Openly accessed and openly published: a celebration of international high-impact surgical research

Cited by: 0; All Open Access, Gold Open Access, Green Open AccessNon peer reviewe

Openly accessed and openly published: a celebration of international high-impact surgical research

Cited by: 0; All Open Access, Gold Open Access, Green Open AccessNon peer reviewe

Surgical strategies for duodenal GISTs: benefits and limitations of minimal resections

Comment on Conservative surgery vs. duodeneopancreatectomy in primary duodenal gastrointestinal stromal tumors (GIST): a retrospective review of 114 patients from the French sarcoma group (FSG). [Eur J Surg Oncol. 2014

Tweeting the meeting: Quantitative and qualitative twitter activity during the 38th ESSO conference

Introduction: Social media is increasingly used to share information with the potential for fast and wide reach. Data on use during surgical oncology conferences is limited. We aimed to monitor twitter usage during a surgical oncology conference to audit impact of activity. Methods: A prospective, time-restricted, observational study of twitter activity using the #ESSO38 hashtag in the week before and during the 38th ESSO conference (10–12 October 2018; Budapest, Hungary). Data on individual tweets and retweets, including date and tweeter or retweeter were collected using NodeXL, FollowTheHashtag, Twitonomy and TAGS. Results: The study period (10–13 October) documented 328 tweets by 58 tweeters with 1167 retweets, with a soaring activity and mentions during the conference days, with a potential reach at over 7.5 million. The nodal network of tweets, the most active tweeters and retweeters are presented as well as the most frequently used hashtags. The top 3 hashtags used were #ESSO38, #SoMe4Surgery# and #EYSAC. A positive influence on the @ESSOweb twitter handle was noted, with the numbers of followers growing from 1.5 K to over 1.8 K representing a 20% growth in just over a week. Conclusions: Activity on tweeter during the conference was considerable, with a potential for a wide reach beyond those attending the conference. A more structured approach to the use of twitter for future conferences may enhance experience, activity and reach.publishedVersio

Tweeting the meeting: Quantitative and qualitative twitter activity during the 38th ESSO conference.

Abstract Introduction Social media is increasingly used to share information with the potential for fast and wide reach. Data on use during surgical oncology conferences is limited. We aimed to monitor twitter usage during a surgical oncology conference to audit impact of activity. Methods A prospective, time-restricted, observational study of twitter activity using the #ESSO38 hashtag in the week before and during the 38th ESSO conference (10–12 October 2018; Budapest, Hungary). Data on individual tweets and retweets, including date and tweeter or retweeter were collected using NodeXL, FollowTheHashtag, Twitonomy and TAGS. Results The study period (10–13 October) documented 328 tweets by 58 tweeters with 1167 retweets, with a soaring activity and mentions during the conference days, with a potential reach at over 7.5 million. The nodal network of tweets, the most active tweeters and retweeters are presented as well as the most frequently used hashtags. The top 3 hashtags used were #ESSO38, #SoMe4Surgery# and #EYSAC. A positive influence on the @ESSOweb twitter handle was noted, with the numbers of followers growing from 1.5 K to over 1.8 K representing a 20% growth in just over a week. Conclusions Activity on tweeter during the conference was considerable, with a potential for a wide reach beyond those attending the conference. A more structured approach to the use of twitter for future conferences may enhance experience, activity and reach

Gastrointestinal stromal tumors: correlation between symptoms at presentation, tumor location and prognostic factors in 47 consecutive patients

<p>Abstract</p> <p>Background</p> <p>Gastrointestinal stromal tumors (GIST) are mesenchymal tumors of the gastrointestinal tract, usually kit-positive, that are believed to originate from interstitial cell of Cajal, or their related stem cells. The most common clinical presentation of these tumors is gastrointestinal bleeding, otherwise they may cause intestinal obstruction, abdominal pain, a palpable mass, or can be incidentally detected during surgery or endoscopic/radiological procedures. Prognosis is related to the size of the tumor and to the mitotic rate; other prognostic factors are tumor location, tumor resection margins, tumor rupture, and c-kit mutation that may interfere with molecular target therapy efficacy.</p> <p>Aim</p> <p>Primary aim of this study was to report our experience regarding GIST patients, correlating symptoms at presentation with tumor localization and risk factors.</p> <p>Patients and methods</p> <p>47 consecutive patients undergone to surgical resection for GISTs were enrolled in a prospective study from December 1999 to March 2009. Patient's clinical and pathological features were collected and analysed.</p> <p>Results</p> <p>The most common symptom was abdominal pain. Bleeding in the digestive tract and abdominal pain were more frequent in gastric GISTs (58% and 61%); acute abdominal symptoms were more frequent in jejunal and ileal GISTs (40% and 60%), p < 0.05. We reported a mild correlation between the mitotic rate index and symptoms at presentation (p 0.074): this correlation was stronger if GISTs causing "acute abdominal symptoms" were compared with GISTs causing "abdominal pain" as main symptom (p 0.039) and with "incidental" GISTs (p 0.022).</p> <p>We observed an higher prevalence of symptomatic patients in the "high risk/malignant group" of both the Fletcher's and Miettines's classification (p < 0.05).</p> <p>Conclusion</p> <p>According with our findings symptoms correlate to tumor location, to class risk criteria as mitotic index and risk classifications, however we cannot conclude that symptoms are <it>per se </it>predictive of survival or patient's outcome.</p

Beyond the Guidelines: The Grey Zones of the Management ofGastric Cancer. Consensus Statements from the Gastric CancerItalian Network (GAIN)

The Grey Zones of the Management ofGastric Cancer. Consensus Statements from the Gastric CancerItalian Network (GAIN

Identification of genes down-regulated during lung cancer progression: A cDNA array study

<p>Abstract</p> <p>Background</p> <p>Lung cancer remains a major health challenge in the world. Survival for patients with stage I disease ranges between 40–70%. This suggests that a significant proportion of patients with stage I NSCLC may actually be under-staged.</p> <p>Methods</p> <p>In order to identify genes relevant for lung cancer development, we carried out cDNA array experiments employing 64 consecutive patients (58 men and 6 women) with a median age of 58 years and stage 1 or stage 2 non-small-cell lung cancer (NSCLC).</p> <p>Results</p> <p>Basic cDNA array data identified 14 genes as differentially regulated in the two groups. Quantitative RT-PCR analysis confirmed an effective different transcriptional regulation of 8 out of 14 genes analyzed. The products of these genes belong to different functional protein types, such as extra-cellular matrix proteins and proteases (<it>Decorin </it>and <it>MMP11</it>), genes involved in DNA repair (<it>XRCC1</it>), regulator of angiogenesis (<it>VEGF</it>), cell cycle regulators (<it>Cyclin D1</it>) and tumor-suppressor genes (<it>Semaphorin 3B</it>, <it>WNT-5A </it>and retinoblastoma-related <it>Rb2/p130</it>). Some previously described differences in expression patterns were confirmed by our array data. In addition, we identified and validated for the first time the reduced expression level of some genes during lung cancer progression.</p> <p>Conclusion</p> <p>Comparative hybridization by means of cDNA arrays assisted in identifying a series of novel progression-associated changes in gene expression, confirming, at the same time, a number of previously described results.</p

Global variation in the long-term outcomes of ypT0 rectal cancers

Background Colorectal cancer mortality presents world-wide variation. In rectal cancers presenting a complete/nearly-complete tumor response (ypT0/ypTis) following neoadjuvant treatment, the features correlated to nodal metastases and relapses still need to be defined. Methods An international cohort study enrolling ypT0/ypTis rectal cancers surgically treated from 2012 to 2017 was conducted. A propensity matching was used to balance nodal-positive and nodal-negative patients and statistical analyses were performed to investigate survivals, using a bootstrap model for internal validation. The features correlated with nodal metastasis were studied. Countries with participating centers were ranked using the World Bank (WBI), Human Development (HDI) and Global Gender Gap (GGG) indexes to compare survivals. Results 680 ypT0/ypTis from 52 European, Australian, Indian and American Institutions were analyzed. Mean follow-up was of 30.4 months. 96.5% were treated with total mesorectal excision, 7.2% were nodal-positive and 8.8% relapsed. Distal cancers (HR 0.71 95%CI: 0.56-0.91) and nodal metastasis and nodal metastasis (HR 3.85 95%CI:1.12–13.19) correlated with worse DFS, whereas a younger age was of borderline significance (HR 0.95 95%CI:0.91–0.99). The bootstrap analysis validated the model on 5000 repetitions. A short-course radiotherapy (OR 0.18 95%CI:0.09–0.37) correlated with the occurrence of nodal metastasis. Those countries classified in the low/medium-WBI, medium-HDI and lower-GGG ranks documented worse DFS curves (respectively p < 0.0001, p < 0.0001 and p 0.0002). However, the clinical stages were similar and patients from medium-HDI countries received more adjuvant chemotherapy than the others (p < 0.0001). Conclusion Sub-groups at risk for relapses and nodal metastasis were identified. A global variation exists also when benchmarking a rectal cancer complete regression

Immediate and long-term impact of the COVID-19 pandemic on delivery of surgical services

Background The ongoing pandemic is having a collateral health effect on delivery of surgical care to millions of patients. Very little is known about pandemic management and effects on other services, including delivery of surgery. Methods This was a scoping review of all available literature pertaining to COVID‐19 and surgery, using electronic databases, society websites, webinars and preprint repositories. Results Several perioperative guidelines have been issued within a short time. Many suggestions are contradictory and based on anecdotal data at best. As regions with the highest volume of operations per capita are being hit, an unprecedented number of operations are being cancelled or deferred. No major stakeholder seems to have considered how a pandemic deprives patients with a surgical condition of resources, with patients disproportionally affected owing to the nature of treatment (use of anaesthesia, operating rooms, protective equipment, physical invasion and need for perioperative care). No recommendations exist regarding how to reopen surgical delivery. The postpandemic evaluation and future planning should involve surgical services as an essential part to maintain appropriate surgical care for the population during an outbreak. Surgical delivery, owing to its cross‐cutting nature and synergistic effects on health systems at large, needs to be built into the WHO agenda for national health planning. Conclusion Patients are being deprived of surgical access, with uncertain loss of function and risk of adverse prognosis as a collateral effect of the pandemic. Surgical services need a contingency plan for maintaining surgical care in an ongoing or postpandemic phase.publishedVersio