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( Massimo Colombo ),( Alessio Aghemo ),( Lin Liu ),( Robert H. Hyland ),( Chohee Yun ),( Diana M. Brainard ),( John G. Mchutchison ),( Sunjin Hwang ),( Marc Bourliere ),( Markus Peck-radosavljevic ),( 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1
Methods: Kidney transplant recipients with chronic GT1 or GT4 HCV infection, treatment-naive and treatment-experienced, with or without compensated cirrhosis were randomized 1:1 at 5 sites in Europe to receive LDV/SOF (90 mg/400 mg) for 12 or 24 weeks. Randomization was stratified by HCV genotype, treatment history and presence or absence of cirrhosis. Cirrhosis was determined by liver biopsy (Metavir score = 4 or Ishak score ≥5), Fibroscan® >12.5 kPa, or Fibrotest® >0.75 and APRI >2. A pretreatment creatinine clearance <40 mL/min was an exclusionary criterion. The primary endpoint was SVR12. Results: 114 patients were randomized and treated; median age was 53, 58% were male, 94% were white, 72% carried the non-CC IL28B allele, 91% had GT 1 infection, 69% were treatment-naive, and 15% had compensated cirrhosis. The median eGFR was 56ml/min (range 35-135ml/min). All 92 patients with SVR4 data available achieved SVR4 including a patient discontinuing treatment at Week 4 due to an AE. SAEs were reported in 12 (11%) patients; 3 were assessed as treatment related: syncope, pulmonary embolism, and blood creatinine increased. The most frequent AEs were headache (19%), asthenia (13%), and fatigue (10%). Conclusions: Administration of LDV/SOF for 12 or 24 weeks in patients with chronic HCV genotype 1 or 4 patients who have undergone kidney transplant was safe and highly effective with an SVR4 rate of 100%. Treatment was well-tolerated. SVR12 data for all patients will be presented.
Mismatched Imaging Findings of Prostate Cancer Diagnosis: 68 Ga-PSMA PET/CT vs mpMRI
Lopci Egesta,Colombo Piergiuseppe,Lazzeri Massimo 대한핵의학회 2021 핵의학 분자영상 Vol.55 No.4
Multiparametric magnetic resonance imaging (mpMRI) is the modality of choice for initial diagnosis of prostate cancer (PCa), including biopsy-naïve patients. Nevertheless, clinicians must be aware of the possibility that up to one-fourth of clinically significant cancers might be missed by the modality. Acknowledgment of this occurrence and the increased availability of 68 Ga-PSMA PET/CT in clinical routine, open the door to new, fascinating, indications for this functional modality in the context of PCa detection. With the case herein illustrated, we report a paradigmatic example of mismatch findings between PET/CT and mpMRI better elucidating the potential indication.
Marco Petrillo,Massimo Zucchettii,Stefano Cianci,Lavinia Morosi,Carlo Ronsini,Andrea Colombo,Maurizio D'Incalci,Giovanni Scambia,Anna Fagotti 대한부인종양학회 2019 Journal of Gynecologic Oncology Vol.30 No.4
Objective: Evidences from animal models seem to suggest that minimally invasive surgery may enhance cisplatin diffusion when the drug is administered in the context of post-operative hyperthermic intraperitoneal chemotherapy (HIPEC). The present study evaluates the cisplatin pharmacokinetic profile in a prospective series of women with platinum sensitive recurrent epithelial ovarian cancer treated with open secondary cytoreductive surgery (O-SCS) or minimally-invasive secondary cytoreductive surgery (MI-SCS).Methods: Cisplatin levels were assessed at 0, 20, 40, 60, and 120 minutes in: 1) blood samples, 2) peritoneal perfusate, and 3) peritoneal biopsies at the end of HIPEC. Median Cmax has been used to identify women with high and low drug levels. Progression-free survival (PFS) was calculated as the time elapsed between SCS+HIPEC and secondary recurrence or last follow-up visit.Results: Nine (45.0%) women received MI-SCS, and 11 (55.0%) O-SCS. At 60 minutes, median cisplatin Cmax in peritoneal tissue was higher in patients treated with MI-SCS compared to O-SCS (Cmax=8.262 μg/mL vs. Cmax=4.057 μg/mL). Furthermore, median cisplatin plasma Cmax was higher in patients treated with MI-SCS compared to O-SCS (Cmax=0.511 vs. Cmax=0.254 μg/mL; p-value=0.012) at 120 minutes. With a median follow-up time of 24 months, women with higher cisplatin peritoneal Cmax showed a longer PFS compared to women with low cisplatin peritoneal levels (2-years PFS=70% vs. 35%; p-value=0.054).Conclusions: We demonstrate for the first time that minimally invasive route enhances cisplatin peritoneal tissue uptake during HIPEC, further evaluations are needed to confirm the correlation between peritoneal cisplatin levels after HIPEC and survival. Trial Registration: ClinicalTrials.gov Identifier: NCT01539785
Global patterns of hepatocellular carcinoma management from diagnosis to death: the BRIDGE Study
Park, Joong-Won,Chen, Minshan,Colombo, Massimo,Roberts, Lewis R,Schwartz, Myron,Chen, Pei-Jer,Kudo, Masatoshi,Johnson, Philip,Wagner, Samuel,Orsini, Lucinda S,Sherman, Morris Wiley-Blackwell Publishing 2015 Liver International Vol.35 No.9
<P><B>Background & Aims</B></P><P>Hepatocellular carcinoma (HCC) is the second most common cause of cancer deaths worldwide. The global HCC BRIDGE study was a multiregional, large-scale, longitudinal cohort study undertaken to improve understanding of real-life management of patients with HCC, from diagnosis to death.</P><P><B>Methods</B></P><P>Data were collected retrospectively from January 2005 to September 2012 by chart reviews of eligible patients newly diagnosed with HCC at participating institutions.</P><P><B>Results</B></P><P>Forty-two sites in 14 countries contributed final data for 18 031 patients. Asia accounted for 67% of patients, Europe for 20% and North America for 13%. As expected, the most common risk factor was hepatitis C virus in North America, Europe and Japan, and hepatitis B virus in China, South Korea and Taiwan. The most common Barcelona Clinic Liver Cancer stage at diagnosis was C in North America, Europe, China and South Korea, and A in Taiwan and Japan. Across all stages, first HCC treatment was most frequently transarterial chemoembolization in North America, Europe, China and South Korea, percutaneous ethanol injection or radiofrequency ablation in Japan and resection in Taiwan. Survival from first HCC treatment varied significantly by region, with median overall survival not reached for Taiwan and 60, 33, 31, 24 and 23 months for Japan, North America, South Korea, Europe and China respectively (<I>P</I> < 0.0001).</P><P><B>Conclusions</B></P><P>Initial results from the BRIDGE study confirm previously reported regional trends in patient demographic characteristics and HCC risk factors, document the heterogeneity of treatment approaches across regions/countries and underscore the need for earlier HCC diagnosis worldwide.</P>
Fabio Grizzi,Gianluigi Taverna,Piergiuseppe Colombo,Mauro Seveso,Guido Giusti,Silvia Proietti,Girolamo Fiorini,Giovanni Lughezzani,Paolo Casale,Nicolò Buffi,Massimo Lazzari,Giorgio Guazzoni 대한비뇨의학회 2015 Investigative and Clinical Urology Vol.56 No.6
Purpose: Prostate cancer is the most frequent cancer in men in Europe. A major focus in urology is the identification of new biomarkerswith improved accuracy in patients with low-risk prostate cancer. Here, we evaluated two-dimensional neovascular complexityin prostate tumor and nontumor biopsy cores by use of a computer-aided image analysis system and assessed the correlationsbetween the results and selected clinical and pathological parameters of prostate carcinoma. Materials and Methods: A total of 280 prostate biopsy sections from a homogeneous series of 70 patients with low-risk prostatecancer (Gleason score 3+3, prostate-specific antigen [PSA]<10 ng/mL, and clinical stage T1c) who underwent systematic biopsysampling and subsequent radical prostatectomy were analyzed. For each biopsy, 2-μm sections were treated with CD34 antibodiesand were digitized by using an image analysis system that automatically estimates the surface fractal dimension. Results: Our results showed that biopsy sections without cancer were significantly more vascularized than were tumors. No correlationswere found between the vascular surface fractal dimension and patient's age, PSA and free-to-total PSA ratios, pathologicalstage, Gleason score, tumor volume, vascular invasion, capsular penetration, surgical margins, and biochemical recurrence. Conclusions: The value of angiogenesis in prostate cancer is still controversial. Our findings suggest that low-risk prostate cancertissues are less vascularized than are nontumor tissues. Further studies are necessary to understand whether angiogenesis is a hallmarkof intermediate- and high-risk prostate cancer.
HCC : The HCC bridge study: a Longitudinal cohort study in hepatocellular carcinoma (초)
( Joong Won Park ),( Morris Sherman ),( Min Shan Chen ),( Pei Jer Chen ),( Massimo Colombo ),( Philip Johnson ),( Masatoshi Kudo ),( Lewis Roberts ),( Myron Schwartz ),( Francoise Degos ),( Lucinda Or 대한간학회 2011 Clinical and Molecular Hepatology(대한간학회지) Vol.17 No.3(S)
Di Tommaso, Luca,Destro, Annarita,Seok, Jae Yeon,Balladore, Emanuela,Terracciano, Luigi,Sangiovanni, Angelo,Iavarone, Massimo,Colombo, Massimo,Jang, Ja June,Yu, Eunsil,Jin, So Young,Morenghi, Emanuela Elsevier 2009 Journal of hepatology Vol.50 No.4
<P><B>Background/Aims</B></P><P>Liver biopsy for hepatocellular carcinoma (HCC) detection is largely restricted to small hepatocellular lesions, which are often morphologically challenging, requiring careful distinction between dysplastic nodules (high-grade) and well-differentiated HCC.</P><P><B>Methods</B></P><P>We investigated the diagnostic accuracy of a panel of markers (HSP70 GPC3 and GS), previously tested in resection specimens, in a series of liver biopsies of large regenerative nodules (<I>n</I>=13), low-grade dysplastic nodules (<I>n</I>=21), high-grade dysplastic nodules (<I>n</I>=50), very well-differentiated (VWD) (<I>n</I>=17), well-differentiated (WD-G1) (<I>n</I>=40) and G2-3 (<I>n</I>=35) HCC.</P><P><B>Results</B></P><P>Almost all cases of large regenerative and low-grade dysplastic nodules did not stain while high-grade dysplastic nodules showed 1 marker (22%) but never 2 or 3. For HCC detection the overall accuracy of marker combination was 60.8% (3 markers) and 78.4% (2 markers) with 100% specificity. When restricted to VWD+WD-G1 HCC the accuracy was 57% (3 markers) and 72.9% (2 markers) with 100% specificity.</P><P><B>Conclusions</B></P><P>This panel proved useful to detect well-differentiated HCC in biopsy. Two immunoreactive markers (out of 3) are recommended as the most valuable diagnostic combination for HCC detection. The diagnostic accuracy of the panel could be improved using additional markers, as suggested by studies of expression profiling in other human models.</P>