CLINICAL SCIENTIFIC DEPARTMENTS

CLINICAL SCIENTIFIC DEPARTMENTS

back to contents clinical-scientific departments SURGERY DEPARTMENT DIRECTOR OF DEPARTMENT: Ugo Pastorino +39 02 23902906 ugo.pastorino@istitutotumori.mi.it The Department of Surgery treats oncological diseases that affect all areas of the body except for the brain, providing elective and emergency surgical activity, in ordinary inpatient and day hospital regimens, as well as specialist outpatient activity for diagnosis and follow-up. Routine clinical activity ensures a high standard of care for all surgically-treated patients, providing conservative surgery (organ/function preserving or minimally invasive) for early stage disease and combined treatment modalities for advanced disease. The Department is organized in the following Units: Gastrointestinal, HepatoPancreatobiliary Surgery, and Liver Transplantation. Has the goal to improve the standard of care for primary and secondary tumors affecting the liver, biliary system, pancreas, and gastrointestinal tract. In the field of hepato-oncology, it offers the complete range of the most up-to-date therapeutic options for liver cancer, including liver transplantation, minimally-invasive and computer assisted surgery, transarterial chemo-/radio-embolization, percutaneous and laparoscopic tumor ablation, and targeted molecular therapies. The Unit is a pioneer in computed-assisted liver surgery performed using an ultrasound navigation system that allows localization of tumors deep in the liver that are not visible with conventional ultrasound. Colorectal Surgery. Devotes special attention to tumors of the distal rectum and has established high standards of care for the management of this subset of patients. Conservative, function-preserving surgical techniques to avoid extensive resection an definitive colostomy have been perfected. The Peritoneal Surface Malignancies (PSM) program is responsible for the treatment of pseudomyxoma peritonei, peritoneal mesothelioma, and peritoneal carcinomatosis from colorectal cancers. In 2013, an important study was published on the role of perioperative systemic chemotherapy in diffuse malignant peritoneal mesothelioma patients treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Breast Surgery. Clinical activity includes all aspects of breast cancer treatment, i.e. diagnosis, primary and adjuvant therapy, and follow-up. Enhanced understanding of the pathogenesis of breast cancer coupled with a growing interest in improved esthetic results led to the investigation of skin- and nipple-sparing mastectomy as a potential improvement over conventional mastectomy. In 2013, the longstanding experience on breast conserving surgical treatment was further strengthened by the publication of the final results of a randomized controlled clinical trial on breast cancer treatment without axillary surgery. 27

SCIENTIFIC REPORT 2013 back to contents Melanoma and Sarcoma. Comprises all aspects of melanoma and sarcoma treatment, i.e. diagnosis, primary and adjuvant therapy, and follow-up. The Unit conducts clinical trials in the field of adjuvant therapy for melanoma and pre-operative therapy for sarcoma. The Unit is the referring center for melanoma and sarcoma guidelines. Diagnostic Endoscopy and Endoscopic Surgery. Includes activities of the multidisciplinary endoscopy, i.e., diagnostic and therapeutic procedures of the gastrointestinal, biliopancreatic, respiratory, and urinary tracts. The Unit is particularly committed to cancer prevention and diagnosis and treatment of early cancers. Otolaryngology Surgery and Maxillo-Facial Surgery. Specialized in the treatment of benign and malignant tumors of the head and neck area. State-of-the-art surgical treatment for patients with head and neck tumors is guaranteed by experts from across disciplines: otolaryngologists and maxillofacial surgeons. Gynecologic Oncology. Deals mainly with primary and secondary tumors of the female genital tract. Surgical research was conducted on the following techniques: nerve sparing radical surgery, debulking surgery, mini-invasive surgery, laparoscopic surgery in diagnosis, staging and treatment of early gynecological tumors; sentinel node detection in endometrial cancer. Thoracic Surgery. Covers all aspects of thoracic oncology, focusing on pulmonary, mediastinal, chest wall, and esophageal tumors. In the management of lung cancer, the mainstay of surgical treatment is maximal functional sparing. Innovative techniques for tridimensional chest wall reconstruction have been developed (rib-like technique), permitting appropriate reconstruction even in case of removal of an entire hemithorax. In mediastinal surgery, superior vena cava (SVC) replacement is performed by procedures not requiring SVC cross-clamping, avoiding intraoperative hemodynamic instability. Pleuro-pneumonectomy is proposed in limited malignant mesothelioma, after induction chemotherapy. Plastic and Reconstructive Surgery. Performs reconstructive surgical procedures related to extensive breast and head and neck surgery, soft-tissue tumors, chest-wall surgery, and other types of aggressive oncologic surgery, as well as surgical treatment and repair of skin cancer. Oncoplastic surgery represents a new standard for reconstructive procedures after tumor excision. Urologic Surgery. Strengthens multidisciplinary care and clinical trials in difficult to treat diseases. In particular, a number of phase II clinical trials have been approved in different clinical settings of urothelial, testicular, and penile cancer and are initiating in 2014. Most importantly, a primary objective of the Unit is to develop a modern framework for clinical research, and with this aim the collaboration with EORTC was fulfilled, together with the establishment of an urothelial cancer patient advocacy group. The multicentric international cooperation for next generation sequencing analyses was another endpoint, and collaboration with MSKCC as well as with UAB Comprehensive Cancer Center of Alabama has been established in urothelial and penile cancers, respectively. The objective of these collaborations will be to characterize extreme responders to specific targeted drugs as well as conventional therapy from a molecular standpoint in order to provide information to design informed clinical trials in multiple urological cancers. Pediatric Surgery. Collaborates with pediatric oncologists and provides a high standard of treatment for the most frequent solid non-cns tumors in children and adolescents. The role of surgery is established according to ongoing European treatment protocols. Laser Therapy Unit. Uses high-quality instrumentation including four lasers for a total of 20 wavelengths. It allows conservative and ablative therapies in diseases where laser therapy is the first or only treatment choice. Selective photothermolysis laser treatment is performed for keloids as well as pigmented and vascular lesions, and laser ablation is used for mucosal and skin cancer lesions requiring histological evaluation. Day Surgery Unit. Devoted to surgical procedures performed in ambulatory and day hospital settings. The clinical activity covers many aspects of oncologic surgery, and in 28

clinical-scientific departments particular includes the treatment of different lesions involving skin, soft tissues, breast, as well lesions in gynecologic, urologic, and head and neck areas. This activity involves the collaboration of physicians from Units within the Surgical Department. HIGHLIGHTS The Liver Transplant Program is mainly focused on establishing oncological guidelines and plays a leading role worldwide in defining consistent indications and prospective lines of research. INT is a referral center for soft-tissue sarcomas of the limbs and trunk, as well as retroperitoneal sarcomas, GIST, and axial bone sarcomas. A special effort is dedicated to the Regional Colorectal Cancer Screening Program as well as to endoscopic surveillance of patients affected by familial adenomatous polyposis (FAP) or Lynch syndrome. Lung cancer early detection program: at INT a large prospective study in heavy smokers volunteers is ongoing, based on plasma mir- NA profiling to assess its efficacy as a first line screening test for lung cancer detection (www.biomild.org). INT is certified as a Center of Excellence by the European Society Neuroendocrine Tumors (ENET). KEYWORDS liver transplantation, peritoneal carcinomatosis, locoregional therapy, immunotherapy, cancer prevention, laser therapy, skin cancer, lung cancer, screening GASTROINTESTINAL, HEPATOPANCREATOBILIARY SURGERY, AND LIVER TRANSPLANTATION Vincenzo Mazzaferro, MD Carlo Battiston, MD; Sherrie Bhoori, MD (hepatogastroenterologist); Jorgelina C. Coppa, MD; Christian Cotsoglou, MD; Alessandro Germini, MD; Andrea Pulvirenti, MD; Enrico Regalia, MD; Raffaele Romito, MD; Carlo F. Sposito MD Research Staff Marco A. Bongini, MD; Maria F. Reyes, MD; Daniela Sia, MD; Elisa Sottotetti, MD Residents Davide Citterio, MD; Glenda Grossi, MD; Cecilia Muscarà, MD; Marco Nencioni, MD; Matteo Origi, MD Elisa Giavari and Francesco Roncacci (Unit secretaries); Daniela Guarneri and Nela Zito (scientific secretaries); Simona G. Marchesi (data manager) Paola Serafin (coordinator), Adriana Blanco, Salvatore Bonafede, Annateresa Bugada, Morena De Santis, Milda Di Giacomo, Angela Mihaela Farcas, Stefania Fici, Francesca Maiorano, Antonella Masiello, Monica Mitarotonda, Nadia Nicoletti, Patrizia Perotto Ghi, Patrizia Rota, Rossina Sitta, Stefania Sperandio, Cristina Stracquadaini, Patrizia Valentini Nicoletta Damiani, Rosa De Felice, Mariangela Lopriore, Annamaria Pancari, Angela Restaini, Enza Spina, Anna Vecchio COLORECTAL SURGERY Ermanno Leo, MD Dario Baratti, MD; Luigi Battaglia, MD; Filiberto Belli, MD; Giuliano Bonfanti, MD; Alessandro Cesa Bianchi, MD; Marcello Deraco, MD; Shigeki Kusamura, MD, PhD; Marco Vitellaro, MD Residents Marcello Guaglio, MD; Mario Moschita, MD; Giovanni Piscitelli, MD; Vincenzo Pruiti, MD; Monica Zisa, MD Roberta Aceto Fabiana Bettoni, Lucia Caracciolo, Rut Cittadin, Angela Colamonaco, Stefania Labori, Magdalena-Alonso Manuel, Marica Melis, Vanessa Neri, Palma, Mirtha Ybazeta Ramos, Riccardo Vacca Monica Anzaghi, Isabella Damasi, Nunzia Di Perna, Fabio Lizzano, Maria Petrosina BREAST SURGERY Roberto Agresti, MD (until 30 November) Marco Greco, MD (since 1 December) Silvia Bohm, MD; Alberto Rudy Conti, MD; Cristina Ferraris, MD; Massimiliano Gennaro, MD; Maria Ilaria Grosso, MD; Gabriele Martelli, MD; Cristina Pellitteri MD (until 30 November); Domenico Piromalli, MD, Gianbattista Spatti MD Research Fellows Mario Rampa, MD; Alessandra Moscaroli, MD (until August 30th), Ilaria Maugeri, MD 29

SCIENTIFIC REPORT 2013 back to contents Angela Allegri Irene Alessandrini, Giovanni Cavaliere, Miriam P. Conti, Stefano Licata, Bruna Nuscis, Maria C. Puddu, Michele Rossello, Gelsomina Sasso, Francesco A. Spagnolo, Liliane Venafra Maria C. Fadda, Luigi Magnifico, Caterina Pianu MELANOMA AND SARCOMA Mario Santinami, MD Melanoma Francesco Gallino, MD; Andrea Maurichi, MD; Daniele Moglia, MD; Roberto Patuzzo, MD; Roberta Ruggeri, MD Surgery of Sarcoma Alessandro Gronchi, MD (); Marco Fiore, MD; Chiara Colombo, MD, Stefano Redaelli, MD Research Staff Valentina Girgenti, MD; Roberto Grillo, MD; Elena Tolomio, MD Residents Consuelo Barbieri, MD; Federica Marazza, MD Antonella Vescera Data Managers Annabella Di Florio, Adele Di Fazio, Giulia Bonarini Research Nurse Gabriella Nicolò and Giovanna Lomartire (coordinator), Nicola Abatangelo, Roberta Allenza, Annamaria Biondo, Sonia Cappellini, Annarita Carluccio, Alessio Cremonesi, Nello Curatolo, Floarea Dorca, Loridana Marino, Silvana Mirante, Erica Panigada, Giusy Pede, Lucia Preto, Esther Reinoso Crespo, Francesca Ruiu, Claudia Sonzogni, Antonella Tomasicchio, Monica Ullio, Addolorata Volpe DIAGNOSTIC ENDOSCOPY AND ENDOSCOPIC SURGERY Emanuele Meroni, MD Giovanni Ballardini, MD; Giuseppe Calarco, MD; Gabriele Delconte, MD; Gianfranco Di Felice, MD; Massimo Falsitta, MD; Andrea Mancini, MD Vittorio Mauro (coordinator), Francesco Bottani, Raffaele Calò, Roberto Fiocco, Daniele Lo Curcio, Francesca Mannai, Giovanni Sammartino, Raffaele Quagliolo Silvia Cara, Rosanna Loi, Salvatore Morfeo Concetta Di Quattro, Annamaria Mercuri OTOLARYNGOLOGY SURGERY Gabriele Scaramellini, MD Roberto Bianchi, MD; Sarah Colombo, MD; Walter Fontanella, MD; Marco Guzzo, MD; Tullio M. Ibba, MD, PhD; Natalia R. E. Pizzi, MD; Madia Pompilio, MD; Stefano Riccio, MD Vincenzo Spanò (coordinator), Giovanna V. Bello, Petronilla D Agostino, Elena Cotellessa, Angelo Di Caro, Giorgio Fumi, Giorgio Inverni, Carmen Minio, Rosita A. Nanna, Laura Ongari, Daniele Pezzera, Francesca Pisano, Federica Prudenzano, Raffaella Repetto, Maura Rimoldi, Maria S. Selva Pablita Endaya, Vincenzo Marotta, Giuseppe Messana, Laura Somma Sabrina Zazzera GYNECOLOGIC ONCOLOGY Francesco Raspagliesi, MD Antonino Ditto, MD; Rosanna Fontanelli, MD; Barbara Grijuela, MD; Domenica Lorusso, MD; Marina Merola, MD; Andrea Papadia, MD; Eugenio Solima, MD; Flavia Zanaboni, MD Research Fellows Fabio Martinelli, Stefano Ramondino, Maria Mancini, Italo Sarno Patricia A. Costa, Alice Casali, Francesco Crugliano, Floriana Dimo, Lorenza Greco, Eva Guitti, Antonio Micello, Marianna Miranda, Claudio Oppido, Rossana Penasa, Ylenia Ponti, Paolo Re, Patrizia Valente Health Care Assistants Rosa Farro, Alessia Formicola, Natalia Munante, Cecilia Muzzupappa Cinzia Marretta, Rosella Zennoni, Stefano Ramondino, Maria Mancini, Italo Sarno THORACIC SURGERY Ugo Pastorino, MD Andrea Billè, MD, PhD student; Leonardo Duranti, MD, PhD student; Riccardo Giovannetti, MD; Francesco Leo, MD, (until March 2013); Paolo Scanagatta, MD; Luca D. Tavecchio, MD Fellows Giuseppe Garofalo, MD; Mara Gisabella, MD; Stefano Sestini, MD Resident Lara Girelli, MD Federica Pirovano (coordinator), Brice Atiomeguim, Francesco Auletta, Marcella Bernardo, Claudia Costa, Yesica Del Rio Mendez, Antonino De Vita, Raffaele Di Nino, Margherita Fersurella, Hilda A. Martinez, Daniele Marino, Maria L. Quitadamo, Anna M. Panareo, Antonio Pantano, Antonella Prete, Antonino Proto 30

clinical-scientific departments Oss Nekpen Eguavoen, Angela Di Luglio, Diego Risuglia, Svitlana Shulzhenko, Pamela K. Soto Fernandez Tiziana Negri (Unit secretary) Research Staff Elena Bertocchi (Research Coordinator) Anna Maria Calanca, Carolina Ninni (Scientific secretaries), Claudio Jacomelli (Informatics); Paola Suatoni (Biol Sci D) External Collaborator Nicola Sverzellati (Radiologist) PLASTIC AND RECONSTRUCTIVE SURGERY Maurizio B. Nava, MD Novella Bruno, MD; Pierfrancesco Cadenelli, MD; Umberto Cortinovis, MD; Joseph Ottolenghi, MD; Angela E. Pennati, MD; Egidio Riggio, MD; Andrea Spano, MD Maria Saracino (coordinator), Samantha F. Castelli, Cinzia Gentilini, Giusppe L Abbate, Marisa Labò, Giovanna Melia, Caterina Pireddu, Irene Rossi, Raffaella Tupputi Nadia Casati, Provvidenza Peci, Nomi Ibazeta Ramos, Iolanda Panipucci, Annunziata Rugolo Luisa Morandi UROLOGIC SURGERY Roberto Salvioni, MD Davide Biasoni, MD; Mario A. Catanzaro, MD; Alessandro Crestani, MD (Fellow, University of Padua School of Urology); MD; Elena Farè, MD (Fellow, University of Milan School of Medicine); Patrizia Giannatempo, MD (Resident, Department of Medical Oncology, Medical Oncology Unit 2); Andrea Guttilla, MD (Fellow, University of Padua School of Urology); Massimo Maffezzini, MD; Andrea Necchi, MD (Faculty, Department of Medical Oncology, Medical Oncology Unit 2); Daniele Raggi, MD (Fellow, University of Milan School of Medicine); Silvia Stagni, MD; Tullio Torelli, MD Testicular Cancer Surgery Nicola Nicolai, MD (Coordinator) Pediatric Surgery Luigi Piva, MD (Coordinator) Graziella Russo (coordinator), Rosanna Candigliota, Maria L. Cennamo, Anna M. Cercaci, Zino Ferro, Francesca Marelli, Lucia Mesiano, Arturo Monetta, Valentina Musarò, Giuseppa Napoli, Veronica P. Rojas, Annalisa Simone, Raffaella Rossi, Rita Sciancalepore Maria G. Bodini Elena Cristiani, De La Cruz, Velesmoro Rocio Del Pilar, Olimpia Liberatore, Anna Mastroianni, Isabella Vurchio, LASER THERAPY Anna Colombetti, MD Silvia Aiello, MD; Mario Z. Raso, MD Maria Saracino (coordinator), Emilia D Arrigo Healthcare Assistant Domenica Lo Prete M. Rosaria Aceto DAY SURGERY Aldo E. Bono, MD Giovanna R. Colaci, Mariangela Lena, Mara D. Luisoni, Pina P. Mele, Anna Picciallo, Domenica Violi, Marina Zocchi Antonella Bordoni, Silvia Cara, Rosa Selvati Maria R. Bignamini, Anna Corella, Loredana Orezzi FOR MORE INFORMATION ABOUT THE UNITS, VISIT US ONLINE AT WWW.ISTITUTOTUMORI.MI.IT 31