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Evaluation of prognostic factors and clinicopathological patterns of recurrence after curative surgery for colorectal cancer

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World Journal of Gastrointestinal Surgery 2021年第1期13卷 50-75页

作者： Filippo melli Ilenia Bartolini matteo Risaliti Rosaria Tucci maria Novella Ringressi Paolo muiesan Antonio Taddei Amedeo Amedei Department of Clinical and Experimental medicine University of FlorenceAzienda Ospedaliero-Universitaria CareggiFlorence 50134Italy

BACKGROUND Colorectal cancer is a common tumor with a quite high-related *** the used curative treatments,patients will develop cancer recurrence in up to 50%of the cases and/or other primary *** most of the recurrences are discovered within 3 years from the first treatment,a small percentage is found after 5 *** early detection of recurrence is crucial to allow further therapies improving patients’*** follow-up programs have been developed but the optimal one is far from being *** To evaluation of potential prognostic factors for timing and patterns of recurrence in order to plan tailored follow-up *** Perioperative and long-term data of all consecutive patients surgically treated with curative intent,from January 2006 to June 2009,for colorectal adenocarcinoma,were retrospectively reviewed to find potential prognostic factors associated with:(1)Recurrence incidence;(2)Incidence of an early(within 3 years from surgery)or late recurrence;and(3)Different sites of *** addition,the incidence of other primary neoplasms has been evaluated in a cohort of patients with a minimum potential follow-up of 10 *** Our study included 234 *** median follow-up period has been 119±46.2 *** recurrence rate has been 25.6%.Patients with a higher chance to develop recurrence had also the following characteristics:Higher levels of preoperative glycemia and carcinoembryonic antigen,highest anaesthesiologists Score score,occlusion,received a complex operation performed with an open technique,after a longer hospital stay,and showed advanced *** independent prognostic factors for recurrence were the hospital stay,N stage 2,and m stage 1(multivariate analysis).Younger ages were significantly associated with an early recurrence *** that received intermediate colectomies or segmental resections,having an N stage 2 or American Joint Committee on Cancer stage 3 tumors were al

关键词： Prognostic factors Recurrence Recurrence patterns Colorectal cancer Longterm follow-up Follow-up programs

Evaluating the best treatment for multifocal hepatocellular carcinoma:A propensity score-matched analysis

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World Journal of Gastroenterology 2022年第29期28卷 3981-3993页

作者： matteo Risaliti Ilenia Bartolini Claudia Campani Umberto Arena Carlotta Xodo Valentina Adotti martina Rosi Antonio Taddei Paolo muiesan Amedeo Amedei Giacomo Batignani Fabio marra Department of Experimental and Clinical medicine AOU CareggiFlorence 50134Italy

BACKGROUND Hepatocellular carcinoma(HCC)is a common tumour often diagnosed with a multifocal *** with multifocal HCC represent a heterogeneous *** Trans-Arterial ChemoEmbolization(TACE)is the most frequently employed treatment for these patients,previous data suggested that liver resection(LR)could be a safe and effective *** To compare LR and TACE in patients with multifocal HCC in terms of procedurerelated morbidity and oncologic *** All patients with multifocal HCC who underwent LR or TACE as the first procedure between may 2011 and march 2021 were *** decision to perform surgery or TACE was made after a multidisciplinary team *** patients in Child-Pugh class A or B7 and stage B(according to the Barcelona Clinic Liver Cancer staging system,without severe portal hypertension,vascular invasion,or extrahepatic spread)were included in the final *** score matching was used to adjust the baseline differences between patients undergoing LR and the TACE group[number and diameter of lesions,presence of cirrhosis,alpha-fetoprotein(AFP)levels,and model for End-Stage Liver Disease score].The Kaplan-meier method was used to estimate overall survival(OS)and disease-free survival(DFS).The outcomes of LR and TACE were compared using the log-rank *** After matching,30 patients were eligible for the final analysis,15 in each *** rates were 42.9% and 40% for LR and TACE,respectively(P=0.876).median OS was not different in the LR and TACE groups(53 mo vs 18 mo,P=0.312),while DFS was significantly longer with LR(19 mo vs 0 mo,P=0.0001).Subgroup analysis showed that patients in the Italian Liver Cancer(***)B2 stage,with AFP levels lower than 400 ng/mL,less than 3 lesions,and lesions bigger than 41 mm,benefited more from LR in terms of *** classified as *** B3,with AFP levels higher than 400 ng/mL and with more than 3 lesions,appeared to receive more benefi

关键词： Hepatocellular carcinoma multifocal hepatocellular carcinoma Liver resection Trans-arterial chemoembolization Guidelines Liver tumour management

Contemporary techniques and outcomes of surgery for locally advanced renal cell carcinoma with focus on inferior vena cava thrombectomy:The value of a multidisciplinary team

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Asian Journal of Urology 2022年第3期9卷 272-281页

作者： Riccardo Campi Paolo Barzaghi Alessio Pecoraro maria Lucia Gallo Damiano Stracci Alberto mariotti Saverio Giancane Simone Agostini Vincenzo Li marzi Arcangelo Sebastianelli Pietro Spatafora mauro Gacci Graziano Vignolini Francesco Sessa Paolo muiesan Sergio Serni Unit of Urological Robotic Surgery and Renal Transplantation University of FlorenceCareggi HospitalFlorenceItaly Department of Experimental and Clinical medicine University of FlorenceFlorenceItaly Department of Radiology Unit of UrogenitalNephrological and Kidney Transplantation ImagingCareggi HospitalUniversity of FlorenceFlorenceItaly Hepatobiliary Unit Department of Clinical and Experimental MedicineUniversity of FlorenceAOU CareggiFlorenceItaly Liver Unit Queen Elizabeth HospitalBirminghamUK

Objective:To report the outcomes of surgery for a contemporary series of patients with locally advanced non-metastatic renal cell carcinoma(RCC)treated at a referral academic centre,focusing on technical nuances and on the value of a multidisciplinary ***:We queried our prospective institutional database to identify patients undergoing surgical treatment for locally advanced(cT3-T4 N0-1 m0)renal masses suspected of RCC at our centre between January 2017 and December ***:Overall,32 patients were included in the analytic *** these,12(37.5%)tumours were staged as cT3a,8(25.0%)as cT3b,5(15.6%)as cT3c,and 7(21.9%)as cT4;6(18.8%)patients had preoperative evidence of lymph node ***(28.1%)patients underwent nephron-sparing surgery while 23(71.9%)received radical nephrectomy.A template-based lymphadenectomy was performed in 12 cases,with evidence of disease in 3(25.0%)at definitive histopathological *** cases of RCC with level IV inferior vena cava thrombosis were successfully treated using liver transplant techniques without the need for extracorporeal *** intraoperative complications were recorded in 3(9.4%)patients,no postoperative major complications(Clavien-Dindo3)were *** histopathological analysis,2(6.2%)patients who underwent partial nephrectomy harboured oncocytoma,while the most common malignant histotype was clear cell RCC(62.5%),with a median Leibovich score of 6(interquartile range 5e7).Conclusion:Locally advanced RCC is a complex and heterogenous disease posing several challenges to surgical *** experience confirms that provided careful patient selection,surgery in experienced hands can achieve favourable perioperative,oncological,and functional outcomes.

关键词： Inferior vena cava Liver transplant Open surgery Nephrectomy Renal cell carcinoma Thrombectomy

拉西地平和阿替洛尔长期抗高血压治疗时心脏结构和功能的改变:欧洲关于拉西地平在治疗动脉粥样硬化中作用的研究(ELSA)

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世界核心医学期刊文摘（心脏病学分册） 2005年第11期1卷 58-59页

作者： Agabiti-Rosei E. Trimarco B. muiesan m. L. 郝广华 Department of medical and Surgical Sciences University of Brescia c/o 2a Medicina Spedali Civili 25100 Brescia Italy

Objectives: To evaluate and correlate the effects of long-term antihypertensive treatment on left ventricular(LV) mass and carotid structural changes in a large group of essential hypertensive patients, participating in the European Lacidipine Study on Atherosclerosis(ELSA). Design: In four(Brescia, Glasgow, Naples and Pisa) of 23 centres participating in the ELSA study, an echocardiographic examination was performed at baseline and repeated, until the end of the 4-year study, in essential hypertensive patients, followed-up for carotid quantitative ultrasound examination of intima-media thickness(ImT), after random allocation to treatment with either lacidipine or atenolol(and added hydrochlorothiazide, as required for control of blood pressure). methods: m-mode, two-dimensional guided echocardiography was used to measure left ventricular(LV) wall thickness and dimensions, from which LV mass was calculated, using an anatomically validated formula(Penn Convention)and indexed to body surface area(left ventricular mass index, LVmI). The echocardiographic tracings were blindly evaluated in a single reading centre(Brescia). Bilateral ImT was measured at the site of common carotid and bifurcation far walls(CBmmax). Results: At baseline, cardiac and carotid ultrasound scans were available in 278 patients(mean age 54±7 years, 57%males, 22%obese). A significant correlation was observed between baseline LVmI and CBmmax(r=0.22, Pmultivariate analysis, CBmmax and mean 24-h pulse pressure were most strongly associated with baseline LVmI. A significant reduction in LVmI was observed both during lacidipine(n=96)(-12.5%reduction) and atenolol(n=78)(-13.9%reduction) treatments(up to 4 years)(Pments). Changes in LVmI were not related to changes in carotid wall thickness. In multivariate analysis, baseline LV mass and mean 24-h systolic blood pressure changes were significantly associated w

关键词：拉西地平 ELSA 抗高血压治疗阿替洛尔心脏结构原发性高血压颈动脉结构平均收缩压抗高血压药物左心室质量

Development and internal validation of the Comprehensive ALPPS Preoperative Risk Assessment(CAPRA)score:is the patient suitable for Associating Liver Partition and Portal vein ligation for Staged hepatectomy(ALPPS)?

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Hepatobiliary Surgery and Nutrition 2022年第1期11卷 52-66,I0007,I0008页

作者： Ivan Capobianco Karl J.Oldhafer mohammed-Hossein Fard-Aghaie Ricardo Robles-Campos Roberto Brusadin Henrik Petrowsky michael Linecker Arianeb mehrabi Katrin Hoffmann Jun Li Asmus Heumann Roberto Hernandez-Alejandro mauro Enrique Tun-Abraham Elio Jovine matteo Serenari Bergthor Bjornsson Per Sandström Ruslan Alikhanov mikhail Efanov Paolo muiesan Andrea Schlegel Thomas m.van Gulik Pim B.Olthof Gregor Alexander Stavrou Lina maria Serna-Higuita Alfred Königsrainer Silvio Nadalin Department of General Visceral and Transplant SurgeryUniversity Hospital TübingenTübingenGermany Department of General and Abdominal Surgery Asklepios Hospital BarmbekHamburgGermany Department of Surgery Virgen de la Arrixaca Clinic and University HospitalMurciaSpain Swiss HPB and Transplantation Center Department of SurgeryZurich University HospitalZurichSwitzerland Department of General Visceraland Transplantation SurgeryUniversity of HeidelbergHeidelbergGermany General Visceral and Thoracic Surgery Department and ClinicHamburg-Eppendorf University Medical CenterHamburgGermany Division of Transplantation and Hepatobiliary Surgery University of RochesterRochesterNYUSA Division of HPB Surgery and Liver Transplantation Department of SurgeryLondon Health Sciences CentreLondonCanada General and Emergency Surgery Unit Azienda Ospedaliero-Universitaria di BolognaMaggiore HospitalBolognaItaly General Surgery and Transplantation Unit Azienda Ospedaliero-Universitaria di BolognaSant’Orsola-Malpighi HospitalBolognaItaly Department of Surgery in Linköping and Department of Biomedical and Clinical SciencesLinköping UniversityLinköpingSweden Department of Hepatopancreatobiliary Surgery Moscow Clinical Scientific CenterMoscowRussia Liver Unit Queen Elizabeth Hospital BirminghamUniversity Hospitals Birmingham NHS Foundation TrustBirminghamUK Department of Surgery Amsterdam UMC(Location AMC)University of AmsterdamAmsterdamThe Netherlands Department of General Abdominal and Thoracic SurgerySurgical OncologySaarbruecken General HospitalSaarbrueckenGermany Department of Clinical Epidemiology and Applied Biometry University of TübingenTübingenGermany

Background:Preoperative patient selection in Associating Liver Partition and Portal vein ligation for Staged hepatectomy(ALPPS)is not always reliable with currently available scores,particularly in patients with primary liver *** study aims to(I)to determine whether comorbidities and patients characteristics are a risk factor in ALPPS and(II)to create a score predicting 90-day mortality ***:Thirteen high-volume centers participated in this retrospective multicentric study.A risk analysis based on patient characteristics,underlying disease and procedure type was performed to identify risk factors and model the Comprehensive ALPPS Preoperative Risk Assessment(CAPRA)score.A nonparametric receiver operating characteristic analysis was performed to estimate the predictive ability of our score against the Charlson Comorbidity Index(CCI),the age-adjusted CCI(aCCI),the ALPPS risk score before Stage 1(ALPPS-RS1)and Stage 2(ALPPS-RS2).The model was internally validated applying ***:A total of 451 patients were *** was 14.4%.The CAPRA score is calculated based on the following formula:(0.1×age)−(2×BSA)+1(in the presence of primary liver tumor)+1(in the presence of severe cardiovascular disease)+2(in the presence of moderate or severe diabetes)+2(in the presence of renal disease)+2(if classic ALPPS is planned).The predictive ability was 0.837 for the CAPRA score,0.443 for CCI,0.519 for aCCI,0.693 for ALPPS-RS1 and 0.807 for *** 1,000 cycles of bootstrapping the C statistic was *** accuracy plot revealed a cut-off for optimal prediction of postoperative mortality of ***:Comorbidities play an important role in ALPPS and should be carefully considered when planning the *** assessing the patient’s preoperative condition in relation to ALPPS,the CAPRA score has a very good ability to predict postoperative mortality.

关键词： Associating Liver Partition and Portal vein ligation for Staged hepatectomy(ALPPS) comorbidity mortality prediction model patient selection

患者独处诊室血压和非独处诊室血压与临床前靶器官损害的关系

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中华高血压杂志 2019年第3期27卷 299-299页

作者： Salvetti m Paini A Aggiusti C Bertacchini F Stassaldi D Capellini S Ciuceis CD Rizzoni D Gatta R Rosei EA muiesan mL 赵狄(摘译) 练桂丽(审校) 不详

患者独处的自动诊室血压或自动血压测量方法可能优于传统血压测量方法。目前一些国际指南建议自动化测量血压作为血压测量的首选方法。与标准血压测量方法所获数据比较,自动化测量血压与心血管事件的关系并不明确。初步数据显示:自动化... 详细信息

患者独处的自动诊室血压或自动血压测量方法可能优于传统血压测量方法。目前一些国际指南建议自动化测量血压作为血压测量的首选方法。与标准血压测量方法所获数据比较,自动化测量血压与心血管事件的关系并不明确。初步数据显示:自动化测量血压可能与靶器官损害更相关。该研究的目的是评估在欧洲高血压学会卓越中心(excellence center)行超声心动图及颈动脉超声检查的564例患者独处诊室血压、非独处诊室血压与靶器官损害的关系。

关键词：靶器官损害诊室血压血压测量

预测20年总死亡与心血管病死亡风险增加的尿酸阈值

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中华高血压杂志 2020年第1期28卷 99-99页

作者： Virdis A masi S Casiglia E Tikhonoff V Cicero AFG Ungar A Rivasi G Salvetti m Barbagallo Cm Bombelli m Dell'Oro R Bruno B Lippa L D'Elia L Verdecchia P mallamaciF Cirillo m Rattazzi m Cirillo P Gesualdo L mazza A Giannattasio C maloberti A Volpe m Tocci G GeorgiopoulosG Iaccarino G Nazzaro P Parati G Palatini P Galletti F Ferri C Desideri G Viazzi F Pontremoli R muiesan mL Grassi G Borghi C 赵狄(摘译) 刘莉(审校) 不详

目前识别心血管病风险不同分层的血清尿酸水平仍未确定。采用基于人群的大数据,研究人员评估了总死亡和与心血管病死亡(cardiovascular mortality,CVm)风险增加的血清尿酸水平。尿酸与心脏健康(uric acid right for heart health,URRAH... 详细信息

目前识别心血管病风险不同分层的血清尿酸水平仍未确定。采用基于人群的大数据,研究人员评估了总死亡和与心血管病死亡(cardiovascular mortality,CVm)风险增加的血清尿酸水平。尿酸与心脏健康(uric acid right for heart health,URRAH)研究是一项收集意大利几个基于大型人群纵向研究大数据的多中心回顾性观察性研究(随访20年),患者均在意大利高血压协会的高血压诊所就诊。

关键词：心血管病尿酸水平死亡风险