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| 1 | Doxorubicin-eluting bead vs conventional transcatheter arterial chemoembolization for hepatocellular carcinoma before liver transplantation显示文摘AIM:To assess the possible effect of two different types of preoperative transcatheter arterial chemoembolization(TACE)on recurrence-free survival after liver transplantation(LT)in patients with hepatocellular carcinoma(HCC)and to analyze the effects of TACE on tumor histology.METHODS:We retrospectively analyzed the histological features of 130 HCC nodules in 63 native livers removed at transplantation.Patients who received any other type of treatment such as radiofrequency tumor ablation,percutaneous ethanol ablation or who were not treated at all were excluded.All patients in the present study were within the Milan Criteria at the last imaging findings before transplantation.Doxorubicineluting bead TACE(DEB-TACE)was performed in 22patients(38 nodules),and conventional TACE(c-TACE)in 16(25 nodules).Patients’and tumors’characteristics were retrospectively reviewed.We performed a pernodule analysis of the explanted livers to establish the mean percentage of necrosis of any nodule treated by TACE(conventional or DEB)and a per-patient analysis to establish the percentage of necrosis in the cumulative tumor area,including 21 nodules not reached by TACE.Inflammatory and fibrotic changes in the tissue surrounding the tumor nodule were analyzed and categorized as poor/absent,moderate and enhanced reaction.Uni-and multivariate analysis of risk factors for HCC-recurrence were performed.RESULTS:The number and diameter of the nodules,the time spent on the waiting list and the number of treatments were similar in the two groups.A trend towards higher appropriate response rates(necrosis≥90%)was observed in the DEB-TACE group(44.7%vs32.0%,P=0.2834).The mean percentage of necrosis in the cumulative tumor area was 58.8%±36.6%in the DEB-TACE group and 50.2%±38.1%in the c-TACE group(P=0.4856).Fibrotic and inflammatory reactions surrounding the tumor nodule were markedly more common in the DEB-TACE group(P<0.0001,for both the parameters).The three-year recurrence-free survival was higher in DEB-TACE-treated patients than in conventionally treated patients(87.4%vs 61.5%,P=0.0493).Other factors affecting recurrence-free survival included viable tumor beyond Milan Criteria on histopathological examination,the percentage of necrosis on CTA≤50%and a pre-transplant serum-fetoprotein level greater than 70 ng/mL.On multivariate analysis,the lack of treatment with DEB-TACE,high levels of-fetoprotein and viable tumor beyond Milan Criteria at histology examination were identified as independent predictors of tumor recurrence.CONCLUSION:DEB-TACE can effectively promote tumor necrosis and improves recurrence-free survival after LT in HCC. | Daniele Nicolini Gianluca Svegliati-Baroni Roberto Candelari Cinzia Mincarelli Alessandra Mandolesi Italo Bearzi Federico Mocchegiani Andrea Vecchi Roberto Montalti Antonio Benedetti Andrea Risaliti Marco Vivarelli | 2013 | World Journal of Gastroenterology2013，19，34： | 12 |
| 2 | Neoadjuvant therapy in the treatment of hilar cholangiocarcinoma:Review of the literature显示文摘Cholangiocarcinoma(CCA)is a malignant tumor of the biliary system and includes,according to the anatomical classification,intra hepatic CCA(iCCA),hilar CCA(hCCA)and distal CCA(dCCA).Hilar CCA is the most challenging type in terms of diagnosis,treatment and prognosis.Surgery is the only treatment possibly providing long-term survival,but only few patients are considered resectable at the time of diagnosis.In fact,tumor’s extension to segmentary or subsegmentary biliary ducts,along with large lymph node involvement or intrahepatic metastases,precludes the surgical approach.To achieve R0 margins is mandatory for the disease-free survival and overall survival.In case of unresectable locally advanced hCCA,radiochemotherapy(RCT)as neoadjuvant treatment demonstrated to be a therapeutic option before either hepatic resection or liver transplantation.Before liver surgery,RCT is believed to enhance the R0 margins rate.For patients meeting the Mayo Clinic criteria,RCT prior to orthotopic liver transplant(OLT)has proved to produce acceptable 5-years survivals.In this review,we analyze the current role of neoadjuvant RCT before resection as well as before OLT. | Fabio Frosio Federico Mocchegiani Grazia Conte Enrico Dalla Bona ANDrea Vecchi Daniele Nicolini Marco Vivarelli | 2019 | World Journal of Gastrointestinal Surgery2019，11，6： | 7 |
| 3 | Predictive factors of short term outcome after liver transplantation: A review显示文摘Liver transplantation represents a fundamental therapeutic solution to end-stage liver disease. The need for liver allografts has extended the set of criteria for organ acceptability, increasing the risk of adverse outcomes. Little is known about the early postoperative parameters that can be used as valid predictive indices for early graft function, retransplantation or surgical reintervention, secondary complications, long intensive care unit stay or death. In this review, we present state-of-the-art knowledge regarding the early posttransplantation tests and scores that can be applied during the first postoperative week to predict liver allograft function and patient outcome, thereby guiding the therapeutic and surgical decisions of the medical staff. Post-transplant clinical and biochemical assessment of patients through laboratory tests(platelet count, transaminase and bilirubin levels, INR, factor V, lactates, and Insulin Growth Factor 1) and scores(model for end-stage liver disease, acute physiology and chronic health evaluation, sequential organ failure assessment and model of early allograft function have been reported to have good performance, but they only allow late evaluation of patient status and graft function, requiring days to be quantified. The indocyanine green plasma disappearance rate has long been used as a liver function assessment technique and has produced interesting, although not univocal, results when performed between the 1th and the 5th day after transplantation. The liver maximal function capacity test is a promising method of metabolic liver activity assessment, but its use is limited by economic cost and extrahepatic factors. To date, a consensual definition of early allograft dysfunction and the integration and validation of the above-mentioned techniques, through the development of numerically consistent multicentric prospective randomised trials, are necessary. The medical and surgical management of transplanted patients could be greatly improved by using clinically reliable tools to predict early graft function. | Giuliano Bolondi Federico Mocchegiani Roberto Montalti Daniele Nicolini Marco Vivarelli Lesley De Pietri | 2016 | World Journal of Gastroenterology2016，22，26： | 5 |
| 4 | Radiological response and inflammation scores predict tumour recurrence in patients treated with transarterial chemoembolization before liver transplantation显示文摘AIM To investigate the prognostic value of the radiological response after transarterial chemoembolization(TACE)and inflammatory markers in patients affected by hepatocellular carcinoma(HCC)awaiting liver transplantation(LT).METHODS We retrospectively evaluated the preoperative pre dictors of HCC recurrence in 70 patients treated with conventional(n=16)or doxorubicin-eluting bead TACE(n=54)before LT.The patient and tumour characteristics,including the static and dynamic alpha-fetoprotein,neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio( LR)measurements,were recorded.Treatment response was classified according to the modified Response Evaluation Criteria in Solid Tumours(m RECIST)and the European Association for the Study of the Liver(EASL)criteria as complete response(CR),partial response( R),stable disease o progressive disease.After examination of the explanted livers,histological necrosis was classified as complete(100%of the cumulative tumour area),partia(50%-99%)or minimal(<50%)and was correlated with the preoperative radiological findings.RESULTS According to the pre-TACE radiological evaluation,22/70(31.4%)and 12/70(17.1%)patients were beyond Milan and University of San Francisco(UCSF)criteria,respectively.After TACE procedures,the objective response(CR+ R)rates were 71.4%and 70.0%according to m RECIST and EASL criteria,respectively.The agreement between the two guidelines in defining the radiological response was rated as very good both for the overall and target lesion response(weighted k-value:0.98 and 0.93,respectively).Complete and partial histological necrosis were achieved in 14/70(20.0%)and 28/70(40.0%)patients,respectively.Using histopathology as the reference standard,m RECIST criteria correctly classified necrosis in 72.9%(51/70)of patients and EASL criteria in 68.6%(48/70)of cases.The m RECIST non-response to TACE[Exp(b)=9.2, =0.012],exceeding UCSF criteria before TACE[Exp(b)=4.7, =0.033]and a preoperative LR>150[Exp(b)=5.9, =0.046]were independent predictors of tumour recurrence.CONCLUSION The radiological response and inflammatory markers are predictive of tumour recurrence and allow the proper selection of TACE-treated candidates for LT. | Daniele Nicolini Andrea Agostini Roberto Montalti Federico Mocchegiani Cinzia Mincarelli Alessandra Mandolesi Nicola L Robertson Roberto Candelari Andrea Giovagnoni Marco Vivarelli | 2017 | World Journal of Gastroenterology2017，23，20： | 4 |
| 5 | NK and NKT cells in aging and longevity:role of zinc and metallothioneins显示文摘 | Mocchegiani E Giacconi R Cipriano C | | 0，，04： | 1 |
| 6 | Zinc metallothioneins and longevity: interrelationships with niacin and selenium 显示文摘 | MOCCHEGIANI E MALAVOLTA M MUTI E | 2008 | Curr Phannac Design2008，14，26： | 1 |
| 7 | Zinc dyshomeostasis,ageing and neurodegeneration:implications of A2M and inflammatory gene polymorphisms显示文摘 | Mocchegiani E Malavolta M | 2007 | J Alzheimers Dis2007，12，1： | 1 |
| 8 | Metalloproteases/anti-metalloproteases imbalance in chronic obstructive pulmonary disease:Genetic factors and treatment implications显示文摘 | MOCCHEGIANI E GIACCONI R COSTARELLI L | 2011 | Curr Opin Pulm Med2011，17，1： | 1 |
| 9 | Different age-related effects of thymectomy in myasthenia gravis:role of thymoma,zinc,thymulin,IL-2 and IL-6显示文摘 | Mocchegiani E Giacconi R Muzzioli M | 2000 | Mech Ageing Dev2000，117，13： | 1 |
| 10 | Plasma zinc level and Thymic hormone activity in young cancer patients显示文摘 | Mocchegiani E Paolucci P Granchi D | 1994 | Blood1994，83，3： | 1 |
| 11 | Brain, aging and neurodegeneration:role of zinc ion availability显示文摘 | Mocchegiani E Bertoni-Freddari C Mareenini F | 2005 | Prog Neurobiol2005，75，6： | 1 |
| 12 | Zinc,metallothioneins and immunosenescenee 显示文摘 | Mocchegiani E Malavoha M Costarelli L | 2010 | Proc Nutr Soc2010，69，3： | 1 |
| 13 | Genetic polymorphisms of inflammatory cytokines and myocardial infarction in the elderly显示文摘 | Fabiola Olivieri Roberto Antonicelli Maurizio Cardelli Francesca Marchegiani Luca Cavallone Eugenio Mocchegiani Claudio Franceschi | 2006 | Mechanisms of Ageing and Development2006，，6： | 1 |
| 14 | Zinc,immune plasticity,aging,and successful aging:role of metallothionein显示文摘 | Mocchegiani E Giacconi R Muti E | 2004 | Ann N Y Acad Sci2004，1019，： | 1 |
| 15 | Plasticity of neuroendocrine-thymus interactions during aging显示文摘 | Fabris N Mocchegiani E Provinciali M | 1997 | Exp Gerontol1997，32，45： | 1 |
| 16 | Pre-treatment of central venous catheters with the cathelicidin BMAP-28 enhances the efficacy of antistaphylococcal agents in the treatment of experimental catheter-related infection 显示文摘 | Cirioni O Giacometti A Ghiselli R Bcrgnach C Orlando F Mocchegiani F Silvestri C Licci A Skerlavaj B Zanetti M Saba V Scalisc G | 2006 | Peptides2006，27，9： | 1 |
| 17 | Nutrient-gene interaction in ageing and successful ageing A single nutrient(zinc)and some target genes related to inflammatory/immune response显示文摘 | Mocchegiani E Costarelli L Giacconi R | 2006 | Mechanisms of ageing and development2006，127，6： | 1 |
| 18 | Zinc, metaUothioneins and longevity : interrelationships with niacin and sele- nium显示文摘 | MOCCHEGIANI E MALAVOLTA M COSTARELLI L | 2008 | Curt Pharm Design2008，14，26： | 1 |
| 19 | Different age-related effects of thymectomy in myasthenia gravis: role of thymoma,zinc,tymulin,IL-2 and IL-6显示文摘 | Mocchegiani E Giacconi R Muzzioli M | 2000 | Mech Ageing Dev2000，117，： | 1 |
| 20 | Metalloprotease anti-metalloproteases imbalance in chronic obstructive pulmonary disease: genetic factors and treatmenl implications 显示文摘 | Mocchegiani E Giacconi R Costarelli L | 2011 | Curr Opin Pulm Med2011，17，1： | 1 |
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