The use of stereotaxic cytology in the diagnosis of non-palpable breast lesions. Personal experience

Background and aims. The increasingly frequent use of mammography for the early diagnosis of breast cancer and the consequent identification of mammary lesions at a preclinical stage raises the fundamental problem of the differential diagnosis between non-suspected non-palpable lesions (NPL) which can therefore be monitored over time and suspected NPL or definite carcinoma requiring histological confirmation and surgical biopsy. The diagnostic accuracy of mammography alone is not sufficiently high to differentiate benign lesions from malignant or strongly suspected ones. The use of surgical biopsy in the event of suspected NPL could be significantly reduced by the use of stereotaxic cytolog…

Editorial: Recent Advances in Thyroid Surgery

Thyroid surgery has been, since its earliest application, one of the most notable fields in medicine, illustrated by the fact that the Nobel Prize in Medicine was won, for the first time, for thyroid surgery by Emil Theodor Kocher (1841–1917) in 1909, for his contributions to thyroid physiology, pathology, and surgery [...]

Affezioni benigne della tiroide: indicazioni al trattamento chirurgico ed attuale ruolo della tiroidectomia totale

Total thyroidectomy is the most popular surgical option in a wide range of indications for the treatment of benign disease of the thyroid. The preference for the procedure derives from a long period of observation and clinical experience dating as far back as the early 'seventies and confirms its safety and efficiency. Nevertheless, many doubts still exist as to the indications in the context of benign thyroid disease, as well as the incidence and seriousness of the complications which, though not frequent, are often invalidating. On the basis of the experience gained over the period from January 1994 to November 2002 in 697 patients undergoing surgery for benign disease of the thyroid, the…

Moving the target on the optimal adjuvant strategy for resected pancreatic cancers: A systematic review with meta-analysis

Combination regimens have shown superiority over single agents in the adjuvant treatment of resected pancreatic cancer (PC), but there are no data supporting definition of the best regimen. This work aimed to compare the efficacy and safety of mFOLFIRINOX, gemcitabine+capecitabine, and gemcitabine+nab/paclitaxel in PC patients. A meta-analysis was performed for direct comparison between trials comparing combination regimens and gemcitabine monotherapy. Subsequently, an indirect comparison was made between trials investigating the efficacy and safety of mFOLFIRINOX, gemcitabine+capecitabine, and gemcitabine+nab/paclitaxel because of the same control arm (gemcitabine). A total of three studie…

Is there any room for PD-1 inhibitors in combination with platinum-based chemotherapy as frontline treatment of extensive-stage small cell lung cancer? A systematic review and meta-analysis with indirect comparisons among subgroups and landmark survival analyses

Background: The addition of PD-L1 inhibitors to platinum-based chemotherapy (CT) has newly received United States Food and Drug Administration (FDA) approval in extensive stage-small cell lung cancer (ES-SCLC). PD-1 agents similarly improved survival rates, even if not yet supported by international regulatory agencies. The current work aims to assess different efficacy and safety profiles among chemoimmunotherapy plus immuno-oncology (CT+IO) approaches according to different immune checkpoint inhibitor (ICI) subtypes. Material & Methods: We included in our meta-analysis six first-line randomised controlled trials (RCTs) comparing the association of single-agent ICI with CT versus CT al…

I tumori stromali gastrointestinali (GIST): presentazione di sei casi e revisione della letteratura

Validity of needle core biopsy in the histological characterisation of mammary lesions

Summary Over the last few years, there has been an enormous increase in the use of needle core biopsy (CB) for the histopathological characterisation of suspect lesions of the breast. The aim of this study was to verify the diagnostic reliability of CB by comparing the histological results obtained with the use of this technique with those obtained from the whole of the surgically resected specimen. We studied 198 out of 426 patients with clinically and/or radiologically suspect breast lesions. We found correspondence between the histological examination of the whole of the excised specimen and that of the CB in 94.9% of the cases of infiltrating carcinoma and in 71.4% of those involving du…

A Case of Follicular Tumor of Uncertain Malignant Potential (FT-UMP) with Glomeruloid Features Showing Capsular Mucinous Degeneration

The most recent revision of the World Health Organization (WHO) Classification of Tumours of Endocrine Organs introduced a new variant of follicular thyroid carcinoma (FTC). It is characterized by a “glomeruloid” architectural pattern of growth. We present a case of follicular tumor with glomeruloid features, with Alcian Blue positive mucinous stromal degeneration in foci of questionable capsular microinvasion. At our knowledge, this the second case of glomeruloid follicular tumor in the literature and the first case in which Alcian Blue staining was used to investigate capsular invasion. Moreover, RAS mutation further supports that this is a variant of follicular tumor with uncertain malig…

The accuracy of sentinel lymph node biopsy in the treatment of multicentric invasive breast cancer using a subareolar injection of tracer.

BACKGROUND: The aim of this study was to evaluate the feasibility and the accuracy of sentinel lymph node biopsy in multicentric breast cancer (MBC) performed by means of a subareolar (SA) injection of both 99Tc-labeled human albumin colloid and lymphazurin. METHODS: Between January 2002 and October 2007, 34 patients with MBC with clinically negative axilla underwent sentinel lymph node biopsy (SLNB) followed by total axillary node dissection (AD). Overall successful identification rate of SLN was 100%; there were no false negatives and overall accuracy rate was 100%. RESULTS: The mean number of sentinel lymph nodes (SLNs) identified was 1.8 +/- 0.88 (range = 1-4); the mean number of axilla…

Analysis of TP53, Ki-Ras and P16INK4A promoter methylation as potential prognostic factors in patients with colorectal cancer

L’uso del hrTSH nel follow up del microcarcinoma tiroideo in pazienti sottoposti a tiroidectomia totale

Molecular Chaperones and Thyroid Cancer

Thyroid cancers are the most common of the endocrine system malignancies and progress must be made in the areas of differential diagnosis and treatment to improve patient management. Advances in the understanding of carcinogenic mechanisms have occurred in various fronts, including studies of the chaperone system (CS). Components of the CS are found to be quantitatively increased or decreased, and some correlations have been established between the quantitative changes and tumor type, prognosis, and response to treatment. These correlations provide the basis for identifying distinctive patterns useful in differential diagnosis and for planning experiments aiming at elucidating the role of t…

Secretory breast carcinoma with metastatic sentinel lymph node

Abstract Background Secretory mammary carcinoma is a rare breast neoplasia originally described in children but sometimes also found in adults. It presents a more favourable outcome than more common histological types of breast carcinoma; published literature in fact reports only a few cases with axillary lymph node metastases and only four cases with distant metastases. Clinical presentation In this paper we report a rare case of secretory breast carcinoma with axillary lymph node metastases in a 33-year-old woman. To our knowledge, this is the first case of secretory carcinoma involving biopsy of the sentinel lymph node and investigation of the e-cadherin expression. We found positivity f…

Primary neuroendocrine carcinoma of the breast: A single Center experience and review of the literature

Neuroendocrine carcinoma of the breast is an extremely rare tumor. A standard treatment has yet to be established because only a few cases have been reported in literature. The authors report five cases observed from January 2007 to December 2014 and a review of literature. Four patients underwent quadrantectomy and in two cases axillary nodal dissection and only one to mastectomy with axillary nodal dissection. Tumor size was from T1 to T2 with N0 to N1, according TNM classification. Pathological specimens were stained with hematoxylin and eosin and an immunohistochemical panel of antibodies (Neuron-specific enolase, Chromogranin, Synaptophysin, Estrogen and Progesterone receptors, c-erb a…

Improving Diagnostic Performance for Thyroid Nodules Classified as Bethesda Category III or IV: How and by Whom Ultrasonography Should be Performed

Background: The purpose of this prospective study is to evaluate if the association of Bethesda system and a 3-categories Ultrasonography (US) risk stratification system proposed by the American Association of Clinical Endocrinologists/American College of Endocrinology/Associazione Medici Endocrinologi improves the performance of cytology alone in III or IV categories and if further variables such as US provider (radiologist; endocrinologist, or endocrine surgeon both coming from a dedicated team) influence the accuracy of the diagnostic. Methods: 570 consecutive patients with complete clinical records, affected by Bethesda III or IV nodules, have been addressed to two public referral surgi…

Hemithyroidectomy versus total thyroidectomy in the intermediate-risk differentiated thyroid cancer: the Italian Societies of Endocrine Surgeons and Surgical Oncology Multicentric Study

The surgical treatment of the intermediate-risk DTC (1–4 cm) remains still controversial. We analyzed the current practice in Italy regarding the surgical management of intermediate-risk unilateral DTC to evaluate risk factors for recurrence and to identify a group of patients to whom propose a total thyroidectomy (TT) vs. hemithyroidectomy (HT). Among 1896 patients operated for thyroid cancer between January 2017 and December 2019, we evaluated 564 (29.7%) patients with unilateral intermediate-risk DTC (1–4 cm) without contralateral nodular lesions on the preoperative exams, chronic autoimmune thyroiditis, familiarity or radiance exposure. Data were collected retrospectively from the clini…

Two-Stage Thyroidectomy Driven by Intraoperative Neuromonitoring: Informed Consent Process and Its Effect on Patient Willingness and Consent Rates

Purpose: Intraoperative neuromonitoring (IONM) of the recurrent laryngeal nerve (RLN) is a useful technique that can be applied to assess the nerve functionality at the end of the first side lobectomy in a planned total resection to prevent the bilateral injury of the RLN. Here we describe the process of informed consent of patients, who were subjected to a 2-stage thyroidectomy, and its effect on the patients' willingness to be operated on as well as their consent rates. Methods: A retrospective observational study of patients, undergoing thyroidectomy with standardized IONM, was conducted from January 2019 to December 2019. All patients were preoperatively informed about the possibility o…

Interpretation of intraoperative parathyroid hormone monitoring according to the Rome criterion in primary hyperparathyroidism

AbstractIntraoperative parathyroid hormone dosage allows real-time monitoring of the decrease in PTH levels during parathyroidectomy and verify procedure’s efficacy. Currently, none of the interpretative criteria used has absolute accuracy. The aim of this study is to evaluate diagnostic accuracy of the Rome criterion verifying diagnostic significance of the individual assays. A total of 205 patients with primary hyperparathyroidism from a single adenoma were retrospectively evaluated and monitored with baseline PTH, PTH at 10 min and PTH at 20 min after adenoma excision. The accuracy of the latter two assays compared with baseline was compared by ROC curves. In addition, was evaluated the …

What is the Meaning of an Early Anastomotic Recurrence after Curative Right Hemicolectomy? A Synchronous, Metachronous, or What Else?

In this paper we present a case of unexpected early local recurrence after surgery for colon cancer. Notably, an anastomotic recurrence was diagnosed two months after curative right hemicolectomy. Accurate preoperative endoscopic and radiological explorations were carried out, the resection was performed according to the oncological surgical principles, and the pathologic report confirmed the oncological radicality of the treatment performed. Therefore, the precocity of local recurrence appeared surprising, and led us to carry out a review of the literature in order to look into its possible explanations. The results of this research are presented.

IL FIBROADENOMA DELLA MAMMELLA: STUDIO SU 447 CASI

The authors examined a total of 519 nodules diagnosed preoperatively as mammary fibroadenomas between 1986 and 1991. 235 nodules were removed immediately after diagnosis, either because they had a diameter of over 3 cm or because they were present in women over 45 years old. The preoperative diagnosis was confirmed in 94.9% of cases and after histological examination the nodule was only found to be a carcinoma in one case (0,4%). Those cases not operated at the time of diagnosis were monitored for period of 2 years. At the end of this period 118 nodules had been removed due to a more or less rapid increase in volume. The histological examination of these nodules confirmed the initial diagno…

VALIDITA' DELL'ECOGRAFIA NELLA DIAGNOSTICA PREOPERATORIA DEI NODULI TIROIDEI MALIGNI

Laryngopharyngeal reflux as a potential cause of persistent local neck symptoms after total thyroidectomy

Abstract Purpose Local neck symptoms (LNS) may be related to goiter, but are also reported by patients suffering from laryngeal–pharyngeal reflux (LPR). The aim of this study was to investigate whether LPR could play a role in the persistence of some LNS after total thyroidectomy (TT). Methods A consecutive case series of 160 patients with multinodular goiter (MNG) candidate for TT were included in this study. Each patient was closely studied for both the thyroid pathology and reflux disease before and 6 months after surgery to assess the persistence of LNS after surgery. Results Only throat discomfort showed a significant improvement (p  = 0.031) after surgery. On the other hand, swallowin…

[Esophageal digital videofluorography with water siphon test in the post-operative evaluation of the anti-reflux laparoscopic surgery].

Background: In recent years digital videoefluorography (VFG) with water siphon test (WST) has been proposed just for diagnosing biatal bernia and/or gastroesophageal reflux. Patients and Methods: Fifteen patients undergone Laparoscopic Nissen (LN) for complicated GFRD associated to biatal bernia, were referred for VFG and WST in order to evaluate the functional results of surgery. At one- month videofluorographic control thirteen patients had just a minimal prolonged esophageal transit time hut only six of these had an early postoperative dysphagia, whereas at six montJh control the prolonged esophageal transit time was present in three patients two of which complained a very light dysphagi…

Quantitative immunomorphological analysis of heat shock proteins in thyroid follicular adenoma and carcinoma tissues reveals their potential for differential diagnosis and points to a role in carcinogenesis

Hsp27, Hsp60, Hsp70, and Hsp90 are chaperones that play a crucial role in cellular homeostasis and differentiation, but they may be implicated in carcinogenesis. Follicular neoplasms of the thyroid include follicular adenoma and follicular carcinoma. The former is a very frequent benign encapsulated nodule, whereas the other is a nodule that infiltrates the capsule, blood vessels and the adjacent parenchyma, with a tendency to metastasize. The main objective was to assess the potential of the Hsps in differential diagnosis and carcinogenesis. We quantified by immunohistochemistry Hsp27, Hsp60, Hsp70, and Hsp90 on thin sections of human thyroid tissue with follicular adenoma or follicular ca…

sj-pdf-3-tam-10.1177_17588359211018018 – Supplemental material for Is there any room for PD-1 inhibitors in combination with platinum-based chemotherapy as frontline treatment of extensive-stage small cell lung cancer? A systematic review and meta-analysis with indirect comparisons among subgroups and landmark survival analyses

Supplemental material, sj-pdf-3-tam-10.1177_17588359211018018 for Is there any room for PD-1 inhibitors in combination with platinum-based chemotherapy as frontline treatment of extensive-stage small cell lung cancer? A systematic review and meta-analysis with indirect comparisons among subgroups and landmark survival analyses by Valerio Gristina, Antonio Galvano, Luisa Castellana, Lavinia Insalaco, Stefania Cusenza, Giuseppa Graceffa, Federica Iacono, Nadia Barraco, Marta Castiglia, Alessandro Perez, Sergio Rizzo, Antonio Russo and Viviana Bazan in Therapeutic Advances in Medical Oncology

Validity of shape memory NiTi colon ring BioDynamix ColonRingTM (or NiTi CAR 27TM) to prevent anastomotic colorectal strictures. Preliminary results

PURPOSE: Anastomotic strictures occur in 3-30% of colorectal anastomosis and one of the main causes may be a reaction to the presence of the metal staples used for suturing. The aim of this study was to evaluate the efficacy of a compression anastomosis ring using the memory shaped device in initial, i.e. nickel-titanium alloy (NiTi) for the prevention of colorectal anastomotic strictures. PATIENTS AND METHODS: A compression anastomosis ring device (NiTi CAR 27) was used to perform compression anastomosis in 20 patients underwent left hemicolectomy and anterior resection of the rectum for carcinoma. An endoscopic check of the anastomosis was carried out at one month and at six months after …

Value of Neurostimulation Plus Laryngeal Palpation to Predict Postoperative Vocal Fold Motility.

ABSTRACT Background The aim of this study was to evaluate the reliability of intraoperative neuromonitoring through recurrent laryngeal nerve stimulation and simultaneous laryngeal palpation (NSLP) in predicting postoperative vocal cord palsy and in providing useful information in the decision to perform a staged surgery in initially planned total thyroidectomy. Materials and Methods A retrospective review was performed involving 552 patients for whom a total thyroidectomy was planned. In all patients, preoperative and postoperative laryngoscopy was performed. The incidence of vocal cord palsy was calculated on 1104 nerves at risk. Results Sensitivity and specificity of NSLP were 0.9411 and…

Application of a predictive model of axillary lymph node status in patients with sentinel node metastasis from breast cancer. A retrospective cohort study

Abstract Background and objectives The Axillary Lymph Node Dissection (ALND) is the standard treatment in patients with invasive breast cancer and sentinel node metastasis, but in 60% of the cases there is no further axillary neoplastic involvement, so this invasive intervention represents an overtreatment. The purpose of the study is to identify patients with low risk of additional nodal metastases, to omit ALND. Methods The MSKCC Additional nodal metastasis nomogram was applied on a sample of 175 patients with invasive breast cancer who underwent ALND after detection of macrometastasis with the extemporaneous examination of the sentinel lymph node. Patients were classified as "low risk" w…

Axillary Nodal Burden in Breast Cancer Patients With Pre-operative Fine Needle Aspiration-proven Positive Lymph Nodes Compared to Those With Positive Sentinel Nodes

BACKGROUND/AIM: Recent years have seen a considerable shift to a more conservative management of the axilla in patients with positive axillary sentinel lymph nodes. The aim of this study was to determine whether some breast cancer patients with a preoperative ultrasound-guided needle aspiration biopsy proven positive node could potentially be spared an axillary lymph node dissection according to the ACOSOG Z0011 trial criteria. PATIENTS AND METHODS: A retrospective review was performed involving 623 breast cancer patients who underwent axillary lymph node dissection after either ultrasound-guided needle aspiration biopsy proven positive node or sentinel lymph node biopsy. RESULTS: Patients …

Aplotype analysis in four sicilian families with 5083del19bp-BRCA1.

Risk Factors for Anaplastic Thyroid Carcinoma: A Case Series From a Tertiary Referral Center for Thyroid Surgery and Literature Analysis

Anaplastic thyroid carcinoma (ATC) is a very rare and extremely aggressive disease with a very poor prognosis. Several risk factors have been hypothesized, but there is no clear-cut literature data on it. We reviewed the literature concerning risk factors for ATC and analyzed the institutional database from 2005 to 2022. In total, 15 papers were suitable for review, while the retrospective data collection search, conducted on our institutional database, provided 13 results. In our experience, in agreement with literature data, ATC seems to be a neoplasm peculiar to old age (in our database, mean age is 72 years), with a higher prevalence in subjects with a low level of education and a long …

Not all KIT 557/558 codons mutations have the same prognostic influence on recurrence-free survival: breaking the exon 11 mutations in gastrointestinal stromal tumors (GISTs)

Background: Although the gastrointestinal stromal tumor (GIST) genotype is not currently included in risk-stratification systems, a growing body of evidence shows that the pathogenic variant (PV) type and codon location hold a strong prognostic influence on recurrence-free survival (RFS). This information has particular relevance in the adjuvant setting, where an accurate prognostication could help to better identify high-risk tumors and guide clinical decision-making. Materials and Methods: Between January 2005 and December 2020, 96 patients with completely resected GISTs harboring a KIT proto-oncogene receptor tyrosine kinase ( KIT) exon 11 PV were included in the study. We analyzed the t…

PS01.057: THYROIDECTOMY AND LARYNGO-PHARYNGEAL REFLUX: WHAT’S NEW

Abstract Background ‘Local neck symptoms’ may be related to goiter; a persistence of those symptoms after an uncomplicated total thyroidectomy (TT) might be referred to the laryngo-pharyngeal reflux (LPR). Our previous study found a correlation between goiter and LPR in selected patients with local neck symptoms; the purpose of our current study is to investigate the presence of a laringopharyngitis in patients with goiter, before and after TT, even in the absence of local neck symptoms, assessing whether the presence of LPR may play a role at the outset of the symptomatology. Methods Two groups of patients were considered and they differred for the presence or absence of local neck symptom…

Sclerosing Angiomatoid Nodular Transformation: Laparoscopic Splenectomy as Therapeutic and Diagnostic Approach at the Same Time

Introduction. Sclerosing angiomatoid nodular transformation (SANT) of the spleen is a rare benign vascular lesion with unknown etiopathogenesis and with definite features of imaging, histopathology, and immunohistochemistry. It was first described by Martel et al. in 2004, and to date, only 151 cases have been reported.Case Description. We report a case of SANT of the spleen detected in a 66-year-old Caucasian, without comorbidities, presented to our department with epigastric pain. We, also, presented a review of the literature.Conclusions. SANT is a benign incidentally vascular condition in the majority of cases. The wide age and gender distribution in our review is in accordance with tha…

Primary schwannoma of the thyroid gland involving the isthmus: report of a case

Primary thyroid schwannomas are extremely rare tumors and there are very few reports of such tumors in the literature. This report presents a rare case of schwannoma involving the isthmus of the thyroid in a 47-year-old male, presenting as a symptomatic predominating cold nodule within a multinodular goiter. The patient underwent total thyroidectomy. The histological examination indicated an Antoni A-type schwannoma. The clinical, radiological and pathological findings of the tumor are discussed, emphasizing the difficulty in reaching a correct preoperative diagnosis. Only 18 cases of primary schwannoma of the thyroid gland have so far been described in the literature and, this is only the …

Does the use of fibrin glue prevent seroma formation after axillary lymphadenectomy for breast cancer? A prospective randomized trial in 159 patients.

Background Seroma formation frequently occurs in patients who have undergone axillary lymphadenectomy. The aim of the study was to evaluate the effect of fibrin glue in the prevention of seroma formation after axillary lymphadenectomy. Materials and Methods Hundred fifty-nine breast cancer patients about to undergo quadrantectomy or mastectomy plus axillary lymphadenectomy were enrolled in the study and randomized into two groups. Fibrin glue spray applied to the axillary fossa plus placement of closed suction drainage were used in 80 patients (group A); placement of closed suction drainage was only used in 79 patients (group B). Results Group A patients showed a slight advantage with regar…

Effectiveness of early administration of a single dose of steroids and escin after loss of signal on electromyographic signal recovery during neuromonitored thyroidectomy

Background: The aim of this study was to evaluate the effect of a single early administration of dexamethasone and escin after loss of signal (LOS) during a neuromonitored total thyroidectomy. Methods: A retrospective analysis of results concerning consecutive patients undergoing total thyroidectomy was performed. Patients included in the study were divided into two groups: Group 1 for which a “wait and see” strategy was used; Group 2, receiving dexamethasone and escin immediately after LOS detection. Results: Overall 37 patients were included in Group 1 and 35 in Group 2. LOS recovery occurring in 29.7% of cases (n. 11) versus 65.7% (n. 23) respectively (p < 0.001). Postoperative fibrol…

L'impiego dell'ecografia ascellare nel follow-up delle pazienti con linfonodi ascellari negativi sottoposte a biopsia del linfonodo sentinella per carcinoma della mammella.

Local neck symptoms before and after thyroidectomy: a possible correlation with reflux laryngopharyngitis

Objective Local symptoms in the neck such as swallowing, voice disorders and throat discomfort might be related to a goiter if present, but are also reported by patients suffering from reflux laryngopharyngitis. The aim of our study was to investigate the presence of reflux laryngopharyngitis in patients with nodular goiter before and after uncomplicated total thyroidectomy (TT) in order to evaluate if its presence could have any role in the origin of swallowing and voice alterations and throat discomfort. Study Design case series prospective study Setting hospitalized care in University Hospital Patients and Methods We consider twenty-five patients, affected by non-toxic nodular goiter and…

sj-pdf-1-tam-10.1177_17588359211018018 – Supplemental material for Is there any room for PD-1 inhibitors in combination with platinum-based chemotherapy as frontline treatment of extensive-stage small cell lung cancer? A systematic review and meta-analysis with indirect comparisons among subgroups and landmark survival analyses

Supplemental material, sj-pdf-1-tam-10.1177_17588359211018018 for Is there any room for PD-1 inhibitors in combination with platinum-based chemotherapy as frontline treatment of extensive-stage small cell lung cancer? A systematic review and meta-analysis with indirect comparisons among subgroups and landmark survival analyses by Valerio Gristina, Antonio Galvano, Luisa Castellana, Lavinia Insalaco, Stefania Cusenza, Giuseppa Graceffa, Federica Iacono, Nadia Barraco, Marta Castiglia, Alessandro Perez, Sergio Rizzo, Antonio Russo and Viviana Bazan in Therapeutic Advances in Medical Oncology

La terapia chirurgica del morbo di Basedow. Tiroidectomia totale o subtotale a confronto

The surgical treatment of Basedow's disease is the most rapid and effective therapeutic approach to obtain the long-term remission of disease. Controversy persists regarding the choice of total or subtotal thyroidectomy. The authors report their experience in 38 cases of Basedow's disease undergoing surgery, of which 20 were treated with total thyroidectomy and 18 with subtotal thyroidectomy. No hemorrhages, wound infections, recurrent lesions, or definitive hypoparathyroidism were observed in the two groups of patients. Those patients undergoing subtotal thyroidectomy reported a 44.5% incidence of hypothyroidism. In particular, hypothyroidism was clinically manifest in 16.7% of cases and s…

Ultrasound-Guided Breast-Conservative Surgery Decreases the Rate of Reoperations for Palpable Breast Cancer

The purpose of this study is to verify whether the performance of ultrasound-guided quadrantectomy (USGQ) versus palpation-guided quadrantectomy (PGQ) can reduce the incidence of positive margins and if it can change the attitude of the surgeon. A retrospective study was conducted on 842 patients underwent quadrantectomy for breast cancer, 332 of them underwent USGQ, whereas 550 underwent PGQ. The histological type of the tumors and the margin status obtained with the histological examination were compared. The histological examination of the surgical specimen showed involvement of the margins in 24/842 patients (2.85%), 22 (2.61%) of them belonged to the PGQ group, and two to the USGQ gro…

sj-pdf-4-tam-10.1177_17588359211018018 – Supplemental material for Is there any room for PD-1 inhibitors in combination with platinum-based chemotherapy as frontline treatment of extensive-stage small cell lung cancer? A systematic review and meta-analysis with indirect comparisons among subgroups and landmark survival analyses

Supplemental material, sj-pdf-4-tam-10.1177_17588359211018018 for Is there any room for PD-1 inhibitors in combination with platinum-based chemotherapy as frontline treatment of extensive-stage small cell lung cancer? A systematic review and meta-analysis with indirect comparisons among subgroups and landmark survival analyses by Valerio Gristina, Antonio Galvano, Luisa Castellana, Lavinia Insalaco, Stefania Cusenza, Giuseppa Graceffa, Federica Iacono, Nadia Barraco, Marta Castiglia, Alessandro Perez, Sergio Rizzo, Antonio Russo and Viviana Bazan in Therapeutic Advances in Medical Oncology

BRCA1/BRCA2 genes mutational screening in Sicilian breast and/or ovarian cancer families.

Genotype analysis of colorectal carcinomas through laser pressare catapulting (LPC)

Recently, new chemotherapy agents which target the non-structural components of mitosis have been developed. An important protein involved in several mitotic phases is the Aurora-A protein. By means of the phosphorylation of different substrates, Aurora-A regulates the correct development of the various phases of mitosis. The kinase activity of this protein makes Aurora-A an excellent candidate as an oncogene. The first data of Aurora-A involvement in cancer regarded the identification of Aurora-A overexpression in primary breast and colon tumour samples. With regard to the predictive role of Aurora-A, it has been shown that its overexpression disrupts the spindle checkpoint activated by pa…

Association between Hashimoto's thyroiditis and papillary thyroid carcinoma: A retrospective analysis of 305 patients

Abstract Background The association between Hashimoto’s thyroiditis (HT) and papillary thyroid carcinoma (PTC) is a controversial question that is still under debate, its pathological significance and the eventual clinical implications of this association remaining unclear. Methods The data regarding 305 patients were retrospectively analyzed. The patients were divided in two different groups. A first group made up of 142 patients undergoing surgery for differentiated thyroid carcinoma was compared to a control group of 142 analogous subjects operated for normofunctioning goiter. A second group was made up of 163 patients who had undergone total thyroidectomy (TT) with pre-operative diagnos…

sj-pdf-2-tam-10.1177_17588359211018018 – Supplemental material for Is there any room for PD-1 inhibitors in combination with platinum-based chemotherapy as frontline treatment of extensive-stage small cell lung cancer? A systematic review and meta-analysis with indirect comparisons among subgroups and landmark survival analyses

Supplemental material, sj-pdf-2-tam-10.1177_17588359211018018 for Is there any room for PD-1 inhibitors in combination with platinum-based chemotherapy as frontline treatment of extensive-stage small cell lung cancer? A systematic review and meta-analysis with indirect comparisons among subgroups and landmark survival analyses by Valerio Gristina, Antonio Galvano, Luisa Castellana, Lavinia Insalaco, Stefania Cusenza, Giuseppa Graceffa, Federica Iacono, Nadia Barraco, Marta Castiglia, Alessandro Perez, Sergio Rizzo, Antonio Russo and Viviana Bazan in Therapeutic Advances in Medical Oncology

Immunomorphological Patterns of Chaperone System Components in Rare Thyroid Tumors with Promise as Biomarkers for Differential Diagnosis and Providing Clues on Molecular Mechanisms of Carcinogenesis

Hurthle cell (HC), anaplastic (AC), and medullary (MC) carcinomas are low frequency thyroid tumors that pose several challenges for physicians and pathologists due to the scarcity of cases, information, and histopathological images, especially in the many areas around the world in which sophisticated molecular and genetic diagnostic facilities are unavailable. It is, therefore, cogent to provide tools for microscopists to achieve accurate diagnosis, such as histopathological images with reliable biomarkers, which can help them to reach a differential diagnosis. We are investigating whether components of the chaperone system (CS), such as the molecular chaperones, can be considered dependabl…

Immunomorphological Pattern of Molecular Chaperones in Normal and Pathological Thyroid Tissues and Circulating Exosomes: Potential Use in Clinics

The thyroid is a major component of the endocrine system and its pathology can cause serious diseases, e.g., papillary carcinoma (PC). However, the carcinogenic mechanisms are poorly understood and clinical useful biomarkers are scarce. Therefore, we determined if there are quantitative patterns of molecular chaperones in the tumor tissue and circulating exosomes that may be useful in diagnosis and provide clues on their participation in carcinogenesis. Hsp27, Hsp60, Hsp70, and Hsp90 were quantified by immunohistochemistry in PC, benign goiter (BG), and normal peritumoral tissue (PT). The same chaperones were assessed in plasma exosomes from PC and BG patients before and after ablative surg…

Analysis of Ki-Ras mutations in stage I rectal carcinomas and respective regional lymph nodes.

In this work we show that the percentage of Ki-RAS mutations in codons 12 and 13 in rectal cancer are sensibly lower than in colon cancer, providing further evidence that these two kinds of tumors should be considered two different entities. Moreover, we show that the detection in regional lymph nodes of the same mutation of primary tumor might represent an indicator of lymph nodes metastasis in rectal carcinoma not detected in routine histologic examination.

sj-pdf-3-tam-10.1177_17588359211018018 – Supplemental material for Is there any room for PD-1 inhibitors in combination with platinum-based chemotherapy as frontline treatment of extensive-stage small cell lung cancer? A systematic review and meta-analysis with indirect comparisons among subgroups and landmark survival analyses

Supplemental material, sj-pdf-3-tam-10.1177_17588359211018018 for Is there any room for PD-1 inhibitors in combination with platinum-based chemotherapy as frontline treatment of extensive-stage small cell lung cancer? A systematic review and meta-analysis with indirect comparisons among subgroups and landmark survival analyses by Valerio Gristina, Antonio Galvano, Luisa Castellana, Lavinia Insalaco, Stefania Cusenza, Giuseppa Graceffa, Federica Iacono, Nadia Barraco, Marta Castiglia, Alessandro Perez, Sergio Rizzo, Antonio Russo and Viviana Bazan in Therapeutic Advances in Medical Oncology

FATTORI PROGNOSTICI DELLA RECIDIVA LOCALE DOPO CHIRURGIA CONSERVATIVA PER CARCINOMA DELLA MAMMELLA. NOSTRA ESPERIENZA

One of the most important problems linked to the conservative surgery of breast cancer consists of local recurrences (LR), even if it has now been proven that the appearance of LR has no influence on overal survival of the patients operated for breast cancer. We have considered 108 patients suffering from breast cancer and treated with quadrantectomy plus axillarydissection. In these patients were found 4 LR (3.7%), that in two cases appeared in the residual mammary gland and in other two cases were found on the skin scar. The mean time of occurrence of the LR was of 43 month (range 18-90 month). The authors have correlated the appearance of LR with some caracteristics of the tumor, as the …

Indication et limites du traitement par la L-Thyroxine dans la prophylaxie de la récidive après exérèse chirurgical pour pathologie thyroidienne bénigne a foncionnement normal.

LigaSure in total thyroidectomy.

PURPOSE: LigaSure is a bipolar diathermy system, which achieves vessel sealing with reduced thermal spread. The device has been used successfully in abdominal operations and because of its features, it has been applied recently in thyroid surgery to minimize the risk of complications such as laryngeal nerve palsy and hypocalcemia, and also to reduce the operating time. METHODS: Between June and December 2005, we performed total thyroidectomy for various disorders in 105 patients. We used the LigaSure diathermy system in 53 patients and traditional hemostatic procedures in the other 52. We evaluated the demographic features, histopathological diagnosis, operating times, and relevant postoper…

sj-pdf-1-tam-10.1177_17588359211018018 – Supplemental material for Is there any room for PD-1 inhibitors in combination with platinum-based chemotherapy as frontline treatment of extensive-stage small cell lung cancer? A systematic review and meta-analysis with indirect comparisons among subgroups and landmark survival analyses

Supplemental material, sj-pdf-1-tam-10.1177_17588359211018018 for Is there any room for PD-1 inhibitors in combination with platinum-based chemotherapy as frontline treatment of extensive-stage small cell lung cancer? A systematic review and meta-analysis with indirect comparisons among subgroups and landmark survival analyses by Valerio Gristina, Antonio Galvano, Luisa Castellana, Lavinia Insalaco, Stefania Cusenza, Giuseppa Graceffa, Federica Iacono, Nadia Barraco, Marta Castiglia, Alessandro Perez, Sergio Rizzo, Antonio Russo and Viviana Bazan in Therapeutic Advances in Medical Oncology

Gastrointestinal stromal tumour of the rectum: Report of a case and review of literature

Gastrointestinal stromal tumour (GIST) is a rare tumour of the gastrointestinal tract which does not generally originate in the rectum. The authors describe a case of a 70-year-old man who underwent an anterior resection of the rectum for a low-risk GIST. The patient was not given adjuvant chemotherapy with imatinib and is still disease-free 30 mo after surgery. The authors conclude that although rectal GIST is extremely uncommon, it should be included in differential diagnosis when a tumour in the rectum is detected. Biopsy of the tumour is essential, since this makes it possible to reach a sure preoperative diagnosis based on the immunohistological features of the CD117 and CD34. Although…

sj-pdf-2-tam-10.1177_17588359211018018 – Supplemental material for Is there any room for PD-1 inhibitors in combination with platinum-based chemotherapy as frontline treatment of extensive-stage small cell lung cancer? A systematic review and meta-analysis with indirect comparisons among subgroups and landmark survival analyses

Supplemental material, sj-pdf-2-tam-10.1177_17588359211018018 for Is there any room for PD-1 inhibitors in combination with platinum-based chemotherapy as frontline treatment of extensive-stage small cell lung cancer? A systematic review and meta-analysis with indirect comparisons among subgroups and landmark survival analyses by Valerio Gristina, Antonio Galvano, Luisa Castellana, Lavinia Insalaco, Stefania Cusenza, Giuseppa Graceffa, Federica Iacono, Nadia Barraco, Marta Castiglia, Alessandro Perez, Sergio Rizzo, Antonio Russo and Viviana Bazan in Therapeutic Advances in Medical Oncology

Predictors of Central Compartment Involvement in Patients with Positive Lateral Cervical Lymph Nodes According to Clinical and/or Ultrasound Evaluation.

Lymph node neck metastases are frequent in papillary thyroid carcinoma (PTC). Current guidelines state, on a weak level of evidence, that level VI dissection is mandatory in the presence of latero-cervical metastases. The aim of our study is to evaluate predictive factors for the absence of level VI involvement despite the presence of metastases to the lateral cervical stations in PTC. Eighty-eight patients operated for PTC with level II–V metastases were retrospectively enrolled in the study. Demographics, thyroid function, autoimmunity, nodule size and site, cancer variant, multifocality, Bethesda and EU-TIRADS, number of central and lateral lymph nodes removed, number of positive lymph n…

Helicobacter pylori and Epstein–Barr Virus Co-Infection in Gastric Disease: What Is the Correlation with p53 Mutation, Genes Methylation and Microsatellite Instability in a Cohort of Sicilian Population?

Genetic predisposition, environmental factors, and infectious agents interact in the development of gastric diseases. Helicobacter pylori (Hp) and Epstein–Barr virus (EBV) infection has recently been shown to be correlated with these diseases. A cross-sectional study was performed on 100 hospitalized Italian patients with and without gastric diseases. The patients were stratified into four groups. Significant methylation status differences among CDH1, DAPK, COX2, hMLH1 and CDKN2A were observed for coinfected (Hp-EBV group) patients; particularly, a significant presence of COX2 (p = 0.0179) was observed. For microsatellite instability, minor stability was described in the Hp-HBV group (69.23…

Breast cancer in previously thyroidectomized patients: which thyroid disorders are a risk factor?

The aim of this study was to evaluate whether there are thyroid diseases in which breast cancer will appear later as well as the role of autoimmunity. This was a retrospective observational study. A total of 410 females (thyroid surgery and later breast cancer) and 524 females (thyroid surgery only) were compared with regard to pathological thyroid findings, thyroid hormones, thyroid autoimmunity and type of breast cancer. Thyroid autoimmunity, especially antithyroid peroxidase antibodies, significantly increased the risk of breast cancer (p < 0.01); however, this was not true for other thyroid diseases, including thyroid cancer. No variant of breast cancer was predominant, and only thyroid…

Hashimoto Thyroiditis Coexistent with Papillary Thyroid Carcinoma

Several studies report a higher rate of papillary thyroid carcinomas (PTC) in patients with Hashimoto thyroiditis (HT), indicating a possible correlation between the two diseases. We studied a group of 89 subjects undergoing surgery for thyroid carcinomas compared with a control group of 89 subjects operated on for normofunctioning goiter, and a second group of 47 patients undergoing total thyroidectomy for HT. Association with HT was found in 19 of the 71 PTC subjects (26.7%) and in 8 goiter patients (8.9%), which was a significant difference ( P &lt; 0.02). Thirteen of the HT patients, mostly with the nodular form, showed coexistent PTC (27.6%). HT and PTC coexisted in several morphologi…

Molecular analysis of TP53, Ki-Ras and P16 methylation status in tissue and plasma of subjects affected by gastrointestinal cancer (GIC)

BACKGROUND: Despite the improvement in detection and surgical therapy in the last years, the outcome of patients affected by colorectal carcinoma (CRC) remains limited by metastatic relapse. The aim of this study was to investigate the presence of free tumor DNA in the plasma of CRC patients in order to understand its possible prognostic role. PATIENTS AND METHODS: Ki-Ras, TP53 mutations and p16(INK4A) methylation status were prospectively evaluated in tumor tissues and plasma of 66 CRC patients. RESULTS: In 50 of the 66 primitive tumor cases (76%) at least one significant alteration was identified in Ki-Ras and/or TP53 and/or p16(INK4A) genes. Eighteen of the 50 patients presented the same…

Current Role of Intraoperative Frozen Section Examination of Sentinel Lymph Node in Early Breast Cancer.

Background/Aim: The aim of this study was to evaluate the current role of frozen section in identifying patients who could benefit from an immediate axillary lymph node dissection (ALND), following the criteria of the ASOCOG Z0011 and IBCSG 23-10 trials. Patients and Methods: A retrospective review was performed involving 2,079 patients with early breast cancer who underwent conservative surgery or total mastectomy with sentinel lymph node biopsy. Results: Sensitivity and diagnostic accuracy were 63.8% and 90.3%, respectively. Sensitivity was significantly higher (p&lt;0.001) in finding macrometastases (81.8%) compared to micrometastases (11.9%). Frozen section was useful only in 7.7% of th…

Giant hepatocellular adenoma as cause of severe abdominal pain: a case report

Abstract The authors describe the case of a large hepatocellular adenoma diagnosed in a 30-year old woman who came to us complaining of acute pain in the upper abdominal quadrants. The patient had been taking an oral contraceptive pill for the last ten years. We present the clinical features, the diagnostic work-up and the treatment prescribed.

Effects of the number of removed lymph nodes on survival outcome in patients with sentinel node-negative breast cancer.

Abstract Background Sentinel lymph node biopsy is the gold standard surgical technique for axillary staging in patients with clinically node-negative. However, it is still uncertain what is the optimal number of sentinel lymph nodes (SLNs) to be removed to reduce the false-negative rate. The aim of this study was to investigate whether patients with a single negative SLN have a worse prognosis than those with two or more negative SLNs. Methods A retrospective review was conducted on a large series of SLN-negative breast cancer patients. Survival outcomes and regional recurrence rate were evaluated according to the number of removed SLNs. Secondly, the contribution of different adjuvant ther…

Navigating the liquid biopsy Minimal Residual Disease (MRD) in Non-Small Cell Lung Cancer: Making the Invisible Visible.

Liquid biopsy has gained increasing interest in the growing era of precision medicine as minimally invasive technique. Recent findings demonstrated that detecting minimal or molecular residual disease (MRD) in NSCLC is a challenging matter of debate that need multidisciplinary competencies, avoiding the overtreatment risk along with achieving a significant survival improvement. This review aims to provide practical consideration for solving data interpretation questions about MRD in NSCLC thanks to the close cooperation between biologists and oncology clinicians. We discussed with a translational approach the critical point of view from benchside, bedside and bunchside to facilitate the fut…

An evaluation score of the difficulty of thyroidectomy considering operating time and preservation of recurrent laryngeal nerve.

The purpose of this study was to edit a renovated thyroidectomy difficulty scale (rTDS) in order to identify underlying thyroid diseases with a longer operative time and higher technical difficulty, also considering preservation of recurrent laryngeal nerve. We developed a renovated scale with a maximum score of 20 points by creating a form in which five variables were considered: vascularity, friability, mobility/fibrosis, gland size and difficulty in preservation of the recurrent laryngeal nerve. Two surgeons separately evaluated each of these. Through a simple linear regression analysis, we have analyzed the relationship between rTDS score and operative times, and between rTDS score and …

Impact of BMI on Preoperative Axillary Ultrasound Assessment in Patients With Early Breast Cancer

Background The accuracy of axillary ultrasound (AUS) with fine-needle aspiration with varying patient body mass index (BMI) is still unclear. The aim of our study was to evaluate whether the US features of axillary lymph nodes changes with BMI of patients. Patients and methods A retrospective review was performed involving 144 out of 270 patients with early breast cancer who underwent breast surgery with sentinel lymph node biopsy. Diagnostic efficacy of AUS in preoperative axillary nodal staging was assessed in relation to BMI. Results Negative predictive values of AUS for the overweight and obese groups were statistically significantly lower compared to the normal/underweight group (p=0.0…

La coagulazione elettrotermica bipolare (ligasure bipolar vessel sealing system) in chirurgia della tiroide

Over the past few years different methods of achieving haemostasis in surgery have been developed. Among these methods, bipolar electrothermal coagulation carried out with the "LigaSure Bipolar Vessel Sealing System" has found numerous applications in some types of abdominal and pelvic surgery, especially when performed laparoscopically, where traditional methods of haemostasis sometimes prove more difficult to perform and are often unsafe. The authors also experimented with the use of electrothermal cautery in thyroid surgery, evaluating its efficacy in achieving haemostasis, as well as in reducing a number of complications such as hypoparathyroidism and recurrent palsy, which can be obtai…

Papillary Thyroid Microcarcinoma: Active Surveillance Against Surgery. Considerations of an Italian Working Group From a Systematic Review

IntroductionActive surveillance is considered a viable option for papillary thyroid microcarcinoma. Since the last decade of the 20th century, this method has spread from Japan to other countries, but has not yet been fully accepted and validated by the major Western Scientific Societies. In 2016, a systematic review on the results of active surveillance was published, based on two articles that showed encouraging results. Other reviews published subsequently, were mainly based on articles from the Far East. The aim of this review is to assess the most recent results published from 2017 to 2020 on this subject.Materials and MethodsA systematic literature search was performed on MEDLINE via …

Potential Activity of Albino Grifola frondosa Mushroom Extract against Biofilm of Meticillin-Resistant Staphylococcus aureus

Mushroom extracts are a rich source of natural compounds with antimicrobial properties, which are able to prevent, to some extent, the growth of foodborne pathogens. The aim of this study was to investigate the potential of extracts from albino Grifola frondosa (GF), commonly known as maitake, to inhibit the growth of some bacteria and the biofilm production by Staphylococcus aureus. We obtained not only a significant reduction of OD score between biofilm and biofilm plus albino G. frondosa extract group, but also a reduction of category of biofilm. In addition, we observed a significant presence of isolates with strong category for the biofilm group and a significant presence of isolates w…

sj-pdf-4-tam-10.1177_17588359211018018 – Supplemental material for Is there any room for PD-1 inhibitors in combination with platinum-based chemotherapy as frontline treatment of extensive-stage small cell lung cancer? A systematic review and meta-analysis with indirect comparisons among subgroups and landmark survival analyses

Supplemental material, sj-pdf-4-tam-10.1177_17588359211018018 for Is there any room for PD-1 inhibitors in combination with platinum-based chemotherapy as frontline treatment of extensive-stage small cell lung cancer? A systematic review and meta-analysis with indirect comparisons among subgroups and landmark survival analyses by Valerio Gristina, Antonio Galvano, Luisa Castellana, Lavinia Insalaco, Stefania Cusenza, Giuseppa Graceffa, Federica Iacono, Nadia Barraco, Marta Castiglia, Alessandro Perez, Sergio Rizzo, Antonio Russo and Viviana Bazan in Therapeutic Advances in Medical Oncology

The value of total thyroidectomy as the definitive treatment for Graves’ disease: A single centre experience of 594 cases

Highlights • Total thyroidectomy is a safe and effective treatment for Graves’ disease. • It is associated with a very low incidence rate of post-operative complications. • Total thyroidectomy offers a rapid and definitive control of hyperthyroidism and its related symptoms.

LES TUMEURS PHYLLODES DU SEIN

The authors report on their experience with six patients suffering from carcinoma phylloides of the breast and discuss the clinical and diagnostic characteristics of this rare neoplasm and its treatment. Clinical examination is the most important procedure in the diagnosis of this tumour of the breast. In most cases, ultrasonography, mammography and cytology are not helpful in establishing the correct diagnosis. Indeed is very difficult to identify valid criteria of differential diagnosis between this tumour and other breast neoplasms especially fibroadenoma. Limited surgery, consisting in a wide excision of the tumour, is the treatment of choice although a higher incidence of local recurre…

TP53, Ki-Ras and P16INK4A gene molecular analysis in salivary gland tumors.