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Article ; Online: The impact of pathological analysis on endobronchial ultrasound diagnostic accuracy.

Bandiera, Alessandro / Arrigoni, Gianluigi

Mediastinum (Hong Kong, China)

2020 Volume 4, Page(s) 19

Abstract: Endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive procedure used for lung cancer diagnosis and staging. Several aspects, including pathological analysis, may impact on its diagnostic accuracy. Differences in ... ...

Abstract	Endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive procedure used for lung cancer diagnosis and staging. Several aspects, including pathological analysis, may impact on its diagnostic accuracy. Differences in diagnostic accuracy between the different specimen processing techniques have not been demonstrated. Cytological slides are generally adequate for diagnosis, subtyping and genotyping. However, some pathological laboratories may require cell blocks or histological core biopsies for a complete molecular profiling. Rapid on-site evaluation (ROSE) is a technique for immediate evaluation of samples obtained with EBUS-TBNA. The aims of ROSE are to increase sampling adequacy, improving diagnostic yield of EBUS-TBNA and ensuring collection of adequate material for ancillary studies. However, the reported data on the impact of ROSE in the diagnostic yield of EBUS-TBNA and in lung cancer diagnosis and staging are controversial. Some series reported a valuable contribution of ROSE to diagnosis and staging of lung cancer and a high concordance between ROSE and the final diagnosis. However, randomized trials failed in finding differences in diagnostic yield between EBUS-TBNA performed with and without ROSE. The yield of EBUS-TBNA for molecular analyses varies between 72% and 98%, and ROSE may warrant the collection of adequate material for molecular profiling. In lung cancer diagnosis and staging a recommended number of three to four passes during EBUS-TBNA at each target is a minimum requirement to obtain enough material for molecular analysis. The use of ROSE may reduce the number of passes for molecular profiling and the number of additional invasive diagnostic procedures. EBUS-TBNA is a procedure with a high accuracy rate and ROSE may contribute to a further improvement of the results. The possibility to avoid additional invasive procedure is an important advantage leading to an overall improvement of patient care.
Language	English
Publishing date	2020-09-30
Publishing country	China
Document type	Journal Article ; Review
ISSN	2522-6711
ISSN (online)	2522-6711
DOI	10.21037/med-20-28
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Article: Perspective: Did Covid-19 Change Non-small Cell Lung Cancer Surgery Approach?

Ciriaco, Paola / Carretta, Angelo / Bandiera, Alessandro / Muriana, Piergiorgio / Negri, Giampiero

Frontiers in surgery

2021 Volume 8, Page(s) 662592

Abstract: The novel coronavirus (Covid-19), as of January 2021, infected more than 85 million people worldwide, causing the death of about 1,840 million. Italy had more than 2 million infected and about 75,000 deaths. Many hospitals reduced their ordinary activity ...

Abstract	The novel coronavirus (Covid-19), as of January 2021, infected more than 85 million people worldwide, causing the death of about 1,840 million. Italy had more than 2 million infected and about 75,000 deaths. Many hospitals reduced their ordinary activity by up to 80%, to leave healthcare staff, wards, and intensive care unit (ICU) beds available for the significant number of Covid-19 patients. All this resulted in a prolonged wait for hospitalization of all other patients, including those with non-small cell lung cancer (NSCLC) eligible for surgery. The majority of thoracic surgery departments changed the clinical-therapeutic path of patients, re-adapting procedures based on the needs dictated by the pandemic while not delaying the necessary treatment. The establishment of Covid-19-free hub centers allowed some elective surgery in NSCLC patients but most of the operations were delayed. The technology has partly facilitated patients' visits through telemedicine when security protocols have prevented face-to-face assessments. Multidisciplinary consultations had to deal also with the priority of the NSCLC cases discussed. Interpretation of radiologic exams had to take into account the differential diagnosis with Covid-19 infection. All the knowledge and experience of the past months reveal that the Covid-19 pandemic has not substantially changed the indications and type of surgical treatment in NSCLC. However, the diagnostic process has become more complex, requiring rigorous planning, thus changing the approach with the patients.
Language	English
Publishing date	2021-05-12
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2773823-1
ISSN	2296-875X
ISSN	2296-875X
DOI	10.3389/fsurg.2021.662592
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Article ; Online: Surgical treatment of single and multiple thymoma recurrences.

Carretta, Angelo / Ciriaco, Paola / Muriana, Piergiorgio / Bandiera, Alessandro / Negri, Giampiero

General thoracic and cardiovascular surgery

2019 Volume 68, Issue 4, Page(s) 350–356

Abstract: Objectives: A significant number of patients with thymoma develop a recurrence after surgery. The results of previous studies analyzing therapeutic strategies in the treatment of recurrences have been controversial. Aim of the study was to evaluate the ... ...

Abstract	Objectives: A significant number of patients with thymoma develop a recurrence after surgery. The results of previous studies analyzing therapeutic strategies in the treatment of recurrences have been controversial. Aim of the study was to evaluate the role of surgery in the treatment of thymoma recurrences assessing prognostic factors related with survival. Methods: Between January 1993 and September 2018, 27 of 161 patients had a recurrence after complete thymoma resection. Twenty-one (13%) underwent surgical treatment of the recurrence. Primary tumor stage was: I in a patient, IIa in five, IIb in nine and III in six. The recurrence was regional in all patients and both regional and distant in four. WHO histological classification was: A in two patients, B1 in two, B2 in seven and B3 in 10 patients. Results: Median disease-free survival from surgical treatment of the primary tumor and recurrence was 44 months (1-124). Thirty-eight operations were performed (range 1-5). Complete resection rate was 66%. Adjuvant radiotherapy and chemotherapy after surgical treatment of recurrences were performed respectively in ten and nine patients, including eight patients with multiple recurrences. Five and 10-year tumor-specific survival from recurrence was, respectively, 79% and 66%. Survival analysis showed a significant correlation between survival and WHO classification, with a significantly lower survival in patients with B3 tumors in comparison with A to B2 tumors (p = 0.026). Conclusions: Long-term survival was observed following surgical treatment of thymoma recurrences. These results were observed even after multiple recurrences when surgical treatment was performed within a multimodality oncological approach.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Disease-Free Survival ; Female ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Neoplasm Recurrence, Local/surgery ; Prognosis ; Radiotherapy, Adjuvant ; Retrospective Studies ; Survival Analysis ; Thymoma/surgery ; Thymus Neoplasms/surgery ; Treatment Outcome
Language	English
Publishing date	2019-10-22
Publishing country	Japan
Document type	Journal Article
ZDB-ID	2376888-5
ISSN	1863-6713 ; 1863-6705
ISSN (online)	1863-6713
ISSN	1863-6705
DOI	10.1007/s11748-019-01229-w
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Article: Therapeutic strategy for tracheal chondrosarcoma: report of two cases.

Carretta, Angelo / Ciriaco, Paola / Bandiera, Alessandro / Muriana, Piergiorgio / Arrigoni, Gianluigi / Negri, Giampiero

Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace

2020 Volume 90, Issue 1

Abstract: Primary chondrosarcoma of the trachea is an extremely rare tumor. We report two cases of tracheal chondrosarcoma describing the role of surgical and conservative treatment. Endoscopic treatment with rigid bronchoscopy was performed in both patients to ... ...

Abstract	Primary chondrosarcoma of the trachea is an extremely rare tumor. We report two cases of tracheal chondrosarcoma describing the role of surgical and conservative treatment. Endoscopic treatment with rigid bronchoscopy was performed in both patients to restore airway patency and obtain histological specimens for diagnosis. One of the patients subsequently underwent successful tracheal resection and reconstruction. The other patient, who had a contraindication to surgical treatment due to associated diseases underwent iterative endoscopic LASER treatment and is alive three years after the first diagnosis. Surgical treatment remains the treatment of choice of tracheal chondrosarcoma. When surgery is contraindicated endoscopic treatment may allow relatively longterm survival due to the slow growth of these tumors.
MeSH term(s)	Bronchoscopy ; Chondrosarcoma/diagnosis ; Chondrosarcoma/therapy ; Endoscopy ; Humans ; Laser Therapy ; Reconstructive Surgical Procedures ; Tracheal Neoplasms/diagnosis ; Tracheal Neoplasms/therapy
Language	English
Publishing date	2020-03-12
Publishing country	Italy
Document type	Case Reports ; Journal Article
ZDB-ID	1160940-0
ISSN	1122-0643 ; 1120-0391
ISSN	1122-0643 ; 1120-0391
DOI	10.4081/monaldi.2020.1223
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Article ; Online: Assessment of the prognostic role of neutrophil-to-lymphocyte ratio following complete resection of thymoma.

Muriana, Piergiorgio / Carretta, Angelo / Ciriaco, Paola / Bandiera, Alessandro / Negri, Giampiero

Journal of cardiothoracic surgery

2018 Volume 13, Issue 1, Page(s) 119

Abstract: Background: The introduction of the new TNM staging system for thymic epithelial malignancies produced a significant increase in the proportion of patients with stage I disease. The identification of new prognostic factors could help to select patients ... ...

Abstract	Background: The introduction of the new TNM staging system for thymic epithelial malignancies produced a significant increase in the proportion of patients with stage I disease. The identification of new prognostic factors could help to select patients for adjuvant therapies based on their risk of recurrence. Neutrophil-to-lymphocyte ratio (NLR) has recently gained popularity as reliable prognostic biomarker in many different solid tumors. The aim of this study is to assess the utility of NLR evaluation as a prognostic marker in patients with surgically-treated thymoma. Methods: A retrospective analysis was conducted among patients who underwent resection for thymoma in a single center. Patients were divided in two groups, under (low-NLR-Group = 47 patients, 60%) and above (high-NLR-Group = 32 patients, 40%) a ROC-derived NLR cut-off (2.27). Associations with clinical-pathological variables were analyzed; disease-free survival (DFS) was identified as the primary endpoint. Results: Between 2007 and 2017, 79 patients had surgery for thymoma. Overall 5-year DFS was 80%. Univariate survival analysis demonstrated that NLR was significantly related to DFS when patients were stratified for TNM stage (p = 0.043). Five-year DFS in the low-NLR-Group and in the high-NLR-Group were respectively 100 and 84% in stage I-II, and 66 and 0% in stage III. TNM stage resulted as the only independent prognostic factor at multivariate analysis, with hazard ratio of 3.986 (95% CI 1.644-9.665, p = 0.002). Conclusions: High preoperative NLR seems to be associated to a shorter DFS in patients submitted to surgery for thymoma and stratified for TNM stage.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Biomarkers, Tumor/blood ; Female ; Humans ; Kaplan-Meier Estimate ; Lymphocyte Count ; Lymphocytes/pathology ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Neutrophils/pathology ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Thymectomy ; Thymoma/blood ; Thymoma/diagnosis ; Thymoma/pathology ; Thymoma/surgery ; Thymus Neoplasms/blood ; Thymus Neoplasms/diagnosis ; Thymus Neoplasms/pathology ; Thymus Neoplasms/surgery
Chemical Substances	Biomarkers, Tumor
Language	English
Publishing date	2018-11-19
Publishing country	England
Document type	Journal Article
ISSN	1749-8090
ISSN (online)	1749-8090
DOI	10.1186/s13019-018-0805-7
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Article ; Online: Correlation of Computed Tomography Parameters with Histology, Stage and Prognosis in Surgically Treated Thymomas.

Carretta, Angelo / Viscardi, Stefano / Muriana, Piergiorgio / Ciriaco, Paola / Bandiera, Alessandro / Varagona, Roberto / Colombo, Michele / Negri, Giampiero

Medicina (Kaunas, Lithuania)

2020 Volume 57, Issue 1

MeSH term(s)	Humans ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Thymoma/diagnostic imaging ; Thymoma/pathology ; Thymoma/surgery ; Thymus Neoplasms/diagnostic imaging ; Thymus Neoplasms/surgery ; Tomography, X-Ray Computed
Language	English
Publishing date	2020-12-24
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2188113-3
ISSN	1648-9144 ; 1010-660X
ISSN (online)	1648-9144
ISSN	1010-660X
DOI	10.3390/medicina57010010
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Zs.A 6270: Show issues

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Article ; Online: Thymoma with intravascular extension into the right atrium.

Melloni, Giulio / Bandiera, Alessandro / Castiglioni, Alessandro / Zannini, Piero

European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery

2014 Volume 45, Issue 4, Page(s) e126

MeSH term(s)	Heart Atria/pathology ; Heart Atria/surgery ; Heart Neoplasms/pathology ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Thrombectomy ; Thymoma/pathology ; Thymoma/surgery ; Thymus Neoplasms/pathology ; Thymus Neoplasms/surgery
Language	English
Publishing date	2014-04
Publishing country	Germany
Document type	Case Reports ; Journal Article
ZDB-ID	639293-3
ISSN	1873-734X ; 1010-7940 ; 1567-4258
ISSN (online)	1873-734X
ISSN	1010-7940 ; 1567-4258
DOI	10.1093/ejcts/ezt618
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Article ; Online: Multidisciplinary management of a giant cervico-mediastinal liposarcoma: A case report and literature review.

Galli, Andrea / Giordano, Leone / Muriana, Piergiorgio / Bandiera, Alessandro / Negri, Giampiero / Zannini, Piero / Bussi, Mario

Ear, nose, & throat journal

2017 Volume 96, Issue 12, Page(s) E10–E13

Abstract: Liposarcomas are rare mesenchymal tumors that usually develop in lower extremities or retroperitoneum; cervico-mediastinal presentation is quite uncommon. These neoplasms are commonly diagnosed at a late stage because they remain asymptomatic until ... ...

Abstract	Liposarcomas are rare mesenchymal tumors that usually develop in lower extremities or retroperitoneum; cervico-mediastinal presentation is quite uncommon. These neoplasms are commonly diagnosed at a late stage because they remain asymptomatic until nearby structures are compressed. This makes radical excision particularly challenging. To date, alternative chemoradiotherapy protocols have not yet been standardized. We report a case of a 55-year-old man with a right laterocervical mass and without substantial symptoms. Fine-needle aspiration cytology results were compatible with a well-differentiated liposarcoma. Contrast-enhanced magnetic resonance imaging revealed the magnitude of the mass, which was expanding into the mediastinum; displacing the trachea, esophagus, cervical neurovascular bundle, and thoracic aorta; and encasing the brachiocephalic artery. Compression of the left brachiocephalic vein resulted in a focal enhancement spot in the fourth liver segment, the expression of superior vena cava compression, which can promote the development of collateral venous pathways, such as the caval-mammary-phrenic-hepatic capsule-portal venous pathway. The mass was successfully excised by a team of surgical subspecialists (otorhinolaryngologists and thoracic, cardiac, and vascular surgeons). Adjuvant tomotherapy was administered to increase local disease control. The patient remained disease-free 38 months postoperatively. This case underlines the importance of accurate preoperative radiologic evaluation in patients presenting with neck masses but without substantial symptoms. Because of the involvement of many critical structures, the cooperation of many surgical subspecialties is mandatory to achieve a satisfying oncologic outcome.
MeSH term(s)	Head and Neck Neoplasms/diagnostic imaging ; Head and Neck Neoplasms/pathology ; Head and Neck Neoplasms/surgery ; Humans ; Liposarcoma/diagnostic imaging ; Liposarcoma/pathology ; Liposarcoma/surgery ; Magnetic Resonance Imaging/methods ; Male ; Mediastinal Neoplasms/diagnostic imaging ; Mediastinal Neoplasms/surgery ; Middle Aged ; Patient Care Team ; Tumor Burden
Language	English
Publishing date	2017-12-12
Publishing country	United States
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	750153-5
ISSN	1942-7522 ; 0145-5613
ISSN (online)	1942-7522
ISSN	0145-5613
DOI	10.1177/014556131709601213
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Article ; Online: Prognostic role of positron emission tomography and computed tomography parameters in stage I lung adenocarcinoma

Carretta Angelo / Bandiera Alessandro / Muriana Piergiorgio / Viscardi Stefano / Ciriaco Paola / Gajate Ana Maria Samanes / Arrigoni Gianluigi / Lazzari Chiara / Gregorc Vanesa / Negri Giampiero

Radiology and Oncology, Vol 54, Iss 3, Pp 278-

2020 Volume 284

Abstract: According to the current pathological classification, lung adenocarcinoma includes histological subtypes with significantly different prognoses, which may require specific surgical approaches. The aim of the study was to assess the role of CT and PET ... ...

Abstract	According to the current pathological classification, lung adenocarcinoma includes histological subtypes with significantly different prognoses, which may require specific surgical approaches. The aim of the study was to assess the role of CT and PET parameters in stratifying patients with stage I adenocarcinoma according to prognosis.
Keywords	adenocarcinoma ; lung ; surgery ; computed tomography ; pet ; Medical physics. Medical radiology. Nuclear medicine ; R895-920
Language	English
Publishing date	2020-05-01T00:00:00Z
Publisher	Sciendo
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Intercostal artery pseudoaneurysm after computed tomography-guided percutaneous fine needle aspiration lung biopsy.

Melloni, Giulio / Bandiera, Alessandro / Crespi, Giulia / Zannini, Piero

Journal of thoracic imaging

2012 Volume 27, Issue 3, Page(s) W48–9

Abstract: Intercostal artery pseudoaneurysm is a rare but life-threatening complication. Herein we report an unusual case of an intercostal artery pseudoaneurysm caused by computed tomography-guided percutaneous fine needle aspiration lung biopsy and successfully ... ...

Abstract	Intercostal artery pseudoaneurysm is a rare but life-threatening complication. Herein we report an unusual case of an intercostal artery pseudoaneurysm caused by computed tomography-guided percutaneous fine needle aspiration lung biopsy and successfully treated with endovascular embolization. Radiologists performing percutaneous fine needle aspiration lung biopsies should be aware of this rare potential complication.
MeSH term(s)	Aged ; Aneurysm, False/diagnostic imaging ; Aneurysm, False/etiology ; Aneurysm, False/therapy ; Aneurysm, Ruptured/diagnostic imaging ; Aneurysm, Ruptured/etiology ; Aneurysm, Ruptured/therapy ; Angiography/methods ; Biopsy, Fine-Needle/adverse effects ; Embolization, Therapeutic/methods ; Female ; Hematoma/diagnostic imaging ; Hematoma/etiology ; Hematoma/therapy ; Humans ; Radiography, Interventional/adverse effects ; Thoracotomy ; Thorax/blood supply ; Tomography, X-Ray Computed/adverse effects
Language	English
Publishing date	2012-05
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	632900-7
ISSN	1536-0237 ; 0883-5993
ISSN (online)	1536-0237
ISSN	0883-5993
DOI	10.1097/RTI.0b013e3182107430
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