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| 1 | Problems faced by evidence-based medicine in evaluating lymphadenectomy for gastric cancer显示文摘Gastric cancer surgical management differs between Eastern Asia and Western countries. Extended lymphadenectomy(D2) is the standard of care in Japan and South Korea since decades, while the majority of United States patients receive at most a limited lymphadenectomy(D1). United States and Northern Europe are considered the scientific leaders in medicine and evidencebased procedures are the cornerstone of their clinical practice. However, surgeons in Eastern Asia are more experienced, as there are more new cases of gastric cancer in Japan(107898 in 2012) than in the entire European Union(81592), or in South Korea(31269) than in the entire United States(21155). For quite a long time evidence-based medicine(EBM) did not solve the question whether D2 improves long-term prognosis with respect to D1. Indeed, eastern surgeons were reluctant to perform D1 even in the frame of a clinical trial, as their patients had a very good prognosis after D2. Evidence-based surgical indications provided by Western trials were questioned, as surgical procedures could not be properly standardized. In the present study we analyzed indications about the optimal extension of lymphadenectomy in gastric cancer according to current scientific literature(2008-2012) and surgical guidelines. We searched PubMed for papers using the key words 'lymphadenectomy or D1 or D2' AND 'gastric cancer' from 2008 to 2012. Moreover, we reviewed national guidelines for gastric cancer management. The support to D2 lymphadenectomy increased progressively from 2008 to 2012: since 2010 papers supporting D2 have achieved a higher overall impact factor than the other papers. Till 2011, D2 was the procedure of choice according to experts' opinion, while three meta-analyses found no survival advantage after D2 with respect to D1. In 2012-2013, however, two meta-analyses reported that D2 improves prognosis with respect to D1. D2 lymphadenectomy was proposed as the standard of care for advanced gastric cancer by Japanese National Guidelines since 1981 and was adopted as the standard procedure by the Italian Research Group for Gastric Cancer since the Nineties. D2 is now indicated as the standard of surgical treatment with curative intent by the German, British and ESMO-ESSO-ESTRO guidelines. At variance American NCCN guidelines recommend a D1+ or a modified D2 lymph node dissection. In conclusion, D2 lymphadenectomy, originally developed by Eastern surgeons, is now becoming the procedure of choice also in the West. In gastric cancer surgery EBM is lagging behind national guidelines, rather than preceding and orienting them. To eliminate this lag, EBM should value to a larger extent Eastern Asian literature and should evaluate not only the quality of the study design but also the quality of surgical procedures. | Giuseppe Verlato Simone Giacopuzzi Maria Bencivenga Paolo Morgagni Giovanni De Manzoni | 2014 | World Journal of Gastroenterology2014，20，36： | 8 |
| 2 | Executive Summary: Heart Disease and Stroke Statistics— 2010 Update: A Report From the American Heart Association显示文摘 | Donald Lloyd-Jones Robert J. Adams Todd M. Brown Mercedes Carnethon Shifan Dai Giovanni De Simone T. Bruce Ferguson Earl Ford Karen Furie Cathleen Gillespie Alan Go Kurt Greenlund Nancy Haase Susan Hailpern P. Michael Ho Virginia Howard Brett Kissela Stev | 2010 | Circulation2010，，7： | 5 |
| 3 | Heart Disease and Stroke Statistics—2011 Update: A Report From the American Heart Association显示文摘 | Véronique L. Roger Alan S. Go Donald M. Lloyd-Jones Robert J. Adams Jarett D. Berry Todd M. Brown Mercedes R. Carnethon Shifan Dai Giovanni de Simone Earl S. Ford Caroline S. Fox Heather J. Fullerton Cathleen Gillespie Kurt J. Greenlund Susan M. Hailpern | 2011 | Circulation2011，，4： | 4 |
| 4 | Heart Disease and Stroke Statistics—2009 Update: A Report From the American Heart Association Statistics Committee and Stroke Statistics Subcommittee显示文摘 | Donald Lloyd-Jones Robert Adams Mercedes Carnethon Giovanni De Simone T Bruce Ferguson Katherine Flegal Earl Ford Karen Furie Alan Go Kurt Greenlund Nancy Haase Susan Hailpern Michael Ho Virginia Howard Brett Kissela Steven Kittner Daniel Lackland Lynda L | 2009 | Circulation2009，，3： | 4 |
| 5 | Recurrence in node-negative advanced gastric cancer:Novel findings from an in-depth pathological analysis of prognostic factors from a multicentric series显示文摘AIM To analyze the clinicopathological characteristics of patients with both node-negative gastric carcinoma and diagnosis of recurrence during follow-up. METHODS We enrolled 41 patients treated with curative gastrectomy for p T2-4 a N0 gastric carcinoma between 1992 and 2010,who developed recurrence(Group 1). We retrospectively selected this group from the prospectively collected database of 4 centers belonging to the Italian Research Group for Gastric Cancer,and compared them with 437 p T2-4 a N0 patients without recurrence(Group 2). We analyzed lymphatic embolization,microvascular infiltration,perineural infiltration,and immunohistochemical determination of p53,Ki67,and HER2 in Group 1 and in a subgroup of Group 2(Group 2 bis) of 41 cases matched with Group 1 according to demographic and pathological characteristics. RESULTS T4 a stage and diffuse histotype were associated with recurrence in the group of p N0 patients. In-depth pathological analysis of two homogenous groups of p N0 patients,with and without recurrence during longterm follow-up(groups 1 and 2 bis),revealed two striking patterns: lymphatic embolization and perineural infiltration(two parameters that pathologists can easily report),and p53 and Ki67,represent significant factors for recurrence.CONCLUSION The reported pathological features should be considered predictive factors for recurrence and could be useful to stratify node-negative gastric cancer patients for adjuvant treatment and tailored follow-up. | Gian Luca Baiocchi Sarah Molfino Carla Baronchelli Simone Giacopuzzi Daniele Marrelli Paolo Morgagni Maria Bencivenga Luca Saragoni Carla Vindigni Nazario Portolani Maristella Botticini Giovanni De Manzoni | 2017 | World Journal of Gastroenterology2017，23，45： | 3 |
| 6 | Mesenteric and portal vein thrombosis associated with hyperhomocysteinemia and heterozygosity for factor V Leiden mutation显示文摘TO THE EDITOR
A 79-year-old man was hospitalized because of worsening upper abdominal pain which started two days before admission and was continuously present. His personal and family historywas uneventful, he did not smoke and denied toxic habits or using any medications, including over the-counter medications, herbal remedies or any vitamin supplements. | Giuseppe Famularo Giovanni Minisola Giulio Cesare Nicotra Claudio De Simone | 2005 | World Journal of Gastroenterology2005，11，48： | 2 |
| 7 | The Ratio Between Metastatic and Examined Lymph Nodes (N Ratio) Is an Independent Prognostic Factor in Gastric Cancer Regardless of the Type of Lymphadenectomy: Results From an Italian Multicentric Study in 1853 Patients显示文摘 | Alberto Marchet Simone Mocellin Alessandro Ambrosi Paolo Morgagni Domenico Garcea Daniele Marrelli Franco Roviello Giovanni de Manzoni Annamaria Minicozzi Giovanni Natalini Francesco De Santis Luca Baiocchi Arianna Coniglio Donato Nitti | 2007 | Annals of Surgery2007，，4： | 1 |
| 8 | Heart Disease and Stroke Statistics— 2010 Update: A Report From the American Heart Association显示文摘 | Donald Lloyd-Jones Robert J. Adams Todd M. Brown Mercedes Carnethon Shifan Dai Giovanni De Simone T. Bruce Ferguson Earl Ford Karen Furie Cathleen Gillespie Alan Go Kurt Greenlund Nancy Haase Susan Hailpern P. Michael Ho Virginia Howard Brett Kissela Stev | 2010 | Circulation2010，，7： | 1 |
| 9 | External Validation of a Score Predictive of Recurrence after Radical Surgery for Non-Cardia Gastric Cancer: Results of a Follow-Up Study显示文摘 | Daniele Marrelli Paolo Morgagni Giovanni de Manzoni Alberto Marchet Gian Luca Baiocchi Simone Giacopuzzi Arianna Coniglio Simone Mocellin Luca Saragoni Franco Roviello | 2015 | Journal of the American College of Surgeons2015，，2： | 1 |
| 10 | Heart Disease and Stroke Statistics— 2010 Update: A Report From the American Heart Association显示文摘 | Donald Lloyd-Jones Robert J. Adams Todd M. Brown Mercedes Carnethon Shifan Dai Giovanni De Simone T. Bruce Ferguson Earl Ford Karen Furie Cathleen Gillespie Alan Go Kurt Greenlund Nancy Haase Susan Hailpern P. Michael Ho Virginia Howard Brett Kissela Stev | 2010 | Circulation2010，，7： | 1 |
| 11 | Rognos-sis of inappropriate left ventricular mass in hypertension:The MAVT study hypertension显示文摘 | DE SIMONE GIOVANNI | 2002 | 40(4):470-4762002，40，4： | 1 |
| 12 | Lack of eduction of left ventricular mass in treated hypertension: the strong heart study显示文摘 | Giovanni de Simone Richard B Devereux Raffaele Izzo | 2013 | Journal of the American Heart Association2013，2，00： | 1 |
| 13 | CT features of malignant mucinous cystic tumors of the pancreas显示文摘 | Carlo Procacci Giovanni Carbognin Simone Accordini Carlo Biasiutti Alessandro Guarise Frank Lombardo Cristina Ghirardi Rossella Graziani Nicoletta Pagnotta Roberto De Marco | 2001 | European Radiology2001，，9： | 1 |
| 14 | stroke volume/pulse pressure ratio and cardiovascular risk in artrial Hypertension显示文摘 | Giovanni de Simone | 1999 | Hypertension1999，33，： | 1 |
| 15 | Link of nonhemodynamic factors to hemodynamic determinants of left ventricular hypertrophy显示文摘 | Giovanni de Simone Pasanisi F Contaldo F | 2001 | Hypertens2001，38，1： | 1 |
| 16 | Relations of Left Ventricular Mass to Demographic and Hemodynamic Variables in American Indians The Strong Heart Study显示文摘 | Richard B. Devereux Mary J. Roman Giovanni de Simone Michael J. O’Grady Mary Paranicas JeunLiang Yeh Richard R. Fabsitz Barbara V. Howard | 1997 | Circulation1997，，5： | 1 |
| 17 | Stroke volume pulse pressure ratio and cardiovascular risk in artrial hypertension 显示文摘 | Giovanni de Simone | 1999 | Hypertension1999，33，： | 1 |
| 18 | The Ratio Between Metastatic and Examined Lymph Nodes (N Ratio) Is an Independent Prognostic Factor in Gastric Cancer Regardless of the Type of Lymphadenectomy: Results From an Italian Multicentric Study in 1853 Patients显示文摘 | Alberto Marchet Simone Mocellin Alessandro Ambrosi Paolo Morgagni Domenico Garcea Daniele Marrelli Franco Roviello Giovanni de Manzoni Annamaria Minicozzi Giovanni Natalini Francesco De Santis Luca Baiocchi Arianna Coniglio Donato Nitti | 2007 | Annals of Surgery2007，，4： | 1 |
| 19 | Prognostic significance of left ventricular diastolic dysfunction in essential hypertension显示文摘 | Giuseppe Schillaci Leonella Pasqualini Paolo Verdecchia Gaetano Vaudo Simona Marchesi Carlo Porcellati Giovanni de Simone Elmo Mannarino | 2002 | Journal of the American College of Cardiology2002，，： | 1 |
| 20 | Heart Disease and Stroke Statistics— 2010 Update: A Report From the American Heart Association显示文摘 | Donald Lloyd-Jones Robert J. Adams Todd M. Brown Mercedes Carnethon Shifan Dai Giovanni De Simone T. Bruce Ferguson Earl Ford Karen Furie Cathleen Gillespie Alan Go Kurt Greenlund Nancy Haase Susan Hailpern P. Michael Ho Virginia Howard Brett Kissela Stev | 2010 | Circulation2010，，7： | 1 |
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