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1Personalized surgical management of colorectal cancer in elderly population显示文摘Colorectal cancer(CRC)in the elderly is extremely common but only a few clinicians are familiar with the complexity of issues which present in the geriatric population.In this phase of the life cycle,treatment is frequently suboptimal.Despite the fact that,nowadays,older people tend to be healthier than in previous generations,surgical undertreatment is frequently encountered.On the other hand,surgical overtreatment in the vulnerable or frail patient can lead to unacceptable postoperative outcomes with high mortality or persistent disability.Unfortunately,due to the geriatric patient being traditionally excluded from randomized controlled trials for a variety of factors(heterogeneity,frailty,etc.),there is a dearth of evidence-based clinical guidelines for the management of these patients.The objective of this review was to summarize the most relevant clinical studies available in order to assist clinicians in the management of CRC in the elderly.More than in any other patient group,both surgical and non-surgical management strategies should be carefully individualized in the elderly population affected by CRC.Although cure and sphincter preservation are the primary goals,many other variables need to be taken into account,such as maintenance of cognitive status,independence,life expectancy and quality of life.Giampaolo Ugolini Federico Ghignone Davide Zattoni Giacomo Veronese Isacco Montroni 2014World Journal of Gastroenterology2014,20,14:5
2How to select elderly colorectal cancer patients for surgery: a pilot study in an Italian academic medical center显示文摘Objective: Cancer is one of the most common diagnoses in elderly patients. Of all types of abdominal cancer, colorectal cancer(CRC) is undoubtedly the most frequent. Median age at diagnosis is approximately 70 years old worldwide. Due to the multiple comorbidities affecting elderly people, frailty evaluation is very important in order to avoid over- or undertreatment. This pilot study was designed to investigate the variables capable of predicting the long-term risk of mortality and living situation after surgery for CRC.Methods: Patients with 70 years old and older undergoing elective surgery for CRC were prospectively enrolled in the study. The patients were preoperatively screened using 11 internationally-validated-frailty-assessment tests. The endpoints of the study were long-term mortality and living situation. The data were analyzed using univariate Cox proportional-hazard regression analysis to verify the predictive value of score indices in order to identify possible risk factors.Results: Forty-six patients were studied. The median follow-up time after surgery was 4.6 years(range, 2.9-5.7 years) and no patients were lost to follow-up. The overall mortality rate was 39%. Four of the patients who survived(4/28, 14%) lost their functional autonomy. The preoperative impaired Timed Up and Go(TUG), Eastern Cooperative Group Performance Status(ECOG PS), Instrumental Activities of Daily Living(IADLs), Vulnerable Elders Survey(VES-13) scoring systems were significantly associated with increased long term mortality risk.Conclusion: Simplified frailty-assessing tools should be routinely used in elderly cancer patients before treatment in order to stratify patient risk. The TUG, ECOG-PS, IADLs and VES-13 scoring systems are potentially able to predict long-term mortality and disability. Additional studies will be needed to confirm the preliminary data in order to improve management strategies for oncogeriatric surgical patients.Giampaolo Ugolini Francesco Pasini Federico Ghignone Davide Zattoni Maria Letizia Bacchi Reggiani Daniele Parlanti Isacco Montroni 2015Cancer Biology & Medicine2015,12,4:4
3Nifedipine versus tamsulosin for the management of lower ureteral stones显示文摘Porpiglia F Ghignone G Fiori C 0,,:1
4Dexmedetomidine and clonidine: from second - to first - line sedative agents in the critical care setting 显示文摘Pichot C Ghignone M Quintin L 2012J Intensive Care Med2012,27,:1
5Nifedipine versus tamsulosin for management of lower ureteral stones 显示文摘Porpiglia F Ghignone G Fiori C 2004J Uro2004,172,2:1
6Dexmedetomidine and clonidine:from second-to first-line sedative agents in the critical care setting?显示文摘Pichot C Ghignone M Quintin L 2012J Intensive Care Med2012,27,4:1
7Dexmedetomidine and clonidine:a review of their pharmacodynamy to define their role for sedation in intensive care patients 显示文摘Pichot C Longrois D Ghignone M 2012Ann Fr Anesth Reanim2012,11,31:1
8Nifedipine versus tamsulosin for the management of lower ureteral stones显示文摘Porpiglia F Ghignone G Fiori C 2004J Urol2004,172,2:1
9The Challenge of Education in Colorectal Cancer Surgery: A Comparison of Early Oncological Results, Morbidity, and Mortality Between Residents and Attending Surgeons Performing an Open Right Colectomy显示文摘Isacco Montroni Federico Ghignone Giancarlo Rosati Davide Zattoni Alessio Manaresi Mario Taffurelli Giampaolo Ugolini 2013Journal of Surgical Education2013,,:1
10Nifedipine versus tamsulosin for the management of lower ureteral stones 显示文摘Porpiglia F Ghignone G Fiori C 2004J Urol2004,172,2:1
11Nifedipine versus tamsulosin for the management of lower ureteral stones显示文摘Porpiglia F Ghignone G Fiori C 2004J Urol2004,172,:1
12Identification of Fusarium oxysporum f sp basilici Isolated from Soil Basil Seed and Plants by RAPD Analysis 显示文摘Annalisa Chiocchetti Stefano Ghignone 1999Plant Disease1999,83,6:1
13Nifedipine versus tamsulosin for the management of lower ureteral stones显示文摘PORPIGLIA F GHIGNONE G FIORI C 2004J Urol2004,172,2:1
14Nifedipine versus tamsulosin for the management of lower ureteral stones 显示文摘Porpiglia F Ghignone G Fiori C 2004J Urol2004,172,2:1
15Dexmedetomidine and Cloni- dine :From Second-to-First-Line Sedative Agents in the Critical Care Setting显示文摘Piehot C Ghignone M Quintin L 2011J Intensive Care Med2011,27,:1
16Nifedipine versus tarnsulosin for the management of lower ureleral stones显示文摘Porpiglia F Ghignone G Fiori C 2004J Und2004,172,2:1
17Nifedipine versus tamsulosin for the management of lower ureteral stones显示文摘PORPIGLIA F GHIGNONE G FIORI C 2004J Urol2004,172,:1
18Nifedipine ver-sus tamsulosin for the management of lower ureteral stones显示文摘PORPIGLIA F GHIGNONE G FIORI C 2004J Urol2004,172,:1
19Dexmedetomidine and clonidine: from second to first llne sedation agents in the critical care setting 显示文摘Pichot C Ghignone M and Quintin L 2012Intensive Care Med2012,27,40:1
20A dehydration-inducible gene in the truffle Tuber borchii identifies a novel group of dehydrins 显示文摘Abba' S Ghignone S Confidante P 2006BMC Genomics2006,7,:1
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