Biomedical subjects

A Esposito

Publications and source records attributed to A Esposito.

At least 19 recordsLinked to original sources

PubMed2006

Pattern of osteophytes and enthesophytes in the proximal ulna: an anatomic, paleopathologic, and radiologic study.

OBJECTIVE: To develop a schematic segmentation of the proximal ulna in order to detect, assess the frequency, and characterize the bony outgrowths arising from the trochlea and from the radial notch of the ulna, to enable differentiation of osteophytes from enthesophytes. MATERIALS AND METHODS: Eighty well-preserved ulna specimens from the collection of the San Diego Museum of Man were analyzed by two musculoskeletal radiologists. The trochlea and the radial notch of the ulna simulate the shape of a clock quadrant. The proximal ulna was divided into 24 anatomic areas. The relationships of the joint capsule and insertions of tendons and ligaments onto these area were assessed by the two readers, and the resulting appearances of bony outgrowths were compared at visual inspection and on Radiographs. RESULTS: The interobserver visual comparison was good in 17 areas out of 24, but poor correlation was found in 7 areas. In one case, difficulties in differentiating osteophytes originating from the brachialis muscle/ tendon (area 9) from an enthesophyte originating from the capsule insertion on the coronoid process (areas 2 or 3) occurredand between two different enthesophytes in a further case. Five cases had difficulties in defining differences in the grading system of the outgrowths. The percentage of outgrowths observed in each of the areas was globally high, especially in areas 9 and 10. On radiographs it was possible to observe irregularities in ten areas; in eight at a threshold of height of 2 mm (areas 1-4, 9, 10, 11, 14) and in two at a threshold of height of 3 mm (areas 5, 6). The two readers had the same difficulties in differentiating enthesophytes from osteophytes at radiographic and visual examination. CONCLUSION: Our segmentation scheme is reproducible and objective, and permitted the differentiation of the bony outgrowths arising from the proximal ulna into osteophytes and enthesophytes, which may be particularly useful for the in vivo assessment of abnormalities seen in elbow overuse syndromes.

Humans↗

PubMed2006

Inter-comparison among different TLD-based techniques in a standard multisphere assembly for the characterisation of neutron fields.

In the framework of collaboration among the ENEA Radiation Protection Institute (Bologna), the ENEA Fusion Department (Frascati) and the INFN-LNF-Radiation Protection Group (Frascati), an experimental campaign was organised on the usage of thermoluminescence dosemeters (TLDs) for the dosimetric and spectrometric characterisation of neutron fields. Commercially available TLDs of different material and different sensitivity to photons and thermal neutrons were selected, namely TLD600H and TLD700H from Harshaw, GR206 and GR207 from SSDML (China), MCP-6s from TLD Poland. The detectors were first calibrated in standard fields of photons ((60)Co) and thermal neutrons at the ENEA-IRP Secondary Standard Calibration Laboratory of Bologna, then exposed in fast neutron standard fields of different energy, using a standard multisphere moderating assembly. The paper compares the dosimetric characteristics of the studied TL detectors, underlining the (n-gamma) discrimination capability, and discusses their spectrometric performances addressed to radiation protection applications.

Calibration↗

PubMed2006

Hyaluronic acid based materials for intestine tissue engineering: a morphological and biochemical study of cell-material interaction.

A wide number of gastro-intestinal disorders are associated with structural alterations of this district leading to an impaired gastrointestinal function. The study of cell material interactions represents one of the major issues for the development of tissue engineering purposes. Benzyl esters of hyaluronic acid are promising materials because they exhibit good tissue compatibility and are available in various configurations. In this work they have been studied for the possible application of intestinal cell growth and functioning. The preliminary investigation on the morphologic and biochemistry data obtained by monitoring the growth and differentiation of intestinal epithelial cells on two hyaluronic acid benzyl esters is reported. Two types of materials structures were studied: a three dimensional matrix and a macroporous flat sheet membrane. Caco-2 cell line was used: these cells undergo spontaneous enterocytic differentiation after several days in culture. The differentiation status of these cells grown on different materials was used as a parameter of biocompatibility and cell functioning. The status of cell growth and differentiation was monitored by studying cell morphology using scanning electron microscopy. The results obtained were confirmed by biochemical determinations. Although both the configurations of the two polymers exhibited good compatibility with respect to intestinal cells, only the flat sheet membrane proved to induce cell differentiation, leading us to the conclusion that it is a promising substrate for the proposed application.

Biocompatible Materials↗

PubMed2006

Same-day endoscopic retrograde cholangiopancreatography after transduodenal endoscopic ultrasound-guided needle aspiration: do we need to be cautious?

Patients who are undergoing endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for suspected pancreatic tumors frequently undergo endoscopic retrograde cholangiopancreatography (ERCP) for palliation of their symptoms. Performing EUS-FNA and ERCP in tandem may be cost-effective and may reduce procedure time, but the potential risks associated with this approach have not been clearly defined in the literature. We report two patients who underwent same-day therapeutic ERCP after transduodenal EUS-FNA for pancreatic tumors. Endoscopic biliary manipulation during ERCP aggravated an inadvertent and subclinical needle puncture injury to the bile duct sustained during the preceding EUS-FNA. This resulted in leakage of bile into the retroperitoneal space, and both patients required laparotomy and surgical drainage. Additional clinical evidence is needed to clarify these issues and to determine whether it would be prudent to perform therapeutic ERCP prior to diagnostic transduodenal EUS-FNA when these two procedures are planned as sequential or same-day procedures.

Bile↗

PubMed2006

Ventricular assistance with microaxial flow pump following mitral repair for dilated cardiomyopathy.

BACKGROUND: Postcardiotomy heart failure is still the main cause of death in patients undergoing palliative surgery for end-stage dilative cardiomyopathy. New micro-axial flow ventricular assisting devices (LVAD) have been suggested in such cases. OBJECTIVE: Evaluate the effect of the new LVAD on short-term outcome of a patient admitted for end-stage heart failure. STUDY DESIGN: Case report. DATA SOURCES: One patient admitted for severe mitral regurgitation secondary to end-stage dilative cardiomyopathy and chronic atrial fibrillation (AF). INTERVENTION: Preoperative intraaortic balloon pump (IABP) insertion, mitral plasty with radiofrequency ablation of AF, microaxial flow LVAD support. RESULTS: The patient was unweanable from cardiopulmonary bypass until microaxial flow LVAD unloaded the left ventricle and restored adequate cardiac function. The patient was discharged home and is still well at 5 months folllow-up. CONCLUSIONS: The miniinvasive insertion and withdrawal, low anticoagulation protocols, and the possibility of coupling with IABP make the microaxial flow LVAD promising for patients with end-stage heart failure undergoing surgery.

Aged↗

PubMed2006

[Health care and infective aspects in patients affected by common variable immunodeficiency assisted in the Lazio Regional Authority Reference Centre for Primary Immunodeficiencies].

Common variable immunodeficiency (CVID) is a chronic condition characterised by a predominant defect of humoral immunity. In most cases the diagnosis of CVID is made during adulthood; the main clinical features of CVID are chronic and relapsing infections (mainly of respiratory and gastroenteric tracts). CVID patients may also develop neoplastic and autoimmune diseases. In our centre (the Regional Centre for Primary Immunodeficiencies of the Lazio Regional Authority) we administered a 23-item questionnaire to 60 patients with CVID undergoing substitutive therapy with intravenous immunoglobulins (IVIG) about their demographic characteristics, time of clinical onset, time of diagnosis of CVID, clinical features, IVIG doses and administration intervals, and self-assessment of health status. In addition, the clinical history of all patients was reviewed, and the levels of serum IgG, IgA and IgM were evaluated and compared with the pre-therapy serum concentration. Moreover, an analysis of the treatment costs was performed. At onset, 67.2% of patients presented recurrent respiratory infections, and 50% had infections of the lower respiratory tract; 39.6% of the patients had gastroenteric infections. Most patients (57%) had recurrent infections of at least 2 of the respiratory, gastroenteric and/or urogenital tracts. In 37.9% of the group the diagnosis of CVID was made in less than 2 years after the beginning of symptoms, but in many cases (22.4%) the diagnosis took more than 10 years. 93% of patients are treated with a dose of IVIG between 6 and 15 g per administration, with intervals between 2 and 3 weeks. The review of patients'clinical history showed that 43% of patients have had respiratory infections during the follow-up in our Centre, 43% have splenomegaly (3% were also subjected to splenectomy) and 18.3% have autoimmune diseases. The mean concentration of IgG before the beginning of IVIG therapy was 235 mg/dl, while during the follow-up it was 664 mg/dl. Given the long time often required for diagnosis, general physicians and specialists should be better informed in order to make diagnosis swifter. The substitutive therapy with IVIG is effective in preventing recurrent infections and complications. A thorough follow-up is important for diagnosing neoplastic and autoimmune complications; in addition, immunologic analysis of peripheral blood and bone marrow are useful in identifying subgroups of patients with more severe clinical features. Finally, in selected patients, treatment costs may be controlled by modifying the dosage of IVIG or the intervals between administrations.

Adolescent↗

PubMed2005

Reduced intrahepatic fat content is associated with increased whole-body lipid oxidation in patients with type 1 diabetes.

AIMS/HYPOTHESIS: Insulin resistance may be associated with ectopic fat accumulation potentially determined by reduced lipid oxidation. In patients with type 1 diabetes peripheral insulin resistance is associated with higher intramyocellular lipid content. We assessed whether these patients are also characterised by intrahepatic fat accumulation and abnormal fat oxidation. METHODS: Nineteen patients with type 1 diabetes (6 women, 13 men, age 35+/-7 years, BMI 23+/-3 kg/m2), HbA1c 8.7+/-1.4%) and 19 healthy matched individuals were studied by (1) euglycaemic-hyperinsulinaemic clamp combined with [6,6-2H2]glucose infusion to assess whole-body glucose metabolism; (2) indirect calorimetry to assess glucose and lipid oxidation; and (3) localised 1H-magnetic resonance spectroscopy of the liver to assess intrahepatic fat content. RESULTS: Patients with type 1 diabetes showed a reduced insulin-stimulated metabolic clearance rate of glucose (4.3+/-1.3 ml kg(-1) min(-1)) in comparison with normal subjects (6.0+/-1.6 ml kg(-1) min(-1); p<0.001). Endogenous glucose production was higher in diabetic patients (p=0.001) and its suppression was impaired during insulin administration (66+/-30 vs 92+/-8%; p=0.047) in comparison with normal subjects. Plasma glucagon concentrations were not different between groups. The estimated hepatic insulin concentration was lower in diabetic patients than in normal subjects (p<0.05), as was the intrahepatic fat content (1.5+/-0.7% and 2.2+/-1.0% respectively; p<0.03), the latter in association with a reduced respiratory quotient (0.74+/-0.05 vs 0.84+/-0.06; p=0.01) and increased fasting lipid oxidation (1.5+/-0.5 vs 0.8+/-0.4 mg kg(-1) min(-1); p<0.01). CONCLUSIONS/INTERPRETATION: In patients with type 1 diabetes, insulin resistance was not associated with increased intrahepatic fat accumulation. In fact, diabetic patients had reduced intrahepatic fat content, which was associated with increased fasting lipid oxidation. The unbalanced hepatic glucagon and insulin concentrations affecting patients with type 1 diabetes may be involved in this abnormality of intrahepatic lipid metabolism.

Adiponectin↗

PubMed2005

Calcium accumulation in neurites and cell bodies of rat cerebellar granule cells in culture: effects on GABA(A) receptor function.

Accumulation of calcium in rat cerebellar granule cells in culture was studied by two photon laser scanning microscopy. Depolarizations by high extracellular potassium induced short-lived increases in calcium in both cell bodies and neurites. However, although the increase in neurites subsided completely after the initial peak, in cell bodies there was a persistent plateau until the high potassium stimulus was removed. On the contrary, the calcium signal due to NMDA receptors activation was persistent in both cell bodies and neurites and remained until the agonist was present. The nature of these calcium signals provides an interpretation key for the effects of NMDA receptors activation on GABA(A) receptors. In particular, the persistent calcium increase in neurites may explain the decrease in GABA activated chloride currents which are related to activation of dendritic/synaptic GABA(A) receptors.

Animals↗

PubMed2005

Polymeric meshes for internal sutures with differentiated adhesion on the two sides.

The aim of this work is to investigate the effects of different plasma treatments on ePTFE abdominal prostheses with the final goal of obtaining a new prosthesis, made of a single strand of ePTFE, with clearly differentiated adhesion properties on the two sides, which should be able to promote tissue ingrowth on one side and prevent post surgical visceral adhesions on the other. Samples obtained from ePTFE Bard Dulex Meshes have been treated sequentially with three different gases (N(2), O(2) and NH(3)) in order to choose the optimal treatment conditions to improve ePTFE wettability. In particular, no modification was induced by N(2) treatment, while the full treatment after the final ammonia gas resulted in the best suitable candidate. As demonstrated by scanning electron microscopy, AFM analyses and contact angle measurements, ammonia plasma treatment increases ePTFE surface roughness and renders it more hydrophilic, thus promoting adhesion without any alteration of the material's bulk properties. The reported results also evidence the possibility to obtain the maximum wettability with a cheap treatment by optimizing plasma exposure time. As a preliminary cell adhesion study, Swiss 3T3 fibroblasts (mouse, embryo) have been seeded on the treated and untreated materials in order to assess whether there was any difference in terms of cell attachment and spreading. Cells seeded on the ammonia plasma treated material showed a better adhesion and spreading when compared to the untreated material.

Adhesiveness↗

PubMed2005

Targeting HER2 as a therapeutic strategy for breast cancer: a paradigmatic shift of drug development in oncology.

Targeted therapies are causing a dramatic change in cancer drug development. Trastuzumab, a humanized recombinant monoclonal antibody that recognizes the extracellular domain of HER2 trans-membrane protein, is among the first target-specific drugs that have been licensed for clinical use and its development represents a model of integration of new agents with classical treatment strategies. In preclinical models, trastuzumab has demonstrated a marked antiproliferative effect and a synergistic action with several chemotherapeutic agents. Monotherapy trials indicate that trastuzumab is active as a single agent in HER2 positive patients, is well tolerated, and is associated with preservation of quality of life (QoL). Furthermore, as first line therapy for metastatic breast cancer overexpressing HER2 receptor, the addition of trastuzumab to taxane-based chemotherapy significantly increased rate of objective response, time to disease progression and survival when compared with chemotherapy alone. Trastuzumab has shown important activity when used with many chemotherapeutic agents such as platinum salts, gemcitabine, vinorelbine and capecitabine and liposomal anthracyclines. Various trials are now ongoing to optimize the use of trastuzumab and to investigate its role in the adjuvant and in the neo-adjuvant setting.

Animals↗

PubMed2004

Effects of modulators of sarcoplasmic Ca2+ release on the development of skeletal muscle fatigue.

The reduced release of Ca2+ from sarcoplasmic reticulum (SR) is considered a major determinant of muscle fatigue. In the present study, we investigated whether the presence of dantrolene, an established inhibitor of SR Ca2+ release, or caffeine, a drug facilitating SR Ca2+ release, modifies muscle fatigue development. Accordingly, the effects of Ca2+ release modulators were analyzed in vitro in mouse fast-twitch [extensor digitorum longus (EDL)] and slow-twitch (soleus) muscles, fatigued by repeated short tetani (40 Hz for 300 ms, 0.5 s(-1) in soleus and 60 Hz for 300 ms, 0.3 s(-1) in EDL, for 6 min). Caffeine produced a substantial increase of tetanic tension of both EDL and soleus muscles, whereas dantrolene decreased tetanic tension only in EDL muscle. In both EDL and soleus muscles, 5 microM dantrolene did not affect fatigue development, whereas 20 microM dantrolene produced a positive staircase during the first 3 min of stimulation in EDL muscle and a slowing of fatigue development in soleus muscle. The development of the positive staircase was abolished by the addition of 15 microM ML-7, a selective inhibitor of myosin light chain kinase. On the other hand, caffeine caused a larger and faster loss of tension in both EDL and soleus muscles. The results seem to indicate that the changes in fatigue profile induced by caffeine or dantrolene are mainly due to the changes in the initial tetanic tension caused by the drugs, with the resulting changes in the level of contraction-dependent factors of fatigue, rather than to changes in the SR Ca2+ release during fatigue development.

Animals↗

PubMed2003

Biomedical application of a superabsorbent hydrogel for body water elimination in the treatment of edemas.

A novel system of body water elimination to be used for the treatment of edemas, based on superabsorbent cellulose derivatives able to absorb large amounts of water and water solutions, has been investigated. Hydrogels have been synthesized starting from water solutions of carboxymethylcellulose sodium salt and hydroxyethylcellulose, chemically crosslinked with divinylsulphone. Polyelectrolyte hydrogels displayed high sensitivity in sorption capacity to variations of the ionic strength and pH of the external solution, which is a key parameter for the application under investigation. Further, swelling properties have been modulated acting on the degree of crosslinking of the macromolecular network, and a direct method for the measurement of this parameter based on NMR solid-state analysis has been provided. The hydrogel biocompatibility has been studied in terms of its capacity either to induce nitric oxide and lactate dehydrogenase release by macrophages or influence their viability. The eventual release of toxic substances from the hydrogel was also investigated using Swiss 3T3 fibroblasts. The results obtained from the biocompatibility studies carried out in this work are consistent with the hypothesis that this gel may represent an alternative to diuretic therapies in those pathologic conditions in which edemas occur.

Absorption↗

PubMed2003

Novel antitenascin antibody with increased tumour localisation for Pretargeted Antibody-Guided RadioImmunoTherapy (PAGRIT).

The Pretargeted Antibody-Guided RadioImmunoTherapy (PAGRIT) method is based on intravenous, sequential administration of a biotinylated antibody, avidin/streptavidin and (90)Y-labelled biotin. The hybridoma clone producing the monoclonal antitenascin antibody BC4, previously used for clinical applications, was found not suitable for further development because of the production of an additional, nonfunctional light chain. In order to solve this problem, the new cST2146 hybridoma clone was generated. The monoclonal antibody ST2146, produced by this hybridoma, having the same specificity as BC4 but lacking the nonfunctional light chain, was characterised. ST2146 was found able to bind human tenascin at an epitope strictly related, if not identical, to the antigenic epitope of BC4. It showed, compared to BC4, higher affinity and immunoreactivity and similar selectivity by immunohistochemistry. Biodistribution studies of biotinylated ST2146 and three other monoclonal antitenascin antibodies showed for ST2146 the highest and more specific tumour localisation in HT29-grafted nude mice. On the overall, ST2146 appears to be a good alternative to BC4 for further clinical development of PAGRIT.

Animals↗

PubMed2003

Metal speciation and pH effect on Pb, Cu, Zn and Cd biosorption onto Sphaerotilus natans: Langmuir-type empirical model.

Biosorption data of lead, copper, zinc and cadmium onto Sphaerotilus natans at different equilibrium pH (3-5 units) were here reported and analysed. Experimental results outlined the positive effect of pH increase on pollutant uptake and also the biomass affinity series (Pb > Cu > Zn > Cd) reflecting the hydrolytic properties of metals. An original empirical model was proposed to represent the effect of pH on heavy metal biosorption inserting q(max) vs. pH empirical functions into the classical Langmuir isotherm.

Adsorption↗

PubMed2003

Meiotic recombination and spermatogenic impairment in Mus musculus domesticus carrying multiple simple Robertsonian translocations.

We quantitatively analyzed the spermatogenic process, including evaluation of seminiferous tubules with defective cycles, rates of germ cell death and sperm morphology, in adult male mice with standard telocentric chromosomes (2n = 40, CD1 strain), homozygous (2n = 24, Mil II population) and heterozygous (2n = 24 x 40) for Robertsonian (Rb) rearrangements. The animals were analyzed at three different ages: three, five and seven months after birth. The number and position of crossover events were also determined by chiasmata counting and immunostaining with an antibody against mouse MLH1 protein. Our analysis of spermatogenesis confirms the impairment of the spermatogenic process in multiple simple heterozygotes due to both germ cell and abnormal sperm morphology. The detrimental effects exerted by Rb heterozygosities were found to be at least partially buffered with time: the frequency of defective tubules was lower and germ cell survival and sperm morphology better in 7-month-old animals than in the 3- and 5-month-old mice. While there are previously published data on germ cell death in multiple simple heterozygotes, this is the first report of a partial rescue of spermatogenesis with time. The mean frequency of MLH1 foci was lower in Rb homozygous and heterozygous mice than in mice carrying all telocentric chromosomes. The lower number of foci in Rb mice can be ascribed to a decrease in the number of multiple chiasmata and the maintenance of single chiasmata preferentially located in the terminal region of both the telocentric and metacentric chromosomes.

Adaptor Proteins, Signal Transducing↗

PubMed2003

[Longitudinal study on osteoarthritis and bone metabolism].

OBJECTIVE: The relationship between Osteoarthritis (OA) and Osteoporosis (OP) is not well defined due to lacking in longitudinal data, mainly regarding correlations between biochemical factors and OA incidence. Aim of this paper was to investigate the predictive value for OA incidence of bone mass variations and of selected biochemical markers in healthy women participating in a population-based longitudinal study carried out in Naples (Italy). SUBJECTS AND METHODS: High completion rate (85.2%) and statistically adequate sample size were obtained: 139 women (45 to 79 years of age) were examined and follow up visit was performed after two years (24+/-2 months), following the same protocol. Patients underwent medical examination, questionnaire, anthropometric measurements, blood sampling and urine collection. Bone mineral density (BMD) measurement was performed by dual energy X-ray absorptiometry (DEXA) at the lumbar spine (L1-L4) and femoral neck. Radiographs of dorsal and lumbar spine in lateral view were performed at basal and at 24 months visits; a team of three experts scored radiographs using Kellgren and Lawrence grading. RESULTS: The score was calculated for two individual radiographic features (narrowing of the joint space, presence of osteophytes) and as a global score. Results show a relevant percentage, 23% up, of subjects presenting both OA and OP. In the cross-sectional study the presence of osteophytosis correlates with anthropometric variables and PTH levels. In the longitudinal study results show a correlation between serum vitamin D and delta score for osteophytosis (beta=0.02 p<0.05). CONCLUSIONS: Data obtained outline the importance of further studies on the pathogenetic link between OA and bone metabolism.

Absorptiometry, Photon↗

PubMed2003

A combined approach of neoadjuvant chemotherapy and surgery for colorectal liver metastases.

Hepatic metastases represent one of major clinical problems in patients affected by solid tumours because liver is the first site of metastatic disease after lymph nodes, (1, 2). The most common origins among adults are from colon and rectum cancer followed by pancreas (adenocarcinoma or neuroendocrine), lung and breast (3-7). It is estimated that in 15-20% of patients affected by adenocarcinoma of colon-rectum liver metastases are present at the time of diagnosis (8-11), while in 40% of cases they will develop during the follow-up (10, 11). Liver metastases are the first determinant for survival (1, 3, 12-17), and both hepatic and extrahepatic involvement have a statistical significant impact on it (3, 14, 18-21). Prognosis of patients affected by untreated disease is very poor, being 5 to 14 months with rare 2-year survivors and a 5-year survival rate of 0% (10, 21-24). In half of all patients affected by colorectal cancer and undergoing to a radical surgery, disease will fail in the liver (8, 25-28); among patients dying for colorectal cancer, 60-70% have a liver involvement (9, 29), and in 20-25% liver is the only site of recurrence and death results from liver failure (3, 29-31). In Autoptic studies those rates increased up to 83% and 38% respectively (1, 10, 17, 32).

Adenocarcinoma↗

PubMed2003

Personal experience on treatment of colorectal liver metastases: a multidisciplinary approach.

UNLABELLED: Diagnosed colorectal cancer patients presents liver metastases at presentation in 25% of cases, an another 25% of patients will develop hepatic recurrence during follow-up period. Natural history of disease in untreated patients is sad without long term survivors. The only chance of curative treatment is surgical resection. Aim of this study was to evaluate recurrence and survival in the multimodal approach of colorectal liver metastases patients. MATERIALS: From 1990 to 2003, 212 colorectal cancer liver metastases patients were observed at the "Regina Elena" cancer institute of Rome, the 48.8% of cases were synchronous. Of 185 patients with minimum follow-up of 12 months, 80 were surgically resected, while 105 were not. Major resection was possible in 45.3% of cases and 66.1% of them were radicals. Tweny were treated by surgery alone, 65% were resected after i.v. chemotherapy, in the last 10% resection followed HAI chemotherapy. Of non resected patients, in the 36.2% i.v. chemotherapy was administered, 26.1% were submitted to HAI chemotherapy, in 18.9% others treatments were carried out and 18.8 were untreated. RESULTS: Operative mortality was contained to 2.5%. The hepatic recurrence was observed in 50.5% of cases while extrahepatic was in the 13.6%. In the resected cases the 5-yr. Overall survival was 38.8%, the disease-free survival decreased to 14.7% with a median time to progression of 15 months. The liver recurrence-free survival was 31.3%. Really bad prognopsis was observed in the non resected patients with none survived at 5 years and 3-yr overall survival of 18.7%. CONCLUSION: In selected patients the multimodality approach to treatment of hepatic metastases showed satisfactory results in terms of local and distal control of disease. Long term survivors were observed in the our experience.

Adenocarcinoma↗