177 results on '"Marcello Migliore"'
Search Results
2. Recent Advancements in Minimally Invasive Surgery for Early Stage Non-Small Cell Lung Cancer: A Narrative Review
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Jibran Ahmad Khan, Ibrahem Albalkhi, Sarah Garatli, and Marcello Migliore
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non-small cell lung cancer ,NSCLC ,RATS ,VATS ,lobectomy ,segmentectomy ,Medicine - Abstract
Introduction: Lung cancer remains a global health concern, with non-small cell lung cancer (NSCLC) comprising the majority of cases. Early detection of lung cancer has led to an increased number of cases identified in the earlier stages of NSCLC. This required the revaluation of the NSCLC treatment approaches for early stage NSCLC. Methods: We conducted a comprehensive search using multiple databases to identify relevant studies on treatment modalities for early stage NSCLC. Inclusion criteria prioritized, but were not limited to, clinical trials and meta-analyses on surgical approaches to early stage NSCLC conducted from 2021 onwards. Discussion: Minimally invasive approaches, such as VATS and RATS, along with lung resection techniques, including sublobar resection, have emerged as treatments for early stage NSCLC. Ground-glass opacities (GGOs) have shown prognostic significance, especially when analyzing the consolidation/tumor ratio (CTR). There have also been updates on managing GGOs, including the non-surgical approaches, the extent of lung resection indicated, and the level of lymphadenectomy required. Conclusions: The management of early stage NSCLC requires a further assessment of treatment strategies. This includes understanding the required extent of surgical resection, interpreting the significance of GGOs (specifically GGOs with a high CTR), and evaluating the efficacy of alternative therapies. Customized treatment involving surgical and non-surgical interventions is essential for advancing patient care.
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- 2024
- Full Text
- View/download PDF
3. Comparison of video-assisted pleurectomy/decortication surgery plus hyperthermic intrathoracic chemotherapy with VATS talc pleurodesis for the treatment of malignant pleural mesothelioma: A pilot study
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Marcello Migliore, Maria Fiore, Tommaso Filippini, Rosario Tumino, Mara Sabbioni, Corrado Spatola, Riccardo Polosa, Paolo Vigneri, Marco Nardini, Sergio Castorina, Francesco Basile, and Margherita Ferrante
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Malignant pleural mesothelioma ,Pleurectomy/decortication ,Hyperthermic intrathoracic chemotherapy (HITHOC) ,Video assisted thoracic surgery (VATS) ,Debulking surgery ,Science (General) ,Q1-390 ,Social sciences (General) ,H1-99 - Abstract
Hyperthermic intrathoracic chemotherapy (HITHOC) adjunct to surgery for Malignant Pleural Mesothelioma (MPM) has no definite role. The primary objective of this pilot-trial was to evaluate the feasibility for future large studies. The study design was a prospective randomized three-centric pilot trial. We recruited patients diagnosed with MPM and prospectively assigned them to two groups: Group A: Video Assisted Thoracic Surgery (VATS) talc pleurodesis or Group B: Video-assisted P/D plus HITHOC. From November-2011 to July-2017 24 males and 3 females, with a median age of 68-years were enrolled (recruitment rate 5 patients/year). Preoperative stage was I-II, and 18 had epithelioid type. 14 patients were in the Group A. Operative mortality was 0. Follow-up ranged 6–80 months. The median overall survival time started to diverge at 20 months, being 19 months (95% CI 12–25) in Group A and 28 months (95% CI 0–56) in Group B. Survival rate for the epithelioid type was 15 months (95% CI 0–34) in Group A and 45 months (95% CI 0–107) in the Group B. These findings suggest that video-assisted P/D plus HITHOC may improve survival time in MPM patients undergoing surgical treatment and support the need for a larger multicenter randomized clinical trial.
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- 2023
- Full Text
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4. Comparing the Effectiveness, Tolerability, and Acceptability of Heated Tobacco Products and Refillable Electronic Cigarettes for Cigarette Substitution (CEASEFIRE): Randomized Controlled Trial
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Pasquale Caponnetto, Davide Campagna, Marilena Maglia, Francesca Benfatto, Rosalia Emma, Massimo Caruso, Grazia Caci, Barbara Busà, Alfio Pennisi, Maurizio Ceracchi, Marcello Migliore, and Maria Signorelli
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Public aspects of medicine ,RA1-1270 - Abstract
BackgroundPeople who smoke and who face challenges trying to quit or wish to continue to smoke may benefit by switching from traditional cigarettes to noncombustible nicotine delivery alternatives, such as heated tobacco products (HTPs) and electronic cigarettes (ECs). HTPs and ECs are being increasingly used to quit smoking, but there are limited data about their effectiveness. ObjectiveWe conducted the first randomized controlled trial comparing quit rates between HTPs and ECs among people who smoke and do not intend to quit. MethodsWe conducted a 12-week randomized noninferiority switching trial to compare effectiveness, tolerability, and product satisfaction between HTPs (IQOS 2.4 Plus) and refillable ECs (JustFog Q16) among people who do not intend to quit. The cessation intervention included motivational counseling. The primary endpoint of the study was the carbon monoxide–confirmed continuous abstinence rate from week 4 to week 12 (CAR weeks 4-12). The secondary endpoints included the continuous self-reported ≥50% reduction in cigarette consumption rate (continuous reduction rate) from week 4 to week 12 (CRR weeks 4-12) and 7-day point prevalence of smoking abstinence. ResultsA total of 211 participants completed the study. High quit rates (CAR weeks 4-12) of 39.1% (43/110) and 30.8% (33/107) were observed for IQOS-HTP and JustFog-EC, respectively. The between-group difference for the CAR weeks 4-12 was not significant (P=.20). The CRR weeks 4-12 values for IQOS-HTP and JustFog-EC were 46.4% (51/110) and 39.3% (42/107), respectively, and the between-group difference was not significant (P=.24). At week 12, the 7-day point prevalence of smoking abstinence values for IQOS-HTP and JustFog-EC were 54.5% (60/110) and 41.1% (44/107), respectively. The most frequent adverse events were cough and reduced physical fitness. Both study products elicited a moderately pleasant user experience, and the between-group difference was not significant. A clinically relevant improvement in exercise tolerance was observed after switching to the combustion-free products under investigation. Risk perception for conventional cigarettes was consistently higher than that for the combustion-free study products under investigation. ConclusionsSwitching to HTPs elicited a marked reduction in cigarette consumption among people who smoke and do not intend to quit, which was comparable to refillable ECs. User experience and risk perception were similar between the HTPs and ECs under investigation. HTPs may be a useful addition to the arsenal of reduced-risk alternatives for tobacco cigarettes and may contribute to smoking cessation. However, longer follow-up studies are required to confirm significant and prolonged abstinence from smoking and to determine whether our results can be generalized outside smoking cessation services offering high levels of support. Trial RegistrationClinicalTrials.gov NCT03569748; https://clinicaltrials.gov/ct2/show/NCT03569748
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- 2023
- Full Text
- View/download PDF
5. ERS International Congress 2022: highlights from the Thoracic Surgery and Lung Transplantation Assembly
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Dimitrios E. Magouliotis, Saskia Bos, Dorina Esendagli, Marco Nardini, Marcello Migliore, Michael Perch, Giuseppe Cardillo, Federica Meloni, Sara Ricciardi, and Merel Hellemons
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Medicine - Abstract
The thoracic surgery and lung transplantation assembly (Assembly 8) of the European Respiratory Society (ERS) is delighted to present the highlights from the 2022 ERS International Congress that took place in a hybrid version in Barcelona, Spain. We have selected the four main sessions that discussed recent advances across a wide range of topics including the effects of coronavirus disease 2019 on thoracic surgery and the challenges regarding lung transplantation in connective tissue diseases and common variable immunodeficiency. The sessions are summarised by early career members in close collaboration with the assembly faculty. We aim to provide the reader with an update and enhanced insight into the highlights of the conference in the fields of thoracic surgery and lung transplantation.
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- 2023
- Full Text
- View/download PDF
6. ERS International Congress 2021: highlights from the Thoracic Surgery and Lung Transplantation Assembly
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Saskia Bos, Sara Ricciardi, Edward J. Caruana, Nilüfer Aylin Acet Öztürk, Dimitrios Magouliotis, Cecilia Pompili, Marcello Migliore, Robin Vos, Federica Meloni, Stefano Elia, and Merel Hellemons
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Medicine - Abstract
The thoracic surgery and lung transplantation assembly of the European Respiratory Society (ERS) is delighted to present the highlights from the 2021 ERS International Congress. We have selected four sessions that discussed recent advances across a wide range of topics including: digital health surveillance in thoracic surgery, emerging concepts in pulmonary metastasectomy, advances in mesothelioma care, and novel developments in lung graft allocation and monitoring. The sessions are summarised by early career members in close collaboration with the assembly faculty. We aim to give the reader an update on the highlights of the conference in the fields of thoracic surgery and lung transplantation.
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- 2022
- Full Text
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7. Does cytoreduction surgery and hyperthermic intrathoracic chemotherapy prolong survival in patients with N0–N1 nonsmall cell lung cancer and malignant pleural effusion?
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Marcello Migliore and Marco Nardini
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Diseases of the respiratory system ,RC705-779 - Abstract
Introduction Debulking surgery and hyperthermic intrathoracic chemotherapy (HITHOC) has been successfully used in the treatment of thoracic tumours. Few authors report on the feasibility of its use in patients with lung cancer and malignant pleural effusion. The aim of this study was to evaluate the efficacy and results of debulking surgery and HITHOC in the treatment of selected patients with nonsmall cell lung cancer (NSCLC) and malignant pleural effusion. Methods A systematic review was conducted in MEDLINE in accordance with PRISMA guidelines. The word search included: “hyperthermic intrathoracic chemotherapy and/or HITHOC or hyperthermic intrapleural”. Inclusion criteria were only those studies reporting a sufficient amount of data on HITHOC and surgery for lung cancer. Single case reports and review articles were excluded. Results 20 articles were selected as they related to the topic of HITHOC and lung cancer. Most were from China (n=8) and Japan (n=6). Only four out of the 20 articles had sufficient data for this review. In total, data for 21 patients were collected. Debulking surgery ranged from wedge resection to pneumonectomy and pleurectomy. Mean survival was 27 months and median survival was 18 months (range 1–74 months). 13 patients out of 21 (62%) were alive at 1 year and six (28.5%) were alive at 2 years. 10 patients were still alive at the time of the respective publication in the 21 patients included. Systemic toxicity and treatment-related mortality were nil. There were insufficient data to perform a meta-analysis. Conclusion Although reported survival in this systematic review is encouraging, available evidence concerning debulking surgery and HITHOC in N0–N1 NSCLC with malignant pleural effusion is weak. Better evidence in the form of a randomised controlled trial is mandatory.
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- 2019
- Full Text
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8. Extension of lymph node dissection in the surgical treatment of esophageal and gastroesophageal junction cancer: seven questions and answers
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Alessio Vagliasindi, Filippo Di Franco, Maurizio Degiuli, Davide Papis, and Marcello Migliore
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Cancer Research ,Oncology ,General Medicine - Abstract
The role of two- or three-field nodal dissection in the surgical treatment of esophageal and gastroesophageal junction cancer in the minimally invasive era is still controversial. This review aims to clarify the extension of nodal dissection in esophageal and gastroesophageal junctional cancer. A basic evidence-based analysis was designed, and seven research questions were formulated and answered with a narrative review. Reports with little or no data, single cases, small series and review articles were not included. Three-field lymph node dissection improves staging accuracy, enhances locoregional disease control and might improve survival in the group of patients with cervical and upper mediastinal metastatic lymph nodal involvement from middle and proximal-third esophageal cancer.
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- 2023
9. Optimism with caution for patients with advanced thymoma and thymic carcinoma
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Marcello Migliore, Marco Lucchi, and Norberto Santana Rodriguez
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- 2023
10. Hyperthermic intrathoracic chemotherapy in thoracic surgical oncology: future challenges of an exciting procedure
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Malgorzata Kornaszewska, Vasileios Valtzoglou, Marcello Migliore, Tom Combellack, Jennifer Williams, and Ainis Pirtnieks
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Mesothelioma ,Cancer Research ,medicine.medical_specialty ,Chemotherapy ,Lung Neoplasms ,business.industry ,medicine.medical_treatment ,Antineoplastic Agents ,Cytoreduction Surgical Procedures ,Hyperthermia, Induced ,General Medicine ,Thoracic Neoplasms ,Thoracic Surgical Procedures ,medicine.disease ,Combined Modality Therapy ,Oncology ,Surgical oncology ,medicine ,Humans ,Radiology ,business - Published
- 2021
11. Comparing the Effectiveness, Tolerability, and Acceptability of Heated Tobacco Products and Refillable Electronic Cigarettes for Cigarette Substitution (CEASEFIRE): Randomized Controlled Trial (Preprint)
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Pasquale Caponnetto, Davide Campagna, Marilena Maglia, Francesca Benfatto, Rosalia Emma, Massimo Caruso, Grazia Caci, Barbara Busà, Alfio Pennisi, Maurizio Ceracchi, Marcello Migliore, and Maria Signorelli
- Abstract
BACKGROUND People who smoke and who face challenges trying to quit or wish to continue to smoke may benefit by switching from traditional cigarettes to noncombustible nicotine delivery alternatives, such as heated tobacco products (HTPs) and electronic cigarettes (ECs). HTPs and ECs are being increasingly used to quit smoking, but there are limited data about their effectiveness. OBJECTIVE We conducted the first randomized controlled trial comparing quit rates between HTPs and ECs among people who smoke and do not intend to quit. METHODS We conducted a 12-week randomized noninferiority switching trial to compare effectiveness, tolerability, and product satisfaction between HTPs (IQOS 2.4 Plus) and refillable ECs (JustFog Q16) among people who do not intend to quit. The cessation intervention included motivational counseling. The primary endpoint of the study was the carbon monoxide–confirmed continuous abstinence rate from week 4 to week 12 (CAR weeks 4-12). The secondary endpoints included the continuous self-reported ≥50% reduction in cigarette consumption rate (continuous reduction rate) from week 4 to week 12 (CRR weeks 4-12) and 7-day point prevalence of smoking abstinence. RESULTS A total of 211 participants completed the study. High quit rates (CAR weeks 4-12) of 39.1% (43/110) and 30.8% (33/107) were observed for IQOS-HTP and JustFog-EC, respectively. The between-group difference for the CAR weeks 4-12 was not significant (P=.20). The CRR weeks 4-12 values for IQOS-HTP and JustFog-EC were 46.4% (51/110) and 39.3% (42/107), respectively, and the between-group difference was not significant (P=.24). At week 12, the 7-day point prevalence of smoking abstinence values for IQOS-HTP and JustFog-EC were 54.5% (60/110) and 41.1% (44/107), respectively. The most frequent adverse events were cough and reduced physical fitness. Both study products elicited a moderately pleasant user experience, and the between-group difference was not significant. A clinically relevant improvement in exercise tolerance was observed after switching to the combustion-free products under investigation. Risk perception for conventional cigarettes was consistently higher than that for the combustion-free study products under investigation. CONCLUSIONS Switching to HTPs elicited a marked reduction in cigarette consumption among people who smoke and do not intend to quit, which was comparable to refillable ECs. User experience and risk perception were similar between the HTPs and ECs under investigation. HTPs may be a useful addition to the arsenal of reduced-risk alternatives for tobacco cigarettes and may contribute to smoking cessation. However, longer follow-up studies are required to confirm significant and prolonged abstinence from smoking and to determine whether our results can be generalized outside smoking cessation services offering high levels of support. CLINICALTRIAL ClinicalTrials.gov NCT03569748; https://clinicaltrials.gov/ct2/show/NCT03569748
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- 2022
12. Minimally Invasive Plication of the Diaphragm: A Single-Center Prospective Study
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Marcello Migliore, Joel Dunning, Ian Paul, Shruti Jayakumar, Marco Nardini, and Mario Nosotti
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Diaphragm paralysis ,medicine.medical_treatment ,Diaphragm ,Single Center ,phrenic nerve palsy ,robotic surgery ,medicine ,Humans ,Robotic surgery ,Prospective Studies ,Thoracotomy ,Prospective cohort study ,Referral and Consultation ,Phrenic Nerve Palsy ,VATS plication ,Thoracic Surgery, Video-Assisted ,business.industry ,General Medicine ,Telephone ,diaphragm paralysis ,Surgery ,Diaphragm (structural system) ,Treatment Outcome ,Diaphragm plication ,Quality of Life ,Cardiology and Cardiovascular Medicine ,business ,diaphragm plication - Abstract
Objective Plication of the diaphragm is a life-changing procedure for patients affected by diaphragm paralysis. Traditionally, this procedure is performed through a thoracotomy. Access to the diaphragm via this incision is poor and the indications for surgery are limited to patients who can actually sustain such an invasive approach and associated morbidities. A minimally invasive approach was developed to improve the surgical management of diaphragm paralysis. Methods Patients underwent minimally invasive diaphragm plication either by video-assisted or robotic surgery through a 3-port technique with CO2 insufflation. Patients were followed at the routine 6-week clinic and also by telephone consultation 6 to 12 months postoperatively. Data were collected on postoperative complications, postoperative pain or numbness, symptomatic improvement, and change to quality of life following surgery. Results Forty-eight patients underwent 49 minimally invasive diaphragm plication. Median postoperative length of hospital stay was 4 days (range: 2 to 34 days) and there were no cases of mortality. Mean reduction in Medical Research Council dyspnea score per patient was 2.2 points (mode: 3 points). Twenty-eight patients (77.8%) reported a significant symptomatic improvement enabling improvements in quality of life, and 97.2% ( n = 35) were satisfied with the surgical outcome. Conclusions Minimally invasive diaphragm plication is a safe procedure associated with prompt postoperative recovery. It is effective at reducing debilitating dyspnea and improving quality of life.
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- 2021
13. Improving the efficiency of identifying malignant pulmonary nodules before surgery via a combination of artificial intelligence CT image recognition and serum autoantibodies
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Yu Ding, Jingyu Zhang, Weitao Zhuang, Zhen Gao, Kaiming Kuang, Dan Tian, Cheng Deng, Hansheng Wu, Rixin Chen, Guojie Lu, Gang Chen, Paolo Mendogni, Marcello Migliore, Min-Woong Kang, Ryu Kanzaki, Yong Tang, Jiancheng Yang, Qiuling Shi, and Guibin Qiao
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validation ,classification ,autoantibodies ,lung-cancer ,tumor-markers ,Radiology, Nuclear Medicine and imaging ,General Medicine ,lung neoplasms ,benign ,artificial intelligence ,nomograms - Abstract
To construct a new pulmonary nodule diagnostic model with high diagnostic efficiency, non-invasive and simple to measure.This study included 424 patients with radioactive pulmonary nodules who underwent preoperative 7-autoantibody (7-AAB) panel testing, CT-based AI diagnosis, and pathological diagnosis by surgical resection. The patients were randomly divided into a training set (n = 212) and a validation set (n = 212). The nomogram was developed through forward stepwise logistic regression based on the predictive factors identified by univariate and multivariate analyses in the training set and was verified internally in the verification set.A diagnostic nomogram was constructed based on the statistically significant variables of age as well as CT-based AI diagnostic, 7-AAB panel, and CEA test results. In the validation set, the sensitivity, specificity, positive predictive value, and AUC were 82.29%, 90.48%, 97.24%, and 0.899 (95%[CI], 0.851-0.936), respectively. The nomogram showed significantly higher sensitivity than the 7-AAB panel test result (82.29% vs. 35.88%, p0.001) and CEA (82.29% vs. 18.82%, p0.001); it also had a significantly higher specificity than AI diagnosis (90.48% vs. 69.04%, p = 0.022). For lesions with a diameter of ≤ 2 cm, the specificity of the Nomogram was higher than that of the AI diagnostic system (90.00% vs. 67.50%, p = 0.022).Based on the combination of a 7-AAB panel, an AI diagnostic system, and other clinical features, our Nomogram demonstrated good diagnostic performance in distinguishing lung nodules, especially those with ≤ 2 cm diameters.• A novel diagnostic model of lung nodules was constructed by combining high-specific tumor markers with a high-sensitivity artificial intelligence diagnostic system. • The diagnostic model has good diagnostic performance in distinguishing malignant and benign pulmonary nodules, especially for nodules smaller than 2 cm. • The diagnostic model can assist the clinical decision-making of pulmonary nodules, with the advantages of high diagnostic efficiency, noninvasive, and simple measurement.
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- 2022
14. Mood disorders and outcomes in lung cancer patients undergoing surgery: a brief summery
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Teresa Surace, Maria Salvina Signorelli, Eugenio Aguglia, and Marcello Migliore
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Cancer Research ,medicine.medical_specialty ,Lung Neoplasms ,mood disorder ,Suicide, Attempted ,Anxiety ,Citalopram ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Risk Factors ,Sertraline ,Internal medicine ,Humans ,Medicine ,030212 general & internal medicine ,Pneumonectomy ,Lung cancer ,Depression (differential diagnoses) ,Randomized Controlled Trials as Topic ,Cause of death ,Patient Care Team ,Cognitive Behavioral Therapy ,Depression ,business.industry ,Cancer ,General Medicine ,medicine.disease ,thoracic surgery ,Combined Modality Therapy ,Survival Rate ,lung cancer ,Treatment Outcome ,Oncology ,Mood disorders ,Cardiothoracic surgery ,030220 oncology & carcinogenesis ,Quality of Life ,Major depressive disorder ,medicine.symptom ,business ,Selective Serotonin Reuptake Inhibitors ,anxiety ,depression - Abstract
Cancer is a leading cause of death worldwide. Literature reports depression and anxiety are the most common psychiatric symptoms in cancer patients. Notably, lung cancer is associated with major depressive disorder in 5–13% of cases. The present article aims to give an overview regarding the impact of mood disorders on the outcomes of patients affected by lung cancer. Our review showed that pharmacological treatment and psychotherapy can be useful to improve the quality of life of patients with lung cancer. Moreover, the treatment of depression and anxiety can be associated with a reduced mortality. In conclusion, it is important to consider psychiatric care as important as other adjuvant oncologic therapies in patients with cancer.
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- 2020
15. Making precision surgical strategies a reality: are we ready for a paradigm shift in thoracic surgical oncology?
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Semih Halezeroglu, Michael Rolf Mueller, and Marcello Migliore
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Cancer Research ,medicine.medical_specialty ,Oncology ,business.industry ,Surgical oncology ,Paradigm shift ,oncology thoracic ,MEDLINE ,Medicine ,Medical physics ,General Medicine ,business - Published
- 2020
16. Reconstructive Surgery in Children with Down Syndrome: Bioethical Implications
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Mariano Martini, Nicola Luigi Bragazzi, Martino Ruggieri, Agata Polizzi, Ignazio Vecchio, Andrea D. Praticò, Marcello Migliore, and Cristina Tornali
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Down syndrome ,Reconstructive surgery ,medicine.medical_specialty ,business.industry ,General surgery ,Down’s syndrome plastic surgery face neurological outcome behavior ,Epicanthus ,medicine.disease ,03 medical and health sciences ,Plastic surgery ,0302 clinical medicine ,medicine.anatomical_structure ,Tongue ,030225 pediatrics ,Pediatrics, Perinatology and Child Health ,Intellectual disability ,medicine ,Neurology (clinical) ,Eyelid ,business ,030217 neurology & neurosurgery ,Nose ,Down. Storia e Bioetica ricostruzione facciale - Abstract
Down Syndrome is a genetic disorder caused by a third copy of chromosome 21. One of the main feature of the syndrome is the facial dysmorphism, characterized by broad, flat face, oblique eyelid rhymes, skin folds at the inner corner of the eyes (epicanthus), receding chin, protrusion of the tongue. These features are often social and functional obstacles, reducible with surgical interventions. The first facial plastic/cosmetic surgery approaches on Down children were performed in 1960 in Germany, Great Britain and the United States, where plastic surgeons began to reshape the Down patients physiognomy through the surgical correction of the face, tongue, eyes, nose, of the nostrils, of the neck. Recent studies have shown that in spite of the tendency to infections and early pulmonary hypertension in children with DS, surgery is not contraindicated, as previously suggested, but can be performed with very good results. This treatment has aesthetic, functional, rehabilitative, social effects, as well as favorable outcome on the familiar behavior. However different issues emerge in cases of patients presenting intellectual disability and unable to understand the consequences or the side effects related to plastic surgery. In this aspect, different Countries have enacted distinct laws directly regulating the consensuses for such intervention, with the goal to reduce the risks for the affected patients and the respect of their willing and social inclusion.
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- 2020
17. Nonintubated Uniportal Video-Assisted Thoracic Surgery for Chest Infections
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Marcello Migliore
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Video-Assisted ,VATS ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Chest infections ,Minimally invasive thoracic surgery ,Randomized controlled trial ,law ,Health care ,medicine ,Humans ,Lung Abscess ,Uniportal thoracic surgery ,Empyema ,Empyema, Pleural ,Thoracic Surgery, Video-Assisted ,business.industry ,General surgery ,Pleural empyema ,Thoracic Surgery ,respiratory system ,medicine.disease ,Patient Care Management ,respiratory tract diseases ,Awake surgery ,Non intubated ,Treatment Outcome ,030228 respiratory system ,Cardiothoracic surgery ,030220 oncology & carcinogenesis ,Video assisted thoracic surgery ,Surgery ,business ,Training program ,Chest infection ,Pleural - Abstract
Chest infection is a health care problem in many regions of the world, and pleural empyema is the most common type of surgical chest infection. In the past decennium, the introduction of nonintubated surgery and uniportal video-assisted thoracic surgery changed considerably surgical treatment of pleural empyema. Although the advantages seem evident, the need for randomized controlled trials is necessary to confirm the usefulness. Moreover, in the future, an education and training program for thoracic surgeons and anesthesiologists would allow increasing the number of awake surgical options in caring for patients with stages II to III empyema.
- Published
- 2020
18. Comparison of VATS Pleurectomy/Decortication Surgery plus Hyperthermic Intrathoracic Chemotherapy with VATS talc pleurodesis for the treatment of Malignant Pleural Mesothelioma: a randomized pilot study
- Author
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Ines Monte, Marcello Migliore, Maria Fiore, Tommaso Filippini, Riccardo POLOSA, Rosario Tumino, Paolo VIGNERI, and Sergio Castorina
- Abstract
IntroductionNo previous study provides compelling evidence to convince surgeons to opt for one procedure over another for the treatment of Malignant Pleural Mesothelioma (MPM). Hyperthermic intrathoracic chemotherapy (HITHOC) adjunct to surgery for MPM has no definite role. The primary objective of this randomized pilot trial was to evaluate the feasibility for future large studies.MethodThe study design was a prospective randomized three-centric pilot trial (ISRCTN12709516). We recruited patients diagnosed with MPM and prospectively assigned them to two groups: Group A Video Assisted Thoracic Surgery (VATS) talc pleurodesis or Group B VATS P/D plus HITHOC. The main outcome measures were description of study feasibility. We collected socio-demographic and clinical patient information. Data of Kaplan-Meier survival analysis and Cox regression analysis are presented.ResultsFrom November-2011 to July-2017 24 males and 3 females, with a median age of 68-years were enrolled (recruitment rate 5 patients/year). Preoperative stage was I-II, and 18 had epithelioid type. 14 patients were in the Group A. Operative mortality was 0. Follow-up ranged from 6 to 80 months. The median overall survival time started to diverge at 20 months. In Group A, it was 19 months (95% CI:12-25) and in Group B, it was 28 months (95% CI:0-56). Survival rate for the epithelioid type was 15 months (0-34) in groups A. and 45 months (0-107) in the Group B with an HR 0.77 (95% CI:0.28-2.2).ConclusionThese findings suggest that VATS P/D plus HITHOC may improve survival time in MPM patients undergoing surgical treatment and support the need for a larger multicenter randomized clinical trial.Strengths and limitations of this studythis pilot study represents an important step forward of the treatment of malignant pleural mesotheliomaThe study demonstrates the feasibility for a multicenter randomized trial to compare VATS P/D plus HITHOC with VATS talc pleurodesis in the management of MPMAlthough survival for the epitheliod type is 45 months, the inclusion of small number of patients is a limitation.Although neoadjuvant, adjuvant chemo-radio or immunotherapy have been administered to the patients, we have no specific information about doses for every single patient.A potential source of bias could be that the house staff of the Centre A has not been formally educated about the study while in the Centre B house staff was informed about the pilot trial.
- Published
- 2021
19. A glimpse into the role of debulking surgery and hyperthermic intrathoracic chemotherapy (HITHOC) in the management of malignant pleural mesothelioma
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Marcello Migliore, Ibrahem Albalkhi, Abdullah Alshammari, Hamsa Aldebakey, Omniyah Alashgar, Joaquín Calatayud Gastardi, and Norberto Santana-Rodríguez
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Pulmonary and Respiratory Medicine ,Surgery ,Cardiology and Cardiovascular Medicine - Published
- 2022
20. HITHOC following uniportal right VATS P/D in a 62-year-old male patient with stage III MPM
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Marcello Migliore, Ibrahem Albalkhi, Abdullah Alshammari, Hamsa Aldebakey, Omniyah Alashgar, Joaquín Calatayud Gastardi, and Norberto Santana-Rodríguez
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Materials Chemistry - Published
- 2022
21. The second modification of a dedicated staging system for lung metastases
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Marcello Migliore and Michel Gonzalez
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Curative resection ,Cancer Research ,medicine.medical_specialty ,Future studies ,Lung ,Lung Neoplasms ,High interest ,business.industry ,Metastasectomy ,General Medicine ,medicine.disease ,Metastasis ,medicine.anatomical_structure ,Oncology ,medicine ,Pulmonary metastasis ,Humans ,Radiology ,business ,Staging system ,Neoplasm Staging - Abstract
The topic of pulmonary metastases has long been of high interest and ongoing controversy. There is a group of patients with pulmonary metastases who may benefit from curative resection. It remains unclear which among them will benefit from surgery in terms of survival. This work updates a previously proposed classification system for pulmonary metastases, similar in its essence to the tumor, nodes, metastasis (TNM) classification used for primary tumors and named pmTNM classification, where ‘pm' stands for ‘pulmonary metastasis’. The objective is to allow future studies to explore predictive and survival prognostic factors for pulmonary metastases and separate patients who will benefit from lung metastasectomy from those who will not. The secondary aim is to provide a classification system that will allow physicians, oncologists and surgeons to speak the same language in comparing their data and assessing the results of treatment of lung metastases.
- Published
- 2021
22. Salvage debulking surgery and hyperthermic intrathoracic chemotherapy for massive recurrent mesothelioma in the mediastinum
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Shi Sum Poon, Caterina Alberti, Marco Nardini, and Marcello Migliore
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Pulmonary and Respiratory Medicine ,Male ,Mesothelioma ,Pleural Neoplasms ,Mesothelioma, Malignant ,Mediastinum ,Cytoreduction Surgical Procedures ,respiratory system ,Combined Modality Therapy ,respiratory tract diseases ,Treatment Outcome ,Humans ,Surgery ,Neoplasm Recurrence, Local ,Cardiology and Cardiovascular Medicine ,Aged - Abstract
Mediastinal malignant pleural mesothelioma with signs of tamponade is rare. Indication for reoperation for recurrent malignant pleural mesothelioma is a controversial but viable option in selected patients. We report a case of a 68-year-old man presenting with epithelioid malignant pleural mesothelioma who underwent a total of three debulking surgeries (pleurectomy/decortication) combined with hyperthermic intrathoracic chemotherapy. Five years after the first procedure, a third urgent operation was performed for recurrence of a large mediastinal mesothelioma causing acute symptoms of pericardial constriction and tamponade. The patient was alive for eight years since the first treatment and 36 months after the second reoperation.
- Published
- 2021
23. Ground glass opacities of the lung before, during and post COVID-19 pandemic
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Marcello Migliore
- Subjects
2019-20 coronavirus outbreak ,Lung ,medicine.anatomical_structure ,Editorial ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Pandemic ,medicine ,General Medicine ,business ,Virology - Published
- 2021
24. Perimammary uniportal VATS decortication in a patient with chronic renal failure on dialysis and empyema stage III who was initially treated with chest tube insertion and multiple doses of intrapleural alteplase
- Author
-
Norberto Santana-Rodríguez, Hamsa Aldebakey, Ibrahem Albalkhi, Mohamed Hussein, Abdullah Alshammari, Ahmed Ahmed, Nasser Alshariff, Hazem Albeyali, Mahmoud Hashim, Bernardino Clavo-Varas, and Marcello Migliore
- Subjects
Materials Chemistry - Published
- 2022
25. Uniportal VATS decortication in a male patient with a complex chronic empyema and right lung completely trapped initially treated with chest tube insertion
- Author
-
Norberto Santana-Rodríguez, Hamsa Aldebakey, Ibrahem Albalkhi, Mohamed Hussein, Abdullah Alshammari, Ahmed Ahmed, Nasser Alshariff, Hazem Albeyali, Mahmoud Hashim, Bernardino Clavo-Varas, and Marcello Migliore
- Subjects
Materials Chemistry - Published
- 2022
26. Surgical management of parapneumonic empyema
- Author
-
Norberto Santana-Rodríguez, Hamsa Aldebakey, Ibrahem Albalkhi, Mohamed Hussein, Abdullah Alshammari, Ahmed Ahmed, Nasser Alshariff, Hazem Albeyali, Mahmoud Hashim, Bernardino Clavo-Varas, and Marcello Migliore
- Subjects
Pulmonary and Respiratory Medicine ,Surgery ,Cardiology and Cardiovascular Medicine - Published
- 2022
27. International consensus statement on robot-assisted minimally invasive esophagectomy (RAMIE)
- Author
-
Harmik J. Soukiasian, Jun Yi, Yang Yang, Marcello Migliore, Abbas E. Abbas, Hiroyuki Daiko, Alper Toker, Zhentao Yu, Yun Wang, Yin-Kai Chao, Kemp H. Kernstine, Hongjing Jiang, Chang Hyun Kang, Jianhua Fu, Ghulam Abbas, Sara Ricciardi, Inderpal S. Sarkaria, Michael Bouvet, Hecheng Li, Zhigang Li, Yong-Hee Kim, Bin Li, and Bentong Yu
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Consensus ,business.industry ,Statement (logic) ,minimally invasive esophagectomy ,General surgery ,Invasive esophagectomy ,MEDLINE ,Medicine ,Robot ,business ,Ramie - Published
- 2021
28. Which is the best approach for minimally invasive oesophagectomy?
- Author
-
Marcello Migliore
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Esophageal Neoplasms ,business.industry ,MIE ,General surgery ,Oesophageal cancer ,VATS ,General Medicine ,Hybrid ,Esophagectomy ,Minimally invasive surgery ,medicine ,Minimally invasive oesophagectomy ,Humans ,Minimally Invasive Surgical Procedures ,Surgery ,Cardiology and Cardiovascular Medicine ,business - Published
- 2021
29. Present and future of hyperthermic intrathoracic chemotherapy (HITHOC) in thoracic surgical oncology
- Author
-
Marcello Migliore
- Subjects
Chemotherapy ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,General surgery ,oncology thoracic ,General Medicine ,Text mining ,Editorial on Hyperthermic Intraoperative Chemotherapy (HITHOC) in Thoracic Surgical Oncology ,Surgical oncology ,mesothelioma ,medicine ,business ,hithoc - Published
- 2021
30. Late Breaking Abstract - Comparison of VATS debulking surgery and HITHOC vs VATS talc pleurodesis alone in malignant pleural mesothelioma: a pilot study
- Author
-
Marco Nardini, Alfreda Meli, Ines Monte, Mariacristina Scuderi, Hector Soto Parra, Paolo Vigneri, Corrado Spatola, Marcello Migliore, Giovanna Fantaci, Marco Aiello, and Tommaso Nicolosi
- Subjects
medicine.medical_specialty ,Pleural mesothelioma ,business.industry ,medicine.medical_treatment ,Debulking ,Group B ,Surgery ,Tolerability ,Quality of life ,malignant pleural mesothelioma ,Medicine ,Stage (cooking) ,business ,Pleurodesis ,Survival analysis - Abstract
Introduction: Although several Authors have emphasized the importance of surgery to obtain long term survival in malignant pleural mesothelioma (MPM), no study identifies evident reasons to convince surgeons to decide for one or another technique. Aim: prospective randomized bi-centric pilot study to investigate the effects and survival of VATS debulking surgery and HITHOC vs VATS-talc pleurodesis in MPM. Method: Patients with MPM were assigned to 2-groups: a) VATS-talc pleurodesis; b) VATS-PD and HITHOC. Several factors and Kaplan-Meier survival curves have been analyzed. Results: 27 patients, 24 male, mean-age 66 (48-82) were enrolled. All patients were stage I-II. 14 pts in group A, 13 pts group B. Age, stage, histology, early complication, hospital stay and quality of life did not differ. Survival after the operation was 19.6 months (group A) vs 31.6 months (group B). Survival after diagnosis was 19.6 months (group A) vs 33.0 (group B). One and 2-year survival was 57% and 28,6% for group A and 69% and 54% group B. A divergent curve at Kaplan Meier analysis at 3 years (fig 1). One patient of group B underwent 2 reoperation. Mortality was 0. Conclusion: VATS debulking surgery and HITHOC may be preferred in MPM because 3-year survival was longer compared to VATS pleurodesis, while safety and tolerability were similar. This study could stimulate larger randomized studies.
- Published
- 2020
31. Video-Assisted Thoracoscopic Surgery
- Author
-
Marcello Migliore and Mahmoud Loubani
- Subjects
medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Video-assisted thoracoscopic surgery ,Medicine ,business ,Surgery - Published
- 2020
32. Imaging patterns of early stage lung cancer for the thoracic surgeon
- Author
-
Marco Nardini, Antonio Basile, Stefano Palmucci, and Marcello Migliore
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Thoracic surgeon ,business.industry ,Cancer ,030204 cardiovascular system & hematology ,Early lung cancer ,medicine.disease ,Ground-glass opacity ,Imaging ,Resection ,Clinical Practice ,Review Article on Novel Diagnostic Techniques for Lung Cancer ,Thoracic surgery ,03 medical and health sciences ,0302 clinical medicine ,Cardiothoracic surgery ,030220 oncology & carcinogenesis ,medicine ,Radiology ,Ground glass ,Stage (cooking) ,medicine.symptom ,Lung cancer ,business - Abstract
In the modern era, thoracic surgeons are experiencing an increase interest in imaging patterns of early stage lung cancer due to the introduction of the ground glass opacity in clinical practice, and for the necessity to an accurate cancer localization to perform the appropriate type of resection. In this brief review we analyze the latest news regarding imaging patterns of early pulmonary nodules with special emphasis to ground glass opacity.
- Published
- 2020
33. Precision treatment of post pneumonectomy unilateral laryngeal paralysis due to cancer
- Author
-
Agostino Serra, Michele Russo, Salvatore Cocuzza, Paola Di Mauro, Giacomo Spinato, Milena Di Luca, Marcello Migliore, and Antonino Maniaci
- Subjects
Male ,Cancer Research ,medicine.medical_specialty ,Lung Neoplasms ,type 1 thyroplasty ,medicine.medical_treatment ,unilateral laryngeal paralysis ,Laryngoplasty ,03 medical and health sciences ,Pneumonectomy ,Postoperative Complications ,0302 clinical medicine ,Swallowing ,Gore-Tex • lung cancer • precision treatment • type 1 thyroplasty • unilateral laryngeal paralysis ,medicine ,Paralysis ,Humans ,Speech ,Gore-Tex ,030223 otorhinolaryngology ,Lung cancer ,Polytetrafluoroethylene ,Aged ,Laryngoscopy ,lung cancer ,precision treatment ,business.industry ,Reproducibility of Results ,Cancer ,General Medicine ,Middle Aged ,medicine.disease ,Deglutition ,Surgery ,Treatment Outcome ,Oncology ,Laryngeal paralysis ,030220 oncology & carcinogenesis ,Recurrent Laryngeal Nerve Injuries ,Cohort ,Female ,Implant ,Larynx ,medicine.symptom ,business ,Vocal Cord Paralysis - Abstract
Aim: The aim of this study is to assess the efficacy of external laryngeal medialization acquired through a Gore-Tex implant in a 45 patients affected by unilateral vocal fold paralysis in abduction after pneumonectomy. Method: The cohort of patients was made up of 30 male (73.1%) and 11 female patients (26.9%) with an average age of 66.7 years in a range between 46 and 78 years. Results: The results were analyzed with the objective and subjective analysis of voicing and swallowing. In 95.2% of cases, voice and swallow improvement with statistically significant evidences. Conclusion: We can conclude that Gore-Tex implantation is a simple, reproducible and minimally invasive procedure for management of selected cases of vocal fold unilateral paralysis in the abductory position.
- Published
- 2020
34. Precision surgery in lung metastasectomy
- Author
-
Marcello Migliore, Marco Nardini, Matthieu Zellweger, and Michel Gonzalez
- Subjects
Cancer Research ,medicine.medical_specialty ,Lung Neoplasms ,Colorectal cancer ,medicine.medical_treatment ,Clinical Decision-Making ,thoracoscopy ,Context (language use) ,colorectal cancer ,030204 cardiovascular system & hematology ,Disease-Free Survival ,03 medical and health sciences ,0302 clinical medicine ,Biomarkers, Tumor ,medicine ,Thoracoscopy ,Humans ,pulmonary metastases ,Thoracotomy ,Pneumonectomy ,FDG-PET ,Lung ,Lymph node ,pulmonary metastasectomy ,medicine.diagnostic_test ,Thoracic Surgery, Video-Assisted ,business.industry ,Patient Selection ,Margins of Excision ,General Medicine ,pulmonary anatomical resection ,Prognosis ,medicine.disease ,Primary tumor ,Dissection ,medicine.anatomical_structure ,Oncology ,Chemotherapy, Adjuvant ,Lymphatic Metastasis ,030220 oncology & carcinogenesis ,Lymph Node Excision ,Lymph Nodes ,Radiology ,Metastasectomy ,Colorectal Neoplasms ,Tomography, X-Ray Computed ,business - Abstract
The value of pulmonary metastasis (PM) resection in the context of controlled primary tumor sites was shown to improve survival of patients if complete resection could be achieved. The surgeon’s approach can be modulated by various parameters pertaining to safety margins including local growth properties, size, spread and location of PMs. Lymph node dissection and assessment is recommended although its impact on survival remains unclear. Thoracoscopic surgery combined to thin slice chest CT scans has shown results comparable to thoracotomy in patients with few PMs. The management of PMs should therefore be discussed on an individual, interdisciplinary basis to offer the best possible oncological and surgical results as well as to maximize long term patient survival rates.
- Published
- 2020
35. Perioperative chemoimmunotherapy in a patient with stage IIIB non-small cell lung cancer
- Author
-
Ziqing Gao, Wenhua Liang, Hongsheng Deng, Weiqiang Yin, Ory Wiesel, Hengrui Liang, Bassam Redwan, Kai Guo, Shuben Li, Raja M. Flores, Jianxing He, Kimberly J. Song, and Marcello Migliore
- Subjects
0301 basic medicine ,iMDT Corner ,medicine.medical_specialty ,Chemotherapy ,Squamous-cell carcinoma of the lung ,business.industry ,medicine.medical_treatment ,non-small cell lung cancer (NSCLC) ,Non-small cell lung cancer (NSCLC) ,General Medicine ,Immunotherapy ,Perioperative ,stage IIIB ,medicine.disease ,Surgery ,Radiation therapy ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Chemoimmunotherapy ,030220 oncology & carcinogenesis ,medicine ,business ,Adjuvant ,perioperative PD-1 inhibitor - Abstract
We present a case of a 56-year-old male patient with stage IIIB (T3N2M0) poorly differentiated squamous cell carcinoma of the lung. Four cycles of chemotherapy were first applied, and the patient had stable disease. However, the patient refused to receive radiotherapy, therefore second-line treatment chemotherapy combined with anti-PD-1 immunotherapy was applied. Partial response was reached at the 4(th) cycle of chemotherapy combined with anti-PD-1 immunotherapy. The neoadjuvant strategy was prolonged to 10 cycles but no significant change was observed on tumor size. The patient then underwent video-assisted thoracoscopic left lower lobectomy. Eight cycles of adjuvant PD-1 immunotherapy were applied postoperatively. Perioperative immunotherapy demonstrated good curative effect in this patient and no recurrence was observed at the clinic 40 months following surgery. Here we intend to explore the concept of immunotherapy combined with chemotherapy and surgery in neoadjuvant and adjuvant setting, and to investigate the possibility of extending this strategy in patients with stage IIIB non-small cell lung cancer (NSCLC).
- Published
- 2020
36. Adenoid cystic carcinoma of trachea: Long-term disease control after endoscopic surgery and radiotherapy
- Author
-
Giuseppe Privitera, Marcello Migliore, Francesco Marletta, Roberto Milazzotto, Alessandra Tocco, Antonio Basile, Stefano Pergolizzi, Grazia Acquaviva, Corrado Spatola, and Dario Marletta
- Subjects
Male ,Cancer Research ,medicine.medical_specialty ,Time Factors ,Adenoid cystic carcinoma ,medicine.medical_treatment ,Biopsy ,Perineural invasion ,tracheal tumor ,Endoscopic surgery ,Prosthesis Implantation ,03 medical and health sciences ,Thoracic region ,0302 clinical medicine ,Bronchoscopy ,medicine ,Humans ,adenoid cystic carcinoma ,IMRT ,030223 otorhinolaryngology ,Head and neck ,Aged ,postoperative radiotherapy ,business.industry ,Radiotherapy Planning, Computer-Assisted ,Radiotherapy Dosage ,perineural invasion ,QUANTEC ,General Medicine ,Middle Aged ,medicine.disease ,Disease control ,Carcinoma, Adenoid Cystic ,Radiation therapy ,Trachea ,Tracheal tumor ,Treatment Outcome ,Oncology ,030220 oncology & carcinogenesis ,Female ,Radiotherapy, Adjuvant ,Tracheal Neoplasms ,Radiology ,Radiotherapy, Intensity-Modulated ,business ,Follow-Up Studies - Abstract
Aim: Adenoid cystic carcinoma is a rare tumor of head and neck region and its development in the thoracic region is even less frequent. This implies the absence of guidelines for therapeutic management and a consequent case-by-case approach. The role of radiotherapy is not yet clearly defined, but intensity-modulated radiotherapy allows for improved organ-at-risk sparing. Materials & methods: We have collected the cases of four patients treated at our institutions by the means of intensity-modulated radiotherapy, after endoscopic resection. Results & conclusion: Patients treated achieved long-term disease control of about 5 years, with a minimal acute toxicity. Longer follow-up is needed to drain conclusion on the impact of this treatment on overall survival.
- Published
- 2020
37. Malignant pleural mesothelioma: between pragmatism and hope
- Author
-
Marcello Migliore
- Subjects
Editorial Commentary ,medicine.medical_specialty ,Pleural mesothelioma ,business.industry ,mesothelioma ,MEDLINE ,medicine ,General Medicine ,Radiology ,business - Published
- 2020
38. Surgery for 'advanced' lung and esophageal cancer: new horizons or false dawn?
- Author
-
Marcello Migliore, Semih Halezeroglu, and Antoon Lerut
- Subjects
Cancer Research ,medicine.medical_specialty ,Lung Neoplasms ,Lung ,New horizons ,Esophageal Neoplasms ,business.industry ,General surgery ,General Medicine ,Esophageal cancer ,medicine.disease ,Survival Analysis ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Oncology ,030220 oncology & carcinogenesis ,Humans ,Medicine ,030211 gastroenterology & hepatology ,business ,Neoplasm Staging - Published
- 2018
39. Searching for evidence of video-assisted thoracoscopic surgery (VATS) lung metastasectomy
- Author
-
Marcello Migliore and Michel Gonzalez
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Lung ,medicine.anatomical_structure ,business.industry ,Medicine ,Surgery ,Radiology ,Metastasectomy ,business ,Computer Science Applications - Published
- 2021
40. Pleural carcinosis caused by extrathoracic malignancies
- Author
-
Misel Milosevic, Bojan Koledin, and Marcello Migliore
- Subjects
medicine.medical_specialty ,Carcinosis ,business.industry ,medicine ,General Medicine ,Radiology ,business - Published
- 2021
41. Safety of video-assisted thoracic surgery lobectomy for non-small-cell lung cancer in a low-volume unit
- Author
-
Marco Nardini, Paola Di Masi, Marcello Migliore, Damiano Calvo, Francesco Borrata, Alessandra Criscione, Mariapia Gangemi, and Francesco Scalieri
- Subjects
Adult ,Diagnostic Imaging ,Male ,Cancer Research ,medicine.medical_specialty ,Lung Neoplasms ,medicine.medical_treatment ,Operative Time ,VATS lobectomy ,low-volume center ,Video-Assisted ,anatomical VATS resection ,non-small-cell lung cancer ,Aged ,Aged, 80 and over ,Carcinoma, Non-Small-Cell Lung ,Female ,Humans ,Length of Stay ,Middle Aged ,Neoplasm Staging ,Pneumonectomy ,Postoperative Complications ,Thoracic Surgery, Video-Assisted ,Treatment Outcome ,Oncology ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,80 and over ,medicine ,Non-Small-Cell Lung ,Lung cancer ,business.industry ,Carcinoma ,Thoracic Surgery ,General Medicine ,medicine.disease ,Surgery ,Low volume ,Cardiothoracic surgery ,030220 oncology & carcinogenesis ,Video assisted thoracic surgery ,Operative time ,Non small cell ,business - Abstract
Several studies have demonstrated that for complex surgical procedures, surgeons who treat more patients have better outcomes than their lower-volume counterparts. The aim of this paper is to review the experience with video-assisted thoracic surgery (VATS) lobectomies in our small thoracic unit (group A), to understand whether our short-term results were different to the outcomes obtained by the same surgeon previously working in a high-volume unit (group B). 37 patients underwent VATS lobectomy. Hospital stay was on average 4.5 days (group A) versus 4.1 days (group B). Operative time and the number of ‘frozen sections’ were higher in group A. Hospital mortality was 0. VATS lobectomies are a safe approach in a low-volume unit formed by a single surgeon with a previous high-volume experience.
- Published
- 2016
42. Video-assisted thoracic surgery techniques for lung cancer: which is better?
- Author
-
Marcello Migliore
- Subjects
0301 basic medicine ,Cancer Research ,medicine.medical_specialty ,Lung Neoplasms ,Video-Assisted ,03 medical and health sciences ,0302 clinical medicine ,Robotic Surgical Procedures ,Humans ,Medicine ,lung cancer ,lung resection ,video-assisted thoracic surgery ,Anesthesia ,Neoplasm Staging ,Thoracic Surgery, Video-Assisted ,Treatment Outcome ,Oncology ,Lung cancer ,business.industry ,General surgery ,Thoracic Surgery ,General Medicine ,medicine.disease ,030104 developmental biology ,030220 oncology & carcinogenesis ,Video assisted thoracic surgery ,Radiology ,Lung resection ,business - Published
- 2016
43. Awake uniportal video-assisted thoracic surgery for complications after pneumonectomy
- Author
-
Francesco Scalieri, Alessandra Criscione, Damiano Calvo, Francesco Borrata, Mariapia Gangemi, Marcello Migliore, and Marco Nardini
- Subjects
Male ,Cancer Research ,Lung Neoplasms ,Thoracic ,medicine.medical_treatment ,Comorbidity ,030204 cardiovascular system & hematology ,Postoperative Complications ,0302 clinical medicine ,80 and over ,Medicine ,Anesthesia ,Local anesthesia ,Pneumonectomy ,Tomography ,awake ,complications ,pneumonectomy ,uniportal ,VATS ,Aged ,Aged, 80 and over ,Empyema ,Humans ,Pneumothorax ,Radiography, Thoracic ,Thoracic Surgery, Video-Assisted ,Tomography, X-Ray Computed ,Treatment Outcome ,Oncology ,Thoracic Surgery ,General Medicine ,X-Ray Computed ,Cardiothoracic surgery ,Video assisted thoracic surgery ,medicine.symptom ,medicine.medical_specialty ,Sedation ,Video-Assisted ,03 medical and health sciences ,business.industry ,medicine.disease ,Surgery ,Radiography ,Tomography x ray computed ,030228 respiratory system ,business - Abstract
Since 1998, we started a clinical program for awake video-assisted thoracic surgery in our unit using four-step local anesthesia and sedation. Throughout the years, we experienced several difficult cases, three of them had complications postpneumonectomy. The aim of this paper is to report these three cases.
- Published
- 2016
44. Uniportal VATS: Comment on the consensus report from the uniportal VATS interest group (UVIG) of the European Society of Thoracic Surgeons
- Author
-
Kyoji Hirai and Marcello Migliore
- Subjects
Expressed Sequence Tags ,Surgeons ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Consensus ,Single trocar ,Thoracic Surgery, Video-Assisted ,business.industry ,Minithoracotomy ,General surgery ,Video-Assisted ,Thoracic Surgery ,VATS ,General Medicine ,Minimally invasive techniques ,Public Opinion ,Interest group ,Humans ,Medicine ,Surgery ,Cardiology and Cardiovascular Medicine ,business ,Single port ,Uniportal - Published
- 2019
45. Pleurectomy/decortication and hyperthermic intrapleural chemotherapy for malignant pleural mesothelioma: initial experience
- Author
-
Hector Soto Parra, Stefano Palmucci, Nicola Ciancio, Corrado Spatola, Rosario Caltabiano, Alessandra Criscione, Giovanni Fuccio Sanzà, Giuseppe Di Maria, Marco Aiello, Damiano Calvo, Giuseppe Privitera, and Marcello Migliore
- Subjects
Male ,Mesothelioma ,Cancer Research ,medicine.medical_specialty ,Lung Neoplasms ,Pleural Neoplasms ,medicine.medical_treatment ,Diaphragmatic breathing ,VATS ,Antineoplastic Combined Chemotherapy Protocols ,Chemotherapy ,cytoreductive surgery ,Humans ,Medicine ,multimodality treatment ,Hyperthermia ,Prospective Studies ,Pleural Neoplasm ,Prospective cohort study ,cisplatin ,HITHOC ,hyperthermic perfusion ,mesothelioma ,Aged ,Cisplatin ,Combined Modality Therapy ,Female ,Hyperthermia, Induced ,Middle Aged ,Thoracic Surgical Procedures ,Performance status ,business.industry ,Induced ,Mesothelioma, Malignant ,General Medicine ,Decortication ,medicine.disease ,Surgery ,Oncology ,business ,Pleurectomy - Abstract
Cytoreductive surgery and hyperthermic intraoperative intrapleural chemotherapy (HITHOC) are a known option for malignant pleural mesothelioma (MPM). This prospective study was started to prove that pleurectomy/decortication and HITHOC could be successfully performed in a low volume center. Criteria of inclusion were a proven diagnosis of MPM, early-stage disease and good performance status. Six consecutive patients were enrolled. After pleurectomy/decortication, intrapleural cisplatin was administered for 60 min at 42.5°C. Wedge resections and diaphragmatic reconstruction were added in two and one patient, respectively. Morbidity was 16.6%. Mortality was nil. Hospital stay was 7.8 days. Mean survival was 21.5 months (range: 6–30). This small experience confirms that pleurectomy/decortication and HITHOC are a good therapeutic option in the multimodality treatment of MPM. A randomized controlled trial is necessary.
- Published
- 2015
46. Personalized approach for video-assisted thoracic surgery lung metastasectomy
- Author
-
Céline Forster, Amaya Ojanguren, Etienne Abdelnour-Berchtold, Marcello Migliore, Michel Gonzalez, Matthieu Zellweger, Jean Yannis Perentes, and Thorsten Krueger
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Lung ,business.industry ,Computer Science Applications ,Pulmonary metastasectomy (PM) ,medicine.anatomical_structure ,Video assisted thoracic surgery ,Pulmonary metastases ,medicine ,Video-assisted thoracic surgery (VATS) ,Surgery ,Radiology ,Metastasectomy ,business - Published
- 2020
47. Uniportal video-assisted thoracic surgery or single-incision video-assisted thoracic surgery for lung resection: clarifying definitions
- Author
-
Marcello Migliore, Semih Halezeroglu, Federico Rea, Subroto Paul, Michael Rolf Mueller, Dirk Van Raemdonck, and Laureano Molins
- Subjects
Cancer Research ,medicine.medical_specialty ,Lung Neoplasms ,Anatomical VATS resection ,VATS lobectomy ,030204 cardiovascular system & hematology ,NSCLC ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Pneumonectomy ,low volume center ,Thoracic Surgery, Video-Assisted ,business.industry ,General surgery ,Anatomical VATS resection, low volume center, NSCLC, VATS lobectomy ,General Medicine ,Surgery ,Oncology ,Single incision ,030220 oncology & carcinogenesis ,Video assisted thoracic surgery ,Lung resection ,business - Published
- 2016
48. 2016 Annual report from the Italian VATS Group
- Author
-
Piergiorgio Solli, Luca Bertolaccini, Andrea Droghetti, Alessandro Bertani, Alessandro Gonfiotti, Mario Nosotti, Marcello Migliore, Roberto Crisci, and Italian VATS Group
- Subjects
medicine.medical_specialty ,lobectomy ,Cancer Research ,Lung Neoplasms ,Consensus Development Conferences as Topic ,VATS lobectomy ,Video-Assisted ,VATS ,030204 cardiovascular system & hematology ,lung cancer ,lung resection ,multicenter study ,study group ,thoracoscopic lobectomy ,Oncology ,Online Systems ,03 medical and health sciences ,0302 clinical medicine ,Medicine ,Humans ,Registries ,Pneumonectomy ,Lung ,business.industry ,Thoracic Surgery, Video-Assisted ,Databases as Topic ,Italy ,Treatment Outcome ,General surgery ,Thoracic Surgery ,General Medicine ,Annual report ,Multicenter study ,Cardiothoracic surgery ,Publishing ,030220 oncology & carcinogenesis ,Lung resection ,business - Abstract
This report highlights the results of the Italian video-assisted thoracoscopic surgery (VATS) Group, launched in mid 2013, which now has a website and an established database with over 4000 VATS lobectomy cases recruited from 67 thoracic surgery units across Italy. The year 2016 has been crucial for the following steps: inclusion of a dedicated biostatistician and a ‘Survey Analysis & Data Quality Check’; the First Consensus Meeting with statements consequently adopted as Recommendations for the Italian Thoracic Surgery Society and published in a peer-reviewed journal; two papers published under the logo Italian VATS Group and seven abstracts accepted at annual international meetings (European Society of Thoracic Surgeons, European Association of Cardio-Thoracic Surgeons, European Lung Cancer Conference and European Respiratory Society); the institution of a Master Course on VATS lobectomy; the partnership with AME Publishing Company.
- Published
- 2018
49. Combined taxane-based chemotherapy and intensity-modulated radiotherapy with simultaneous integrated boost for gastroesophageal junction adenocarcinoma
- Author
-
Vincenzo Salamone, Raffaele Luigi, Giuseppe Privitera, Marcello Migliore, Antonio Di Cataldo, Corrado Spatola, Alessandra Tocco, Grazia Acquaviva, Pietro Valerio Foti, Carmelo Militello, Roberto Milazzotto, and Antonio Pagana
- Subjects
Simultaneous integrated boost ,Male ,Cancer Research ,medicine.medical_specialty ,Esophageal Neoplasms ,medicine.medical_treatment ,Gastroesophageal Junction Adenocarcinoma ,Adenocarcinoma ,Radiation Dosage ,Disease-Free Survival ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Stomach Neoplasms ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,Aged ,Neoplasm Staging ,Aged, 80 and over ,Chemotherapy ,Taxane ,business.industry ,Incidence (epidemiology) ,Induction chemotherapy ,General Medicine ,Chemoradiotherapy ,Middle Aged ,intensity-modulated radiotherapy ,Magnetic Resonance Imaging ,Neoadjuvant Therapy ,Radiation therapy ,gastroesophageal junction adenocarcinoma ,Oncology ,simultaneous integrated boost ,030220 oncology & carcinogenesis ,Female ,Taxoids ,Intensity modulated radiotherapy ,Radiology ,Esophagogastric Junction ,Radiotherapy, Intensity-Modulated ,business ,Tomography, X-Ray Computed ,Follow-Up Studies - Abstract
We describe our experience, gained over the past 3 years, in the treatment of gastroesophageal junction adenocarcinoma, whose incidence has been increasing in recent years. In our series, we present the results to a follow-up of about 2 years for a total of 18 patients, treated with a particularly intensive combination treatment. It consists of neoadjuvant induction chemotherapy with the protocol docetaxel-cisplatin-5-fluorouracil for four cycles, before a concomitant chemoradiotherapy treatment. During combined phase, patients received an intensity-modulated radiotherapy and a weekly cisplatin. We will present the data to a long follow-up time and we will discuss the literature, the integration with thoracoabdominal surgery and other specific issues of this pathology.
- Published
- 2018
50. 99mTechnetium and methylene blue guided pulmonary nodules resections: preliminary British experience
- Author
-
Richard Hartley, Rocco Bilancia, Pavlos Papoulidis, Marco Nardini, Shruti Jayakumar, Mark Richardson, Mohamed ElSaegh, Joel Dunning, Pankash Misra, Ian Paul, and Marcello Migliore
- Subjects
Pulmonary and Respiratory Medicine ,Target lesion ,medicine.medical_specialty ,Suspicious for Malignancy ,business.industry ,chemistry.chemical_element ,Nodule (medicine) ,Technetium ,University hospital ,medicine.disease ,030218 nuclear medicine & medical imaging ,Resection ,03 medical and health sciences ,0302 clinical medicine ,chemistry ,Pneumothorax ,Maximum diameter ,030220 oncology & carcinogenesis ,medicine ,Original Article ,Radiology ,medicine.symptom ,business - Abstract
Background: Subcentimetre pulmonary nodules can be challenging to locate either during video-assisted thoracoscopic surgery (VATS) or by open techniques. In an era of increasing computed tomography scan availability the number of nodules that are identified that are suspicious for malignancy is rising, and thoracic surgeons require a reliable method to locate these nodules intraoperatively. Methods: Our aim was to evaluate, for the first time in the UK, resection of pulmonary nodules using radioactive dye labelling. Local research ethics approval was obtained and the study was submitted to the Integrated Research Application System (IRAS). All data were prospectively collected in our dedicated thoracic surgical database and analyzed at the conclusion of the study. This represents a consecutive series of patients, from January 2016 and until April 2017, who underwent this procedure at our institution: James Cook University Hospital, Middlesbrough, United Kingdom. The primary outcome measured was successful resection rate of the target nodules. Results: Twenty-three patients underwent radiolabeled excision of pulmonary nodules, their average age was 61 years (range, 28–79 years), 13 women and 10 men. The average maximum diameter of the nodule was 8 mm (range, 3–16 mm). All patients underwent successful excision of the target lesion (success rate 100%). One patient (4.3%) sustained pneumothorax following the CT-guided injection of the radio-labelled dye and this required chest drainage prior to general anesthesia. Conclusions: We conclude that technetium guided pulmonary nodule resection is a very reliable method for localization and resection of subcentimetre nodules which may be otherwise be difficult to identify.
- Published
- 2018
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