Platelets and hepatocellular cancer: Bridging the bench to the clinics

Growing interest is recently being focused on the role played by the platelets in favoring hepatocellular cancer (HCC) growth and dissemination. The present review reports in detail both the experimental and clinical evidence published on this topic. Several growth factors and angiogenic molecules specifically secreted by platelets are directly connected with tumor progression and neo-angiogenesis. Among them, we can list the platelet-derived growth factor, the vascular endothelial growth factor, the endothelial growth factor, and serotonin. Platelets are also involved in tumor spread, favoring endothelium permeabilization and tumor cells\u2019 extravasation and survival in the bloodstream. From the bench to the clinics, all of these aspects were also investigated in clinical series, showing an evident correlation between platelet count and size of HCC, tumor biological behavior, metastatic spread, and overall survival rates. Moreover, a better understanding of the mechanisms involved in the platelet\u2013tumor axis represents a paramount aspect for optimizing both current tumor treatment and development of new therapeutic strategies against HCC

X-ray and radio follow-up observations of the X-ray transient Swift J0840.7-3516

We report on follow-up X-ray and radio observations of the transientsource Swift J0840.7-3516, which triggered the Swift BAT on February 5th (GCN 26982). Swift XRT is monitoring the source on a daily cadence

A very young radio-loud magnetar

International audienceThe magnetar Swift J1818.0–1607 was discovered in 2020 March when Swift detected a 9 ms hard X-ray burst and a long-lived outburst. Prompt X-ray observations revealed a spin period of 1.36 s, soon confirmed by the discovery of radio pulsations. We report here on the analysis of the Swift burst and follow-up X-ray and radio observations. The burst average luminosity was L burst ∼ 2 × 1039 erg s−1 (at 4.8 kpc). Simultaneous observations with XMM-Newton and NuSTAR three days after the burst provided a source spectrum well fit by an absorbed blackbody ( = (1.13 ± 0.03) × 1023 cm−2 and kT = 1.16 ± 0.03 keV) plus a power law (Γ = 0.0 ± 1.3) in the 1–20 keV band, with a luminosity of ∼8 × 1034 erg s−1, dominated by the blackbody emission. From our timing analysis, we derive a dipolar magnetic field B ∼ 7 × 1014 G, spin-down luminosity erg s−1, and characteristic age of 240 yr, the shortest currently known. Archival observations led to an upper limit on the quiescent luminosity <5.5 × 1033 erg s−1, lower than the value expected from magnetar cooling models at the source characteristic age. A 1 hr radio observation with the Sardinia Radio Telescope taken about 1 week after the X-ray burst detected a number of strong and short radio pulses at 1.5 GHz, in addition to regular pulsed emission; they were emitted at an average rate 0.9 min−1 and accounted for ∼50% of the total pulsed radio fluence. We conclude that Swift J1818.0–1607 is a peculiar magnetar belonging to the small, diverse group of young neutron stars with properties straddling those of rotationally and magnetically powered pulsars. Future observations will make a better estimation of the age possible by measuring the spin-down rate in quiescence

Preoperative or perioperative docetaxel, oxaliplatin, and capecitabine (GASTRODOC regimen) in patients with locally-advanced resectable gastric cancer: A randomized phase-II trial

Docetaxel associated with oxaliplatin and 5-fluorouracil (FLOT) has been reported as the best perioperative treatment for gastric cancer. However, there is still some debate about the most appropriate number and timing of chemotherapy cycles. In this randomized multicenter phase II study, patients with resectable gastric cancer were staged through laparoscopy and peritoneal lavage cytology, and randomly assigned (1:1) to either four cycles of neoadjuvant chemotherapy (arm A) or two preoperative + two postoperative cycles of docetaxel, oxaliplatin, and capecitabine (DOC) chemotherapy (arm B). The primary endpoint was to assess the percentage of patients receiving all the planned preoperative or perioperative chemotherapeutic cycles. Ninety-one patients were enrolled between September 2010 and August 2016. The treatment was well tolerated in both arms. Thirty-three (71.7%) and 24 (53.3%) patients completed the planned cycles in arms A and B, respectively (p = 0.066), reporting an odds ratio for early interruption of treatment of 0.45 (95% confidence interval (CI): 0.18\u20131.07). Resection was curative in 39 (88.6%) arm A patients and 35 (83.3%) arm B patients. Five-year progression-free survival (PFS) was 51.2% (95% CI: 34.2\u201365.8) in arm A and 40.3% (95% CI: 28.9\u201355.2) in arm B (p = 0.300). Five-year survival was 58.5% (95% CI: 41.3\u201372.2) and 53.9% (95% CI: 35.5\u201369.3) (p = 0.883) in arms A and B, respectively. The planned treatment was more frequently completed and was more active, albeit not significantly, in the neoadjuvant arm than in the perioperative group

Multicentre evaluation of case volume in minimally invasive hepatectomy

Background: Surgical outcomes may be associated with hospital volume and the influence of volume on minimally invasive liver surgery (MILS) is not known. Methods: Patients entered into the prospective registry of the Italian Group of MILS from 2014 to 2018 were considered. Only centres with an accrual period of at least 12 months and stable MILS activity during the enrolment period were included. Case volume was defined by the mean number of minimally invasive liver resections performed per month (MILS/month). Results: A total of 2225 MILS operations were undertaken by 46 centres; nine centres performed more than two MILS/month (1376 patients) and 37 centres carried out two or fewer MILS/month (849 patients). The proportion of resections of anterolateral segments decreased with case volume, whereas that of major hepatectomies increased. Left lateral sectionectomies and resections of anterolateral segments had similar outcome in the two groups. Resections of posterosuperior segments and major hepatectomies had higher overall and severe morbidity rates in centres performing two or fewer MILS/month than in those undertaking a larger number (posterosuperior segments resections: overall morbidity 30\ub74 versus 18\ub77 per cent respectively, and severe morbidity 9\ub79 versus 4\ub70 per cent; left hepatectomy: 46 versus 22 per cent, and 19 versus 5 per cent; right hepatectomy: 42 versus 34 per cent, and 25 versus 15 per cent). Conclusion: A volume\u2013outcome association existed for minimally invasive hepatectomy. Complex and major resections may be best managed in high-volume centres

How radical prostatectomy procedures have changed over the last 10\ua0years in Italy: a comparative analysis based on more than 1500 patients participating in the MIRROR-SIU/LUNA and the Pros-IT CNR study

Purpose: Therapeutic strategies for prostate cancer (PCa) have been evolving dramatically worldwide. The current article reports on the evolution of surgical management strategies for PCa in Italy. Methods: The data from two independent Italian multicenter projects, the MIRROR-SIU/LUNA (started in 2007, holding data of 890 patients) and the Pros-IT-CNR project (started in 2014, with data of 692 patients), were compared. Differences in patients\u2019 characteristics were evaluated. Multivariable logistic regression models were used to identify characteristics associated with robot-assisted (RA) procedure, nerve sparing (NS) approach, and lymph node dissection (LND). Results: The two cohorts did not differ in terms of age and prostate-specific antigen (PSA) levels at biopsy. Patients enrolled in the Pros-IT-CNR project more frequently were submitted to RA (58.8% vs 27.6%, p &lt; 0.001) and NS prostatectomy (58.4% vs. 52.9%, p = 0.04), but received LND less frequently (47.7% vs. 76.7%, p &lt; 0.001), as compared to the MIRROR-SIU/LUNA patients. At multivariate logistic models, Lower Gleason Scores (GS) and PSA levels were significantly associated with RA prostatectomy in both cohorts. As for the MIRROR-SIU/LUNA data, clinical T-stage was a predictor for NS (OR = 0.07 for T3, T4) and LND (OR = 2.41 for T2) procedures. As for Pros-IT CNR data, GS 65 (4 + 3) and positive cancer cores 65 50% were decisive factors both for NS (OR 0.29 and 0.30) and LND (OR 7.53 and 2.31) strategies. Conclusions: PCa management has changed over the last decade in Italian centers: RA and NS procedures without LND have become the methods of choice to treat newly medium\u2013high risk diagnosed PCa