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A Di Giorgio

Publications and source records attributed to A Di Giorgio.

At least 37 records · Page 2Linked to original sources
PubMed1995

[Long-term survival after resection surgery for cancer of the lung in the elderly patient].

Five hundred and twenty (520) patients with lung resection for cancer and known follow-up were studied. The aim of the study was to analyse long-term results in relation to the age of the patients. Two hundred and forty (240) cases were less than 55 years old, 227 were aged between 55 and 65 years, 53 were aged over 65 years. Type of lung resection, extent of resection, histological type, Degree of Nuclear Differentiation of primary tumours (NG), Degree of Lymphocytic Infiltration of primary tumours (LI) and Post-Surgical Stage were tested to assay their influence on long-term survival. The data were statistically analysed by the Number Cruncher Statistical System (NCSS 5.5). Univariate (Logrank Test) and multivariate analyses (Cox's Proportional Hazards Model for survival data) were used to test the influence of age and the above-mentioned prognostic factors on survival. The results of the study demonstrated that age doesn't influence long-term prognosis while Post-Surgical Stage (p < 0.00001), NG (p < 0.0001) and LI (p < 0.00001) are related to survival as independent variables. Then patients should not be denied lung resection on the basis of age alone.

Aged↗
PubMed1995

Gastric cancer: prognosis and lymph node reactivity.

OBJECTIVE: To assess the prognostic value of various immunomorphological variables in the prognosis of gastric cancer after curative resection. DESIGN: Retrospective study. SETTING: University hospital, Italy. SUBJECTS: 180 Patients who underwent curative resection for carcinoma of the distal two thirds of stomach between January 1960 and December 1978. Curative was defined as no residual cancer at the resection margins and no distant metastases. INTERVENTIONS: All living patients were followed-up, and missing survival data were obtained from the Official Census Registry. MAIN OUTCOME MEASURES: Correlation between survival and nuclear grade, lymphocytic infiltration, and types of lymph node reaction such as sinus histiocytosis, paracortical lymphoid cellular hyperplasia, and follicular hyperplasia in the cortical area. RESULTS: Crude 5 year and 10 year survival rates were 46% and 36%, respectively. Sex, site, and histological type of the tumour did not correlate with survival. Multivariate analysis showed that only pTNM stage of disease and degree of sinus histiocytosis were significantly related to survival. CONCLUSION: There may be an argument for using the presence or absence of sinus histiocytosis to stratify patients in prospective studies of adjuvant treatment.

Female↗
PubMed1994

[Surgical excision of lung neoplasms in the elderly. Immediate results].

The authors have analyzed a series of 807 patients who underwent resection for Bronchogenic Carcinoma at the "I Istituto di Clinica Chirurgica" of the University of Rome "La Sapienza" since 1950. The aim of the search was to evaluate the immediate results of surgical treatment in relation to age of the patients. Seventy-one patients were < 65 years old, 91 patients were older. The incidence of post-operative complications and mortality rate (within the 30th day from surgery) was related to the following risk factors: concomitant pulmonary and extrapulmonary diseases, cigarette smoking, laboratory values (red blood cell count, protein electrophoresis, urea nitrogen, glucose), type of lung resection, extent of resection, histology and post-surgical stage. The rates of post-operative complications and mortality were 34.1% and 27.5% in elderly patients, while in younger patients they were respectively 26.3% and 16.2%. In the elderly, cigarette smoking, cardiovascular diseases, diabetes, renal failure, type of lung resection and extent of resection, were related to an increase of the post-operative complications and mortality rate. In the younger patients, the extent of resection to adjacent structures was the primary risk factor for immediate results. Screenings in elderly and early diagnosis represent the strategy to allow more conservative surgical treatments and reduction of complications and mortality.

Adenocarcinoma↗
PubMed1994

Results of curative gastrectomy for carcinoma.

BACKGROUND: In the western literature, controversy exists regarding the operative management of carcinoma of the stomach. Still debated are the extent of gastric resection, the role of splenectomy, and the significance of lymphadenectomy. STUDY DESIGN: We performed a retrospective study of 646 consecutive patients who underwent curative gastrectomy for carcinoma of the stomach from 1950 to 1989. A multivariate analysis of nine clinicopathologic and treatment-related variables, including type of gastrectomy, splenectomy, and extent of lymphadenectomy was done to assess the relative influence of these variables on survival. RESULTS: The following variables emerged as independent predictors of death: serosal involvement, distant lymph node metastases, and total gastrectomy. Splenectomy and lymphadenectomy were not related to prognosis. However, a separate analysis on defined subsets of patients revealed that radical lymphadenectomy (removal of N2 nodes) provided a survival benefit in patients with T1-2 N0-1 disease. CONCLUSIONS: These findings suggest that although prognosis of carcinoma of the stomach is mainly determined by the stage of disease at time of operation, the choice of the surgeon can affect survival. Total gastrectomy should be avoided when it is not necessary for proximal tumor location. Subtotal gastrectomy in distally located tumors seems to be the best option. Radical lymph node dissection should be performed when nodal involvement is expected to be limited or absent.

Adult↗
PubMed1992

Surgical treatment of adenocarcinoma of the cardia.

BACKGROUND: Adenocarcinoma of the gastric cardia presents different features from other gastric carcinomas. This study was performed to analyze the results of a 40-year experience with these lesions. METHODS: Of the 365 patients reviewed, 211 (57.8%) underwent resection. One hundred fifty patients underwent total gastrectomy with lower esophageal resection (TGER) and 46 underwent proximal gastrectomy with distal esophageal resection (PGER). More recently, 15 patients were submitted to total gastrectomy with subtotal esophagectomy (TGSE) without thoracotomy. RESULTS: The tumors were far advanced in most patients: extraparietal invasion in 77.7% of patients, lymph node involvement in 55%, and distant metastases in 11%. The postoperative mortality rate was 25.1% in patients who underwent resection: 26.7% after TGER, 17.4% after PGER, and 33.3% after TGSE (difference not significant). Cardiovascular and respiratory complications were common causes of death after both TGER and PGER. After TGSE, deaths were related exclusively to local complications, mainly as a result of cervical anastomotic leaks. The actuarial 5-year survival rate for all patients surviving resection was 16.7%. No improvement in the results of surgical therapy was observed during the past 20 years. The actuarial 5-year survival rate was significantly affected by pathologic staging: 61.0% stage I, 23.3% stage II, 9.8% stage III, and 0% stage IV (p less than 0.001). No significant differences in actuarial 5-year survival rates were observed between TGER (17.8%) and PGER (14.9%). Sex, duration of symptoms, and histologic type did not reveal prognostic significance. CONCLUSIONS: In early tumors a total gastrectomy with resection of 10 cm of esophagus above the tumor is advocated.

Adenocarcinoma↗
PubMed1989

[Radical surgery and loco-regional chemotherapy in the treatment of liver metastases of stomach and colorectal cancer].

The results of surgical treatment of hepatic metastasis from stomach and colo-rectal cancer in a series of 28 patients have been assessed. 21 cases were subjected to hepatic resection (stomach cancer: 7 cases; colorectal: 14 cases) and 7 underwent locoregional chemotherapy through the gastroduodenal artery with fully implantable catheters (stomach ca.: 1 case; colorectal ca.: 6 cases). Of patients who underwent hepatic resection, 3 died postoperatively and 4 are still alive 5 years after the operation. Of the 7 patients treated with locoregional chemotherapy, 4 can be evaluated: 2 responded to treatment, 1 stabilised and 1 progressed. Clinically noteworthy toxicity was observed in one patient only.

Adenocarcinoma↗
PubMed1989

[Embryologic and anatomo-surgical presuppositions in intraoperative injuries of the spleen. A clinical study].

Records related to 2559 patients submitted to main abdominal surgery have been reviewed. Accidental splenic injury and subsequent splenectomy occurred in 4.5% of cases. A study of the embryological development and anatomical patterns of the splenic peritoneum has been carried out as well as an analysis of the site and the shape of the capsular damage in order to assess the mechanism of injury. Avulsion of splenic capsule occurring from traction on the peritoneal attachment of the spleen appears to be the most common mechanism of injury. Previous surgery and geriatric age seem to be factors predisposing to splenic injury.

Abdomen↗
PubMed1985

Lung cancer: long-term survival after surgical treatment.

The authors have carried out an analysis on a series of 1802 patients with lung cancer. 1254 patients were considered operable (69.5%) and 828 were resected. Overall 5-year survival rate was 28.3%. Results of surgical treatment were analysed in relation to the specific features both of primary tumour and the host organism. Although patients affected with epidermoid carcinoma showed a better survival as compared to those affected with tumours of other histotypes. Conversely long-term results were significantly related to post-surgical stage. Patients treated for stage I tumour showed a significantly better long-term survival (5-year survival rate 48.2%) as compared to those undergone resection for stage II and III neoplasms (22.8% and 12%, respectively; p: less than 0.001). From the prognostic standpoint female patients undergone resection showed markedly lower long-term survival (5-year survival rate 12.5%) as compared to male patients (5-year survival rate 29.5%), but the numerical differences between the two groups of patients does not permit to detect statistically significant differences (P: less than 0.05). Type and intensity of the immune response affect significantly long-term survival.

Female↗
PubMed1983

Segmental and wedge resections for lung cancer: a palliative or curative procedure?

Among 1000 consecutive patients submitted to surgery for lung carcinoma, 24 underwent minimal resections. Minimal resections although occasionally curative are, as a rule, palliative procedures to be used in patients with limited cardio-pulmonary reserve or previously submitted to lung resection. Whenever possible lateral, muscle-sparing thoracotomy and wedge resections should be performed.

Adenocarcinoma↗
PubMed1983

Results of surgical treatment for small cell carcinoma of the lung.

The records of 288 patients treated for small cell carcinomas of the lung are reviewed. Resectional surgery was performed in 150 cases (147 apparently curative and 3 palliative procedures), 73 patients were submitted to exploratory thoracotomy and 65 were deemed unsuitable for surgical treatment. Overall postoperative mortality after resection was 14,6% and 5-year survival rate 20,7%. Long term prognosis was significantly correlated to p-TNM (p less than 0,002) and host's immune response as evidenced by circulating peripheral lymphocytes/cumm (p less than 0,003), primary tumor lymphocytic infiltration (L.I.) (p less than 0.03), regional lymph-node reactivity (P.C.A., S.H. and C.A. development) (p less than 0,0001). Patients treated for Stage I disease and showing enhanced immune reactivity had a significantly better long term prognosis than Stage II, III and non reactive patients. Oat cell subtype had worse 5-year survival rates (10,7%) than intermediate cell subtype (25,4%), this difference however is devoid of statistical significance (p: not significant).

Carcinoma, Small Cell↗