LEANDRO CARDOSO BARCHI
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- Developing the surgical technique reporting checklist and standards: a study protocol(2021) ZHANG, Kaiping; MA, Yanfang; SHI, Qianling; WU, Jinlin; SHEN, Jianfei; HE, Yulong; ZHANG, Xianzhuo; JIAO, Panpan; LI, Grace S.; TANG, Xueqin; PETERSEN, Rene Horsleben; NG, Calvin S. H.; FIORELLI, Alfonso; NOVOA, Nuria M.; BEDETTI, Benedetta; SANDRI, Giovanni Battista Levi; HOCHWALD, Steven; LERUT, Toni; SIHOE, Alan D. L.; BARCHI, Leandro Cardoso; GILBERT, Sebastien; WASEDA, Ryuichi; TOKER, Alper; GONZALEZ-RIVAS, Diego; FRUSCIO, Robert; SCARCI, Marco; DAVOLI, Fabio; PIESSEN, Guillaume; QIU, Bin; WANG, Stephen D.; CHEN, Yaolong; GAO, ShugengBackground: Standardized and transparent reporting of surgical technique is the cornerstone of effective dissemination, implementation and improvement. However, current reporting of surgical techniques is inadequate. The existing guidelines potentially applied to guide surgical technique reporting are with a minimal highlight of the surgical technique, lack requirements explaining what extent and dimensions need to be described in detail, or are unlikely to extrapolate to a wide range of surgical techniques. This study aims to formulate a rigorous protocol to develop a surgical technique reporting checklist and standards (SUPER) that defines what a clear, comprehensive and detailed surgical technique report should be contained. Methods: This protocol is designed following the classic guidance for developing reporting guidelines recommended by the EQUATOR network. Results: The development team will consist of surgeons (similar to 80%), methodologists, and journal editors. The draft checklist sources will include a scoping review of existing reporting guidelines related to surgical technique, surgical technique articles from 15 top journals published in the last year, and brainstorming by the multidisciplinary development team. The final SUPER checklist will be formed after three rounds of Delphi surveys, one round of face-to-face meeting, and a month-long pilot test. The SUPER checklist will be published as open-access and be used in combination with existing reporting guidelines related to surgical techniques (e.g., IDEAL). This protocol will steer the SUPER checklist's development, allowing us to further elaborate surgical technique reporting for all surgical specialties, and enabling a more favorable experience for surgeons, nurses, medical students, residents, editors, and reviewers.
- Development and Validation of a Nomogram for Early Detection of Malignant Gallbladder Lesions(2019) CHEN, Mingyu; CAO, Jiasheng; BAI, Yang; TONG, Chenhao; LIN, Jian; JINDAL, Vishal; BARCHI, Leandro Cardoso; NADALIN, Silvio; YANG, Sherry X.; PESCE, Antonio; PANARO, Fabrizio; ARICHE, Arie; KAI, Keita; MEMEO, Riccardo; BEKAII-SAAB, Tanios; CAI, XiujunOBJECTIVES: Preoperative decision-making for differentiating malignant from benign lesions in the gallbladder remains challenging. We aimed to create a diagnostic nomogram to identify gallbladder cancer (GBC), especially for incidental GBC (IGBC), before surgical resection. METHODS: A total of 587 consecutive patients with pathologically confirmed gallbladder lesions from a hospital were randomly assigned to a training cohort (70%) and an internal validation cohort (30%), with 287 patients from other centers as an external validation cohort. Radiological features were developed by the least absolute shrinkage and selection operator logistic regression model. Significant radiological features and independent clinical factors, identified by multivariate analyses, were used to construct a nomogram. RESULTS: A diagnostic nomogram was established by age, CA19.9, and 6 radiological features. The values of area under the curve in the internal and external validation cohorts were up to 0.91 and 0.89, respectively. The calibration curves for probability of GBC showed optimal agreement between nomogram prediction and actual observation. Compared with previous methods, it demonstrated superior sensitivity (91.5%) and accuracy (85.1%) in the diagnosis of GBC. The accuracy using the nomogram was significantly higher in GBC groups compared with that by radiologists in the training cohort (P< 0.001) and similarly in each cohort. Notably, most of the IGBC, which were misdiagnosed as benign lesions, were successfully identified using this nomogram. DISCUSSION: A novel nomogram provides a powerful tool for detecting the presence of cancer in gallbladder masses, with an increase in accuracy and sensitivity. It demonstrates an unprecedented potential for IGBC identification.
- Predicting recurrence after curative resection for gastric cancer: External validation of the Italian Research Group for Gastric Cancer (GIRCG) prognostic scoring system(2016) BARCHI, L. C.; YAGI, O. K.; JACOB, C. E.; MUCERINO, D. R.; RIBEIRO JR., U.; MARRELLI, D.; ROVIELLO, F.; CECCONELLO, I.; ZILBERSTEIN, B.Background: Most nomograms for Gastric Cancer (GC) were developed to predict overall survival (OS) after curative resection. The Italian Research Group for Gastric Cancer (GIRCG) prognostic scoring system (PSS) was designed to predict the recurrence risk after curative treatment based on pathologic tumor stage and treatment performed (D1 D2/D3 lymphadenectomy). This study was carried out to externally validate the GIRCG's PSS. Patients and methods: Adopting the same criteria used by GIRCG to build the PSS, 185 patients with GC operated with curative intention were selected. The median follow-up period was 77.8 months (1.93-150.8) for all patients and 102.5 months (60.9-150.8) for patients free of disease. The NRI (net reclassification improvement) was calculated to estimate the overall improvement in the reclassification of patients using the PSS in place of the TNM stage system. Results: GC recurrence occurred in 70 (37.8%) patients. The mean time to recurrence was 22.2 (range 1.9-98.1) months. For patients with recurrence, the gain in the proportion of reclassification was 0.257 (p < 0.001), indicating an improvement of 26%. For patients without recurrence, the gain in the proportion of reclassification was 0.122 (p < 0.001), indicating a worsening of 12%. The NRI calculated was 0.135 (p = 0.0527). Conclusion: The GIRCG's PSS, which predicts the likelihood of recurrence after radical surgical treatment for GC, is more accurate than TNM system to predict recurrence mainly for high-risk patients. Yet, the PSS does not have the same effectiveness for low-risk patients, overestimating the chance of recurrence occurs even for disease-free patients.