74 results match your criteria: "Miulli General Regional Hospital[Affiliation]"

. Adult medulloblastoma (AMB) patients should receive postoperative craniospinal irradiation (CSI) as a standard treatment. Volumetric intensity-modulated arc therapy (VMAT) is a promising method for CSI.

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Objective: To validate the ISGPS complexity grading system for minimally invasive pancreaticoduodenectomy (MIPD).

Background: Although concerns about patient safety persist, MIPD is gaining popularity. The ISGPS recently introduced a difficulty grading system to improve patient selection by aligning procedural complexity with surgeon and center expertise.

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Complete hepatic caudate lobe resection: is robotic approach safe? Report from experienced centers.

J Robot Surg

December 2024

Hepato-Biliary and Pancreatic Surgery Unit, Department of Surgery, Hospital del Mar, Pompeu Fabra University, Barcelona, Spain.

Minimally invasive liver surgery has become widely accepted as a safe and effective approach, especially with experienced surgeons. Robotic hepatectomy may offer significant benefits in challenging procedures like caudate lobe resection. The caudate lobe's intricate anatomy and deep-seated location make its resection particularly challenging, with limited reports on minimally invasive techniques.

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Is robotic liver resection feasible in patients with lesions in close proximity to major vessels? A propensity score matching analysis.

HPB (Oxford)

September 2024

Department of Hepato-Pancreatc-Biliary Surgery, "F. Miulli" General Regional Hospital, Acquaviva Delle Fonti, Department of Medicine and Surgery, LUM University, Casamassima, Bari, Italy.

Article Synopsis
  • - Robotic surgery is gaining popularity in the surgical field, especially for liver resections, but its effectiveness near major blood vessels needs further investigation.
  • - A study of 1030 patients categorized them into two groups (lesions in contact with major vessels vs. those free from) to compare surgical outcomes before and after adjusting for other variables.
  • - Findings indicated that while the Pringle Manoeuvre was more frequently used in surgeries near major vessels, overall operative time, complication rates, and surgery success were similar between both groups, suggesting robotic surgery is safe even for challenging cases.
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  • This study looked at how different hospitals approach treating liver cancer, especially regarding liver transplants.
  • They surveyed 75 hospital directors to see if those with liver transplant programs treat patients differently compared to those without.
  • The results showed that hospitals with transplant programs were more likely to recommend transplants for certain types of liver cancer and other liver diseases than those without, showing a need for better communication between the two types of centers.
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  • A study was conducted to compare robotic minor liver resections (RMLR) with laparoscopic minor liver resections (LMLR) in patients undergoing surgery on the anterolateral liver segments.
  • The analysis included over 10,000 patients and employed propensity score matching to balance the groups for accuracy in comparisons.
  • Results indicated RMLR had benefits like less blood loss, lower major morbidity, and shorter hospital stays than LMLR, although the difference in 30-day readmission rates suggested RMLR may have some drawbacks.
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The gene () is involved in telomere maintenance and stability and plays a crucial role in the preservation of genomic stability. is considered a high-penetrance melanoma susceptibility gene; however, the number of cancer types associated with the pathogenic germline variants of is gradually increasing, including chronic lymphocytic leukemia (CLL), angiosarcomas, and gliomas, even though many associations are still elusive. Here, we reported a case of a 60-year-old man who showed early-onset multiple neoplasms, including multiple melanomas, gastrointestinal stromal tumor (GIST), and lung adenocarcinoma.

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  • - This national survey aimed to assess the use of liver hypertrophy techniques in Italy, focusing on trends and differences among various medical centers.
  • - In December 2022, 46 centers completed a detailed online questionnaire, revealing that hypertrophy techniques were used in 6.2% of liver resections, with PVE and ALPPS being the most common techniques employed.
  • - The findings indicated that while these techniques play a crucial role in increasing resectability, there is substantial inconsistency in how centers define the need for them and the protocols used for patient allocation.
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Article Synopsis
  • The study aimed to create global benchmark outcome indicators for laparoscopic right posterior sectionectomies (L-RPS/H67) to improve surgical standards.
  • It analyzed data from 854 patients across 57 centers globally, establishing key performance benchmarks for low-risk cases based on specific outcome indicators.
  • The findings set standard benchmarks for metrics like operation time and complication rates, serving as a reference for surgical auditing and improvement.
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Malignant central nervous system (CNS) cancers include a group of heterogeneous dis-eases characterized by a relative resistance to treatments and distinguished as either primary tumors arising in the CNS or secondary tumors that spread from other organs into the brain. Despite therapeutic efforts, they often cause significant mortality and morbidity across all ages. Radiotherapy (RT) remains the main treatment for brain cancers, improving associated symptoms, improving tumor control, and inducing a cure in some.

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Purpose: Errors and incidents may occur at any point within radiotherapy (RT). The aim of the present retrospective analysis is to evaluate the impact of a customized ARIA Visual Care Path (VCP) on quality assurance (QA) for the RT process.

Materials And Methods: The ARIA VCP was implemented in June 2019.

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Impact of neoadjuvant chemotherapy on short-term outcomes after simple and complex minimally invasive minor hepatectomy for colorectal liver metastases: A propensity-score matched and coarsened exact matched study.

Eur J Surg Oncol

June 2024

Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore; Surgery Academic Clinical Programme, Duke-National University of Singapore Medical School, Singapore. Electronic address:

Article Synopsis
  • Minimally invasive liver surgery has become more common over the last 30 years, especially for treating colorectal liver metastases, but the effects of neoadjuvant chemotherapy on surgical outcomes are not well understood.
  • A study analyzed a large database of nearly 5,000 patients who underwent minimally invasive liver surgeries to compare outcomes between those who received neoadjuvant chemotherapy and those who did not.
  • The results showed that neoadjuvant chemotherapy did not significantly affect the short-term surgical outcomes in patients undergoing these liver procedures.
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Alpelisib for PIK3CA-mutated advanced gynecological cancers: First clues of clinical activity.

Gynecol Oncol

April 2024

Unit of Medical Oncology and Cancer Prevention, Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), Aviano, Italy.

Article Synopsis
  • Recurrent gynecological tumors like endometrial and ovarian cancers lack effective treatments, prompting research into the PTEN-AKT-PI3K pathway as a target, with alpelisib being a notable PI3K inhibitor.
  • A study involving 36 patients with PIK3CA-mutated advanced gynecological cancers showed an overall objective response rate (ORR) of 28% and a disease control rate (DCR) of 61%, with the best results in endometrial cancer patients.
  • The findings suggest that alpelisib could be a promising treatment option for these patients and highlight the importance of further clinical trials focusing on biomarker-driven approaches for PI3K inhibitors in gynecological cancers
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Background: In the randomized phase II REGOMA trial, regorafenib showed promising activity in patients with recurrent glioblastoma. We conducted a large, multicenter, prospective, observational study to confirm the REGOMA data in a real-world setting.

Patients And Methods: The major inclusion criteria were histologically confirmed diagnosis of glioblastoma according to the World Health Organization (WHO) 2016 classification and relapse after radiotherapy with concurrent/adjuvant temozolomide treatment, good performance status [Eastern Cooperative Oncology Group performance status (ECOG PS 0-1)] and good liver function.

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  • The REDISCOVER consensus conference focused on creating guidelines for the perioperative care of patients with borderline-resectable and locally advanced pancreatic ductal adenocarcinoma (PDAC).
  • Using a structured methodology and expert consensus, the conference developed 34 recommendations on various aspects of surgical care, patient selection, and management of pancreatic cancer.
  • Despite the low evidence quality for most recommendations, participants highlighted the importance of establishing an international registry to enhance understanding and care for this patient group.
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Purpose: To evaluate intra-patient and interobserver agreement in patients who underwent liver MRI with gadoxetic acid using two different multi-arterial phase (AP) techniques.

Methods: A total of 154 prospectively enrolled patients underwent clinical gadoxetic acid-enhanced liver MRI twice within 12 months, using two different multi-arterial algorithms: CAIPIRINHA-VIBE and TWIST-VIBE. For every patient, breath-holding time, body mass index, sex, age were recorded.

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Multimodal Management of Colorectal Liver Metastases: State of the Art.

Oncol Rev

January 2024

Division of Medical Oncology, A.O.U. Consorziale Policlinico di Bari, Bari, Italy.

Liver is the most common site of colorectal cancer (CRC) metastases. Treatment of CRC liver metastases (CRLM) includes different strategies, prevalently based on the clinical and oncological intent. Valid approaches in liver-limited or liver-prevalent disease include surgery, percutaneous ablative procedures (radiofrequency ablation, microwave ablation), intra-arterial perfusional techniques (chemo-embolization, radio-embolization) as well as stereotactic radiotherapy.

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Background: This study aims to evaluate the strength of the association between frailty and intraoperative/postoperative complications in patients undergoing minimally invasive surgery (MIS) for endometrial cancer.

Methods: In this retrospective observational multicenter cohort study, frailty was defined beforehand by a modified frailty index (mFI) score of ≥3. Multiple logistic regressions were performed to investigate possible preoperative predictors-including frailty, age, and body mass index-of intraoperative and early (within 30 days from surgery) or delayed (beyond 30 days from surgery) postoperative complications.

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Glioblastoma (GBM) is the most common and aggressive primary malignant brain tumor. Standard therapies, including surgical resection, chemoradiation, and tumor treating fields, have not resulted in major improvements in the survival outcomes of patients with GBM. The lack of effective strategies has led to an increasing interest in immunotherapic approaches, considering the success in other solid tumors.

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Purpose: No standard treatment has yet been established for recurrent glioblastoma (GBM). In this context, the aim of the current study was to evaluate safety and efficacy of reirradiation (re-RT) by radiosurgery or fractionated stereotactic radiotherapy (SRS/FSRT) in association with regorafenib.

Methods: Patients with a histological or radiological diagnosis of recurrent GBM who received re-RT by SRS/FSRT and regorafenib as second-line systemic therapy were included in the analysis.

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Impact of liver cirrhosis, severity of cirrhosis and portal hypertension on the difficulty of laparoscopic and robotic minor liver resections for primary liver malignancies in the anterolateral segments.

Eur J Surg Oncol

January 2024

Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore; Surgery Academic Clinical Programme, Duke National University of Singapore Medical School, Singapore. Electronic address:

Article Synopsis
  • This study assessed how liver cirrhosis (LC) influences the challenges of minimally invasive liver resection (MILR), specifically for minor surgeries involving primary liver tumors in anterolateral segments.
  • Conducted from 2004 to 2021 across 60 centers, the research involved 3,675 patients, with varying degrees of cirrhosis classified as Child A and Child B.
  • Results indicated that patients with Child A cirrhosis faced higher risks of complications, such as increased blood loss and rates of open conversion, while those with Child B cirrhosis had longer hospital stays and more significant morbidity; overall, the severity of LC complicates the surgical process, highlighting the need for better difficulty
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Article Synopsis
  • Minimally invasive liver resections (MILR) can reduce blood loss and recovery time compared to traditional methods, but the impact of cirrhosis on these procedures is not fully understood.
  • A study reviewed data from 2534 patients who underwent minimally invasive major liver surgeries worldwide, focusing on outcomes related to different levels of cirrhosis.
  • Results showed that advanced cirrhosis leads to higher blood transfusion rates, more postoperative complications, and longer hospital stays, suggesting that cirrhosis severity should be considered in future assessments of surgical difficulty in MILR.*
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Objective: Aim of our study was to evaluate whether the different laparotomic (ARH) or minimally invasive (laparoscopic and robotic) approaches (MIS) in FIGO stage IB1-IB2 cervical cancer, present different patterns of recurrence of the disease. The secondary endpoint of the study was the evaluation of the variables most involved with the risk of relapse and therefore lower DFS and OS.

Material And Methods: The study enrolled patients with definitive histological diagnosis of squamous or adenocarcinoma stage IB1-IB2 cervical cancer who underwent minimally invasive or abdominal radical hysterectomy from 2001 to 2018.

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Introduction: Three-dimensional liver modeling can lead to substantial changes in choosing the type and extension of liver resection. This study aimed to explore whether 3D reconstruction helps to better understand the relationship between liver tumors and neighboring vascular structures compared to standard 2D CT scan images.

Methods: Contrast-enhanced CT scan images of 11 patients suffering from primary and secondary hepatic tumors were selected.

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Clinical Updates for Gastrointestinal Malignancies.

J Pers Med

September 2023

Unit of Hepato-Pancreatic-Biliary Surgery, "F. Miulli" General Regional Hospital, 70021 Acquaviva Delle Fonti, Italy.

Gastrointestinal (GI) cancers include hepatobiliary tumors, pancreatic cancer (PC), neuroendocrine tumors of the gastrointestinal tract, small bowel carcinomas, gastric cancer (GC), anal canal cancer, primary gastric and intestinal lymphomas, gastrointestinal stromal tumors (GISTs) and the most frequent colorectal cancer (CRC) [...

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