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| 1 | Endoscopic submucosal dissection vs endoscopic mucosal resection for early gastric cancer: A meta-analysis显示文摘AIM: To compare endoscopic submucosal dissection(ESD) and endoscopic mucosal resection(EMR) for early gastric cancer(EGC).METHODS: Computerized bibliographic search was performed on PubMed/Medline, Embase, Google Schol-ar and Cochrane library databases. Quality of each included study was assessed according to current Co-chrane guidelines. Primary endpoints were en bloc re-section rate and histologically complete resection rate. Secondary endpoints were length of procedure, post-treatment bleeding, post-procedural perforation and re-currence rate. Comparisons between the two treatment groups across all the included studies were performed by using Mantel-Haenszel test for fixed-effects mod-els(in case of low heterogeneity) or DerSimonian and Laird test for random-effects models(in case of high heterogeneity).RESULTS: Ten retrospective studies(8 full text and 2 abstracts) were included in the meta-analysis. Overall data on 4328 lesions, 1916 in the ESD and 2412 in the EMR group were pooled and analyzed. The mean operation time was longer for ESD than for EMR(stan-dardized mean difference 1.73, 95%CI: 0.52-2.95, P =0.005) and the 'en bloc ' and histological complete re-section rates were significantly higher in the ESD group [OR = 9.69(95%CI: 7.74-12.13), P < 0.001 and OR = 5.66,(95%CI: 2.92-10.96), P < 0.001, respectively]. As a consequence of its greater radicality, ESD provided lower recurrence rate [OR = 0.09,(95%CI: 0.05-0.17), P < 0.001]. Among complications, perforation rate was significantly higher after ESD [OR = 4.67,(95%CI, 2.77-7.87), P < 0.001] whereas the bleeding incidences did not differ between the two techniques [OR = 1.49(0.6-3.71), P = 0.39].CONCLUSION: In the endoscopic therapy of EGC, ESD showed a superior efficacy but higher complication rate with respect to EMR. | Antonio Facciorusso Matteo Antonino Marianna Di Maso Nicola Muscatiello | 2014 | World Journal of Gastrointestinal Endoscopy2014，6，11： | 50 |
| 2 | Transarterial chemoembolization:Evidences from the literature and applications in hepatocellular carcinoma patients显示文摘Transarterial chemoembolization(TACE) is the current standard of care for patients with large or multinodular hepatocellular carcinoma(HCC), preserved liver function, absence of cancer-related symptoms and no evidence of vascular invasion or extrahepatic spread(i.e., those classified as intermediate stage according to the Barcelona Clinic Liver Cancer staging system). The rationale for TACE is that the intra-arterial injection of a chemotherapeutic drug such as doxorubicin or cisplatin followed by embolization of the blood vessel will result in a strong cytotoxic effect enhanced by ischemia. However, TACE is a very heterogeneous operative technique and varies in terms of chemotherapeutic agents, treatment devices and schedule. In order to overcome the major drawbacks of conventional TACE(c TACE), non-resorbable drug-eluting beads(DEBs) loaded with cytotoxic drugs have been developed. DEBs are able to slowly release the drug upon injection and increase the intensity and duration of ischemia while enhancing the drug delivery to the tumor. Unfortunately, despite the theoretical advantages of this new device and the promising results of the pivotal studies, definitive data in favor of its superiority over c TACE are still lacking. The recommendation for TACE as the standard-of-care for intermediate-stage HCC is based on the demonstration of improved survival compared with best supportive care or suboptimal therapies in a meta-analysis of six randomized controlled trials, but other therapeutic options(namely, surgery and radioembolization) proved competitive in selected subsets of intermediate HCC patients. Other potential fields of application of TACE in hepato-oncology are the pre-transplant setting(as downstaging/bridging treatment) and the early stage(in patients unsuitable to curative therapy). The potential of TACE in selectedadvanced patients with segmental portal vein thrombosis and preserved liver function deserves further reports. | Antonio Facciorusso Raffaele Licinio Nicola Muscatiello Alfredo Di Leo Michele Barone | 2015 | World Journal of Hepatology2015，7，16： | 25 |
| 3 | Local ablative treatments for hepatocellular carcinoma:An updated review显示文摘Ablative treatments currently represent the first-line option for the treatment of early stage unresectable hepatocellular carcinoma(HCC).Furthermore,they are effective as bridging/downstaging therapies before orthotopic liver transplantation.Contraindications based on size,number,and location of nodules are quite variable in literature and strictly dependent on local expertise.Among ablative therapies,radiofrequency ablation(RFA) has gained a pivotal role due to its efficacy,with a reported 5-year survival rate of 40%-70%,and safety.Although survival outcomes are similar to percutaneous ethanol injection,the lower local recurrence rate stands for a wider application of RFA in hepato-oncology.Moreover,RFA seems to be even more cost-effective than liver resection for very early HCC(single nodule ≤ 2 cm) and in the presence of two or three nodules ≤ 3 cm.There is increasing evidence that combining RFA to transarterial chemoembolization may increase the therapeutic benefit in larger HCCs without increasing the major complication rate,but more robust prospective data is still needed to validate these pivotal findings.Among other thermal treatments,microwave ablation(MWA) uses high frequency electromagnetic energy to induce tissue death via coagulation necrosis.In comparison to RFA,MWA has several theoretical advantages such as a broader zone of active heating,higher temperatures within the targeted area in a shorter treatment time and the lack of heatsink effect.The safety concerns raised on the risks of this procedure,due to the broader and less predictable necrosis areas,have been recently overcome.However,whether MWA ability to generate a larger ablation zone will translate into a survival gain remains unknown.Other treatments,such as high-intensity focused ultrasound ablation,laser ablation,and cryoablation,are less investigated but showed promising results in early HCC patients and could be a valuable therapeutic option in the next future. | Antonio Facciorusso Gaetano Serviddio Nicola Muscatiello | 2016 | World Journal of Gastrointestinal Pharmacology and Therapeutics2016，7，4： | 23 |
| 4 | Drug-eluting beads transarterial chemoembolization for hepatocellular carcinoma: Current state of the art显示文摘Transarterial chemoembolization(TACE) represents the current gold standard for hepatocellular carcinoma(HCC) patients in intermediate stage. Conventional TACE(c TACE) is performed with the injection of an emulsion of a chemotherapeutic drug with lipiodol into the artery feeding the tumoral nodules, followed by embolization of the same vessel to obtain a synergistic effect of drug cytotoxic activity and ischemia. Aim of this review is to summarize the main characteristics of drug-eluting beads(DEB)-TACE and the clinical results reported so far in the literature. A literature search was conducted using Pub Med until June 2017. In order to overcome the drawbacks of c TACE, namely lack of standardization and unpredictability of outcomes, non-absorbable embolic microspheres charged with cytotoxic agents(DEBs) have been developed. DEBs are able to simultaneously exert both the therapeutic components of TACE, either drug-carrier function and embolization, unlike c TACE in which applying the embolic agent is a second moment after drug injection. This way, risk of systemic drug release is minimal due to both high-affinity carrier activity of DEBs and absence of a time interval between injection and embolization. However, despite promising results of preliminary studies, clear evidence of superiority of DEB-TACE over c TACE is still lacking. A number of novel technical devices are actually in development in the field of loco-regional treatments for HCC, but only a few of them have entered the clinical arena. In absence of well-designed randomized-controlled trials, the decision on whether use DEB-TACE or c TACE is still controversial. | Antonio Facciorusso | 2018 | World Journal of Gastroenterology2018，24，2： | 21 |
| 5 | Non-polypoid colorectal neoplasms:Classification,therapy and follow-up显示文摘In the last years,an increasing interest has been raised on non-polypoid colorectal tumors(NPT) and in particular on large flat neoplastic lesions beyond 10 mm tending to grow laterally,called laterally spreading tumors(LST).LSTs and large sessile polyps have a greater frequency of high-grade dysplasia and local invasiveness as compared to pedunculated lesions of the same size and usually represent a technical challenge for the endoscopist in terms of either diagnosis and resection.According to the Paris classification,NPTs are distinguished in slightly elevated(0-Ⅱa,less than 2.5 mm),flat(0-Ⅱb) or slightly depressed(0-Ⅱc).NPTs are usually flat or slightly elevated and tend to spread laterally while in case of depressed lesions,cell proliferation growth progresses in depth in the colonic wall,thus leading to an increased risk of submucosal invasion(SMI) even for smaller neoplasms.NPTs may be frequently missed by inexperienced endoscopists,thus a careful training and precise assessment of all suspected mucosal areas should be performed.Chromoendoscopy or,if possible,narrow-band imaging technique should be considered for the estimation of SMI risk of NPTs,and the characterization of pit pattern and vascular pattern may be useful to predict the risk of SMI and,therefore,to guide the therapeutic decision.Lesions suitable to endoscopic resection are those confined to the mucosa(or superficial layer of submucosa in selected cases) whereas deeper invasion makes endoscopic therapy infeasible.Endoscopic mucosal resection(EMR,piecemeal for LSTs > 20 mm,en bloc for smaller neoplasms) remains the first-line therapy for NPTs,whereas endoscopic submucosal dissection in high-volume centers or surgery should be considered for large LSTs for which en bloc resection is mandatory and cannot be achieved by means of EMR.After piecemeal EMR,follow-up colonoscopy should be performed at 3 mo to assess resection completeness.In case of en bloc resection,surveillance colonoscopy should be scheduled at 3 years for adenomatous lesions ≥ 1 cm,or in presence of villous features or high-grade dysplasia patients(regardless of the size),while less intensive surveillance(colonoscopy at 5-10 years) is needed in case of single(or two) NPT < 1 cm presenting tubular features or low-grade dysplasia at histology. | Antonio Facciorusso Matteo Antonino Marianna Di Maso Michele Barone Nicola Muscatiello | 2015 | World Journal of Gastroenterology2015，21，17： | 20 |
| 6 | Development and validation of a risk score for advanced colorectal adenoma recurrence after endoscopic resection显示文摘AIM: To develop and validate a risk score for advanced colorectal adenoma(ACA) recurrence after endoscopic polypectomy.METHODS: Out of 3360 patients who underwent colon polypectomy at University of Foggia between 2004 and 2008, data of 843 patients with 1155 ACAs was retrospectively reviewed. Surveillance intervals were scheduled by guidelines at 3 years and primary endpoint was considered 3-year ACA recurrence. Baseline clinical parameters and the main features of ACAs were entered into a Cox regression analysis and variables with P < 0.05 in the univariate analysis were then tested as candidate variables into a stepwise Cox regression model(conditional backward selection). The regression coefficients of the Cox regression model were multiplied by 2 and rounded in order to obtain easy to use point numbers facilitating the calculation of the score. To avoid overoptimistic results due to model fitting and evaluation in the same dataset, we performed an internal 10-fold cross-validation by means of bootstrap sampling. RESULTS: Median lesion size was 16 mm(12-23) while median number of adenomas was 2.5(1-3), whereof the number of ACAs was 1.5(1-2). At 3 years after polypectomy, recurrence was observed in 229 ACAs(19.8%), of which 157(13.5%) were metachronous neoplasms and 72(6.2%) local recurrences. Multivariate analysis, after exclusion of the variable 'type of resection' due to its collinearity with other predictive factors, confirmed lesion size, number of ACAs and grade of dysplasia as significantly associated to the primary outcome. The score was then built by multiplying the regression coefficients times 2 and the cut-off point 5 was selected by means of a Receiver Operating Characteristic curve analysis. In particular, 248 patients with 365 ACAs fell in the higher-risk group(score ≥ 5) where 3-year recurrence was detected in 174 ACAs(47.6%) whereas the remaining 595 patients with 690 ACAs were included in the low-risk group(score < 5) where 3-year recurrence rate was 7.9%(55/690 ACAs). Area under the curve of the model was 0.81(0.72-0.86) with an overall classification error rate of 0.09. The model was finally validated by means of 10-fold cross validation.CONCLUSION: Our study provides support for the use of a novel risk score as a clinical predictor of ACA recurrence after colon polypectomy. | Antonio Facciorusso Marianna Di Maso Gaetano Serviddio Gianluigi Vendemiale Nicola Muscatiello | 2016 | World Journal of Gastroenterology2016，22，26： | 8 |
| 7 | Transarterial radioembolization vs chemoembolization for hepatocarcinoma patients:A systematic review and metaanalysis显示文摘AIM: To compare the efficacy and safety of yttrium-90 radioembolization(Y90RE) and transarterial chemoembolization(TACE) in hepatocellular carcinoma patients. METHODS: Bibliographic research was conducted on main scientific databases. When there was no statistically significant heterogeneity, pooled effects were calculated using a fixed-effects model by means of Mantel-Haenszel test, otherwise, a random-effects model was used with Der Simonian and Laird test. Summary estimates were expressed in terms of odds ratios(ORs) and 95%CI. The probability of publication bias was assessed using funnel plots and with Begg and Mazumdar's test. Sensitivity analysis was finally conducted using the method of excluding extreme data.RESULTS: A total of 10 studies were analyzed, of which 2 randomized controlled trials. Survival rate(SR) assessed at 1 year showed an absolute similarity between the two treatment groups(OR = 1.01, 95%CI: 0.78-1.31, P = 0.93). As long as time elapsed since the treatment, ORs for survival rate tended to significantly increase, thus meaning better long-term outcomes in patients who underwent Y90RE(2-year SR: OR = 1.43, 1.08-1.89, P = 0.01; 3-year SR: OR = 1.48, 1.03-2.13, P = 0.04). Meta-analysis of plotted hazard ratios(HRs) determined a non-significant overall estimate in favor of Y90RE(HR = 0.91, 0.80-1.04, P = 0.16). Y90 RE showed a statistically significant benefit as compared to TACE in terms of higher progression-free survival rateassessed at 1 year(OR = 1.67; 95%CI: 1.10-2.55; P = 0.02). Pooled analyses do not revealed a statistically significant increase in OR for tumor objective responses after Y90 RE with respect to TACE(OR = 1.22, 95%CI: 0.69-2.16, P = 0.50). A non-significant trend in favor of Y90 RE was observed according to adverse event rate(OR = 0.70, 0.38-1.30, P = 0.26).CONCLUSION: Our meta-analysis reveals that Y90 RE and TACE show similar effects in terms of survival, response rate and safety profile, although tumor progression is delayed after radioembolization. | Antonio Facciorusso Gaetano Serviddio Nicola Muscatiello | 2016 | World Journal of Hepatology2016，8，18： | 5 |
| 8 | WJH 6^(th) Anniversary Special Issues(4): Cirrhosis Role of vaptans in the management of hydroelectrolytic imbalance in liver cirrhosis显示文摘Ascites and hyponatremia are the most common complications in patients with liver cirrhosis and develop as a consequence of a severe impairment of liver function and portal hypertension. Increasing evidences support the central role of renal function alterations in the pathogenesis of hydroelectrolytic imbalances in cirrhotic patients, thus implying a dense cross-talk between liver and kidney in the systemic and splanchnic vascular homeostasis in such subjects. Since Arginin Vasopressin(AVP) hyperincretion occurs at late stage of cirrhosis and plays an important role in the development of refractory ascites, dilutional hyponatremia and finally hepato-renal syndrome, selective antagonists of AVP receptors V2(vaptans) have been recently introduced in the therapeutic algorithm of advanced cirrhotic patients. Despite the promising results of earlier phasetwo studies, randomized controlled trials failed to find significant results in terms of efficacy of such drugs both in refractory ascites and hyponatremia. Moreover, concerns on their safety profile arise, due to the number of potentially severe side effects of vaptans in the clinical setting, such as hypernatremia, dehydration, renal impairment, and osmotic demyelination syndrome. More robust data from randomized controlled trials are needed in order to confirm the potential role of vaptans in the management of advanced cirrhotic patients. | Antonio Facciorusso Annabianca Amoruso Viviana Neve Matteo Antonino Valentina Del Prete Michele Barone | 2014 | World Journal of Hepatology2014，6，11： | 4 |
| 9 | Lymphocyte-to-monocyte ratio predicts survival after radiofrequency ablation for colorectal liver metastases显示文摘AIM: To test the correlation between lymphocyte-tomonocyte ratio(LMR) and survival after radiofrequency ablation(RFA) for colorectal liver metastasis(CLMs). METHODS: From July 2003 to Feb 2012, 127 consecutive patients with 193 histologically-proven unresectable CLMs were treated with percutaneous RFA at the University of Foggia. All patients had undergone primary colorectal tumor resection before RFA and received systemic chemotherapy. LMR was calculated by dividing lymphocyte count by monocyte count assessed at baseline. Treatment-related toxicity was defined as any adverse events occurred within 4 wk after the procedure. Overall survival(OS) and time to recurrence(TTR) were estimated from the date of RFA by Kaplan-Meier with plots and median(95%CI). The inferential analysis for time to event data was conducted using the Cox univariate and multivariate regression model to estimate hazard ratios(HR) and 95%CI. Statistically significant variables from the univariate Cox analysis were considered for the multivariate models.RESULTS: Median age was 66 years(range 38-88) and patients were prevalently male(69.2%). Median LMR was 4.38%(0.79-88) whereas median number of nodules was 2(1-3) with a median maximum diameter of 27 mm(10-45). Median OS was 38 mo(34-53) and survival rate(SR) was 89.4%, 40.4% and 33.3% at 1, 4 and 5 years respectively in the whole cohort. Running log-rank test analysis found 3.96% as the most significant prognostic cut-off point for LMR and stratifying the study population by this LMR value median OS resulted 55 mo(37-69) in patients with LMR > 3.96% and 34(26-39) mo in patients with LMR ≤ 3.96%(HR = 0.53, 0.34-0.85, P = 0.007). Nodule size and LMR were the only significant predictors for OS in multivariate analysis. Median TTR was 29 mo(22-35) with a recurrence-free survival(RFS) rate of 72.6%, 32.1% and 21.8% at 1, 4 and 5 years, respectively in the whole study group. Nodule size and LMR were confirmed as significant prognostic factors for TTR in multivariate Cox regression. TTR, when stratified by LMR, was 35 mo(28-57) in the group > 3.96% and 25 mo(18-30) in the group ≤ 3.96%(P = 0.02).CONCLUSION: Our study provides support for the use of LMR as a novel predictor of outcome for CLM patients. | Antonio Facciorusso Valentina Del Prete Nicola Crucinio Gaetano Serviddio Gianluigi Vendemiale Nicola Muscatiello | 2016 | World Journal of Gastroenterology2016，22，16： | 4 |
| 10 | Transarterial chemoembolization using 40 μm drug eluting beads for hepatocellular carcinoma显示文摘AIM To assess the safety and efficacy of transarterial chemoembolization(TACE) of hepatocellular carcinoma(HCC) using a new generation of 40 μm drug eluting beads in patients not eligible for curative treatment.METHODS Drug eluting bead TACE(DEB-TACE) using a new generation of microspheres(embozene tandem,40 μm) preloaded with 100 mg of doxorubicin was performed on 48 early or intermediate HCC patients with compensatedcirrhosis.Response to therapy was assessed with Response Evaluation Criteria in Solid Tumors(RECIST) and modified RECIST(m RECIST) guidelines applied to computed tomography or magnetic resonance imaging.Eleven out of the 48 treated patients treated progressed on to receive liver orthotopic transplantation(OLT).This allowed for histological analysis on the treated explanted nodules.RESULTS DEB-TACE with 40 μm showed a good safety profile without major complications or 30-d mortality.The objective response rate of treated tumors was 72.6% and 26.7% according to m RECIST and RECIST respectively.Histological examination in 11 patients assigned to OLT showed a necrosis degree > 90% in 78.6% of cases.The overall time to progression was 13 mo(11-21).CONCLUSION DEB-TACE with 40 μm particles is an effective treatment for the treatment of HCC in early-intermediate patients(Barcelona Clinic Liver Cancer stage A/B) with a good safety profile and good results in term of objective response rate and necrosis. | Giorgio Greco Tommaso Cascella Antonio Facciorusso Roberto Nani Rodolfo Lanocita Carlo Morosi Marta Vaiani Giuseppina Calareso Francesca G Greco Antonio Ragnanese Marco A Bongini Alfonso V Marchianò Vincenzo Mazzaferro Carlo Spreafico | 2017 | World Journal of Radiology2017，9，5： | 3 |
| 11 | Post-recurrence survival in hepatocellular carcinoma after percutaneous radiofrequency ablation显示文摘 | Antonio Facciorusso Valentina Del Prete Matteo Antonino Nicola Crucinio Viviana Neve Alfredo Di Leo Brian I. Carr Michele Barone | 2014 | Digestive and Liver Disease2014，，11： | 2 |
| 12 | Angiotensin receptor blockers improve survival outcomes after radiofrequency ablation in hepatocarcinoma patients显示文摘 | Antonio Facciorusso Valentina Del Prete Nicola Crucinio Nicola Muscatiello Brian I Carr Alfredo Di Leo Michele Barone | 2015 | J Gastroenterol Hepatol2015，，11： | 2 |
| 13 | Polidocanol injection decreases the bleeding rate after colon polypectomy: a propensity score analysis显示文摘 | Antonio Facciorusso Marianna Di Maso Matteo Antonino Valentina Del Prete Carmine Panella Michele Barone Nicola Muscatiello | 2015 | Gastrointestinal Endoscopy2015，，2： | 2 |
| 14 | Transarterial Chemoembolization for Hepatocellular Carcinoma with a New Generation of Beads: Clinical–Radiological Outcomes and Safety Profile显示文摘 | Carlo Spreafico Tommaso Cascella Antonio Facciorusso Carlo Sposito Lanocita Rodolfo Carlo Morosi Enrico M. Civelli Marta Vaiani Sherrie Bhoori Alessandro Pellegrinelli Alfonso Marchianò Vincenzo Mazzaferro | 2015 | CardioVascular and Interventional Radiology2015，，1： | 2 |
| 15 | The Influence of Diabetes in the Pathogenesis and the Clinical Course of Hepatocellular Carcinoma: Recent Findings and New Perspectives显示文摘 | Antonio Facciorusso | 2013 | Current Diabetes Reviews2013，，5： | 2 |
| 16 | Anomalous origina of the left coronary artery from the pulmonary artery in an elderly patient,football player in youth显示文摘 | Facciorusso A Lanna P Viqna C | 2008 | J Cardiovasc Med2008，9，10： | 1 |
| 17 | Diagnosis of Hepatocellular Carcinoma Complicating Liver Cirrhosis: Utility of Repeat Ultrasound-Guided Biopsy after Unsuccessful First Sampling显示文摘 | Eugenio Caturelli Elisabetta Biasini Francesca Bartolucci Domenico Facciorusso Francesco Decembrino Vito Attino Michele Bisceglia | 2002 | CardioVascular and Interventional Radiology2002，，4： | 1 |
| 18 | Serum ferritin as a new prognostic factor in hepatocellular carcinoma patients treated with radioffequency ablation 显示文摘 | Facciorusso A Del Prete V Antonino M | 2014 | J Gastroenterol Hepatol2014，29，11： | 1 |
| 19 | Enhanced endoscopic ultrasound imaging for pancreatic lesions: The road to artificial intelligence显示文摘Early detection of pancreatic cancer has long eluded clinicians because of its insidious nature and onset.Often metastatic or locally invasive when symptomatic,most patients are deemed inoperable.In those who are symptomatic,multi-modal imaging modalities evaluate and confirm pancreatic ductal adenocarcinoma.In asymptomatic patients,detected pancreatic lesions can be either solid or cystic.The clinical implications of identifying small asymptomatic solid pancreatic lesions(SPLs)of<2 cm are tantamount to a better outcome.The accurate detection of SPLs undoubtedly promotes higher life expectancy when resected early,driving the development of existing imaging tools while promoting more comprehensive screening programs.An imaging tool that has matured in its reiterations and received many image-enhancing adjuncts is endoscopic ultrasound(EUS).It carries significant importance when risk stratifying cystic lesions and has substantial diagnostic value when combined with fine needle aspiration/biopsy(FNA/FNB).Adjuncts to EUS imaging include contrast-enhanced harmonic EUS and EUS-elastography,both having improved the specificity of FNA and FNB.This review intends to compile all existing enhancement modalities and explore ongoing research around the most promising of all adjuncts in the field of EUS imaging,artificial intelligence. | Marco Spadaccini Glenn Koleth James Emmanuel Kareem Khalaf Antonio Facciorusso Fabio Grizzi Cesare Hassan Matteo Colombo Benedetto Mangiavillano Alessandro Fugazza Andrea Anderloni Silvia Carrara Alessandro Repici | 2022 | World Journal of Gastroenterology2022，28，29： | 1 |
| 20 | Salivary markers of work stress in an emergency team of urban police (1 degree step)显示文摘 | Zefferino R Facciorusso A Lasalvia M | 2006 | G Ital Med Lay Ergon2006，28，4： | 1 |
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