Alfonso Carli
University of Siena
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Featured researches published by Alfonso Carli.
Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery | 1999
Carlo D'Aniello; Luca Grimaldi; Alfonso Barbato; B. Bosi; Alfonso Carli
The surgery of breast cancer has changed lately in favour of breast conserving treatment, the main purpose of which is to provide good cosmetic results together with radical resection of the tumour. In this paper we describe the cosmetic results obtained in 242 patients treated by conservative surgery (226 quadrantectomies, 93%, and 16 lumpectomies, 7%) for low risk breast cancer. Several of these resections were combined with plastic surgical techniques for residual breast reshaping. The technique chosen depended on the site of tumour, width of resection, and breast volume. The cosmetic assessment was made by the patient and the physician. Our data suggest that better cosmetic results may be obtained when plastic surgical procedures are combined with conservative surgery for breast cancer.
Gastric Cancer | 1998
Giovanni de Manzoni; Paolo Morgagni; Franco Roviello; Alberto Di Leo; Luca Saragoni; Daniele Marrelli; Alfredo Guglielmi; Alfonso Carli; Secondo Folli; Claudio Cordiano
Background. Precise knowledge of the abdominal nodal spread of cardia adenocarcinoma in relation to the depth of invasion of the tumor and its longitudinal extension may be very important for the surgeon as a guide in choosing the type of resection and lymphadenectomy. Methods. The frequency of node metastases in each abdominal station of the first and second tier was prospectively studied in 101 patients with type II and III cardia cancer (defined as approved by the consensus conference held during the second International Gastric Cancer Conference in Munich in April, 1997) who underwent total gastrectomy with D2 lymphadenectomy during the period January 1994 to April 1998. Lymph nodes were retrieved immediately after operation by the surgeon and assigned to the appropriate station according to the classification of the Japanese Research Society for Gastric Cancer. Results. In early gastric cancer, of both type II and type III, lymph node involvement was limited to the perigastric nodes of the upper half of the stomach and to the lymph node station of the celiac trunk. In advanced cancers, whether of type II or type III, there was a fairly high frequency of metastases to the perigastric nodes of the lower half of the stomach; there was also high frequency of metastases at N2 stations, without differences in frequency between pT2 and pT3 tumors (staged according to the classification of the Japanese Research Society for Gastric Cancer). Conclusions. The results of our study provide evidence for the need to perform a total gastrectomy with D2 lymphadenectomy in all patients with advanced cardia cancer type II or type III. In early cancers, a less extensive resection (proximal gastrectomy) with D2 lymphadenectomy may be indicated.
European Journal of Surgery | 2001
Alfredo Guarnieri; Alessandro Neri; Pier Paolo Correale; M. Lottini; M. Testa; F. Mariani; Enrico Tucci; Tiziana Megha; Marcella Cintorino; Alfonso Carli
OBJECTIVE To identify those patients with T1 breast cancers with lower risk of nodal metastases who can safely be spared axillary dissection. DESIGN Retrospective study. SETTING University hospital, Italy. SUBJECTS Review of clinical records and histopathological slides of 547 patients with T1 breast cancer, operated on between 1984 and 1997. MAIN OUTCOME MEASURES Incidence of axillary metastases in relation to age, menopausal status, diameter and grade of tumour, vascular invasion, DNA ploidy, S-phase fraction and hormone receptor state, by univariate and multivariate analysis. RESULTS Axillary metastases were present in 159 patients (29%). On univariate analysis, diameter of tumour 10 mm or less (pT1a/pT1b cancers), no vascular invasion, and grade 1 tumour were significantly correlated with a lower risk of nodal metastases, but only vascular invasion (p = 0.0001, odds ratio = 3.1) and diameter of tumour (p = 0.04, odds ratio = 1.6) were independent predictors on multivariate analysis. Among 34 pT1a/pT1b cancers, with low grade of tumour and no vascular invasion, only 2 (6%) had axillary metastases. When only one favourable predictive factor was associated with diameter of tumour of 10 mm or less, the incidence of axillary metastases ranged from 12% for 43 patients with grade 1 cancers to 13% for 76 patients with no vascular invasion. CONCLUSIONS Axillary dissection may be avoided in pT1a and pT1b breast cancers (< or = 10 mm), with low grade of tumour or no vascular invasion. T1 breast cancers 10 mm or less in diameter should be treated by a two-step approach, first wide excision of the tumour and then axillary dissection or not depending on pathological examination of the primary tumour.
Japanese Journal of Clinical Oncology | 2001
Secondo Folli; Paolo Morgagni; Franco Roviello; Giovanni de Manzoni; Daniele Marrelli; Luca Saragoni; Alberto Di Leo; Michele Gaudio; Oriana Nanni; Alfonso Carli; Claudio Cordiano; Davide Dell’Amore; Antonio Vio
Japanese Journal of Clinical Oncology | 1998
Franco Roviello; Daniele Marrelli; Alfonso De Stefano; Angelo Messano; Enrico Pinto; Alfonso Carli
La chirurgia geriatrica nel terzo millenio | 2001
Alfonso Carli; F. Mariani; M. Testa; G. Vuolo; Luigi Verre; Alessandro Neri; Alessandro Piccolomini
XXIV Congresso Nazionale di Oncologia | 1998
Alfredo Guarnieri; Alessandro Neri; M. Lottini; A. Collini; S Nepi; Giuliana Ruggieri; Vinno Savelli; Enrico Pinto; Alfonso Carli
VII GIornata di Facoltà dell'Università degli Studi di Siena | 1995
Carlo D'Aniello; Luca Grimaldi; A. Barbato; Alfredo Guarnieri; Alfonso Carli
V Settimana della Cultura Scientifica - Siena | 1995
Alfonso Carli; Mario Antonio Reda; Carlo D'Aniello; Alfredo Guarnieri
INTERNATIONAL JOURNAL OF SURGICAL SCIENCES | 1995
Alessandro Piccolomini; L. Di Cosmo; D. Masellis; A. Bianchi; Cesare Brandi; G. Vuolo; Luigi Verre; Anton Ferdinando Carli; Alfonso Carli