Prof. Fabio Pacelli
  • Chi sono
  • Patologie trattate
    • Patologia oncologica
    • Patologia benigna
  • Pubblicazioni
  • Videogallery
  • Dicono di me
  • Prenota una visita
  • Chi sono
  • Patologie trattate
    • Patologia oncologica
    • Patologia benigna
  • Pubblicazioni
  • Videogallery
  • Dicono di me
  • Prenota una visita

Archives

Monthly Archives: Luglio 2013
/2013/Luglio
Lug23
0

Multivisceral resection for locally advanced gastric cancer: an italian multicenter observational study.

By Prof. Fabio Pacelli - Pubblicazioni

Jama Surgery

JAMA Surg. 2013 Apr 1;148(4):353-60. doi: 10.1001/2013.jamasurg.309.

Pacelli F, Cusumano G, Rosa F, Marrelli D, Dicosmo M, Cipollari C, Marchet A, Scaringi S, Rausei S, di Leo A, Roviello F, de Manzoni G, Nitti D, Tonelli F, Doglietto GB.
Italian Research Group for Gastric Cancer (IRGGC).

IMPORTANCE:
The role of multivisceral resection, in the setting of locally advanced gastric cancer, is still debated. Previous studies have reported a higher risk for perioperative morbidity and mortality, with limited objective benefit in terms of survival. Conversely, recent studies have shown the feasibility of enlarged resections and the potential advantage of extended resection for clinical stage T4b gastric adenocarcinoma with good long-term results.

OBJECTIVE
To analyze the role of multivisceral resection for locally advanced gastric cancer with particular attention to the brief and long-term results and to the prognostic value of clinical and pathologic factors.

DESIGN:
Prospective multicenter study using data from between January 1, 1995, and December 31, 2008.

SETTINGS:
Seven Italian surgery centers.

PATIENTS:
A total of 2208 patients underwent curative resections for gastric carcinoma at the centers. Among them, 206 patients presented with a clinical T4b carcinoma. One hundred twelve underwent a combined resection of the adjacent organs with a gastrectomy owing to suspicion or direct invasion of these organs by the gastric cancer.

MAIN OUTCOMES AND MEASURES:
Clinical and pathologic variables were prospectively collected and the feasibility and efficacy of multivisceral resection for locally advanced clinical T4b gastric cancer were assessed.

RESULTS:
Postoperative mortality and complication rates of patients who underwent a gastrectomy with a combined resection of the involved organs were 3.6% and 33.9%, respectively. Pathologic factors revealed that the nodal involvement was present in about 89.3% of patients and the mean (SD) number of pathologic lymph nodes was 14.8 (16.6). The overall 5-year survival rate was 27.2%. The completeness of resection and lymph node invasion represent independent prognostic parameters at multivariate analysis.

CONCLUSIONS AND RELEVANCE:
Our study indicates that patients undergoing extended resections experience acceptable postoperative morbidity and mortality rates, and an en bloc multivisceral resection should be performed in patients when a complete resection can be realistically obtained and when lymph node metastasis is not evident.

Lug23
0

Improved outcomes for rectal cancer in the era of preoperative chemoradiation and tailored mesorectal excision: a series of 338 consecutive cases.

By Prof. Fabio Pacelli - Pubblicazioni

The American Surgeon

Improved outcomes for rectal cancer in the era of preoperative chemoradiation and tailored mesorectal excision: a series of 338 consecutive cases.

Am Surg. 2013 Feb;79(2):151-61.

Pacelli F, Sanchez AM, Covino M, Tortorelli AP, Bossola M, Valentini V, Gambacorta MA, Doglietto GB.

Departments of Surgical Sciences, Catholic University, School of Medicine, Rome, Italy.

Neoadjuvant chemoradiation (CRT), tailored mesorectal excision, and intraoperative radiotherapy (IORT) have become the leading measures for rectal cancer treatment. The objective of this study was to evaluate early and long-term results of a multimodal treatment model for rectal cancer followed by curative surgery. Prospectively collected hospital records of 338 patients surgically treated for rectal cancer between January 1998 and December 2008 were retrospectively reviewed. Patients with high rectum level cancers and those with middle and low rectum cancers with clinical stage T1 to T2 underwent surgery, whereas those with T3 to T4 and N+ disease at the middle and low rectum received neoadjuvant CRT in 96.2 per cent of cases. Short-course neoadjuvant radiotherapy was not considered for neoadjuvant treatment. Postoperative major complications and mortality rates were 12.7 and 2.3 per cent, respectively. Overall 5-year disease-specific and disease-free survival were 80 and 73.1 per cent, respectively, whereas local recurrence rate was 6.1 per cent. At multivariate analysis, nodal status and circumferential margin status were independently associated with poor survival; local recurrence rates were independently affected by nodal and marginal status and tumor stage. The extent of mesorectal excision should be tailored depending on tumor location and the use of neoadjuvant chemotherapy, combined with IORT in advanced middle and low rectal cancer, leading to remarkable tumor downstaging with excellent prognosis in responding patients.
Torna alle pubblicazioni
Lug23
0

Immediate definitive prosthetic reconstruction in patients with ptotic breasts

By Prof. Fabio Pacelli - Pubblicazioni

Annals of Plastic Surgery

Immediate definitive prosthetic reconstruction in patients with ptotic breasts.

Ann Plast Surg. 2013 Feb;70(2):144-8. doi: 10.1097/SAP.0b013e3182367bfd.

Gentileschi S, Bracaglia R, Garganese G, Gallucci V, Corrado G, Pacelli F, Scambia G, Fagotti A.

Lug23
0

Role of different approaches to the abdominal retroperitoneum for aortic lymphadenectomy in patients with gynecological cancers

By Prof. Fabio Pacelli - Pubblicazioni

European Journal of Surgical Oncology

Role of different approaches to the abdominal retroperitoneum for aortic lymphadenectomy in patients with gynecological cancers.

Eur J Surg Oncol. 2013 Jan;39(1):94-9. doi: 10.1016/j.ejso.2012.07.114. Epub 2012 Nov 9.

Ercoli A, Fanfani F, D’Asta M, Naldini A, Pacelli F, Scambia G, Fagotti A.

Ultimi articoli

  • Systemic chemotherapy and pressurized intraperitoneal aerosol chemotherapy (PIPAC): A bidirectional approach for gastric cancer peritoneal metastasis
    Systemic chemotherapy and pressurized intraperitoneal aerosol chemotherapy (PIPAC): A bidirectional approach for gastric cancer peritoneal metastasis

    Surgical Oncology; 2020 34:270-275. Di G...

  • Systemic chemotherapy and pressurized intraperitoneal aerosol chemotherapy (PIPAC): A case report of a multimodal treatment for peritoneal metastases of pancreatic origin
    Systemic chemotherapy and pressurized intraperitoneal aerosol chemotherapy (PIPAC): A case report of a multimodal treatment for peritoneal metastases of pancreatic origin

    International Journal of Surgery Case Re...

  • Pressurized intraperitoneal aerosol chemotherapy with cisplatin and doxorubicin or oxaliplatin for peritoneal metastasis from pancreatic adenocarcinoma and cholangiocarcinoma
    Pressurized intraperitoneal aerosol chemotherapy with cisplatin and doxorubicin or oxaliplatin for peritoneal metastasis from pancreatic adenocarcinoma and cholangiocarcinoma

    Therapeutic Advances in Medical Oncology...

  • Hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal malignancies using new hybrid CO2 system: preliminary experience in referral center
    Hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal malignancies using new hybrid CO2 system: preliminary experience in referral center

    Updates in Surgery; 2019 71:555-560. Cia...

  • The Cholegas trial: long-term results of prophylactic cholecystectomy during gastrectomy for cancer‚ a randomized-controlled trial
    The Cholegas trial: long-term results of prophylactic cholecystectomy during gastrectomy for cancer‚ a randomized-controlled trial

    Gastric Cancer; 2019 22:632-639. Bencini...

Archivi

  • Febbraio 2021
  • Febbraio 2018
  • Gennaio 2018
  • Novembre 2016
  • Ottobre 2016
  • Luglio 2013
  • Maggio 2012

CONTATTI

Prof. Fabio Pacelli
E-mail: fabio.pacelli@policlinicogemelli.it

Policlinico Universitario "A. Gemelli"
Direttore UOC Chirurgia del peritoneo e del retroperitoneo
Largo F. Vito, 1 - 00168 Roma
Tel. (+39) 06 30157255

PRENOTA UNA VISITA

Visite private - Tel. (+39) 06 88818881

Visite online - Videoconsulto@policlinicogemelli.it

In alternativa utilizza la nostra FORM DI CONTATTO per inviarci un messaggio

Copyright © 2012-. All Rights Reserved - Powered by Apiweb Srl