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| 1 | Precision medicine in gastric cancer显示文摘Gastric cancer(GC)is a complex disease linked to a series of environmental factors and unhealthy lifestyle habits,and especially to genetic alterations.GC represents the second leading cause of cancer-related deaths worldwide.Its onset is subtle,and the majority of patients are diagnosed once the cancer is already advanced.In recent years,there have been innovations in the management of advanced GC including the introduction of new classifications based on its molecular characteristics.Thanks to new technologies such as next-generation sequencing and microarray,the Cancer Genome Atlas and Asian Cancer Research Group classifications have also paved the way for precision medicine in GC,making it possible to integrate diagnostic and therapeutic methods.Among the objectives of the subdivision of GC into subtypes is to select patients in whom molecular targeted drugs can achieve the best results;many lines of research have been initiated to this end.After phase III clinical trials,trastuzumab,anti-Erb-B2 receptor tyrosine kinase 2(commonly known as ERBB2)and ramucirumab,anti-vascular endothelial growth factor receptor 2(commonly known as VEGFR2)monoclonal antibodies,were approved and introduced into first-and second-line therapies for patients with advanced/metastatic GC.However,the heterogeneity of this neoplasia makes the practical application of such approaches difficult.Unfortunately,scientific progress has not been matched by progress in clinical practice in terms of significant improvements in prognosis.Survival continues to be low in contrast to the reduction in deaths from many common cancers such as colorectal,lung,breast,and prostate cancers.Although several target molecules have been identified on which targeted drugs can act and novel products have been introduced into experimental therapeutic protocols,the overall approach to treating advanced stage GC has not substantially changed.Currently,surgical resection with adjuvant or neoadjuvant radiotherapy and chemotherapy are the most effective treatments for this disease.Future research should not underestimate the heterogeneity of GC when developing diagnostic and therapeutic strategies aimed toward improving patient survival. | Patrizia Bonelli Antonella Borrelli Franca Maria Tuccillo Lucrezia Silvestro Raffaele Palaia Franco Maria Buonaguro | 2019 | World Journal of Gastrointestinal Oncology2019，11，10： | 8 |
| 2 | Minimally invasive surgical treatment of intrahepatic cholangiocarcinoma:A systematic review显示文摘BACKGROUND Intrahepatic cholangiocarcinoma(ICC)is the second most common primary liver cancer and is characterized by an aggressive behavior and a dismal prognosis.Radical surgical resection represents the only potentially curative treatment.Despite the increasing acceptance of laparoscopic liver resection for surgical treatment of malignant liver diseases,its use for ICC is not commonly performed.In fact,to achieve surgical free margins a major resection and/or vascular and/or biliary reconstructions is often needed,as well as an associated lymph node dissection.AIM To review and summarize the current evidences on the minimally invasive resection of ICC.METHODS A systematic review of the literature based on the criteria predetermined by the investigators was performed from the 1st of January 2009 up to the 1st of January2021 in 4 databases(PubMed,Scopus,Google Scholar,and Cochrane databases).All retrospective and prospective studies reporting on the comparative outcomes of open vs minimally invasive treatment of ICC were included.An evaluation of manuscripts quality was achieved using Methodological Index for Non-Randomized Studies criteria and Newcastle-Ottawa Scale.RESULTS After a systematic search 9 studies fulfilled the inclusion criteria.Among the all 3012 included patients,2450 were operated by an open approach and 562 by a minimally invasive(laparoscopic)approach.Baseline characteristics,tumor characteristics,surgical outcomes and oncological outcomes were collected and analyzed,highlighting values with a statistical significant difference between patients treated with open or laparoscopic approach.Shorter hospital stay and lower intraoperative blood losses were reported by some Authors in minimally invasive surgery,on the contrary,in the open group there was a higher number of lymphadenectomies and a higher percentage of major hepatectomies.CONCLUSION Minimally invasive resection of ICC has some short-term benefits and it is safe and feasible only in selected centers with a high experience in laparoscopic approach for liver surgery.Minimally invasive surgery,actually,was considered mainly in patients with a tumor with a diameter<5 cm,without invasion of main biliary duct or main vessel and no vascular or biliary reconstructions were planned.Further studies are needed to elucidate its impact on long term oncologic outcomes. | Renato Patrone Francesco Izzo Raffaele Palaia Vincenza Granata Guglielmo Nasti Alessandro Ottaiano Gilda Pasta Andrea Belli | 2021 | World Journal of Gastrointestinal Oncology2021，13，12： | 3 |
| 3 | Early radiological assessment of locally advanced pancreatic cancer treated with electrochemotherapy显示文摘AIM To report early imaging assessment of ablated area post electrochemotherapy(ECT) in patients with locally advanced pancreatic cancer(LAPC). METHODS ECT was performed in 19 LAPC patients enrolled in an approved ongoing clinical phase Ⅰ/Ⅱ study. Before and after ECT, 18 patients underwent computed tomography(CT) scan, 11 patients underwent morphological and functional magnetic resonance(MR) scan(dynamic contrast enhanced-MRI) calculating wash-in slope(WIS) and wash-out slope(WOS); diffusion weighted imaging calculating pseudo-diffusivity(Dp), perfusion fraction(fp) and tissue diffusivity(Dt); 10 patients underwentpositron emission tomography(PET). Response evaluation criteria in solid tumour(RECIST) on MR and CT were used to assess tumour therapy response. Choi on CT, PET response criteria in solid tumors(PERCIST) on PET and functional parameters on MR were used to evaluate treatment response.RESULTS For each patient no significant reduction was measurable by CT and MR using RECIST. According Choi criteria a partial response was obtained in 18/18(100.0%) patients. According PERCIST criteria 6/10(60.0%) patients showed a partial response, 3/10(30.0%) stable disease and 1/10(10.0%) progression disease. Moreover, using functional MR parameters, a significant reduction of viable tumour after ECT can be observed. According ΔWIS and ΔWOS 9/11(81.8%) patients exhibited a partial response and 2/11(18.2%) stable disease; 8/11(72.7%) patients were considered in partial response by ΔDp evaluation and 3/11(27.3%) in stable disease; according ΔDt 7/11(63.6%) patients showed a partial response, 1/11(9.1%) showed progression of disease and 3/11(27.3%) were stable. Perfusion fraction fp showed a significant reduction after ECT only in four patients. No significant difference was observed after ECT in signal intensity of T1-weighted images and T2-weighted images, and in equilibrium-phase of contrast study, according to χ2 test was observed. A good correlation was reported between ΔHounsfield unit and Δmaximum standardized uptake value and between Δfp and ΔWOS, with a significant statistically difference(P < 0.05) using Spearman correlation coefficient.CONCLUSION Perfusion and diffusion MR derived parameters, Choi, PERCIST criteria are more performant than morphological MR and CT criteria to assess ECT treatment response. | Vincenza Granata Roberta Fusco Sergio Venanzio Setola Mauro Piccirillo Maddalena Leongito Raffaele Palaia Francesco Granata Secondo Lastoria Francesco Izzo Antonella Petrillo | 2017 | World Journal of Gastroenterology2017，23，26： | 3 |
| 4 | Expression of the Antiapoptotic Protein BAG3 Is a Feature of Pancreatic Adenocarcinoma and Its Overexpression Is Associated With Poorer Survival显示文摘 | Alessandra Rosati Samantha Bersani Francesca Tavano Elisa Dalla Pozza Margot De Marco Marta Palmieri Vincenzo De Laurenzi Renato Franco Giosuè Scognamiglio Raffaele Palaia Andrea Fontana Pierluigi di Sebastiano Massimo Donadelli Ilaria Dando Jan Paul Mede | 2012 | The American Journal of Pathology2012，，5： | 1 |
| 5 | Local ablation of pancreatic tumors: State of the art and future perspectives显示文摘BACKGROUND Currently,the technologies most commonly used to treat locally advanced pancreatic cancer are radiofrequency ablation(RFA),microwave ablation,and irreversible(IRE)or reversible electroporation combined with low doses of chemotherapeutic drugs.AIM To report an overview and updates on ablative techniques in pancreatic cancer.METHODS Several electronic databases were searched.The search covered the years from January 2000 to January 2021.Moreover,the reference lists of the found papers were analysed for papers not indexed in the electronic databases.All titles and abstracts were analysed.RESULTS We found 30 studies(14 studies for RFA,3 for microwave therapy,10 for IRE,and 3 for electrochemotherapy),comprising 1047 patients,which were analysed further.Two randomized trials were found for IRE.Percutaneous and laparotomy approaches were performed.In the assessed patients,the median maximal diameter of the lesions was in the range of 2.8 to 4.5 cm.All series included patients unfit for surgical treatment,but Martin et al assessed a subgroup of patients with borderline resectable tumours who underwent resection with margin attenuation with IRE.Most studies administered chemotherapy prior to ablative therapies.However,several studies suggest that the key determinant of improved survival is attributable to ablative treatment alone.Nevertheless,the authors suggested chemotherapy before local therapies for several reasons.This strategy may not only downstage a subgroup of patients to curative-intent surgery but also support to recognize patients with biologically unfavourable tumours who would likely not benefit from ablation treatments.Ablation therapies seem safe based on the 1047 patients assessed in this review.The mortality rate ranged from 1.8%to 2%.However,despite the low mortality,the reported rates of severe post procedural complications ranged from 0%-42%.Most reported complications have been self-limiting and manageable.Median overall survival varied between 6.0 and 33 mo.Regarding the technical success rate,assessed papers reported an estimated rate in the range of 85%to 100%.However,the authors reported early recurrence after treatment.A distinct consideration should be made on whether local treatments induce an immune response in the ablated area.Preclinical and clinical studies have shown that RFA is a promising mechanism for inducing antigen-presenting cell infiltration and enhancing the systemic antitumour T-cell immune response and tumour regression.CONCLUSION In the management of patients with pancreatic cancer,the possibility of a multimodal approach should be considered,and conceptually,the combination of RFA with immunotherapy represents a novel angle of attack against this tumour. | Vincenza Granata Roberta Grassi Roberta Fusco Andrea Belli Raffaele Palaia Gianpaolo Carrafiello Vittorio Miele Roberto Grassi Antonella Petrillo Francesco Izzo | 2021 | World Journal of Gastroenterology2021，27，23： | 1 |
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