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Article ; Online: ASO Author Reflections: Low-grade Appendiceal Mucinous Neoplasia (LAMN): Which Criteria for a "Watch and Wait" Strategy?

Guaglio, Marcello

2018 Volume 25, Issue Suppl 3, Page(s) 774–775

MeSH term(s)	Adenocarcinoma, Mucinous ; Appendiceal Neoplasms ; Humans ; Prospective Studies
Language	English
Publishing date	2018-11-27
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	1200469-8
ISSN	1534-4681 ; 1068-9265
ISSN (online)	1534-4681
ISSN	1068-9265
DOI	10.1245/s10434-018-7047-8
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Article ; Online: ASO Author Reflections: Preoperative Staging for Nongynecological Peritoneal Malignancies Mimicking Ovarian Cancer-Making the Omelet without Breaking the Eggs.

Guaglio, Marcello / Baratti, Dario

Annals of surgical oncology

2021 Volume 28, Issue 5, Page(s) 2909–2910

MeSH term(s)	Carcinoma, Ovarian Epithelial ; Female ; Humans ; Ovarian Neoplasms/diagnosis ; Peritoneal Neoplasms/diagnosis
Language	English
Publishing date	2021-02-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	1200469-8
ISSN	1534-4681 ; 1068-9265
ISSN (online)	1534-4681
ISSN	1068-9265
DOI	10.1245/s10434-021-09681-w
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Article ; Online: ASO Author Reflections: Perioperative Systemic Chemotherapy in Diffuse Malignant Peritoneal Mesothelioma treated with CRS-HIPEC.

Chatterjee, Ambarish / Kusamura, Shigeki / Baratti, Dario / Guaglio, Marcello / Battaglia, Luigi / Deraco, Marcello

Annals of surgical oncology

2024 Volume 31, Issue 4, Page(s) 2511–2512

MeSH term(s)	Humans ; Hyperthermic Intraperitoneal Chemotherapy ; Mesothelioma, Malignant/therapy ; Mesothelioma/drug therapy ; Mesothelioma/pathology ; Peritoneal Neoplasms/pathology ; Cytoreduction Surgical Procedures ; Hyperthermia, Induced ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Combined Modality Therapy ; Retrospective Studies
Language	English
Publishing date	2024-01-13
Publishing country	United States
Document type	Journal Article
ZDB-ID	1200469-8
ISSN	1534-4681 ; 1068-9265
ISSN (online)	1534-4681
ISSN	1068-9265
DOI	10.1245/s10434-023-13768-x
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Article ; Online: Risk factors for gastrointestinal perforation and anastomotic leak in patients submitted to cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC).

Nogueiro, Jorge / Fathi, Nik Qisti / Guaglio, Marcello / Baratti, Dario / Kusamura, Shigeki / Deraco, Marcello

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology

2023 Volume 49, Issue 10, Page(s) 107020

Abstract: Background: Gastrointestinal leak is one of the most feared complications after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) and harbors significant postoperative morbidity and mortality. We aim to identify risk- ... ...

Abstract	Background: Gastrointestinal leak is one of the most feared complications after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) and harbors significant postoperative morbidity and mortality. We aim to identify risk-factors for anastomotic leak (AL) and gastrointestinal perforation (GP) to optimize postoperative outcomes of this population. Methods: We performed a retrospective analysis of 1043 consecutive patients submitted to CRS in a single institution. Potential risk factors for AL and GP, both related to patient overall condition, disease status and surgical technique were reviewed. Results: Anastomotic leaks were identified in 5.2% of patients, and GPs in 7.0%. The independent risk-factors for AL were age at surgery (OR1.40; CI95% 1.10-1.79); peritoneal cancer index (PCI) (OR1.04, CI95% 1.01-1.07); Cisplatin dose >240 mg during HIPEC (OR3.53; CI95% 1.47-8.56) and the presence of colorectal (CR) or colo-colic (CC) anastomosis (OR5.09; CI95% 2.71-9.53, and 4.58; CI95% 1.22-17.24 respectively). Male gender and intraoperative red blood cell transfusions were the only independent risk factors for GP identified (OR1.70; CI95% 1.04-2.78 and 1.06; CI95% 1.01-1.12, respectively). Regarding 30-day and 90-day postoperative mortality, independent risk-factors were mainly related to patient's overall condition. Conclusion: Gastrointestinal leaks are a frequent source of postoperative morbidity, mainly at the expense of GP. A careful and systematic intraoperative revision of all potential gastrointestinal injuries is equally critical to perfecting anastomotic fashioning techniques to decrease gastrointestinal complication rates. We identified multiple risk-factors for AL and GP related to disease status and patient condition. Our study suggests that patient-related conditions are of paramount relevance, highlighting the importance of patient selection and preoperative patient optimization.
MeSH term(s)	Humans ; Male ; Anastomotic Leak/epidemiology ; Anastomotic Leak/etiology ; Hyperthermic Intraperitoneal Chemotherapy ; Combined Modality Therapy ; Peritoneal Neoplasms/therapy ; Prognosis ; Cytoreduction Surgical Procedures/adverse effects ; Retrospective Studies ; Chemotherapy, Cancer, Regional Perfusion/adverse effects ; Hyperthermia, Induced/adverse effects ; Risk Factors ; Survival Rate
Language	English
Publishing date	2023-08-14
Publishing country	England
Document type	Journal Article
ZDB-ID	632519-1
ISSN	1532-2157 ; 0748-7983
ISSN (online)	1532-2157
ISSN	0748-7983
DOI	10.1016/j.ejso.2023.107020
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Article ; Online: Indocyanine green-guided lymphadenectomy of the inferior mesenteric artery in laparoscopic total mesorectal excision for low rectal cancer after neoadjuvant chemoradiotherapy - A Video Vignette.

Colletti, Gaia / Battaglia, Luigi / Sorrentino, Luca / Guaglio, Marcello / Cosimelli, Maurizio

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

2022 Volume 24, Issue 4, Page(s) 547

MeSH term(s)	Chemoradiotherapy ; Humans ; Indocyanine Green ; Laparoscopy ; Lymph Node Excision ; Mesenteric Artery, Inferior/surgery ; Neoadjuvant Therapy ; Rectal Neoplasms/surgery ; Treatment Outcome
Chemical Substances	Indocyanine Green (IX6J1063HV)
Language	English
Publishing date	2022-01-06
Publishing country	England
Document type	Letter ; Video-Audio Media
ZDB-ID	1440017-0
ISSN	1463-1318 ; 1462-8910
ISSN (online)	1463-1318
ISSN	1462-8910
DOI	10.1111/codi.16031
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Zs.A 5799: Show issues

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Article ; Online: Impact of Perioperative Systemic Chemotherapy on Survival for Patients Who have Diffuse Malignant Peritoneal Mesothelioma Treated with CRS-HIPEC.

Chatterjee, Ambarish / Kusamura, Shigeki / Baratti, Dario / Guaglio, Marcello / Battaglia, Luigi / Deraco, Marcello

Annals of surgical oncology

2023 Volume 31, Issue 1, Page(s) 556–566

Abstract: Background: The available data on the role of perioperative systemic chemotherapy (SC) for diffuse malignant peritoneal mesothelioma (DMPM) patients undergoing (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is heterogeneous and ... ...

Abstract	Background: The available data on the role of perioperative systemic chemotherapy (SC) for diffuse malignant peritoneal mesothelioma (DMPM) patients undergoing (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is heterogeneous and unstandardized. This study aimed to evaluate the impact of SC on the survival outcomes of DMPM patients undergoing CRS-HIPEC and to identify prognostic factors that affect the decision to administer SC. Methods: Patients who underwent CRS-HIPEC in the National Cancer Institute Milan (1995-2020) were retrospectively analyzed using propensity score-matching of known covariates. The patients were grouped into three groups: group A (neoadjuvant chemotherapy [NACT] and no-SC), group B (no-SC and adjuvant chemotherapy [ACT]), and group C (NACT and ACT). Overall survival (OS) and progression-free survival (PFS) were calculated using the Kaplan-Meir method, and prognostic factors were calculated using the Cox-regression method. Results: After a median follow-up period of 45 months (95% confidence interval [CI], 6.348-83.652 months) for group A, 115 months (95% CI, 44.379-185.621 months) for group B, and 88 months (95% CI, 3.296-172.704 months) for group C, the study analyzed 154 DMPM patients consisting of matched group A (NACT: 60 + no-SC: 52 = 112), group B (ACT: 38 + no-SC: 38 = 76), and group C (NACT: 31 + ACT: 31 = 62). The patients undergoing ACT had better 5-year OS and PFS than the patients undergoing NACT. In the multivariate analysis, ACT was significantly associated with improved OS by 48% (hazard ratio [HR], 0.52; 95% CI, 0.280-0.965, p = 0.038). For PFS, the association of ACT did not reach statistical significance (HR, 0.531; 95% CI, 0.266-1.058; p = 0.072). Conclusion: The optimum treatment sequence for DMPM is CRS-HIPEC followed by adjuvant chemotherapy for high-risk patients. Upfront surgery appears preferable to NACT for patients amenable to complete CRS.
MeSH term(s)	Humans ; Mesothelioma/pathology ; Hyperthermic Intraperitoneal Chemotherapy ; Retrospective Studies ; Lung Neoplasms/pathology ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Hyperthermia, Induced/methods ; Mesothelioma, Malignant/drug therapy ; Peritoneal Neoplasms/surgery ; Cytoreduction Surgical Procedures/methods ; Survival Rate ; Combined Modality Therapy
Language	English
Publishing date	2023-11-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	1200469-8
ISSN	1534-4681 ; 1068-9265
ISSN (online)	1534-4681
ISSN	1068-9265
DOI	10.1245/s10434-023-13640-y
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Article ; Online: Elective colorectal cancer surgery at the oncologic hub of Lombardy inside a pandemic COVID-19 area.

Sorrentino, Luca / Guaglio, Marcello / Cosimelli, Maurizio

Journal of surgical oncology

2020 Volume 122, Issue 2, Page(s) 117–119

MeSH term(s)	Aged ; Betacoronavirus/isolation & purification ; COVID-19 ; Colorectal Neoplasms/surgery ; Colorectal Neoplasms/virology ; Coronavirus Infections/diagnosis ; Coronavirus Infections/epidemiology ; Coronavirus Infections/prevention & control ; Coronavirus Infections/transmission ; Digestive System Surgical Procedures/methods ; Digestive System Surgical Procedures/standards ; Disease Transmission, Infectious/prevention & control ; Female ; Humans ; Infection Control/methods ; Infection Control/standards ; Italy/epidemiology ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures/methods ; Minimally Invasive Surgical Procedures/standards ; Pandemics/prevention & control ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/prevention & control ; Pneumonia, Viral/transmission ; SARS-CoV-2
Keywords	covid19
Language	English
Publishing date	2020-05-31
Publishing country	United States
Document type	Journal Article
ZDB-ID	82063-5
ISSN	1096-9098 ; 0022-4790
ISSN (online)	1096-9098
ISSN	0022-4790
DOI	10.1002/jso.26052
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Article ; Online: Prediction of R0/R+ surgery by different classifications for locally recurrent rectal cancer.

Sorrentino, Luca / Belli, Filiberto / Guaglio, Marcello / Daveri, Elena / Cosimelli, Maurizio

Updates in surgery

2021 Volume 73, Issue 2, Page(s) 539–545

Abstract: A widely adopted classification system for locally recurrent rectal cancer (LRRC) is currently missing, and the indication for surgery is not standardized. To evaluate all the published classification systems in a large monocentric cohort of LRRC ... ...

Abstract	A widely adopted classification system for locally recurrent rectal cancer (LRRC) is currently missing, and the indication for surgery is not standardized. To evaluate all the published classification systems in a large monocentric cohort of LRRC patients, assessing their capability to predict a radical (R0) resection. A total of 152 consecutive LRRC patients treated at the National Cancer Institute of Milan (NCIM) from 2009 to 2017 were classified according to Pilipshen, Mayo Clinic, Memorial Sloan-Kettering Cancer Center (MSKCC), Wanebo, Yamada, Boyle, Dutch TME Trial, Royal Marsden and National Cancer Institute of Milan (NCIM) classification systems. Central location of LRRC was significantly predictive of R0 resection across all classification systems. R + resection was predicted by the "anterior" category of MSKCC (OR 2.66, p = 0.007), the "S2b" (OR 3.50, p = 0.04) and the "S3" (OR 2.70, p = 0.01) categories of NCIM, "pelvic disease through anastomosis" of Pilipshen (OR 2.89, p = 0.002), "fixed at 2 sites" of Mayo Clinic (OR 2.68, p = 0.019), and "TR4" of Wanebo (OR 3.39, p = 0.002). The NCIM was the most predictive classification for R0 surgery. The NCIM classification seems to be superior among the others in predicting R0 surgery. Generally, lateral invasive and high sacral invasive relapses are associated with reduced probability of R0 surgery and unfavorable outcomes.
MeSH term(s)	Humans ; Neoplasm Recurrence, Local ; Pelvis ; Rectal Neoplasms/surgery ; Rectum/surgery ; Recurrence
Language	English
Publishing date	2021-02-08
Publishing country	Italy
Document type	Journal Article
ZDB-ID	2572692-4
ISSN	2038-3312 ; 2038-131X
ISSN (online)	2038-3312
ISSN	2038-131X
DOI	10.1007/s13304-020-00941-0
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Article ; Online: Systemic metastases from low-grade and high-grade pseudomyxoma peritonei: Treatments and outcomes.

Baratti, Dario / Milito, Pamela / Kusamura, Shigeki / Martin Roman, Lorena / Guaglio, Marcello / Deraco, Marcello

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology

2022 Volume 48, Issue 7, Page(s) 1590–1597

Abstract: Background: The metastasizing potential of pseudomyxoma peritonei (PMP) is largely unknown. We assessed incidence, impact on prognosis, treatments, and outcomes of systemic metastases after cytoreductive surgery and hyperthermic intraperitoneal ... ...

Abstract	Background: The metastasizing potential of pseudomyxoma peritonei (PMP) is largely unknown. We assessed incidence, impact on prognosis, treatments, and outcomes of systemic metastases after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC). Methods: A prospective database of 327 patients undergoing CRS/HIPEC for PMP of appendiceal origin was reviewed. PMP was graded according to the Peritoneal Surface Oncology Group International (PSOGI) classification. Haematogenous metastases, and non-regional lymph-node involvement were considered as systemic metastases. Results: After a median follow-up of 74.8 months (95% confidence interval [CI] = 68.0-94.8), systemic metastases occurred in 21 patients. Eleven patients were affected by low-grade PMP, and ten by high-grade PMP. Metastatic disease involved the lung (n = 12), bone (n = 1), liver (n = 4), distant nodes (n = 3), both lung and distant nodes (n = 1). Systemic metastases independently correlated with PSOGI histological subtypes (P = 0.001), and incomplete cytoreduction (P = 0.026). Median OS was 139.0 months (95%CI = 56.6-161.9) for patients who experienced systemic metastases, and 213.8 months (95%CI = 148.7-not reached) for those who did not (P = 0.159). Eight of eleven patients who had curative-intent surgery are presently alive at a median of 52.5 months (range 2.0-112.7). Seven are disease-free at a median of 27.4 months (range 2.0-110.4). At multivariate analysis, PSOGI histological subtypes (P = 0.001), completeness of cytoreduction (P = 0.001), and preoperative systemic chemotherapy (P = 0.020) correlated with poorer survival. Systemic metastases did not (P = 0.861). Conclusions: After CRS/HIPEC, systemic metastases occur in a small but clinically relevant number of patients, and the risk increases with incomplete cytoreduction and aggressive histology. In selected patients, surgical resection of metastatic disease can result in long survival.
MeSH term(s)	Appendiceal Neoplasms/pathology ; Appendiceal Neoplasms/therapy ; Combined Modality Therapy ; Cytoreduction Surgical Procedures/adverse effects ; Humans ; Hyperthermia, Induced ; Peritoneal Neoplasms/secondary ; Pseudomyxoma Peritonei/pathology ; Retrospective Studies ; Survival Rate
Language	English
Publishing date	2022-01-20
Publishing country	England
Document type	Journal Article
ZDB-ID	632519-1
ISSN	1532-2157 ; 0748-7983
ISSN (online)	1532-2157
ISSN	0748-7983
DOI	10.1016/j.ejso.2022.01.010
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Article ; Online: Correlation between biological and mechanical properties of extracellular matrix from colorectal peritoneal metastases in human tissues.

Lorenc, Ewelina / Varinelli, Luca / Chighizola, Matteo / Brich, Silvia / Pisati, Federica / Guaglio, Marcello / Baratti, Dario / Deraco, Marcello / Gariboldi, Manuela / Podestà, Alessandro

Scientific reports

2023 Volume 13, Issue 1, Page(s) 12175

Abstract: Peritoneal metastases (PM) are common routes of dissemination for colorectal cancer (CRC) and remain a lethal disease with a poor prognosis. The properties of the extracellular matrix (ECM) are important in cancer development; studying their changes is ... ...

Abstract	Peritoneal metastases (PM) are common routes of dissemination for colorectal cancer (CRC) and remain a lethal disease with a poor prognosis. The properties of the extracellular matrix (ECM) are important in cancer development; studying their changes is crucial to understand CRC-PM development. We studied the elastic properties of ECMs derived from human samples of normal and neoplastic PM by atomic force microscopy (AFM); results were correlated with patient clinical data and expression of ECM components related to metastatic spread. We show that PM progression is accompanied by stiffening of the ECM, increased cancer associated fibroblasts (CAF) activity and increased deposition and crosslinking in neoplastic matrices; on the other hand, softer regions are also found in neoplastic ECMs on the same scales. Our results support the hypothesis that local changes in the normal ECM can create the ground for growth and spread from the tumour of invading metastatic cells. We have found correlations between the mechanical properties (relative stiffening between normal and neoplastic ECM) of the ECM and patients' clinical data, like age, sex, presence of protein activating mutations in BRAF and KRAS genes and tumour grade. Our findings suggest that the mechanical phenotyping of PM-ECM has the potential to predict tumour development.
MeSH term(s)	Humans ; Peritoneal Neoplasms/pathology ; Extracellular Matrix/metabolism ; Colorectal Neoplasms/pathology
Language	English
Publishing date	2023-07-27
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-023-38763-w
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