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Molecular Biology and Translational Research

Oncological Surgery Santa Maria alle Scotte,
viale Bracci 2, Siena
Tel. 0577 585156

Principal Investigator: Prof. Franco Roviello

Staff

  • Mr. Garosi Lorenzo
  • Dr. Corso Giovanni
  • Dr. Marrelli Daniele
  • Dr. Pedrazzani Corrado
  • Dr. Berardi Anna
  • Dr. Zagaglia Katia

Availability of a tissue and serum bank of about 1400 patients operated in our unit together with clinical and follow-up data in regard to stomach, colorectal, breast and pancreas cancer. DNA, RNA and protein databank.
The Surgical Oncology Unit became an independent ward in 1999 under the guidance of Prof. Enrico Pinto. Our surgical activities include treatment of general and oncology pathologies of the gastrointestinal tract, hepatobiliopancreatic, ovarian and peritoneal cancer. Surgical treatment of stomach cancer, which is of particular concern in the province of Siena, is treated with a Japanese method according to the National Cancer Center of Tokyo Gastric Cancer Section with which there has been collaboration since 1995. Our molecular biology translational research includes basic research such as genetic screening, identification of circulating biomarkers in cancer patients and selection of other genetic factors responsible for oncogenesis and especially gastric cancer.

Main Research Themes

  • Surgical treatment of gastric cancer:
    The standardized surgical approach to stomach cancer which is used and has been perfected by our research team includes extended and super-extended lymphoadenectomy according to the Japanese method with classification of the various lymphonodal sites. This includes removal of lymphonodal sites according to the criteria of Japanese authors, and research on single lymph nodes. The aim of the study is to evaluate the incidence of postoperative complications and risk factors for morbidity and mortality in patients undergoing this treatment.
  • Italian Group for Research on Gastric Cancer (GIRCG): In October of 1999 three Italian centers (Siena, Verona, Forlì) specialized in surgical treatment of gastric carcinoma and using the Japanese approach, formed a study group to unify clinical data and research on patients with stomach adenocarcinoma. Prof. Franco Roviello is president of the group. The work of the GIRCG has been demonstrated by articles published in high-impact journals and this is one of the most important European groups working in this field today.
  • Biological materials archive: Our research center has a large databank of biological material conserved at -80°C. The archive includes tumor and control tissue of gastric origin (about 800 pieces), colon rectal cancer (c. 500 pieces) and breast (about 100). The databank also contains the corresponding genomic DNA and RNA for each sample. Serum from each oncology patient which has been sampled at various critical phases is also conserved at -80°C. Due to the interest in hereditary cancer, we also have genomic DNA samples and whole blood from individuals from families affected by hereditary oncological diseases (about 300 families).
  • Treatment of peritoneal carcinomatosis in gastric cancer: The aim of the project is to evaluate the efficacy of intraperitoneal chemohyperthermia in the treatment of peritoneal relapse of gastric cancer. The technique consists of the intraabdominal perfusion of chemotherapic drugs (mitomycin C, cisplatin) at 42-43°C using a specifically designed pump for this treatment.
  • Follow-up of patients operated for gastric cancer and clinical use of tumor markers: Patients operated for gastric cancer are followed according to a postoperative protocol designed by our research team, considering clinical, instrumental and laboratory data such as serological course of tumor markers (CEA, CA 19-9, CA 72-4, CA 125). The prognostic significance of preoperative levels, the correlation between preoperative levels and site of any tumor relapse, the efficacy of serum assay during follow-up (sensitivity of diagnosis of relapse, early diagnosis compared to instrumental examinations, specificity for disease-free patients).
  • Surgical treatment of advanced ovarian cancer and pharmacokinetic and cell toxicity studies: Surgical approach for the prevention and treatment of peritoneal carcinomatosis originating with ovarian cancer includes cytoreductive surgery with partial or total exportation from peritoneum, followed by intraperitoneal and hyperthermic chemotherapy using cytotoxic chemotherapeutic drugs at high temperature (41-42°C). Systemic toxicity of the drugs was evaluated using pharmacokinetic methods to establish objective parameters and adapt the therapy to the individual patient with the optimum dose, maximum locoregional effect and minimum systemic damage.
  • International Gastric Cancer Linkage Consortium (IGCLC): This international group was founded in 1999 and is coordinated by Carlos Caldas (Cambridge) to establish clinical criteria for selecting families with hereditary gastric carcinoma. This project emerged after the discovery of germinal mutations of Caderine-E in Maori families in New Zealand. Later these mutations were also found in various European and American groups in families affected by diffused hereditary gastric cancer.
  • Genetic screening of Caderine-E and risk factors: Due to the high incidence of gastric cancer in Tuscany, our research group has presented a selection of 14 families meeting the clinical criteria established by the IGCLC in 1999. Caderine-E genetic screening was carried out on the probands of this pedigree and the first germinal mutation was found in an Italian family presenting hereditary characteristics of gastric cancer. This mutation was studied in collaboration with the University of Porto and demonstrated to be functionally pathogenic equal to a deletion of the genetic code. Of the genetic factors identified by various research groups in the promoter polymorphisms the CDH1 gene is considered a risk factor associated with gastric cancer in that it is responsible for altering its transcription activity. Our research group designed a study on this polymorphism in a control population of about 520 cases and a population of about 500 individuals with gastric cancer in order to evaluate the impact of this polymorphism on healthy and affected individuals.
  • Second genetic screening of Caderine-E: Clinical criteria were later widened to individuals at the age of <50 years diagnosed sporadically with diffused gastric cancer. Our research center, on the basis of this new classification, selected another 53 cases as candidates for mutational screening of the Caderine-E germinal line. The preliminary results demonstrate the emergence of a second mutation in an individual with gastric cancer of diffused histotype, and the functional effect of this mutation is now being studied.
  • Research on new prognostic markers for colorectal carcinoma: The aim of this project is to evaluate the clinical utility of serum assay and tissue expression of recently identified factors involved in the process of angiogenesis (VEGF, CD34, CD105) and cellular adhesion (ICAM-1, VCAM-1, Selectin-E, Caderine-E) in patients operated for colorectal carcinoma. The study involves assay of serum levels of the studied factors and the correlation between serum levels and tissue expression with disease stage, prognosis and type of metastasis will be made. The aim is to find new useful prognostic markers to guide the selection of patients for adjuvant treatment, especially for those categories of patients for whom there are no standardized indications for adjuvant therapy. The sensitivity, specificity and predictive value of the diagnosis of relapse during follow-up will be evaluated as well as the possibility of monitoring chemotherapy response in treated patients who have relapsed.
  • Characterization of Helicobacter pylori genotype in gastric carcinoma: The aim of this project is to identify and establish the incidence of different genotypes in Helicobacter pylori infection in patients with gastric cancer in order to assess the virulence of these strains. The final aim of the study is to identify the incidence of different genotypes in subjects with stomach cancer.
  • Identification of new circulating markers in patients with gastric cancer: This ongoing research involves identification of new molecular factors circulating in serum in patients with gastric cancer. The ideal model is recognized in circulating nucleic acids present in serum and in higher concentrations in individuals with advanced cancer, and it is therefore obvious that expression levels are correlated with disease relapse so that therapy can be immediately adjusted. Molecular specificity of gastric cancer is currently undergoing research in our center.
  • Breast cancer and prognostic factors: Mammaglobin (MGA) is a gene expressed selectively in mammary tissue which codifies for serum protein in uteroglobin families. Given that its expression is limited to normal mammary epithelium and is increased in breast cancer patients, various studies have evaluated the possible role of MGA as tumor marker in peripheral blood, in bone marrow and in lymph nodes. The results obtained have demonstrated a relationship between the presence of circulating MGA-mRNA and breast cancer. There is a significant percentage of breast cancers which do not overexpress MGA and its biological role is still not clear. This study is designed to evaluate overexpression of MGA using RT-PCR in a series of about 150 frozen tissue samples coming from breast cancer patients treated surgically in our Center.

Research Grants

  • Treatment of peritoneal carcinomatosis using hyperthermic intraperitoneal chemotherapy and study of factors relating to therapeutic response: Monte dei Paschi di Siena 2006 (Prof. Enrico Pinto, principal investigator).
  • Research on new prognostic markers for colorectal carcinoma. Clinical significance of serum levels and tissue expression as a guide to adjuvant therapy and diagnosis of early relapse. Piano Ateneo Ricerca 2005-PAR 2005 (Prof. Alfonso De Stefano, principal investigator).
  • Genetic and hereditary factors of gastric cancer. PRIN 2005 (National coordinator: Università degli Studi di Padova: Prof. Mitti; Local coordinator: Università degli Studi di Siena: Prof. Franco Roviello).
  • Correlation between tissue expression of Mammaglobin and tumor phenotypes of breast cancer and their prognostic significance. Piano Ateneo Ricerca 2005-PAR 2005 (Coordinator: Dr. Alessandro Neri).
  • Identification of circulating DNA/RNA in patients with gastric, breast or colorectal cancer. Monte dei Paschi di Siena 2004 (Coordinator: Prof. Enrico Pinto
  • Clinical implications of Caderine-E in the predisposition and genesis of gastric carcinoma in a high-incidence zone. Piano Ateneo Ricerca 2004-PAR 2004 (Coordinator: Prof. Franco Rovello)
  • Gastric cancer and Helicobacter pilori infections: importance of bacterial genotype and host genetic polymorphism. PRIN 2004 (National coordinator: Università degli Studi di Siena: Prof. Natale Figura; local coordinator: Prof. Alfonso De Stefano).
  • Identification of new circulating tumor markers in gastric cancer patients. MIUR 2002 (National coordinator: Università degli Studi di Padova: Prof. Mitti; Local coordinator: Università degli Studi di Siena: Prof. Franco Roviello).
  • Use of innovative instruments in advanced laparoscopic surgery. Monte dei Paschi di Siena 2001 (Coordinator: Prof. Enrico Pinto).
  • Prognostic significance of microsatellite instability in gastric cancer patients in a high-risk area. Piano Ateneo Ricerca 2000-PAR 2000 (Coordinator: Prof. Franco Roviello).

Publications

  1. P. Vogiatzi, C. Vindigni, F. Roviello, A. Renieri, A. Giordano: Deciphering the underlying genetic and epigenetic events leading to gastric carcinogenesis. J. Cell Physiol. Epub ahead of print, 2007
  2. A. Neri, D. Marrelli, S. Rossi, A. De Stefano, F. Mariani, G. De Marco, S. Caruso, G. Corso, T. Cioppa, E. Pinto, F. Roviello: Breast cancer local recurrence: risk factors and prognostic relevance of early time to recurrence. World J. Surg. 31,36-45, 2007
  3. C. Pedrazzani, G. de Manzoni, D. Marrelli, S. Giacopuzzi, G. Corso, M. Bernini, F. Roviello: Nodal staging in adenocarcinoma of the gastro-esophageal junction. Proposal of a specific staging system. Ann. Surg. Oncol. 14,299-305, 2007
  4. D. Marrelli, F. Roviello: Prognostic score in gastric cancer patients. Ann. Surg. Oncol. 14,362-4, 2007
  5. D. Marrelli, C. Pedrazzani, A. Neri, G. Corso, A. De Stefano, E. Pinto, F. Roviello: Complications after extended (D2) and superextended (D3) lymphadenectomy for gastric cancer: analysis of potential risk factors. Ann. Surg. Oncol. 14,25-33, 2007
  6. R. Petrioli, L. Paolelli, S. Marsili, S. Civitelli, E. Francini, T. Cioppa, F. Roviello, R. Nettuno, C. Intrivici, G. Tanzini, M. Lorenzi, G. Francini: FOLFOX-4 stop and go and capecitabine maintenance chemotherapy in the treatment of metastatic colorectal cancer. Oncology. 70,345-50, 2006
  7. F. Roviello, G. Corso, C. Pedrazzani, D. Marrelli, G. De Falco, A. Berardi, L. Garosi, G. Suriano, C. Vindigni, A. De Stefano, L. Leoncini, R. Seruca, E. Pinto: Hereditary diffuse gastric cancer and E-cadherin: Description of the first germline mutation in an Italian family. Eur. J. Surg. Oncol. Epub ahead of print, 2006
  8. S. Battistelli, A. Vittoria, M. Stefanoni, C. Bing, F. Roviello: Total plasma homocysteine and methylenetetrahydrofolate reductase C677T polymorphism in patients with colorectal carcinoma. World J. Gastroenterol. 12,6128-32, 2006
  9. F. Roviello, D. Marrelli, A. Neri, D. Cerretani, G. de Manzoni, C. Pedrazzani, T. Cioppa, G. Nastri, G. Giorgi, E. Pinto: Treatment of peritoneal carcinomatosis by cytoreductive surgery and intraperitoneal hyperthermic chemoperfusion (IHCP): postoperative outcome and risk factors for morbidity. World J. Surg. 30,2033-40, 2006
  10. G. Cerullo, D. Marrelli, F. Roviello, F.S. Ferrari, F. Vigni, B. Rampone, M. Di Martino, G. De Marco, E. Pinto: Empiric antibiotic therapy in the treatment of postoperative abdominal abscesses. Clinical and microbiological data. Chir. Ital. 58,477-84, 2006
  11. F. Roviello, S. Rossi, D. Marrelli, C. Pedrazzani, G. Corso, C. Vindigni, P. Morgagni, L. Saragoni, G. de Manzoni, A. Tomezzoli: Number of lymph node metastases and its prognostic significance in early gastric cancer: a multicenter Italian study. J. Surg. Oncol. 94,275-80, 2006
  12. B. Rampone, F. Roviello, D. Marrelli, G. De Marco, S. Rossi, G. Corso, G. Cerullo, E. Pinto: Late recurrence of malignant melanoma presenting as small bowel intussusception. Dig. Dis. Sci. 51,1047-8, 2006
  13. T. Cioppa, A. De Stefano, D. Marrelli, A. Neri, S. Rossi, G. De Marco, E. Pinto, F. Roviello: Pseudoaneurysm of the splenic artery fistulized in the stomach and associated to a pancreatic pseudocyst: case report. Minerva Chir. 61,261-264, 2006
  14. S. Battistelli, M. Stefanoni, A. Genovese, A. Vittoria, R. Cappelli, F. Roviello: Prevalence of factor V Leiden and prothrombin G20210A in patients with gastric cancer. World J. Gastroenterol. 12,4179-80, 2006
  15. F. Roviello, S. Caruso, S. Moscovita Falzarano, D. Marrelli, A. Neri, B. Rampone, G. De Marco, M.E. Perrotta, F. Mariani: Small bowel metastases from renal cell carcinoma: a rare cause of intestinal intussusception. J. Nephrol. 19,234-8, 2006
  16. A.L. Komorowski, W.M. Wysocki, F. Roviello, D. Marrelli: Gastric resection Billroth or Rydygier? Chir. Ital. 58,231-4, 2006
  17. F. Roviello, S. Rossi, D. Marrelli, G. de Manzoni, C. Pedrazzani, P. Morgagni, G. Corso, E. Pinto: Perforated gastric carcinoma: a report of 10 cases and review of the literature. World J. Surg. Oncol. 30,4-19, 2006
  18. B. Rampone, F. Roviello, D. Marrelli, A. De Stefano, A. Neri, F. Mariani, G. De Marco, G. Corso, G. Cerullo, S. Caruso, E. Pinto: Peritoneal carcinomatosis due to ocular melanoma. Minerva Chir. 61,72-3, 2006
  19. M. Bernini, S. Barbi, F. Roviello, A. Scarpa, P. Moore, C. Pedrazzani, S. Beghelli, D. Marrelli, G. de Manzoni: Family history of gastric cancer: a correlation between epidemiologic findings and clinical data. Gastric Cancer. 9,9-13, 2006
  20. P. Morgagni, D. Garcea, D. Marrelli, G. de Manzoni, G. Natalini, H. Kurihara, A. Marchet, G. Vittimberga, L. Saragoni, F. Roviello, A. Di Leo, F. De Santis, V. Panizza, D. Nitti: Does resection line involvement affect prognosis in early gastric cancer patients? An Italian multicentric study. World J. Surg. 30,585-9, 2006
  21. S. Beghelli, G. de Manzoni, S. Barbi, A. Tomezzoli, F. Roviello, C. Di Gregorio, C. Vindigni, L. Bortesi, A. Parisi, L. Saragoni, A. Scarpa, P.S. Moore: Microsatellite instability in gastric cancer is associated with better prognosis in only stage II cancers. Surgery. 139,347-56, 2006
  22. A. Neri, D. Marrelli, F. Roviello, G. De Marco, F. Mariani, A. De Stefano, T. Megha, S. Caruso, G. Corso, T. Cioppa, E. Pinto: Bcl-2 expression correlates with lymphovascular invasion and long-term prognosis in breast cancer. Breast Cancer Res. Treat. 99,77-83, 2006
  23. D. Cerretani, C. Nencini, R. Urso, G. Giorgi, D. Marrelli, A. De Stefano, E. Pinto, T. Cioppa, G. Nastri, F. Roviello: Pharmacokinetics of mitomycin C after resection of peritoneal carcinomatosis and intraperitoneal chemohyperthermic perfusion. J. Chemother. 17,668-73, 2005
  24. D. Marrelli, E. Pinto, A. Neri, T. Megha, W. Gioffrè, T. Cioppa, G. De Marco, A. De Stefano, F. Roviello: Mib-1 proliferation index is an independent predictor of lymph node metastasis in invasive breast cancer: a prospective study on 675 patients. Oncol. Rep. 15,425-9, 2006
  25. E. Bragantini, S. Barbi, S. Beghelli, P.S. Moore, G. de Manzoni, F. Roviello, A. Tomezzoli, C. Vindigni, R. Baffa, A. Scarpa: Loss of Fhit expression is associated with poorer survival in gastric cancer but is not an independent prognostic marker. J. Cancer Res. Clin. Oncol. 132,45-50, 2006
  26. G. De Marco, F. Roviello, D. Marrelli, A. De Stefano, A. Neri, S. Rossi, G. Corso, B. Rampone, G. Nastri, E. Pinto: A clinical case of duodenal gastrointestinal stromal tumor with a peculiarity in the surgical approach. Tumori. May-Jun;91,261-3, 2005
  27. R. Petrioli, M. Sabatino, F. Roviello, D. Marrelli, G. Nastri, S. Marsili, P. Correale, D. Pozzesser, S. Messinese, A. De Martino, F. Tani, G. Marzocca, M. Lorenzi, S. Civitelli, G. Tanzini, E. Pinto, G. Francini: Folinic acid, 5-fluorouracil and etoposide after curative resection for gastric cancer. Hepatogastroenterology. 52, 1626-30, 2005
  28. B. Rampone, F. Roviello, D. Marrelli, E. Pinto: Giant appendiceal mucocele: report of a case and brief review. World J. Gastroenterol. 11,4761-3, 2005
  29. S. Battistelli, A. Vittoria, R. Cappelli, M. Stefanoni, F. Roviello: Protein S in cancer patients with non-metastatic solid tumours. Eur. J. Surg. Oncol. 31,798-802, 2005
  30. A. Neri, D. Marrelli, F. Roviello, A. De Stefano, A. Guarnieri, E. Pallucca, E. Pinto: Prognostic value of extracapsular extension of axillary lymph node metastases in T1 to T3 breast cancer. Ann. Surg. Oncol. 12,246-53, 2005
  31. D. Marrelli, A. De Stefano, G. de Manzoni, P. Morgagni, A. Di Leo, F. Roviello: Prediction of recurrence after radical surgery for gastric cancer: a scoring system obtained from a prospective multicenter study. Ann. Surg. 241,247-55, 2005
  32. P. Lusini, N. Figura, M. Valassina, F. Roviello, C. Vindigni, L. Trabalzini, R. Nuti, C. Lenzi, C. Gonnelli, M. Nardi, P. Martelli, A. Cantucci: Increased phospholipase activity in Helicobacter pilori strains isolated from patients with gastric carcinoma. Dig. Liver Dis. 37,232-9, 2005
  33. D. Marrelli, A. De Stefano, G. de Manzoni, P. Morgagni, A. Di Leo, F. Roviello: Prediction of Recurrence After Radical Surgery for Gastric Cancer: A Scoring System Obtained From a Prospective Multicenter Study. Ann. Surg. 241, 247-255, 2005
  34. G. Fotia, D. Marrelli, A. De Stefano, E. Pinto, F. Roviello: Factors influencing outcome in gastric cancer involving muscularis and subserosal layer. Eur. J. Surg. Oncol. 30, 930-4, 2004
  35. F. Roviello, G. Fotia, D. Marrelli, A. De Stefano, R. Macchiarelli, E. Pinto: Iron deficiency anemia after subtotal gastrectomy for gastric cancer.Hepatogastroenterology 51, 1510-4, 2004
  36. AJ. French, G. Petroni, SN Thibideau, M. Smolkin, E. Bissonette, F. Roviello, JC Harper, BR Koch, SA Anderson, SJ Hebbring, SM Powell.: Allelic imbalance of 8p indicates poor survival in gastric cancer.J. Mol. Diagn. 6, 243-52, 2004
  37. G. de Manzoni, C. Pedrazzani, G. Verlato, F. Roviello, F. Pasini, R. Pugliese, C. Cordiano: Comparison of old and new TNM systems for nodal staging in adenocarcinoma of the gastro-oesophageal junction.Br. J. Surg. 91, 296-303, 2004
  38. G. Maconi, H. Kurihara, V. Panizzo, A. Russo, M. Cristaldi, D. Marrelli, F. Roviello, G. de Manzoni, A. Di Leo, P. Morgagni, P. Bechi, G. Bianchi Porro, AM. Taschieri; Italian Research Group for Gastric Cancer.: Gastric cancer in young patients with no alarm symptoms: focus on delay in diagnosis, stage of neoplasm and survival.Scand. J. Gastroenterol. 38, 1249-55., 2003
  39. F. Roviello, G. De Marco, G. Nastri, T. Cioppa, C. De Bartolomeis, G. Fotia, D. Marrelli, A. De Stefano, E. Pinto: Cystadenoma of the pancreas: 4 cases in our clinical experience.Chir. Ital. 55, 907-12, 2003
  40. G. De Manzoni, G. Verlato, F. Roviello, A. Di Leo, D. Marrelli, P. Morgagni, F. Pasini, L. Saragoni, A. Tomezzoli; Italian Research Group for Gastric Cancer.: Subtotal versus total gastrectomy for T3 adenocarcinoma of the antrum.Gastric Cancer. 6, 237-42, 2003
  41. D. Marrelli, F. Roviello, A. De Stefano, G. Fotia, C. Giliberto, L. Garosi, E. Pinto: Risk factors for liver metastases after curative surgical procedures for gastric cancer: a prospective study of 208 patients treated with surgical resection.J. Am. Coll. Surg. 198, 51-8, 2004
  42. F. Roviello, D. Marrelli, G. de Manzoni, P. Morgagni, A. Di Leo, L. Saragoni, A. De Stefano; Italian Research Group for Gastric Cancer: Prospective study of peritoneal recurrence after curative surgery for gastric cancer.Br. J. Surg. 9, 1113-9, 2003
  43. F. Roviello, T. Cioppa, D. Marrelli, G. Nastri, A. De Stefano, L. Hako, E. Pinto: Primary ano-rectal melanoma: considerations on a clinical case and review of the literature.Chir. Ital. 4, 575-80, 2003
  44. F. Roviello, D. Marrelli, P. Morgagni, G. de Manzoni, A. Di Leo, C. Vindigni, G. Nastri, L. Saragoni, A. Tomezzoli, H. Kurihara, A. De Stefano: Benefits of extended lymphadenectomy in patients with gastric carcinoma with metastasis to second level lymph nodes. An Italian multicenter study.Chir. Ital. 4, 491-8, 2003
  45. P. Correale, D. Cerretani, S. Marsili, D. Pozzessere, R. Petrioli, S. Messinese, M. Sabatino, F. Roviello, E. Pinto, G. Francini, G. Giorgi: Gemcitabine increases systemic 5-fluorouracil exposure in advanced cancer patients.Eur. J. Cancer. 11, 1547-51, 2003
  46. L. Saragoni, P. Morgagni, G. de Manzoni, A. Tomezzoli, F. Roviello, D. rrelli,A. Di Leo, C. Vindigni, H. Kurihara, P. Fociani; Gruppo Italiano di Ricerca del Cancro Gastrico (IRGGC) : Expression of p27 and proliferative (MIB-1), mitotic (MI) and apoptotic indices in early-phase (EGF) gastric carcinoma. Results of a study by the Italian Gastric Cancer Research Group (IRGGC).Patologica 1, 22-30, 2003
  47. F. Roviello,G. Nastri, L. Hako, D. Marrelli, A. De Stefano, T. Cioppa, E. Pinto: Pancreatic metastasis from clear cell renal carcinoma: a clinical case.Chir. Ital. 54, 873-7, 2002
  48. G. Suriano, C. Oliveira, P. Ferreira, J.C. Machado, MC.Bordin, O. De Wever, EA. Bruyneel, N. Moguilevsky, N. Grehan, TR. Porter, FM. Richards, RH. Hruban, F. Roviello, D. Huntsman, M. Mareel, F. Carneiro, C. Caldas, R. Seruca: Identification of CDH1 germline missense mutations associated with functional inactivation of the E-cadherin protein in young gastric cancer probands.Hum. Mol. Genet. 12, 575-82, 2003
  49. G. Fotia, D. Marrelli, A. De Stefano, F. Roviello: Correlation between chronic gastritis of the gastric stump, Helicobacter pylori infections and iron deficiency after gastrectomy for gastric cancer.Giorn. Chir. 23, 237-42, 2002
  50. E. Neri, C. Sassi, M. Massetti, F. Roviello, P. Giomarelli, F. Bizzarri, S. Scolletta, C. Setacci: Nonocclusive intestinal ischemia in patients with acute aortic dissection.J. Vasc. Surg. 36, 738-45, 2002
  51. G. De Manzoni, G. Verlato, F. Roviello, P. Morgagni, A. Di Leo, L. Saragoni, D. Marrelli, Kurihara H, Pasini F.: The new TNM classification of lymph node metastasis minimises stage migration problems in gastric cancer patients.Br. J. Cancer. 87, 171-4, 2002
  52. F. Roviello, D. Marrelli, P. Morgagni, G. De Manzoni, A. Di Leo, C. Vindigni, L. Saragoni, A. Tomezzoli, H. Kurihara, A. De Stefano: Survival benefit of extended D2 lymphadenectomy in gastric cancer with involvement of N2 lymphnodes. An Italian multicenter study.Ann. Surg. Oncol. 9, 894-900, 2002
  53. D. Cerretani, F. Roviello, M. Pieraccini, L. Civeli, P. Correale, G. Francini, D. Marrelli, G. De Manzoni, E. Pinto, G. Giorgi: Pharmacokinetics of intraarterial mitomycin C in hypoxic hepatic infusion with embolization in the treatment of liver metastases.Vascul. Pharmacol. 39,1-6, 2002
  54. D. Marrelli, E. Pinto, A. De Stefano, M. Farnetani, L. Garosi, F. Roviello: Preoperative positivity of serum tumor markers is a strong predictor of hematogenous recurrence of gastric cancer.J. Surg. Oncol. 78, 253-8, 2001
  55. D. Marrelli, F. Roviello, G. De Manzoni, P. Morgagni, A. Di Leo, L. Saragoni, A. De Stefano, S. Folli, C. Cordiano, E. Pinto, for the Italian Research Group for Gastric Cancer: Different patterns of recurrence in gastric cancer depending on Lauren's histological type: a longitudinal study. World J. Surg. 26, 1160-5, 2002

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