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| 1 | untreatable hepatocellular 癌的自然历史: 回顾的队研究显示文摘 AIM:To investigate the clinical course of untreatable hepatocellular carcinoma(HCC) identified at any stage and to identify factors associated with mortality.METHODS:From January 1999 to December 2010,320 out of 825 consecutive patients with a diagnosis of HCC and not appropriate for curative or palliative treatments were followed and managed with supportive therapy.Cirrhosis was diagnosed by histological or clinical features and liver function was evaluated according to Child-Pugh score.The diagnosis of HCC was performed by Ultra-Sound guided biopsy or by multiphasic contrast-enhanced computed tomography or gadolinium-enhanced magnetic resonance imaging.Data were collected for each patient including all clinical,laboratory and imaging variables necessary for the outcome prediction staging systems considered.HCC staging was performed according Barcelona Clinic Liver Cancer(BCLC) and Cancer of the Liver Italian Program scores.Follow-up time was defined as the number of months from the diagnosis of HCC to death.Prognostic baseline variables were analyzed by multivariate Cox analysis to identify the independent predictors of survival.RESULTS:Seventy-five per cent of patients had hepatitis C.Ascites was present in 169 patients(53%),while hepatic encephalopathy was present in 49 patients(15%).The Child-Pugh score was class A in 105 patients(33%),class B in 142 patients(44%),and class C in 73 patients(23%).One hundred patients(31%) had macroscopic vascular invasion and/or extrahepatic spread of the tumor.A single lesion > 10 cm was observed in 34 patients(11%),while multinodular HCC was present in 189 patients(59%).Thirty nine patients(12%) were BCLC early(A) stage,55(17%) were BCLC intermediate(B) stage,124(39%) were BCLC advanced(C) stage,and 102(32%) were endstage BCLC(D).At the time of this analysis(July 2011),28(9%) patients were still alive.Six(2%) patients who were lost during follow-up were censored at the last visit.The overall median survival was 6.8 mo,and the 1-year survival was 32%.The 1-year survival according to BCLC classes was 100%,79%,12% and 0%,for BCLC A,B,C and D,respectively.There was a significant difference in survival between each BCLC class.The median survival of patients of BCLC stages A,B,C and D was 33,17.4,6.9,and 1.8 mo,respectively(P < 0.05 for comparison between stages).The median survival of Child-Pugh A,B and C classes were 9.8 mo(range 6.4-13),6.1(range 4.9-7.3),and 3.7(range 1.5-6),respectively(P < 0.05 for comparison between stages).By univariate analysis,the variables significantly associated to an increased liklihood of mortality were Eastern Cooperative Oncology Group performance status(PS),presence of ascites,low level of albumin,elevated level of bilirubin,international normalized ratio(INR) and Log-[(α fetoprotein(AFP)].At multivariate analysis,mortality was independently predicted by bad PS(P < 0.0001),high INR values(P = 0.0001) and elevated Log-(AFP) levels(P = 0.009).CONCLUSION:This study confirms the heterogeneous behavior of untreated HCC.BCLC staging remains an important prognostic guide and may be important in decision-making for palliative treatment. | Giuseppe Cabibbo Marcello Maida Chiara Genco Pietro Parisi Marco Peralta Michela Antonucci Giuseppe Brancatelli Calogero Cammà Antonio Craxì Vito Di Marco | 2012 | World Journal of Hepatology2012，4，9： | 11 |
| 2 | Liver resection versus radiofrequency ablation in the treatment of cirrhotic patients with hepatocellular carcinoma显示文摘BACKGROUND: Hepatocellular carcinoma is the most common type of primary liver tumor and its incidence is increasing worldwide. The study aimed to compare patients subjected to liver resection or radiofrequency ablation. METHODS: One hundred and forty cirrhotic patients in stage A or B of Child-Pugh with single nodular or multinodular hepatocellular carcinoma were included in this retrospective study. Among them, 87 underwent surgical resection, and 53 underwent percutaneous radiofrequency ablation. Patient charac-teristics, survival, and recurrence-free survival were analyzed. RESULTS: Recurrence-free survival was longer in the resection group in comparison to the radiofrequency group with a median recurrence-free time of 36 versus 26 months, respectively (P=0.01, HR=1.52, 95% CI: 1.05-2.25). In the resection group, median survival was 46 months, with the 1-, 3- and 5-year survival rates of 89.7%, 72.4% and 40.2%. In the radiofrequency group, median survival was 32 months, with the 1-, 3- and 5-year survival rates of 83.0%, 43.4% and 22.6% (P<0.01). CONCLUSIONS: Surgical resection improves the overall survival and recurrence-free survival in comparison with radiofrequency ablation. New evidences are needed to define the real role of the percutaneous technique as an alternative to surgery. | Amilcare Parisi Jacopo Desiderio Stefano Trastulli Elisa Castellani Rosario Pasquale Roberto Cirocchi Carlo Boselli Giuseppe Noya | 2013 | Hepatobiliary & Pancreatic Diseases International2013，12，3： | 8 |
| 3 | Clinical impact of selective transarterial chemoembolization on hepatocellular carcinoma:A cohort study显示文摘AIM:To prospectively evaluate the short and long term clinical impact of selective transarterial chemoembolization (TACE) on liver function in patients with hepatocellular carcinoma (HCC).To assess side effects in relation to treatments.To analyze the overall survival and HCC progression free survival probability. METHODS:One hundred and seventeen cirrhotic patients with HCC were enrolled.Baseline liver function included Child-Pugh score and serum levels of alanineaminotransferase (ALT),prothrombin time(PT)and bilirubin.According to Cancer Liver Italian Program (CLIP) and Barcelona Clinic Liver Cancer (BCLC) staging systems,71 patients were eligible for TACE; 32 had previously received treatment for HCC.No significant differences in liver function were observed between previously treated and not treated patients. TACE was performed by selective catheterization of the arteries nourishing the lesions.While hospitalized, patient sunder went clinical,hematologicand ultrasonographic assessments.One month after TACE a CT scan was performed to assess tumor response. A second TACE was performed'on demand'.Liver function tests were checked in all patients every four months.RESULTS:After first TACE,the mean Child-Pugh score increased from a mean baseline 5.62±1.12 to 6.11±1.57 at discharge time (P<0.0001),decreasing after four months to 5.81±0.73 (not significant).ALT,PT and bilirubin significantly (P<0.0001)increased 24 h after TACE and progressively decreased until discharge. After the second TACE,variations in Child-Pugh score,ALT,PT and bilirubin were comparable to that described after the first TACE.No major complications were observed.The mean follow-up was 14.7±6.3 mo (median:16 mo).Only one patient died.No other patient experienced important long term worsening of clinical status.The overall survival probability at twenty-four months was 98.18%with a correspondent HCC progression free survival probability of 69%. CONCLUSION:Selectiv TAC Emayproduce significant,but transitory increases in ALT values, with no major impact on liver function and Child-Pugh score.Preservation of liver function is achievable also in patients previously treated with other therapeutic modalities and in patients undergoing multiple TACE cycles.Liver function can remain stable in the long-term, with optimal medium term survival.This result can be achieved through rigorous patient selection on the basis of tumour characteristics and clinical conditions. | Rodolfo Sacco Marco Bertini Pasquale Petruzzi Michele Bertoni Irene Bargellini Giampaolo Bresci Graziana Federici Luigi Gambardella Salvatore Metrangolo Giuseppe Parisi Antonio Romano Antonio Scaramuzzino Emanuele Tumino Alessandro Silvestri Emanuele Altomare Claudio Vignali Alfonso Capria | 2009 | World Journal of Gastroenterology2009，15，15： | 7 |
| 4 | Endotics system vs colonoscopy for the detection of polyps显示文摘AIM: To compare the endotics system (ES), a set of new medical equipment for diagnostic colonoscopy, with video-colonoscopy in the detection of polyps. METHODS: Patients with clinical or familial risk of colonic polyps/carcinomas were eligible for this study. After a standard colonic cleaning, detection of polyps by the ES and by video-colonoscopy was performed in each patient on the same day. In each single patient, the assessment of the presence of polyps was performed by two independent endoscopists, who were randomly assigned to evaluate, in a blind fashion, the presence of polyps either by ES or by standard colonoscopy. The frequency of successful procedures (i.e. reaching to the cecum), the time for endoscopy, and the need for sedation were recorded. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the ES were also calculated. RESULTS: A total of 71 patients (40 men, mean age51.9 ± 12.0 years) were enrolled. The cecum was reached in 81.6% of ES examinations and in 94.3% of colonoscopies (P = 0.03). The average time of endoscopy was 45.1 ± 18.5 and 23.7 ± 7.2 min for the ES and traditional colonoscopy, respectively (P < 0.0001). No patient required sedation during ES examination, compared with 19.7% of patients undergoing colonoscopy (P < 0.0001). The sensitivity and specificity of ES for detecting polyps were 93.3% (95% CI: 68-98) and 100% (95% CI: 76.8-100), respectively. PPV was 100% (95% CI: 76.8-100) and NPV was 97.7% (95% CI: 88-99.9). CONCLUSION: The ES allows the visualization of the entire colonic mucosa in most patients, with good sensitivity/specificity for the detection of lesions and without requiring sedation. | Emanuele Tumino Rodolfo Sacco Marco Bertini Michele Bertoni Giuseppe Parisi Alfonso Capria | 2010 | World Journal of Gastroenterology2010，16，43： | 5 |
| 5 | Treatment of active steroid-refractory inflammatory bowel diseases with granulocytapheresis: Our experience with a prospective study显示文摘瞄准:与活跃的类固醇倔强的煽动性的肠疾病(IBD ) 在 14 个病人与 granulocytapheresis (GCAP ) 的使用报导我们的经验以便在完成宽恕并且维持一个长持续没有症状的时期评估它的功效。方法:疾病的活动被临床的活动索引(蔡) 和内视镜的索引(EI ) 在 ulcerative (UC ) 评估,当时由 Crohn 在 Crohn 的疾病(CD ) 的疾病活动索引(CDAI ) 。病人用 Adacolumn 系统被对待,有选择地绑在 granulocytes 和单核白血球的吸附列。GCAP 的一个会议 / 星期为 5 wk 被执行。类固醇在词首字母的脱落期间被停止。结果:所有病人完成了不显示出复杂并发症的五星期的功课。在最后会议的结束, 93% 病人显示出为 6 瞬间坚持了的疾病的临床的宽恕。在治疗的结束以后的九个月, 60% 案例维持了宽恕,当 23% 病人仍然在在 12 瞬间以后的临床的宽恕时。结论:就算我们有类固醇倔强的 IBD 的病人的数字不大,我们能断言 GCAP 很好被容忍并且有效特别在在治疗以后的开始的六个月内,在盒子的一个重要百分比。持续反应的率在 12 瞬间以后在 6 瞬间以后并且显著地稍微落下,然而,严重副作用的缺席能是为进一步评估治疗的新时间表的刺激。 | Bresci Giampaolo Parisi Giuseppe Bertoni Michele Mazzoni Alessandro Scatena Fabrizio Capria Alfonso | 2006 | World Journal of Gastroenterology2006，12，14： | 5 |
| 6 | Safety and efficacy of endoscopic colonic stenting as a bridge to surgery in the management of intestinal obstruction due to left colon and rectal cancer: A systematic review and meta-analysis显示文摘 | Roberto Cirocchi Eriberto Farinella Stefano Trastulli Jacopo Desiderio Chiara Listorti Carlo Boselli Amilcare Parisi Giuseppe Noya Jayesh Sagar | 2012 | Surgical Oncology2012，，： | 4 |
| 7 | Transarterial radioembolization for hepatocellular carcinoma:An update and perspectives显示文摘In the last decade trans-arterial radioembolization has given promising results in the treatment of patients with intermediate or advanced stage hepatocellular carcinoma(HCC),both in terms of disease control and tolerability profile.This technique consists of the selective intra-arterial administration of microspheres loaded with a radioactive compound(usually Yttrium90),and exerts its therapeutic effect through the radiation carried by these microspheres.A careful and meticulous selection of patients is crucial before performing the radioembolization to correctly perform the procedure and reduce the incidence of complications.Radioembolization is a technically complex and expensive technique,which has only recently entered clinical practice and is supported by scant results from phase Ⅲ clinical trials.Nevertheless,it may represent a valid alternative to transarterial chemoembolization(TACE) in the treatment of intermediate-stage HCC patients,as shown by a comparative retrospective assessment that reported a longer time to progression,but not of overall survival,and a more favorable safety profile for radioembolization.In addition,this treatment has reported a higher percentage of tumor shrinkage,if compared to TACE,for pre-transplant downsizing and it represents a promising therapeutic option in patients with large extent of disease and insufficient residual liver volume who are not immediately eligible for surgery.Radioembolization might also be a suitable companion to sorafenib in advanced HCC or it can be used as a potential alternative to this treatment in patients who are not responding or do not tolerate sorafenib. | Rodolfo Sacco Valeria Mismas Sara Marceglia Antonio Romano Luca Giacomelli Marco Bertini Graziana Federici Salvatore Metrangolo Giuseppe Parisi Emanuele Tumino Giampaolo Bresci Ambra Corti Manuel Tredici Michele Piccinno Luigi Giorgi Carlo Bartolozzi Irene Bargellini | 2015 | World Journal of Gastroenterology2015，21，21： | 4 |
| 8 | Transarterial chemoembolization in very early and early-stage hepatocellular carcinoma patients excluded from curative treatment: A prospective cohort study显示文摘 | Irene Bargellini Rodolfo Sacco Elena Bozzi Marco Bertini Barbara Ginanni Antonio Romano Antonio Cicorelli Emanuele Tumino Graziana Federici Roberto Cioni Salvatore Metrangolo Michele Bertoni Giampaolo Bresci Giuseppe Parisi Emanuele Altomare Alfonso Capri | 2011 | European Journal of Radiology2011，，6： | 2 |
| 9 | Assessment of clinical and radiological response to sorafenib in hepatocellular carcinoma patients显示文摘Sorafenib is an effective anti-angiogenic treatment forhepatocellular carcinoma(HCC). The assessment of tumor progression in patients treated with sorafenib is crucial to help identify potentially-resistant patients,avoiding unnecessary toxicities. Traditional methods to assess tumor progression are based on variations in tumor size and provide unreliable results in patients treated with sorafenib. New methods to assess tumor progression such as the modified Response Evaluation Criteria in Solid Tumors or European Association for the Study of Liver criteria are based on imaging to measure the vascularization and tumor volume(viable or necrotic). These however fail especially when the tumor response results in irregular development of necrotic tissue. Newer assessment techniques focus on the evaluation of tumor volume,density or perfusion. Perfusion computed tomography and Dynamic ContrastEnhanced-UltraS ound can measure the vascularization of HCC lesions and help predict tumor response to antiangiogenic therapies. Mean Transit Time is a possible predictive biomarker to measure tumor response. Volumetric techniques are reliable,reproducible and time-efficient and can help measure minimal changes in viable tumor or necrotic tissue,allowing the prompt identification of non-responders. Volume ratio may be a reproducible biomarker for tumor response. Larger trials are needed to confirm the use of these techniques in the prediction of response to sorafenib. | Rodolfo Sacco Valeria Mismas Antonio Romano Marco Bertini Michele Bertoni Graziana Federici Salvatore Metrangolo Giuseppe Parisi Emanuele Tumino Giampaolo Bresci Luca Giacomelli Sara Marceglia Irene Bargellini | 2015 | World Journal of Hepatology2015，7，1： | 2 |
| 10 | High tie versus low tie of the inferior mesenteric artery in colorectal cancer: A RCT is needed显示文摘 | Roberto Cirocchi Stefano Trastulli Eriberto Farinella Jacopo Desiderio Nereo Vettoretto Amilcare Parisi Carlo Boselli Giuseppe Noya | 2012 | Surgical Oncology2012，，3： | 2 |
| 11 | The role of video capsule endoscopy for evaluating obscure gastrointestinal bleeding: usefulness of early use显示文摘 | Giampaolo Bresci Giuseppe Parisi Michele Bertoni Emanuele Tumino Alfonso Capria | 2005 | Journal of Gastroenterology2005，，3： | 2 |
| 12 | The role of video capsule endoscopy for evaluating obscure gastrointestinal bleeding: usefulness of early use显示文摘 | Giampaolo Bresci Giuseppe Parisi Michele Bertoni Emanuele Tumino Alfonso Capria | 2005 | Journal of Gastroenterology2005，，3： | 1 |
| 13 | A new Caucasian case of neonatal intrahepatic cholestasis caused by citrin deficiency (NICCD): A clinical, molecular, and functional study显示文摘 | Giuseppe Fiermonte Giovanni Parisi Diego Martinelli Francesco De Leonardis Giuliano Torre Ciro Leonardo Pierri Alessia Saccari Francesco Massimo Lasorsa Angelo Vozza Ferdinando Palmieri Carlo Dionisi-Vici | 2011 | Molecular Genetics and Metabolism2011，，4： | 1 |
| 14 | Safety and efficacy of endoscopic colonic stenting as a bridge to surgery in the management of intestinal obstruction due to left colon and rectal cancer: A systematic review and meta-analysis显示文摘 | Roberto Cirocchi Eriberto Farinella Stefano Trastulli Jacopo Desiderio Chiara Listorti Carlo Boselli Amilcare Parisi Giuseppe Noya Jayesh Sagar | 2012 | Surgical Oncology2012，，： | 1 |
| 15 | Safety and efficacy of endoscopic colonic stenting as a bridge to surgery in the management of intestinal obstruction due to left colon and rectal cancer: A systematic review and meta-analysis显示文摘 | Roberto Cirocchi Eriberto Farinella Stefano Trastulli Jacopo Desiderio Chiara Listorti Carlo Boselli Amilcare Parisi Giuseppe Noya Jayesh Sagar | 2012 | Surgical Oncology2012，，： | 1 |
| 16 | Intracorporeal versus extracorporeal anastomosis during laparoscopic right hemicolectomy – Systematic review and meta-analysis显示文摘 | Roberto Cirocchi Stefano Trastulli Eriberto Farinella Salvatore Guarino Jacopo Desiderio Carlo Boselli Amilcare Parisi Giuseppe Noya Karem Slim | 2012 | Surgical Oncology2012，，： | 1 |
| 17 | Robotic right colectomy for cancer with intracorporeal anastomosis: short-term outcomes from a single institution显示文摘 | Stefano Trastulli Jacopo Desiderio Federico Farinacci Francesco Ricci Chiara Listorti Roberto Cirocchi Carlo Boselli Giuseppe Noya Amilcare Parisi | 2013 | International Journal of Colorectal Disease2013，，6： | 1 |
| 18 | Conventional versus Doxorubicin-eluting Bead Transarterial Chemoembolization for Hepatocellular Carcinoma显示文摘 | Rodolfo Sacco Irene Bargellini Marco Bertini Elena Bozzi Antonio Romano Pasquale Petruzzi Emanuele Tumino Barbara Ginanni Graziana Federici Roberto Cioni Salvatore Metrangolo Michele Bertoni Giampaolo Bresci Giuseppe Parisi Emanuele Altomare Alfonso Capri | 2011 | Journal of Vascular and Interventional Radiology2011，，11： | 1 |
| 19 | Molecular aspects of the cardioprotective effect of exercise in the elderly显示文摘 | Giuseppe Rengo Valentina Parisi Grazia Daniela Femminella Gennaro Pagano Claudio de Lucia Alessandro Cannavo Daniela Liccardo Francesco Giallauria Oriana Scala Carmela Zincarelli Pasquale Perrone Filardi Nicola Ferrara Dario Leosco | 2013 | Aging Clinical and Experimental Research2013，，5： | 1 |
| 20 | Seeking rents in the shadow of Coase显示文摘 | Giuseppe Dari-Mattiacci Sander Onderstal Francesco Parisi | 2009 | Public Choice (-)2009，，1： | 1 |
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