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1. TACE versus TARE for patients with hepatocellular carcinoma: Overall and individual patient level meta analysis

Author

Andrew M. Brown, Ihab Kassab, Marco Massani, Whitney Townsend, Amit G. Singal, Cigdem Soydal, Laura Moreno‐Luna, Lewis R. Roberts, Vincent L. Chen, and Neehar D. Parikh

Subjects
HCC, locoregional therapy, TACE, Y‐90, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Abstract Background Transarterial radioembolization (TARE) is increasingly used as an alternative to transarterial chemoembolization (TACE) for the treatment of hepatocellular carcinoma (HCC). We aimed to perform an overall and individual patient data (IPD) meta‐analysis of studies comparing TACE and TARE. Methods We performed a systematic literature search using pre‐specified keywords with the aid of an informationist for articles from inception to 3/2020. The primary endpoint was overall survival (OS), and the secondary endpoint was time to progression (TTP). Results Seventeen studies met inclusion criteria with 2465 unique patients, with one randomized trial, 4 prospective studies and 12 retrospective studies. Barcelona Clinic Liver Cancer (BCLC) stage B (42.8%) was the most common stage followed by BCLC A (30.3%) and BCLC C (29.0%). There was no difference in OS between the two modalities (−0.55 months, 95% CI −1.95 to 3.05). In three studies with available TTP data, TARE resulted in a longer TTP than TACE (mean TTP 17.5 vs. 9.8 months; mean TTP difference 4.8 months, 95% CI 1.3–8.3 months). IPD‐level meta‐analysis of 311 patients from three studies showed no difference in overall OS between the two modalities including among subgroups stratified by tumor stage and liver function. Limitations of the current literature include inconsistent length of follow‐up, inconsistency in response criteria, and safety reporting. Conclusions Current data suggest TARE provides significantly longer TTP than TACE, although the two treatments do not significantly differ in terms of OS. Given limitations of the current data, there is rationale for prospective studies comparing these modalities.

Published
2023
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2. The ChoCO-W prospective observational global study: Does COVID-19 increase gangrenous cholecystitis?

Author

Belinda De Simone, Fikri M. Abu-Zidan, Elie Chouillard, Salomone Di Saverio, Massimo Sartelli, Mauro Podda, Carlos Augusto Gomes, Ernest E. Moore, Susan J. Moug, Luca Ansaloni, Yoram Kluger, Federico Coccolini, Aitor Landaluce-Olavarria, Begoña Estraviz-Mateos, Ana Uriguen-Etxeberria, Alessio Giordano, Alfonso Palmieri Luna, Luz Adriana Hernández Amín, Adriana María Palmieri Hernández, Amanda Shabana, Zakaria Andee Dzulkarnaen, Muhammad Asyraf Othman, Mohamad Ikhwan Sani, Andrea Balla, Rosa Scaramuzzo, Pasquale Lepiane, Andrea Bottari, Fabio Staderini, Fabio Cianchi, Andrea Cavallaro, Antonio Zanghì, Alessandro Cappellani, Roberto Campagnacci, Angela Maurizi, Mario Martinotti, Annamaria Ruggieri, Asri Che Jusoh, Karim Abdul Rahman, Anis Suraya M. Zulkifli, Barbara Petronio, Belén Matías-García, Ana Quiroga-Valcárcel, Fernando Mendoza-Moreno, Boyko Atanasov, Fabio Cesare Campanile, Ilaria Vecchioni, Luca Cardinali, Grazia Travaglini, Elisa Sebastiani, Serge Chooklin, Serhii Chuklin, Pasquale Cianci, Enrico Restini, Sabino Capuzzolo, Giuseppe Currò, Rosalinda Filippo, Michele Rispoli, Daniel Aparicio-Sánchez, Virginia Durán Muñóz-Cruzado, Sandra Dios Barbeito, Samir Delibegovic, Amar Kesetovic, Diego Sasia, Felice Borghi, Giorgio Giraudo, Diego Visconti, Emanuele Doria, Mauro Santarelli, Davide Luppi, Stefano Bonilauri, Ugo Grossi, Giacomo Zanus, Alberto Sartori, Giacomo Piatto, Maurizio De Luca, Domenico Vita, Luigi Conti, Patrizio Capelli, Gaetano Maria Cattaneo, Athanasios Marinis, Styliani-Aikaterini Vederaki, Mehmet Bayrak, Yasemin Altıntas, Mustafa Yener Uzunoglu, Iskender Eren Demirbas, Yuksel Altinel, Serhat Meric, Yunus Emre Aktimur, Derya Salim Uymaz, Nail Omarov, Ibrahim Azamat, Eftychios Lostoridis, Eleni-Aikaterini Nagorni, Antonio Pujante, Gabriele Anania, Cristina Bombardini, Francesco Bagolini, Emre Gonullu, Baris Mantoglu, Recayi Capoglu, Stefano Cappato, Elena Muzio, Elif Colak, Suleyman Polat, Zehra Alan Koylu, Fatih Altintoprak, Zülfü Bayhan, Emrah Akin, Enrico Andolfi, Sulce Rezart, Jae Il Kim, Sung Won Jung, Yong Chan Shin, Octavian Enciu, Elena Adelina Toma, Fabio Medas, Gian Luigi Canu, Federico Cappellacci, Fabrizio D’Acapito, Giorgio Ercolani, Leonardo Solaini, Francesco Roscio, Federico Clerici, Roberta Gelmini, Francesco Serra, Elena Giulia Rossi, Francesco Fleres, Guglielmo Clarizia, Alessandro Spolini, Francesco Ferrara, Gabriela Nita, Jlenia Sarnari, Mahir Gachabayov, Abakar Abdullaev, Gaetano Poillucci, Gian Marco Palini, Simone Veneroni, Gianluca Garulli, Micaela Piccoli, Gianmaria Casoni Pattacini, Francesca Pecchini, Giulio Argenio, Mariano Fortunato Armellino, Giuseppe Brisinda, Silvia Tedesco, Pietro Fransvea, Giuseppe Ietto, Caterina Franchi, Giulio Carcano, Gennaro Martines, Giuseppe Trigiante, Giulia Negro, Gustavo Machain Vega, Agustín Rodríguez González, Leonardo Ojeda, Gaetano Piccolo, Andrea Bondurri, Anna Maffioli, Claudio Guerci, Boo Han Sin, Zamri Zuhdi, Azlanudin Azman, Hussam Mousa, Shadi al Bahri, Goran Augustin, Ivan Romic, Trpimir Moric, Ioannis Nikolopoulos, Jacopo Andreuccetti, Giusto Pignata, Rossella D’Alessio, Jakub Kenig, Urszula Skorus, Gustavo Pereira Fraga, Elcio Shiyoiti Hirano, Jackson Vinícius de Lima Bertuol, Arda Isik, Eray Kurnaz, Mohammad Sohail Asghar, Ameer Afzal, Ali Akbar, Taxiarchis Konstantinos Nikolouzakis, Konstantinos Lasithiotakis, Emmanuel Chrysos, Koray Das, Nazmi Özer, Ahmet Seker, Mohamed Ibrahim, Hytham K. S. Hamid, Ahmed Babiker, Konstantinos Bouliaris, George Koukoulis, Chrysoula-Christina Kolla, Andrea Lucchi, Laura Agostinelli, Antonio Taddei, Laura Fortuna, Carlotta Agostini, Leo Licari, Simona Viola, Cosimo Callari, Letizia Laface, Emmanuele Abate, Massimiliano Casati, Alessandro Anastasi, Giuseppe Canonico, Linda Gabellini, Lorenzo Tosi, Anna Guariniello, Federico Zanzi, Lovenish Bains, Larysa Sydorchuk, Oksana Iftoda, Andrii Sydorchuk, Michele Malerba, Federico Costanzo, Raffaele Galleano, Michela Monteleone, Andrea Costanzi, Carlo Riva, Maciej Walędziak, Andrzej Kwiatkowski, Łukasz Czyżykowski, Piotr Major, Marcin Strzałka, Maciej Matyja, Michal Natkaniec, Maria Rosaria Valenti, Maria Domenica Pia Di Vita, Maria Sotiropoulou, Stylianos Kapiris, Damien Massalou, Massimiliano Veroux, Alessio Volpicelli, Rossella Gioco, Matteo Uccelli, Marta Bonaldi, Stefano Olmi, Matteo Nardi, Giada Livadoti, Cristian Mesina, Theodor Viorel Dumitrescu, Mihai Calin Ciorbagiu, Michele Ammendola, Giorgio Ammerata, Roberto Romano, Mihail Slavchev, Evangelos P. Misiakos, Emmanouil Pikoulis, Dimitrios Papaconstantinou, Mohamed Elbahnasawy, Sherief Abdel-elsalam, Daniel M. Felsenreich, Julia Jedamzik, Nikolaos V. Michalopoulos, Theodoros A. Sidiropoulos, Maria Papadoliopoulou, Nicola Cillara, Antonello Deserra, Alessandro Cannavera, Ionuţ Negoi, Dimitrios Schizas, Athanasios Syllaios, Ilias Vagios, Stavros Gourgiotis, Nick Dai, Rekha Gurung, Marcus Norrey, Antonio Pesce, Carlo Vittorio Feo, Nicolo’ Fabbri, Nikolaos Machairas, Panagiotis Dorovinis, Myrto D. Keramida, Francesk Mulita, Georgios Ioannis Verras, Michail Vailas, Omer Yalkin, Nidal Iflazoglu, Direnc Yigit, Oussama Baraket, Karim Ayed, Mohamed hedi Ghalloussi, Parmenion Patias, Georgios Ntokos, Razrim Rahim, Miklosh Bala, Asaf Kedar, Robert G. Sawyer, Anna Trinh, Kelsey Miller, Ruslan Sydorchuk, Ruslan Knut, Oleksandr Plehutsa, Rumeysa Kevser Liman, Zeynep Ozkan, Saleh Abdel Kader, Sanjay Gupta, Monika Gureh, Sara Saeidi, Mohsen Aliakbarian, Amin Dalili, Tomohisa Shoko, Mitsuaki Kojima, Raira Nakamoto, Semra Demirli Atici, Gizem Kilinc Tuncer, Tayfun Kaya, Spiros G. Delis, Stefano Rossi, Biagio Picardi, Simone Rossi del Monte, Tania Triantafyllou, Dimitrios Theodorou, Tadeja Pintar, Jure Salobir, Dimitrios K. Manatakis, Nikolaos Tasis, Vasileios Acheimastos, Orestis Ioannidis, Lydia Loutzidou, Savvas Symeonidis, Tiago Correia de Sá, Mónica Rocha, Tommaso Guagni, Desiré Pantalone, Gherardo Maltinti, Vladimir Khokha, Wafaa Abdel-elsalam, Basma Ghoneim, José Antonio López-Ruiz, Yasin Kara, Syaza Zainudin, Firdaus Hayati, Nornazirah Azizan, Victoria Tan Phooi Khei, Rebecca Choy Xin Yi, Harivinthan Sellappan, Zaza Demetrashvili, Nika Lekiashvili, Ana Tvaladze, Caterina Froiio, Daniele Bernardi, Luigi Bonavina, Angeles Gil-Olarte, Sebastiano Grassia, Estela Romero-Vargas, Francesco Bianco, Andrew A. Gumbs, Agron Dogjani, Ferdinando Agresta, Andrey Litvin, Zsolt J. Balogh, George Gendrikson, Costanza Martino, Dimitrios Damaskos, Nikolaos Pararas, Andrew Kirkpatrick, Mikhail Kurtenkov, Felipe Couto Gomes, Adolfo Pisanu, Oreste Nardello, Fabrizio Gambarini, Hager Aref, Nicola de’ Angelis, Vanni Agnoletti, Antonio Biondi, Marco Vacante, Giulia Griggio, Roberta Tutino, Marco Massani, Giovanni Bisetto, Savino Occhionorelli, Dario Andreotti, Domenico Lacavalla, Walter L. Biffl, and Fausto Catena

Subjects
Acute cholecystitis, Cholecystectomy, Gangrene, COVID-19, SARS-CoV-2, Laparoscopy, Surgery, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Background The incidence of the highly morbid and potentially lethal gangrenous cholecystitis was reportedly increased during the COVID-19 pandemic. The aim of the ChoCO-W study was to compare the clinical findings and outcomes of acute cholecystitis in patients who had COVID-19 disease with those who did not. Methods Data were prospectively collected over 6 months (October 1, 2020, to April 30, 2021) with 1-month follow-up. In October 2020, Delta variant of SARS CoV-2 was isolated for the first time. Demographic and clinical data were analyzed and reported according to the STROBE guidelines. Baseline characteristics and clinical outcomes of patients who had COVID-19 were compared with those who did not. Results A total of 2893 patients, from 42 countries, 218 centers, involved, with a median age of 61.3 (SD: 17.39) years were prospectively enrolled in this study; 1481 (51%) patients were males. One hundred and eighty (6.9%) patients were COVID-19 positive, while 2412 (93.1%) were negative. Concomitant preexisting diseases including cardiovascular diseases (p

Published
2022
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4. Which Role for Hyperbaric Oxygen Therapy in the Treatment of Fournier's Gangrene? A Retrospective Study

Author

Roberta Tutino, Francesco Colli, Giovanna Rizzo, Sebastiano Bonventre, Gregorio Scerrino, Giuseppe Salamone, Giuseppina Melfa, Giuseppina Orlando, Gaetano Gallo, Mauro Santarelli, Marco Massani, and Gianfranco Cocorullo

Subjects
Fournier's gangrene, hyperbaric therapy, fasciitis, perineum, necrosis, Surgery, RD1-811
Abstract

PurposeIn Fournier's gangrene, surgical debridement plus antimicrobial therapy is the mainstay of treatment but can cause a great loss of tissue. The disease needs long hospital stays and, despite all, has a high mortality rate. The aim of our study is to investigate if factors, such as hyperbaric therapy, can offer an improvement in prognosis.MethodsWe retrospectively evaluated data on 23 consecutive patients admitted for Fournier's gangrene at the University Hospital “P. Giaccone” of Palermo from 2011 to 2018. Factors related to length of hospital stay and mortality were examined.ResultsMortality occurred in three patients (13.1%) and was correlated with the delay between admission and surgical operation [1.7 days (C.I. 0.9–3.5) in patients who survived vs. 6.8 days (C.I. 3.5–13.4) in patients who died (p = 0.001)]. Hospital stay was longer in patients treated with hyperbaric oxygen therapy [mean 11 (C.I. 0.50–21.89) vs. mean 25 (C.I. 18.02–31.97); p = 0.02] without an improvement in survival (p = 1.00).ConclusionOur study proves that a delay in the treatment of patients with Fournier's gangrene has a correlation with the mortality rate, while the use of hyperbaric oxygen therapy seems to not improve the survival rate, increasing the hospital stay instead.

Published
2022
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5. A Stepwise Proposal for Low-Grade Hemorrhoidal Disease: Injection Sclerotherapy as a First-Line Treatment and Rubber Band Ligation for Persistent Relapses

Author

Roberta Tutino, Marco Massani, Leonel Jospin Kamdem Mambou, Paolina Venturelli, Immacolata Della Valle, Giuseppina Melfa, Matilde Micheli, Gaia Russo, Gregorio Scerrino, Sebastiano Bonventre, and Gianfranco Cocorullo

Subjects
hemorrhoids, hemorrhoid ligation, hemorrhoid sclerotherapy, review, outpatient treatment, hemorrhoid complications, Surgery, RD1-811
Abstract

Outpatient treatments are actually the techniques of choice in the management of low-grade hemorrhoidal disease. Among these, rubber band ligation (RBL) and injection sclerotherapy (IS) are the most frequently performed. Both techniques are used, without one having been determined to be superior over the other. We analyzed the studies that compare these two techniques in terms of efficacy and safety in order to offer a proposal for treatment choice. RBL seems to be most efficient in terms of symptom resolution for second-degree hemorrhoidal disease and equal or superior for treatment of third-degree disease. However, IS offers lower rates of severe post-operative pain and minor complications. Since outpatient treatments are offered to patients as painless options that allow a prompt recovery, we propose a stepwise protocol using 3% polidocanol or aluminum potassium sulfate and tannic acid IS as the first treatment option, as it has less complications, followed by RBL in cases of relapse.

Published
2022
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6. More Favorable Short and Long-Term Outcomes for Screen-Detected Colorectal Cancer Patients

Author

Gaya Spolverato, Giulia Capelli, Jessica Battagello, Andrea Barina, Susi Nordio, Elena Finotti, Isabella Mondi, Corrado Da Lio, Emilio Morpurgo, Josè Adolfo Navarro, Fabio Ceccato, Alessandro Perin, Corrado Pedrazzani, Giulia Turri, Giacomo Zanus, Michela Campi, Marco Massani, Adriana Di Giacomo, Daniela Prando, Ferdinando Agresta, Salvatore Pucciarelli, Manuel Zorzi, and Massimo Rugge

Subjects
colorectal cancer, surgery, screening, colorectal cancer outcomes, disease free survival, overall survival, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

BackgroundScreening significantly reduces mortality from colorectal cancer (CRC). Screen detected (SD) tumors associate with better prognosis, even at later stage, compared to non-screen detected (NSD) tumors. We aimed to evaluate the association between diagnostic modality (SD vs. NSD) and short- and long-term outcomes of patients undergoing surgery for CRC.Materials and MethodsThis retrospective cohort study involved patients aged 50–69 years, residing in Veneto, Italy, who underwent curative-intent surgery for CRC between 2006 and 2018. The clinical multi-institutional dataset was linked with the screening dataset in order to define diagnostic modality (SD vs. NSD). Short- and long-term outcomes were compared between the two groups.ResultsOf 1,360 patients included, 464 were SD (34.1%) and 896 NSD (65.9%). Patients with a SD CRC were more likely to have less comorbidities (p = 0.013), lower ASA score (p = 0.001), tumors located in the proximal colon (p = 0.0018) and earlier stage at diagnosis (p < 0.0001). NSD patients were found to have more aggressive disease at diagnosis, higher complication rate and higher readmission rate due to surgical complications (all p < 0.05). NSD patients had a significantly lower Disease Free Survival and Overall Survival (all p < 0.0001), even after adjusting by demographic, clinic-pathological, tumor, and treatment characteristics.ConclusionsSD tumors were associated with better long-term outcomes, even after multiple adjustments. Our results confirm the advantages for the target population to participate in the screening programs and comply with their therapeutic pathways.

Published
2021
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7. Colorectal polypoid lesions and expression of vascular endothelial growth factor in a consecutive series of endoscopic and surgical patients

Author

Cesare Ruffolo, Luisa Toffolatti, Fabio Canal, Andromachi Kotsafti, Giulia Pagura, Anna Pozza, Marta Campo Dell’Orto, Francesco Ferrara, Marco Massani, Angelo P Dei Tos, Carlo Castoro, Nicolò Bassi, and Marco Scarpa

Subjects
Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Colorectal cancer incidence in patients undergoing screening protocols is decreasing because of the higher rate of discovered preneoplastic colonic lesions; however, adenomatous polyps may not always be removable endoscopically and surgery may still be necessary. The aim of this study was to assess the vascular endothelial growth factor expression in the different steps of colorectal carcinogenesis to explore its potential role as a marker of malignancy in polypoid lesions. A total of 92 subjects with colonic adenoma or cancer who underwent screening colonoscopy or surgery were prospectively enrolled. Real-time reverse transcription polymerase chain reaction for VEGF-A messenger RNA expression and immunohistochemistry for VEGF-A were performed. Immunoassays for VEGF-A, VEGF-C, VEGFR-1, VEGFR-2, and VEGFR-3 were also performed. Non-parametric statistics, receiver operating characteristic curve analysis, and logistic multiple regression analysis were used. VEGF-A messenger RNA expression was higher in patients with high-grade dysplasia or colorectal cancer than in those with low-grade dysplasia adenomas (p = 0.01). At immunohistochemistry, VEGF-A expression was significantly higher in colorectal cancer patients compared to dysplastic adenomas (p

Published
2017
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