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1.
Acta Chir Belg ; 118(5): 287-293, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30071769

RESUMO

BACKGROUND: Microsatellite instability (MSI) is currently a new molecular subtype of gastric cancer (GC). About 90% of GC cases appear sporadically. MSI seems to be responsible for both sporadic and familial GC. The aim of this study was to analyze the frequency of MSI in GC with familial history of GC. METHODS: The MSI analysis was conducted using five quasi-monomorphic mononucleotide repeats: BAT-26, BAT-25, NR-24, NR-21 and NR-27. From our database, we analyzed 457 patients in terms of cancer history across family members, particularly focusing on GC. RESULTS: MSI status in patients without familial history of GC was present in 22.1% of the cases, whereas in the patients with familial history of GC it was present in 28% of the cases (p = 0.220). For 1st or 2nd degree family members with GC, MSI was observed in 27.6% and in 30.8%, respectively (p = 0.812). MSI was observed in hereditary gastric cancer (HGC) in 33.3% and in familial gastric cancer (FGC) in 30%. No difference in survival rates was observed between the analyzed groups. CONCLUSIONS: In our publication, we could not find any link between familial background and the MSI status in GC patients. More detailed molecular and genetic analysis of subgroups of these patients is required.


Assuntos
Proteínas Adaptadoras de Transdução de Sinal/genética , Predisposição Genética para Doença/epidemiologia , Instabilidade de Microssatélites , Neoplasias Gástricas/genética , Neoplasias Gástricas/mortalidade , Idoso , Bases de Dados Factuais , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Linhagem , Reação em Cadeia da Polimerase/métodos , Prognóstico , Estudos Retrospectivos , Medição de Risco , Estatísticas não Paramétricas , Neoplasias Gástricas/patologia , Neoplasias Gástricas/cirurgia , Análise de Sobrevida , Resultado do Tratamento
2.
Nanoscale ; 10(25): 11913-11922, 2018 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-29901055

RESUMO

Here we present a comprehensive study on the photophysics of QDs-fullerene blends, aiming to elucidate the impact of ligands on the extraction of carriers from QDs. We investigated how three different ligands (oleylamine, octadecanethiol and propanethiol) influence the dynamics of charge generation, separation, and recombination in blends of CdSe/CdS core/shell QDs and PCBM. We accessed each relevant process directly by combining the results from both optical and magnetic spectroscopies. Transient absorption measurements revealed a faster interaction dynamics in thiol-capped ligands. Through phenomenological modeling of the interaction processes, i.e., energy transfer and electron transfer, we estimated the suppression of exciton migration and the enhancement of electron transfer processes when alkyl-thiols are employed as ligands. Contextually, we report the profound impact of the ligands' alkyl chain length, leading to strengthened interactions with PCBM acceptors. Quantitatively, we measured a 10-fold increase in the electron transfer rate when oleylamine ligands were exchanged with propanethiol ligands. EPR spectroscopy gave access to subtle details regarding both the enhanced charge generation and lower binding energy of charge-transfer states in blends compared to PCBM alone. Moreover, through pulsed EPR techniques, we inferred the localization of deep electron traps in localized sites close to QDs in the blends. Therefore, our thorough characterization evidenced the essential role of ligands in determining QD interactions. We believe that these discoveries will contribute to the efficient incorporation of QDs in existing organic PV technologies.

3.
Pathol Oncol Res ; 24(2): 393-400, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28555306

RESUMO

The purpose of this study is to investigate perineural invasion (PNI) as a prognostic factor in gastric cancer patients. 455 patients submitted to extended (D2 or more) lymphadenectomy (median number of 39 retrieved lymph nodes, range: 15-140) between 1995 and 2012 were retrospectively studied. Patients were categorized in two groups according to the PNI status, and PNI positivity was assessed in presence of cancer cells in the perinerium or the neural fascicles using hematoxylin and eosin staining. Median follow-up for surviving patients was 80.3 months. Survival analysis was performed by univariate and multivariate analysis, using a Cox proportional hazards model. 162 patients (33.9%) had positive PNI; this was strongly associated with advanced stages of disease, residual tumor, lymphovascular invasion, Lauren diffuse-mixed histotype and tumor size. Five-year cancer-related survival was 65,7% and 20,6% in PNI negative vs. positive groups, respectively (p < 0.001). The prognostic impact of PNI at univariate analysis was particularly evident in patients submitted to R0 surgery, early as well as advanced stage, advanced nodal stage and T status. At multivariate analysis, PNI did not result statistically significant in the overall series, but emerged as an independent prognostic factor in the group of patients with Lauren intestinal histotype (p = 0.005, hazard ratio: 1.99, 95% confidence interval 1.24-3.19). PNI is related to advanced stage and poor long-term survival in gastric cancer, and may serve as an adjunctive prognostic factor in the intestinal histotype.


Assuntos
Adenocarcinoma/patologia , Invasividade Neoplásica/patologia , Nervos Periféricos/patologia , Neoplasias Gástricas/patologia , Adenocarcinoma/mortalidade , Idoso , Estudos de Coortes , Intervalo Livre de Doença , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Neoplasias Gástricas/mortalidade
4.
J Genet Couns ; 27(3): 732-743, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-28944441

RESUMO

The aim in this study was to translate and cross-culturally adapt the Genetic Counseling Outcome Scale (GCOS-24) for use in Spain and to carry out a preliminary psychometric validation in a sample of Spanish patients. With oversight by an expert panel, forward and backward translations were conducted to create the draft Spanish GCOS-24. Fourteen patients were recruited from a clinical genetics service in Madrid, Spain, to participate in cognitive interviews designed to explore readability and interpretability of the draft. Following qualitative analysis of interview transcripts, a final version of the Spanish GCOS-24 was agreed with the expert panel. No significant cross-cultural differences were identified. The Spanish GCOS-24 was then completed prior to and 2-4 weeks after genetic counseling by 59 patients attending the service, and data were analysed using analysis of variance. Preliminary psychometric validation of the Spanish GCOS-24 showed significantly higher GCOS-24 scores after genetic counseling (p < 0.0001), with good internal consistency (α = 0.84) and sensitivity to change over time, with a medium-to-large size effect (Cohen's d = 0.70). This compares well with the original English language GCOS-24. Findings demonstrate that the Spanish GCOS-24 has potential for use in evaluating clinical genetics services in Spain, but would benefit from assessment of test-retest reliability as well as structural and construct validity.


Assuntos
Aconselhamento Genético , Adulto , Comparação Transcultural , Feminino , Humanos , Idioma , Masculino , Pessoa de Meia-Idade , Psicometria , Reprodutibilidade dos Testes , Espanha , Inquéritos e Questionários , Tradução , Traduções
5.
Chemistry ; 24(12): 2920-2928, 2018 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-29266567

RESUMO

The peptide-driven formation of charge transfer (CT) supramolecular gels featuring both directional hydrogen-bonding and donor-acceptor (D-A) complexation is reported. Our design consists of the coassembly of two dipeptide-chromophore conjugates, namely diphenylalanine (FF) dipeptide conveniently functionalized at the N-terminus with either a pyrene (Py-1, donor) or naphthalene diimide (NDI-1, acceptor). UV/Vis spectroscopy confirmed the formation of CT complexes. FTIR and 1 H NMR spectroscopy studies underlined the pivotal role of hydrogen bonding in the gelation process, and electronic paramagnetic resonance (EPR) measurements unraveled the advantage of preorganized CT supramolecular architectures for charge transport over solutions containing non-coassembled D and A molecular systems.

6.
J Phys Chem Lett ; 8(24): 5981-5986, 2017 Dec 21.
Artigo em Inglês | MEDLINE | ID: mdl-29188716

RESUMO

Hybrid organic/inorganic perovskite nanoparticles (NPs) have garnered remarkable research attention because of their promising photophysical properties. New and interesting properties emerge after combining perovskite NPs with semiconducting materials. Here, we report the synthesis and investigation of a composite material obtained by mixing CH3NH3PbBr3 nanocrystals with the semiconducting polymer poly(3-hexylthiophene) (P3HT). By the combination of structural techniques and optical and magnetic spectroscopies we observed multiple effects of the perovskite NPs on the P3HT: (i) an enlargement of P3HT crystalline domains, (ii) a strong p-doping of the P3HT, and (iii) an enhancement of interchain order typical of H-aggregates. These observations open a new avenue toward innovative perovskite NP-based applications.

7.
Phys Chem Chem Phys ; 19(40): 27716-27724, 2017 Oct 18.
Artigo em Inglês | MEDLINE | ID: mdl-28984327

RESUMO

We investigated the photophysical properties of a newly synthesized hybrid material composed of a triphenylamine dye covalently bound to reduced graphene oxide, potentially relevant as a stable photosensitizer in dye-sensitized solar cells. The photophysical characterization has been carried out by means of fluorescence quenching and fluorescence lifetime measurements, complemented by Electron Paramagnetic Resonance (EPR) spectroscopy, aimed at the detailed description of the photoinduced processes occurring in the hybrid and in the mixed hybrid/N-doped TiO2 material. The combined optical/magnetic study unequivocally demonstrates a fast quenching of the dye excited state in the isolated hybrid and an efficient electron transfer to N-doped titania nanopowders. In the latter case, a metastable radical cation on the dye moiety is photogenerated and the corresponding negative charge, an electron, is trapped in defect sites of the doped semiconductor oxide. The spin distribution in the stable radical has been determined by EPR spectroscopy and correlated with DFT calculations.

8.
Cardiovasc Diabetol ; 16(1): 118, 2017 09 19.
Artigo em Inglês | MEDLINE | ID: mdl-28927403

RESUMO

BACKGROUND: Microparticles (MPs) are vesicular structures shed from endothelial or circulating blood cells, after activation or apoptosis, and can be considered markers of vascular damage. We aimed to determine the levels of circulating MPs, their content of miRNA-126-3p and 5p, and their relationship with early endothelial activation/damage, in patients with different degree of glucose tolerance. METHODS: CD62E+, CD62P+, CD142+, CD45+ circulating MPs, their apoptotic (AnnexinV+) fractions, and miRNA-126 expression were determined in 39 prediabetic (PreDM), 68 type 2 diabetic (T2DM), and 53 control (NGT) subjects, along with main anthropometric and biochemical measurements. MPs were analysed by flow cytometry. miRNA-126 was measured by quantitative real-time PCR. Plasma antioxidant capacity was determined by electronic spin resonance; ICAM-1, and VCAM-1 by ELISA. RESULTS: Activated endothelial cell-derived MPs (CD62E+) were significantly increased in PreDM and T2DM in comparison to NGT (p < 0.0001). AnnexinV+/CD62E+ MPs and Annexin V+ MPs were significantly increased in T2DM compared to PreDM and NGT (p < 0.001); other MPs were not significantly different among groups. Plasma antioxidant capacity was significantly decreased in PreDM and T2DM compared to NGT (p = 0.001); VCAM-1 significantly increased in PreDM and T2DM in comparison to NGT (p = 0.001). miR-126-3p expression, but not miR-126-5p, in MPs, decreased significantly and progressively from NGT, to PreDM, and T2DM (p < 0.001). In PreDM and T2DM, CD62E+ MPs level was significantly and negatively associated with plasma glucose (p = 0.004). CONCLUSION: We show for the first time that circulating CD62E+ MPs level and miR-126-3p content in MPs are abnormal in subjects with pre-diabetes; the content of miR-126-3p correlates with markers of endothelial inflammation, such as VCAM-1, plasma antioxidant capacity, and microparticles, well-accepted markers of endothelial dysfunction.


Assuntos
Glicemia/metabolismo , Micropartículas Derivadas de Células/metabolismo , Diabetes Mellitus Tipo 2/sangue , Selectina E/sangue , MicroRNAs/sangue , Estado Pré-Diabético/sangue , Biomarcadores/sangue , Diabetes Mellitus Tipo 2/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estado Pré-Diabético/diagnóstico , Molécula 1 de Adesão de Célula Vascular/sangue
9.
World J Clin Oncol ; 8(3): 273-284, 2017 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-28638798

RESUMO

AIM: To evaluate the potential effectiveness of robot-assisted gastrectomy (RAG) in comparison to open gastrectomy (OG) for gastric cancer patients. METHODS: A comprehensive systematic literature search using PubMed, EMBASE, and the Cochrane Library was carried out to identify studies comparing RAG and OG in gastric cancer. Participants of any age and sex were considered for inclusion in comparative studies of the two techniques independently from type of gastrectomy. A meta-analysis of short-term perioperative outcomes was performed to evaluate whether RAG is equivalent to OG. The primary outcome measures were set for estimated blood loss, operative time, conversion rate, morbidity, and hospital stay. Secondary among postoperative complications, wound infection, bleeding and anastomotic leakage were also analysed. RESULTS: A total of 6 articles, 5 retrospective and 1 randomized controlled study, involving 6123 patients overall, with 689 (11.3%) cases submitted to RAG and 5434 (88.7%) to OG, satisfied the eligibility criteria and were included in the meta-analysis. RAG was associated with longer operation time than OG (weighted mean difference 72.20 min; P < 0.001), but with reduction in blood loss and shorter hospital stay (weighted mean difference -166.83 mL and -1.97 d respectively; P < 0.001). No differences were found with respect to overall postoperative complications (P = 0.65), wound infection (P = 0.35), bleeding (P = 0.65), and anastomotic leakage (P = 0.06). The postoperative mortality rates were similar between the two groups. With respect to oncological outcomes, no statistical differences among the number of harvested lymph nodes were found (weighted mean difference -1.12; P = 0.10). CONCLUSION: RAG seems to be a technically valid alternative to OG for performing radical gastrectomy in gastric cancer resulting in safe complications.

10.
J Phys Chem Lett ; 8(10): 2236-2242, 2017 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-28471190

RESUMO

The controversial nature of the fluorescent properties of carbon dots (CDs), ascribed either to surface states or to small molecules adsorbed onto the carbon nanostructures, is an unresolved issue. To date, an accurate picture of CDs and an exhaustive structure-property correlation are still lacking. Using two unconventional spectroscopic techniques, fluorescence correlation spectroscopy (FCS) and time-resolved electron paramagnetic resonance (TREPR), we contribute to fill this gap. Although electron micrographs indicate the presence of carbon cores, FCS reveals that the emission properties of CDs are based neither on those cores nor on molecular species linked to them, but rather on free molecules. TREPR provides deeper insights into the structure of carbon cores, where C sp2 domains are embedded within C sp3 scaffolds. FCS and TREPR prove to be powerful techniques, characterizing CDs as inherently heterogeneous systems, providing insights into the nature of such systems and paving the way to standardization of these nanomaterials.

11.
Ann Surg Oncol ; 24(8): 2273-2280, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28405772

RESUMO

BACKGROUND: The purpose of this retrospective study was to evaluate the incidence and prognostic value of metastases to "posterior" (8p, 12b/p, 13) and para-aortic lymph nodes in a large cohort of Western patients submitted to D2 plus lymphadenectomy. METHODS: Removal of "posterior" nodes was performed in 743 patients, and para-aortic lymphadenectomy in a subgroup of 390 patients. After lymph node mapping and retrieval on the fresh specimen, a median number of 41 total lymph nodes were analyzed. The median follow-up period was 37 months for the entire series and 68 months for survivors. RESULTS: Of 743 included patients, 23 (3.1%) had metastases in station 8p, 12 (1.6%) in station 12b/p, and 19 (2.6%) in station 13. On the whole, 47 of 743 patients (6.3%) had positive "posterior" nodes. Para-aortic metastases were present in 42 of 390 patients (10.8%). Metastases to "posterior" stations were significantly related to depth of invasion, number of positive nodes, and surgical radicality. Distal tumors showed higher trend to metastasize to "posterior" nodes than upper third, whereas for para-aortic metastases it was the reverse. 5-year survival in patients with positivity to "posterior" nodes was 17%, with no significant difference according to 8p, 12b/p, and 13 stations; long-term outcome was overlapping to pN3b stage. 5-year survival in para-aortic positive cases was 11%, and a trend to better outcome was observed in proximal tumors. CONCLUSIONS: Although metastases to "posterior" and para-aortic nodes are expression of an advanced nodal stage, not negligible survival rates are observed in subgroups of patients.


Assuntos
Excisão de Linfonodo/mortalidade , Linfonodos/patologia , Glomos Para-Aórticos/patologia , Complicações Pós-Operatórias/epidemiologia , Neoplasias Gástricas/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Incidência , Itália/epidemiologia , Linfonodos/cirurgia , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Neoplasias Gástricas/cirurgia , Taxa de Sobrevida , Adulto Jovem
12.
Artigo em Inglês | MEDLINE | ID: mdl-28217753

RESUMO

The extent of lymphadenectomy in gastric cancer (GC) surgery has been for long time a matter of debate. Randomized trials performed in the West reported worse results of D2 dissection, in terms of postoperative complications and long-term survival benefit, than Eastern series and observational studies from specialized Western centers. However, long-term re-evaluation of such trials and in depth-analysis of other experiences demonstrated the potential benefit of D2 in reducing the probability of cancer-related death and the safety of this procedure when avoiding unnecessary spleno-pancreatectomy and in centers with ad adequate surgical volume. Nowadays, the D2 is considered the standard treatment in most guidelines all over the world. More limited procedures (D1, D1 plus) may be adequate in selected cases, and more extended dissections (D2 plus) could be indicated in advanced forms with high risk of metastases to distant nodes, but in specialized centers or in the setting of clinical studies. The integration with neoadjuvant therapies and multimodality approach could offer a chance of cure in groups of patients with poor results when approached with standard treatment.

13.
Gastric Cancer ; 20(1): 70-82, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26732876

RESUMO

BACKGROUND: Resection margin (RM) involvement is associated with negative prognosis after gastrectomy. Intraoperative frozen section (IFS) analysis allows radical resection to be achieved in a single operation but is time-consuming and resource-consuming. The aim of this study was to assess risk factors associated with RM involvement to identify patients who would benefit from IFS analysis. METHODS: We retrospectively analyzed patients who underwent gastrectomy with curative intent for gastric or esophagogastric junction (EGJ) cancer from 2000 to 2014 in six Italian hospitals. RM status was assessed by IFS analysis and/or definitive histopathology examination. A set of 21 potential risk factors were compared in a multivariate analysis between patients with positive RMs on IFS analysis or definitive histopathology examination and a control cohort of similar patients with negative RMs, with the samples stratified into three subgroups (T1, T2-T4 Lauren intestinal pattern, T2-T4 Lauren diffuse/mixed pattern). RESULTS: One hundred forty-five patients had positive RMs. Survival was significantly worse in positive RM patients than in negative RM patients (89.5 months vs 28.9 months). Multivariate analysis showed that in T1 cancers a margin distance of less than 2 cm is a risk factor for RM involvement (odds ratio 15.7), in T2-T4 intestinal pattern cancers, serosa invasion (odds ratio 6.0), EGJ location (odds ratio 4.1), and a margin distance of less than 3 cm (odds ratio 4.0) are independent risk factors, and in T2-T4 diffuse/mixed pattern cancers, lymphatic infiltration (odds ratio 4.2), tumor diameter greater than 4 cm (odds ratio 3.5), EGJ location (odds ratio 2.8), and serosa invasion (odds ratio 2.2) are independent risk factors. CONCLUSIONS: Survival after gastrectomy is negatively affected by positive RMs. IFS analysis should be routinely used in patients with a high risk of positive RMs, especially in diffuse pattern cancers.


Assuntos
Adenocarcinoma/cirurgia , Neoplasias Esofágicas/cirurgia , Junção Esofagogástrica/cirurgia , Análise Fatorial , Gastrectomia/mortalidade , Neoplasias Gástricas/cirurgia , Adenocarcinoma/patologia , Idoso , Neoplasias Esofágicas/patologia , Junção Esofagogástrica/patologia , Feminino , Seguimentos , Humanos , Itália , Masculino , Margens de Excisão , Gradação de Tumores , Invasividade Neoplásica , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Neoplasias Gástricas/patologia , Taxa de Sobrevida
14.
Phys Chem Chem Phys ; 18(45): 31286-31295, 2016 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-27824179

RESUMO

The design of novel nanostructures with tailored opto-electronic properties is a crucial step for third-generation photovoltaics, and the development of cheap and environmentally compatible materials is still a challenge. Carbon quantum dots (CQDs) emerged as promising candidates but usually a low processability and poor electron-donor properties hampered their photovoltaic applications. We tackle these issues through the synthesis and photophysical characterization of N-doped CQDs functionalized with different thiophene-containing groups. Functionalization was aimed at enhancing the electron donating properties of the carbon dots and improving the solubility in nonpolar solvents. The increased solubility in organic solvents allowed us to investigate the photoinduced interactions of the functionalized carbon dots with the fullerene derivative PCBM in solution and in solid blends. The investigation was carried out by cyclic voltammetry, photoluminescence spectroscopy and electron paramagnetic resonance (EPR). The remarkable oxidation potential shift of the functionalized carbon dots with respect to the pristine materials and the HOMO-LUMO energies strongly suggest them as good electron donors towards PCBM. The electron transfer process between CQDs and PCBM resulted in efficient fluorescence quenching in solution and in total quenching in solid blends. By using EPR spectroscopy in the solid blends, we demonstrated the efficient electron transfer by observing the photoinduced formation of a PCBM radical anion in the presence of functionalized CQDs. Time-resolved EPR allowed us to identify differences in the charge transport efficiency for different CQD:PCBM blends. The enhanced processability of CQDs with PCBM and the promising charge-generation and separation properties pave the way to the development of "all-carbon" photovoltaic devices.

15.
World J Gastroenterol ; 22(25): 5694-717, 2016 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-27433084

RESUMO

Radical gastrectomy with an adequate lymphadenectomy is the main procedure which makes it possible to cure patients with resectable gastric cancer (GC). A number of randomized controlled trials and meta-analysis provide phase III evidence that laparoscopic gastrectomy is technically safe and that it yields better short-term outcomes than conventional open gastrectomy for early-stage GC. While laparoscopic gastrectomy has become standard therapy for early-stage GC, especially in Asian countries such as Japan and South Korea, the use of minimally invasive techniques is still controversial for the treatment of more advanced tumours, principally due to existing concerns about its oncological adequacy and capacity to carry out an adequately extended lymphadenectomy. Some intrinsic drawbacks of the conventional laparoscopic technique have prevented the worldwide spread of laparoscopic gastrectomy for cancer and, despite technological advances in recent year, it remains a technically challenging procedure. The introduction of robotic surgery over the last ten years has implied a notable mutation of certain minimally invasive procedures, making it possible to overcome some limitations of the traditional laparoscopic technique. Robot-assisted gastric resection with D2 lymph node dissection has been shown to be safe and feasible in prospective and retrospective studies. However, to date there are no high quality comparative studies investigating the advantages of a robotic approach to GC over traditional laparoscopic and open gastrectomy. On the basis of the literature review here presented, robot-assisted surgery seems to fulfill oncologic criteria for D2 dissection and has a comparable oncologic outcome to traditional laparoscopic and open procedure. Robot-assisted gastrectomy was associated with the trend toward a shorter hospital stay with a comparable morbidity of conventional laparoscopic and open gastrectomy, but randomized clinical trials and longer follow-ups are needed to evaluate the possible influence of robot gastrectomy on GC patient survival.


Assuntos
Adenocarcinoma/cirurgia , Gastrectomia/métodos , Neoplasias Gástricas/cirurgia , Adenocarcinoma/patologia , Humanos , Laparoscopia/métodos , Tempo de Internação , Excisão de Linfonodo/métodos , Estadiamento de Neoplasias , Procedimentos Cirúrgicos Robóticos/métodos , Neoplasias Gástricas/patologia , Resultado do Tratamento
16.
Tumour Biol ; 37(1): 127-40, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26566626

RESUMO

Gastric cancer (GC) is the second leading cause of cancer-related death, and despite having improved treatment modalities over the last decade, for most patients, only modest improvements have been seen in overall survival. Recent progress in understanding the molecular biology of GC and the related signaling pathways offers, from the clinical point of view, promising advances for selected groups of patients. In the past, targeted therapies have significantly impacted the treatment strategy of several common solid tumors such as breast, colorectal, and lung cancers. Unfortunately, translational and clinical research shows fewer encouraging targeted treatments with regards to the GC. To date, only two monoclonal antibodies (mAb), named trastuzumab and ramucirumab, are approved for the treatment of advanced GC, suggesting that in GC, maybe more than in other cancers, effective targeted therapy requires patient selection based on precise predictive molecular biomarkers. The aim of this review is to summarize the available data on the clinical advantages offered by the use of mAbs in the treatment of advanced/metastatic GC. Future perspective is also discussed.


Assuntos
Anticorpos Monoclonais/uso terapêutico , Neoplasias Gástricas/imunologia , Neoplasias Gástricas/terapia , Anticorpos Monoclonais Humanizados/uso terapêutico , Antineoplásicos/uso terapêutico , Bevacizumab/uso terapêutico , Cetuximab/uso terapêutico , Ensaios Clínicos como Assunto , Tratamento Farmacológico/métodos , Receptores ErbB/química , Humanos , Imunoterapia/métodos , Imunoterapia/tendências , Maitansina/análogos & derivados , Maitansina/uso terapêutico , Terapia de Alvo Molecular/métodos , Terapia de Alvo Molecular/tendências , Cuidados Paliativos/métodos , Panitumumabe , Transdução de Sinais , Trastuzumab/uso terapêutico , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores , Fator A de Crescimento do Endotélio Vascular/química
17.
Int J Hyperthermia ; 32(2): 173-9, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26670720

RESUMO

The number of new gastric cancer (GC) cases is decreasing, and these patients have longer survival thanks to new oncological treatments. In advanced GC a common evolution of this neoplasm is peritoneal metastases (PM). In the past this finding meant no chance for cure. However, today, using high quality operations and HIPEC, we are able to increase the number of patients treated with curative intention. New options in the diagnosis of PM, tumour susceptibility for different drugs, importance of quality of life, usage in ascites treatment, diagnostic tools in image-guided surgery, new targeted therapies and analysis of currently ongoing trials are presented together with today's knowledge of HIPEC efficacy in order to evaluate gastric PM. HIPEC is an effective tool in the treatment of selected patients with PM from GC. Together with new diagnostic options such as targeted therapies, HIPEC may improve the prognosis of these patients, not only by treating clinically manifest carcinomatosis, but also in the prophylactic setting, addressing occult peritoneal seeding.


Assuntos
Quimioterapia do Câncer por Perfusão Regional , Procedimentos Cirúrgicos de Citorredução , Hipertermia Induzida , Neoplasias Peritoneais/terapia , Neoplasias Gástricas/terapia , Antineoplásicos/uso terapêutico , Terapia Combinada , Humanos , Recidiva Local de Neoplasia/prevenção & controle , Neoplasias Peritoneais/tratamento farmacológico , Neoplasias Peritoneais/secundário , Qualidade de Vida , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/patologia
18.
Ann Surg Oncol ; 23(3): 943-50, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26530444

RESUMO

BACKGROUND: The clinical role of microsatellite instability (MSI) in gastric cancer (GC) is controversial. A large series of patients submitted to respective surgery for primary GC with a long follow-up time was evaluated. METHODS: 472 patients with prospectively collected frozen samples of normal mucosa and tumor tissue stored in a biological tissue bank were included. Microsatellite analysis was evaluated using 5 quasi monomorphic mononucleotide repeats (BAT-26, BAT-25, NR-24, NR-21, and NR-27). The presence of MSI in 2 or more loci was classified as MSI-H, whereas all other cases were included in the microsatellite-stable (MSS) group. RESULTS: MSI-H phenotype was found in 111 of 472 patients (23.5%). MSI-H status was related significantly with older age, female gender, non-cardia location, WHO histotype, non-cardia Lauren intestinal type, and less advanced stages. Cancer-related 5-year survival was significantly higher in MSI-H versus MSS group (67.6% vs. 35%, p < 0.001). Stratified analysis revealed a significant impact of MSI on prognosis in non-cardia tumors of intestinal type or tubular/poorly differentiated histology, particularly in stages II and III; multivariate Cox regression analysis confirmed MSS status as a strong predictor of poor prognosis (hazard ratio 2.65, 95% CI 1.56-4.51, p < 0.001) in non-cardia intestinal type. No prognostic value of MSI in the diffuse-mixed type and signet-ring cell/mucinous histotypes was observed. CONCLUSIONS: MSI was confirmed as a significant predictor of long term outcome in a large series of GC with a long follow-up time, but the prognostic value is limited to selected histotypes of non-cardia tumors.


Assuntos
Adenocarcinoma/secundário , Carcinoma Papilar/secundário , Carcinoma de Células em Anel de Sinete/secundário , Cárdia/patologia , Neoplasias Intestinais/patologia , Instabilidade de Microssatélites , Neoplasias Gástricas/patologia , Adenocarcinoma/genética , Adenocarcinoma/cirurgia , Idoso , Carcinoma Papilar/genética , Carcinoma Papilar/cirurgia , Carcinoma de Células em Anel de Sinete/genética , Carcinoma de Células em Anel de Sinete/cirurgia , Cárdia/metabolismo , Estudos de Casos e Controles , Feminino , Seguimentos , Gastrectomia , Humanos , Neoplasias Intestinais/genética , Neoplasias Intestinais/cirurgia , Excisão de Linfonodo , Metástase Linfática , Masculino , Invasividade Neoplásica , Estadiamento de Neoplasias , Fenótipo , Reação em Cadeia da Polimerase , Prognóstico , Estudos Prospectivos , Neoplasias Gástricas/genética , Neoplasias Gástricas/cirurgia , Taxa de Sobrevida
19.
Int J Surg ; 21: 63-7, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26207692

RESUMO

INTRODUCTION: We describe a novel technique that could aid the surgeon to perform a total proctocolectomy with a single docking position of the da Vinci Si HD System. METHODS: Patients were positioned in 20° Trendelenburg lithotomy split legs position. A 12-mm trocar was for camera and 3 more trocars were placed: two robotics on left and right flanks and one laparoscopic in left iliac fossa. The robot was docked between the legs of the patients. RESULTS: Four proctocolectomies were performed. Mean operative time was 235 min (range 215-255); mean blood loss was 100 cc (range 50-200). Median post-operative stay was 6 days. Overall morbidity was 75%, whereas major complications occurred in 25%. Post-operative mortality was null. CONCLUSIONS: The robotic single docking approach to perform total proctocolectomy for ulcerative colitis is a time-saving technique respect to the multiple docking approach.


Assuntos
Colectomia/métodos , Colite Ulcerativa/cirurgia , Laparoscopia/métodos , Procedimentos Cirúrgicos Robóticos , Adulto , Feminino , Humanos , Masculino , Duração da Cirurgia , Adulto Jovem
20.
Gastroenterol Res Pract ; 2015: 810134, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25759721

RESUMO

Introduction. The impact of preoperative BMI on surgical outcomes and long-term survival of gastric cancer patients was investigated in various reports with contrasting results. Materials & Methods. A total of 378 patients who underwent a surgical resection for primary gastric cancer between 1994 and 2011 were retrospectively studied. Patients were stratified according to BMI into a normal group (<25, group A), an overweight group (25-30, group B), and an obesity group (≥30, group C). These 3 groups were compared according to clinical-pathological characteristics, surgical treatment, and long-term survival. Results. No significant correlations between BMI and TNM (2010), UICC stage (2010), Lauren's histological type, surgical results, lymph node dissection, and postoperative morbidity and mortality were observed. Factors related to higher BMI were male gender (P < 0.05), diabetes (P < 0.001), and serum blood proteins (P < 0.01). A trend to fewer lymph nodes retrieved during gastrectomy with lymphadenectomy in overweight patients (B and C groups) was observed, although not statistically significant. There was no difference in overall survival or disease-specific survival between the three groups. Conclusion. According to our data, BMI should not be considered a significant predictor of postoperative complications or long-term result in gastric cancer patients.

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