31 results on '"VICIDOMINI, Giovanni"'
Search Results
2. The texture analysis as a predictive method in the assessment of the cytological specimen of CT-guided FNAC of the lung cancer
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Reginelli, Alfonso, Belfiore, Maria Paola, Monti, Riccardo, Cozzolino, Immacolata, Costa, Matilde, Vicidomini, Giovanni, Grassi, Roberta, Morgillo, Floriana, Urraro, Fabrizio, Nardone, Valerio, and Cappabianca, Salvatore
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- 2020
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3. Antitumor activity of dual blockade of PD-L1 and MEK in NSCLC patients derived three-dimensional spheroid cultures
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Della Corte, Carminia Maria, Barra, Giusi, Ciaramella, Vincenza, Di Liello, Raimondo, Vicidomini, Giovanni, Zappavigna, Silvia, Luce, Amalia, Abate, Marianna, Fiorelli, Alfonso, Caraglia, Michele, Santini, Mario, Martinelli, Erika, Troiani, Teresa, Ciardiello, Fortunato, and Morgillo, Floriana
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- 2019
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4. Blue Lung: A Complication of Methylene Blue Paravertebral Block During Video-Assisted Thoracoscopic Surgery Lobectomy.
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Leonardi, Beatrice, Natale, Giovanni, Leone, Francesco, Rainone, Anna, Puca, Maria Antonietta, Grande, Mario, Messina, Gaetana, Vicidomini, Giovanni, and Fiorelli, Alfonso
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- 2023
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5. Outcomes of Thoracoscopic Lobectomy after Recent COVID-19 Infection.
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Leonardi, Beatrice, Sagnelli, Caterina, Natale, Giovanni, Leone, Francesco, Noro, Antonio, Opromolla, Giorgia, Capaccio, Damiano, Ferrigno, Francesco, Vicidomini, Giovanni, Messina, Gaetana, Di Crescenzo, Rosa Maria, Sica, Antonello, and Fiorelli, Alfonso
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COVID-19 ,COVID-19 pandemic ,LENGTH of stay in hospitals ,LUNG cancer ,SURGICAL complications - Abstract
Background: The COVID-19 outbreak had a massive impact on lung cancer patients with the rise in the incidence and mortality of lung cancer. Methods: We evaluated whether a recent COVID-19 infection affected the outcome of patients undergoing thoracoscopic lobectomy for lung cancer using a retrospective observational mono-centric study conducted between January 2020 and August 2022. Postoperative complications and 90-day mortality were reported. We compared lung cancer patients with a recent history of COVID-19 infection prior to thoracoscopic lobectomy to those without recent COVID-19 infection. Univariable and multivariable analyses were performed. Results: One hundred and fifty-three consecutive lung cancer patients were enrolled. Of these 30 (19%), had a history of recent COVID-19 infection prior to surgery. COVID-19 was not associated with a higher complication rate or 90-day mortality. Patients with recent COVID-19 infection had more frequent pleural adhesions (p = 0.006). There were no differences between groups regarding postoperative complications, conversion, drain removal time, total drainage output, and length of hospital stay. Conclusions: COVID-19 infection did not affect the outcomes of thoracoscopic lobectomy for lung cancer. The treatment of these patients should not be delayed in case of recent COVID-19 infection and should not differ from that of the general population. [ABSTRACT FROM AUTHOR]
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- 2023
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6. One‐lung ventilation in obese patients undergoing thoracoscopic lobectomy for lung cancer.
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Leonardi, Beatrice, Forte, Stefano, Natale, Giovanni, Messina, Gaetana, Rainone, Anna, Opromolla, Giorgia, Puca, Maria Antonietta, Grande, Mario, Martone, Mario, Leone, Francesco, Fiorito, Roberta, Molino, Francesca, Liguori, Giovanni, Russo, Fara, Ferraro, Fausto, Pace, Maria Caterina, Molino, Antonio, Ferrante, Luigi, Forte, Mauro, and Vicidomini, Giovanni
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OBESITY ,PERIOPERATIVE care ,THORACIC surgery ,LUNG tumors ,RETROSPECTIVE studies ,ARTIFICIAL respiration ,TREATMENT effectiveness ,COMPARATIVE studies ,POSTOPERATIVE period ,DESCRIPTIVE statistics ,PNEUMONECTOMY ,PATIENT safety - Abstract
Background: We evaluated the safety and feasibility of one‐lung ventilation in obese patients undergoing thoracoscopic lobectomy and whether obesity affected peri‐ and postoperative outcomes. Methods: This was a retrospective single center study including consecutive patients undergoing thoracoscopic lobectomy between October 2019 and February 2022. Obese patients were statistically compared to a control group to evaluate any differences in relation to one‐lung ventilation and peri‐ and postoperative outcomes. Results: Our study population included 111 patients; of these, 26 (23%) were included in the obese group, while 85 (77%) were included within the nonobese group. To obtain one‐lung ventilation in nonobese patients, a double‐lumen tube was more frequently used than a single‐lumen tube with bronchial blocker (61% vs. 39%; p = 0.02), while in obese patients a single‐lumen tube with bronchial blocker was used more than a double‐lumen tube (81% vs. 19%, p = 0.001). Intergroup comparison showed that a double‐lumen tube was the preferred method in nonobese patients, while a single‐lumen tube with bronchial blockers was the strategy of choice in obese patients (p = 0.0002). Intubation time was longer in the obese group than in the nonobese group (94.0 ± 6.1 vs. 85.0 ± 7.0 s; p = 0.0004) and failure rate of first attempt at intubation was higher in the obese group (23% vs. 5%; p = 0.01). Obesity was not associated with increased intra‐, peri‐ and postoperative complications and/or mortality. Conclusions: One‐lung ventilation is a feasible and safe procedure also in obese patients and obesity did not negatively affect peri‐ and postoperative outcomes after lung resection. [ABSTRACT FROM AUTHOR]
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- 2023
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7. Intraoperative ultrasound: "Alternative eye" in lymph nodal dissection in non‐small cell lung cancer.
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Messina, Gaetana, Bove, Mary, Noro, Antonio, Opromolla, Giorgia, Natale, Giovanni, Mirra, Rosa, Capasso, Francesca, Pica, Davide Gerardo, Di Filippo, Vincenzo, Pirozzi, Mario, Caterino, Marianna, Facchini, Sergio, Zotta, Alessia, Polito, Rita, Vicidomini, Giovanni, Santini, Mario, Fiorelli, Alfonso, Ciardiello, Fortunato, and Fasano, Morena
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LUNG cancer ,INTRAOPERATIVE care ,METASTASIS ,LYMPH nodes ,VIDEO-assisted thoracic surgery ,INTRAOPERATIVE monitoring - Abstract
Introduction: Staging of the mediastinum lymph nodes involvement in patients with non–small cell lung cancer (NSCLC) is an important prognostic factor determining the most appropriate multimodality treatment plan. The objective of this study is to assess ultrasound characteristics of mediastinal lymph nodes metastasis and effectiveness of intraoperative ultrasound‐guided mediastinal nodal dissection in patients with resected NSCLC. Materials and Methods: All patients undergoing video‐assisted thoracoscopic surgery lobectomy and pulmonary lymphadenectomy from November 2020 to March 2022 at the thoracic surgery department of the Vanvitelli University of Naples underwent intraoperative ultrasound‐guided mediastinal lymph nodal dissection. Results: This study evaluates whether individual B‐mode features and a compounding thereof can be used to accurately and reproducibly predict lymph node malignancy. Discussion: Intraoperative ultrasound, during systematic mediastinal lymph node dissection, is helpful in preventing lesion to mediastinal structures. Pathological nodal sonographic characteristics are round shape, short‐axis diameter, echogenicity, margin, the absence or presence of coagulation necrosis sign, and the absence or presence of central hilar structure, increased color Doppler flow, the absence or presence of calcification, and nodal conglomeration. Operating time was not substantially prolonged. The procedure is simple, safe and highly accurate. Conclusions: Ultrasonic techniques allow surgeons to detect the relationship between lymph nodes and surrounding large blood vessels during biopsy, improving the safety and simplicity of the operation, increasing the number of harvested lymph nodes, and reducing the risk of intraoperative injury; it is a fast, easily reproducible, and inexpensive method. [ABSTRACT FROM AUTHOR]
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- 2022
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8. Left upper lobectomy in a patient with congenital pericardial defect.
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Fiorelli, Alfonso, Natale, Giovanni, Filippo, Vincenzo Di, Opromolla, Giorgia, Vicidomini, Giovanni, and Santini, Mario
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Congenital pericardial defect is an uncommon anomaly due to the congenital absence of the pericardium. In this case, it was associated with diaphragmatic hernia and incidentally discovered during thoracoscopic left upper lobectomy for lung cancer. The thoracoscopic dissection of the hilar structures was complicated with arrhythmia and hypotension. Thus, we converted thoracoscopy to thoracotomy, and the lobectomy was successfully performed. The pericardial defect and diaphragmatic hernia were not repaired, but the vessels and bronchial stump were covered to avoid heart injury. Postoperative course was unremarkable and at six-month follow-up patient did not have any problems. [ABSTRACT FROM AUTHOR]
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- 2022
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9. Lung adenocarcinoma and its thyroid metastasis characterized on fine-needle aspirates by cytomorphology, immunocytochemistry, and next-generation sequencing
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BELLEVICINE, CLAUDIO, VIGLIAR, ELENA, MALAPELLE, UMBERTO, Carelli, Emanuele, Fiorelli, Alfonso, Vicidomini, Giovanni, Cappabianca, Salvatore, Santini, Mario, TRONCONE, GIANCARLO, Bellevicine, C, Vigliar, E, Malapelle, U, Carelli, E, Fiorelli, A, Vicidomini, G, Cappabianca, S, Santini, M, Troncone, G, Bellevicine, Claudio, Vigliar, Elena, Malapelle, Umberto, Carelli, Emanuele, Fiorelli, Alfonso, Vicidomini, Giovanni, Cappabianca, Salvatore, Santini, Mario, and Troncone, Giancarlo
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Male ,Lung Neoplasms ,Cytodiagnosis ,Biopsy, Fine-Needle ,Thyroid Nuclear Factor 1 ,Thyroid Gland ,Gene Expression ,Adenocarcinoma of Lung ,Adenocarcinoma ,NSCLC ,Proto-Oncogene Proteins p21(ras) ,thyroid metastasis ,Biomarkers, Tumor ,Humans ,Thyroid Neoplasms ,Thyroid Nodule ,metastases ,Lung ,Thyroid ,Lung Cancer ,Carcinoma ,High-Throughput Nucleotide Sequencing ,Nuclear Proteins ,Middle Aged ,PAX8 ,Immunohistochemistry ,Carcinoma, Papillary ,FNA ,Thyroid Cancer, Papillary ,NGS ,Transcription Factors - Abstract
Lung adenocarcinoma and papillary thyroid carcinoma (PTC) share a number of microscopic and immunophenotypical features. Thus, patients presenting with thyroid and lung synchronous neoplasms may be difficult on fine-needle aspiration (FNA) samples to define the site of origin of the malignancy. In the case reported here, inherent to a 57-years-old man presenting with a right lung mass and a large (44 mm) thyroid nodule, an integrated cytological, immunocytochemical and molecular approach enabled to clarify the primary nature of the neoplasm. FNA cytology showed in both sites papillary structures and nuclear changes reminiscent of PTC. The lung origin of the neoplasm was suggested on cell-block immunocytochemistry showing thyroid transcription factor-1 positive and PAX8 and TGB negative neoplastic cells. Next generation sequencing performed on the Ion Torrent platforms by the Ion Ampliseq Colon and Lung Cancer panel showed a similar genomic profile in both neoplastic sites with a concurrent KRAS G12C mutation. An integrated approach on FNA biospecimen is safe, cost effective, and may be coupled effectively with modern ancillary molecular techniques that may be useful, besides their predictive value, as a adjunctive diagnostic tool when the synchronous occurrence of lesions featuring overlapping morphologies challenge the cytopathologist.
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- 2014
10. The Influence of Body Mass Index and Weight Loss on Outcome of Elderly Patients Undergoing Lung Cancer Resection.
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Fiorelli, Alfonso, Vicidomini, Giovanni, Mazzella, Antonio, Messina, Gaetana, Milione, Roberta, Di Crescenzo, Vincenzo Giuseppe, and Santini, Mario
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SURGICAL complications , *BODY mass index , *ONCOLOGIC surgery , *LUNG cancer treatment , *WEIGHT loss , *OLDER patients - Abstract
Background: The aim of the study was to evaluate the influence of nutritional status on outcome of elderly patients resected for lung cancer. Materials and Methods: A total of 117 consecutive patients aged > 70 years undergoing lung cancer resection were enrolled. In addition to routine preoperative evaluations, other variables such as body mass index, weight loss, serum albumin, lymphocytes, and transferrin were counted. According to the body mass index value, patients were divided into Group A (≤ 18.5, underweight) and Group B (> 18.5) and risk factors for morbidity and mortality were analyzed. Results: Group A and Group B counted 21 and 96 patients, respectively. The mean age was 74.9 ± 2.6; body mass index of Group A was significantly lower than that of Group B (16.7 ± 1.3 vs. 23.5 ± 1.7, respectively, p < 0.0001). On multivariate analysis, significant risk factors for complications were pneumonectomy (p = 0.001), stage (p = 0.006), predictive postoperative flow expiratory volume in 1 second (ppoFEV1%) (p = 0.003), and coronary disease (p = 0.04) and significant risk factors for early mortality were pneumonectomy (p = 0.0002), ppoFEV1% (p < 0.0001), BMI (0.02), and weight loss (0.007). The median survival time of Group A and Group B was 41 versus 54 months, respectively (p = 0.1). However, body mass index of less than 18.5 (p = 0.01) and weight loss of > 5% before operation (p = 0.01) were independent risk factors for 1 year mortality. Conclusions: In elderly patients, malnutrition was a significant additional risk factor for early death. Nutritional assessment should be included in the routine preoperative selection. In malnourished patients, nutritional support before and after operation and a careful postdischarge care might be beneficial, but it should be corroborated by further prospective studies. [ABSTRACT FROM AUTHOR]
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- 2014
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11. The effects of lung resection on physiological motor activity of the oesophagus†.
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Fiorelli, Alfonso, Vicidomini, Giovanni, Milione, Roberta, Grassi, Roberto, Rotondo, Antonio, and Santini, Mario
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LUNG cancer treatment , *SURGICAL excision , *ESOPHAGEAL motility , *PNEUMONECTOMY , *ONCOLOGIC surgery - Abstract
OBJECTIVES To assess the modifications of oesophageal function after major lung resection and whether these modifications are correlated with the extent of resection (pneumonectomy vs others). METHODS In the last 5 years, 40 consecutive surgical patients with lung cancer were prospectively enrolled and divided in two groups: Group A (n = 20) patients scheduled for elective pneumonectomy and Group B (n = 20) for more limited resections (lobectomy or bilobectomy). In addition to routine evaluations, all patients underwent preoperative (within 5 days) and postoperative (6 months) oesophageal manometry to assess the lower oesophageal sphincter (LES), the oesophageal body and the upper oesophageal sphincter functions. Symptoms scoring questionnaires were recorded for each patient and the oesophageal dislocation assessed by radiological examinations. RESULTS Thirty-three (15 of Group A and 18 of Group B) patients completed the study. After operation, we found that LES resting pressure was significantly lower in Group A compared with Group B (P = 0.01); conversely, the relaxing pressure resulted as being higher in Group A than in Group B (P = 0.01). In Group A compared with Group B, a significant reduction of amplitude and that of wave duration of oesophageal contractions were seen at the upper (0.0001 and 0.02, respectively), middle (0.0003 and 0.002, respectively) and lower (0.0001 and 0.0004, respectively) oesophageal body. In addition, 12 of 15 (80%) patients of Group A and 3 of 18 (17%) of Group B presented a lack of regular peristaltic movement (P = 0.001). Despite chest CT scan showing a shift of the oesophagus in 11 of 15 (73%) and 2 of 18 (11.1%) patients of Groups A and B (P = 0.001), the oesophagus dislocation resulted ‘severe’ on barium swallow study in only two patients of Group A. The manometric alterations were subclinical; heartburn was recorded in three patients (two of Group A and one of Group B) and epigastric pain in four (two for each group). No other symptoms were observed. CONCLUSIONS Pneumonectomy may cause significant oesophageal motility disorders that are mostly subclinical. Thus, this type of surgery should not be denied to patients if required to treat their cancer. [ABSTRACT FROM AUTHOR]
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- 2013
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12. F-18-2-Fluoro-2-Deoxyglucose Positron Emission Tomography Compared to Technetium-99m Hexakis-2-Methoxyisobutyl Isonitrile Single Photon Emission Chest Tomography in the Diagnosis of Indeterminate Lung Lesions.
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Santini, Mario, Fiorelli, Alfonso, Vicidomini, Giovanni, Laperuta, Paolo, Busiello, Luigi, Rambaldi, Pier Francesco, Mansi, Luigi, and Rotondo, Antonio
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CHI-squared test ,LUNG diseases ,LUNG tumors ,TECHNETIUM ,POSITRON emission tomography ,U-statistics ,DATA analysis ,RECEIVER operating characteristic curves ,DIAGNOSIS ,CLASSIFICATION - Abstract
Background:
18 FDG-PET plays a significant role in diagnosing malignancy of lung lesions but remains an expensive test available at a limited number of sites in Italy. Objective: We prospectively compare the diagnostic accuracy of99m Tc-MIBI- SPECT and18 FDG-PET in patients with indeterminate lung lesions to demonstrate that99m Tc-MIBI-SPECT may be considered as a valid alternative when18 FDG-PET is not available. Methods: 52 patients with indeterminate lung lesion were examined by18 FDG-PET and99m Tc-MIBI-SPECT before surgery. The scintigraphic findings were analyzed visually and semiquantitatively and then correlated to the definitive diagnosis. Results: 38 were malignant lesions while 14 were benign. At visual analysis, the sensitivities of18 FDG-PET and99m Tc-MIBI-SPECT were 92 and 84%, respectively (McNemar test p = 0.4), whereas the specificities were 78.6 and of 93% (p = 1.0), respectively. At semiquantitative analysis,18 FDG-PET showed a sensitivity and specificity of 92 and 71.4%, respectively, while99m Tc-MIBI-SPECT produced a sensitivity and specificity of 86 and 100%, respectively (p = 0.194). For lymph node staging,18 FDG-PET and99m Tc-MIBI-SPECT have a sensitivity and specificity of 88 and 92 of 77 and 100%, respectively. Conclusion:99m Tc-MIBI-SPECT is similar to18 FDG-PET in the detection of lung malignancies and represents an alternative when PET is not available. Yet, the combination of both techniques may improve patient selection for surgery. Copyright © 2010 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]- Published
- 2010
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13. Intraoperative Pleural Lavage: Is It a Valid Prognostic Factor in Lung Cancer?
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Vicidomini, Giovanni, Santini, Mario, Fiorello, Alfonso, Parascandolo, Vincenzo, Calabrò, Barbara, and Pastore, Vincenzo
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LUNG cancer ,CANCER patients ,CANCER prognosis ,CYTOLOGY - Abstract
Background: In patients undergoing lung resection for non-small cell lung cancer (NSCLC), the primary TNM (tumor–regional lymph node–distant metastasis) staging system is the best prognostic factor. However, it is necessary to investigate other factors that could more accurately predict a patient''s prognosis. In this study we evaluated the significance of positive intraoperative pre-resectional lavage in patients with NSCLC. Methods: We enrolled 84 patients (79 men, 5 women) aged between 36 and 81 years (mean age, 64.8 years) undergoing a major lung resection for NSCLC, with no preoperative evidence of pleural effusions. Intraoperatively, the patients were given a pre-resectional pleural lavage with physiologic saline solution. The fluid was aspirated and sent to cytology. Results: Pre-resectional pleural lavage was positive in 19 patients (22.6%). The lavage was positive in 7.3% in patients with early stage I disease (3/41) and 37.2% in patients with stage II/III disease. In the group of 16 patients with chest wall neoplastic involvement (T3), 9 had a positive lavage (56.2%; p = 0.05). No significant correlation was found between positive lavage and nodal status, visceral pleural involvement, or histologic findings. Patients with malignant cells in the pre-resectional lavage had a significantly shorter survival than patients with a negative lavage (p = 0.025). Conclusions: A positive cytology finding of intraoperative pre-resectional pleural lavage could be an important prognostic factor in patients undergoing major lung resection for NSCLC. Patients with a positive lavage should be upstaged. However, larger series are needed to define accurately the role of this technique in early stage lung cancer. [Copyright &y& Elsevier]
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- 2005
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14. One-lung ventilation in obese patients undergoing thoracoscopic lobectomy for lung cancer
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Beatrice Leonardi, Stefano Forte, Giovanni Natale, Gaetana Messina, Anna Rainone, Giorgia Opromolla, Maria Antonietta Puca, Mario Grande, Mario Martone, Francesco Leone, Roberta Fiorito, Francesca Molino, Giovanni Liguori, Fara Russo, Fausto Ferraro, Maria Caterina Pace, Antonio Molino, Luigi Ferrante, Mauro Forte, Giovanni Vicidomini, Alfonso Fiorelli, Leonardi, Beatrice, Forte, Stefano, Natale, Giovanni, Messina, Gaetana, Rainone, Anna, Opromolla, Giorgia, Puca, Maria Antonietta, Grande, Mario, Martone, Mario, Leone, Francesco, Fiorito, Roberta, Molino, Francesca, Liguori, Giovanni, Russo, Fara, Ferraro, Fausto, Pace, Maria Caterina, Molino, Antonio, Ferrante, Luigi, Forte, Mauro, Vicidomini, Giovanni, and Fiorelli, Alfonso
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Pulmonary and Respiratory Medicine ,lobectomy ,lung cancer ,one-lung ventilation ,Oncology ,obese ,thoracoscopy ,General Medicine - Abstract
Background: We evaluated the safety and feasibility of one-lung ventilation in obese patients undergoing thoracoscopic lobectomy and whether obesity affected peri- and postoperative outcomes.Methods: This was a retrospective single center study including consecutive patients undergoing thoracoscopic lobectomy between October 2019 and February 2022. Obese patients were statistically compared to a control group to evaluate any differences in relation to one-lung ventilation and peri- and postoperative outcomes.Results: Our study population included 111 patients; of these, 26 (23%) were included in the obese group, while 85 (77%) were included within the nonobese group. To obtain one-lung ventilation in nonobese patients, a double-lumen tube was more frequently used than a single-lumen tube with bronchial blocker (61% vs. 39%; p = 0.02), while in obese patients a single-lumen tube with bronchial blocker was used more than a double-lumen tube (81% vs. 19%, p = 0.001). Intergroup comparison showed that a double-lumen tube was the preferred method in nonobese patients, while a single-lumen tube with bronchial blockers was the strategy of choice in obese patients (p = 0.0002). Intubation time was longer in the obese group than in the nonobese group (94.0 +/- 6.1 vs. 85.0 +/- 7.0 s; p = 0.0004) and failure rate of first attempt at intubation was higher in the obese group (23% vs. 5%; p = 0.01). Obesity was not associated with increased intra-, peri- and postoperative complications and/or mortality.Conclusions: One-lung ventilation is a feasible and safe procedure also in obese patients and obesity did not negatively affect peri- and postoperative outcomes after lung resection.
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- 2022
15. Pulmonary Hamartoma Associated With Lung Cancer (PHALC Study): Results of a Multicenter Study
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Francesco Puma, Erino A. Rendina, Antonio D'Andrilli, Mark Ragusa, Alfonso Fiorelli, Nicoletta Pia Ardò, G. Bocchialini, Marco Anile, Paolo Carbognani, Simona Sobrero, Francesco Sollitto, Nicola Serra, Mario Santini, Luigi Ventura, Beatrice Trabalza Marinucci, Federico Venuta, Domenico Loizzi, Annalisa Carlucci, Giacomo Argento, Roberta Rapana, Giovanni Vicidomini, Francesco Ardissone, Valentina Tassi, Fiorelli, Alfonso, D'Andrilli, Antonio, Carlucci, Annalisa, Vicidomini, Giovanni, Argento, Giacomo, Trabalza Marinucci, Beatrice, Ardissone, Francesco, Rapanà, Roberta, Sobrero, Simona, Carbognani, Paolo, Ventura, Luigi, Bocchialini, Giovanni, Ragusa, Mark, Tassi, Valentina, Sollitto, Francesco, Loizzi, Domenico, Ardò, Nicoletta Pia, Anile, Marco, Puma, Francesco, Rendina, Erino Angelo, Venuta, Federico, Serra, Nicola, and Santini, Mario
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,congenital, hereditary, and neonatal diseases and abnormalities ,Lung Neoplasms ,Hamartoma ,Enucleation ,Pulmonary Hamartoma ,Benign tumor ,03 medical and health sciences ,hamartoma ,lung cancer ,pulmonary ,surgical resection ,aged ,humans ,lung ,retrospective studies ,smokers ,lung neoplasms ,0302 clinical medicine ,medicine ,Humans ,030212 general & internal medicine ,Lung cancer ,Lung ,Aged ,Retrospective Studies ,Smokers ,business.industry ,Pulmonary ,medicine.disease ,Surgery ,medicine.anatomical_structure ,030228 respiratory system ,Multicenter study ,Surgical resection ,Population study ,business ,Wedge resection (lung) - Abstract
Purpose Pulmonary hamartoma is the most common benign tumor of the lung. We analyzed a 20-year historical series of patients with pulmonary hamartoma undergoing surgical resection, aiming to evaluate the characteristics, the outcomes, and the association between hamartoma and lung cancer. Methods It was a retrospective multicenter study including the data of all consecutive patients with pulmonary hamartoma undergoing surgical resection. The end-points were to evaluate: (i) the characteristics of hamartoma, (ii) outcomes, and (iii) whether hamartoma was a predictive factor for lung cancer development Results Our study population included 540 patients. Upfront surgical or endoscopic resection was performed in 385 (71%) cases while in the remaining 155 (29%) cases, the lesions were resected 20 ± 3.5 months later due to increase in size. In most cases, lung sparing resection was carried out including enucleation (n = 259; 48%) and wedge resection (n = 230; 43%) while 5 (1%) patients underwent endoscopic resection. Only two patients (0, 2%) had major complications. One patient (0.23%) had recurrence after endoscopic resection, while no cases of malignant degeneration were seen (mean follow-up:103.3 ± 93 months). Seventy-six patients (14%) had associated lung cancer, synchronous in 9 (12%) and metachronous in 67 (88%). Only age > 70-year-old (p = 0.0059) and smokers > 20 cigarettes/day (p Conclusion PH was a benign tumor, with no evidence of recurrence and/or of malignant degeneration after resection. The association between hamartoma and lung cancer was a spurious phenomenon due to common risk factors.
- Published
- 2021
16. The texture analysis as a predictive method in the assessment of the cytological specimen of CT-guided FNAC of the lung cancer
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Maria Paola Belfiore, Floriana Morgillo, Alfonso Reginelli, Immacolata Cozzolino, Fabrizio Urraro, Giovanni Vicidomini, Salvatore Cappabianca, Valerio Nardone, Riccardo Monti, Matilde Costa, Roberta Grassi, Reginelli, Alfonso, Belfiore, Maria Paola, Monti, Riccardo, Cozzolino, Immacolata, Costa, Matilde, Vicidomini, Giovanni, Grassi, Roberta, Morgillo, Floriana, Urraro, Fabrizio, Nardone, Valerio, and Cappabianca, Salvatore
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Adult ,Male ,Cancer Research ,medicine.medical_specialty ,Lung Neoplasms ,Cytodiagnosis ,Biopsy, Fine-Needle ,Adenocarcinoma of Lung ,Adenocarcinoma ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Lung cancer ,Aged ,Retrospective Studies ,Radiomics ,business.industry ,Second opinion ,Retrospective cohort study ,Hematology ,General Medicine ,Middle Aged ,Prognosis ,medicine.disease ,Precision medicine ,Institutional review board ,Tumor Burden ,Oncology ,Feature (computer vision) ,030220 oncology & carcinogenesis ,Kurtosis ,Feature extraction ,Female ,Radiology ,Personalized medicine ,Tomography, X-Ray Computed ,business ,Algorithms ,Follow-Up Studies - Abstract
The lung cancer is the principle cause of the worldwide deaths and its prognosis is poor with a 5-year overall survival rate. Computed tomography (CT) gives many information about the prognosis, but the problem is the subject interpretation of the findings. Thanks to the computer-aided diagnosis/detection (CAD), it is possible to reduce the second opinion. "Radiomics" is an extension of CAD and overlaps the quantitative imaging data of the CT texture analysis (CTTA) with the clinical information, increasing the power and precision of the decision going through the personalized medicine. The aim of this study is to describe the role of the radiomics in the characterization of the pulmonary nodule. For this study, we retrospectively analyzed the images of the 87 NSCLC patients with a waiver of informed consent from the Institutional Review Board (IRB) at the Campania University "Luigi Vanvitelli" of Naples. All tumors were semiautomatically segmented by a radiologist with 10years of experience using three diameters (AW Server 3.2). The examinations were acquired using 128 MDCT (GSI CT, GE) with a peak tube voltage of 120 kVp, tube current of 100 or 200mA, and rotation times of 0.5 or 0.8s. To confirm the imaging results, the FNAC was performed and for every nodule the following parameters were extracted: the presence of the solid component (named = 1), papillary component (named = 2), and mixed component (named = 3). Feature calculation was performed using the HealthMyne software and Integrated Platform That Enables Better Patient Management Decisions For Oncology. The radiologist uses the Rapid Precise Metrics (RPM)™ functionality to identify a lesion with the algorithm and these methods are put to work. The correlation between each feature and the tumor volume was calculated using a two-step cluster statistical analysis. In this retrospective study, in one year from 2018 to 2019 20 patients with lung adenocarcinoma confirmed with FNAC were enrolled. The pathologic results were subdivided into three categories: the solid architecture (group 1), papillary architecture (group 2), and mixed architecture (group 3). Nine lesions resulted with component 1, seven patients with component 2, and 3 patients with component 3. Eight females and 12 males with a median age 61 and 15years (mean ± SD = 67.4 ± 9.7years, range 39-73years) were enrolled. The two results suggest, with p
- Published
- 2020
17. The role of coronary artery calcification score in lung cancer patients.
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Nardone, Valerio, Reginelli, Alfonso, De Marco, Giuseppina, Di Pietro, Teresa, Grassi, Roberta, Corte, Carminia Maria Della, Fasano, Morena, Ciammella, Patrizia, Vicidomini, Giovanni, Morgillo, Floriana, Ciardiello, Fortunato, and Cappabianca, Salvatore
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CORONARY artery calcification , *LUNG cancer , *CANCER patients , *LUNG tumors , *CORONARY artery disease - Published
- 2022
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18. Correlation between matrix metalloproteinase 9 and 18F-2-fluoro-2-deoxyglucose-positron emission tomography as diagnostic markers of lung cancer†.
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Fiorelli, Alfonso, Rizzo, Antonietta, Messina, Gaetana, Izzo, Anna, Vicidomini, Giovanni, Pannone, Giuseppe, Santini, Mario, and Di Domenico, Marina
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MATRIX metalloproteinases , *POSITRON emission tomography , *LUNG cancer treatment , *BLOOD sugar , *BIOMARKERS , *BRONCHOALVEOLAR lavage , *STATISTICAL correlation - Abstract
OBJECTIVES This study was conducted to evaluate the diagnostic role of matrix metalloproteinase 9 (MMP9) measured in bronchoalveolar lavage (BAL), serum and tissue samples of patients with indeterminate lung lesions and its correlation with F-18-2-fluoro-2-deoxyglucose-positron emission tomography (18FDG-PET) findings in diagnostic work. METHODS MMP9 levels (ng/ml) in serum and BAL were analysed using enzyme-linked immunosorbent assay in 60 consecutive patients with lung mass. 18FDG-PET was performed on all patients and a standard uptake value (SUV) threshold of 2.5 was used to differentiate benign from malignant lesions. In tissue samples of resectable patients, MMP9 expression was also revealed by immunohistochemical staining. RESULTS Twenty patients had benign disease and 40 patients had malignant lesions, of which 7 (17.5%) were classified as Stage I, 18 (45%) as Stage II, 7 (17.5%) as Stage III and 8 (20%) as Stage IV. MMP9 levels in serum were significantly higher in malignant than in benign lesions (673 ± 182 versus 309 ± 96, respectively, P < 0.0001), and were significantly higher in patients with metastatic disease than in patients of other stage groups; no significant difference was found between different histological types. MMP9 levels in BAL were higher in malignant than in benign lesions (502 ± 137 versus 325 ± 118, respectively, P = 0.001); no significant differences were found between different stages or histological groups. In patients with malignant lesions, MMP9 levels in BAL were inversely correlated with FEV1 (volume that has been exhaled at the end of the first second of forced expiration) and FVC (forced vital capacity of maximally forced expiratory effort) values. In patients with SUV > 2.5, MMP9 levels in serum and BAL had a sensitivity, specificity, positive predictive value and negative predictive value of 73, 100, 100 and 81% (cut-off point of 601; area under the curve (AUC): 0.7) and 94, 100, 100 and 83% (cut-off point of 745; AUC: 0.9), respectively. In patients with SUV < 2.5, MMP9 levels in serum and BAL had a sensitivity, specificity, positive predictive value and negative predictive value of 94, 100, 100 and 75% (cut-off point of 240; AUC: 0.9) and 70, 100, 100 and 73% (cut-off point of 321; AUC: 0.7), respectively. Of the 26 tumour samples, 9 (34%) showed positive immunohistochemical staining for MMP9. CONCLUSIONS The measurement of MMP9 levels helps to differentiate benign from malignant lung mass. Its use in combination with PET study adds further information to the diagnosis work-up of lesions to select patients who may or may not benefit from additional invasive procedures. [ABSTRACT FROM AUTHOR]
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- 2012
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19. The role of technetium-99m hexakis-2-methoxyisobutyl isonitrile in the detection of neoplastic lung lesions
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Santini, Mario, Fiorello, Alfonso, Mansi, Luigi, Rambaldi, Pier Francesco, Vicidomini, Giovanni, Busiello, Luigi, Messina, Gaetana, and Nargi, Paola
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TECHNETIUM compounds , *SINGLE-photon emission computed tomography , *QUALITATIVE chemical analysis , *PRECANCEROUS conditions , *LUNG cancer diagnosis , *CANCER patients , *STANDARD deviations - Abstract
Abstract: Objective: Our goal was to determine the role of technetium-99m hexakis-2-methoxyisobutyl isonitrile (99mTc-MIBI) in the detection of neoplastic lung lesions. Materials and methods: We prospectively studied 79 consecutive patients with indeterminate lung lesion between January 2006 and September 2007. All patients were submitted to 99mTc-MIBI single-photon emission chest tomography (SPECT) before invasive diagnostic procedure. Qualitative analysis was performed to evaluate SPECT images in order to localize abnormal activity in the radiologically demonstrated lesion. In addition, semiquantitative analysis was made by calculating tumor/contralateral normal lung ratio (T/N). Finally, the scintigraphic findings were correlated to the histopathological diagnosis obtained by invasive procedure or confirmation of instrumental exams. Results: Sixty patients had a malignant lesion: 44 squamous cell carcinoma, 7 adenocarcinomas, 4 large cell carcinoma, 1 small cell lung cancer, and 4 metastases. The mean size±standard deviation of malignant nodules was 3.9±1.61cm (range 1.5–5.5cm). Nineteen patients had a benign disease. The mean size±standard deviation of benign nodules was 3.3±1.71cm (range 2–6cm). 99mTc-MIBI SPECT delineated focal lesions with an increase in tracer accumulation in 55/60 malignant lesions; in 5/60 malignant lesions was negative. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 91%, 73%, 91%, and 73%, respectively. In patients with neoplastic lesion, the mean T/N ratio value±standard deviation was 1.72±0.35 whereas in patients with benign lesions was 1.14±0.25. Semiquantitative analysis showed that for a T/N value >1.23, the value of sensitivity, specificity, PPV, and PNV were 91%, 84%, 94%, and 76%, respectively (ROC curve). Metastatic mediastinal lymph nodes were found in 3/57 patients. 99mTc-MIBI SPECT showed a specificity and PPV of 100% in the detection of mediastinal lymph nodes with sensitivity, and PNV of 66% and 97%, respectively. Age, sex, histological type, and size of lesion did not affect the SPECT results. Conclusion: Our experiences seem to confirm that 99mTc-MIBI SPECT is a reliable diagnostic tool in the finding of lung cancer particularly cases in which radiological evaluation is indeterminate. [Copyright &y& Elsevier]
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- 2009
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20. In the era of ultrasound technology, could conventional trans-bronchial needle aspiration still play a role in lung cancer mediastinal staging?
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Davide Di Natale, Alfonso Fiorelli, Mario Polverino, Nicola Serra, Valentina Musella, Carlo Santoriello, Roberto Cascone, Mario Santini, Rossella Mastromarino, Giovanni Vicidomini, Fiorelli, Alfonso, Santoriello, Carlo, Di Natale, Davide, Cascone, Roberto, Musella, Valentina, Mastromarino, Rossella, Serra, Nicola, Vicidomini, Giovanni, Polverino, Mario, and Santini, Mario
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Ultrasound ,Mediastinal staging ,medicine.disease ,Conventional trans-bronchial needle aspiration (C-TBNA) ,Mediastinoscopy ,03 medical and health sciences ,0302 clinical medicine ,030228 respiratory system ,Induction therapy ,Subcarinal ,Paratracheal ,Medicine ,Sampling (medicine) ,Original Article ,030212 general & internal medicine ,Radiology ,business ,Lung cancer ,Ultrasound transbronchial needle aspiration - Abstract
Background: To evaluate the feasibility of a combined strategy including conventional-trans-bronchial needle aspiration biopsy (C-TBNA) and endobronchial ultrasounds transbronchial needle aspiration (EBUS-TBNA) for sampling mediastinal adenopathies in patients with lung cancer in order to determinate whether in the era of ultrasound technology C-TBNA could still play a role in mediastinal staging.Methods: It was a retrospective multicenter study including all consecutive patients with lung cancer and radiological mediastinal adenopathies undergoing TBNA for mediastinal staging (January 2014-July 2016). C-TBNA was performed as first diagnostic procedure. All negative C-TBNA results were corroborated by EBUS-TBNA, and, if EBUS-TBNA was negative, by mediastinoscopy or surgery. The diagnostic yield of C-TBNA were then calculated.Results: A total of 175 patients were included in the study for a total of 197 mediastinal adenopathies sampled. C-TBNA was positive in 125 cases and negative in 72 cases who underwent EBUS-TBNA. It was positive in 58 cases and negative in 14 patients. After surgical exploration (n=12) and mediastinoscopy (n=2), 11 patients did not present metastases (true negative) while 3 presented mediastinal involvement (false negative). Thus, C-TBNA had a sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of 67.2%, 100%, 100%, 15.3% and 69.0%, respectively. The sensitivity increased for sampling paratracheal versus subcarinal stations (80% versus 49%; P= 15 mm) versus small adenopathies (
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- 2017
21. The effects of lung resection on physiological motor activity of the oesophagus†
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Alfonso Fiorelli, Antonio Rotondo, Roberta Milione, Mario Santini, Giovanni Vicidomini, Roberto Grassi, Fiorelli, Alfonso, Vicidomini, Giovanni, Milione, Roberta, Grassi, Roberto, Rotondo, Antonio, and Santini, Mario
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Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Lung Neoplasms ,Manometry ,medicine.medical_treatment ,Gastroenterology ,Preoperative care ,Esophageal Sphincter, Lower ,Group B ,Pneumonectomy ,Esophagus ,Internal medicine ,Humans ,Medicine ,Esophageal Motility Disorders ,Prospective Studies ,Prospective cohort study ,Lung cancer ,Aged ,Chi-Square Distribution ,business.industry ,Heartburn ,General Medicine ,Middle Aged ,Resection ,medicine.disease ,Biomechanical Phenomena ,Surgery ,Radiography ,Oesophageal motility ,medicine.anatomical_structure ,Esophageal motility disorder ,Female ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Muscle Contraction - Abstract
Objectives To assess the modifications of oesophageal function after major lung resection and whether these modifications are correlated with the extent of resection (pneumonectomy vs others). Methods In the last 5 years, 40 consecutive surgical patients with lung cancer were prospectively enrolled and divided in two groups: Group A (n = 20) patients scheduled for elective pneumonectomy and Group B (n = 20) for more limited resections (lobectomy or bilobectomy). In addition to routine evaluations, all patients underwent preoperative (within 5 days) and postoperative (6 months) oesophageal manometry to assess the lower oesophageal sphincter (LES), the oesophageal body and the upper oesophageal sphincter functions. Symptoms scoring questionnaires were recorded for each patient and the oesophageal dislocation assessed by radiological examinations. Results Thirty-three (15 of Group A and 18 of Group B) patients completed the study. After operation, we found that LES resting pressure was significantly lower in Group A compared with Group B (P = 0.01); conversely, the relaxing pressure resulted as being higher in Group A than in Group B (P = 0.01). In Group A compared with Group B, a significant reduction of amplitude and that of wave duration of oesophageal contractions were seen at the upper (0.0001 and 0.02, respectively), middle (0.0003 and 0.002, respectively) and lower (0.0001 and 0.0004, respectively) oesophageal body. In addition, 12 of 15 (80%) patients of Group A and 3 of 18 (17%) of Group B presented a lack of regular peristaltic movement (P = 0.001). Despite chest CT scan showing a shift of the oesophagus in 11 of 15 (73%) and 2 of 18 (11.1%) patients of Groups A and B (P = 0.001), the oesophagus dislocation resulted 'severe' on barium swallow study in only two patients of Group A. The manometric alterations were subclinical; heartburn was recorded in three patients (two of Group A and one of Group B) and epigastric pain in four (two for each group). No other symptoms were observed. Conclusions Pneumonectomy may cause significant oesophageal motility disorders that are mostly subclinical. Thus, this type of surgery should not be denied to patients if required to treat their cancer.
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- 2013
22. Correlation between matrix metalloproteinase 9 and 18F-2-fluoro-2-deoxyglucose-positron emission tomography as diagnostic markers of lung cancer
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Alfonso Fiorelli, Marina Di Domenico, Antonietta Rizzo, Anna Cecilia Izzo, Giovanni Vicidomini, Mario Santini, Giuseppe Pannone, Gaetana Messina, Fiorelli, Alfonso, Rizzo, Antonietta, Messina, G, Izzo, A, Vicidomini, Giovanni, Pannone, G, Santini, Mario, and DI DOMENICO, Marina
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Adult ,Male ,Pulmonary and Respiratory Medicine ,18FDG-PET ,medicine.medical_specialty ,Lung Neoplasms ,Vital Capacity ,Matrix metalloproteinase 9 ,Standardized uptake value ,Gastroenterology ,Fluorodeoxyglucose F18 ,Predictive Value of Tests ,Forced Expiratory Volume ,Internal medicine ,Biomarkers, Tumor ,Humans ,Medicine ,Stage (cooking) ,Lung cancer ,Aged ,Neoplasm Staging ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Respiratory disease ,Area under the curve ,General Medicine ,Middle Aged ,medicine.disease ,Bronchoalveolar lavage ,Positron emission tomography ,Positron-Emission Tomography ,Predictive value of tests ,Female ,Surgery ,Radiopharmaceuticals ,Cardiology and Cardiovascular Medicine ,business ,Nuclear medicine ,Bronchoalveolar Lavage Fluid - Abstract
OBJECTIVES: This study was conducted to evaluate the diagnostic role of matrix metalloproteinase 9 (MMP9) measured in bronchoalveolar lavage (BAL), serum and tissue samples of patients with indeterminate lung lesions and its correlation with F-18-2-fluoro-2-deoxyglucose-positron emission tomography ((18)FDG-PET) findings in diagnostic work. METHODS: MMP9 levels (ng/ml) in serum and BAL were analysed using enzyme-linked immunosorbent assay in 60 consecutive patients with lung mass. (18)FDG-PET was performed on all patients and a standard uptake value (SUV) threshold of 2.5 was used to differentiate benign from malignant lesions. In tissue samples of resectable patients, MMP9 expression was also revealed by immunohistochemical staining. RESULTS: Twenty patients had benign disease and 40 patients had malignant lesions, of which 7 (17.5%) were classified as Stage I, 18 (45%) as Stage II, 7 (17.5%) as Stage III and 8 (20%) as Stage IV. MMP9 levels in serum were significantly higher in malignant than in benign lesions (673 ± 182 versus 309 ± 96, respectively, P < 0.0001), and were significantly higher in patients with metastatic disease than in patients of other stage groups; no significant difference was found between different histological types. MMP9 levels in BAL were higher in malignant than in benign lesions (502 ± 137 versus 325 ± 118, respectively, P = 0.001); no significant differences were found between different stages or histological groups. In patients with malignant lesions, MMP9 levels in BAL were inversely correlated with FEV(1) (volume that has been exhaled at the end of the first second of forced expiration) and FVC (forced vital capacity of maximally forced expiratory effort) values. In patients with SUV > 2.5, MMP9 levels in serum and BAL had a sensitivity, specificity, positive predictive value and negative predictive value of 73, 100, 100 and 81% (cut-off point of 601; area under the curve (AUC): 0.7) and 94, 100, 100 and 83% (cut-off point of 745; AUC: 0.9), respectively. In patients with SUV < 2.5, MMP9 levels in serum and BAL had a sensitivity, specificity, positive predictive value and negative predictive value of 94, 100, 100 and 75% (cut-off point of 240; AUC: 0.9) and 70, 100, 100 and 73% (cut-off point of 321; AUC: 0.7), respectively. Of the 26 tumour samples, 9 (34%) showed positive immunohistochemical staining for MMP9. CONCLUSIONS: The measurement of MMP9 levels helps to differentiate benign from malignant lung mass. Its use in combination with PET study adds further information to the diagnosis work-up of lesions to select patients who may or may not benefit from additional invasive procedures.
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- 2011
23. Role of Diffusing Capacity in Predicting Complications after Lung Resection for Cancer
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Giovanni Vicidomini, Mario Santini, V.G. Di Crescenzo, Alfonso Fiorello, Paolo Laperuta, Santini, Mario, Fiorelli, Alfonso, Vicidomini, Giovanni, DI CRESCENZO, V. G., and Laperuta, P.
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Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Lung Neoplasms ,medicine.medical_treatment ,Pulmonary function testing ,Bilobectomy ,Pneumonectomy ,Postoperative Complications ,Carcinoma, Non-Small-Cell Lung ,Diffusing capacity ,medicine ,Humans ,Respiratory function ,Lung cancer ,Aged ,Retrospective Studies ,Lung ,business.industry ,Middle Aged ,carbon monoxide (DL (CO) ,Prognosis ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Cardiothoracic surgery ,lung resection ,Pulmonary Diffusing Capacity ,Female ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
BACKGROUND: The purpose of our study was to determine whether the assessment of the diffusing capacity of the lung for carbon monoxide (DL (CO)), together with the forced expiratory volume in 1 second (FEV (1)), could improve the selection of surgical patients. METHODS: The data of 76 patients undergoing major lung resection (pnemonectomy, bilobectomy or lobectomy) for non-small cell lung cancer were retrospectively studied. All patients were reviewed for age, sex, preexisting medical conditions, operative, and pathological findings and postoperative outcome. RESULTS: Univariate and multivariable logistic regression analysis showed that ppoFEV (1) and ppoDL (CO) were the only statistically significant predictors of pulmonary complications. In the group of patients with marginal ppoFEV (1) (between 30 - 40 %), ppoDL (CO) predicted pulmonary morbidity with a better accuracy ( P < 0.005) than ppoFEV (1) ( P > 0.05). Multiple regression analysis showed that pneumonectomy was the only statistical factor correlated with mortality ( P < 0.05). CONCLUSION: Our experience seems to suggest that ppoDL (CO) is a strong predictor of pulmonary complications after major lung resection, allowing a better surgical selection of the patients with compromised respiratory function.
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- 2007
24. Intraoperative Pleural Lavage: Is It a Valid Prognostic Factor in Lung Cancer?
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Giovanni Vicidomini, Alfonso Fiorello, Barbara Calabrò, Vincenzo Parascandolo, V. Pastore, Mario Santini, Vicidomini, Giovanni, Santini, Mario, Fiorelli, Alfonso, Parascandolo, V., Calabrò, B., and Pastore, V.
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Adult ,Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Lung Neoplasms ,Pleural effusion ,medicine.medical_treatment ,Therapeutic irrigation ,Adenocarcinoma ,Metastasis ,Pneumonectomy ,Predictive Value of Tests ,Carcinoma, Non-Small-Cell Lung ,medicine ,Carcinoma ,Humans ,Life Tables ,Neoplasm Invasiveness ,Stage (cooking) ,Therapeutic Irrigation ,Lung cancer ,Aged ,Neoplasm Staging ,Aged, 80 and over ,NSCLC ,Pleural Cavity ,Intraoperative Care ,business.industry ,Respiratory disease ,pleural lavage ,Middle Aged ,Prognosis ,medicine.disease ,Survival Analysis ,Pleural Effusion, Malignant ,respiratory tract diseases ,lung cancer ,Carcinoma, Squamous Cell ,Female ,Surgery ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
Background In patients undergoing lung resection for non-small cell lung cancer (NSCLC), the primary TNM (tumor–regional lymph node–distant metastasis) staging system is the best prognostic factor. However, it is necessary to investigate other factors that could more accurately predict a patient's prognosis. In this study we evaluated the significance of positive intraoperative pre-resectional lavage in patients with NSCLC. Methods We enrolled 84 patients (79 men, 5 women) aged between 36 and 81 years (mean age, 64.8 years) undergoing a major lung resection for NSCLC, with no preoperative evidence of pleural effusions. Intraoperatively, the patients were given a pre-resectional pleural lavage with physiologic saline solution. The fluid was aspirated and sent to cytology. Results Pre-resectional pleural lavage was positive in 19 patients (22.6%). The lavage was positive in 7.3% in patients with early stage I disease (3/41) and 37.2% in patients with stage II/III disease. In the group of 16 patients with chest wall neoplastic involvement (T3), 9 had a positive lavage (56.2%; p = 0.05). No significant correlation was found between positive lavage and nodal status, visceral pleural involvement, or histologic findings. Patients with malignant cells in the pre-resectional lavage had a significantly shorter survival than patients with a negative lavage ( p = 0.025). Conclusions A positive cytology finding of intraoperative pre-resectional pleural lavage could be an important prognostic factor in patients undergoing major lung resection for NSCLC. Patients with a positive lavage should be upstaged. However, larger series are needed to define accurately the role of this technique in early stage lung cancer.
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- 2005
25. Prognostic significance of cyclooxygenase-2 (COX-2) and expression of cell cycle inhibitors p21 and p27 in human pleural malignant mesothelioma
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Giovanni Vicidomini, Daniele Santini, M Pia Di Marino, G. Liuzzi, V. Esposito, Feliciano Baldi, Bruno Vincenzi, A M Groeger, M Piccoli, Fortunata Vasaturo, Mario Santini, Alfonso Baldi, Giuseppe Tonini, Susanna Scarpa, Baldi, Alfonso, Santini, D., Vasaturo, F., Santini, Mario, Vicidomini, Giovanni, DI MARINO, M., Esposito, V., Groeger, A., Liuzzi, G., Vincenzi, B., Tonini, G., Piccoli, M., Baldi, F., and Scarpa, S.
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Cyclin-Dependent Kinase Inhibitor p21 ,Mesothelioma ,Pulmonary and Respiratory Medicine ,Oncology ,medicine.medical_specialty ,Pathology ,Pleural Neoplasms ,Cell Cycle Proteins ,Pleural disease ,Cyclins ,Internal medicine ,medicine ,Humans ,Survival rate ,Survival analysis ,Univariate analysis ,Proportional hazards model ,business.industry ,p21 and p53 expression ,Tumor Suppressor Proteins ,Lung Cancer ,Univariate ,Membrane Proteins ,mesotheliomas ,Prognosis ,medicine.disease ,Immunohistochemistry ,Survival Analysis ,Isoenzymes ,Survival Rate ,cyclooxygenase-2 ,Cyclooxygenase 2 ,Prostaglandin-Endoperoxide Synthases ,Tumor Suppressor Protein p53 ,business ,Cyclin-Dependent Kinase Inhibitor p27 - Abstract
Background: A study was undertaken to analyse the potential prognostic value of the immunohistochemical expression of cyclooxygenase-2 (COX-2) and p27 in 29 malignant mesotheliomas already screened for the expression of p21 and p53. Methods: Immunohistochemistry was used to determine the expression of COX-2 and p27. The correlation with survival of these factors and of p21 and p53 expression was assessed by univariate and multivariate analyses. Results: A positive statistically significant correlation was found between p27 and p21 expression (p
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- 2004
26. Results of the safety run-in part of the METAL (METformin in Advanced Lung cancer) study: a multicentre, open-label phase I–II study of metformin with erlotinib in second-line therapy of patients with stage IV non-small-cell lung cancer
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Ferdinando Carlo Sasso, Liberato Berrino, Carminia Maria Della Corte, Giuseppe Viscardi, Giovanna Esposito, Alfonso Fiorelli, Mario Santini, Giovanni Vicidomini, Annalisa Capuano, Federica Papaccio, Morena Fasano, Nicola Normanno, Raimondo Di Liello, Fortunato Ciardiello, Floriana Morgillo, Morgillo, Floriana, Fasano, Morena, Della Corte, Carminia Maria, Sasso, Ferdinando Carlo, Papaccio, Federica, Viscardi, Giuseppe, Esposito, Giovanna, Di Liello, Raimondo, Normanno, Nicola, Capuano, Annalisa, Berrino, Liberato, Vicidomini, Giovanni, Fiorelli, Alfonso, Santini, Mario, and Ciardiello, Fortunato
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0301 basic medicine ,Oncology ,erlotinib ,Cancer Research ,medicine.medical_specialty ,LKB1 ,medicine.drug_class ,NSCLC ,Erlotinib ,Metformin ,Population ,Pharmacology ,Tyrosine-kinase inhibitor ,03 medical and health sciences ,0302 clinical medicine ,Gefitinib ,Internal medicine ,medicine ,Epidermal growth factor receptor ,Adverse effect ,education ,Lung cancer ,Original Research ,education.field_of_study ,biology ,business.industry ,medicine.disease ,respiratory tract diseases ,030104 developmental biology ,030220 oncology & carcinogenesis ,biology.protein ,metformin ,business ,medicine.drug - Abstract
Our previous works demonstrated the ability of metformin to revert resistance to gefitinib, a selective epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, in non-small-cell lung cancer (NSCLC) EGFR/LKB1 wild-type (WT) cell lines. However, the optimal dose of metformin to be used in non-diabetic patients still remains to be defined. The phase I-II trial METformin in Advanced Lung cancer (METAL) was designed to identify the maximum tolerated dose and to evaluate safety and activity of metformin combined with erlotinib in second-line treatment of patients with stage IV NSCLC, whose tumours harbour the WT EGFR gene. Purpose Our previous works demonstrated the ability of metformin to revert resistance to gefitinib, a selective epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, in non-small-cell lung cancer (NSCLC) EGFR/LKB1 wild-type (WT) cell lines. However, the optimal dose of metformin to be used in non-diabetic patients still remains to be defined. The phase I-II trial METformin in Advanced Lung cancer (METAL) was designed to identify the maximum tolerated dose and to evaluate safety and activity of metformin combined with erlotinib in second-line treatment of patients with stage IV NSCLC, whose tumours harbour the WT EGFR gene.Patients and methods We report results from the safety run-in part designed to detect acute toxicities, to study pharmacokinetics and to identify the recommended phase II dose (RPD) to be used for the following phase of the study. In the run-in phase, metformin treatment was administered according to a dose escalation scheme and, subsequently, combined with erlotinib.Results Twelve patients were enrolled. Common adverse events were diarrhoea, decreased appetite, abdominal pain, vomiting and skin toxicity, mostly reversible with symptomatic medical treatment. Dose-limiting toxicities were vomiting and diarrhoea registered in the initial cohort receiving metformin 2000 mg plus erlotinib at 150 mg die, which was declared the maximum administered dose. Only one of nine patients treated at the next lower dose of 1500 mg of metformin plus erlotinib at 150 mg experienced G3 gastrointestinal toxicity. Metformin plasma-concentration profile confirmed the trend already observed in nondiabetic population. Glycemic profiles showed stability of the blood glucose level within the physiological range for non-diabetic subjects. At a follow-up of 30 weeks, six (50%) patients experienced a disease control (5 SD and 1 partial response).Conclusions The RP2D of metformin dose was defined at 1500 mg/day to be combined with erlotinib 150 mg.
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- 2017
27. The influence of body mass index and weight loss on outcome of elderly patients undergoing lung cancer resection
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Giovanni Vicidomini, Alfonso Fiorelli, Roberta Milione, Antonio Mazzella, Gaetana Messina, Vincenzo Giuseppe Di Crescenzo, Mario Santini, Fiorelli, Alfonso, Vicidomini, Giovanni, Mazzella, Antonio, Messina, Gaetana, Milione, Roberta, Di Crescenzo Vincenzo, Giuseppe, and Santini, Mario
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Pulmonary and Respiratory Medicine ,Male ,medicine.medical_specialty ,Lung Neoplasms ,medicine.medical_treatment ,Nutritional Status ,Gastroenterology ,Body Mass Index ,Pneumonectomy ,Postoperative Complications ,Weight loss ,Risk Factors ,Internal medicine ,Weight Loss ,medicine ,80 and over ,Humans ,Risk factor ,Lung cancer ,Prospective cohort study ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Retrospective cohort study ,medicine.disease ,Prognosis ,Female ,Follow-Up Studies ,Italy ,Morbidity ,Survival Rate ,Surgery ,Underweight ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Body mass index - Abstract
BACKGROUND: The aim of the study was to evaluate the influence of nutritional status on outcome of elderly patients resected for lung cancer. MATERIALS AND METHODS: A total of 117 consecutive patients aged ≥ 70 years undergoing lung cancer resection were enrolled. In addition to routine preoperative evaluations, other variables such as body mass index, weight loss, serum albumin, lymphocytes, and transferrin were counted. According to the body mass index value, patients were divided into Group A (≤ 18.5, underweight) and Group B (> 18.5) and risk factors for morbidity and mortality were analyzed. RESULTS: Group A and Group B counted 21 and 96 patients, respectively. The mean age was 74.9 ± 2.6; body mass index of Group A was significantly lower than that of Group B (16.7 ± 1.3 vs. 23.5 ± 1.7, respectively, p 5% before operation (p = 0.01) were independent risk factors for 1 year mortality. CONCLUSIONS: In elderly patients, malnutrition was a significant additional risk factor for early death. Nutritional assessment should be included in the routine preoperative selection. In malnourished patients, nutritional support before and after operation and a careful postdischarge care might be beneficial, but it should be corroborated by further prospective studies.
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- 2014
28. Vascular endothelial growth factor in pleural fluid for differential diagnosis of benign and malignant origin and its clinical applications
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Mario Santini, Fortunato Ciardiello, Alfonso Fiorelli, Marina Di Domenico, Gaetana Messina, Giovanni Vicidomini, Filomena Napolitano, Floriana Morgillo, Fiorelli, Alfonso, Vicidomini, Giovanni, DI DOMENICO, Marina, Napolitano, F, Messina, G, Morgillo, Floriana, Ciardiello, Fortunato, and Santini, Mario
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Pulmonary and Respiratory Medicine ,Adult ,Male ,Vascular Endothelial Growth Factor A ,Pathology ,medicine.medical_specialty ,Pleural effusion ,Enzyme-Linked Immunosorbent Assay ,Malignancy ,Risk Assessment ,Diagnosis, Differential ,chemistry.chemical_compound ,Young Adult ,Predictive Value of Tests ,Risk Factors ,medicine ,Odds Ratio ,Humans ,Paracentesis ,Mesothelioma ,Lung cancer ,Aged ,Aged, 80 and over ,L-Lactate Dehydrogenase ,business.industry ,Cancer ,Middle Aged ,medicine.disease ,Prognosis ,Pleural Effusion, Malignant ,Vascular endothelial growth factor ,Pleural Effusion ,Vascular endothelial growth factor A ,Glucose ,Logistic Models ,chemistry ,Italy ,ROC Curve ,Amylases ,Surgery ,Female ,Differential diagnosis ,Cardiology and Cardiovascular Medicine ,business ,Vascular endothelial grow factor Pleural effusion Exudate ,Biomarkers - Abstract
Our goal was to determine the role of vascular endothelial growth factor (VEGF) in diagnosing of pleural effusion (PE) in order to select patients deserving of more aggressive procedures. Seventy-nine consecutive patients with undiagnosed unilateral PE were enrolled. Pleural VEGF levels, measured using enzyme-linked immunosorbent assay (ELISA), were correlated to etiology of PEs and other markers (protein, lactic dehydrogenase, amylase, glucose). The median level of VEGF in exudates (n=65) was significantly higher than that in transudates (P=0.0001) and among exudates, it was significantly higher in malignant (n=49) than that in benign exudates (P=0.005). No significant differences were observed between malignant effusions due to lung cancer (n=11) and other malignant effusions [mesothelioma (n=13) and/or extra-thoracic cancer]. Among all variables evaluated, logistic regression found that only VEGF was significantly correlated with the presence of malignant disease (P=0.002). Analysis of the receiver operating characterists (ROC) curves showed that the areas under the curve of VEGF were significantly larger than that of amylase (P=0.02), glucose (P=0.01), lactic dehydrogenase (P=0.001) and protein (P=0.01). VEGF increased the diagnostic rate of cytological examination by 24%. VEGF may represent a helpful adjunct to conventional diagnostic tools in ruling out malignancy as a probable diagnosis, thus guiding the selection of patients who might benefit from further invasive procedures.
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- 2011
29. F-18-2-Fluoro-2-Deoxyglucose Positron Emission Tomography Compared to Technetium-99m Hexakis-2-Methoxyisobutyl Isonitrile Single Photon Emission Chest Tomography in the Diagnosis of Indeterminate Lung Lesions
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Alfonso Fiorelli, Mario Santini, Giovanni Vicidomini, Pier Francesco Rambaldi, Antonio Rotondo, Luigi Mansi, Paolo Laperuta, Luigi Busiello, Santini, Mario, Fiorelli, Alfonso, Vicidomini, Giovanni, Laperuta, P, Busiello, L, Rambaldi, Pier Francesco, Mansi, Luigi, and Rotondo, Antonio
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Pulmonary and Respiratory Medicine ,Thorax ,Adult ,Male ,Technetium Tc 99m Sestamibi ,medicine.medical_specialty ,18FDG-PET ,Lung Neoplasms ,Malignancy ,Fluorodeoxyglucose F18 ,medicine ,Humans ,Prospective Studies ,Lung cancer ,Lung mass ,Aged ,Solitary pulmonary nodule ,Lung ,medicine.diagnostic_test ,business.industry ,Deoxyglucose ,Carcinoma ,Middle Aged ,medicine.disease ,medicine.anatomical_structure ,Positron emission tomography ,Positron-Emission Tomography ,Female ,Radiology ,Lymph Nodes ,Radiopharmaceuticals ,Nuclear medicine ,business ,Technetium-99m - Abstract
Background:18FDG-PET plays a significant role in diagnosing malignancy of lung lesions but remains an expensive test available at a limited number of sites in Italy. Objective: We prospectively compare the diagnostic accuracy of 99mTc-MIBI- SPECT and 18FDG-PET in patients with indeterminate lung lesions to demonstrate that 99mTc-MIBI-SPECT may be considered as a valid alternative when 18FDG-PET is not available. Methods: 52 patients with indeterminate lung lesion were examined by 18FDG-PET and 99mTc-MIBI-SPECT before surgery. The scintigraphic findings were analyzed visually and semiquantitatively and then correlated to the definitive diagnosis. Results: 38 were malignant lesions while 14 were benign. At visual analysis, the sensitivities of 18FDG-PET and 99mTc-MIBI-SPECT were 92 and 84%, respectively (McNemar test p = 0.4), whereas the specificities were 78.6 and of 93% (p = 1.0), respectively. At semiquantitative analysis, 18FDG-PET showed a sensitivity and specificity of 92 and 71.4%, respectively, while 99mTc-MIBI-SPECT produced a sensitivity and specificity of 86 and 100%, respectively (p = 0.194). For lymph node staging, 18FDG-PET and 99mTc-MIBI-SPECT have a sensitivity and specificity of 88 and 92 of 77 and 100%, respectively. Conclusion:99mTc-MIBI-SPECT is similar to 18FDG-PET in the detection of lung malignancies and represents an alternative when PET is not available. Yet, the combination of both techniques may improve patient selection for surgery.
- Published
- 2010
30. The use of LigaSure for preservation of a previous coronary artery bypass graft by using the left internal thoracic artery in a left upper lobectomy
- Author
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Alfonso Fiorello, Giovanni Vicidomini, Mario Santini, Paolo Laperuta, Santini, Mario, Fiorelli, Alfonso, Vicidomini, Giovanni, and Laperuta, P.
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Pulmonary and Respiratory Medicine ,Male ,Reoperation ,medicine.medical_specialty ,Lung Neoplasms ,Gauche effect ,Dissection (medical) ,Anterior Descending Coronary Artery ,LigaSure ,Thoracic Arteries ,Bronchoscopy ,Blood vessel prosthesis ,Carcinoma, Non-Small-Cell Lung ,medicine ,Pericardium ,Humans ,Coronary Artery Bypass ,Bronchus ,medicine.diagnostic_test ,business.industry ,Biopsy, Needle ,Middle Aged ,medicine.disease ,Surgery ,Blood Vessel Prosthesis ,lung cancer ,medicine.anatomical_structure ,Carcinoma, Squamous Cell ,Tissue Adhesives ,Radiology ,business ,Cardiology and Cardiovascular Medicine ,Chemokines, CXC ,Artery - Abstract
We report an interesting clinical case concerning the use of an electrothermal bipolar tissue-sealing system (LigaSure, Valleylab, Inc, Boulder, Colo) 1 in a particularly challenging technical situation, such as the resection of the left upper pulmonary lobe in a patient with a previous coronary artery bypass graft (CABG) with the left internal thoracic artery (LITA). Clinical Summary In a 63-year-old man, an opacity localized in the left upper pulmonary lobe was incidentally discovered on chest radiographic analysis. He had undergone CABG 8 years before with the LITA on the left anterior descending coronary artery. Clinical and laboratory evaluation showed no abnormalities. Spirometric results were normal. Computed tomographic analysis demonstrated a peripheral mass in the left upper lobe, and there was no significant mediastinal adenopathy. Bronchoscopy did not demonstrate abnormalities of the left upper bronchus, and percutaneous needle biopsy showed a non‐small cell lung cancer (NSCLC). A standard posterolateral thoracotomy incision was performed through the fifth intercostal space. A 6-cm tumor was found in the left upper lobe (Figure 1). The dissection of the lobe from the pericardium was possible, but dense adhesions were identified between the LITA and the apex of the upper lobe. The challenge was to do an upper lobectomy while avoiding injury to the LITA. Therefore the part of parenchyma adjacent to the LITA was separated from the upper lobe by using LigaSure system (Figure 2). After this maneuver, we performed an anatomic upper lobectomy, leaving a small strip of parenchyma adjacent to the LITA; we tested the arterial graft manually, and a good pulsation was found. Anatomopathologic studies showed a 6‐cm stage IB squamous cell carcinoma, according to TNM classification. 2 The patient’s postoperative course was unremarkable, and he was discharged on the seventh postoperative day.
- Published
- 2007
31. Gemcitabine and small cell lung cancer
- Author
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Giovanni Vicidomini, Michele Della Vittoria Scarpati, Mario Santini, M., DELLA VITTORIA SCARPATI, Vicidomini, Giovanni, and Santini, Mario
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Pulmonary and Respiratory Medicine ,Oncology ,Cancer Research ,medicine.medical_specialty ,Chemotherapy ,Vincristine ,Performance status ,business.industry ,medicine.medical_treatment ,medicine.disease ,Chemotherapy regimen ,Carboplatin ,Gemcitabine ,Regimen ,chemistry.chemical_compound ,chemistry ,Internal medicine ,medicine ,business ,Lung cancer ,medicine.drug - Abstract
Dear Sir, In most cases, small-cell lung cancer (SCLC) is an advanced and widespread disease at the time of diagnosis. The results of chemotherapy, which is the primary treatment modality, have remained disappointing and essentially unchanged over the past 10 years. The most effective polychemotherapy combinations for first and second-line therapy include cyclophosphamide/adriamycin/vincristine (CAV) and cisplatin/etoposide (PE), with nausea, vomiting, alopecia, nephrotoxicity, myelotoxicity, and neurotoxicity being the major adverse reactions [1]. A 62-year-old male (performance status, ECOG=0) was admitted to our department in June 1996 with SCLC that included bone-marrow metastasis. The disease was classified as right upper lobe SCLC, stage IV (T2N2M1). Since it was not eligible for surgery and/or radiotherapy, we commenced CAV chemotherapy. The patient was re-evaluated after receiving four treatment cycles and found to have a stable disease. Therefore, we opted for a second-line chemotherapy regimen, carboplatin plus VP-16, that was not cross-resistant with CAV. Carboplatin (300 mg/m) was administered every 21 days and 100 mg/m VP-16 was administered over days 1–3. Upon standard re-evaluation after three additional cycles, the patient still had a stable disease, with positive bone-marrow biopsies (T2N2M1). Because of the patient’s age and good performance status, we had to decide whether to continue this treatment regimen or administer a third-line monotherapy regimen that would minimize the toxic effects. Considering the limited survival time and general unresponsiveness to chemotherapy in advanced disease, and the toxic effects encountered after each chemotherapy cycle, we decided to proceed with third-line treatment using the novel agent, gemcitabine [2]; a 1000 mg/m dose was administered on days 1, 8, and 15 every 28 days. We initiated gemcitabine treatment on 18 April 1997, and continued to monitor the disease at the end of each cycle using chest X-rays and abdominal/pelvic sonograms. After six cycles, the patient was fully restaged. Again, there was no evidence of progression of the disease in other sites, including the brain; the primary lung tumour appeared stable and the bone-marrow biopsies showed ‘rare neoplastic, microcytoma-like cells’. On the basis of this finding, we no longer considered it necessary to monitor the disease at bone-marrow level. Gemcitabine therapy was continued and on 18 April 1998, exactly 1 year after starting the first cycle of gemcitabine, the patient completed the tenth cycle of treatment. During the treatment with gemcitabine, the patient did not experience any nausea/vomiting, asthenia/fever, or myelotoxicity that could compromise continuation of treatment. Unfortunately, 1 month after the tenth cycle, the patient showed brain metastases and died 2 months later. Because SCLC usually progresses to distant metastases, and the advanced stage of the disease is generally unresponsive to chemotherapy, the prognosis for this patient was poor. Gemcitabine, however, halted the progression of this highly aggressive disease without producing toxicity. It is also important to note that the patient was not chemonaive before receiving gemcitabine treatment [3]; he had undergone first-line therapy with multiple regimens including four cycles of CAV and second-line therapy with three cycles of carboplatin plus VP-16. The patient was able to complete ten cycles of gemcitabine, and then he died of brain metastases. Most importantly, during the gemcitabine treatment, there was no clinical evidence that would have contraindicated prolonged use of the drug. Gemcitabine’s ability to be administered in an ambulatory setting and its toxicity profile could translate into eco* Corresponding author. Present address: Via II Traversa Gran Sasso, 21, I-80026 Casoria (NA), Italy. Tel.: +39-081-566-5227; fax: +39-081-566-5230. E-mail address: mdvs.t@tiscalinet.it (M.D.V. Scarpati).
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