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| 1 | 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 |
| 2 | 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 |
| 3 | 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 |
| 4 | Clinical epidemiology of chronic viral hepatitis B:A Tuscany real-world large-scale cohort study显示文摘AIM To build a regional database of chronic patients to define the clinical epidemiology of hepatitis B virus(HBV)-infected patients in the Tuscan public health care system.METHODS This study used a cross-sectional cohort design. We evaluated chronic viral hepatitis patients with HBV referred to the outpatient services of 16 hospital units. Information in the case report forms included main demographic data, blood chemistry data, viral hepatitis markers, instrumental evaluations, and eligibility for treatment or ongoing therapy and liver transplantation. RESULTS Of 4015 chronic viral hepatitis patients, 1096(27.3%) were HBV infected. The case report form was correctly completed for only 833 patients(64% males, 36% females; mean age 50.1 ± 15.4). Of these HBV-infected patients, 73% were Caucasian, 21% Asian, 4% Central African, 1% North African and 1% American. Stratifying patients by age and nationality, we found that 21.7% of HBV-infected patients were aged < 34 years(only 2.8% were Italian). The most represented routes of transmission were nosocomial/dental procedures(23%), mother-to-child(17%) and sexual transmission(12%). The most represented HBV genotypes were D(72%) and A(14%). Of the patients, 24.7% of patients were HBe Ag positive, and 75.3% were HBe Ag negative. Of the HBV patients 7% were anti-HDV positive. In the whole cohort, 26.9% were cirrhotic(35.8% aged < 45 years), and 47% were eligible for or currently undergoing treatment, of whom 41.9 % were cirrhotic. CONCLUSION Only 27.3% of chronic viral hepatitis patients were HBV infected. Our results provide evidence of HBV infection in people aged < 34 years, especially in the foreign population not protected by vaccination. In our cohort of patients, liver cirrhosis was also found in young adults. | Cristina Stasi Caterina Silvestri Roberto Berni Maurizia Rossana Brunetto Anna Linda Zignego Cristina Orsini Stefano Milani Liana Ricciardi Andrea De Luca Pierluigi Blanc Cesira Nencioni Donatella Aquilini Alessandro Bartoloni Giampaolo Bresci Santino Marchi Franco Filipponi Piero Colombatto Paolo Forte Andrea Galli Sauro Luchi Silvia Chigiotti Alessandro Nerli Giampaolo Corti Rodolfo Sacco Paola Carrai Angelo Ricchiuti Massimo Giusti Paolo Almi Andrea Cozzi Silvia Carloppi Giacomo Laffi Fabio Voller Francesco Cipriani | 2018 | World Journal of Hepatology2018，10，5： | 3 |
| 5 | Management of hepatocellular carcinoma in the elderly显示文摘Mean age of hepatocellular carcinoma(HCC) patients has been progressively increasing over the last decades and ageing of these patients is becoming a real challenge in every day clinical practice. Unfortunately, international guidelines on HCC management do not address this problem exhaustively and do not provide any specific recommendation. We carried out a literature search in MEDLINE database for studies reporting on epidemiology, clinical characteristics and treatment outcome of HCC in elderly patients. Available data seem to indicate that in elderly patients the outcome of HCC is mostly influenced by liver function and tumor stage rather than by age and the latter should not influence treatment allocation. Age is not a risk for resection and older patients with resectable HCC and good liver function could gain benefit from surgery. Mild comorbidities do not seem a contraindication for surgery in aged patients. Conversely, major resection in elderly, even when performed in experienced high-volume centres, should be avoided. Both percutaneous ablation and transarterial chemoembolization are not contraindicated in aged patients and safety profile of these procedures is acceptable. Sorafenib is a viable option for advanced HCC in elderly provided that a careful evaluation of concomitant comorbidities, particularly cardiovascular ones, is taken into account. Available data seem to suggest that in either elderly and younger, treatment is a main predictor of outcome. Consequently, a nihilistic attitude of physicians towards under- or no-treatment of aged patients should not be longer justified. | Mauro Borzio Elena Dionigi Giancarlo Parisi Ivana Raguzzi Rodolfo Sacco | 2015 | World Journal of Hepatology2015，7，11： | 2 |
| 6 | 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 |
| 7 | 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 |
| 8 | TRANSFORMING GROWTH FACTOR β1 AND SOLUBLE FAS SERUM LEVELS IN HEPATOCELLULAR CARCINOMA显示文摘 | Rodolfo Sacco Domenico Leuci Cosimo Tortorella Giorgio Fiore Felice Marinosci Salvatore Antonaci | 2000 | Cytokine2000，，6： | 2 |
| 9 | Pulmonary or otolaryngologic extraesophageal manifestations in patients with gastroesophageal reflux disease显示文摘The extraesophageal manifestations of gastroesophageal reflux disease that are similar to a heart attack or gastric diseases are well known, while those categorized as pulmonary or otolaryngological are less known and less studied. In this article, we introduce this less known aspect of gastroesophageal reflux. | Giampaolo Bresci Rodolfo Sacco | 2010 | World Journal of Gastrointestinal Endoscopy2010，2，2： | 2 |
| 10 | Assessment of radiologic response to targeted therapies in patients with hepatocellular carcinoma显示文摘 | Rodolfo Sacco | 2014 | Future Oncol2014，，13： | 1 |
| 11 | 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 |
| 12 | Transarterial chemoembolization as adjuvant treatment after surgery: The cure of huge hepatocellular carcinoma?显示文摘Hepatocellular carcinoma(HCC) represents the sixth common cancer and the second leading cause of cancer-related death. Its incidence is higher in Eastern countries. HCC is frequently detected at advanced stage of disease, and therefore, the mortality is high [1]. | Andrea Chierici Andrew Ofosu Ivan Cincione Rodolfo Sacco Christian Cotsoglou Antonio Facciorusso | 2021 | Hepatobiliary & Pancreatic Diseases International2021，20，3： | 1 |
| 13 | Boceprevir or telaprevir in hepatitis C virus chronic infection:The Italian real life experience显示文摘AIM: To check the safety and efficacy of boceprevir/telaprevir with peginterferon/ribavirin for hepatitis C virus(HCV) genotype 1 in the real-world settings. METHODS: This study was a non-randomized, observational, prospective, multicenter. This study involved 47 centers in Italy. A database was prepared for the homogenous collection of the data, was used by all of the centers for data collection, and was updated continuously. All of the patients enrolled in this study were older than 18 years of age and were diagnosed with chronic infection due to HCV genotype 1. The HCV RNA testing was performed using COBAS-Taq Man2.0(Roche, LLQ 25 IU/m L). RESULTS: All consecutively treated patients were included. Forty-seven centers enrolled 834 patients as follows: Male 64%; median age 57(range 18-78), of whom 18.3% were over 65; mean body mass index 25.6(range 16-39); genotype 1b(79.4%); diagnosis of cirrhosis(38.2%); and fibrosis F3/4(71.2%). The following drugs were used: Telaprevir(66.2%) and PEG-IFN-alpha2a(67.6%). Patients were na?ve(24.4%), relapsers(30.5%), partial responders(14.8%) and null responders(30.3%). Overall, adverse events(AEs) occurred in 617 patients(73.9%) during the treatment. Anemia was the most frequent AE(52.9% of cases), especially in cirrhotic. The therapy was stopped for 14.6% of the patients because of adverse events or virological failure(15%). Sustained virological response was achieved in 62.7% of the cases, but was 43.8% in cirrhotic patients over 65 years of age. CONCLUSION: In everyday practice, triple therapy is safe but has moderate efficacy, especially for patients over 65 years of age, with advanced fibrosis, nonresponders to peginterferon + ribavirin. | Antonio Ascione Luigi Elio Adinolfi Pietro Amoroso Angelo Andriulli Orlando Armignacco Tiziana Ascione Sergio Babudieri Giorgio Barbarini Michele Brogna Francesco Cesario Vincenzo Citro Ernesto Claar Raffaele Cozzolongo Giuseppe D’Adamo Emilio D’Amico Pellegrino Dattolo Massimo De Luca Vincenzo De Maria Massimo De Siena Giuseppe De Vita Antonio Di Giacomo Rosanna De Marco Giorgio De Stefano Giulio De Stefano Sebastiano Di Salvo Raffaele Di Sarno Nunzia Farella Laura Felicioni Basilio Fimiani Luca Fontanella Giuseppe Foti Caterina Furlan Francesca Giancotti Giancarlo Giolitto Tiziana Gravina Barbara Guerrera Roberto Gulminetti Angelo Iacobellis Michele Imparato Angelo Iodice Vincenzo Iovinella Antonio Izzi Alfonso Liberti Pietro Leo Gennaro Lettieri Ileana Luppino Aldo Marrone Ettore Mazzoni Vincenzo Messina Roberto Monarca Vincenzo Narciso Lorenzo Nosotti Adriano Maria Pellicelli Alessandro Perrella Guido Piai Antonio Picardi Paola Pierri Grazia Pietromatera Francesco Resta Luca Rinaldi Mario Romano Angelo Rossini Maurizio Russello Grazia Russo Rodolfo Sacco Vincenzo Sangiovanni Antonio Schiano Antonio Sciambra Gaetano Scifo Filomena Simeone Annarita Sullo Pierluigi Tarquini Paolo Tundo Alfredo Vallone | 2016 | World Journal of Hepatology2016，8，22： | 1 |
| 14 | 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 |
| 15 | Dissecting signaling pathways in hepatocellular carcinoma: new perspectives in medical therapy显示文摘 | Lorenzo Fornaro Caterina Vivaldi Chiara Caparello Rodolfo Sacco Virginia Rotella Gianna Musettini Sauro Luchi Edi Editta Baldini Alfredo Falcone Gianluca Masi | 2014 | Future Oncol2014，，2： | 1 |
| 16 | Beneficial and detrimental effects of natural dietary products on the risk of hepatocellular carcinoma, and their roles in its management显示文摘Hepatocellular carcinoma(HCC)is a common solid malignancy and a leading cause of cancer-related death worldwide.The mechanisms underlying the pathogenesis and development of HCC are complex and heterogeneous.Although mainly related to hepatitis B and C chronic infection;HCC may also arise from diet-associated conditions such as non-alcoholic fatty liver disease and non-alcoholic steatohepatitis.Furthermore,toxins and nutrients such as mycotoxins and alcohol have an established role in the pathogenesis of chronic liver diseases,whereas specific diet patterns or foods have been associated with a reduction in HCC risk.The aim of this review is to provide a thorough overview of the clinically relevant effects-either beneficial or detrimental-of natural products consumed by humans on HCC risk and management. | Rodolfo Sacco Caterina Conte Sara Marceglia Valeria Mismas Giampaolo Bresci Antonio Romano Roberto Eggenhoffner Luca Giacomelli | 2016 | Hepatoma Research2016，2，1： | 0 |
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