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Giannini V, Mazzetti S, Bertotto I, Chiarenza C, Cauda S, Delmastro E, Bracco C, Di Dia A, Leone F, Medico E, Pisacane A, Ribero D, Stasi M, Regge D. Predicting locally advanced rectal cancer response to neoadjuvant therapy with 18F-FDG PET and MRI radiomics features. Eur J Nucl Med Mol Imaging 2019; 46:878-888. [PMID: 30637502 DOI: 10.1007/s00259-018-4250-6] [Citation(s) in RCA: 95] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 12/26/2018] [Indexed: 12/12/2022]
Abstract
PURPOSE Pathological complete response (pCR) following neoadjuvant chemoradiotherapy or radiotherapy in locally advanced rectal cancer (LARC) is reached in approximately 15-30% of cases, therefore it would be useful to assess if pretreatment of 18F-FDG PET/CT and/or MRI texture features can reliably predict response to neoadjuvant therapy in LARC. METHODS Fifty-two patients were dichotomized as responder (pR+) or non-responder (pR-) according to their pathological tumor regression grade (TRG) as follows: 22 as pR+ (nine with TRG = 1, 13 with TRG = 2) and 30 as pR- (16 with TRG = 3, 13 with TRG = 4 and 1 with TRG = 5). First-order parameters and 21 second-order texture parameters derived from the Gray-Level Co-Occurrence matrix were extracted from semi-automatically segmented tumors on T2w MRI, ADC maps, and PET/CT acquisitions. The role of each texture feature in predicting pR+ was assessed with monoparametric and multiparametric models. RESULTS In the mono-parametric approach, PET homogeneity reached the maximum AUC (0.77; sensitivity = 72.7% and specificity = 76.7%), while PET glycolytic volume and ADC dissimilarity reached the highest sensitivity (both 90.9%). In the multiparametric analysis, a logistic regression model containing six second-order texture features (five from PET and one from T2w MRI) yields the highest predictivity in distinguish between pR+ and pR- patients (AUC = 0.86; sensitivity = 86%, and specificity = 83% at the Youden index). CONCLUSIONS If preliminary results of this study are confirmed, pretreatment PET and MRI could be useful to personalize patient treatment, e.g., avoiding toxicity of neoadjuvant therapy in patients predicted pR-.
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Affiliation(s)
- V Giannini
- Imaging Unit, Candiolo Cancer Institute, FPO-IRCCS, Strada Provinciale 142 km 3.95, 10060, Candiolo, TO, Italy. .,Department of Surgical Sciences, University of Turin, 10124, Turin, Italy.
| | - S Mazzetti
- Imaging Unit, Candiolo Cancer Institute, FPO-IRCCS, Strada Provinciale 142 km 3.95, 10060, Candiolo, TO, Italy.,Department of Surgical Sciences, University of Turin, 10124, Turin, Italy
| | - I Bertotto
- Imaging Unit, Candiolo Cancer Institute, FPO-IRCCS, Strada Provinciale 142 km 3.95, 10060, Candiolo, TO, Italy
| | - C Chiarenza
- Imaging Unit, Candiolo Cancer Institute, FPO-IRCCS, Strada Provinciale 142 km 3.95, 10060, Candiolo, TO, Italy
| | - S Cauda
- Nuclear Medicine Unit, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
| | - E Delmastro
- Radiation Therapy Unit, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
| | - C Bracco
- Medical Physics Unit, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
| | - A Di Dia
- Medical Physics Unit, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
| | - F Leone
- Medical Oncology Unit, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
| | - E Medico
- Laboratory of Oncogenomics, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
| | - A Pisacane
- Pathology Unit, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
| | - D Ribero
- Hepatobilio-Pancreatic and Colorectal Surgery Unit, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
| | - M Stasi
- Medical Physics Unit, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
| | - D Regge
- Imaging Unit, Candiolo Cancer Institute, FPO-IRCCS, Strada Provinciale 142 km 3.95, 10060, Candiolo, TO, Italy.,Department of Surgical Sciences, University of Turin, 10124, Turin, Italy
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Peraldo-Neia C, Ostano P, Cavalloni G, Pignochino Y, Sangiolo D, De Cecco L, Marchesi E, Ribero D, Scarpa A, De Rose AM, Giuliani A, Calise F, Raggi C, Invernizzi P, Aglietta M, Chiorino G, Leone F. Transcriptomic analysis and mutational status of IDH1 in paired primary-recurrent intrahepatic cholangiocarcinoma. BMC Genomics 2018; 19:440. [PMID: 29871612 PMCID: PMC5989353 DOI: 10.1186/s12864-018-4829-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 05/25/2018] [Indexed: 12/14/2022] Open
Abstract
Background Effective target therapies for intrahepatic cholangiocarcinoma (ICC) have not been identified so far. One of the reasons may be the genetic evolution from primary (PR) to recurrent (REC) tumors. We aim to identify peculiar characteristics and to select potential targets specific for recurrent tumors. Eighteen ICC paired PR and REC tumors were collected from 5 Italian Centers. Eleven pairs were analyzed for gene expression profiling and 16 for mutational status of IDH1. For one pair, deep mutational analysis by Next Generation Sequencing was also carried out. An independent cohort of patients was used for validation. Results Two class-paired comparison yielded 315 differentially expressed genes between REC and PR tumors. Up-regulated genes in RECs are involved in RNA/DNA processing, cell cycle, epithelial to mesenchymal transition (EMT), resistance to apoptosis, and cytoskeleton remodeling. Down-regulated genes participate to epithelial cell differentiation, proteolysis, apoptotic, immune response, and inflammatory processes. A 24 gene signature is able to discriminate RECs from PRs in an independent cohort; FANCG is statistically associated with survival in the chol-TCGA dataset. IDH1 was mutated in the RECs of five patients; 4 of them displayed the mutation only in RECs. Deep sequencing performed in one patient confirmed the IDH1 mutation in REC. Conclusions RECs are enriched for genes involved in EMT, resistance to apoptosis, and cytoskeleton remodeling. Key players of these pathways might be considered druggable targets in RECs. IDH1 is mutated in 30% of RECs, becoming both a marker of progression and a target for therapy. Electronic supplementary material The online version of this article (10.1186/s12864-018-4829-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- C Peraldo-Neia
- Medical Oncology Division, Candiolo Cancer Institute - FPO, IRCCS, Str. Prov. 142, km 3.95, 10060, Candiolo, Turin, Italy. .,Cancer Genomics Lab, Fondazione Edo ed Elvo Tempia Valenta, Biella, Italy.
| | - P Ostano
- Cancer Genomics Lab, Fondazione Edo ed Elvo Tempia Valenta, Biella, Italy
| | - G Cavalloni
- Medical Oncology Division, Candiolo Cancer Institute - FPO, IRCCS, Str. Prov. 142, km 3.95, 10060, Candiolo, Turin, Italy
| | - Y Pignochino
- Department of Oncology, University of Turin, Torino, Italy
| | - D Sangiolo
- Medical Oncology Division, Candiolo Cancer Institute - FPO, IRCCS, Str. Prov. 142, km 3.95, 10060, Candiolo, Turin, Italy.,Department of Oncology, University of Turin, Torino, Italy
| | - L De Cecco
- Functional Genomics and Bioinformatics, Department of Applied Research and Technology Development, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - E Marchesi
- Functional Genomics and Bioinformatics, Department of Applied Research and Technology Development, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - D Ribero
- Division of Hepatobilio-Pancreatic and Colorectal Surgery, Candiolo Cancer Institute - FPO, IRCCS, Str. Prov. 142, km 3.95, Candiolo, Italy
| | - A Scarpa
- ARC-Net Research Centre and Department of Diagnostics and Public Health - Section of Pathology, University and Hospital Trust of Verona, Verona, Italy
| | - A M De Rose
- Hepatobiliary Surgery Unit, Gemelli Hospital, Catholic University of the Sacred Heart, Rome, Italy
| | - A Giuliani
- Department of Health's Sciences and Medicine "V. Tiberio", University of Molise, Campobasso, Italy
| | - F Calise
- Hepatobiliary and Liver Transplant Unit, Cardarelli Hospital, Naples, Italy
| | - C Raggi
- Center for Autoimmune Liver Diseases, Humanitas Clinical and Research Center, Rozzano, Italy.,Department of Experimental and Clinical Medicine, University of Firenze, Florence, Italy
| | - P Invernizzi
- Center for Autoimmune Liver Diseases, Humanitas Clinical and Research Center, Rozzano, Italy.,UOC di Gastroenterologia, Azienda Ospedaliera San Gerardo, Monza, Italy
| | - M Aglietta
- Medical Oncology Division, Candiolo Cancer Institute - FPO, IRCCS, Str. Prov. 142, km 3.95, 10060, Candiolo, Turin, Italy.,Department of Oncology, University of Turin, Torino, Italy
| | - G Chiorino
- Cancer Genomics Lab, Fondazione Edo ed Elvo Tempia Valenta, Biella, Italy
| | - F Leone
- Medical Oncology Division, Candiolo Cancer Institute - FPO, IRCCS, Str. Prov. 142, km 3.95, 10060, Candiolo, Turin, Italy. .,Department of Oncology, University of Turin, Torino, Italy.
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Petz W, Ribero D, Bertani E, Borin S, Formisano G, Esposito S, Spinoglio G, Bianchi P. Suprapubic approach for robotic complete mesocolic excision in right colectomy: Oncologic safety and short-term outcomes of an original technique. Eur J Surg Oncol 2017; 43:2060-2066. [DOI: 10.1016/j.ejso.2017.07.020] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 05/30/2017] [Accepted: 07/27/2017] [Indexed: 02/06/2023] Open
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Petz W, Ribero D, Bertani E, Formisano G, Spinoglio G, Bianchi PP. Robotic right colectomy with complete mesocolic excision: bottom-to-up suprapubic approach - a video vignette. Colorectal Dis 2017; 19:788-789. [PMID: 28667688 DOI: 10.1111/codi.13790] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 06/12/2017] [Indexed: 02/08/2023]
Affiliation(s)
- W Petz
- Department of Hepatobiliary, Pancreatic and Digestive Surgery, European Institute of Oncology, Milano, Italy
| | - D Ribero
- Department of Hepatobiliary, Pancreatic and Digestive Surgery, European Institute of Oncology, Milano, Italy
| | - E Bertani
- Department of Hepatobiliary, Pancreatic and Digestive Surgery, European Institute of Oncology, Milano, Italy
| | - G Formisano
- Department of General and Minimally Invasive Surgery, Misericordia Hospital, Grosseto, Italy
| | - G Spinoglio
- Department of Hepatobiliary, Pancreatic and Digestive Surgery, European Institute of Oncology, Milano, Italy
| | - P P Bianchi
- Department of General and Minimally Invasive Surgery, Misericordia Hospital, Grosseto, Italy
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Ravenda PS, Zampino MG, Guerini-Rocco E, Chiocca S, Dell'Acqua V, Trovato C, Biffi R, Ribero D, Spada F, Cella CA, Fazio N. High-risk human papillomavirus in anal squamous cell carcinoma: a 'conservative' leading role. Ann Oncol 2017; 28:1160. [PMID: 28453691 DOI: 10.1093/annonc/mdx032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- P S Ravenda
- European Institute of Oncology (IEO), Milan, Italy
| | - M G Zampino
- European Institute of Oncology (IEO), Milan, Italy
| | | | - S Chiocca
- European Institute of Oncology (IEO), Milan, Italy
| | - V Dell'Acqua
- European Institute of Oncology (IEO), Milan, Italy
| | - C Trovato
- European Institute of Oncology (IEO), Milan, Italy
| | - R Biffi
- European Institute of Oncology (IEO), Milan, Italy
| | - D Ribero
- European Institute of Oncology (IEO), Milan, Italy
| | - F Spada
- European Institute of Oncology (IEO), Milan, Italy
| | - C A Cella
- European Institute of Oncology (IEO), Milan, Italy
| | - N Fazio
- European Institute of Oncology (IEO), Milan, Italy
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Bertani E, Fazio N, Radice D, Zardini C, Spinoglio G, Chiappa A, Ribero D, Biffi R, Partelli S, Falconi M. Assessing the role of primary tumour resection in patients with synchronous unresectable liver metastases from pancreatic neuroendocrine tumour of the body and tail. A propensity score survival evaluation. Eur J Surg Oncol 2017; 43:372-379. [DOI: 10.1016/j.ejso.2016.09.011] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 09/13/2016] [Accepted: 09/19/2016] [Indexed: 02/08/2023] Open
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Ribero D, Passarello C, Russolillo N, Tesoriere RL, Langella S, Polizzi M, Ferrero A. Liver resection for colorectal liver metastases: can we cure our patients? Ann Oncol 2016. [DOI: 10.1093/annonc/mdw335.03] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ribero D, Abdalla EK, Vauthey JN. Authors' reply: Portal vein embolization before major hepatectomy and its effects on regeneration, resectability and outcome (Br J Surg 2007; 94: 1386–1394). Br J Surg 2008. [DOI: 10.1002/bjs.6167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- D Ribero
- The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 444, Houston, Texas 77030-4009, USA
| | - E K Abdalla
- The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 444, Houston, Texas 77030-4009, USA
| | - J-N Vauthey
- The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 444, Houston, Texas 77030-4009, USA
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Ribero D, Abdalla EK, Madoff DC, Donadon M, Loyer EM, Vauthey JN. Portal vein embolization before major hepatectomy and its effects on regeneration, resectability and outcome. Br J Surg 2007; 94:1386-94. [PMID: 17583900 DOI: 10.1002/bjs.5836] [Citation(s) in RCA: 366] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND This study evaluated the safety of portal vein embolization (PVE), its impact on future liver remnant (FLR) volume and regeneration, and subsequent effects on outcome after liver resection. METHODS Records of 112 patients were reviewed. Standardized FLR (sFLR) and degree of hypertrophy (DH; difference between the sFLR before and after PVE), complications and outcomes were analysed to determine cut-offs that predict postoperative hepatic dysfunction. RESULTS Ten (8.9 per cent) of 112 patients had PVE-related complications. Postoperative complications occurred in 34 (44 per cent) of 78 patients who underwent hepatic resection and the 90-day mortality rate was 3 per cent. A sFLR of 20 per cent or less after PVE or DH of not more than 5 per cent (versus sFLR greater than 20 per cent and DH above 5 per cent) had a sensitivity of 80 per cent and a specificity of 94 per cent in predicting hepatic dysfunction. Overall, major and liver-related complications, hepatic dysfunction or insufficiency, hospital stay and 90-day mortality rate were significantly greater in patients with a sFLR of 20 per cent or less or DH of not more than 5 per cent compared with patients with higher values. CONCLUSION DH contributes prognostic information additional to that gained by volumetric evaluation in patients undergoing PVE.
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Affiliation(s)
- D Ribero
- Department of Surgical Oncology, University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
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Capussotti L, Muratore A, Ferrero A, Massucco P, Ribero D, Polastri R. Randomized clinical trial of liver resection with and without hepatic pedicle clamping. Br J Surg 2006; 93:685-9. [PMID: 16703653 DOI: 10.1002/bjs.5301] [Citation(s) in RCA: 98] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND The purpose of this study was to compare the perioperative outcome of liver resection with and without intermittent hepatic pedicle clamping. METHODS Between June 2002 and June 2004, 126 consecutive patients with resectable liver tumours were randomized to undergo resection with (63 patients) or without (63 patients) intermittent hepatic pedicle clamping. RESULTS The transection time was significantly higher in the group without hepatic pedicle clamping. The blood loss per cm(2) was similar in the two groups: 2.7 ml/cm(2) in the group with versus 3.2 ml/cm(2) in group without hepatic pedicle clamping (P = 0.425). In the subset of patients with an abnormal liver, there were no differences in blood loss per transection surface: 3.1 ml/cm(2) in the group with versus 2.9 ml/cm(2) in the group without clamping (P = 0.829). The rate of blood transfusions was not higher in the non-clamping group. No differences were observed in the postoperative liver enzyme serum levels, the in-hospital mortality (one patient in each group) or the number of complications. CONCLUSION This study showed clearly that liver resection without hepatic pedicle clamping is safe, even in patients with a diseased liver.
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Affiliation(s)
- L Capussotti
- Division of Surgical Oncology, Institute of Cancer Research and Treatment, Candiolo, Turin, Italy.
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Affiliation(s)
- L Capussotti
- Division de Chirurgie Oncologique, Institut de Recherche et de Traitement du Cancer, Candiolo - Turin (Italie).
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Capussotti L, Ferrero A, Viganò L, Polastri R, Ribero D, Berrino E. Hepatic bisegmentectomy 7-8 for a colorectal metastasis. Eur J Surg Oncol 2006; 32:469-71. [PMID: 16522363 DOI: 10.1016/j.ejso.2006.01.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2005] [Accepted: 01/13/2006] [Indexed: 12/13/2022] Open
Affiliation(s)
- L Capussotti
- Unit of Surgical Oncology, Institute for Cancer Research and Treatment, Strada Provinciale 142, km 3,95, 10060 Candiolo, Italy.
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Muratore A, Ribero D, Ferrero A, Bergero R, Capussotti L. Prospective randomized study of steroids in the prevention of ischaemic injury during hepatic resection with pedicle clamping. Br J Surg 2003; 90:17-22. [PMID: 12520569 DOI: 10.1002/bjs.4055] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND The major drawback of hepatic pedicle clamping is ischaemia-reperfusion injury with impairment of liver function. Perioperative steroid administration has been advocated to reduce liver damage. The aim of this prospective, randomized study was to determine whether steroid administration can reduce liver injury and improve short-term outcome. METHODS Fifty-three patients undergoing liver resection were randomized to a steroid group (group 1) or to a control group (group 2); patients in group 1 received methylprednisolone 30 mg/kg 30 min before liver resection whereas those in group 2 did not. Serum levels of interleukin (IL) 6, total bilirubin, aspartate aminotransferase (AST) and alanine aminotransferase (ALT), and prothrombin time (PT) were measured. Length of stay, and type and number of complications were recorded. RESULTS Serum IL-6 levels were significantly lower in the steroid group than in the control group 24 h after surgery. Steroid administration significantly modified AST, ALT and PT levels only in patients with chronic liver disease. Overall and lung-related morbidity were not significantly different between the two groups. CONCLUSIONS Steroid administration suppresses serum IL-6 levels, but has no effect on short-term outcome.
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Affiliation(s)
- A Muratore
- Department of Surgical Oncology, Istituto per la Ricerca e la Cura del Cancro, Candiolo, Torino, Italy.
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Capussotti L, Ferrero A, Polastri R, Bouzari H, Vergara V, Amisano M, Ribero D, Muratore A. Hepatocellular carcinoma on cirrhosis: resections. Tumori 2001; 87:S43-5. [PMID: 11693820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Affiliation(s)
- L Capussotti
- Surgical Department, Ospedale Mauriziano Umberto I, Turin, Italy
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