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3 results on '"Pirozzi GA"'

1. Prevalence of nonpolypoid colorectal neoplasia: an italian multicenter observational study

Author

Bianco, Ma, Cipolletta, L, Rotondano, G, Buffoli, F, Gizzi, G, Tessari, F, Crotta, S, Strini, G, Orsello, M, Ballare, M, Gallo, M, Salacone, P, Asnaghi, G, Manca, A, Rizzi, R, Predebon, S, Quattrone, P, Vanni, R, Di Placido, R, Bastardini, R, Cristoni, Mv, Praiano, F, Meroni, E, Fasoli, A, Coccia, G, Allegretti, A, Manes, G, Cesari, P, Rolfi, F, Zambelli, A, Manfredi, G, Lisi, S, Cestari, R, Lancini, Gp, Crosta, C, Fiori, G, De Roberto, G, Dal Fante, M, Fazzini, L, Dinelli, M, Frego, R, Parente, F, Bargiggia, S, Paggi, S, Viale, E, Testoni, Pa, Iiritano, E, Andrian, G, Dinca, M, Germana, B, Lecis, P, Cappiello, R, Sablich, R, Tonello, C, Buri, L, Cannizzaro, R, Maiero, S, Fasoli, R, Ceroni, L, Eusebi, Lh, Iori, V, Tioli, C, Villani, V, Cortini, C, Maltoni, S, Forti, E, Solmi, L, Giovanardi, M, Calella, F, Tarantino, O, Widmayer, C, Silvestrelli, M, Bou Serhal, T, Feliciangeli, G, Tombesi, G, Anti, M, Pastorelli, A, Costamagna, G, Petruzziello, L, Cesaro, P, De Masi, E, Errico, A, Di Giulio, E, Carnuccio, A, Gabbrielli, Armando, Pandolfi, M, Lamazza, A, Femia, S, Morini, S, Lorenzetti, R, Del Vecchio Blanco, G, Grasso, E, Ferrara, M, Apuzzo, M, Iacopini, F, Milano, A, Balatsinou, C, Spadaccini, A, Silla, M, Ingrosso, M, Pirozzi, Ga, De Luca, L, De Bellis, M, Tempesta, A, De Palma GD, Siciliano, S, Di Giorgio, P, Giannattasio, F, Galloro, G, Grimaldi, E, Ciarleglio, A, Sarrantonio, G, Delle Cave, M, Lamanda, R, De Stefano, S, Labianca, O, Maisto, T, Montanaro, F, Pasquale, L, Di Girolamo, E, Piscopo, R, De Seta, M, Romano, M, Borgheresi, P, Gravina, Ag, Sarracco, P, Scaglione, G, Marmo, R, Salerno, R, Gentile, M, Annese, V, Della Valle, N, Muscatiello, N, Di Matteo, G, Giorgio, P, Fregola, G, Quatraro, F, Pisani, A, Tonti, P, Stoppino, G, Corazza, L, D'Ascoli, B, Ciuffi, M, Ignomirelli, O, Giglio, A, Rodino, S, Scanu, Am, Loriga, P, Murgia, R, Giacobbe, G, Grande, D, Montalbano, L, Linea, C., Bianco, Ma, Cipolletta, L, Rotondano, G, Buffoli, F, Gizzi, G, Tessari, F, Testoni, PIER ALBERTO, Flat Lesions Italian, Network, DE PALMA, GIOVANNI DOMENICO, Ma, Bianco, L., Cipolletta, G., Rotondano, F., Buffoli, G., Gizzi, F., Tessari, Romano, Marco, Gravina, A. G., Maria Antonia, Bianco, Livio, Cipolletta, Gianluca, Rotondano, Federico, Buffoli, Giuseppe, Gizzi, Francesco, Tessari, and Galloro, Giuseppe

Subjects
Male, medicine.medical_specialty, Colorectal cancer, Prevalence, Colonic Polyps, Colonoscopy, Colorectal Neoplasm, colonoscopy, flat lesions, colorectal neoplasia, Gastroenterology, Internal medicine, Epidemiology, medicine, Humans, Prospective Studies, Aged, Intraepithelial neoplasia, medicine.diagnostic_test, business.industry, Cancer, Histology, Middle Aged, medicine.disease, Colonic Polyp, Prospective Studie, Italy, Observational study, Female, Colorectal Neoplasms, business, Human
Abstract

BACKGROUND AND STUDY AIM: The aim of this study was to assess the prevalence of nonpolypoid lesions (NPLs) in Italy and their risk of containing neoplasia or advanced histology. PATIENTS AND METHODS: This was a multicenter cross-sectional observational study on consecutive patients undergoing total colonoscopy over a 3-month period in 80 Italian centers. RESULTS: In all, 27,400 total colonoscopies were analyzed. Cancer was diagnosed in 801 patients (2.9 %). A total of 6553 precancerous lesions were detected in 5609 patients. Of these, 4154 patients (74.1 %) had polypoid lesions and 1455 patients (25.9 %) had NPLs. Therefore, the prevalence of NPLs was 5.3 % (95 %CI 5.0 - 5.6). NPLs larger than 10 mm were detected in 254 patients (17.5 %). NPLs were more predominant in the proximal colon (OR 2.92, 95 %CI 2.56 - 3.43; P < 0.0001 vs. polypoid lesions). Neoplastic tissue was diagnosed in 79.0 % and advanced histology (high-grade intraepithelial neoplasia or more) in 20.9 % of resected lesions. The risk of advanced histology was similar for polypoid and nonpolypoid lesions when adjusted for size. Depressed lesions had the highest risk of advanced histology (OR 10.56, 95 %CI 6.02 - 18.55; P < 0.0000 vs. flat-elevated). Age was an independent predictor of both neoplasia and advanced histology ( P = 0.0001). CONCLUSIONS: NPLs are relatively common in the Italian population, with a prevalence similar to that in other Western series. NPLs are not more aggressive than polypoid lesions, except for those with depressed morphology. Georg Thieme Verlag KG Stuttgart. New York.

Published
2010

2. Early proctoscopy is a surrogate endpoint of late rectal toxicity in prostate cancer treated with radiotherapy

Author

Mariangela Massaccesi, Daniele Cuscunà, Gian Carlo Mattiucci, Giovanna Mantini, Numa Cellini, Vincenzo Valentini, Cinzia Digesù, Gabriella Macchia, Giuseppe Antonio Pirozzi, Francesco Deodato, Edy Ippolito, Marcello Ingrosso, Alessio G. Morganti, Savino Cilla, Alessandra Di Lallo, Fabio Pacelli, Ippolito E, Massaccesi M, Digesù C, Deodato F, Macchia G, Pirozzi GA, Cilla S, Cuscunà D, Di Lallo A, Mattiucci GC, Mantini G, Pacelli F, Valentini V, Cellini N, Ingrosso M, and Morganti AG

Subjects
Male, Cancer Research, medicine.medical_specialty, medicine.medical_treatment, Rectum, Adenocarcinoma, Gastroenterology, Proctoscopy, Vienna Rectoscopy Score, Rectal bleeding, Prostate cancer, Intestinal mucosa, Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, Telangiectasis, Intestinal Mucosa, Radiation Injuries, Radiation, medicine.diagnostic_test, Radiotherapy, Surrogate endpoint, business.industry, Prostatic Neoplasms, Radiotherapy Dosage, medicine.disease, Surgery, Radiation therapy, medicine.anatomical_structure, Rectal Diseases, Oncology, Toxicity, business, Gastrointestinal Hemorrhage, Late toxicity
Abstract

Purpose To predict the grade and incidence of late clinical rectal toxicity through short-term (1 year) mucosal alterations. Methods and Materials Patients with prostate adenocarcinoma treated with curative or adjuvant radiotherapy underwent proctoscopy a year after the course of radiotherapy. Mucosal changes were classified by the Vienna Rectoscopy Score (VRS). Late toxicity data were analyzed according to the Kaplan-Meier method. Comparison between prognosis groups was performed by log-rank analysis. Results After a median follow-up time of 45 months (range, 18–99), the 3-year incidence of grade ≥2 rectal late toxicity according to the criteria of the European Organization for Research and Treatment of Cancer and the Radiation Therapy Oncology Group was 24%, with all patients (24/24; 100%) experiencing rectal bleeding. The occurrence of grade ≥2 clinical rectal late toxicity was higher in patients with grade ≥2 (32% vs. 15 %, p = 0.02) or grade ≥3 VRS telangiectasia (47% vs. 17%, p ≤ 0.01) and an overall VRS score of ≥2 (31% vs. 16 %, p = 0.04) or ≥3 (48% vs. 17%, p = 0.01) at the 1-year proctoscopy. Conclusions Early proctoscopy (1 year) predicts late rectal bleeding and therefore can be used as a surrogate endpoint for late rectal toxicity in studies aimed at reducing this frequent complication.

Published
2012

3. Early radiation-induced mucosal changes evaluated by proctoscopy: predictive role of dosimetric parameters

Author

Mariangela Massaccesi, Angelo Piermattei, Vincenzo Valentini, Marcello Ingrosso, Emanuele Annoscia, Gianluca Spera, Gabriella Macchia, Alessio G. Morganti, Giuseppe Antonio Pirozzi, Francesco Deodato, Edy Ippolito, Savino Cilla, Cinzia Digesù, Stefania Marangi, Numa Cellini, Ippolito E, Deodato F, Macchia G, Massaccesi M, Digesù C, Pirozzi GA, Spera G, Marangi S, Annoscia E, Cilla S, Piermattei A, Valentini V, Cellini N, Ingrosso M, and Morganti AG

Subjects
Male, medicine.medical_treatment, Rectum, Adenocarcinoma, Late rectal toxicity, Proctoscopy, Vienna Rectoscopy Score, Prostate cancer, Prostate, medicine, Humans, Radiology, Nuclear Medicine and imaging, Telangiectasis, Intestinal Mucosa, Aged, Receiver operating characteristic, medicine.diagnostic_test, Radiotherapy, business.industry, Prostatic Neoplasms, Radiotherapy Dosage, Hematology, Middle Aged, medicine.disease, Endoscopy, Radiation therapy, medicine.anatomical_structure, Oncology, Rectoscopy, Nuclear medicine, business
Abstract

Background and purpose: Late rectal complications are assessed according to different scoring systems. Endoscopy can provide a more sensitive estimation of early radiation damage. The aim of this paper is to investigate the correlation between dosimetric parameters and rectal mucosal changes after radiotherapy (RT). Materials and methods: Patients with prostate adenocarcinoma treated with curative or adjuvant RT underwent endoscopy 1 year after RT. Receiver operating characteristics (ROC) analysis was performed to analyze the predictive capability of the dosimetric variables in determining mucosal changes classified by Vienna Rectoscopy Score (VRS). Results: The best dosimetric predictors of grade ≥2 telangiectasia were rectal (r) V 60 Gy (p = 0.014), rV 70 Gy (p = 0.017) and rD mean (p = 0.018). Similar results were obtained for grade ≥2 VRS. The set of rV 60 Gy < 34.4%, rV 70 Gy < 16.7% and rD mean < 57.5 Gy was associated with a decreased risk of grade ≥2 telangiectasia and VRS. Conclusions: rV 60 Gy, rV 70 Gy and rD mean were the strongest predictors of rectal mucosal alterations. In-depth analysis is required to correlate each mucosal alteration with late rectal toxicity in order to suggest early proctoscopy as surrogate end-point for rectal late toxicity in studies aimed at reducing this important complication.

Published
2010

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