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| 1 | Systematic review of surgical resection vs radiofrequency ablation for hepatocellular carcinoma显示文摘Hepatocellular carcinoma (HCC) represents one of the most common neoplasms worldwide. Surgical resection and local ablative therapies represent the most frequent first lines therapies adopted when liver transplantation can not be offered or is not immediately accessible. Hepatic resection (HR) is currently considered the most curative strategy, but in the last decade local ablative therapies have started to obtain satisfactory results in term of efficacy and, of them, radiofrequency ablation (RFA) is considered the reference standard. An extensive literature review, from the year 2000, was performed, focusing on results coming from studies that directly compared HR and RFA. Qualities of the studies, characteristics of patients included, and patient survival and recurrence rates were analyzed. Except for three randomized controlled trials (RCT), most studies are affected by uncertain methodological approaches since surgical and ablated patients represent different populations as regards clinical and tumor features that are known to affect prognosis. Unfortunately, even the available RCTs report conflicting results. Until further evidences become available, it seems reasonable to offer RFA to very small HCC (< 2 cm) with no technical contraindications, since in this instance complete necrosis is most likely to be achieved. In larger nodules, namely > 2 cm and especially if > 3 cm, and/or in tumor locations in which ablation is not expected to be effective or safe, surgical removal is to be preferred. | Alessandro Cucchetti Fabio Piscaglia Matteo Cescon Giorgio Ercolani Antonio Daniele Pinna | 2013 | World Journal of Gastroenterology2013，19，26： | 40 |
| 2 | Prognostic factors for hepatocellular carcinoma recurrence显示文摘The recurrence of hepatocellular carcinoma,the sixth most common neoplasm and the third leading cause of cancer-related mortality worldwide,represents an important clinical problem,since it may occur after both surgical and medical treatment.The recurrence rate involves 2 phases:an early phase and a late phase.The early phase usually occurs within 2 years after resection;it is mainly related to local invasion and intrahepatic metastases and,therefore,to the intrinsic biology of the tumor.On the other hand,the late phase occurs more than 2 years after surgery and is mainly related to de novo tumor formation as a consequence of the carcinogenic cirrhotic environment.Since recent studies have reported that early and late recurrences may have different risk factors,it is clinically important to recognize these factors in the individual patient as soon as possible.The aim of this review was,therefore,to identify predicting factors for the recurrence of hepatocellularcarcinoma,by means of invasive and non-invasive methods,according to the different therapeutic strategies available.In particular the role of emerging techniques(e.g.,transient elastography)and biological features of hepatocellular carcinoma in predicting recurrence have been discussed.In particular,invasive methods were differentiated from non-invasive ones for research purposes,taking into consideration the emerging role of the genetic signature of hepatocellular carcinoma in order to better allocate treatment strategies and surveillance follow-up in patients with this type of tumor. | Antonio Colecchia Ramona Schiumerini Alessandro Cucchetti Matteo Cescon Martina Taddia Giovanni Marasco Davide Festi | 2014 | World Journal of Gastroenterology2014，20，20： | 28 |
| 3 | Current concepts in hepatic resection for hepatocellular carcinoma in cirrhotic patients显示文摘Hepatocellular carcinoma(HCC) is one of the most frequent neoplasms worldwide and in most cases it is associated with liver cirrhosis.Liver resection is considered the most potentially curative therapy for HCC patients when liver transplantation is not an option or is not immediately accessible.This review is aimed at investigating the current concepts that drive the surgical choice in the treatment of HCC in cirrhotic patients;Eastern and Western perspectives are highlighted.An extensive literature review of the last two decades was performed,on topics covering various aspects of hepatic resection.Early post-operative and long-term outcome measures adopted were firstly analyzed in an attempt to define an optimal standardization useful for research comparison.The need to avoid the development of post-hepatectomy liver failure represents the 'conditio sine qua non' of surgical choice and the role of the current tools available for the assessment of liver function reserve were investigated.Results of hepatic resection in relationship with tumor burden were compared with those of available competing strategies,namely,radiofrequency ablation for early stages,and trans-arterial chemoembolization for intermediate and advanced stages.Finally,the choice for anatomical versus non-anatomical,as well as the role of laparoscopic approach,was overviewed.The literature review suggests that partial hepatectomy for HCC should be considered in the context of multi-disciplinary evaluation of cirrhotic patients.Scientific research on HCC has moved,in recent years,from surgical therapy toward non-surgical approaches and most of the literature regarding topics debated in the present review is represented by observational studies,whereas very few well-designed randomized controlled trials are currently available;thus,no robust recommendations can be derived. | Alessandro Cucchetti Matteo Cescon Franco Trevisani Antonio Daniele Pinna | 2012 | World Journal of Gastroenterology2012，18，44： | 22 |
| 4 | Ten years of sorafenib in hepatocellular carcinoma: Are there any predictive and/or prognostic markers?显示文摘Sorafenib has been considered the standard of care for patients with advanced unresectable hepatocellular carcinoma(HCC) since 2007 and numerous studieshave investigated the role of markers involved in the angiogenesis process at both the expression and genetic level and clinical aspect. What results have ten years of research produced? Several clinical and biological markers are associated with prognosis. The most interesting clinical parameters are adverse events, Barcelona Clinic Liver Cancer stage, and macroscopic vascular invasion, while several single nucleotide polymorphisms and plasma angiopoietin-2 levels represent the most promising biological biomarkers. A recent pooled analysis of two phase III randomized trials showed that the neutrophil-to-lymphocyte ratio, etiology and extra-hepatic spread are predictive factors of response to sorafenib, but did not identify any predictive biological markers. After 10 years of research into sorafenib there are still no validated prognostic or predictive factors of response to the drug in HCC. The aim of the present review was to summarize 10 years of research into sorafenib, looking in particular at the potential of associated clinical and biological markers to predict its efficacy in patients with advanced HCC. | Giorgia Marisi Alessandro Cucchetti Paola Ulivi Matteo Canale Giuseppe Cabibbo Leonardo Solaini Francesco G Foschi Serena De Matteis Giorgio Ercolani Martina Valgiusti Giovanni L Frassineti Mario Scartozzi Andrea Casadei Gardini | 2018 | World Journal of Gastroenterology2018，24，36： | 14 |
| 5 | Surveillance for early diagnosis of hepatocellular carcinoma: How best to do it?显示文摘Surveillance for hepatocellular carcinoma(HCC)is considered a standard of care for patients with chronic liver disease who are at risk of developing this malignancy.Several studies have shown that surveillance can improve the prognosis of patients diagnosed with HCC through an increased likelihood of application of curative or effective treatments.Repetition of liver ultrasonography(US)every 6 mo is the recommended surveillance program to detect early HCCs,and a positive US has to entrain a well-defined recall policy based on contrast-enhanced,dynamic radiological imaging or biopsy for the diagnosis of HCC.Although HCC fulfills the accepted criteria regarding cost-effective cancer screening and surveillance,the implementation of surveillance in clinical practice is defective and this has a negative impact on the cost-effectiveness of the procedure.Education of both physicians and patients is of paramount importance in order to improve the surveillance application and its benefits in patients at risk of HCC.The promotion of specific educational programs for practitioners,clinicians and patients is instrumental in order to expand the correct use of surveillance in clinical practice and eventually improve HCC prognosis. | Edoardo G Giannini Alessandro Cucchetti Virginia Erroi Francesca Garuti Federica Odaldi Franco Trevisani | 2013 | World Journal of Gastroenterology2013，19，47： | 10 |
| 6 | Liver transplantation for hepatic tumors:a systematic review显示文摘Improvements in the medical and pharmacological management of liver transplantation(LT)recipients have led to a better long-term outcome and extension of the indications for this procedure.Liver tumors are relevant to LT;however,the use of LT to treat malignancies remains a debated issue because the high risk of recurrence.In this review we considered LT for hepatocellular carcinoma(HCC),cholangiocarcinoma(CCA),liver metastases(LM)and other rare tumors.We reviewed the literature,focusing on the past 10 years.The highly selected Milan criteria of LT for HCC(single nodule<5 cm or up to 3 nodules<3cm)have been recently extended by a group from the University of S.Francisco(1 lesion<6.5 cm or up to3 lesions<4.5 cm)with satisfying results in terms of recurrence-free survival and the'up-to-seven criteria'.Moreover,using these criteria,other transplant groups have recently developed downstaging protocols,including surgical or loco-regional treatments of HCC,which have increased the post-operative survival of recipients.CCA may be treated by LT in patients who cannot undergo liver resection because of underlying liver disease or for anatomical technical challenges.A well-defined protocol of chemoirradiation and staging laparotomy before LT has been developed by the Mayo Clinic,which has resulted in long term diseasefree survival comparable to other indications.LT for LM has also been investigated by multicenter studies.It offers a real benefit for metastases from neuroendocrine tumors that are well differentiated and when a major extrahepatic resection is not required.If LT is an option in these selected cases,liver metastases from colorectal cancer is still a borderline indication because data concerning the disease-free survival are still lacking.Hepatoblastoma and hemangioendothelioma represent rare primary tumors for which LT is often the only possible and effective cure because of the frequent multifocal,intrahepatic nature of the disease.LT is a very promising procedure for both primary and secondary liver malignancies;however,it needs an accurate evaluation of the costs and benefits for each indication to balance the chances of cure with actual organ availability. | Matteo Ravaioli Giorgio Ercolani Flavia Neri Matteo Cescon Giacomo Stacchini Massimo Del Gaudio Alessandro Cucchetti Antonio Daniele Pinna | 2014 | World Journal of Gastroenterology2014，20，18： | 8 |
| 7 | Prophylaxis for venous thromboembolism after resection of hepatocellular carcinoma on cirrhosis: Is it necessary?显示文摘AIM: To assess the safety and effectiveness of prophylaxis for venous thromboembolism (VTE) in a large population of patients with hepatocellular carcinoma (HCC) on cirrhosis.METHODS: Two hundred and twenty nine consecutive cirrhotic patients with HCC who underwent hepatic resection were retrospectively evaluated to assess whether there was any difference in the incidence of thrombotic or hemorrhagic complications between those who received and those who did not receive prophylaxis with low-molecular weight heparin.Differences and possible effects of the following parameters were investigated: age,sex,Child-Pugh and model for end-stage liver disease (MELD) score,platelet count,presence of esophageal varices,type of hepatic resection,duration of surgery,intraoperative transfusion of blood and fresh frozen plasma (FFP),body mass index,diabetes and previous cardiovascular disease.RESULTS: One hundred and fifty seven of 229 (68.5%) patients received antithromboembolic prophylaxis (group A) while the remaining 72 (31.5%) patients did not (group B).Patients in group B had higher Child-Pugh and MELD scores,lower platelet counts,a higher prevalence of esophageal varices and higher requirements for intraoperative transfusion of FFP.The incidence of VTE and postoperative hemorrhage was 0.63% and 3.18% in group A and 1.38% and 1.38% in group B,respectively;these differences were not significant.None of the variables analyzed including prophylaxis proved to be risk factors for VTE,and only the presence of esophageal varices was associated with an increased risk of bleeding.CONCLUSION: Prophylaxis is safe in cirrhotic patients without esophageal varices;the real need for prophylaxis should be better assessed. | Marco Vivarelli Matteo Zanello Chiara Zanfi Alessandro Cucchetti Matteo Ravaioli Massimo Del Gaudio Matteo Cescon Augusto Lauro Eva Montanari Gian Luca Grazi Antonio Daniele Pinna | 2010 | World Journal of Gastroenterology2010，16，17： | 6 |
| 8 | Liver function impairment in liver transplantation and after extended hepatectomy显示文摘Extended hepatectomy,or liver transplantation of reduced-size graft,can lead to a pattern of clinical manifestations,namely'post-hepatectomy liver failure'and'small-for-size syndrome'respectively,that can range from mild cholestasis to irreversible organ non-function and death of the patient.Many mechanisms are involved in their occurrence but in the recent past,high portal blood flow through a relatively small liver vascular bed has taken a central role.Therefore,several techniques of inflow modulation have been attempted in cases of portal hyperperfusion first in liver transplantation,such as portocaval shunt,mesocaval shunt,splenorenal shunt,splenectomy or ligation of the splenic artery.However,high portal flow is not the only factor responsible,and before major liver resections,preoperative assessment of the residual liver function is necessary.Techniques such as portal vein embolization or portal vein ligation can be adopted to increase the future liver volume,preventing posthepatectomy liver failure.More recently,a new surgical procedure,that combines in situ splitting of the liver and portal vein ligation,has gradually come to light,inducing remarkable hypertrophy of the healthy liver in just a few days.Further studies are needed to confirm this hypothesis and overcome one of the biggest issues in the field of liver surgery. | Matteo Serenari Matteo Cescon Alessandro Cucchetti Antonio Daniele Pinna | 2013 | World Journal of Gastroenterology2013，19，44： | 6 |
| 9 | Liver grafts from hepatitis B surface antigen-positive donors: A review of the literature显示文摘The scarcity of available organs and the gap between supply and demand continue to be the main limitations of liver transplantation. To relieve the organ shortage, current transplant strategies have implemented extended criteria, which include the use of liver from patients with signs of past or present hepatitis B virus(HBV) infection. While the use of liver grafts from donors with evidence of past HBV infection is quite limited, some data have been collected regarding the feasibility of transplanting a liver graft from a hepatitis B surface antigen(HBs Ag) positive donor. The aim of the present work was to review the literature regarding liver transplants from HBs Ag-positive donors. A total of 17 studies were identified by a search in Medline. To date, HBs Ag positive grafts have preferentially been allocated to HBs Ag positive recipients. The large majority of these patients continue to be HBs Ag positive despite the use of immunoglobulin, and infection prevention can only be guaranteed by using antiviral prophylaxis. Although serological persistence is evident, no significant HBV-related disease has been observed, except in patients coinfected with delta virus. Consistently less data are available for HBs Ag negative recipients, although they are mostly promising. HBs Agpositive grafts could be an additional organ source for liver transplantation, provided that the risk of reinfection/reactivation is properly prevented. | Elisabetta Loggi Fabio Conti Alessandro Cucchetti Giorgio Ercolani Antonio Daniele Pinna Pietro Andreone | 2016 | World Journal of Gastroenterology2016，22，35： | 5 |
| 10 | Is Portal Hypertension a Contraindication to Hepatic Resection?显示文摘 | Alessandro Cucchetti Giorgio Ercolani Marco Vivarelli Matteo Cescon Matteo Ravaioli Giovanni Ramacciato Gian Luca Grazi Antonio Daniele Pinna | 2009 | Annals of Surgery2009，，6： | 5 |
| 11 | Long term follow-up and outcome of liver transplantation from hepatitis B surface antigen positive donors显示文摘Liver transplant for hepatitis B virus(HBV) currently yields excellent outcomes: it allows to rescue patients with an HBV-related advanced liver disease, resulting in a demographical modification of the waiting list for liver transplant. In an age of patient-tailored treatments, in liver transplantation as well the aim is to offer the best suitable graft to the patient who can benefit from it, also expanding the criteria for organ acceptance and allocation. With the intent of developing strategies to increase the donor pool, we set-up a multicenter study involving 3 Liver Transplant Centers in Italy: patients undergoing liver transplantation between March 03, 2004, and May 21, 2010, were retrospectively evaluated. 1408 patients underwent liver transplantation during the study period, 28(2%) received the graft from hepatitis B surface antigen positive(HBs Ag)-positive deceased donors. The average follow-up after liver transplantation was 63.7 mo [range: 0.1-119.4; SD ± 35.8]. None Primary nonfunction, re-liver transplantation, early or late hepatic artery thrombosis occurred. The 1-, 3-and 5-year graft and patient survival resulted of 85.7%, 82.1%, 78.4%. Our results suggest that the use of HBs Agpositive donors liver grafts is feasible, since HBV can be controlled without affecting graft stability. However, the selection of grafts and the postoperative antiviral therapy should be managed appropriately. | Roberto Ballarin Alessandro Cucchetti Francesco Paolo Russo Paolo Magistri Matteo Cescon Umberto Cillo Patrizia Burra Antonio Daniele Pinna Fabrizio Di Benedetto | 2017 | World Journal of Gastroenterology2017，23，12： | 4 |
| 12 | A Comprehensive Meta-regression Analysis on Outcome of Anatomic Resection Versus Nonanatomic Resection for Hepatocellular Carcinoma显示文摘 | Alessandro Cucchetti Matteo Cescon Giorgio Ercolani Eleonora Bigonzi Guido Torzilli Antonio D. Pinna | 2012 | Annals of Surgical Oncology2012，，12： | 3 |
| 13 | Cost-effectiveness of hepatic resection versus percutaneous radiofrequency ablation for early hepatocellular carcinoma<!-- Doctopic: CAN -->显示文摘 | Alessandro Cucchetti Fabio Piscaglia Matteo Cescon Antonio Colecchia Giorgio Ercolani Luigi Bolondi Antonio D. Pinna | 2013 | Journal of Hepatology2013，，2： | 3 |
| 14 | Liver transplantation from hepatitis B surface antigen positive donors: A safe way to expand the donor pool显示文摘 | Elisabetta Loggi Lorenzo Micco Giorgio Ercolani Alessandro Cucchetti Florian K. Bihl Gian Luca Grazi Stefano Gitto Andrea Bontadini Mauro Bernardi Paolo Grossi Alessandro Nanni Costa Antonio Daniele Pinna Christian Brander Pietro Andreone | 2011 | Journal of Hepatology2011，，3： | 2 |
| 15 | Anatomic versus non-anatomic resection in cirrhotic patients with early hepatocellular carcinoma显示文摘 | A. Cucchetti G.L. Qiao M. Cescon J. Li Y. Xia G. Ercolani F. Shen A.D. Pinna | 2013 | Surgery2013，，： | 2 |
| 16 | Liver Transplantation for Hepatocellular Carcinoma Under Calcineurin Inhibitors: Reassessment of Risk Factors for Tumor Recurrence显示文摘 | Marco Vivarelli Alessandro Cucchetti Giuliano La Barba Matteo Ravaioli Massimo Del Gaudio Augusto Lauro Gian Luca Grazi Antonio Daniele Pinna | 2008 | Annals of Surgery2008，，5： | 2 |
| 17 | The impact of extent of pancreatic and venous resection on survival for patients with pancreatic cancer显示文摘Background:Borderline resectable pancreatic cancer may require extended resections in order to achieve tumor-free margins,especially in the case of up-front resections,but it is important to know the limits of surgical therapy in this disease.This study aimed to investigate the impact of extent of pancreatic and venous resection on short-and long-term outcomes in patients with pancreatic adenocarcinoma(PDAC).Methods:This was a retrospective study from a prospectively maintained database of pancreatic resections for PDAC.Short-and long-term outcomes were analyzed in patients having borderline resectable PDAC submitted to up-front total pancreatectomy(TP)or pancreaticoduodenectomy(PD)with simultaneous portal vein(PV)and/or superior mesenteric vein(SMV)resection.Venous resections were carried out as tangential venous resection(TVR)or segmental venous resection(SVR).Patients were divided into 4 groups:(1)PD+TVR,(2)PD+SVR,(3)TP+TVR,(4)TP+SVR.Uni-and multivariate Cox regression analysis were performed to identify factors associated with survival.Results:Ninety-nine patients were submitted to simultaneous pancreatic and venous resection for PDAC.Among them,25 were submitted to PD+TVR(25.3%),12 to PD+SVR(12.1%),23 to TP+TVR(23.2%),and 39 to TP+SVR(39.4%).Overall,major morbidity(Clavien-Dindo grade≥IIIA)was 26.3%.Thirty-and 90-day mortality were 3%and 11.1%,respectively.There were no significant differences among groups in terms of short-term outcomes.Median overall survival of patients submitted to PD+TVR was significantly higher than those to TP+SVR(29.5 vs 7.9 months,P=0.001).Multivariate analysis identified TP(HR=2.11;95%CI:1.31–3.44;P=0.002)and SVR(HR=2.01;95%CI:1.27–3.15;P=0.003)as the only independent prognostic factors for overall survival.Conclusions:Up-front TP associated to SVR was predictive of worse survival in borderline resectable PDAC.Perioperative treatments in high-risk surgical groups may improve such poor outcomes. | Matteo Serenari Giorgio Ercolani Alessandro Cucchetti Matteo Zanello Enrico Prosperi Guido Fallani Michele Masetti Raffaele Lombardi Matteo Cescon Elio Jovine | 2019 | Hepatobiliary & Pancreatic Diseases International2019，18，4： | 2 |
| 18 | Indocyanine green retention test as a noninvasive marker of portal hypertension and esophageal varices in compensated liver cirrhosis显示文摘 | Andrea Lisotti Francesco Azzaroli Federica Buonfiglioli Marco Montagnani Paolo Cecinato Laura Turco Claudio Calvanese Patrizia Simoni Massimo Guardigli Rosario Arena Alessandro Cucchetti Antonio Colecchia Davide Festi Rita Golfieri Giuseppe Mazzella | 2014 | Hepatology2014，，2： | 2 |
| 19 | Hepatocellular Carcinomas and Primary Liver Tumors as Predictive Factors for Postoperative Mortality after Liver Resection: A Meta-Analysis of More than 35,000 Hepatic Resections显示文摘 | Ramacciato Giovanni D’Angelo Francesco Baldini Rossella Petrucciani Niccoló Antolino Laura Aurello Paolo Nigri Giuseppe Bellagamba Riccardo Pezzoli Francesca Balesh Albert Cucchetti Alessandro Cescon Matteo Del Gaudio Massimo Ravaioli Matteo | 2012 | EN2012，，4： | 2 |
| 20 | Comparison of Recurrence of Hepatocellular Carcinoma After Resection in Patients with Cirrhosis to Its Occurrence in a Surveilled Cirrhotic Population显示文摘 | Alessandro Cucchetti MD Fabio Piscaglia MD Eugenio Caturelli MD Luisa Benvegnù MD Marco Vivarelli MD Giorgio Ercolani MD Matteo Cescon MD Matteo Ravaioli MD Gian Luca Grazi MD Luigi Bolondi MD Antonio Daniele Pinna MD | 2009 | Annals of Surgical Oncology2009，，2： | 2 |
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