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F Roviello

Publications and source records attributed to F Roviello.

48 records · Page 3Linked to original sources
PubMed1994

Early gastric cancer: report on 142 patients observed over 13 years.

Between 1977 and 1989, 958 patients were admitted for gastric carcinoma to the Second Department of Surgery, University of Siena, Italy. Of these, 142 (15%) had early gastric cancer. The diagnosis of this form of cancer has increased from 7% in 1977 to 22% in 1989. Following a detailed analysis of the clinical data and diagnostic techniques, it can be concluded that endoscopy is a far better method for diagnosis than x-ray. The data presented in the present paper strongly support this conclusion. Tumors were classified according to the Japanese Research Society Committee on Histological Classification of Gastric Cancer. The five-year survival rate which we have obtained is 89%, slightly lower than that of Japanese authors, but higher than that reported by other western authors. Lesions confined to the mucosa were observed in 75 patients (52.8%) while those involving the submucosa were observed in 67 patients (47.2%), with survival rates of 94 and 85%, respectively. Lymph node involvement was present in 14 cases (9.8%), with primary lymph nodes (N1) in 11 cases (7.7%) and secondary lymph nodes (N2) in three (2.1%). The five-year survival rates, with respect to lymph node involvement, was 57% in the presence of lymph node metastases and 93% in their absence (P < 0.001). The lesions were frequently found to be localized in the lower third of the stomach (106 cases, 74.6%). Patients with such lesions had a survival rate of 93%, a significant difference from those cases with lesions localized in the middle or upper third of the stomach (P < 0.05). The surgical treatment preferred in our Institute, has been subtotal gastrectomy associated with lymphadenectomy R1 and R2, leaving total gastrectomy for lesions localized in the upper third of the stomach.

Adenocarcinoma↗
PubMed1992

[Postoperative morbidity and mortality after surgical intervention for gastric carcinoma in advanced stage].

The paper reports the authors' experience in a group of 546 patients who underwent surgical treatment for gastric cancer from 1981 to 1988. Of 437 patients (80%) with advanced gastric cancer, 121 (28%) received palliative treatment and 316 (72%) were treated for curative purposes. Postoperative care was normal in 331 patients with a mean hospital stay of 11 days; various complications occurred in 106 patients with a mean hospital stay of 26 days. Overall operative mortality was 6% (27 patients). This study aimed to assess the main factor responsible for postoperative morbidity and mortality. Findings were compared to previously reported data and were shown to be similar.

Adult↗
PubMed1989

[Validity and limitations of the CEA test in the treatment of colorectal carcinoma].

CEA appears to be a good marker in the follow up of patients operated for colorectal cancer. The Authors analyse, on the base of literature data, the results of CEA test in their experience of colorectal cancers operated from 1978 to 1987. They confirm the importance of CEA as recurrence marker, however the test, by itself, is not sufficient to always identify a new onset of the disease.

Carcinoembryonic Antigen↗
PubMed1989

[Use of mechanical staplers in colostomy].

The authors used the technique of Chung, slightly modified, to perform the end colostomy in five patients who underwent abdomino-perineal resection according to Miles for rectal carcinoma. The technique proved to be easy and quick. The results have been satisfactory, without complications such as infections, necrosis, stenosis, retraction or paracolostomy hernias.

Aged↗
PubMedDate not supplied

Kinetic patterns in advanced gastric cancer as related to histotype and tumor extension.

Kinetic patterns of advanced gastric cancers were analyzed for comparison between intestinal- and diffuse-types by using the mean values of mitotic index (MI), apoptotic index (AI), the sum of the two [i.e., the turnover index (TI)] and growth index (GI), and the values of the same parameters in the three layers (upper, intermediate, lower) in which cancers were subdivided from surface to depth. Site and extent of tumors, lymph node invasion, and p53 and PCNA expression were not different between the two histotypes; tumor cell dissociation (TCD) was higher in diffuse-type cancers. Mean MI, AI, TI, and GI were not different between the two histotypes, while MI, AI, TI, and GI were higher in the upper layer of intestinal-type cancers than in that of diffuse-type. MI and GI decreased while AI increased from upper to deeper layers in intestinal-type tumors; MI, AI, and TI increase from upper to lower layers in diffuse-type tumors. In intestinal-type cancers, but not in diffuse cases, TI and GI were higher in the T2 group than in T3. This different behavior between the two histotypes is discussed.

Apoptosis↗
PubMedDate not supplied

[Influence of histologic type on prognosis of patients undergoing curative intervention for gastric adenocarcinoma. Italian multicenter study].

BACKGROUND: The prognostic significance of the histological type in gastric cancer is still debated. The correlation between intestinal-diffuse type and tumor recurrence was investigated in a prospective multicentric study which collects the cases from three surgical Departments of Italy. PATIENTS AND METHODS: Four-hundred and twelve patients who underwent a potentially curative resection between 1988 and 1995 were considered; 273 cases were classified as intestinal type (group A), and 139 cases as diffuse type (group B). Mixed cases were excluded from the study. All patients were included in a complete follow-up program for the early diagnosis of recurrence. Clinical, histopathological and surgical factors were examined for their influence on tumor recurrence by univariate and multivariate analysis. RESULTS: Recurrence rate was 41.4% in intestinal type, and 65.5% in diffuse type cases (p < 0.0001). In group A, multivariate analysis identified nodal status (p < 0.0001), depth of invasion (p < 0.005), lymph node dissection (D1 vs. D2-D4, p < 0.01), advanced age (p < 0.01) and male sex (p < 0.05) as significant prognostic factors. In group B, depth of invasion (p < 0.0005), lymph node dissection (p < 0.005), tumor size (p < 0.01) and nodal status (p < 0.05) resulted as significant variables; no preventive effect on tumor recurrence was found for D2 vs. D1 lymphadenectomy. Multivariate analysis performed on the totality of the cases demonstrated diffuse type as an independent predictor of poor prognosis (relative risk: 1.67, p < 0.001). CONCLUSIONS: Diffuse type of gastric cancer is an independent risk factor for tumor recurrence as compared with intestinal type; clinical and pathological variables play a different role as prognostic factors in the two histotypes.

Adenocarcinoma↗
PubMedDate not supplied

[Correlation between chronic gastritis of the gastric stump, Helicobacter pylori infections and iron deficiency after gastrectomy for gastric cancer].

Atrophic chronic gastritis and Helicobacter pylori infection are considered possible causes of iron deficiency anemia, and sideropenic anemia is also frequent after subtotal gastrectomy. In this study, thirty-three patients who underwent subtotal gastrectomy for primary adenocarcinoma of stomach were follow-up for at least 3 years, and included in this analysis. The presence of atrophic gastritis and H. pylori infection were detected by biopsy sampling and endoscopy every year after surgery. The iron status was evaluated by the assay of serum ferritin, serum iron and hemoglobin level. Statistical analysis revealed that atrophic gastritis was associated with lower iron serum levels, and gastric stump H. pylori infection was related to lower serum ferritin levels; on the contrary, no correlation of these factors with sex, age, malabsorption symptoms and stage of tumor was found. Atrophic chronic gastritis and Helicobacter pylori infection seem to play an important role as possible causes of post gastrectomy anaemia.

Adult↗
PubMedDate not supplied

[Rationalization of transfusional therapy in elective surgery. Our experience].

The paper reports the authors' experience regarding the rationalisation of transfusional therapy. The high risks of infection or damage to the immune system have highlighted the need to review the approach used by the anesthetist, surgeon or hematologist resulting in major cultural changes and the development of methods for the use of autologous blood. The study was carried out by comparing 2 similar periods of surgical activity in which the sole variant was the different attitude of the anesthetist who utilised blood transfusion on the basis of pre, intra and postoperative hematocrit values; in addition, the Authors report the results obtained in a group of patients enrolled for EIN. They observed that by using simple rationalisation a 30% saving, equivalent to 101 blood units, was achieved; EIN was performed in 20 patients out of the 32 enrolled with an effective 20% saving equivalent to 40 units; calculating the theoretical saving which could be obtained by total EIN and rationalisation, a saving of as much as 58% equivalent to 198 units could be achieved. Even if many aspects still require definition, good rationalisation, even using simple techniques, coupled with the availability of autologous blood certainly makes blood transfusion safer and less expensive.

Blood Transfusion↗