Publications by authors named "Marcello Deraco"

The Peritoneal Surface Oncology Group International (PSOGI) previously issued a recommendation endorsing cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for treating diffuse malignant peritoneal mesothelioma (DMPM). However, broader acceptance of this approach, particularly within some segments of medical oncology, remains limited. To address this, PSOGI initiated a multisociety consensus effort, involving multidisciplinary International Societies, to strengthen and expand the endorsement of CRS-HIPEC for DMPM.

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Colorectal peritoneal metastases (CPM) are common in colorectal cancer patients. This article aims to provide GRADE guidelines for the use of hyperthermic intraperitoneal chemotherapy (HIPEC) in two clinical situations: (1) To determine the value of adjuvant HIPEC for the prevention of CPM in high-risk colorectal cancer patients; (2) to determine the impact on survival of cytoreductive surgery and HIPEC followed by adjuvant systemic chemotherapy as compared to systemic chemotherapy alone in patients with CPM.

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Background And Objectives: Few preclinical models of pseudomyxoma peritonei (PMP) have been developed, probably due to the tumor's low incidence and its peculiar characteristics of slow growth. Therefore, there is a need to develop more refined PMP models that better reflect its characteristics. The aim of the study is to develop a culture strategy to generate organoid models derived from PMP patient samples.

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Peritoneal surface oncology (PSO) is a novel field dealing with the knowledge of peritoneal neoplasms, primary or secondary, and their clinical management. As a specific treatment with curative intent for peritoneal neoplasms developed over the years, there is a growing need to comprehensively educate and train surgical oncologists worldwide in this discipline, a recognized unmet need. The European School of Peritoneal Surface Oncology (ESPSO) emerged in 2014 to provide an answer to this need.

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Article Synopsis
  • The PRECINCT study evaluated how different morphological appearances of peritoneal malignancies on imaging related to pathological findings in a large patient group.
  • It involved the analysis of imaging from 630 patients across seven centers, using 24 morphological terms to describe peritoneal tumors, highlighting high pathological positivity rates for several specific appearances.
  • The study recommends standardizing morphological descriptions in radiology reports to improve diagnostic accuracy and proposes that expert radiologists develop a consensus on terminology for better communication in clinical practice.
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The 2022 PSOGI (Peritoneal Surface Oncology Group International) and RENAPE (French Network for Rare Peritoneal Malignancies) consensus on hyperthermic intraperitoneal chemotherapy (HIPEC) was a comprehensive effort aimed at standardizing treatment protocols for various peritoneal malignancies. This initiative is critical due to the wide range of technical variations in HIPEC procedures and the resulting need for standardization to ensure consistent and effective patient care and meaningful audit of multicenter data.

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Article Synopsis
  • The PRECINCT study is a multicenter analysis of surgical documentation and disease incidence in patients with peritoneal tumors, focusing on the surgical peritoneal cancer index (sPCI) and its variations across centers.
  • Among 707 enrolled patients from September 2020 to December 2021, the study found that different morphological terminologies were used to describe peritoneal lesions, with the most common being "normal peritoneum," "tumor nodules," and "confluent disease."
  • The research revealed that the incidence of pathologically confirmed disease was higher in cases with more severe lesion scores and suggested that using frozen section analysis could be beneficial, indicating the need for larger studies correlating imaging and pathology.
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Purpose: Pseudomyxoma peritonei (PMP) is a rare and poorly understood malignant condition characterized by the accumulation of intra-abdominal mucin produced from peritoneal metastases. Currently, cytoreductive surgery remains the mainstay of treatment but disease recurrence and death after relapse frequently occur in patients with PMP. New therapeutic strategies are therefore urgently needed for these patients.

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Background: The combination of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) constitutes the established standard of care for pseudomyxoma peritonei patients. However, the role of HIPEC lacks validation through randomized trials, leading to diverse proposed treatment protocols. This consensus seeks to standardize HIPEC regimens and identify research priorities for enhanced clarity.

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Article Synopsis
  • Peritoneal metastases from colorectal cancer are tough to treat, and while surgeries combined with hyperthermic intraperitoneal chemotherapy (HIPEC) can help, high recurrence rates and a lack of a standard chemotherapy choice remain challenges.
  • This study explored the use of patient-derived organoids (PDO) as a model to enhance the effectiveness of HIPEC by testing various chemotherapy drugs on PDOs from twelve patients.
  • Results showed significant variability in drug responses, highlighting that certain combinations, like mitomycin-c with cisplatin, were most effective, suggesting that PDOs can help tailor treatments and improve strategies for individual patients with colorectal cancer peritoneal metastases.
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Introduction: The selection of patients undergoing cytoreductive- surgery (CRS) followed by hyperthermic intraperitoneal chemotherapy (HIPEC) is crucial. BIOSCOPE and COMPASS are prognostic scores designed to stratify survival into four classes according to clinical and pathological features. The purpose of this study is to analyze the prognostic role of these scores using a large cohort of patients as an external reference.

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Background: The available data on the role of perioperative systemic chemotherapy (SC) for diffuse malignant peritoneal mesothelioma (DMPM) patients undergoing (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is heterogeneous and unstandardized. This study aimed to evaluate the impact of SC on the survival outcomes of DMPM patients undergoing CRS-HIPEC and to identify prognostic factors that affect the decision to administer SC.

Methods: Patients who underwent CRS-HIPEC in the National Cancer Institute Milan (1995-2020) were retrospectively analyzed using propensity score-matching of known covariates.

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Article Synopsis
  • The study investigates the effectiveness of systemic chemotherapy (SC) and its timing in conjunction with surgical cytoreduction (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for treating colorectal cancer peritoneal metastases (CRC-PM).
  • Researchers analyzed data from 367 patients across 13 Italian centers, noting different timings for chemotherapy administration: before, after, or both surrounding the CRS-HIPEC procedure.
  • Results indicated that while SC was not linked to an overall survival benefit, receiving SC after the surgery improved disease-free survival rates compared to receiving it before the procedure, highlighting the need for further research on optimal chemotherapy strategies.
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Introduction: Pseudomyxoma peritonei (PMP) is a rare, slow growing tumor, traditionally considered chemoresistant. The only curative approach is cytoreductive surgery (CRS) followed by hyperthermic intraperitoneal chemotherapy (HIPEC). At disease relapse, or in patients with inoperable disease at diagnosis, no standard treatment has been defined, though nonrandomized series showed promising results with fluoropyrimidine-based regimens.

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Background: Gastrointestinal leak is one of the most feared complications after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) and harbors significant postoperative morbidity and mortality. We aim to identify risk-factors for anastomotic leak (AL) and gastrointestinal perforation (GP) to optimize postoperative outcomes of this population.

Methods: We performed a retrospective analysis of 1043 consecutive patients submitted to CRS in a single institution.

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In pseudomyxoma peritonei (PMP), and mutations are frequent. We hypothesized that these mutations may contribute to the suppression of antitumor immunity: may induce GMCSF expression, while may enhance the expression of cyclic adenosine monophosphate and A2AR signaling. This study aimed to explore possible mechanisms facilitated by and mutations for escaping immune surveillance.

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Peritoneal metastases (PM) are common routes of dissemination for colorectal cancer (CRC) and remain a lethal disease with a poor prognosis. The properties of the extracellular matrix (ECM) are important in cancer development; studying their changes is crucial to understand CRC-PM development. We studied the elastic properties of ECMs derived from human samples of normal and neoplastic PM by atomic force microscopy (AFM); results were correlated with patient clinical data and expression of ECM components related to metastatic spread.

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Background: Diffuse malignant peritoneal mesothelioma (DMPM) is a rare and aggressive primary peritoneal disease, with recommended treatment, in eligible patients, of a combination of complete cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). As treatment is multimodal, there is a wide heterogeneity of HIPEC protocols precluding clear comparisons. Standardization at an international level is required.

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Article Synopsis
  • * A systematic review included 28 studies that analyzed various HIPEC regimens and their outcomes, identifying cisplatin as the most commonly used and effective drug, particularly when paired with doxorubicin.
  • * The review stresses the need for standardized protocols and additional comparative studies to optimize HIPEC treatment for DMPM patients.
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Article Synopsis
  • Pseudomyxoma peritonei (PMP) is a rare disease that lacks enough scientific research for a definitive treatment trial, highlighting the need for a standardized diagnostic and therapeutic algorithm (DTA).
  • The Italian Society of Surgical Oncology (SICO) convened a consensus panel of experts to create a DTA specifically for PMP and primary appendiceal tumors in Italy.
  • The panel reached agreement on 33 out of 34 treatment statements and developed flowcharts for managing appendiceal cancer and peritoneal disease, although some debates remain regarding the criteria for HIPEC treatment.
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Diffuse malignant peritoneal mesothelioma (DMPM) is a rare form of mesothelioma that carries a very poor prognosis. The 5-year overall survival is about 20% (±5.9).

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