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37 results on '"Rea Lo Dico"'

1. Selected Patients With Peritoneal Metastases From Breast Cancer May Benefit From Cytoreductive Surgery: The Results of a Multicenter Survey

Author: Maurizio Cardi, Marc Pocard, Rea Lo Dico, Gianmaria Fiorentini, Mario Valle, Roberta Gelmini, Marco Vaira, Enrico Maria Pasqual, Salvatore Asero, Gianluca Baiocchi, Andrea Di Giorgio, Alessandra Spagnoli, Francesco Di Marzo, Bianca Sollazzo, Giuseppe D’Ermo, Daniele Biacchi, Franco Iafrate, and Paolo Sammartino
Subjects: breast cancer, peritoneal metastases, cytoreductive surgery, oligometastatic disease, ascites treatment, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract: BackgroundEven though breast cancer is the most frequent extra-abdominal tumor causing peritoneal metastases, clear clinical guidelines are lacking. Our aim is to establish whether cytoreductive surgery (CRS) could be considered in selected patients with peritoneal metastases from breast cancer (PMBC) to manage abdominal spread and allow patients to resume or complete other medical treatments.MethodsWe considered patients with PMBC treated in 10 referral centers from January 2002 to May 2019. Clinical data included primary cancer characteristics (age, histology, and TNM) and data on metastatic disease (interval between primary BC and PM, molecular subtype, other metastases, and peritoneal spread). Overall survival (OS) was estimated using the Kaplan–Meier method. Univariate and multivariable data for OS were analyzed using the Cox proportional hazards model.ResultsOf the 49 women with PMBC, 20 were treated with curative aim (CRS with or without HIPEC) and 29 were treated with non-curative procedures. The 10-year OS rate was 27%. Patients treated with curative intent had a better OS than patients treated with non-curative procedures (89.2% vs. 6% at 36 months, p < 0.001). Risk factors significantly influencing survival were age at primary BC, interval between BC and PM diagnosis, extra-peritoneal metastases, and molecular subtype.ConclusionsThe improved outcome in selected cases after a multidisciplinary approach including surgery should lead researchers to regard PMBC patients with greater attention despite their scarce epidemiological impact. Our collective efforts give new information, suggest room for improvement, and point to further research for a hitherto poorly studied aspect of metastatic BC.
Published: 2022
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2. Multicenter phase III randomized trial comparing laparoscopy and laparotomy for colon cancer surgery in patients older than 75 years: the CELL study, a Fédération de Recherche en Chirurgie (FRENCH) trial

Author: Gilles Manceau, Antoine Brouquet, Pascal Chaibi, Guillaume Passot, Olivier Bouché, Murielle Mathonnet, Jean-Marc Regimbeau, Rea Lo Dico, Jérémie H. Lefèvre, Frédérique Peschaud, Olivier Facy, Enrico Volpin, Elie Chouillard, Laura Beyert-Berjot, Marc Verny, Mehdi Karoui, and Stéphane Benoist
Subjects: Elderly patient, Colon cancer, Surgery, Laparoscopy, Laparotomy, Morbidity, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract: Abstract Background Several multicenter randomized controlled trials comparing laparoscopy and conventional open surgery for colon cancer have demonstrated that laparoscopic approach achieved the same oncological results while improving significantly early postoperative outcomes. These trials included few elderly patients, with a median age not exceeding 71 years. However, colon cancer is a disease of the elderly. More than 65% of patients operated on for colon cancer belong to this age group, and this proportion may become more pronounced in the coming years. In current practice, laparoscopy is underused in this population. Methods The CELL (Colectomy for cancer in the Elderly by Laparoscopy or Laparotomy) trial is a multicenter, open-label randomized, 2-arm phase III superiority trial. Patients aged 75 years or older with uncomplicated colonic adenocarcinoma or endoscopically unresectable colonic polyp will be randomized to either colectomy by laparoscopy or laparotomy. The primary endpoint of the study is overall postoperative morbidity, defined as any complication classification occurring up to 30 days after surgery. The secondary endpoints are: 30-day and 90-day postoperative mortality, 30-day readmission rate, quality of surgical resection, health-related quality of life and evolution of geriatric assessment. A 35 to 20% overall postoperative morbidity rate reduction is expected for patients operated on by laparoscopy compared with those who underwent surgery by laparotomy. With a two-sided α risk of 5% and a power of 80% (β = 0.20), 276 patients will be required in total. Discussion To date, no dedicated randomized controlled trial has been conducted to evaluate morbidity after colon cancer surgery by laparoscopy or laparotomy in the elderly and the benefits of laparoscopy is still debated in this context. Thus, a prospective multicenter randomized trial evaluating postoperative outcomes specifically in elderly patients operated on for colon cancer by laparoscopy or laparotomy with curative intent is warranted. If significant, such a study might change the current surgical practices and allow a significant improvement in the surgical management of this population, which will be the vast majority of patients treated for colon cancer in the coming years. Trial registration ClinicalTrials.gov NCT03033719 (January 27, 2017).
Published: 2019
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3. Kallikrein-Related Peptidase 6 (KLK6) as a Contributor toward an Aggressive Cancer Cell Phenotype: A Potential Role in Colon Cancer Peritoneal Metastasis

Author: Hayet Bouzid, Feryel Soualmia, Katerina Oikonomopoulou, Antoninus Soosaipillai, Francine Walker, Khaoula Louati, Rea Lo Dico, Marc Pocard, Chahrazade El Amri, Natalia A. Ignatenko, and Dalila Darmoul
Subjects: kallikrein-related peptidase 6, protease-activated receptors, colorectal cancer, metastasis, signaling, extracellular matrix, Microbiology, QR1-502
Abstract: Kallikrein-related peptidases (KLKs) are implicated in many cancer-related processes. KLK6, one of the 15 KLK family members, is a promising biomarker for diagnosis of many cancers and has been associated with poor prognosis of colorectal cancer (CRC) patients. Herein, we evaluated the expression and cellular functions of KLK6 in colon cancer-derived cell lines and in clinical samples from CRC patients. We showed that, although many KLKs transcripts are upregulated in colon cancer-derived cell lines, KLK6, KLK10, and KLK11 are the most highly secreted proteins. KLK6 induced calcium flux in HT29 cells by activation and internalization of protease-activated receptor 2 (PAR2). Furthermore, KLK6 induced extracellular signal–regulated kinases 1 and 2 (ERK1/2) phosphorylation. KLK6 suppression in HCT-116 colon cancer cells decreased the colony formation, increased cell adhesion to extracellular matrix proteins, and reduced spheroid formation and compaction. Immunohistochemistry (IHC) analysis demonstrated ectopic expression of KLK6 in human colon adenocarcinomas but not in normal epithelia. Importantly, high levels of KLK6 protein were detected in the ascites of CRC patients with peritoneal metastasis, but not in benign ascites. These data indicate that KLK6 overexpression is associated with aggressive CRC, and may be applied to differentiate between benign and malignant ascites.
Published: 2022
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4. Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Author: Shalaby, M, Elsheikh, A, Hamed, H, Null, N, Elsheik, A, Sakr, A, Fouad, A, Kassem, A, Elfeki, H, Madbouly, K, Alzahrani, K, Marzouk, K, Ali, M, Helal, M, Elsorogy, M, Farid, M, Di Lorenzo, N, Sileri, P, Wexner, S, Khafagy, W, Adeyeye, A, El-Hussuna, A, Frontali, A, Saklani, A, Lelpo, B, Molena, D, Pandey, D, Karbovnichaya, E, Pata, F, Van Ramshor, G, Gallo, G, Spolverato, G, Pellino, G, Bagaglini, G, Rubio-Perez, I, Negoi, I, Frigerio, I, Juloski, J, Ninkovic, M, Franceschilli, M, Azer, M, Efetov, S, Ippoliti, S, Garoufalia, Z, Fazli, M, Dogjani, A, Cherfa, H, Omar, T, Minoldo, J, Alvarez Gallesio, J, Quesada, M, Bacher, A, Kropshofer, S, Ponholzer, F, Tesik, P, Gehwolf, P, Isci, S, Uranitsch, S, Berchtold, V, Samadov, E, Abualsel, A, Mitul, A, Islam, S, Vanlander, A, Van Praet, C, Van Daele, E, Vanommeslaeghe, H, Stijns, J, Abosi-Appeadu, K, Depuydt, M, Allaeys, M, Yves, V, Colleoni, R, Slavchev, M, Elbahrawy, A, Luc, J, Milford, K, Romic, I, Monti, A, Haydal, A, Klein, M, Ocklind, M, Hadi, S, Alqasaby, A, Elganash, A, Daibes, A, Elsaied, A, Elhattab, A, Lotfy, A, Alnashar, A, Elnour, A, Abdelhalim, A, Abdelhamid, A, Abdellatif, A, Abdelmohsen, A, Abdelrafee, A, Elhawary, A, Zidan, A, Eleshra, A, Elkafoury, A, Ezz, A, Abdelmomen, A, Elkased, A, Fawzy, A, Elkhouly, A, Hemidan, A, Abbas, A, Ismail, A, Attia, A, Farid, A, Elnakash, A, Negida, A, Soliman, A, Taki-Eldin, A, Albadry, A, Sanad, A, Elbatal, A, Elgazar, A, Saleh, A, Fahiem, A, Mohamed, A, Nageeb, A, Elmetwally, A, Alkhalegy, A, El-Wakeel, A, Shemes, A, Fadel, B, Lutfi, B, Ali, D, Abolnasr, K, Gamal, E, Abdallah, E, Ahmed, E, Salem, E, Hamed, E, Elshikh, E, Enad, F, Sarhan, F, Abouelnagah, G, Tagg, G, Atef, G, Shaker, G, Beshir, H, Zakaria, H, Barbary, H, Elgendy, H, Sharaf, H, Elnaghi, H, Elghadban, H, Elzayat, I, Fakhr, I, Sallam, I, Abdelmoneim, I, Elnemr, I, Zewar, K, Elalfy, K, Sabet, K, Mansour, K, Osman, K, Elgaly, M, Shams, M, Abozeid, M, Mohammed, M, Elkatt, M, Samaha, M, Mikhael, M, Khalil, M, Alhendawey, M, Elrefai, M, Gabr, M, Fayed, M, Abdelmaksoud, M, Salem, M, Mohamed Mohamed, M, Nabeeh, M, Elsayed, M, Abdelmonem, M, Eldemery, M, Elmesery, M, Fikry, M, Gharbia, M, Omar, M, Elmoghazy, M, Ghazala, M, Hamed, M, Metwally, M, Arnouse, M, Amen, M, Amary, M, Kandel, M, Abuzeid, M, Rabea, M, Sobh, M, Taman, M, Fathy, M, Moustafa, M, Zuhdy, M, Adel, M, Alaa, M, Alawady, M, Edassy, M, Eldesouki, M, Salim, M, Sanad, M, Khalaf, M, Henes, M, Abdelglil, M, Mohmmed, M, Abdelkhalik, M, Shetiwy, M, Elshazli, M, Hegazy, M, Ahmed, M, Abdelhalim, M, Shahein, M, Sofan, M, Hammad, M, Ahmad, M, Milad, N, Farouk, N, Eldesouky, O, Mohamed, O, Mahadel, O, Gaarour, O, Torky, R, Elhafez, R, Adly, R, Nageeb, R, Hamdi, S, Gamal, S, Emile, S, Regal, S, Abdelrasheed, S, Elzeftawy, S, Khashshan, S, Ashraf, T, Khafagy, T, Nabil, T, Abdelazim, T, Rizk, T, Amr, W, Yousef, Y, Youssef, Y, Castaldi, A, Fiore, A, Hasani, A, Mariani, A, Dagorno, C, Antonio, D, Izzo, G, Addari, G, Mangiameli, G, Rea, L, Pio, L, Paci, M, Andrea, P, De Fatico, G, Elvira, T, Schuldes, A, Rihan, E, Moeslein, G, Lederhuber, H, Botros, I, Jaman, I, Doerner, J, Elseberbihy, J, Sherbiny, K, Ghonim, M, Mikrish, A, Aziz, M, Hatm, M, Archid, R, Gendy, S, Ahmad, S, Charalabopoulos, A, Prodromidou, A, Ioannidis, A, Mpaili, E, Boukorou, G, Papadopoulos, G, Liakakos, T, Styliani, V, Agrawal, A, Jain, A, Rashid, A, Mehraj, A, Brahmachari, S, Lakshmi, H, Vishwakarma, K, Parida, L, Sharma, M, Zaieem, M, Makasarwala, M, Nittala, R, Kumar, S, Vikrantmr, S, Junaid, S, Khuller, S, More, V, Ahmed, A, Alomieri, A, Alhamdany, A, Del, M, Najm, G, Lateef, N, Mcnamara, D, Abdelmageed, M, Majeed, M, Troci, A, Porcu, A, Marano, A, Di Bartolomeo, A, Giani, A, Giardino, A, Canfora, A, Balla, A, Barberis, A, Belli, A, Borasi, A, Manetti, A, Mingoli, A, Morini, A, Maurizi, A, Marra, A, Epifani, A, Iossa, A, Parello, A, Guida, A, Maffioli, A, Scafa, A, Spinelli, A, Matarangolo, A, Picciariello, A, Pirozzi, B, Cirillo, B, Gazia, C, Ratto, C, Foppa, C, Marafante, C, Andrea, C, Tanda, C, Guerci, C, Don, C, Zigiotto, D, Coniglio, D, Sasia, D, Visconti, D, Altomare, D, Guaitoli, E, Botteri, E, Pinotti, E, Martinelli, F, Uggeri, F, Bàmbina, F, Falaschi, F, Costanzo, F, La Torre, F, Milana, F, Abbatini, F, De Lucia, F, Tropeano, F, Colombo, F, Ferrara, F, Litta, F, Carrano, F, Orlando, F, Roscio, F, Selvaggi, F, Giarratano, G, Pagano, G, Lisi, G, Argenio, G, Zancana, G, Cavallaro, G, Frazzetta, G, Mariateresa, G, Sciaudone, G, Vella, I, Siragusa, L, Santurro, L, Ferri, L, Petagna, L, Ferrario, L, Pitoni, L, Pignatelli, M, Angrisani, M, Giugliano, M, Inama, M, Marino, M, Veltri, M, Giuffrida, M, Menna, M, Valente, M, Rottoli, M, Sacchi, M, Uccelli, M, Rho, M, Garino, M, Montuori, M, Campanelli, M, Zese, M, De Falco, N, Cillara, N, Mariani, N, Tamini, N, Adorisio, O, Campennì, P, Venturelli, P, Bernante, P, Sapienza, P, Cianci, P, Marsanic, P, Lapolla, P, Tecchio, P, Familiari, P, Fransvea, P, Bruzzaniti, P, Hassan, R, Pirovano, R, Rimonda, R, Di Saverio, S, Di Carlo, S, Perra, T, Campagnaro, T, Testa, V, Andriola, V, Grappelli, V, Capizzi, V, Chiarella, V, Bellato, V, Yanaga, K, Farouk, M, Uraiqat, A, Almasri, M, Nabwana, A, Siboe, M, W, N, Njoroge, G, Ilkul, J, Obure, R, Palkhi, Y, Alkhayat, A, Ali, A, Malek, A, Abdelsayed, E, Zahra, T, Ayoub, L, Sleilati, F, Aoun, R, Algatanesh, N, Fieturi, N, Ng, J, Díaz, A, Duran, E, Guerrero, J, Jasso, M, Flores, M, Felix, M, Angulo, V, Mejdane, A, Aitali, A, Amal, B, Zentar, A, Bensaad, A, Yacir, E, Jawad, F, Rachid, M, Maliki-Alaoui, M, Ouadii, M, Mohammed, O, Thein, N, Koirala, D, Hilling, D, Pouwels, S, Okunlola, A, Adejumo, A, Akinmade, A, Shittu, A, Oluyomi, A, Abiodun, A, Lawal, B, Odion, C, Popoola, A, Jolayemi, E, Shomoye, E, Wuraola, F, Eke, G, Abiyere, H, Oluwasuyi, I, George, I, Njokanma, I, Aremu, I, Dare, J, Abdur-Rahman, L, Oludara, M, Mohammad, M, Adeoluwa, O, Situ, O, Agbonrofo, P, Kewulere, R, Aliyu, Y, Adebowale, Y, Galala, A, Rao, S, Waleed, A, Inam, A, Shaikh, A, Qureshi, A, Muhammad, A, Kerawala, A, Aslam, M, Mehr, A, Javed, A, Ahmad, F, Majid, H, Ahmed, H, Daudi, I, Akhtar, K, Niaz, K, Anwer, M, Amir, M, Hanif, M, Asif, M, Raza, M, Khokhar, M, Jameel, M, Nasir, M, Shafique, M, Ateeb, M, Nadeem, M, Shah, R, Waqar, S, Shah, S, Waseem, T, Ghafoor, T, Fatima, T, Bashir, U, Gonzales, E, Ruiz, L, Freitas, C, De Sousa, X, Al-Bahrani, A, Portela, C, Elgazar, E, Robles, E, Khan, I, Jarboa, L, Khawar, M, Echevarria, M, Bashah, M, Dawdi, S, Musthafa, S, Ali, S, Ciubotaru, C, Bonci, E, Muresan, M, Bogdan, S, Ioan, T, Zubayraeva, A, Derinov, A, Zakharenko, A, Novikova, A, Bashlachev, A, Kaldarov, A, Stanislav, B, Gorin, D, Puzenko, D, Kazachenko, E, Ashimov, E, Medkova, I, Ignatov, I, Sergeevich, K, Sidorova, L, Kiselev, M, Danilov, M, Aleksandr, O, Rodimov, S, Garmanovs, T, Kitsenko, Y, Valery, N, Japhet, N, Sibiany, A, Saadeldin, A, Abuosba, A, Alawadhi, A, Alharbi, A, Althumali, A, Alghuliga, A, Alotaibi, A, Abduraboh, A, Kateb, A, Sindy, A, Al Eisa, A, Almulhim, A, Aljawhari, A, Abozeid, A, Saad, A, Alqarni, A, Alwan, A, Alwusaibie, A, Bafaraj, A, Eldeeb, A, Tarabay, A, Alhedaithy, A, Almaghrabi, A, Abed, A, Abdullah, A, Semilan, A, Farag, M, Khudhayr, E, Hussain, M, Abbas, G, Alqudaihi, H, Abualnaja, Y, Shaheen, A, Mubarak, A, Ali, B, Alhazmi, B, Hijazi, B, Abdulrahman, C, Oyedepo, C, Alzamel, H, Tairab, E, Alsuwaimel, M, Hejazi, S, Alnoqaidan, E, Alhussien, F, Jallad, F, Khadwardi, F, Alghamdi, F, Haddad, F, Sauri, F, Alafghani, H, Alfalah, H, Gad, H, Aboelmagid, H, Ibrahim, H, Elzayady, H, Sharafeldin, H, Sembawa, H, Alabbas, H, Abbas, H, Elgamal, H, Alawfi, H, Al-Sadery, H, Abdelmotaleb, H, Al Hassn, I, Mudawi, I, Nekhala, I, Elsanhoury, K, Said, K, Albeshri, K, Albahooth, K, Mohammed, K, Asar, K, Osman, L, Alzamanan, M, Alnabarawi, M, Althobaiti, M, Al Naeb, M, Hassan, M, Abdelhamid, M, Alyami, M, Mirza, M, Sayouh, M, Alkhayat, M, Basendowah, M, Ghunaim, M, Alhussaini, M, Khoj, M, Sbaih, M, Saeed, M, Abdelaziz, N, Malibary, N, Abdo, N, Amer, N, Al Turki, N, Durayb, N, Yassin, N, Akeel, N, Larbi, N, Alsallum, O, Suliman, O, Elsherbiny, O, Abusalem, O, Albalawi, I, Abutalib, R, Alarabi, R, Khan, R, Alazzam, S, Alghamdi, S, Alsawat, S, Salim, S, Alshukr, S, Alzahrani, S, Golea, S, Alowairdhi, T, Salman, U, Abusiam, W, Abualkhair, W, Saber, W, Tashkandi, W, Alhazmi, W, Yassine, W, Alshabi, Y, Ibrahim, Y, Shahin, Y, Aljathlany, Y, Alnahas, Y, Alrashidi, Y, Wali, Z, Ndong, A, Ba, M, Faye, P, Arbutina, D, Milic, L, Cuk, V, Hussein, A, Mccaul, J, Bertels, L, Pohl, L, Arnold, M, Mbatani, N, Oosthuizen, P, Rayamajhi, S, Vosloo, S, Jooma, U, Landaluce-Olavarria, A, Vázquez-Melero, A, Marcos, A, Puerto Puerto, A, De La Hermosa, A, Senent-Boza, A, Ugarte-Sierra, B, Montalbán, B, Martin-Perez, B, Gomez, C, Colás-Ruiz, E, Santos, E, Senra, F, Mora-Guzmán, I, Dziakova, J, Díaz, J, Silva, J, Laina, J, Tallon-Aguilar, L, Di Martino, M, Chacón, M, Frasson, M, Calvo, M, Millan, M, Tejedoe, P, Pérez-Bertólez, S, Turrado-Rodríguez, V, Elsanosi, A, Abdalbakheet, D, Salim, O, Youssef, M, Barbon, C, Bouchrika, A, Maghrebi, H, Loukil, I, Yildiz, A, Dursun, A, Gulcu, B, Calik, B, Eral, B, Yeşilyurt, D, Yakar, F, Akin, F, Kilinc, G, Uslu, G, Tuncer, K, Koc, M, Leventoğlu, S, Sokmen, S, Atici, S, Kaya, T, Dere, Ü, Kırmızı, Y, Ssenono, K, Lule, H, Mbiine, R, Hamza, A, Peediyakkal, S, Varma, G, Mussa, H, Al-Masari, H, Shehata, M, Seiam, M, Nimir, N, Khare, R, Rashid, S, Kazim, S, Gondal, Z, Sherif, A, Ghanem, A, Helmy, A, Ibrahim, A, Elshaer, A, Marzouk, A, Tamburrini, A, Parente, A, Light, A, Diamantopoulou, A, Singh, B, Gurung, B, Frauenfelder, C, Leo, C, Raptis, D, Thakrar, D, Madhuri, T, Tsounaki, E, Garreffa, E, Soggiu, F, Stavrou, G, Ng, H, Tabasi, H, Nasef, H, Kostakis, I, Jeffery, J, Warusavitarne, J, Lund, J, Qurashi, K, Sahnan, K, Tong, K, Orecchia, L, Kaur, M, Zaidi, M, Ganau, M, Curtis, N, Bhatt, N, Machairas, N, Zafar, N, Toma, O, Sarmah, P, Bassuni, M, Davies, J, Shawer, S, Lewis, S, Subramanian, S, Nadeem, U, Njau, A, Tohamy, A, Pakula, A, Simioni, A, Jarvis, B, Skandalakis, G, Hesham, H, Isaiah, I, Villwock, J, Martin, L, Kress, M, Sebelik, M, Lathan, S, Towfigh, S, Holubar, S, Demeester, S, Alshehari, M, Ghabisha, S, Abdulatef, S, Al-Kubati, W, Obadiel, Y, Gots, A, Nakazwe, M, Chipaila, J, Mazingi, D, Shalaby, Mostafa, ElSheikh, Ahmed M., Hamed, Hosam, null, null, Elsheik, Ahmed, Sakr, Ahmad, Fouad, Amgad, Kassem, Amr, Elfeki, Hossam, Madbouly, Khaled, Alzahrani, Khalid H., Marzouk, Khalid, Ali, Mahmoud, Helal, Mohamed Alaa Abdelmoez, Elsorogy, Mohamed, Farid, Mohamed, Di Lorenzo, Nicola, Sileri, Pierpaolo, Wexner, Steven, Khafagy, Wael, Adeyeye, Ademola, El-Hussuna, Alaa, Frontali, Alice, Saklani, Avanish, Lelpo, Benedettao, Molena, Daniela, Pandey, Diwakar, Karbovnichaya, Elena, Pata, Francesco, Van Ramshor, Gabrielle H., Gallo, Gaetano, Spolverato, Gaya, Pellino, Gianluca, Bagaglini, Giulia, Rubio-Perez, Ines, Negoi, Ionut, Frigerio, Isabella, Juloski, Jovan, Ninkovic, Marijana, Franceschilli, Marzia, Azer, Mina, Efetov, Sergey, Ippoliti, Simona, Garoufalia, Zoe, Fazli, Mohammad Rafi, Dogjani, Agron, Cherfa, Harieche Abdennour Abderahim, Omar, Tilioua, Minoldo, Javier, Alvarez Gallesio, José Maria, Quesada, Matias, Bacher, Annica, Kropshofer, Stephan, Ponholzer, Florian, Tesik, Philip, Gehwolf, Philipp, Isci, Sevim, Uranitsch, Stefan, Berchtold, Valeria, Samadov, Elgun, Abualsel, Abdulmenem, Mitul, Ashrarur Rahman, Islam, S. M. Nazmul, Vanlander, Aude, Van Praet, Charles, Van Daele, Elke, Vanommeslaeghe, Hanne, Stijns, Jasper, Abosi-Appeadu, Kessewa, Depuydt, Martijn, Allaeys, Mathias, Yves, Van Nieuwenhove, Colleoni, Ramiro, Slavchev, Mihail, Elbahrawy, Aly, Luc, Jessica G. Y., Milford, Karen, Romic, Ivan, Monti, Alessio, Haydal, Ashraf, Klein, Mads Falk, Ocklind, Miranda E. K., Hadi, Sabah Anwar, Alqasaby, Abdallah, Elganash, Abdelazim, Daibes, Adel Goda Hussein, Elsaied, Adham, Elhattab, Ahmad, Lotfy, Ahmad, Alnashar, Ahmed, Elnour, Ahmed Abd Elbaset Elsayed Abu, Abdelhalim, Ahmed, Abdelhamid, Ahmed, Abdellatif, Ahmed, Abdelmohsen, Ahmed, Abdelrafee, Ahmed, Elhawary, Ahmed Adel, Zidan, Ahmed Azmy, Eleshra, Ahmed, Elkafoury, Ahmed, Ezz, Ahmed, Abdelmomen, Ahmed Ezzat Elghrieb, Elkased, Ahmed Farag, Fawzy, Ahmed, Elkhouly, Ahmed G., Hemidan, Ahmed Gamal Abouelfetouh Ibrahim, Abbas, Ahmed Hosam Eldin Hasan, Ismail, Ahmed Mahmoud Ahmed, Attia, Ahmed Mohamed, Farid, Ahmed Mohammed, Elnakash, Ahmed Mostafa, Negida, Ahmed, Soliman, Ahmed, Taki-Eldin, Ahmed, Albadry, Ali Almahdy Ali, Sanad, Aly, Elbatal, Amira Alsayed Abdelhai, Elgazar, Amr, Saleh, Amr, Fahiem, Andrew, Mohamed, Anwar Yahya A., Nageeb, Ashraf, Elmetwally, Ashraf S., Alkhalegy, Ayman, El-Wakeel, Ayman, Shemes, Ayman, Fadel, Bashir A., Lutfi, Basma Waseem, Ali, Doaa, Abolnasr, Khaled Samir, Gamal, Ehab, Abdallah, Emad, Ahmed, Emad Ali, Salem, Eman Abdalla Mohamed, Hamed, Esmael Ali, Elshikh, Essam, Enad, Farazdaq, Sarhan, Fetoh Alaaeldin Fetoh, Abouelnagah, Galal, Tagg, Gamal Hassan El, Atef, Gehad, Shaker, George Samir Habib, Beshir, Hatem, Zakaria, Hazem M., Barbary, Hesham, Elgendy, Hesham, Sharaf, Hesham, Elnaghi, Hisham, Elghadban, Hosam, Elzayat, Ibrahim, Fakhr, Ibrahim, Sallam, Ibrahim, Abdelmoneim, Ibrahim Tharwat Mohamed, Elnemr, Islam, Zewar, Karem Shahin Mohamed, Elalfy, Khaled, Sabet, Khaled, Mansour, Khaled Yousery Ibrahim, Osman, Khalid Abdalla Abdelgadir, Elgaly, Maher Elesawi Kamel, Shams, Maher, Abozeid, Mahmoud, Mohammed, Mahmoud M., Elkatt, Mahmoud Mohamed, Samaha, Mahmoud Yahia, Mikhael, Marolla Maher Eskander, Khalil, Medhat M. H. A., Alhendawey, Moaaz, Elrefai, Mohamad, Gabr, Mohamed A., Fayed, Mohamed Abdelaziz Mohamed Abdalla M, Abdelmaksoud, Mohamed, Salem, Mohamed Abouelmagd, Mohamed Mohamed, Mohamed Adel, Nabeeh, Mohamed Adel, Elsayed, Mohamed Ahmed Abdelhalim Ahmed, Abdelmonem, Mohamed Ahmed, Ali, Mohamed Anwar Abdel Razik, Eldemery, Mohamed, Elmesery, Mohamed, Fikry, Mohamed, Gharbia, Mohamed, Omar, Mohamed I., Elmoghazy, Mohamed Ibrahim, Ghazala, Mohamed Jomma, Hamed, Mohamed Korayem Fattouh, Metwally, Mohamed, Arnouse, Mohamed Mohamed Hamdy, Amen, Mohamed Mohsen, Amary, Mohamed Mokhtar, Kandel, Mohamed Mosaad, Abuzeid, Mohamed Mostafa, Rabea, Mohamed, Sobh, Mohamed Ramadan, Taman, Mohamed, Fathy, Mohammad, Moustafa, Mohammad Montaser Hassan, Zuhdy, Mohammad, Adel, Mohammed, Alaa, Mohammed, Alawady, Mohammed, Edassy, Mohammed El, Mohammed, Mohammed Mustafa Hassan, Eldesouki, Mohammed Nabil, Salim, Mohammed Said Mahmoud, Sanad, Mohammed, Khalaf, Mohsen George, Henes, Mohsen Michael, Abdelglil, Momen, Mohmmed, Mona Mhmoud, Abdelkhalik, Morsi Mohamed Morsi, Shetiwy, Mosab, Elshazli, Mostafa, Hegazy, Mostafa, Ahmed, Mostafa Mahmoud, Abdelhalim, Mostafa Mohammed, Shahein, Mostafa, Sofan, Mostafa, Hammad, Muhammed Alaa Moukhtar, Ahmad, Mustafa, Milad, Nader, Farouk, Nehal, Eldesouky, Omnia, Mohamed, Omnia Y., Mahadel, Osama Abdel Salam, Gaarour, Osama, Torky, Radwan Abdelsabour, Elhafez, Raheem El-Gohary Abd, Adly, Ramy Magdy, Nageeb, Ramy Mikhael, Hamdi, Salah, Gamal, Sameh, Emile, Sameh Hany, Regal, Samer, Abdelrasheed, Sayed, Elzeftawy, Shady Ahmed, Khashshan, Sohib Mohammed Mohammed, Ashraf, Tamer, Khafagy, Tamer, Nabil, Tamer, Abdelazim, Tarek, Rizk, Tarek Taher, Amr, Wesam, Yousef, Yousef Mohamed, Youssef, Youssef Abdel Aziz, Castaldi, Antonio, Fiore, Antonio, Hasani, Ariola, Mariani, Aurora, Dagorno, Claire, Antonio, D'Alessandro, Izzo, Giuliano, Addari, Giulio, Mangiameli, Giuseppe, Rea, Lo Dico, Pio, Luca, Paci, Marco, Andrea, Police, De Fatico, GSerena, Elvira, Tartaglia, Schuldes, Alejandro Daniel Lira, Rihan, Eslam, Moeslein, Gabriela, Lederhuber, Hans, Botros, Ibram, Jaman, Ismail, Doerner, Johannes, Elseberbihy, John Rezk Hanna, Sherbiny, Kareem El, Ghonim, Mostafa, Mikrish, Amir, Aziz, Mina, Hatm, Mohamed, Archid, Rami, Gendy, Samuel Elkess Morcos, Ahmad, Sufian, Charalabopoulos, Alexandros, Prodromidou, Anastasia, Ioannidis, Argyrios, Mpaili, Eustratia, Boukorou, Garyfallia, Papadopoulos, Georgios, Liakakos, Theodore, Styliani, Vasileiadou, Agrawal, Abhishek, Jain, Amita, Rashid, Arshad, Mehraj, Asif, Brahmachari, Swagata, Lakshmi, Harish Neelamraju, Vishwakarma, Kushagra, Parida, Lalit, Sharma, Meenakshi, Zaieem, Mohammad, Makasarwala, Murtaza, Nittala, Rigved, Kumar, Sanjeev, Vikrantmr, Sharma, Junaid, Sheikh, Khuller, Somyaa, More, Vinal, Ahmed, Abeer Abdul Hameed, Alomieri, Adil, Alhamdany, Arkan Shubber, Del, Muslim Ka, Najm, Ghadah, Lateef, Nawras Falah, Mcnamara, Deborah, Abdelmageed, Mohammed Elkassaby, Majeed, Mudassar, Troci, Albert, Porcu, Alberto, Marano, Alessandra, Di Bartolomeo, Alessandro, Giani, Alessandro, Giardino, Alessandro, Canfora, Alfonso, Balla, Andrea, Barberis, Andrea, Belli, Andrea, Borasi, Andrea, Manetti, Andrea, Mingoli, Andrea, Morini, Andrea, Maurizi, Angela, Marra, Angelo Alessandro, Epifani, Angelo Gabriele, Iossa, Angelo, Parello, Angelo, Guida, Anna, Maffioli, Anna, Scafa, Anthony Kevin, Spinelli, Antonino, Matarangolo, Antonio, Picciariello, Arcangelo, Pirozzi, Brunella, Cirillo, Bruno, Gazia, Carlo, Ratto, Carlo, Foppa, Caterina, Marafante, Chiara, Andrea, Chierici, Tanda, Cinzia, Guerci, Claudio, Don, Cristine, Zigiotto, Daniele, Coniglio, Denise, Sasia, Diego, Visconti, Diego, Altomare, Donato F., Guaitoli, Eleonora, Botteri, Emanuele, Pinotti, Enrico, Martinelli, Fabio, Uggeri, Fabio, Bàmbina, Fabrizio, Falaschi, Federica, Costanzo, Federico, La Torre, Filippo, Milana, Flavio, Abbatini, Francesca, De Lucia, Francesca, Tropeano, Francesca Paola, Colombo, Francesco, Ferrara, Francesco, Litta, Francesco, Carrano, Francesco Maria, Orlando, Francesco, Roscio, Francesco, Selvaggi, Francesco, Giarratano, Gabriella, Pagano, Gianluca, Lisi, Giorgio, Argenio, Giulio, Zancana, Giuseppa, Cavallaro, Giuseppe, Frazzetta, Giuseppe, Mariateresa, Grasso, Sciaudone, Guido, Vella, Ivan, Siragusa, Leandro, Santurro, Letizia, Ferri, Lorenzo, Petagna, Lorenzo, Ferrario, Luca, Pitoni, Ludovica, Pignatelli, Marcello Filograna, Angrisani, Marco, Giugliano, Marco, Inama, Marco, Marino, Marco V., Veltri, Marco, Giuffrida, Maria Carmela, Menna, Maria Paola, Valente, Marina, Rottoli, Matteo, Sacchi, Matteo, Uccelli, Matteo, Rho, Maurizio, Garino, Mauro, Montuori, Mauro, Campanelli, Michela, Zese, Monica, De Falco, Nadia, Cillara, Nicola, Mariani, Nicolò Maria, Tamini, Nicolò, Adorisio, Ottavio, Campennì, Paola, Venturelli, Paolina, Bernante, Paolo, Sapienza, Paolo, Cianci, Pasquale, Marsanic, Patrizia, Lapolla, Pierfrancesco, Tecchio, Piero, Familiari, Pietro, Fransvea, Pietro, Bruzzaniti, Placido, Hassan, Redan, Pirovano, Riccardo, Rimonda, Roberto, Di Saverio, Salomone, Di Carlo, Sara, Perra, Teresa, Campagnaro, Tommaso, Testa, Valentina, Andriola, Valeria, Grappelli, Virgilio Michael Ambrosi, Capizzi, Vita, Chiarella, Vito, Bellato, Vittoria, Yanaga, Katsuhiko, Farouk, Mohamed, Uraiqat, Ahmad, Almasri, Mahmoud, Nabwana, Ambrose, Siboe, Mark M. 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Eke, Grace, Abiyere, Henry, Oluwasuyi, Ige, George, Ihediwa, Njokanma, Iloba Gabriel, Aremu, Isiaka, Dare, Julius Kolajo, Abdur-Rahman, Lukman, Ahmad, Misbahu Haruna, Oludara, Mobolaji Adewale, Mohammad, Mohammad Aminu, Adeoluwa, Ojajuni, Situ, Oladele, Agbonrofo, Peter, Kewulere, Raji Taofiq, Aliyu, Yakubu, Adebowale, Yusuf, Galala, Ahmed, Rao, Satish, Waleed, Aasma, Inam, Aatif, Shaikh, Abdul Razaque, Qureshi, Ahmad Uzair, Muhammad, Aneeqah Din, Ahmed, Arooj, Kerawala, Asad Ali, Aslam, Mohammad, Mehr, Asma, Javed, Ayesha, Ahmad, Farooq, Majid, Haroon Javaid, Ahmed, Hassan, Daudi, Irfan, Akhtar, Khalid, Niaz, Khurram, Anwer, Mariyah, Amir, Mohammed, Hanif, Muhammad Amir, Asif, Muhammad, Raza, Muhammad Asif, Khokhar, Muhammad Imran, Jameel, Muhammad Khurram, Nasir, Muhammad, Shafique, Muhammad Salman, Ateeb, Mujammad, Nadeem, Munawar, Shah, Rahmat Ullah, Waqar, Shahzad Hussain, Shah, Shahzad Alam, Waseem, Talat, Ghafoor, Tariq, Fatima, Tauseef, Bashir, Umar, Gonzales, Erick Ivan Huaman, Ruiz, Luis Angel Garcia, Freitas, Carla, De Sousa, Xavier, Al-Bahrani, Ahmed, Portela, Carlos Antonio Sanchez, Elgazar, Elsayed Aly, Robles, Eloy Morasen, Khan, Irfan Jan, Jarboa, Lutfi, Khawar, Mahwish, Echevarria, Miguel Jose Pinto, Bashah, Moataz M., Dawdi, Salahaldeen, Musthafa, Shameel, Ali, Syed Muhammad, Ciubotaru, Cezar, Bonci, Eduard-Alexandru, Muresan, Mihai-Stefan, Bogdan, Stoica, Ioan, Tanase, Zubayraeva, Albina, Derinov, Aleksandr, Zakharenko, Alexander, Novikova, Anastasia, Bashlachev, Andrey, Kaldarov, Ayrat, Stanislav, Berelavichus, Gorin, David, Puzenko, Dmitriy, Kazachenko, Ekaterina, Ashimov, Erkin, Medkova, Iuliia, Ignatov, Ivan, Sergeevich, Kochetkov Viktor, Sidorova, Lyudmila, Kiselev, Michail, Danilov, Michail, Aleksandr, Ogoreltsev, Rodimov, Sergey, Garmanovs, Tatiana, Kitsenko, Yury, Valery, Nekoval, Japhet, Ntezamizero, Sibiany, Abdulrahman, Saadeldin, Abdelhalim, Abuosba, Abdelrahman, Alawadhi, Abdulbari Mohammed, Alharbi, Abdulhamid, Althumali, Abdullah, Alghuliga, Abdullah, Alotaibi, Abdullah, Abduraboh, Abdullah Fayez, Kateb, Abdullah, Sindy, Abdullah, Al Eisa, Abdulmohsen, Alotaibi, Abdulrahman, Almulhim, Abdulrhman, Aljawhari, Adel Ali, Abozeid, Ahmad Mahmoud, Saad, Ahmad, Alqarni, Ahmed, Alwan, Ahmed, Alwusaibie, Ahmed, Bafaraj, Ahmed, Eldeeb, Ahmed, Tarabay, Ahmed, Mohammed, Mahfoudh, Alhedaithy, Alhanouf, Almaghrabi, Alhassan Hesham, Abed, Ali Ibrahim Eldawy, Abdullah, Alqahtani Ali, Semilan, Anmar, Farag, Mohamed, Khudhayr, Essa, Hussain, Marwah, Abbas, Ghanem, Alqudaihi, Heba, Abualnaja, Yousra, Shaheen, Abelnasser, Mubarak, Ashraf Abdelazeem Mohamed, Ali, Bandar Idrees A., Alhazmi, Barrag, Hijazi, Bilal Ahmed, Abdulrahman, Chadi, Oyedepo, Charles Olajide, Alzamel, Heythem, Tairab, Elsanousi Ibrahim Sabir, Alsuwaimel, Munir A., Hejazi, Soha, Alnoqaidan, Emad, Alhussien, Fade Ahmed, Jallad, Fadi Sami, Khadwardi, Faisal, Alghamdi, Faisal Saleh, Haddad, Feras, Sauri, Fozan, Alafghani, Haitham, Alfalah, Haitham, Gad, Hamada, Aboelmagid, Hamdy Haggag Ebrahim, Ibrahim, Hamed, Elzayady, Hany M., Sharafeldin, Hatem Abdelrahman Ahmed, Sembawa, Hatem A., Alabbas, Haytham, Abbas, Hazem, Elgamal, Hesham, Alawfi, Homoud, Al-Sadery, Humood, Abdelmotaleb, Hussien Ali, Al Hassn, Ibrahim, Mudawi, Ishag M., Nekhala, Islam, Elsanhoury, Kareem, Said, Khalid Babieker, Albeshri, Khalid A., Albahooth, Khalid, Mohammed, Khalid Fathelrahman Bakier, Asar, Khalid Mohammad Ibrahim, Osman, Luqman, Alzamanan, Mahdi, Alnabarawi, Mahmoud, Althobaiti, Majid, Elsayed, Mohamed Abdelmoneim, Al Naeb, Mohamed, Hassan, Mohamed Salah Eldin, Abdelhamid, Mohamed Sayed, Alyami, Mohammad, Mirza, Mohammad Amin, Sayouh, Mohammad, Alkhayat, Mohammed Amer, Basendowah, Mohammed, Ghunaim, Mohammed, Alhussaini, Mohammed Khalid, Khoj, Mohammed, Sbaih, Mohammed, Saeed, Muhammad Ahmad, Ali, Muhammad Zulfiqar, Abdelaziz, Nabil Yassin Tammam, Malibary, Nadim, Abdo, Nael, Amer, Nasser Mohammed, Al Turki, Neamat Ahmed Ali, Durayb, Norah, Yassin, Nouf, Akeel, Nouf, Larbi, Noureddine, Alsallum, Ofays, Suliman, Omar AAbu, Elsherbiny, Osama, Abusalem, Osama, Albalawi, Ibrahim Altedlawi, Abutalib, Raid Abdullah, Alarabi, Rayan, Khan, Roaa Ghazi, Alazzam, Saleh, Alghamdi, Saleh, Alsawat, Salem, Salim, Sami, Alshukr, Sarah, Alzahrani, Saud, Golea, Smain, Alowairdhi, Tumadher, Salman, Usama, Abusiam, Wael, Abualkhair, Wael, Saber, Wael, Tashkandi, Wail, Alhazmi, Waleed, Tashkandi, Waleed, Yassine, Wassim Abou, Alshabi, Yaser Ahmad, Ibrahim, Yaser, Shahin, Yasser, Ibrahim, Yassin, Aljathlany, Yousef, Alnahas, Yousef, Alrashidi, Yousef, Wali, Zubair, Ndong, Abdourahmane, Ba, Mamadou, Faye, Papa Mamadou, Arbutina, Dragana, Milic, Ljiljana, Cuk, Vladica, Hussein, Abdinafic Mohamud, Mccaul, Jeannie, Bertels, Laurie, Pohl, Linda, Arnold, Marion, Mbatani, Nomonde, Oosthuizen, Pj, Rayamajhi, Shreya, Vosloo, Susan, Jooma, Uzair, Landaluce-Olavarria, Aitor, Vázquez-Melero, Alba, Marcos, Alberto, Puerto Puerto, Alejandro, De La Hermosa, Alicia Ruiz, 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L, Arnold, M, Mbatani, N, Oosthuizen, P, Rayamajhi, S, Vosloo, S, Jooma, U, Landaluce-Olavarria, A, Vázquez-Melero, A, Marcos, A, Puerto Puerto, A, De La Hermosa, A, Senent-Boza, A, Ugarte-Sierra, B, Montalbán, B, Martin-Perez, B, Gomez, C, Colás-Ruiz, E, Santos, E, Senra, F, Mora-Guzmán, I, Dziakova, J, Díaz, J, Silva, J, Laina, J, Tallon-Aguilar, L, Di Martino, M, Chacón, M, Frasson, M, Calvo, M, Millan, M, Tejedoe, P, Pérez-Bertólez, S, Turrado-Rodríguez, V, Elsanosi, A, Abdalbakheet, D, Salim, O, Youssef, M, Barbon, C, Bouchrika, A, Maghrebi, H, Loukil, I, Yildiz, A, Dursun, A, Gulcu, B, Calik, B, Eral, B, Yeşilyurt, D, Yakar, F, Akin, F, Kilinc, G, Uslu, G, Tuncer, K, Koc, M, Leventoğlu, S, Sokmen, S, Atici, S, Kaya, T, Dere, Ü, Kırmızı, Y, Ssenono, K, Lule, H, Mbiine, R, Hamza, A, Peediyakkal, S, Varma, G, Mussa, H, Al-Masari, H, Shehata, M, Seiam, M, Nimir, N, Khare, R, Rashid, S, Kazim, S, Gondal, Z, Sherif, A, Ghanem, A, Helmy, A, Ibrahim, A, Elshaer, A, Marzouk, A, Tamburrini, A, Parente, A, Light, A, Diamantopoulou, A, Singh, B, Gurung, B, Frauenfelder, C, Leo, C, Raptis, D, Thakrar, D, Madhuri, T, Tsounaki, E, Garreffa, E, Soggiu, F, Stavrou, G, Ng, H, Tabasi, H, Nasef, H, Kostakis, I, Jeffery, J, Warusavitarne, J, Lund, J, Qurashi, K, Sahnan, K, Tong, K, Orecchia, L, Kaur, M, Zaidi, M, Ganau, M, Curtis, N, Bhatt, N, Machairas, N, Zafar, N, Toma, O, Sarmah, P, Bassuni, M, Davies, J, Shawer, S, Lewis, S, Subramanian, S, Nadeem, U, Njau, A, Tohamy, A, Pakula, A, Simioni, A, Jarvis, B, Skandalakis, G, Hesham, H, Isaiah, I, Villwock, J, Martin, L, Kress, M, Sebelik, M, Lathan, S, Towfigh, S, Holubar, S, Demeester, S, Alshehari, M, Ghabisha, S, Abdulatef, S, Al-Kubati, W, Obadiel, Y, Gots, A, Nakazwe, M, Chipaila, J, Mazingi, D, Shalaby, Mostafa, ElSheikh, Ahmed M., Hamed, Hosam, null, null, Elsheik, Ahmed, Sakr, Ahmad, Fouad, Amgad, Kassem, Amr, Elfeki, Hossam, Madbouly, Khaled, Alzahrani, Khalid H., Marzouk, Khalid, Ali, Mahmoud, Helal, Mohamed Alaa Abdelmoez, Elsorogy, Mohamed, Farid, Mohamed, Di Lorenzo, Nicola, Sileri, Pierpaolo, Wexner, Steven, Khafagy, Wael, Adeyeye, Ademola, El-Hussuna, Alaa, Frontali, Alice, Saklani, Avanish, Lelpo, Benedettao, Molena, Daniela, Pandey, Diwakar, Karbovnichaya, Elena, Pata, Francesco, Van Ramshor, Gabrielle H., Gallo, Gaetano, Spolverato, Gaya, Pellino, Gianluca, Bagaglini, Giulia, Rubio-Perez, Ines, Negoi, Ionut, Frigerio, Isabella, Juloski, Jovan, Ninkovic, Marijana, Franceschilli, Marzia, Azer, Mina, Efetov, Sergey, Ippoliti, Simona, Garoufalia, Zoe, Fazli, Mohammad Rafi, Dogjani, Agron, Cherfa, Harieche Abdennour Abderahim, Omar, Tilioua, Minoldo, Javier, Alvarez Gallesio, José Maria, Quesada, Matias, Bacher, Annica, Kropshofer, Stephan, Ponholzer, Florian, Tesik, Philip, Gehwolf, Philipp, Isci, Sevim, Uranitsch, Stefan, Berchtold, Valeria, Samadov, Elgun, Abualsel, Abdulmenem, Mitul, Ashrarur Rahman, Islam, S. M. Nazmul, Vanlander, Aude, Van Praet, Charles, Van Daele, Elke, Vanommeslaeghe, Hanne, Stijns, Jasper, Abosi-Appeadu, Kessewa, Depuydt, Martijn, Allaeys, Mathias, Yves, Van Nieuwenhove, Colleoni, Ramiro, Slavchev, Mihail, Elbahrawy, Aly, Luc, Jessica G. Y., Milford, Karen, Romic, Ivan, Monti, Alessio, Haydal, Ashraf, Klein, Mads Falk, Ocklind, Miranda E. K., Hadi, Sabah Anwar, Alqasaby, Abdallah, Elganash, Abdelazim, Daibes, Adel Goda Hussein, Elsaied, Adham, Elhattab, Ahmad, Lotfy, Ahmad, Alnashar, Ahmed, Elnour, Ahmed Abd Elbaset Elsayed Abu, Abdelhalim, Ahmed, Abdelhamid, Ahmed, Abdellatif, Ahmed, Abdelmohsen, Ahmed, Abdelrafee, Ahmed, Elhawary, Ahmed Adel, Zidan, Ahmed Azmy, Eleshra, Ahmed, Elkafoury, Ahmed, Ezz, Ahmed, Abdelmomen, Ahmed Ezzat Elghrieb, Elkased, Ahmed Farag, Fawzy, Ahmed, Elkhouly, Ahmed G., Hemidan, Ahmed Gamal Abouelfetouh Ibrahim, Abbas, Ahmed Hosam Eldin Hasan, Ismail, Ahmed Mahmoud Ahmed, Attia, Ahmed Mohamed, Farid, Ahmed Mohammed, Elnakash, Ahmed Mostafa, Negida, Ahmed, Soliman, Ahmed, Taki-Eldin, Ahmed, Albadry, Ali Almahdy Ali, Sanad, Aly, Elbatal, Amira Alsayed Abdelhai, Elgazar, Amr, Saleh, Amr, Fahiem, Andrew, Mohamed, Anwar Yahya A., Nageeb, Ashraf, Elmetwally, Ashraf S., Alkhalegy, Ayman, El-Wakeel, Ayman, Shemes, Ayman, Fadel, Bashir A., Lutfi, Basma Waseem, Ali, Doaa, Abolnasr, Khaled Samir, Gamal, Ehab, Abdallah, Emad, Ahmed, Emad Ali, Salem, Eman Abdalla Mohamed, Hamed, Esmael Ali, Elshikh, Essam, Enad, Farazdaq, Sarhan, Fetoh Alaaeldin Fetoh, Abouelnagah, Galal, Tagg, Gamal Hassan El, Atef, Gehad, Shaker, George Samir Habib, Beshir, Hatem, Zakaria, Hazem M., Barbary, Hesham, Elgendy, Hesham, Sharaf, Hesham, Elnaghi, Hisham, Elghadban, Hosam, Elzayat, Ibrahim, Fakhr, Ibrahim, Sallam, Ibrahim, Abdelmoneim, Ibrahim Tharwat Mohamed, Elnemr, Islam, Zewar, Karem Shahin Mohamed, Elalfy, Khaled, Sabet, Khaled, Mansour, Khaled Yousery Ibrahim, Osman, Khalid Abdalla Abdelgadir, Elgaly, Maher Elesawi Kamel, Shams, Maher, Abozeid, Mahmoud, Mohammed, Mahmoud M., Elkatt, Mahmoud Mohamed, Samaha, Mahmoud Yahia, Mikhael, Marolla Maher Eskander, Khalil, Medhat M. H. A., Alhendawey, Moaaz, Elrefai, Mohamad, Gabr, Mohamed A., Fayed, Mohamed Abdelaziz Mohamed Abdalla M, Abdelmaksoud, Mohamed, Salem, Mohamed Abouelmagd, Mohamed Mohamed, Mohamed Adel, Nabeeh, Mohamed Adel, Elsayed, Mohamed Ahmed Abdelhalim Ahmed, Abdelmonem, Mohamed Ahmed, Ali, Mohamed Anwar Abdel Razik, Eldemery, Mohamed, Elmesery, Mohamed, Fikry, Mohamed, Gharbia, Mohamed, Omar, Mohamed I., Elmoghazy, Mohamed Ibrahim, Ghazala, Mohamed Jomma, Hamed, Mohamed Korayem Fattouh, Metwally, Mohamed, Arnouse, Mohamed Mohamed Hamdy, Amen, Mohamed Mohsen, Amary, Mohamed Mokhtar, Kandel, Mohamed Mosaad, Abuzeid, Mohamed Mostafa, Rabea, Mohamed, Sobh, Mohamed Ramadan, Taman, Mohamed, Fathy, Mohammad, Moustafa, Mohammad Montaser Hassan, Zuhdy, Mohammad, Adel, Mohammed, Alaa, Mohammed, Alawady, Mohammed, Edassy, Mohammed El, Mohammed, Mohammed Mustafa Hassan, Eldesouki, Mohammed Nabil, Salim, Mohammed Said Mahmoud, Sanad, Mohammed, Khalaf, Mohsen George, Henes, Mohsen Michael, Abdelglil, Momen, Mohmmed, Mona Mhmoud, Abdelkhalik, Morsi Mohamed Morsi, Shetiwy, Mosab, Elshazli, Mostafa, Hegazy, Mostafa, Ahmed, Mostafa Mahmoud, Abdelhalim, Mostafa Mohammed, Shahein, Mostafa, Sofan, Mostafa, Hammad, Muhammed Alaa Moukhtar, Ahmad, Mustafa, Milad, Nader, Farouk, Nehal, Eldesouky, Omnia, Mohamed, Omnia Y., Mahadel, Osama Abdel Salam, Gaarour, Osama, Torky, Radwan Abdelsabour, Elhafez, Raheem El-Gohary Abd, Adly, Ramy Magdy, Nageeb, Ramy Mikhael, Hamdi, Salah, Gamal, Sameh, Emile, Sameh Hany, Regal, Samer, Abdelrasheed, Sayed, Elzeftawy, Shady Ahmed, Khashshan, Sohib Mohammed Mohammed, Ashraf, Tamer, Khafagy, Tamer, Nabil, Tamer, Abdelazim, Tarek, Rizk, Tarek Taher, Amr, Wesam, Yousef, Yousef Mohamed, Youssef, Youssef Abdel Aziz, Castaldi, Antonio, Fiore, Antonio, Hasani, Ariola, Mariani, Aurora, Dagorno, Claire, Antonio, D'Alessandro, Izzo, Giuliano, Addari, Giulio, Mangiameli, Giuseppe, Rea, Lo Dico, Pio, Luca, Paci, Marco, Andrea, Police, De Fatico, GSerena, Elvira, Tartaglia, Schuldes, Alejandro Daniel Lira, Rihan, Eslam, Moeslein, Gabriela, Lederhuber, Hans, Botros, Ibram, Jaman, Ismail, Doerner, Johannes, Elseberbihy, John Rezk Hanna, Sherbiny, Kareem El, Ghonim, Mostafa, Mikrish, Amir, Aziz, Mina, Hatm, Mohamed, Archid, Rami, Gendy, Samuel Elkess Morcos, Ahmad, Sufian, Charalabopoulos, Alexandros, Prodromidou, Anastasia, Ioannidis, Argyrios, Mpaili, Eustratia, Boukorou, Garyfallia, Papadopoulos, Georgios, Liakakos, Theodore, Styliani, Vasileiadou, Agrawal, Abhishek, Jain, Amita, Rashid, Arshad, Mehraj, Asif, Brahmachari, Swagata, Lakshmi, Harish Neelamraju, Vishwakarma, Kushagra, Parida, Lalit, Sharma, Meenakshi, Zaieem, Mohammad, Makasarwala, Murtaza, Nittala, Rigved, Kumar, Sanjeev, Vikrantmr, Sharma, Junaid, Sheikh, Khuller, Somyaa, More, Vinal, Ahmed, Abeer Abdul Hameed, Alomieri, Adil, Alhamdany, Arkan Shubber, Del, Muslim Ka, Najm, Ghadah, Lateef, Nawras Falah, Mcnamara, Deborah, Abdelmageed, Mohammed Elkassaby, Majeed, Mudassar, Troci, Albert, Porcu, Alberto, Marano, Alessandra, Di Bartolomeo, Alessandro, Giani, Alessandro, Giardino, Alessandro, Canfora, Alfonso, Balla, Andrea, Barberis, Andrea, Belli, Andrea, Borasi, Andrea, Manetti, Andrea, Mingoli, Andrea, Morini, Andrea, Maurizi, Angela, Marra, Angelo Alessandro, Epifani, Angelo Gabriele, Iossa, Angelo, Parello, Angelo, Guida, Anna, Maffioli, Anna, Scafa, Anthony Kevin, Spinelli, Antonino, Matarangolo, Antonio, Picciariello, Arcangelo, Pirozzi, Brunella, Cirillo, Bruno, Gazia, Carlo, Ratto, Carlo, Foppa, Caterina, Marafante, Chiara, Andrea, Chierici, Tanda, Cinzia, Guerci, Claudio, Don, Cristine, Zigiotto, Daniele, Coniglio, Denise, Sasia, Diego, Visconti, Diego, Altomare, Donato F., Guaitoli, Eleonora, Botteri, Emanuele, Pinotti, Enrico, Martinelli, Fabio, Uggeri, Fabio, Bàmbina, Fabrizio, Falaschi, Federica, Costanzo, Federico, La Torre, Filippo, Milana, Flavio, Abbatini, Francesca, De Lucia, Francesca, Tropeano, Francesca Paola, Colombo, Francesco, Ferrara, Francesco, Litta, Francesco, Carrano, Francesco Maria, Orlando, Francesco, Roscio, Francesco, Selvaggi, Francesco, Giarratano, Gabriella, Pagano, Gianluca, Lisi, Giorgio, Argenio, Giulio, Zancana, Giuseppa, Cavallaro, Giuseppe, Frazzetta, Giuseppe, Mariateresa, Grasso, Sciaudone, Guido, Vella, Ivan, Siragusa, Leandro, Santurro, Letizia, Ferri, Lorenzo, Petagna, Lorenzo, Ferrario, Luca, Pitoni, Ludovica, Pignatelli, Marcello Filograna, Angrisani, Marco, Giugliano, Marco, Inama, Marco, Marino, Marco V., Veltri, Marco, Giuffrida, Maria Carmela, Menna, Maria Paola, Valente, Marina, Rottoli, Matteo, Sacchi, Matteo, Uccelli, Matteo, Rho, Maurizio, Garino, Mauro, Montuori, Mauro, Campanelli, Michela, Zese, Monica, De Falco, Nadia, Cillara, Nicola, Mariani, Nicolò Maria, Tamini, Nicolò, Adorisio, Ottavio, Campennì, Paola, Venturelli, Paolina, Bernante, Paolo, Sapienza, Paolo, Cianci, Pasquale, Marsanic, Patrizia, Lapolla, Pierfrancesco, Tecchio, Piero, Familiari, Pietro, Fransvea, Pietro, Bruzzaniti, Placido, Hassan, Redan, Pirovano, Riccardo, Rimonda, Roberto, Di Saverio, Salomone, Di Carlo, Sara, Perra, Teresa, Campagnaro, Tommaso, Testa, Valentina, Andriola, Valeria, Grappelli, Virgilio Michael Ambrosi, Capizzi, Vita, Chiarella, Vito, Bellato, Vittoria, Yanaga, Katsuhiko, Farouk, Mohamed, Uraiqat, Ahmad, Almasri, Mahmoud, Nabwana, Ambrose, Siboe, Mark M. W., W, Njoroge P., Njoroge, Githu, Ilkul, Jh., Obure, Ralph Ombati, Palkhi, Yusuf, Alkhayat, Ali, Ali, Ali Sayed, Malek, Amgad Nashaat Abdel, Abdelsayed, Emad Fahim, Zahra, Tarek, Ayoub, Larissa, Sleilati, Fadi, Aoun, Rany, Algatanesh, Nassib, Fieturi, Nura Ahmed, Ng, Jen Siang, Díaz, Andrés Vega, Duran, Erik Efrain Sosa, Guerrero, José Eaazim Flores, Jasso, Manuel Meza, Flores, Manuel SSalas, Felix, Marcos José Serrato, Angulo, Victor Manuel Pinto, Mejdane, Abdelhadi, Aitali, Abdelmounaim, Amal, Benzakour, Zentar, Aziz, Bensaad, Ahmed, Yacir, El Alami, Jawad, Fassi Fihri Mohamed, Rachid, Mohamed Ghassane, Maliki-Alaoui, Mohamed, Ouadii, Mouaqit, Mohammed, Ouazni, Thein, Nyan, Koirala, Dinesh Prasad, Hilling, Denise, Pouwels, Sjaak, Okunlola, Abiodun Idowu, Adejumo, Adeyinka, Akinmade, Akinola, Shittu, Asimiyu Adekunle, Oluyomi, Ayodele Samuel, Abiodun, Azeez Lateef, Lawal, Bashir, Odion, Clement, Popoola, Ademola, Jolayemi, Edward, Shomoye, El-Zaki, Wuraola, Funmilola Olanike, Eke, Grace, Abiyere, Henry, Oluwasuyi, Ige, George, Ihediwa, Njokanma, Iloba Gabriel, Aremu, Isiaka, Dare, Julius Kolajo, Abdur-Rahman, Lukman, Ahmad, Misbahu Haruna, Oludara, Mobolaji Adewale, Mohammad, Mohammad Aminu, Adeoluwa, Ojajuni, Situ, Oladele, Agbonrofo, Peter, Kewulere, Raji Taofiq, Aliyu, Yakubu, Adebowale, Yusuf, Galala, Ahmed, Rao, Satish, Waleed, Aasma, Inam, Aatif, Shaikh, Abdul Razaque, Qureshi, Ahmad Uzair, Muhammad, Aneeqah Din, Ahmed, Arooj, Kerawala, Asad Ali, Aslam, Mohammad, Mehr, Asma, Javed, Ayesha, Ahmad, Farooq, Majid, Haroon Javaid, Ahmed, Hassan, Daudi, Irfan, Akhtar, Khalid, Niaz, Khurram, Anwer, Mariyah, Amir, Mohammed, Hanif, Muhammad Amir, Asif, Muhammad, Raza, Muhammad Asif, Khokhar, Muhammad Imran, Jameel, Muhammad Khurram, Nasir, Muhammad, Shafique, Muhammad Salman, Ateeb, Mujammad, Nadeem, Munawar, Shah, Rahmat Ullah, Waqar, Shahzad Hussain, Shah, Shahzad Alam, Waseem, Talat, Ghafoor, Tariq, Fatima, Tauseef, Bashir, Umar, Gonzales, Erick Ivan Huaman, Ruiz, Luis Angel Garcia, Freitas, Carla, De Sousa, Xavier, Al-Bahrani, Ahmed, Portela, Carlos Antonio Sanchez, Elgazar, Elsayed Aly, Robles, Eloy Morasen, Khan, Irfan Jan, Jarboa, Lutfi, Khawar, Mahwish, Echevarria, Miguel Jose Pinto, Bashah, Moataz M., Dawdi, Salahaldeen, Musthafa, Shameel, Ali, Syed Muhammad, Ciubotaru, Cezar, Bonci, Eduard-Alexandru, Muresan, Mihai-Stefan, Bogdan, Stoica, Ioan, Tanase, Zubayraeva, Albina, Derinov, Aleksandr, Zakharenko, Alexander, Novikova, Anastasia, Bashlachev, Andrey, Kaldarov, Ayrat, Stanislav, Berelavichus, Gorin, David, Puzenko, Dmitriy, Kazachenko, Ekaterina, Ashimov, Erkin, Medkova, Iuliia, Ignatov, Ivan, Sergeevich, Kochetkov Viktor, Sidorova, Lyudmila, Kiselev, Michail, Danilov, Michail, Aleksandr, Ogoreltsev, Rodimov, Sergey, Garmanovs, Tatiana, Kitsenko, Yury, Valery, Nekoval, Japhet, Ntezamizero, Sibiany, Abdulrahman, Saadeldin, Abdelhalim, Abuosba, Abdelrahman, Alawadhi, Abdulbari Mohammed, Alharbi, Abdulhamid, Althumali, Abdullah, Alghuliga, Abdullah, Alotaibi, Abdullah, Abduraboh, Abdullah Fayez, Kateb, Abdullah, Sindy, Abdullah, Al Eisa, Abdulmohsen, Alotaibi, Abdulrahman, Almulhim, Abdulrhman, Aljawhari, Adel Ali, Abozeid, Ahmad Mahmoud, Saad, Ahmad, Alqarni, Ahmed, Alwan, Ahmed, Alwusaibie, Ahmed, Bafaraj, Ahmed, Eldeeb, Ahmed, Tarabay, Ahmed, Mohammed, Mahfoudh, Alhedaithy, Alhanouf, Almaghrabi, Alhassan Hesham, Abed, Ali Ibrahim Eldawy, Abdullah, Alqahtani Ali, Semilan, Anmar, Farag, Mohamed, Khudhayr, Essa, Hussain, Marwah, Abbas, Ghanem, Alqudaihi, Heba, Abualnaja, Yousra, Shaheen, Abelnasser, Mubarak, Ashraf Abdelazeem Mohamed, Ali, Bandar Idrees A., Alhazmi, Barrag, Hijazi, Bilal Ahmed, Abdulrahman, Chadi, Oyedepo, Charles Olajide, Alzamel, Heythem, Tairab, Elsanousi Ibrahim Sabir, Alsuwaimel, Munir A., Hejazi, Soha, Alnoqaidan, Emad, Alhussien, Fade Ahmed, Jallad, Fadi Sami, Khadwardi, Faisal, Alghamdi, Faisal Saleh, Haddad, Feras, Sauri, Fozan, Alafghani, Haitham, Alfalah, Haitham, Gad, Hamada, Aboelmagid, Hamdy Haggag Ebrahim, Ibrahim, Hamed, Elzayady, Hany M., Sharafeldin, Hatem Abdelrahman Ahmed, Sembawa, Hatem A., Alabbas, Haytham, Abbas, Hazem, Elgamal, Hesham, Alawfi, Homoud, Al-Sadery, Humood, Abdelmotaleb, Hussien Ali, Al Hassn, Ibrahim, Mudawi, Ishag M., Nekhala, Islam, Elsanhoury, Kareem, Said, Khalid Babieker, Albeshri, Khalid A., Albahooth, Khalid, Mohammed, Khalid Fathelrahman Bakier, Asar, Khalid Mohammad Ibrahim, Osman, Luqman, Alzamanan, Mahdi, Alnabarawi, Mahmoud, Althobaiti, Majid, Elsayed, Mohamed Abdelmoneim, Al Naeb, Mohamed, Hassan, Mohamed Salah Eldin, Abdelhamid, Mohamed Sayed, Alyami, Mohammad, Mirza, Mohammad Amin, Sayouh, Mohammad, Alkhayat, Mohammed Amer, Basendowah, Mohammed, Ghunaim, Mohammed, Alhussaini, Mohammed Khalid, Khoj, Mohammed, Sbaih, Mohammed, Saeed, Muhammad Ahmad, Ali, Muhammad Zulfiqar, Abdelaziz, Nabil Yassin Tammam, Malibary, Nadim, Abdo, Nael, Amer, Nasser Mohammed, Al Turki, Neamat Ahmed Ali, Durayb, Norah, Yassin, Nouf, Akeel, Nouf, Larbi, Noureddine, Alsallum, Ofays, Suliman, Omar AAbu, Elsherbiny, Osama, Abusalem, Osama, Albalawi, Ibrahim Altedlawi, Abutalib, Raid Abdullah, Alarabi, Rayan, Khan, Roaa Ghazi, Alazzam, Saleh, Alghamdi, Saleh, Alsawat, Salem, Salim, Sami, Alshukr, Sarah, Alzahrani, Saud, Golea, Smain, Alowairdhi, Tumadher, Salman, Usama, Abusiam, Wael, Abualkhair, Wael, Saber, Wael, Tashkandi, Wail, Alhazmi, Waleed, Tashkandi, Waleed, Yassine, Wassim Abou, Alshabi, Yaser Ahmad, Ibrahim, Yaser, Shahin, Yasser, Ibrahim, Yassin, Aljathlany, Yousef, Alnahas, Yousef, Alrashidi, Yousef, Wali, Zubair, Ndong, Abdourahmane, Ba, Mamadou, Faye, Papa Mamadou, Arbutina, Dragana, Milic, Ljiljana, Cuk, Vladica, Hussein, Abdinafic Mohamud, Mccaul, Jeannie, Bertels, Laurie, Pohl, Linda, Arnold, Marion, Mbatani, Nomonde, Oosthuizen, Pj, Rayamajhi, Shreya, Vosloo, Susan, Jooma, Uzair, Landaluce-Olavarria, Aitor, Vázquez-Melero, Alba, Marcos, Alberto, Puerto Puerto, Alejandro, De La Hermosa, Alicia Ruiz, Senent-Boza, Ana, Ugarte-Sierra, Bakarne, Montalbán, Beatriz Cros, Martin-Perez, Beatriz, Gomez, Caroina Gonzalez, Colás-Ruiz, Enrique, Santos, Esther Garcia, Senra, Fatima, Mora-Guzmán, Ismael, Dziakova, Jana, Díaz, Jeancarlos J. Trujillo, Silva, Jesús, Laina, Juan Luis Blas, Tallon-Aguilar, Luis, Di Martino, Marcello, Chacón, Mario Franco, Frasson, Matteo, Calvo, Mikel Prieto, Millan, Monica, Tejedoe, Patricia, Pérez-Bertólez, Sonia, Turrado-Rodríguez, Víctor, Elsanosi, Abdelrhman Azhari Mohammed, Abdalbakheet, Duaa, Ahmed, Mohamed, Salim, Omer El Faroug H., Youssef, Mohamed, Barbon, Carlotta, Bouchrika, Amal, Maghrebi, Houcine, Loukil, Issam, Yildiz, Alp, Dursun, Ayberk, Gulcu, Baris, Calik, Bulent, Eral, Burak, Yeşilyurt, Değercan, Yakar, Fatih, Akin, Furkan Atakan, Kilinc, Gizem, Uslu, Gülberk, Tuncer, Korhan, Koc, Mehmet Ali, Leventoğlu, Sezai, Sokmen, Selman, Atici, Semra Demirli, Kaya, Tayfun, Dere, Ümit Akın, Kırmızı, Yasemin, Ssenono, Kavuma Daniel, Lule, Herman, Mbiine, Ronald, Hamza, Ahmed, Ali, Shabeer, Peediyakkal, Saidalavi Padinhare, Varma, Gopala Pillay, Mussa, Haidar Aal, Al-Masari, Hayder Makki, Shehata, Mina, Seiam, Moham, Aziz, Muhammad Akram Abdul, Nimir, Nessrein, Khare, Ritu, Rashid, Shahid, Kazim, Shuiab, Gondal, Zafar, Sherif, Ahmed Elshawadfy, Ghanem, Ahmed, Helmy, Ahmed Hazem I., Ibrahim, Ahmed, Elshaer, Ahmed Mohammed, Marzouk, Ahmed Msm, Tamburrini, Alessandro Paolo, Parente, Alessandro, Light, Alexander, Diamantopoulou, Angela, Singh, Baljit, Gurung, Binay, Frauenfelder, Claire, Leo, Cosimo Alex, Raptis, Dimitri, Thakrar, Dixa, Madhuri, Thumuluru Kavitha, Tsounaki, Efthymia, Garreffa, Emanuele, Soggiu, Fiammetta, Stavrou, George, Ng, Hwei Jene, Tabasi, Hani, Nasef, Hazem, Kostakis, Ioannis D., Jeffery, James, Warusavitarne, Janindra, Lund, Jon, Qurashi, Kamran, Sahnan, Kapil, Tong, Kin Seng, Orecchia, Luca, Kaur, Mandeep, Zaidi, Mariam, Ganau, Mario, Hassan, Mohamed Ali Gad, Curtis, Nathan, Bhatt, Nikita, Machairas, Nikolaos, Zafar, Noman, Toma, Omar, Sarmah, Panchali, Bassuni, Majid, Davies, Justin, Shawer, Sami, Shawer, Sherif, Lewis, Sophia, Subramanian, Sivaraman, Ahmad, Suhaib, Nadeem, Uqba, Njau, Aidan, Tohamy, Aley Eldin, Pakula, Andrea M., Simioni, Andrea, Jarvis, Bennie L., Skandalakis, Georgios P., Hesham, Hosai Todd, Isaiah, Isaac A., Villwock, Jennifer, Martin, Linda W., Kress, Melissa, Sebelik, Merry, Lathan, Sanaz, Towfigh, Shirin, Holubar, Stefan D., Demeester, Steve, Alshehari, Mohammed Mohammed Hasan, Ghabisha, Saif Ali, Abdulatef, Shehab Ahmed Ali, Al-Kubati, Waheeb, Obadiel, Yasser Abdurabo, Gots, Alexander, Nakazwe, Mildred, Chipaila, Jackson, and Mazingi, Dennis
Abstract: BackgroundSARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice.MethodsThis is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure.ResultsNine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout.There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management.ResultsNine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout.There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits
Published: 2024

5. Impact of laparoscopy on oncological outcomes after colectomy for stage III colon cancer: A post-hoc multivariate analysis from PETACC8 European randomized clinical trial

Author: Julien Taieb, Eloy Espin, Rea Lo Dico, Weitz Jürgen, Côme Lepage, Thibault Voron, Mehdi Karoui, Antoine Cazelles, Richard Douard, Alexis Buggenhout, Karine Le Malicot, F. Denimal, Matthieu Bruzzi, and Fabio Cianchi
Subjects: Male, Laparoscopic surgery, medicine.medical_specialty, Organoplatinum Compounds, Colorectal cancer, medicine.medical_treatment, Leucovorin, Cetuximab, Antineoplastic Agents, Disease-Free Survival, law.invention, 03 medical and health sciences, 0302 clinical medicine, FOLFOX, Randomized controlled trial, law, Antineoplastic Combined Chemotherapy Protocols, medicine, Humans, Stage (cooking), Propensity Score, Laparoscopy, Colectomy, Aged, Neoplasm Staging, Hepatology, medicine.diagnostic_test, business.industry, Gastroenterology, Prognosis, medicine.disease, Surgery, Europe, Survival Rate, Clinical trial, Treatment Outcome, 030220 oncology & carcinogenesis, Colonic Neoplasms, Multivariate Analysis, Female, 030211 gastroenterology & hepatology, Fluorouracil, business, Follow-Up Studies, medicine.drug
Abstract: Background In colon cancer (CC), surgery remains the mainstay of treatment with curative intent. Despite several clinical trials comparing open and laparoscopic approaches, data on long-term outcomes for stage III CC are lacking. Methods This post-hoc analysis of the European PETACC8 randomized phase 3 trial included patients from 340 sites between December 2005 and November 2009, with long follow-up (median 7.56 years). Patients were randomly assigned to FOLFOX or FOLFOX+cetuximab after colonic resection. The surgical approach was left to the referring surgeon's discretion. Results Among 2555 patients included, 1796 (70.29%) were operated on by open surgery and 759 (29.71%) by laparoscopy. The 5-year OS rate was better after laparoscopic resection (85.4%, 95%CI 82.5–87.7) than after open surgery (80.2%, 95%CI 78.2–82.0; p = 0.002). The 5-year DFS rate was also better after laparoscopy (p = 0.016). However, in multivariate analysis using a propensity matching, the surgical approach was not found to be an independent prognostic factor for OS or DFS. OS (p = 0.0243) and DFS (p = 0.035) were increased after laparoscopic surgery in KRAS/BRAF WT sub-group Conclusion We showed that laparoscopic resection has comparable long-term outcomes to open surgery in patients with stage III CC. For those with RAS and BRAF WT CC, laparoscopic colectomy may favorably impact survival.
Published: 2021
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6. Impact of preoperative chemotherapy on the histological response of patients with peritoneal metastases from colorectal cancer according to peritoneal regression grading score (PRGS) and TRG

Author: Rachid Kaci, Muriel Mathonnet, Abdelkader Taibi, Marc Pocard, Rea Lo Dico, and Anne Laure Naneix
Subjects: Male, medicine.medical_specialty, Organoplatinum Compounds, Colorectal cancer, Leucovorin, Cetuximab, Histological response, Hyperthermic Intraperitoneal Chemotherapy, Adenocarcinoma, Gastroenterology, Disease-Free Survival, 03 medical and health sciences, Antineoplastic Agents, Immunological, 0302 clinical medicine, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, medicine, Humans, Preoperative chemotherapy, In patient, Laparoscopy, Grading (tumors), Peritoneal Neoplasms, Proportional Hazards Models, Tumor Regression Grade, medicine.diagnostic_test, business.industry, fungi, food and beverages, Cytoreduction Surgical Procedures, medicine.disease, Adenocarcinoma, Mucinous, Neoadjuvant Therapy, Regression, Bevacizumab, Oncology, 030220 oncology & carcinogenesis, Camptothecin, Female, 030211 gastroenterology & hepatology, Surgery, Fluorouracil, Colorectal Neoplasms, business
Abstract: Background This study evaluated the histologic response after preoperative systemic therapy (pST) using the Peritoneal Regression Grading Score (PRGS) and tumor regression grade (TRG) classifications for patients with peritoneal metastases (PM) from colorectal cancer (CRC). Methods Twenty-three patients were selected from a prospective database of 196 patients who underwent CRS followed by HIPEC for synchronous PM from CRC. In all study patients, biopsies of the PM obtained before pST (during the first laparoscopy) and after pST (during cytoreductive surgery) were compared. Results Complete (PRGS 1), Major (PRGS 2), Minor (PRGS 3) and no histological responses (PRGS 4) were obtained in 17,5%, 52% and 13% and 17,5% of patients, respectively. Major (TRG 1–2), partial (TRG3), and no (TRG4-5) histological tumor regression were observed in 61%, 9% and 30% of patients, respectively. Regardless of the classification applied, median OS was significantly higher in patients with a “complete or major” response than in those with a “minor/partial or no” response (54 vs. 26 months, p Conclusions The PRGS and TRG can be used in clinical practice to evaluate the histological response after pST. This study demonstrated that a complete histologic response of PM from CRC can be obtained after pST.
Published: 2020
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7. Emergency surgery admissions and the COVID-19 pandemic: did the first wave really change our practice? Results of an ACOI/WSES international retrospective cohort audit on 6263 patients

Author: Tebala, G.D., Milani, M.S., Mark, B., Giles, B., Christopher, L., Roberto, C., Salomone Di Saverio, Fausto, C., Marco, S., Pierluigi, M., Rea Lo Dico, Antonio, S., Giuseppe, R., Sara, D., Pasquale, C., Enrico, R., Grazia, S., Gianluca, G., Gennaro, M., Angela, P., Altomare, D.F., Arcangelo, P., Giuseppe, T., Rigers, D., Vincenzo, P., Carolina, R., Roberto, P., Jacopo, A., Giusto, P., Rossella, D., Elisa, A., Ilaria, C., Nicola, C., Antonello, D., Raffaele, S., Francesco, B., Simona, G., Antonio, C., Paola, I., Alan, B., Gabriele, B., Paola, G., Nicolò De Manzini, Marco, B., Paladino, F.P., Diego, S., Felice, B., Valentina, T., Giorgio, G., Fabrizio, A., Giuffrida, M.C., Martino, G., Alessandro, F., Dario, M., Nicolò, F., Feo, C.V., Erica, B., Ilaria, P., Vincenzo, L., Tricarico, F.G., Giovanni Di Gioia, Rocco, M., Nicola, T., Antonio, A., Giovanna, P., Mario, P., Fernanda, V., Fiorenza, B., Andrea, B., Andrea, C., Roberto, B., Stefano, B., Michele, S., Andrea, G., Laura, D., Roberto, F., Giacomo, P., Valeria, A., Giampiero, P., Alice, F., Danelli, P., Luca, F., Claudio, G., Mariani, N.M., Andrea Pisani Ceretti, Nicastro, V., Opocher, E., Davide, G., Gianmaria Casoni Pattacini, Maurizio, C., Alfonso, A., Maria, G., Giuseppe, P., Petracca, G.L., Gennaro, P., Mario, G., Gianluigi, M., Harmony, I., Mauro, F., Sonia, A., Cattaneo, G.M., Palomba, C., Andrea, M., Marcello, C., Pipitore Federico, N.S., Bruno, C., Riccardo, D., Alessandra, M., Federico, C., Erica, P., Massimo, C., Dario, T., Sandro, G., Riccardo, S., Martina, T., Massimo, F., Rosita De Vincenti, Anna, G., Michele, G., Giulia, B., Brunella, P., Guida, A.M., Sara, I., Don, C.P., Leandro, S., Orazio, C., Daniele, C., Emanuele, S., Vito, P., Alessia, F., Gioia, B., Martina, Z., Pierfranco, C., Simona, M., Paolo, S., Antonella, P., Filippo La Torre, Pietro, F., Marta Di Grezia, Gabriele, S., Armellino, M.F., Giovanna, I., Bernardino, R., Marcello Della Corte, Francesco, F., Guglielmo, C., Pierpaolo, B., Alessandro, S., Marco, F., Alessandro, G., Monica, S., Dario, B., Donatella, S., Christian, C., Sissi, P., Chierici, A.P., Matteo, U., Stefano, O., Giovanni, C., Nadia, T., Andre, M., Daniela, M., Clara, L., Bruno, V., Bakarne, U., Irune, V., Marta, D., Amaia, S., Ibanez-Aguirre, F.J., Carlos, Y., Issa, T., Blas, J.L., Roberta, G., Saskia, C., Angus, W., Andrew Di Carlo, Ellen, W., Konain, E., Kellen, B., Emma, G., Paul, C., Raheel, A., Roshneen, A., Aswani, S.S., Afzal, B., Catalina, C., Aruna, D., Abishek, D., Amr, E., Diana, G., Lucia, L., Mitul, P., Amanda, S., Mohamed, S., Ola, S., Zoe Slack and, Tebala, Giovanni D, Milani, Marika S, Bignell, Mark, Bond-Smith, Gile, Lewis, Christopher, Cirocchi, Roberto, Di Saverio, Salomone, Catena, Fausto, Scatizzi, Marco, Marini, Pierluigi, de Manzini, Nicolo', Tebala, G. D., Milani, M. S., Bignell, M., Bond-Smith, G., Lewis, C., Cirocchi, R., Di Saverio, S., Catena, F., Scatizzi, M., Marini, P, Olmi, S, and on behalf of CovidICE-International, Collaborative
Subjects: Admission, Covid-19, emergency surgery, hospitalization, humans, retrospective studies, SARS-CoV-2, pandemics, RD1-811, RC86-88.9, Research, COVID-19, Medical emergencies. Critical care. Intensive care. First aid, Emergency surgery, Hospitalization, Humans, Retrospective Studies, Pandemics, Settore MED/18 - Chirurgia Generale, Retrospective Studie, Emergency Medicine, Surgery, Human
Abstract: Introduction The COVID-19 pandemic is having a deep impact on emergency surgical services, with a significant reduction of patients admitted into emergency surgical units world widely. Reliable figures of this reduction have not been produced yet. Our international audit aimed at giving a precise snapshot of the absolute and relative changes of emergency surgical admissions at the outbreak of the pandemic. Materials and methods Datasets of patients admitted as general surgical emergencies into 45 internationally distributed emergency surgical units during the months of March and April 2020 (Covid-19 pandemic outbreak) were collected and compared with those of patients admitted into the same units during the months of March and April 2019 (pre-Covid-19). Primary endpoint was to evaluate the relative variation of the presentation symptoms and discharge diagnoses between the two study periods. Secondary endpoint was to identify the possible change of therapeutic strategy during the same two periods. Results Forty-five centres participated sent their anonymised data to the study hub, for a total of 6263 patients. Of these, 3810 were admitted in the pre-Covid period and 2453 in the Covid period, for a 35.6% absolute reduction. The most common presentation was abdominal pain, whose incidence did not change between the two periods, but in the Covid period patients presented less frequently with anal pain, hernias, anaemia and weight loss. ASA 1 and low frailty patients were admitted less frequently, while ASA>1 and frail patients showed a relative increase. The type of surgical access did not change significantly, but lap-to-open conversion rate halved between the two study periods. Discharge diagnoses of appendicitis and diverticulitis reduced significantly, while bowel ischaemia and perianal ailments had a significant relative increase. Conclusions Our audit demonstrates a significant overall reduction of emergency surgery admissions at the outbreak of the Covid-19 pandemic with a minimal change of the proportions of single presentations, diagnoses and treatments. These findings may open the door to new ways of managing surgical emergencies without engulfing the already busy hospitals.
Published: 2022

8. The location of the primary colon cancer has no impact on outcomes in patients undergoing cytoreductive surgery for peritoneal metastasis

Author: Julien Péron, Olivia Sgarbura, Bertrand Le Roy, Rami Younan, Lucas Sideris, Frederic Mercier, Olivier Glehen, Rea Lo Dico, Jean-Jacques Tuech, Guillaume Passot, Frédéric Bibeau, Maximiliano Gelli, Frédéric Dumont, Hospices Civils de Lyon (HCL), Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal (UdeM), CHU Rouen, Normandie Université (NU), Hôpital Maisonneuve-Rosemont, Institut Gustave Roussy (IGR), CRLCC René Gauducheau, CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand, Institut du Cancer de Montpellier (ICM), Université de Montpellier (UM), Service de Chirurgie d'Oncologie Digestive [CHU Lariboisière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Institut de Recherche en Cancérologie de Montpellier (IRCM - U1194 Inserm - UM), CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Université de Lyon, Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), and CCSD, Accord Elsevier
Subjects: Proto-Oncogene Proteins B-raf, Oncology, medicine.medical_specialty, Peritoneal metastasis, Colorectal cancer, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Operative Time, 030230 surgery, 03 medical and health sciences, 0302 clinical medicine, Cytoreduction Surgical Procedures, Internal medicine, medicine, Humans, Progression-free survival, Peritoneal Neoplasms, Retrospective Studies, Chemotherapy, business.industry, Microsatellite instability, Retrospective cohort study, Prognosis, medicine.disease, Progression-Free Survival, 3. Good health, [SDV] Life Sciences [q-bio], Chemotherapy, Adjuvant, 030220 oncology & carcinogenesis, Colonic Neoplasms, Mutation, ras Proteins, Surgery, Cytoreductive surgery, business, Follow-Up Studies
Abstract: International audience; BACKGROUND:The impact of the location of colorectal cancer on patient outcomes has been reported in several settings. The objective of this study was to assess the prognostic impact of the location of the primary colon cancer among patients with colorectal cancer peritoneal metastases undergoing complete cytoreductive surgery.METHODS:Using the prospectively maintained clinical and biological digestive peritoneal metastasis database of the BIG-RENAPE network, we identified 796 patients treated by a complete cytoreductive surgery between January 2004 and January 2017 for colorectal cancer peritoneal metastases in 16 different institutions. The 2 primary endpoints were overall survival and progression-free survival. To evaluate the impact on overall survival and progression-free survival of potential prognostic factors (including the location of the primary colorectal cancer), these factors were included in univariate and multivariate Cox proportional hazard models.RESULTS:Right-sided colorectal cancers were more often BRAF mutated and had microsatellite instability, whereas the frequency of RAS mutation was similar between right-sided and left-sided colorectal cancers. After a median follow-up time of 3.3 years, there was no significant difference in overall survival or progression-free survival according to tumor side. The lack of effect of tumor location on overall survival and progression-free survival was consistent across subgroups.CONCLUSION:Among patients undergoing complete cytoreductive surgery for peritoneal metastases, the site of the primary colorectal cancer was not associated with differences in progression-free survival or overall survival. Tumor side should not be used as a stratification factor in trials of colorectal cancer peritoneal metastases and should not be used in the selection process of patients for cytoreductive surgery.
Published: 2019
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9. Hepatectomy increases metastatic graft and growth in an immunocompetent murine model of peritoneal metastases

Author: Marc Pocard, Philippe Bonnin, Annemilaï Tijeras-Raballand, Jean-Marie Launay, R. Kaci, Rea Lo Dico, Brice Malgras, Anthony Dohan, Gianluigi Maria Lo Dico, and Cynthia Pimpie
Subjects: medicine.medical_specialty, Colorectal cancer, Angiogenesis, medicine.medical_treatment, Intraperitoneal injection, Gastroenterology, Metastasis, Immunocompromised Host, Mice, 03 medical and health sciences, Peritoneal Neoplasm, 0302 clinical medicine, Internal medicine, Laparotomy, Tumor Cells, Cultured, medicine, Animals, Hepatectomy, Peritoneal Neoplasms, Mice, Inbred BALB C, business.industry, Liver Neoplasms, Neoplasms, Experimental, General Medicine, Prognosis, medicine.disease, Liver regeneration, Liver Regeneration, Liver, Oncology, 030220 oncology & carcinogenesis, Disease Progression, Female, 030211 gastroenterology & hepatology, Surgery, Colorectal Neoplasms, business, Neoplasm Transplantation
Abstract: Background Curative surgery of synchronous peritoneal metastases (PM) and colorectal liver metastases (LM) has been recently investigated as feasible option. When synchronous peritoneal and liver resection is not achievable, the sequence of the surgery remains unknown. Our hypothesis was that liver resection (LR) promotes peritoneal growth resulting in a non-resectable PM. We sought to analyse the effects of major LR and liver regeneration after hepatectomy in a murine model of PM and the associated angiogenesis. Methods Murine model of colorectal PM in Balb/C mice was developed by intraperitoneal injection of different CT-26 tumour cell concentrations. Five days after the injection, mice were randomized into three groups: 68% hepatectomy group, sham laparotomy and control group without surgery. On post-operative days 1, 5 and 20, PM was evaluated macroscopically, tumour growth and liver regeneration by immunohistochemistry, and angiogenesis by immunofluorescence. Circulating progenitor cells, plasmatic cytokines and digestive arterial blood flow velocity measurements were also analysed. Results Reproducible murine model of limited colorectal PM was obtained. Surgery induced PM increases and promoted neo-angiogenesis. Major hepatectomy influence the tumour growth in the late phase after surgery, the extent of extra-peritoneal metastasis and the increase of Ki-67 expression in the remnant liver. Conclusions This animal model confirms the pro-tumoural and pro-angiogenic role of surgery, laparotomy and major LR, which promotes the increase of angiogenic factors and their participation in PM growth. These results suggest that peritoneal resection should be first step in the case of two-step liver and peritoneal surgery for patients with colorectal PM and LM.
Published: 2018
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10. Bidirectional chemotherapy combining intraperitoneal docetaxel with intravenous 5-fluorouracil and oxaliplatin for patients with unresectable peritoneal metastasis from gastric cancer: the first study in Western countries

Author: Rea Lo Dico, Nicola Guglielmo, Julien Taieb, Jean Marc Gornet, Aziz Zaanan, and Marc Pocard
Subjects: medicine.medical_specialty, medicine.medical_treatment, intraperitoneal chemotherapy, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, FOLFOX, Internal medicine, Internal Medicine, medicine, cytoreductive surgery, advanced gastric cancer, Chemotherapy, HIPEC, business.industry, Oxaliplatin, Regimen, Docetaxel, Fluorouracil, 030220 oncology & carcinogenesis, peritoneal metastasis, Conventional PCI, Peritoneal Cancer Index, 030211 gastroenterology & hepatology, business, medicine.drug, Research Article, bidirectional chemotherapy
Abstract: BackgroundA new treatment using bidirectional intraperitoneal (IP) and intravenous (IV) chemotherapy developed by Asiatic surgeons improves outcomes in patients with synchronous peritoneal metastasis (PM) from gastric cancer (GC).MethodsWe enrolled six consecutive patients with unresectable PM from GC who underwent bidirectional chemotherapy using IP docetaxel and IV FOLFOX or LV5FU2. In one course, IP docetaxel 30 mg/m2 was administrated on days 1, 8 and 15, and IV FOLFOX or LV5FU2 was administered on days 1 and 15, followed by 7 days of rest. Before and after a complete bidirectional cycle of three courses, the peritoneal cancer index (PCI) was evaluated by laparoscopy. The primary endpoint was to evaluate the feasibility and safety of bidirectional chemotherapy. Secondary endpoints were overall survival (OS), and the success of the therapeutic strategy was reflected by a decrease of 25% of the initial PCI.ResultsAll patients completed one bidirectional cycle. The regimen was well tolerated. The median OS was 13 months [range 5–18], and the 1-year OS rate was 67%. After the first bidirectional cycle, the PCI decrease ≥25% of the initial value in four patients. A major histological response was observed in four patients.ConclusionsThis is the first Western study and confirms the feasibility and safety of bidirectional treatment using IP and IV chemotherapy for patients with unresectable PM from GC, resulting in a 13-month median OS with limited morbidity. The decrease in PCI after one bidirectional cycle is promising.
Published: 2019

11. Multicenter phase III randomized trial comparing laparoscopy and laparotomy for colon cancer surgery in patients older than 75 years: the CELL study, a Fédération de Recherche en Chirurgie (FRENCH) trial

Author: Murielle Mathonnet, Stéphane Benoist, Antoine Brouquet, Pascal Chaïbi, Gilles Manceau, Jérémie H. Lefevre, Enrico Volpin, Marc Verny, Laura Beyert-Berjot, Olivier Bouché, Olivier Facy, Jean-Marc Regimbeau, Elie Chouillard, Frédérique Peschaud, Mehdi Karoui, Rea Lo Dico, Guillaume Passot, CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Sorbonne Université (SU), AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Université Paris-Sud - Paris 11 (UP11), CHU Charles Foix [AP-HP], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Hôpital universitaire Robert Debré [Reims], Université de Limoges (UNILIM), Université de Picardie Jules Verne (UPJV), CHU Amiens-Picardie, Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Diderot - Paris 7 (UPD7), CHU Saint-Antoine [AP-HP], Hôpital Ambroise Paré [AP-HP], Université Paris-Saclay, CHU Dijon, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), CHI Poissy-Saint-Germain, Aix Marseille Université (AMU), Service de Chirurgie Digestive, Hépato-Bilio-pancréatique et Transplantation Hépatique [CHU Pitié-Salpétrière], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Médecine Gériatrique [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de gériatrie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
Subjects: Cancer Research, Colorectal cancer, [SDV]Life Sciences [q-bio], medicine.medical_treatment, 030230 surgery, law.invention, Study Protocol, Postoperative Complications, 0302 clinical medicine, Randomized controlled trial, law, Laparotomy, Clinical endpoint, Laparoscopy, Colectomy, Randomized Controlled Trials as Topic, Aged, 80 and over, education.field_of_study, medicine.diagnostic_test, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Colon cancer, 3. Good health, Oncology, 030220 oncology & carcinogenesis, Colonic Neoplasms, Phase III trial, Elderly patient, medicine.medical_specialty, Population, lcsh:RC254-282, 03 medical and health sciences, Genetics, medicine, Humans, education, Geriatric Assessment, Aged, business.industry, Cancer, medicine.disease, Surgery, Clinical Trials, Phase III as Topic, Quality of Life, Morbidity, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: Background Several multicenter randomized controlled trials comparing laparoscopy and conventional open surgery for colon cancer have demonstrated that laparoscopic approach achieved the same oncological results while improving significantly early postoperative outcomes. These trials included few elderly patients, with a median age not exceeding 71 years. However, colon cancer is a disease of the elderly. More than 65% of patients operated on for colon cancer belong to this age group, and this proportion may become more pronounced in the coming years. In current practice, laparoscopy is underused in this population. Methods The CELL (Colectomy for cancer in the Elderly by Laparoscopy or Laparotomy) trial is a multicenter, open-label randomized, 2-arm phase III superiority trial. Patients aged 75 years or older with uncomplicated colonic adenocarcinoma or endoscopically unresectable colonic polyp will be randomized to either colectomy by laparoscopy or laparotomy. The primary endpoint of the study is overall postoperative morbidity, defined as any complication classification occurring up to 30 days after surgery. The secondary endpoints are: 30-day and 90-day postoperative mortality, 30-day readmission rate, quality of surgical resection, health-related quality of life and evolution of geriatric assessment. A 35 to 20% overall postoperative morbidity rate reduction is expected for patients operated on by laparoscopy compared with those who underwent surgery by laparotomy. With a two-sided α risk of 5% and a power of 80% (β = 0.20), 276 patients will be required in total. Discussion To date, no dedicated randomized controlled trial has been conducted to evaluate morbidity after colon cancer surgery by laparoscopy or laparotomy in the elderly and the benefits of laparoscopy is still debated in this context. Thus, a prospective multicenter randomized trial evaluating postoperative outcomes specifically in elderly patients operated on for colon cancer by laparoscopy or laparotomy with curative intent is warranted. If significant, such a study might change the current surgical practices and allow a significant improvement in the surgical management of this population, which will be the vast majority of patients treated for colon cancer in the coming years. Trial registration ClinicalTrials.gov NCT03033719 (January 27, 2017).
Published: 2019
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12. Post-operative wall shear stress in the superior mesenteric artery: Biomarker of long term outcome in patients with residual disease after incomplete cytoreductive surgery for pseudomyxoma peritonei

Author: Jean-Marie Launay, Imane El sanharawi, Philippe Bonnin, Matthias Barral, Anthony Dohan, Marc Pocard, Clarisse Eveno, Rea Lo Dico, CCSD, Accord Elsevier, Université Paris Diderot - Paris 7 (UPD7), Carcinose Angiogenèse et Recherche Translationnelle, Angiogenese et recherche translationnelle (CART U965), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Marqueurs cardiovasculaires en situation de stress (MASCOT (UMR_S_942 / U942)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Centre National de la Recherche Scientifique (CNRS)-Université de Paris (UP)-Université Sorbonne Paris Nord
Subjects: Adult, Male, medicine.medical_specialty, Neoplasm, Residual, [SDV]Life Sciences [q-bio], Disease, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Mesenteric Artery, Superior, medicine.artery, medicine, Biomarkers, Tumor, Pseudomyxoma peritonei, Humans, In patient, Superior mesenteric artery, Prospective Studies, Prospective cohort study, Aged, Aged, 80 and over, business.industry, Ultrasonography, Doppler, General Medicine, Cytoreduction Surgical Procedures, Middle Aged, medicine.disease, SMA, Pseudomyxoma Peritonei, Surgery, [SDV] Life Sciences [q-bio], Oncology, Tumor progression, 030220 oncology & carcinogenesis, Disease Progression, Biomarker (medicine), Female, Vascular Resistance, business
Abstract: Background After incomplete cytoreductive surgery (CRS), the assessment of pseudomyxoma peritonei (PMP) progression remains challenging. The objective was to assess the efficacy of wall shear stress (WSS) measured in superior mesenteric artery (SMA) to predict PMP progression in the postoperative setting to propose additional treatments. Methods In a prospective study, 52 patients with PMP had Doppler-ultrasound examination of the SMA with WSS calculation within one year after CRS with a mean follow-up of 43.3 ± 18.3 months. Patients were categorized according to the completeness of CRS and clinical outcome: Group-1 (n = 19): complete CRS and no recurrence, group-2 (n = 20): incomplete CRS with slowly progressive disease (alive at 2 years without severe clinical symptoms), group-3 (n = 13): incomplete CRS and severe clinical symptoms or dead within two years. Results of WSS were compared between groups and to 24 healthy subjects. Results WSS measured in the SMA was superior in Group-3 (19.6 ± 8.2 dynes/cm2) than in Group-2 (9.2 ± 1.8 dynes/cm2, p = 1.10−6), Group-1 (10.4 ± 2.8 dynes/cm2, p = 8.10−5), and healthy patients (8.7 ± 2.8 dynes/cm2, p = 9.10−7). One year after surgery, among patients with incomplete CRS a cut-off value of 12.1dynes/cm2 allowed distinguishing patients without from those with severe disease progression with a sensitivity of 100% and a specificity of 100% (p Conclusion Post-operative assessment of the WSS in the SMA in patients with incomplete CRS for PMP should be considered as biomarker of tumor progression in the postoperative setting. Therefore, WSS could be useful to target patients needing adjuvant systemic chemotherapy one year after CRS.
Published: 2019
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13. Evaluation of a new histological grading system for assessing the response to chemotherapy of peritoneal metastases from colorectal cancer: A mouse model study

Author: Anne Laure Naneix, Abdelkader Taibi, Rea Lo Dico, Rachid Kaci, Brice Malgras, Muriel Mathonnet, Marc Pocard, XLIM (XLIM), and Université de Limoges (UNILIM)-Centre National de la Recherche Scientifique (CNRS)
Subjects: medicine.medical_specialty, Colorectal cancer, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Histological response, Gastroenterology, 03 medical and health sciences, Mice, 0302 clinical medicine, Fibrosis, Internal medicine, Ascites, Antineoplastic Combined Chemotherapy Protocols, medicine, Animals, Peritoneal Neoplasms, Chemotherapy, Mice, Inbred BALB C, business.industry, Histology, General Medicine, medicine.disease, 3. Good health, Oxaliplatin, Disease Models, Animal, Oncology, 030220 oncology & carcinogenesis, Conventional PCI, Luminescent Measurements, 030211 gastroenterology & hepatology, Surgery, Fluorouracil, medicine.symptom, Neoplasm Grading, business, Colorectal Neoplasms, medicine.drug
Abstract: This experimental study evaluated the histological response of peritoneal metastases (PM) from colorectal cancer (CRC) after preoperative systemic chemotherapy (pCT). The results demonstrated that the Peritoneal Regression Grade Score could be used in medical practice. Aim The aim was to evaluate the histological criteria used by the tumour regression grade (TRG) and Peritoneal Regression Grade Score (PRGS) for determining the response to chemotherapy (CT), in a mouse model of peritoneal metastases (PM) from colorectal cancer (CRC). Methods Twenty immunocompetent BALB/c mice were randomized into four groups at day (D) 10 after intraperitoneal (ip) injection with bioluminescent CRC tumour cells (CT26-luc). A histology before treatment group was obtained by sacrifice on D10; the other groups all received one of the following ip treatments over 15 days: 5% glucose (control, G5); 5-fluorouracil (5FU, 0.03 mg/g); or 5FU with oxaliplatin (Ox, 0.006 mg/g). The histological response (HR) was analysed by comparing the histology of PM before and after treatment, using both scores: TRG and PRGS. Results All mice showed limited PM as visualised by bioluminescence and confirmed at the time of sacrifice in the histology before treatment group. The mean peritoneal carcinomatosis index (PCI) was = 8 [6–10], The rate of complete HR was significantly higher in the Ox-5FU group (83.3%) than 5FU group (0%) and G5 group (0%) (p = 0.016). Fibrosis was present only in CT-treated groups (p = 0.05). PCI, ascites volume and haemorrhagic ascites were significantly higher in the G5 group than CT groups (p Conclusions The TRG score can be used in practice when we want to compare the HR between the primary tumour and the PMs. The PRGS is a good measure of HR and is correlated with the efficacy of CT.
Published: 2019
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14. Multivariate statistical analysis of the polyphenols content for the discrimination of honey produced in Sicily (Southern Italy)

Author: Alessandro Ulrici, Stefania Graci, Gianluigi Maria Lo Dico, Vita Giaccone, Vittorio Calabrese, Antonio Vella, Vincenzo Ferrantelli, Gaetano Cammilleri, Rea Lo Dico, Angela Trovato Salinaro, Maria Scuto, Andrea Macaluso, Giovanni Lo Cascio, and Andrea Pulvirenti
Subjects: 0303 health sciences, Polyphenols Nutraceutical Liquid chromatography High resolution mass spectrometry Multivariate analysis, Production area, Polyphenols, Nutraceutical, Liquid chromatography, High resolution mass spectrometry, Multivariate analysis, 030309 nutrition & dietetics, 010401 analytical chemistry, Liquid chromatography, Polyphenols, Subspecies, Biology, 01 natural sciences, Honey samples, High resolution mass spectrometry, 0104 chemical sciences, 03 medical and health sciences, chemistry.chemical_compound, Horticulture, chemistry, Multivariate analysis, Polyphenol, Nutraceutical, Multivariate statistical, Quercetin, Kaempferol, Food Science
Abstract: The polyphenols content of 105 honey samples produced by black honeybees (Apis Mellifera ssp. Sicula) and common honeybees (Apis mellifera ssp. Ligustica) from Western Sicily (Southern Italy) was examined using TurboFlow™ liquid chromatography Orbitrap™ high-resolution mass spectrometry. The results showed very high kaempferol and quercetin contents, with average values higher than what was reported in literature (3967.9 ± 2184.16 and 2206.1 ± 1666.4 μg kg−1 for kaempferol and quercetin, respectively). The honey samples produced by Apis Mellifera ssp. Sicula subspecies showed polyphenols content up to two times higher than Apis mellifera ssp. Ligustica. The Principal Component Analysis (PCA) model calculated on the polyphenols content showed a satisfactory separation of the honey samples in terms of honeybee subspecies and production area. The model proposed in this work shows the possibility to safeguard the authenticity of the honey produced in the various geographic areas of Sicily.
Published: 2019

15. Outcomes of Rehepatectomy for Colorectal Liver Metastases: A Contemporary Multi-Institutional Analysis from the French Surgical Association Database

Author: Alexis Laurent, Antonio Iannelli, Antonio Sa cunha, Fabrice Muscari, Antoine Brouquet, JEAN ROBERT DELPERO, Olivier Turrini, Astrid Herrero, REA LO DICO, Olivier Glehen, Maximiliano Gelli, Dimitrios Ntourakis, Tullio Piardi, L'Institut hospitalo-universitaire de Strasbourg (IHU Strasbourg), Institut National de Recherche en Informatique et en Automatique (Inria)-l'Institut de Recherche contre les Cancers de l'Appareil Digestif (IRCAD)-Les Hôpitaux Universitaires de Strasbourg (HUS)-La Fédération des Crédits Mutuels Centre Est (FCMCE)-L'Association pour la Recherche contre le Cancer (ARC)-La société Karl STORZ, Institut de Recherche Contre les Cancers de l'Appareil Digestif-European Institute of Telesurgery (IRCAD/EITS), Sunnybrook Research Institute [Toronto] (SRI), Sunnybrook Health Sciences Centre, Hôpital Paul Brousse, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse, Département de chirurgie générale [Gustave Roussy], Institut Gustave Roussy (IGR), Hôpital Henri Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL), Chirurgie Générale et Digestive [Rangueil], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Hôpital Saint-André, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), CHU Strasbourg, CHU Toulouse [Toulouse]-Hôpital de Rangueil, and CHU Toulouse [Toulouse]
Subjects: Male, Oncology, Databases, Factual, medicine.medical_treatment, Kaplan-Meier Estimate, 030230 surgery, Gastroenterology, Metastasis, 0302 clinical medicine, Overall survival, Liver resection, Liver Neoplasms, Hazard ratio, Middle Aged, Primary tumor, 3. Good health, Survival Rate, Extrahepatic disease, 030220 oncology & carcinogenesis, Colonic Neoplasms, Female, France, Cohort study, Reoperation, medicine.medical_specialty, Operative Time, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, Adenocarcinoma, Disease-Free Survival, 03 medical and health sciences, Internal medicine, medicine, Hepatectomy, Humans, Repeat hepatectomy, Survival rate, Aged, Retrospective Studies, Rectal Neoplasms, business.industry, Retrospective cohort study, Length of Stay, medicine.disease, Confidence interval, Surgery, Neoplasm Recurrence, Local, Colorectal liver metastasis, business
Abstract: International audience; BACKGROUND:Recurrence remains frequent after curative-intent hepatectomy for colorectal liver metastases (CRLM). We sought to define short- and long-term outcomes, and identify prehepatectomy factors associated with survival, following rehepatectomy (RH) for recurrence.METHODS:We conducted a multi-institutional cohort study of hepatectomy for CRLM over 2006-2013. Second-stage resections were excluded. Primary outcomes were overall survival (OS) and recurrence-free survival (RFS) assessed using Kaplan-Meier methods. Secondary outcomes included 30-day overall morbidity and mortality, and survival from recurrence. Outcomes of RH and initial hepatectomy (IH) were compared.RESULTS:Of 2771 hepatectomies included in the study, 447 were RH. Median operative time, 30-day morbidity, mortality, and median length of stay did not differ for RH and IH. Five-year OS did not statistically differ, i.e. 56.5 % from RH and 67.6 % from IH [adjusted hazard ratio (HR) 0.9, 95 % confidence interval (CI) 0.5-1.7], and 5-year RFS was inferior after RH (18.5 vs. 28.8 %; adjusted HR 1.3, 95 % CI 1.0-1.7). In patients who eventually recurred, 5-year survival from the time of recurrence did not differ whether it was after RH (46.5 %) or after IH (60.3 %) (adjusted HR 1.1, 95 % CI 0.8-1.8). Rectal primary tumor (HR 1.4, 95 % CI 1.0-2.1) and metastasis ≥3 cm (HR 1.3, 95 % CI 1.1-2.7) were independently associated with RFS, but not OS, after RH.CONCLUSION:Short-term outcomes of RH did not differ from IH. While recurrence was more frequent after RH than IH, it did not impact OS. Survival from the time of recurrence did not differ whether recurrence occurred after RH or after IH. CRLM recurrence can be treated with curative intent with excellent long-term outcomes.
Published: 2016
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16. Radio-frequency plasma polymerized biodegradable carrier for in vivo release of cis-platinum

Author: Rea Lo Dico, Iman Al-Dybiat, Sudhir Bhatt, Farzaneh Arefi-Khonsari, Massoud Mirshahi, Marc Pocard, Jerome Pulpytel, Fatemeh Valamanesh, Aliby Baiyukha, Laboratoire Interfaces et Systèmes Electrochimiques (LISE), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS), Franck Reidy Research Center for Bioelectrics, Old Dominion University [Norfolk] (ODU), Carcinose Angiogenèse et Recherche Translationnelle, Angiogenese et recherche translationnelle (CART U965), and Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: biodegradable coatings, Polymers, Radio Waves, 02 engineering and technology, 01 natural sciences, Polyethylene Glycols, Polymerization, Lactones, Mice, media_common, Drug Implants, Drug Carriers, Mice, Inbred BALB C, Chemistry, plasma polymers, targeted therapy, 021001 nanoscience & nanotechnology, Controlled release, 3. Good health, Membrane, Liver, Oncology, Drug delivery, Female, 0210 nano-technology, Research Paper, Drug, medicine.medical_specialty, Plasma polymer, Cellophane, media_common.quotation_subject, Antineoplastic Agents, [SDV.CAN]Life Sciences [q-bio]/Cancer, Biodegradable Plastics, 010402 general chemistry, In vivo, medicine, Animals, [CHIM]Chemical Sciences, Caproates, Spectrum Analysis, Capsule, Molecular biology, 0104 chemical sciences, Surgery, in vivo drug delivery system, anti-cancer drug, Delayed-Action Preparations, Cancer cell, Microscopy, Electron, Scanning, Implant, Cisplatin, [CHIM.OTHE]Chemical Sciences/Other
Abstract: // Sudhir Bhatt 1, 3 , Fatemeh Valamanesh 2 , Jerome Pulpytel 1 , Rea Lo Dico 2 , Aliby Baiyukha 1 , Iman Al-dybiat 2 , Marc Pocard 2 , Farzaneh Arefi-Khonsari 1 , Massoud Mirshahi 2 1 Sorbonne Universites, UPMC Univ. Paris 6, CNRS, Laboratoire Interfaces et Systemes Electrochimiques, 75005, Paris, France 2 Sorbonne Paris Cite Universites, UMR Univ. Paris 7, INSERM U965 Carcinose, Angiogenese et Recherche Translationnelle, L’Hopital Lariboisiere, 75010, Paris, France 3 Current address: Frank Reidy Research Center for Bioelectrics, Old Dominion University, Norfolk, 23508, VA, USA Correspondence to: Massoud Mirshahi, email: massoud.mirshahi@inserm.fr Keywords: plasma polymers, biodegradable coatings, in vivo drug delivery system, anti-cancer drug, targeted therapy Received: May 11, 2016 Accepted: July 19, 2016 Published: July 29, 2016 ABSTRACT A low pressure plasma process based on plasma deposition has been used to develop a drug delivery strategy. In this study, a drug delivery system based on different layers of plasma co-polymerized Poly e-caprolactone-Polyethylene glycol (PCL-PEG) co-polymers was deposited on biocompatible substrates. Cis-platinum (118 μgm/cm 2 ) was used as an anti-cancer drug and incorporated for local delivery of the chemotherapeutic agent. The co-polymer layers and their interaction with cancer cells were analyzed by scanning electron microscopy. Our study showed that the plasma-PCL-PEG coated cellophane membranes, in which the drug, was included did not modify the flexibility and appearance of the membranes. This system was actively investigated as an alternative method of controlling localized delivery of drug in vivo . The loading of the anti-cancer drug was investigated by UV-VIS spectroscopy and its release from plasma deposited implants against BALB/c mice liver tissues were analyzed through histological examination and apoptosis by TUNEL assay. The histological examination of liver tissues revealed that when the plasma-modified membranes encapsulated the cis-platinum, the Glisson’s capsule and liver parenchyma were damaged. In all cases, inflammatory tissues and fibrosis cells were observed in contact zones between the implant and the liver parenchyma. In conclusion, low pressure plasma deposited uniform nano-layers of the co-polymers can be used for controlled release of the drug in vivo.
Published: 2016
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17. A feasibility study of the use of computed virtual chromoendoscopy for laparoscopic evaluation of peritoneal metastases

Author: Marc Pocard, H. Najah, Anthony Dohan, Rea Lo Dico, Clarisse Eveno, and Lucy Marry
Subjects: Adult, Male, medicine.medical_specialty, Light, Breast Neoplasms, Abdominal cavity, Vascular architecture, Chromoendoscopy, 03 medical and health sciences, 0302 clinical medicine, Stomach Neoplasms, Image Processing, Computer-Assisted, medicine, Humans, Coloring Agents, Peritoneal Neoplasms, Aged, Ovarian Neoplasms, medicine.diagnostic_test, business.industry, Carcinoma, Target tissue, Middle Aged, Endoscopy, Peritoneal carcinomatosis, medicine.anatomical_structure, Appendiceal Neoplasms, 030220 oncology & carcinogenesis, Spectral image, White light endoscopy, Colonic Neoplasms, Feasibility Studies, Female, Laparoscopy, 030211 gastroenterology & hepatology, Surgery, Radiology, business
Abstract: Detection of an incipient peritoneal carcinomatosis (PC) is still challenging, and there is a crucial need for technological improvements in order to diagnose and to treat early this condition. Fujinon Intelligent Chromo Endoscopy (FICE) is a spectral image processing technology that enhances the contrast of the target tissue. The aim of this study is to investigate the usefulness of FICE system during peritoneal endoscopy and to establish the optimal FICE preset(s) for peritoneal exploration and PC detection. A total of 561 images corresponding to 51 different areas of PC nodules and normal peritoneum were recorded during peritoneal endoscopies (For each area, one white light endoscopy (WLE) image and 10 FICE images). Three groups of 5 evaluators each: senior surgeons, surgical residents and medical students assessed these images. In a first questionnaire, the evaluators gave a score ranging from 1 to 10 to each image, and the three best FICE channels were determined. In a second questionnaire, five criteria were studied specifically: contrast, brightness, vascular architecture, differentiation between organs and detection of PC. The evaluators ranked the WLE and the three best FICE channel images according to these criteria. The three best FICE channels were channels 6, 2 and 9 with mean scores of 6.21 ± 1.59, 6.17 ± 1.48 and 6.06 ± 1.52, respectively. FICE Channel 2 was superior to WLE and other FICE channels, in terms of contrast (p
Published: 2016
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18. The close relationship between heparanase and epithelial mesenchymal transition in gastric signet-ring cell adenocarcinoma

Author: Shahsoltan Mirshahi, Geneviève Contant, Shahid Shah, Caroline Fourgeaud, Jeannette Soria, Simon Derieux, Massoud Mirshahi, Rea Lo Dico, Cynthia Pimpie, and Marc Pocard
Subjects: 0301 basic medicine, signet ring cell adenocarcinoma, biology, Cell growth, Chemistry, epithelial mesenchymal transition, Cell, Vimentin, carcinomatosis, KATO-III cell line, heparanase, Extracellular matrix, Fibronectin, 03 medical and health sciences, 030104 developmental biology, medicine.anatomical_structure, Oncology, medicine, biology.protein, Cancer research, Heparanase, Epithelial–mesenchymal transition, Autocrine signalling, Research Paper
Abstract: Heparanase (HPSE), a heparan sulfate-specific endo-β-D-glucuronidase, plays an important role in tumor cell metastasis through the degradation of extracellular matrix heparan sulfate proteoglycans. Suramin, a polysulfonated naphthylurea, is an inhibitor of HPSE with suramin analogues. Our objective was to analyze the HPSE involvement in gastric signet ring cell adenocarcinoma (SRCA) invasion. High expression of HPSE mRNA and protein was found in the tumor and in ascites of SRCA as well as in KATO-III cell line. Beside of collagen-I, growth factors (TGF-β1 and VEGF-A, except FGF-2) and epithelial mesenchymal transition (EMT) markers (Snail, Slug, Vimentin, α-SMA and Fibronectin, except E-cadherin) were found higher in main nodules of SRCA as compared to peritumoral sites. Among MDR proteins, MDR-1 and LRP (lung resistance protein) were highly expressed in tumor cells. The formation of 3D cell spheroids was found to be correlated with their origin (adherent or non-adherent KATO-III). After treatment of KATO-III cells with a HPSE inhibitor (suramin), cell proliferation and EMT-related markers, besides collagen-1 expression, were down regulated. In conclusion, in SRCA, HPSE via an autocrine secretion is involved in acquisition of mesenchymal phenotype and tumor cell malignancy. Therefore, HPSE could be an interesting pharmacological target for the treatment of SRCA.
Published: 2018

19. La chimiothérapie hyperthermique intra-péritonéale (CHIP) (podcast)

Author: Rea Lo Dico, Etienne Gayat, Nathalie Poirier, Clarisse Eveno, Marion Grienay, François Bart, Charles Damoisel, Matthieu Le Dorze, Lucie Marry, Alexandre Mebazaa, Sophie Dagois, and Marc Pocard
Subjects: Gynecology, medicine.medical_specialty, Anesthesiology and Pain Medicine, business.industry, Emergency Medicine, Medicine, Emergency Nursing, business, Peritoneal carcinomatosis
Abstract: Resume La chimiotherapie hyperthermique intra-peritoneale (CHIP) decrite au debut des annees 1990 est une procedure utilisee dans le traitement des carcinoses peritoneales (cancers colorectaux, maladies primitives du peritoine) dont la survie etait souvent inferieure a 6 mois. Elle associe une chirurgie de cytoreduction complete et une chimiotherapie par voie intra-peritoneale et systemique. C’est une chirurgie grevee d’une morbi-mortalite elevee pour laquelle la selection des patients est primordiale afin de garder un bon rapport benefice/risque. Elle doit etre realisee par des equipes entrainees. En phase peroperatoire, la prise en charge anesthesique consiste principalement a maintenir l’equilibre hydroelectrolytique, a gerer les variations hemodynamiques et la temperature du patient tout au long de la chirurgie qui peut durer plus de 10 heures. Les complications postoperatoires les plus frequentes peuvent etre chirurgicales (hemoperitoine, peritonite, fistule) ou medicales (hematotoxicite, embolie pulmonaire, sepsis, pneumopathie). Grâce a la CHIP, la survie mediane des patients est passee de 6 mois a 22 a 63 mois selon les series. Apres une phase de convalescence d’environ 3 mois, la qualite de vie des patients est bonne.
Published: 2015
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20. Peritoneal Carcinomatosis of Urachus Origin Treated by Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC): An International Registry of 36 Patients

Author: LUIS GONZÁLEZ BAYÓN, LAURENT VILLENEUVE, Kuno Lehmann, Ahmed Mekkawy, Frédéric Dumont, REA LO DICO, Olivier Glehen, Mohammad Alyami, Frederic Guyon, Pablo Ortega-Deballon, and Olivier Facy
Subjects: Adult, Male, medicine.medical_specialty, medicine.medical_treatment, 030232 urology & nephrology, Urachus, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Surgical oncology, Antineoplastic Combined Chemotherapy Protocols, medicine, Pseudomyxoma peritonei, Humans, Prospective Studies, Registries, Prospective cohort study, Survival rate, Peritoneal Neoplasms, Retrospective Studies, Chemotherapy, business.industry, International Agencies, Retrospective cohort study, Cytoreduction Surgical Procedures, Hyperthermia, Induced, Middle Aged, medicine.disease, Prognosis, Combined Modality Therapy, Surgery, Survival Rate, medicine.anatomical_structure, Oncology, 030220 oncology & carcinogenesis, Chemotherapy, Cancer, Regional Perfusion, Hyperthermic intraperitoneal chemotherapy, Female, Neoplasm Recurrence, Local, business, Follow-Up Studies
Abstract: Peritoneal carcinomatosis or pseudomyxoma peritonei from urachus is a rare form of presentation, often diagnosed at an advanced state of tumor burden. Because of its rarity, little is known about its natural history, prognosis, or optimal treatment. We searched a large international multicenter database of peritoneal surface disease to identify cases of peritoneal carcinomatosis of urachus that were treated with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) at expert centers. The aim is to improve knowledge and understanding of the disease and standardize its treatment. A prospective multicenter international database was retrospectively searched to identify all patients with urachus tumor and peritoneal metastases who underwent CRS and HIPEC through the Peritoneal Surface Oncology Group International (PSOGI). Postoperative complications, long-term results, and principal prognostic factors were analyzed. The analysis included 36 patients. After median follow-up of 48 months, median overall survival (OS) was 58.5 months. Three- and 5-year OS was 55.4 and 46.2%, respectively. Patients who underwent complete macroscopic CRS had significantly better survival than those treated with incomplete CRS, with median OS not achieved and of 20.1 months, respectively [95% confidence interval (CI) 4.4–30.5, p
Published: 2017

21. Natural History of Pneumoperitoneum After Laparotomy: Findings on Multidetector-Row Computed Tomography

Author: Rea Lo Dico, Anthony Dohan, Sandrine Duron, Marc Pocard, Brice Malgras, Philippe Soyer, and Vinciane Placé
Subjects: Adult, Male, medicine.medical_specialty, medicine.medical_treatment, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, Pneumoperitoneum, Laparotomy, Multidetector Computed Tomography, medicine, Humans, Digestive System Surgical Procedures, Retrospective Studies, business.industry, Vascular surgery, Middle Aged, medicine.disease, Cardiac surgery, Surgery, body regions, Natural history, Cardiothoracic surgery, 030220 oncology & carcinogenesis, Female, Radiology, business, Complication, Abdominal surgery
Abstract: Postoperative pneumoperitoneum after abdominal surgery represents a diagnostic challenge. This study was designed to analyze the appearance of pneumoperitoneum on computed tomography after uncomplicated abdominal surgery through laparotomy. The database of the department of digestive surgery was retrospectively queried to identify all patients who underwent abdominal surgery through laparotomy during a 13-month period. This initial search retrieved a total of 384 consecutive patients. Criteria for inclusion in this study were: (a) the operation was performed in our institution, (b) the patient had computed tomography examination postoperatively, and (c) the patient had no postoperative grade ≥3 complication. Postoperative pneumoperitoneum was visible in 38/80 patients (47.5 %), with a mean volume of 15 ± 22.8 (SD) cm3 and multiple locations in 32/38 patients (84 %). Postoperative pneumoperitoneum was observed in 22/26 patients (85 %) until day 5 postoperative, 14/34 patients (41 %) between day 6 and day 15 postoperative, and in 2/21 patients (9.5 %) after day 15 postoperative. Its volume decreased when the time interval between surgery and computed tomography increased. Results of multivariate analysis showed that the time interval between surgery and computed tomography was the single independent variable that was associated with the presence of postoperative pneumoperitoneum. Postoperative pneumoperitoneum is a frequent finding on computed tomography in the early period following abdominal surgery and commonly with multiple locations. Although commonly observed before day 5 postoperative, its presence must be considered as an alarming finding after day 7 postoperative, if present in a single location with a volume >20 cm3.
Published: 2016

22. Parenchymal-sparing hepatectomies (PSH) for bilobar colorectal liver metastases are associated with a lower morbidity and similar oncological results: a propensity score matching analysis

Author: Riccardo Memeo, Vito de Blasi, René Adam, Diane Goéré, Daniel Azoulay, Ahmet Ayav, Emilie Gregoire, Reza Kianmanesh, Francis Navarro, Antonio Sa Cunha, Patrick Pessaux, Cyril Cosse, Delphine Lignier, Jean Marc Regimbeau, Julien Barbieux, Emilie Lermite, Antoine Hamy, François Mauvais, Christophe Laurent, Irchid Al Naasan, Alexis Laurent, Philippe Compagnon, Mohammed Sbai Idrissi, Frédéric Martin, Jérôme Atger, Jacques Baulieux, Benjamin Darnis, Jean Yves Mabrut, Vahan Kepenekian, Julie Perinel, Mustapha Adham, Olivier Glehen, Michel Rivoire, Jean Hardwigsen, Anaïs Palen, Yves Patrice Le Treut, Jean Robert Delpero, Olivier Turrini, Astrid Herrero, Fabrizio Panaro, Laurent Bresler, Philippe Rauch, François Guillemin, Frédéric Marchal, Jean Gugenheim, Antonio Iannelli, Stéphane Benoist, Antoine Brouquet, Marc Pocard, Rea Lo Dico, David Fuks, Olivier Scatton, Olivier Soubrane, Jean-Christophe Vaillant, Tullio Piardi, Daniel Sommacale, Michel Comy, Philippe Bachellier, Elie Oussoultzoglou, Pietro Addeo, Dimitrios Ntourakis, Didier Mutter, Jacques Marescaux, Loïc Raoux, Bertrand Suc, Fabrice Muscari, Georges Elhomsy, Maximiliano Gelli, Denis Castaing, Daniel Cherqui, Gabriella PIttau, Oriana Ciacio, Eric Vibert, Dominique Elias, Fabrizio Vittadello, L'Institut hospitalo-universitaire de Strasbourg (IHU Strasbourg), Institut National de Recherche en Informatique et en Automatique (Inria)-l'Institut de Recherche contre les Cancers de l'Appareil Digestif (IRCAD)-Les Hôpitaux Universitaires de Strasbourg (HUS)-La Fédération des Crédits Mutuels Centre Est (FCMCE)-L'Association pour la Recherche contre le Cancer (ARC)-La société Karl STORZ, Institut de Recherche Contre les Cancers de l'Appareil Digestif-European Institute of Telesurgery (IRCAD/EITS), CHU Strasbourg, Hôpital Paul Brousse, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse, Département de chirurgie générale [Gustave Roussy], Institut Gustave Roussy (IGR), Hôpital Henri Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Hôpital de la Timone [CHU - APHM] (TIMONE), AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB), and Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)
Subjects: Male, Time Factors, Hepatocellular carcinoma, medicine.medical_treatment, Treatment outcome, Kaplan-Meier Estimate, Remnant liver, Gastroenterology, Wedge resection, 0302 clinical medicine, Risk Factors, Cancer, Aged, 80 and over, education.field_of_study, Liver Neoplasms, Middle Aged, 3. Good health, Treatment Outcome, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Female, Original Article, France, Colorectal Neoplasms, Adult, medicine.medical_specialty, Disease free survival, Population, Risk Assessment, Disease-Free Survival, 03 medical and health sciences, Internal medicine, medicine, 2 stage hepatectomy, Hepatectomy, Humans, Laparoscopic resection, Systemic chemotherapy, Mortality, education, Propensity Score, Aged, Retrospective Studies, Chi-Square Distribution, Hepatology, business.industry, Liver failure, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Retrospective cohort study, Length of Stay, Hepatic resection, Surgery, Logistic Models, Dysfunction, Propensity score matching, business, Chi-squared distribution, Liver Failure
Abstract: International audience; OBJECTIVE:The aim of this study is to evaluate whether a parenchymal-sparing strategy provides similar results in terms of morbidity, mortality, and oncological outcome of non-PSH hepatectomies in a propensity score matched population (PSMP) in case of multiple (>3) bilobar colorectal liver metastases (CLM).BACKGROUND:The surgical treatment of bilobar liver metastasis is challenging due to the necessity to achieve complete resection margins and a sufficient future remnant liver. Two approaches are adaptable as follows: parenchymal-sparing hepatectomies (PSH) and extended hepatectomies (NON-PSH).METHODS:A total of 3036 hepatectomies were analyzed from a multicentric retrospective cohort of hepatectomies. Patients were matched in a 1:1 propensity score analysis in order to compare PSH versus NON-PSH resections.RESULTS:PSH was associated with a lower number of complications (≥1) (25% vs. 34%, p = 0.04) and a lower grade of Dindo-Clavien III and IV (10 vs. 16%, p = 0.03). Liver failure was less present in PSH (2 vs. 7%, p = 0.006), with a shorter ICU stay (0 day vs. 1 day, p = 0.004). No differences were demonstrated in overall and disease-free survival.CONCLUSION:In conclusion, PSH resection for bilobar multiple CLMs represents a valid alternative to NON-PSH resection in selected patients with a reduced morbidity and comparable oncological results.
Published: 2016
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23. A new internet tool to report peritoneal malignancy extent. PeRitOneal MalIgnancy Stage Evaluation (PROMISE) application

Author: François Quenet, Frédéric Marchal, François-Noël Gilly, Laurent Villeneuve, Jean-Marc Guilloit, M. Carretier, S. Carrere, Clarisse Eveno, Julien Fontaine, Faheez Mohamed, Delphine Vaudoyer, S. Isaac, A. Chevallier, A. Dohan, Cécile Brigand, P. Rousset, F. Poizat, Peggy Dartigues, Julio Abba, Frédéric Dumont, Nicolas Pirro, C. Petorin, Frédéric Guyon, G. Lang-Averous, S. Evrard, Gérard Lorimier, Karine Abboud, P. Rat, E. Mery, G. Pourcher, Jack Porcheron, Pablo Ortega-Deballon, M. Messager, Rea Lo Dico, Nicolas Goasguen, Pierre Meeus, R. Tetreau, Houda Ben Rejeb, S. Durand-Fontanier, P. Peyrat, A. Mariani, Dominique Elias, D. Bouzard, D. Geffroy, D. Delroeux, J.M. Bereder, C. de Chaisemartin, Christophe Mariette, R. Kianmanesh, Pierre-Jean Valette, Jean-Jacques Tuech, M. H. Laverrière, B. Lelong, Guillaume Piessen, C. Labbé, Mehdi Karoui, S. Velasco, Guillaume Passot, Diane Goéré, V. Barrau, G. Balague, V. Loi, Olivier Glehen, P. Rousselot, Jean-Marc Regimbeau, Emilie Thibaudeau, Thomas Courvoisier, V. Verriele-Beurrier, Frédéric Bibeau, G. Desolneux, M. Chassang, Marc Pocard, Magali Svrcek, Jérémie H. Lefevre, J. Lacroix, O. Fay, Franck Zinzindohoué, Catherine Arvieux, Naoual Bakrin, Denis Pezet, A. Leroux, Cédric Nadeau, Charles Sabbagh, Romuald Wernert, Bruno Heyd, Pascale Mariani, S. Msika, S. Valmary-Degano, L. Ghouti, A. Thivolet, Clarisse Dromain, R. Kaci, G. Ferron, Pôle Information Médicale Evaluation Recherche (IMER), Hospices Civils de Lyon (HCL), Ciblage thérapeutique en Oncologie (EA3738), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Institut de Recherche en Cancérologie de Montpellier (IRCM - U1194 Inserm - UM), CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Département de chirurgie, CRLCC Val d'Aurelle - Paul Lamarque, and Département de radiothérapie
Subjects: MESH: Medical Records, medicine.medical_specialty, Scoring application, [SDV.CAN]Life Sciences [q-bio]/Cancer, Medical Records, Peritoneal malignancy, 03 medical and health sciences, Peritoneal Neoplasm, 0302 clinical medicine, MESH: Patient Care Team, Predictive Value of Tests, Medicine, Resectability, MESH: Peritoneal Neoplasms, Humans, Stage (cooking), Peritoneal Neoplasms, Neoplasm Staging, Patient Care Team, Internet, MESH: Humans, business.industry, Medical record, MESH: Peritoneum, Reproducibility of Results, General Medicine, MESH: Neoplasm Staging, Peritoneal cancer index, MESH: Predictive Value of Tests, 3. Good health, Surgery, MESH: Reproducibility of Results, MESH: Internet, Oncology, 030220 oncology & carcinogenesis, Predictive value of tests, Conventional PCI, Peritoneal Cancer Index, 030211 gastroenterology & hepatology, Radiology, Peritoneal diseases, Extent disease, Peritoneum, business, Peritoneal carcinomatosis, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; Based on the importance of assessing the true extent of peritoneal disease, PeRitOneal MalIgnancy Stage Evaluation (PROMISE) internet application (www.e-promise.org) has been developed to facilitate tabulation and automatically calculate surgically validated peritoneal cancer index (PCI), and other surgically validated scores as Gilly score, simplified peritoneal cancer index (SPCI), Fagotti and Fagotti-modified scores. This application offers computer-assistance to produce simple, quick but precise and standardized pre, intra and postoperative reports of the extent of peritoneal metastases and may help specialized and non-specialized institutions in their current practice but also facilitate research and multicentre studies on peritoneal surface malignancies.
Published: 2016
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24. Pladoyer pour une chirurgie radicale de rattrapage du cancer de l’anus récidivé ?

Author: Rea Lo Dico and Marc Pocard
Subjects: Cancer Research, medicine.medical_specialty, Abdominoperineal resection, business.industry, medicine.medical_treatment, Colostomy, Hematology, General Medicine, Anal canal, medicine.disease, Perineal Colostomy, Perineum, Surgery, Abdominal wall, medicine.anatomical_structure, Oncology, medicine, Anal cancer, Abdomen, Radiology, Nuclear Medicine and imaging, business
Abstract: Salvage abdomino-perineal resection is justified in case of failure of the conservative treatment of a cancer of the anal canal. This surgery must be offered if surgery could be complete. In case of R0 resection, more than a patient on two will be alive after 5 years. The rate of perineal complication is important and gives proof to accomplish associated procedure to fill up the perineal cavity as muscular flap taken from the abdominal wall, the perineal colostomy that avoids the iliac colostomy or the simple flap of gracilis. This linked procedure allows to diminish the length of healing and improves postoperative time.
Published: 2011
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25. Single-incision flexible endoscopy (SIFE) for detection and staging of peritoneal carcinomatosis

Author: Xavier Dray, H. Najah, Anthony Dohan, Marion Grienay, Rea Lo Dico, and Marc Pocard
Subjects: Laparoscopic surgery, Adult, Male, medicine.medical_specialty, medicine.medical_treatment, Endoscopy, Gastrointestinal, 03 medical and health sciences, Peritoneal Neoplasm, 0302 clinical medicine, Laparotomy, Medicine, Animals, Humans, Prospective Studies, Prospective cohort study, Laparoscopy, Peritoneal Cavity, Peritoneal Neoplasms, Aged, Neoplasm Staging, Endoscopes, medicine.diagnostic_test, business.industry, Sire, Carcinoma, Middle Aged, Surgery, 030220 oncology & carcinogenesis, Conventional PCI, Feasibility Studies, 030211 gastroenterology & hepatology, Female, Radiology, business, Abdominal surgery
Abstract: To show the feasibility and the safety of peritoneal carcinomatosis (PC) evaluation by single-incision flexible endoscopy (SIFE) and to compare it to single-incision rigid endoscopy (SIRE). Direct peritoneal visualization, either by laparotomy or laparoscopy, continues to be the gold standard in diagnosing PC. We reported, in animal study, that combining single-incision laparoscopic surgery and flexible endoscopy improved evaluation of the peritoneal cavity in a live porcine model and in four human cadavers. Patients, undergoing surgical exploration for diagnosis and staging of PC, were included in a prospective study. Using a superiority design a sample size of 47 patients was determined. Through a single incision, a standardized peritoneoscopy was conducted with rigid (SIRE) and with flexible endoscope (SIFE). Primary outcome was the access success rates for the 13 regions of the Peritoneal Carcinomatosis Index (PCI). Overall access to the 13 regions of PCI was successful in 83 % of the cases with SIRE and in 91.1 % with SIFE (p
Published: 2015

26. Insertion of a Stent in Obstructive Colon Cancer Can Induce a Metastatic Process in an Experimental Murine Model

Author: Marc Pocard, Sylvie Robine, Brice Malgras, Rea Lo Dico, Laura Brulle, Fatima El Marjou, and Amu Therwath
Subjects: medicine.medical_specialty, Colorectal cancer, medicine.medical_treatment, Urology, Lumen (anatomy), Peritoneal Neoplasm, Mice, Circulating tumor cell, Surgical oncology, Occlusion, medicine, Animals, Humans, Peritoneal Neoplasms, medicine.diagnostic_test, business.industry, Liver Neoplasms, Stent, medicine.disease, Endoscopy, Surgery, Disease Models, Animal, Oncology, Colonic Neoplasms, Stents, business, Intestinal Obstruction
Abstract: Colonic self-expanding metallic stents (SEMS) are used in obstructive colorectal cancer patients as a bridge to surgery. However, its oncologic safety remains uncertain. Therefore, we attempted to clarify this further with an experimental study and constructed a mouse model of colonic cancer. CT26 cells were injected in the rectal wall, and to mimic SEMS, a cardiac stent was inserted under endoscopy in occlusive (75 % lumen occlusion) tumors. We set up a control group (n = 22) and a stent group (n = 16), and the findings were compared. We focused on serum lactate dehydrogenase (LDH) concentrations, circulating tumor cells, survival time, peritoneal carcinomatosis, liver metastases, and bioluminescence. One week after stent insertion, the serum LDH concentrations were significantly higher in the stent group (506 ± 203 IU/L) compared to the controls (229 ± 52 IU/L) (P = 0.005). The average survival time before sacrifice was significantly lower in the stent group (15.2 ± 1 days) compared to the controls (20 ± 5 days) (P = 0.005). The presence of a peritoneal carcinomatosis was more frequently observed in the stent group (75 %) than in the controls (50 %). Liver metastases were observed in 19 % of the stent group compared to the controls (4.5 %) (P = 0.29). After multivariate analysis, the stent group was still found to be associated with significantly lower survival time (P = 0.002). These observations led us to conclude that in our mouse model, SEMS resulted in an increased metastatic process and a shorter survival time. We suggest, therefore, that the utmost caution be exercised when opting for a stent as a bridge to surgery.
Published: 2015

27. La réponse histologique après chimiothérapie néo-adjuvante est-elle un facteur prédictif sur la survie des patients opérés de carcinose péritonéale d’origine colorectale ? Étude clinique

Author: Philipe Bonnin, Marc Pocard, Rachid Kaci, Anne Laure Naneix, Rea Lo Dico, Muriel Mathonnet, and Abdel Taibi
Subjects: Surgery
Abstract: Contexte Aucun critere histologique valide ne permet de guider le choix postoperatoire de reprendre ou non la chimiotherapie (CT) neoadjuvante dans la carcinose peritoneale colique (CPc) totalement resequee avec association d’une CHIP. L’objectif de cette etude etait d’evaluer dans la CPc, les criteres de reponse histologique (RH) deja valides dans d’autres localisations : le taux de cellules tumorales residuelles seul, ou associe a la fibrose (score de regression tumorale, TRG). Materiels Une etude retrospective a ete realisee sur une serie consecutive de patients operes de CPc synchrone, et traites par CT systemique apres biopsie. Nous devions disposer de biopsies initiales au diagnostic puis de l’histologie lors de la chirurgie en condition de CHIP. Une analyse histologique a ete faite sur tous les nodules avant et apres CT. Resultats Parmi les 394 patients, 23 ont pu etre analyses. La RH complete, majeure et mineure a ete respectivement de 17,5%, 52% et 30,5% pour le critere « cellules tumorales » et respectivement de 61%, 9% et 30% si on utilise les deux criteres. Quels que soient les criteres utilises, la survie des patients avec une reponse complete ou majeure etait significativement plus elevee que celle des patients avec reponse mineure (p Conclusion Les taux de cellules tumorales et de fibrose residuelles sont de bons criteres d’evaluation de la RH et pronostiques dans la CPc. Une RH complete est possible chez 17,5% des patients porteurs d’une CPc. Declaration d’interet Les auteurs n’ont pas transmis de conflits d’interets.
Published: 2015
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28. Is preoperative chemotherapy related to the survival of patient operated for peritoneal colorectal carcinomatosis and can it induce complete pathological response?

Author: Anne Laure Naneix, Abdelkader Taibi, Clarisse Eveno, Muriel Mathonnet, Gaetan Des Guetz, Rachid Kaci, Rea Lo Dico, and Marc Pocard
Subjects: Cancer Research, medicine.medical_specialty, Systemic chemotherapy, business.industry, Pathological response, Intraperitoneal chemotherapy, Surgery, Oncology, parasitic diseases, medicine, Preoperative chemotherapy, business, Cytoreductive surgery, hormones, hormone substitutes, and hormone antagonists
Abstract: e15159Background: Preoperative Systemic chemotherapy (pCT) often complements cytoreductive surgery and intraperitoneal chemotherapy in the peritoneal colorectal carcinomatosis (PCC) treatment. But ...
Published: 2016
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29. Peritoneal mesothelioma: Evaluation of chemotherapeutic agents used for HIPEC through the RENAPE database

Author: Clarisse Eveno, Brice Malgras, Marc Pocard, Etienne Gayat, Karine Pautrat, Rea Lo Dico, and Thierry André
Subjects: Cancer Research, medicine.medical_specialty, Oncology, business.industry, Peritoneal mesothelioma, Medicine, Neoplasm, Radiology, business, medicine.disease, Cytoreductive surgery, respiratory tract diseases
Abstract: 4101Background: peritoneal mesothelioma (PM) is a rare and rapidly fatal neoplasm with an estimated survival of one year. The introduction of cytoreductive surgery with hyperthermic intraperitonal ...
Published: 2016
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30. Curative treatment for patients with synchronous liver metastases and peritoneal carcinomatosis of advanced colorectal cancer (aCRC): A multicenter study of the French Association of Surgery

Author: Marc Pocard, François Quenet, Rea Lo Dico, Thierry André, Diane Goéré, Olivier Glehen, Etienne Gayat, and Clarisse Eveno
Subjects: Oncology, Cancer Research, medicine.medical_specialty, Colorectal cancer, business.industry, Palliative chemotherapy, medicine.disease, Metastasis, Peritoneal carcinomatosis, Advanced colorectal cancer, Multicenter study, Curative treatment, Internal medicine, medicine, business
Abstract: 3558Background: Patients with synchronous peritoneal carcinomatosis (PC) and liver metastasis (LM) of colorectal cancer (CRC) are generally considered for exclusive systemic palliative chemotherapy...
Published: 2016
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31. Endoscopic reduction of a volvulus of the sigmoid colon in a pregnant woman

Author: Xavier Dray, Emmanuel Barranger, Lounis Hamzi, and Rea Lo Dico
Subjects: medicine.medical_specialty, medicine.medical_treatment, Gastroenterology, Young Adult, X ray computed, Colon, Sigmoid, Pregnancy, Internal medicine, Medicine, Humans, Intestinal obstruction surgery, Reduction (orthopedic surgery), Sigmoid Diseases, Hepatology, business.industry, Sigmoid colon, medicine.disease, Volvulus, Pregnancy Complications, medicine.anatomical_structure, Female, business, Tomography, X-Ray Computed, Intestinal Obstruction, Intestinal Volvulus
Published: 2011

32. Étude stent et processus métastatique

Author: Sylvie Robine, Laura Brulle, Fatima El Marjou, Rea Lo Dico, Brice Malgras, and Marc Pocard
Subjects: Surgery
Abstract: Introduction Le traitement d’une occlusion colique sur cancer par un stent reste sujet a debat quant au risque oncologique (baisse de la survie, essaimage de cellules tumorales circulantes (CTC), presence d’engainements perinerveux et de microperforations sur les pieces de colectomies). Methodes Modele experimental murin de greffe orthotopique avec injection sous muqueuse de cellules tumorales murines par un endoscope. Une fois la tumeur occlusive obtenue, randomisation entre pose d’un stent colique ou non et evaluation de la dissemination metastatique en bioluminescence, taux serique de LDH, recherche de metastases hepatiques (MH) et de carcinose peritoneale (CP), qRT-PCR sur les foies sains et recherche de CTC. Resultats 38 souris dont 16 stentees avec une baisse significative de la survie en analyse multivariee en cas de stent (en moyenne de 5 jours, p = 0,002). Aussi augmentation significative des taux de LDH apres pose de stent (p = 0,0001). Tendance a un plus grand nombre de MH (p = 0,3), a une plus forte progression des lesions en bioluminescence (p = 0,4) malgre un volume plus petit (p = 0,1). Pas de difference sur la CP, les CTC et les PCR. Conclusion Dans ce modele experimental murin la pose d’un stent diminue significativement la survie, augmente les taux de LDH, avec une tendance a une plus forte progression metastatique. Cela va dans le sens d’etudes recentes visant a proscrire l’utilisation des stents coliques en cas de cancer occlusif notamment a but curatif.
Published: 2014
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33. Clinical presentation and treatment of gastrointestinal stromal tumors

Author: Nello Grassi, Gianni Pantuso, Salvatore Vieni, Salvatore Fricano, Maria Rosaria Valerio, Luigi Sandonato, Mario Adelfio Latteri, Fabio Fulfaro, Nicola Gebbia, Calogero Cipolla, Rea Lo Dico, CIPOLLA C, FULFARO F, SANDONATO L, FRICANO S, PANTUSO G, GRASSI N, VIENI, S, VALERIO MR, LO DICO R, GEBBIA N, and LATTERI M
Subjects: Male, Reoperation, Cancer Research, medicine.medical_specialty, Gastrointestinal Stromal Tumors, Antineoplastic Agents, Disease, Gastroenterology, Piperazines, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Adjuvant therapy, Humans, Radical surgery, Protein Kinase Inhibitors, Aged, Gastrointestinal tract, business.industry, Standard treatment, Imatinib, General Medicine, Middle Aged, Survival Analysis, Surgery, Pyrimidines, Treatment Outcome, Imatinib mesylate, gastrointestinal stromal tumors, treatment, Oncology, Chemotherapy, Adjuvant, 030220 oncology & carcinogenesis, Localized disease, Benzamides, Imatinib Mesylate, Female, 030211 gastroenterology & hepatology, business, medicine.drug
Abstract: Aims and background Gastrointestinal stromal tumors (GISTs), although rare, are the most common mesenchymal neoplasms affecting the gastrointestinal tract. We present our experience in the treatment of localized and metastatic disease and a review of literature. Patients and methods Nine patients were observed from April 2002 to July 2004. Eight tumors were in the gastric area and J was in the small bowel. In 5 cases, complete surgical removal was performed, and none of these patients underwent adjuvant therapy. The remaining 4 cases, with locally advanced or recurrent disease, were treated with imatinib. Results The patients with localized disease treated only by surgery did not relapse. In the patients with locally advanced or metastatic disease treated by imatinib, we observed 3 partial responses, and one case was not assessable because he had no measurable disease. In 2 of 3 responders, it was possible to perform a new radical surgery. Conclusions Our series is too small to draw any conclusion. According to our review of the literature, surgery remains the standard treatment for non-metastatic GISTs. Imatinib mesylate represents a major breakthrough in the treatment of advanced GISTs and is the first effective systemic therapy for the disease.
Published: 2006

34. Multimodality treatment combining chemotherapy, liver surgery, peritoneal resection and hyperthermic intraperitoneal chemotherapy (HIPEC) for metastatic colorectal cancer (mCRC) patients with synchronous liver metastases (LM) and peritoneal carcinomatosis (PC): A multicenter study of the French Association of Surgery

Author: Dominique Elias, Guillaume Passot, Gérard Lorimier, Marc Pocard, François Quenet, and Rea Lo Dico
Subjects: Liver surgery, Cancer Research, medicine.medical_specialty, Chemotherapy, business.industry, Colorectal cancer, medicine.medical_treatment, medicine.disease, Peritoneal carcinomatosis, Resection, Oncology, Multicenter study, Medicine, Hyperthermic intraperitoneal chemotherapy, Radiology, Hepatectomy, business
Abstract: e14534 Background: Pts with synchronous PC and LM are generally considered for exclusive systemic palliative chemotherapy only. Aggressive surgical approaches combining hepatectomy associated to peritoneal resection with curative intent remain controversial in such a setting and almost no data are available on such patients.The aim of this prospective cohort was to assess morbidity, mortality, disease-free survival (DFS) and overall survival (OS) of peritoneal and liver mCRC patients (pts) treated with an aggressive therapeutic approach combining surgical treatment of liver and peritoneal lesions followed by HIPEC. Methods: All patients registered in the French Association of Surgeryprospective database with PC and synchronous LM who had undergone cytoreductive surgery and LM resection followed by intraperitoneal chemotherapy were analysed. The primary endpoint was survival from the time of surgery. The following criteria were recorded and analyzed: sex, age, differentiation and localization of the primary tumor, lymph node involvement (pN+), peritoneal cancer index (PCI), completeness of cytoreduction of peritoneal carcinomatosis, number of associated liver metastases. Results: From 1993 to 2011, 101 pts with PC and LM were analyzed. After a mean follow-up of 25 months, the median OS and DFS, were respectively 24.9 and 9.5 months. Post-operative morbidity and mortality was 14.8 and 0%, respectively. In pts with a complete cytoreductive surgery OS was 29 months (n=), as compared to 4 months in pts (n=) with incomplete cytoreduction (p=0.0001). Rectal primary tumor, PCI of 13 or more, pN+ status, and more than 3 LM were not identified as independent factors for poor OS. Conclusions: This multicenter study confirms that prolonged survival can be achieved in selected patients suitable for PC and LM surgery if they underwent multimodality treatment including surgical treatment of PC and LM with curative intent, using intraperitoneal chemotherapy.
Published: 2013
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35. Mo1385 Diagnostic and Therapeutic Impacts of Elective Colonoscopy Following Acute Sigmoid Diverticulitis

Author: Abdullah Alatawi, Violaine Ozenne, Patrice Valleur, Ulriikka Chaput, Philippe Soyer, Philippe Marteau, Christelle Duteil, Karine Pautrat, Rea Lo Dico, and Xavier Dray
Subjects: medicine.medical_specialty, Past medical history, medicine.diagnostic_test, Adenoma, Colorectal cancer, business.industry, General surgery, Gastroenterology, Colonoscopy, Retrospective cohort study, Diverticulitis, medicine.disease, medicine, Radiology, Nuclear Medicine and imaging, Elective surgery, Complication, business
Abstract: Mo1385 Diagnostic and Therapeutic Impacts of Elective Colonoscopy Following Acute Sigmoid Diverticulitis Abdullah Alatawi, Karine Pautrat, Philippe Soyer, Violaine Ozenne, Ulriikka Chaput, Rea Lo Dico, Christelle Duteil, Patrice D. Valleur, Philippe R. Marteau, Xavier Dray* Digestive Diseases, APHP, Lariboisiere Hospital, & Denis Diderot, Paris 7 University, Paris, France; Abdominal Imaging, APHP, Lariboisiere Hospital, & Denis Diderot, Paris 7 University, Paris, France; Epidemiology, APHP, Lariboisiere Hospital, Paris, France Introduction: The diagnosis of acute sigmoid diverticulitis (ASD) is mainly based on clinical, biological and CT-scan findings. Elective colonoscopy is sometimes proposed after medical treatment, to rule out differential diagnosis and to detect associated conditions (such as advanced adenomas and cancer) before surveillance or elective surgery is considered. Aims and Methods: In this 6-year, monocentric, retrospective study, we aimed to evaluate the diagnostic and therapeutic impact of elective colonoscopy in patients with recent onset of ASD. Clinical, radiological, and endoscopic data from patients who had an elective colonoscopy after medical treatment admitted for ASD were reviewed. Endpoints were (i) overall adenoma detection rate (ADR), (ii) advanced adenoma detection rate ( 10mm diameter, villous lesions 25%, high-grade dysplasia), (iii) therapeutic impact (as defined by changes in the surgical strategy, based on endoscopic findings). Results: From January 2005 to January 2011, 252 patients admitted in our institution for ASD. Among them, 121 (48%, 67 women, mean age 62 year) had an elective colonoscopy after conservative treatment of ASD. Past medical history included previous colonoscopy (25 patients, 20.8%), previous onset of ASD (27 patients, 22.4%), familial history of digestive cancer (7 patients, 5,5%). CT-scan displayed patterns of tumor-like lesions of the sigmoid in 7 patients (5.5%), sigmoid stenosis in 10 patients (8.3%), peri-sigmoidal abscess in 21 patients (18%). Elective colonoscopy was performed in a mean time of 62 days after admission for ASD. Colonoscopy was not completed in 8 patients, because of sigmoid stenosis in 7 cases. In one patient with incomplete colonoscopy, a tumor upstream the sigmoid stenosis was suspected on the initial CT-scan, and adenocarcinoma was confirmed during elective surgery (and therefore not credited as a therapeutic change based on colonoscopy). Colonoscopy was total in 113 (93.3%) patients. No endoscopic complication was observed. Adenoma, advanced adenoma, and adenocarcinoma detection rates were 13.2%, 1.6% and 0.8%, respectively. The therapeutic impact of colonoscopy was 0.8%. Conclusion: Elective colonoscopy following medical treatment of ASD has low diagnostic rates for adenomas, for advanced adenomas and for colorectal cancer, and therefore rarely modifies the therapeutic strategy. It should be proposed after ASD only in highly selected patients, those presenting with reasonable doubt on initial CT-scan, and those with identified risk factors for advanced adenomas and adenocarcinoma of the colon.
Published: 2012
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36. 510 Single-Incision Flexible Endoscopic Peritoneoscopy for Staging of Peritoneal Carcinomatosis: High Diagnostic and Therapeutic Impact

Author: Patrice Valleur, Sylvain Kirzin, Philippe Marteau, Rea Lo Dico, Marc Pocard, and Xavier Dray
Subjects: medicine.medical_specialty, Single incision, business.industry, Peritoneoscopy, Gastroenterology, medicine, Radiology, Nuclear Medicine and imaging, Radiology, business, Peritoneal carcinomatosis
Published: 2012
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37. Su1585 Single-Incision Laparoscopic Evaluation of Peritoneal Carcinomatosis: First Human Cases With Combined Flexible Endoscopy

Author: Xavier Dray, Philippe Marteau, Karine Pautrat, Marc Pocard, Rea Lo Dico, and Patrice Valleur
Subjects: medicine.medical_specialty, business.industry, Flexible endoscopy, General surgery, Gastroenterology, medicine, Radiology, Nuclear Medicine and imaging, business, Peritoneal carcinomatosis, Single incision laparoscopic, Surgery
Published: 2011
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