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226 results on '"Zavaglia, C."'

51. A pilot study of thymosin-alpha 1 therapy for chronic hepatitis D

Author

Zavaglia, C., Bottelli, R., Smedile, Antonina, Iamoni, G., Mondazzi, L., Airoldi, A., LANZANI FZAVAGLIA, C., Smedile, A., Lanzani, F., and Idéo, G.

Subjects
Adult, Male, Thymalfasin, medicine.medical_treatment, Pilot Projects, Chronic hepatitis, Adjuvants, Immunologic, medicine, Humans, Hepatitis, Chronic, business.industry, Gastroenterology, Thymosin, Alanine Transaminase, Immunotherapy, Middle Aged, Virology, Hepatitis D, Immunology, RNA, Viral, Female, Viral disease, business, Thymosin α1, Follow-Up Studies
Published
1996

55. OC-1 Prospective Italian multicenter field-practice study with sorafenib for advanced hepatocellular carcinoma

Author

Iavarone, M., primary, Cabibbo, G., additional, Sangiovanni, A., additional, Cammà, C., additional, Borghi, A., additional, Zavaglia, C., additional, Grieco, A., additional, Granito, A., additional, Airoldi, A., additional, Biolato, M., additional, Di Marco, V., additional, Piscaglia, F., additional, Pinzello, G.B., additional, Racco, S., additional, Bolondi, L., additional, Craxì, A., additional, and Colombo, M., additional

Published
2011
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56. Influence of immunogenetic background on the outcome of recurrent hepatitis C after liver transplantation

Author

Belli, L, Zavaglia, C, Alberti, A, Poli, F, Rondinara, G, Silini, E, Taioli, E, De Carlis, L, Scalamogna, M, Forti, D, Pinzello, G, Idèo, G, Belli, Luca Saverio, Zavaglia, Claudio, Alberti, Alberto Battista, Poli, Francesca, Rondinara, Gianfranco, Silini, Enrico, Taioli, Emanuela, De Carlis, Luciano, Scalamogna, Mario, Forti, Domenico, Pinzello, Giovambattista, Idèo, Gaetano, Belli, L, Zavaglia, C, Alberti, A, Poli, F, Rondinara, G, Silini, E, Taioli, E, De Carlis, L, Scalamogna, M, Forti, D, Pinzello, G, Idèo, G, Belli, Luca Saverio, Zavaglia, Claudio, Alberti, Alberto Battista, Poli, Francesca, Rondinara, Gianfranco, Silini, Enrico, Taioli, Emanuela, De Carlis, Luciano, Scalamogna, Mario, Forti, Domenico, Pinzello, Giovambattista, and Idèo, Gaetano

Abstract

In immunocompetent patients, specific human leukocyte antigen (HLA) class II alleles have been associated with the severity of hepatitis C virus (HCV)-related disease, in particular, HLA-DRBI* 1 I has been found to exert a protective effect. The authors have analyzed the role of HLA class I and II alleles in determining the frequency, timing, and progression of histologically proven recurrent hepatitis C in 89 patients who underwent a liver transplant for HCV-related cirrhosis. In addition, the influence of HLA mismatch between donor and recipient, HCV genotype, and use of steroid pulses was also evaluated. Median patient follow up was 35 months (range 4-119). HLA-DRBI typing was performed by genomic analysis in all cases. Liver biopsies were obtained routinely and at least at yearly intervals. Histologically proven recurrent hepatitis was observed in 46 patients (52%), 10 patients progressing to stage 5-6 fibrosis in most cases within 2 years after transplant. By univariate analysis, 3 variables, HLA-B14, HLA-DRB1*04, and HLA-DRB1 donor/recipient mismatch, showed a significant effect on time to recurrent hepatitis C disease. These parameters were included in a multivariate regression model along with HCV genotype, treatment with steroid pulses and DRB1*11. HLA-B14, HLA-DRBI*04, and HLA-DRBI donor/recipient mismatch were confirmed to provide a significant and independent contribution to the risk of hepatitic disease recurrence. As for the severity of the disease, none of the 10 patients with stage 5-6 hepatitis carried the HLA- DRBI*11 allele, in line with what was observed in nontransplant subjects. Our results suggest that in posttransplant recurrent hepatitis C, immunogenetic factors are relevant in determining HCV infection outcome

Published
2000

58. Lack of a strong association between HLA class II, tumour necrosis factor and transporter associated with antigen processing gene polymorphisms and virological response to alpha-interferon treatment in patients with chronic hepatitis C

Author

Airoldi, A., primary, Zavaglia, C., additional, Silini, E., additional, Tinelli, C., additional, Martinetti, M., additional, Asti, M., additional, Rossini, A., additional, Vangeli, M., additional, Salvaneschi, L., additional, and Pinzello, G., additional

Published
2004
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63. BOVINE PERICARDIUM (BP)

Author

Leirner, A A, primary, Maizato, M JS, additional, Hayashida, S A, additional, Mathor, M B, additional, Higa, O Z, additional, Pitombo, R, additional, and Zavaglia, C AC, additional

Published
2002
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64. Análise de ensaios in vitro do compósito de 50% HA-50% TiO2 fabricados pelo método da esponja polimérica.

Author

Galdino, A. G. S., Oliveira, E. M., Filippin-Monteiro, F. B., and Zavaglia, C. A. C.

Abstract

Copyright of Ceramica is the property of Associacao Brasileira de Ceramica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2014
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65. HLA genes and chronic hepatitis C severity

Author

Asti, M., primary, Martinetti, M., additional, Zavaglia, C., additional, Cuccia, M., additional, Bruno, S., additional, Cividini, A., additional, Ideo, G., additional, Mondelli, M.U., additional, and Silini, E., additional

Published
1998
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69. A randomized controlled trial of thymosin-?1 versus interferon alfa treatment in patients with hepatitis B e antigen antibody?and hepatitis B virus DNA?positive chronic hepatitis B

Author

Andreone, P, primary, Cursaro, C, additional, Gramenzi, A, additional, Zavaglia, C, additional, Rezakovic, I, additional, Altomare, E, additional, Severini, R, additional, Franzone, J S, additional, Albano, O, additional, Ideo, G, additional, Bernardi, M, additional, and Gasbarrini, G, additional

Published
1996
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74. The virtual biomodel as a complementary resource for the diagnosis of mandibular ankylosis.

Author

Villela, C. H. S., Noritomi, P. Y., Silva, A. M., Silva, J. V. L., Cavalcanti, M. G. P., Passini, A. C., and Zavaglia, C. A. C.

Subjects
TEMPOROMANDIBULAR joint ankylosis, SKULL growth, MANDIBULAR condyle, JAWS, JOINT diseases
Abstract

Ankylosis of the mandibular joint is one of many pathologies that affect the temporomanbibular joint. It comprises the mandible condyle, the base of the skull bone and the joint itself, inducing changes in the skull bone and face complex, affecting their growth to different degrees, which can cause morphofunctional alterations. The objective of this paper is to show the gains of using a virtual biomodel as an additional resource in the diagnosis of mandibular joint ankylosis, besides the analysis of multiplanar slices. [ABSTRACT FROM AUTHOR]

Published
2007
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75. Lack of a strong association between HLA class II, tumour necrosis factor and transporter associated with antigen processing gene polymorphisms and virological response toα-interferon treatment in patients with chronic hepatitis C.

Author

Airoldi, A., Zavaglia, C., Silini, E., Tinelli, C., Martinetti, M., Asti, M., Rossini, A., Vangeli, M., Salvaneschi, L., and Pinzello, G.

Subjects
*HLA histocompatibility antigens, *GENETIC polymorphisms, *HEPATITIS C virus, *HEPATITIS viruses, *NUCLEIC acids, *GENETIC research, *POLYMERASE chain reaction
Abstract

The aim of the study was to investigate whether polymorphisms of the HLA class II, tumour necrosis factor (TNF) and transporter associated with antigen processing (TAP) genes influence the response toα-interferon in patients with chronic hepatitis C. Twenty-seven sustained responders and 55 non-responders toα-interferon monotherapy were investigated. HLA-DRB1, DQA1, DQB1, TNFA, TNFB, TAP1 and TAP2 alleles were determined by PCR-based molecular techniques. Sustained virological response was defined as undetectable serum hepatitis C virus (HCV) RNA for at least 3 years after the end of treatment. Probability (P) values were corrected for the number of alleles tested (Pc). Viral genotype 1b was more frequent in responders than in non-responders (56% vs. 26%,P = 0.009). HLA-DQB1*02 occurred less frequently in responders than in non-responders (14.8% vs. 29%,Pc not significant). HLA-DRB1*11 and DQB1*0602 were found in 22.2% and 9.3% of responders and in 10.9% and 1.8% of non-responders, respectively (Pc not significant). There was no difference in the distribution of TNF alleles in the two groups. Twenty-four (88.8%) responder patients as compared with 34 (61.8%) non-responders were TAP1*0101 homozygous (Pc not significant). Thus, in European Caucasoids with chronic hepatitis C, we could not demonstrate a strong association between HLA class II, TNF, and TAP gene polymorphisms and response to interferon treatment. [ABSTRACT FROM AUTHOR]

Published
2004
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77. A randomized, controlled study of thymosin-alpha1 therapy in patients with anti-HBe, HBV-DNA-positive chronic hepatitis B.

Author

Zavaglia, C, Severini, R, Tinelli, C, Franzone, J S, Airoldi, A, Tempini, S, Bettale, G, and Ideo, G

Abstract

No consistently effective therapy is yet available for the treatment of chronic HBsAg, anti-HBe, HBV-DNA-positive hepatitis. A multicenter trial has shown that the response rates are not significantly different when patients with anti-HBe-positive hepatitis are treated with six-month course of thymosin-alpha1 or of interferon-alpha. However, since among these patients, interferon's real efficacy is still debated, with sustained biochemical response achieved in only a few of the treated patients, we conducted this controlled study to investigate the safety and efficacy of thymosin-alpha1 as compared with no treatment. Forty-four chronic hepatitis B virus (HBV) carriers, who were anti-HBe- and HBV-DNA-positive, were randomized, with stratification for the presence of cirrhosis at baseline liver biopsy, to receive either thymosin-alpha1 at a dose of 900 microg/m2 twice a week for six months or no treatment. At entry, both groups of patients were comparable for sex, age, liver histology, ALT, IgM anti-HBc, and HBV-DNA levels. Forty-two patients were followed-up for 20 months (median; range 12-32 months) after completion of therapy: one dropped out, and one developed hepatocellular carcinoma at six months. Thymosin-alpha1 treatment had no side effects. Six months after the end of the therapy, HBV-DNA was negative and ALT had normalized in 14% of treated cases and in 4.5% of control group, while IgM anti-HBc was negative (<0.200) in 14% of the treated patients and in 4.5% of the controls. Among the treated patients, the median ALT levels stayed significantly lower compared to the pretreatment values during the treatment period and six months of follow-up. During the first year, there were six flares of hepatitis in the control group and five among the treated patients (P = NS), yielding a per year average of 0.3 and 0.23 flares per patient, respectively. Among the treated patients, median IgM anti-HBc levels were low with respect to baseline values 4-10 months after treatment started. None became HBsAg negative. In conclusion, these results indicate that, in anti-HBe, HBV-DNA-positive chronic hepatitis B, thymosin-alpha1 therapy alone does not increase the response rate, but may contribute to reduce the immune-mediated liver cell necrosis as indirectly assessed by ALT and IgM anti-HBc levels. [ABSTRACT FROM AUTHOR]

Published
2000

80. Porous and dense poly(L-lactic acid) and poly(D,L-lactic acid-co-glycolic acid) scaffolds: In vitrodegradation in culture medium and osteoblasts culture

Author

Barbanti, S. H., Santos, A. R., Zavaglia, C. A. C., and Duek, E. A. R.

Abstract

The use of bioresorbable polymers as a support for culturing cells has received special attention as an alternative for the treatment of lesions and the loss of tissue. The aim of this work was to evaluate the degradation in cell culture medium of dense and porous scaffolds of poly(L-lactic acid) (PLLA) and poly(D,L-lactic acid-co-glycolic acid) (50:50) (PLGA50) prepared by casting. The adhesion and morphology of osteoblast cells on the surface of these polymers was evaluated. Thermal analyses were done by differential scanning calorimetry and thermogravimetric analysis and cell morphology was assessed by scanning electron microscopy. Autocatalysis was observed in PLGA50samples because of the concentration of acid constituents in this material. Samples of PLLA showed no autocatalysis and hence no changes in their morphology, indicating that this polymer can be used as a structural support. Osteoblasts showed low adhesion to PLLA compared to PLGA50. The cell morphology on the surface of these materials was highly dispersed, which indicated a good interaction of the cells with the polymer substrate.

Published
2004
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83. Cyclosporin monotherapy (after 3 months) in liver transplant patients: A prospective randomized trial

Author

Romani, F., Belli, L. S., De Carlis, L., Rondinara, G. F., Alberti, A., Sansalone, C. V., Bellati, G., Zavaglia, C., Fesce, E., Ideo, G., Belli, L., Romani, F, Belli, L, De Carlis, L, Rondinara, G, Alberti, A, Sansalone, C, Bellati, G, Zavaglia, C, Fesce, E, and Ideo, G

Subjects
Adult, Graft Rejection, Immunosuppression Therapy, Male, Transplantation, Incidence, Middle Aged, Liver Transplantation, Survival Rate, Acute Disease, Chronic Disease, Cyclosporine, Humans, Female, Steroids, Surgery

87. Il registro nazionale delle varietà e cloni di vite

Author

Zavaglia, C., MARIO PECILE, Bavaresco, L., Massimo Gardiman, Pezza, L., Mancusi, D., and D’aristotile, M.

Subjects
informazioni, Settore AGR/03 - ARBORICOLTURA GENERALE E COLTIVAZIONI ARBOREE, sito web, applicazione on line

96. Small‐Angle X‐ray Scattering of Heat‐Treated Flame‐Fused Silica Glass from Amorphous and Crystalline Powders

Author

Shinohara, A. H., Omote, K., Sekiya, E. H., Shinoda, K., Torikai, D., Suzuki, C. K., and Zavaglia, C. A. C.

Abstract

High‐quality as‐fused silica glass, heat treated at 1523 K and prepared by the flame‐fusion process using natural crystalline quartz and high‐purity amorphous silica glass powders, was investigated by small‐angle X‐ray scattering (SAXS). The X‐ray scattering intensity amplitude from the amorphous structure after heat treatment was analysed in terms of viscosity, density and metallic impurity content. It is shown that SAXS scattering of the amorphous sample is sensitive to the structural change induced by annealing.

Published
1997
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99. Hepatocellular carcinoma recurrence after direct-acting antiviral therapy: An individual patient data meta-analysis

Author

Javier Crespo, Amit G. Singal, Pei-Chien Tsai, Giuseppe Cabibbo, Zoe Mariño, Alberto Zanetto, Elisabetta Degasperi, Xavier Forns, Pierre Nahon, Hiroko Nagata, Calogero Cammà, Francesco Paolo Russo, Mohamed El Kassas, Stefano Brillanti, Mina Nakagawa, Luisa Cavalletto, Tatsuya Minami, Giacomo Emanuele Maria Rizzo, Rob Bielen, Maria Reig, Liliana Chemello, Caitlin C. Murphy, Ming-Lung Yu, Mohamed Kohla, Sarah Shalaby, Gaetano Serviddio, Jose Luis Calleja, Angelo Sangiovanni, Ashraf Omar, Rosanna Villani, Franco Trevisani, Yasuhiro Asahina, Victor Sapena, Jean-François Dufour, Claudio Zavaglia, Fabio Conti, Jordi Bruix, Kévin Jean, Ciro Celsa, José Ríos, Hend Ibrahim Shousha, Nicolás Merchante, Stanislas Pol, C. Masetti, Marco Enea, Ferran Torres, Ryosuke Tateishi, Hidenori Toyoda, Universitat de Barcelona (UB), Università degli studi di Palermo - University of Palermo, Génomique Fonctionnelle des Tumeurs Solides (U1162), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), The University of Tokyo (UTokyo), Università degli Studi di Milano [Milano] (UNIMI), University of Bologna, University of Milan, National Kaohsiung University of Science and Technology [Taiwan], Laboratoire Modélisation, épidémiologie et surveillance des risques sanitaires (MESuRS), Conservatoire National des Arts et Métiers [CNAM] (CNAM), Pasteur-Cnam Risques infectieux et émergents (PACRI), Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM), Helwan University [Caire], Cairo University - Faculty of Medicine, Tokyo Medical and Dental University [Japan] (TMDU), University of Texas Southwestern Medical Center, National Liver Institute [Menoufia, Egypt], Menoufia University [Egypte], PoliclinicoTor Vergata - Fondatione PTV, Bern University Hospital [Berne] (Inselspital), Universita degli Studi di Padova, ANRS France Recherche Nord & sud Sida-hiv hépatites, Universidad de Cantabria [Santander], Centro de Investigación Biomédica en Red en el Área temática de Enfermedades Hepáticas y Digestivas (CIBERehd), Liver Unit, Clínica Universitaria, CIBER-EHD, Università degli Studi di Foggia - University of Foggia, Hasselt University (UHasselt), Alma Mater Studiorum University of Bologna (UNIBO), The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors., Jean, Kevin/0000-0001-6462-7185, Tateishi, Ryosuke/0000-0003-3021-2517, Rios, Jose/0000-0002-0716-8784, Reig, Maria/0000-0002-5711-9534, Bruix, Jordi/0000-0002-9826-0753, Celsa, Ciro/0000-0002-5662-2162, Youssef, Naglaa/0000-0002-0368-1759, Torres, Ferran/0000-0002-7355-7913, Sapena, Victor/0000-0003-4379-6486, RUSSO, FRANCESCO PAOLO/0000-0003-4127-8941, Minami, Tatsuya/0000-0002-2918-892X, Rizzo, Giacomo Emanuele, Maria/0000-0001-9335-6740, Merchante, Nicolas/0000-0003-1120-8942, Crespo, Javier/0000-0001-8248-0172, SHALABY, SARAH/0000-0002-8700-6282, El Kassas, Mohamed/0000-0002-3396-6894, Sapena, Victor, Enea, Marco, Torres , Ferran, Celsa, Ciro, Rios, Jose, Rizzo, Giacomo Emanuele Maria, Nahon, Pierre, Marino, Zoe, Tateishi, Ryosuke, Minami, Tatsuya, Sangiovanni, Angelo, Forns, Xavier, Toyoda, Hidenori, Brillanti, Stefano, Conti, Fabio, Degasperi, Elisabetta, Yu, Ming-Lung, Tsai, Pei-Chien, Jean, Kevin, El Kassas, Mohamed, Shousha, Hend Ibrahim, Omar, Ashraf, Zavaglia, Claudio, Nagata, Hiroko, Nakagawa, Mina, Asahina, Yasuhiro, Singal, Amit G., Murphy, Caitlin, Kohla, Mohamed, Masetti, Chiara, Dufour, Jean-Francois, Merchante, Nicolas, Cavalletto, Luisa, Chemello, Liliana L. C., Pol, Stanislas, Crespo, Javier, Calleja, Jose Luis, Villani, Rosanna, Serviddio, Gaetano, Zanetto, Alberto, Shalaby, Sarah, Russo, Francesco Paolo, BIELEN, Rob, Trevisani, Franco, Camma, Calogero, Bruix, Jordi, Cabibbo, Giuseppe, Reig, Maria, Sapena V., Enea M., Torres F., Celsa C., Rios J., Rizzo G.E.M., Nahon P., Marino Z., Tateishi R., Minami T., Sangiovanni A., Forns X., Toyoda H., Brillanti S., Conti F., Degasperi E., Yu M.-L., Tsai P.-C., Jean K., El Kassas M., Shousha H.I., Omar A., Zavaglia C., Nagata H., Nakagawa M., Asahina Y., Singal A.G., Murphy C., Kohla M., Masetti C., Dufour J.-F., Merchante N., Cavalletto L., Chemello L.L.C., Pol S., Crespo J., Calleja J.L., Villani R., Serviddio G., Zanetto A., Shalaby S., Russo F.P., Bielen R., Trevisani F., Camma C., Bruix J., Cabibbo G., Reig M., Università degli Studi di Milano = University of Milan (UNIMI), University of Bologna/Università di Bologna, HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM), Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), Università degli Studi di Padova = University of Padua (Unipd), Università degli Studi di Foggia = University of Foggia (Unifg), and Cammà Calogero

Subjects
medicine.medical_specialty, Carcinoma, Hepatocellular, Cirrhosis, Antiviral Agents, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, antiviral therapy, medicine, Humans, Propensity Score, hepatocellular carcinoma, meta-analysis, business.industry, Liver Neoplasms, Antiviral therapy, Patient data, medicine.disease, 3. Good health, 030220 oncology & carcinogenesis, Meta-analysis, Hepatocellular carcinoma, Relative risk, Cohort, 030211 gastroenterology & hepatology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Neoplasm Recurrence, Local, business, Direct acting
Abstract

ObjectiveThe benefit of direct-acting antivirals (DAAs) against HCV following successful treatment of hepatocellular carcinoma (HCC) remains controversial. This meta-analysis of individual patient data assessed HCC recurrence risk following DAA administration.DesignWe pooled the data of 977 consecutive patients from 21 studies of HCV-related cirrhosis and HCC, who achieved complete radiological response after surgical/locoregional treatments and received DAAs (DAA group). Recurrence or death risk was expressed as HCC recurrence or death per 100 person-years (100PY). Propensity score-matched patients from the ITA.LI.CA. cohort (n=328) served as DAA-unexposed controls (no-DAA group). Risk factors for HCC recurrence were identified using random-effects Poisson.ResultsRecurrence rate and death risk per 100PY in DAA-treated patients were 20 (95% CI 13.9 to 29.8, I2=74.6%) and 5.7 (2.5 to 15.3, I2=54.3), respectively. Predictive factors for recurrence were alpha-fetoprotein logarithm (relative risk (RR)=1.11, 95% CI 1.03 to 1.19; p=0.01, per 1 log of ng/mL), HCC recurrence history pre-DAA initiation (RR=1.11, 95% CI 1.07 to 1.16; pConclusionEffects of DAA exposure on HCC recurrence risk remain inconclusive. Active clinical and radiological follow-up of patients with HCC after HCV eradication with DAA is justified.

Published
2021
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100. Pulmonary Resection for Metastasis of Hepatocellular Carcinoma Recurring After Liver Transplant: An Italian Multicenter Experience

Author

Federico Rea, Daniele Dondossola, Pietro Lampertico, Serena Conforti, Giovanni Maria Comacchio, Arianna Rimessi, Massimo Torre, Federica Invenizzi, Umberto Cillo, Riccardo Boetto, Paolo Mendogni, Maria Francesca Donato, Luciano De Carlis, Claudio Zavaglia, Mario Nosotti, Massimo Iavarone, Alessandra Mazzucco, Marco Schiavon, Invenizzi, F, Iavarone, M, Donato, M, Mazzucco, A, Torre, M, Conforti, S, Rimessi, A, Zavaglia, C, Schiavon, M, Comacchio, G, Rea, F, Boetto, R, Cillo, U, Dondossola, D, De Carlis, L, Lampertico, P, Nosotti, M, and Mendogni, P

Subjects
0301 basic medicine, Cancer Research, medicine.medical_specialty, recurrence, medicine.medical_treatment, Liver transplantation, hepatocellular carcinoma, liver transplantation, pulmonary metastases, pulmonary resection, lcsh:RC254-282, 03 medical and health sciences, 0302 clinical medicine, pulmonary metastase, Medicine, Thoracotomy, Original Research, business.industry, Wound dehiscence, Perioperative, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, medicine.disease, Surgery, 030104 developmental biology, Oncology, Cardiothoracic surgery, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, Metastasectomy, business, Wedge resection (lung)
Abstract

Background and aim: Liver transplantation (LT) is a validated treatment for hepatocellular carcinoma (HCC). HCC recurrence occurred between 8 and 20% of patients and lung is the most frequent site. Pulmonary metastases resection (PMR) prolongs survival, however in LT-setting the impact on survival is unclear. To give new lights on this issue, we report the experience of three Italian LT Centers. Methods: All consecutive HCC transplanted patients in three Italian LT Centers, who developed pulmonary metastasis from HCC (PM-HCC), as first metastasis, from 2008 to 2018, were included whenever treated with PMR. Results: Twenty-five patients were enrolled (median age 58 yrs, 84% male, 3% cirrhotics). HCC recurred after 34 months (9–306) since LT and PMR was performed after 2.4 months (0–43.1). A total of 28 PMR (19 single resections; 9 multiple resections; 16 right; 2 left) have been performed on 24 patients while in one case percutaneous microwave ablation (MWA) was preferred. Four patients have been re-operated due to pulmonary HCC-recurrence after surgery. The majority of surgical resection type was wedge resection (26, 89%). Surgical access was: video-assisted thoracic surgery (VATS) in 17 cases (59%); thoracotomy in 11 (38%); MWA in 1 (3%). The 48% of nodule was in right lower lobe. Perioperative in-hospital mortality and 30 days mortality were nil; median surgical time 90 min (50–365); median post-operative overall stay 5 days (2–11). Post-operative ICU treatment was necessary in 1 case (3%) for 3 days; blood transfusions in 2 cases (7%). Overall, 5 complications (2 bleeding; 1 AKI; 1 major cardiac; 1 wound dehiscence) occurred, with an overall complications rate of 23%. Eight (32%) patients died during a follow-up after HCC recurrence of 32 months (7–213): 7 for HCC progression, 1 for severe liver failure due to chronic rejection. The 1 and 5 year cumulative probability of OS from recurrence were 100 and 43% (95%CI 12–74), respectively, with a median OS of 51 months (95%CI 24–78). Conclusion: Selected patients with isolated pulmonary HCC-recurrence after LT and with preserved hepatic function showed that a pulmonary metastasectomy could be efficacious in managing a PM-HCC and could give an opportunity for long-term survival.

Published
2019

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