Antonio Sommariva

Istituto Oncologico Veneto · Surgical Oncology Department

Background: Pseudomyxoma peritonei (PMP) is a rare malignant disease. Adding of the Ki67 proliferation index to the PSOGI PMP classification provided two different subcategories of the extensive HG-PMP group (HG-PMP ≤15% and HG-PMP >15%) with different survival in a previous unicentric study. This study aims to carry out an external and multicentr...

Background: Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a novel intraperitoneal drug delivery method of low-dose chemotherapy as a pressurized aerosol in patients affected by peritoneal cancer of primary or secondary origin. We performed a systematic review and meta-analysis with the aim of assessing the feasibility, safety, and ef...

Aim: Pseudomyxoma peritonei (PMP) is an uncommon pathology, and its rarity causes a lack of scientific evidence, precluding the design of a prospective trial. A diagnostic and therapeutic algorithm (DTA) is necessary in order to standardize the disease treatment while balancing optimal patient management and the correct use of resources. The Consen...

Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has gained increasing acceptance in clinical practice. Performing CRS and HIPEC laparoscopically represents a challenging and intriguing technical evolution. However, the experiences are limited, and the evidence is low. This retrospective analysis was performed on pa...

HIPEC is a potentially useful locoregional treatment combined with cytoreduction in patients with peritoneal colorectal metastases. Despite being widely used in several cancer centers around the world, its role had never been investigated before the results of three important RCTs appeared on this topic. The PRODIGE 7 trial clarified the role of ox...

Introduction The selection of patients undergoing cytoreductive-surgery (CRS) followed by hyperthermic intraperitoneal chemotherapy (HIPEC) is crucial. BIOSCOPE and COMPASS are prognostic scores designed to stratify survival into four classes according to clinical and pathological features. The purpose of this study is to analyze the prognostic rol...

Aim of the study: Postoperative coagulopathy is a poorly investigated condition after Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC). This study aims to evaluate the occurrence and risk factors of coagulative disorders after surgery for peritoneal metastases. Patients and methods: The records were extracted fro...

Purpose: Peritoneal carcinomatosis from appendiceal goblet cell carcinoma (A-GCC) is a rare and aggressive form of appendiceal tumor. Cytoreductive surgery (CRS) and hyperthermic intra peritoneal chemotherapy (HIPEC) was reported as an interesting alternative regarding survival compared to surgery without HIPEC and/or systemic chemotherapy. Our ai...

Background We report the first case of a patient affected by peritoneal metastases from colon cancer, arising in the context of Lynch syndrome with pathological complete response. The patient was treated with immunotherapy and cytoreductive surgery. This paper discusses the implications of these novel therapies for the management of PM. Case prese...

The melanoma incidence is rapidly increasing. Males are 1.5 times more likely to develop melanoma than females. The most important risk factor for development of melanoma is the exposure to ultraviolet rays. The most important host risk factors are the number of melanocytic nevi, familiar history, and genetic susceptibility. The dermatological diag...

Pseudomyxoma Peritonei (PMP) is an anatomo-clinical condition characterized by the implantation of neoplastic cells on peritoneal surfaces with the production of a large amount of mucin. The rarity of the disease precludes the evaluation of treatment strategies within randomized controlled trials. Cytoreductive Surgery (CRS) combined with Hyperther...

Background: Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) leads to prolonged survival for selected patients with colorectal (CRC) peritoneal metastases (PM). This study aimed to analyze the prognostic role of micro-satellite (MS) status and RAS/RAF mutations for patients treated with CRS. Methods: Data were c...

Purpose Non-neuroendocrine neoplasms of the appendix are a phenotypically heterogeneous group of lesions; a comprehensive molecular characterization of these tumors is still lacking. Methods A total of 52 samples taken from 49 patients was evaluated: 18 sessile serrated lesions (SSL; 3 with dysplasia), 2 high-grade tubular adenomas, 1 tubulo-villo...

Background Videoscopic inguinal lymphadenectomy (VIL) represents an innovative approach for patients with melanoma lymph node (LN) metastases, mainly aimed at lowering wound-related morbidity. However, long-term data on oncologic safety are still lacking. The aim of this study is to review the oncologic outcome of videoscopic groin dissection in a...

Purpose Complete mesocolic excision (CME) has introduced a promising surgical approach for treatment of right colon cancer. However, benefits of CME are still a matter of debate. We conducted a systematic review and meta-analysis to assess safety and long-term outcomes of CME versus conventional right hemicolectomy (CRH). Methods We systematically...

Introduction The PRODIGE 7-trial investigated the additional value of Hyperthermic Intraperitoneal Chemotherapy (HIPEC) to cytoreductive surgery (CRS) for patients with colorectal peritoneal metastases (CPM). The results of PRODIGE 7 were presented at the 2018 ASCO meeting showing that 30 min oxaliplatin-based HIPEC did not improve overall survival...

Background Reproducible, high-quality surgery is a key point in the management of cancer patients. Quality indicators for surgical treatment of melanoma has been presented with benchmarks but data on morbidity are still limited. This study presents the quality indicators on morbidity after surgical treatment for non-metastatic skin melanoma in an I...

Introduction A laparoscopic approach for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (L-CRS+HIPEC) in highly selected patients has been reported in small cohorts with a demonstrable reduction in length of stay and post-operative morbidity. This study aims to analyse individual patient data from these international centres co...

The mechanisms by which neoplastic cells disseminate from the primary tumor to metastatic sites, so-called metastatic organotropism, remain poorly understood. Epithelial–mesenchymal transition (EMT) plays a role in cancer development and progression by converting static epithelial cells into the migratory and microenvironment-interacting mesenchyma...

Postoperative outcome after cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is strongly related to surgical and anesthesiologic expertise. This study aims to evaluate the clinical significance and prognostic value of lactate levels (LL) measured during CRS-HIPEC on postoperative outcome compared to similar ma...

Aim: the surgical workup for colorectal cancer peritoneal metastases (CRCPM) is complex and should be managed in specialized centers. Diagnostic and therapeutic algorithms (DTA) have been proposed to balance optimal patients management and correct use of resources. Aim of this study was to establish a consensus on DTA for CRCPM patients in Italy....

Background: Reproducible, high-quality surgery is a key point in the management of cancer patients. Quality indicators for surgical treatment of melanoma has been presented with benchmarks but data on morbidity are still limited. This study presents the quality indicators on morbidity after surgical treatment for non-metastatic skin melanoma in an...

Background: Reproducible, high-quality surgery is a key point in the management of cancer patients. Quality indicators for surgical treatment of melanoma has been presented with benchmarks but data on morbidity are still limited. This study presents the quality indicators on morbidity after surgical treatment for non-metastatic skin melanoma in an...

Background: Reproducible, high-quality surgery is a key point in the management of cancer patients. Quality indicators for surgical treatment of melanoma has been presented with benchmarks but data on morbidity are still limited. This study presents the quality indicators on morbidity after surgical treatment for non-metastatic skin melanoma in an...

e18084 Background: The use of PARP inhibitors (Olaparib-Niraparib) has shown an important benefit in PFS in patients with relapsed ovarian cancer both with gBRCA and non-BRCA mutation. Methods: This was a single-institution, retrospective cohort study of 93 patients. Clinical data were obtained by the review of the electronic medical report. The 93...

Purpose: Inter-patient clinical variability in soft tissue sarcomas (STS) highlights the need for novel prognostic markers supporting patient risk stratification. As sarcomas might exhibit a more mesenchymal or a more epithelial state, we focused on epithelial-mesenchymal and mesenchymal-epithelial transitions (EMT/MET) for prognostic clues, and s...

Introduction: The application of hyperthermic intraperitoneal chemotherapy (HIPEC) in colorectal and appendix cancer at risk of peritoneal seeding is an appealing strategy to prevent peritoneal metastases. Here, we present the technical details and postoperative outcomes of laparoscopic HIPEC performed with prophylactic intent in three patients wi...

Colorectal cancer (CRC) peritoneal metastasis (PM) is one of the most important cause of cancer-related death in world. CRC PM is considered as a homogeneous disease without differentiating colonic or rectal origin. Aim of this study is to analyze survival of patients treated with cytoreductive surgery and HIPEC, according to the origin of PM. Lite...

Introduction Lymphocele occurs frequently after regional lymph node dissection. Surgery with multiple lymphatic ligation represents the only reliable treatment for long‐standing chronic lymphocele. Materials and Surgical Technique We report the case of a man with chronic axillary seroma after axillary lymphadenectomy for melanoma. The lymphocele w...

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: The aim of this work is to evaluate the efficacy of cytoreductive surgery alone versus cytoreductive surgery in combination with hyperthermic intraperitoneal chemotherapy (HIPEC), on patient benefits, complications and short-term outcomes in patients with pseudo...

To verify technical feasibility, postoperative outcome of laparoscopic prophylactic approach in patients affected by LAMN

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: The aim of this work is to evaluate the efficacy of cytoreductive surgery alone versus cytoreductive surgery in combination with hyperthermic intraperitoneal chemotherapy (HIPEC), on patient benefits, complications and short-term outcomes in patients with pseudo...

Background: Our aim was to analyze the safety and efficacy of iterative cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (iCRS-HIPEC) in patients with peritoneal recurrence from different tumor types. Patients and methods: Data on indications, intraoperative findings and postoperative outcome of all patients treated with iCRS-...

Background: A significant disparity regarding survival outcome for melanoma among European regions is well recognized and access to high quality care for European melanoma patients needs to be improved. There is an unmet need for the implementation of minimal standard of care within defined clinical pathways and Quality Assurance (QA) indicators....

Background: At present, selected patients with resectable colorectal peritoneal metastases (CRC-PM) are increasingly treated with a combination therapy of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). The aim of this study was to investigate the current worldwide practice. Methods: HIPEC experts from 19 count...

Purpose: Aim of the study is to assess the reliability and correlation with surgical peritoneal cancer index (PCI) of combined PET/CT and ceCT scans (PET/ceCT) performed in a session in patients with peritoneal carcinomatosis candidates for cytoreductive surgery (CS) and hyperthermic intraperitoneal chemotherapy (HIPEC). Methods: We retrospectiv...

Introduction: Peritoneal metastasis (PM) of hepatocellular carcinoma (HCC) without distant spread are rare. The related prognosis is poor without standard treatment available. The role of cytoreduction surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is poorly documented. Methods: An international multicentric cohort was const...

The management of pediatric abdominopelvic angiosarcoma remains unclear due to limited clinical experience. Herein, we presented the first 2 pediatric patients with abdominal angiosarcoma who were treated with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) after neoadjuvant therapy. The first patient is alive with...

Values with relative benchmark of short term morbidity have been identified in Italy. These parameters can now be used for promoting QA programs for surgical treatment of melanoma through a continuous feedback of performance of these values to the Italian centers performing melanoma surgery.

Metastatic melanoma is characterized by complex genomic alterations including a high rate of mutations in driver genes and widespread deletions and amplifications encompassing various chromosome regions. Among them, chromosome 7 is frequently gained in BRAF mutant melanoma, inducing a mutant allele-specific imbalance. Although BRAF amplification is...

Every surgeon dealing with groin metastases knows that inguinal lymphadenectomy (IL) is burdened by substantial morbidity, including wound infection and dehiscence, seroma, leg lymphedema and deep venous thromboembolism (DVT). One of the most effective ways to reduce wound-related morbidity after groin dissection would simply be by avoiding skin in...

Cytoreductive surgery (CS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have gained increasing consensus in treatment of peritoneal carcinomatosis from colorectal cancer. The presence of liver metastases is generally considered a contraindication for CS + HIPEC, as hepatic involvement no longer represents a loco-regional aspect of disease....

Objectives: This study was aimed at investigating the prognostic role of multiple lymph node basin drainage (MLBD) in patients with positive sentinel lymph node (SLN) biopsy. Background: MLBD is frequently observed in patients with trunk melanoma undergoing SLN. The prognostic value of MLBD in SLN-positive patients is still debated. Methods: R...

Sclerosing angiomatoid nodular transformation (SANT) is a rare, benign, proliferative vascular lesion that arises from the splenic red pulp. Most patients with SANT have no clinical symptoms and are discovered incidentally on imaging. There are no definitive radiological signs and a distinction from other splenic diseases, and malignant processes r...

Technical details of laparoscopic HIPEC

Update of a single institution experience on Peritoneal Sarcomatosis treated with surgery and HIPEC

Aim of the study is to review the oncologic outcome of videoscopic groin dissection in a single institution caseload.

Background Groin dissection is the recommended treatment in patients with melanoma metastases in the groin. The videoscopic ilio-inguinal lymphadenectomy showed a lower wound-related morbidity than the open technique. However, oncologic outcome data are still lacking. Aim of the study is to review the oncologic outcome of videoscopic groin dissecti...

Introduction: Contrast enhanced (ce) CT represents the gold standard for selecting patients candidate for cytoreductive surgery (CS)+HIPEC. Aim of the study was to investigate the relationships between 18F-FDG PET/CT, ceCT, PET/ceCT and surgical exploration in patients with peritoneal carcinomatosis candidates to CS+HIPEC. Materials and methods: fr...

In an attempt to ensure high standards of cancer care, there is increasing interest in determining and monitoring the quality of surgical interventions in surgical oncology. In recent years, this has been particularly the case for melanoma surgery. The vast majority of patients with melanoma undergo surgery. Usually, this is with combinations of wi...

Background: Groin lymph node dissection for melanoma is burdened by high postoperative morbidity. Videoscopic lymphadenectomy may lower the incidence of complications, including infection, dehiscence and lymphoedema. This pilot study aimed to investigate the feasibility and postoperative outcomes of videoscopic ilioinguinal lymphadenectomy in pati...

Results of the VideoSIIO trial on videoscopic groin lymphadenectomy

Results of videoSIIO trial (ClinicalTrials.gov NCT0250890) and future perspectives

Background: Multiple lymphatic basin drainage (MLBD) is frequently observed in patients with trunk melanoma undergoing sentinel lymph node (SLN) biopsy. Conflicting data regarding the prognostic association of MLBD in SLN-negative patients have been reported. This study aimed to investigate the prognostic role of MLBD in patients with negative SLN...

Results of IOV-CAR-CRC-1- Trial

Melanoma has shown a consistent increase of incidence resulting from an unidentified interaction between inherited factors combined with environmental factors, mainly solar ultraviolet radiations. Surgery represents the standard treatment for primary melanoma and guarantees an optimal locoregional control in the presence of lymph nodes metastasis....

In 2012, 447,000 new cases of colorectal cancer (CRC) were reported in Europe [1]. In two large population-based studies, peritoneal carcinomatosis (PC) was present in 4.8–8.3 % of all CRC patients [2, 3]. Incidence rates may vary among study populations, as the incidence of PC is slightly higher (> 10%) in hospital-based studies [4, 5], most likel...

Inguinal lymphadenectomy (IL) is the standard treatment for inguinal lymph node (LN) metastases from genitourinary neoplasm and other cutaneous malignancies. Video endoscopic inguinal lymphadenectomy (VEIL) is emerging as a new modality for treating inguinal LN metastasis, with the aim of reducing post-operative complications. However, the safety a...

Accessory liver lobe (ALL) is a rare congenital abnormality characterized by the presence of hepatic tissue outside of, but attached to, the liver. ALL is usually asymptomatic, but in the case of torsion, it can be confused with an acute surgical emergency or a tumoral mass. Conventional imaging is often inconclusive, and diagnosis is generally ma...

Background: Background: electroporation, an effective drug delivery system, enhances the uptake of chemotherapeutic agents by means of short electrical fields which open transient pores on the cell membrane. Electrochemotherapy (ECT) has proven to be an effective local therapy for patients with superficial (i.e., cutaneous and subcutaneous), small-...

Background Quality of surgical care can be an important contributor to differences in survival among patients, and this suggests considerable potential for quality improvement in surgery of melanoma. Although clinical practice guidelines (CPG) for melanoma have been produced by various organizations, none address in detail some aspects of care rela...