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Why is early detection of colon cancer still not possible in 2023?

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World Journal of Gastroenterology 2024年第3期30卷 211-224页

作者： Valeria tonini Manuel Zanni Department of Medical and surgical sciences University of BolognaBologna 40138Italy

Colorectal cancer(CRC)screening is a fundamental tool in the prevention and early detection of one of the most prevalent and lethal *** the years,screening,particularly in those settings where it is well organized,has succeeded in reducing the incidence of colon and rectal cancer and improving the prognosis related to *** considerable advancements in screening technologies and strategies,the effectiveness of CRC screening programs remains less than *** paper examined the multifaceted reasons behind the persistent lack of effect-iveness in CRC screening *** a critical analysis of current methodologies,technological limitations,patient-related factors,and systemic challenges,we elucidated the complex interplay that hampers the successful reduction of CRC morbidity and mortality *** acknowledging the ad-vancements that have improved aspects of screening,we emphasized the necessity of addressing the identified barriers *** study aimed to raise awareness of how important CRC screening is in reducing costs for this *** and early diagnosis are not only important in improving the prognosis of patients with CRC but can lead to an important reduction in the cost of treating a disease that is often diagnosed at an advanced *** more sooner can mean saving money later.

关键词： Colorectal cancer Colorectal cancer screening Colorectal screening test Colon and rectal cancer

Pain in chronic pancreatitis:What can we do today?

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World Journal of Methodology 2024年第3期14卷 30-39页

作者： Margherita Binetti Valeria tonini Department of Medical and surgical science University of BolognaAlma mater StudiorumBologna 40138Italy

The aim of this study is to illustrate the complexity of pain management in chronic pancreatitis(CP).In this context,pain represents the most common and debilitating symptom,and it deeply affects patient’s quality of *** rating scales(unidimensional,bidimensional and multidimensional)have been proposed to quantify CP ***,it represents the result of complex mechanisms,involving genetic,neuropathic and neurogenic *** all these aspects,the treatment should be discussed in a multidisciplinary setting and it should be approached in a stepwise ***,a lifestyle change is recommended and nonsteroidal anti-inflammatory drugs represent the gold standard among medical treatments for CP *** second step,after medical approach,is endoscopic therapy,especially for complicated *** case of failure,tailored surgery represents the third step and decompressive or resection procedures can be *** conclusion,CP pain’s management is challenging considering all these complex aspects and the lack of international protocols.

关键词： Chronic pancreatitis Pain Multifactorial mechanism stepwise approach Endoscopic treatment Early surgery

Pancreatic cancer in 2021:What you need to know to win

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World Journal of Gastroenterology 2021年第35期27卷 5851-5889页

作者： Valeria tonini Manuel Zanni Department of Medical sciences and surgery University of Bologna-Emergency Surgery UnitIRCCS Sant’Orsola HospitalBologna 40121Italy University of Bologna Emergency Surgery UnitIRCCS Sant'Orsola HospitalBologna 40121Italy

Pancreatic cancer is one of the solid tumors with the worst ***-year survival rate is less than 10%.surgical resection is the only potentially curative treatment,but the tumor is often diagnosed at an advanced stage of the disease and surgery could be performed in a very limited number of ***,surgery is still associated with high post-operative morbidity,while other therapies still offer very disappointing *** article reviews every aspect of pancreatic cancer,focusing on the elements that can improve *** was written with the aim of describing everything you need to know in 2021 in order to face this difficult challenge.

关键词： Pancreatic cancer treatment Advanced pancreatic cancer Metastatic pancreatic cancer Pancreatic cancer surgery Pancreatic cancer chemotherapy Pancreatic cancer screening

Early diagnosis of pancreatic cancer:What strategies to avoid a foretold catastrophe

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World Journal of Gastroenterology 2022年第31期28卷 4235-4248页

作者： Valeria tonini Manuel Zanni Department of Medical and surgical sciences University of BolognaBologna 40138Italy

While great strides in improving survival rates have been made for most cancers in recent years,pancreatic ductal adenocarcinoma(PDAC)remains one of the solid tumors with the worst *** mortality often overlaps with *** resection is the only potentially curative treatment,but it can be performed in a very limited number of *** order to improve the prognosis of PDAC,there are ideally two possible ways:the discovery of new strategies or drugs that will make it possible to treat the tumor more successfully or an earlier diagnosis that will allow patients to be operated on at a less advanced *** aim of this review was to summarize all the possible strategies available today for the early diagnosis of PDAC and the paths that research needs to take to make this goal ever *** the most recent studies on risk factors and screening modalities,new laboratory tests including liquid biopsy,new imaging methods and possible applications of artificial intelligence and machine learning were reviewed and commented ***,in 2022 the results for this type of cancer still remain discouraging,while a catastrophic increase in cases is expected in the coming *** article was also written with the aim of highlighting the urgency of devoting more attention and resources to this pathology in order to reach a solution that seems more and more unreachable every day.

关键词： Pancreatic cancer Pancreatic ductal adenocarcinoma Early diagnosis Liquid biopsy Pancreatic cancer biomarkers Artificial intelligence Pancreatic cancer screening

Impact of anastomotic leakage on long-term prognosis after colorectal cancer surgery

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World Journal of Gastrointestinal surgery 2023年第5期15卷 745-756页

作者： Valeria tonini Manuel Zanni Department of Medical and surgical sciences University of BolognaBologna 40138BolognaItaly

Colorectal cancer(CRC)is one of the most common malignancies in the *** significant improvements in surgical technique,postoperative complications still occur in a fair percentage of patients undergoing colorectal *** most feared complication is anastomotic *** negatively affects shortterm prognosis,with increased post-operative morbidity and mortality,higher hospitalization time and ***,it may require further surgery with the creation of a permanent or temporary *** there is no doubt about the negative impact of anastomotic dehiscence on the short-term prognosis of patients operated on for CRC,still under discussion is its impact on the long-term *** authors have described an association between leakage and reduced overall survival,disease-free survival,and increased recurrence,while other Authors have found no real impact of dehiscence on long term *** purpose of this paper is to review all the literature about the impact of anastomotic dehiscence on long-term prognosis after CRC *** main risk factors of leakage and early detection markers are also summarized.

关键词： Anastomotic leakage Colorectal surgery Colon cancer Rectal cancer Long term prognosis Long term survival

Phenotypical statin-associated immune-mediated necrotizing myositis with histological features of inclusion body myositis

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Rheumatology & Autoimmunity 2023年第1期3卷 50-55页

作者： Nicole Daver sara tonini Overlook Medical Center Institute for Rheumatic and Autoimmune DiseasesAtlantic Health SystemsSummitNew JerseyUSA

Introduction:statin-associated immune-mediated necrotizing myositis(IMNM)is a rare but distinct idiopathic inflammatory myopathy(IIM)that requires early recognition and intervention to prevent irreversible muscle *** is typically characterized by active statin use,elevated creatinine kinase(CK)levels,proximal muscle weakness,and at times,a positive 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase(HMGCR)*** includes immediate discontinuation of the statin and may include corticosteroids,intravenous immunoglobulin(IVIG),and/or immunosuppressive *** body myositis(IBM),another distinct IIM,also presents with elevated CK levels but with insidious onset of distal upper and proximal lower extremity weakness and is typically refractory to *** Description:A 64-year-old female patient presented with proximal muscle weakness,elevated CK levels,and a positive HMGCR antibody in the setting of statin use with muscle pathology suggestive of both statinassociated IMNM and *** responded to subcutaneous methotrexate and a slow prednisone taper over several months,however,will require close monitoring for symptoms associated with either ***:In conclusion,we report a case of muscle weakness with muscle pathology demonstrating both statin-associated IMNM and *** case highlights the importance of understanding the clinical and pathological features of statin-associated IMNM and IBM.

关键词： 3-hydroxy-3-methyl-glutaryl-coenzympe A reductase antibody idiopathic inflammatory myopathy immune-mediated necrotizing myositis inclusion body myositis statin-associated myositis

Target therapy in gastrointestinal tract sarcoma:What is new?

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World Journal of Gastrointestinal Oncology 2010年第1期2卷 1-4页

作者： Bruno Vincenzi Anna Maria Frezza Daniele santini Giuseppe tonini Department of Medical Oncology University Campus Bio-MedicoVia Alvaro del Portillo 200

soft tissue sarcoma are rare tumors arising mostly from embryonic mesoderm, that can affect almost any part of the human body, including the gastrointestinal tract. The prognosis associated with soft tissue sarcoma is still poor, mainly because of the low efficacy of traditional approaches based on surgery and chemotherapy. As a result of genetic and molecular analysis, several new target therapies have been developed, leading to a significant improvement in the survival of patients affected by advanced disease. In this review we aim to explore the therapeutic potential and benefit of target therapy in the management of gastrointestinal soft tissue sarcoma and the possible complications or pitfalls of such an approach.

关键词： soft tissue sarcoma Target therapy Angiogenesis

Liver involvement in the course of thymoma-associated multiorgan autoimmunity:The first histological description

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Hepatobiliary & Pancreatic Diseases International 2022年第1期21卷 86-89页

作者： Fabrizio Citarella Umberto Vespasiani-Gentilucci Anna Crescenzi Antonella Bianchi Vladimir Virzì Giuseppe tonini Department of Medical Oncology Policlinico Universitario Campus Bio-Medicovia Alvaro del PortilloRome 00128Italy Area of Internal Medicine Unit of HepatologyPoliclinico Universitario Campus Bio-Medicovia Alvaro del PortilloRome 00128Italy Unit of Pathology Policlinico Universitario Campus Bio-Medicovia Alvaro del PortilloRome 00128Italy

To the Editor:Thymoma-associated multiorgan autoimmunity(TAMA)is a rare paraneoplastic syndrome described in patients with thymoma and characterized by multiorgan failure and graft-versus-host dis-ease(GVHD)like pathology affecting the skin,the gastrointestinal tract,and the *** date,only 21 cases are reported in liter-ature[1],with some patients presenting gastrointestinal and hep-atic manifestations,mainly colitis,diarrhea,and abnormal liver en-zymes,but the hepatic involvement has not been histologically characterized yet.

关键词： involvement gastrointestinal diarrhea

Ovarian cancer standard of care: are there real alternatives?

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Chinese Journal of Cancer 2015年第1期34卷 17-27页

作者： Chiara Della Pepa Giuseppe tonini Carmela Pisano Marilena Di Napoli sabrina Chiara Cecere Rosa Tambaro Gaetano Facchini sando Pignata Department of Medical Oncology Campus BioMedico University of RomeVia Alvaro Del Portillo200Rome 00128Italy Department of Urology and Gynecology Istituto Nazionale Tumori Fondazione Pascale-Istituto Di Ricovero E Cura A Carattere ScientificoVia Mariano Semmola52Naples 80131Italy

Ovarian cancer remains a major issue for gynecological oncologists, and most patients are diagnosed when the disease is already advanced with a poor chance of survival. Debulking surgery followed by platinum-taxane chemotherapy is the current standard of care, but based on several different strategies currently under evaluation, some encouraging data have been published in the last 4 to 5 years. This review provides a state-of-the-art overview of the available alternatives to conventional treatment and the most promising new combinations. For example, neoadjuvant chemotherapy does not seem to be inferior to primary debulking. Despite its outcome improvements, intraperitoneal chemotherapy struggles for acceptance due to the heavy toxicity. Dose-dense chemotherapy, after showing an impressive efficacy in Asian populations, has not produced equal results in a European cohort, and the results of alternative platinum doublets are not superior to those of carboplatin and paclitaxel. In this setting, adherence to a maintenance therapy after first-line treatment and multiple(primarily antiangiogenic) agents appears to be effective. Although many questions, including the duration of maintenance treatment and the use of bevacizumab beyond progression, remain unanswered, new biologic agents, such as poly(ADP-ribose) polymerase(PARP) inhibitors, nintedanib, and mitogen-activated protein/extracellular signal-regulated kinase(MEK) inhibitors, have emerged as potential therapeutic options in the very near future. Based on the multiplicity of available strategies, the histological and molecular features of the tumor, in addition to patient's clinical condition and disease state, continue to gain importance in guiding treatment choices.

关键词：卵巢癌标准护理治疗方案抗血管生成丝裂原活化持续时间生物制剂