Publications by authors named "Provenzano L"

Lung cancer patients generally receive several information regarding their illness characteristics and available intervention. Therefore, patients can experience confusion, leading to anxiety and distress that might damage the relationship with physicians and treatment adherence. Literature showed that implementing decision aid tools during consultation can promote patients' knowledge and awareness about lung cancer and available oncological intervention, improving a shared decision-making process.

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Introduction: KRAS mutation the most common molecular alteration in advanced non-small cell lung cancer (NSCLC) and is associated with an unfavourable prognosis, largely due to the lack of targeted therapeutic options for the majority of the KRAS mutated isoforms. The landscape of NSCLC treatment has expanded with the introduction of immune checkpoint inhibitors (ICIs). Nonetheless, data regarding the efficacy of ICI in NSCLC patients harbouring KRAS mutations are conflicting.

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Background: The aim of this prospective, controlled study was to assess the 5-year follow-up of Laparoscopic Heller-Dor (LHD) in patients with esophago-gastric junction outflow obstruction (EGJOO), compared with achalasia patients (ACH). The management of EGJOO reflects the experience gained with esophageal achalasia, for which LHD has been proven to be an effective long-term treatment. Prospective long-term results of LHD in EGJOO patients are still lacking.

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In preclinical experiments, cyclic fasting-mimicking diets (FMDs) showed broad anticancer effects in combination with chemotherapy. Among different tumor types, triple-negative breast cancer (TNBC) is exquisitely sensitive to FMD. However, the antitumor activity and efficacy of cyclic FMD in TNBC patients remain unclear.

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Background: There is no consensus on the definition of failure after treatment in patients with achalasia. The Eckardt score is used to define clinical outcomes. However, objective metrics are lacking.

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Background: Most existing literature studies reported that laparoscopic fundoplication (LF) is safe in the setting of ineffective or weak peristalsis. However, the effect of the wrap on esophageal motility is still debated. This study aimed to assess how a functioning and effective fundoplication could affect esophageal motility in patients with gastroesophageal reflux disease (GERD).

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Article Synopsis
  • Ascites is a common issue in patients with advanced gastrointestinal cancers that have spread to the peritoneum, impacting survival negatively; this study is the first to look specifically at ascites, peritoneal metastases (PM), and survival in metastatic colorectal cancer (mCRC) and metastatic gastric cancer (mGC).
  • A retrospective analysis of clinical trial data showed that mCRC patients with ascites had significantly shorter progression-free and overall survival compared to those without PM, while gastric cancer patients with ascites also had poorer survival outcomes and higher disease severity scores.
  • The findings suggest that ascites can indicate worse prognoses for certain cancer patients, highlighting the need for more focused research and tailored treatments for these individuals.
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Background: In the last 3 decades, laparoscopic Heller myotomy (LHM) has represented the treatment of choice for esophageal achalasia, solving symptoms in most patients. Little is known about the fate of patients relapsing after LHM or their treatment. In this study, we aimed at evaluating the results of complementary pneumatic dilations (CPDs) after ineffective LHM.

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Despite the increased incidence of esophageal cancer (EC) in elderly people, there are no clear guidelines for its treatment in these patients. The aim of this study was to compare the outcomes of patients ≥ 75 years with resectable EC, receiving either upfront esophagectomy or neoadjuvant treatment. : We retrospectively identified 127 patients with resectable EC ≥ 75 years who underwent esophagectomy between January 2000 and December 2022 at our Clinic in the University Hospital of Padova.

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Body image distortion (BID) is a crucial aspect of anorexia nervosa (AN), leading to body overestimation, dissatisfaction, and low self-esteem. BID significantly influences the onset, maintenance, and relapse of the pathology. We assessed whether a Full Body Illusion (FBI) using under and normal-weight avatars' bodies affects perceptual body image and body schema estimations in both individuals with anorexia nervosa (AN) and healthy controls (HC).

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Introduction: To date, lung cancer is one of the most lethal diagnoses worldwide. A variety of lung cancer treatments and modalities are available, which are generally presented during the patient and doctor consultation. The implementation of decision tools to facilitate patient's decision-making and the management of their healthcare process during medical consultation is fundamental.

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Background: The treatment of patients with end-stage achalasia with a sigmoid-shaped esophagus is particularly challenging. A modified technique (pull-down technique) has been developed to straighten the esophageal axis, but only a limited number of studies on this topic are available in the literature. This study aimed to compare the outcome of patients who underwent the pull-down technique with that of patients who had a classical laparoscopic Heller-Dor (CLHD) myotomy.

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Article Synopsis
  • High-resolution manometry (HRM) has significantly improved the diagnosis of foregut symptoms over the past 20 years, yet its role in assessing patients before and after antireflux surgery remains uncertain.
  • A multi-disciplinary group of 29 experts, including surgeons and gastroenterologists, collaborated to clarify the role of HRM in relation to antireflux surgery and to create a classification system for interpreting HRM findings.
  • The resulting Padova Classification aims to enhance understanding and communication of HRM results for patients undergoing antireflux surgery, based on a thorough literature review and agreement among the experts.
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It has been shown that observing a face being touched or moving in synchrony with our own face increases self-identification with the former which might alter both cognitive and affective processes. The induction of this phenomenon, termed enfacement illusion, has often relied on laboratory tools that are unavailable to a large audience. However, digital face filters applications are nowadays regularly used and might provide an interesting tool to study similar mechanisms in a wider population.

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Background: The pathophysiological and clinical value of performing High-Resolution Manometry (HRM) after laparoscopic fundoplication (LF) for gastroesophageal reflux disease (GERD) is still unclear and debated.

Objective: We sought to establish the HRM parameters indicative of functioning fundoplications, and whether HRM could distinguish them from tight or defective ones.

Methods: The study involved patients with GERD who underwent laparoscopic Nissen (LN) or Toupet (LT) fundoplication between 2010 and 2022.

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Introduction: Despite several therapeutic efforts, lung cancer remains a highly lethal disease. Novel therapeutic approaches encompass immune-checkpoint inhibitors, targeted therapeutics and antibody-drug conjugates, with different results. Several studies have been aimed at identifying biomarkers able to predict benefit from these therapies and create a prediction model of response, despite this there is a lack of information to help clinicians in the choice of therapy for lung cancer patients with advanced disease.

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Background: Cyclin-Dependent Kinase 4/6 inhibitors (CDK4/6i) combined with Endocrine Therapy (ET) are the standard treatment for patients with Hormone Receptor-positive/HER2-negative advanced breast cancer (HR+/HER2- aBC).

Objectives: While CDK4/6i are known to reduce several peripheral blood cells, such as neutrophils, lymphocytes and platelets, the impact of these modulations on clinical outcomes is unknown.

Design: A multicenter, retrospective-prospective Italian study.

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Article Synopsis
  • The use of immune checkpoint inhibitors (ICIs) has changed cancer treatment, but identifying which patients will benefit is still difficult, and AI can help analyze large amounts of cancer data.
  • A systematic review analyzed 90 studies on ICI efficacy prediction across various data types, with a majority focusing on genomic information; most studies employed standard machine learning techniques.
  • Although promising AI methods for predicting ICI responses were found, none of the studies demonstrated high-level evidence, with many using AI only after the fact rather than from the start.
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Breast cancers (BCs) arising in carriers of germline BRCA1 and BRCA2 pathogenic variants (PVs) have long been considered as indistinguishable biological and clinical entities. However, the loss of function of BRCA1 or BRCA2 proteins has different consequences in terms of tumor cell reliance on estrogen receptor signaling and tumor microenvironment composition. Here, we review accumulating preclinical and clinical data indicating that BRCA1 or BRCA2 inactivation may differentially affect BC sensitivity to standard systemic therapies.

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Purpose Of Review: Metabolic reprogramming is a new and potentially targetable hallmark of cancer. In recent years, fasting and fasting-mimicking diets (FMDs) have been tested as anticancer strategies both in preclinical experiments and in clinical trials. In this review, we aim at summarizing the available evidence about the antitumour activity of these approaches in preclinical breast cancer models, as well as results from clinical trials investigating fasting/FMD in breast cancer patients.

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Severe calorie restriction, in the form of cyclic fasting or fasting-mimicking diets (FMDs), boosts the antitumor activity of cytotoxic chemotherapy in mouse models of triple-negative breast cancer (TNBC). This effect is mostly mediated by fasting/FMD-induced reduction of plasma glucose concentration and by a boost in antitumor immunity. However, clinical evidence that cyclic FMD may impact on the outcomes of advanced TNBC (aTNBC) patients is lacking.

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Background: Chemoimmunotherapy represents the standard of care for patients with advanced non-small cell lung cancer (NSCLC) and programmed death-ligand 1 (PD-L1) <50%. Although single-agent pembrolizumab has also demonstrated some activity in this setting, no reliable biomarkers yet exist for selecting patients likely to respond to single-agent immunotherapy. The main purpose of the study was to identify potential new biomarkers associated with progression-free-survival (PFS) within a multiomics analysis.

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Article Synopsis
  • The study highlights that patients with mismatch-repair deficient (dMMR) and microsatellite instability-high (MSI-high) advanced gastric cancer show better outcomes with PD-1-based therapies compared to chemotherapy.
  • The research included 130 patients, revealing a median progression-free survival (PFS) of 30.3 months and median overall survival (OS) of 62.5 months, indicating promising results for the treatment.
  • Four clinical factors (performance status, non-resected primary tumor, bone metastases, and malignant ascites) were identified as significant predictors of survival and used to create a prognostic score that categorizes patients into risk groups for better treatment planning.
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