Gennaro Galizia | Università della Campania Luigi Vanvitelli (original) (raw)
Papers by Gennaro Galizia
Jop Journal of the Pancreas, 2011
Thanks to the wide use of diagnostic imaging modalities, multiple primary malignancies are being ... more Thanks to the wide use of diagnostic imaging modalities, multiple primary malignancies are being diagnosed more frequently and different associations of malignancies have been reported in this setting. In this paper, we describe the case of a patient with non-functioning well-differentiated neuroendocrine carcinoma of the head of the pancreas associated with extra-hepatic cholangiocarcinoma, in which an early diagnosis using magnetic resonance imaging allowed a good outcome. The simultaneous association of neuroendocrine pancreatic tumors and cholangiocarcinoma has not yet been described; however, this association should be considered and, due to the high contrast of magnetic resonance imaging, this technique is recommended in such patient in order to reach an accurate diagnosis.
Annales De Chirurgie, 1990
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Annals of Surgery, May 1, 1989
The American Journal of Surgery, Jul 31, 1989
Preoperative detectability rates of bepatocellular carcinoma smaller than 5 cm in 113 cirrhotic p... more Preoperative detectability rates of bepatocellular carcinoma smaller than 5 cm in 113 cirrhotic patients were 91 percent by ultrasonograpby, 93 percent by computed tomography, and 92 percent by selective angiograpby. Tbe combination of two methods produced detectability rates of 97 to 99 percent. One hundred tbree patients underwent various types of bepatic resection with the aid of intraoperative ultrasonograpby. Forty-four tumors (43 percent) were embedded in the liver, and these tumors were not detected by conventional surgical exploration. Tbe detectability rates were 38 percent for bepatocellular carcinomas smaller than 2 cm, 57 percent for 2 to 3.5 cm tumors, and 71 percent for 3.5 to 5 cm tumors. All undetectable bepatocellular carcinomas were identified by intraoperative echography. Tbe overall detection rate by this method was 98 percent, which was substantially higher than tbe preoperative rate. Intraoperative ultrasonograpby is a useful and indispensable method for performing atypical minor bepatectomy for the treatment of small bepatocellular carcinomas associated with liver cirrhosis.
The American Journal of Surgery, 1989
Preoperative detectability rates of bepatocellular carcinoma smaller than 5 cm in 113 cirrhotic p... more Preoperative detectability rates of bepatocellular carcinoma smaller than 5 cm in 113 cirrhotic patients were 91 percent by ultrasonograpby, 93 percent by computed tomography, and 92 percent by selective angiograpby. Tbe combination of two methods produced detectability rates of 97 to 99 percent. One hundred tbree patients underwent various types of bepatic resection with the aid of intraoperative ultrasonograpby. Forty-four tumors (43 percent) were embedded in the liver, and these tumors were not detected by conventional surgical exploration. Tbe detectability rates were 38 percent for bepatocellular carcinomas smaller than 2 cm, 57 percent for 2 to 3.5 cm tumors, and 71 percent for 3.5 to 5 cm tumors. All undetectable bepatocellular carcinomas were identified by intraoperative echography. Tbe overall detection rate by this method was 98 percent, which was substantially higher than tbe preoperative rate. Intraoperative ultrasonograpby is a useful and indispensable method for performing atypical minor bepatectomy for the treatment of small bepatocellular carcinomas associated with liver cirrhosis.
British Journal of Surgery, 1989
During the past 8 years we have treated 268 patients with primary hepatocellular carcinoma (HCC);... more During the past 8 years we have treated 268 patients with primary hepatocellular carcinoma (HCC); total extirpation of the tumor was carried out in 138. Thirty-one of the patients with resectable HCCs had already been treated with transcatheter arterial embolization (TAE) of the liver before they were referred to us. The clinical values of preoperative TAE were retrospectively evaluated for those 31 patients and for the remaining 107 patients without TAE. There were no substantial differences between the two study groups in the clinical and histopathologic backgrounds. No differences were observed in the extent of liver resection, estimated blood loss during surgery, and operation time. During surgery, however, troublesome intra-abdominal complications relevant to TAE were encountered in 15 patients, and detection of tumors was impossible, even with intraoperative ultrasonography, in five patients in the group with TAE. Such findings were not present in any of the patients without TAE. Postoperative morbidity and mortality rates were similar in the two groups. There was no significant difference in the rate of recurrence of tumor in the liver, but the recurrence time was significantly shorter in the group with TAE. TAE did not improve the long-term survival rates in patients either with or without cirrhosis. Results of our study seem to indicate that preoperative TAE is meaningless in the treatment of resectable HCCs and therefore should be avoided, particularly in patients with advanced cirrhosis of the liver.
Annales De Chirurgie, Feb 1, 1992
The caudate lobe is the only real and constant hepatic lobe of mammals and it requires a better d... more The caudate lobe is the only real and constant hepatic lobe of mammals and it requires a better delimitation in a modern conception of human liver segmentation. Owing to its dorsal, central and low anatomical situation, this lobe is connected to many segments of the liver and its inflow and outflow vessels are complex and variable. The authors, who studied 242 human livers, describe the typical pattern of these vessels and their anatomical and numerical variants. By its portal branches the lobe seems to depend upon the left lobe of the liver and its arterial and portal inflow as well as its hepatic vein system are better than these of other segments of the liver; moreover this segment can be compared to a quadrangular pyramid which presents an external part, superficial with easy surgical access, and an internal part, deeper and very difficult to resect. It is possible to remove segment I of the liver without any other hepatic resections but, usually, a partial resection of the lobe is performed or a left lateral segmentectomy is required. In liver cancer, the invasion of the lobe generally means widespread tumor dissemination and its resection is not justified; on the contrary, the caudate lobe should be resected for radical operation in hilar cholangiocarcinoma. The tendency of the caudate lobe to overlap with the other 2 liver lobes and its very good inflow and outflow systems explain its ability to avoid postoperative hepatic failure because it can support the hepatic vein drainage and it has a considerable disposition to regenerate.
World Journal of Surgery, 2008
Surgical innovation, 2012
In liver surgery, clamp-crushing (CC) procedure has been shown to be the most efficient system fo... more In liver surgery, clamp-crushing (CC) procedure has been shown to be the most efficient system for liver transection. Recently, it has been suggested that radiofrequency-assisted liver resection (RFALR) may be more advantageous, but sufficient evidence has yet to be accumulated. The control group was constituted by 32 patients undergoing CC liver transection. The study group included 13 patients undergoing RFALR with a new fully automated radiofrequency generator supplying a comb-shaped bipolar multielectrode device. RFALR allowed a faster hepatic transection and reduced both surgical time and intraoperative blood loss. RFALR was the only independent prognostic indicator of bleeding during liver transection. No significant liver damage and postoperative complications, particularly biliary leakage and stenosis, were experienced in the RFALR group. Compared with the CC procedure, this bipolar device was shown to be safe and effective in liver resections, allowing a very clean surgical...
Surgery, Jan 24, 2015
Systemic inflammation and immune response play a crucial role in tumor growth, and the neutrophil... more Systemic inflammation and immune response play a crucial role in tumor growth, and the neutrophil to lymphocyte ratio (NLR) may be a simple way to assess the host inflammatory response. The NLR has been shown to be a prognostic indicator in many human tumors; in early colon cancers, it has been evaluated only in a few studies and its role remains controversial. We analyzed data from 503 colon cancer patients. The best cutoff value for NLR was defined by receiver operating characteristic curve analysis. We grouped 276 Dukes A/B colon cancers, not receiving adjuvant chemotherapy, into low (<2.36) and high (>2.36) NLR and subjected to further analyses related to disease-free survival (DFS). A propensity score-matched analysis and the inverse probability of treatment weighting (IPTW) were performed to avoid confounding bias. The NLR correlated with tumor stage and oncologic outcome. The best NLR cutoff value was identical in the whole cohort and in Dukes A/B patients. Low NLR pati...
International journal of oncology, 2013
Esophageal cancer (EC) is an aggressive malignancy with increasing incidence worldwide. Surgery i... more Esophageal cancer (EC) is an aggressive malignancy with increasing incidence worldwide. Surgery is still the most effective treatment, however, both the high rate of local and distant recurrences and surgery-related complications led us to investigate new preoperative strategies. In this review, we discuss the role of neoadjuvant therapy for locally advanced EC with a focus on preoperative chemoradiation (trimodality treatment). Furthermore, the last fifteen years of published literature and our experience have been also reviewed. In the preoperative setting, few trials have reported a significant benefit with fluoropyrimidine and platinum compound-based neoadjuvant chemotherapy, compared to surgery alone. A large number of phase III trials and meta-analyses have demonstrated improved outcomes with preoperative chemoradiation vs. neoadjuvant chemotherapy or surgery alone. Therefore, trimodality therapy can be considered the most effective option in the management of locally advanced...
Nature biotechnology, 2001
The analysis of loss of heterozygosity (LOH) is perhaps the most widely used technique in cancer ... more The analysis of loss of heterozygosity (LOH) is perhaps the most widely used technique in cancer genetics. In primary tumors, however, the analysis of LOH is fraught with technical problems that have limited its reproducibility and interpretation. In particular, tumors are mixtures of neoplastic and nonneoplastic cells, and the DNA from the nonneoplastic cells can mask LOH. We here describe a new experimental approach, involving two components, to overcome these problems. First, a form of digital PCR was employed to directly count, one by one, the number of each of the two alleles in tumor samples. Second, Bayesian-type likelihood methods were used to measure the strength of the evidence for the allele distribution being different from normal. This approach imparts a rigorous statistical basis to LOH analyses, and should be able to provide more reliable information than heretofore possible in LOH studies of diverse tumor types.
Journal of Molecular Biomarkers & Diagnosis, 2012
Recent findings suggested the presence in several cancers, comprising colorectal malignancies, of... more Recent findings suggested the presence in several cancers, comprising colorectal malignancies, of a small subset of tumor-initiating cells, or cancer stem cells. So the isolation and characterization of tumorigenic colorectal cancer cells was extremely important for the development of new diagnostic and therapeutic procedures. Even if a defined and universally approved phenotype of colorectal cancer stem cells has not been defined yet, several markers have been reported able to isolate cancer stem-like cells. For the majority of these markers, it has not been associated a clear function but more of them seem to be involved in colon cancer stem cell maintenance, survival and proliferation through well known pathways such as the Wnt-β-catenin pathway whose activity has been demonstrated to define colorectal cancer stem cells. Even if the knowledge on colorectal cancer stem cell "functioning" is still little detailed and elusive, the importance to develop new therapeutic strategies that precisely target colorectal cancer stem cells prompted researchers to test different approaches to this aim. We summarize here the phenotypic and functional characteristics associated with colon cancer stem cells along with the approaches experimented to selectively target and kill these cancer cells. We also reviewed innovative approaches targeting colorectal cancer stem cells based on new delivery systems to precisely kill them or also on the combination of conventional therapies with functional dietary elements.
Alarm Bells in Medicine, 2005
Annals of surgery, Jan 8, 2015
Journal of Clinical Immunology, 2011
CD4+CD25+Foxp3+ regulatory T cells (Treg) specialize in suppressing immune responses. In this stu... more CD4+CD25+Foxp3+ regulatory T cells (Treg) specialize in suppressing immune responses. In this study, 47 consecutive colon cancer patients were subjected to circulating Treg frequency assessment by flow cytometry before and after cancer resection. Thirty-two healthy subjects served as controls. Circulating Treg frequencies were significantly higher in colon cancer patients with respect to healthy controls. When patients were subgrouped according to Dukes stages, a linear relationship was observed between Dukes stages and Treg frequencies. In radically resected patients, Treg frequencies were shown to have significantly dropped down. Patients with advanced colon cancer were more likely to have significantly higher proportions of circulating Treg frequencies than Dukes A and B patients when compared to healthy subjects. Of note, nonradically resected patients were found to display reductions in-but not normalization of-Treg frequencies. These results suggest that cancer itself may be able to drive Treg recruitment as a strategy of immunoevasion.
Jop Journal of the Pancreas, 2011
Thanks to the wide use of diagnostic imaging modalities, multiple primary malignancies are being ... more Thanks to the wide use of diagnostic imaging modalities, multiple primary malignancies are being diagnosed more frequently and different associations of malignancies have been reported in this setting. In this paper, we describe the case of a patient with non-functioning well-differentiated neuroendocrine carcinoma of the head of the pancreas associated with extra-hepatic cholangiocarcinoma, in which an early diagnosis using magnetic resonance imaging allowed a good outcome. The simultaneous association of neuroendocrine pancreatic tumors and cholangiocarcinoma has not yet been described; however, this association should be considered and, due to the high contrast of magnetic resonance imaging, this technique is recommended in such patient in order to reach an accurate diagnosis.
Annales De Chirurgie, 1990
RefDoc Bienvenue - Welcome. Refdoc est un service / is powered by. ...
Annals of Surgery, May 1, 1989
The American Journal of Surgery, Jul 31, 1989
Preoperative detectability rates of bepatocellular carcinoma smaller than 5 cm in 113 cirrhotic p... more Preoperative detectability rates of bepatocellular carcinoma smaller than 5 cm in 113 cirrhotic patients were 91 percent by ultrasonograpby, 93 percent by computed tomography, and 92 percent by selective angiograpby. Tbe combination of two methods produced detectability rates of 97 to 99 percent. One hundred tbree patients underwent various types of bepatic resection with the aid of intraoperative ultrasonograpby. Forty-four tumors (43 percent) were embedded in the liver, and these tumors were not detected by conventional surgical exploration. Tbe detectability rates were 38 percent for bepatocellular carcinomas smaller than 2 cm, 57 percent for 2 to 3.5 cm tumors, and 71 percent for 3.5 to 5 cm tumors. All undetectable bepatocellular carcinomas were identified by intraoperative echography. Tbe overall detection rate by this method was 98 percent, which was substantially higher than tbe preoperative rate. Intraoperative ultrasonograpby is a useful and indispensable method for performing atypical minor bepatectomy for the treatment of small bepatocellular carcinomas associated with liver cirrhosis.
The American Journal of Surgery, 1989
Preoperative detectability rates of bepatocellular carcinoma smaller than 5 cm in 113 cirrhotic p... more Preoperative detectability rates of bepatocellular carcinoma smaller than 5 cm in 113 cirrhotic patients were 91 percent by ultrasonograpby, 93 percent by computed tomography, and 92 percent by selective angiograpby. Tbe combination of two methods produced detectability rates of 97 to 99 percent. One hundred tbree patients underwent various types of bepatic resection with the aid of intraoperative ultrasonograpby. Forty-four tumors (43 percent) were embedded in the liver, and these tumors were not detected by conventional surgical exploration. Tbe detectability rates were 38 percent for bepatocellular carcinomas smaller than 2 cm, 57 percent for 2 to 3.5 cm tumors, and 71 percent for 3.5 to 5 cm tumors. All undetectable bepatocellular carcinomas were identified by intraoperative echography. Tbe overall detection rate by this method was 98 percent, which was substantially higher than tbe preoperative rate. Intraoperative ultrasonograpby is a useful and indispensable method for performing atypical minor bepatectomy for the treatment of small bepatocellular carcinomas associated with liver cirrhosis.
British Journal of Surgery, 1989
During the past 8 years we have treated 268 patients with primary hepatocellular carcinoma (HCC);... more During the past 8 years we have treated 268 patients with primary hepatocellular carcinoma (HCC); total extirpation of the tumor was carried out in 138. Thirty-one of the patients with resectable HCCs had already been treated with transcatheter arterial embolization (TAE) of the liver before they were referred to us. The clinical values of preoperative TAE were retrospectively evaluated for those 31 patients and for the remaining 107 patients without TAE. There were no substantial differences between the two study groups in the clinical and histopathologic backgrounds. No differences were observed in the extent of liver resection, estimated blood loss during surgery, and operation time. During surgery, however, troublesome intra-abdominal complications relevant to TAE were encountered in 15 patients, and detection of tumors was impossible, even with intraoperative ultrasonography, in five patients in the group with TAE. Such findings were not present in any of the patients without TAE. Postoperative morbidity and mortality rates were similar in the two groups. There was no significant difference in the rate of recurrence of tumor in the liver, but the recurrence time was significantly shorter in the group with TAE. TAE did not improve the long-term survival rates in patients either with or without cirrhosis. Results of our study seem to indicate that preoperative TAE is meaningless in the treatment of resectable HCCs and therefore should be avoided, particularly in patients with advanced cirrhosis of the liver.
Annales De Chirurgie, Feb 1, 1992
The caudate lobe is the only real and constant hepatic lobe of mammals and it requires a better d... more The caudate lobe is the only real and constant hepatic lobe of mammals and it requires a better delimitation in a modern conception of human liver segmentation. Owing to its dorsal, central and low anatomical situation, this lobe is connected to many segments of the liver and its inflow and outflow vessels are complex and variable. The authors, who studied 242 human livers, describe the typical pattern of these vessels and their anatomical and numerical variants. By its portal branches the lobe seems to depend upon the left lobe of the liver and its arterial and portal inflow as well as its hepatic vein system are better than these of other segments of the liver; moreover this segment can be compared to a quadrangular pyramid which presents an external part, superficial with easy surgical access, and an internal part, deeper and very difficult to resect. It is possible to remove segment I of the liver without any other hepatic resections but, usually, a partial resection of the lobe is performed or a left lateral segmentectomy is required. In liver cancer, the invasion of the lobe generally means widespread tumor dissemination and its resection is not justified; on the contrary, the caudate lobe should be resected for radical operation in hilar cholangiocarcinoma. The tendency of the caudate lobe to overlap with the other 2 liver lobes and its very good inflow and outflow systems explain its ability to avoid postoperative hepatic failure because it can support the hepatic vein drainage and it has a considerable disposition to regenerate.
World Journal of Surgery, 2008
Surgical innovation, 2012
In liver surgery, clamp-crushing (CC) procedure has been shown to be the most efficient system fo... more In liver surgery, clamp-crushing (CC) procedure has been shown to be the most efficient system for liver transection. Recently, it has been suggested that radiofrequency-assisted liver resection (RFALR) may be more advantageous, but sufficient evidence has yet to be accumulated. The control group was constituted by 32 patients undergoing CC liver transection. The study group included 13 patients undergoing RFALR with a new fully automated radiofrequency generator supplying a comb-shaped bipolar multielectrode device. RFALR allowed a faster hepatic transection and reduced both surgical time and intraoperative blood loss. RFALR was the only independent prognostic indicator of bleeding during liver transection. No significant liver damage and postoperative complications, particularly biliary leakage and stenosis, were experienced in the RFALR group. Compared with the CC procedure, this bipolar device was shown to be safe and effective in liver resections, allowing a very clean surgical...
Surgery, Jan 24, 2015
Systemic inflammation and immune response play a crucial role in tumor growth, and the neutrophil... more Systemic inflammation and immune response play a crucial role in tumor growth, and the neutrophil to lymphocyte ratio (NLR) may be a simple way to assess the host inflammatory response. The NLR has been shown to be a prognostic indicator in many human tumors; in early colon cancers, it has been evaluated only in a few studies and its role remains controversial. We analyzed data from 503 colon cancer patients. The best cutoff value for NLR was defined by receiver operating characteristic curve analysis. We grouped 276 Dukes A/B colon cancers, not receiving adjuvant chemotherapy, into low (<2.36) and high (>2.36) NLR and subjected to further analyses related to disease-free survival (DFS). A propensity score-matched analysis and the inverse probability of treatment weighting (IPTW) were performed to avoid confounding bias. The NLR correlated with tumor stage and oncologic outcome. The best NLR cutoff value was identical in the whole cohort and in Dukes A/B patients. Low NLR pati...
International journal of oncology, 2013
Esophageal cancer (EC) is an aggressive malignancy with increasing incidence worldwide. Surgery i... more Esophageal cancer (EC) is an aggressive malignancy with increasing incidence worldwide. Surgery is still the most effective treatment, however, both the high rate of local and distant recurrences and surgery-related complications led us to investigate new preoperative strategies. In this review, we discuss the role of neoadjuvant therapy for locally advanced EC with a focus on preoperative chemoradiation (trimodality treatment). Furthermore, the last fifteen years of published literature and our experience have been also reviewed. In the preoperative setting, few trials have reported a significant benefit with fluoropyrimidine and platinum compound-based neoadjuvant chemotherapy, compared to surgery alone. A large number of phase III trials and meta-analyses have demonstrated improved outcomes with preoperative chemoradiation vs. neoadjuvant chemotherapy or surgery alone. Therefore, trimodality therapy can be considered the most effective option in the management of locally advanced...
Nature biotechnology, 2001
The analysis of loss of heterozygosity (LOH) is perhaps the most widely used technique in cancer ... more The analysis of loss of heterozygosity (LOH) is perhaps the most widely used technique in cancer genetics. In primary tumors, however, the analysis of LOH is fraught with technical problems that have limited its reproducibility and interpretation. In particular, tumors are mixtures of neoplastic and nonneoplastic cells, and the DNA from the nonneoplastic cells can mask LOH. We here describe a new experimental approach, involving two components, to overcome these problems. First, a form of digital PCR was employed to directly count, one by one, the number of each of the two alleles in tumor samples. Second, Bayesian-type likelihood methods were used to measure the strength of the evidence for the allele distribution being different from normal. This approach imparts a rigorous statistical basis to LOH analyses, and should be able to provide more reliable information than heretofore possible in LOH studies of diverse tumor types.
Journal of Molecular Biomarkers & Diagnosis, 2012
Recent findings suggested the presence in several cancers, comprising colorectal malignancies, of... more Recent findings suggested the presence in several cancers, comprising colorectal malignancies, of a small subset of tumor-initiating cells, or cancer stem cells. So the isolation and characterization of tumorigenic colorectal cancer cells was extremely important for the development of new diagnostic and therapeutic procedures. Even if a defined and universally approved phenotype of colorectal cancer stem cells has not been defined yet, several markers have been reported able to isolate cancer stem-like cells. For the majority of these markers, it has not been associated a clear function but more of them seem to be involved in colon cancer stem cell maintenance, survival and proliferation through well known pathways such as the Wnt-β-catenin pathway whose activity has been demonstrated to define colorectal cancer stem cells. Even if the knowledge on colorectal cancer stem cell "functioning" is still little detailed and elusive, the importance to develop new therapeutic strategies that precisely target colorectal cancer stem cells prompted researchers to test different approaches to this aim. We summarize here the phenotypic and functional characteristics associated with colon cancer stem cells along with the approaches experimented to selectively target and kill these cancer cells. We also reviewed innovative approaches targeting colorectal cancer stem cells based on new delivery systems to precisely kill them or also on the combination of conventional therapies with functional dietary elements.
Alarm Bells in Medicine, 2005
Annals of surgery, Jan 8, 2015
Journal of Clinical Immunology, 2011
CD4+CD25+Foxp3+ regulatory T cells (Treg) specialize in suppressing immune responses. In this stu... more CD4+CD25+Foxp3+ regulatory T cells (Treg) specialize in suppressing immune responses. In this study, 47 consecutive colon cancer patients were subjected to circulating Treg frequency assessment by flow cytometry before and after cancer resection. Thirty-two healthy subjects served as controls. Circulating Treg frequencies were significantly higher in colon cancer patients with respect to healthy controls. When patients were subgrouped according to Dukes stages, a linear relationship was observed between Dukes stages and Treg frequencies. In radically resected patients, Treg frequencies were shown to have significantly dropped down. Patients with advanced colon cancer were more likely to have significantly higher proportions of circulating Treg frequencies than Dukes A and B patients when compared to healthy subjects. Of note, nonradically resected patients were found to display reductions in-but not normalization of-Treg frequencies. These results suggest that cancer itself may be able to drive Treg recruitment as a strategy of immunoevasion.