Davide Ferrari

I’m going to halve my publication output. You should consider slow science, too nature.com/articles/d4158…

🆕🗞️ A Vaccine💉for cancer🦀interception. A preventative approach aiming to reduce cancer incidence by targeting precancers and early-stage cancers. For patients with Lynch syndrome. Out @NatureMedicine📰 Paradigm↩️intervene early✅ #Cancer @OncoAlert nature.com/articles/s4159…

Is it sexy? No. Is it incredibly important for how we treat patients? Absolutely 🧠🧬 For over 20 years, 6 months of oxaliplatin plus a fluoropyrimidine has been the default for stage III colon cancer, and often high-risk stage II and rectal cancer. The cost has always been cumulative neuropathy that can follow patients for life ⚡️🖐️ The SCOT trial, the largest study in the IDEA collaboration, gives us long-term clarity with nearly 6,100 patients and more than 6 years of follow-up: 📊 5-yr DFS identical with 3 vs 6 months: 72.9% vs 72.9% 📈 5-yr OS identical: 82.4% vs 82.4% ✅ Noninferiority for OS formally met for 3 months Where this really matters clinically: 🟢 CAPOX clearly supports 3 months 🟢 Low-risk stage III shows no OS penalty 🟡 Even high-risk disease sees only tiny absolute OS differences ⚠️ Meanwhile, neuropathy nearly doubles when oxaliplatin is extended to 6 months. Many patients pay a lifelong price for minimal benefit. SCOT also uniquely included rectal cancer patients treated with upfront surgery, and here too, 3 months held up. This fits perfectly with modern TNT strategies 🧩 Takeaway: This isn’t flashy, but it’s foundational. For most patients with localized colon or rectal cancer, 3 months of adjuvant CAPOX is enough. Six months should be the exception, not the rule, and always a shared decision 🤝 Sometimes the most important advance is knowing when to stop. @OncoAlert @TheGutOncLab #GI26 ascopubs.org/doi/pdf/10.120…

Does organ preservation after cCR with TNT🧨 affect distant metasases rate in rectal ca? Results of NO-CUT🚫🔪trial @TheLancetOncol show 26% of pMMR/MSS pts achieve cCR and distant RFS 95% in nonop group vs 74% SOC @OHSUKnight @tsikitis @HKennecke sciencedirect.com/science/articl…

Ten steps towards better perioperative intravenous fluid therapy ➡️ doi.org/10.1093/bjs/zn… 💧 IV fluids are drugs — both deficit and overload worsen outcomes, yet perioperative prescribing is often overlooked and delegated to juniors 🩺 The paper stresses ABCDE assessment and clear indication (resuscitation, replacement, maintenance), plus better pre-op hydration with “SipTilSend” ⚖️ Intraoperatively, it advocates balanced crystalloids over 0.9% saline, low-rate background infusions, and goal-directed boluses to avoid salt–water overload 🩸 For bleeding, early 1:1:1 blood product transfusion is advised 🥤 Post-op care focuses on tailored maintenance (≤2–2.5 L/day), early oral intake, and aiming for near-zero or negative fluid balance to reduce complications Work by Michael Ess, Dileep N Lobo @DL08OMD #SoMe4Surgery #MedTwitter #SurgEd #Surgery @RCPSGTrainees @aecirujanos @SEIQuirurgica @iss_sic #MedicalTechniques @BJSAcademy @young_bjs @BJSOpen @des_winter @evanscolorectal @robhinchliffe1 @bplwijn @MalinASund @nfmkok @TejedorPat @paulo_sutt @PVaughanShaw @JJEarnshaw @juliomayol @ksoreide #some4hpb #some4tpl @DPCG_official @pancreatitis_nl @PancreasClub #PancreasClub2023 #PancreaticCancer #Pancreatitis #HCC @PanCAN#PanCANawareness @EurPancClub @P_C_E_ @dice_europe #PancreaticCancer#cholangiocarcinoma #colorectalsurgery #StepUp4CRC @FightCRC @ACPGBI #ERAS @dice_europe #Crohn #proctology @Dukes_Club @ACPGBI_EduTrain @AECP_FAECP @PelvExGroup @escp_tweets @YouESCP #TeachMeColoproctology #Some4COLoprocto

🧠 You can shrink the tumour—but not the tumour bed. New RAPIDO analysis in BJS 2025 shows why small margins after TNT can turn dangerous 👇 💡 Trial: RAPIDO (n = 920, LARC) 🎯 TNT = 5×5 Gy + 6 CAPOX / 9 FOLFOX → TME vs CRT = 25–28×1.8–2 Gy + capecitabine → TME 📊 8-year results: • LRR 10.8% (TNT) vs 5.8% (CRT) → HR 1.91 • Spike seen only after sphincter-preserving surgery (SPS)  → 12.1% (TNT) vs 4.8% (CRT) (HR 2.6) • 🚨 If distal margin ≤ 10 mm → 25.4% (TNT) vs 1.8% (CRT) 💥 (HR 15.5) 🔍 Why? TNT causes tumour shrinkage but leaves scattered viable cells in the original tumour bed. ✂️ Cutting “too close” (<1 cm) may slice through microscopic disease → higher local recurrence. 🇸🇪🇳🇱 Geography tells the story: Sweden = more APR → no difference Netherlands = more SPS & tight margins → higher TNT LRR 🩻 Takeaway: TNT reduces distant mets ✅ but may raise local relapse if DRM ≤ 1 cm ⚠️ ➡️ Surgeons must factor in baseline tumour bed, not just post-TNT shrinkage. 📖 Prata I et al. Br J Surg 2025 🔗 doi.org/10.1093/bjs/zn… #OncoTwitter #ColorectalCancer #RectalCancer #RadOnc #Surgery @OncoAlert @esmo_open @BJSurgery @myESMO

Is Minimally Invasive Surgery at an Inflection Point? facs.org/for-medical-pr…

#Rise of the #Robots 🦾 in the Netherlands 🇳🇱 GI surgery @AnnalsofSurgery 😳 How does this compare to your country? Data? Nationwide use 🦾 per organ among 77,361 resections (2014-2023): ✅ pancreas 1% to 33% ✅ thoracic 3% to 11% ✅ colon 6% to 14% ✅ rectum 19% to 45% ✅ liver 10% to 25% ✅ esophageal 33% to 40% ↔️ gastric 19% to 19% ⏩️ journals.lww.com/annalsofsurger…

Interesting paper questioning the need for routine type and screen by @KhanSidrah786 from her year at @MayoClinicSurg colorectal surgery fellowship

Which pts undergoing elective colorectal resections need a preop type & screen? Find out exclusively in #DCRJournal: bit.ly/4fZIeIX

RA-CUSUM charts offer a powerful tool to track surgeon performance in rectal cancer cases—spotting trends in complications, operative time, and outcomes in real time. journals.lww.com/annalsofsurger…

This study shows how RA-CUSUM can identify high and low outliers in robotic rectal surgery—offering a data-driven path to continuous surgical improvement. journals.lww.com/annalsofsurger…

For the 36th consecutive year since U.S. News & World Report launched its "Best Hospitals" rankings, Mayo Clinic again ranks at the top of the 2025–2026 list. Read more: mayocl.in/4716aJm

For dMMR colon cancer, FOLFOX + atezolizumab per ATOMIC is now incorporated into the NCCN Guidelines. @MayoCancerCare @ALLIANCE_org @ASCOPost @CCAlliance @RueschCenter @FightCRC

Great work team @JyiChengNg @RichardSassun @AnnaclaraS65 @MayoClinic @MayoCancerCare @MayoClinicSurg

Vacation: #sailing with Capt Marco in #Sardinia fantastic water, beaches, mountains, food and Friends. @DFerrariMD @RichardSassun @tommyv1992 @EricaCento

Safe Same-Day and Short-Stay Stoma Closures Revolutionize Care by Ferrari D, Violante T (...) Larson DW et 7 al. in J Gastrointest Surg 🪡 read our summary 👉 stitches.today/2025/06/10/saf… 📖 read the article: sciencedirect.com/science/articl…

Spectacular wedding of Roberta and Tommaso in #sardinia. To my friend and colleague may your marriage be blessed and your new surgical practice in Bologna equally blessed. Love and respect to @tommyv1992 @DFerrariMD @EricaCento @AnnaclaraS65 @RichardSassun

Game-changer at #ASCO25 🔥 Pre-plenary press release!! ATOMIC is the most important adjuvant study yet for MSI-H colon cancer—and it’s practice-changing. 🧬 Stage III dMMR colon cancer 🧪 Atezolizumab + mFOLFOX6 vs mFOLFOX6 alone 💥 3-yr DFS: 86.4% vs 76.6% ⚖️ HR 0.50 | p < .0001 Across subgroups, benefit was consistent. Toxicity was manageable. Immunotherapy has arrived in the adjuvant setting! MSI-H colon cancer now has a new standard overnight. ❓ But do all patients still need chemo? @ASCO @OncoAlert @JCO_ASCO @oncoalert @oncbrothers 🎙️ Featured Voices: @yekeduz_emre @DRBakaloudiMD @AndreaAnampaG @ReginaBarCar @cwspeers @FunchainMD @MKnoll_MD @bavilima @KrishanJethwa @cancerassassin1 @ReneeSaliby @MikeSerzanMD @OncBrothers @coloncancergal @ShannonWestin @SuyogCancer @supriyadocc @UGrewalMD @coffeemommy @RyanNipp @realbowtiedoc @crisbergerot

If this were a pill, we’d call it revolutionary. It would headline plenaries, get FDA priority review, and cost $10,000 a month. Instead—it’s structured exercise. 🆕 NEJM June 2025 | CHALLENGE Trial Stage II–III colon cancer patients post-chemo (n=889) 📦 RCT of 3 years of supervised aerobic activity vs health education 🕒 Median follow-up: 7.9 years Primary Endpoint: Disease-Free Survival ✅ HR 0.72 (95% CI: 0.55–0.94), p=0.02 ➡️ 5-yr DFS: 80.3% vs 73.9% Overall Survival ✅ HR 0.63 (95% CI: 0.43–0.94) ➡️ 8-yr OS: 90.3% vs 83.2% Other takeaways: 🔻 Lower liver recurrence (3.6% vs 6.5%) 🔻 Fewer new primaries (5.2% vs 9.7%) 💪 Gains in fitness, QoL, and physical function ⚠️ Mild MSK toxicity more common (18.5% vs 11.5%) A major win for survivorship—and for rethinking what “treatment” means. Dr. Chris Booth and colleagues move the field forward. #ASCO25 @ASCO @OncoAlert @JCO_ASCO @oncbrothers 🎙️ Featured Voices: @yekeduz_emre @DRBakaloudiMD @AndreaAnampaG @ReginaBarCar @cwspeers @FunchainMD @MKnoll_MD @bavilima @KrishanJethwa @cancerassassin1 @ReneeSaliby @MikeSerzanMD @OncBrothers @coloncancergal @ShannonWestin @SuyogCancer @supriyadocc @UGrewalMD @coffeemommy @RyanNipp @realbowtiedoc @crisbergerot