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4. Predicting a Prolonged Air Leak After Video-Assisted Thoracic Surgery, Is It Really Possible?

Author

Mancuso, M., Pernazza, F., Refai, M., Srella, F., Argnani, D., Marulli, G., De Palma, A., Bortolotti, L., Rizzardi, G., Solli, P.G., Dolci, G.P., Perkmann, R., Zaraca, F., Benvenuti, M., Gavezzoli, D., Cherchi, R., Ferrari, P., Mucilli, F., Camplese, P., Melloni, G., Mazza, F., Cavallesco, G., Maniscalco, P., Voltolini, L., Gonfiotti, A., Sollitto, F., Ardò, N., Pariscenti, G.L., Risso, C., Surrente, C., Lopez, C., Droghetti, A., Giovanardi, M., Breda, C., Giudice, Lo F., Alloisio, M., Bottoni, E., Spaggiari, L., Gasparri, R., Torre, M., Rinaldo, A., Nosotti, M., Tosi, D., Negri, G.P., Bandiera, A., Baisi, A., Raveglia, F., Stefani, A., Natali, P., Scarci, M., Pirondini, E., Curcio, C., Amore, D., Rena, O., Nicotra, S., Dell’ Amore, A., Bertani, A., Tancredi, G., Ampollini, L., Carbognani, P., Puma, F., Vinci, D., Cardillo, G., Carleo, F., Margaritora, S., Meacci, E., Luzzi, L., Ghisalberti, M., Crisci, R., Divisi, D., Lausi, P., Guerrera, F., Fontana, D., Beffa, V. Della, Morelli, A., Londero, F., Imperatori, A., Rotolo, N., Terzi, A., Viti, A., Infante, M., Benato, C., Zaraca, Francesco, Pipitone, Marco, Feil, Birgit, Perkmann, Reinhold, Bertolaccini, Luca, Curcio, Carlo, and Crisci, Roberto

Published
2021
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6. Comparison of operative and postoperative characteristics and outcomes between thoracoscopic segmentectomy and lobectomy for non-small-cell lung cancer: a propensity score matching study from the Italian VATS Group Registry

Author

Dell'Amore, A., Lomangino, I., Cannone, G., Terzi, S., Pangoni, A., Lorenzoni, G., Nicotra, S., Schiavon, M., Zuin, A., Gregori, D., Crisci, R., Curcio, C., Rea, F., Mancuso, M., Pernazza, F., Refai, M., Bortolotti, L., Rizzardi, G., Solli, P., Brandolini, I., Perkmann, R., Zaraca, F., Benvenuti, M., Gavezzoli, D., Cherchi, R., Ferrari, P., Mucilli, F., Camplese, P., Melloni, G., Mazza, F., Cavallesco, G., Maniscalco, P., Voltolini, L., Gonfiotti, A., Stella, F., Argnani, D., Pariscenti, G. L., Iurilli, S., Surrente, C., Lopez, C., Droghett, A., Giovanardi, M., Breda, C., Lo Giudice, F., Alloisio, M., Bottoni, E., Spaggiari, L., Gasparri, R., Torre, M., Rinaldo, A., Nosotti, M., Rosso, L., Negri, G. P., Bandiera, A., Stefani, A., Natali, P., Scarci, M., Pirondini, E., Amore, D., Baietto, G., Casadio, C., Bertani, A., Russo, E., Ampollini, L., Carbognani, P., Puma, F., Vinci, D., Andreetti, C., Poggi, C., Cardillo, G., Margaritora, S., Meacci, E., Luzzi, L., Ghisalberti, M., Zaccagna, G., Lausi, P., Guerrera, F., Fontana, D., Della Beffa, V., Morelli, A., Londero, F., Imperatori, N., Rotolo, A., Terzi, A., Viti, A., Infante, M., and Benato, C.

Subjects
Segmentectomy, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Lung Neoplasms, medicine.medical_treatment, VATS lobectomy, Video-assisted thoracic surgery, Context (language use), Mastectomy, Segmental, Postoperative outcome, Postoperative Complications, Lobectomy, Non-small-cell lung cancer, Carcinoma, Non-Small-Cell Lung, Humans, Medicine, Registries, Thoracotomy, Pneumonectomy, Propensity Score, Lung cancer, Retrospective Studies, Thoracic Surgery, Video-Assisted, business.industry, Confounding, Postoperative complication, General Medicine, medicine.disease, Surgery, Propensity score matching, Non small cell, Cardiology and Cardiovascular Medicine, business
Abstract

OBJECTIVES Only few studies compared the surgical morbidity and mortality of thoracoscopic segmentectomy versus lobectomy for non-small-cell lung cancer, in particular, by relating the segmental resections with the corresponding anatomical lobes. METHODS We enrolled a total of 7487 patients who underwent VATS lobectomy (7269) or segmentectomy (218) from January 2014 to July 2019. A propensity score matching approach was used to account for potential confounding factors between the 2 groups. After matching, 349 lobectomies and 208 segmentectomies were included in the analysis. We analysed the operative and postoperative outcomes of video-assisted anatomical segmentectomy compared with video-assisted lobectomy and, in details, the results of segmentectomy with its corresponding lobectomy in a large cohort of patients from the Italian VATS Group Registry. RESULTS The overall conversion rate to thoracotomy was not statistically different between the groups (27 patients 8% vs 7 patients 3%, P = 0.1). The lobectomy group had a greater number of resected lymph nodes (median 11 vs 8, P = 0.006). No significant differences were detected in 30-day mortality (1.4%, 5 patients vs 0.9%, 2 patients), overall complications (18%, 62 patients vs 14%, 29 patients) and prolonged air leakage (31 patients, 9% vs 12 patients, 6%) between lobectomy and segmentectomy, respectively. No statistical differences were found regarding the median duration of drainage (3.2 days, P = 1) and the overall median length of hospital stay (6.4 days, P = 0.1) between the 2 groups. In the context of segmentectomy versus corresponding lobectomy, the right upper lobectomy compared with right upper segmentectomy showed a higher number of resected lymph nodes (P = 0.027). No statistical differences were reported in terms of conversion rate and postoperative complication and mortality. CONCLUSIONS Segmentectomy could be considered a safe procedure without significant differences compared to thoracoscopic lobectomy in terms of postoperative morbidity and mortality.

Published
2021

9. Simultaneous Detection of NF1, SPRED1, LZTR1, and NF2 Gene Mutations by Targeted NGS in an Italian Cohort of Suspected NF1 Patients.

Author

Bianchessi, D, Ibba, M, Saletti, V, Blasa, S, Langella, T, Paterra, R, Cagnoli, G, Melloni, G, Scuvera, G, Natacci, F, Cesaretti, C, Finocchiaro, G, Eoli, M, Bianchessi D, Ibba MC, Saletti V, Blasa S, Langella T, Paterra R, Cagnoli GA, Melloni G, Scuvera G, Natacci F, Cesaretti C, Finocchiaro G, Eoli M, Bianchessi, D, Ibba, M, Saletti, V, Blasa, S, Langella, T, Paterra, R, Cagnoli, G, Melloni, G, Scuvera, G, Natacci, F, Cesaretti, C, Finocchiaro, G, Eoli, M, Bianchessi D, Ibba MC, Saletti V, Blasa S, Langella T, Paterra R, Cagnoli GA, Melloni G, Scuvera G, Natacci F, Cesaretti C, Finocchiaro G, and Eoli M

Abstract

Neurofibromatosis type 1 (NF1) displays overlapping phenotypes with other neurocutaneous diseases such as Legius Syndrome. Here, we present results obtained using a next generation sequencing (NGS) panel including NF1, NF2, SPRED1, SMARCB1, and LZTR1 genes on Ion Torrent. Together with NGS, the Multiplex Ligation-Dependent Probe Amplification Analysis (MLPA) method was performed to rule out large deletions/duplications in NF1 gene; we validated the MLPA/NGS approach using Sanger sequencing on DNA or RNA of both positive and negative samples. In our cohort, a pathogenic variant was found in 175 patients; the pathogenic variant was observed in NF1 gene in 168 cases. A SPRED1 pathogenic variant was also found in one child and in a one year old boy, both NF2 and LZTR1 pathogenic variants were observed; in addition, we identified five LZTR1 pathogenic variants in three children and two adults. Six NF1 pathogenic variants, that the NGS analysis failed to identify, were detected on RNA by Sanger. NGS allows the identification of novel mutations in five genes in the same sequencing run, permitting unambiguous recognition of disorders with overlapping phenotypes with NF1 and facilitating genetic counseling and a personalized follow-up.

Published
2020

14. Uniportal and three-portal video-assisted thoracic surgery lobectomy: analysis of the Italian video-assisted thoracic surgery group database

Author

Tosi, D, Nosotti, M, Bonitta, G, Mazzucco, A, Righi, I, Mendogni, P, Rosso, L, Palleschi, A, Rocco, G, Crisci, R, Mancuso, M, Pernazza, F, Refai, M, Bortolotti, L, Rizzardi, G, Gargiulo, G, Dolci, Gp, Perkmann, R, Zaraca, F, Benvenuti, M, Gavezzoli, D, Cherchi, R, Ferrari, P, Mucilli, F, Camplese, P, Melloni, G, Mazza, F, Cavallesco, G, Maniscalco, P, Voltolini, L, Gonfiotti, A, Stella, F, Argnani, D, Pariscenti, Gl, Lurilli, Surrente, C, Lopez, C, Droghetti, A, Giovanardi, M, Breda, C, Lo Giudice, F, Alloisio, M, Bottoni, E, Spaggiari, L, Gasparri, R, Torre, M, Rinaldo, A, Negri, Gp, Bandiera, A, Stefani, A, Natali, P, Scarci, M, Pirondini, E, Curcio, C, Amore, D, Baietto, G, Casadio, C, Nicotra, S, Dell'Amore, A, Bertani, A, Russo, E, Ampollini, L, Carbognani, P, Puma, F, Vinci, D, Andreetti, C, Poggi, C, Cardillo, G, Margaritora, S, Meacci, Elisa, Luzzi, L, Ghisalberti, M, Zaccagna, G, Lausi, P, Guerrera, F, Fontana, D, Della Beffa, V, Morelli, A, Londero, F, Imperatori, A, Rotolo, N, Terzi, A, Viti, A, Infante, M, Benato, C, Tosi, D., Nosotti, M., Bonitta, G., Mazzucco, A., Righi, I., Mendogni, P., Rosso, L., Palleschi, A., Rocco, G., Crisci, R., Mancuso, M., Pernazza, F., Refai, M., Bortolotti, L., Rizzardi, G., Gargiulo, G., Dolci, G. P., Perkmann, R., Zaraca, F., Benvenuti, M., Gavezzoli, D., Cherchi, R., Ferrari, P., Mucilli, F., Camplese, P., Melloni, G., Mazza, F., Cavallesco, G., Maniscalco, P., Voltolini, L., Gonfiotti, A., Stella, F., Argnani, D., Pariscenti, G. L., Surrente, C., Lopez, C., Droghetti, A., Giovanardi, M., Breda, C., Lo Giudice, F., Alloisio, M., Bottoni, E., Spaggiari, L., Gasparri, R., Torre, M., Rinaldo, A., Negri, G, Bandiera, A., Stefani, A., Natali, P., Scarci, M., Pirondini, E., Curcio, C., Amore, D., Baietto, G., Casadio, C., Nicotra, S., Dell'Amore, A., Bertani, A., Russo, E., Ampollini, L., Carbognani, P., Puma, F., Vinci, D., Andreetti, C., Poggi, C., Cardillo, G., Margaritora, S., Meacci, E., Luzzi, L., Ghisalberti, M., Zaccagna, G., Lausi, P., Guerrera, F., Fontana, D., Della Beffa, V., Morelli, A., Londero, F., Imperatori, A., Rotolo, N., Terzi, A., Viti, A., Infante, M., Benato, C., Tosi D., Nosotti M., Bonitta G., Mazzucco A., Righi I., Mendogni P., Rosso L., Palleschi A., Rocco G., Crisci R., Mancuso M., Pernazza F., Refai M., Bortolotti L., Rizzardi G., Gargiulo G., Dolci G.P., Perkmann R., Zaraca F., Benvenuti M., Gavezzoli D., Cherchi R., Ferrari P., Mucilli F., Camplese P., Melloni G., Mazza F., Cavallesco G., Maniscalco P., Voltolini L., Gonfiotti A., Stella F., Argnani D., Pariscenti G.L., Surrente C., Lopez C., Droghetti A., Giovanardi M., Breda C., Lo Giudice F., Alloisio M., Bottoni E., Spaggiari L., Gasparri R., Torre M., Rinaldo A., Negri G.P., Bandiera A., Stefani A., Natali P., Scarci M., Pirondini E., Curcio C., Amore D., Baietto G., Casadio C., Nicotra S., Dell'amore A., Bertani A., Russo E., Ampollini L., Carbognani P., Puma F., Vinci D., Andreetti C., Poggi C., Cardillo G., Margaritora S., Meacci E., Luzzi L., Ghisalberti M., Zaccagna G., Lausi P., Guerrera F., Fontana D., Della Beffa V., Morelli A., Londero F., Imperatori A., Rotolo N., Terzi A., Viti A., Infante M., and Benato C.

Subjects
Male, Lung Neoplasms, Thoracic, Italian VATS Group, computer.software_genre, Postoperative pain, Settore MED/21 - CHIRURGIA TORACICA, Carcinoma, Non-Small-Cell Lung, Lobectomy, Three-portal, Uniportal, Video-assisted thoracic surgery, Aged, Equipment Design, Female, Humans, Neoplasm Staging, Operative Time, Pneumonectomy, Retrospective Studies, Thoracic Surgery, Video-Assisted, Tomography, X-Ray Computed, Stage (cooking), Non-Small-Cell Lung, Tomography, Database, Thoracic Surgery, X-Ray Computed, Cardiothoracic surgery, Cohort, Cardiology and Cardiovascular Medicine, Pulmonary and Respiratory Medicine, Italian VATS Group, Lobectomy, Postoperative pain, Three-portal, Uniportal, Video-assisted thoracic surgery, medicine.medical_specialty, VATS lobectomy, Video-Assisted, NO, medicine, Lung cancer, business.industry, Carcinoma, Odds ratio, medicine.disease, Confidence interval, Propensity score matching, Surgery, business, computer
Abstract

OBJECTIVES This study compares the uniportal with the 3-portal video-assisted thoracic surgery (VATS) by examining the data collected in the Italian VATS Group Database. The primary end point was early postoperative pain; secondary end points were intraoperative and postoperative complications, surgical time, number of dissected lymph nodes and length of stay. METHODS This was an observational, retrospective, cohort, multicentre study on data collected by 49 Italian thoracic units. Inclusion criteria were clinical stage I–II non-small-cell lung cancer, uniportal or 3-portal VATS lobectomy and R0 resection. Exclusion criteria were cT3 disease, previous thoracic malignancy, induction therapy, significant comorbidities and conversion to other techniques. The pain parameter was dichotomized: the numeric rating scale ≤3 described mild pain, whereas the numeric rating scale score >3 described moderate/severe pain. The propensity score-adjusted generalized estimating equation was used to compare the uniportal with 3-portal lobectomy. RESULTS Among 4338 patients enrolled from January 2014 to July 2017, 1980 met the inclusion criteria; 1808 patients underwent 3-portal lobectomy and 172 uniportal surgery. The adjusted generalized estimating equation regression model using the propensity score showed that over time pain decreased in both groups (P CONCLUSIONS Data from the Italian VATS Group Database showed that in clinical practice uniportal lobectomy seems to entail a higher risk of moderate/severe pain on second and third postoperative days.

Published
2019

16. What counts more: The patient, the surgical technique, or the hospital? A multivariable analysis of factors affecting perioperative complications of pulmonary lobectomy by video-assisted thoracoscopic surgery from a large nationwide registry

Author

Infante, Maurizio V, Benato, Cristiano, Silva, Ronaldo, Rocco, Gaetano, Bertani, Alessandro, Bertolaccini, Luca, Gonfiotti, Alessandro, Giovannetti, Riccardo, Bonadiman, Cinzia, Lonardoni, Alessandro, Canneto, Barbara, Falezza, Giovanni, Gandini, Paola, Curcio, Carlo, Crisci, Roberto, Alloisio, M, Amore, D, Ampollini, L, Andreetti, C, Argnani, D, Baietto, G, Bandiera, A, Benato, C, Benvenuti, M, Bertani, A, Bertolaccini, L, Bortolotti, L, Bottoni, E, Breda, C, Camplese, P, Carbognani, P, Cardillo, G, Casadio, C, Cavallesco, G, Cherchi, R, Crisci, R, Curcio, C, Dell'Amore, A, Beffa, V, Dolci, G, Droghetti, A, Ferrari, Pa, Fontana, D, Gargiulo, G, Gasparri, R, Gavezzoli, D, Ghisalberti, M, Giovanardi, M, Gonfiotti, A, Guerrera, F, Imperatori, A, Infante, M, Iurilli, L, Lausi, P, Logiudice, F, Londero, F, Lopez, C, Luzzi, L, Mancuso, M, Maniscalco, P, Margaritora, S, Meacci, E, Melloni, G, Morelli, A, Mucilli, F, Natali, P, Negri, G, Nicotra, S, Nosotti, M, Pariscenti, G, Perkmann, R, Pernazza, F, Pirondini, E, Poggi, C, Puma, F, Refai, M, Rinaldo, A, Rizzardi, G, Rosso, L, Rotolo, N, Russo, E, Sabbatini, A, Scarci, M, Spaggiari, L, Stefani, A, Solli, P, Surrente, C, Terzi, A, Torre, M, Vinci, D, Viti, A, Voltolini, L, Zaccagna, G, Zaraca, F., Infante M.V., Benato C., Silva R., Rocco G., Bertani A., Bertolaccini L., Gonfiotti A., Giovannetti R., Bonadiman C., Lonardoni A., Canneto B., Falezza G., Gandini P., Curcio C., Crisci R., Zaraca F., Alloisio M., Amore D., Ampollini L., Andreetti C., Argnani D., Baietto G., Bandiera A., Benvenuti M., Bortolotti L., Bottoni E., Breda C., Camplese P., Carbognani P., Cardillo G., Casadio C., Cavallesco G., Cherchi R., Dell'Amore A., Beffa V., Dolci G., Droghetti A., Ferrari P.A., Fontana D., Gargiulo G., Gasparri R., Gavezzoli D., Ghisalberti M., Giovanardi M., Guerrera F., Imperatori A., Iurilli L., Lausi P., Lo Giudice F., Londero F., Lopez C., Luzzi L., Mancuso M., Maniscalco P., Margaritora S., Meacci E., Melloni G., Morelli A., Mucilli F., Natali P., Negri G., Nicotra S., Nosotti M., Pariscenti G., Perkmann R., Pernazza F., Pirondini E., Poggi C., Puma F., Refai M., Rinaldo A., Rizzardi G., Rosso L., Rotolo N., Russo E., Sabbatini A., Scarci M., Spaggiari L., Stefani A., Solli P., Surrente C., Terzi A., Torre M., Vinci D., Viti A., Voltolini L., Zaccagna G., Infante, M. V., Benato, C., Silva, R., Rocco, G., Bertani, A., Bertolaccini, L., Gonfiotti, A., Giovannetti, R., Bonadiman, C., Lonardoni, A., Canneto, B., Falezza, G., Gandini, P., Curcio, C., Crisci, R., the Italian VATS group, Member, and Negri, G.

Subjects
Male, Registrie, Conversion, Morbidity, Postoperative complications, Video-assisted thoracoscopic surgery lobectomy, Lung Neoplasms, Intraoperative Complication, Aged, Female, Hospitals, Humans, Intraoperative Complications, Lung, Middle Aged, Pneumonectomy, Postoperative Complications, Registries, Retrospective Studies, Risk Factors, Thoracic Surgery, Video-Assisted, medicine.medical_treatment, Interquartile range, Retrospective Studie, Settore MED/21 - CHIRURGIA TORACICA, Conversion, Morbidity, Postoperative complications, Video-assisted thoracoscopic surgery lobectomy, Thoracic Surgery, General Medicine, Video-assisted thoracoscopic surgery, Cardiology and Cardiovascular Medicine, Human, Pulmonary and Respiratory Medicine, medicine.medical_specialty, VATS lobectomy, Video-Assisted, NO, Hospital, medicine, business.industry, Risk Factor, Retrospective cohort study, Perioperative, medicine.disease, Comorbidity, Surgery, Postoperative complication, Lung Neoplasm, Complication, business
Abstract

OBJECTIVESInherent technical aspects of pulmonary lobectomy by video-assisted thoracoscopic surgery (VATS) may limit surgeons’ ability to deal with factors predisposing to complications. We analysed complication rates after VATS lobectomy in a prospectively maintained nationwide registry.METHODSThe registry was queried for all consecutive VATS lobectomy procedures from 49 Italian Thoracic Units. Baseline condition, tumour features, surgical techniques, devices, postoperative care, complications, conversions and the reasons thereof were detailed. Univariable and multivariable regressions were used to assess factors potentially linked to complications.RESULTSFour thousand one hundred and ninety-one VATS lobectomies in 4156 patients (2480 men, 1676 women) were analysed. The median age-adjusted Charlson index of the patients was 4 (interquartile range 3–6). Grade 1 and 2 and Grade 3–5 complications were observed in 20.1% and in 5.8%, respectively. Ninety-day mortality was 0.55%. The overall conversion rate was 9.2% and significantly higher in low-volume centres (CONCLUSIONSVATS lobectomy is a safe procedure even in medically compromised patients. An improved classification system for conversions is proposed and prevention strategies are suggested to reduce conversion rates and possibly complications in less-experienced centres.

Published
2019

17. PATRI, a Genomics Data Integration Tool for Biomarker Discovery

Author

Ukmar, G, Melloni, G, Raddrizzani, L, Rossi, P, Di Bella, S, Pirchio, M, Vescovi, M, Leone, A, Callari, M, Cesarini, M, Somaschini, A, Della Vedova, G, Daidone, M, Pettenella, M, Isacchi, A, Bosotti, R, Ukmar G., Melloni G. E. M., Raddrizzani L., Rossi P., Di Bella S., Pirchio M. R., Vescovi M., Leone A., Callari M., Cesarini M., Somaschini A., Della Vedova G., Daidone M. G., Pettenella M., Isacchi A., Bosotti R., Ukmar, G, Melloni, G, Raddrizzani, L, Rossi, P, Di Bella, S, Pirchio, M, Vescovi, M, Leone, A, Callari, M, Cesarini, M, Somaschini, A, Della Vedova, G, Daidone, M, Pettenella, M, Isacchi, A, Bosotti, R, Ukmar G., Melloni G. E. M., Raddrizzani L., Rossi P., Di Bella S., Pirchio M. R., Vescovi M., Leone A., Callari M., Cesarini M., Somaschini A., Della Vedova G., Daidone M. G., Pettenella M., Isacchi A., and Bosotti R.

Abstract

The availability of genomic datasets in association with clinical, phenotypic, and drug sensitivity information represents an invaluable source for potential therapeutic applications, supporting the identification of new drug sensitivity biomarkers and pharmacological targets. Drug discovery and precision oncology can largely benefit from the integration of treatment molecular discriminants obtained from cell line models and clinical tumor samples; however this task demands comprehensive analysis approaches for the discovery of underlying data connections. Here we introduce PATRI (Platform for the Analysis of TRanslational Integrated data), a standalone tool accessible through a user-friendly graphical interface, conceived for the identification of treatment sensitivity biomarkers from user-provided genomics data, associated with information on sample characteristics. PATRI streamlines a translational analysis workflow: first, baseline genomics signatures are statistically identified, differentiating treatment sensitive from resistant preclinical models; then, these signatures are used for the prediction of treatment sensitivity in clinical samples, via random forest categorization of clinical genomics datasets and statistical evaluation of the relative phenotypic features. The same workflow can also be applied across distinct clinical datasets. The ease of use of the PATRI tool is illustrated with validation analysis examples, performed with sensitivity data for drug treatments with known molecular discriminants

Published
2018

18. Predictors of nodal upstaging in patients with cT1-3N0 non-small cell lung cancer (NSCLC): results from the Italian VATS Group Registry

Author

Marulli, G., Faccioli, E., Mammana, M., Nicotra, S., Comacchio, G., Verderi, E., De Palma, A., Curcio, C., Rea, F., Bertani, A., Russo, E., Voltolini, L., Gonfiotti, A., Nosotti, M., Rosso, L., Muriana, G., Droghetti, A., Crisci, R., Zaccagna, G., Amore, D., di Rienzo, G., Lopez, C., Morelli, A., Londero, F., Spaggiari, L., Gasparri, R., Baietto, G., Casadio, C., Infante, M., Benato, C, Alloisio, M., Bottoni, E, Cardillo, G., Carleo, F., Stella, F., Dolci, G., Puma, F., Vinci, D., Cavallesco, G., Maniscalco, P., Ampollini, L., Carbognani, P., Terzi, A., Viti, A, Negri, G., Bandiera, A., Perkmann, R., Zaraca, F., Andreetti, C., Poggi, C., Mucilli, F., Camplese, P., Luzzi, L., Ghisalberti, M., Imperatori, A., Rotolo, N., Bortolotti, L., Rizzardi, G., Torre, M., Rinaldo, A., Sabbatini, A., Refai, M., Benvenuti, M. R., Benetti, D., Stefani, A., Natali, P., Lausi, P., Guerrera, F., Melloni, G., Mazza, F., Argnani, D., Sanna, S., Fontana, D., Beffa, V. D., Meda, S., Pernazza, F. a, and Italian VATS Group

Subjects
Oncology, Male, Lung Neoplasms, medicine.medical_treatment, non-small cell lung cancer (NSCLC), Nodal upstaging, VATS lobectomy, 0302 clinical medicine, Risk Factors, Carcinoma, Non-Small-Cell Lung, 80 and over, Registries, Non-Small-Cell Lung, Child, Pneumonectomy, GeneralLiterature_REFERENCE(e.g.,dictionaries,encyclopedias,glossaries), Aged, 80 and over, Thoracic Surgery, Video-Assisted, Thoracic Surgery, General Medicine, Middle Aged, Lymph node dissection, Mediastinal staging, Predictive risk factors, Adolescent, Adult, Aged, Disease Progression, Female, Humans, Italy, Lymph Node Excision, Neoplasm Staging, Predictive Value of Tests, Young Adult, 030220 oncology & carcinogenesis, Predictive value of tests, 030211 gastroenterology & hepatology, Lymph node dissection, Mediastinal staging, Nodal upstaging, Predictive risk factors, VATS lobectomy, medicine.medical_specialty, Video-Assisted, NO, 03 medical and health sciences, Internal medicine, medicine, In patient, business.industry, Disease progression, Carcinoma, medicine.disease, Surgery, Neoplasm staging, business
Abstract

Accurate staging of early non-small cell lung cancer is fundamental for selecting the best treatment. The aim of this study was to identify risk factors for nodal upstaging after video-assisted thoracoscopic lobectomy for clinical T1-3N0 tumors.From 2014 to 2017, 3276 thoracoscopic lobectomies were recorded in the prospective database "Italian VATS Group". Linear and multiple logistic regression models were adapted to identify independent predictors of nodal upstaging and factors associated with progression in postoperative N status.Nodal upstaging was found in 417 cases (12.7%), including 206 cases (6.2%) of N1-positive nodes, 81 cases of N2 nodes (2.4%), and 130 cases (4%) of involvement of both N1 + N2 nodes. A total of 241 (7.3%) patients had single-station nodal involvement, whereas 176 (5.3%) had multiple-station involvement. In the final regression model, the tumor grade, histology, pathologic T status, and 12 resected nodes were independent predictors of nodal upstaging.The number of resected lymph nodes seems to predict nodal upstaging better than the type of intraoperative lymph node management. Other preoperative risk factors correspond to those for which the current guidelines of the European Society of Thoracic Surgery recommend more extensive preoperative mediastinal staging.

Published
2020

19. Correction to: Predictors of nodal upstaging in patients with cT1-3N0 non-small cell lung cancer (NSCLC): results from the Italian VATS Group Registry (Surgery Today, (2020), 50, 7, (711-718), 10.1007/s00595-019-01939-x)

Author

Marulli, G., Faccioli, E., Mammana, M., Nicotra, S., Comacchio, G., Verderi, E., De Palma, A., Curcio, C., Rea, F., Bertani, A., Russo, E., Voltolini, L., Gonfiotti, A., Nosotti, M., Rosso, L., Muriana, G., Droghetti, A., Crisci, R., Zaccagna, G., Amore, D., di Rienzo, G., Lopez, C., Morelli, A., Londero, F., Spaggiari, L., Gasparri, R., Baietto, G., Casadio, C., Infante, M., Benato, C., Alloisio, M., Bottoni, E., Cardillo, G., Carleo, F., Stella, F., Dolci, G., Puma, F., Vinci, D., Cavallesco, G., Maniscalco, P., Ampollini, L., Carbognani, P., Terzi, A., Viti, A., Negri, G., Bandiera, A., Perkmann, R., Zaraca, F., Andreetti, C., Poggi, C., Mucilli, F., Camplese, P., Luzzi, L., Ghisalberti, M., Imperatori, A., Rotolo, N., Bortolotti, L., Rizzardi, G., Torre, M., Rinaldo, A., Sabbatini, A., Refai, M., Benvenuti, M. R., Benetti, D., Stefani, A., Natali, P., Lausi, P., Guerrera, F., Melloni, G., Mazza, F., Argnani, D., Sanna, S., Fontana, D., Beffa, V. D., Meda, S., and Pernazza, F.

Subjects
NO
Published
2020

22. Predicting a Prolonged Air Leak After Video-Assisted Thoracic Surgery, Is It Really Possible?

Author

Zaraca, Francesco, primary, Pipitone, Marco, additional, Feil, Birgit, additional, Perkmann, Reinhold, additional, Bertolaccini, Luca, additional, Curcio, Carlo, additional, Crisci, Roberto, additional, Mancuso, M., additional, Pernazza, F., additional, Refai, M., additional, Srella, F., additional, Argnani, D., additional, Marulli, G., additional, De Palma, A., additional, Bortolotti, L., additional, Rizzardi, G., additional, Solli, P.G., additional, Dolci, G.P., additional, Perkmann, R., additional, Zaraca, F., additional, Benvenuti, M., additional, Gavezzoli, D., additional, Cherchi, R., additional, Ferrari, P., additional, Mucilli, F., additional, Camplese, P., additional, Melloni, G., additional, Mazza, F., additional, Cavallesco, G., additional, Maniscalco, P., additional, Voltolini, L., additional, Gonfiotti, A., additional, Sollitto, F., additional, Ardò, N., additional, Pariscenti, G.L., additional, Risso, C., additional, Surrente, C., additional, Lopez, C., additional, Droghetti, A., additional, Giovanardi, M., additional, Breda, C., additional, Giudice, Lo F., additional, Alloisio, M., additional, Bottoni, E., additional, Spaggiari, L., additional, Gasparri, R., additional, Torre, M., additional, Rinaldo, A., additional, Nosotti, M., additional, Tosi, D., additional, Negri, G.P., additional, Bandiera, A., additional, Baisi, A., additional, Raveglia, F., additional, Stefani, A., additional, Natali, P., additional, Scarci, M., additional, Pirondini, E., additional, Curcio, C., additional, Amore, D., additional, Rena, O., additional, Nicotra, S., additional, Dell’ Amore, A., additional, Bertani, A., additional, Tancredi, G., additional, Ampollini, L., additional, Carbognani, P., additional, Puma, F., additional, Vinci, D., additional, Cardillo, G., additional, Carleo, F., additional, Margaritora, S., additional, Meacci, E., additional, Luzzi, L., additional, Ghisalberti, M., additional, Crisci, R., additional, Divisi, D., additional, Lausi, P., additional, Guerrera, F., additional, Fontana, D., additional, Beffa, V. Della, additional, Morelli, A., additional, Londero, F., additional, Imperatori, A., additional, Rotolo, N., additional, Terzi, A., additional, Viti, A., additional, Infante, M., additional, and Benato, C., additional

Published
2021
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24. Corrigendum to: What counts more: The patient, the surgical technique, or the hospital? A multivariable analysis of factors affecting perioperative complications of pulmonary lobectomy by video-assisted thoracoscopic surgery from a large nationwide registry (European Journal of Cardio-thoracic Surgery (2019) DOI: 10.1093/ejcts/ezz187)

Author

Infante, M. V., Benato, C., Silva, R., Rocco, G., Bertani, A., Bertolaccini, L., Gonfiotti, A., Giovannetti, R., Bonadiman, C., Lonardoni, A., Canneto, B., Falezza, G., Gandini, P., Curcio, C., Crisci, R., Zaraca, F., Alloisio, M., Amore, D., Ampollini, L., Andreetti, C., Argnani, D., Baietto, G., Bandiera, A., Benvenuti, M., Bortolotti, L., Bottoni, E., Breda, C., Camplese, P., Carbognani, P., Cardillo, G., Casadio, C., Cavallesco, G., Cherchi, R., Dell'Amore, A., Beffa, V., Dolci, G, Droghetti, A, Ferrari, P. A., Fontana, D., Gargiulo, G., Gasparri, R., Gavezzoli, D., Ghisalberti, M., Giovanardi, M., Guerrera, F., Imperatori, A., Iurilli, L., Lausi, P., Lo Giudice, F., Londero, F., Lopez, C., Luzzi, L., Mancuso, M., Maniscalco, P., Margaritora, S., Meacci, E., Melloni, G., Morelli, A., Mucilli, F., Natali, P., Negri, G., Nicotra, S., Nosotti, M., Pariscenti, G., Perkmann, R., Pernazza, F., Pirondini, E., Poggi, C., Puma, F., Refai, M., Rinaldo, A., Rizzardi, G, Rosso, L., Rotolo, N., Russo, E., Sabbatini, A., Scarci, M., Spaggiari, L., Stefani, A., Solli, P., Surrente, C., Terzi, A., Torre, M., Vinci, D., Viti, A., Voltolini, L., Zaccagna, G., and the Italian VATS group members

Subjects
Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Lung Neoplasms, Thoracic, medicine.medical_treatment, MEDLINE, NO, Postoperative Complications, Risk Factors, Pulmonary lobectomy, Humans, Medicine, Registries, Intraoperative Complications, Pneumonectomy, Lung, Aged, Retrospective Studies, Thoracic Surgery, Video-Assisted, business.industry, General surgery, General Medicine, Perioperative, Middle Aged, Corrigenda, Hospitals, Video-assisted thoracoscopic surgery, Female, Surgery, Cardiology and Cardiovascular Medicine, business
Abstract

OBJECTIVES: Inherent technical aspects of pulmonary lobectomy by video-assisted thoracoscopic surgery (VATS) may limit surgeons’ ability to deal with factors predisposing to complications. We analysed complication rates after VATS lobectomy in a prospectively maintained nationwide registry. METHODS: The registry was queried for all consecutive VATS lobectomy procedures from 49 Italian Thoracic Units. Baseline condition, tumour features, surgical techniques, devices, postoperative care, complications, conversions and the reasons thereof were detailed. Univariable and multivariable regressions were used to assess factors potentially linked to complications. RESULTS: Four thousand one hundred and ninety-one VATS lobectomies in 4156 patients (2480 men, 1676 women) were analysed. The median age-adjusted Charlson index of the patients was 4 (interquartile range 3–6). Grade 1 and 2 and Grade 3–5 complications were observed in 20.1% and in 5.8%, respectively. Ninety-day mortality was 0.55%. The overall conversion rate was 9.2% and significantly higher in low-volume centres (

Published
2019

25. What counts more: the patient, the surgical technique, or the hospital? A multivariable analysis of factors affecting perioperative complications of pulmonary lobectomy by video-assisted thoracoscopic surgery from a large nationwide registry

Author

Infante, Mv, Benato, C, Silva, R, Rocco, G, Bertani, A, Bertolaccini, L, Gonfiotti, A, Giovannetti, R, Bonadiman, C, Lonardoni, A, Canneto, B, Falezza, G, Gandini, P, Curcio, C, Crisci, R, Alloisio, M, Amore, D, Ampollini, L, Andreetti, C, Argnani, D, Baietto, G, Bandiera, A, Benvenuti, Mr, Bortolotti, L, Bottoni, E, Breda, C, Camplese, P, Carbognani, P, Cardillo, G, Casadio, C, Cavallesco, G, Cherchi, R, Dell'Amore, A, Della Beffa, V, Dolci, G, Droghetti, A, Ferrari, Pa, Fontana, D, Gargiulo, G, Gasparri, R, Gavezzoli, D, Ghisalberti, M, Giovanardi, M, Guerrera, F, Imperatori, A, Infante, M, Iurilli, L, Lausi, P, Lo Giudice, F, Londero, F, Lopez, C, Luzzi, L, Mancuso, M, Maniscalco, P, Margaritora, Stefano, Meacci, Elisa, Melloni, G, Morelli, A, Mucilli, F, Natali, P, Negri, G, Nicotra, S, Nosotti, M, Pariscenti, G, Perkmann, R, Pernazza, F, Pirondini, E, Poggi, C, Puma, F, Refai, M, Rinaldo, A, Rizzardi, G, Rosso, L, Rotolo, N, Russo, E, Sabbatini, A, Scarci, M, Spaggiari, L, Stefani, A, Solli, P, Surrente, C, Terzi, A, Torre, M, Vinci, D, Viti, A, Voltolini, L, Zaccagna, G, Zaraca, F, Margaritora, S (ORCID:0000-0002-9796-760X), Meacci, E (ORCID:0000-0001-8424-3816), Infante, Mv, Benato, C, Silva, R, Rocco, G, Bertani, A, Bertolaccini, L, Gonfiotti, A, Giovannetti, R, Bonadiman, C, Lonardoni, A, Canneto, B, Falezza, G, Gandini, P, Curcio, C, Crisci, R, Alloisio, M, Amore, D, Ampollini, L, Andreetti, C, Argnani, D, Baietto, G, Bandiera, A, Benvenuti, Mr, Bortolotti, L, Bottoni, E, Breda, C, Camplese, P, Carbognani, P, Cardillo, G, Casadio, C, Cavallesco, G, Cherchi, R, Dell'Amore, A, Della Beffa, V, Dolci, G, Droghetti, A, Ferrari, Pa, Fontana, D, Gargiulo, G, Gasparri, R, Gavezzoli, D, Ghisalberti, M, Giovanardi, M, Guerrera, F, Imperatori, A, Infante, M, Iurilli, L, Lausi, P, Lo Giudice, F, Londero, F, Lopez, C, Luzzi, L, Mancuso, M, Maniscalco, P, Margaritora, Stefano, Meacci, Elisa, Melloni, G, Morelli, A, Mucilli, F, Natali, P, Negri, G, Nicotra, S, Nosotti, M, Pariscenti, G, Perkmann, R, Pernazza, F, Pirondini, E, Poggi, C, Puma, F, Refai, M, Rinaldo, A, Rizzardi, G, Rosso, L, Rotolo, N, Russo, E, Sabbatini, A, Scarci, M, Spaggiari, L, Stefani, A, Solli, P, Surrente, C, Terzi, A, Torre, M, Vinci, D, Viti, A, Voltolini, L, Zaccagna, G, Zaraca, F, Margaritora, S (ORCID:0000-0002-9796-760X), and Meacci, E (ORCID:0000-0001-8424-3816)

Abstract

OBJECTIVES: Inherent technical aspects of pulmonary lobectomy by video-assisted thoracoscopic surgery (VATS) may limit surgeons' ability to deal with factors predisposing to complications. We analysed complication rates after VATS lobectomy in a prospectively maintained nationwide registry.METHODS: The registry was queried for all consecutive VATS lobectomy procedures from 49 Italian Thoracic Units. Baseline condition, tumour features, surgical techniques, devices, postoperative care, complications, conversions and the reasons thereof were detailed. Univariable and multivariable regressions were used to assess factors potentially linked to complications.RESULTS: Four thousand one hundred and ninety-one VATS lobectomies in 4156 patients (2480 men, 1676 women) were analysed. The median age-adjusted Charlson index of the patients was 4 (interquartile range 3-6). Grade 1 and 2 and Grade 3-5 complications were observed in 20.1% and in 5.8%, respectively. Ninety-day mortality was 0.55%. The overall conversion rate was 9.2% and significantly higher in low-volume centres (<100 cases, P < 0.001), but there was no significant difference between intermediate- and high-volume centres under this aspect. Low-volume centres were significantly more likely to convert due to issues with difficult local anatomy, but not significantly so for bleeding. Conversion, lower case-volume, comorbidity burden, male gender, adhesions, blood loss, operative time, sealants and epidural analgesia were significantly associated with increased postoperative morbidity.CONCLUSIONS: VATS lobectomy is a safe procedure even in medically compromised patients. An improved classification system for conversions is proposed and prevention strategies are suggested to reduce conversion rates and possibly complications in less-experienced centres.

Published
2019

26. Acute/Chronic respiratory failure III

Author

Mondèjar, E. Fernàndez, Mata, G. Vazquez, Ferròn, F., Navarrete, P., Ruiz, J. M. Torres, Lestavel, P., Tronchon, L., Chambrin, M. C., Mangalaboyi, J., Rime, A., Chopin, C., Valta, P., Campodonico, R., Corbeil, C., Chassè, M., Châtillon, A., Braidy, J., Matar, N., Milic-Emili, J., Lòpez-Messa, J., Penas, L., Valverde, A., Dambrosio, M., Roupie, E., Carneiro, A., Anglade, M. C., Vasile, N., Brochard, L., Lemaire, F., Rubio, J., Carrasco, M. S., Mateo, I., Sierra, R., Escolar, A., Cozar, J., Bastin, K., Knapen, R., Moraine, J. J., Melot, C., Sergysels, R., Kahn, R. J., Pelosi, P., Cereda, M., Foti, G., D’Andrea, L., Manetti, B., Lissoni, A., Pesenti, A., Gallego, J. M. Allegue, Rubi, J. A. Gòmez, Sànchez, C. Palazòn, Moreno, A. Melgarejo, Lherm, T., Boiteau, R., Valente, E., Beaussier, M., Chamieh, F., Tenaillon, A., Righini, E. R., Alvisi, R., Ragazzi, R., Volta, C. A., Capuzzo, M., Gritti, G., Sydow, M., Burchardi, H., Zinserling, J., Crozier, T. A., Guttmann, J., Eberhard, L., Bertschmann, W., Fabry, B., Wolff, G., Rubini, A., DelMonte, D. D., Catena, V., Attar, I., Rattazzi, G., Alati, G. L., Diaz, M. Arias, Mata, G. Vàzquez, Navarro, P. Navarrete, Lòpez, F. Guerrero, Morales, A. Mèrida, Isenegger, J., Picazo, L., Sanchez, A., Hernandez, B., Pons, A., Conti, G., Di Chiara, L., De Blasi, R. A., Dell’Utri, D., Cogliati, A., Pelaia, P., Ferretti, A., Bernasconi, F., Banfi, G., Pesenti, A., Putensen, C., Putensen-Himmer, G., Leon, M., Huygen, P. E. M., Gültuna, I., Zwart, A., Ince, C., Bruining, H. A., Pompe, J. C., Kesecioĝlu, J., Rabbat, A., Laaban, J. P., Orvoen-Frija, E., Achkar, A., Rochemaure, J., Frigo, V., Solca, M., Melloni, G., Gerbsa, C., Ornaghi, A., Mancini, S., Cavagnoli, R., Fasano, W., Santos, C., Roca, J., Torres, A., Cardùs, J., Barberà, J. A., Felez, M. A., Rodriguez-Roisin, R., Oviedo-Moreira, R., Beydon, L., Nakos, G., Precates, A., Mathas, C., Bassilakis, N., Chagianagnostou, K., Massoura, L., Labropoulos, S., Devroey, M., Vansnick, P., Mèlot, C., Naeije, R., Nagy, V., Kiiski, R., Kaitainen, S., Karppi, R., Takala, J., Kesecioglu, J., Erdmann, W., Marin, J., Arnau, A., Tejeda, M., Olivares, D., Servera, E., Boix, J. H., Alvarez, F., Peydro, F., Mira, J. P., Belghith, M., Renaud, B., Deland, E., Brunet, F., Brusset, A., Lanore, J. J., Hamy, I., Termignon, J. L., Soubrane, O., Pochard, F., Dhainaut, J. F., Sidhu, P. S., Cockburn, J. F., Nicholson, D. A., Kennedy, A., Dawson, P., and Servera, F. E.

Published
1992
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29. Lesioni tracheo-bronchiali

Author

Zannini P, Carretta A, Melloni G, Negri G, Negri, G, Carretta, A, Zannini, P, and Melloni, G

Published
2016

30. Precision trial drawer, a computational tool to assist planning of genomics-driven trials in oncology

Author

Melloni, G. E. M., Guida, A., Curigliano, G., Botteri, E., Esposito, A., Kamal, M., Tourneau, C. L., Riva, L., Magi, A., De Maria Marchiano, Ruggero, Pelicci, P., Mazzarella, L., de Maria R. (ORCID:0000-0003-2255-0583), Melloni, G. E. M., Guida, A., Curigliano, G., Botteri, E., Esposito, A., Kamal, M., Tourneau, C. L., Riva, L., Magi, A., De Maria Marchiano, Ruggero, Pelicci, P., Mazzarella, L., and de Maria R. (ORCID:0000-0003-2255-0583)

Abstract

Purpose Trials that accrue participants on the basis of genetic biomarkers are a powerful means of testing targeted drugs, but they are often complicated by the rarity of the biomarker-positive population. Umbrella trials circumvent this by testing multiple hypotheses to maximize accrual. However, bigger trials have higher chances of conflicting treatment allocations because of the coexistence of multiple actionable alterations; allocation strategies greatly affect the efficiency of enrollment and should be carefully planned on the basis of relative mutation frequencies, leveraging information from large sequencing projects. Methods We developed software named Precision Trial Drawer (PTD) to estimate parameters that are useful for designing precision trials, most importantly, the number of patients needed to molecularly screen (NNMS) and the allocation rule that maximizes patient accrual on the basis of mutation frequency, systematically assigning patients with conflicting allocations to the drug associated with the rarer mutation. We used data from The Cancer Genome Atlas to show their potential in a 10-arm imaginary trial of multiple cancers on the basis of genetic alterations suggested by the past Molecular Analysis for Personalised Therapy (MAP) conference. We validated PTD predictions versus real data from the SHIVA (A Randomized Phase II Trial Comparing Therapy Based on Tumor Molecular Profiling Versus Conventional Therapy in Patients With Refractory Cancer) trial. Results In the MAP imaginary trial, PTD-optimized allocation reduces number of patients needed to molecularly screen by up to 71.8% (3.5 times) compared with nonoptimal trial designs. In the SHIVA trial, PTD correctly predicted the fraction of patients with actionable alterations (33.51% [95% CI, 29.4% to 37.6%] in imaginary v 32.92% [95% CI, 28.2% to 37.6%] expected) and allocation to specific treatment groups (RAS/MEK, PI3K/mTOR, or both). Conclusion PTD correctly predicts crucial parameters for t

Published
2018

32. PATRI, a Genomics Data Integration Tool for Biomarker Discovery

Author

Ukmar, G., primary, Melloni, G. E. M., additional, Raddrizzani, L., additional, Rossi, P., additional, Di Bella, S., additional, Pirchio, M. R., additional, Vescovi, M., additional, Leone, A., additional, Callari, M., additional, Cesarini, M., additional, Somaschini, A., additional, Della Vedova, G., additional, Daidone, M. G., additional, Pettenella, M., additional, Isacchi, A., additional, and Bosotti, R., additional

Published
2018
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36. The E3 ubiquitin ligase WWP1 sustains the growth of acute myeloid leukaemia

Author

Sanarico, A G, primary, Ronchini, C, additional, Croce, A, additional, Memmi, E M, additional, Cammarata, U A, additional, De Antoni, A, additional, Lavorgna, S, additional, Divona, M, additional, Giacò, L, additional, Melloni, G E M, additional, Brendolan, A, additional, Simonetti, G, additional, Martinelli, G, additional, Mancuso, P, additional, Bertolini, F, additional, Coco, F Lo, additional, Melino, G, additional, Pelicci, P G, additional, and Bernassola, F, additional

Published
2017
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37. Decortication for Chronic Parapneumonic Empyema: Results of a Prospective Study

Author

Melloni G, Carretta A, Ciriaco P, NEGRI, GIAMPIERO, Voci C, Augello G, ZANNINI , PIERO, CARRETTA, ANGELO, Melloni, G, Carretta, A, Ciriaco, P, Negri, Giampiero, Voci, C, Augello, G, Zannini, Piero, and Carretta, Angelo

Subjects
Adult, Male, medicine.medical_specialty, medicine.medical_treatment, Pneumonia, Bacterial, medicine, Humans, Pseudomonas Infections, Prospective Studies, Empyema, Prospective cohort study, Lung, Aged, Univariate analysis, Thoracic Surgery, Video-Assisted, business.industry, Pleural empyema, Middle Aged, Decortication, Vascular surgery, medicine.disease, Surgery, Pneumonia, Treatment Outcome, Thoracotomy, Chronic Disease, Female, business, Abdominal surgery
Abstract

Despite advances in diagnostic methods, surgical techniques, and supportive therapy, chronic parapneumonic empyema is still associated with considerable morbidity and mortality. A prospective study was performed on a consecutive series of patients with chronic parapneumonic empyema to analyze the results of surgical treatment and identify clinical predictors of poor outcome. From 1993 to 2000 a total of 40 patients underwent decortication for chronic parapneumonic empyema. There was no mortality. All 40 patients had definitive resolution of the empyema. Altogether, 34 patients (87.5%) had an uneventful postoperative course, and 5 (12.5%) experienced complications (2 prolonged febrile syndromes, 3 cases of sepsis requiring mechanical respiratory assistance). All complications resolved well with adequate treatment without further consequences. Definitive results of the surgical procedures assessed at the 6-month follow-up examination were good in 21 patients and satisfactory in 19. No unsatisfactory results were observed in any of the patients. Univariate analysis showed that three variables predicted morbidity: co-morbidities (p = 0.039), symptom duration greater than or equal to 60 days (p = 0.009), and duration of preoperative conservative treatment greater than or equal to 30 days (p = 0.006). Multivariate analysis showed that only symptom duration 60 days (p = 0.041) and duration of conservative treatment greater than or equal to 30 days (p = 0.025) were associated with morbidity. Decortication is a highly effective treatment for chronic parapneumonic empyema and may be performed with low morbidity and mortality. Because prolonged duration of symptoms and conservative treatment increase morbidity, early surgical intervention seems to be the optimal modality for the treatment of chronic parapneumonic empyema. RI ciriaco, paola/H-5716-2012 Abstract. Despite advances in diagnostic methods, surgical techniques, and supportive therapy, chronic parapneumonic empyema is still associated with considerable morbidity and mortality. A prospective study was performed on a consecutive series of patients with chronic parapneumonic empyema to analyze the results of surgical treatment and identify clinical predictors of poor outcome. From 1993 to 2000 a total of 40 patients underwent decortication for chronic parapneumonic empyema. There was no mortality. All 40 patients had definitive resolution of the empyema. Altogether, 34 patients (87.5%) had an uneventful postoperative course, and 5 (12.5%) experienced complications (2 prolonged febrile syndromes, 3 cases of sepsis requiring mechanical respiratory assistance). All complications resolved well with adequate treatment without further consequences. Definitive results of the surgical procedures assessed at the 6-month follow-up examination were good in 21 patients and satisfactory in 19. No unsatisfactory results were observed in any of the patients. Univariate analysis showed that three variables predicted morbidity: co-morbidities (p = 0.039), symptom duration ≥ 60 days (p=0.009), and duration of preoperative conservative treatment ≥ 30 days (p = 0.006). Multivariate analysis showed that only symptom duration ≥ 60 days (p = 0.041) and duration of conservative treatment ≥ 30 days (p = 0.025) were associated with morbidity. Decortication is a highly effective treatment for chronic parapneumonic empyema and may be performed with low morbidity and mortality. Because prolonged duration of symptoms and conservative treatment increase morbidity, early surgical intervention seems to be the optimal modality for the treatment of chronic parapneumonic empyema.

Published
2004

38. Diagnosis and Treatment of Traumatic Pulmonary Pseudocysts

Author

Melloni G, Cremona G, Ciriaco P, Pansera M, Carretta A, NEGRI , GIAMPIERO, Zannini P., CARRETTA, ANGELO, Melloni, G, Cremona, G, Ciriaco, P, Pansera, M, Carretta, A, Negri, Giampiero, Zannini, P., and Carretta, Angelo

Subjects
Adult, Male, Thorax, medicine.medical_specialty, Adolescent, Thoracic Injuries, Lung injury, Wounds, Nonpenetrating, Critical Care and Intensive Care Medicine, Diagnosis, Differential, Injury Severity Score, Blunt, medicine, Humans, Retrospective Studies, Cysts, business.industry, Respiratory disease, Retrospective cohort study, Lung Injury, medicine.disease, Surgery, Treatment Outcome, Female, Radiology, Differential diagnosis, Tomography, X-Ray Computed, business, Complication
Abstract

Background: Traumatic pulmonary pseudocysts (TPPs) are rare sequelae of blunt chest trauma. We present a retrospective review of TPPs observed in our hospital and discuss the diagnosis, treatment, and complications of these unusual lesions. Methods: Between 1991 and 1999, 11 TPPs were diagnosed in 10 patients. None of the lesions was detectable on the chest radiograph obtained on the day of injury. In contrast, computed tomographic scan of the chest always demonstrated the TPPs. Results: in nine cases, spontaneous healing of the lesions was observed. One patient with a large lesion of the left lower lobe developed significant endobronchial bleeding and underwent successful emergency lobectomy. Conclusion: TPPs are often missed by chest radiography, particularly when it is obtained in the supine position, whereas computed tomographic scan allows the identification of these lesions in all cases. TPPs are self-limiting, benign lesions that usually require no specific therapy. Surgical treatment is indicated in rare instances and only when complications occur. RI ciriaco, paola/H-5716-2012

Published
2003

44. PML-RARA-associated cooperating mutations belong to a transcriptional network that is deregulated in myeloid leukemias

Author

Ronchini, C, primary, Brozzi, A, additional, Riva, L, additional, Luzi, L, additional, Gruszka, A M, additional, Melloni, G E M, additional, Scanziani, E, additional, Dharmalingam, G, additional, Mutarelli, M, additional, Belcastro, V, additional, Lavorgna, S, additional, Rossi, V, additional, Spinelli, O, additional, Biondi, A, additional, Rambaldi, A, additional, Lo-Coco, F, additional, di Bernardo, D, additional, and Pelicci, P G, additional

Published
2016
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47. Correlazione tra dosaggio di paratormone ed elevati valori di PSA prebioptici in pazienti con successivo esito istologico di benignità

Author

ROMEO, Salvatore, DISPENSA, Nino, MELLONI, Darvinio, Napoli, G, Melloni, G, Romeo, S, Napoli, G, Melloni, G, Dispensa, N, and Melloni, D

Subjects
PSA,PTH, IPB, Biopsia prostatica, Settore MED/24 - Urologia
Abstract

The functional relationship between parathyroid glands and prostatic gland is commonly very well known. The aim of our study was to investigate the relationship between serum levels of PTH and serum levels of PSA in patients with pathological finding of BPH. According to 261 transrectal ultra- sound-guided prostatic biopsies performed from March 2009 to March 2010, 75 patients, responding to our inclusion criteria, were selected. 26 patients (34.6%) ended the study. All patients with high serum levels of PSA (>4 ng/mL), with histological diagnosis of benign prostatic hyperplasia, underwent the assay of serum levels of PTH. We observed high levels of PTH (> 66 pg/mL) in 9 patients (35.2%)

Published
2012

48. LowMACA: exploiting protein family analysis for the identification of rare driver mutations in cancer

Author

Melloni, G, de Pretis, S, Riva, L, Pelizzola, M, Ceol, A, Costanza, J, Muller, H, Zammataro, L, Melloni GEM, de Pretis S, Riva L, Pelizzola M, Ceol A, Costanza J, Muller H, Zammataro L, Melloni, G, de Pretis, S, Riva, L, Pelizzola, M, Ceol, A, Costanza, J, Muller, H, Zammataro, L, Melloni GEM, de Pretis S, Riva L, Pelizzola M, Ceol A, Costanza J, Muller H, and Zammataro L

Abstract

Background: The increasing availability of resequencing data has led to a better understanding of the most important genes in cancer development. Nevertheless, the mutational landscape of many tumor types is heterogeneous and encompasses a long tail of potential driver genes that are systematically excluded by currently available methods due to the low frequency of their mutations. We developed LowMACA (Low frequency Mutations Analysis via Consensus Alignment), a method that combines the mutations of various proteins sharing the same functional domains to identify conserved residues that harbor clustered mutations in multiple sequence alignments. LowMACA is designed to visualize and statistically assess potential driver genes through the identification of their mutational hotspots. Results: We analyzed the Ras superfamily exploiting the known driver mutations of the trio K-N-HRAS, identifying new putative driver mutations and genes belonging to less known members of the Rho, Rab and Rheb subfamilies. Furthermore, we applied the same concept to a list of known and candidate driver genes, and observed that low confidence genes show similar patterns of mutation compared to high confidence genes of the same protein family. Conclusions: LowMACA is a software for the identification of gain-of-function mutations in putative oncogenic families, increasing the amount of information on functional domains and their possible role in cancer. In this context LowMACA emphasizes the role of genes mutated at low frequency otherwise undetectable by classical single gene analysis.

Published
2016

49. Manuale di Urologia e Andrologia. Capitolo 1: Anatomia dell'apparato genito-urinario

Author

Artibani, W, Capra, M, D'elia, C, Galfano, A, Melloni, G, MELLONI, Darvinio, DISPENSA, Nino, SERRETTA, Vincenzo, Collegio dei Professori Universitari di Prima Fascia di Urologia in Ruolo e Fuori Ruolo, Artibani, W, Melloni, D, Capra, M, D'elia, C, Dispensa, N, Galfano, A, Melloni, G, and Serretta, V

Subjects
Anatomia, apparato genito-urinario, Settore MED/24 - Urologia
Published
2010

50. Prognostic factors and analysis of S100aS protein in resected pulmonary metastases from renal cell carcinoma

Author

BANDIERA A, MELLONI G, FRESCHI M, GIOVANARDI M, CARRETTA A, BORRI A, CIRIACO P, ZANNINI P, Bandiera, A, Melloni, G, Freschi, M, Giovanardi, M, Carretta, A, Borri, A, Ciriaco, P, and Zannini, P

Abstract

This study analyzes our experience with pulmonary resection for metastases from renal cell carcinoma. The goals were to search for factors influencing prognosis and to investigate the presence and the prognostic value of S100A4 protein in lung metastases and corresponding primary renal tumors. Sixty-five patients underwent surgical resection for renal and pulmonary lesions between 1992 and 2007. S100A4 protein expression was immunohistochemically examined in the peritumoral infiltrate of 64 lesions (32 metastases and the 32 corresponding primary carcinomas). Overall 3-, 5-, and 10-year survival rates were 58, 46, and 25%, respectively. Univariate analysis revealed that surgical radicality (p = 0.0039) and stratification into groups according to the International Registry of Lung Metastases classification (p = 0.0137) were prognostic factors. Multivariate analysis confirmed that this classification was a significant prognostic factor (p = 0.01). All metastases and the corresponding primary carcinomas expressed S100A4 protein. Twenty-one metastases (66%) had weak expression and 11 (34%) had strong expression. Twelve (37.5%) primary lesions had weak expression and 20 (62.5%) had strong expression. The 5-year survival rate for patients with strong expression in primary carcinoma was 41%, significantly lower than that of patients with weak expression (78%; p = 0.05). Pulmonary resection in metastatic renal cell carcinoma results in long-term survival. Complete resection and stratification into groups according to the International Registry of Lung Metastases classification were prognostic factors. Overexpression of S100A4 protein in primary tumors was correlated with a poor prognosis. If confirmed in larger studies this finding could be used to schedule adjuvant treatments in patients undergoing nephrectomy for renal cell carcinoma. RI ciriaco, paola/H-5716-2012 Background This study analyzes our experience withpulmonary resection for metastases from renal cell carcinoma.The goals were to search for factors influencingprognosis and to investigate the presence and the prognosticvalue of S100A4 protein in lung metastases andcorresponding primary renal tumors.Methods Sixty-five patients underwent surgical resectionfor renal and pulmonary lesions between 1992 and 2007.S100A4 protein expression was immunohistochemicallyexamined in the peritumoral infiltrate of 64 lesions (32metastases and the 32 corresponding primary carcinomas).Results Overall 3-, 5-, and 10-year survival rates were 58,46, and 25%, respectively. Univariate analysis revealedthat surgical radicality (p = 0.0039) and stratification intogroups according to the International Registry of LungMetastases classification (p = 0.0137) were prognosticfactors. Multivariate analysis confirmed that this classificationwas a significant prognostic factor (p = 0.01). Allmetastases and the corresponding primary carcinomasexpressed S100A4 protein. Twenty-one metastases (66%)had weak expression and 11 (34%) had strong expression.Twelve (37.5%) primary lesions had weak expression and20 (62.5%) had strong expression. The 5-year survival ratefor patients with strong expression in primary carcinomawas 41%, significantly lower than that of patients withweak expression (78%; p = 0.05).Conclusions Pulmonary resection in metastatic renal cellcarcinoma results in long-term survival. Complete resectionand stratification into groups according to the InternationalRegistry of Lung Metastases classification wereprognostic factors. Overexpression of S100A4 protein inprimary tumors was correlated with a poor prognosis. Ifconfirmed in larger studies this finding could be used toschedule adjuvant treatments in patients undergoingnephrectomy for renal cell carcinoma.

Published
2009

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