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| 1 | Chemotherapy for hepatocellular carcinoma:The present and the future显示文摘Hepatocellular carcinoma(HCC) is the most common primary tumor of the liver. Its relationship to chronic liver diseases, in particular cirrhosis, develops on a background of viral hepatitis, excessive alcohol intake or metabolic steatohepatitis, leads to a high incidence and prevalence of this neoplasia worldwide. Despite the spread of HCC, its treatment it's still a hard challenge, due to high rate of late diagnosis and to lack of therapeutic options for advanced disease. In fact radical surgery and liver transplantation, the most radical therapeutic approaches, are indicated only in case of early diagnosis. Even local therapies, such as transarterial chemoembolization, find limited indications, leading to an important problem regarding treatment of advanced disease. In this situation, until terminal HCC occurs, systemic therapy is the only possible approach, with sorafenib as the only standard treatment available. Anyway, the efficacy of this drug is limited and many efforts are necessary to understand who could benefit more with this treatment. Therefore, other molecules for a targeted therapy were evaluated, but only regorafenib showed promising results. Beside molecular target therapy, also cytotoxic drugs, in particular oxaliplatinand gemcitabine-based regimens, and immune-checkpoint inhibitors were tested with interesting results. The future of the treatment of this neoplasia is linked to our ability to understand its mechanisms of resistance and to find novel therapeutic targets, with the objective to purpose individualized approaches to patients affected by advanced HCC. | Marco Le Grazie Maria Rosa Biagini Mirko Tarocchi Simone Polvani Andrea Galli | 2017 | World Journal of Hepatology2017,9,21: | 11 |
| 2 | Peliosis hepatis: Personal experience and literature review显示文摘Peliosis hepatis(PH) is a disease characterized by multiple and small,blood-filled cysts within the parenchymatous organs. PH is a very rare disease,more common in adults,and when it affects the liver,it comes to the surgeon's attention only in an extremely urgent situation after the lesion's rupture with the resulting hemoperitoneum. This report describes the case of a 29-year-old woman affected by recurring abdominal pain. Computed tomography scans showed a hepatic lesion formed by multiple hypodense areas,which showed an early acquisition of the contrast during the arterial phase. Furthermore,it remained isodense with the remaining parenchyma during the late venous phase. We decided on performing a liver resection of segment Ⅶ while avoiding a biopsy for safety reasons. The histopathologic examination confirmed the diagnosis of focal PH. PH should always be considered in the differential diagnosis of hepatic lesions. Clinicians should discuss the possible causes and issues related to the differential diagnosis in addition to the appropriate therapeutic approach. The fortuitous finding of a lesion,potentially compatible with PH,requires elective surgery with diagnostic and therapeutic intents. The main aim is to prevent the risk of a sudden bleeding that,in absence of properly equipped structures,may have a fatal outcome. | Daniele Crocetti Andrea Palmieri Giuseppe Pedullà Vittorio Pasta Valerio D'Orazi Gian Luca Grazi | 2015 | World Journal of Gastroenterology2015,21,46: | 7 |
| 3 | 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 |
| 4 | 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 |
| 5 | Predicting survival after liver transplantation in patients with hepatocellular carcinoma beyond the Milan criteria: a retrospective, exploratory analysis显示文摘 | Vincenzo Mazzaferro Josep M Llovet Rosalba Miceli Sherrie Bhoori Marcello Schiavo Luigi Mariani Tiziana Camerini Sasan Roayaie Myron E Schwartz Gian Luca Grazi René Adam Peter Neuhaus Mauro Salizzoni Jordi Bruix Alejandro Forner Luciano De Carlis Umberto | 2009 | Lancet Oncology2009,,1: | 4 |
| 6 | Enteric neuropathology of congenital intestinal obstruction:A case report显示文摘试验性的证据显示肠的长期的机械亚吸藏可以损坏伤寒神经系统(ENS ) ,尽管在人的数据正在缺乏。我们这里描述伤寒的第一诉讼与内脏的先天的阻塞有关的退化神经病。3 年的 A 和老女孩开始抱怨了呕吐的 9 瞬间,腹的扩张,有空气液体的便秘在飞机铺平腹的辐射学。她的随后的病历被 3 操作描绘:首先显示出的扩大 duodeno-jejunal 当闭塞的损害不在时循环;第二(2 年以后) 被执行获得扩大的肠的环的完整厚度的活体检视并且在组织病理学说揭示了 hyperganglionosis;第三(在 hyperganglionosis 以后的 9 年被识别) 揭示了 Ladd 被移开的乐队,联系内脏旋转不良被改正。完整厚度的活体检视显示出的重复 intraoperative 与 Cajal 的减少的空隙的房间一起的退化神经病在 Ladd 的乐队下面在阻塞和正常的神经与肌的层上面在扩大的环联网的伤寒。病人容忍了的在最近的外科以后的一年口头的喂并且很好,建议那先天(部分) 在人的小肠的机械阻塞能唤起类似于在肠的机械吸藏的动物模型发现的那些的 ENS 的进步适应变化。如此的 ENS 变化模仿在肠的伪阻塞观察的神经元畸形。 | Giovanni Di Nardo Vincenzo Stanghellini Salvatore Cucchiara Giovanni Barbara Gianandrea Pasquinelli Donatella Santini Cristina Felicani Gianluca Grazi Antonio D Pinna Rosanna Cogliandro Cesare Cremon Alessandra Gori Roberto Corinaldesi Kenton M Sanders Roberto De Giorgio | 2006 | World Journal of Gastroenterology2006,12,32: | 4 |
| 7 | 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 |
| 8 | Contrast-induced nephropathy in patients undergoing primary angioplasty for acute myocardial infarction显示文摘 | Giancarlo Marenzi Gianfranco Lauri Emilio Assanelli Jeness Campodonico Monica De Metrio Ivana Marana Marco Grazi Fabrizio Veglia Antonio L. Bartorelli | 2004 | Journal of the American College of Cardiology2004,,9: | 2 |
| 9 | Hepatitis C virus recurrence after liver transplantation:A 10-year evaluation显示文摘AIM: To evaluate the predictors of 10-year survival of patients with hepatitis C recurrence. METHODS: Data from 358 patients transplanted between 1989 and 2010 in two Italian transplant centers and with evidence of hepatitis C recurrence were analyzed. A χ2, Fisher's exact test and Kruskal Wallis' test were used for categorical and continuous variables, respectively. Survival analysis was performed at 10 years after transplant using the Kaplan-Meier method, and a log-rank test was used to compare groups. A P level less than 0.05 was considered significant for all tests. Multivariate analysis of the predictive role of different variables on 10-year survival was performed by a stepwise Cox logistic regression.RESULTS: The ten-year survival of the entire population was 61.2%. Five groups of patients were identified according to the virological response or lack of a response to antiviral treatment and, among those who were not treated, according to the clinical status(mild hepatitis C recurrence, 'too sick to be treated' and patients with comorbidities contraindicating the treatment). While the 10-year survival of treated and untreated patients was not different(59.1% vs 64.7%, P = 0.192), patients with a sustained virological response had a higher 10-year survival rate than both the 'non-responders'(84.7% vs 39.8%, P < 0.0001) and too sick to be treated(84.7% vs 0%, P < 0.0001). Sustained virological responders had a survival rate comparable to patients untreated with mild recurrence(84.7% vs 89.3%). A sustained virological response and young donor age were independent predictors of 10-year survival. CONCLUSION: Sustained virological response significantly increased long-term survival. Awaiting the interferon-free regimen global availability, antiviral treatment might be questionable in selected subjects with mild hepatitis C recurrence. | Stefano Gitto Luca Saverio Belli Ranka Vukotic Stefania Lorenzini Aldo Airoldi Arrigo Francesco Giuseppe Cicero Marcello Vangeli Lucia Brodosi Arianna Martello Panno Roberto Di Donato Matteo Cescon Gian Luca Grazi Luciano De Carlis Antonio Daniele Pinna Mauro Bernardi Pietro Andreone | 2015 | World Journal of Gastroenterology2015,21,13: | 2 |
| 10 | Liver Resection for Hepatocellular Carcinoma on Cirrhosis: Univariate and Multivariate Analysis of Risk Factors for Intrahepatic Recurrence显示文摘 | Giorgio Ercolani Gian Luca Grazi Matteo Ravaioli Massimo Del Gaudio Andrea Gardini Matteo Cescon Giovanni Varotti Francesco Cetta Antonino Cavallari | 2003 | Annals of Surgery2003,,4: | 2 |
| 11 | 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 |
| 12 | 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 |
| 13 | Prognostic criteria for postoperative mortality in 170 patients undergoing major right hepatectomy显示文摘BACKGROUND: Postoperative hepatic failure is a dreadful complication after major hepatectomy and carries high morbidity and mortality rates. In this study, we assessed the accuracy of the 50/50 criteria (bilirubin >2.9 mg/dL and international normalized ratio >1.7 on postoperative day 5) and the Mullen criteria (bilirubin peak >7 mg/dL on postoperative days 1-7) in predicting death from hepatic failure in patients undergoing right hepatectomy only. In addition, we identified prognostic factors linked to intra-hospital morbidity and mortality in these patients. METHODS: One hundred seventy consecutive patients underwent major right hepatectomy at a tertiary medical center from 2000 to 2008. Nineteen (11.2%) patients suffered from liver cirrhosis. Univariate and multivariate analyses were performed to identify predictors of intra-hospital mortality, morbidity and death from hepatic failure. RESULTS: The intra-hospital mortality was 6.5% (11/170). Of the six patients who died from hepatic failure, one was positive for the 50/50 criteria, but all six patients were positive for the Mullen criteria. Multivariate analysis showed that male gender, hepatitis C (HCV), hepatocellular carcinoma, postoperative bilirubin >7 mg/dL and ALT<188 U/L on postoperative day 1 were predictive of death from hepatic failure in the postoperative period. Age >65 years, HCV, reoperation, andrenal failure were significant predictors of overall intra-hospital mortality on multivariate analysis. CONCLUSIONS: The Mullen criteria were more accurate than the 50/50 criteria in predicting death from hepatic failure in patients undergoing right hepatectomy. A bilirubin peak >7 mg/dL in the postoperative period, HCV positivity, hepatocellular carcinoma, and an ALT level <188 U/L on postoperative day 1 were associated with death from hepatic failure in our patient population. | Filippo Filicori Xavier M Keutgen Matteo Zanello Giorgio Ercolani Salomone Di Saverio Federico Sacchetti Antonio Daniele Pinna Gian Luca Grazi | 2012 | Hepatobiliary & Pancreatic Diseases International2012,11,5: | 2 |
| 14 | Liver resection for hepato- cellular carcinoma on cirrhosis:univariate and multivariate analysis of risk factors for intrahepatic recurrence显示文摘 | Ercolani G Grazi G L Ravaioli M | 2003 | Ann Surg2003,237,4: | 1 |
| 15 | The effect of aprotinin on renal function in orthotopic liver transplantation显示文摘 | Molenaar IQ Begliomini B Grazi GL | 2001 | Transplantation2001,71,2: | 1 |
| 16 | The role of lymphadenectomy for liver tumors: further considerations on the appropriateness of treatment strategy显示文摘 | Ereolani ( Grazi GL Ravaioli M el al | 2004 | Ann Surg2004,239,2: | 1 |
| 17 | The effect of aprotinin on renal function in orthotopic liver transplantation 显示文摘 | Molenaar I Q Begliomini B Grazi G L a al | 2001 | Transplantation2001,71,2: | 1 |
| 18 | The effect aprotinin on renal function in orthotopic liver transplantation显示文摘 | Molenaar IQ Begliomini B Grazi GL | 2001 | Transpl2001,71,2: | 1 |
| 19 | Influence of prognostic factors on the outcome of liver transplantation for hepatocellular carcinoma on cirrhosis:a univariate and multivariate analysis显示文摘 | Del Gaudio M Grazi GL Principe A | 2004 | Hepatogastroenterology2004,51,56: | 1 |
| 20 | A revised consid- eration on the use of very aged donors for liver transplan- tation显示文摘 | Grazi GL Cescon M Ravaioli M | 2001 | Am J Transplant2001,1,1: | 1 |