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  1. Article ; Online: Impact of colorectal cancer screening on incidence, mortality and surgery rates: Evidences from programs based on the fecal immunochemical test in Italy.

    Zorzi, Manuel / Urso, Emanuele Damiano Luca

    Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver

    2022  Volume 55, Issue 3, Page(s) 336–341

    Abstract: Fecal immunochemical tests (FIT) are among the most commonly used tests for colorectal cancer (CRC) screening programs worldwide. However, no randomised controlled trials have been carried out evaluating the impact of FIT-based screening programs (FIT- ... ...

    Abstract Fecal immunochemical tests (FIT) are among the most commonly used tests for colorectal cancer (CRC) screening programs worldwide. However, no randomised controlled trials have been carried out evaluating the impact of FIT-based screening programs (FIT-progr) on CRC incidence and mortality rates. Italian FIT-progr represent one of the most widespread and established experience worldwide. This paper reviews the evidence on the impact of FIT-progr on CRC incidence, tumor stage at diagnosis, mortality and surgery rates, deriving from Italian routine programs, i.e., outside the research setting. Unfortunately, the application of FIT-progr in Italy can be considered as an unplanned experimental model, due to the differences between Regions, both in health system management and adherence of the target population to the screening programs. The analysis of the manuscripts considered in the review, confirms that FIT-progr are effective in reducing CRC incidence and mortality rates and in improving the rate of endoscopic treatment of early invasive lesions. The review also highlights that FIT-progr are less performing for proximal colon than for distal colon and rectum.
    MeSH term(s) Humans ; Incidence ; Early Detection of Cancer ; Colorectal Neoplasms/diagnosis ; Colonoscopy ; Mass Screening ; Occult Blood ; Italy/epidemiology ; Feces
    Language English
    Publishing date 2022-08-21
    Publishing country Netherlands
    Document type Journal Article ; Review
    ZDB-ID 1459373-7
    ISSN 1878-3562 ; 1125-8055
    ISSN (online) 1878-3562
    ISSN 1125-8055
    DOI 10.1016/j.dld.2022.08.013
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  2. Article: Isoperistaltic Jejunal Loop Interposition after Total Gastrectomy for Gastric Cancer in Patients with Familial Adenomatous Polyposis.

    Zuin, Matteo / Celotto, Francesco / Pucciarelli, Salvatore / Urso, Emanuele Damiano Luca

    Journal of gastric cancer

    2020  Volume 20, Issue 2, Page(s) 225–231

    Abstract: Gastric cancer is a rare condition affecting patients with familial adenomatous polyposis (FAP). The mainstay of treatment is total gastrectomy. Since duodenal cancer is the most common cause of death after total colectomy in FAP, endoscopic surveillance ...

    Abstract Gastric cancer is a rare condition affecting patients with familial adenomatous polyposis (FAP). The mainstay of treatment is total gastrectomy. Since duodenal cancer is the most common cause of death after total colectomy in FAP, endoscopic surveillance for duodenal cancer is mandatory. Here, we describe the use of an isoperistaltic jejunal loop interposition technique to reconstruct the digestive tract after total gastrectomy in 2 patients with FAP. There were no early or late complications. Both patients are still alive and in good clinical condition. They did not experience weight loss or symptoms of dumping syndrome. Duodenal endoscopic surveillance after this technique was easier than after the classical Roux-en-Y reconstruction. Hence, regular follow-up was possible for both patients.
    Language English
    Publishing date 2020-04-13
    Publishing country Korea (South)
    Document type Case Reports
    ZDB-ID 2637180-7
    ISSN 2093-5641 ; 2093-582X
    ISSN (online) 2093-5641
    ISSN 2093-582X
    DOI 10.5230/jgc.2020.20.e16
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  3. Article ; Online: Biallelic

    Pedroni, Monica / Ponz de Leon, Maurizio / Reggiani Bonetti, Luca / Rossi, Giuseppina / Viel, Alessandra / Urso, Emanuele Damiano Luca / Roncucci, Luca

    Genes

    2022  Volume 13, Issue 11

    Abstract: We describe a patient with constitutional mismatch repair-deficiency (CMMR-D) in whom the syndrome started at age 10 with the development of multiple adenomas in the large bowel. In the successive 25 years, four malignancies developed in different organs ...

    Abstract We describe a patient with constitutional mismatch repair-deficiency (CMMR-D) in whom the syndrome started at age 10 with the development of multiple adenomas in the large bowel. In the successive 25 years, four malignancies developed in different organs (rectum, ileum, duodenum, and lymphoid tissue). The patient had biallelic constitutional pathogenic variants in the
    MeSH term(s) Male ; Humans ; Mismatch Repair Endonuclease PMS2/genetics ; DNA Repair Enzymes/genetics ; Adenosine Triphosphatases/genetics ; DNA-Binding Proteins/genetics ; Neoplastic Syndromes, Hereditary/genetics ; Microsatellite Instability
    Chemical Substances Mismatch Repair Endonuclease PMS2 (EC 3.6.1.3) ; DNA Repair Enzymes (EC 6.5.1.-) ; Adenosine Triphosphatases (EC 3.6.1.-) ; DNA-Binding Proteins ; PMS2 protein, human (EC 3.6.1.-)
    Language English
    Publishing date 2022-10-26
    Publishing country Switzerland
    Document type Case Reports
    ZDB-ID 2527218-4
    ISSN 2073-4425 ; 2073-4425
    ISSN (online) 2073-4425
    ISSN 2073-4425
    DOI 10.3390/genes13111953
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  4. Article: Rectal Sparing Approaches after Neoadjuvant Treatment for Rectal Cancer: A Systematic Review and Meta-Analysis Comparing Local Excision and Watch and Wait.

    Bao, Quoc Riccardo / Ferrari, Stefania / Capelli, Giulia / Ruffolo, Cesare / Scarpa, Marco / Agnes, Amedea / Chiloiro, Giuditta / Palazzari, Elisa / Urso, Emanuele Damiano Luca / Pucciarelli, Salvatore / Spolverato, Gaya

    Cancers

    2023  Volume 15, Issue 2

    Abstract: Local Excision (LE) or Watch and Wait (WW) for patients with complete clinical response or near-complete clinical response after neoadjuvant chemoradiotherapy (nCRT) were proposed to avoid morbidity and impairment of quality of life after rectal ... ...

    Abstract Local Excision (LE) or Watch and Wait (WW) for patients with complete clinical response or near-complete clinical response after neoadjuvant chemoradiotherapy (nCRT) were proposed to avoid morbidity and impairment of quality of life after rectal resection. The aim of this study is to perform a systematic review of the literature, and to compare rectal-sparing approaches, in terms of rectum-preservation rate, local control, and distant recurrences. A systematic review and meta-analysis were performed of studies published until July 2022 (PROSPERO, registration CRD42022341480), and the quality of evidence was assessed using a GRADE approach. Seven retrospective studies and one prospective trial were included. In six studies, patients were treated with standard long-course nCRT, and in two with Total Neoadjuvant Therapy (TNT). Overall, there were 213 and 188 patients in WW and LE group, respectively, and no difference was found between WW and LE when considering rectum-preservation rate (OR 0.80 95%CI 0.31-2.01,
    Language English
    Publishing date 2023-01-11
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2527080-1
    ISSN 2072-6694
    ISSN 2072-6694
    DOI 10.3390/cancers15020465
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  5. Article ; Online: Association between Pancreatoblastoma and Familial Adenomatous Polyposis: Review of the Literature with an Additional Case.

    Remo, Andrea / Negro, Silvia / Bao, Riccardo Quoc / d'Angelo, Edoardo / Alaggio, Rita / Crivellari, Gino / Mammi, Isabella / Intini, Rossana / Bergamo, Francesca / Fassan, Matteo / Agostini, Marco / Vitellaro, Marco / Pucciarelli, Salvatore / Urso, Emanuele Damiano Luca

    Genes

    2023  Volume 15, Issue 1

    Abstract: Background: Adult pancreatoblastoma (PBL) is a rare pancreatic malignancy, with recent evidence suggesting a possible link to familial adenomatous polyposis (FAP). This study aims to review the latest evidence and explore a possible association between ... ...

    Abstract Background: Adult pancreatoblastoma (PBL) is a rare pancreatic malignancy, with recent evidence suggesting a possible link to familial adenomatous polyposis (FAP). This study aims to review the latest evidence and explore a possible association between adult PBL and FAP.
    Methods: Two independent literature reviews were conducted: (1) on PBL and FAP, and (2) on PBL in the adult population not diagnosed with FAP.
    Results: Out of 26 articles on PBL and FAP screened, 5 were selected for systematic review, including 1 additional case. We identified eight FAP-related PBL cases, with a median age of 40 (IQR: 34-50). Of these, seven (87%) occurred in adults. We found 65 cases of adult PBL not FAP-related; thus, 7 out of 65 cases (10.7%) of adult PBL reported in the literature are associated with a clinical diagnosis of FAP or were carriers of
    Conclusion: Data suggest a non-random association between adult PBL and FAP. Further research is essential to optimise surveillance protocols and develop more effective treatment strategies.
    MeSH term(s) Adult ; Humans ; Adenomatous Polyposis Coli/genetics ; Germ-Line Mutation ; Pancreatic Neoplasms/epidemiology ; Pancreatic Neoplasms/genetics
    Language English
    Publishing date 2023-12-27
    Publishing country Switzerland
    Document type Review ; Case Reports
    ZDB-ID 2527218-4
    ISSN 2073-4425 ; 2073-4425
    ISSN (online) 2073-4425
    ISSN 2073-4425
    DOI 10.3390/genes15010044
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  6. Article ; Online: Robotic Resection of Giant Duodenal Hamartoma After

    Urso, Emanuele Damiano Luca / Crimì, Filippo / Rivella, Giorgio / Celotto, Francesco / Zucchetta, Pietro / Albertoni, Laura / Pucciarelli, Salvatore / Bao, Quoc Riccardo

    The American surgeon

    2021  Volume 89, Issue 4, Page(s) 1267–1270

    Abstract: Brunner's gland hamartoma is a rare duodenal lesion. Resection for benign neoplasms of the duodenum should be considered in case of malignant potential or in case of symptomatic lesions. An accurate preoperative staging is mandatory in order to allow ... ...

    Abstract Brunner's gland hamartoma is a rare duodenal lesion. Resection for benign neoplasms of the duodenum should be considered in case of malignant potential or in case of symptomatic lesions. An accurate preoperative staging is mandatory in order to allow minimally invasive surgical approach, and to avoid under- or overtreatment. Endoscopic ultrasonography (EUS), Computed tomography (CT) scan, Magnetic Resonance Imaging (MRI) and PET/CT are techniques widely used for gastrointestinal tumor staging. We report a case of a 41-year-old female presenting a giant lesion of the second portion of the duodenum. Pathological examination of multiple forceps biopsies was inconclusive for histological characterization of the lesion. After a clinical staging including Esophagusgastroduodenoscopy, EUS, and CT scan, a Hybrid
    MeSH term(s) Female ; Humans ; Adult ; Fluorodeoxyglucose F18 ; Positron Emission Tomography Computed Tomography/methods ; Robotic Surgical Procedures ; Positron-Emission Tomography/methods ; Magnetic Resonance Imaging/methods ; Hamartoma/diagnostic imaging ; Hamartoma/surgery ; Hamartoma/pathology ; Brunner Glands/pathology ; Radiopharmaceuticals
    Chemical Substances Fluorodeoxyglucose F18 (0Z5B2CJX4D) ; Radiopharmaceuticals
    Language English
    Publishing date 2021-02-19
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 202465-2
    ISSN 1555-9823 ; 0003-1348
    ISSN (online) 1555-9823
    ISSN 0003-1348
    DOI 10.1177/0003134821995071
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  7. Article: Obesity may not be related to pathologic response in locally advanced rectal cancer following neoadjuvant chemoradiotherapy.

    Bao, Quoc Riccardo / Crimì, Filippo / Valotto, Giovanni / Chiminazzo, Valentina / Bergamo, Francesca / Prete, Alessandra Anna / Galuppo, Sara / El Khouzai, Badr / Quaia, Emilio / Pucciarelli, Salvatore / Urso, Emanuele Damiano Luca

    Frontiers in oncology

    2022  Volume 12, Page(s) 994444

    Abstract: Background: The aim of this study is to evaluate the correlation between body mass index (BMI) and body fat composition (measured with radiological fat parameters (RFP)) and pathological response after neoadjuvant chemoradiotherapy for locally advanced ... ...

    Abstract Background: The aim of this study is to evaluate the correlation between body mass index (BMI) and body fat composition (measured with radiological fat parameters (RFP)) and pathological response after neoadjuvant chemoradiotherapy for locally advanced rectal cancer patients. The secondary aim of the study was to assess the role of BMI and RFP on major surgical complications, overall survival (OS), and disease-free survival (DFS).
    Methods: All patients who underwent surgical resection following nCRT between 2005 and 2017 for mid-low rectal cancer were retrospectively collected. Visceral fat area (VFA), superficial fat area (SFA), visceral/superficial fat area ratio (V/S), perinephric fat thickness (PNF), and waist circumference (WC) were estimated by baseline CT scan. Predictors of pathologic response and postoperative complications were investigated using logistic regression analysis. The correlations between BMI and radiologic fat parameters and survival were investigated using the Kaplan-Meier method and log-rank test.
    Results: Out of 144 patients included, a complete (TRG1) and major (TRG1+2) pathologic response was reported in 32 (22%) and 60 (45.5%) cases, respectively. A statistically significant correlation between BMI and all the RFP was found. At a median follow-up of 60 (35-103) months, no differences in terms of OS and DFS were found considering BMI and radiologic fat parameters. At univariable analysis, neither BMI nor radiologic fat parameters were predictors of complete or major pathologic response; nevertheless, VFA, V/S>1, and BMI were predictors of postoperative major complications.
    Conclusions: We found no associations between BMI and body fat composition and pathological response to nCRT, although VFA, V/S, and BMI were predictors of major complications. BMI and RFP are not related to worse long-term OS and DFS.
    Language English
    Publishing date 2022-09-29
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2649216-7
    ISSN 2234-943X
    ISSN 2234-943X
    DOI 10.3389/fonc.2022.994444
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  8. Article ; Online: Rectal sparing approach after preoperative radio - and/or Chemo-therapy (ReSARCh): a prospective, multicentre, observational study.

    Spolverato, Gaya / Bao, Quoc Riccardo / Delrio, Paolo / Guerrieri, Mario / Ortenzi, Monica / Cillara, Nicola / Restivo, Angelo / Deidda, Simona / Spinelli, Antonino / Romano, Carmela / Bianco, Francesco / Sarzo, Giacomo / Morpurgo, Emilio / Belluco, Claudio / Palazzari, Elisa / Chiloiro, Giuditta / Meldolesi, Elisa / Coco, Claudio / Pafundi, Donato Paolo /
    Feleppa, Cosimo / Aschele, Carlo / Bonomo, Michele / Muratore, Andrea / Mellano, Alfredo / Chiaulon, Germana / Crimì, Filippo / Maretto, Isacco / Perin, Alessandro / Urso, Emanuele Damiano Luca / Scarpa, Marco / Bigon, Mariasole / Scognamiglio, Federico / Bergamo, Francesca / Del Bianco, Paola / Gambacorta, Maria Antonietta / Rega, Daniela / Pucciarelli, Salvatore

    International journal of surgery (London, England)

    2024  

    Abstract: Background: Rectal-sparing approaches for patients with rectal cancer who achieved a complete or major response following neoadjuvant therapy constitute a paradigm of a potential shift in the management of patients with rectal cancer, however their role ...

    Abstract Background: Rectal-sparing approaches for patients with rectal cancer who achieved a complete or major response following neoadjuvant therapy constitute a paradigm of a potential shift in the management of patients with rectal cancer, however their role remains controversial. The aim of this study was to investigate the feasibility of rectal-sparing approaches to preserve the rectum without impairing the outcomes.
    Methods: This prospective, multicentre, observational study investigated the outcomes of patients with clinical stage II-III mid-low rectal adenocarcinoma treated with any neoadjuvant therapy, and either transanal local excision or watch-and-wait approach, based on tumor response (major or complete) and patient/surgeon choice. The primary endpoint of the study was rectum preservation at a minimum follow-up of two years. Secondary endpoints were overall, disease-free, local and distant recurrence-free, and stoma-free survival at three years.
    Results: Of 178 patients enrolled in 16 centres, 112 (62.9%) were managed with local excision and 66 (37.1%) with watch-and-wait. At a median (interquartile range) follow-up of 36.1 (30.6-45.6) months, the rectum was preserved in 144 (80.9%) patients. The 3-year rectum-sparing, overall, disease-free, local recurrence-free, distant recurrence-free survival was 80.6% (95%CI 73.9-85.8), 97.6% (95%CI 93.6-99.1), 90.0% (95%CI 84.3-93.7), 94.7% (95%CI 90.1-97.2), and 94.6% (95%CI 89.9-97.2), respectively. The 3-year stoma-free survival was 95.0% (95%CI 89.5-97.6). The 3-year regrowth-free survival in the watch-and-wait group was 71.8% (95%CI 59.9-81.2).
    Conclusions: In rectal cancer patients with major or complete clinical response after neoadjuvant therapy, the rectum can be preserved in about 80% of cases, without compromise the outcomes.
    Language English
    Publishing date 2024-03-21
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2212038-5
    ISSN 1743-9159 ; 1743-9191
    ISSN (online) 1743-9159
    ISSN 1743-9191
    DOI 10.1097/JS9.0000000000001322
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    Zs.A 6502: Show issues Location:
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  9. Article ; Online: Definition and management of colorectal polyposis not associated with APC/MUTYH germline pathogenic variants: AIFEG consensus statement.

    Urso, Emanuele Damiano Luca / Ponz de Leon, Maurizio / Vitellaro, Marco / Piozzi, Guglielmo Niccolò / Bao, Quoc Riccardo / Martayan, Aline / Remo, Andrea / Stigliano, Vittoria / Oliani, Cristina / Lucci Cordisco, Emanuela / Pucciarelli, Salvatore / Ranzani, Guglielmina Nadia / Viel, Alessandra

    Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver

    2021  Volume 53, Issue 4, Page(s) 409–417

    Abstract: An expert consensus panel convened by the Italian Association for Inherited and Familial Gastrointestinal Tumors (Associazione Italiana per lo Studio della Familiarità ed Ereditarietà dei Tumori Gastrointestinali, AIFEG) reviewed the literature and ... ...

    Abstract An expert consensus panel convened by the Italian Association for Inherited and Familial Gastrointestinal Tumors (Associazione Italiana per lo Studio della Familiarità ed Ereditarietà dei Tumori Gastrointestinali, AIFEG) reviewed the literature and agreed on a number of position statements regarding the definition and management of polyposis coli without an identified pathogenic mutation on the APC or MUTYH genes, defined in the document as NAMP (non-APC/MUTYH polyposis).
    MeSH term(s) Adenomatous Polyposis Coli/diagnosis ; Adenomatous Polyposis Coli/therapy ; Adenomatous Polyposis Coli Protein/genetics ; Consensus ; DNA Glycosylases/genetics ; Germ Cells ; Humans ; Italy ; Societies, Medical
    Chemical Substances APC protein, human ; Adenomatous Polyposis Coli Protein ; DNA Glycosylases (EC 3.2.2.-) ; mutY adenine glycosylase (EC 3.2.2.-)
    Language English
    Publishing date 2021-01-25
    Publishing country Netherlands
    Document type Practice Guideline ; Journal Article
    ZDB-ID 1459373-7
    ISSN 1878-3562 ; 1125-8055
    ISSN (online) 1878-3562
    ISSN 1125-8055
    DOI 10.1016/j.dld.2020.11.018
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  10. Article ; Online: Relationship between hospital volume and short-term outcomes: a nationwide population-based study including 75,280 rectal cancer surgical procedures.

    Pucciarelli, Salvatore / Zorzi, Manuel / Gennaro, Nicola / Marchegiani, Francesco / Barina, Andrea / Rugge, Massimo / Zuin, Matteo / Perin, Alessandro / Maretto, Isacco / Bergamo, Francesca / Boso, Caterina / Urso, Emanuele Damiano Luca / Frambach, Patrick / Corti, Maria Chiara

    Oncotarget

    2018  Volume 9, Issue 24, Page(s) 17149–17159

    Abstract: There is growing interest on the potential relationship between hospital volume (HV) and outcomes as it might justify the centralization of care for rectal cancer surgery. From the National Italian Hospital Discharge Dataset, data on 75,280 rectal cancer ...

    Abstract There is growing interest on the potential relationship between hospital volume (HV) and outcomes as it might justify the centralization of care for rectal cancer surgery. From the National Italian Hospital Discharge Dataset, data on 75,280 rectal cancer patients who underwent elective major surgery between 2002 and 2014 were retrieved and analyzed. HV was grouped into tertiles: low-volume performed 1-12, while high-volume hospitals performed 33+ procedures/year. The impact of HV on in-hospital mortality, abdominoperineal resection (APR), 30-day readmission, and length of stay (LOS) was assessed. Risk factors were calculated using multivariate logistic regression. The proportion of procedures performed in low-volume hospitals decreased by 6.7 percent (p<0.001). The rate of in-hospital mortality, APR and 30-day readmission was 1.3%, 16.3%, and 7.2%, respectively, and the median LOS was 13 days. The adjusted risk of in-hospital mortality (OR = 1.49, 95% CI = 1.25-1.78), APR (OR 1.10, 95%CI 1.02-1.19), 30-day readmission (OR 1.49, 95%CI 1.38-1.61), and prolonged LOS (OR 2.29, 95%CI 2.05-2.55) were greater for low-volume hospitals than for high-volume hospitals. This study shows an independent impact of HV procedures on all short-term outcome measures, justifying a policy of centralization for rectal cancer surgery, a process which is underway.
    Language English
    Publishing date 2018-03-30
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2560162-3
    ISSN 1949-2553 ; 1949-2553
    ISSN (online) 1949-2553
    ISSN 1949-2553
    DOI 10.18632/oncotarget.24699
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