Observation of the baryonic decay B¯0→Λ+cp¯K−K+

We report the observation of the baryonic decay (B) over bar (0) -> Lambda(+)(c)(p) over barK(-)K(+) using a data sample of 471 x 10(6) B (B) over bar pairs produced in e(+)e(-) annihilations at root s = 10.58 GeV. This data sample was recorded with the BABAR detector at the PEP- II storage ring at SLAC. We find B((B) over bar (0) -> Lambda(+)(c)(p) over barK(-)K(+)) = (2.5 +/- 0.4((stat)) +/- 0.2((syst)) +/- 0.6(B(Lambda c+)) ) x 10(-5) where the uncertainties are statistical, systematic, and due to the uncertainty of the Lambda(+)(c) -> (p) over barK(-)pi(+) branching fraction, respectively. The result has a significance corresponding to 5.0 standard deviations, including all uncertainties. For the resonant decay (B) over bar (0) -> Lambda(+)(c)(p) over bar phi, we determine the upper limit B((B) over bar (0) -> Lambda(+)(c)(p) over bar phi) < 1.2 x 10(-5) at 90% confidence level

Elastofibroma dorsi: three cases of personal experience

Elastofibroma dorsi is a rare, slow growing, soft tissue lesion, which occurs mainly in elderly women, tipically located in the infrascapular region. This lesion is characterized by a poorly defined solid mass of fibroelastic and fatty tissue, enlarging into intermuscular spaces. Elastofibroma may simulate an aggressive behaviour, and differential diagnosis with malignant tumors is sometimes difficult. Surgical resection is generally recommended in symptomatic lesions or in the suspicion of malignancy. We report our experience of three cases of elastofibroma, two of which typically located in the infrascapular region and one located in the supraclavear fossa, atypical site never reported so far

Evidence of tumor microsatellite instability in gastric cancer with familial aggregation

9About 90% of gastric cancer (GC) cases appear in a sporadic setting. Nonetheless, in high incidence areas high familial aggregation rates have been recently described. Microsatellite instability (MSI) is thought to be an important molecular phenotype both in sporadic GC and in tumors of the HNPCC spectrum. The aim of this study was to assess the frequency of MSI in GC with familial aggregation. Five quasimonomorphic mononucleotide repeats (BAT-26, BAT-25, NR-24, NR-21 and NR-27) were analyzed in 250 GC patients. Seventy-five patients (30%) had at least one-first-degree family member affected by GC and 63 patients (25.2%) showed MSI. The frequency of MSI was significantly higher in patients with a positive family history of GC (38.7%) compared to patients with other tumor types within the family (15.7%) or with a negative oncological familial history (21.9%, P = 0.004). Within cases with a positive familial oncological history, the MSI frequency in families with GC only was similar to the one observed in families with GC and colon cancer (P = 0.96). Nonetheless, in families with GC and lung cancer, the frequency of MSI was significantly lower (5.6%, P = 0.007). MSI occurs in GCs with familial aggregation. Similar MSI rates have been observed in GC patients with other family members affected by GC or colon cancer. The same does not occur in families with other members affected by lung cancer. Our data seem to suggest that familial aggregation for either GC alone or gastric and colon cancer share common etiological factors in contrast to families with gastric and lung cancers.reservedmixedPEDRAZZANI C; CORSO G; VELHO S; LEITE M; PASCALE V; BETTARINI F; D. MARRELLI; SERUCA R; ROVIELLO FPedrazzani, Corrado; Corso, Giovanni; Velho, S; Leite, M; Pascale, V; Bettarini, Francesca; Marrelli, Daniele; Seruca, R; Roviello, Franc

Is circulating D-dimer level a better prognostic indicator than CEA in resectable colorectal cancer? Our experience on 199 cases

To evaluate the clinical impact of D-dimer (DD) as a tumor marker in patients with colorectal cancer (CRC). The prognostic value of preoperative DD measurement was assessed in relation to carcinoembryonic antigen (CEA) levels

Is circulating D-dimer level a better prognostic indicator than CEA in resectable colorectal cancer? Our experience on 199 cases.

PURPOSE: To evaluate the clinical impact of D-dimer (DD) as a tumor marker in patients with colorectal cancer (CRC). The prognostic value of preoperative DD measurement was assessed in relation to carcinoembryonic antigen (CEA) levels. METHODS: DD and CEA levels were measured preoperatively in 199 patients who underwent resection for CRC and the results were analyzed statistically. RESULTS: The preoperative mean (± SD) levels of DD and CEA were 347.5 (± 940.1) ng/mL and 106.4 (± 1099.2) ng/mL. The DD level was significantly correlated with the nature of surgery (emergency vs. elective; p=0.002), presence of residual tumor (R1-2 vs R0; p=0.037), and tumor diameter (p<0.001). Conversely, DD was not correlated with tumor grade, pT, pN and M stages, and stage according to the Dukes classification. The 5-year survival rates were 80% and 64% for patients with negative and positive DD values, respectively (p=0.156). CEA was significantly related to all major prognostic factors (resection category, pT, pN and M stages as well as Dukes stage). A significantly worse prognosis was observed for patients with positive CEA levels. Multivariate analysis confirmed CEA as an independent prognostic factor (p=0.005), whilst DD was not (p=0.796). CONCLUSIONS: The possible clinical usefulness of preoperative assessment of DD suggested by previous studies has not been confirmed by our data. CEA was confirmed to be the most reliable and valid indicator of prognosis

Gastric linitis plastica: which role for surgical resection?

BACKGROUND: The role of surgery for gastric linitis plastica (GLP) is questioned. This study aimed to analyze our experience in the surgical treatment of GLP with specific reference to the resectability rate, prognosis, and mode of recurrence. METHODS: Results of surgery were analyzed in 102 patients with GLP. RESULTS: Of the 102 patients, 92 underwent surgical exploration, with resection performed in 60 cases. R2 resection was carried out in 20 patients and R1 in 12 patients, while the resection was considered potentially curative (R0) in 28 (27.5%). Overall, the median (95% confidence interval [CI]) survival time was 5.7 (3.7-7.5) months, with none of the patients alive at the end date of the study. For R0 patients the median (95% CI) survival time was 15.8 (11-20.7) months. The great majority of recurrences were intra-abdominal (peritoneal and/or locoregional), with a systemic component of the relapse that was rarely observed (5 cases). CONCLUSIONS: After primary surgery, GLP showed a poor prognosis without regard to the extent or type of resection. The failure of surgical treatment related mainly to the peritoneal spread of the disease. Specifically designed multimodality treatment protocols should be tested in this settin

Assessment of Microsatellite Instability in Familial Gastric Cancer

Background: Classically, gastric cancer (GC) appears as sporadic form, nonetheless recently a very high familial aggregation rates have been recently described in high incidence areas. Microsatellite instability (MSI) is recognized as an important molecular pathway in gastric tumor. The aim of this study was to assess the frequency of MSI in GC with familial aggregation. Methods: Five quasimonomorphic mononucleotide repeats (BAT-26, BAT-25, NR-24, NR-21 and NR-27) were analyzed in 250 GC patients and analyzed with respect to family history. Results: Seventy-five patients (30%) had at least one firstdegree family member affected by GC and MSI was identified in 63 patients (25.2%). MSI was significantly more frequent in patients with familial aggregation for GC (38.7% vs. 19.4%; P=0.001). Even stratifying according to Lauren histotype, a significant associationbetween MSI status and familial aggregation for GC was observed in intestinal as well as non–intestinal Lauren histotype. A similar frequency of MSI was observed in families with history of GC only or in families with members with colon cancer (P=0.96). Conversely, in families with history of lung cancer the frequency of MSI cases was significantly lower (5.6%) (P=0.007). Conclusions: MSI occurs in GC with familial aggregation, especially in families with members affected with gastric cancer as sole neoplasia or with colon cancer. The same in not verified in families with lung cancer. These data suggests that the first two types of families share common ethiological factors in contrast to GC families with involvement of lung cancer

Changes in surgicaL behaviOrs dUring the CoviD-19 pandemic. The SICE CLOUD19 Study

BACKGROUND: The spread of the SARS-CoV2 virus, which causes COVID-19 disease, profoundly impacted the surgical community. Recommendations have been published to manage patients needing surgery during the COVID-19 pandemic. This survey, under the aegis of the Italian Society of Endoscopic Surgery, aims to analyze how Italian surgeons have changed their practice during the pandemic.METHODS: The authors designed an online survey that was circulated for completion to the Italian departments of general surgery registered in the Italian Ministry of Health database in December 2020. Questions were divided into three sections: hospital organization, screening policies, and safety profile of the surgical operation. The investigation periods were divided into the Italian pandemic phases I (March-May 2020), II (June-September 2020), and III (October-December 2020).RESULTS: Of 447 invited departments, 226 answered the survey. Most hospitals were treating both COVID-19-positive and -negative patients. The reduction in effective beds dedicated to surgical activity was significant, affecting 59% of the responding units. 12.4% of the respondents in phase I, 2.6% in phase II, and 7.7% in phase III reported that their surgical unit had been closed. 51.4%, 23.5%, and 47.8% of the respondents had at least one colleague reassigned to non-surgical COVID-19 activities during the three phases. There has been a reduction in elective (>200 procedures: 2.1%, 20.6% and 9.9% in the three phases, respectively) and emergency (<20 procedures: 43.3%, 27.1%, 36.5% in the three phases, respectively) surgical activity. The use of laparoscopy also had a setback in phase I (25.8% performed less than 20% of elective procedures through laparoscopy). 60.6% of the respondents used a smoke evacuation device during laparoscopy in phase I, 61.6% in phase II, and 64.2% in phase III. Almost all responders (82.8% vs. 93.2% vs. 92.7%) in each analyzed period did not modify or reduce the use of high-energy devices.CONCLUSION: This survey offers three faithful snapshots of how the surgical community has reacted to the COVID-19 pandemic during its three phases. The significant reduction in surgical activity indicates that better health policies and more evidence-based guidelines are needed to make up for lost time and surgery not performed during the pandemic