Raffaele Rocco - Academia.edu (original) (raw)

Papers by Raffaele Rocco

PubMed, Oct 1, 2014

The conclusions from the new IASLC/ATS/ERS lung adenocarcinoma classification portend important c... more The conclusions from the new IASLC/ATS/ERS lung adenocarcinoma classification portend important clinical consequences. The interpretation of the histological, biomolecular and radiological correlates of this classification not only allows for the definitive abandonment of the bronchoalveolar carcinoma definition but provides surgeons with significant clues to better understand the adenocarcinoma subsets and their surgical management. Indeed, the information will benefit surgeons who are fully involved in the lung cancer CT screening programs as well as in the diagnostic and therapeutic pathways of both early and locally advanced lung cancer. Moreover, intriguing perspectives are disclosing on the inclusion of the surgical modality among the ones used in the oligometastatic disease status. On the other hand, the new adenocarcinoma classification also emphasizes the need for surgeons working in a multidisciplinary environment to be thoroughly cognizant of the ever evolving lung cancer biomolecular knowledge and, in particular, of the potentially druggable somatic mutations in line with the modern professional profile of the so-called "surgeon scientist".

PubMed, Aug 1, 2013

Spindle cell lipoma (SCL) is a rare mediastinal tumor hard to be differentiated from myxoid lipos... more Spindle cell lipoma (SCL) is a rare mediastinal tumor hard to be differentiated from myxoid liposarcoma. We report a patient with an expanding fat density in the aorto-pulmonary window and with a previous history of invasive melanoma of the left pectoralis and subsequent pulmonary metastases successfully treated with chemotherapy. Preoperative diagnosis of the mediastinal lesion was difficult but crucial to determine further therapeutic plan.

Journal of Vascular Surgery, Feb 1, 2022

Thoracic Surgery Clinics, Feb 1, 2017

Despite several randomized trials and meta-analyses, the dilemma as to whether to apply suction a... more Despite several randomized trials and meta-analyses, the dilemma as to whether to apply suction after subtotal pulmonary resection has not been solved. The combination of a poorly understood pathophysiology of the air leak phenomenon and the inadequate quality of the published randomized trials is actually preventing thoracic surgeons from abandoning an empirical management of chest drains. Even digital systems do not seem to have made the difference so far. Based on the evidence of the literature, the authors propose a new air leak predictor score (ALPS) as a contributing step toward appropriateness in using intraoperative sealants, opting for an external suction and managing and chest tubes.

Intraoperative identification of pulmonary nodules has become a challenging endeavor with the inc... more Intraoperative identification of pulmonary nodules has become a challenging endeavor with the increasing refinement of minimally invasive approaches to lung cancer surgery. The identification of the nodule via a thorough palpation of the lung, once possible through open incisions, has been replaced by a combination of imaging and localization techniques which are tailored to the nature of the lesions (i.e., GGO’s), let alone their site in the parenchyma [1].

Current Surgery Reports, Jun 12, 2017

Purpose of Review The role of this systematic review is to analyse and compare with a meta-analyt... more Purpose of Review The role of this systematic review is to analyse and compare with a meta-analytic approach the outcomes of lobectomy versus intentional segmentectomy in the surgical treatment of stage I non-small cell lung cancer (NSCLC) as reported in the largest studies on the subject published to date. Recent Findings Regarding the results, most of these studies were based on the retrospective data. The size of the cohorts varied from 17 to 11,520 with a total number of 31,684 patients. The pooled hazard ratio was 1.08 (95% CI = 0.97-1.21; p = 0.16). Summary The survival in the lobectomy group was not superior to patients treated with intentional segmentectomy in stage I NSCLC. A large numbered, prospective, randomised trials are needed to assess the feasibility of intentional segmentectomy and its oncologic value in this group of patients, in order to dissolve the questions raised by retrospective data.

Annals of Thoracic Surgery Short Reports

American Surgeon, Jan 31, 2021

Background In Jan 2018, we began routinely obtaining neck ultrasound (US) with 123I/99Tc-sestamib... more Background In Jan 2018, we began routinely obtaining neck ultrasound (US) with 123I/99Tc-sestamibi (MIBI) for parathyroid gland localization and to identify thyroid pathology in the setting of primary hyperparathyroidism (1HPT). The aim of this study is to assess if routine neck US is a useful adjunct to 123I/99Tc-MIBI in 1HPT. Methods Patients undergoing surgery for 1HPT with both 123I/99Tc-MIBI and US at our institution after implementation of routine US were reviewed. Biopsy and surgical management of thyroid pathology was evaluated. 123I/99Tc-MIBI and US results were compared to intraoperative findings to determine sensitivity and positive predictive value (PPV) for parathyroid localization. Results From January 2018 to September 2019, there were 423 patients (mean, 61 years) that met inclusion criteria (80% women). Thyroid nodules were found on US in 57%, mean size 1.3 + 0.8 cm. Fine needle aspiration (FNA) was performed in 87 patients with nodules (36%). 35 patients (8.5%) required total or partial thyroidectomy for diagnoses/treatment. Papillary thyroid cancer (PTC) was found in 3.5% of the cohort with micro-PTC 53% and PTC 1-2 cm 40%. A successful parathyroid operation for 1HPT was achieved in 98.6% of patients. Positive predictive value for localization of abnormal parathyroid glands was 97% when US and 123I/99Tc-MIBI had concordant findings. Discussion Routine use of US in 1HPT commonly identifies nodules that are benign or low-risk PTC. Ultrasound is less sensitive for parathyroid localization but when used with 123I/99Tc-MIBI, concordant imaging has a high PPV.

The Annals of Thoracic Surgery

Journal of Vascular Surgery, 2022

Breath Analysis, 2019

Lung cancer is the leading cause of cancer-related death for both men and women worldwide, mainly... more Lung cancer is the leading cause of cancer-related death for both men and women worldwide, mainly because diagnosis is typically done in the presence of signs and/or symptoms concealing the presence of advanced stages of the disease. In an effort to achieve an early diagnosis, volatile organic compounds (VOCs) might be used to reduce the rate of false positive results emerging from screening programs using low-dose CT scans. We reviewed recent studies focusing on this topic to assess the state of the art in an effort to provide guidance for future research.

Annals of Surgical Oncology

Surgery, 2019

Background.-In spite of the current strategies aimed at avoiding opioid over prescription by impl... more Background.-In spite of the current strategies aimed at avoiding opioid over prescription by implementing institutional guidelines, the use of opioids after surgical procedures remains highly variable. It is well known that opioids are activated by the cytochrome p450 CYP2D6 enzyme in order to exert pharmacologic effect. Individual variation in CYP2D6 activity impacts drug metabolism, and genotyping can be performed to predict an individual's ability to metabolize CYP2D6 substrates. We postulate that the pharmacogenomic identification of patients with different opioid metabolism capacity may allow for the individualization of postsurgical opioid prescription. Methods.-This study was generated by the unison of data from two prior initiatives taking place at our Institution. In the first study, patients undergoing one of 25 elective surgical procedures were prospectively identified as part of a quality initiative and surveyed by phone 21

Atlas of Uniportal Video Assisted Thoracic Surgery, 2019

The American Surgeon

Human Pathology: Case Reports

Paragangliomas (PGLs) originate from neuroendocrine cells of the autonomic paraganglia and are cl... more Paragangliomas (PGLs) originate from neuroendocrine cells of the autonomic paraganglia and are classically found in the neck and skull base region, chest cavity, abdomen, pelvis, and bladder. We report a rare case of a mesenteric PGL in a 65-year-old asymptomatic female. She was treated by surgical resection of the small bowel mass and corresponding mesentery. Twelve prior cases of mesenteric paragangliomas exist in the literature. We report our findings and brief review of the current literature to date.

Journal of Thoracic Oncology

The electronic nose (e-nose) is a promising technology as a useful addition to the currently avai... more The electronic nose (e-nose) is a promising technology as a useful addition to the currently available modalities to achieve lung cancer diagnosis. The e-nose can assess the volatile organic compounds detected in the breath and derived from the cellular metabolism. Volatile organic compounds can be analyzed to identify the individual chemical elements as well as their pattern of expression to reproduce a sensorial combination similar to a fingerprint (breathprint). The e-nose can be used alone, mimicking the combinatorial selectivity of the human olfactory system, or as part of a multisensorial platform. This review analyzes the progress made by investigators interested in this technology as well as the perspectives for its future utilization.

Water

The increasing number of water abstractions and water-use conflicts in alpine regions represents ... more The increasing number of water abstractions and water-use conflicts in alpine regions represents a significant threat for these fragile aquatic ecosystems. The use of tools, like multicriteria analysis (MCA), can support related decision-making processes towards sustainable solutions. In this paper, an innovative approach to assess water withdrawals sustainability by integrating the MesoHABSIM (Mesohabitat Simulation Model) into an MCA framework is presented and discussed. The methodology was implemented by replacing, within the MCA assessment, Water Framework Directive biological indicators with the MesoHABSIM based river Habitat Integrity Index, related to watercourse discharge and morphology, which allows quantifying the impacts of withdrawals on river ecosystems and fish communities. The resulting MCA procedure considers four criteria (energy, environment and fishing, landscape, economy) and requires only the use of measurable indicators based on watercourse discharge and its co...

Current Surgery Reports

We present a successful use of the plasmid inhibition detection and DNA isolation protocol optimi... more We present a successful use of the plasmid inhibition detection and DNA isolation protocol optimisation for four food/feed samples in qPCR analysis of the sequence coding for chloroplast tRNA-Leu: two meat meal samples and two samples made of cranberries (jam and dried fruit). The quantitative real-time polymerase chain reaction (qPCR) can be inhibited by various substances and the DNA content in the sample can be underestimated. It is necessary to identify the PCR inhibition and choose an optimal DNA isolation protocol to correctly evaluate the sample. In a previous study, we have developed an assay using plasmid DNA carrying a non-homologous random sequence identifying possible inhibitors in qPCR in food/feed samples. The plasmid assay allowed to effectively reveal the PCR inhibition in all of the different sample matrices and to choose an optimal DNA isolation protocol.