Treatment of rectal cancer has changed during the last decades. Major advances in the management of rectal cancer include establishment of multimodal therapy, introduction of total mesorectal excision (TME) by Heald in 1979.

Background: According to the TNM classification, the analysis of 16 or more lymph nodes is required for the appropriate staging of gastric cancer. The aim of this study was to evaluate whether this number of resected lymph nodes also affects survival.Methods: This was a multicenter retrospective study based on an analysis of 992 patients with gastric adenocarcinoma who underwent curative resection between January 1980 and December 2009. Patients were classified according to the number of resected lymph nodes (<16 and << 16 lymph nodes), the anatomical extent of lymph node dissection (D2 vs. D1), and the staging criteria of the seventh edition of the UICC/AJCC TNM staging system. Survival estimates were determined by univariate and multivariate analyses.Results: Based on the univariate and multivariate analyses, the resection of 16 or more lymph nodes was associated with significantly better survival [p = 0.002; hazard ratio (BR) (95% confidence interval [CI]): 0.519 (0.345-0.780)]. Patients with a lymph node count <16 had a significantly worse survival rate than patients with a lymph node count >= 16 in the pN0 (p = 0.001), pN1 (p = 0.007) and pN2 (p = 0.001) stages. In the majority of cases, >= 16 lymph nodes were retrieved when D2 dissection was performed.Conclusions: In gastric cancer the retrieval of less than 16 lymph nodes may cause inaccurate staging and/or inadequate treatment, thus affecting survival rates. These patients should be considered a high-risk group for stage migration and worse survival compared with those who have a retrieval of more than 16 lymph nodes. (C) 2015 Elsevier Ltd. All rights reserved.

Gastrointestinal stromal tumours (GISTs) represent a quite rare tumour accounting for less than 1% of malignant neoplasm. Notwithstanding they are the most common mesenchymal tumours of the gastrointestinal tract, arising from the interstitial cells of Cajal, the pacemaker cells of the gastrointestinal tract.

The aim of this study was to compare the prognostic values of three different node staging classifications in gastric cancer: log of the ratio between the numbers of positive and negative lymph nodes (LODDS), UICC/AJCC TNM and lymph node ratio (LNR).

Background: Survival of patients after curative surgical resection for gastric cancer (GC) remains poor, thus emphasizing the need for better definition of prognostic factors to improve the long-term course of disease.Methods: From 1999 to 2009, 110 patients had curative-intent gastrectomy for adenocarcinoma. Clinicopathological features, Helicobacter pylori infection, dietary habits and lifestyle, and the presence of proinflammatory gene polymorphisms were evaluated.Results: At the end of follow-up, 55 deaths had occurred, 48 of them due to GC, whereas the median overall survival (OS) and disease-free survival (DFS) were 62 and 51 months, respectively. From the Kaplan-Meier analysis and log-rank test, statistically significant differences in OS and DFS were found for tumor site (only for DFS), tumor size, lymph node metastasis ratio (NR), and tumor-node-metastasis stage, but not for age, comorbidity, H. pylori infection, cigarette smoking, and IL1B or TNFA polymorphisms. Multivariable Cox regression analysis revealed NR was an independent prognostic factor for OS and DFS. Cardia tumor and patient age 65 years or older were also independent prognostic, factors for OS and DFS.Conclusions: Tumor-related factors remain strongest predictors of survival in GC patients after surgery. Particularly, NR was an effective feature in identifying patients at high risk for adverse outcome. (C) 2013 Elsevier Ltd. All rights reserved.

The aim of this study was to identify reliable factors affecting the survival of locally advanced gastric cancer (LAGC) patients treated with neo-adjuvant chemotherapy followed by surgery.

Background: The aim of this study was to evaluate the possibility of a different path to achieve R0 resection in patients > 70-years old, affected by resectable gastric cancer.

Background: According to the TNM classification, 16 or more lymph nodes are required for appropriate staging of gastric cancer. The aim of this study was to evaluate whether this number of resected lymph nodes affects survival as well.

Background: Long-term survival after R0 resection in locally advanced gastric cancer (LAGC) remains poor, suggesting that a truly curative treatment has not been performed. Preoperative treatment protocols have been proven to be effective in LAGC by large-scale randomised trials, theoretically by increasing control over distant and loco-regional recurrences. Aim of this study is the evaluation of the effects induced by preoperative chemotherapy and its impact on the survival on a series of locally advanced gastric carcinomas.

The use of marginal donors has become more common worldwide due to the sharp increase in recipients with a consequent shortage of suitable organs. The definition of “marginal donor” has not been reached by all centers. We herein analyzed our single-center experience over the last 3 years in liver transplantation (OLT) to evaluate the outcomes of using a high percentage of so-called “marginal donors”, according to the current classification from the National (Italian) Center of Transplantation (CNT). Among the 78 OLT performed in 77 patients from January 1, 2003 to October 31, 2005, donor livers were divided into three groups according to the CNT classification. We evaluated donor variables, cold ischemia time (CIT), warm ischemia time (WIT), MELD score, and length of hospital stay. Histologic graft steatosis was correlated with estimated steatosis by ultrasound. There were no differences among the three graft recipient groups concerning CIT, WIT, MELD score, and the length of hospital stay. Steatosis is indicated in all series as a definite variable for a higher risk of postoperative mortality. CIT is necessarily related to donor retrieval policy and organization. Donor age seemed also to be related to a possible increase in postoperative mortality, but there are significant variations in the definition of the age limit. We failed to observe a correlation between a higher mortality rate and any of the variables currently listed to define a “marginal donor.” A shorter CIT seemed to positively influence the role played by the other variables identifying a “marginal liver.” Finally, the use of HCV+ or HBV+ grafts did not lead to an increased mortality.