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Gallina FT, Tajè R, Forcella D, Corzani F, Cerasoli V, Visca P, Coccia C, Pierconti F, Sperduti I, Cecere FL, Cappuzzo F, Melis E, Facciolo F. Oncological Outcomes of Robotic Lobectomy and Radical Lymphadenectomy for Early-Stage Non-Small Cell Lung Cancer. J Clin Med 2022; 11:jcm11082173. [PMID: 35456265 PMCID: PMC9025272 DOI: 10.3390/jcm11082173] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/10/2022] [Accepted: 04/11/2022] [Indexed: 12/14/2022] Open
Abstract
Background: While the thoracotomy approach was considered the gold standard until two decades ago, robotic surgery has increasingly strengthened its role in lung cancer treatment, improving patients’ peri-operative outcomes. In this study, we report our experience in robotic lobectomy for early-stage non-small cell lung cancer, with particular attention to oncological outcomes and nodal upstaging rate. Methods: We retrospectively reviewed patients who underwent lobectomy and radical lymphadenectomy at our Institute between 2016 and 2020. We selected 299 patients who met the inclusion criteria of the study. We analyzed the demographic features of the groups as well as their nodal upstaging rate after pathological examination. Then, we analyzed disease-free and overall survival of the entire enrolled patient population and we compared the same oncological outcomes in the upstaging and the non-upstaging group. Results: A total of 299 patients who underwent robotic lobectomy were enrolled. After surgery, 55 patients reported nodal hilar or mediastinal upstaging. The 3-year overall survival of the entire population was 82.8%. The upstaging group and the non-upstaging group were homogeneous for age, gender, smoking habits, clinical stage, tumor site, tumor histology. The non-upstaging group had better OS (p = 0.004) and DFS (p < 0.0001). Conclusion: Our results show that robotic surgery is a safe and feasible approach for the treatment of early-stage NSCLC, especially for its accuracy in mediastinal lymphadenectomy. The oncological outcomes were encouraging and consistent with previous findings.
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Affiliation(s)
- Filippo Tommaso Gallina
- Thoracic Surgery Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (R.T.); (D.F.); (F.C.); (V.C.); (E.M.); (F.F.)
- Correspondence: ; Tel.: +39-0652665218
| | - Riccardo Tajè
- Thoracic Surgery Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (R.T.); (D.F.); (F.C.); (V.C.); (E.M.); (F.F.)
| | - Daniele Forcella
- Thoracic Surgery Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (R.T.); (D.F.); (F.C.); (V.C.); (E.M.); (F.F.)
| | - Felicita Corzani
- Thoracic Surgery Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (R.T.); (D.F.); (F.C.); (V.C.); (E.M.); (F.F.)
| | - Virna Cerasoli
- Thoracic Surgery Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (R.T.); (D.F.); (F.C.); (V.C.); (E.M.); (F.F.)
| | - Paolo Visca
- Department of Pathology, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy;
| | - Cecilia Coccia
- Anesthesiology and Intensive Care Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (C.C.); (F.P.)
| | - Federico Pierconti
- Anesthesiology and Intensive Care Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (C.C.); (F.P.)
| | - Isabella Sperduti
- Biostatistics, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy;
| | | | - Federico Cappuzzo
- Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy;
| | - Enrico Melis
- Thoracic Surgery Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (R.T.); (D.F.); (F.C.); (V.C.); (E.M.); (F.F.)
| | - Francesco Facciolo
- Thoracic Surgery Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (R.T.); (D.F.); (F.C.); (V.C.); (E.M.); (F.F.)
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Gallina FT, Melis E, Mercadante E, Alessandrini G, Forcella D, Cerasoli V, Corzani F, Mosillo L, Facciolo F. Oncologic thoracic surgery during the second wave of COVID-19 pandemic: How to be ready for the storm. J Surg Oncol 2020; 123:1167-1168. [PMID: 33333617 DOI: 10.1002/jso.26330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 11/23/2020] [Accepted: 11/23/2020] [Indexed: 11/10/2022]
Affiliation(s)
- Filippo T Gallina
- Thoracic Surgery, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Enrico Melis
- Thoracic Surgery, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Edoardo Mercadante
- Thoracic Surgery, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | | | - Daniele Forcella
- Thoracic Surgery, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Virna Cerasoli
- Thoracic Surgery, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Felicita Corzani
- Thoracic Surgery, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Luigi Mosillo
- Thoracic Surgery, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Francesco Facciolo
- Thoracic Surgery, IRCCS Regina Elena National Cancer Institute, Rome, Italy
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Casini B, Gallo E, Melis E, Cecere F, Laquintana V, Cerasoli V, Facciolo F, Pescarmona E, Fazi F, Marino M. MS08.04 Novel Biomarkers for Thymic Carcinoma. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Lattanzio R, La Sorda R, Facciolo F, Sioletic S, Lauriola L, Martucci R, Gallo E, Palmieri G, Evoli A, Alessandrini G, Ruco L, Rendina EA, Truini M, Chiarle R, Barreca A, Pich A, Ascani S, Remotti D, Tunesi G, Granone P, Ratto GB, Puma F, Pescarmona E, Piantelli M, Marino M, Carlini S, Cerasoli V, Corzani F, Melis E, Filippetti M, Canalini P, Palestro G, Lalle M, Ruffini E, Ceribelli A, Rinaldi M. Thymic epithelial tumors express vascular endothelial growth factors and their receptors as potential targets of antiangiogenic therapy: A tissue micro array-based multicenter study. Lung Cancer 2014; 85:191-6. [DOI: 10.1016/j.lungcan.2014.05.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 04/12/2014] [Accepted: 05/08/2014] [Indexed: 01/11/2023]
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Bria E, Milella M, Sperduti I, Alessandrini G, Visca P, Corzani F, Giannarelli D, Cerasoli V, Cuppone F, Cecere FL, Marchetti A, Sacco R, Mucilli F, Malatesta S, Guetti L, Vitale L, Ceribelli A, Rinaldi M, Terzoli E, Cognetti F, Facciolo F. A novel clinical prognostic score incorporating the number of resected lymph-nodes to predict recurrence and survival in non-small-cell lung cancer. Lung Cancer 2009; 66:365-71. [PMID: 19327866 DOI: 10.1016/j.lungcan.2009.02.024] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2008] [Revised: 02/05/2009] [Accepted: 02/25/2009] [Indexed: 11/15/2022]
Abstract
BACKGROUND The number of resected lymph-nodes (#RNs) has proven prognostic in breast and colorectal cancer. Here we evaluated its prognostic impact in a series of resected NSCLC patients. METHODS A panel of established prognostic factors plus (1) #RNs or (2) the ratio between the number of metastatic nodes and #RNs (NR) were correlated to overall- (OS), cancer-specific- (CSS), and disease-free-survival (DFS), using the Cox-model. Risk-classes according to hazard ratios (HR) were generated. Internal and external validation was accomplished. RESULTS A dataset of 415 resected NSCLC patients was retrieved. At multivariate analysis, #RNs and NR were independent factor for longer OS, CSS and DFS (p<0.0001). Patients with a #RNs>10 (identified optimal cut-off) had a statistically significant OS (p=0.02) and DFS (p=0.0005) benefit. In node-positive patients, a NR<9% significantly correlated with better outcome. Stratification into High-, Medium-, and Low-Risk classes, based on High- (HRFs: stage, N-status, age, #RNs) and Intermediate-Risk Factors (IRFs: sex, grading, histology), efficiently predicted outcomes (p<0.0001). The risk class model performance was externally validated in and independent dataset of 297 patients. CONCLUSIONS These results contribute to complete the panel of prognostic factors for resected NSCLC. A prospective larger validation and comparison with molecular prognostic tools is warranted.
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Affiliation(s)
- Emilio Bria
- Department of Medical Oncology, Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy.
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6
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Lalle M, Minellli M, Tarantini P, Marino M, Cerasoli V, Facciolo F, Iani C, Antimi M. Cellular and humoral immune alterations in thymectomized patients for thymoma. Ann Hematol 2009; 88:847-53. [PMID: 19165484 DOI: 10.1007/s00277-008-0693-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2008] [Accepted: 12/23/2008] [Indexed: 10/21/2022]
Abstract
The aim of this study was to analyze the impact of thymectomy on kinetics of the immune reconstitution in thymoma patients. Nine consecutive patients with completely resected thymoma were enrolled. Immunophenotype analysis (total lymphocytes, CD3, CD4, CD8, CD19, NK subsets) and detection of autoantibodies at 6, 12, 18, and 24 months after thymectomy were planned. A prolonged inversion of CD4/CD8 ratio was present, due to a diminished number of CD4+ cells; CD8+ cell numbers remaining constantly normal at different time points; CD19+ cells remained for a long time understatement, achieving almost normal levels at 24 months; and NK cells always showed a normal amount. Autoantibodies against the muscle acetylcholine receptor were detected in four patients (44.4%) at the time of diagnosis, while antinuclear antibody were detected in eight patients (88.8%) at different time points during postthymectomy. A high incidence of multiple primary neoplasms was observed (66.6% of cases). Our study showed that cellular and humoral immune alterations are a common sequelae of postthymectomy. Further studies, a longer surveillance and a cooperative approach, due to the rarity of the disease, are necessary to define eventual implications of immune alterations on patient's outcome.
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Affiliation(s)
- Maurizio Lalle
- UOC Oncologia Medica, Ospedale S Eugenio, Piazzale Umanesimo 10, Rome, Italy.
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Affiliation(s)
- Stefano Telera
- Divisione di Neurochirurgia, Divisione di Chirurgia Toracica, Servizio di Radiologia e Diagnostica per Immagini, e Servizio di Anatomia Patologica, Istituto Nazionale Tumori Regina Elena, Roma, Italia.
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d'Annibale M, Piovanello P, Cerasoli V, Campioni N. Liver metastases from breast cancer: the role of surgical treatment. Hepatogastroenterology 2005; 52:1858-62. [PMID: 16334793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
BACKGROUND/AIMS To evaluate short- and long-term outcomes in the surgical treatment of liver metastases from breast cancer METHODOLOGY Between 1984 and 1999 we observed 26 patients with secondary liver localization (25 metachronous) from breast cancer. The median disease-free interval was 70 months (4-136). Median age at the time of liver surgery was 56 years (36-76). The 18 patients included: 1 patient at stage 1, 10 at IIA, 6 stage II B and 1 patient at stage IV. Seven patients were found to have axillary lymph nodes metastases. Fifteen patients had infiltrating ductal carcinoma, 2 a lobular carcinoma and 1 patient a mixed-component carcinoma. The grading was G3 in 10 and G2 in 8 patients. Regarding the recettorial status, 5 patients were ER+ PR-, 8 patients were ER+PR-, 4 patients were ER-PR-. In 9 cases the patients underwent adjuvant chemotherapy (5 of them following postoperative radiotherapy) and in 14 cases Tamoxifen was used. Surgery was conservative in 13 cases and demolitive in 5 cases. RESULTS The follow-up (3-70 months) was completed in 15 patients out of 18 observed cases. Nine patients died; six patients are still living, 4 of them "disease-free", 2 having advanced metastatic disease, in treatment. There was neither long-term or perioperative major morbidity nor mortality in our group. The overall 5-year-survival was 25% in patients whose liver metastases developed within 3 years after breast surgery compared with 40% in those ones with metastatic disease diagnosed more than 3 years after. CONCLUSIONS Surgery of liver metastases from breast cancer can be performed with low morbidity and mortality in selected patients.
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Affiliation(s)
- M d'Annibale
- III Division of Surgical Oncology, Regina Elena Cancer Institute, Rome, Italy
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9
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Milella M, Ceribelli A, Gelibter A, Malaguti P, Cecere F, Facciolo F, Cerasoli V, Mirri A, Caterino M, Cognetti F. P-218 Celecoxib combined with fixed dose-rate gemcitabine (FDR-Gem)/CDDP as induction chemotherapy for stage III non-small cell lung cancer (NSCLC). Lung Cancer 2005. [DOI: 10.1016/s0169-5002(05)80712-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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10
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Milella M, Ceribelli A, Gelibter A, Malaguti P, Di Cocco B, Cecere F, Facciolo F, Cerasoli V, Mirri A, Cognetti F. Celecoxib combined with fixed dose-rate gemcitabine (FDR-Gem)/CDDP as induction chemotherapy for stage III non-small cell lung cancer (NSCLC). J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.7324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- M. Milella
- Regina Elena National Cancer Institute, Rome, Italy; Regina Elena National Institute, Rome, Italy
| | - A. Ceribelli
- Regina Elena National Cancer Institute, Rome, Italy; Regina Elena National Institute, Rome, Italy
| | - A. Gelibter
- Regina Elena National Cancer Institute, Rome, Italy; Regina Elena National Institute, Rome, Italy
| | - P. Malaguti
- Regina Elena National Cancer Institute, Rome, Italy; Regina Elena National Institute, Rome, Italy
| | - B. Di Cocco
- Regina Elena National Cancer Institute, Rome, Italy; Regina Elena National Institute, Rome, Italy
| | - F. Cecere
- Regina Elena National Cancer Institute, Rome, Italy; Regina Elena National Institute, Rome, Italy
| | - F. Facciolo
- Regina Elena National Cancer Institute, Rome, Italy; Regina Elena National Institute, Rome, Italy
| | - V. Cerasoli
- Regina Elena National Cancer Institute, Rome, Italy; Regina Elena National Institute, Rome, Italy
| | - A. Mirri
- Regina Elena National Cancer Institute, Rome, Italy; Regina Elena National Institute, Rome, Italy
| | - F. Cognetti
- Regina Elena National Cancer Institute, Rome, Italy; Regina Elena National Institute, Rome, Italy
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Guadagni F, Ferroni P, Basili S, Facciolo F, Carlini S, Crecco M, Martini F, Spila A, D'Alessandro R, Aloe S, Cerasoli V, Del Monte G, Mariotti S, Mineo TC, Roselli M. Correlation between tumor necrosis factor-alpha and d-dimer levels in non-small cell lung cancer patients. Lung Cancer 2004; 44:303-10. [PMID: 15140543 DOI: 10.1016/j.lungcan.2003.11.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2003] [Revised: 11/17/2003] [Accepted: 11/18/2003] [Indexed: 10/26/2022]
Abstract
The present study was designed to investigate whether a correlation exists between IL-6, TNF-alpha and coagulation (Thrombin-antithrombin, TATc) or fibrinolysis (D-dimer) activation in non-small cell lung cancer (NSCLC) patients. One hundred thirty patients with NSCLC (n=65, 53 males, mean age 65 +/- 8, adenocarcinoma n=32, squamous cancer n=33) or chronic obstructive pulmonary disease (COPD) (n=65, 51 males, mean age 67 +/- 9) were studied. As control group 65 healthy donors (51 males, mean age 61 +/- 14) were also evaluated. The results obtained showed that median D-dimer levels were higher in NSCLC patients (3.0 microg/ml) compared either to COPD patients (1.1 microg/ml, P<0.05) or controls (0.3 microg/ml, P<0.0001). Positive TNF-alpha levels (>10 pg/ml) were found in 26% of NSCLC compared to 3% of COPD (P<0.002) and 5% of controls (P<0.0005). On the other hand, positive (>8.5 pg/ml) IL-6 levels were found in 53% of NSCLC and 21% of COPD patients, compared to 5% of control subjects (P<0.001). Median TATc levels were elevated in either NSCLC (6.9 microg/l) or COPD (5.7 microg/l) patients compared to controls (1.8 microg/l, P<0.0001). Elevated D-dimer levels were significantly associated to positive TNF-alpha levels in patients without distant metastasis (F=4.3, P<0.05). Moreover, TNF-alpha levels (P<0.01) were independently related to the presence of positive D-dimer levels in patients with non-metastatic NSCLC. These results suggest that increased levels of TNF-alpha might be responsible for an activation of fibrinolysis in patients with NSCLC.
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Affiliation(s)
- F Guadagni
- Laboratory of Clinical Pathology, Regina Elena Cancer Institute, Via E. Chianesi 53, Rome 00144, Italy
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Talarico C, Cerasoli V, Mancini B, Mulieri G, Cancellario D'Alena F, Montemurro L, Verna F. [Lymphangiomatosis of the spleen. Report of a clinical case]. Ann Ital Chir 2000; 71:599-602. [PMID: 11217478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Lymphangiomatosis confined to the spleen is a very are condition. The authors in this article describes one new case and briefly reviews the literature. In this case, after the exclusion of an hydatidosis of the spleen, a total splenectomy was performed. The histologic findings confirmed the lymphangiomatosis of the spleen. The authors emphasize the surgical strategy in splenic lymphangiomyomatosis, infact the total splenectomy is mandatory, because the splenic parenchyma is nearly completely substitute by the cysts. For this reason is preferably, before surgery, to perform the antibateric profilaxis against the OPSI.
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Affiliation(s)
- C Talarico
- Università degli Studi di Roma La Sapienza Divisione di Chirurgia Generale, II Clinica Chirurgica
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d'Annibale M, Cerasoli V, Barbarosos A, Carlini S, Campioni N. [Papillary carcinoma of the thyroid arising on thyroglossal duct cysts: report of a case and review of the literature]. Chir Ital 2000; 52:435-9. [PMID: 11190536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Thyroglossal duct cysts are the most common congenital disorder of the neck. One percent of cases may degenerate and give rise to a cancer, mainly arising in the pericystic thyroid tissue. Some 250 cases have been reported in the literature to date. We report here on a 39-year-old man with a midline mass in the neck measuring 4 cm max. The patient was examined preoperatively by ultrasonography of the neck and assay of thyroid hormones, which yielded a diagnosis of a thyroglossal duct cyst. On the basis of these findings, the patient underwent surgery to remove the mass and, after an extempore histopathological examination, was submitted to total thyroidectomy owing to the presence of papillary carcinoma of the thyroid arising on the thyroglossal duct cyst with multiple foci in the context of the thyroid gland. Most thyroid cancers at the time of surgery are confined to the thyroid gland, infiltrating the adjacent structures in approximately 20% of cases and the local-regional lymph nodes in 8 to 11.5%. Thyroid papillary adenocarcinoma is multifocal in 21% of cases. The multifocal nature of the cancer makes total thyroidectomy mandatory at the same time as surgery is performed to remove the cyst.
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Affiliation(s)
- M d'Annibale
- III Divisione di Chirurgia Oncologica, Istituto Regina Elena, Roma
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Zaraca F, Di Paola M, Gossetti F, Catarci M, Trentino P, Proposito D, Filippoussis P, Talarico E, Cerasoli V, Talarico C, Montemurro L, Carboni M. [Acute biliary pancreatitis. Role of laparoscopy after 30 years of traditional surgery experience]. Ann Ital Chir 1999; 70:705-11. [PMID: 10692791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
The authors herein show their own experience in the treatment of acute biliary pancreatitis. Aim of this study is to evaluate the effectiveness and the safety of the "early" laparoscopic approach to the mild to moderate acute biliary pancreatitis. The authors studied sixty cases of laparoscopic cholecystectomy with intraoperative colangiography for acute biliary pancreatitis (M/F 1:1.2; mean age 59.6 yrs, range 29.79). The patients were divided in two groups on the basis of the severity of the pancreatitis, defined through Ranson's score and Balthazar classification. The mortality rate was nil. Intraoperative morbidity rate was 6.6% in the group I (3/45), and 13.3% in the group II (2/15). Postoperative morbidity rate was 6.7% (3/45) in the group I and 40% in the group II (6/15). The authors show an original diagnostic and therapeutic algorithm for the treatment of acute biliary pancreatitis. Early laparoscopic cholecystectomy with I.O.C. is proposed as the gold standard treatment for mild to moderate acute biliary pancreatitis. This approach appears to be effective and safe in their experience. In case of severe acute biliary pancreatitis, further investigations are mandatory to evaluate the role of laparoscopic approach.
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Affiliation(s)
- F Zaraca
- Divisione di Chirurgia Generale, Università di Roma La Sapienza
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Carlini S, Grauso F, Perri P, Pasquali Lasagni R, Piarulli L, Cavallari A, Bruno P, Benaglia A, Cerasoli V, Campioni N. Role of surgery in the treatment of recurrent esophageal cancer. Hepatogastroenterology 1997; 44:187-91. [PMID: 9058142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Neoplastic recurrence is the most common cause of death after surgery for esophageal cancer. The Authors review the therapeutic options evaluating in terms of palliation of dysphagia and complication and mortality rates. Prognostic factors and mechanisms determining the recurrence are also reviewed. A strategy for a rational approach in the management of recurrent esophageal cancer emerges from both the literature and their own experience. Notwithstanding the small life span of these patients, the treatment of esophageal obstruction is mandatory. The therapeutic options that be considered are: palliative resection, surgical bypass, laser therapy, intubation, radiotherapy. The site of obstruction, the presence of metastasis, the general status can lead to the optimal choice. In terms of palliation of dysphagia the surgical approach seems to obtain the best results, even if high complication and mortality rates have been reported. Bypass is the second surgical choice when applicable. The other non-surgical modalities have been administered in large series of patients with good results. Combination therapies can obtain better results.
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Affiliation(s)
- S Carlini
- Third Department of Surgery, Regina Elena Cancer Institute, Rome, Italy
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