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Indications and outcomes of endoscopic resection for nonpedunculated colorectal lesions:A narrative review

World Journal of Gastrointestinal Endoscopy 2021年第8期13卷 275-295页

作者： Endrit Shahini Diogo Libanio giacomo lo secco Antonio Pisani Alberto Arezzo Department of Gastroenterology and Digestive Endoscopy Unit National Institute of Research“Saverio De Bellis”Castellana Grotte(Bari)70013Italy Department of Gastroenterology Portuguese Oncology InstitutePorto 4200-072Portugal Department of Surgical Sciences University of TorinoTurin 10126Italy

In the last years,endoscopic techniques gained a crucial role in the treatment of colorectal flat *** the same time,the importance of a reliable assessment of such lesions to predict the malignancy and the depth of invasion of the colonic wall *** current unsolved dilemma about the endoscopic excision techniques concerns the necessity of a reliable submucosal invasive cancer assessment system that can stratify the risk of the post-procedural need for ***,this narrative literature review aims to compare the available diagnostic strategies in predicting malignancy and to give a guide about the best techniques to *** performed a literature search using electronic databases(MEDLINE/PubMed,EMBASE,and Cochrane Library).We collected all articles about endoscopic mucosal resection(EMR)and endoscopic submucosal dissection(ESD)registering the ***,we analyzed all meta-analyses comparing EMR vs ESD outcomes for colorectal sessile or nonpolypoid lesions of any size,preoperatively estimated as *** meta-analysis studies,mainly Eastern,were included in the analysis comparing 124 studies and overall 22954 patients who underwent EMR and ESD *** these,eighty-two were retrospective,twenty-four perspective,nine casecontrol,and six cohorts,while three were randomized clinical trials.A total of 18118 EMR and 10379 ESD were completed for a whole of 28497 colorectal sessile or non-polypoid lesions>5-10 mm in *** conclusion,it is crucial to enhance the preoperative diagnostic workup,especially in deciding the most suitable endoscopic method for radical resection of flat colorectal lesions at risk of underlying ***,the ESD necessitates further improvement because of the excessively time-consuming as well as the intraprocedural technical hindrances and related *** found a higher rate of en bloc resections and R0 for ESD than EMR for non-pedunculated colorectal ***,d

关键词： Colorectal cancer Adenoma detection High-resolution colonoscopy Chromoendoscopy Pit pattern Dysplasia

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Conservative management of malignant gastric outlet obstruction syndrome-evidence based evaluation of endoscopic ultrasoundguided gastroentero-anastomosis

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World Journal of Gastrointestinal Oncology 2021年第9期13卷 1086-1098页

作者： Anna Cominardi giacomo Tamanini Nicole Brighi Pietro Fusaroli Andrea Lisotti Department of Gastroenterology Unit Hospital of ImolaUniversity of BolognaImola 40026BOItaly Department of Medical Oncology Istituto Scientifico Romagnolo Per Lo Studio Dei Tumori“Dino Amadori”(IRST)IRCCSMeldola 47014FCItaly Department of Medical and Surgical Sciences University of Bologna/Hospital of ImolaBologna 40121Italy

Gastric outlet obstruction(GOO)is a clinical syndrome characterized by postprandial vomiting,abdominal pain,bloating and,in advanced cases,by weight loss secondary to inadequate oral *** clinical entity may be caused by mechanical obstruction,either benign or malignant,or by motility *** this review we will focus on malignant GOO and on its endoscopic ultrasound(EUS)-guided palliative *** most frequent malignant causes of this syndrome are gastric and locally advanced pancreatic carcinomas;other causes include duodenal or ampullary neoplasms,gastric lymphomas,retroperitoneal lymphadenopathies and,more infrequently,gallbladder and bile duct *** represents the treatment of choice when radical and curative resection is potentially feasible;if the malignant cause is not likely to be completely resected,palliative treatments should be *** treatments for malignant GOO are primarily based on surgical gastro-jejunostomy and endoscopic placement of an enteral self-expanding metal *** treatments are effective;however,endoscopic stent placement is less invasive and it is associated with good short-term results,while surgery provides longer-lasting effects with a lower frequency of *** the last few years,EUS-guided gastroenterostomy(GE)has been proposed as palliative treatment for malignant *** novel technique consists of the creation of an anastomosis between the gastric lumen and a small bowel loop distal to the malignant obstruction,through the deployment of a lumen-apposing metal stent under ***-GE has the advantage of being as minimally invasive as enteral stent placement,and of guaranteeing long-term results similar to those of surgery.

关键词： Gastric outlet obstruction Endoscopic ultrasound-guided gastroenterostomy Endoscopic ultrasound Enteric anastomosis Lumen-apposing metal stents

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Endoscopic ultrasound assessment and tissue acquisition of mediastinal and abdominal lymph nodes

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World Journal of Gastrointestinal Oncology 2021年第10期13卷 1475-1491页

作者： giacomo Tamanini Anna Cominardi Nicole Brighi Pietro Fusaroli Andrea Lisotti Department of Gastroenterology Unit Hospital of ImolaUniversity of BolognaImola 40026BOItaly Department of Medical Oncology IRCCS Istituto Romagnolo per lo Studio dei Tumori(IRST)"Dino Amadori"Meldola 47014FCItaly

The differential diagnosis between benign and malignant lymph nodes(LNs)has a fundamental role in the characterization and staging of malignant conditions,as well as in subsequent patients’*** imaging modalities(*** tomography and magnetic resonance imaging)rely mainly on size;endoscopic ultrasound(EUS)criteria based on B-mode evaluation and Doppler features fail to adequately characterize with high specificity LNs *** introduction of EUS-elastography and contrast-enhanced harmonic EUS are useful techniques to increase the diagnostic yield in identifying metastatic LNs,to identify which suspicious LN should require pathological characterization and,finally,to target tissue ***-guided tissue acquisition(EUS-TA)is increasingly being used for diagnosing lymphadenopathy whenever the characterization modifies patients’subsequent management and when no superficial LN is *** target therapy are currently available(*** cancer,breast cancer),EUS-TA of malignant LNs could be required to identify tumor *** this field,both fine needle aspiration and biopsy needles are able to guarantee accurate results with almost perfect specificity and sub-optimal *** finally propose a diagnostic algorithm based on most recent,high-level evidence for the diagnostic approach to suspected LNs assessment.

关键词： Endoscopic ultrasound-guided tissue acquisition Endoscopic ultrasound-fine needle aspiration Endoscopic ultrasound-fine needle biopsy Biopsy Aspiration Cancer

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Engineering Design Study on an Innovative Hydrokinetic Turbine with on Shore Foundation

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Journal of Energy and Power Engineering 2014年第3期8卷 476-486页

作者： Silvio Barbarelli Gaetano Florio Mario Amelio Nino Michele Scomaienchi Antonino Cutrupi ManuelSanchez Blanco giacomo lo Zupone Department of Mechanical Energy and Management Engineering University of Calabria Rende 87036 Italy SintEnergy srl-Technest Incubator University of Calabria Rende 87036 Italy

Tidal currents are a resource of great potentiality and not yet fully explored. Several efforts have been made to exploit these resources, but the costs associated to the deployment of tidal plants in marine environments are usually too high. The aim of this work is to present a system able to handle with the above mentioned problems, through the development of a particular hydrokinetic turbine design. In previous works, the authors described a basic turbine configuration achieving interesting performances, although some operational inconveniences were detected. Those problems have been existing so the solution should be optimized and redesigned. As a result, a new design of the turbine is proposed, consisting of a double rotor spinning in opposite directions in order to balance the induced mechanical torque. From preliminary evaluations related to the Messina Strait tidal cycles （Punta Pezzo site, RC, Italy）, a single 12 m diameter turbine can supply a power of about 500 kW with a peak current speed of 3 m/s and deliver up to 450 MWh/year.

关键词： Tidal currents kinetic turbine double rotor configuration equilibrium pilot plant estimation.

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Robotic rectal surgery: State of the art

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World Journal of Gastrointestinal Oncology 2016年第11期8卷 757-771页

作者： Fabio Staderini Caterina Foppa Alessio Minuzzo Benedetta Badii Etleva Qirici giacomo Trallori Beatrice Mallardi Gabriele Lami Giuseppe Macrì Andrea Bonanomi Siro Bagnoli Giuliano Perigli Fabio Cianchi Center of Oncological Minimally Invasive Surgery Department of Surgery and Translational Medicine University of Florence Department of Experimental and Clinical Biomedical Sciences University of Florence Istituto per lo Studio e Prevenzione Onco-logica Unit of Gastroenterology

Laparoscopic rectal surgery has demonstrated its superiority over the open approach, however it still has some technical limitations that lead to the development of robotic platforms. Nevertheless the literature on this topic is rapidly expanding there is still no consensus about benefits of robotic rectal cancer surgery over the laparoscopic one. For this reason a review of all the literature examining robotic surgery for rectal cancer was performed. Two reviewers independently conducted a search of electronic databases (PubMed and EMBASE) using the key words “rectum”, “rectal”, “cancer”, “laparoscopy”, “robot”. After the initial screen of 266 articles, 43 papers were selected for review. A total of 3013 patients were included in the review. The most commonly performed intervention was low anterior resection (1450 patients, 48.1%), followed by anterior resections (997 patients, 33%), ultra-low anterior resections (393 patients, 13%) and abdominoperineal resections (173 patients, 5.7%). Robotic rectal surgery seems to offer potential advantages especially in low anterior resections with lower conversions rates and better preservation of the autonomic function. Quality of mesorectum and status of and circumferential resection margins are similar to those obtained with conventional laparoscopy even if robotic rectal surgery is undoubtedly associated with longer operative times. This review demonstrated that robotic rectal surgery is both safe and feasible but there is no evidence of its superiority over laparoscopy in terms of postoperative, clinical outcomes and incidence of complications. In conclusion robotic rectal surgery seems to overcome some of technical limitations of conventional laparoscopic surgery especially for tumors requiring low and ultra-low anterior resections but this technical improvement seems not to provide, until now, any significant clinical advantages to the patients.

关键词： Robotic surgery Robotic rectal surgery DaVinci rectal surgery Robotic rectal cancer Robotics for rectal cancer Robotic rectal resection

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Three-dimensional collagen-based scaffold model to study the microenvironment and drug-resistance mechanisms of oropharyngeal squamous cell carcinomas

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Cancer Biology & Medicine 2021年第2期18卷 502-516页

作者： giacomo Miserocchi Claudia Cocchi Alessandro De Vita Chiara Liverani Chiara Spadazzi Sebastiano Calpona Giandomenico Di Menna Massimo Bassi Giuseppe Meccariello Giovanni De Luca Angelo Campobassi Maria Maddalena Tumedei Alberto Bongiovanni Valentina Fausti Franco Cotelli Toni Ibrahim Laura Mercatali Osteoncology and Rare Tumors Center IRCCS Istituto Romagnolo per lo Studio dei Tumori(IRST)“Dino Amadori”Meldola 47014Italy Maxillofacial Surgery Unit Bufalini HospitalCesena 47521Italy Department of Head-Neck Surgery OtolaryngologyHead-Neck and Oral Surgery UnitMorgagni Pierantoni HospitalForlì47121Italy Pathology Unit “Bufalini”HospitalAUSL RomagnaCesena 47521Italy Biosciences Laboratory IRCCS Istituto Romagnolo per lo Studio dei Tumori(IRST)“Dino Amadori”Meldola 47014Italy Department of Biosciences Universitàdegli Studi di MilanoMilan 20133Italy

Objective:Squamous cell carcinoma(SCC)represents the most common histotype of all head and neck malignancies and includes oropharyngeal squamous cell carcinoma(OSCC),a tumor associated with different clinical outcomes and linked to human papilloma virus(HPV)*** research has few available in vitro models with which to study the different pathophysiological behavior of *** present study proposes a 3-dimensional(3 D)biomimetic collagen-based scaffold to mimic the tumor microenvironment and the crosstalk between the extracellular matrix(ECM)and cancer ***:We compared the phenotypic and genetic features of HPV-positive and HPV-negative OSCC cell lines cultured on common monolayer supports and on *** also explored cancer cell adaptation to the 3 D microenvironment and its impact on the efficacy of drugs tested on cell lines and primary ***:HPV-positive and HPV-negative cell lines were successfully grown in the 3 D model and displayed different collagen fiber *** 3 D cultures induced an increased expression of markers related to epithelial–mesenchymal transition(EMT)and to matrix interactions and showed different migration behavior,as confirmed by zebrafish embryo *** expression of hypoxia-inducible factor 1α(1α)and glycolysis markers were indicative of the development of a hypoxic microenvironment inside the scaffold ***,the 3 D cultures activated drug-resistance signaling pathways in both cell lines and primary ***:Our results suggest that collagen-based scaffolds could be a suitable model for the reproduction of the pathophysiological features of ***,3 D architecture appears capable of inducing drug-resistance processes that can be studied to better our understanding of the different clinical outcomes of HPV-positive and HPV-negative patients with OSCCs.

关键词： Oropharyngeal squamous cell carcinoma collagen biomimetic scaffold zebrafish drug-resistance primary culture

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Uveal melanoma:Recent advances in immunotherapy

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World Journal of Clinical Oncology 2024年第1期15卷 23-31页

作者： Francesco Saverio Sorrentino Francesco De Rosa Patrick Di Terlizzi giacomo Toneatto Andrea Gabai Lucia Finocchio Carlo Salati Leopoldo Spadea Marco Zeppieri Department of Surgical Sciences Unit of OphthalmologyOspedale MaggioreBologna 40100Italy Department of Oncology IRCCS Istituto Romagnolo per lo Studio dei Tumori“Dino Amadori”Meldola 47014Italy Department of Ophthalmology University Hospital of UdineUdine 33100Italy Eye Clinic Policlinico Umberto I“Sapienza”University of RomeRome 00142Italy

Uveal melanoma(UM)is the most common primary intraocular cancer in *** incidence in Europe and the United States is 6-7 per million population per *** most primary UMs can be successfully treated and locally controlled by irradiation therapy or local tumor resection,up to 50%of UM patients develop metastases that usually involve the liver and are fatal within 1 *** date,chemotherapy and targeted treatments only obtain minimal responses in patients with metastatic UM,which is still characterized by poor *** standard therapeutic approaches for its prevention or treatment have been *** application of immunotherapy agents,such as immune checkpoint inhibitors that are effective in cutaneous melanoma,has shown limited effects in the treatment of ocular *** is due to UM’s distinct genetics,natural history,and complex interaction with the immune *** cutaneous melanomas characterized mainly by BRAF or NRAS mutations,UMs are usually triggered by a mutation in GNAQ or *** a result,more effective immunotherapeutic approaches,such as cancer vaccines,adoptive cell transfer,and other new molecules are currently being *** this review,we examine novel immunotherapeutic strategies in clinical and preclinical studies and highlight the latest insight in immunotherapy and the development of tailored treatment of UM.

关键词： Uveal melanoma Immunotherapy Ocular oncology Tumor Metastatic disease Genetic mutations

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First-line pazopanib in patients with advanced non-clear cell renal carcinoma:An Italian case series

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World Journal of Clinical Oncology 2021年第11期12卷 1037-1046页

作者： Sebastiano Buti Melissa Bersanelli Francesco Massari Ugo De Giorgi Orazio Caffo Gaetano Aurilio Umberto Basso giacomo Carteni Claudia Caserta Luca Galli Francesco Boccardo Giuseppe Procopio Gaetano Facchini Giuseppe Fornarini Alfredo Berruti Elena Fea Emanuele Naglieri Fausto Petrelli Roberto Iacovelli Camillo Porta Alessandra Mosca Medical Oncology Unit University Hospital of ParmaParma 43126Italy Medicine and Surgery Department University of ParmaParma 43126Italy Division of Oncology Policlinico Sant’Orsola-Malpighi HospitalBologna 40138Italy Department of Oncology IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori(I.R.S.T.)Meldola 47014Italy Department of Medical Oncology Santa Chiara HospitalTrento 38122Italy Department of Medical Oncology Division of Urogenital and Head and Neck TumoursEuropean Institute of Oncology IRCCSMilan 20141Italy Medical Oncology Unit 3 Istituto Oncologico Veneto IOV IRCCSCastelfranco VenetoPadova 31033Italy Division of Oncology Azienda Ospedaliera di Rilievo Nazionale A.CardarelliNapoli 80131Italy Medical Oncology Unit Azienda Ospedaliera S.MariaTerni 05100Italy Oncology Unit 2 University Hospital of PisaPisa 56126Italy Academic Unit of Medical Oncology IRCCS San Martino Polyclinic HospitalGenova 16132Italy Medical Oncology Genitourinary Section Fondazione IRCCS Istituto Nazionale Dei TumoriMilan 20133Italy Departmental Unit of Clinical and Experimental Uro-Andrologic Oncology Istituto Nazionale Tumori IRCCS Fondazione G.PascaleNapoli 80131Italy Medical Oncology Unit Istituto di Ricovero e Cura a Carattere Scientifico(IRCCS)Ospedale Policlinico San MartinoGenova 16132Italy University of Brescia ASST-Spedali CiviliBresciaBrescia 25123Italy Medical Oncology Unit S Croce and Carle Teaching HospitalCuneo 12100Italy Division of Medical Oncology Istituto Tumori G Paolo IIIRCCSBari 70124Italy Medical Oncology Unit ASST Bergamo OvestTreviglioBergamo 24047Italy Medical Oncology Unit Fondazione Policlinico Universitario Agostino Gemelli IRCCSRome 00161Italy Division of Oncology AOU Consorziale Policlinico di BariBari 70124Italy Department of Biomedical Sciences and Human Oncology University of Bari"A.Moro"Bari 70124Italy Multidisciplinary Outpatient Oncology Clinic Candiolo Cancer InstituteFPO-IRCCSCandioloTurin 10060Italy

BACKGROUND Non-clear cell(ncc)metastatic renal-cell carcinoma(RCC)has dismal results with standard systemic therapies and a generally worse prognosis when compared to its clear-cell *** systemic combination therapies have emerged for metastatic RCC(mRCC),but the pivotal phase III trials excluded patients with nccRCC,which constitute about 30%of metastatic RCC *** To provide a piece of real-life evidence on the use of pazopanib in this patient *** The present study is a multicenter retrospective observational analysis aiming to assess the activity,efficacy,and safety of pazopanib as first-line therapy for advanced nccRCC patients treated in a real-life *** Overall,48 patients were *** the median follow-up of 40.6 mo,the objective response rate was 27.1%,the disease control rate was 83.3%,and the median progression-free survival and overall survival were 12.3(95%confidence interval[CI]:3.6-20.9)and 27.7(95%CI:18.2-37.1)mo,*** 3 adverse events occurred in 20%of patients,and no grade 4 or 5 toxicities were *** Pazopanib should be considered as a good first-line option for metastatic RCC with variant histology.

关键词： Pazopanib Non-clear cell Kidney cancer Renal-cell carcinoma Variant histology Tyrosine kinase inhibitors

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