A Dramatic Response to Second-Line Nivolumab and Ipilimumab in BRAF-V600-Mutated Metastatic Melanoma.

Introduction: Current treatment options for BRAF V600-mutated unresectable stage III/IV melanoma include anti-PD-1 monotherapy or combination with anti-CTLA-4 or anti-LAG-3 agents, BRAF/MEK inhibitors, and clinical trials. The strategy of combination immunotherapy with nivolumab and ipilimumab has shown promising results, achieving higher response rates, longer duration of response, improved progression-free survival, and enhanced overall survival. The optimal sequence of treatments remains a topic of interest, with preliminary data suggesting a greater effectiveness of immunotherapy as the first-line approach.

Acute and complicated diverticulitis: are there significant differences between young and elderly patients?

Aim: The aim of our study was to assess if there were any differences in clinical presentation, management, and outcome, between younger and elderly patients with acute diverticulitis (AD).

Material Of Study: 279 patients with diagnosis of AD treated at the General Surgery Department of Trieste from January 2007 to December 2015 were retrospectively examined and then followed for a minimum of 4 years. We divided patients in two categories: young ≤ 50 years and elderly > 50.

Touch Imprinting Cytology may be useful in the intraoperative evaluation of the sentinel lymph node in melanoma.

Purpose: The aim of the study was to assess whether the reliability of Touch Imprinting Cytology (TIC) of Sentinel lymph node biopsy (SLNB) in skin melanoma patients allows intraoperative decisions regarding simultaneous radical lymphadenectomy to be made. Previous experiences have shown that the limit of TIC in extemporaneous diagnosis was represented by the minimal deposits of the tumor. Many current data seem to show that in this situation radical lymphadenectomy is no longer necessary, so we wondered if TIC could regain importance in the intraoperative management of these patients.

Quality of life after laparoscopic sigmoid resection for uncomplicated diverticular disease.

Purpose: The study aimed to evaluate the QoL in patients who underwent elective surgery for uncomplicated diverticulitis using a recently developed diverticulitis quality of life questionnaire (DV-QoL).

Methods: All consecutive patients who underwent surgery for uncomplicated diverticulitis or who were hospitalized and treated conservatively for acute uncomplicated diverticulitis episodes in three referral centers, in a 5-year period, were included in the study. The 36-Item Short Form Survey and the DV-QoL were administered to the patients to assess their QoL before and after treatment of diverticular disease.

Modifiable and non-modifiable risk factors for surgical site infection after colorectal surgery: a single-center experience.

Purpose: Surgical site infection (SSI) is the most common complication of colorectal surgery, resulting in significant burden in terms of morbidity and length of hospital stay. The aims of this study were to establish the incidence of SSI in patients undergoing colorectal surgeries and to identify potentially modifiable risk factors to reduce overall SSI rates.

Methods: This retrospective study analyzed patients who underwent colorectal resection at our Department.

Does sigmoidectomy for diverticular disease have a negative impact on patients' quality of life and bowel function?

Aim: Aim of this study was to evaluate bowel function after colonic resection for diverticular disease and assess its impact on patients' quality of life.

Material Of Study: 47 patients who underwent urgent or elective surgery for diverticular disease were either personally contacted or interviewed by telephone and given a questionnaire. The Memorial Bowel functional index, the short form (36) health survey questionnaire, and the fecal incontinence severity index were used.

Differential diagnosis between splenic nodules and peritoneal metastases with contrast-enhanced ultrasound based on signal-intensity characteristics during the late phase.

Purpose: This study was done to assess the enhancement characteristics of splenic implants and to evaluate whether contrast-enhanced ultrasound (CEUS) after SonoVue injection allows the differential diagnosis with peritoneal metastases.

Material And Methods: Thirteen consecutive patients with splenosis and 13 consecutive patients with peritoneal metastases were investigated with CEUS after injection of 2.4 ml of SonoVue.

Expression profiling of angiogenic genes for the characterisation of colorectal carcinoma.

The development of new blood and lymphatic vessels is a crucial event for cancer growth, metastatic spread and relapse after therapy. In this work, the expression levels of chemokines, angiogenic and angiostatic factors and their receptors were determined in paired mucosal and tumour samples of patients with colorectal carcinoma and correlated with clinical and histological parameters by advanced multivariate analyses. The most important predictors to discriminate between tumour and paired normal mucosa turned out to be the levels of expression of plexin-A1 and stromal cell-derived factor 1 (SDF-1), the former overexpressed and the latter downregulated in tumours.

[Adhesive small bowel occlusion: a clinical and therapeutic study of 163 consecutive patients].

The aim of this retrospective study is to evaluate the immediate and late outcomes of the surgical and conservative treatment of adhesive small bowel obstruction. A series of 163 consecutive patients affected by adhesive occlusion were analysed. 63 patients were submitted to emergency surgery and 100 to conservative treatment; 15 of these ones were operated on because they did not improve or deteriorated.

[Emergencies in colorectal carcinoma: negative prognostic factor?].

The authors analyze a consecutive series of 219 patients affected by complicated colorectal cancer who underwent surgery in emergency. In hospital mortality, 5-year survival and recurrence's incidence in 104 of these patients who underwent curative treatment are calculated and compared with a series of 701 patients who underwent elective surgical treatment. There was no significative statistical difference between emergency and elective group.

[Inflammatory pseudotumour of the liver: case report and review of the literature].

We report a case of inflammatory pseudotumour of the liver in a 53-year-old woman who over the previous month had presented malaise, fever and right-sided hypochondralgia. On physical examination the liver was tender at palpation 2 cm below the right costal margin. Laboratory data were normal.

Sentinel lymph node mapping in the management of colorectal cancer: preliminary report.

Aim And Background: The problem of understaging the lymph node status in colorectal cancer because of missed micrometastases led authors to investigate the role of sentinel node (SN) mapping also in colorectal malignancies. The aim of this study was to evaluate the feasibility of the technique and to correlate the results with some characteristics of the primary tumor.

Methods: Sentinel lymph node mapping was performed in 23 patients who underwent a standard lymphadenectomy for colorectal cancer.

[Non-functioning neuroendocrine tumor of the pancreas: report of a clinical case and review of the literature].

The authors report the case of a 26-year-old woman, with a palpable abdominal mass, dyspepsia, pain and weight loss. These symptoms were caused by a non-functioning or biologically inactive neuroendocrine tumour (BINT), weighing 510 g and located in the tail of the pancreas. The treatment opted for was a surgical resection consisting in a distal pancreatectomy.

[Functional complications of the lower urinary tract after curative exeresis for cancer of the rectum].

The aim of the study is to assess the incidence and the pathogenesis of urinary dysfunction in the surgical treatment of rectal cancer. A series of 219 patients, who underwent surgery for rectal cancer with normal urinary preoperative function, was submitted to a prospective follow-up for the urinary function. Symptomatic patients in the follow-up were studied by ultrasonography, cystomanometry and pressure-flow electromyography.

[Preoperative CEA: prognostic significance in colorectal carcinoma].

The prognostic meaning of preoperative CEA level and its relation to the other risk factors are still under debate. In 512 patients who underwent surgical treatment for colorectal cancer, CEA preoperative plasma level had been evaluated. The prognostic value of CEA was compared with other prognostic factors and the characteristics of the tumor.

[Role of intensive follow-up in colorectal cancer surgery patients].

Authors analyze the role of follow-up after curative resection for colo-rectal cancer. In 129 patients (29.6%) a recurrence was observed, whilst in 6 (1.

[Prognostic importance of preoperative CEA in patients with colorectal cancer].

Carcinoembryonic antigen is an acid glycoprotein, the levels of which may increase in patients with colorectal carcinoma. The prognostic significance of preoperative carcinoembryonic antigen levels and their relationship to other risk factors are still debatable issues. Among 512 patients operated on for colorectal cancer, whose preoperative carcinoembryonic antigen concentrations were evaluated, linear correlations were established between carcinoembryonic antigen overexpression and carcinoma staging, diameter and grading, though these were not statistically significant.

[Crohn disease: prognostic factors and therapeutic choices].

The treatment of Crohn's disease is still a debatable issue especially as regards the integrated implementation of medical and surgical therapy, the timing of surgery and the choice of surgical technique. Prognostic factors seem to be important in the choice and planning of therapeutic procedures. The authors retrospectively review 81 patients, 31 of whom submitted to surgery.

[Current trends in the treatment of rectal carcinoma].

Authors report their personal experience about 336 cases of curative surgery for rectal cancer. They describe technical surgical details universally accepted in Literature such as sharp total mesorectal excision, the extension of lymphadenectomy with high ligature of inferior mesenteritis artery while pelvic lymphadenectomy seems to be unuseful and burdened by high morbidity; finally they underline advantages offered by a colic pouch above all for lower incidence of anastomotic leakages. As adjuvant therapy is concerned, our actual tendency is a preoperative radiochemiotherapy of which we are still evaluating long-term results.

Local excision for rectal cancer.

Background And Objectives: The aim of this retrospective study is to evaluate the results of local excision (LE) for rectal cancer for curative purposes.

Methods: From 1969 to December 1997, a total of 456 operations were performed for surgical treatment of rectal carcinoma (262 males and 194 females, mean age 66 years). Twenty patients (4.

[Role of curative local excision in rectal cancer].

The aim of this retrospective study is to evaluate the results of local excision (LE) for rectal cancer for curative purposes. From 1969 to December 1997, a total of 456 operations were performed for surgical treatment of rectal carcinoma (262 males and 194 females, mean age 66 years). 20 patients (4.

[Serous cysts of the transverse mesocolon: a review of the literature in the light of 2 cases brought to our notice].

Mesenteric cyst is one of the rarest tumours, with about 820 cases reported since 1507. Ultrasound and TC are the most valuable modalities for diagnosis of mesenteric cyst. Surgical resection is the treatment of choice.

[Surgical therapy of right colon cancer].

The debate about the management of frequent advanced right colon cancer is still opened: the opportunity of extended resections when the surrounding organs or tissues are infiltrated, the lymphadenectomy extension and its role, the possibility of identifying prognostic factors that could be useful to decide adjuvant therapy, the definition of the role of laparoscopy. Considering these problems, we have reviewed a series of 159 operations performed by the Institute of Clinical Surgery of the University of Trieste from 1980. 112 of these operations had a curative goal.

[Extended resection in locally advanced colon cancer].

Colorectal malignant tumors with a mono o multivisceral involvement have a poor prognosis and surgery is the only treatment with a hope to be curative. Aggressive surgical management of locally advanced colo-rectal cancer seems to be justified by good oncological results. At the Institute of Clinica Chirurgica of the University of Trieste 58 extended resections were performed for advanced tumors of colon and rectum.