancreatitis, prognosis, thrombo-inflammatory prognostic score (tips), bedside index for severity in acute pancreatitis (bisap), risk stratification, Pathology, RB1-214, Therapeutics. Pharmacology, RM1-950
Abstract

Tianyong Han,1,&ast; Tao Cheng,1,&ast; Ye Liao,2 Qiang Lai,1 Shiyuan Tang,1 Bofu Liu,1 Yarong He,1 Chenxi Lei,1 Yuling Cao,3 Yu Cao1 1Emergency Department, West China Hospital of Sichuan University, Chengdu, Sichuan, People’s Republic of China; 2Medical Intensive Care Unit, West China Hospital of Sichuan University, Chengdu, Sichuan, People’s Republic of China; 3Operations Management Department, West China Hospital of Sichuan University, Chengdu, Sichuan, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yu Cao, Emergency Department, West China Hospital of Sichuan University, 37 Guoxue Lane, Wuhou District, Chengdu, Sichuan, 610041, People’s Republic of China, Tel +86 28-85422288, Email caoyu@wchscu.cnPurpose: The thrombo-inflammatory prognostic score (TIPS) and the bedside index for severity in acute pancreatitis (BISAP) are both scoring systems that enable the rapid prognostic assessment of early-stage acute pancreatitis (AP) patients, but the overall prognostic utility of these individual systems is limited. This study was thus developed to explore whether a combination of TIPS and BISAP scores would offer better insight to facilitate the risk stratification of AP patients.Methods: This single-center retrospective cohort research evaluated AP cases referred to the emergency department from January 1, 2017 to September 30, 2017. The ability of TIPS scores to improve BISAP-based AP patient risk stratification was appraised employing the curves of receiver-operating characteristic (ROC) and decision curve analysis (DCA) approaches. The initial endpoint for this research was 28-day mortality, while secondary endpoints comprised intensive care unit admission (AICU) and mechanical ventilation (MV) over a 28-day follow-up period.Results: Totally, 440 cases enrolled in the current study were divided at a ratio of 1:1 to derivation and validation cohorts. When estimating 28-day mortality, the combination of TIPS and BISAP (T-BISAP) improved the area under the curve (AUC) value in the derivation group from 0.809 to 0.903 (P

Published
2022

7. Development and Validation of a Nomogram for Predicting Overall Survival in Patients with Second Primary Small Cell Lung Cancer After Non-Small Cell Lung Cancer: A SEER-Based Study

Author

Zhu J, Shi H, Ran H, Lai Q, Shao Y, and Wu Q

Subjects
nomogram, non-small cell lung cancer (nsclc), small cell lung cancer (sclc), seer database, Medicine (General), R5-920
Abstract

Ju Zhu,1 Haoming Shi,1 Haoyu Ran,1 Qiancheng Lai,2 Yue Shao,1 Qingchen Wu1 1Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 2Department of Cardiothoracic Surgery, Chengdu Fifth People’ Hospital, Chengdu, People’s Republic of ChinaCorrespondence: Qingchen Wu, Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China, Email wuqingchencqmu@126.comBackground: Non-small cell lung cancer (NSCLC) survivors are at an increased risk of developing second primary malignancies, such as small cell lung cancer. This paper sought to establish a prognostic nomogram to assess overall survival (OS) in patients with second primary small cell lung cancer (SPSCLC) after NSCLC.Methods: 420 patients who developed SPSCLC after NSCLC were randomly split into the training and validation groups. A nomogram was established by stepwise regression. Area under the curve (AUC) and calibration plots were applied to assess the prognostic performance of the nomogram. Concordance index (C-index), integrated discrimination improvement (IDI), net reclassification index (NRI) and decision curve analysis (DCA) were performed to compare the nomogram with the American Joint Committee on Cancer (AJCC) 8th staging system. Survival risk classification was constructed based on the nomogram.Results: Five variables were chosen to construct the nomogram. The AUC showed that it had a satisfactory discrimination ability. All calibration plots displayed good concordance between nomogram and observation. The C-index, IDI, NRI and DCA showed the nomogram was superior to the AJCC 8th staging system. The Kaplan-Meier curves suggested huge differences in prognosis among the three risk groups.Conclusion: This study build a nomogram and risk stratification system for predicting probabilities of OS in patients with SPSCLC after NSCLC, which can help clinicians in individualized survival assessment and treatment decisions.Keywords: nomogram, non-small cell lung cancer (NSCLC), small cell lung cancer (SCLC), SEER database

Published
2022

8. Use of Modified Balthazar Grades for the Early Prediction of Acute Pancreatitis Severity in the Emergency Department

Author

Cheng T, Han TY, Liu BF, Pan P, Lai Q, Yu H, and Cao Y

Subjects
acute pancreatitis, severity, balthazar grade, revised atlanta classification, Medicine (General), R5-920
Abstract

Tao Cheng,1,2,&ast; Tian-Yong Han,1,2,&ast; Bo-Fu Liu,1,2 Pan Pan,1,2 Qiang Lai,1,2 Haifang Yu,1,2 Yu Cao1,2 1Emergency Department, West China Hospital of Sichuan University, Chengdu, Sichuan, People’s Republic of China; 2Laboratory of Emergency Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yu CaoEmergency Department of West China Hospital and Laboratory of Emergency Medicine of West China Hospital, Sichuan University, 37 Guoxue Road, Chengdu, 610041, Sichuan, People’s Republic of China, Tel +86-28-85422288, Email caoyu@wchscu.cnObjective: To develop a new approach based on Balthazar grades of acute pancreatitis (AP) and to assess this modified method as a tool for the early prediction of AP severity in the emergency department (ED).Methods: Data pertaining to AP patients ≥ 18 years old that had undergone computed tomography (CT) scanning within 24 h following ED admission between January 1, 2017 and September 30, 2017 were retrospectively analyzed. Patients were separated into two groups based on the length of time between the onset of their AP symptoms and the completion of CT scanning (Group 1: < 72 h; Group 2: ≥ 72 h). Modified Balthazar grades for these patients were then assessed, with the concordance between these modified grades and the 2012 revised Atlanta classification being assessed using the Kappa (κ) statistic. The modified grade with the largest κ value was evaluated based on performance traits including Harrell’s concordance index (C-index), area under the receiver operating characteristic curve (AUC) analyses, calibration curves, and decision curve analyses (DCA) in comparison with bedside index for severity in AP (BISAP) scores.Results: In total, 372 patients were included in the present analysis. These patients were regraded according to six methods, with the method yielding the largest κ value consisting of regraded Balthazar grades A–C, D, and E, respectively, corresponding to mild, moderate, and severe AP. The κ values for this method were 0.786 (95% CI, 0.706– 0.853) in Group 1 and 0.907 (95% CI, 0.842– 0.955) in Group 2, exhibiting nearly complete agreement with the latest Atlanta classification of AP. AUROC values for these modified Balthazar grades when used to predict SAP were significantly higher than those for BISAP scores in Group 1, Group 2, and the overall cohort (P < 0.05). The DCA curves for Group 1, Group 2, and the overall patient cohort exhibited substantial net benefits when using these modified grades across a range of POFs relative to BISAP scores. The calibration curve for this modified approach to predicting POF in AP patients revealed good agreement in this cohort.Conclusion: Modified Balthazar grades exhibited substantial to near-total agreement with the 2012 revised Atlanta classification of AP patients, and this modified method can thus be used for the early prediction of AP severity in the ED.Keywords: acute pancreatitis, severity, Balthazar grade, revised Atlanta classification

Published
2022

9. Development and Validation of a Novel Prognostic Score Based on Thrombotic and Inflammatory Biomarkers for Predicting 28-Day Adverse Outcomes in Patients with Acute Pancreatitis

Author

Han T, Cheng T, Liao Y, He Y, Liu B, Lai Q, Pan P, Liu J, Lei C, and Cao Y

Subjects
acute pancreatitis, prognosis, clinical outcomes, thrombosis, inflammation, Pathology, RB1-214, Therapeutics. Pharmacology, RM1-950
Abstract

Tianyong Han,1,&ast; Tao Cheng,1,&ast; Ye Liao,2 Yarong He,1 Bofu Liu,1 Qiang Lai,1 Pan Pan,1 Junzhao Liu,1 Chenxi Lei,1 Yu Cao1 1Emergency Department, West China Hospital of Sichuan University, Chengdu, Sichuan, People’s Republic of China; 2Medical Intensive Care Unit, West China Hospital of Sichuan University, Chengdu, Sichuan, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yu CaoEmergency Department, West China Hospital of Sichuan University, 37 Guoxue Lane, Wuhou District, Chengdu, 610041, Sichuan, People’s Republic of China, Tel +86 28-85422288, Email caoyu@wchscu.cnBackground: Acute pancreatitis (AP) is a multifactorial disease that is associated with substantial morbidity and mortality. Thrombosis and inflammation are involved in the development and progression of AP.Aim: To develop and validate a novel and simple scoring system for predicting 28-day adverse outcomes in AP patients based on a thrombotic and an inflammatory biomarker.Methods: A single-center, retrospective cohort study was used to establish the new scoring system (thrombo-inflammatory prognostic score; TIPS), and another study was used to verify it. The study end points were 28-day mortality, requirement for mechanical ventilation (MV), persistent organ failure (POF), and admission to the intensive care unit (AICU). Receiver operating characteristic (ROC) curves was drawn to validate the predictive value of the TIPS. The performance of the TIPS was compared with that of conventional predictive scoring systems. Logistic regression models were used to investigate the relationship between the TIPS and the different end points.Results: Among 440 patients with AP in the derivation group, 27 patients died within the 28-day follow-up period. Prothrombin time (PT) and interleukin-6 (IL-6) were used to calculate the TIPS. The TIPS (AUC=0.843) showed a performance comparable to that of the more established APACHE II (AUC=0.841), SOFA (AUC=0.797), BISAP (AUC=0.762), and Balthazar CT (AUC=0.655) in predicting 28-day mortality in AP. The 28-day mortality and the incidence of MV, POF, and AICU were significantly higher among patients with a higher TIPS (P< 0.001). The results of logistic regression analyses indicated that the TIPS was independently associated with the risks of 28-day mortality, AICU, MV and POF.Conclusion: The TIPS can enable prediction of 28-day adverse clinical outcomes with AP patients in the ED.Keywords: acute pancreatitis, prognosis, clinical outcomes, thrombosis, inflammation

Published
2022

10. Portal vein thrombosis and liver transplantation: management, matching, and outcomes: a retrospective multicenter cohort study

Author

Di Benedetto, F, Magistri, P, Di Sandro, S, Boetto, R, Tandoi, F, Camagni, S, Lauterio, A, Pagano, D, Nicolini, D, Violi, P, Dondossola, D, Guglielmo, N, Cherchi, V, Lai, Q, Toti, L, Bongini, M, Frassoni, S, Bagnardi, V, Mazzaferro, V, Tisone, G, Rossi, M, Baccarani, U, Ettorre, G, Caccamo, L, Carraro, A, Vivarelli, M, Gruttadauria, S, De Carlis, L, Colledan, M, Romagnoli, R, Cillo, U, Di Benedetto, Fabrizio, Magistri, Paolo, Di Sandro, Stefano, Boetto, Riccardo, Tandoi, Francesco, Camagni, Stefania, Lauterio, Andrea, Pagano, Duilio, Nicolini, Daniele, Violi, Paola, Dondossola, Daniele, Guglielmo, Nicola, Cherchi, Vittorio, Lai, Quirino, Toti, Luca, Bongini, Marco, Frassoni, Samuele, Bagnardi, Vincenzo, Mazzaferro, Vincenzo, Tisone, Giuseppe, Rossi, Massimo, Baccarani, Umberto, Ettorre, Giuseppe Maria, Caccamo, Lucio, Carraro, Amedeo, Vivarelli, Marco, Gruttadauria, Salvatore, De Carlis, Luciano, Colledan, Michele, Romagnoli, Renato, Cillo, Umberto, Di Benedetto, F, Magistri, P, Di Sandro, S, Boetto, R, Tandoi, F, Camagni, S, Lauterio, A, Pagano, D, Nicolini, D, Violi, P, Dondossola, D, Guglielmo, N, Cherchi, V, Lai, Q, Toti, L, Bongini, M, Frassoni, S, Bagnardi, V, Mazzaferro, V, Tisone, G, Rossi, M, Baccarani, U, Ettorre, G, Caccamo, L, Carraro, A, Vivarelli, M, Gruttadauria, S, De Carlis, L, Colledan, M, Romagnoli, R, Cillo, U, Di Benedetto, Fabrizio, Magistri, Paolo, Di Sandro, Stefano, Boetto, Riccardo, Tandoi, Francesco, Camagni, Stefania, Lauterio, Andrea, Pagano, Duilio, Nicolini, Daniele, Violi, Paola, Dondossola, Daniele, Guglielmo, Nicola, Cherchi, Vittorio, Lai, Quirino, Toti, Luca, Bongini, Marco, Frassoni, Samuele, Bagnardi, Vincenzo, Mazzaferro, Vincenzo, Tisone, Giuseppe, Rossi, Massimo, Baccarani, Umberto, Ettorre, Giuseppe Maria, Caccamo, Lucio, Carraro, Amedeo, Vivarelli, Marco, Gruttadauria, Salvatore, De Carlis, Luciano, Colledan, Michele, Romagnoli, Renato, and Cillo, Umberto

Abstract

BACKGROUND AND AIMS: Besides the increased risk of perioperative morbidity, graft failure, and mortality, the majority of PVT are diagnosed at liver transplantation (LT). Improving preoperative management and patient selection may lead to better short-term and long-term outcomes and reduce the risk of a futile LT. The authors aimed to identify predictors of adverse outcomes after LT in patients with nonmalignant portal vein thrombosis (PVT) and improve donor to recipient matching by analyzing the results of the Italian cohort of LT recipients. METHODS: Adult patients who underwent LT in Italy between January 2000 and February 2020 diagnosed with PVT pre-LT or at time of LT were considered eligible for inclusion. Based on a survey encompassing all 26 surgeons participating in the study, a binary composite outcome was defined. Patients were classified as having the composite event if at least one of these conditions occurred: operative time more than 600 min, estimated blood loss greater than 5000 ml, more than 20 ICU days, 90 days mortality, 90 days retransplant. RESULTS: Seven hundred fourteen patients were screened and 698 met the inclusion criteria. The analysis reports the results of 568 patients that fulfilled the criteria to enter the composite outcome analysis.Overall, 156 patients (27.5%) developed the composite outcome. PVT stage 3/4 at transplant and need for any surgical correction of PVT are independent predictors of the composite outcome occurrence. When stratified by PVT grade, overall survival at 1-year ranges from 89.0% with PVT grade 0/1 to 67.4% in patients with PVT grade 3/4 at LT ( P <0.001). Nevertheless, patients with severe PVT can improve their survival when identified risk factors are not present. CONCLUSIONS: Potential LT candidates affected by PVT have a benefit from LT that should be adequately balanced on liver function and type of inflow reconstruction needed to mitigate the incidence of adverse events. Nonetheless, the absence of spe

Published
2024

11. Both Prevalence and Severity of Pruritus are Associated with Age in Chinese Patients with Skin Diseases

Author

Wang X, Lai Q, Zheng B, Ye L, Wen S, Yan Y, Yang B, and Man MQ

Subjects
skin disorder, pruritus, prevalence, severity, gender, age, Dermatology, RL1-803
Abstract

Xiaohua Wang,1,* Qingsong Lai,2,* Baoqing Zheng,1 Li Ye,1 Si Wen,1 Yunling Yan,1 Bin Yang,1 Mao-Qiang Man1 1Dermatology Hospital, Southern Medical University, Guangdong, 510091, People’s Republic of China; 2Center for Chronic Disease Prevention and Control of Puning City, Puning, Guangdong, 515300, People’s Republic of China*These authors contributed equally to this workCorrespondence: Mao-Qiang Man; Bin YangDermatology Hospital, Southern Medical University, 2 Lujing Road, Yuexiu District, Guangzhou, Guangdong, 510091, People’s Republic of ChinaEmail mqman@hotmail.com; yangbin101@hotmail.comBackground: Although the characteristics of pruritus in some skin diseases are documented, characteristics of pruritus related to gender-, age-, and skin disorder have not yet been well defined.Objective: To characterize dermatosis-associated pruritus in Chinese patients.Methods: A cross-sectional study was carried out in a single center. The intensity of pruritus was evaluated using a 0– 10 visual analog scale (VAS). Skin disorders were diagnosed by dermatologists. The prevalence and intensity of pruritus were compared among skin disorders, and between males and females.Results: Valid questionnaires were obtained from 1,246 female and 864 male patients. Patients with acne, eczematous dermatitis, and urticaria accounted for 18%, 17%, and 14%, respectively. Both the prevalence and severity of pruritus varied greatly with skin disorders (p< 0.0001). Patients with either urticaria or eczematous dermatitis displayed a higher prevalence of pruritus (92% and 82%, respectively), while subjects with urticaria exhibited the highest VAS in comparison to those with other skin disorders (p< 0.05 to p< 0.001 vs the others). Moreover, both the prevalence and severity of pruritus were positively associated with age in both males and females (p< 0.0001). Furthermore, 60 out of 77 patients (78%) with topical glucocorticoid-induced dermatitis experienced pruritus, with a VAS of 2.03± 0.21. Finally, a lower VAS was found in subjects with oily skin than those with either dry or normal skin.Conclusion: The prevalence and severity of pruritus vary with skin disorders, skin type, age, and gender in Chinese patients.Keywords: skin disorder, pruritus, prevalence, severity, gender, age

Published
2021

12. The Role of Extraversion and Openness on Host Country Nationals’ Task Performance and Contextual Performance at Work

Author

Jannesari MT, Wang Z, Zheng J, Xie W, Lai Q, and Wu L

Subjects
host country nationals, expatriates, career, personality, socialization self-efficacy, Psychology, BF1-990, Industrial psychology, HF5548.7-5548.85
Abstract

Milad T Jannesari,1 Zhongming Wang,2 Jianzhuang Zheng,1 Wenwu Xie,1 Qin Lai,1 Lu Wu1 1School of Business, Zhejiang University City College, Hangzhou, People’s Republic of China; 2School of Management, Zhejiang University, Hangzhou, People’s Republic of ChinaCorrespondence: Milad T JannesariSchool of Business, Zhejiang University City College, Hangzhou, People’s Republic of ChinaEmail miladjannesari@gmail.comPurpose: This study answer calls for research on host country nationals (HCNs) by examining factors that may influence HCN task performance and contextual performance during work with their self-initiated expatriate (SIE) colleagues.Participants and Methods: Data on personality traits (extraversion, openness), socialization self-efficacy, and frequency of interaction, task, and contextual performance were collected by surveying 373 Chinese HCNs. The first author recruited the HCNs through SIEs working and living in China. SIEs who participated in this project provided the email addresses of HCNs with whom they worked.Results: The frequency of interactions fully mediated the relationship between (a) extraversion with task and contextual performance and (b) openness with task and contextual performance. Only socialization self-efficacy moderated the mediating effects of extraversion on task performance via the frequency of interaction; it also moderated the mediating effects of openness on contextual performance via the frequency of interactions, but not in the hypothesized direction.Conclusion: This study investigated the neglected stakeholder in the expatriation process, namely, HCNs, and what factors may impact HCNs’ performance during work and collaboration with their SIE colleagues.Keywords: host country nationals, expatriates, career, personality, socialization self-efficacy

Published
2021

13. Clinical Value of Postoperative Neutrophil-to-Lymphocyte Ratio Change as a Detection Marker of Bladder Cancer Recurrence

Author

Zhang Q, Lai Q, Wang S, Meng Q, and Mo Z

Subjects
bladder cancer, nlr dynamic change, prognosis, recurrence, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Qingyun Zhang,1– 3 Qinqiao Lai,1 Shan Wang,4 Qinggui Meng,1 Zengnan Mo2,3,5 1Department of Urology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region 530021, People’s Republic of China; 2Institute of Urology and Nephrology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region 530021, People’s Republic of China; 3Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region 530021, People’s Republic of China; 4Department of Research, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region 530021, People’s Republic of China; 5Department of Urology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region 530021, People’s Republic of ChinaCorrespondence: Qinggui MengDepartment of Urology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021, Guangxi, People’s Republic of ChinaEmail mqg15315@163.comZengnan MoInstitute of Urology and Nephrology, The First Affiliated Hospital of Guangxi Medical University, No. 6 Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region 530021, People’s Republic of ChinaTel/Fax +86-771-5353342Email mozengnan@gxmu.edu.cnPurpose: This study investigated the clinical significance of postoperative neutrophil-to-lymphocyte ratio (NLR) changes in bladder cancer recurrence.Patients and Methods: For evaluating the predictive value of postoperative dynamic change of NLR, a retrospective cohort study was performed to analyze 213 patients with bladder cancer who underwent surgical treatment from January 2013 to December 2019 at the Affiliated Tumor Hospital of Guangxi Medical University. Baseline characteristics and recurrence-free survival (RFS) were statistically compared, and a multivariate analysis was used to identify prognostic factors.Results: Compared with preoperative NLR levels, postoperative decreased NLR in 130 patients and postoperative increased NLR in 83 patients were detected. The 1-, 3- and 5-year RFS rates were 88.0%, 75.4% and 75.4% in the decreased postoperative NLR group, respectively, and 51.2%, 25.8% and 16.1% in the increased postoperative NLR group, respectively (P < 0.05). Kaplan–Meier curves showed that the cumulative DFS rate in the increased group was significantly lower than that in the decreased group (P < 0.05). The preoperative NLR showed significant difference with postoperative NLR in the total cohort, high-grade non-muscle-invasive bladder cancer (HG-NMIBC) and muscle-invasive bladder cancer (MIBC) group, while there was no significant difference between postoperative NLR and NLR of recurrence or last follow-up. Multivariate analysis suggested that postoperative-preoperative NLR was an independent predictor for RFS (HR=6.206, 95% CI: 3.826– 10.067, P < 0.001) in the total cohort, RFS (HR=9.373, 95% CI: 2.724– 32.245, P < 0.001) in the LG-NMIBC group, RFS rates (HR=6.873, 95% CI: 2.486– 18.999, P < 0.001) in the HG-NMIBC group and RFS rates (HR=6.109, 95% CI: 2.847– 13.109, P < 0.001) in the MIBC group.Conclusion: The dynamic change of postoperative NLR is a potential marker for the early detection of bladder cancer recurrence. Patients with increased NLR after surgery tend to have higher risk of recurrence.Keywords: bladder cancer, NLR dynamic change, prognosis, recurrence

Published
2021

14. 413.11: The Improvement Study: Call for a New International Prospective Non-competitive, Observational Study to Validate And Optimize Kinetic Models to Predict Liver Allograft Failure At 3 and 12 Months After Liver Transplantation

Author

Avolio, A, (PI), Agopian, V, (coPI), Pascale, Marco, Burra, P, Croome, K, de Santibanes, M, Egawa, H, Fondevila, C, Guo, Z, Lai, Q, Martins, P, Oniscu, G, Polak, W, Quintini, C, Rela, M, Sapisochin, G, Wielderkeher, J, Spoletini, G, Agnes, S, Pafundi, P, Pasciuto, T, and Cillo, U

Published
2022
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15. Prevalence and Severity of Dermatological Condition-Associated Skin Pain in the Chinese

Author

Wang X, Lai Q, Zheng B, Ye L, Wen S, Yan Y, Yang B, and Man MQ

Subjects
skin disorders, skin pain, gender, prevalence, Medicine (General), R5-920
Abstract

Xiaohua Wang,1,* Qingsong Lai,2,* Baoqing Zheng,1 Li Ye,1 Si Wen,1 Yunling Yan,1 Bin Yang,1 Mao-Qiang Man1 1Dermatology Hospital, Southern Medical University, Guangdong 510095, People’s Republic of China; 2Puning City Chronic Disease Prevention and Control Center, Guangdong 515300, People’s Republic of China*These authors contributed equally to this workCorrespondence: Mao-Qiang Man; Bin Yang Email mqman@hotmail.com; yangbin101@hotmail.comBackground/Aim: Although the characteristics of cutaneous sensory symptoms in the general population have been documented, dermatological condition-associated skin pain has not been characterized yet. In the present study, we aimed to characterize dermatological condition-associated skin pain in the Chinese.Subjects and Methods: A questionnaire was given to outpatients to identify self-proclaimed skin pain at our dermatology clinic. The severity of skin pain was assessed using pain scale 0– 10. Prevalence and pain severity were compared between males and females.Results: A total of 2144 patients, including 1254 females and 890 males aged 13– 94 years, were included in this study. The overall prevalence of skin pain was 9.93% in this cohort. The prevalence of skin pain varied greatly with dermatological conditions (p< 0.0001). Moreover, a higher prevalence of skin pain was observed in males than in females (p< 0.05). Among the dermatological conditions reported, higher skin pain scales were found in subjects with either glucocorticoid-induced dermatitis (4.20 ± 0.73) or herpes zoster (4.00 ± 0.29). While the overall pain scales were comparable between males and females (2.38 ± 0.13 versus 2.68 ± 0.13), pain scales in patients with eczematous dermatitis were higher in females than in males (p< 0.05). Furthermore, pain scales correlated positively with age. However, pain scales did not differ between subjects with versus without a family history of cutaneous sensory symptoms. These results demonstrate that the prevalence and severity of dermatological condition-associated skin pain vary with dermatological conditions and gender in the Chinese.Conclusion: Patients with some dermatological conditions may experience skin pain. Although the pain is moderate, it can negatively impact the quality of patients’ lives. Alleviation of skin pain should be considered when treating patients with certain dermatological conditions.Keywords: skin disorders, skin pain, gender, prevalence

Published
2020

17. The Effect of a Liver Transplant Program on the Outcomes of Resectable Hepatocellular Carcinoma: A Nationwide Multicenter Analysis

Author

Serenari, M, Lenzi, J, Cucchetti, A, Cipriani, F, Donadon, M, Ardito, F, Fazio, F, Nicolini, D, Iaria, M, Famularo, S, Perri, P, Ansaloni, L, Zanello, M, Lai, Q, Conci, S, Molfino, S, Ferrari, C, Germani, P, Zago, M, Romano, M, Zimmitti, G, Antonucci, A, Fumagalli, L, Troci, A, Ferraro, V, Memeo, R, Crespi, M, Chiarelli, M, Ercolani, G, Hilal, M, Zanus, G, Pinotti, E, Tarchi, P, Griseri, G, Baiocchi, G, Ruzzenente, A, Rossi, M, Jovine, E, Maestri, M, Grazi, G, Romano, F, Dalla Valle, R, Ravaioli, M, Vivarelli, M, Ferrero, A, Giuliante, F, Torzilli, G, Aldrighetti, L, Cescon, M, Gorgone, M, Ratti, F, Costa, G, Razionale, F, Russolillo, N, Marinelli, L, Giuffrida, M, Scotti, M, Garancini, M, De Peppo, V, De Stefano, F, Laureiro, Z, Marchitelli, I, Franceschi, A, Cosola, D, Corleone, P, Montuori, M, Salvador, L, Manzoni, A, La Barba, G, Calcagno, P, Pennacchi, L, Conticchio, M, Serenari M., Lenzi J., Cucchetti A., Cipriani F., Donadon M., Ardito F., Fazio F., Nicolini D., Iaria M., Famularo S., Perri P., Ansaloni L., Zanello M., Lai Q., Conci S., Molfino S., Ferrari C., Germani P., Zago M., Romano M., Zimmitti G., Antonucci A., Fumagalli L., Troci A., Ferraro V., Memeo R., Crespi M., Chiarelli M., Ercolani G., Hilal M. A., Zanus G., Pinotti E., Tarchi P., Griseri G., Baiocchi G. L., Ruzzenente A., Rossi M., Jovine E., Maestri M., Grazi G. L., Romano F., Dalla Valle R., Ravaioli M., Vivarelli M., Ferrero A., Giuliante F., Torzilli G., Aldrighetti L., Cescon M., Gorgone M., Ratti F., Costa G., Razionale F., Russolillo N., Marinelli L., Giuffrida M., Scotti M., Garancini M., De Peppo V., De Stefano F., Laureiro Z. L., Marchitelli I., Franceschi A., Cosola D., Corleone P., Montuori M., Salvador L., Manzoni A., La Barba G., Calcagno P., Pennacchi L., Conticchio M., Serenari, M, Lenzi, J, Cucchetti, A, Cipriani, F, Donadon, M, Ardito, F, Fazio, F, Nicolini, D, Iaria, M, Famularo, S, Perri, P, Ansaloni, L, Zanello, M, Lai, Q, Conci, S, Molfino, S, Ferrari, C, Germani, P, Zago, M, Romano, M, Zimmitti, G, Antonucci, A, Fumagalli, L, Troci, A, Ferraro, V, Memeo, R, Crespi, M, Chiarelli, M, Ercolani, G, Hilal, M, Zanus, G, Pinotti, E, Tarchi, P, Griseri, G, Baiocchi, G, Ruzzenente, A, Rossi, M, Jovine, E, Maestri, M, Grazi, G, Romano, F, Dalla Valle, R, Ravaioli, M, Vivarelli, M, Ferrero, A, Giuliante, F, Torzilli, G, Aldrighetti, L, Cescon, M, Gorgone, M, Ratti, F, Costa, G, Razionale, F, Russolillo, N, Marinelli, L, Giuffrida, M, Scotti, M, Garancini, M, De Peppo, V, De Stefano, F, Laureiro, Z, Marchitelli, I, Franceschi, A, Cosola, D, Corleone, P, Montuori, M, Salvador, L, Manzoni, A, La Barba, G, Calcagno, P, Pennacchi, L, Conticchio, M, Serenari M., Lenzi J., Cucchetti A., Cipriani F., Donadon M., Ardito F., Fazio F., Nicolini D., Iaria M., Famularo S., Perri P., Ansaloni L., Zanello M., Lai Q., Conci S., Molfino S., Ferrari C., Germani P., Zago M., Romano M., Zimmitti G., Antonucci A., Fumagalli L., Troci A., Ferraro V., Memeo R., Crespi M., Chiarelli M., Ercolani G., Hilal M. A., Zanus G., Pinotti E., Tarchi P., Griseri G., Baiocchi G. L., Ruzzenente A., Rossi M., Jovine E., Maestri M., Grazi G. L., Romano F., Dalla Valle R., Ravaioli M., Vivarelli M., Ferrero A., Giuliante F., Torzilli G., Aldrighetti L., Cescon M., Gorgone M., Ratti F., Costa G., Razionale F., Russolillo N., Marinelli L., Giuffrida M., Scotti M., Garancini M., De Peppo V., De Stefano F., Laureiro Z. L., Marchitelli I., Franceschi A., Cosola D., Corleone P., Montuori M., Salvador L., Manzoni A., La Barba G., Calcagno P., Pennacchi L., and Conticchio M.

Abstract

Objective: To evaluate the effect of a liver transplantation (LT) program on the outcomes of resectable hepatocellular carcinoma (HCC). Background: Surgical treatment of HCC includes both hepatic resection (HR) and LT. However, the presence of cirrhosis and the possibility of recurrence make the management of this disease complex and probably different according to the presence of a LT program. Methods: Patients undergoing HR for HCC between January 2005 and December 2019 were identified from a national database of HCC. The main study outcomes were major surgical complications according to the Comprehensive Complication Index, posthepatectomy liver failure (PHLF), 90-day mortality, overall survival, and disease-free survival. Secondary outcomes were salvage liver transplantation (SLT) and postrecurrence survival. Results: A total of 3202 patients were included from 25 hospitals over the study period. Three of 25 (12%) had an LT program. The presence of an LT program within a center was associated with a reduced probability of PHLF (odds ratio=0.38) but not with overall survival and disease-free survival. There was an increased probability of SLT when HR was performed in a transplant hospital (odds ratio=12.05). Among transplant-eligible patients, those who underwent LT had a significantly longer postrecurrence survival. Conclusions: This study showed that the presence of a LT program was associated with decreased PHLF rates and an increased probability to receive SLT in case of recurrence.

Published
2023

18. Personalised management of patients with hepatocellular carcinoma: a multiparametric therapeutic hierarchy concept

Author

Vitale, A, Cabibbo, G, Iavarone, M, Vigano, L, Pinato, D, Ponziani, F, Lai, Q, Casadei-Gardini, A, Celsa, C, Galati, G, Gambato, M, Crocetti, L, Renzulli, M, Giannini, E, Farinati, F, Trevisani, F, Cillo, U, Baccarani, U, Brancaccio, G, Cozzolongo, R, Cucchetti, A, De Matthaeis, N, Di Sandro, S, Famularo, S, Finotti, M, Foschi, F, Ghinolfi, D, Guarracino, M, Gruttadauria, S, Guarino, M, Kostandini, A, Lenci, I, Levi Sandri, G, Manzia, T, Marasco, G, Masarone, M, Mazzarelli, C, Melandro, F, Miele, L, Morisco, F, Nicolini, D, Pagano, D, Pelizzaro, F, Pieri, G, Piscaglia, F, Plaz Torres, M, Pravisani, R, Rendina, M, Romano, F, Russo, F, Sacco, R, Sangiovanni, A, Sposito, C, Tortora, R, Tovoli, F, Vigano, M, Violi, P, Vitale A., Cabibbo G., Iavarone M., Vigano L., Pinato D. J., Ponziani F. R., Lai Q., Casadei-Gardini A., Celsa C., Galati G., Gambato M., Crocetti L., Renzulli M., Giannini E. G., Farinati F., Trevisani F., Cillo U., Baccarani U., Brancaccio G., Cozzolongo R., Cucchetti A., De Matthaeis N., Di Sandro S., Famularo S., Finotti M., Foschi F. G., Ghinolfi D., Guarracino M., Gruttadauria S., Guarino M., Kostandini A., Lenci I., Levi Sandri G. B., Manzia T. M., Marasco G., Masarone M., Mazzarelli C., Melandro F., Miele L., Morisco F., Nicolini D., Pagano D., Pelizzaro F., Pieri G., Piscaglia F., Plaz Torres M. C., Pravisani R., Rendina M., Romano F., Russo F. P., Sacco R., Sangiovanni A., Sposito C., Tortora R., Tovoli F., Vigano M., Violi P., Vitale, A, Cabibbo, G, Iavarone, M, Vigano, L, Pinato, D, Ponziani, F, Lai, Q, Casadei-Gardini, A, Celsa, C, Galati, G, Gambato, M, Crocetti, L, Renzulli, M, Giannini, E, Farinati, F, Trevisani, F, Cillo, U, Baccarani, U, Brancaccio, G, Cozzolongo, R, Cucchetti, A, De Matthaeis, N, Di Sandro, S, Famularo, S, Finotti, M, Foschi, F, Ghinolfi, D, Guarracino, M, Gruttadauria, S, Guarino, M, Kostandini, A, Lenci, I, Levi Sandri, G, Manzia, T, Marasco, G, Masarone, M, Mazzarelli, C, Melandro, F, Miele, L, Morisco, F, Nicolini, D, Pagano, D, Pelizzaro, F, Pieri, G, Piscaglia, F, Plaz Torres, M, Pravisani, R, Rendina, M, Romano, F, Russo, F, Sacco, R, Sangiovanni, A, Sposito, C, Tortora, R, Tovoli, F, Vigano, M, Violi, P, Vitale A., Cabibbo G., Iavarone M., Vigano L., Pinato D. J., Ponziani F. R., Lai Q., Casadei-Gardini A., Celsa C., Galati G., Gambato M., Crocetti L., Renzulli M., Giannini E. G., Farinati F., Trevisani F., Cillo U., Baccarani U., Brancaccio G., Cozzolongo R., Cucchetti A., De Matthaeis N., Di Sandro S., Famularo S., Finotti M., Foschi F. G., Ghinolfi D., Guarracino M., Gruttadauria S., Guarino M., Kostandini A., Lenci I., Levi Sandri G. B., Manzia T. M., Marasco G., Masarone M., Mazzarelli C., Melandro F., Miele L., Morisco F., Nicolini D., Pagano D., Pelizzaro F., Pieri G., Piscaglia F., Plaz Torres M. C., Pravisani R., Rendina M., Romano F., Russo F. P., Sacco R., Sangiovanni A., Sposito C., Tortora R., Tovoli F., Vigano M., and Violi P.

Abstract

Advances in the surgical and systemic therapeutic landscape of hepatocellular carcinoma have increased the complexity of patient management. A dynamic adaptation of the available staging-based algorithms is required to allow flexible therapeutic allocation. In particular, real-world hepatocellular carcinoma management increasingly relies on factors independent of oncological staging, including patients’ frailty, comorbid burden, critical tumour location, multiple liver functional parameters, and specific technical contraindications impacting the delivery of treatment and resource availability. In this Policy Review we critically appraise how treatment allocation strictly based on pretreatment staging features has shifted towards a more personalised treatment approach, in which expert tumour boards assume a central role. We propose an evidence-based framework for hepatocellular carcinoma treatment based on the novel concept of multiparametric therapeutic hierarchy, in which different therapeutic options are ordered according to their survival benefit (ie, from surgery to systemic therapy). Moreover, we introduce the concept of converse therapeutic hierarchy, in which therapies are ordered according to their conversion abilities or adjuvant abilities (ie, from systemic therapy to surgery).

Published
2023

19. How future surgery will benefit from SARS-COV-2-related measures: a SPIGC survey conveying the perspective of Italian surgeons

Author

Siragusa, L, Angelico, R, Angrisani, M, Zampogna, B, Materazzo, M, Sorge, R, Giordano, L, Meniconi, R, Coppola, A, Marino, A, Giraudo, G, Esposito, S, Urbani, A, De Pastena, M, Mastrapasqua, R, Garancini, M, Frontal, A, Pascal, G, Martellucc, J, Falb, F, Boscarelli, A, Bertoglio, P, Trecca, E, Galassi, L, Vento, V, Chiappini, A, Antonelli, A, Bennardo, F, Familiari, F, Giannaccare, G, Zappia, A, Giuliani, G, Falcone, F, Sebastiani, S, Montuori, M, Rossi, S, Sagnotta, A, Giuliani, B, Imbriani, G, Restaino, S, Andreani, L, Di Maria, F, Lagana, A, Vitiello, L, Berton, F, Virgilio, E, Palisi, M, Portigliotti, L, Calussi, M, Conti, L, Mauriello, C, Barone, M, Saladino, E, Giaquinta, A, Zerb, D, Frazzetta, G, Merola, G, Chierici, A, Bini, R, Centonze, L, De Carlis, R, Ferrario, L, Giani, A, Lauterio, A, Tamini, N, Corti, S, Botteri, E, Andreuccetti, J, D'Alessio, R, Cestaro, G, Clarizia, G, Spolini, A, Carboni, A, Benzoni, E, Galiffa, G, Perotti, B, Veroux, M, Randazzo, V, Topa, D, Pranteda, C, Contini, G, Iacusso, C, Voglino, V, Vita, P, Carrano, F, Ambrosio, L, Cammarata, R, Capolupo, G, Caputo, D, Carannante, F, Cascone, C, Esperto, F, Farolfi, T, Frasca, L, Gallo, I, Gibin, G, Giurazza, G, Improta, L, La Vaccara, V, Luffarelli, P, Luvero, D, Marangi, G, Masciana, G, Mazzola, A, Mazzotta, E, Miligi, C, Montelione, N, Nenna, A, Orsaria, P, Papalia, R, Papalia, G, Parisi, F, Prata, F, Salzillo, R, Santini, S, Sofo, F, Zampoli, A, Tanda, C, Altieri, G, Ardito, F, Belia, F, Bianchi, V, Biondi, A, Brisinda, G, Chiappetta, M, Ciolli, G, Ciolli, A, Ferracci, F, Ferri, L, Fico, V, Fiorillo, C, Fransvea, P, Galiandro, F, Giovinazzo, F, La Greca, A, Litta, F, Mele, C, Pafundi, D, Panettieri, E, Papa, V, Patini, R, Perrotta, G, Puccioni, C, Santocchi, P, Armatura, G, Olmi, S, Casoni Pattacini, G, Salgarello, S, Trompetto, M, Bombardini, C, La Rocca, R, Celentano, G, Micalef, A, Mazzella, A, Settembrini, A, Zoia, C, Degrate, L, Musumeci, G, Palopoli, C, Montori, G, Bonati, E, Dinuzzi, V, Velluti, F, Balla, A, Bonasia, D, Coletta, D, Berardi, G, Colasanti, M, Ferretti, S, Gasparoli, C, Mariano, G, Avenia, S, Cianci, P, Cestino, L, Festa, F, Fazio, F, Ascari, F, Desio, M, Arroyo Murillo, G, Cereda, M, Galleano, R, David, G, Pansini, A, Gazia, C, Atzori, G, Desideri, L, Famularo, S, Galvanin, J, Giudici, V, Mangiameli, G, Mei, S, Milana, F, Pansa, A, Sacchi, M, Testori, A, Di Carlo, G, Paratore, M, Perrone, U, Vagge, A, Vigano, J, Torre, B, Scotti, M, Carbone, G, Cerchione, R, De Nardi, P, Gozzini, L, Ottaviani, L, Senni, C, Piccin, O, Pio, L, Colombo, F, Avantifiori, R, Baldassarri, V, Caronna, R, Cicerchia, P, Corallino, D, Crocetti, D, Gallo, G, Giovanardi, F, Giovannetti, F, Hassan, R, Iossa, A, Lai, Q, Lancellotti, F, Lucarini, A, Lucchese, S, Mazzarella, G, Melandro, F, Minervini, A, Muttillo, E, Palmieri, L, Pasqua, R, Rosiello, F, Salina, G, Sibio, S, Sirignano, P, Tarallo, M, Usai, S, Vanni, C, Viglietta, E, Zambon, M, Conversano, N, Epifani, A, Milano, V, Sacco, L, Nava, M, Maffioli, A, Giuratrabocchetta, S, Baracchi, F, Zuolo, M, Ceresoli, M, Verdi, D, Belli, A, Pata, F, Piovano, E, Pastore, G, Bernabei, F, Deiana, S, Arceri, A, D'Agostino, C, Marafante, C, Moggia, E, Parini, S, Moretti, M, Uggeri, F, Pontarolo, N, Fontana, T, Palmisano, G, Giuffrida, M, Guaitoli, E, Ferretti, C, Iacopino, G, Gioco, R, Roscitano, G, Montanelli, P, Pinotti, E, Monati, E, Fazio, G, Di Pietro, F, Damarco, F, Barberis, A, Razzore, A, Pascale, A, Loi, S, Ferrara, F, Rossi, M, Lisi, G, Viel, G, Sasia, D, Bono, D, Cordaro, E, Giacomelli, E, Giani, I, Seriau, L, Pellino, G, Sparavigna, M, Trigiante, G, D'Ambrogio, R, Cardella, F, Guzzetti, S, Luzzi, A, Carganico, G, Drago, B, Micheletto, G, Orlandi, R, Cutolo, C, Gibello, U, Mistrangelo, M, Forcignano, E, D'Ugo, S, Losurdo, P, Manitto, M, Caroli, G, Franco, M, Tilocca, P, Mendogni, P, Sena, G, Sambucci, D, Luciani, C, Atelli, P, Guida, A, Marino, F, Morini, A, Sibilla, M, Longo, F, Giaccari, S, Vigorita, V, Balduzzi, A, Barra, F, Delogu, D, Milone, E, Bencini, L, Aprile, V, Papini, P, Montemurro, N, Cavallo, M, Picciariello, A, Tomasicchio, G, Fittipaldi, A, Maruccia, M, Gerardi, S, Cillara, N, Deidda, S, Demarinis, G, Peiretti, E, Tatti, F, Iovino, C, Isola, G, Progno, V, Migliore, M, Badessi, G, Barilla, C, Calleri, G, Cianci, S, Fama, F, Fleres, F, Mazzeo, C, Visaloco, M, Marchetto, C, Bolognesi, F, Benuzzi, L, Bracchetti, G, Brucchi, F, Manzo, C, Scaravilli, L, Ferrari, C, Rocca, A, Napolitano, P, Anoldo, P, Caricato, C, Manigrasso, M, Milone, M, Napolitano, L, Palomba, G, Schiavone, V, Vetrella, M, Grossi, U, Moletta, L, Annicchiarico, A, Vella, I, Talesa, G, Boggi, U, Aiello, F, Anselmo, A, Bacchiocchi, G, Beati, F, Bellato, V, Billeci, F, Blasi, F, Buonomo, O, Campanelli, M, Coco, G, Contadini, A, Conte, L, D'Ippolito, G, Di Marcantonio, A, Spicchiale, C, Afflitto, G, Gismondi, A, Gorgolini, G, Granai, A, Grande, S, Gravina, A, Ingallinella, S, Keci, L, Latini, E, Marino, D, Oddi, F, Orecchia, L, Don, C, Pellicciaro, M, Petagna, L, Pirozzi, B, Quaranta, C, Rho, M, Rosina, A, Santicchia, M, Saraceno, F, Schiavone, A, Sensi, B, Spina, A, Sullo, L, Tacconi, F, Taje, R, Vanni, G, Vinci, D, Vita, G, Alba, G, Badalucco, S, Carbone, L, Samorani, O, Chisci, G, Cuomo, R, Francia, A, Fusario, D, Gargiulo, B, Pasqui, E, Pasquetti, L, Puoti, P, Resca, L, Cumbo, J, Ganio, S, Vizzielli, G, Anastasi, M, Guerra, D, Romanzi, A, Vannelli, A, Baia, M, Siragusa L., Angelico R., Angrisani M., Zampogna B., Materazzo M., Sorge R., Giordano L., Meniconi R., Coppola A., Marino A., Giraudo G., Esposito S., Urbani A., De Pastena M., Mastrapasqua R., Garancini M., Frontal A., Pascal G., Martellucc J., Falb F., Boscarelli A., Bertoglio P., Trecca E., Galassi L., Vento V., Chiappini A., Antonelli A., Bennardo F., Familiari F., Giannaccare G., Zappia A. S., Giuliani G., Falcone F., Sebastiani S., Montuori M., Rossi S., Sagnotta A., Giuliani B., Imbriani G. C., Restaino S., Andreani L., Di Maria F., Lagana A. S., Vitiello L., Berton F., Virgilio E., Palisi M., Portigliotti L., Calussi M., Conti L., Mauriello C., Barone M., Saladino E., Giaquinta A., Zerb D., Frazzetta G., Merola G., Chierici A., Bini R., Centonze L., De Carlis R., Ferrario L., Giani A., Lauterio A., Tamini N., Corti S., Botteri E., Andreuccetti J., D'Alessio R., Cestaro G., Clarizia G., Spolini A., Carboni A. S., Benzoni E., Galiffa G., Perotti B., Veroux M., Randazzo V., Topa D., Pranteda C., Contini G., Iacusso C., Voglino V., Vita P., Carrano F. M., Ambrosio L., Cammarata R., Capolupo G. T., Caputo D., Carannante F., Cascone C., Esperto F., Farolfi T., Frasca L., Gallo I. F., Gibin G., Giurazza G., Improta L., La Vaccara V., Luffarelli P., Luvero D., Marangi G., Masciana G., Mazzola A., Mazzotta E., Miligi C. I., Montelione N., Nenna A., Orsaria P., Papalia R., Papalia G. F., Parisi F. R., Prata F., Salzillo R., Santini S., Sofo F., Zampoli A., Tanda C., Altieri G., Ardito F., Belia F., Bianchi V., Biondi A., Brisinda G., Chiappetta M., Ciolli G., Ciolli A., Ferracci F., Ferri L., Fico V., Fiorillo C., Fransvea P., Galiandro F., Giovinazzo F., La Greca A., Litta F., Mele C., Pafundi D. P., Panettieri E., Papa V., Patini R., Perrotta G., Puccioni C., Santocchi P., Armatura G., Olmi S., Casoni Pattacini G., Salgarello S., Trompetto M., Bombardini C., La Rocca R., Celentano G., Micalef A., Mazzella A., Settembrini A., Zoia C., Degrate L., Musumeci G., Palopoli C. A. M., Montori G., Bonati E., Dinuzzi V. P., Velluti F., Balla A., Bonasia D. E., Coletta D., Berardi G., Colasanti M., Ferretti S., Gasparoli C., Mariano G., Avenia S., Cianci P., Cestino L., Festa F., Fazio F., Ascari F., Desio M., Arroyo Murillo G. A., Cereda M., Galleano R., David G., Pansini A., Gazia C., Atzori G., Desideri L. F., Famularo S., Galvanin J., Giudici V. M., Mangiameli G., Mei S., Milana F., Pansa A., Sacchi M., Testori A., Di Carlo G., Paratore M., Perrone U., Vagge A., Vigano J., Torre B., Scotti M. A., Carbone G., Cerchione R., De Nardi P., Gozzini L., Ottaviani L., Senni C., Piccin O., Pio L., Colombo F., Avantifiori R., Baldassarri V., Caronna R., Cicerchia P. M., Corallino D., Crocetti D., Gallo G., Giovanardi F., Giovannetti F., Hassan R., Iossa A., Lai Q., Lancellotti F., Lucarini A., Lucchese S., Mazzarella G., Melandro F., Minervini A., Muttillo E. M., Palmieri L., Pasqua R., Rosiello F., Salina G., Sibio S., Sirignano P., Tarallo M., Usai S., Vanni C., Viglietta E., Zambon M., Conversano N. I., Epifani A. G., Milano V., Sacco L., Nava M., Maffioli A., Giuratrabocchetta S., Baracchi F., Zuolo M., Ceresoli M., Verdi D., Belli A., Pata F., Piovano E., Pastore G., Bernabei F., Deiana S., Arceri A., D'Agostino C., Marafante C., Moggia E., Parini S., Moretti M., Uggeri F., Pontarolo N., Fontana T., Palmisano G., Giuffrida M., Guaitoli E., Ferretti C., Iacopino G., Gioco R., Roscitano G., Montanelli P., Chiappetta M. F., Pinotti E., Monati E., Fazio G., Di Pietro F., Damarco F., Barberis A., Razzore A., Pascale A., Loi S., Ferrara F., Rossi M., Lisi G., Viel G., Sasia D., Bono D., Cordaro E. R., Giacomelli E., Giani I., Seriau L., Pellino G., Sparavigna M., Trigiante G., D'Ambrogio R. G., Cardella F., Guzzetti S., Luzzi A. -P., Carganico G., Drago B., Micheletto G., Orlandi R., Cutolo C., Gibello U., Mistrangelo M., Forcignano E., D'Ugo S., Losurdo P., Manitto M., Caroli G., Franco M., Tilocca P. L., Mendogni P., Sena G., Sambucci D., Luciani C., Atelli P., Guida A., Marino F., Morini A., Sibilla M. G., Longo F., Giaccari S., Vigorita V., Balduzzi A., Barra F., Delogu D., Milone E., Bencini L., Aprile V., Papini P., Montemurro N., Cavallo M., Picciariello A., Tomasicchio G., Fittipaldi A., Maruccia M., Gerardi S., Cillara N., Deidda S., Demarinis G., Peiretti E., Tatti F., Iovino C., Isola G., Progno V. C., Migliore M., Badessi G., Barilla C., Calleri G. S., Cianci S., Fama F., Fleres F., Mazzeo C., Visaloco M. G., Marchetto C., Bolognesi F., Benuzzi L., Bracchetti G., Brucchi F., Manzo C. A., Scaravilli L., Ferrari C., Rocca A., Napolitano P., Anoldo P., Caricato C., Manigrasso M., Milone M., Napolitano L., Palomba G., Schiavone V., Vetrella M., Grossi U., Moletta L., Annicchiarico A., Vella I., Talesa G., Boggi U., Aiello F., Anselmo A., Bacchiocchi G., Beati F., Bellato V., Billeci F., Blasi F., Buonomo O. C., Campanelli M., Coco G., Contadini A., Conte L. E., D'Ippolito G., Di Marcantonio A., Spicchiale C. F., Afflitto G. G., Gismondi A., Gorgolini G., Granai A. V., Grande S., Gravina A., Guida A. M., Ingallinella S., Keci L., Latini E., Marino D., Oddi F. M., Orecchia L., Don C. B. P., Pellicciaro M., Petagna L., Pirozzi B. M., Quaranta C., Rho M., Rosina A., Santicchia M. S., Saraceno F., Schiavone A., Sensi B., Spina A., Sullo L., Tacconi F., Taje R., Vanni G., Vinci D., Vita G., Alba G., Badalucco S., Carbone L., Samorani O. C., Chisci G., Cuomo R., Francia A., Fusario D., Gargiulo B., Pasqui E., Pasquetti L., Puoti P., Resca L., Cumbo J., Ganio S., Vizzielli G., Anastasi M., Guerra D., Romanzi A., Vannelli A., Baia M., Siragusa, L, Angelico, R, Angrisani, M, Zampogna, B, Materazzo, M, Sorge, R, Giordano, L, Meniconi, R, Coppola, A, Marino, A, Giraudo, G, Esposito, S, Urbani, A, De Pastena, M, Mastrapasqua, R, Garancini, M, Frontal, A, Pascal, G, Martellucc, J, Falb, F, Boscarelli, A, Bertoglio, P, Trecca, E, Galassi, L, Vento, V, Chiappini, A, Antonelli, A, Bennardo, F, Familiari, F, Giannaccare, G, Zappia, A, Giuliani, G, Falcone, F, Sebastiani, S, Montuori, M, Rossi, S, Sagnotta, A, Giuliani, B, Imbriani, G, Restaino, S, Andreani, L, Di Maria, F, Lagana, A, Vitiello, L, Berton, F, Virgilio, E, Palisi, M, Portigliotti, L, Calussi, M, Conti, L, Mauriello, C, Barone, M, Saladino, E, Giaquinta, A, Zerb, D, Frazzetta, G, Merola, G, Chierici, A, Bini, R, Centonze, L, De Carlis, R, Ferrario, L, Giani, A, Lauterio, A, Tamini, N, Corti, S, Botteri, E, Andreuccetti, J, D'Alessio, R, Cestaro, G, Clarizia, G, Spolini, A, Carboni, A, Benzoni, E, Galiffa, G, Perotti, B, Veroux, M, Randazzo, V, Topa, D, Pranteda, C, Contini, G, Iacusso, C, Voglino, V, Vita, P, Carrano, F, Ambrosio, L, Cammarata, R, Capolupo, G, Caputo, D, Carannante, F, Cascone, C, Esperto, F, Farolfi, T, Frasca, L, Gallo, I, Gibin, G, Giurazza, G, Improta, L, La Vaccara, V, Luffarelli, P, Luvero, D, Marangi, G, Masciana, G, Mazzola, A, Mazzotta, E, Miligi, C, Montelione, N, Nenna, A, Orsaria, P, Papalia, R, Papalia, G, Parisi, F, Prata, F, Salzillo, R, Santini, S, Sofo, F, Zampoli, A, Tanda, C, Altieri, G, Ardito, F, Belia, F, Bianchi, V, Biondi, A, Brisinda, G, Chiappetta, M, Ciolli, G, Ciolli, A, Ferracci, F, Ferri, L, Fico, V, Fiorillo, C, Fransvea, P, Galiandro, F, Giovinazzo, F, La Greca, A, Litta, F, Mele, C, Pafundi, D, Panettieri, E, Papa, V, Patini, R, Perrotta, G, Puccioni, C, Santocchi, P, Armatura, G, Olmi, S, Casoni Pattacini, G, Salgarello, S, Trompetto, M, Bombardini, C, La Rocca, R, Celentano, G, Micalef, A, Mazzella, A, Settembrini, A, Zoia, C, Degrate, L, Musumeci, G, Palopoli, C, Montori, G, Bonati, E, Dinuzzi, V, Velluti, F, Balla, A, Bonasia, D, Coletta, D, Berardi, G, Colasanti, M, Ferretti, S, Gasparoli, C, Mariano, G, Avenia, S, Cianci, P, Cestino, L, Festa, F, Fazio, F, Ascari, F, Desio, M, Arroyo Murillo, G, Cereda, M, Galleano, R, David, G, Pansini, A, Gazia, C, Atzori, G, Desideri, L, Famularo, S, Galvanin, J, Giudici, V, Mangiameli, G, Mei, S, Milana, F, Pansa, A, Sacchi, M, Testori, A, Di Carlo, G, Paratore, M, Perrone, U, Vagge, A, Vigano, J, Torre, B, Scotti, M, Carbone, G, Cerchione, R, De Nardi, P, Gozzini, L, Ottaviani, L, Senni, C, Piccin, O, Pio, L, Colombo, F, Avantifiori, R, Baldassarri, V, Caronna, R, Cicerchia, P, Corallino, D, Crocetti, D, Gallo, G, Giovanardi, F, Giovannetti, F, Hassan, R, Iossa, A, Lai, Q, Lancellotti, F, Lucarini, A, Lucchese, S, Mazzarella, G, Melandro, F, Minervini, A, Muttillo, E, Palmieri, L, Pasqua, R, Rosiello, F, Salina, G, Sibio, S, Sirignano, P, Tarallo, M, Usai, S, Vanni, C, Viglietta, E, Zambon, M, Conversano, N, Epifani, A, Milano, V, Sacco, L, Nava, M, Maffioli, A, Giuratrabocchetta, S, Baracchi, F, Zuolo, M, Ceresoli, M, Verdi, D, Belli, A, Pata, F, Piovano, E, Pastore, G, Bernabei, F, Deiana, S, Arceri, A, D'Agostino, C, Marafante, C, Moggia, E, Parini, S, Moretti, M, Uggeri, F, Pontarolo, N, Fontana, T, Palmisano, G, Giuffrida, M, Guaitoli, E, Ferretti, C, Iacopino, G, Gioco, R, Roscitano, G, Montanelli, P, Pinotti, E, Monati, E, Fazio, G, Di Pietro, F, Damarco, F, Barberis, A, Razzore, A, Pascale, A, Loi, S, Ferrara, F, Rossi, M, Lisi, G, Viel, G, Sasia, D, Bono, D, Cordaro, E, Giacomelli, E, Giani, I, Seriau, L, Pellino, G, Sparavigna, M, Trigiante, G, D'Ambrogio, R, Cardella, F, Guzzetti, S, Luzzi, A, Carganico, G, Drago, B, Micheletto, G, Orlandi, R, Cutolo, C, Gibello, U, Mistrangelo, M, Forcignano, E, D'Ugo, S, Losurdo, P, Manitto, M, Caroli, G, Franco, M, Tilocca, P, Mendogni, P, Sena, G, Sambucci, D, Luciani, C, Atelli, P, Guida, A, Marino, F, Morini, A, Sibilla, M, Longo, F, Giaccari, S, Vigorita, V, Balduzzi, A, Barra, F, Delogu, D, Milone, E, Bencini, L, Aprile, V, Papini, P, Montemurro, N, Cavallo, M, Picciariello, A, Tomasicchio, G, Fittipaldi, A, Maruccia, M, Gerardi, S, Cillara, N, Deidda, S, Demarinis, G, Peiretti, E, Tatti, F, Iovino, C, Isola, G, Progno, V, Migliore, M, Badessi, G, Barilla, C, Calleri, G, Cianci, S, Fama, F, Fleres, F, Mazzeo, C, Visaloco, M, Marchetto, C, Bolognesi, F, Benuzzi, L, Bracchetti, G, Brucchi, F, Manzo, C, Scaravilli, L, Ferrari, C, Rocca, A, Napolitano, P, Anoldo, P, Caricato, C, Manigrasso, M, Milone, M, Napolitano, L, Palomba, G, Schiavone, V, Vetrella, M, Grossi, U, Moletta, L, Annicchiarico, A, Vella, I, Talesa, G, Boggi, U, Aiello, F, Anselmo, A, Bacchiocchi, G, Beati, F, Bellato, V, Billeci, F, Blasi, F, Buonomo, O, Campanelli, M, Coco, G, Contadini, A, Conte, L, D'Ippolito, G, Di Marcantonio, A, Spicchiale, C, Afflitto, G, Gismondi, A, Gorgolini, G, Granai, A, Grande, S, Gravina, A, Ingallinella, S, Keci, L, Latini, E, Marino, D, Oddi, F, Orecchia, L, Don, C, Pellicciaro, M, Petagna, L, Pirozzi, B, Quaranta, C, Rho, M, Rosina, A, Santicchia, M, Saraceno, F, Schiavone, A, Sensi, B, Spina, A, Sullo, L, Tacconi, F, Taje, R, Vanni, G, Vinci, D, Vita, G, Alba, G, Badalucco, S, Carbone, L, Samorani, O, Chisci, G, Cuomo, R, Francia, A, Fusario, D, Gargiulo, B, Pasqui, E, Pasquetti, L, Puoti, P, Resca, L, Cumbo, J, Ganio, S, Vizzielli, G, Anastasi, M, Guerra, D, Romanzi, A, Vannelli, A, Baia, M, Siragusa L., Angelico R., Angrisani M., Zampogna B., Materazzo M., Sorge R., Giordano L., Meniconi R., Coppola A., Marino A., Giraudo G., Esposito S., Urbani A., De Pastena M., Mastrapasqua R., Garancini M., Frontal A., Pascal G., Martellucc J., Falb F., Boscarelli A., Bertoglio P., Trecca E., Galassi L., Vento V., Chiappini A., Antonelli A., Bennardo F., Familiari F., Giannaccare G., Zappia A. S., Giuliani G., Falcone F., Sebastiani S., Montuori M., Rossi S., Sagnotta A., Giuliani B., Imbriani G. C., Restaino S., Andreani L., Di Maria F., Lagana A. S., Vitiello L., Berton F., Virgilio E., Palisi M., Portigliotti L., Calussi M., Conti L., Mauriello C., Barone M., Saladino E., Giaquinta A., Zerb D., Frazzetta G., Merola G., Chierici A., Bini R., Centonze L., De Carlis R., Ferrario L., Giani A., Lauterio A., Tamini N., Corti S., Botteri E., Andreuccetti J., D'Alessio R., Cestaro G., Clarizia G., Spolini A., Carboni A. S., Benzoni E., Galiffa G., Perotti B., Veroux M., Randazzo V., Topa D., Pranteda C., Contini G., Iacusso C., Voglino V., Vita P., Carrano F. M., Ambrosio L., Cammarata R., Capolupo G. T., Caputo D., Carannante F., Cascone C., Esperto F., Farolfi T., Frasca L., Gallo I. F., Gibin G., Giurazza G., Improta L., La Vaccara V., Luffarelli P., Luvero D., Marangi G., Masciana G., Mazzola A., Mazzotta E., Miligi C. I., Montelione N., Nenna A., Orsaria P., Papalia R., Papalia G. F., Parisi F. R., Prata F., Salzillo R., Santini S., Sofo F., Zampoli A., Tanda C., Altieri G., Ardito F., Belia F., Bianchi V., Biondi A., Brisinda G., Chiappetta M., Ciolli G., Ciolli A., Ferracci F., Ferri L., Fico V., Fiorillo C., Fransvea P., Galiandro F., Giovinazzo F., La Greca A., Litta F., Mele C., Pafundi D. P., Panettieri E., Papa V., Patini R., Perrotta G., Puccioni C., Santocchi P., Armatura G., Olmi S., Casoni Pattacini G., Salgarello S., Trompetto M., Bombardini C., La Rocca R., Celentano G., Micalef A., Mazzella A., Settembrini A., Zoia C., Degrate L., Musumeci G., Palopoli C. A. M., Montori G., Bonati E., Dinuzzi V. P., Velluti F., Balla A., Bonasia D. E., Coletta D., Berardi G., Colasanti M., Ferretti S., Gasparoli C., Mariano G., Avenia S., Cianci P., Cestino L., Festa F., Fazio F., Ascari F., Desio M., Arroyo Murillo G. A., Cereda M., Galleano R., David G., Pansini A., Gazia C., Atzori G., Desideri L. F., Famularo S., Galvanin J., Giudici V. M., Mangiameli G., Mei S., Milana F., Pansa A., Sacchi M., Testori A., Di Carlo G., Paratore M., Perrone U., Vagge A., Vigano J., Torre B., Scotti M. A., Carbone G., Cerchione R., De Nardi P., Gozzini L., Ottaviani L., Senni C., Piccin O., Pio L., Colombo F., Avantifiori R., Baldassarri V., Caronna R., Cicerchia P. M., Corallino D., Crocetti D., Gallo G., Giovanardi F., Giovannetti F., Hassan R., Iossa A., Lai Q., Lancellotti F., Lucarini A., Lucchese S., Mazzarella G., Melandro F., Minervini A., Muttillo E. M., Palmieri L., Pasqua R., Rosiello F., Salina G., Sibio S., Sirignano P., Tarallo M., Usai S., Vanni C., Viglietta E., Zambon M., Conversano N. I., Epifani A. G., Milano V., Sacco L., Nava M., Maffioli A., Giuratrabocchetta S., Baracchi F., Zuolo M., Ceresoli M., Verdi D., Belli A., Pata F., Piovano E., Pastore G., Bernabei F., Deiana S., Arceri A., D'Agostino C., Marafante C., Moggia E., Parini S., Moretti M., Uggeri F., Pontarolo N., Fontana T., Palmisano G., Giuffrida M., Guaitoli E., Ferretti C., Iacopino G., Gioco R., Roscitano G., Montanelli P., Chiappetta M. F., Pinotti E., Monati E., Fazio G., Di Pietro F., Damarco F., Barberis A., Razzore A., Pascale A., Loi S., Ferrara F., Rossi M., Lisi G., Viel G., Sasia D., Bono D., Cordaro E. R., Giacomelli E., Giani I., Seriau L., Pellino G., Sparavigna M., Trigiante G., D'Ambrogio R. G., Cardella F., Guzzetti S., Luzzi A. -P., Carganico G., Drago B., Micheletto G., Orlandi R., Cutolo C., Gibello U., Mistrangelo M., Forcignano E., D'Ugo S., Losurdo P., Manitto M., Caroli G., Franco M., Tilocca P. L., Mendogni P., Sena G., Sambucci D., Luciani C., Atelli P., Guida A., Marino F., Morini A., Sibilla M. G., Longo F., Giaccari S., Vigorita V., Balduzzi A., Barra F., Delogu D., Milone E., Bencini L., Aprile V., Papini P., Montemurro N., Cavallo M., Picciariello A., Tomasicchio G., Fittipaldi A., Maruccia M., Gerardi S., Cillara N., Deidda S., Demarinis G., Peiretti E., Tatti F., Iovino C., Isola G., Progno V. C., Migliore M., Badessi G., Barilla C., Calleri G. S., Cianci S., Fama F., Fleres F., Mazzeo C., Visaloco M. G., Marchetto C., Bolognesi F., Benuzzi L., Bracchetti G., Brucchi F., Manzo C. A., Scaravilli L., Ferrari C., Rocca A., Napolitano P., Anoldo P., Caricato C., Manigrasso M., Milone M., Napolitano L., Palomba G., Schiavone V., Vetrella M., Grossi U., Moletta L., Annicchiarico A., Vella I., Talesa G., Boggi U., Aiello F., Anselmo A., Bacchiocchi G., Beati F., Bellato V., Billeci F., Blasi F., Buonomo O. C., Campanelli M., Coco G., Contadini A., Conte L. E., D'Ippolito G., Di Marcantonio A., Spicchiale C. F., Afflitto G. G., Gismondi A., Gorgolini G., Granai A. V., Grande S., Gravina A., Guida A. M., Ingallinella S., Keci L., Latini E., Marino D., Oddi F. M., Orecchia L., Don C. B. P., Pellicciaro M., Petagna L., Pirozzi B. M., Quaranta C., Rho M., Rosina A., Santicchia M. S., Saraceno F., Schiavone A., Sensi B., Spina A., Sullo L., Tacconi F., Taje R., Vanni G., Vinci D., Vita G., Alba G., Badalucco S., Carbone L., Samorani O. C., Chisci G., Cuomo R., Francia A., Fusario D., Gargiulo B., Pasqui E., Pasquetti L., Puoti P., Resca L., Cumbo J., Ganio S., Vizzielli G., Anastasi M., Guerra D., Romanzi A., Vannelli A., and Baia M.

Abstract

COVID-19 negatively affected surgical activity, but the potential benefits resulting from adopted measures remain unclear. The aim of this study was to evaluate the change in surgical activity and potential benefit from COVID-19 measures in perspective of Italian surgeons on behalf of SPIGC. A nationwide online survey on surgical practice before, during, and after COVID-19 pandemic was conducted in March–April 2022 (NCT:05323851). Effects of COVID-19 hospital-related measures on surgical patients’ management and personal professional development across surgical specialties were explored. Data on demographics, pre-operative/peri-operative/post-operative management, and professional development were collected. Outcomes were matched with the corresponding volume. Four hundred and seventy-three respondents were included in final analysis across 14 surgical specialties. Since SARS-CoV-2 pandemic, application of telematic consultations (4.1% vs. 21.6%; p < 0.0001) and diagnostic evaluations (16.4% vs. 42.2%; p < 0.0001) increased. Elective surgical activities significantly reduced and surgeons opted more frequently for conservative management with a possible indication for elective (26.3% vs. 35.7%; p < 0.0001) or urgent (20.4% vs. 38.5%; p < 0.0001) surgery. All new COVID-related measures are perceived to be maintained in the future. Surgeons’ personal education online increased from 12.6% (pre-COVID) to 86.6% (post-COVID; p < 0.0001). Online educational activities are considered a beneficial effect from COVID pandemic (56.4%). COVID-19 had a great impact on surgical specialties, with significant reduction of operation volume. However, some forced changes turned out to be benefits. Isolation measures pushed the use of telemedicine and telemetric devices for outpatient practice and favored communication for educational purposes and surgeon–patient/family communication. From the Italian surgeons’ perspective, COVID-related measures will continue to influence

Published
2023

20. Survival benefit of second line therapies for recurrent hepatocellular carcinoma: repeated hepatectomy, thermoablation and second-line transplant referral in a real life national scenario

Author

Famularo, S, Cillo, U, Lauterio, A, Donadon, M, Vitale, A, Serenari, M, Cipriani, F, Fazio, F, Giuffrida, M, Ardito, F, Dominioni, T, Garancini, M, Lai, Q, Nicolini, D, Molfino, S, Perri, P, Pinotti, E, Conci, S, Ferrari, C, Zanello, M, Patauner, S, Zimmitti, G, Germani, P, Chiarelli, M, Romano, M, De Angelis, M, La Barba, G, Troci, A, Ferraro, V, Izzo, F, Antonucci, A, Belli, A, Memeo, R, Crespi, M, Ercolani, G, Boccia, L, Zanus, G, Tarchi, P, Hilal, M, Frena, A, Jovine, E, Griseri, G, Ruzzenente, A, Zago, M, Grazi, G, Baiocchi, G, Vivarelli, M, Rossi, M, Romano, F, Maestri, M, Giuliante, F, Valle, R, Ferrero, A, Aldrighetti, L, De Carlis, L, Cescon, M, Torzilli, G, Milana, F, Bertacco, A, De Carlis, R, Ratti, F, Russolillo, N, Iaria, M, Razionale, F, Tartaglia, G, Ciulli, C, Carissimi, F, Laureiro, Z, Marinelli, L, Depeppo, V, Montuori, M, Marchitelli, I, Franceschi, A, Notte, F, Manzoni, A, Cosola, D, Corleone, P, Fumagalli, L, Salvador, L, Mantovani, G, Cucchetti, A, Cammarata, F, Conticchio, M, Patrone, R, Bernasconi, D, Famularo S., Cillo U., Lauterio A., Donadon M., Vitale A., Serenari M., Cipriani F., Fazio F., Giuffrida M., Ardito F., Dominioni T., Garancini M., Lai Q., Nicolini D., Molfino S., Perri P., Pinotti E., Conci S., Ferrari C., Zanello M., Patauner S., Zimmitti G., Germani P., Chiarelli M., Romano M., De Angelis M., La Barba G., Troci A., Ferraro V., Izzo F., Antonucci A., Belli A., Memeo R., Crespi M., Ercolani G., Boccia L., Zanus G., Tarchi P., Hilal M. A., Frena A., Jovine E., Griseri G., Ruzzenente A., Zago M., Grazi G., Baiocchi G. L., Vivarelli M., Rossi M., Romano F., Maestri M., Giuliante F., Valle R. D., Ferrero A., Aldrighetti L., De Carlis L., Cescon M., Torzilli G., Milana F., Bertacco A., De Carlis R., Ratti F., Russolillo N., Iaria M., Razionale F., Tartaglia G., Ciulli C., Carissimi F., Laureiro Z. L., Marinelli L., DePeppo V., Montuori M., Marchitelli I., Franceschi A., Notte F., Manzoni A., Cosola D., Corleone P., Fumagalli L., Salvador L., Mantovani G., Cucchetti A., Cammarata F., Conticchio M., Patrone R., Bernasconi D. P., Famularo, S, Cillo, U, Lauterio, A, Donadon, M, Vitale, A, Serenari, M, Cipriani, F, Fazio, F, Giuffrida, M, Ardito, F, Dominioni, T, Garancini, M, Lai, Q, Nicolini, D, Molfino, S, Perri, P, Pinotti, E, Conci, S, Ferrari, C, Zanello, M, Patauner, S, Zimmitti, G, Germani, P, Chiarelli, M, Romano, M, De Angelis, M, La Barba, G, Troci, A, Ferraro, V, Izzo, F, Antonucci, A, Belli, A, Memeo, R, Crespi, M, Ercolani, G, Boccia, L, Zanus, G, Tarchi, P, Hilal, M, Frena, A, Jovine, E, Griseri, G, Ruzzenente, A, Zago, M, Grazi, G, Baiocchi, G, Vivarelli, M, Rossi, M, Romano, F, Maestri, M, Giuliante, F, Valle, R, Ferrero, A, Aldrighetti, L, De Carlis, L, Cescon, M, Torzilli, G, Milana, F, Bertacco, A, De Carlis, R, Ratti, F, Russolillo, N, Iaria, M, Razionale, F, Tartaglia, G, Ciulli, C, Carissimi, F, Laureiro, Z, Marinelli, L, Depeppo, V, Montuori, M, Marchitelli, I, Franceschi, A, Notte, F, Manzoni, A, Cosola, D, Corleone, P, Fumagalli, L, Salvador, L, Mantovani, G, Cucchetti, A, Cammarata, F, Conticchio, M, Patrone, R, Bernasconi, D, Famularo S., Cillo U., Lauterio A., Donadon M., Vitale A., Serenari M., Cipriani F., Fazio F., Giuffrida M., Ardito F., Dominioni T., Garancini M., Lai Q., Nicolini D., Molfino S., Perri P., Pinotti E., Conci S., Ferrari C., Zanello M., Patauner S., Zimmitti G., Germani P., Chiarelli M., Romano M., De Angelis M., La Barba G., Troci A., Ferraro V., Izzo F., Antonucci A., Belli A., Memeo R., Crespi M., Ercolani G., Boccia L., Zanus G., Tarchi P., Hilal M. A., Frena A., Jovine E., Griseri G., Ruzzenente A., Zago M., Grazi G., Baiocchi G. L., Vivarelli M., Rossi M., Romano F., Maestri M., Giuliante F., Valle R. D., Ferrero A., Aldrighetti L., De Carlis L., Cescon M., Torzilli G., Milana F., Bertacco A., De Carlis R., Ratti F., Russolillo N., Iaria M., Razionale F., Tartaglia G., Ciulli C., Carissimi F., Laureiro Z. L., Marinelli L., DePeppo V., Montuori M., Marchitelli I., Franceschi A., Notte F., Manzoni A., Cosola D., Corleone P., Fumagalli L., Salvador L., Mantovani G., Cucchetti A., Cammarata F., Conticchio M., Patrone R., and Bernasconi D. P.

Abstract

Background: Despite second-line transplant(SLT) for recurrent hepatocellular carcinoma(rHCC) leads to the longest survival after recurrence(SAR), its real applicability has never been reported. The aim was to compare the SAR of SLT versus repeated hepatectomy and thermoablation(CUR group). Methods: Patients were enrolled from the Italian register HE.RC.O.LE.S. between 2008 and 2021. Two groups were created: CUR versus SLT. A propensity score matching (PSM) was run to balance the groups. Results: 743 patients were enrolled, CUR = 611 and SLT = 132. Median age at recurrence was 71(IQR 6575) years old and 60(IQR 53-64, p < 0.001) for CUR and SLT respectively. After PSM, median SAR for CUR was 43 months(95%CI = 37 – 93) and not reached for SLT(p < 0.001). SLT patients gained a survival benefit of 9.4 months if compared with CUR. MilanCriteria(MC)-In patients were 82.7% of the CUR group. SLT(HR 0.386, 95%CI = 0.23 – 0.63, p < 0.001) and the MELD score(HR 1.169, 95%CI = 1.07 – 1.27, p < 0.001) were the only predictors of mortality. In case of MC-Out, the only predictor of mortality was the number of nodules at recurrence(HR 1.45, 95%CI= 1.09 – 1.93, p = 0.011). Conclusion: It emerged an important transplant under referral in favour of repeated hepatectomy or thermoablation. In patients with MC-Out relapse, the benefit of SLT over CUR was not observed.

Published
2023

21. AFP score and metroticket 2.0 perform similarly and could be used in a “within-ALL” clinical decision tool

Author

Piñero, F, Costentin, C, Degroote, H, Notarpaolo, A, Boin, I, Boudjema, K, Baccaro, C, Chagas, A, Bachellier, P, Ettorre, G, Poniachik, J, Muscari, F, Dibenedetto, F, Duque, S, Salame, E, Cillo, U, Marciano, S, Vanlemmens, C, Fagiuoli, S, Carrilho, F, Cherqui, D, Burra, P, Van Vlierberghe, H, Lai, Q, Silva, M, Rubinstein, F, Duvoux, C, Conti, F, Scatton, O, Bernard, P, Francoz, C, Durand, F, Dharancy, S, Woehl, M, Laurent, A, Radenne, S, Dumortier, J, Abergel, A, Barbier, L, Houssel-Debry, P, Pageaux, G, Chiche, L, Deledinghen, V, Hardwigsen, J, Gugenheim, J, Altieri, M, Hilleret, M, Decaens, T, Costa, P, de Ataide, E, Quiñones, E, Anders, M, Varón, A, Zerega, A, Soza, A, Machaca, M, Arufe, D, Menéndez, J, Zapata, R, Vilatoba, M, Muñoz, L, Menéndez, R, Maraschio, M, Podestá, L, Mccormack, L, Mattera, J, Gadano, A, Parente García, J, Magini, G, Miglioresi, L, Gambato, M, D'Ambrosio, C, Vitale, A, Colledan, M, Pinelli, D, Magistri, P, Vennarecci, G, Colasanti, M, Giannelli, V, Pellicelli, A, Eduard, C, Samuele, I, Jeroen, D, Jonas, S, Jacques, P, Chris, V, Dirk, Y, Peter, M, Valerio, L, Christophe, M, Olivier, D, Jean, D, Roberto, T, Paul, L, Piñero F., Costentin C., Degroote H., Notarpaolo A., Boin I. F., Boudjema K., Baccaro C., Chagas A., Bachellier P., Ettorre G. M., Poniachik J., Muscari F., Dibenedetto F., Duque S. H., Salame E., Cillo U., Marciano S., Vanlemmens C., Fagiuoli S., Carrilho F., Cherqui D., Burra P., Van Vlierberghe H., Lai Q., Silva M., Rubinstein F., Duvoux C., Conti F., Scatton O., Bernard P. H., Francoz C., Durand F., Dharancy S., Woehl M. l., Laurent A., Radenne S., Dumortier J., Abergel A., Barbier L., Houssel-Debry P., Pageaux G. P., Chiche L., Deledinghen V., Hardwigsen J., Gugenheim J., altieri M., Hilleret M. N., Decaens T., Costa P., de Ataide E. C., Quiñones E., Anders M., Varón A., Zerega A., Soza A., Machaca M. P., Arufe D., Menéndez J., Zapata R., Vilatoba M., Muñoz L., Menéndez R. C., Maraschio M., Podestá L. G., McCormack L., Mattera J., Gadano A., Parente García J. H., Magini G., Miglioresi L., Gambato M., D'Ambrosio C., Vitale A., Colledan M., Pinelli D., Magistri P., Vennarecci G., Colasanti M., Giannelli V., Pellicelli A., Eduard C., Samuele I., Jeroen D., Jonas S., Jacques P., Chris V., Dirk Y., Peter M., Valerio L., Christophe M., Olivier D., Jean D., Roberto T., Paul L. J., Piñero, F, Costentin, C, Degroote, H, Notarpaolo, A, Boin, I, Boudjema, K, Baccaro, C, Chagas, A, Bachellier, P, Ettorre, G, Poniachik, J, Muscari, F, Dibenedetto, F, Duque, S, Salame, E, Cillo, U, Marciano, S, Vanlemmens, C, Fagiuoli, S, Carrilho, F, Cherqui, D, Burra, P, Van Vlierberghe, H, Lai, Q, Silva, M, Rubinstein, F, Duvoux, C, Conti, F, Scatton, O, Bernard, P, Francoz, C, Durand, F, Dharancy, S, Woehl, M, Laurent, A, Radenne, S, Dumortier, J, Abergel, A, Barbier, L, Houssel-Debry, P, Pageaux, G, Chiche, L, Deledinghen, V, Hardwigsen, J, Gugenheim, J, Altieri, M, Hilleret, M, Decaens, T, Costa, P, de Ataide, E, Quiñones, E, Anders, M, Varón, A, Zerega, A, Soza, A, Machaca, M, Arufe, D, Menéndez, J, Zapata, R, Vilatoba, M, Muñoz, L, Menéndez, R, Maraschio, M, Podestá, L, Mccormack, L, Mattera, J, Gadano, A, Parente García, J, Magini, G, Miglioresi, L, Gambato, M, D'Ambrosio, C, Vitale, A, Colledan, M, Pinelli, D, Magistri, P, Vennarecci, G, Colasanti, M, Giannelli, V, Pellicelli, A, Eduard, C, Samuele, I, Jeroen, D, Jonas, S, Jacques, P, Chris, V, Dirk, Y, Peter, M, Valerio, L, Christophe, M, Olivier, D, Jean, D, Roberto, T, Paul, L, Piñero F., Costentin C., Degroote H., Notarpaolo A., Boin I. F., Boudjema K., Baccaro C., Chagas A., Bachellier P., Ettorre G. M., Poniachik J., Muscari F., Dibenedetto F., Duque S. H., Salame E., Cillo U., Marciano S., Vanlemmens C., Fagiuoli S., Carrilho F., Cherqui D., Burra P., Van Vlierberghe H., Lai Q., Silva M., Rubinstein F., Duvoux C., Conti F., Scatton O., Bernard P. H., Francoz C., Durand F., Dharancy S., Woehl M. l., Laurent A., Radenne S., Dumortier J., Abergel A., Barbier L., Houssel-Debry P., Pageaux G. P., Chiche L., Deledinghen V., Hardwigsen J., Gugenheim J., altieri M., Hilleret M. N., Decaens T., Costa P., de Ataide E. C., Quiñones E., Anders M., Varón A., Zerega A., Soza A., Machaca M. P., Arufe D., Menéndez J., Zapata R., Vilatoba M., Muñoz L., Menéndez R. C., Maraschio M., Podestá L. G., McCormack L., Mattera J., Gadano A., Parente García J. H., Magini G., Miglioresi L., Gambato M., D'Ambrosio C., Vitale A., Colledan M., Pinelli D., Magistri P., Vennarecci G., Colasanti M., Giannelli V., Pellicelli A., Eduard C., Samuele I., Jeroen D., Jonas S., Jacques P., Chris V., Dirk Y., Peter M., Valerio L., Christophe M., Olivier D., Jean D., Roberto T., and Paul L. J.

Abstract

Background & Aims: Two recently developed composite models, the alpha-fetoprotein (AFP) score and Metroticket 2.0, could be used to select patients with hepatocellular carcinoma (HCC) who are candidates for liver transplantation (LT). The aim of this study was to compare the predictive performance of both models and to evaluate the net risk reclassification of post-LT recurrence between them using each model's original thresholds. Methods: This multicenter cohort study included 2,444 adult patients who underwent LT for HCC in 47 centers from Europe and Latin America. A competing risk regression analysis estimating sub-distribution hazard ratios (SHRs) and 95% CIs for recurrence was used (Fine and Gray method). Harrell's adapted c-statistics were estimated. The net reclassification index for recurrence was compared based on each model's original thresholds. Results: During a median follow-up of 3.8 years, there were 310 recurrences and 496 competing events (20.3%). Both models predicted recurrence, HCC survival and survival better than Milan criteria (p <0.0001). At last tumor reassessment before LT, c-statistics did not significantly differ between the two composite models, either as original or threshold versions, for recurrence (0.72 vs. 0.68; p = 0.06), HCC survival, and overall survival after LT. We observed predictive gaps and overlaps between the model's thresholds, and no significant gain on reclassification. Patients meeting both models (“within-ALL”) at last tumor reassessment presented the lowest 5-year cumulative incidence of HCC recurrence (7.7%; 95% CI 5.1-11.5) and higher 5-year post-LT survival (70.0%; 95% CI 64.9-74.6). Conclusions: In this multicenter cohort, Metroticket 2.0 and the AFP score demonstrated a similar ability to predict HCC recurrence post-LT. The combination of these composite models might be a promising clinical approach. Impact and implications: Composite models were recently proposed for the selection of liver transplant (LT

Published
2023

23. Effects Of Exercise Training With Dietary Restriction On Arterial Stiffness, Central Hemodynamic Parameters And Cardiac Autonomic Function In Obese Adolescents

Author

Huang J, Lai Q, Wang D, Yin H, Liao J, Wang S, Xu F, Hou X, and Hu M

Subjects
obesity, adolescents, exercise, cardiac autonomic function, arterial stiffness, diet, Specialties of internal medicine, RC581-951
Abstract

Junhao Huang,1 Qinhao Lai,1 Dan Wang,1 Honggang Yin,1 Jingwen Liao,1 Shen Wang,1–3 Fengpeng Xu,1 Xiaohui Hou,2 Min Hu1 1Guangdong Provincial Key Laboratory of Sports and Health Promotion, Scientific Research Center, Guangzhou Sport University, Guangzhou, Guangdong, People’s Republic of China; 2Department of Sports and Health, Guangzhou Sport University, Guangzhou, Guangdong, People’s Republic of China; 3School of Kinesiology, Shanghai University of Sport, Shanghai, People’s Republic of ChinaCorrespondence: Min HuScientific Research Center, Guangzhou Sport University, 1268 Middle Guangzhou Avenue, Guangzhou 510500, People’s Republic of ChinaTel/fax +86-20-38027669Email whoomin@aliyun.comXiaohui HouDepartment of Sports and Health, Guangzhou Sport University, 1268 Middle Guangzhou Avenue, Guangzhou 510500, People’s Republic of ChinaTel +86-20-38025087Fax +86-20-38027669Email lilyhxh@163.comPurpose: This study aimed to assess the effects of exercise with dietary restriction on arterial stiffness, central hemodynamics, and cardiac autonomic function in obese adolescents.Patients and methods: Twenty-one obese adolescents completed a 6-week exercise and dietary program. Body composition and metabolic parameters were measured. Carotid-femoral pulse wave velocity (cfPWV) and brachial-ankle pulse wave velocity (baPWV) were used to assess central and systemic arterial stiffness, respectively. Using applanation tonometry, the analyses of central hemodynamic parameters [central blood pressure, heart rate (HR), augmentation index normalized at 75 bpm (AIx75), and subendocardial viability ratio (SEVR)] were performed. To determine cardiac autonomic function, heart rate variability (HRV) was analyzed by standard deviation of normal R–R intervals (SDNN), root mean square of successive R–R interval differences (RMSSD), percentage of successive R–R intervals that differed by >50 ms (pNN50), total power (TP), low-frequency (LF) and high-frequency (HF) power, and LF/HF ratio.Results: Following the intervention, obese adolescents had reductions in body mass index, body fat percentage, brachial systolic and diastolic blood pressure, and HR; and they had shown improvements in lipid profiles. There were reductions in both cfPWV and baPWV following the intervention. Moreover, there were reductions in AIx75, aortic systolic and diastolic blood pressure and an augmentation in SEVR after intervention. The intervention increased cardiac autonomic function (determined by increased SDNN, RMSSD, pNN50, HF, and reduced LF/HF). Furthermore, we observed a correlation between increased cardiac autonomic function (SDNN, RMSSD, pNN50 and HF) and increased central hemodynamics, as measured by SEVR and AIx75.Conclusion: Obese adolescents had increased central hemodynamics and autonomic function with reduced arterial stiffness after exercise and dietary restriction. Moreover, a positive correlation between an enhancement of cardiac autonomic function and an augmentation in central hemodynamics was found after the intervention.Keywords: obesity, adolescents, exercise, cardiac autonomic function, arterial stiffness, diet

Published
2019

28. Early post-treatment changes in body composition parameters are associated with overall survival and need of transplantation in cirrhotic patients with HCC undergoing locoregional treatments

Author

Parisse, S., primary, Mieli, M., additional, Ponzo, M., additional, Rocco, B., additional, Poli, E., additional, Pintore, A., additional, Ferri, F., additional, De Santis, A., additional, Lucatelli, P., additional, Corona, M., additional, Melandro, F., additional, Mennini, G., additional, Rossi, M., additional, Lai, Q., additional, and Corradini, S. Ginanni, additional

Published
2023
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29. The largest western experience on salvage hepatectomy for recurrent hepatocellular carcinoma: propensity score-matched analysis on behalf of He.RC.O.Le.Study Group

Author

Iaria, M, Bianchi, G, Fazio, F, Ardito, F, Perri, P, Pontarolo, N, Conci, S, Donadon, M, Zanello, M, Lai, Q, Famularo, S, Molfino, S, Sciannamea, I, Fumagalli, L, Germani, P, Floridi, A, Ferrari, C, Zimmitti, G, Troci, A, Zago, M, Ferraro, V, Cipriani, F, Patauner, S, La Barba, G, Romano, M, Zanus, G, Ercolani, G, Frena, A, Aldrighetti, L, Memeo, R, Pinotti, E, Crespi, M, Hilal, M, Griseri, G, Tarchi, P, Chiarelli, M, Antonucci, A, Baiocchi, G, Romano, F, Rossi, M, Jovine, E, Torzilli, G, Ruzzenente, A, Maestri, M, Grazi, G, Giuliante, F, Ferrero, A, Dalla Valle, R, Giuffrida, M, Russolillo, N, Razionale, F, De Peppo, V, Tomasoni, M, Marchitelli, I, Costa, G, Laureiro, Z, Scotti, M, Calcagno, P, Cosola, D, Franceschi, A, Manzoni, A, Pennacchi, L, Montuori, M, Conticchio, M, Ratti, F, Notte, F, Cucchetti, A, Salvador, L, Corleone, P, Garancini, M, Ciulli, C, Iaria M., Bianchi G., Fazio F., Ardito F., Perri P., Pontarolo N., Conci S., Donadon M., Zanello M., Lai Q., Famularo S., Molfino S., Sciannamea I., Fumagalli L., Germani P., Floridi A., Ferrari C., Zimmitti G., Troci A., Zago M., Ferraro V., Cipriani F., Patauner S., La Barba G., Romano M., Zanus G., Ercolani G., Frena A., Aldrighetti L., Memeo R., Pinotti E., Crespi M., Hilal M. A., Griseri G., Tarchi P., Chiarelli M., Antonucci A., Baiocchi G. L., Romano F., Rossi M., Jovine E., Torzilli G., Ruzzenente A., Maestri M., Grazi G. L., Giuliante F., Ferrero A., Dalla Valle R., Giuffrida M., Russolillo N., Razionale F., De Peppo V., Tomasoni M., Marchitelli I., Costa G., Laureiro Z. L., Scotti M., Calcagno P., Cosola D., Franceschi A., Manzoni A., Pennacchi L., Montuori M., Conticchio M., Ratti F., Notte F., Cucchetti A., Salvador L., Corleone P., Garancini M., Ciulli C., Iaria, M, Bianchi, G, Fazio, F, Ardito, F, Perri, P, Pontarolo, N, Conci, S, Donadon, M, Zanello, M, Lai, Q, Famularo, S, Molfino, S, Sciannamea, I, Fumagalli, L, Germani, P, Floridi, A, Ferrari, C, Zimmitti, G, Troci, A, Zago, M, Ferraro, V, Cipriani, F, Patauner, S, La Barba, G, Romano, M, Zanus, G, Ercolani, G, Frena, A, Aldrighetti, L, Memeo, R, Pinotti, E, Crespi, M, Hilal, M, Griseri, G, Tarchi, P, Chiarelli, M, Antonucci, A, Baiocchi, G, Romano, F, Rossi, M, Jovine, E, Torzilli, G, Ruzzenente, A, Maestri, M, Grazi, G, Giuliante, F, Ferrero, A, Dalla Valle, R, Giuffrida, M, Russolillo, N, Razionale, F, De Peppo, V, Tomasoni, M, Marchitelli, I, Costa, G, Laureiro, Z, Scotti, M, Calcagno, P, Cosola, D, Franceschi, A, Manzoni, A, Pennacchi, L, Montuori, M, Conticchio, M, Ratti, F, Notte, F, Cucchetti, A, Salvador, L, Corleone, P, Garancini, M, Ciulli, C, Iaria M., Bianchi G., Fazio F., Ardito F., Perri P., Pontarolo N., Conci S., Donadon M., Zanello M., Lai Q., Famularo S., Molfino S., Sciannamea I., Fumagalli L., Germani P., Floridi A., Ferrari C., Zimmitti G., Troci A., Zago M., Ferraro V., Cipriani F., Patauner S., La Barba G., Romano M., Zanus G., Ercolani G., Frena A., Aldrighetti L., Memeo R., Pinotti E., Crespi M., Hilal M. A., Griseri G., Tarchi P., Chiarelli M., Antonucci A., Baiocchi G. L., Romano F., Rossi M., Jovine E., Torzilli G., Ruzzenente A., Maestri M., Grazi G. L., Giuliante F., Ferrero A., Dalla Valle R., Giuffrida M., Russolillo N., Razionale F., De Peppo V., Tomasoni M., Marchitelli I., Costa G., Laureiro Z. L., Scotti M., Calcagno P., Cosola D., Franceschi A., Manzoni A., Pennacchi L., Montuori M., Conticchio M., Ratti F., Notte F., Cucchetti A., Salvador L., Corleone P., Garancini M., and Ciulli C.

Abstract

Background: We aimed to evaluate, in a large Western cohort, perioperative and long-term oncological outcomes of salvage hepatectomy (SH) for recurrent hepatocellular carcinoma (rHCC) after primary hepatectomy (PH) or locoregional treatments. Methods: Data were collected from the Hepatocarcinoma Recurrence on the Liver Study Group (He.RC.O.Le.S.) Italian Registry. After 1:1 propensity score-matched analysis (PSM), two groups were compared: the PH group (patients submitted to resection for a first HCC) and the SH group (patients resected for intrahepatic rHCC after previous HCC-related treatments). Results: 2689 patients were enrolled. PH included 2339 patients, SH 350. After PSM, 263 patients were selected in each group with major resected nodule median size, intraoperative blood loss and minimally invasive approach significantly lower in the SH group. Long-term outcomes were compared, with no difference in OS and DFS. Univariate and multivariate analyses revealed only microvascular invasion as an independent prognostic factor for OS. Conclusion: SH proved to be equivalent to PH in terms of safety, feasibility and long-term outcomes, consistent with data gathered from East Asia. In the awaiting of reliable treatment-allocating algorithms for rHCC, SH appears to be a suitable alternative in patients fit for surgery, regardless of the previous therapeutic modality implemented.

Published
2022

30. How useful is the machine perfusion in liver transplantation? An answer from a national survey

Author

Scalera, I, De Carlis, R, Patrono, D, Gringeri, E, Olivieri, T, Pagano, D, Lai, Q, Rossi, M, Gruttadauria, S, Di Benedetto, F, Cillo, U, Romagnoli, R, Lupo, L, De Carlis, L, Scalera I., De Carlis R., Patrono D., Gringeri E., Olivieri T., Pagano D., Lai Q., Rossi M., Gruttadauria S., Di Benedetto F., Cillo U., Romagnoli R., Lupo L. G., De Carlis L., Scalera, I, De Carlis, R, Patrono, D, Gringeri, E, Olivieri, T, Pagano, D, Lai, Q, Rossi, M, Gruttadauria, S, Di Benedetto, F, Cillo, U, Romagnoli, R, Lupo, L, De Carlis, L, Scalera I., De Carlis R., Patrono D., Gringeri E., Olivieri T., Pagano D., Lai Q., Rossi M., Gruttadauria S., Di Benedetto F., Cillo U., Romagnoli R., Lupo L. G., and De Carlis L.

Abstract

Machine perfusion (MP) has been shown worldwide to offer many advantages in liver transplantation, but it still has some gray areas. The purpose of the study is to evaluate the donor risk factors of grafts, perfused with any MP, that might predict an ineffective MP setting and those would trigger post-transplant early allograft dysfunction (EAD). Data from donors of all MP-perfused grafts at six liver transplant centers have been analyzed, whether implanted or discarded after perfusion. The first endpoint was the negative events after perfusion (NegE), which is the number of grafts discarded plus those that were implanted but lost after the transplant. A risk factor analysis for NegE was performed and marginal grafts for MP were identified. Finally, the risk of EAD was analyzed, considering only implanted grafts. From 2015 to September 2019, 158 grafts were perfused with MP: 151 grafts were implanted and 7 were discarded after the MP phase because they did not reach viability criteria. Of 151, 15 grafts were lost after transplant, so the NegE group consisted of 22 donors. In univariate analysis, the donor risk index >1.7, the presence of hypertension in the medical history, static cold ischemia time, and the moderate or severe macrovesicular steatosis were the significant factors for NegE. Multivariate analysis confirmed that macrosteatosis >30% was an independent risk factor for NegE (odd ratio 5.643, p = 0.023, 95% confidence interval, 1.27–24.98). Of 151 transplanted patients, 34% experienced EAD and had worse 1- and 3-year-survival, compared with those who did not face EAD (NoEAD), 96% and 96% for EAD vs. 89% and 71% for NoEAD, respectively (p = 0.03). None of the donor/graft characteristics was associated with EAD even if the graft was moderately steatotic or fibrotic or from an aged donor. For the first time, this study shows that macrovesicular steatosis >30% might be a warning factor involved in the risk of graft loss or a cause of graft discard aft

Published
2022

31. Current practice of normothermic regional perfusion and machine perfusion in donation after circulatory death liver transplants in Italy

Author

De Carlis, R, Lauterio, A, Centonze, L, Buscemi, V, Schlegel, A, Muiesan, P, De Carlis, L, Carraro, A, Ghinolfi, D, De Simone, P, Ravaioli, M, Cescon, M, Dondossola, D, Bongini, M, Mazzaferro, V, Pagano, D, Gruttadauria, S, Gringeri, E, Cillo, U, Patrono, D, Romagnoli, R, Camagni, S, Colledan, M, Olivieri, T, Di Benedetto, F, Vennarecci, G, Baccarani, U, Lai, Q, Rossi, M, Manzia, T, Tisone, G, Vivarelli, M, Scalera, I, Lupo, L, Andorno, E, Meniconi, R, Ettorre, G, Avolio, A, Agnes, S, Pellegrino, R, Zamboni, F, De Carlis R., Lauterio A., Centonze L., Buscemi V., Schlegel A., Muiesan P., De Carlis L., Carraro A., Ghinolfi D., De Simone P., Ravaioli M., Cescon M., Dondossola D., Bongini M., Mazzaferro V., Pagano D., Gruttadauria S., Gringeri E., Cillo U., Patrono D., Romagnoli R., Camagni S., Colledan M., Olivieri T., Di Benedetto F., Vennarecci G., Baccarani U., Lai Q., Rossi M., Manzia T. M., Tisone G., Vivarelli M., Scalera I., Lupo L. G., Andorno E., Meniconi R. L., Ettorre G. M., Avolio A. W., Agnes S., Pellegrino R. A., Zamboni F., De Carlis, R, Lauterio, A, Centonze, L, Buscemi, V, Schlegel, A, Muiesan, P, De Carlis, L, Carraro, A, Ghinolfi, D, De Simone, P, Ravaioli, M, Cescon, M, Dondossola, D, Bongini, M, Mazzaferro, V, Pagano, D, Gruttadauria, S, Gringeri, E, Cillo, U, Patrono, D, Romagnoli, R, Camagni, S, Colledan, M, Olivieri, T, Di Benedetto, F, Vennarecci, G, Baccarani, U, Lai, Q, Rossi, M, Manzia, T, Tisone, G, Vivarelli, M, Scalera, I, Lupo, L, Andorno, E, Meniconi, R, Ettorre, G, Avolio, A, Agnes, S, Pellegrino, R, Zamboni, F, De Carlis R., Lauterio A., Centonze L., Buscemi V., Schlegel A., Muiesan P., De Carlis L., Carraro A., Ghinolfi D., De Simone P., Ravaioli M., Cescon M., Dondossola D., Bongini M., Mazzaferro V., Pagano D., Gruttadauria S., Gringeri E., Cillo U., Patrono D., Romagnoli R., Camagni S., Colledan M., Olivieri T., Di Benedetto F., Vennarecci G., Baccarani U., Lai Q., Rossi M., Manzia T. M., Tisone G., Vivarelli M., Scalera I., Lupo L. G., Andorno E., Meniconi R. L., Ettorre G. M., Avolio A. W., Agnes S., Pellegrino R. A., and Zamboni F.

Abstract

Background: Normothermic regional perfusion (NRP) and machine perfusion (MP) are variously used in many European centers to improve the outcomes after liver transplantation from donation after circulatory death (DCD). In Italy, a combination of NRP and subsequent MP has been used since the start of the activity. While NRP is mandatory for every DCD recovery, the subsequent use of MP is left to each center. Methods: We have designed a national survey to investigate practices and policies of these techniques. The questionnaire included 46 questions and was distributed to all the 21 Italian centers using an online form between June and July 2021. Results: The overall response rate was 100%. A local NRP program for controlled Maastricht type 3 DCD was active in 11/21 (52.4%) centers. Organization and availability of personnel were perceived as the main difficulties in starting such a program. Between 2015 and 2020, 119 DCD livers were transplanted, with an overall utilization rate of 69.2%. Pump flow and gross aspect were considered the most reliable parameters in liver selection during NRP. Eight (72.7%) centers adopted subsequent hypothermic MP, 1 (9.1%) center normothermic MP, and the remaining 2 (18.2%) used both MP types. Conclusion: This first snapshot survey shows that NRP with subsequent MP is the most used protocol in Italy for DCD livers, although some heterogeneity exists in the type and purpose of MP between centers. Overall, this policy ensures a high utilization rate, considering the high risk of the DCD donor population in Italy. Graphical abstract: [Figure not available: see fulltext.]

Published
2022

32. Impact of MELD 30-allocation policy on liver transplant outcomes in Italy

Author

Ravaioli, M, Lai, Q, Sessa, M, Ghinolfi, D, Fallani, G, Patrono, D, Di Sandro, S, Avolio, A, Odaldi, F, Bronzoni, J, Tandoi, F, De Carlis, R, Pascale, M, Mennini, G, Germinario, G, Rossi, M, Agnes, S, De Carlis, L, Cescon, M, Romagnoli, R, De Simone, P, Ravaioli M., Lai Q., Sessa M., Ghinolfi D., Fallani G., Patrono D., Di Sandro S., Avolio A., Odaldi F., Bronzoni J., Tandoi F., De Carlis R., Pascale M. M., Mennini G., Germinario G., Rossi M., Agnes S., De Carlis L., Cescon M., Romagnoli R., De Simone P., Ravaioli, M, Lai, Q, Sessa, M, Ghinolfi, D, Fallani, G, Patrono, D, Di Sandro, S, Avolio, A, Odaldi, F, Bronzoni, J, Tandoi, F, De Carlis, R, Pascale, M, Mennini, G, Germinario, G, Rossi, M, Agnes, S, De Carlis, L, Cescon, M, Romagnoli, R, De Simone, P, Ravaioli M., Lai Q., Sessa M., Ghinolfi D., Fallani G., Patrono D., Di Sandro S., Avolio A., Odaldi F., Bronzoni J., Tandoi F., De Carlis R., Pascale M. M., Mennini G., Germinario G., Rossi M., Agnes S., De Carlis L., Cescon M., Romagnoli R., and De Simone P.

Abstract

Background & Aims: In Italy, since August 2014, liver transplant (LT) candidates with model for end-stage liver disease (MELD) scores ≥30 receive national allocation priority. This multicenter cohort study aims to evaluate time on the waiting list, dropout rate, and graft survival before and after introducing the macro-area sharing policy. Methods: A total of 4,238 patients registered from 2010 to 2018 were enrolled and categorized into an ERA-1 Group (n = 2,013; before August 2014) and an ERA-2 Group (n = 2,225; during and after August 2014). A Cox proportional hazards model was used to estimate the hazard ratio (HR) of receiving a LT or death between the two eras. The Fine-Gray model was used to estimate the HR for dropout from the waiting list and graft loss, considering death as a competing risk event. A Fine-Gray model was also used to estimate risk factors of graft loss. Results: Patients with MELD ≥30 had a lower median time on the waiting list (4 vs.12 days, p <0.001) and a higher probability of being transplanted (HR 2.27; 95% CI 1.78–2.90; p = 0.001) in ERA-2 compared to ERA-1. The subgroup analysis on 3,515 LTs confirmed ERA-2 (odds ratio 0.56; 95% CI 0.46–0.68; p = 0.001) as a protective factor for better graft survival rate. The protective variables for lower dropouts on the waiting list were: ERA-2, high-volume centers, no competition centers, male recipients, and hepatocellular carcinoma. The protective variables for graft loss were high-volume center and ERA-2, while MELD ≥30 remained related to a higher risk of graft loss. Conclusions: The national MELD ≥30 priority allocation was associated with improved patient outcomes, although MELD ≥30 was associated with a higher risk of graft loss. Transplant center volumes and competition among centers may have a role in recipient prioritization and outcomes. Clinical trial number: NCT04530240 Lay summary: Italy introduced a new policy in 2014 to give national allocation priority to patients with a mo

Published
2022

33. Clinical update on risks and efficacy of anti-SARS-CoV-2 vaccines in patients with autoimmune hepatitis and summary of reports on post-vaccination liver injury

Author

Lleo, A, Cazzagon, N, Rigamonti, C, Cabibbo, G, Lai, Q, Muratori, L, Carbone, M, Lleo A., Cazzagon N., Rigamonti C., Cabibbo G., Lai Q., Muratori L., Carbone M., Lleo, A, Cazzagon, N, Rigamonti, C, Cabibbo, G, Lai, Q, Muratori, L, Carbone, M, Lleo A., Cazzagon N., Rigamonti C., Cabibbo G., Lai Q., Muratori L., and Carbone M.

Abstract

Patients with liver diseases, especially those with cirrhosis, have an increased mortality risk when infected by SARS-CoV-2 and therefore anti-SARS-CoV-2 vaccine has been recommended by leading Scientific Associations for all patients with chronic liver diseases. However, previous reports have shown a reduced antibody response following the full course of vaccination in immunosuppressed patients, including liver transplant recipients and several rheumatic diseases. This document, drafted by an expert panel of hepatologists appointed by the Italian Association for the Study of the Liver (AISF), aims to present the updated scientific data on the safety and efficacy of anti-SARS-CoV-2 mRNA vaccines in patients with autoimmune hepatitis (AIH). Furthermore, given the recent reports of sporadic cases of AIH-like cases following anti-SARS-CoV-2 mRNA vaccines, we summarize available data. Finally, we provide experts recommendations based on the limited data available.

Published
2022

35. On the Error of Li-ion Battery Parameter Estimation Subject to System Uncertainties

Author

Fogelquist, J, Fogelquist, J, Lai, Q, Lin, X, Fogelquist, J, Fogelquist, J, Lai, Q, and Lin, X

Abstract

Emerging lithium-ion battery systems require high-fidelity electrochemical models for advanced control, diagnostics, and design. Accordingly, battery parameter estimation is an active research domain where novel algorithms are being developed to calibrate complex models from input-output data. Amidst these efforts, little focus has been placed on the fundamental mechanisms governing estimation accuracy, spurring the question, why is an estimate accurate or inaccurate? In response, we derive a generalized estimation error equation under the commonly adopted least-squares objective function, which reveals that the error can be represented as a combination of system uncertainties (i.e., in model, measurement, and parameter) and uncertainty-propagating sensitivity structures in the data. We then relate the error equation to conventional error analysis criteria, such as the Fisher information matrix, Cramér-Rao bound, and parameter sensitivity, to assess the benefits and limitations of each. The error equation is validated through several uni- and bivariate estimations of lithium-ion battery electrochemical parameters using experimental data. These results are also analyzed with the error equation to study the error compositions and parameter identifiability under different data. Finally, we show that adding target parameters to the estimation without increasing the amount of data intrinsically reduces the robustness of the results to system uncertainties.

Published
2023

36. The Effect of a Liver Transplant Program on the Outcomes of Resectable Hepatocellular Carcinoma: A Nationwide Multicenter Analysis

Author

Serenari, M., Lenzi, J., Cucchetti, A., Cipriani, F., Donadon, M., Ardito, Francesco, Fazio, F., Nicolini, D., Iaria, M., Famularo, S., Perri, P., Ansaloni, L., Zanello, M., Lai, Q., Conci, S., Molfino, S., Ferrari, C., Germani, P., Zago, M., Romano, M., Zimmitti, G., Antonucci, A., Fumagalli, L., Troci, A., Ferraro, V., Memeo, R., Crespi, M., Chiarelli, M., Ercolani, G., Hilal, M. A., Zanus, G., Pinotti, E., Tarchi, P., Griseri, G., Baiocchi, G. L., Ruzzenente, A., Rossi, M., Jovine, E., Maestri, M., Grazi, G. L., Romano, F., Dalla Valle, R., Ravaioli, M., Vivarelli, M., Ferrero, A., Giuliante, Felice, Torzilli, G., Aldrighetti, L., Cescon, M., Gorgone, M., Ratti, F., Costa, G., Razionale, Francesco, Russolillo, N., Marinelli, Luca, Giuffrida, M., Scotti, M., Garancini, M., De Peppo, V., De Stefano, F., Laureiro, Z. L., Marchitelli, I., Franceschi, A., Cosola, D., Corleone, P., Montuori, M., Salvador, L., Manzoni, Annamaria, La Barba, G., Calcagno, P., Pennacchi, L., Conticchio, M., Ardito F. (ORCID:0000-0003-1596-2862), Giuliante F. (ORCID:0000-0001-9517-8220), Razionale F., Marinelli L., Manzoni A., Serenari, M., Lenzi, J., Cucchetti, A., Cipriani, F., Donadon, M., Ardito, Francesco, Fazio, F., Nicolini, D., Iaria, M., Famularo, S., Perri, P., Ansaloni, L., Zanello, M., Lai, Q., Conci, S., Molfino, S., Ferrari, C., Germani, P., Zago, M., Romano, M., Zimmitti, G., Antonucci, A., Fumagalli, L., Troci, A., Ferraro, V., Memeo, R., Crespi, M., Chiarelli, M., Ercolani, G., Hilal, M. A., Zanus, G., Pinotti, E., Tarchi, P., Griseri, G., Baiocchi, G. L., Ruzzenente, A., Rossi, M., Jovine, E., Maestri, M., Grazi, G. L., Romano, F., Dalla Valle, R., Ravaioli, M., Vivarelli, M., Ferrero, A., Giuliante, Felice, Torzilli, G., Aldrighetti, L., Cescon, M., Gorgone, M., Ratti, F., Costa, G., Razionale, Francesco, Russolillo, N., Marinelli, Luca, Giuffrida, M., Scotti, M., Garancini, M., De Peppo, V., De Stefano, F., Laureiro, Z. L., Marchitelli, I., Franceschi, A., Cosola, D., Corleone, P., Montuori, M., Salvador, L., Manzoni, Annamaria, La Barba, G., Calcagno, P., Pennacchi, L., Conticchio, M., Ardito F. (ORCID:0000-0003-1596-2862), Giuliante F. (ORCID:0000-0001-9517-8220), Razionale F., Marinelli L., and Manzoni A.

Abstract

Objective: To evaluate the effect of a liver transplantation (LT) program on the outcomes of resectable hepatocellular carcinoma (HCC). Background: Surgical treatment of HCC includes both hepatic resection (HR) and LT. However, the presence of cirrhosis and the possibility of recurrence make the management of this disease complex and probably different according to the presence of a LT program. Methods: Patients undergoing HR for HCC between January 2005 and December 2019 were identified from a national database of HCC. The main study outcomes were major surgical complications according to the Comprehensive Complication Index, posthepatectomy liver failure (PHLF), 90-day mortality, overall survival, and disease-free survival. Secondary outcomes were salvage liver transplantation (SLT) and postrecurrence survival. Results: A total of 3202 patients were included from 25 hospitals over the study period. Three of 25 (12%) had an LT program. The presence of an LT program within a center was associated with a reduced probability of PHLF (odds ratio=0.38) but not with overall survival and disease-free survival. There was an increased probability of SLT when HR was performed in a transplant hospital (odds ratio=12.05). Among transplant-eligible patients, those who underwent LT had a significantly longer postrecurrence survival. Conclusions: This study showed that the presence of a LT program was associated with decreased PHLF rates and an increased probability to receive SLT in case of recurrence.

Published
2023

37. Machine Learning Predictive Model to Guide Treatment Allocation for Recurrent Hepatocellular Carcinoma After Surgery

Author

Famularo, S., Donadon, M., Cipriani, F., Fazio, F., Ardito, Francesco, Iaria, M., Perri, P., Conci, S., Dominioni, T., Lai, Q., La Barba, G., Patauner, S., Molfino, S., Germani, P., Zimmitti, G., Pinotti, E., Zanello, M., Fumagalli, L., Ferrari, C., Romano, M., Delvecchio, A., Valsecchi, M. G., Antonucci, A., Piscaglia, F., Farinati, F., Kawaguchi, Y., Hasegawa, K., Memeo, R., Zanus, G., Griseri, G., Chiarelli, M., Jovine, E., Zago, M., Abu Hilal, M., Tarchi, P., Baiocchi, G. L., Frena, A., Ercolani, G., Rossi, M., Maestri, M., Ruzzenente, A., Grazi, G. L., Dalla Valle, R., Romano, F., Giuliante, Felice, Ferrero, A., Aldrighetti, L., Bernasconi, D. P., Torzilli, G., Ardito F. (ORCID:0000-0003-1596-2862), Giuliante F. (ORCID:0000-0001-9517-8220), Famularo, S., Donadon, M., Cipriani, F., Fazio, F., Ardito, Francesco, Iaria, M., Perri, P., Conci, S., Dominioni, T., Lai, Q., La Barba, G., Patauner, S., Molfino, S., Germani, P., Zimmitti, G., Pinotti, E., Zanello, M., Fumagalli, L., Ferrari, C., Romano, M., Delvecchio, A., Valsecchi, M. G., Antonucci, A., Piscaglia, F., Farinati, F., Kawaguchi, Y., Hasegawa, K., Memeo, R., Zanus, G., Griseri, G., Chiarelli, M., Jovine, E., Zago, M., Abu Hilal, M., Tarchi, P., Baiocchi, G. L., Frena, A., Ercolani, G., Rossi, M., Maestri, M., Ruzzenente, A., Grazi, G. L., Dalla Valle, R., Romano, F., Giuliante, Felice, Ferrero, A., Aldrighetti, L., Bernasconi, D. P., Torzilli, G., Ardito F. (ORCID:0000-0003-1596-2862), and Giuliante F. (ORCID:0000-0001-9517-8220)

Abstract

Importance: Clear indications on how to select retreatments for recurrent hepatocellular carcinoma (HCC) are still lacking. Objective: To create a machine learning predictive model of survival after HCC recurrence to allocate patients to their best potential treatment. Design, Setting, and Participants: Real-life data were obtained from an Italian registry of hepatocellular carcinoma between January 2008 and December 2019 after a median (IQR) follow-up of 27 (12-51) months. External validation was made on data derived by another Italian cohort and a Japanese cohort. Patients who experienced a recurrent HCC after a first surgical approach were included. Patients were profiled, and factors predicting survival after recurrence under different treatments that acted also as treatment effect modifiers were assessed. The model was then fitted individually to identify the best potential treatment. Analysis took place between January and April 2021. Exposures: Patients were enrolled if treated by reoperative hepatectomy or thermoablation, chemoembolization, or sorafenib. Main Outcomes and Measures: Survival after recurrence was the end point. Results: A total of 701 patients with recurrent HCC were enrolled (mean [SD] age, 71 [9] years; 151 [21.5%] female). Of those, 293 patients (41.8%) received reoperative hepatectomy or thermoablation, 188 (26.8%) received sorafenib, and 220 (31.4%) received chemoembolization. Treatment, age, cirrhosis, number, size, and lobar localization of the recurrent nodules, extrahepatic spread, and time to recurrence were all treatment effect modifiers and survival after recurrence predictors. The area under the receiver operating characteristic curve of the predictive model was 78.5% (95% CI, 71.7%-85.3%) at 5 years after recurrence. According to the model, 611 patients (87.2%) would have benefited from reoperative hepatectomy or thermoablation, 37 (5.2%) from sorafenib, and 53 (7.6%) from chemoembolization in terms of potential survival after re

Published
2023

38. How future surgery will benefit from SARS-COV-2-related measures: a SPIGC survey conveying the perspective of Italian surgeons

Author

Siragusa, L., Angelico, R., Angrisani, M., Zampogna, B., Materazzo, M., Sorge, R., Giordano, Lucia, Meniconi, R., Coppola, A., Marino, A., Giraudo, G., Esposito, S., Urbani, A., De Pastena, M., Mastrapasqua, R., Garancini, M., Frontal, A., Pascal, G., Martellucc, J., Falb, F., Boscarelli, A., Bertoglio, P., Trecca, E., Galassi, L., Vento, V., Chiappini, A., Antonelli, A., Bennardo, F., Familiari, F., Giannaccare, G., Zappia, A. S., Giuliani, G., Falcone, F., Sebastiani, S., Montuori, M., Rossi, S., Sagnotta, A., Giuliani, B., Imbriani, G. C., Restaino, S., Andreani, L., Di Maria, F., Lagana, A. S., Vitiello, L., Berton, F., Virgilio, E., Palisi, M., Portigliotti, L., Calussi, M., Conti, L., Mauriello, C., Barone, Alessia Maria Addolorata, Saladino, E., Giaquinta, A., Zerb, D., Frazzetta, G., Merola, G., Chierici, A., Bini, R., Centonze, L., De Carlis, R., Ferrario, L., Giani, A., Lauterio, A., Tamini, N., Corti, Serafino, Botteri, E., Andreuccetti, J., D'Alessio, R., Cestaro, G., Clarizia, G., Spolini, A., Carboni, A. S., Benzoni, E., Galiffa, G., Perotti, B., Veroux, M., Randazzo, V., Topa, D., Pranteda, C., Contini, G., Iacusso, C., Voglino, V., Vita, P., Carrano, F. M., Ambrosio, L., Cammarata, R., Capolupo, G. T., Caputo, D., Carannante, F., Cascone, C., Esperto, F., Farolfi, T., Frasca, L., Gallo, I. F., Gibin, G., Giurazza, G., Improta, L., La Vaccara, V., Luffarelli, P., Luvero, D., Marangi, Giuseppe, Masciana, G., Mazzola, A., Mazzotta, E., Miligi, C. I., Montelione, N., Nenna, A., Orsaria, P., Papalia, R., Papalia, G. F., Parisi, F. R., Prata, F., Salzillo, R., Santini, Stefano Angelo, Sofo, F., Zampoli, A., Tanda, C., Altieri, G., Ardito, Francesco, Belia, Francesco, Bianchi, V., Biondi, Alberto, Brisinda, Giuseppe, Chiappetta, M., Ciolli, G., Ciolli, Alessandro, Ferracci, Federica, Ferri, L., Fico, V., Fiorillo, Claudio, Fransvea, Pietro, Galiandro, F., Giovinazzo, F., La Greca, Antonio, Litta, Francesco, Mele, C., Pafundi, D. P., Panettieri, Elena, Papa, Valerio, Patini, Romeo, Perrotta, Generoso, Puccioni, Caterina, Santocchi, P., Armatura, G., Olmi, S., Casoni Pattacini, G., Salgarello, S., Trompetto, M., Bombardini, C., La Rocca, R., Celentano, G., Micalef, A., Mazzella, A., Settembrini, A., Zoia, C., Degrate, L., Musumeci, Giampaolo, Palopoli, C. A. M., Montori, G., Bonati, E., Dinuzzi, V. P., Velluti, F., Balla, A., Bonasia, D. E., Coletta, D., Berardi, Giulia, Colasanti, M., Ferretti, Serena, Gasparoli, C., Mariano, Giuseppantonio, Avenia, S., Cianci, P., Cestino, L., Festa, F., Fazio, F., Ascari, F., Desio, M., Arroyo Murillo, G. A., Cereda, M., Galleano, R., David, G., Pansini, A., Gazia, C., Atzori, G., Desideri, L. F., Famularo, S., Galvanin, J., Giudici, V. M., Mangiameli, Gaetano, Mei, S., Milana, F., Pansa, A., Sacchi, Dario Marco, Testori, A., Di Carlo, Giampiero, Paratore, Mattia, Perrone, U., Vagge, A., Vigano, J., Torre, B., Scotti, M. A., Carbone, G., Cerchione, R., De Nardi, P., Gozzini, L., Ottaviani, Letizia, Senni, C., Piccin, O., Pio, L., Colombo, F., Avantifiori, R., Baldassarri, V., Caronna, R., Cicerchia, P. M., Corallino, D., Crocetti, D., Gallo, Giuseppe, Giovanardi, F., Giovannetti, F., Hassan, R., Iossa, A., Lai, Q., Lancellotti, F., Lucarini, A., Lucchese, S., Mazzarella, Giulio, Melandro, F., Minervini, A., Muttillo, E. M., Palmieri, L., Pasqua, R., Rosiello, F., Salina, Giulia, Sibio, S., Sirignano, P., Tarallo, M., Usai, S., Vanni, C., Viglietta, E., Zambon, M., Conversano, N. I., Epifani, A. G., Milano, Valentina, Sacco, L., Nava, Bruna Maria, Maffioli, A., Giuratrabocchetta, S., Baracchi, F., Zuolo, M., Ceresoli, M., Verdi, D., Belli, Andrea, Pata, F., Piovano, E., Pastore, G., Bernabei, F., Deiana, S., Arceri, A., D'Agostino, Cinzia, Marafante, C., Moggia, E., Parini, S., Moretti, M., Uggeri, F., Pontarolo, N., Fontana, T., Palmisano, Gerardo, Giuffrida, M., Guaitoli, E., Ferretti, C., Iacopino, G., Gioco, R., Roscitano, G., Montanelli, P., Chiappetta, M. F., Pinotti, E., Monati, E., Fazio, G., Di Pietro, F., Damarco, F., Barberis, A., Razzore, A., Pascale, A., Loi, S., Ferrara, F., Rossi, Marco, Lisi, G., Viel, G., Sasia, D., Bono, D., Cordaro, E. R., Giacomelli, E., Giani, I., Seriau, L., Pellino, Giuseppe, Sparavigna, M., Trigiante, G., D'Ambrogio, R. G., Cardella, F., Guzzetti, S., Luzzi, A. -P., Carganico, G., Drago, B., Micheletto, G., Orlandi, R., Cutolo, C., Gibello, U., Mistrangelo, M., Forcignano, E., D'Ugo, S., Losurdo, P., Manitto, M., Caroli, G., Franco, Manuela, Tilocca, P. L., Mendogni, P., Sena, G., Sambucci, D., Luciani, C., Atelli, P., Guida, Maria Antonietta, Marino, Filippo, Morini, A., Sibilla, M. G., Longo, Fabio, Giaccari, S., Vigorita, V., Balduzzi, A., Barra, F., Delogu, D., Milone, E., Bencini, L., Aprile, V., Papini, P., Montemurro, N., Cavallo, Michele, Picciariello, A., Tomasicchio, G., Fittipaldi, A., Maruccia, M., Gerardi, S., Cillara, N., Deidda, Silvia, Demarinis, G., Peiretti, E., Tatti, F., Iovino, C., Isola, G., Progno, V. C., Migliore, M., Badessi, G., Barilla, C., Calleri, G. S., Cianci, Stefano, Fama, F., Fleres, F., Mazzeo, C., Visaloco, M. G., Marchetto, C., Bolognesi, F., Benuzzi, L., Bracchetti, G., Brucchi, F., Manzo, C. A., Scaravilli, L., Ferrari, C., Rocca, A., Napolitano, Paola, Anoldo, P., Caricato, Chiara, Manigrasso, M., Milone, Maria, Napolitano, L., Palomba, G., Schiavone, V., Vetrella, M., Grossi, U., Moletta, L., Annicchiarico, A., Vella, I., Talesa, G., Boggi, U., Aiello, F., Anselmo, Anna, Bacchiocchi, G., Beati, F., Bellato, V., Billeci, F., Blasi, F., Buonomo, O. C., Campanelli, M., Coco, G., Contadini, A., Conte, L. E., D'Ippolito, G., Di Marcantonio, A., Spicchiale, C. F., Afflitto, G. G., Gismondi, A., Gorgolini, G., Granai, A. V., Grande, S., Gravina, A., Guida, A. M., Ingallinella, S., Keci, L., Latini, E., Marino, D., Oddi, F. M., Orecchia, L., Don, C. B. P., Pellicciaro, M., Petagna, L., Pirozzi, B. M., Quaranta, Caterina, Rho, M., Rosina, Alessandro, Santicchia, M. S., Saraceno, F., Schiavone, A., Sensi, B., Spina, A., Sullo, L., Tacconi, F., Taje, R., Vanni, G., Vinci, D., Vita, G., Alba, G., Badalucco, S., Carbone, Luigi, Samorani, O. C., Chisci, G., Cuomo, Rosa, Francia, A., Fusario, D., Gargiulo, B., Pasqui, E., Pasquetti, L., Puoti, P., Resca, L., Cumbo, J., Ganio, S., Vizzielli, Giuseppe, Anastasi, M., Guerra, D., Romanzi, A., Vannelli, A., Baia, M., Giordano L., Barone M., Corti S., Marangi G. (ORCID:0000-0002-6898-8882), Santini S. (ORCID:0000-0003-1956-5899), Ardito F. (ORCID:0000-0003-1596-2862), Belia F., Biondi A. (ORCID:0000-0002-2470-7858), Brisinda G. (ORCID:0000-0001-8820-9471), Ciolli A., Ferracci F., Fiorillo C. (ORCID:0000-0001-7681-3567), Fransvea P. (ORCID:0000-0003-4969-3373), La Greca A. (ORCID:0000-0002-7587-7427), Litta F., Panettieri E., Papa V. (ORCID:0000-0002-3709-8924), Patini R. (ORCID:0000-0001-7358-8763), Perrotta G., Puccioni C., Musumeci G., Berardi G., Ferretti S., Mariano G., Mangiameli G., Sacchi M. (ORCID:0000-0003-2826-8431), Di Carlo G., Paratore M., Ottaviani L. (ORCID:0009-0001-0967-8809), Gallo G., Mazzarella G., Salina G., Milano V., Nava M., Belli A., D'Agostino C., Palmisano G., Rossi M. (ORCID:0000-0002-4539-5670), Pellino G., Franco M., Guida A., Marino F., Longo F., Cavallo M., Deidda S., Cianci S., Napolitano P., Caricato C., Milone M., Anselmo A., Quaranta C., Rosina A. (ORCID:0000-0002-0158-0583), Carbone L., Cuomo R., Vizzielli G., Siragusa, L., Angelico, R., Angrisani, M., Zampogna, B., Materazzo, M., Sorge, R., Giordano, Lucia, Meniconi, R., Coppola, A., Marino, A., Giraudo, G., Esposito, S., Urbani, A., De Pastena, M., Mastrapasqua, R., Garancini, M., Frontal, A., Pascal, G., Martellucc, J., Falb, F., Boscarelli, A., Bertoglio, P., Trecca, E., Galassi, L., Vento, V., Chiappini, A., Antonelli, A., Bennardo, F., Familiari, F., Giannaccare, G., Zappia, A. S., Giuliani, G., Falcone, F., Sebastiani, S., Montuori, M., Rossi, S., Sagnotta, A., Giuliani, B., Imbriani, G. C., Restaino, S., Andreani, L., Di Maria, F., Lagana, A. S., Vitiello, L., Berton, F., Virgilio, E., Palisi, M., Portigliotti, L., Calussi, M., Conti, L., Mauriello, C., Barone, Alessia Maria Addolorata, Saladino, E., Giaquinta, A., Zerb, D., Frazzetta, G., Merola, G., Chierici, A., Bini, R., Centonze, L., De Carlis, R., Ferrario, L., Giani, A., Lauterio, A., Tamini, N., Corti, Serafino, Botteri, E., Andreuccetti, J., D'Alessio, R., Cestaro, G., Clarizia, G., Spolini, A., Carboni, A. S., Benzoni, E., Galiffa, G., Perotti, B., Veroux, M., Randazzo, V., Topa, D., Pranteda, C., Contini, G., Iacusso, C., Voglino, V., Vita, P., Carrano, F. M., Ambrosio, L., Cammarata, R., Capolupo, G. T., Caputo, D., Carannante, F., Cascone, C., Esperto, F., Farolfi, T., Frasca, L., Gallo, I. F., Gibin, G., Giurazza, G., Improta, L., La Vaccara, V., Luffarelli, P., Luvero, D., Marangi, Giuseppe, Masciana, G., Mazzola, A., Mazzotta, E., Miligi, C. I., Montelione, N., Nenna, A., Orsaria, P., Papalia, R., Papalia, G. F., Parisi, F. R., Prata, F., Salzillo, R., Santini, Stefano Angelo, Sofo, F., Zampoli, A., Tanda, C., Altieri, G., Ardito, Francesco, Belia, Francesco, Bianchi, V., Biondi, Alberto, Brisinda, Giuseppe, Chiappetta, M., Ciolli, G., Ciolli, Alessandro, Ferracci, Federica, Ferri, L., Fico, V., Fiorillo, Claudio, Fransvea, Pietro, Galiandro, F., Giovinazzo, F., La Greca, Antonio, Litta, Francesco, Mele, C., Pafundi, D. P., Panettieri, Elena, Papa, Valerio, Patini, Romeo, Perrotta, Generoso, Puccioni, Caterina, Santocchi, P., Armatura, G., Olmi, S., Casoni Pattacini, G., Salgarello, S., Trompetto, M., Bombardini, C., La Rocca, R., Celentano, G., Micalef, A., Mazzella, A., Settembrini, A., Zoia, C., Degrate, L., Musumeci, Giampaolo, Palopoli, C. A. M., Montori, G., Bonati, E., Dinuzzi, V. P., Velluti, F., Balla, A., Bonasia, D. E., Coletta, D., Berardi, Giulia, Colasanti, M., Ferretti, Serena, Gasparoli, C., Mariano, Giuseppantonio, Avenia, S., Cianci, P., Cestino, L., Festa, F., Fazio, F., Ascari, F., Desio, M., Arroyo Murillo, G. A., Cereda, M., Galleano, R., David, G., Pansini, A., Gazia, C., Atzori, G., Desideri, L. F., Famularo, S., Galvanin, J., Giudici, V. M., Mangiameli, Gaetano, Mei, S., Milana, F., Pansa, A., Sacchi, Dario Marco, Testori, A., Di Carlo, Giampiero, Paratore, Mattia, Perrone, U., Vagge, A., Vigano, J., Torre, B., Scotti, M. A., Carbone, G., Cerchione, R., De Nardi, P., Gozzini, L., Ottaviani, Letizia, Senni, C., Piccin, O., Pio, L., Colombo, F., Avantifiori, R., Baldassarri, V., Caronna, R., Cicerchia, P. M., Corallino, D., Crocetti, D., Gallo, Giuseppe, Giovanardi, F., Giovannetti, F., Hassan, R., Iossa, A., Lai, Q., Lancellotti, F., Lucarini, A., Lucchese, S., Mazzarella, Giulio, Melandro, F., Minervini, A., Muttillo, E. M., Palmieri, L., Pasqua, R., Rosiello, F., Salina, Giulia, Sibio, S., Sirignano, P., Tarallo, M., Usai, S., Vanni, C., Viglietta, E., Zambon, M., Conversano, N. I., Epifani, A. G., Milano, Valentina, Sacco, L., Nava, Bruna Maria, Maffioli, A., Giuratrabocchetta, S., Baracchi, F., Zuolo, M., Ceresoli, M., Verdi, D., Belli, Andrea, Pata, F., Piovano, E., Pastore, G., Bernabei, F., Deiana, S., Arceri, A., D'Agostino, Cinzia, Marafante, C., Moggia, E., Parini, S., Moretti, M., Uggeri, F., Pontarolo, N., Fontana, T., Palmisano, Gerardo, Giuffrida, M., Guaitoli, E., Ferretti, C., Iacopino, G., Gioco, R., Roscitano, G., Montanelli, P., Chiappetta, M. F., Pinotti, E., Monati, E., Fazio, G., Di Pietro, F., Damarco, F., Barberis, A., Razzore, A., Pascale, A., Loi, S., Ferrara, F., Rossi, Marco, Lisi, G., Viel, G., Sasia, D., Bono, D., Cordaro, E. R., Giacomelli, E., Giani, I., Seriau, L., Pellino, Giuseppe, Sparavigna, M., Trigiante, G., D'Ambrogio, R. G., Cardella, F., Guzzetti, S., Luzzi, A. -P., Carganico, G., Drago, B., Micheletto, G., Orlandi, R., Cutolo, C., Gibello, U., Mistrangelo, M., Forcignano, E., D'Ugo, S., Losurdo, P., Manitto, M., Caroli, G., Franco, Manuela, Tilocca, P. L., Mendogni, P., Sena, G., Sambucci, D., Luciani, C., Atelli, P., Guida, Maria Antonietta, Marino, Filippo, Morini, A., Sibilla, M. G., Longo, Fabio, Giaccari, S., Vigorita, V., Balduzzi, A., Barra, F., Delogu, D., Milone, E., Bencini, L., Aprile, V., Papini, P., Montemurro, N., Cavallo, Michele, Picciariello, A., Tomasicchio, G., Fittipaldi, A., Maruccia, M., Gerardi, S., Cillara, N., Deidda, Silvia, Demarinis, G., Peiretti, E., Tatti, F., Iovino, C., Isola, G., Progno, V. C., Migliore, M., Badessi, G., Barilla, C., Calleri, G. S., Cianci, Stefano, Fama, F., Fleres, F., Mazzeo, C., Visaloco, M. G., Marchetto, C., Bolognesi, F., Benuzzi, L., Bracchetti, G., Brucchi, F., Manzo, C. A., Scaravilli, L., Ferrari, C., Rocca, A., Napolitano, Paola, Anoldo, P., Caricato, Chiara, Manigrasso, M., Milone, Maria, Napolitano, L., Palomba, G., Schiavone, V., Vetrella, M., Grossi, U., Moletta, L., Annicchiarico, A., Vella, I., Talesa, G., Boggi, U., Aiello, F., Anselmo, Anna, Bacchiocchi, G., Beati, F., Bellato, V., Billeci, F., Blasi, F., Buonomo, O. C., Campanelli, M., Coco, G., Contadini, A., Conte, L. E., D'Ippolito, G., Di Marcantonio, A., Spicchiale, C. F., Afflitto, G. G., Gismondi, A., Gorgolini, G., Granai, A. V., Grande, S., Gravina, A., Guida, A. M., Ingallinella, S., Keci, L., Latini, E., Marino, D., Oddi, F. M., Orecchia, L., Don, C. B. P., Pellicciaro, M., Petagna, L., Pirozzi, B. M., Quaranta, Caterina, Rho, M., Rosina, Alessandro, Santicchia, M. S., Saraceno, F., Schiavone, A., Sensi, B., Spina, A., Sullo, L., Tacconi, F., Taje, R., Vanni, G., Vinci, D., Vita, G., Alba, G., Badalucco, S., Carbone, Luigi, Samorani, O. C., Chisci, G., Cuomo, Rosa, Francia, A., Fusario, D., Gargiulo, B., Pasqui, E., Pasquetti, L., Puoti, P., Resca, L., Cumbo, J., Ganio, S., Vizzielli, Giuseppe, Anastasi, M., Guerra, D., Romanzi, A., Vannelli, A., Baia, M., Giordano L., Barone M., Corti S., Marangi G. (ORCID:0000-0002-6898-8882), Santini S. (ORCID:0000-0003-1956-5899), Ardito F. (ORCID:0000-0003-1596-2862), Belia F., Biondi A. (ORCID:0000-0002-2470-7858), Brisinda G. (ORCID:0000-0001-8820-9471), Ciolli A., Ferracci F., Fiorillo C. (ORCID:0000-0001-7681-3567), Fransvea P. (ORCID:0000-0003-4969-3373), La Greca A. (ORCID:0000-0002-7587-7427), Litta F., Panettieri E., Papa V. (ORCID:0000-0002-3709-8924), Patini R. (ORCID:0000-0001-7358-8763), Perrotta G., Puccioni C., Musumeci G., Berardi G., Ferretti S., Mariano G., Mangiameli G., Sacchi M. (ORCID:0000-0003-2826-8431), Di Carlo G., Paratore M., Ottaviani L. (ORCID:0009-0001-0967-8809), Gallo G., Mazzarella G., Salina G., Milano V., Nava M., Belli A., D'Agostino C., Palmisano G., Rossi M. (ORCID:0000-0002-4539-5670), Pellino G., Franco M., Guida A., Marino F., Longo F., Cavallo M., Deidda S., Cianci S., Napolitano P., Caricato C., Milone M., Anselmo A., Quaranta C., Rosina A. (ORCID:0000-0002-0158-0583), Carbone L., Cuomo R., and Vizzielli G.

Abstract

COVID-19 negatively affected surgical activity, but the potential benefits resulting from adopted measures remain unclear. The aim of this study was to evaluate the change in surgical activity and potential benefit from COVID-19 measures in perspective of Italian surgeons on behalf of SPIGC. A nationwide online survey on surgical practice before, during, and after COVID-19 pandemic was conducted in March–April 2022 (NCT:05323851). Effects of COVID-19 hospital-related measures on surgical patients’ management and personal professional development across surgical specialties were explored. Data on demographics, pre-operative/peri-operative/post-operative management, and professional development were collected. Outcomes were matched with the corresponding volume. Four hundred and seventy-three respondents were included in final analysis across 14 surgical specialties. Since SARS-CoV-2 pandemic, application of telematic consultations (4.1% vs. 21.6%; p < 0.0001) and diagnostic evaluations (16.4% vs. 42.2%; p < 0.0001) increased. Elective surgical activities significantly reduced and surgeons opted more frequently for conservative management with a possible indication for elective (26.3% vs. 35.7%; p < 0.0001) or urgent (20.4% vs. 38.5%; p < 0.0001) surgery. All new COVID-related measures are perceived to be maintained in the future. Surgeons’ personal education online increased from 12.6% (pre-COVID) to 86.6% (post-COVID; p < 0.0001). Online educational activities are considered a beneficial effect from COVID pandemic (56.4%). COVID-19 had a great impact on surgical specialties, with significant reduction of operation volume. However, some forced changes turned out to be benefits. Isolation measures pushed the use of telemedicine and telemetric devices for outpatient practice and favored communication for educational purposes and surgeon–patient/family communication. From the Italian surgeons’ perspective, COVID-related measures will continue to influence

Published
2023

41. Preoperative CA19.9 Level Predicts Lymph-Nodal Involvement in Resectable Pancreatic Head Adenocarcinoma: A Further Plea for Neoadjuvant Treatment

Author

Coppola, A., primary, Farolfi, T., additional, La Vaccara, V., additional, Asbun, H.J., additional, Boggi, U., additional, Conlon, K., additional, Edwin, B., additional, Ferrone, C., additional, Jonas, E., additional, Kokudo, N., additional, Martin Perez, E., additional, Satoi, S., additional, Sparrelid, E., additional, Stauffer, J., additional, Zerbi, A., additional, Takemura, N., additional, Lai, Q., additional, Almerey, T., additional, Bernon, M., additional, Cammarata, R., additional, Caputo, D., additional, Djoumi, Y., additional, Gallagher, T., additional, Ghorbani, P., additional, Ginesini, M., additional, Hashimoto, D., additional, Kauffmann, E.F., additional, Kleive, D., additional, Lluís, N.L., additional, Maqueda González, R., additional, Napoli, N., additional, Nappo, G., additional, Nebbia, M., additional, Richhhitelli, S., additional, Sahakyan, M.A., additional, Yamamoto, T., additional, and Coppola, R., additional

Published
2023
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44. The role of antiplatelet therapies on incidence and mortality of hepatocellular carcinoma

Author

Lai, Q., De Matthaeis, N., Finotti, M., Galati, G., Marrone, G., Melandro, F., Morisco, F., Nicolini, D., Pravisani, R., Giannini, E. G., Aglitti, A., Aliberti, C., Baccarani, U., Bhoori, S., Borzio, M., Brancaccio, G., Burra, P., Cabibbo, G., Casadei Gardini, A., Carrai, P., Cillo, U., Conti, F., Cucchetti, A., D'Ambrosio, R., Dell'Unto, C., Di Costanzo, G. G., Di Sandro, S., Foschi, F. G., Fucilli, F., Gambato, M., Gasbarrini, A., Giuliante, F., Ghinolfi, D., Grieco, A., Gruttaduria, S., Guarino, M., Kostandini, A., Iavarone, M., Lenci, I., Levi Sandri, G. B., Losito, F., Lupo, L. G., Manzia, T. M., Mazzocato, S., Mescoli, C., Miele, L., Muley, M., Persico, M., Plaz Torres, M. C., Pompili, M., Ponziani, F. R., Rapaccini, G. L., Rendina, M., Renzulli, M., Rossi, M., Rreka, E., Russo, F. P., Sacco, R., Sangiovanni, A., Sessa, A., Simonetti, N., Sposito, C., Tortora, R., Trevisani, F., Vigano, L., Vigano, M., Villa, E., Vincenzi, V., Violi, P., and Vitale, A.

Subjects
clopidogrel, aspirin, Clinical Biochemistry, incidence, occurrence, survival, General Medicine, Biochemistry, Settore MED/18
Abstract

To evaluate the impact of antiplatelet therapy (APT)on the incidence of hepatocellular carcinoma (HCC) and mortality following its treatment.A systematic literature search was performed using PubMed and Cochrane Central Register of Controlled Trials Databases. Two HCC clinical settings were explored: (i) incidence, and (ii) death after any HCC treatment. Odds ratios (OR) and 95% confidence intervals (95%CI) were calculated to compare the pooled data between patients who received or did not receive APT.A total of 20 studies were identified, of whom 15 focused on HCC incidence, including 2,685,009 patients, and five on post-treatment death, including 3281 patients. APT was associated with an overall reduced risk of HCC incidence (OR: 0.63; 95%CI = 0.51-0.79; p 0.001) as well as of post-treatment mortality (OR: 0.54; 95%CI = 0.35-0.83; p = 0.006).Current data suggest that APT correlated with higher HCC incidence and poor overall survival following tumour treatment.

Published
2023

45. Pharmacokinetic and nephroprotective benefits of using Schisandra chinensis extracts in a cyclosporine A-based immune-suppressive regime

Author

Lai Q, Wei JB, Mahmoodurrahman M, Zhang CX, Quan SJ, Li TM, and Yu Y

Subjects
Therapeutics. Pharmacology, RM1-950
Abstract

Qiao Lai,1 Jiabao Wei,1 Mohammed Mahmoodurrahman,2 Chenxue Zhang,1 Shijian Quan,1 Tongming Li,1 Yang Yu11Department of Formulas of Traditional Chinese Medicine, School of Chinese Materia Medica, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, People’s Republic of China; 2College of Medicine, Alfaisal University, Riyadh, Saudi ArabiaAbstract: Cyclosporine A (CsA) is a powerful immunosuppressive drug. However, nephrotoxicity resulting from its long-term usage has hampered its prolonged therapeutic usage. Schisandra chinensis extracts (SCE) have previously been used in traditional Chinese medicine and more recently coadministered with Western medicine for the treatment of CsA-induced side effects in the People’s Republic of China. This study aimed to investigate the possible effects of SCE on the pharmacokinetics of CsA in rats and elucidate the potential mechanisms by which it hinders the development of CsA-induced nephrotoxicity. A liquid chromatography/tandem mass spectrometry method was developed and validated for determining the effect of SCE on the pharmacokinetics of CsA. Male Sprague Dawley rats, which were administered with CsA (25 mg/kg/d) alone or in combination with SCE (54 mg/kg/d and 108 mg/kg/d) for 28 days, were used to evaluate the nephroprotective effects of SCE. Our study showed that SCE increased the mean blood concentration of CsA. Furthermore, we found that the concomitant administration of SCE alongside CsA prevented the disruption of catalase activity and reduction in creatinine, urea, renal malondialdehyde, and glutathione peroxidase levels that would have otherwise occurred in the absence of SCE administration. SCE treatment markedly suppressed the expression of 4-hydroxynonenal, Bcl-2-associated X protein, cleaved caspase 3, and autophagy-related protein LC3 A/B. On the other hand, the expression of heme oxygenase-1, nuclear factor erythroid 2-related factor 2 (Nrf2), and P-glycoprotein was enhanced by the very same addition of SCE. SCE was also able to increase the systemic exposure of CsA in rats. The renoprotective effects of SCE were thought to be mediated by its antiapoptotic and antioxidant abilities, which caused the attenuation of CsA-induced autophagic cell death. All in all, these findings suggest the prospective use of SCE as an effective adjunct in a CsA-based immunosuppressive regimen.Keywords: Schisandra chinensis extracts, cyclosporine A, pharmacokinetics, nephroprotective, oxidative stress, apoptosis, autophagy

Published
2015

48. Current practice of normothermic regional perfusion and machine perfusion in donation after circulatory death liver transplants in Italy

Author

De Carlis, R., Lauterio, A., Centonze, L., Buscemi, V., Schlegel, A., Muiesan, P., De Carlis, L., Carraro, A., Ghinolfi, D., De Simone, P., Ravaioli, M., Cescon, M., Dondossola, D., Bongini, M., Mazzaferro, V., Pagano, D., Gruttadauria, S., Gringeri, E., Cillo, U., Patrono, D., Romagnoli, R., Camagni, S., Colledan, M., Olivieri, T., Di Benedetto, F., Vennarecci, G., Baccarani, U., Lai, Q., Rossi, M., Manzia, T. M., Tisone, G., Vivarelli, M., Scalera, I., Lupo, L. G., Andorno, E., Meniconi, R. L., Ettorre, G. M., Avolio, A. W., Agnes, S., Pellegrino, R. A., Zamboni, F., De Carlis, R, Lauterio, A, Centonze, L, Buscemi, V, Schlegel, A, Muiesan, P, De Carlis, L, Carraro, A, Ghinolfi, D, De Simone, P, Ravaioli, M, Cescon, M, Dondossola, D, Bongini, M, Mazzaferro, V, Pagano, D, Gruttadauria, S, Gringeri, E, Cillo, U, Patrono, D, Romagnoli, R, Camagni, S, Colledan, M, Olivieri, T, Di Benedetto, F, Vennarecci, G, Baccarani, U, Lai, Q, Rossi, M, Manzia, T, Tisone, G, Vivarelli, M, Scalera, I, Lupo, L, Andorno, E, Meniconi, R, Ettorre, G, Avolio, A, Agnes, S, Pellegrino, R, and Zamboni, F

Subjects
Warm ischemia, Hypothermic oxygenated perfusion, Ischemic-type biliary lesions, Liver preservation, Liver utilization, Graft Survival, Organ Preservation, Ischemic-type biliary lesion, Tissue Donors, Settore MED/18, Liver Transplantation, Perfusion, Humans, Surgery
Abstract

Background: Normothermic regional perfusion (NRP) and machine perfusion (MP) are variously used in many European centers to improve the outcomes after liver transplantation from donation after circulatory death (DCD). In Italy, a combination of NRP and subsequent MP has been used since the start of the activity. While NRP is mandatory for every DCD recovery, the subsequent use of MP is left to each center. Methods: We have designed a national survey to investigate practices and policies of these techniques. The questionnaire included 46 questions and was distributed to all the 21 Italian centers using an online form between June and July 2021. Results: The overall response rate was 100%. A local NRP program for controlled Maastricht type 3 DCD was active in 11/21 (52.4%) centers. Organization and availability of personnel were perceived as the main difficulties in starting such a program. Between 2015 and 2020, 119 DCD livers were transplanted, with an overall utilization rate of 69.2%. Pump flow and gross aspect were considered the most reliable parameters in liver selection during NRP. Eight (72.7%) centers adopted subsequent hypothermic MP, 1 (9.1%) center normothermic MP, and the remaining 2 (18.2%) used both MP types. Conclusion: This first snapshot survey shows that NRP with subsequent MP is the most used protocol in Italy for DCD livers, although some heterogeneity exists in the type and purpose of MP between centers. Overall, this policy ensures a high utilization rate, considering the high risk of the DCD donor population in Italy. Graphical abstract: [Figure not available: see fulltext.]

Published
2022

49. Overview of prognostic systems for hepatocellular carcinoma and ITA.LI.CA external validation of MESH and CNLC classifications

Author

Vitale, A, Farinati, F, Finotti, M, Di Renzo, C, Brancaccio, G, Piscaglia, F, Cabibbo, G, Caturelli, E, Missale, G, Marra, F, Sacco, R, Giannini, E, Trevisani, F, Cillo, U, Bhoori, S, Borzio, M, Burra, P, Casadei Gardini, A, Carrai, P, Conti, F, Cozzolongo, R, Cucchetti, A, D'Ambrosio, R, Dell'Unto, C, De Matthaeis, N, Di Costanzo, G, Di Sandro, S, Famularo, S, Foschi, F, Fucilli, F, Galati, G, Gambato, M, Gasbarrini, A, Giuliante, F, Ghinolfi, D, Grieco, A, Gruttadauria, S, Guarino, M, Iavarone, M, Kostandini, A, Lai, Q, Lenci, I, Levi Sandri, G, Losito, F, Lupo, L, Marasco, G, Manzia, T, Mazzocato, S, Masarone, M, Melandro, F, Mescoli, C, Miele, L, Morisco, F, Muley, M, Nicolini, D, Pagano, D, Persico, M, Pompili, M, Ponziani, F, Pravisani, R, Rapaccini, G, Rendina, M, Renzulli, M, Romano, F, Rossi, M, Rreka, E, Russo, F, Sangiovanni, A, Sessa, A, Simonetti, N, Sposito, C, Tortora, R, Vigano, L, Vigano, M, Villa, E, Vincenzi, V, Violi, P, Azzaroli, F, Brunetto, M, Di Marco, A, Masotto, A, Mega, A, Nardone, G, Oliveri, F, Raimondo, G, Svegliati Baroni, G, Vidili, G, Zoli, M, Vitale A., Farinati F., Finotti M., Di Renzo C., Brancaccio G., Piscaglia F., Cabibbo G., Caturelli E., Missale G., Marra F., Sacco R., Giannini E. G., Trevisani F., Cillo U., Bhoori S., Borzio M., Burra P., Casadei Gardini A., Carrai P., Conti F., Cozzolongo R., Cucchetti A., D'ambrosio R., Dell'unto C., De Matthaeis N., Di Costanzo G. G., Di Sandro S., Famularo S., Foschi F. G., Fucilli F., Galati G., Gambato M., Gasbarrini A., Giuliante F., Ghinolfi D., Grieco A., Gruttadauria S., Guarino M., Iavarone M., Kostandini A., Lai Q., Lenci I., Levi Sandri G. V., Losito F., Lupo L. G., Marasco G., Manzia T. M., Mazzocato S., Masarone M., Melandro F., Mescoli C., Miele L., Morisco F., Muley M., Nicolini D., Pagano D., Persico M., Pompili M., Ponziani F. R., Pravisani R., Rapaccini G. L., Rendina M., Renzulli M., Romano F., Rossi M., Rreka E., Russo F. P., Sangiovanni A., Sessa A., Simonetti N., Sposito C., Tortora R., Vigano L., Vigano M., Villa E., Vincenzi V., Violi P., Azzaroli F., Brunetto M. R., Di Marco A., Masotto A., Mega A., Nardone G., Oliveri F., Raimondo G., Svegliati Baroni G., Vidili G., Zoli M., Vitale, A, Farinati, F, Finotti, M, Di Renzo, C, Brancaccio, G, Piscaglia, F, Cabibbo, G, Caturelli, E, Missale, G, Marra, F, Sacco, R, Giannini, E, Trevisani, F, Cillo, U, Bhoori, S, Borzio, M, Burra, P, Casadei Gardini, A, Carrai, P, Conti, F, Cozzolongo, R, Cucchetti, A, D'Ambrosio, R, Dell'Unto, C, De Matthaeis, N, Di Costanzo, G, Di Sandro, S, Famularo, S, Foschi, F, Fucilli, F, Galati, G, Gambato, M, Gasbarrini, A, Giuliante, F, Ghinolfi, D, Grieco, A, Gruttadauria, S, Guarino, M, Iavarone, M, Kostandini, A, Lai, Q, Lenci, I, Levi Sandri, G, Losito, F, Lupo, L, Marasco, G, Manzia, T, Mazzocato, S, Masarone, M, Melandro, F, Mescoli, C, Miele, L, Morisco, F, Muley, M, Nicolini, D, Pagano, D, Persico, M, Pompili, M, Ponziani, F, Pravisani, R, Rapaccini, G, Rendina, M, Renzulli, M, Romano, F, Rossi, M, Rreka, E, Russo, F, Sangiovanni, A, Sessa, A, Simonetti, N, Sposito, C, Tortora, R, Vigano, L, Vigano, M, Villa, E, Vincenzi, V, Violi, P, Azzaroli, F, Brunetto, M, Di Marco, A, Masotto, A, Mega, A, Nardone, G, Oliveri, F, Raimondo, G, Svegliati Baroni, G, Vidili, G, Zoli, M, Vitale A., Farinati F., Finotti M., Di Renzo C., Brancaccio G., Piscaglia F., Cabibbo G., Caturelli E., Missale G., Marra F., Sacco R., Giannini E. G., Trevisani F., Cillo U., Bhoori S., Borzio M., Burra P., Casadei Gardini A., Carrai P., Conti F., Cozzolongo R., Cucchetti A., D'ambrosio R., Dell'unto C., De Matthaeis N., Di Costanzo G. G., Di Sandro S., Famularo S., Foschi F. G., Fucilli F., Galati G., Gambato M., Gasbarrini A., Giuliante F., Ghinolfi D., Grieco A., Gruttadauria S., Guarino M., Iavarone M., Kostandini A., Lai Q., Lenci I., Levi Sandri G. V., Losito F., Lupo L. G., Marasco G., Manzia T. M., Mazzocato S., Masarone M., Melandro F., Mescoli C., Miele L., Morisco F., Muley M., Nicolini D., Pagano D., Persico M., Pompili M., Ponziani F. R., Pravisani R., Rapaccini G. L., Rendina M., Renzulli M., Romano F., Rossi M., Rreka E., Russo F. P., Sangiovanni A., Sessa A., Simonetti N., Sposito C., Tortora R., Vigano L., Vigano M., Villa E., Vincenzi V., Violi P., Azzaroli F., Brunetto M. R., Di Marco A., Masotto A., Mega A., Nardone G., Oliveri F., Raimondo G., Svegliati Baroni G., Vidili G., and Zoli M.

Abstract

Prognostic assessment in patients with HCC remains an extremely difficult clinical task due to the complexity of this cancer where tumour characteristics interact with degree of liver dysfunction, patient general health status, and a large span of available treatment options. Several prognostic systems have been proposed in the last three decades, both from the Asian and European/North American countries. Prognostic scores, such as the CLIP score and the recent MESH score, have been generated on a solid statistical basis from real life population data, while staging systems, such as the BCLC scheme and the recent CNLC classification, have been created by experts according to recent HCC prognostic evidences from the literature. A third category includes combined prognostic systems that can be used both as prognostic scores and staging systems. A recent example is the ITA.LI.CA prognostic system including either a prognostic score and a simplified staging system. This review focuses first on an overview of the main prognostic systems for HCC classified according to the above three categories, and, second, on a comprehensive description of the methodology required for a correct comparison between different systems in terms of prognostic performance. In this second section the main studies in the literature comparing different prognostic systems are described in detail. Lastly, a formal comparison between the last prognostic systems proposed for each of the above three categories is performed using a large Italian database including 6882 HCC patients in order to concretely apply the comparison rules previously described.

Published
2021

50. First world consensus conference on pancreas transplantation: Part I—Methods and results of literature search

Author

Boggi, U, Vistoli, F, Marchetti, P, Kandaswamy, R, Berney, T, Andres, A, Arbogast, H, Badet, L, Baronti, W, Bartlett, S, Benedetti, E, Branchereau, J, Burke, G, Buron, F, Caldara, R, Cardillo, M, Casanova, D, Cipriani, F, Cooper, M, Cupisti, A, de Koning, E, Davide, J, Drachenberg, C, Ettorre, G, Fernandez Cruz, L, Fridell, J, Friend, P, Furian, L, Gaber, O, Gruessner, A, Gruessner, R, Gunton, J, Han, D, Iacopi, S, Kauffmann, E, Kaufman, D, Kenmochi, T, Khambalia, H, Lai, Q, Langer, R, Maffi, P, Marselli, L, Menichetti, F, Miccoli, M, Mittal, S, Morelon, E, Napoli, N, Neri, F, Oberholzer, J, Odorico, J, Ollinger, R, Oniscu, G, Orlando, G, Ortenzi, M, Perosa, M, Perrone, V, Redfield, R, Ricci, C, Rigotti, P, Robertson, R, Ross, L, Rossi, M, Saudek, F, Scalea, J, Schenker, P, Secchi, A, Socci, C, Sousa Silva, D, Squifflet, J, Stock, P, Stratta, R, Terrenzio, C, Uva, P, Watson, C, White, S, Boggi U., Vistoli F., Marchetti P., Kandaswamy R., Berney T., Andres A., Arbogast H. P., Badet L., Baronti W., Bartlett S. T., Benedetti E., Branchereau J., Burke G. W. 3., Buron F., Caldara R., Cardillo M., Casanova D., Cipriani F., Cooper M., Cupisti A., de Koning E. J. P., Davide J., Drachenberg C., Ettorre G. M., Fernandez Cruz L., Fridell J. A., Friend P. J., Furian L., Gaber O. A., Gruessner A. C., Gruessner R. W. G., Gunton J. E., Han D. -J., Iacopi S., Kauffmann E. F., Kaufman D., Kenmochi T., Khambalia H. A., Lai Q., Langer R. M., Maffi P., Marselli L., Menichetti F., Miccoli M., Mittal S., Morelon E., Napoli N., Neri F., Oberholzer J., Odorico J. S., Ollinger R., Oniscu G., Orlando G., Ortenzi M., Perosa M., Perrone V. G., Redfield R. R., Ricci C., Rigotti P., Robertson R. P., Ross L. F., Rossi M., Saudek F., Scalea J. R., Schenker P., Secchi A., Socci C., Sousa Silva D., Squifflet J. P., Stock P. G., Stratta R. J., Terrenzio C., Uva P., Watson C. C. E., White S. A., Boggi, U, Vistoli, F, Marchetti, P, Kandaswamy, R, Berney, T, Andres, A, Arbogast, H, Badet, L, Baronti, W, Bartlett, S, Benedetti, E, Branchereau, J, Burke, G, Buron, F, Caldara, R, Cardillo, M, Casanova, D, Cipriani, F, Cooper, M, Cupisti, A, de Koning, E, Davide, J, Drachenberg, C, Ettorre, G, Fernandez Cruz, L, Fridell, J, Friend, P, Furian, L, Gaber, O, Gruessner, A, Gruessner, R, Gunton, J, Han, D, Iacopi, S, Kauffmann, E, Kaufman, D, Kenmochi, T, Khambalia, H, Lai, Q, Langer, R, Maffi, P, Marselli, L, Menichetti, F, Miccoli, M, Mittal, S, Morelon, E, Napoli, N, Neri, F, Oberholzer, J, Odorico, J, Ollinger, R, Oniscu, G, Orlando, G, Ortenzi, M, Perosa, M, Perrone, V, Redfield, R, Ricci, C, Rigotti, P, Robertson, R, Ross, L, Rossi, M, Saudek, F, Scalea, J, Schenker, P, Secchi, A, Socci, C, Sousa Silva, D, Squifflet, J, Stock, P, Stratta, R, Terrenzio, C, Uva, P, Watson, C, White, S, Boggi U., Vistoli F., Marchetti P., Kandaswamy R., Berney T., Andres A., Arbogast H. P., Badet L., Baronti W., Bartlett S. T., Benedetti E., Branchereau J., Burke G. W. 3., Buron F., Caldara R., Cardillo M., Casanova D., Cipriani F., Cooper M., Cupisti A., de Koning E. J. P., Davide J., Drachenberg C., Ettorre G. M., Fernandez Cruz L., Fridell J. A., Friend P. J., Furian L., Gaber O. A., Gruessner A. C., Gruessner R. W. G., Gunton J. E., Han D. -J., Iacopi S., Kauffmann E. F., Kaufman D., Kenmochi T., Khambalia H. A., Lai Q., Langer R. M., Maffi P., Marselli L., Menichetti F., Miccoli M., Mittal S., Morelon E., Napoli N., Neri F., Oberholzer J., Odorico J. S., Ollinger R., Oniscu G., Orlando G., Ortenzi M., Perosa M., Perrone V. G., Redfield R. R., Ricci C., Rigotti P., Robertson R. P., Ross L. F., Rossi M., Saudek F., Scalea J. R., Schenker P., Secchi A., Socci C., Sousa Silva D., Squifflet J. P., Stock P. G., Stratta R. J., Terrenzio C., Uva P., Watson C. C. E., and White S. A.

Abstract

Comprehensive evidence-based guidelines for the practice of pancreas transplantation are yet to be established. The First World Consensus Conference on Pancreas Transplantation was convened for this purpose. A steering committee selected the participants and defined the questions to be addressed. A group of literature reviewers identified 597 studies to be included in summaries for guidelines production. Expert groups formulated the first draft of recommendations. Two rounds of discussion and voting occurred online, using the Delphi method (agreement rate ≥85%). After each round, critical responses of experts were reviewed, and recommendations were amended accordingly. Recommendations were finalized after live discussions. Each session was preceded by expert presentations and a summary of results of systematic literature review. Up to three voting rounds were allowed for each recommendation. To avoid potential conflicts of interest, deliberations on issues regarding the impact of pancreas transplantation on the management of diabetes were conducted by an independent jury. Recommendations on technical issues were determined by experts and validated using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. Quality of evidence was assessed using the Scottish Intercollegiate Guidelines Network (SIGN) methodology. Each recommendation received a GRADE rating (Grading of Recommendations, Assessment, Development and Evaluations).

Published
2021

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