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1Systematic 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 2013World Journal of Gastroenterology2013,19,26:40
2Post reperfusion syndrome during liver transplantation:From pathophysiology to therapy and preventive strategies显示文摘This review aims at evaluating the existing evidence regarding post reperfusion syndrome, providing a description of the pathophysiologic mechanisms involved and possible management and preventive strategies. A Pub Med search was conducted using the Me SH database, 'Reperfusion' AND 'liver transplantation' were the combined Me SH headings; EMBASE and the Cochrane library were also searched using the same terms. 52 relevant studies and one ongoing trial were found. The concept of post reperfusion syndrome has evolved through years to a multisystemic disorder. The implications of the main organ, recipient and procedure related factors in the genesis of this complex syndrome are discussed in the text as the novel pharmacologic and technical approaches to reduce its incidence. However the available evidence about risk factors, physiopathology and preventive measures is still confusing, the presence of two main definitions and the numerosity of possible confounding factors greatly complicates the interpretation of the studies.Antonio Siniscalchi Lorenzo Gamberini Cristiana Laici Tommaso Bardi Giorgio Ercolani Laura Lorenzini Stefano Faenza 2016World Journal of Gastroenterology2016,22,4:20
3Ten 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 2018World Journal of Gastroenterology2018,24,36:14
4Liver transplantation for hepatocellular carcinoma:Role of inflammatory and immunological state on recurrence and prognosis显示文摘Criteria for liver transplantation(LT)for hepatocellular carcinoma(HCC)and post-LT indicators of prognosis are historically based on the measurement of the tumor mass.Recently,high throughput technologies have increased the prediction of recurrence,but these tools are not yet routinely available.The interaction between HCC and the immune system has revealed an imbalance of lymphocyte phenotypes in the peritumoral tissue,and the increase of regulatory T cells with respect to cytotoxic lymphocytes has been linked to a higher rate of post-LT HCC recurrence.Moreover,some inflammatory markers have shown good reliability in predicting cancer reappearance after surgery,as a result of either a systemic inflammatory response or a decreased capacity of the organism to control the tumor growth.Among these markers,the neutrophil-tolymphocyte ratio appears to be the most promising and easily available serum parameter able to predict HCC recurrence after LT and following other types of treatment,although the exact mechanisms determining its elevation have not been clarified.Post-LT immunosuppression may impact on cancer control,and the exposure to high levels of calcineurin inhibitors or other immunusuppressants has recently emerged as a negative prognostic factor for HCC recurrence and patient survival.Despite the absence of prospective randomized trials,inhibitors of the mammalian target of rapamycin have been shown to be associated with lower rates of tumor recurrence compared to other immunosuppressors,suggesting their use especially in patients with HCC exceeding the conventional indication criteria for LT.Matteo Cescon Valentina Rosa Bertuzzo Giorgio Ercolani Matteo Ravaioli Federica Odaldi Antonio Daniele Pinna 2013World Journal of Gastroenterology2013,19,48:8
5Liver 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 2014World Journal of Gastroenterology2014,20,18:8
6Liver 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 2016World Journal of Gastroenterology2016,22,35:5
7Is 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 2009Annals of Surgery2009,,6:5
8A 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 2012Annals of Surgical Oncology2012,,12:3
9The meaning of tissue and serum HCV RNA quantitation in hepatitis C recurrence after liver transplantation: A retrospective study显示文摘Francesco Vasuri Maria Cristina Morelli Elisa Gruppioni Michelangelo Fiorentino Giorgio Ercolani Matteo Cescon Antonio Daniele Pinna Walter Franco Grigioni Antonia D’Errico-Grigioni 2013Digestive and Liver Disease2013,,6:3
10Cost-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 2013Journal of Hepatology2013,,2:3
11Liver 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 2011Journal of Hepatology2011,,3:2
12Anatomic 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 2013Surgery2013,,:2
13Liver 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 2003Annals of Surgery2003,,4:2
14The 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 2019Hepatobiliary & Pancreatic Diseases International2019,18,4:2
15Comparison 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 2009Annals of Surgical Oncology2009,,2:2
16New insights into the brain involvement in patients with Crohn’s disease: a voxel‐based morphometry study显示文摘A. Agostini F. Benuzzi N. Filippini A. Bertani A. Scarcelli V. Farinelli C. Marchetta C. Calabrese F. Rizzello P. Gionchetti M. Ercolani M. Campieri P. Nichelli 2012Neurogastroenterology & Motility2012,,2:2
17Prognostic 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 2012Hepatobiliary & Pancreatic Diseases International2012,11,5:2
18Liver transplantation for recurrent hepatocellular carcinoma on cirrhosis after liver resection: University of Bologna experience显示文摘Gaudio M D Ercolani G Ravaioli M 2008Am J Transplant2008,8,6:1
19Colocalization of GAPDH and band 3(AE1) proteins in rat erythrocytes and kidney intercalated cell membranes显示文摘Ercolani L Brown D Stuart-Tilley A 1992Am J Physiol1992,262,52:1
20Liver 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 2003Ann Surg2003,237,4:1
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