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Article ; Online: Total portal vein replacement with peritoneal interposition graft during Whipple's procedure for extrahepatic cholangiocarcinoma: a technical report.

Marino, Rebecca / Tudisco, Antonella / Ratti, Francesca / Pedica, Federica / Aldrighetti, Luca

2023 Volume 21, Issue 1, Page(s) 117

Abstract: Background: Aggressive surgical resection in locally advanced hepatopancreatobiliary (HPB) malignancies is frequently advocated as the only potentially curative treatment. In recent years, advances in chemotherapy regimens and surgical techniques have ... ...

Abstract	Background: Aggressive surgical resection in locally advanced hepatopancreatobiliary (HPB) malignancies is frequently advocated as the only potentially curative treatment. In recent years, advances in chemotherapy regimens and surgical techniques have led to improved oncologic outcomes and overall survival, by increasing the rates of radical (R0) resections. Vascular resections are increasingly reported to further increase disease clearance rates. Within this perspective, the issue of vascular reconstruction has raised growing interest, drawing particular attention to vascular substitutes and surgical techniques for reconstruction. Case presentation: A case of extrahepatic cholangiocarcinoma with high clinical suspicion of vascular infiltration of the portal trunk at preoperative assessment is reported. An autologous interposition graft, harvested from diaphragmatic peritoneum, was chosen as a vascular substitute leading to successful portal trunk reconstruction and overcoming all possible drawbacks associated with cadaveric and artificial grafts reconstructions. Conclusion: This solution was strategic to ensure complete oncologic clearance averting the risk of positive margins (R1) at final pathology.
MeSH term(s)	Humans ; Peritoneum/pathology ; Portal Vein/surgery ; Portal Vein/pathology ; Cholangiocarcinoma/pathology ; Bile Ducts, Intrahepatic/pathology ; Bile Duct Neoplasms/pathology
Language	English
Publishing date	2023-03-29
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	2118383-1
ISSN	1477-7819 ; 1477-7819
ISSN (online)	1477-7819
ISSN	1477-7819
DOI	10.1186/s12957-023-02995-x
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Article ; Online: 3D Models as a Tool to Assess the Anti-Tumor Efficacy of Therapeutic Antibodies: Advantages and Limitations.

Guzzeloni, Virginia / Veschini, Lorenzo / Pedica, Federica / Ferrero, Elisabetta / Ferrarini, Marina

Antibodies (Basel, Switzerland)

2022 Volume 11, Issue 3

Abstract: Therapeutic monoclonal antibodies (mAbs) are an emerging and very active frontier in clinical oncology, with hundred molecules currently in use or being tested. These treatments have already revolutionized clinical outcomes in both solid and ... ...

Abstract	Therapeutic monoclonal antibodies (mAbs) are an emerging and very active frontier in clinical oncology, with hundred molecules currently in use or being tested. These treatments have already revolutionized clinical outcomes in both solid and hematological malignancies. However, identifying patients who are most likely to benefit from mAbs treatment is currently challenging and limiting the impact of such therapies. To overcome this issue, and to fulfill the expectations of mAbs therapies, it is urgently required to develop proper culture models capable of faithfully reproducing the interactions between tumor and its surrounding native microenvironment (TME). Three-dimensional (3D) models which allow the assessment of the impact of drugs on tumors within its TME in a patient-specific context are promising avenues to progressively fill the gap between conventional 2D cultures and animal models, substantially contributing to the achievement of personalized medicine. This review aims to give a brief overview of the currently available 3D models, together with their specific exploitation for therapeutic mAbs testing, underlying advantages and current limitations to a broader use in preclinical oncology.
Language	English
Publishing date	2022-07-08
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2661514-9
ISSN	2073-4468 ; 2073-4468
ISSN (online)	2073-4468
ISSN	2073-4468
DOI	10.3390/antib11030046
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Article ; Online: Defining and predicting textbook outcomes for perihilar cholangiocarcinoma: analysis of factors improving achievement of desired postoperative outcomes.

Clocchiatti, Lucrezia / Marino, Rebecca / Ratti, Francesca / Pedica, Federica / Casadei Gardini, Andrea / Lorenzin, Dario / Aldrighetti, Luca

International journal of surgery (London, England)

2024 Volume 110, Issue 1, Page(s) 209–218

Abstract: Background: Definition of textbook outcome (TO), defined as a single indicator combining the most advantageous short-term outcomes, is still lacking for perihilar cholangiocarcinoma (PHC). The primary endpoint of the present study is to analyze the rate ...

Abstract	Background: Definition of textbook outcome (TO), defined as a single indicator combining the most advantageous short-term outcomes, is still lacking for perihilar cholangiocarcinoma (PHC). The primary endpoint of the present study is to analyze the rate of achievement of a disease-specific TO for PHC within a high volume tertiary referral centre. Secondary endpoints are to identify predictive factors of TO-achievement and to analyze the impact of achieving TO on long-term results. Methods: Between 2010 and 2022, a total of 237 patients undergoing combined liver and biliary resection for PHC at tertiary referral centre were included. Disease-specific TO were defined as: no 90-day mortality, no postoperative complications, no readmission, no intraoperative transfusions and resection margins. A logistic regression model was developed to identify predictors associated with TO-achievement. Kaplan-Meier curves were designed to determine TO's impact on survival. Results: TO was achieved in 60 (25.3%) patients. At multivariate logistic regression, preoperative biliary drainage [odds ratio (OR) 2.90 (1.13-3.40), P =0.026], high prognostic nutritional index [OR 7.11 (6.71-9.43), P =0.007[ and minimally invasive approach [OR 3.57 (2.31-3.62), P =0.013] were identified as independent predictors of TO. High ASA score [OR 0.38 (0.17-0.82), P =0.013] decreased the odds of TO. A significant improvement in both overall survival and disease-free survival was associated to TO fulfilment. Conclusion: Since the achievement of TO correlates with better disease-free and overall survival, every effort should be made to ameliorate modifiable aspects prior to surery: management within referral centres with dedicated experience in biliary tract cancer and preoperative optimization protocol may positively contribute to improve postoperative outcomes, increasing the chance to obtain TO. Moreover, the implementation of advanced minimally invasive programs plays as well.
MeSH term(s)	Humans ; Klatskin Tumor ; Hepatectomy/adverse effects ; Hepatectomy/methods ; Bile Duct Neoplasms ; Disease-Free Survival ; Postoperative Complications/surgery ; Cholangiocarcinoma ; Retrospective Studies ; Treatment Outcome
Language	English
Publishing date	2024-01-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	2212038-5
ISSN	1743-9159 ; 1743-9191
ISSN (online)	1743-9159
ISSN	1743-9191
DOI	10.1097/JS9.0000000000000793
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Zs.A 6502: Show issues

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Article ; Online: Minimally Invasive Approach Provides Oncological Benefit in Patients with High Risk of Very Early Recurrence (VER) After Surgery for Intrahepatic Cholangiocarcinoma (iCCA).

Ratti, Francesca / Maina, Cecilia / Clocchiatti, Lucrezia / Marino, Rebecca / Pedica, Federica / Casadei Gardini, Andrea / De Cobelli, Francesco / Aldrighetti, Luca Antonio Maria

Annals of surgical oncology

2024 Volume 31, Issue 4, Page(s) 2557–2567

Abstract: Background: Surgery for intrahepatic cholangiocarcinoma (iCCA) is jeopardized by significant risk of early recurrence (≤ 6 months). The aim of the present study is to analyze the oncological benefit provided by laparoscopic over open approach for iCCA ... ...

Abstract	Background: Surgery for intrahepatic cholangiocarcinoma (iCCA) is jeopardized by significant risk of early recurrence (≤ 6 months). The aim of the present study is to analyze the oncological benefit provided by laparoscopic over open approach for iCCA in patients with high risk of very early recurrence (VER). Materials and methods: A total of 532 liver resections (LR) were performed for iCCA [265 by minimally invasive surgery (MIS) and 267 with open approach, matched through a 1:1 propensity score] and stratified using the postoperative prediction model of VER. Outcomes were compared between open and laparoscopic approaches, specifically evaluating oncological benefit. Results: The percentage of patients with high risk of VER was similar (32.7% in the laparoscopic group and 35.3% in the open group, pNS). The number of retrieved nodes as well as the rate and depth of negative resection margins were comparable between laparoscopic and open. The surgery-adjuvant treatment interval was shorter in laparoscopic patients in the overall series, as well in the subgroup of high risk of VER. The rate of patients starting adjuvant treatments within 2 months from surgery was higher in laparoscopic group compared with open group. In VER high-risk group both disease-free survival (DFS) and overall survival (OS) were significantly improved in MIS compared with open group (p = 0.032 and p = 0.026, respectively). Conclusions: In patients with high risk of VER, laparoscopy translates into an advantage in terms of recurrence-free survival, likely related to lower biological impact of surgery, together with a shorter interval between surgery and start of adjuvant treatments, even allowing for a higher number of patients to start adjuvant therapies within 2 months from resection.
MeSH term(s)	Humans ; Cholangiocarcinoma/surgery ; Hepatectomy ; Disease-Free Survival ; Laparoscopy ; Bile Ducts, Intrahepatic/surgery ; Bile Duct Neoplasms/surgery ; Retrospective Studies ; Treatment Outcome
Language	English
Publishing date	2024-01-02
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/s10434-023-14807-3
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Zs.A 4042: Show issues

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Article ; Online: Distinctive features of hepatocellular carcinoma in non-alcoholic fatty liver disease.

Valenti, Luca / Pedica, Federica / Colombo, Massimo

Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver

2021 Volume 54, Issue 2, Page(s) 154–163

Abstract: Hepatocellular carcinoma (HCC) is on the rise globally, causing more than 800 thousand deaths annually, with an estimated annual percent change of 0.51 for causes other than viral hepatitis, including nonalcoholic fatty liver disease (NAFLD). The ... ...

Abstract	Hepatocellular carcinoma (HCC) is on the rise globally, causing more than 800 thousand deaths annually, with an estimated annual percent change of 0.51 for causes other than viral hepatitis, including nonalcoholic fatty liver disease (NAFLD). The incidence of NAFLD-related HCC is peaking in several Far East regions (6-12% vs. 2-3% in Western Europe and USA), HCC risk being mainly driven by the epidemic of obesity and diabetes, both favored by an unhealthy diet and sedentary lifestyle. Under inherited susceptibility outlined by such genetic markers as variants in PNPLA3, TM6SF2 and MBOAT7, neoplastic transformation of NAFLD is driven by sublethal lipotoxicity consequent to hepatocyte lipid overload, whereas a myriad of factors spanning from subverted circadian homeostasis and gut dysbiosis to alcohol abuse and tobacco may interact as risk modifiers. At variance with viral HCC, NAFLD-HCC shows a frequent association with cardiovascular co-morbidities, absence of cirrhosis in up to half of patients and an association with persistently normal transaminase values. All these misleading features of NAFLD-related HCC account for the low uptake of surveillance and linkage to curative treatments that has been reported in patients with this cancer, a downside that could be attenuated when scores for cost-effective risk stratification become available.
MeSH term(s)	Acyltransferases/metabolism ; Carcinoma, Hepatocellular/epidemiology ; Carcinoma, Hepatocellular/etiology ; Carcinoma, Hepatocellular/pathology ; Genetic Predisposition to Disease/genetics ; Hepatocytes/metabolism ; Humans ; Incidence ; Lipid Metabolism ; Lipids ; Liver/metabolism ; Liver Neoplasms/epidemiology ; Liver Neoplasms/etiology ; Liver Neoplasms/pathology ; Membrane Proteins/metabolism ; Non-alcoholic Fatty Liver Disease/complications ; Phospholipases A2, Calcium-Independent/metabolism
Chemical Substances	Lipids ; Membrane Proteins ; TM6SF2 protein, human ; Acyltransferases (EC 2.3.-) ; MBOAT7 protein, human (EC 2.3.-) ; adiponutrin, human (EC 3.1.1.3) ; Phospholipases A2, Calcium-Independent (EC 3.1.1.4)
Language	English
Publishing date	2021-07-20
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	1459373-7
ISSN	1878-3562 ; 1125-8055
ISSN (online)	1878-3562
ISSN	1125-8055
DOI	10.1016/j.dld.2021.06.023
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Zs.A 1134: Show issues

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Article ; Online: Peribiliary glands pathology in a large series of end-stage alcohol-related liver disease.

Pedica, Federica / Heaton, Nigel / Quaglia, Alberto

Virchows Archiv : an international journal of pathology

2020 Volume 477, Issue 6, Page(s) 817–823

Abstract: The peribiliary glands are intramural or extramural structures with multiple functions related to bile secretion. The peribiliary glands can develop cystic alterations in several conditions, such as alcohol addiction. Peribiliary cysts can enlarge till ... ...

Abstract	The peribiliary glands are intramural or extramural structures with multiple functions related to bile secretion. The peribiliary glands can develop cystic alterations in several conditions, such as alcohol addiction. Peribiliary cysts can enlarge till being radiologically visible and mimic cancer. We studied 217 consecutive explanted livers for end-stage alcohol-related liver disease from the Pathology Unit of the Liver Unit at the King's College Hospital in Denmark Hill, with particular focus on peribiliary glands. Our cohort consisted of 31 females and 186 males, with a median age of 51 and of 56 years respectively. 92,2% had established cirrhosis, 73,3% had only alcohol-induced liver disease, whilst 26,7% had other co-morbidities. We found a mild ectasia of the peribiliary glands (<2 mm) in 37,8% and peribiliary cysts (> = 2 mm) in 22,6% of cases. The diameter of the peribiliary glands varied from 1 mm to 8 mm. Inflammation of the peribiliary glands was found in the majority of cases with dilatation (p value = 0,000). 4,6% of the peribiliary cysts had low-grade intraductal papillary neoplasm of the bile ducts confined to the peribiliary glands. Pancreatic heterotopia was found in 10,6% and associated with the presence of ectasia. Our findings fit with what is reported in literature, such as the alcohol-induced damage at the peribiliary glands. Moreover these results underline the possible role of peribiliary glands in the development of the intraductal papillary neoplasm of the bile ducts, the biliary counterpart of the branch type intraductal mucinous neoplasm of the pancreas.
MeSH term(s)	Adult ; Aged ; Cysts/pathology ; Female ; Humans ; Liver/pathology ; Liver Diseases, Alcoholic/pathology ; Male ; Middle Aged
Language	English
Publishing date	2020-06-07
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1184867-4
ISSN	1432-2307 ; 0945-6317
ISSN (online)	1432-2307
ISSN	0945-6317
DOI	10.1007/s00428-020-02851-3
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Ud III Zs.10: Show issues

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Article ; Online: Subcutaneous dirofilariosis in Italy: a diagnostic hypothesis to remind when the anamnesis is misleading.

Ahmed, Naghia / Tonelli, Leonardo / Labagnara, Giuseppina / Doglioni, Claudio / Pedica, Federica

Pathologica

2021 Volume 114, Issue 2, Page(s) 174–177

Abstract: Subcutaneous parasitic infections are possible matches in routine pathology and can be detected not only in patients coming from or travelling in tropical countries, but also when the anamnesis does not suggest at first worm infestations.: Here we ... ...

Abstract	Subcutaneous parasitic infections are possible matches in routine pathology and can be detected not only in patients coming from or travelling in tropical countries, but also when the anamnesis does not suggest at first worm infestations. Here we report the case of a young man from the north-west of Italy, with a negative anamnesis for travels but the presence of dogs at home, who presented a subcutaneous nodule showing a nematode surrounded by a fibrous capsule; the morphology was suggestive for Dirofilaria repens. Dirofilariosis is a zoonosis caused by D. repens or D. immitis, which can be acquired by dogs and cats through mosquitos bites; the disease is widespread in developing countries, but it is also emerging in Western countries, becoming an important public health issue.
MeSH term(s)	Animals ; Cat Diseases ; Cats ; Dirofilaria repens ; Dirofilariasis/diagnosis ; Dirofilariasis/parasitology ; Dirofilariasis/pathology ; Dog Diseases/parasitology ; Dogs ; Humans ; Italy
Language	English
Publishing date	2021-08-10
Publishing country	Italy
Document type	Case Reports
ZDB-ID	418229-7
ISSN	1591-951X ; 0031-2983
ISSN (online)	1591-951X
ISSN	0031-2983
DOI	10.32074/1591-951X-297
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Article ; Online: Acute and Chronic Manifestations of Sympathetic Ophthalmia on Multimodal Imaging.

Marchese, Alessandro / Filipello, Federica / Cicinelli, Maria Vittoria / Sanvito, Francesca / Pedica, Federica / Bandello, Francesco / Modorati, Giulio / Miserocchi, Elisabetta

Ocular immunology and inflammation

2023 , Page(s) 1–9

Abstract: Purpose: To report the clinical and multimodal imaging features of sympathetic ophthalmia in the acute and chronic phases.: Methods: Retrospective cohort study of consecutive patients with sympathetic ophthalmia seen at a tertiary referral center. ... ...

Abstract	Purpose: To report the clinical and multimodal imaging features of sympathetic ophthalmia in the acute and chronic phases. Methods: Retrospective cohort study of consecutive patients with sympathetic ophthalmia seen at a tertiary referral center. Charts, imaging studies, and histopathological specimens were reviewed. The clinical features and multimodal imaging in the sympathizing eye were analyzed by sorting features into those seen in the acute and chronic phase. Results: Ten patients were included in the analysis and all of them had previous ocular trauma or complicated retinal detachment. In the acute phase, 70% had anterior uveitis, 70% had vitritis, and 100% had active posterior uveitis; posterior uveitis included multifocal choroiditis (80%), optic disc swelling (40%), multiple serous retinal detachments (20%), MEWDS-like findings (10%), and retinal vasculitis with chorioretinitis (10%). In the chronic phase, posterior manifestations included widespread patches of chorioretinal atrophy in the mid- and far-periphery (80%), peripapillary subretinal fibrosis (50%), and nummular perivascular atrophy (50%). Conclusions: Sympathetic ophthalmia shows different posterior segment manifestations in the acute and chronic phase. Active sympathetic ophthalmia should be ruled out in eyes with a MEWDS-like presentation or rapidly progressing chorioretinitis, and history of trauma in the fellow eye. Peripapillary subretinal fibrosis and perivascular nummular atrophy may be useful features to suspect SO once acute inflammation has resolved.
Language	English
Publishing date	2023-09-15
Publishing country	England
Document type	Journal Article
ZDB-ID	1193873-0
ISSN	1744-5078 ; 0927-3948
ISSN (online)	1744-5078
ISSN	0927-3948
DOI	10.1080/09273948.2023.2245048
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Zs.A 4004: Show issues

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Article ; Online: IgG4-related autoimmune liver disease.

Capurso, Gabriele / Pedica, Federica / Palumbo, Diego / Della-Torre, Emanuel

Minerva gastroenterology

2020 Volume 69, Issue 1, Page(s) 23–49

Abstract: The term IgG4-related autoimmune liver disease (AILD) refers to hepato-biliary manifestations of Immunoglobin G4-related disease (IgG4-RD) including IgG4-related sclerosing cholangitis and IgG4-related pseudotumor. The association of some forms of ... ...

Abstract	The term IgG4-related autoimmune liver disease (AILD) refers to hepato-biliary manifestations of Immunoglobin G4-related disease (IgG4-RD) including IgG4-related sclerosing cholangitis and IgG4-related pseudotumor. The association of some forms of autoimmune hepatitis to IgG4-RD remains controversial. Although autoimmune phenomena have not been clearly observed in IgG4-AILD, perturbation of the adaptive immune system and activation of the humoral response represent established pathophysiological hallmarks and potential therapeutic targets. Clinical manifestations of IgG4-AILD are virtually indistinguishable from bile duct cancer or primary sclerosing cholangitis and are due to mass forming lesions and thickening of the biliary tract that progressively lead to biliary ducts obstruction. There are no current reliable biomarkers for IgG4-AILD and diagnosis should rely on the integration of clinical, serological, radiological, and histological findings. In analogy to most IgG4-RD manifestations, and in contrast to its major mimickers, IgG4-AILD promptly responds to glucocorticoids but frequently relapses, thus requiring long-term maintenance therapy to avoid progressive fibrosclerotic disease and liver cirrhosis. Accumulating evidence on the efficacy of B-cell depletion therapy in patients with systemic IgG4-RD is gradually changing the treatment paradigm of IgG4-AILD and biologics will be increasingly used also for gastroenterological manifestations of IgG4-RD to spare glucocorticoids and traditional immunosuppressive agents. Looking ahead, identification of reliable biomarkers and of mini-invasive strategies to obtain informative biopsies from the biliary tree represent unavoidable priorities to optimize diagnosis and management of IgG4-AILD.
MeSH term(s)	Humans ; Immunoglobulin G4-Related Disease/diagnosis ; Immunoglobulin G ; Neoplasm Recurrence, Local ; Liver Diseases/diagnosis ; Hepatitis, Autoimmune/diagnosis ; Hepatitis, Autoimmune/drug therapy ; Hepatitis, Autoimmune/pathology ; Glucocorticoids ; Bile Duct Neoplasms/diagnosis ; Bile Ducts, Intrahepatic/pathology
Chemical Substances	Immunoglobulin G ; Glucocorticoids
Language	English
Publishing date	2020-12-03
Publishing country	Italy
Document type	Journal Article
ZDB-ID	3062713-8
ISSN	2724-5365
ISSN (online)	2724-5365
DOI	10.23736/S2724-5895.20.02794-4
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Article: Case report:

Lazzari, Chiara / Pecciarini, Lorenza / Doglioni, Claudio / Pedica, Federica / Gajate, Ana Maria Samanes / Bulotta, Alessandra / Gregorc, Vanesa / Cangi, Maria Giulia

Frontiers in oncology

2022 Volume 12, Page(s) 1038774

Abstract: Rearrangements involving the neurotrophin kinase ( ...

Abstract	Rearrangements involving the neurotrophin kinase (
Language	English
Publishing date	2022-11-07
Publishing country	Switzerland
Document type	Case Reports
ZDB-ID	2649216-7
ISSN	2234-943X
ISSN	2234-943X
DOI	10.3389/fonc.2022.1038774
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