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Alessandria, Italy

Levis A.,SS Antonio and Biagio Hospital | Stacchini A.,Flow Cytometry Unit | Ciriello M.M.,Laboratory of Clinical Pathology | Geuna M.,Flow Cytometry Unit | And 14 more authors.
European Journal of Haematology | Year: 2011

Objectives:Morphology and cytogenetics are currently used to define prognosis in myelodysplastic syndromes (MDS). However, these parameters have some limits. Flow cytometry has been recently included in the diagnostic panel for MDS, and its prognostic significance is under evaluation. Methods: Marrow aspirates from 424 MDS patients were analyzed by flow cytometry to evaluate the impact of bone marrow cell immunophenotype on overall survival (OS) and leukemia-free survival (LFS). The immature compartment of myeloblasts was analyzed by the quantitative expression of CD34 (<3% vs. ≥3%), CD117, and CD11b -/CD66b - (<5% vs. ≥5%); myeloid maturation was analyzed by the expression of CD11b +/CD66b ++ (<15% vs. ≥15%) and CD11b +/CD66b + (<25% vs. ≥25%). Results:  In univariate analysis, the expression of immaturity markers (CD34 +, CD117 +, and CD11b -/CD66b -) was associated with shorter LFS and OS (P<0.0001); higher expression of differentiation markers (CD11b +/CD66b ++ and CD11b +/CD66b +) was associated with longer LFS (P<0.0001 and P=0.0002, respectively) and OS (P<0.0001). In multivariate analysis, expression of CD34 + (P=0.007), CD117 + (P=0.013), and CD11b +/CD66b ++ (P=0.023) retained independent prognostic value for OS, while only the expression of CD34 + was a prognostic factor for LFS (P=0.0003). Two different risk groups were defined according to the presence of 0-1 or ≥2 of these factors with significant different LFS and OS (P<0.0001). This score showed prognostic value in predicting survival even in subanalysis according to IPSS and WHO subgroups. Conclusions: Flow cytometric analysis in MDS may provide meaningful prognostic information. Blast percentage expressed as CD117 + or CD34 + cells and the quantitative assessment of myeloid maturation showed prognostic value for survival. © 2011 John Wiley & Sons A/S. Source


Spinoglio G.,SS Antonio and Biagio Hospital | Lenti L.M.,SS Antonio and Biagio Hospital | Ravazzoni F.,SS Antonio and Biagio Hospital | Formisano G.,SS Antonio and Biagio Hospital | And 2 more authors.
International Journal of Medical Robotics and Computer Assisted Surgery | Year: 2015

Background: Robotic Single-Site™ surgery overcomes the technical constraints of single-access laparoscopy. After performing over 130 Single-Site robotic cholecystectomies and stabilizing operative times, we applied this technology to right colon surgery. Methods: We successfully completed three Single-Site robotic right colectomies (SSRRCs) using the da Vinci Si Surgical System® with a Single-Site kit (Intuitive Surgical™) inserted through a suprapubic incision. Results: Overall SSRRC operative time was 218.3±75.9min. A side-to-side anisoperistaltic anastomosis was fashioned intracorporeally (two cases) or extracorporeally (one case). All patients were discharged within 5days. There were no complications and oncological principles were satisfied. There were no recurrences up to 12months. Conclusions: This is the first report of SSRRC with intracorporeal anastomosis using the da Vinci® Single-Site™ port inserted through a suprapubic incision. This approach is feasible and safe, with oncological outcomes potentially equivalent to those of robotic or laparoscopic multiport surgery. © 2014 John Wiley & Sons, Ltd.. Source

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