|
|
|
题名
|
作者
|
年代
|
出处
|
被引量
|
| 1 | Neoadjuvant chemotherapy for gastric cancer. Is it a must or a fake?显示文摘AIM To investigate the neoadjuvant chemotherapy(NAC) effect on the survival of patients with proper stomach cancer submitted to D2 gastrectomy.METHODS We proceeded to a review of the literature with Pub Med, Embase, ASCO and ESMO meeting abstracts as well as computerized use of the Cochrane Library for randomized controlled trials(RCTs) comparing NAC followed by surgery(NAC + S) with surgery alone(SA) for gastric cancer(GC). The primary outcome was the overall survival rate. Secondary outcomes were the site of the primary tumor, extension of node dissection according to Japanese Gastric Cancer Association(JGCA) performed in both arms, disease-specific(DSS) and disease-free survival(DFS) rates, clinical and pathological response rates and resectability rates after perioperative treatment. RESULTS We identified a total of 16 randomized controlled trials comparing NAC + S(n = 1089) with SA(n = 973) published in the period from January 1993-March 2017. Only 6 of these studies were well-designed, structured trials in which the type of lymph node(LN) dissection performed or at least suggested in the trial protocol was reported. Two out of three of the RCTs with D2 lymphadenectomy performed in almost all cases failed to show survival benefit in the NAC arm. Inthe third RCT, the survival rate was not even reported, and the primary end points were the clinical outcomes of surgery with and without NAC. In the remaining three RCTs, D2 lymph node dissection was performed in less than 50% of cases or only recommended in the 'Study Treatment' protocol without any description in the results of the procedure really perfomed. In one of the two studies, the benefit of NAC was evident only for esophagogastric junction(EGJ) cancers. In the second study, there was no overall survival benefit of NAC. In the last trial, which documented a survival benefit for the NAC arm, the chemotherapy effect was mostly evident for EGJ cancer, and more than one-fourth of patients did not have a proper stomach cancer. Additionally, several patients did not receive resectional surgery. Furthermore, the survival rates of international reference centers that provide adequate surgery for homogeneous stomach cancer patients' populations are even higher than the survival rates reported after NAC followed by incomplete surgery.CONCLUSION NAC for GC has been rapidly introduced in international western guidelines without an evidence-based medicinerelated demonstration of its efficacy for a homogeneous population of patients with only stomach tumors submitted to adequate surgery following JGCA guidelines with extended(D2) LN dissection. Additional larger sample-size multicentre RCTs comparing the newer NAC regimens including molecular therapies followed by adequate extended surgery with surgery alone are needed. | Rossella Reddavid Silvia Sofia Paolo Chiaro Fabio Colli Renza Trapani Laura Esposito Mario Solej Maurizio Degiuli | 2018 | World Journal of Gastroenterology2018，24，2： | 25 |
| 2 | Early detection and prevention of pancreatic cancer:Is it really possible today?显示文摘Pancreatic cancer is the 4th leading cause of cancerrelated death in Western countries.Considering the low incidence of pancreatic cancer,population-based screening is not feasible.However,the existence of a group of individuals with an increased risk to develop pancreatic cancer has been well established.In particular,individuals suffering from a somatic or genetic condition associated with an increased relative risk of more than 5-to 10-fold seem to be suitable for enrollment in a surveillance program for prevention or early detection of pancreatic cancer.The aim of such a program is to reduce pancreatic cancer mortality through early or preemptive surgery.Considering the risk associated with pancreatic surgery,the concept of preemptive surgery cannot consist of a prophylactic removal of the pancreas in high-risk healthy individuals,but must instead aim at treating precancerous lesions such as intraductal papillary mucinous neoplasms or pancreatic intraepithelial neoplasms,or early cancer.Currently,results from clinical trials do not convincingly demonstrate the efficacy of this approach in terms of identification of precancerous lesions,nor do they define the outcome of the surgical treatment of these lesions.For this reason,surveillance programs for individuals at risk of pancreatic cancer are thus far generally limited to the setting of a clinical trial.However,the acquisition of a deeper understanding of this complex area,together with the increasing request for screening and treatment by individuals at risk,will usher pancreatologists into a new era of preemptive pancreatic surgery.Along with the growing demand to treat individuals with precancerous lesions,the need for low-risk investigation,lowmorbidity operation and a minimally invasive approach becomes increasingly pressing.All of these considerations are reasons for preemptive pancreatic surgery programs to be undertaken in specialized centers only. | Marco Del Chiaro Ralf Segersvrd Matthias Lohr Caroline Verbeke | 2014 | World Journal of Gastroenterology2014，20，34： | 11 |
| 3 | European experts consensus statement on cystic tumours of the pancreas显示文摘 | Marco Del Chiaro Caroline Verbeke Roberto Salvia Gunter Kl?ppel Jens Werner Colin McKay Helmut Friess Riccardo Manfredi Eric Van Cutsem Matthias L?hr Ralf Segersv?rd | 2013 | Digestive and Liver Disease2013，，： | 3 |
| 4 | Methods and outcomes of screening for pancreatic adenocarcinoma in high-risk individuals显示文摘Pancreatic ductal adenocarcinoma(PDAC) is a lethal neoplasia, for which secondary prevention(i.e., screening) is advisable for high-risk individuals with 'familiar pancreatic cancer' and with other specific genetic syndromes(Peutz-Jeghers, p16, BRCA2, PALB and mismatch repair gene mutation carriers). There is limited evidence regarding the accuracy of screening tests, their acceptability, costs and availability, and agreement on whom to treat. Successful target of screening are small resectable PDAC, intraductal papillary mucinous neoplasms with high-grade dysplasia and advanced pancreatic intraepithelial neoplasia. Both magnetic resonance imaging(MRI) and endoscopic ultrasound(EUS) are employed for screening, and the overall yield for pre-malignant or malignant pancreatic lesions is of about 20% with EUS and 14% with MRI/magnetic resonance colangiopancreatography. EUS performs better for solid and MRI for cystic lesions. However, only 2% of these detected lesions can be considered a successful target, and there are insufficient data demonstrating that resection of benign or low grade lesions improves survival. Many patients in the published studies therefore seemed to have received an overtreatment by undergoing surgery. It is crucial to better stratify the risk of malignancy individually, and to better define optimal screening intervals and methods either with computerized tools or molecular biomarkers, possibly in large multicentre studies. At the moment, screening should be carefully performed within research protocols at experienced centres, offering involved individuals medical and psychological advice. | Gabriele Capurso Marianna Signoretti Roberto Valente Urban Arnelo Matthias Lohr Jan-Werner Poley Gianfranco Delle Fave Marco Del Chiaro | 2015 | World Journal of Gastrointestinal Endoscopy2015，7，9： | 2 |
| 5 | MicroRNA-21 in pancreatic cancer:correlation with clinical outcome and pharmacologic aspects underlying its role in the modulation of gemcitabine activity显示文摘 | Giovannetti E Funel N Peters G J Del Chiaro M Erozenci LA Vasile E | | 0，，： | 1 |
| 6 | Celastrol Inhibits Tat-Media- ted Human Immunodeficicncy Virus (HIV) Transcription and Replica- tion 显示文摘 | Narayan V Ravindra KC Chiaro C | 2011 | Journal of Molecular Biology2011，410，5： | 1 |
| 7 | A simplified technique for the en bloc procurement of abdominal organs that is suitable for pancreas and small bowel transplantation显示文摘 | Boggi U Vistoli F Chiaro Del M | 2004 | Surgery2004，135，5： | 1 |
| 8 | European experts con- sensus statement on cystic tumours of the pancreas显示文摘 | Del Chiaro M Verbeke C Salvia R | 2013 | Dig Liver Dis2013，45，9： | 1 |
| 9 | Antiwear tribofilm formation on steel surface lubricated with gear oil containing borate,phosphorus,and sulfur additives显示文摘 | Komvopoulos K Chiaro V Pakter B | 2002 | Tribology Transactions2002，45，4： | 1 |
| 10 | Evaluation of a high avidity anti - dsDNA IgG enzyme - linked immunosorbent assay for the diagnosis of systemic lupus erythematosus显示文摘 | Suh - Lailam BB Chiaro TR Davis KW | 2011 | lnt J Clin Exp Pathol2011，4，8： | 1 |
| 11 | Prognostic implications of tumor invasion or adhesion to peripancreatic vessels in resected pancreatic cancer显示文摘 | Ugo Boggi Marco Del Chiaro Chiara Croce Fabio Vistoli Stefano Signori Carlo Moretto Gabriella Amorese Salvatore Mazzeo Carla Cappelli Daniela Campani Franco Mosca | 2009 | Surgery2009，，： | 1 |
| 12 | European experts consensus statement on cystic tumours of the pancreas显示文摘 | Marco Del Chiaro Caroline Verbeke Roberto Salvia Gunter Kl?ppel Jens Werner Colin McKay Helmut Friess Riccardo Manfredi Eric Van Cutsem Matthias L?hr Ralf Segersv?rd | 2013 | Digestive and Liver Disease2013，，： | 1 |
| 13 | Interpreters' perception of linguistic and non-linguistic factors affecting quality : A Survey through the world wide web显示文摘 | Chiaro D | 2004 | Meta2004，49，2： | 1 |
| 14 | Evaluationof a high avidity anti-dsDNA IgG enzyme-linked immunosorbentassay for the diagnosis of systemic lupus erythematosus显示文摘 | SUH-LAILAM BB CHIARO TR DAVIS K W | 2011 | Int JClin Exp Pathol2011，4，8： | 1 |
| 15 | Extracorporeal repair and liver autotransplantation after total avulsion of hepatic veins and retrohepatic inferior vena cava injury secondary to blunt abdominal trauma显示文摘 | Boggi U Vistoli F Del Chiaro M | 2006 | J trauma2006，60，2： | 1 |
| 16 | Tissue microarray-chip featuring computerized immunophenotypical characterization more accurately subtypes ampullary adenocarcinoma than routine histology显示文摘BACKGROUND Ampullary adenocarcinomas(AACs)are heterogeneous tumors currently classified into three important sub-classes(SC):Intestinal(INT),Pancreato-Biliary(PB)and Mixed-Type(MT).The different subgroups have similar clinical presentation and are treated by pancreatoduodenectomy with curative intent.However,they respond differently to chemotherapy and have different prognostic outcomes.The SC are often difficult to identify with conventional histology alone.The clinical outcome of all three remains unclear,particularly for MT.AIM To identify two main subtypes of AACs,using an immunohistochemical(IHC)score based on CDX2,CK7 and CK20.METHODS Tissue samples from 21 patients who had undergone resection of AAC were classified by HE histology and IHC expression of CDX2,CK7 and CK 20.An IHC score was obtained for each marker by counting the number of positive cells(0=no stained cells;1<25%;2<50%and 3>50%)and their intensity(1=weak;2=moderate and 3=strong).A global score(GS)was then obtained by summation of the IHC scores of each marker.The MT tumors were grouped either with the INT or PB group based on the predominant immuno-molecular phenotype,obtaining only two AACs subtypes.The overall survival in INT and PB patients was obtained by Kaplan-Meier methods.RESULTS Histological parameters defined the AACs subtypes as follows:15%INT,45%PB and 40%MT.Using IHC expression and the GS,75%and 25%of MT samples were assigned to either the INT or the PB group.The mean value of the GS was 9.5(range 4-16).All INT samples had a GS above the average,distinct from the PB samples which had a GS score significantly below the average(P=0.0011).The INT samples were identified by high expression of CDX2 and CK20,whereas PB samples exhibited high expression of CK7 and no expression of CK20(P=0.0008).The INT group had a statistically significant higher overall survival than in the PB group(85.7 mo vs 20.3 mo,HR:8.39;95%CI:1.38 to 18.90;P=0.0152).CONCLUSION The combination of histopathological and molecular criteria enables the classification of AACs into two clinically relevant histo-molecular phenotypes,which appear to represent distinct disorders with potentially significant changes to the current therapeutic strategies. | Matteo Palmeri Niccola Funel Gregorio Di Franco Niccolo Furbetta Desiree Gianardi Simone Guadagni Matteo Bianchini Luca E Pollina Claudio Ricci Marco Del Chiaro Giulio Di Candio Luca Morelli | 2020 | World Journal of Gastroenterology2020，26，43： | 1 |
| 17 | Nucleus pulposus cells synthesize a functional extracellular matrix and respond to inflammatory cytokine challenge following long-term a- garose culture显示文摘 | Smith LI Chiaro JA Nerurkar NL | 2011 | Eur Cell Mater2011，22，： | 1 |
| 18 | Structural model proposition and thermodynamic and vibrational analysis of hydrotalcite-like compounds by dft calculations显示文摘 | COSTA D G ROCHA A B DINIZ R SOUZA W F CHIARO S S X LEIT?O A A | | 0，，33： | 1 |
| 19 | Comparative structural,thermodynamic and electronic analyses of ZnAIAn-hydrotalcite-like compounds (An-CI-,F-,Br-,OH-,CO32-or NO3):An ab initio study显示文摘 | COSTA D G ROCHA A B SOUZA W F CHIARO S S X LEITA O A A | | 0，，： | 1 |
| 20 | Nucleus pulposus cel s synthesize a functional extracel ular matrix and respond to inflammatory cytokine chal enge fol owing long-term agarose culture显示文摘 | Smith LJ Chiaro JA Nerurkar NL | | 0，，： | 1 |
您所在的机构暂未开通此部分的功能，请联系管理员