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| 1 | Hepatic resection beyond barcelona clinic liver cancer indication:When and how显示文摘Hepatocellular carcinoma(HCC)is the main common primary tumour of the liver and it is usually associated with cirrhosis.The barcelona clinic liver cancer(BCLC)classification has been approved as guidance for HCC treatment algorithms by the European Association for the Study of Liver and the American Association for the Study of Liver Disease.According to this algorithm,hepatic resection should be performed only in patients with small single tumours of 2-3 cm without signs of portal hypertension(PHT)or hyperbilirubinemia.BCLC classification has been criticised and many studies have shown that multiple tumors and large tumors,as wide as those with macrovascular infiltration and PHT,could benefit from liver resection.Consequently,treatment guidelines should be revised and patients with intermediate/advanced stage HCC,when technically resectable,should receive the opportunity to be treated with radical surgical treatment.Nevertheless,the surgical treatment of HCC on cirrhosis is complex:The goal to be oncologically radical has always to be balanced with the necessity to minimize organ damage.The aim of this review was to analyze when and how liver resection could be indicated beyond BCLC indication.In particular,the role of multidisciplinary approach to assure a proper indication,of the intraoperative ultrasound for intraoperative restaging and resection guidance and of laparoscopy to minimize surgical trauma have been enhanced. | Mattia Garancini Enrico Pinotti Stefano Nespoli Fabrizio Romano Luca Gianotti Vittorio Giardini | 2016 | World Journal of Hepatology2016，8，11： | 8 |
| 2 | Rethinking the Barcelona clinic liver cancer guidelines:Intermediate stage and Child-Pugh B patients are suitable for surgery?显示文摘According to Barcelona Clinic Liver Cancer recommendations,intermediate stage hepatocellular carcinomas(stage B)are excluded from liver resection and are referred to palliative treatment.Moreover,Child-Pugh B patients are not usually candidates for liver resection.However,many hepatobiliary centers in the world manage patients with intermediate stage hepatocellular carcinoma or Child-Pugh B cirrhosis with liver resection,maintaining that hepatic resection is not contraindicated in selected patients with non–early-stage hepatocellular carcinoma and without normal liver function.Several studies demonstrate that resection provides the best survival benefit for selected patients in very early/early and even in intermediate stages of Barcelona Clinic Liver Cancer classification,and this treatment gives good results in the setting of multinodular,large tumors in patients with portal hypertension and/or Child-Pugh B cirrhosis.In this review we explore this controversial topic,and we show through the literature analysis how liver resection may improve the short-and long-term survival rate of carefully selected Barcelona Clinic Liver Cancer B and Child-Pugh B hepatocellular carcinoma patients.However,other large clinical studies are needed to clarify which patients with intermediate stage hepatocellular carcinoma are most likely to benefit from liver resection. | Fabrizio Romano Marco Chiarelli Mattia Garancini Mauro Scotti Mauro Zago Gerardo Cioffi Matilde De Simone Ugo Cioffi | 2021 | World Journal of Gastroenterology2021，27，21： | 5 |
| 3 | Hepatitis C virus-related B cell subtypes in non Hodgkin's lymphoma显示文摘AIM:To evaluate if indolent B cell-non Hodgkin's lymphoma(B-NHL) and diffuse large B-cell lymphoma(DLBCL) in hepatitis C virus(HCV) positive patients could have different biological and clinical characteristics requiring different management strategies.METHODS:A group of 24 HCV related B-NHL patients(11 indolent,13 DLBCL) in whom the biological and clinical characteristics were described and confronted.Patients with DLBCL were managed with the standard of care of treatment.Patients with indolent HCV-related B-NHL were managed with antiviral treatment pegylated interferon plus ribavirin and their course observed.The outcomes of the different approaches were compared.RESULTS:Patients with DLBCL had a shorter duration of HCV infection and a higher prevalence of HCV genotype 1 compared to patients with indolent B-NHL in which HCV genotype 2 was the more frequent genotype.Five of the 9 patients with indolent HCV-relatedB-NHL treated with only antiviral therapy,achieved a complete response of their onco-haematological disease(55%).Seven of the 13 DLBCL patients treated with immunochemotheraphy obtained a complete response(54%).CONCLUSION:HCV genotypes and duration of HCV infection differed between B-NHL subtypes.Indolent lymphomas can be managed with antiviral treatment,while DLBCL is not affected by the HCV infection. | Adriano M Pellicelli Massimo Marignani Valerio Zoli Mario Romano Aldo Morrone Lorenzo Nosotti Giuseppe Barbaro Antonio Picardi Umberto Vespasiani Gentilucci Daniele Remotti Cecilia D'Ambrosio Caterina Furlan Fabrizio Mecenate Ettore Mazzoni Ignazio Majolino Roberto Villani Arnaldo Andreoli Giorgio Barbarini | 2011 | World Journal of Hepatology2011，3，11： | 4 |
| 4 | Is there a role for treatment-oriented surgery in liver metastases from gastric cancer?显示文摘BACKGROUND Distant metastases are found in approximately 35%of patients with gastric cancer at their first clinical observation,and of these,4%-14%involves the liver.Unfortunately,only 0.4%-2.3%of patients with metastatic gastric cancer are eligible for radical surgery.Although surgical resection for gastric cancer metastases is still debated,there have been changes in recent years,although several clinical issues remain to be defined and that must be taken into account before surgery is proposed.AIM To analyze the clinicopathological factors related to primary gastric tumor and metastases that impact the survival of patients with liver metastatic gastric cancer.METHODS We performed a systematic review of the literature from 2000 to 2018 according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.The study protocol was based on identifying studies with clearly defined purpose,eligibility criteria,methodological analysis,and patient outcome.RESULTS We selected 47 studies pertaining to the purpose of the review,which involved a total of 2304 patients.Median survival was 7-52.3 mo,median disease-free survival was 4.7-18 mo.The 1-,2-,3-,and 5-year overall survival(OS)was 33%-90.1%,10%-60%,6%-70.4%,and 0%-40.1%,respectively.Only five papers reported the 10-year OS,which was 5.5%–31.5%.The general recurrence rate was between 55.5%and 96%,and that for hepatic recurrence was between 15%and 94%.CONCLUSION Serous infiltration and lymph node involvement of the primary cancer indicate an unfavorable prognosis,while the presence of single metastasis or≤3 metastases associated with a size of<5 cm may be considered data that do not contraindicate liver resection. | Fabio Uggeri Lorenzo Ripamonti Enrico Pinotti Mauro Alessandro Scotti Simone Famularo Mattia Garancini Luca Gianotti Marco Braga Fabrizio Romano | 2020 | World Journal of Clinical Oncology2020，11，7： | 3 |
| 5 | Recurrent Giant Hemangioma Causing Severe Respiratory Distress显示文摘 | Fabrizio Romano Grazia Messinesi Francesco Tana Franco Uggeri | 2007 | Digestive Diseases and Sciences2007，，12： | 2 |
| 6 | Surgical Treatment of Metastatic Tumors to the Pancreas: A Single Center Experience and Review of the Literature显示文摘 | Stefano Crippa MD Carlo Angelini MD Chiara Mussi Claudia Bonardi MD Fabrizio Romano MD Paola Sartori MD Franco Uggeri MD Giorgio Bovo MD | 2006 | World Journal of Surgery2006，，8： | 2 |
| 7 | Low-dose interleukin-2 administered pre-operatively topatients with gastric cancer activates peripheral and perit-umoral lymphocytes but does not affect prognosis显示文摘 | Giovanni Carlo Cesana Fabrizio Romano Gaia Piacentini | 2007 | Annals Surgical Oncology2007，14，4： | 1 |
| 8 | Hepatic Surgery Using the Ligasure Vessel Sealing System显示文摘 | Fabrizio Romano M.D. Claudio Franciosi M.D. Roberto Caprotti M.D. Fabio Uggeri M.D. Franco Uggeri M.D | 2005 | World Journal of Surgery2005，，1： | 1 |
| 9 | Surgical Treatment of Metastatic Tumors to the Pancreas: A Single Center Experience and Review of the Literature显示文摘 | Stefano Crippa Carlo Angelini Chiara Mussi Claudia Bonardi Fabrizio Romano Paola Sartori Franco Uggeri Giorgio Bovo | 2006 | World Journal of Surgery2006，，： | 1 |
| 10 | Thrombosis of the splenoportal axis after splenectomy显示文摘 | Fabrizio Romano Roberto Caprotti Matteo Conti Maria Gaia Piacentini Fabio Uggeri Vittorio Motta Enrico Maria Pogliani Franco Uggeri | 2006 | Langenbeck’s Archives of Surgery2006，，5： | 1 |
| 11 | The use of LigaSure during pediatric laparoscopic splenectomy: a preliminary report显示文摘 | Fabrizio Romano Roberto Caprotti Claudio Franciosi Sergio De Fina Giovanni Colombo Paola Sartori Franco Uggeri | 2003 | Pediatric Surgery International2003，，11： | 1 |
| 12 | Surgical Treatment of Metastatic Tumors to the Pancreas: A Single Center Experience and Review of the Literature显示文摘 | Stefano Crippa MD Carlo Angelini MD Chiara Mussi Claudia Bonardi MD Fabrizio Romano MD Paola Sartori MD Franco Uggeri MD Giorgio Bovo MD | 2006 | World Journal of Surgery2006，，8： | 1 |
| 13 | Low-dose Interleukin-2 Administered Pre-operatively to Patients with Gastric Cancer Activates Peripheral and Peritumoral Lymphocytes But Does Not Affect Prognosis显示文摘 | Giovanni Carlo Cesana Fabrizio Romano Gaia Piacentini Marco Scotti Ambrogio Brenna Giorgio Bovo Massimo Vaghi Giacomo Aletti Roberto Caprotti Howard Kaufman Franco Uggeri | 2007 | Annals of Surgical Oncology2007，，4： | 1 |
| 14 | Role of contrast-enhanced MR venography in the preoperative evaluation of parasagittal meningiomas显示文摘 | Alessandro Bozzao Vanina Finocchi Andrea Romano Michele Ferrante Fabrizio Fasoli Giuseppe Trillò Luigi Ferrante Luigi Maria Fantozzi | 2005 | European Radiology2005，，9： | 1 |
| 15 | Branching patterns of the left portal vein and consequent implications in liver surgery:The left anterior sector显示文摘To the Editor: There are still some open issues about the systematization of the knowledge of the branching of the left portal vein(LPV) and the division in anatomo-functional units within the left liver. The first controversial topic concerns the division of S4 in subsegments. The Brisbane 20 0 0 system of Nomenclature of Hepatic Anatomy and Resections(B20 0 0) [1] does not mention such subdivision, but in literature this is still a matter of discussion. | Mattia Garancini Mauro Alessandro Scotti Luca Gianotti Antonio Rovere Fabio Uggeri Marco Braga Fabrizio Romano | 2022 | Hepatobiliary & Pancreatic Diseases International2022，21，4： | 0 |
| 16 | Effect of oral mesalamine on inflammatory response in acute uncomplicated diverticulitis显示文摘AIM: To evaluate the impact of mesalamine administration on inflammatory response in acute uncomplicated diverticulitis.METHODS: We conducted a single centre retrospective cohort study on patients admitted to our surgical department between January 2012 and May 2014 with a computed tomography-confirmed diagnosis of acute uncomplicated diverticulitis. A total of 50 patients were included in the analysis, 20(study group) had received 3.2 g/d of mesalamine starting from the day of admission in addition to the usual standard treatment, 30(control group) had received standard therapy alone. Data was retrieved from a prospective database. Our primary study endpoints were: C reactive protein mean levels over time and their variation from baseline(ΔCRP) over the first three days of treatment. Secondary end points included: mean white blood cell and neutrophile count over time, time before regaining of regular bowel movements(passing of stools), time before reintroduction of food intake, intensity of lower abdominal pain over time, analgesic consumption and length of hospital stay.RESULTS: Patients characteristics and inflammatoryparameters were similar at baseline in the two groups. The evaluation of CRP levels over time showed, in treated patients, a distinct trend towards a faster decrease compared to controls. This difference approached statistical significance on day 2(mean CRP 6.0 +/- 4.2 mg/d L and 10.0 +/- 6.7 mg/d L respectively in study group vs controls, P = 0.055). ΔCRP evaluation evidenced a significantly greater increment of this inflammatory marker in the control group on day 1(P = 0.03). A similar trend towards a faster resolution of inflammation was observed evaluating the total white blood cell count. Neutrophile levels were significantly lower in treated patients on day 2 and on day 3(P < 0.05 for both comparisons). Mesalamine administration was also associated with an earlier reintroduction of food intake(median 1.5 d and 3 d, study group vs controls respectively, P < 0.001) and with a shorter hospital stay(median 5 d and 5.5 d, study group vs controls respectively, P = 0.03).CONCLUSION: Despite its limitations, this study suggests that mesalamine may allow for a faster recovery and for a reduction of inflammatory response in acute uncomplicated diverticulitis. | Luca Nespoli Giulia Lo Bianco Fabio Uggeri Fabrizio Romano Angelo Nespoli Davide Paolo Bernasconi Luca Gianotti | 2015 | World Journal of Gastroenterology2015，21，27： | 0 |
| 17 | Finding the seed of recurrence:Hepatocellular carcinoma circulating tumor cells and their potential to drive the surgical treatment显示文摘The treatment for hepatocellular carcinoma(HCC)relies on liver resection,which is,however,burdened by a high rate of recurrence after surgery,up to 60%at 5 years.No pre-operative tools are currently available to assess the recurrence risk tailored to every single patient.Recently liquid biopsy has shown interesting results in diagnosis,prognosis and treatment allocation strategies in other types of cancers,since its ability to identify circulating tumor cells(CTCs)derived from the primary tumor.Those cells were advocated to be responsible for the majority of cases of recurrence and cancer-related deaths for HCC.In fact,after being modified by the epithelial-mesenchymal transition,CTCs circulate as“seeds”in peripheral blood,then reach the target organ as dormant cells which could be subsequently“awakened”and activated,and then initiate metastasis.Their presence may justify the disagreement registered in terms of efficacy of anatomic vs non-anatomic resections,particularly in the case of microvascular invasion,which has been recently pointed as a histological sign of the spread of those cells.Thus,their presence,also in the early stages,may justify the recurrence event also in the contest of liver transplant.Understanding the mechanism behind the tumor progression may allow improving the treatment selection according to the biological patient-based characteristics.Moreover,it may drive the development of novel biological tailored tests which could address a specific patient to neoadjuvant or adjuvant strategies,and in perspective,it could also become a new method to allocate organs for transplantation,according to the risk of relapse after liver transplant.The present paper will describe the most recent evidence on the role of CTCs in determining the relapse of HCC,highlighting their potential clinical implication as novel tumor behavior biomarkers able to influence the surgical choice. | Francesca Carissimi Matteo Nazzareno Barbaglia Livia Salmi Cristina Ciulli Linda Roccamatisi Giuseppe Cordaro Venkata Ramana Mallela Rosalba Minisini Biagio Eugenio Leone Matteo Donadon Guido Torzilli Mario Pirisi Fabrizio Romano Simone Famularo | 2021 | World Journal of Gastrointestinal Surgery2021，13，9： | 0 |
| 18 | Cytomegalovirus reactivation after autologous stem cell transplantation in myeloma and lymphoma patients:A single-center study显示文摘AIM: To determine the incidence of and the risk factors for cytomegalovirus(CMV) symptomatic infection and end-organ disease after autologous stem cell transplantation(ASCT).METHODS: A total of 327 consecutive non CD34+ selected autografts performed from the Hematology and Stem Cell Transplantation Unit of Regina Elena National Cancer Institute of Rome(Italy) in the period comprised between January 2003 to January 2015, were reviewed. Over the 327 autografts, 201 were performed in patients with multiple myeloma, whereas the remaining 126 in patients affected by non-Hodgkin's lymphoma and Hodgkin's lymphoma. The patients who underwent an ASCT for an acute leukemia(n = 20) in the sameperiod were excluded from this analysis. CMV DNA load in the blood has been determined by polymerasechain reaction in the case of a clinical suspicion of reactivation, therefore, no routine monitoring strategy was adopted. In the presence of signs and symptoms of CMV reactivation an antiviral treatment was performed.RESULTS: Overall, 36 patients(11%) required a specific antiviral treatment for a symptomatic CMV reactivation(n = 32) or an end-organ disease(n = 4). We observed 20 and 16 cases of CMV reactivation among lymphoma(16%) and myeloma patients(8%), respectively. Among cases of end-organ disease, 3 were diagnosed as interstitial pneumonia and one remaining case as hemorrhagic enteritis. All cases of CMV reactivation were observed in Ig G seropositive patients, with no documented cases of primary CMV infection. All patients were treated with a specific antiviral therapy, with a global rate of hospitalization of 55%; four patients received intravenous immunoglobulins. Transplantrelated mortality was significantly higher in patients who experienced a CMV reactivation(8.4% ± 4.7% vs 1.7% ± 0.8%; P = 0.047). In univariate analysis, a pretransplant HBc Ig G seropositivity, a diagnosis of T-cell non-Hodgkin's lymphoma and higher median age at transplant were significantly associated with the risk of developing a clinically relevant CMV infection requiring specific antiviral therapy(P < 0.001, P = 0.042 and P = 0.004, respectively). In multivariate analysis, only a pretransplant HBc Ig G seropositivity(OR = 8.928, 95%CI: 1.991-33.321; P = 0.023) and a diagnosis of T-cell nonHodgkin's lymphoma(OR = 4.739, 95%CI: 1.511-11.112; P = 0.042) proved to be independent predictors of a post-transplant clinically relevant CMV reactivation. CONCLUSION: A symptomatic CMV infection can occur in about 11% of adult patients with lymphoma or myeloma undergoing ASCT. A pre-transplant HBc Ig G seropositivity and a diagnosis of T-cell non-Hodgkin's lymphoma should be considered as independent predictor factors of CMV reactivation. | Francesco Marchesi Fulvia Pimpinelli Svitlana Gumenyuk Daniela Renzi Francesca Palombi Francesco Pisani Atelda Romano Antonio Spadea Elena Papa Marco Canfora Fabrizio Ensoli Andrea Mengarelli | 2015 | World Journal of Transplantation2015，5，3： | 0 |
| 19 | Comparative case study of two methods to assess the eruptive potential of selected active regions显示文摘Solar eruptive events,like flares and coronal mass ejections,are characterized by the rapid release of energy that can give rise to emission of radiation across the entire electromagnetic spectrum and to an abrupt significant increase in the kinetic energy of particles.These energetic phenomena can have important effects on the space weather conditions and therefore it is necessary to understand their origin,in particular,what is the eruptive potential of an active region(AR).In these case studies,we compare two distinct methods that were used in previous works to investigate the variations of some characteristic physical parameters during the pre-flare states of flaring ARs.These methods consider:i)the magnetic flux evolution and magnetic helicity accumulation,and ii)the fractal and multi-fractal properties of flux concentrations in ARs.Our comparative analysis is based on time series of photospheric data obtained by the Solar Dynamics Observatory between March 2011 and June 2013.We selected two distinct samples of ARs:one is distinguished by the occurrence of more energetic M-and X-class flare events,that may have a rapid effect on not just the near-Earth space,but also on the terrestrial environment;the second is characterized by no-flares or having just a few C-and B-class flares.We found that the two tested methods complement each other in their ability to assess the eruptive potentials of ARs and could be employed to identify ARs prone to flaring activity.Based on the presented case study,we suggest that using a combination of different methods may aid to identify more reliably the eruptive potentials of ARs and help to better understand the pre-flare states. | Francesca Zuccarello Ilaria Ermolli Marianna B.Korsós Fabrizio Giorgi Salvo L.Guglielmino Robertus Erdélyi Paolo Romano | 2021 | Research in Astronomy and Astrophysics2021，21，12： | 0 |
| 20 | Comparison of partners-heart failure algorithm vs care alert in remote heart failure management显示文摘AIM: To compare the utility of the partners-heart failure(HF) algorithm with the care alert strategy for remote monitoring,in guiding clinical actions oriented to treat impending HF.METHODS: Consecutive cardiac resynchronizationdefibrillator recipients were followed with biweekly automatic transmissions. After every transmission,patients received a phone contact in order to check their health status,eventually followed by clinical actions,classified as 'no-action','non-active' and 'active'. Active clinical actions were oriented to treat impending HF. The sensitivity,specificity,positive and negative predictive values and diagnostic accuracy of the partners-HF algorithm vs care alert in determining active clinical actions oriented to treat pre-HF status and to prevent an acute decompensation,were also calculated.RESULTS: The study population included 70 patients with moderate to advanced systolic HF and QRS duration longer than 120 ms. During a mean follow-up of 8 ± 2 mo,665 transmissions were collected. No deaths or HF hospitalizations occurred. The sensitivity and specificity of the partners-HF algorithm for active clinical actions oriented to treat impending HF were 96.9%(95%CI: 0.96-0.98) and 92.5%(95%CI: 0.90-0.94) respectively. The positive and negative predictive values were 84.6%(95%CI: 0.82-0.87) and 98.6%(95%CI: 0.98-0.99) respectively. The partners-HF algorithm had an accuracy of 93.8%(95%CI: 0.92-0.96) in determining active clinical actions. With regard to active clinical actions,care alert had a sensitivity and specificity of 11.05%(95%CI: 0.09-0.13) and 93.6% respectively(95%CI: 0.92-0.95). The positive predictive value was 42.3%(95%CI: 0.38-0.46); the negative predictive value was 71.1%(95%CI: 0.68-0.74). Care alert had an accuracy of 68.9%(95%CI: 0.65-0.72) in determining active clinical actions.CONCLUSION: The partners-HF algorithm proved higher accuracy and sensitivity than care alert in determining active clinical actions oriented to treat impending HF. Future studies in larger populations should evaluate partners-HF ability to improve HF-related clinical outcomes. | Leonardo Calo’ Annamaria Martino Claudia Tota Alessandro Fagagnini Renzo Iulianella Marco Rebecchi Luigi Sciarra Giuseppe Giunta Maria Grazia Romano Roberto Colaceci Antonio Ciccaglioni Fabrizio Ammirati Ermenegildo de Ruvo | 2015 | World Journal of Cardiology2015，7，12： | 0 |
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