Publications by authors named "Gianni Mura"

Background: Many gastric cancer patients in Western countries are diagnosed as metastatic with a median overall survival of less than twelve months using standard chemotherapy. Innovative treatments, like targeted therapy or immunotherapy, have recently proved to ameliorate prognosis, but a general agreement on managing oligometastatic disease has yet to be achieved. An international multi-disciplinary workshop was held in Bertinoro, Italy, in November 2022 to verify whether achieving a consensus on at least some topics was possible.

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Article Synopsis
  • Interest in metastatic gastric cancer is rising, with the META-GASTRO registry aiming to gather clinical data on oligometastatic patients to guide multimodal treatment, including surgery.
  • The study analyzed data from 383 patients, identifying oligometastatic cases through two definitions: quantitative/anatomical (specific site metastases) and dynamic (percentage based on site), finding relevant statistical significance.
  • The results indicated that 30% of patients fit the quantitative definition and 16% the dynamic definition, with outcomes for conversion therapy similar to those who had surgery after initial chemotherapy.
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Article Synopsis
  • The Italian Research Group for Gastric Cancer created a database to assess how a practical approach influences stage IV gastric cancer management and patient outcomes.
  • Data from 383 patients collected between 2018 and September 2022 showed increased use of laparoscopic techniques and a significant difference in surgical treatment strategies compared to past practices.
  • The study found that while different metastatic sites didn't significantly affect survival rates, having multiple sites did worsen survival, indicating that better diagnosis and staging can improve outcomes for patients eligible for curative surgery.
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We read, with great interest, the article by Huang Ruo-Yi and colleagues entitled "Outcomes of Conversion Surgery for Metastatic Gastric Cancer Compared with In-Front Surgery Plus Palliative Chemotherapy or In-Front Surgery Alone", published on 1 April 2022 [...

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Unlabelled: Robotic surgery is becoming more and more frequent. In colon surgery it can be used safely with similar results to laparoscopic surgery. The objective of our work is to retrospectively compare the short-term results (30 days) of robotic and laparoscopic right hemicolectomy.

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Background: The coronavirus pandemic had a major impact in Italy. The Italian health system's re-organization to face the emergency may have led to significant consequences especially in the diagnosis and treatment of malignancies. This study aimed to assess the impact of the pandemic in the diagnosis and treatment of gastric cancer in nine Gruppo Italiano RIcerca Cancro Gastrico (GIRCG) centers.

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Background: The present study provides a snapshot of Italian patients with peritoneal metastasis from gastric cancer treated by surgery in Italian centers belonging to the Italian Research Group on Gastric Cancer. Prognostic factors affecting survival in such cohort of patients were evaluated with the final aim to identify patients who may benefit from radical intent surgery.

Methods: It is a multicentric retrospective study based on a prospectively collected database including demographics, clinical, surgical, pathological, and follow-up data of patients with gastric cancer and synchronous macroscopic peritoneal metastases.

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Purpose: Non-occlusive mesenteric ischemia (NOMI) is a misdiagnosed and dangerous condition. To our knowledge, a comprehensive evaluation of CT parameters that can predict the outcome of patients suffering from NOMI is still missing.

Materials And Methods: Contrast-enhanced CT examination of 84 patients with a confirmed diagnosis of NOMI (37 with clinical and laboratory confirmation and 47 biopsy or surgery proven) was retrospectively reviewed by assessing vessels, mesentery, bowel, and peritoneal cavity CT quantitative and dichotomous parameters, and data were analyzed with Fisher's test.

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Objectives: Written radiological report remains the most important means of communication between radiologist and referring medical/surgical doctor, even though CT reports are frequently just descriptive, unclear, and unstructured. The Italian Society of Medical and Interventional Radiology (SIRM) and the Italian Research Group for Gastric Cancer (GIRCG) promoted a critical shared discussion between 10 skilled radiologists and 10 surgical oncologists, by means of multi-round consensus-building Delphi survey, to develop a structured reporting template for CT of GC patients.

Methods: Twenty-four items were organized according to the broad categories of a structured report as suggested by the European Society of Radiology (clinical referral, technique, findings, conclusion, and advice) and grouped into three "CT report sections" depending on the diagnostic phase of the radiological assessment for the oncologic patient (staging, restaging, and follow-up).

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Background: To predict response to neoadjuvant chemotherapy (NAC) of gastric cancer (GC), prior to surgery, would be pivotal to customize patient treatment. The aim of this study is to investigate the reliability of computed tomography (CT) texture analysis (TA) in predicting the histo-pathological response to NAC in patients with resectable locally advanced gastric cancer (AGC).

Methods: Seventy (40 male, mean age 63.

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Docetaxel associated with oxaliplatin and 5-fluorouracil (FLOT) has been reported as the best perioperative treatment for gastric cancer. However, there is still some debate about the most appropriate number and timing of chemotherapy cycles. In this randomized multicenter phase II study, patients with resectable gastric cancer were staged through laparoscopy and peritoneal lavage cytology, and randomly assigned (1:1) to either four cycles of neoadjuvant chemotherapy (arm A) or two preoperative + two postoperative cycles of docetaxel, oxaliplatin, and capecitabine (DOC) chemotherapy (arm B).

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Background: The present study aimed to better define the usefulness of F-FDG PET/CT in predicting pathological tumor response (PTR) and survival in patients with noncardia gastric cancer treated with preoperative chemotherapy.

Methods: Seventy-one patients were recruited in 6 Italian centers. The SUV of F-FDG PET/CT was measured at baseline and after treatment, and the difference (dSUV) was computed.

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This work explored the prognostic role of curative versus non-curative surgery, the prognostic value of the various localizations of metastatic disease, and the possibility of identifying patients to be submitted to aggressive therapies. Retrospective chart review of stage IV patients operated on in our institutions. Two hundred and eighty-two patients were considered; 73.

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Background: The aim of this study is to report the experience with conversion surgery from six Gruppo Italiano Ricerca Cancro Gastrico (GIRCG) centers, focusing our analysis on factors affecting survival and the risk of recurrence.

Methods: A retrospective, multicenter cohort study was performed in patients who had undergone conversion gastrectomy between 2005 and 2017. Data were extracted from a GIRCG database including all metastatic gastric cancer patients submitted to surgery.

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Article Synopsis
  • - The study aimed to evaluate how well the maximum tumour diameter (D-max) reduction rate observed through CT scans can predict the histopathological tumour regression grade (TRG) following neoadjuvant chemotherapy in patients with advanced gastric cancer.
  • - Eighty-six patients with resectable advanced gastric cancer were analyzed, undergoing staging and restaging CT scans after receiving neoadjuvant chemotherapy and undergoing surgery, with results showing a promising correlation between D-max measurements and TRG.
  • - The findings indicated high sensitivity and specificity for different Becker TRG grades based on D-max reduction rates, suggesting that D-max can be a reliable radiological indicator for predicting treatment response in these patients.
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This article reports the guidelines for gastric cancer staging and treatment developed by the GIRCG, and contains comprehensive indications for clinical management, including radiological, endoscopic, surgical, pathological, and oncological paths.

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Castleman's Disease is a rare tumour involving lymph node tissues; a case of benign localized disease and a case of rapid progressive multicentric disease are reported. Case report 1: A 19-year-old man presented with four months of hypogastric and left iliac pain. Castleman's Disease was suspected after CT-scan.

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Background: The role of surgery for gastric linitis plastica (GLP) is questioned. This study aimed to analyze our experience in the surgical treatment of GLP with specific reference to the resectability rate, prognosis, and mode of recurrence.

Methods: Results of surgery were analyzed in 102 patients with GLP.

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Background And Aims: Survival rates of patients with stage IV melanoma are poor: Median survival is 7-8 months and 5-year survival rates about 5%. There is no agreement on the role of surgery at this stage. Most patients with metastatic melanoma are not able to undergo resection and usually are sent to systemic chemo- and immunotherapy.

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Peritoneal carcinomatosis is the first cause of death after surgery for abdominal cancer, with a mean survival of 7 months. In selected patients, aggressive cytoreductive therapy combined with hyperthermic intraperitoneal chemotherapy my improve medium to long-term survival. Over the period from 2004 to January 2006, 86 patients were operated on for peritoneal carcinomatosis at the Division of Surgical Oncology, Forli, Italy.

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Background And Aims: Sentinel node biopsy is currently used in surgery of malignant melanoma and breast cancer. The feasibility of sentinel node mapping in gastrointestinal cancers and its diagnostic sensitivity is unclear. It could be of particular value in the management of early gastric cancer in which radical D2 lymphadenectomy may be unnecessary.

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