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1,112 results on '"Crespi M."'

1. How geodesy can contribute to the understanding and prediction of earthquakes

Author

Panza, G. F., Peresan, A., Sansò, F., Crespi, M., Mazzoni, A., and Nascetti, A.

Subjects
Physics - Geophysics
Abstract

Earthquakes cannot be predicted with precision, but algorithms exist for intermediate-term middle range prediction of main shocks above a pre-assigned threshold, based on seismicity patterns. Few years ago, a first attempt was made in the framework of project SISMA, funded by Italian Space Agency, to jointly use seismological tools, like CN algorithm and scenario earthquakes, and geodetic methods and techniques, like GPS and SAR monitoring, in order to effectively constrain priority areas where to concentrate prevention and seismic risk mitigation. We present a further development of integration of seismological and geodetic information, clearly showing the contribution of geodesy to the understanding and prediction of earthquakes. As a relevant application, the seismic crisis that started in Central Italy in August 2016 is considered in a retrospective analysis. Differently from the much more common approach, here GPS data are not used to estimate the standard 2D velocity and strain field in the area, but to reconstruct the velocity and strain pattern along transects, which are properly oriented according to the a priori information about the known tectonic setting. Overall, the analysis of the available geodetic data indicates that it is possible to highlight the velocity variation and the related strain accumulation in the area of Amatrice event, within the area alarmed by CN since November 1st, 2012. The considered counter examples, across CN alarmed and not-alarmed areas, do not show any comparable spatial acceleration localized trend. Therefore, we show that the combined analysis of the results of CN prediction algorithms, with those from the processing of adequately dense and permanent GNSS network data, may allow the routine highlight in advance of the strain accumulation. Thus it is possible to significantly reduce the size of the CN alarmed areas., Comment: Added 1 reference

Published
2017

5. The Effect of a Liver Transplant Program on the Outcomes of Resectable Hepatocellular Carcinoma: A Nationwide Multicenter Analysis

Author

Serenari, M, Lenzi, J, Cucchetti, A, Cipriani, F, Donadon, M, Ardito, F, Fazio, F, Nicolini, D, Iaria, M, Famularo, S, Perri, P, Ansaloni, L, Zanello, M, Lai, Q, Conci, S, Molfino, S, Ferrari, C, Germani, P, Zago, M, Romano, M, Zimmitti, G, Antonucci, A, Fumagalli, L, Troci, A, Ferraro, V, Memeo, R, Crespi, M, Chiarelli, M, Ercolani, G, Hilal, M, Zanus, G, Pinotti, E, Tarchi, P, Griseri, G, Baiocchi, G, Ruzzenente, A, Rossi, M, Jovine, E, Maestri, M, Grazi, G, Romano, F, Dalla Valle, R, Ravaioli, M, Vivarelli, M, Ferrero, A, Giuliante, F, Torzilli, G, Aldrighetti, L, Cescon, M, Gorgone, M, Ratti, F, Costa, G, Razionale, F, Russolillo, N, Marinelli, L, Giuffrida, M, Scotti, M, Garancini, M, De Peppo, V, De Stefano, F, Laureiro, Z, Marchitelli, I, Franceschi, A, Cosola, D, Corleone, P, Montuori, M, Salvador, L, Manzoni, A, La Barba, G, Calcagno, P, Pennacchi, L, Conticchio, M, Serenari M., Lenzi J., Cucchetti A., Cipriani F., Donadon M., Ardito F., Fazio F., Nicolini D., Iaria M., Famularo S., Perri P., Ansaloni L., Zanello M., Lai Q., Conci S., Molfino S., Ferrari C., Germani P., Zago M., Romano M., Zimmitti G., Antonucci A., Fumagalli L., Troci A., Ferraro V., Memeo R., Crespi M., Chiarelli M., Ercolani G., Hilal M. A., Zanus G., Pinotti E., Tarchi P., Griseri G., Baiocchi G. L., Ruzzenente A., Rossi M., Jovine E., Maestri M., Grazi G. L., Romano F., Dalla Valle R., Ravaioli M., Vivarelli M., Ferrero A., Giuliante F., Torzilli G., Aldrighetti L., Cescon M., Gorgone M., Ratti F., Costa G., Razionale F., Russolillo N., Marinelli L., Giuffrida M., Scotti M., Garancini M., De Peppo V., De Stefano F., Laureiro Z. L., Marchitelli I., Franceschi A., Cosola D., Corleone P., Montuori M., Salvador L., Manzoni A., La Barba G., Calcagno P., Pennacchi L., Conticchio M., Serenari, M, Lenzi, J, Cucchetti, A, Cipriani, F, Donadon, M, Ardito, F, Fazio, F, Nicolini, D, Iaria, M, Famularo, S, Perri, P, Ansaloni, L, Zanello, M, Lai, Q, Conci, S, Molfino, S, Ferrari, C, Germani, P, Zago, M, Romano, M, Zimmitti, G, Antonucci, A, Fumagalli, L, Troci, A, Ferraro, V, Memeo, R, Crespi, M, Chiarelli, M, Ercolani, G, Hilal, M, Zanus, G, Pinotti, E, Tarchi, P, Griseri, G, Baiocchi, G, Ruzzenente, A, Rossi, M, Jovine, E, Maestri, M, Grazi, G, Romano, F, Dalla Valle, R, Ravaioli, M, Vivarelli, M, Ferrero, A, Giuliante, F, Torzilli, G, Aldrighetti, L, Cescon, M, Gorgone, M, Ratti, F, Costa, G, Razionale, F, Russolillo, N, Marinelli, L, Giuffrida, M, Scotti, M, Garancini, M, De Peppo, V, De Stefano, F, Laureiro, Z, Marchitelli, I, Franceschi, A, Cosola, D, Corleone, P, Montuori, M, Salvador, L, Manzoni, A, La Barba, G, Calcagno, P, Pennacchi, L, Conticchio, M, Serenari M., Lenzi J., Cucchetti A., Cipriani F., Donadon M., Ardito F., Fazio F., Nicolini D., Iaria M., Famularo S., Perri P., Ansaloni L., Zanello M., Lai Q., Conci S., Molfino S., Ferrari C., Germani P., Zago M., Romano M., Zimmitti G., Antonucci A., Fumagalli L., Troci A., Ferraro V., Memeo R., Crespi M., Chiarelli M., Ercolani G., Hilal M. A., Zanus G., Pinotti E., Tarchi P., Griseri G., Baiocchi G. L., Ruzzenente A., Rossi M., Jovine E., Maestri M., Grazi G. L., Romano F., Dalla Valle R., Ravaioli M., Vivarelli M., Ferrero A., Giuliante F., Torzilli G., Aldrighetti L., Cescon M., Gorgone M., Ratti F., Costa G., Razionale F., Russolillo N., Marinelli L., Giuffrida M., Scotti M., Garancini M., De Peppo V., De Stefano F., Laureiro Z. L., Marchitelli I., Franceschi A., Cosola D., Corleone P., Montuori M., Salvador L., Manzoni A., La Barba G., Calcagno P., Pennacchi L., and Conticchio M.

Abstract

Objective: To evaluate the effect of a liver transplantation (LT) program on the outcomes of resectable hepatocellular carcinoma (HCC). Background: Surgical treatment of HCC includes both hepatic resection (HR) and LT. However, the presence of cirrhosis and the possibility of recurrence make the management of this disease complex and probably different according to the presence of a LT program. Methods: Patients undergoing HR for HCC between January 2005 and December 2019 were identified from a national database of HCC. The main study outcomes were major surgical complications according to the Comprehensive Complication Index, posthepatectomy liver failure (PHLF), 90-day mortality, overall survival, and disease-free survival. Secondary outcomes were salvage liver transplantation (SLT) and postrecurrence survival. Results: A total of 3202 patients were included from 25 hospitals over the study period. Three of 25 (12%) had an LT program. The presence of an LT program within a center was associated with a reduced probability of PHLF (odds ratio=0.38) but not with overall survival and disease-free survival. There was an increased probability of SLT when HR was performed in a transplant hospital (odds ratio=12.05). Among transplant-eligible patients, those who underwent LT had a significantly longer postrecurrence survival. Conclusions: This study showed that the presence of a LT program was associated with decreased PHLF rates and an increased probability to receive SLT in case of recurrence.

Published
2023

6. Survival benefit of second line therapies for recurrent hepatocellular carcinoma: repeated hepatectomy, thermoablation and second-line transplant referral in a real life national scenario

Author

Famularo, S, Cillo, U, Lauterio, A, Donadon, M, Vitale, A, Serenari, M, Cipriani, F, Fazio, F, Giuffrida, M, Ardito, F, Dominioni, T, Garancini, M, Lai, Q, Nicolini, D, Molfino, S, Perri, P, Pinotti, E, Conci, S, Ferrari, C, Zanello, M, Patauner, S, Zimmitti, G, Germani, P, Chiarelli, M, Romano, M, De Angelis, M, La Barba, G, Troci, A, Ferraro, V, Izzo, F, Antonucci, A, Belli, A, Memeo, R, Crespi, M, Ercolani, G, Boccia, L, Zanus, G, Tarchi, P, Hilal, M, Frena, A, Jovine, E, Griseri, G, Ruzzenente, A, Zago, M, Grazi, G, Baiocchi, G, Vivarelli, M, Rossi, M, Romano, F, Maestri, M, Giuliante, F, Valle, R, Ferrero, A, Aldrighetti, L, De Carlis, L, Cescon, M, Torzilli, G, Milana, F, Bertacco, A, De Carlis, R, Ratti, F, Russolillo, N, Iaria, M, Razionale, F, Tartaglia, G, Ciulli, C, Carissimi, F, Laureiro, Z, Marinelli, L, Depeppo, V, Montuori, M, Marchitelli, I, Franceschi, A, Notte, F, Manzoni, A, Cosola, D, Corleone, P, Fumagalli, L, Salvador, L, Mantovani, G, Cucchetti, A, Cammarata, F, Conticchio, M, Patrone, R, Bernasconi, D, Famularo S., Cillo U., Lauterio A., Donadon M., Vitale A., Serenari M., Cipriani F., Fazio F., Giuffrida M., Ardito F., Dominioni T., Garancini M., Lai Q., Nicolini D., Molfino S., Perri P., Pinotti E., Conci S., Ferrari C., Zanello M., Patauner S., Zimmitti G., Germani P., Chiarelli M., Romano M., De Angelis M., La Barba G., Troci A., Ferraro V., Izzo F., Antonucci A., Belli A., Memeo R., Crespi M., Ercolani G., Boccia L., Zanus G., Tarchi P., Hilal M. A., Frena A., Jovine E., Griseri G., Ruzzenente A., Zago M., Grazi G., Baiocchi G. L., Vivarelli M., Rossi M., Romano F., Maestri M., Giuliante F., Valle R. D., Ferrero A., Aldrighetti L., De Carlis L., Cescon M., Torzilli G., Milana F., Bertacco A., De Carlis R., Ratti F., Russolillo N., Iaria M., Razionale F., Tartaglia G., Ciulli C., Carissimi F., Laureiro Z. L., Marinelli L., DePeppo V., Montuori M., Marchitelli I., Franceschi A., Notte F., Manzoni A., Cosola D., Corleone P., Fumagalli L., Salvador L., Mantovani G., Cucchetti A., Cammarata F., Conticchio M., Patrone R., Bernasconi D. P., Famularo, S, Cillo, U, Lauterio, A, Donadon, M, Vitale, A, Serenari, M, Cipriani, F, Fazio, F, Giuffrida, M, Ardito, F, Dominioni, T, Garancini, M, Lai, Q, Nicolini, D, Molfino, S, Perri, P, Pinotti, E, Conci, S, Ferrari, C, Zanello, M, Patauner, S, Zimmitti, G, Germani, P, Chiarelli, M, Romano, M, De Angelis, M, La Barba, G, Troci, A, Ferraro, V, Izzo, F, Antonucci, A, Belli, A, Memeo, R, Crespi, M, Ercolani, G, Boccia, L, Zanus, G, Tarchi, P, Hilal, M, Frena, A, Jovine, E, Griseri, G, Ruzzenente, A, Zago, M, Grazi, G, Baiocchi, G, Vivarelli, M, Rossi, M, Romano, F, Maestri, M, Giuliante, F, Valle, R, Ferrero, A, Aldrighetti, L, De Carlis, L, Cescon, M, Torzilli, G, Milana, F, Bertacco, A, De Carlis, R, Ratti, F, Russolillo, N, Iaria, M, Razionale, F, Tartaglia, G, Ciulli, C, Carissimi, F, Laureiro, Z, Marinelli, L, Depeppo, V, Montuori, M, Marchitelli, I, Franceschi, A, Notte, F, Manzoni, A, Cosola, D, Corleone, P, Fumagalli, L, Salvador, L, Mantovani, G, Cucchetti, A, Cammarata, F, Conticchio, M, Patrone, R, Bernasconi, D, Famularo S., Cillo U., Lauterio A., Donadon M., Vitale A., Serenari M., Cipriani F., Fazio F., Giuffrida M., Ardito F., Dominioni T., Garancini M., Lai Q., Nicolini D., Molfino S., Perri P., Pinotti E., Conci S., Ferrari C., Zanello M., Patauner S., Zimmitti G., Germani P., Chiarelli M., Romano M., De Angelis M., La Barba G., Troci A., Ferraro V., Izzo F., Antonucci A., Belli A., Memeo R., Crespi M., Ercolani G., Boccia L., Zanus G., Tarchi P., Hilal M. A., Frena A., Jovine E., Griseri G., Ruzzenente A., Zago M., Grazi G., Baiocchi G. L., Vivarelli M., Rossi M., Romano F., Maestri M., Giuliante F., Valle R. D., Ferrero A., Aldrighetti L., De Carlis L., Cescon M., Torzilli G., Milana F., Bertacco A., De Carlis R., Ratti F., Russolillo N., Iaria M., Razionale F., Tartaglia G., Ciulli C., Carissimi F., Laureiro Z. L., Marinelli L., DePeppo V., Montuori M., Marchitelli I., Franceschi A., Notte F., Manzoni A., Cosola D., Corleone P., Fumagalli L., Salvador L., Mantovani G., Cucchetti A., Cammarata F., Conticchio M., Patrone R., and Bernasconi D. P.

Abstract

Background: Despite second-line transplant(SLT) for recurrent hepatocellular carcinoma(rHCC) leads to the longest survival after recurrence(SAR), its real applicability has never been reported. The aim was to compare the SAR of SLT versus repeated hepatectomy and thermoablation(CUR group). Methods: Patients were enrolled from the Italian register HE.RC.O.LE.S. between 2008 and 2021. Two groups were created: CUR versus SLT. A propensity score matching (PSM) was run to balance the groups. Results: 743 patients were enrolled, CUR = 611 and SLT = 132. Median age at recurrence was 71(IQR 6575) years old and 60(IQR 53-64, p < 0.001) for CUR and SLT respectively. After PSM, median SAR for CUR was 43 months(95%CI = 37 – 93) and not reached for SLT(p < 0.001). SLT patients gained a survival benefit of 9.4 months if compared with CUR. MilanCriteria(MC)-In patients were 82.7% of the CUR group. SLT(HR 0.386, 95%CI = 0.23 – 0.63, p < 0.001) and the MELD score(HR 1.169, 95%CI = 1.07 – 1.27, p < 0.001) were the only predictors of mortality. In case of MC-Out, the only predictor of mortality was the number of nodules at recurrence(HR 1.45, 95%CI= 1.09 – 1.93, p = 0.011). Conclusion: It emerged an important transplant under referral in favour of repeated hepatectomy or thermoablation. In patients with MC-Out relapse, the benefit of SLT over CUR was not observed.

Published
2023

7. Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study

Author

Podda, M, Pellino, G, Di Saverio, S, Coccolini, F, Pacella, D, Cioffi, S, Virdis, F, Balla, A, Ielpo, B, Pata, F, Poillucci, G, Ortenzi, M, Damaskos, D, De Simone, B, Sartelli, M, Leppaniemi, A, Jayant, K, Catena, F, Giuliani, A, Di Martino, M, Pisanu, A, Gerardi, C, Gourgiotis, S, Riboni, C, Giordano, A, Ferrario, L, Agnoletti, V, Kruger, Y, Mole, D, Agresta, F, Prieto Calvo, M, Wilson, M, Soggiu, F, Hamdan, A, Gomes, C, Fraga, G, Ioannidis, A, Demetrashvili, Z, Sahani, S, Bains, L, Khamees, A, Ababneh, H, Aljaiuossi, O, Pimentel, S, Mohamad, I, Yusoff, A, Zarnescu, N, Calu, V, Litvin, A, Lesko, D, Elmehrath, A, Elshami, M, de Santibanes, M, Gundara, J, Alawadhi, K, Lui, R, Julianov, A, Ralon, S, Garzali, I, Machain, G, Villalabeitia, I, Quispe-Cruz, D, Orantia, A, Waledziak, M, de Sa, T, Ali, S, Kovacevic, B, Noel, C, Abdalah, H, Kchaou, A, Isik, A, Ansaloni, L, Biffl, W, Guerrieri, M, Sartori, A, Abradelo, M, Nigri, G, Di Lorenzo, N, Mingoli, A, Chiarugi, M, Di Menno Stavron, J, Mazza, O, Valenzuela, J, Pachajoa, D, Alvarez, F, Liano, J, Tefay, J, Alshaikh, A, Hasan, L, Couto Gomes, F, Calderan, T, Hirano, E, Dardanov, D, Saroglu, A, Atanasov, B, Belev, N, Kovachev, N, Chan, S, Lok, H, Salcedo, D, Robayo, D, Trivino, M, Manak, J, de Araujo, J, Sethi, A, Awad, A, Elbadawy, M, Farid, A, Hanafy, A, Nafea, A, Sherief, G, Salah Alzhraa, A, Abdelsalam, W, Emile, S, Elfallal, A, Elfeki, H, Elghadban, H, Shoma, A, Shetiwy, M, Elbahnasawy, M, Mohamed, S, Hamed, E, Khalil, U, Chouillard, E, Gumbs, A, Police, A, Mabilia, A, Khutsishvili, K, Tvaladze, A, Ioannidis, O, Anestiadou, E, Loutzidou, L, Konstantinidis, K, Konstantinidou, S, Manatakis, D, Acheimastos, V, Tasis, N, Michalopoulos, N, Kokoropoulos, P, Papadoliopoulou, M, Sotiropoulou, M, Kapiris, S, Metaxas, P, Tsouknidas, I, Kefili, D, Petrakis, G, Synekidou, E, Dakis, K, Alexandridou, E, Papadopoulos, A, Chouliaras, C, Mouzakis, O, Mulita, F, Maroulis, I, Vailas, M, Triantafyllou, T, Theodorou, D, Lostoridis, E, Nagorni, E, Tourountzi, P, Baili, E, Charalabopoulos, A, Liakakos, T, Schizas, D, Kozadinos, A, Syllaios, A, Machairas, N, Kykalos, S, Stamopoulos, P, Delis, S, Farazi-Chongouki, C, Kalaitzakis, E, Giannarakis, M, Lasithiotakis, K, Petra, G, Gupta, A, Medappil, N, Muthukrishnan, V, Kamar, J, Lal, P, Agarwal, R, Magnoli, M, Aonzo, P, Serventi, A, Di Lascio, P, Pinto, M, Bergamini, C, Bottari, A, Fortuna, L, Martellucci, J, Cicako, A, Miglietta, C, Morino, M, Delogu, D, Picchetto, A, Assenza, M, D'Ambrosio, G, Argenio, G, Armellino, M, Ioia, G, Occhionorelli, S, Andreotti, D, Domenico, L, Luppi, D, Casadei, M, Di Donato, L, Manoochehri, F, Marchese, T, Sergi, W, Manca, R, Murgia, R, Piras, E, Conti, L, Gianazza, S, Rizzi, A, Segalini, E, Monti, M, Iiritano, E, Mariani, N, De Nicola, E, Scifo, G, Pignata, G, Andreuccetti, J, Fleres, F, Clarizia, G, Spolini, A, Biloslavo, A, Germani, P, Mastronardi, M, Bogoni, S, Palmisano, S, De Manzini, N, Marino, M, Martines, G, Trigiante, G, Lagouvardou, E, Anania, G, Bombardini, C, Oppici, D, Pilia, T, Murzi, V, Gessa, E, Bracale, U, Di Nuzzo, M, Peltrini, R, Salvetti, F, Vigano, J, Sganga, G, Bianchi, V, Fransvea, P, Fontana, T, Sarro, G, Dinuzzi, V, Scaravilli, L, Papa, M, Jovine, E, Ciabatti, G, Mastrangelo, L, Rottoli, M, Ricci, C, Russo, I, Aiolfi, A, Bona, D, Lombardo, F, Cianci, P, Sederino, M, Bini, R, Chiara, O, Cantafio, S, Coretti, G, Licitra, E, Savino, G, Grimaldi, S, Porfidia, R, Moggia, E, Garino, M, Marafante, C, Pesce, A, Fabbri, N, Feo, C, Marra, E, Troian, M, Drigo, D, Nagliati, C, Muratore, A, Danna, R, Murgese, A, Crespi, M, Guerci, C, Frontali, A, Ferrari, L, Favi, F, Picariello, E, Rampini, A, D'Acapito, F, Ercolani, G, Solaini, L, Palmieri, F, Cali, M, Ferrara, F, Muttillo, I, Muttillo, E, Picardi, B, Galleano, R, Badran, A, Ghazouani, O, Cervellera, M, Campanella, G, Papa, G, Di Bella, A, Perrone, G, Petracca, G, Prioriello, C, Giuffrida, M, Cozzani, F, Rossini, M, Inama, M, Butturini, G, Moretto, G, Morelli, L, Candio, G, Guadagni, S, Cicuttin, E, Cremonini, C, Tartaglia, D, Genovese, V, Cillara, N, Cannavera, A, Deserra, A, Picciariello, A, Papagni, V, Vincenti, L, Bagaglini, G, Sica, G, Lapolla, P, Brachini, G, Bono, D, Nicotera, A, Zago, M, Sammartano, F, Benuzzi, L, Stella, M, Rossi, S, Cerioli, A, Puccioni, C, Olmi, S, Rubicondo, C, Uccelli, M, Guida, A, Lepiane, P, Sasia, D, Giraudo, G, Salomone, S, Belloni, E, Cossa, A, Lancellotti, F, Caronna, R, Chirletti, P, Saullo, P, Troiano, R, Mucilli, F, Barone, M, Ippoliti, M, Grande, M, Sensi, B, Siragusa, L, Santini, A, Di Carlo, I, Veroux, M, Gioco, R, Veroux, G, Curro, G, Ammendola, M, Komaei, I, Navarra, G, Tonini, V, Sartarelli, L, Ceresoli, M, Perrone, S, Roccamatisi, L, Millo, P, Brachet Contul, R, Ponte, E, Zuin, M, Portale, G, Tonello, A, Fratini, G, Bianchini, M, Perotti, B, Doria, E, Lunghi, E, Visconti, D, Al-Shami, K, Awadi, S, Buwaitel, M, Naffa', M, Samhouri, A, Sawalha, H, Ani, M, Fathil, I, Huei, J, Beristain-Hernandez, J, Garcia-Meza, A, Sepulveda-Rdriguez, R, Hernandez, E, Pinzon, C, Condoy, J, Garcia, F, Sadik, M, Kadir, B, Devi, J, Seerani, N, Zainab, Sohail-Asghar, M, Afzal, A, Akbar, A, Lohse, H, Cabrera, Z, Seto, G, Chiuyari, J, Ordemar, J, Rodriguez, M, Orantia-Carlos, A, Quitoy, M, Kwiatkowski, A, Mawlichanow, M, Rocha, M, Soares, C, Stoian, A, Draghici, A, Grigorean, V, Radulescu, R, Costea, R, Zarnescu, E, Kurtenkov, M, Gendrikson, G, Alla-Angelina, V, Arina, T, Kaldarov, A, Gachabayov, M, Abdullaev, A, Milentijevic, M, Karamarkovic, M, Panyko, A, Radonak, J, Soltes, M, Moran, L, Garcia, H, Vega, P, Estevez, S, Ausania, F, Farguell, J, Gonzalez-Abos, C, Sanchez-Cabus, S, Martin, B, Molina, V, Oms, L, Ilzarbe, L, Feijoo, E, Perra, E, Rojas-Bonet, N, Penalba-Palmi, R, Perez-Bru, S, Tur-Martinez, J, Alvarez-Torrado, A, Domingo-Gonzalez, M, Tejedor-Tejada, J, del Alamo, Y, Mendoza-Moreno, F, Garcia-Moreno-Nisa, F, Matias-Garcia, B, Duran, M, Calleja-Lozano, R, de Villar, J, Sanchez-Guillen, L, Caravaca, I, Triguero-Canovas, D, Aparicio, A, Melendez, B, Palacios, A, Landaluce-Olavarria, A, De Francisco, M, Estraviz-Mateos, B, Alconchel, F, Nicolas-Lopez, T, Ramirez, P, Munoz-Cruzado, V, Ciuro, F, del Pozo, E, Pizarro, S, Cabrera, V, Bayo, J, Hamid, H, Roesel, R, Cristaudi, A, Abbas, K, Ali, I, Tlili, A, Bayhan, H, Turkoglu, M, Uzunoglu, M, Azamat, I, Omarov, N, Uymaz, D, Altintoprak, F, Akin, E, First, N, Das, K, Ozer, N, Seker, A, Kara, Y, Bozkurt, M, Kocatas, A, Atici, S, Akalin, M, Calik, B, Colak, E, Altinel, Y, Meric, S, Aktimur, Y, Hudson, V, Duval, J, Khan, M, Saad, A, Kaur, M, Bradley, A, Fox, K, Tomasi, I, Beasley, D, Prasanti, A, Kotecha, P, Ebied, H, Paul, M, Sheth, H, Gerogiannis, I, Gaber, M, Sheikh, Z, Seth, S, Kunitsyna, M, Leo, C, Bellato, V, Zafar, N, Elserafy, A, Bond-smith, G, Tebala, G, Mathur, P, Abid, I, Chidumije, N, Sandhar, P, Ullah, S, Lezama, T, Anwaar, M, Magee, C, Ahmed, S, Davies, B, Apollos, J, Mccormack, K, Choudhary, H, Doulias, T, Morrison, T, Palepa, A, Cal, F, Sanchez, L, Dominguez, F, Al-Raimi, I, Alshargabi, H, Meead, A, Chooklin, S, Chuklin, S, Bilyak, A, Podda M., Pellino G., Di Saverio S., Coccolini F., Pacella D., Cioffi S. P. B., Virdis F., Balla A., Ielpo B., Pata F., Poillucci G., Ortenzi M., Damaskos D., De Simone B., Sartelli M., Leppaniemi A., Jayant K., Catena F., Giuliani A., Di Martino M., Pisanu A., Gerardi C., Gourgiotis S., Riboni C., Giordano A., Ferrario L., Agnoletti V., Kruger Y., Mole D., Agresta F., Prieto Calvo M., Wilson M., Soggiu F., Hamdan A., Gomes C. A., Fraga G., Ioannidis A., Demetrashvili Z., Sahani S., Bains L., Khamees A., Ababneh H., Aljaiuossi O., Pimentel S., Mohamad I. S., Yusoff A. R., Zarnescu N. O., Calu V., Litvin A., Lesko D., Elmehrath A., Elshami M., de Santibanes M., Gundara J., Alawadhi K., Lui R., Julianov A., Ralon S., Garzali I. -U., Machain G. M., Villalabeitia I., Quispe-Cruz D. A., Orantia A. C. C., Waledziak M., de Sa T. C., Ali S. M., Kovacevic B., Noel C., Abdalah H. M., Kchaou A., Isik A., Ansaloni L., Biffl W., Guerrieri M., Sartori A., Abradelo M., Nigri G., Di Lorenzo N., Mingoli A., Chiarugi M., Di Menno Stavron J., Mazza O., Valenzuela J. I., Pachajoa D. A. P., Alvarez F. A., Liano J. E., Tefay J., Alshaikh A., Hasan L., Couto Gomes F., Calderan T. R. A., Hirano E. S., Dardanov D., Saroglu A., Atanasov B., Belev N., Kovachev N., Chan S. M., Lok H. -T., Salcedo D., Robayo D., Trivino M. A., Manak J., de Araujo J., Sethi A., Awad A., Elbadawy M., Farid A., Hanafy A., Nafea A., Sherief G., Salah Alzhraa A., Abdelsalam W., Emile S., Elfallal A., Elfeki H., Elghadban H., Shoma A., Shetiwy M., Elbahnasawy M., Mohamed S., Hamed E. F., Khalil U. A., Chouillard E., Gumbs A., Police A., Mabilia A., Khutsishvili K., Tvaladze A., Ioannidis O., Anestiadou E., Loutzidou L., Konstantinidis K., Konstantinidou S., Manatakis D., Acheimastos V., Tasis N., Michalopoulos N., Kokoropoulos P., Papadoliopoulou M., Sotiropoulou M., Kapiris S., Metaxas P., Tsouknidas I., Kefili D., Petrakis G., Synekidou E., Dakis K., Alexandridou E., Papadopoulos A., Chouliaras C., Mouzakis O., Mulita F., Maroulis I., Vailas M., Triantafyllou T., Theodorou D., Lostoridis E., Nagorni E. -A., Tourountzi P., Baili E., Charalabopoulos A., Liakakos T., Schizas D., Kozadinos A., Syllaios A., Machairas N., Kykalos S., Stamopoulos P., Delis S., Farazi-Chongouki C., Kalaitzakis E., Giannarakis M., Lasithiotakis K., Petra G., Gupta A., Medappil N., Muthukrishnan V., Kamar J., Lal P., Agarwal R., Magnoli M., Aonzo P., Serventi A., Di Lascio P., Pinto M., Bergamini C., Bottari A., Fortuna L., Martellucci J., Cicako A., Miglietta C., Morino M., Delogu D., Picchetto A., Assenza M., D'Ambrosio G., Argenio G., Armellino M. F., Ioia G., Occhionorelli S., Andreotti D., Domenico L., Luppi D., Casadei M., Di Donato L., Manoochehri F., Marchese T. R. L., Sergi W., Manca R., Murgia R., Piras E., Conti L., Gianazza S., Rizzi A., Segalini E., Monti M., Iiritano E., Mariani N. M., De Nicola E., Scifo G., Pignata G., Andreuccetti J., Fleres F., Clarizia G., Spolini A., Biloslavo A., Germani P., Mastronardi M., Bogoni S., Palmisano S., De Manzini N., Marino M. V., Martines G., Trigiante G., Lagouvardou E., Anania G., Bombardini C., Oppici D., Pilia T., Murzi V., Gessa E., Bracale U., Di Nuzzo M. M., Peltrini R., Salvetti F., Vigano J., Sganga G., Bianchi V., Fransvea P., Fontana T., Sarro G., Dinuzzi V. P., Scaravilli L., Papa M. V., Jovine E., Ciabatti G., Mastrangelo L., Rottoli M., Ricci C., Russo I. S., Aiolfi A., Bona D., Lombardo F., Cianci P., Sederino M., Bini R., Chiara O., Cioffi S., Cantafio S., Coretti G., Licitra E., Savino G., Grimaldi S., Porfidia R., Moggia E., Garino M., Marafante C., Pesce A., Fabbri N., Feo C. V., Marra E., Troian M., Drigo D., Nagliati C., Muratore A., Danna R., Murgese A., Crespi M., Guerci C., Frontali A., Ferrari L., Favi F., Picariello E., Rampini A., D'Acapito F., Ercolani G., Solaini L., Palmieri F., Cali M., Ferrara F., Muttillo I. A., Muttillo E. M., Picardi B., Galleano R., Badran A., Ghazouani O., Cervellera M., Campanella G., Papa G., Di Bella A., Perrone G., Petracca G. L., Prioriello C., Giuffrida M., Cozzani F., Rossini M., Inama M., Butturini G., Moretto G., Morelli L., Candio G., Guadagni S., Cicuttin E., Cremonini C., Tartaglia D., Genovese V., Cillara N., Cannavera A., Deserra A., Picciariello A., Papagni V., Vincenti L., Bagaglini G., Sica G., Lapolla P., Brachini G., Bono D., Nicotera A., Zago M., Sammartano F., Benuzzi L., Stella M., Rossi S., Cerioli A., Puccioni C., Olmi S., Rubicondo C., Uccelli M., Guida A., Lepiane P., Sasia D., Giraudo G., Salomone S., Belloni E., Cossa A., Lancellotti F., Caronna R., Chirletti P., Saullo P., Troiano R., Mucilli F., Barone M., Ippoliti M., Grande M., Sensi B., Siragusa L., Santini A., Di Carlo I., Veroux M., Gioco R., Veroux G., Curro G., Ammendola M., Komaei I., Navarra G., Tonini V., Sartarelli L., Ceresoli M., Perrone S., Roccamatisi L., Millo P., Brachet Contul R., Ponte E., Zuin M., Portale G., Tonello A. S., Fratini G., Bianchini M., Perotti B., Doria E., Lunghi E. G., Visconti D., Al-Shami K., Awadi S., Buwaitel M. M. K., Naffa' M. F. N., Samhouri A., Sawalha H., Ani M. F. C., Fathil I. N. A., Huei J., Beristain-Hernandez J. -L., Garcia-Meza A., Sepulveda-Rdriguez R., Hernandez E. E. L., Pinzon C. L. A., Condoy J. N., Garcia F. C. B., Sadik M., Kadir B., Devi J., Seerani N., Sohail-Asghar M., Afzal A., Akbar A., Lohse H. S., Cabrera Z. S. L., Seto G. S. Y., Chiuyari J. R., Ordemar J., Rodriguez M., Orantia-Carlos A. C. C., Quitoy M. A., Kwiatkowski A., Mawlichanow M., Rocha M., Soares C., Stoian A. R., Draghici A. D., Grigorean V. T., Radulescu R. B., Costea R. V., Zarnescu E. C., Kurtenkov M., Gendrikson G., Alla-Angelina V., Arina T., Kaldarov A., Gachabayov M., Abdullaev A., Milentijevic M., Karamarkovic M., Panyko A., Radonak J., Soltes M., Moran L. A., Garcia H. C., Vega P. S., Estevez S., Ausania F., Farguell J., Gonzalez-Abos C., Sanchez-Cabus S., Martin B., Molina V., Oms L., Ilzarbe L., Feijoo E. P., Perra E. S., Rojas-Bonet N., Penalba-Palmi R., Perez-Bru S., Tur-Martinez J., Alvarez-Torrado A., Domingo-Gonzalez M., Tejedor-Tejada J., del Alamo Y. G., Mendoza-Moreno F., Garcia-Moreno-Nisa F., Matias-Garcia B., Duran M., Calleja-Lozano R., de Villar J. M. P., Sanchez-Guillen L., Caravaca I., Triguero-Canovas D., Aparicio A. C. M., Melendez B. D., Palacios A. M., Landaluce-Olavarria A., De Francisco M., Estraviz-Mateos B., Alconchel F., Nicolas-Lopez T., Ramirez P., Munoz-Cruzado V. D., Ciuro F. P., del Pozo E. P., Pizarro S. O., Cabrera V. H., Bayo J. M., Hamid H. K. S., Roesel R., Cristaudi A., Abbas K., Ali I., Tlili A., Bayhan H., Turkoglu M. A., Uzunoglu M. Y., Azamat I. F., Omarov N., Uymaz D. S., Altintoprak F., Akin E., First N., Das K., Ozer N., Seker A., Kara Y., Bozkurt M. A., Kocatas A., Atici S. D., Akalin M., Calik B., Colak E., Altinel Y., Meric S., Aktimur Y. E., Hudson V., Duval J. -L., Khan M., Saad A., Kaur M., Bradley A., Fox K., Tomasi I., Beasley D., Prasanti A. K., Kotecha P., Ebied H., Paul M., Sheth H., Gerogiannis I., Gaber M., Sheikh Z., Seth S., Kunitsyna M., Leo C. A., Bellato V., Zafar N., Elserafy A., Bond-smith G., Tebala G., Mathur P., Abid I., Chidumije N., Sandhar P., Ullah S. O. Z., Lezama T., Anwaar M. H., Magee C., Ahmed S., Davies B., Apollos J., McCormack K., Choudhary H., Doulias T., Morrison T., Palepa A., Cal F. B., Sanchez L., Dominguez F., Al-Raimi I., Alshargabi H., Meead A., Chooklin S., Chuklin S., Bilyak A., Podda, M, Pellino, G, Di Saverio, S, Coccolini, F, Pacella, D, Cioffi, S, Virdis, F, Balla, A, Ielpo, B, Pata, F, Poillucci, G, Ortenzi, M, Damaskos, D, De Simone, B, Sartelli, M, Leppaniemi, A, Jayant, K, Catena, F, Giuliani, A, Di Martino, M, Pisanu, A, Gerardi, C, Gourgiotis, S, Riboni, C, Giordano, A, Ferrario, L, Agnoletti, V, Kruger, Y, Mole, D, Agresta, F, Prieto Calvo, M, Wilson, M, Soggiu, F, Hamdan, A, Gomes, C, Fraga, G, Ioannidis, A, Demetrashvili, Z, Sahani, S, Bains, L, Khamees, A, Ababneh, H, Aljaiuossi, O, Pimentel, S, Mohamad, I, Yusoff, A, Zarnescu, N, Calu, V, Litvin, A, Lesko, D, Elmehrath, A, Elshami, M, de Santibanes, M, Gundara, J, Alawadhi, K, Lui, R, Julianov, A, Ralon, S, Garzali, I, Machain, G, Villalabeitia, I, Quispe-Cruz, D, Orantia, A, Waledziak, M, de Sa, T, Ali, S, Kovacevic, B, Noel, C, Abdalah, H, Kchaou, A, Isik, A, Ansaloni, L, Biffl, W, Guerrieri, M, Sartori, A, Abradelo, M, Nigri, G, Di Lorenzo, N, Mingoli, A, Chiarugi, M, Di Menno Stavron, J, Mazza, O, Valenzuela, J, Pachajoa, D, Alvarez, F, Liano, J, Tefay, J, Alshaikh, A, Hasan, L, Couto Gomes, F, Calderan, T, Hirano, E, Dardanov, D, Saroglu, A, Atanasov, B, Belev, N, Kovachev, N, Chan, S, Lok, H, Salcedo, D, Robayo, D, Trivino, M, Manak, J, de Araujo, J, Sethi, A, Awad, A, Elbadawy, M, Farid, A, Hanafy, A, Nafea, A, Sherief, G, Salah Alzhraa, A, Abdelsalam, W, Emile, S, Elfallal, A, Elfeki, H, Elghadban, H, Shoma, A, Shetiwy, M, Elbahnasawy, M, Mohamed, S, Hamed, E, Khalil, U, Chouillard, E, Gumbs, A, Police, A, Mabilia, A, Khutsishvili, K, Tvaladze, A, Ioannidis, O, Anestiadou, E, Loutzidou, L, Konstantinidis, K, Konstantinidou, S, Manatakis, D, Acheimastos, V, Tasis, N, Michalopoulos, N, Kokoropoulos, P, Papadoliopoulou, M, Sotiropoulou, M, Kapiris, S, Metaxas, P, Tsouknidas, I, Kefili, D, Petrakis, G, Synekidou, E, Dakis, K, Alexandridou, E, Papadopoulos, A, Chouliaras, C, Mouzakis, O, Mulita, F, Maroulis, I, Vailas, M, Triantafyllou, T, Theodorou, D, Lostoridis, E, Nagorni, E, Tourountzi, P, Baili, E, Charalabopoulos, A, Liakakos, T, Schizas, D, Kozadinos, A, Syllaios, A, Machairas, N, Kykalos, S, Stamopoulos, P, Delis, S, Farazi-Chongouki, C, Kalaitzakis, E, Giannarakis, M, Lasithiotakis, K, Petra, G, Gupta, A, Medappil, N, Muthukrishnan, V, Kamar, J, Lal, P, Agarwal, R, Magnoli, M, Aonzo, P, Serventi, A, Di Lascio, P, Pinto, M, Bergamini, C, Bottari, A, Fortuna, L, Martellucci, J, Cicako, A, Miglietta, C, Morino, M, Delogu, D, Picchetto, A, Assenza, M, D'Ambrosio, G, Argenio, G, Armellino, M, Ioia, G, Occhionorelli, S, Andreotti, D, Domenico, L, Luppi, D, Casadei, M, Di Donato, L, Manoochehri, F, Marchese, T, Sergi, W, Manca, R, Murgia, R, Piras, E, Conti, L, Gianazza, S, Rizzi, A, Segalini, E, Monti, M, Iiritano, E, Mariani, N, De Nicola, E, Scifo, G, Pignata, G, Andreuccetti, J, Fleres, F, Clarizia, G, Spolini, A, Biloslavo, A, Germani, P, Mastronardi, M, Bogoni, S, Palmisano, S, De Manzini, N, Marino, M, Martines, G, Trigiante, G, Lagouvardou, E, Anania, G, Bombardini, C, Oppici, D, Pilia, T, Murzi, V, Gessa, E, Bracale, U, Di Nuzzo, M, Peltrini, R, Salvetti, F, Vigano, J, Sganga, G, Bianchi, V, Fransvea, P, Fontana, T, Sarro, G, Dinuzzi, V, Scaravilli, L, Papa, M, Jovine, E, Ciabatti, G, Mastrangelo, L, Rottoli, M, Ricci, C, Russo, I, Aiolfi, A, Bona, D, Lombardo, F, Cianci, P, Sederino, M, Bini, R, Chiara, O, Cantafio, S, Coretti, G, Licitra, E, Savino, G, Grimaldi, S, Porfidia, R, Moggia, E, Garino, M, Marafante, C, Pesce, A, Fabbri, N, Feo, C, Marra, E, Troian, M, Drigo, D, Nagliati, C, Muratore, A, Danna, R, Murgese, A, Crespi, M, Guerci, C, Frontali, A, Ferrari, L, Favi, F, Picariello, E, Rampini, A, D'Acapito, F, Ercolani, G, Solaini, L, Palmieri, F, Cali, M, Ferrara, F, Muttillo, I, Muttillo, E, Picardi, B, Galleano, R, Badran, A, Ghazouani, O, Cervellera, M, Campanella, G, Papa, G, Di Bella, A, Perrone, G, Petracca, G, Prioriello, C, Giuffrida, M, Cozzani, F, Rossini, M, Inama, M, Butturini, G, Moretto, G, Morelli, L, Candio, G, Guadagni, S, Cicuttin, E, Cremonini, C, Tartaglia, D, Genovese, V, Cillara, N, Cannavera, A, Deserra, A, Picciariello, A, Papagni, V, Vincenti, L, Bagaglini, G, Sica, G, Lapolla, P, Brachini, G, Bono, D, Nicotera, A, Zago, M, Sammartano, F, Benuzzi, L, Stella, M, Rossi, S, Cerioli, A, Puccioni, C, Olmi, S, Rubicondo, C, Uccelli, M, Guida, A, Lepiane, P, Sasia, D, Giraudo, G, Salomone, S, Belloni, E, Cossa, A, Lancellotti, F, Caronna, R, Chirletti, P, Saullo, P, Troiano, R, Mucilli, F, Barone, M, Ippoliti, M, Grande, M, Sensi, B, Siragusa, L, Santini, A, Di Carlo, I, Veroux, M, Gioco, R, Veroux, G, Curro, G, Ammendola, M, Komaei, I, Navarra, G, Tonini, V, Sartarelli, L, Ceresoli, M, Perrone, S, Roccamatisi, L, Millo, P, Brachet Contul, R, Ponte, E, Zuin, M, Portale, G, Tonello, A, Fratini, G, Bianchini, M, Perotti, B, Doria, E, Lunghi, E, Visconti, D, Al-Shami, K, Awadi, S, Buwaitel, M, Naffa', M, Samhouri, A, Sawalha, H, Ani, M, Fathil, I, Huei, J, Beristain-Hernandez, J, Garcia-Meza, A, Sepulveda-Rdriguez, R, Hernandez, E, Pinzon, C, Condoy, J, Garcia, F, Sadik, M, Kadir, B, Devi, J, Seerani, N, Zainab, Sohail-Asghar, M, Afzal, A, Akbar, A, Lohse, H, Cabrera, Z, Seto, G, Chiuyari, J, Ordemar, J, Rodriguez, M, Orantia-Carlos, A, Quitoy, M, Kwiatkowski, A, Mawlichanow, M, Rocha, M, Soares, C, Stoian, A, Draghici, A, Grigorean, V, Radulescu, R, Costea, R, Zarnescu, E, Kurtenkov, M, Gendrikson, G, Alla-Angelina, V, Arina, T, Kaldarov, A, Gachabayov, M, Abdullaev, A, Milentijevic, M, Karamarkovic, M, Panyko, A, Radonak, J, Soltes, M, Moran, L, Garcia, H, Vega, P, Estevez, S, Ausania, F, Farguell, J, Gonzalez-Abos, C, Sanchez-Cabus, S, Martin, B, Molina, V, Oms, L, Ilzarbe, L, Feijoo, E, Perra, E, Rojas-Bonet, N, Penalba-Palmi, R, Perez-Bru, S, Tur-Martinez, J, Alvarez-Torrado, A, Domingo-Gonzalez, M, Tejedor-Tejada, J, del Alamo, Y, Mendoza-Moreno, F, Garcia-Moreno-Nisa, F, Matias-Garcia, B, Duran, M, Calleja-Lozano, R, de Villar, J, Sanchez-Guillen, L, Caravaca, I, Triguero-Canovas, D, Aparicio, A, Melendez, B, Palacios, A, Landaluce-Olavarria, A, De Francisco, M, Estraviz-Mateos, B, Alconchel, F, Nicolas-Lopez, T, Ramirez, P, Munoz-Cruzado, V, Ciuro, F, del Pozo, E, Pizarro, S, Cabrera, V, Bayo, J, Hamid, H, Roesel, R, Cristaudi, A, Abbas, K, Ali, I, Tlili, A, Bayhan, H, Turkoglu, M, Uzunoglu, M, Azamat, I, Omarov, N, Uymaz, D, Altintoprak, F, Akin, E, First, N, Das, K, Ozer, N, Seker, A, Kara, Y, Bozkurt, M, Kocatas, A, Atici, S, Akalin, M, Calik, B, Colak, E, Altinel, Y, Meric, S, Aktimur, Y, Hudson, V, Duval, J, Khan, M, Saad, A, Kaur, M, Bradley, A, Fox, K, Tomasi, I, Beasley, D, Prasanti, A, Kotecha, P, Ebied, H, Paul, M, Sheth, H, Gerogiannis, I, Gaber, M, Sheikh, Z, Seth, S, Kunitsyna, M, Leo, C, Bellato, V, Zafar, N, Elserafy, A, Bond-smith, G, Tebala, G, Mathur, P, Abid, I, Chidumije, N, Sandhar, P, Ullah, S, Lezama, T, Anwaar, M, Magee, C, Ahmed, S, Davies, B, Apollos, J, Mccormack, K, Choudhary, H, Doulias, T, Morrison, T, Palepa, A, Cal, F, Sanchez, L, Dominguez, F, Al-Raimi, I, Alshargabi, H, Meead, A, Chooklin, S, Chuklin, S, Bilyak, A, Podda M., Pellino G., Di Saverio S., Coccolini F., Pacella D., Cioffi S. P. B., Virdis F., Balla A., Ielpo B., Pata F., Poillucci G., Ortenzi M., Damaskos D., De Simone B., Sartelli M., Leppaniemi A., Jayant K., Catena F., Giuliani A., Di Martino M., Pisanu A., Gerardi C., Gourgiotis S., Riboni C., Giordano A., Ferrario L., Agnoletti V., Kruger Y., Mole D., Agresta F., Prieto Calvo M., Wilson M., Soggiu F., Hamdan A., Gomes C. A., Fraga G., Ioannidis A., Demetrashvili Z., Sahani S., Bains L., Khamees A., Ababneh H., Aljaiuossi O., Pimentel S., Mohamad I. S., Yusoff A. R., Zarnescu N. O., Calu V., Litvin A., Lesko D., Elmehrath A., Elshami M., de Santibanes M., Gundara J., Alawadhi K., Lui R., Julianov A., Ralon S., Garzali I. -U., Machain G. M., Villalabeitia I., Quispe-Cruz D. A., Orantia A. C. C., Waledziak M., de Sa T. C., Ali S. M., Kovacevic B., Noel C., Abdalah H. M., Kchaou A., Isik A., Ansaloni L., Biffl W., Guerrieri M., Sartori A., Abradelo M., Nigri G., Di Lorenzo N., Mingoli A., Chiarugi M., Di Menno Stavron J., Mazza O., Valenzuela J. I., Pachajoa D. A. P., Alvarez F. A., Liano J. E., Tefay J., Alshaikh A., Hasan L., Couto Gomes F., Calderan T. R. A., Hirano E. S., Dardanov D., Saroglu A., Atanasov B., Belev N., Kovachev N., Chan S. M., Lok H. -T., Salcedo D., Robayo D., Trivino M. A., Manak J., de Araujo J., Sethi A., Awad A., Elbadawy M., Farid A., Hanafy A., Nafea A., Sherief G., Salah Alzhraa A., Abdelsalam W., Emile S., Elfallal A., Elfeki H., Elghadban H., Shoma A., Shetiwy M., Elbahnasawy M., Mohamed S., Hamed E. F., Khalil U. A., Chouillard E., Gumbs A., Police A., Mabilia A., Khutsishvili K., Tvaladze A., Ioannidis O., Anestiadou E., Loutzidou L., Konstantinidis K., Konstantinidou S., Manatakis D., Acheimastos V., Tasis N., Michalopoulos N., Kokoropoulos P., Papadoliopoulou M., Sotiropoulou M., Kapiris S., Metaxas P., Tsouknidas I., Kefili D., Petrakis G., Synekidou E., Dakis K., Alexandridou E., Papadopoulos A., Chouliaras C., Mouzakis O., Mulita F., Maroulis I., Vailas M., Triantafyllou T., Theodorou D., Lostoridis E., Nagorni E. -A., Tourountzi P., Baili E., Charalabopoulos A., Liakakos T., Schizas D., Kozadinos A., Syllaios A., Machairas N., Kykalos S., Stamopoulos P., Delis S., Farazi-Chongouki C., Kalaitzakis E., Giannarakis M., Lasithiotakis K., Petra G., Gupta A., Medappil N., Muthukrishnan V., Kamar J., Lal P., Agarwal R., Magnoli M., Aonzo P., Serventi A., Di Lascio P., Pinto M., Bergamini C., Bottari A., Fortuna L., Martellucci J., Cicako A., Miglietta C., Morino M., Delogu D., Picchetto A., Assenza M., D'Ambrosio G., Argenio G., Armellino M. F., Ioia G., Occhionorelli S., Andreotti D., Domenico L., Luppi D., Casadei M., Di Donato L., Manoochehri F., Marchese T. R. L., Sergi W., Manca R., Murgia R., Piras E., Conti L., Gianazza S., Rizzi A., Segalini E., Monti M., Iiritano E., Mariani N. M., De Nicola E., Scifo G., Pignata G., Andreuccetti J., Fleres F., Clarizia G., Spolini A., Biloslavo A., Germani P., Mastronardi M., Bogoni S., Palmisano S., De Manzini N., Marino M. V., Martines G., Trigiante G., Lagouvardou E., Anania G., Bombardini C., Oppici D., Pilia T., Murzi V., Gessa E., Bracale U., Di Nuzzo M. M., Peltrini R., Salvetti F., Vigano J., Sganga G., Bianchi V., Fransvea P., Fontana T., Sarro G., Dinuzzi V. P., Scaravilli L., Papa M. V., Jovine E., Ciabatti G., Mastrangelo L., Rottoli M., Ricci C., Russo I. S., Aiolfi A., Bona D., Lombardo F., Cianci P., Sederino M., Bini R., Chiara O., Cioffi S., Cantafio S., Coretti G., Licitra E., Savino G., Grimaldi S., Porfidia R., Moggia E., Garino M., Marafante C., Pesce A., Fabbri N., Feo C. V., Marra E., Troian M., Drigo D., Nagliati C., Muratore A., Danna R., Murgese A., Crespi M., Guerci C., Frontali A., Ferrari L., Favi F., Picariello E., Rampini A., D'Acapito F., Ercolani G., Solaini L., Palmieri F., Cali M., Ferrara F., Muttillo I. A., Muttillo E. M., Picardi B., Galleano R., Badran A., Ghazouani O., Cervellera M., Campanella G., Papa G., Di Bella A., Perrone G., Petracca G. L., Prioriello C., Giuffrida M., Cozzani F., Rossini M., Inama M., Butturini G., Moretto G., Morelli L., Candio G., Guadagni S., Cicuttin E., Cremonini C., Tartaglia D., Genovese V., Cillara N., Cannavera A., Deserra A., Picciariello A., Papagni V., Vincenti L., Bagaglini G., Sica G., Lapolla P., Brachini G., Bono D., Nicotera A., Zago M., Sammartano F., Benuzzi L., Stella M., Rossi S., Cerioli A., Puccioni C., Olmi S., Rubicondo C., Uccelli M., Guida A., Lepiane P., Sasia D., Giraudo G., Salomone S., Belloni E., Cossa A., Lancellotti F., Caronna R., Chirletti P., Saullo P., Troiano R., Mucilli F., Barone M., Ippoliti M., Grande M., Sensi B., Siragusa L., Santini A., Di Carlo I., Veroux M., Gioco R., Veroux G., Curro G., Ammendola M., Komaei I., Navarra G., Tonini V., Sartarelli L., Ceresoli M., Perrone S., Roccamatisi L., Millo P., Brachet Contul R., Ponte E., Zuin M., Portale G., Tonello A. S., Fratini G., Bianchini M., Perotti B., Doria E., Lunghi E. G., Visconti D., Al-Shami K., Awadi S., Buwaitel M. M. K., Naffa' M. F. N., Samhouri A., Sawalha H., Ani M. F. C., Fathil I. N. A., Huei J., Beristain-Hernandez J. -L., Garcia-Meza A., Sepulveda-Rdriguez R., Hernandez E. E. L., Pinzon C. L. A., Condoy J. N., Garcia F. C. B., Sadik M., Kadir B., Devi J., Seerani N., Sohail-Asghar M., Afzal A., Akbar A., Lohse H. S., Cabrera Z. S. L., Seto G. S. Y., Chiuyari J. R., Ordemar J., Rodriguez M., Orantia-Carlos A. C. C., Quitoy M. A., Kwiatkowski A., Mawlichanow M., Rocha M., Soares C., Stoian A. R., Draghici A. D., Grigorean V. T., Radulescu R. B., Costea R. V., Zarnescu E. C., Kurtenkov M., Gendrikson G., Alla-Angelina V., Arina T., Kaldarov A., Gachabayov M., Abdullaev A., Milentijevic M., Karamarkovic M., Panyko A., Radonak J., Soltes M., Moran L. A., Garcia H. C., Vega P. S., Estevez S., Ausania F., Farguell J., Gonzalez-Abos C., Sanchez-Cabus S., Martin B., Molina V., Oms L., Ilzarbe L., Feijoo E. P., Perra E. S., Rojas-Bonet N., Penalba-Palmi R., Perez-Bru S., Tur-Martinez J., Alvarez-Torrado A., Domingo-Gonzalez M., Tejedor-Tejada J., del Alamo Y. G., Mendoza-Moreno F., Garcia-Moreno-Nisa F., Matias-Garcia B., Duran M., Calleja-Lozano R., de Villar J. M. P., Sanchez-Guillen L., Caravaca I., Triguero-Canovas D., Aparicio A. C. M., Melendez B. D., Palacios A. M., Landaluce-Olavarria A., De Francisco M., Estraviz-Mateos B., Alconchel F., Nicolas-Lopez T., Ramirez P., Munoz-Cruzado V. D., Ciuro F. P., del Pozo E. P., Pizarro S. O., Cabrera V. H., Bayo J. M., Hamid H. K. S., Roesel R., Cristaudi A., Abbas K., Ali I., Tlili A., Bayhan H., Turkoglu M. A., Uzunoglu M. Y., Azamat I. F., Omarov N., Uymaz D. S., Altintoprak F., Akin E., First N., Das K., Ozer N., Seker A., Kara Y., Bozkurt M. A., Kocatas A., Atici S. D., Akalin M., Calik B., Colak E., Altinel Y., Meric S., Aktimur Y. E., Hudson V., Duval J. -L., Khan M., Saad A., Kaur M., Bradley A., Fox K., Tomasi I., Beasley D., Prasanti A. K., Kotecha P., Ebied H., Paul M., Sheth H., Gerogiannis I., Gaber M., Sheikh Z., Seth S., Kunitsyna M., Leo C. A., Bellato V., Zafar N., Elserafy A., Bond-smith G., Tebala G., Mathur P., Abid I., Chidumije N., Sandhar P., Ullah S. O. Z., Lezama T., Anwaar M. H., Magee C., Ahmed S., Davies B., Apollos J., McCormack K., Choudhary H., Doulias T., Morrison T., Palepa A., Cal F. B., Sanchez L., Dominguez F., Al-Raimi I., Alshargabi H., Meead A., Chooklin S., Chuklin S., and Bilyak A.

Abstract

The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135–15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359–5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138–5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184–5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598–9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090–6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286–5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p < 0.001; 95% CI 1.912–7.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (p = 0.018; 95% CI 0.138–0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143–0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible.

Published
2023

11. Measurement of the neutrino velocity with the OPERA detector in the CNGS beam

Author

The OPERA Collaboration, Adam, T., Agafonova, N., Aleksandrov, A., Altinok, O., Sanchez, P. Alvarez, Anokhina, A., Aoki, S., Ariga, A., Ariga, T., Autiero, D., Badertscher, A., Dhahbi, A. Ben, Bertolin, A., Bozza, C., Brugiere, T., Brugnera, R., Brunet, F., Brunetti, G., Buontempo, S., Carlus, B., Cavanna, F., Cazes, A., Chaussard, L., Chernyavsky, M., Chiarella, V., Chukanov, A., Colosimo, G., Crespi, M., D'Ambrosio, N., De Lellis, G., De Serio, M., Declais, Y., Sanchez, P. del Amo, Di Capua, F., Di Crescenzo, A., Di Ferdinando, D., Di Marco, N., Dmitrievsky, S., Dracos, M., Duchesneau, D., Dusini, S., Dzhatdoev, T., Ebert, J., Efthymiopoulos, I., Egorov, O., Ereditato, A., Esposito, L. S., Favier, J., Ferber, T., Fini, R. A., Fukuda, T., Garfagnini, A., Giacomelli, G., Giorgini, M., Giovannozzi, M., Girerd, C., Goldberg, J., Gollnitz, C., Golubkov, D., Goncharova, L., Gornushkin, Y., Grella, G., Grianti, F., Gschwendtner, E., Guerin, C., Guler, A. M., Gustavino, C., Hagner, C., Hamada, K., Hara, T., Enikeev, R., Hierholzer, M., Hollnagel, A., Ieva, M., Ishida, H., Ishiguro, K., Jakovcic, K., Jollet, C., Jones, M., Juget, F., Kamiscioglu, M., Kawada, J., Kim, S. H., Kimura, M., Kiritsis, E., Kitagawa, N., Klicek, B., Knuesel, J., Kodama, K., Komatsu, M., Kose, U., Kreslo, I., Lazzaro, C., Lenkeit, J., Ljubicic, A., Longhin, A., Malgin, A., Mandrioli, G., Marteau, J., Matsuo, T., Matveev, V., Mauri, N., Mazzoni, A., Medinaceli, E., Meisel, F., Meregaglia, A., Migliozzi, P., Mikado, S., Missiaen, D., Monacelli, P., Morishima, K., Moser, U., Muciaccia, M. T., Naganawa, N., Naka, T., Nakamura, M., Nakano, T., Nakatsuka, Y., Naumov, D., Nikitina, V., Nitti, F., Ogawa, S., Okateva, N., Olchevsky, A., Palamara, O., Paoloni, A., Park, B. D., Park, I. G., Pastore, A., Patrizii, L., Pennacchio, E., Pessard, H., Pistillo, C., Polukhina, N., Pozzato, M., Pretzl, K., Pupilli, F., Rescigno, R., Riguzzi, F., Roganova, T., Rokujo, H., Rosa, G., Rostovtseva, I., Rubbia, A., Russo, A., Ryasny, V., Ryazhskaya, O., Sato, O., Sato, Y., Sahnoun, Z., Schembri, A., Schuler, J., Lavina, L. Scotto, Serrano, J., Shakiryanova, I., Sheshukov, A., Shibuya, H., Shoziyoev, G., Simone, S., Sioli, M., Sirignano, C., Sirri, G., Song, J. S., Spinetti, M., Stanco, L., Starkov, N., Stellacci, S., Stipcevic, M., Strauss, T., Takahashi, S., Tenti, M., Terranova, F., Tezuka, I., Tioukov, V., Tolun, P., Tran, N. T., Tufanli, S., Vilain, P., Vladimirov, M., Votano, L., Vuilleumier, J. -L., Wilquet, G., Wonsak, B., Wurtz, J., Yakushev, V., Yoon, C. S., Yoshida, J., Zaitsev, Y., Zemskova, S., and Zghiche, A.

Subjects
High Energy Physics - Experiment, High Energy Physics - Phenomenology
Abstract

The OPERA neutrino experiment at the underground Gran Sasso Laboratory has measured the velocity of neutrinos from the CERN CNGS beam over a baseline of about 730 km. The measurement is based on data taken by OPERA in the years 2009, 2010 and 2011. Dedicated upgrades of the CNGS timing system and of the OPERA detector, as well as a high precision geodesy campaign for the measurement of the neutrino baseline, allowed reaching comparable systematic and statistical accuracies. An arrival time of CNGS muon neutrinos with respect to the one computed assuming the speed of light in vacuum of (6.5 +/- 7.4(stat.)((+8.3)(-8.0)sys.))ns was measured corresponding to a relative difference of the muon neutrino velocity with respect to the speed of light (v-c)/c =(2.7 +/-3.1(stat.)((+3.4)(-3.3)(sys.))x10^(-6). The above result, obtained by comparing the time distributions of neutrino interactions and of protons hitting the CNGS target in 10.5 microseconds long extractions, was confirmed by a test performed at the end of 2011 using a short bunch beam allowing to measure the neutrino time of flight at the single interaction level., Comment: 34 pages, 22 figures This version replaces all previous ones

Published
2011
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15. The largest western experience on salvage hepatectomy for recurrent hepatocellular carcinoma: propensity score-matched analysis on behalf of He.RC.O.Le.Study Group

Author

Iaria, M, Bianchi, G, Fazio, F, Ardito, F, Perri, P, Pontarolo, N, Conci, S, Donadon, M, Zanello, M, Lai, Q, Famularo, S, Molfino, S, Sciannamea, I, Fumagalli, L, Germani, P, Floridi, A, Ferrari, C, Zimmitti, G, Troci, A, Zago, M, Ferraro, V, Cipriani, F, Patauner, S, La Barba, G, Romano, M, Zanus, G, Ercolani, G, Frena, A, Aldrighetti, L, Memeo, R, Pinotti, E, Crespi, M, Hilal, M, Griseri, G, Tarchi, P, Chiarelli, M, Antonucci, A, Baiocchi, G, Romano, F, Rossi, M, Jovine, E, Torzilli, G, Ruzzenente, A, Maestri, M, Grazi, G, Giuliante, F, Ferrero, A, Dalla Valle, R, Giuffrida, M, Russolillo, N, Razionale, F, De Peppo, V, Tomasoni, M, Marchitelli, I, Costa, G, Laureiro, Z, Scotti, M, Calcagno, P, Cosola, D, Franceschi, A, Manzoni, A, Pennacchi, L, Montuori, M, Conticchio, M, Ratti, F, Notte, F, Cucchetti, A, Salvador, L, Corleone, P, Garancini, M, Ciulli, C, Iaria M., Bianchi G., Fazio F., Ardito F., Perri P., Pontarolo N., Conci S., Donadon M., Zanello M., Lai Q., Famularo S., Molfino S., Sciannamea I., Fumagalli L., Germani P., Floridi A., Ferrari C., Zimmitti G., Troci A., Zago M., Ferraro V., Cipriani F., Patauner S., La Barba G., Romano M., Zanus G., Ercolani G., Frena A., Aldrighetti L., Memeo R., Pinotti E., Crespi M., Hilal M. A., Griseri G., Tarchi P., Chiarelli M., Antonucci A., Baiocchi G. L., Romano F., Rossi M., Jovine E., Torzilli G., Ruzzenente A., Maestri M., Grazi G. L., Giuliante F., Ferrero A., Dalla Valle R., Giuffrida M., Russolillo N., Razionale F., De Peppo V., Tomasoni M., Marchitelli I., Costa G., Laureiro Z. L., Scotti M., Calcagno P., Cosola D., Franceschi A., Manzoni A., Pennacchi L., Montuori M., Conticchio M., Ratti F., Notte F., Cucchetti A., Salvador L., Corleone P., Garancini M., Ciulli C., Iaria, M, Bianchi, G, Fazio, F, Ardito, F, Perri, P, Pontarolo, N, Conci, S, Donadon, M, Zanello, M, Lai, Q, Famularo, S, Molfino, S, Sciannamea, I, Fumagalli, L, Germani, P, Floridi, A, Ferrari, C, Zimmitti, G, Troci, A, Zago, M, Ferraro, V, Cipriani, F, Patauner, S, La Barba, G, Romano, M, Zanus, G, Ercolani, G, Frena, A, Aldrighetti, L, Memeo, R, Pinotti, E, Crespi, M, Hilal, M, Griseri, G, Tarchi, P, Chiarelli, M, Antonucci, A, Baiocchi, G, Romano, F, Rossi, M, Jovine, E, Torzilli, G, Ruzzenente, A, Maestri, M, Grazi, G, Giuliante, F, Ferrero, A, Dalla Valle, R, Giuffrida, M, Russolillo, N, Razionale, F, De Peppo, V, Tomasoni, M, Marchitelli, I, Costa, G, Laureiro, Z, Scotti, M, Calcagno, P, Cosola, D, Franceschi, A, Manzoni, A, Pennacchi, L, Montuori, M, Conticchio, M, Ratti, F, Notte, F, Cucchetti, A, Salvador, L, Corleone, P, Garancini, M, Ciulli, C, Iaria M., Bianchi G., Fazio F., Ardito F., Perri P., Pontarolo N., Conci S., Donadon M., Zanello M., Lai Q., Famularo S., Molfino S., Sciannamea I., Fumagalli L., Germani P., Floridi A., Ferrari C., Zimmitti G., Troci A., Zago M., Ferraro V., Cipriani F., Patauner S., La Barba G., Romano M., Zanus G., Ercolani G., Frena A., Aldrighetti L., Memeo R., Pinotti E., Crespi M., Hilal M. A., Griseri G., Tarchi P., Chiarelli M., Antonucci A., Baiocchi G. L., Romano F., Rossi M., Jovine E., Torzilli G., Ruzzenente A., Maestri M., Grazi G. L., Giuliante F., Ferrero A., Dalla Valle R., Giuffrida M., Russolillo N., Razionale F., De Peppo V., Tomasoni M., Marchitelli I., Costa G., Laureiro Z. L., Scotti M., Calcagno P., Cosola D., Franceschi A., Manzoni A., Pennacchi L., Montuori M., Conticchio M., Ratti F., Notte F., Cucchetti A., Salvador L., Corleone P., Garancini M., and Ciulli C.

Abstract

Background: We aimed to evaluate, in a large Western cohort, perioperative and long-term oncological outcomes of salvage hepatectomy (SH) for recurrent hepatocellular carcinoma (rHCC) after primary hepatectomy (PH) or locoregional treatments. Methods: Data were collected from the Hepatocarcinoma Recurrence on the Liver Study Group (He.RC.O.Le.S.) Italian Registry. After 1:1 propensity score-matched analysis (PSM), two groups were compared: the PH group (patients submitted to resection for a first HCC) and the SH group (patients resected for intrahepatic rHCC after previous HCC-related treatments). Results: 2689 patients were enrolled. PH included 2339 patients, SH 350. After PSM, 263 patients were selected in each group with major resected nodule median size, intraoperative blood loss and minimally invasive approach significantly lower in the SH group. Long-term outcomes were compared, with no difference in OS and DFS. Univariate and multivariate analyses revealed only microvascular invasion as an independent prognostic factor for OS. Conclusion: SH proved to be equivalent to PH in terms of safety, feasibility and long-term outcomes, consistent with data gathered from East Asia. In the awaiting of reliable treatment-allocating algorithms for rHCC, SH appears to be a suitable alternative in patients fit for surgery, regardless of the previous therapeutic modality implemented.

Published
2022

16. Hepatectomy for Metabolic Associated Fatty Liver Disease (MAFLD) related HCC: Propensity case-matched analysis with viral- and alcohol-related HCC

Author

Conci, S, Cipriani, F, Donadon, M, Marchitelli, I, Ardito, F, Famularo, S, Perri, P, Iaria, M, Ansaloni, L, Zanello, M, La Barba, G, Patauner, S, Pinotti, E, Molfino, S, Germani, P, Romano, M, Sciannamea, I, Ferrari, C, Manzoni, A, Troci, A, Fumagalli, L, Delvecchio, A, Floridi, A, Memeo, R, Chiarelli, M, Crespi, M, Zimmitti, G, Griseri, G, Antonucci, A, Zanus, G, Tarchi, P, Baiocchi, G, Zago, M, Frena, A, Ercolani, G, Jovine, E, Maestri, M, Valle, R, Grazi, G, Romano, F, Giuliante, F, Torzilli, G, Aldrighetti, L, Ruzzenente, A, Conci S., Cipriani F., Donadon M., Marchitelli I., Ardito F., Famularo S., Perri P., Iaria M., Ansaloni L., Zanello M., La Barba G., Patauner S., Pinotti E., Molfino S., Germani P., Romano M., Sciannamea I., Ferrari C., Manzoni A., Troci A., Fumagalli L., Delvecchio A., Floridi A., Memeo R., Chiarelli M., Crespi M., Zimmitti G., Griseri G., Antonucci A., Zanus G., Tarchi P., Baiocchi G. L., Zago M., Frena A., Ercolani G., Jovine E., Maestri M., Valle R. D., Grazi G. L., Romano F., Giuliante F., Torzilli G., Aldrighetti L., Ruzzenente A., Conci, S, Cipriani, F, Donadon, M, Marchitelli, I, Ardito, F, Famularo, S, Perri, P, Iaria, M, Ansaloni, L, Zanello, M, La Barba, G, Patauner, S, Pinotti, E, Molfino, S, Germani, P, Romano, M, Sciannamea, I, Ferrari, C, Manzoni, A, Troci, A, Fumagalli, L, Delvecchio, A, Floridi, A, Memeo, R, Chiarelli, M, Crespi, M, Zimmitti, G, Griseri, G, Antonucci, A, Zanus, G, Tarchi, P, Baiocchi, G, Zago, M, Frena, A, Ercolani, G, Jovine, E, Maestri, M, Valle, R, Grazi, G, Romano, F, Giuliante, F, Torzilli, G, Aldrighetti, L, Ruzzenente, A, Conci S., Cipriani F., Donadon M., Marchitelli I., Ardito F., Famularo S., Perri P., Iaria M., Ansaloni L., Zanello M., La Barba G., Patauner S., Pinotti E., Molfino S., Germani P., Romano M., Sciannamea I., Ferrari C., Manzoni A., Troci A., Fumagalli L., Delvecchio A., Floridi A., Memeo R., Chiarelli M., Crespi M., Zimmitti G., Griseri G., Antonucci A., Zanus G., Tarchi P., Baiocchi G. L., Zago M., Frena A., Ercolani G., Jovine E., Maestri M., Valle R. D., Grazi G. L., Romano F., Giuliante F., Torzilli G., Aldrighetti L., and Ruzzenente A.

Abstract

Background and aims: We investigated the clinical impact of the newly defined metabolic-associated fatty liver disease (MAFLD) in patients undergoing hepatectomy for HCC (MAFLD-HCC) comparing the characteristics and outcomes of patients with MAFLD-HCC to viral- and alcoholic-related HCC (HCV-HCC, HBV-HCC, A-HCC). Methods: A retrospective analysis of patients included in the He.RC.O.Le.S. Group registry was performed. The characteristics, short- and long-term outcomes of 1315 patients included were compared according to the study group before and after an exact propensity score match (PSM). Results: Among the whole study population, 264 (20.1%) had MAFLD-HCC, 205 (15.6%) had HBV-HCC, 671 (51.0%) had HCV-HCC and 175 (13.3%) had A-HCC. MAFLD-HCC patients had higher BMI (p < 0.001), Charlson Comorbidities Index (p < 0.001), size of tumour (p < 0.001), and presence of cirrhosis (p < 0.001). After PSM, the 90-day mortality and severe morbidity rates were 5.9% and 7.1% in MAFLD-HCC, 2.3% and 7.1% in HBV-HCC, 3.5% and 11.7% in HCV-HCC, and 1.2% and 8.2% in A-HCC (p = 0.061 and p = 0.447, respectively). The 5-year OS and RFS rates were 54.4% and 37.1% in MAFLD-HCC, 64.9% and 32.2% in HBV-HCC, 53.4% and 24.7% in HCV-HCC and 62.0% and 37.8% in A-HCC (p = 0.345 and p = 0.389, respectively). Cirrhosis, multiple tumours, size and satellitosis seems to be the independent predictors of OS. Conclusion: Hepatectomy for MAFLD-HCC seems to have a higher but acceptable operative risk. However, long-term outcomes seems to be related to clinical and pathological factors rather than aetiological risk factors.

Published
2022

17. Early non compliance to enhanced recovery pathway might be an alert for underlying complications following colon surgery

Author

Ceresoli, M, Pedrazzani, C, Pellegrino, L, Ficari, F, Braga, M, Muratore, A, Tamini, N, Beretta, L, Azzola, M, Radrizzani, D, Borghi, F, Missana, G, Scatizzi, M, Totis, M, Crespi, M, Bima, C, Bouzari, H, Valenti, A, Ceretti, A, Polastri, R, Longhin, R, Maurizi, A, Cassini, D, Di Marzo, F, Fumagalli, S, Muratori, S, Casati, M, Ceresoli M., Pedrazzani C., Pellegrino L., Ficari F., Braga M., Muratore A., Tamini N., Beretta L., Azzola M., Radrizzani D., Borghi F., Missana G., Scatizzi M., Totis M., Crespi M., Bima C., Bouzari H., Valenti A., Ceretti A. P., Polastri R., Longhin R., Maurizi A., Cassini D., Di Marzo F., Fumagalli S., Muratori S., Casati M., Ceresoli, M, Pedrazzani, C, Pellegrino, L, Ficari, F, Braga, M, Muratore, A, Tamini, N, Beretta, L, Azzola, M, Radrizzani, D, Borghi, F, Missana, G, Scatizzi, M, Totis, M, Crespi, M, Bima, C, Bouzari, H, Valenti, A, Ceretti, A, Polastri, R, Longhin, R, Maurizi, A, Cassini, D, Di Marzo, F, Fumagalli, S, Muratori, S, Casati, M, Ceresoli M., Pedrazzani C., Pellegrino L., Ficari F., Braga M., Muratore A., Tamini N., Beretta L., Azzola M., Radrizzani D., Borghi F., Missana G., Scatizzi M., Totis M., Crespi M., Bima C., Bouzari H., Valenti A., Ceretti A. P., Polastri R., Longhin R., Maurizi A., Cassini D., Di Marzo F., Fumagalli S., Muratori S., and Casati M.

Abstract

Purpose: Early non compliance to postoperative ERAS pathway has been reported in 20–30% of patients who underwent elective colon surgery. The aim of the present study is to investigate the possible relationship between early non compliance and postoperative complications. Methods: We reviewed a prospective database including 1391 consecutively collected patients undergoing elective colon surgery in 22 Italian hospitals between January 2017 and June 2020. Early compliance to ERAS protocol was assessed on postoperative day (POD) 2. Failure of oral feeding, urinary catheter removal, intravenous fluids stop, and adequate mobilization were indicators of non compliance. Postoperative follow-up was carried out for 30 days after hospital discharge. The association among early postoperative ERAS compliance and the occurrence of complications was assessed with uni- and multivariate analysis. Results: A total of 1089 (78.3%) patients had malignancy and minimally invasive surgery was successfully performed in 1174 (84.3%) patients. Postoperative morbidity occurred in 403 (29.0%) patients. At multivariate analysis, male gender, open surgery, and each of the four non compliance indicators on POD 2 were significantly associated to postoperative complications. Morbidity progressively increased from 16.8% in patients with full compliance to ERAS protocol to 47.2% in patients with two non compliance indicators and 69.2% in patients with all four indicators (p < 0.001). Conclusions: Early non compliance to ERAS protocol was significantly associated with postoperative morbidity.

Published
2022

23. The Effect of a Liver Transplant Program on the Outcomes of Resectable Hepatocellular Carcinoma: A Nationwide Multicenter Analysis

Author

Serenari, M., Lenzi, J., Cucchetti, A., Cipriani, F., Donadon, M., Ardito, Francesco, Fazio, F., Nicolini, D., Iaria, M., Famularo, S., Perri, P., Ansaloni, L., Zanello, M., Lai, Q., Conci, S., Molfino, S., Ferrari, C., Germani, P., Zago, M., Romano, M., Zimmitti, G., Antonucci, A., Fumagalli, L., Troci, A., Ferraro, V., Memeo, R., Crespi, M., Chiarelli, M., Ercolani, G., Hilal, M. A., Zanus, G., Pinotti, E., Tarchi, P., Griseri, G., Baiocchi, G. L., Ruzzenente, A., Rossi, M., Jovine, E., Maestri, M., Grazi, G. L., Romano, F., Dalla Valle, R., Ravaioli, M., Vivarelli, M., Ferrero, A., Giuliante, Felice, Torzilli, G., Aldrighetti, L., Cescon, M., Gorgone, M., Ratti, F., Costa, G., Razionale, Francesco, Russolillo, N., Marinelli, Luca, Giuffrida, M., Scotti, M., Garancini, M., De Peppo, V., De Stefano, F., Laureiro, Z. L., Marchitelli, I., Franceschi, A., Cosola, D., Corleone, P., Montuori, M., Salvador, L., Manzoni, Annamaria, La Barba, G., Calcagno, P., Pennacchi, L., Conticchio, M., Ardito F. (ORCID:0000-0003-1596-2862), Giuliante F. (ORCID:0000-0001-9517-8220), Razionale F., Marinelli L., Manzoni A., Serenari, M., Lenzi, J., Cucchetti, A., Cipriani, F., Donadon, M., Ardito, Francesco, Fazio, F., Nicolini, D., Iaria, M., Famularo, S., Perri, P., Ansaloni, L., Zanello, M., Lai, Q., Conci, S., Molfino, S., Ferrari, C., Germani, P., Zago, M., Romano, M., Zimmitti, G., Antonucci, A., Fumagalli, L., Troci, A., Ferraro, V., Memeo, R., Crespi, M., Chiarelli, M., Ercolani, G., Hilal, M. A., Zanus, G., Pinotti, E., Tarchi, P., Griseri, G., Baiocchi, G. L., Ruzzenente, A., Rossi, M., Jovine, E., Maestri, M., Grazi, G. L., Romano, F., Dalla Valle, R., Ravaioli, M., Vivarelli, M., Ferrero, A., Giuliante, Felice, Torzilli, G., Aldrighetti, L., Cescon, M., Gorgone, M., Ratti, F., Costa, G., Razionale, Francesco, Russolillo, N., Marinelli, Luca, Giuffrida, M., Scotti, M., Garancini, M., De Peppo, V., De Stefano, F., Laureiro, Z. L., Marchitelli, I., Franceschi, A., Cosola, D., Corleone, P., Montuori, M., Salvador, L., Manzoni, Annamaria, La Barba, G., Calcagno, P., Pennacchi, L., Conticchio, M., Ardito F. (ORCID:0000-0003-1596-2862), Giuliante F. (ORCID:0000-0001-9517-8220), Razionale F., Marinelli L., and Manzoni A.

Abstract

Objective: To evaluate the effect of a liver transplantation (LT) program on the outcomes of resectable hepatocellular carcinoma (HCC). Background: Surgical treatment of HCC includes both hepatic resection (HR) and LT. However, the presence of cirrhosis and the possibility of recurrence make the management of this disease complex and probably different according to the presence of a LT program. Methods: Patients undergoing HR for HCC between January 2005 and December 2019 were identified from a national database of HCC. The main study outcomes were major surgical complications according to the Comprehensive Complication Index, posthepatectomy liver failure (PHLF), 90-day mortality, overall survival, and disease-free survival. Secondary outcomes were salvage liver transplantation (SLT) and postrecurrence survival. Results: A total of 3202 patients were included from 25 hospitals over the study period. Three of 25 (12%) had an LT program. The presence of an LT program within a center was associated with a reduced probability of PHLF (odds ratio=0.38) but not with overall survival and disease-free survival. There was an increased probability of SLT when HR was performed in a transplant hospital (odds ratio=12.05). Among transplant-eligible patients, those who underwent LT had a significantly longer postrecurrence survival. Conclusions: This study showed that the presence of a LT program was associated with decreased PHLF rates and an increased probability to receive SLT in case of recurrence.

Published
2023

28. Anthropogenic earthquakes monitoring with high-rate GNSS: Event detection and focal mechanism determination

Author

Kudłacik, I., Tymińska, A., Kapłon, J., Lizurek, G., Fortunato, M., Kaźmierski, K., and Crespi, M.

Abstract

Anthropogenic earthquakes are rarely monitored with high-rate GNSS. Nevertheless, the progress in the GNSS processing techniques allows recording the mining tremors of smaller amplitudes, i.e., magnitudes about 4, with high-rate GNSS as well as complementary sensors to the seismic instruments. Although high-rate GNSS recording frequency and sensitivity are lower than seismic sensors, high-rate GNSS can capture the waveforms appropriately.Here we demonstrate that if the GNSS observations are carefully filtered, we can retrieve the small signal of ground vibrations of the low-magnitude shallow anthropogenic earthquakes with the accuracy of very few millimetres for displacements and 1-2 cm/s for velocities. We analysed five mining tremors with magnitudes of 3.4-4.0 and presented the results from high-rate GNSS position changes calculated parallel with the PPP and variometric approach. We obtained satisfying correlations with seismological data in correlation, peak values comparison and earthquake first epoch determination.Moreover, we show that high-rate GNSS can be a supplementary tool for seismic moment tensor inversion for small magnitude shallow anthropogenic earthquakes and might be crucial in case of a lack of seismic data, complementing unfavourable focal coverage. The obtained full, deviatoric, and double-couple solutions are similar, which shows that GNSS data may be added for moment tensor inversion in place of seismometers if needed without significant loss of the solution quality. Finally, considering the high-rate GNSS positioning noise level, we demonstrate the capacity to resolve the dynamic displacements from high-rate GNSS at the epicentral distance of about 7-8 km., The 28th IUGG General Assembly (IUGG2023) (Berlin 2023)

Published
2023
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32. Curative versus palliative treatments for recurrent hepatocellular carcinoma: a multicentric weighted comparison

Author

Famularo, S, Donadon, M, Cipriani, F, Bernasconi, D, Labarba, G, Dominioni, T, Iaria, M, Molfino, S, Conci, S, Ferrari, C, Garatti, M, Delvecchio, A, Troci, A, Patauner, S, Frassani, S, Cosimelli, M, Zanus, G, Giuliante, F, Jovine, E, Valsecchi, M, Grazi, G, Antonucci, A, Frena, A, Crespi, M, Memeo, R, Zimmitti, G, Griseri, G, Ruzzenente, A, Baiocchi, G, Dallavalle, R, Maestri, M, Ercolani, G, Aldrighetti, L, Torzilli, G, Romano, F, Ciulli, C, Giani, A, Carissimi, F, Costa, G, Ratti, F, Cucchetti, A, Calabrese, F, Cremaschi, E, Lazzari, G, Franceschi, A, Sega, V, Conticchio, M, Pennacchi, L, Ciola, M, Sciannamea, I, De Peppo, V, Famularo S., Donadon M., Cipriani F., Bernasconi D. P., LaBarba G., Dominioni T., Iaria M., Molfino S., Conci S., Ferrari C., Garatti M., Delvecchio A., Troci A., Patauner S., Frassani S., Cosimelli M., Zanus G., Giuliante F., Jovine E., Valsecchi M. G., Grazi G., Antonucci A., Frena A., Crespi M., Memeo R., Zimmitti G., Griseri G., Ruzzenente A., Baiocchi G., DallaValle R., Maestri M., Ercolani G., Aldrighetti L., Torzilli G., Romano F., Ciulli C., Giani A., Carissimi F., Costa G., Ratti F., Cucchetti A., Calabrese F., Cremaschi E., Lazzari G., Franceschi A., Sega V., Conticchio M., Pennacchi L., Ciola M., Sciannamea I., De Peppo V., Famularo, S, Donadon, M, Cipriani, F, Bernasconi, D, Labarba, G, Dominioni, T, Iaria, M, Molfino, S, Conci, S, Ferrari, C, Garatti, M, Delvecchio, A, Troci, A, Patauner, S, Frassani, S, Cosimelli, M, Zanus, G, Giuliante, F, Jovine, E, Valsecchi, M, Grazi, G, Antonucci, A, Frena, A, Crespi, M, Memeo, R, Zimmitti, G, Griseri, G, Ruzzenente, A, Baiocchi, G, Dallavalle, R, Maestri, M, Ercolani, G, Aldrighetti, L, Torzilli, G, Romano, F, Ciulli, C, Giani, A, Carissimi, F, Costa, G, Ratti, F, Cucchetti, A, Calabrese, F, Cremaschi, E, Lazzari, G, Franceschi, A, Sega, V, Conticchio, M, Pennacchi, L, Ciola, M, Sciannamea, I, De Peppo, V, Famularo S., Donadon M., Cipriani F., Bernasconi D. P., LaBarba G., Dominioni T., Iaria M., Molfino S., Conci S., Ferrari C., Garatti M., Delvecchio A., Troci A., Patauner S., Frassani S., Cosimelli M., Zanus G., Giuliante F., Jovine E., Valsecchi M. G., Grazi G., Antonucci A., Frena A., Crespi M., Memeo R., Zimmitti G., Griseri G., Ruzzenente A., Baiocchi G., DallaValle R., Maestri M., Ercolani G., Aldrighetti L., Torzilli G., Romano F., Ciulli C., Giani A., Carissimi F., Costa G., Ratti F., Cucchetti A., Calabrese F., Cremaschi E., Lazzari G., Franceschi A., Sega V., Conticchio M., Pennacchi L., Ciola M., Sciannamea I., and De Peppo V.

Abstract

Background: Management of recurrence after surgery for hepatocellular carcinoma (rHCC) is still a debate. The aim was to compare the Survival after Recurrence (SAR) of curative (surgery or thermoablation) versus palliative (TACE or Sorafenib) treatments for patients with rHCC. Methods: This is a multicentric Italian study, which collected data between 2007 and 2018 from 16 centers. Selected patients were then divided according to treatment allocation in Curative (CUR) or Palliative (PAL) Group. Inverse Probability Weighting (IPW) was used to weight the groups. Results: 1,560 patients were evaluated, of which 421 experienced recurrence and were then eligible: 156 in CUR group and 256 in PAL group. Tumor burden and liver function were weighted by IPW, and two pseudo-population were obtained (CUR = 397.5 and PAL = 415.38). SAR rates at 1, 3 and 5 years were respectively 98.3%, 76.7%, 63.8% for CUR and 91.7%, 64.2% and 48.9% for PAL (p = 0.007). Median DFS was 43 months (95%CI = 32-74) for CUR group, while it was 23 months (95%CI = 18-27) for PAL (p = 0.017). Being treated by palliative approach (HR = 1.75; 95%CI = 1.14–2.67; p = 0.01) and having a median size of the recurrent nodule>5 cm (HR = 1.875; 95%CI = 1.22–2.86; p = 0.004) were the only predictors of mortality after recurrence, while time to recurrence was the only protective factor (HR = 0.616; 95%CI = 0.54–0.69; p<0.001). Conclusion: Curative approaches may guarantee long-term survival in case of recurrence.

Published
2021

33. The Impact of Postoperative Ascites on Survival After Surgery for Hepatocellular Carcinoma: a National Study

Author

Famularo, S, Donadon, M, Cipriani, F, Ardito, F, Iaria, M, Carissimi, F, Perri, P, Dominioni, T, Zanello, M, Conci, S, Molfino, S, D'Acapito, F, Germani, P, Ferrari, C, Patauner, S, Pinotti, E, Sciannamea, I, Garatti, M, Lodo, E, Troci, A, Delvecchio, A, Floridi, A, Bernasconi, D, Fumagalli, L, Chiarelli, M, Memeo, R, Crespi, M, Zanus, G, Zimmitti, G, Antonucci, A, Zago, M, Frena, A, Griseri, G, Tarchi, P, Ercolani, G, Baiocchi, G, Ruzzenente, A, Jovine, E, Maestri, M, Grazi, G, Valle, R, Giuliante, F, Aldrighetti, L, Romano, F, Torzilli, G, Costa, G, Ciulli, C, Giani, A, Ratti, F, Bellobono, M, Cremaschi, E, Valsecchi, M, De Peppo, V, Calabrese, F, Desario, G, Lazzari, G, Cucchetti, A, Cosola, D, Percivale, A, Ciola, M, Montuori, M, Frassani, S, Manzoni, A, Salvador, L, Pennacchi, L, Corleone, P, Conticchio, M, Famularo S., Donadon M., Cipriani F., Ardito F., Iaria M., Carissimi F., Perri P., Dominioni T., Zanello M., Conci S., Molfino S., D'Acapito F., Germani P., Ferrari C., Patauner S., Pinotti E., Sciannamea I., Garatti M., Lodo E., Troci A., Delvecchio A., Floridi A., Bernasconi D. P., Fumagalli L., Chiarelli M., Memeo R., Crespi M., Zanus G., Zimmitti G., Antonucci A., Zago M., Frena A., Griseri G., Tarchi P., Ercolani G., Baiocchi G. L., Ruzzenente A., Jovine E., Maestri M., Grazi G. L., Valle R. D., Giuliante F., Aldrighetti L., Romano F., Torzilli G., Costa G., Ciulli C., Giani A., Ratti F., Bellobono M., Cremaschi E., Valsecchi M. G., De Peppo V., Calabrese F., DeSario G., Lazzari G., Cucchetti A., Cosola D., Percivale A., Ciola M., Montuori M., Frassani S., Manzoni A., Salvador L., Pennacchi L., Corleone P., Conticchio M., Famularo, S, Donadon, M, Cipriani, F, Ardito, F, Iaria, M, Carissimi, F, Perri, P, Dominioni, T, Zanello, M, Conci, S, Molfino, S, D'Acapito, F, Germani, P, Ferrari, C, Patauner, S, Pinotti, E, Sciannamea, I, Garatti, M, Lodo, E, Troci, A, Delvecchio, A, Floridi, A, Bernasconi, D, Fumagalli, L, Chiarelli, M, Memeo, R, Crespi, M, Zanus, G, Zimmitti, G, Antonucci, A, Zago, M, Frena, A, Griseri, G, Tarchi, P, Ercolani, G, Baiocchi, G, Ruzzenente, A, Jovine, E, Maestri, M, Grazi, G, Valle, R, Giuliante, F, Aldrighetti, L, Romano, F, Torzilli, G, Costa, G, Ciulli, C, Giani, A, Ratti, F, Bellobono, M, Cremaschi, E, Valsecchi, M, De Peppo, V, Calabrese, F, Desario, G, Lazzari, G, Cucchetti, A, Cosola, D, Percivale, A, Ciola, M, Montuori, M, Frassani, S, Manzoni, A, Salvador, L, Pennacchi, L, Corleone, P, Conticchio, M, Famularo S., Donadon M., Cipriani F., Ardito F., Iaria M., Carissimi F., Perri P., Dominioni T., Zanello M., Conci S., Molfino S., D'Acapito F., Germani P., Ferrari C., Patauner S., Pinotti E., Sciannamea I., Garatti M., Lodo E., Troci A., Delvecchio A., Floridi A., Bernasconi D. P., Fumagalli L., Chiarelli M., Memeo R., Crespi M., Zanus G., Zimmitti G., Antonucci A., Zago M., Frena A., Griseri G., Tarchi P., Ercolani G., Baiocchi G. L., Ruzzenente A., Jovine E., Maestri M., Grazi G. L., Valle R. D., Giuliante F., Aldrighetti L., Romano F., Torzilli G., Costa G., Ciulli C., Giani A., Ratti F., Bellobono M., Cremaschi E., Valsecchi M. G., De Peppo V., Calabrese F., DeSario G., Lazzari G., Cucchetti A., Cosola D., Percivale A., Ciola M., Montuori M., Frassani S., Manzoni A., Salvador L., Pennacchi L., Corleone P., and Conticchio M.

Abstract

Background: Postoperative ascites (POA) is the most common complication after liver surgery for hepatocarcinoma (HCC), but its impact on survival is not reported. The aim of the study is to investigate its impact on overall survival (OS) and disease-free survival (DFS), and secondarily to identify the factors that may predict the occurrence. Method: Data were collected from 23 centers participating in the Italian Surgical HCC Register (HE.RC.O.LE.S. Group) between 2008 and 2018. POA was defined as ≥500 ml of ascites in the drainage after surgery. Survival analysis was conducted by the Kaplan Meier method. Risk adjustment analysis was conducted by Cox regression to investigate the risk factors for mortality and recurrence. Results: Among 2144 patients resected for HCC, 1871(88.5%) patients did not experience POA while 243(11.5%) had the complication. Median OS for NO-POA group was not reached, while it was 50 months (95%CI = 41–71) for those with POA (p < 0.001). POA independently increased the risk of mortality (HR = 1.696, 95%CI = 1.352–2.129, p < 0.001). Relapse risk after surgery was not predicted by the occurrence of POA. Presence of varices (OR = 2.562, 95%CI = 0.921–1.822, p < 0.001) and bilobar disease (OR = 1.940, 95%CI = 0.921–1.822, p: 0.004) were predictors of POA, while laparoscopic surgery was protective (OR = 0.445, 95%CI = 0.295–0.668, p < 0.001). Ninety-day mortality was higher in the POA group (9.1% vs 1.9% in NO-POA group, p < 0.001). Conclusion: The occurrence of POA after surgery for HCC strongly increases the risk of long-term mortality and its occurrence is relatively frequent. More efforts in surgical planning should be made to limit its occurrence.

Published
2021

36. The Impact of Postoperative Ascites on Survival After Surgery for Hepatocellular Carcinoma: a National Study

Author

Famularo, S., Donadon, M., Cipriani, F., Ardito, F., Iaria, M., Carissimi, F., Perri, P., Dominioni, T., Zanello, M., Conci, S., Molfino, S., D'Acapito, F., Germani, P., Ferrari, C., Patauner, S., Pinotti, E., Sciannamea, I., Garatti, M., Lodo, E., Troci, A., Delvecchio, A., Floridi, A., Bernasconi, D. P., Fumagalli, L., Chiarelli, M., Memeo, R., Crespi, M., Zanus, G., Zimmitti, G., Antonucci, A., Zago, M., Frena, A., Griseri, G., Tarchi, P., Ercolani, G., Baiocchi, G. L., Ruzzenente, A., Jovine, E., Maestri, M., Grazi, G. L., Valle, R. D., Giuliante, F., Aldrighetti, L., Romano, F., Torzilli, G., Costa, G., Ciulli, C., Giani, A., Ratti, F., Bellobono, M., Cremaschi, E., Valsecchi, M. G., De Peppo, V., Calabrese, F., Desario, G., Lazzari, G., Cucchetti, A., Cosola, D., Percivale, A., Ciola, M., Montuori, M., Frassani, S., Manzoni, A., Salvador, L., Pennacchi, L., Corleone, P., Conticchio, M., Famularo, S., Donadon, M., Cipriani, F., Ardito, F., Iaria, M., Carissimi, F., Perri, P., Dominioni, T., Zanello, M., Conci, S., Molfino, S., D'Acapito, F., Germani, P., Ferrari, C., Patauner, S., Pinotti, E., Sciannamea, I., Garatti, M., Lodo, E., Troci, A., Delvecchio, A., Floridi, A., Bernasconi, D. P., Fumagalli, L., Chiarelli, M., Memeo, R., Crespi, M., Zanus, G., Zimmitti, G., Antonucci, A., Zago, M., Frena, A., Griseri, G., Tarchi, P., Ercolani, G., Baiocchi, G. L., Ruzzenente, A., Jovine, E., Maestri, M., Grazi, G. L., Valle, R. D., Giuliante, F., Aldrighetti, L., Romano, F., Torzilli, G., Costa, G., Ciulli, C., Giani, A., Ratti, F., Bellobono, M., Cremaschi, E., Valsecchi, M. G., De Peppo, V., Calabrese, F., Desario, G., Lazzari, G., Cucchetti, A., Cosola, D., Percivale, A., Ciola, M., Montuori, M., Frassani, S., Manzoni, A., Salvador, L., Pennacchi, L., Corleone, P., Conticchio, M., Famularo S., Donadon M., Cipriani F., Ardito F., Iaria M., Carissimi F., Perri P., Dominioni T., Zanello M., Conci S., Molfino S., D'Acapito F., Germani P., Ferrari C., Patauner S., Pinotti E., Sciannamea I., Garatti M., Lodo E., Troci A., Delvecchio A., Floridi A., Bernasconi D.P., Fumagalli L., Chiarelli M., Memeo R., Crespi M., Zanus G., Zimmitti G., Antonucci A., Zago M., Frena A., Griseri G., Tarchi P., Ercolani G., Baiocchi G.L., Ruzzenente A., Jovine E., Maestri M., Grazi G.L., Valle R.D., Giuliante F., Aldrighetti L., Romano F., Torzilli G., Costa G., Ciulli C., Giani A., Ratti F., Bellobono M., Cremaschi E., Valsecchi M.G., De Peppo V., Calabrese F., DeSario G., Lazzari G., Cucchetti A., Cosola D., Percivale A., Ciola M., Montuori M., Frassani S., Manzoni A., Salvador L., Pennacchi L., Corleone P., Conticchio M., Famularo, S, Donadon, M, Cipriani, F, Ardito, F, Iaria, M, Carissimi, F, Perri, P, Dominioni, T, Zanello, M, Conci, S, Molfino, S, D'Acapito, F, Germani, P, Ferrari, C, Patauner, S, Pinotti, E, Sciannamea, I, Garatti, M, Lodo, E, Troci, A, Delvecchio, A, Floridi, A, Bernasconi, D, Fumagalli, L, Chiarelli, M, Memeo, R, Crespi, M, Zanus, G, Zimmitti, G, Antonucci, A, Zago, M, Frena, A, Griseri, G, Tarchi, P, Ercolani, G, Baiocchi, G, Ruzzenente, A, Jovine, E, Maestri, M, Grazi, G, Valle, R, Giuliante, F, Aldrighetti, L, Romano, F, Torzilli, G, Costa, G, Ciulli, C, Giani, A, Ratti, F, Bellobono, M, Cremaschi, E, Valsecchi, M, De Peppo, V, Calabrese, F, Desario, G, Lazzari, G, Cucchetti, A, Cosola, D, Percivale, A, Ciola, M, Montuori, M, Frassani, S, Manzoni, A, Salvador, L, Pennacchi, L, Corleone, P, and Conticchio, M

Subjects
Laparoscopic surgery, medicine.medical_specialty, endocrine system, Carcinoma, Hepatocellular, Disease-free survival, Hepatocellular carcinoma, medicine.medical_treatment, Settore MED/18 - CHIRURGIA GENERALE, 030230 surgery, NO, Liver surgery, Overall survival, Postoperative ascites, Postoperative complications, 03 medical and health sciences, 0302 clinical medicine, Retrospective Studie, Ascites, Risk of mortality, Medicine, Hepatectomy, Humans, Survival analysis, LS7_4, Retrospective Studies, business.industry, Proportional hazards model, Carcinoma, Liver Neoplasms, Gastroenterology, Hepatocellular, medicine.disease, Surgery, Postoperative complication, Postoperative ascite, Neoplasm Recurrence, Local, 030220 oncology & carcinogenesis, Ascite, medicine.symptom, Neoplasm Recurrence, Local, business, Complication, Varices, Human
Abstract

Background: Postoperative ascites (POA) is the most common complication after liver surgery for hepatocarcinoma (HCC), but its impact on survival is not reported. The aim of the study is to investigate its impact on overall survival (OS) and disease-free survival (DFS), and secondarily to identify the factors that may predict the occurrence. Method: Data were collected from 23 centers participating in the Italian Surgical HCC Register (HE.RC.O.LE.S. Group) between 2008 and 2018. POA was defined as ≥500 ml of ascites in the drainage after surgery. Survival analysis was conducted by the Kaplan Meier method. Risk adjustment analysis was conducted by Cox regression to investigate the risk factors for mortality and recurrence. Results: Among 2144 patients resected for HCC, 1871(88.5%) patients did not experience POA while 243(11.5%) had the complication. Median OS for NO-POA group was not reached, while it was 50 months (95%CI = 41–71) for those with POA (p < 0.001). POA independently increased the risk of mortality (HR = 1.696, 95%CI = 1.352–2.129, p < 0.001). Relapse risk after surgery was not predicted by the occurrence of POA. Presence of varices (OR = 2.562, 95%CI = 0.921–1.822, p < 0.001) and bilobar disease (OR = 1.940, 95%CI = 0.921–1.822, p: 0.004) were predictors of POA, while laparoscopic surgery was protective (OR = 0.445, 95%CI = 0.295–0.668, p < 0.001). Ninety-day mortality was higher in the POA group (9.1% vs 1.9% in NO-POA group, p < 0.001). Conclusion: The occurrence of POA after surgery for HCC strongly increases the risk of long-term mortality and its occurrence is relatively frequent. More efforts in surgical planning should be made to limit its occurrence.

Published
2021

38. The Impact of Hospital Volume on Failure to Rescue after Liver Resection for Hepatocellular Carcinoma: Analysis from the HE.RC.O.LE.S. Italian Registry

Author

Ardito, F, Famularo, S, Aldrighetti, L, Grazi, G, Dallavalle, R, Maestri, M, Jovine, E, Ruzzenente, A, Baiocchi, G, Ercolani, G, Griseri, G, Frena, A, Zanus, G, Zimmitti, G, Antonucci, A, Crespi, M, Memeo, R, Romano, F, Giuliante, F, Ardito F., Famularo S., Aldrighetti L., Grazi G. L., DallaValle R., Maestri M., Jovine E., Ruzzenente A., Baiocchi G. L., Ercolani G., Griseri G., Frena A., Zanus G., Zimmitti G., Antonucci A., Crespi M., Memeo R., Romano F., Giuliante F., Ardito, F, Famularo, S, Aldrighetti, L, Grazi, G, Dallavalle, R, Maestri, M, Jovine, E, Ruzzenente, A, Baiocchi, G, Ercolani, G, Griseri, G, Frena, A, Zanus, G, Zimmitti, G, Antonucci, A, Crespi, M, Memeo, R, Romano, F, Giuliante, F, Ardito F., Famularo S., Aldrighetti L., Grazi G. L., DallaValle R., Maestri M., Jovine E., Ruzzenente A., Baiocchi G. L., Ercolani G., Griseri G., Frena A., Zanus G., Zimmitti G., Antonucci A., Crespi M., Memeo R., Romano F., and Giuliante F.

Abstract

OBJECTIVE: The aim of this study was to evaluate correlation between centers' volume and incidence of failure to rescue (FTR) following liver resection for hepatocellular carcinoma (HCC). SUMMARY BACKGROUND DATA: FTR, defined as the probability of postoperative death among patients with major complication, has been proposed to assess quality of care during hospitalization. Perioperative management is challenging in cirrhotic patients and the ability to recognize and treat a complication may be fundamental to rescue patients from the risk of death. METHODS: Patients undergoing liver resection for HCC between 2008 and 2018 in 18 Centers enrolled in the He.Rc.O.Le.S. Italian register. Early results included major complications (Clavien ≥3), 90-day mortality, and FTR and were analyzed according to center's volume. RESULTS: Among 1935 included patients, major complication rate was 9.4% (8.6%, 12.3%, and 7.0% for low-, intermediate- and high-volume centers, respectively, P = 0.001). Ninety-day mortality rate was 2.6% (3.7%, 4.2% and 0.9% for low-, intermediate- and high-volume centers, respectively, P < 0.001). FTR was significantly higher at low- and intermediate-volume centers (28.6% and 26.5%, respectively) than at high-volume centers (6.1%, P = 0.002). Independent predictors for major complications were American Society of Anesthesiologists (ASA) >2, portal hypertension, intraoperative blood transfusions, and center's volume. Independent predictors for 90-day mortality were ASA >2, Child-Pugh score B, BCLC stage B-C, and center's volume. Center's volume and BCLC stage were strongly associated with FTR. CONCLUSIONS: Risk of major complications and mortality was related with comorbidities, cirrhosis severity, and complexity of surgery. These factors were not correlated with FTR. Center's volume was the only independent predictor related with severe complications, mortality, and FTR.

Published
2020

39. Hepatocellular carcinoma surgical and oncological trends in a national multicentric population: the HERCOLES experience

Author

Famularo, S, Donadon, M, Cipriani, F, Ardito, F, Carissimi, F, Perri, P, Iaria, M, Dominioni, T, Zanello, M, Conci, S, Molfino, S, Labarba, G, Ferrari, C, Germani, P, Patauner, S, Pinotti, E, Lodo, E, Garatti, M, Sciannamea, I, Troci, A, Conticchio, M, Floridi, A, Chiarelli, M, Fumagalli, L, Memeo, R, Crespi, M, Antonucci, A, Zimmitti, G, Zanus, G, Zago, M, Frena, A, Tarchi, P, Griseri, G, Ercolani, G, Baiocchi, G, Ruzzenente, A, Jovine, E, Maestri, M, Dallavalle, R, Grazi, G, Giuliante, F, Aldrighetti, L, Torzilli, G, Romano, F, Bernasconi, D, Ciulli, C, Giani, A, Costa, G, Ratti, F, Bellobono, M, Calabrese, F, Cremaschi, E, De Peppo, V, Cucchetti, A, Lazzari, G, Percivale, A, Ciola, M, Sega, V, Frassani, S, Del Vecchio, A, Pennacchi, L, Corleone, P, Cosola, D, Salvador, L, Montuori, M, Famularo S., Donadon M., Cipriani F., Ardito F., Carissimi F., Perri P., Iaria M., Dominioni T., Zanello M., Conci S., Molfino S., LaBarba G., Ferrari C., Germani P., Patauner S., Pinotti E., Lodo E., Garatti M., Sciannamea I., Troci A., Conticchio M., Floridi A., Chiarelli M., Fumagalli L., Memeo R., Crespi M., Antonucci A., Zimmitti G., Zanus G., Zago M., Frena A., Tarchi P., Griseri G., Ercolani G., Baiocchi G. L., Ruzzenente A., Jovine E., Maestri M., DallaValle R., Grazi G. L., Giuliante F., Aldrighetti L., Torzilli G., Romano F., Bernasconi D. P., Ciulli C., Giani A., Costa G., Ratti F., Bellobono M., Calabrese F., Cremaschi E., De Peppo V., Cucchetti A., Lazzari G., Percivale A., Ciola M., Sega V., Frassani S., Del Vecchio A., Pennacchi L., Corleone P., Cosola D., Salvador L., Montuori M., Famularo, S, Donadon, M, Cipriani, F, Ardito, F, Carissimi, F, Perri, P, Iaria, M, Dominioni, T, Zanello, M, Conci, S, Molfino, S, Labarba, G, Ferrari, C, Germani, P, Patauner, S, Pinotti, E, Lodo, E, Garatti, M, Sciannamea, I, Troci, A, Conticchio, M, Floridi, A, Chiarelli, M, Fumagalli, L, Memeo, R, Crespi, M, Antonucci, A, Zimmitti, G, Zanus, G, Zago, M, Frena, A, Tarchi, P, Griseri, G, Ercolani, G, Baiocchi, G, Ruzzenente, A, Jovine, E, Maestri, M, Dallavalle, R, Grazi, G, Giuliante, F, Aldrighetti, L, Torzilli, G, Romano, F, Bernasconi, D, Ciulli, C, Giani, A, Costa, G, Ratti, F, Bellobono, M, Calabrese, F, Cremaschi, E, De Peppo, V, Cucchetti, A, Lazzari, G, Percivale, A, Ciola, M, Sega, V, Frassani, S, Del Vecchio, A, Pennacchi, L, Corleone, P, Cosola, D, Salvador, L, Montuori, M, Famularo S., Donadon M., Cipriani F., Ardito F., Carissimi F., Perri P., Iaria M., Dominioni T., Zanello M., Conci S., Molfino S., LaBarba G., Ferrari C., Germani P., Patauner S., Pinotti E., Lodo E., Garatti M., Sciannamea I., Troci A., Conticchio M., Floridi A., Chiarelli M., Fumagalli L., Memeo R., Crespi M., Antonucci A., Zimmitti G., Zanus G., Zago M., Frena A., Tarchi P., Griseri G., Ercolani G., Baiocchi G. L., Ruzzenente A., Jovine E., Maestri M., DallaValle R., Grazi G. L., Giuliante F., Aldrighetti L., Torzilli G., Romano F., Bernasconi D. P., Ciulli C., Giani A., Costa G., Ratti F., Bellobono M., Calabrese F., Cremaschi E., De Peppo V., Cucchetti A., Lazzari G., Percivale A., Ciola M., Sega V., Frassani S., Del Vecchio A., Pennacchi L., Corleone P., Cosola D., Salvador L., and Montuori M.

Abstract

Liver surgery is the first line treatment for hepatocarcinoma. Hepatocarcinoma Recurrence on the Liver Study (HERCOLES) Group was established in 2018 with the goal to create a network of Italian centres sharing data and promoting scientific research on hepatocellular carcinoma (HCC) in the surgical field. This is the first national report that analyses the trends in surgical and oncological outcomes. Register data were collected by 22 Italian centres between 2008 and 2018. One hundred sixty-four variables were collected, regarding liver functional status, tumour burden, radiological, intraoperative and perioperative data, histological features and oncological follow-up. 2381 Patients were enrolled. Median age was 70 (IQR 63–75) years old. Cirrhosis was present in 1491 patients (62.6%), and Child-A were 89.9% of cases. HCC was staged as BCLC0-A in almost 50% of cases, while BCLC B and C were 20.7% and 17.9% respectively. Major liver resections were 481 (20.2%), and laparoscopy was employed in 753 (31.6%) cases. Severe complications occurred only in 5%. Postoperative ascites was recorded in 10.5% of patients, while posthepatectomy liver failure was observed in 4.9%. Ninety-day mortality was 2.5%. At 5 years, overall survival was 66.1% and disease-free survival was 40.9%. Recurrence was intrahepatic in 74.6% of cases. Redo-surgery and thermoablation for recurrence were performed up to 32% of cases. This is the most updated Italian report of the national experience in surgical treatment for HCC. This dataset is consistently allowing the participating centres in creating multicentric analysis which are already running with a very large sample size and strong power.

Published
2020

40. Performance of comprehensive complication index and clavien‐dindo complication scoring system in liver surgery for hepatocellular carcinoma

Author

Giani, A, Cipriani, F, Famularo, S, Donadon, M, Bernasconi, D, Ardito, F, Fazio, F, Nicolini, D, Perri, P, Giuffrida, M, Pontarolo, N, Zanello, M, Lai, Q, Conci, S, Molfino, S, Germani, P, Pinotti, E, Romano, M, La Barba, G, Ferrari, C, Patauner, S, Manzoni, A, Sciannamea, I, Fumagalli, L, Troci, A, Ferraro, V, Floridi, A, Memeo, R, Crespi, M, Chiarelli, M, Antonucci, A, Zimmitti, G, Frena, A, Percivale, A, Ercolani, G, Zanus, G, Zago, M, Tarchi, P, Baiocchi, G, Ruzzenente, A, Rossi, M, Jovine, E, Maestri, M, Valle, R, Grazi, G, Vivarelli, M, Ferrero, A, Giuliante, F, Torzilli, G, Aldrighetti, L, Gianotti, L, Romano, F, Ciulli, C, Braga, M, Ratti, F, Costa, G, Razionale, F, Russolillo, N, Marinelli, L, De Peppo, V, Cremaschi, E, Calabrese, F, Laureiro, Z, Lazzari, G, Cosola, D, Montuori, M, Salvador, L, Cucchetti, A, Franceschi, A, Ciola, M, Sega, V, Calcagno, P, Pennacchi, L, Tedeschi, M, Giani A., Cipriani F., Famularo S., Donadon M., Bernasconi D. P., Ardito F., Fazio F., Nicolini D., Perri P., Giuffrida M., Pontarolo N., Zanello M., Lai Q., Conci S., Molfino S., Germani P., Pinotti E., Romano M., La Barba G., Ferrari C., Patauner S., Manzoni A., Sciannamea I., Fumagalli L., Troci A., Ferraro V., Floridi A., Memeo R., Crespi M., Chiarelli M., Antonucci A., Zimmitti G., Frena A., Percivale A., Ercolani G., Zanus G., Zago M., Tarchi P., Baiocchi G. L., Ruzzenente A., Rossi M., Jovine E., Maestri M., Valle R. D., Grazi G. L., Vivarelli M., Ferrero A., Giuliante F., Torzilli G., Aldrighetti L., Gianotti L., Romano F., Ciulli C., Braga M., Ratti F., Costa G., Razionale F., Russolillo N., Marinelli L., De Peppo V., Cremaschi E., Calabrese F., Laureiro Z. L., Lazzari G., Cosola D., Montuori M., Salvador L., Cucchetti A., Franceschi A., Ciola M., Sega V., Calcagno P., Pennacchi L., Tedeschi M., Giani, A, Cipriani, F, Famularo, S, Donadon, M, Bernasconi, D, Ardito, F, Fazio, F, Nicolini, D, Perri, P, Giuffrida, M, Pontarolo, N, Zanello, M, Lai, Q, Conci, S, Molfino, S, Germani, P, Pinotti, E, Romano, M, La Barba, G, Ferrari, C, Patauner, S, Manzoni, A, Sciannamea, I, Fumagalli, L, Troci, A, Ferraro, V, Floridi, A, Memeo, R, Crespi, M, Chiarelli, M, Antonucci, A, Zimmitti, G, Frena, A, Percivale, A, Ercolani, G, Zanus, G, Zago, M, Tarchi, P, Baiocchi, G, Ruzzenente, A, Rossi, M, Jovine, E, Maestri, M, Valle, R, Grazi, G, Vivarelli, M, Ferrero, A, Giuliante, F, Torzilli, G, Aldrighetti, L, Gianotti, L, Romano, F, Ciulli, C, Braga, M, Ratti, F, Costa, G, Razionale, F, Russolillo, N, Marinelli, L, De Peppo, V, Cremaschi, E, Calabrese, F, Laureiro, Z, Lazzari, G, Cosola, D, Montuori, M, Salvador, L, Cucchetti, A, Franceschi, A, Ciola, M, Sega, V, Calcagno, P, Pennacchi, L, Tedeschi, M, Giani A., Cipriani F., Famularo S., Donadon M., Bernasconi D. P., Ardito F., Fazio F., Nicolini D., Perri P., Giuffrida M., Pontarolo N., Zanello M., Lai Q., Conci S., Molfino S., Germani P., Pinotti E., Romano M., La Barba G., Ferrari C., Patauner S., Manzoni A., Sciannamea I., Fumagalli L., Troci A., Ferraro V., Floridi A., Memeo R., Crespi M., Chiarelli M., Antonucci A., Zimmitti G., Frena A., Percivale A., Ercolani G., Zanus G., Zago M., Tarchi P., Baiocchi G. L., Ruzzenente A., Rossi M., Jovine E., Maestri M., Valle R. D., Grazi G. L., Vivarelli M., Ferrero A., Giuliante F., Torzilli G., Aldrighetti L., Gianotti L., Romano F., Ciulli C., Braga M., Ratti F., Costa G., Razionale F., Russolillo N., Marinelli L., De Peppo V., Cremaschi E., Calabrese F., Laureiro Z. L., Lazzari G., Cosola D., Montuori M., Salvador L., Cucchetti A., Franceschi A., Ciola M., Sega V., Calcagno P., Pennacchi L., and Tedeschi M.

Abstract

Background: We aimed to assess the ability of comprehensive complication index (CCI) and Clavien‐Dindo complication (CDC) scale to predict excessive length of hospital stay (e‐LOS) in patients undergoing liver resection for hepatocellular carcinoma. Methods: Patients were identified from an Italian multi‐institutional database and randomly selected to be included in either a derivation or validation set. Multivariate logistic regression models and ROC curve analysis including either CCI or CDC as predictors of e‐LOS were fitted to compare predictive performance. E‐LOS was defined as a LOS longer than the 75th percentile among patients with at least one complication. Results: A total of 2669 patients were analyzed (1345 for derivation and 1324 for validation). The odds ratio (OR) was 5.590 (95%CI 4.201; 7.438) for CCI and 5.507 (4.152; 7.304) for CDC. The AUC was 0.964 for CCI and 0.893 for CDC in the derivation set and 0.962 vs. 0.890 in the validation set, respectively. In patients with at least two complications, the OR was 2.793 (1.896; 4.115) for CCI and 2.439 (1.666; 3.570) for CDC with an AUC of 0.850 and 0.673, respectively in the derivation cohort. The AUC was 0.806 for CCI and 0.658 for CDC in the validation set. Conclusions: When reporting postoperative morbidity in liver surgery, CCI is a preferable scale.

Published
2020

42. The critical view of safety during laparoscopic cholecystectomy: Strasberg Yes or No? An Italian Multicentre study

Author

Sgaramella, L. I., Gurrado, A., Pasculli, A., de Angelis, N., Memeo, R., Prete, F. P., Berti, S., Ceccarelli, G., Rigamonti, M., Badessi, F. G. A., Solari, N., Milone, M., Catena, F., Scabini, S., Vittore, F., Perrone, G., de Werra, C., Cafiero, F., Testini, M., Baiocchi, G. L., Baldazzi, G., Battocletti, M., Bertoglio, S., Bianco, P., Bugiantella, W., Ciaccio, G., Cobianchi, L., Conzo, G., Crespi, M., De Rosa, M., Di Meo, G., Docimo, L., Fabris, L., Feleppa, C., Ferraro, V., Fontana, T., Gambardella, C., Gennai, A., Guida, F., Invernizzi, L., Massobrio, A., Medas, F., Monaco, L., Muntoni, G., Musella, M., Palombo, D., Perinotti, R., Pertile, D., Pezzolla, A., Piccirillo, G., Polastri, R., Ruggiero, R., Scatizzi, M., Somaglino, C., Tolone, S., Traverso, E., Tutino, R., Valduga, C., Zuolo, M., Sgaramella, L. I., Gurrado, A., Pasculli, A., de Angelis, N., Memeo, R., Prete, F. P., Berti, S., Ceccarelli, G., Rigamonti, M., Badessi, F. G. A., Solari, N., Milone, M., Catena, F., Scabini, S., Vittore, F., Perrone, G., de Werra, C., Cafiero, F., Testini, M., Baiocchi, G. L., Baldazzi, G., Battocletti, M., Bertoglio, S., Bianco, P., Bugiantella, W., Ciaccio, G., Cobianchi, L., Conzo, G., Crespi, M., De Rosa, M., Di Meo, G., Docimo, L., Fabris, L., Feleppa, C., Ferraro, V., Fontana, T., Gambardella, C., Gennai, A., Guida, F., Invernizzi, L., Massobrio, A., Medas, F., Monaco, L., Muntoni, G., Musella, M., Palombo, D., Perinotti, R., Pertile, D., Pezzolla, A., Piccirillo, G., Polastri, R., Ruggiero, R., Scatizzi, M., Somaglino, C., Tolone, S., Traverso, E., Tutino, R., Valduga, C., Zuolo, M., Sgaramella L.I., Gurrado A., Pasculli A., de Angelis N., Memeo R., Prete F.P., Berti S., Ceccarelli G., Rigamonti M., Badessi F.G.A., Solari N., Milone M., Catena F., Scabini S., Vittore F., Perrone G., de Werra C., Cafiero F., Testini M., Baiocchi G.L., Baldazzi G., Battocletti M., Bertoglio S., Bianco P., Bugiantella W., Ciaccio G., Cobianchi L., Conzo G., Crespi M., De Rosa M., Di Meo G., Docimo L., Fabris L., Feleppa C., Ferraro V., Fontana T., Gambardella C., Gennai A., Guida F., Invernizzi L., Massobrio A., Medas F., Monaco L., Muntoni G., Musella M., Palombo D., Perinotti R., Pertile D., Pezzolla A., Piccirillo G., Polastri R., Ruggiero R., Scatizzi M., Somaglino C., Tolone S., Traverso E., Tutino R., Valduga C., and Zuolo M.

Subjects
medicine.medical_specialty, Critical view of safety, medicine.medical_treatment, Laparoscopic training, bBile duct injuries, Bile duct injuries, Cholecystectomy, Intraoperative bleeding, Laparoscopy, Bile Duct Diseases, Article, cholecystectomy, critical view of safety, intraoperative bleeding, laparoscopic training, laparoscopy, Medicine, Humans, Intraoperative Complications, medicine.diagnostic_test, business.industry, Bile duct, General surgery, Gallbladder, Incidence (epidemiology), Gold standard, Perioperative, medicine.anatomical_structure, Cholecystectomy, Laparoscopic, Italy, Surgery, Bile Ducts, business, Bile duct injurie, Abdominal surgery
Abstract

Background Laparoscopic cholecystectomy is considered the gold standard for the treatment of gallbladder lithiasis; nevertheless, the incidence of bile duct injuries (BDI) is still high (0.3–0.8%) compared to open cholecystectomy (0.2%). In 1995, Strasberg introduced the "Critical View of Safety" (CVS) to reduce the risk of BDI. Despite its widespread use, the scientific evidence supporting this technique to prevent BDI is controversial. Methods Between March 2017 and March 2019, the data of patients submitted to laparoscopic cholecystectomy in 30 Italian surgical departments were collected on a national database. A survey was submitted to all members of Italian Digestive Pathology Society to obtain data on the preoperative workup, the surgical and postoperative management of patients and to judge, at the end of the procedure, if the isolation of the elements was performed according to the CVS. In the case of a declared critical view, iconographic documentation was obtained, finally reviewed by an external auditor. Results Data from 604 patients were analysed. The study population was divided into two groups according to the evidence (Group A; n = 11) or absence (Group B; N = 593) of BDI and perioperative bleeding. The non-use of CVS was found in 54.6% of procedures in the Group A, and 25.8% in the Group B, and evaluating the operator-related variables the execution of CVS was associated with a significantly lower incidence of BDI and intraoperative bleeding. Conclusions The CVS confirmed to be the safest technique to recognize the elements of the Calot triangle and, if correctly performed, it significantly impacted on preventing intraoperative complications. Additional educational programs on the correct application of CVS in clinical practice would be desirable to avoid extreme conditions that may require additional procedures.

Published
2020

43. The largest western experience on salvage hepatectomy for recurrent hepatocellular carcinoma: propensity score-matched analysis on behalf of He.RC.O.Le.Study Group

Author

Iaria, M., Bianchi, G., Fazio, F., Ardito, Francesco, Perri, P., Pontarolo, N., Conci, S., Donadon, M., Zanello, M., Lai, Q., Famularo, S., Molfino, S., Sciannamea, I., Fumagalli, L., Germani, P., Floridi, A., Ferrari, C., Zimmitti, Giuseppe, Troci, A., Zago, M., Ferraro, V., Cipriani, F., Patauner, S., La Barba, G., Romano, M., Zanus, G., Ercolani, G., Frena, A., Aldrighetti, L., Memeo, R., Pinotti, E., Crespi, M., Hilal, M. A., Griseri, G., Tarchi, P., Chiarelli, M., Antonucci, A., Baiocchi, G. L., Romano, F., Rossi, M., Jovine, E., Torzilli, G., Ruzzenente, A., Maestri, M., Grazi, G. L., Giuliante, Felice, Ferrero, A., Dalla Valle, R., Giuffrida, M., Russolillo, N., Razionale, Francesco, De Peppo, V., Tomasoni, M., Marchitelli, I., Costa, G., Laureiro, Z. L., Scotti, M., Calcagno, P., Cosola, D., Franceschi, A., Manzoni, A., Pennacchi, L., Montuori, M., Conticchio, M., Ratti, F., Notte, F., Cucchetti, A., Salvador, L., Corleone, P., Garancini, M., Ciulli, C., Ardito F. (ORCID:0000-0003-1596-2862), Zimmitti G. (ORCID:0000-0003-4925-4012), Giuliante F. (ORCID:0000-0001-9517-8220), Razionale F., Iaria, M., Bianchi, G., Fazio, F., Ardito, Francesco, Perri, P., Pontarolo, N., Conci, S., Donadon, M., Zanello, M., Lai, Q., Famularo, S., Molfino, S., Sciannamea, I., Fumagalli, L., Germani, P., Floridi, A., Ferrari, C., Zimmitti, Giuseppe, Troci, A., Zago, M., Ferraro, V., Cipriani, F., Patauner, S., La Barba, G., Romano, M., Zanus, G., Ercolani, G., Frena, A., Aldrighetti, L., Memeo, R., Pinotti, E., Crespi, M., Hilal, M. A., Griseri, G., Tarchi, P., Chiarelli, M., Antonucci, A., Baiocchi, G. L., Romano, F., Rossi, M., Jovine, E., Torzilli, G., Ruzzenente, A., Maestri, M., Grazi, G. L., Giuliante, Felice, Ferrero, A., Dalla Valle, R., Giuffrida, M., Russolillo, N., Razionale, Francesco, De Peppo, V., Tomasoni, M., Marchitelli, I., Costa, G., Laureiro, Z. L., Scotti, M., Calcagno, P., Cosola, D., Franceschi, A., Manzoni, A., Pennacchi, L., Montuori, M., Conticchio, M., Ratti, F., Notte, F., Cucchetti, A., Salvador, L., Corleone, P., Garancini, M., Ciulli, C., Ardito F. (ORCID:0000-0003-1596-2862), Zimmitti G. (ORCID:0000-0003-4925-4012), Giuliante F. (ORCID:0000-0001-9517-8220), and Razionale F.

Abstract

Background: We aimed to evaluate, in a large Western cohort, perioperative and long-term oncological outcomes of salvage hepatectomy (SH) for recurrent hepatocellular carcinoma (rHCC) after primary hepatectomy (PH) or locoregional treatments. Methods: Data were collected from the Hepatocarcinoma Recurrence on the Liver Study Group (He.RC.O.Le.S.) Italian Registry. After 1:1 propensity score-matched analysis (PSM), two groups were compared: the PH group (patients submitted to resection for a first HCC) and the SH group (patients resected for intrahepatic rHCC after previous HCC-related treatments). Results: 2689 patients were enrolled. PH included 2339 patients, SH 350. After PSM, 263 patients were selected in each group with major resected nodule median size, intraoperative blood loss and minimally invasive approach significantly lower in the SH group. Long-term outcomes were compared, with no difference in OS and DFS. Univariate and multivariate analyses revealed only microvascular invasion as an independent prognostic factor for OS. Conclusion: SH proved to be equivalent to PH in terms of safety, feasibility and long-term outcomes, consistent with data gathered from East Asia. In the awaiting of reliable treatment-allocating algorithms for rHCC, SH appears to be a suitable alternative in patients fit for surgery, regardless of the previous therapeutic modality implemented.

Published
2022

44. Benchmarking postoperative outcomes after open liver surgery for cirrhotic patients with hepatocellular carcinoma in a national cohort

Author

Famularo, S., Russolillo, N., Donadon, M., Cipriani, F., Ardito, Francesco, Perri, P., Giani, A., De Stefano, F., Lai, Q., Molfino, S., Zanello, M., Iaria, M., La Barba, G., Pinotti, E., Germani, P., Conci, S., Ferrari, C., Fumagalli, L., Romano, M., Antonucci, A., Zimmitti, Giuseppe, Troci, A., Floridi, A., Ferraro, V., Patauner, S., Frena, A., Memeo, R., Crespi, M., Hilal, M. A., Zanus, G., Chiarelli, M., Percivale, A., Ruzzenente, A., Tarchi, P., Zago, M., Ercolani, G., Dalla Valle, R., Jovine, E., Baiocchi, G. L., Rossi, M., Maestri, M., Romano, F., Grazi, G. L., Giuliante, Felice, Aldrighetti, L., Ferrero, A., Torzilli, G., Costa, G., Milana, F., Fazio, F., Ratti, F., Razionale, Francesco, De Peppo, V., Carissimi, F., Paolo Graziano, G. M., Laurerio, Z. L., Giuffrida, M., Cucchetti, A., Montuori, M., Cosola, D., Corleone, P., Lazzari, G., Franceschi, A., Calcagno, P., Salvador, L., Manzoni, A., Pennacchi, L., Libia, A., Notte, F., Bernasconi, D. P., Mori, S., Gaudesi, D., Ardito F. (ORCID:0000-0003-1596-2862), Zimmitti G. (ORCID:0000-0003-4925-4012), Giuliante F. (ORCID:0000-0001-9517-8220), Razionale F., Famularo, S., Russolillo, N., Donadon, M., Cipriani, F., Ardito, Francesco, Perri, P., Giani, A., De Stefano, F., Lai, Q., Molfino, S., Zanello, M., Iaria, M., La Barba, G., Pinotti, E., Germani, P., Conci, S., Ferrari, C., Fumagalli, L., Romano, M., Antonucci, A., Zimmitti, Giuseppe, Troci, A., Floridi, A., Ferraro, V., Patauner, S., Frena, A., Memeo, R., Crespi, M., Hilal, M. A., Zanus, G., Chiarelli, M., Percivale, A., Ruzzenente, A., Tarchi, P., Zago, M., Ercolani, G., Dalla Valle, R., Jovine, E., Baiocchi, G. L., Rossi, M., Maestri, M., Romano, F., Grazi, G. L., Giuliante, Felice, Aldrighetti, L., Ferrero, A., Torzilli, G., Costa, G., Milana, F., Fazio, F., Ratti, F., Razionale, Francesco, De Peppo, V., Carissimi, F., Paolo Graziano, G. M., Laurerio, Z. L., Giuffrida, M., Cucchetti, A., Montuori, M., Cosola, D., Corleone, P., Lazzari, G., Franceschi, A., Calcagno, P., Salvador, L., Manzoni, A., Pennacchi, L., Libia, A., Notte, F., Bernasconi, D. P., Mori, S., Gaudesi, D., Ardito F. (ORCID:0000-0003-1596-2862), Zimmitti G. (ORCID:0000-0003-4925-4012), Giuliante F. (ORCID:0000-0001-9517-8220), and Razionale F.

Abstract

Background: Benchmark analysis for open liver surgery for cirrhotic patients with hepatocellular carcinoma (HCC) is still undefined. Methods: Patients were identified from the Italian national registry HE.RC.O.LE.S. The Achievable Benchmark of Care (ABC) method was employed to identify the benchmarks. The outcomes assessed were the rate of complications, major comorbidities, post-operative ascites (POA), post-hepatectomy liver failure (PHLF), 90-day mortality. Benchmarking was stratified for surgical complexity (CP1, CP2 and CP3). Results: A total of 978 of 2698 patients fulfilled the inclusion criteria. 431 (44.1%) patients were treated with CP1 procedures, 239 (24.4%) with CP2 and 308 (31.5%) with CP3 procedures. Patients submitted to CP1 had a worse underlying liver function, while the tumor burden was more severe in CP3 cases. The ABC for complications (13.1%, 19.2% and 28.1% for CP1, CP2 and CP3 respectively), major complications (7.6%, 11.1%, 12.5%) and 90-day mortality (0%, 3.3%, 3.6%) increased with the surgical difficulty, but not POA (4.4%, 3.3% and 2.6% respectively) and PHLF (0% for all groups). Conclusion: We propose benchmarks for open liver resections in HCC cirrhotic patients, stratified for surgical complexity. The difference between the benchmark values and the results obtained during everyday practice reflects the room for potential growth, with the aim to encourage constant improvement among liver surgeons.

Published
2022

45. Hepatectomy Versus Sorafenib in Advanced Non-Metastatic Hepatocellular Carcinoma: A Real-Life Multicentric Weighted Comparison

Author

Famularo, S, Donadon, M, Cipriani, F, Giuliante, F, Ferri, S, Celsa, C, Ferrero, A, Foschi, F, Baiocchi, G, Biasini, E, Campani, C, Valle, R, Pellizzaro, F, Baroni, G, Raimondo, G, Mega, A, Chiarelli, M, Maestri, M, Gasbarrini, A, Jovine, E, Grazi, G, Rapaccini, G, Ruzzenente, A, Morisco, F, Sacco, R, Memeo, R, Crespi, M, Antonucci, A, Bernasconi, D, Romano, F, Griseri, G, Aldrighetti, L, Torzilli, G, Trevisani, F, Famularo, Simone, Donadon, Matteo, Cipriani, Federica, Giuliante, Felice, Ferri, Silvia, Celsa, Ciro, Ferrero, Alessandro, Foschi, Francesco Giuseppe, Baiocchi, Gian Luca, Biasini, Elisabetta, Campani, Claudia, Valle, Raffaele Dalla, Pellizzaro, Filippo, Baroni, Gianluca Svegliati, Raimondo, Giovanni, Mega, Andrea, Chiarelli, Marco, Maestri, Marcello, Gasbarrini, Antonio, Jovine, Elio, Grazi, Gian Luca, Rapaccini, Gian Ludovico, Ruzzenente, Andrea, Morisco, Filomena, Sacco, Rodolfo, Memeo, Riccardo, Crespi, Michele, Antonucci, Adelmo, Bernasconi, Davide P, Romano, Fabrizio, Griseri, Guido, Aldrighetti, Luca, Torzilli, Guido, Trevisani, Franco, Famularo, S, Donadon, M, Cipriani, F, Giuliante, F, Ferri, S, Celsa, C, Ferrero, A, Foschi, F, Baiocchi, G, Biasini, E, Campani, C, Valle, R, Pellizzaro, F, Baroni, G, Raimondo, G, Mega, A, Chiarelli, M, Maestri, M, Gasbarrini, A, Jovine, E, Grazi, G, Rapaccini, G, Ruzzenente, A, Morisco, F, Sacco, R, Memeo, R, Crespi, M, Antonucci, A, Bernasconi, D, Romano, F, Griseri, G, Aldrighetti, L, Torzilli, G, Trevisani, F, Famularo, Simone, Donadon, Matteo, Cipriani, Federica, Giuliante, Felice, Ferri, Silvia, Celsa, Ciro, Ferrero, Alessandro, Foschi, Francesco Giuseppe, Baiocchi, Gian Luca, Biasini, Elisabetta, Campani, Claudia, Valle, Raffaele Dalla, Pellizzaro, Filippo, Baroni, Gianluca Svegliati, Raimondo, Giovanni, Mega, Andrea, Chiarelli, Marco, Maestri, Marcello, Gasbarrini, Antonio, Jovine, Elio, Grazi, Gian Luca, Rapaccini, Gian Ludovico, Ruzzenente, Andrea, Morisco, Filomena, Sacco, Rodolfo, Memeo, Riccardo, Crespi, Michele, Antonucci, Adelmo, Bernasconi, Davide P, Romano, Fabrizio, Griseri, Guido, Aldrighetti, Luca, Torzilli, Guido, and Trevisani, Franco

Abstract

OBJECTIVE: The aim of the study was to compare SURG vs SOR regarding the OS and progression-free survival (PFS) in a real-world clinical scenario. BACKGROUND DATA: The treatment for advanced nonmetastatic HCC belonging to the Barcelona Clinic Liver Cancer stage C (BCLC C) is still controversial. METHODS: BCLC C patients without extrahepatic spread and tumoral invasion of the main portal trunk were considered. Surgical patients were obtained from the HE.RC.O.LE.S. Register, whereas sorafenib patients were obtained from the ITA.LI.CA register The inverse probability weighting (IPW) method was adopted to balance the confounders between the 2 groups. RESULTS: Between 2008 and 2019, 478 patients were enrolled: 303 in SURG and 175 in SOR group. Eastern Cooperative Oncological Group Performance Status (ECOG-PS), presence of cirrhosis, steatosis, Child-Pugh grade, hepatitis B virus and hepatitis C virus, alcohol intake, collateral veins, bilobar disease, localization of the tumor thrombus, number of nodules, alpha-fetoprotein, age, and Charlson Comorbidity index were weighted by IPW to create two balanced pseudo-populations: SURG = 374 and SOR = 263. After IPW, 1-3-5 years OS was 83.6%, 68.1%, 55.9% for SURG, and 42.3%, 17.8%, 12.8% for SOR (P [removed]0, and by the intrahepatic location of portal vein invasion. At Cox regression, sorafenib treatment (hazard ratio 4.436; 95% confidence interval 3.19-6.15; P < 0.001) and Charlson Index (hazard ratio 1.162; 95% confidence interval 1.06-1.27; P = 0.010) were the only independent predictors of mortality. PFS at 1-3-5 years were 65.9%, 40.3%, 24.3% for SURG and 21.6%, 3.5%, 2.9% for SOR (P = 0.007). CONCLUSIONS: In BCLC C patients without extrahepatic spread but with intrahepatic portal invasion, liver resection, if feasible, was followed by better OS and PFS compared with sorafenib.

Published
2022

47. Control of Root Nodule Initiation in Medicago

Author

Kondorosi, A., Crespi, M., Charon, C., Sousa, C., Johansson, C., Sautter, C., Cebolla, A., Roudier, F., Foucher, F., Olah, B., Kiss, E., Trinh, H., Kondorosi, E., Martĺnez, Esperanza, editor, and Hernández, Georgina, editor

Published
1999
Full Text
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49. The Effect of a Liver Transplant Program on the Outcomes of Resectable Hepatocellular Carcinoma: A Nationwide Multicenter Analysis

Author

Serenari, M., Lenzi, J., Cucchetti, A., Cipriani, F., Donadon, M., Ardito, Francesco, Fazio, F., Nicolini, D., Iaria, M., Famularo, S., Perri, P., Ansaloni, L., Zanello, M., Lai, Q., Conci, S., Molfino, S., Ferrari, C., Germani, P., Zago, M., Romano, M., Zimmitti, G., Antonucci, A., Fumagalli, L., Troci, A., Ferraro, V., Memeo, R., Crespi, M., Chiarelli, M., Ercolani, G., Hilal, M. A., Zanus, G., Pinotti, E., Tarchi, P., Griseri, G., Baiocchi, G. L., Ruzzenente, A., Rossi, M., Jovine, E., Maestri, M., Grazi, G. L., Romano, F., Dalla Valle, R., Ravaioli, M., Vivarelli, M., Ferrero, A., Giuliante, Felice, Torzilli, G., Aldrighetti, L., Cescon, M., Gorgone, M., Ratti, F., Costa, G., Razionale, Francesco, Russolillo, N., Marinelli, Luca, Giuffrida, M., Scotti, M., Garancini, M., De Peppo, V., De Stefano, F., Laureiro, Z. L., Marchitelli, I., Franceschi, A., Cosola, D., Corleone, P., Montuori, M., Salvador, L., Manzoni, Annamaria, La Barba, G., Calcagno, P., Pennacchi, L., Conticchio, M., Serenari, Matteo, Lenzi, Jacopo, Cucchetti, Alessandro, Cipriani, Federica, Donadon, Matteo, Ardito, Francesco, Fazio, Federico, Nicolini, Daniele, Iaria, Maurizio, Famularo, Simone, Perri, Pasquale, Ansaloni, Luca, Zanello, Matteo, Lai, Quirino, Conci, Simone, Molfino, Sarah, Ferrari, Cecilia, Germani, Paola, Zago, Mauro, Romano, Maurizio, Zimmitti, Giuseppe, Antonucci, Adelmo, Fumagalli, Luca, Troci, Albert, Ferraro, Valentina, Memeo, Riccardo, Crespi, Michele, Chiarelli, Marco, Ercolani, Giorgio, Hilal, Mohamed Abu, Zanus, Giacomo, Pinotti, Enrico, Tarchi, Paola, Griseri, Guido, Baiocchi, Gian Luca, Ruzzenente, Andrea, Rossi, Massimo, Jovine, Elio, Maestri, Marcello, Grazi, Gian Luca, Romano, Fabrizio, Dalla Valle, Raffaele, Ravaioli, Matteo, Vivarelli, Marco, Ferrero, Alessandro, Giuliante, Felice, Torzilli, Guido, Aldrighetti, Luca, and Cescon, Matteo

Subjects
hepatectomy, complications, liver transplantation, salvage, Settore MED/18 - CHIRURGIA GENERALE, Surgery, hepatocellular carcinoma, case-mix
Abstract

To evaluate the effect of a liver transplantation (LT) program on the outcomes of resectable hepatocellular carcinoma (HCC).Surgical treatment of HCC includes both hepatic resection (HR) and LT. However, the presence of cirrhosis and the possibility of recurrence make the management of this disease complex and probably different according to the presence of a LT program.Patients undergoing HR for HCC between January 2005 and December 2019 were identified from a national database of HCC. The main study outcomes were major surgical complications according to the Comprehensive Complication Index (CCI), post-hepatectomy liver failure (PHLF), 90-day mortality, overall survival (OS), and disease-free survival (DFS). Secondary outcomes were salvage liver transplantation (SLT) and post-recurrence survival (PRS).A total of 3202 patients were included from 25 hospitals over the study period. Three out of 25 (12%) had a LT program. The presence of a LT program within a center was associated with a reduced probability of PHLF (OR=0.38) but not with OS and DFS. There was an increased probability of SLT when HR was performed in a transplant hospital (OR=12.05). Among transplant-eligible patients, those who underwent LT had a significantly longer PRS.This study showed that the presence of a LT program was associated with decreased PHLF rates and an increased probability to receive SLT in case of recurrence.

Published
2022

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