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The 16, members of the notorious Casalesi clan, were appealing against life sentences handed down in 2005.
The original trial was among the biggest in Italian history, lasting a total of seven years.
Clan leader Francesco Schiavone was nicknamed Sandokan, the name of a fictional pirate, because of his beard.
The prosecutor general welcomed the verdict.
"The bulk of the original sentence has been confirmed," Francesco Iacone said.
"I remind you that first time round the Spartacus case lasted seven years," he added.
During the first trial, the court handed down a total of 21 life sentences and 95 other sentences with a combined total prison sentence of more than 800 years, Italian newspaper Corriere del Mezzogiorno reports.
Schiavone, considered one of Italy's most-wanted fugitives, was arrested in Naples in 1998 after more than two years on the run.
Investigators said he was behind one of the bloodiest clan wars of recent decades, which left dozens of people dead.
(BBC)
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