150 results on '"Vitellaro M"'
Search Results
2. A comparison of surgical techniques for perineal wound closure following perineal excision: a systematic review and network meta-analysis
- Author
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Riva, C. G., Kelly, M. E., Vitellaro, M., Rottoli, M., Aiolfi, A., Ferrari, D., Bonitta, G., and Rausa, E.
- Published
- 2023
- Full Text
- View/download PDF
3. Superior rectal artery preservation to reduce anastomotic leak rates in familial adenomatous polyposis patients treated with total colectomy and ileorectal anastomosis
- Author
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Rausa, E., Colletti, G., Ciniselli, C. M., Signoroni, S., Duroni, V., Cavalcoli, F., Magarotto, A., Ricci, M. T., Brignola, C., Biasoni, D., Verderio, P., and Vitellaro, M.
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- 2023
- Full Text
- View/download PDF
4. Preliminary results of a program for the implementation of laparoscopic colorectal surgery in an Italian comprehensive cancer center during the COVID-19 pandemic
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Baratti, D., Battaglia, L., Belli, F., Bonfanti, G., Cesa Bianchi, A., Deraco, M., Guaglio, M., Kusamura, S., Sorrentino, L., Vitellaro, M., and Cosimelli, M.
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- 2022
- Full Text
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5. Cold snare polypectomy in the management of duodenal adenoma in familial adenomatous polyposis
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Cavalcoli, F., additional, Magarotto, A., additional, Rausa, E., additional, Rosa, R., additional, Borsotti, E., additional, Benedicenti, F., additional, Mancini, A., additional, Lauricella, S., additional, Vitellaro, M., additional, and Cantù, P., additional
- Published
- 2024
- Full Text
- View/download PDF
6. OC.01.6: COLD SNARE POLYPECTOMY IN THE MANAGEMENT OF DUODENAL ADENOMA IN FAMILIAL ADENOMATOUS POLYPOSIS
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Cavalcoli, F., primary, Magarotto, A., additional, Emanuele, R., additional, Rosa, R., additional, Borsotti, E., additional, Mancini, A., additional, Benedicenti, F., additional, Lauricella, S., additional, Vitellaro, M., additional, and Cantù, P., additional
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- 2024
- Full Text
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7. T.02.1 DELPHI INITIATIVE FOR EARLY-ONSET COLORECTAL CANCER (DIRECT): INTERNATIONAL MANAGEMENT GUIDELINES
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Cavestro, G.M., primary, Mannucci, A., additional, Balaguer, F., additional, Heather, H., additional, Kupfer, S., additional, Repici, A., additional, Sartore-Bianchi, A., additional, Seppala, T., additional, Valentini, V., additional, Boland, C., additional, Brand, R., additional, Buffart, T., additional, Burke, C., additional, Caccialanza, R., additional, Cannizzaro, R., additional, Cascinu, S., additional, Cercek, A., additional, Crosbie, E., additional, Danese, S., additional, Dekker, E., additional, Daca-Alvarez, M., additional, Deni, F., additional, Latchford, A., additional, Liska, D., additional, Lynch, P., additional, Malesci, A., additional, Mauri, G., additional, Meldolesi, E., additional, Pal, M., additional, Monahan, K., additional, Moslein, G., additional, Murphy, C., additional, Nass, K., additional, Ng, K., additional, Oliani, C., additional, Papaleo, E., additional, Patel, S., additional, Puzzono, M., additional, Remo, A., additional, Ricciardiello, L., additional, Ripamonti, C., additional, Siena, S., additional, Singh, S., additional, Stadler, Z., additional, Stanich, P., additional, Syngal, S., additional, Turi, S., additional, Urso, E., additional, Valle, L., additional, Vanni, V., additional, Vilar, E., additional, Vitellaro, M., additional, You, Y., additional, Yurgelun, M., additional, Zuppardo, R., additional, and Stoffel, E., additional
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- 2023
- Full Text
- View/download PDF
8. Delphi initiative for early-onset colorectal cancer (DIRECt). International Management Guidelines
- Author
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Cavestro Giulia, M, Mannucci, A, Balaguer, F, Hampel, H, Kupfer, SS, Repici, A, Sartore-Bianchi, A, Seppälä Toni, T, Valentini, V, Boland Clement, R, Brand, RE, Buffart, TE, Burke, CA, Caccialanza, R, Cannizzaro, R, Cascinu, S, Cercek, A, Crosbie, EJ, Danese, S, Dekker, E, Daca-Alvarez, M, Deni, F, Dominguez-Valentin, M, Eng, C, Goel, A, Guillem Josè, G, Houwen, B, Kahi, C, Kalady, MF, Kastrinos, F, Kühn, F, Laghi, L, Latchford, A, Liska, D, Lynch, P, Malesci, A, Mauri, G, Meldolesi, E, Møller, P, Monahan, KJ, Moslein, G, Murphy, CC, Nass, K, Ng, K, Oliani, C, Papaleo, E, Patel, SG, Puzzono, M, Remo, A, Ricciardiello, L, Ripamonti Carla, I, Siena, S, Singh, SK, Stadler, ZK, Stanich, PP, Syngal, S, Turi, S, Urso Emanuele, D, Valle, L, Vanni Valeria, S, Vilar, E, Vitellaro, M, You, Y-QN, Yurgelun, MB, Zuppardo Raffaella, A, Stoffel, EM, Associazione Italiana Familiarità Ereditarietà Tumori, Collaborative Group of the Americas on Inherited Gastrointestinal Cancers, European Hereditary Tumor Group, International Society for Gastrointestinal Hereditary Tumours, Tampere University, Clinical Medicine, Department of Gastroenterology, Gastroenterology and Hepatology, CCA - Cancer Treatment and Quality of Life, CCA - Imaging and biomarkers, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, CCA -Cancer Center Amsterdam, and Internal medicine
- Subjects
Colorectal Cancer ,50 Years ,Clinical ,Hepatology ,Settore MED/06 - Oncologia Medica ,3122 Cancers ,Gastroenterology ,Young ,Recommendation - Abstract
BACKGROUND & AIMS: Patients with early-onset colorectal cancer (eoCRC) are managed according to guidelines that are not age-specific. A multidisciplinary international group (DIRECt), composed of 69 experts, was convened to develop the first evidence-based consensus recommendations for eoCRC. METHODS: After reviewing the published literature, a Delphi methodology was used to draft and respond to clinically relevant questions. Each statement underwent 3 rounds of voting and reached a consensus level of agreement of ≥80%. RESULTS: The DIRECt group produced 31 statements in 7 areas of interest: diagnosis, risk factors, genetics, pathology-oncology, endoscopy, therapy, and supportive care. There was strong consensus that all individuals younger than 50 should undergo CRC risk stratification and prompt symptom assessment. All newly diagnosed eoCRC patients should receive germline genetic testing, ideally before surgery. On the basis of current evidence, endoscopic, surgical, and oncologic treatment of eoCRC should not differ from later-onset CRC, except for individuals with pathogenic or likely pathogenic germline variants. The evidence on chemotherapy is not sufficient to recommend changes to established therapeutic protocols. Fertility preservation and sexual health are important to address in eoCRC survivors. The DIRECt group highlighted areas with knowledge gaps that should be prioritized in future research efforts, including age at first screening for the general population, use of fecal immunochemical tests, chemotherapy, endoscopic therapy, and post-treatment surveillance for eoCRC patients. CONCLUSIONS: The DIRECt group produced the first consensus recommendations on eoCRC. All statements should be considered together with the accompanying comments and literature reviews. We highlighted areas where research should be prioritized. These guidelines represent a useful tool for clinicians caring for patients with eoCRC. publishedVersion
- Published
- 2022
9. OC.08.2 CANCER OCCURRENCE IN FAMILIAL ADENOMATOUS POLYPOSIS PATIENTS AFTER ILEO-RECTAL ANASTOMOSIS: DATA FROM A LARGE RETROSPECTIVE SERIES
- Author
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Cavalcoli, F., primary, Colletti, G., additional, Magarotto, A., additional, Ciniselli, C.M., additional, Signoroni, S., additional, Ricci, M.T., additional, Mancini, A., additional, Vitellaro, M., additional, and Tringali, A., additional
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- 2022
- Full Text
- View/download PDF
10. A prospective prostate cancer screening programme for men with pathogenic variants in mismatch repair genes (IMPACT): initial results from an international prospective study.
- Author
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Bancroft E.K., Page E.C., Brook M.N., Thomas S., Taylor N., Pope J., McHugh J., Jones A.-B., Karlsson Q., Merson S., Ong K.R., Hoffman J., Huber C., Maehle L., Grindedal E.M., Stormorken A., Evans D.G., Rothwell J., Lalloo F., Brady A.F., Bartlett M., Snape K., Hanson H., James P., McKinley J., Mascarenhas L., Syngal S., Ukaegbu C., Side L., Thomas T., Barwell J., Teixeira M.R., Izatt L., Suri M., Macrae F.A., Poplawski N., Chen-Shtoyerman R., Ahmed M., Musgrave H., Nicolai N., Greenhalgh L., Brewer C., Pachter N., Spigelman A.D., Azzabi A., Helfand B.T., Halliday D., Buys S., Ramon y Cajal T., Donaldson A., Cooney K.A., Harris M., McGrath J., Davidson R., Taylor A., Cooke P., Myhill K., Hogben M., Aaronson N.K., Ardern-Jones A., Bangma C.H., Castro E., Dearnaley D., Dias A., Dudderidge T., Eccles D.M., Green K., Eyfjord J., Falconer A., Foster C.S., Gronberg H., Hamdy F.C., Johannsson O., Khoo V., Lilja H., Lindeman G.J., Lubinski J., Axcrona K., Mikropoulos C., Mitra A.V., Moynihan C., Ni Raghallaigh H., Rennert G., Collier R., Adams L., Adlard J., Alfonso R., Ali S., Andrew A., Araujo L., Azam N., Ball D., Barker Q., Basevitch A., Benton B., Berlin C., Bermingham N., Biller L., Bloss A., Bradford M., Bradshaw N., Branson A., Brendler C., Brennan M., Bulman B., Burgess L., Cahill D., Callard A., Calvo Verges N., Cardoso M., Carter V., Catanzaro M., Chamberlain A., Chapman C., Chong M., Clark C., Clowes V., Cogley L., Cole T., Compton C., Conner T., Cookson S., Cornford P., Costello P., Coulier L., Davies M., Dechet C., DeSouza B., Devlin G., Douglas F., Douglas E., Dudakia D., Duncan A., Ellery N., Everest S., Freemantle S., Frydenberg M., Fuller D., Gabriel C., Gale M., Garcia L., Gay S., Genova E., George A., Georgiou D., Gisbert A., Gleeson M., Glover W., Gnanapragasam V., Goff S., Goldgar D., Goncalves N., Goodman S., Gorrie J., Gott H., Grant A., Gray C., Griffiths J., Gupwell K., Gurasashvili J., Hanslien E., Haraldsdottir S., Hart R., Hartigan C., Hawkes L., Heaton T., Henderson A., Henrique R., Hilario K., Hill K., Hulick P., Hunt C., Hutchings M., Ibitoye R., Inglehearn T., Ireland J., Islam F., Ismail S., Jacobs C., James D., Jenkins S., Jobson I., Johnstone A., Jones O., Josefsberg Ben-Yehoshua S., Kaemba B., Kaul K., Kemp Z., Kinsella N., Klehm M., Kockelbergh R., Kohut K., Kosicka-Slawinska M., Kulkarni A., Kumar P., Lam J., LeButt M., Leibovici D., Lim R., Limb L., Lomas C., Longmuir M., Lopez C., Magnani T., Maia S., Maiden J., Male A., Manalo M., Martin P., McBride D., McGuire M., McMahon R., McNally C., McVeigh T., Melzer E., Mencias M., Mercer C., Mitchell G., Mora J., Morton C., Moss C., Murphy M., Murphy D., Mzazi S., Nadolski M., Newlin A., Nogueira P., O'Keefe R., O'Toole K., O'Connell S., Ogden C., Okoth L., Oliveira J., Paez E., Palou J., Park L., Patel N., Paulo Souto J., Pearce A., Peixoto A., Perez K., Petelin L., Pichert G., Poile C., Potter A., Preitner N., Purnell H., Quinn E., Radice P., Rankin B., Rees K., Renton C., Richardson K., Risby P., Rogers J., Ruderman M., Ruiz A., Sajoo A., Salvatore N., Sands V., Sanguedolce F., Sattar A., Saunders K., Schofield L., Scott R., Searle A., Sehra R., Selkirk C., Shackleton K., Shanley S., Shaw A., Shevrin D., Shipman H., Sidat Z., Siguake K., Simon K., Smyth C., Snadden L., Solanky N., Solomons J., Sorrentino M., Stayner B., Stephenson R., Stoffel E., Thomas M., Thompson A., Tidey L., Tischkowitz M., Torokwa A., Townshend S., Treherne K., Tricker K., Trinh Q.-D., Tripathi V., Turnbull C., Valdagni R., Van As N., Venne V., Verdon L., Vitellaro M., Vogel K., Walker L., Watford A., Watt C., Weintroub I., Weiss S., Weissman S., Weston M., Wiggins J., Wise G., Woodhouse C., Yesildag P., Youngs A., Yurgelun M., Zollo F., Offman J., Kote-Jarai Z., Eeles R.A., Bancroft E.K., Page E.C., Brook M.N., Thomas S., Taylor N., Pope J., McHugh J., Jones A.-B., Karlsson Q., Merson S., Ong K.R., Hoffman J., Huber C., Maehle L., Grindedal E.M., Stormorken A., Evans D.G., Rothwell J., Lalloo F., Brady A.F., Bartlett M., Snape K., Hanson H., James P., McKinley J., Mascarenhas L., Syngal S., Ukaegbu C., Side L., Thomas T., Barwell J., Teixeira M.R., Izatt L., Suri M., Macrae F.A., Poplawski N., Chen-Shtoyerman R., Ahmed M., Musgrave H., Nicolai N., Greenhalgh L., Brewer C., Pachter N., Spigelman A.D., Azzabi A., Helfand B.T., Halliday D., Buys S., Ramon y Cajal T., Donaldson A., Cooney K.A., Harris M., McGrath J., Davidson R., Taylor A., Cooke P., Myhill K., Hogben M., Aaronson N.K., Ardern-Jones A., Bangma C.H., Castro E., Dearnaley D., Dias A., Dudderidge T., Eccles D.M., Green K., Eyfjord J., Falconer A., Foster C.S., Gronberg H., Hamdy F.C., Johannsson O., Khoo V., Lilja H., Lindeman G.J., Lubinski J., Axcrona K., Mikropoulos C., Mitra A.V., Moynihan C., Ni Raghallaigh H., Rennert G., Collier R., Adams L., Adlard J., Alfonso R., Ali S., Andrew A., Araujo L., Azam N., Ball D., Barker Q., Basevitch A., Benton B., Berlin C., Bermingham N., Biller L., Bloss A., Bradford M., Bradshaw N., Branson A., Brendler C., Brennan M., Bulman B., Burgess L., Cahill D., Callard A., Calvo Verges N., Cardoso M., Carter V., Catanzaro M., Chamberlain A., Chapman C., Chong M., Clark C., Clowes V., Cogley L., Cole T., Compton C., Conner T., Cookson S., Cornford P., Costello P., Coulier L., Davies M., Dechet C., DeSouza B., Devlin G., Douglas F., Douglas E., Dudakia D., Duncan A., Ellery N., Everest S., Freemantle S., Frydenberg M., Fuller D., Gabriel C., Gale M., Garcia L., Gay S., Genova E., George A., Georgiou D., Gisbert A., Gleeson M., Glover W., Gnanapragasam V., Goff S., Goldgar D., Goncalves N., Goodman S., Gorrie J., Gott H., Grant A., Gray C., Griffiths J., Gupwell K., Gurasashvili J., Hanslien E., Haraldsdottir S., Hart R., Hartigan C., Hawkes L., Heaton T., Henderson A., Henrique R., Hilario K., Hill K., Hulick P., Hunt C., Hutchings M., Ibitoye R., Inglehearn T., Ireland J., Islam F., Ismail S., Jacobs C., James D., Jenkins S., Jobson I., Johnstone A., Jones O., Josefsberg Ben-Yehoshua S., Kaemba B., Kaul K., Kemp Z., Kinsella N., Klehm M., Kockelbergh R., Kohut K., Kosicka-Slawinska M., Kulkarni A., Kumar P., Lam J., LeButt M., Leibovici D., Lim R., Limb L., Lomas C., Longmuir M., Lopez C., Magnani T., Maia S., Maiden J., Male A., Manalo M., Martin P., McBride D., McGuire M., McMahon R., McNally C., McVeigh T., Melzer E., Mencias M., Mercer C., Mitchell G., Mora J., Morton C., Moss C., Murphy M., Murphy D., Mzazi S., Nadolski M., Newlin A., Nogueira P., O'Keefe R., O'Toole K., O'Connell S., Ogden C., Okoth L., Oliveira J., Paez E., Palou J., Park L., Patel N., Paulo Souto J., Pearce A., Peixoto A., Perez K., Petelin L., Pichert G., Poile C., Potter A., Preitner N., Purnell H., Quinn E., Radice P., Rankin B., Rees K., Renton C., Richardson K., Risby P., Rogers J., Ruderman M., Ruiz A., Sajoo A., Salvatore N., Sands V., Sanguedolce F., Sattar A., Saunders K., Schofield L., Scott R., Searle A., Sehra R., Selkirk C., Shackleton K., Shanley S., Shaw A., Shevrin D., Shipman H., Sidat Z., Siguake K., Simon K., Smyth C., Snadden L., Solanky N., Solomons J., Sorrentino M., Stayner B., Stephenson R., Stoffel E., Thomas M., Thompson A., Tidey L., Tischkowitz M., Torokwa A., Townshend S., Treherne K., Tricker K., Trinh Q.-D., Tripathi V., Turnbull C., Valdagni R., Van As N., Venne V., Verdon L., Vitellaro M., Vogel K., Walker L., Watford A., Watt C., Weintroub I., Weiss S., Weissman S., Weston M., Wiggins J., Wise G., Woodhouse C., Yesildag P., Youngs A., Yurgelun M., Zollo F., Offman J., Kote-Jarai Z., and Eeles R.A.
- Abstract
Background: Lynch syndrome is a rare familial cancer syndrome caused by pathogenic variants in the mismatch repair genes MLH1, MSH2, MSH6, or PMS2, that cause predisposition to various cancers, predominantly colorectal and endometrial cancer. Data are emerging that pathogenic variants in mismatch repair genes increase the risk of early-onset aggressive prostate cancer. The IMPACT study is prospectively assessing prostate-specific antigen (PSA) screening in men with germline mismatch repair pathogenic variants. Here, we report the usefulness of PSA screening, prostate cancer incidence, and tumour characteristics after the first screening round in men with and without these germline pathogenic variants. Method(s): The IMPACT study is an international, prospective study. Men aged 40-69 years without a previous prostate cancer diagnosis and with a known germline pathogenic variant in the MLH1, MSH2, or MSH6 gene, and age-matched male controls who tested negative for a familial pathogenic variant in these genes were recruited from 34 genetic and urology clinics in eight countries, and underwent a baseline PSA screening. Men who had a PSA level higher than 3.0 ng/mL were offered a transrectal, ultrasound-guided, prostate biopsy and a histopathological analysis was done. All participants are undergoing a minimum of 5 years' annual screening. The primary endpoint was to determine the incidence, stage, and pathology of screening-detected prostate cancer in carriers of pathogenic variants compared with non-carrier controls. We used Fisher's exact test to compare the number of cases, cancer incidence, and positive predictive values of the PSA cutoff and biopsy between carriers and non-carriers and the differences between disease types (ie, cancer vs no cancer, clinically significant cancer vs no cancer). We assessed screening outcomes and tumour characteristics by pathogenic variant status. Here we present results from the first round of PSA screening in the IMPACT study. This
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- 2022
11. 491P Lipid-engulfed macrophages at the root of gut carcinogenesis
- Author
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Daveri, E., primary, Sorrentino, L., additional, Vergani, B., additional, Cattaneo, L., additional, Lalli, L., additional, Cosimelli, M., additional, Vitellaro, M., additional, Huber, V., additional, Cova, A., additional, Gariboldi, M., additional, Belfiore, A., additional, Leone, B.E., additional, Milione, M., additional, and Rivoltini, L., additional
- Published
- 2021
- Full Text
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12. Experience of a specialist center in the management of anastomotic sinus following leaks after low rectal or ileal pouch–anal anastomosis with diverting stoma
- Author
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Zhuo, C., Trencheva, K., Maggiori, L., Milsom, J. W., Sonoda, T., Shukla, P. J., Vitellaro, M., Makino, T., and Lee, S. W.
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- 2014
- Full Text
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13. Risk of desmoid tumours after open and laparoscopic colectomy in patients with familial adenomatous polyposis
- Author
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Vitellaro, M., Sala, P., Signoroni, S., Radice, P., Fortuzzi, S., Civelli, E. M., Ballardini, G., Kleiman, D. A., Morrissey, K. P., and Bertario, L.
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- 2014
- Full Text
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14. Experience of a specialist centre in the management of anastomotic sinus following leaks after low rectal or ileal pouch–anal anastomosis with diverting stoma
- Author
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Zhuo, C., Trencheva, K., Maggiori, L., Milsom, J. W., Sonoda, T., Shukla, P. J., Vitellaro, M., Makino, T., and Lee, S. W.
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- 2013
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15. Comment on Koskenvuo et al.: Risk of cancer and secondary proctectomy after colectomy and ileorectal anastomosis in familial adenomatous polyposis
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Bertario, L., Sala, P., and Vitellaro, M.
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- 2015
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16. Total rectal resection and colo-anal anastomosis with colonic reservoir for low rectal cancer
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Leo, E., Belli, F., Baldini, M. T., Vitellaro, M., Mascheroni, L., Andreola, S., Bellomi, M., Rebuffoni, G., Lombardi, F., Audisio, R., and Filiberti, A.
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- 1994
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17. Laparoscopic appendectomy in Italy:an appraisal of 28.863 cases
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AGRESTA F, DE SIMONE P, LEONE L, AREZZO A, BIONDI A, BOTTERO L, CATENA F, CONZO, Giovanni, DEL GENIO, Gianmattia, FERSINI A, GUERRIERI M, ILLOMEI G, TONELLI P, VITELLARO M, DOCIMO, Giovanni, CRUCITTI A, ITALIAN SOCIETY OF YOUNG SURGEONS, Agresta, F, DE SIMONE, P, Leone, L, Arezzo, A, Biondi, A, Bottero, L, Catena, F, Conzo, Giovanni, DEL GENIO, Gianmattia, Fersini, A, Guerrieri, M, Illomei, G, Tonelli, P, Vitellaro, M, Docimo, Giovanni, Crucitti, A, and ITALIAN SOCIETY OF YOUNG, Surgeons
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Laparoscopic appendectomy ,Italy - Abstract
The low response rate of the present survey does not allow us to assess the diffusion of LA in Italy. but rather to appraise its practice in centers routinely performing laparoscopic surgery. In the hands of experienced surgeons. LA has morbitdity rates comparable to those of in- ternational series. 'I`he higher diagnostic yield of laparoscopy makes it an invaluable tool in the management algorithm of women of childbearing age: its advantages in the presence of severe peritonitis are less clear-cut. Surgeons remain the main limiting factor preventing a wider dilfusion of LA in our country.
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- 2004
18. Comment on Koskenvuo et al.: Risk of cancer and secondary proctectomy after colectomy and ileorectal anastomosis in familial adenomatous polyposis
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Bertario, L., primary, Sala, P., additional, and Vitellaro, M., additional
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- 2014
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19. Which treatment for cholecystitis and coledocholithiasis?
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Palazzini, Giorgio, DI MATTEO, Filippo Maria, and Vitellaro, M.
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- 1999
20. Chirurgia Laparoscopica - Quaderni di tecnica-Appendicectomia
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Novellino, L, Longoni, M, Palazzini, Giorgio, Andretta, M, Spinelli, L, Faillace, G, Perrucchini, G, PIAZZINI ALBANI, A, Vitellaro, M, Campanati, L, Stefanini, P, and DE BENEDETTI, D.
- Published
- 1996
21. Long-Term Results of Laparoscopic Retroperitoneal Lymph Node Dissection (RPLND) in Low-Stage Nonseminomatous Germ-Cell Testicular Tumors (NSGCTT) Performed by a Senior Surgeon: 1999–2003
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Pizzocaro, G., primary, Schiavo, M., additional, Solima, S., additional, Vitellaro, M., additional, Blasoni, D., additional, and Nicolai, N., additional
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- 2010
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22. Local recurrence rate in rectal cancer patients with distal resection margin less than 9 mm
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Leo, E., primary, Andreola, S., additional, Belli, F., additional, Bonfanti, G., additional, Gallino, G., additional, Vitellaro, M., additional, and Battaglia, L., additional
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- 2001
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23. Sphyncter preserving procedures for low rectal cancer
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Leo, E., primary, Belli, F., additional, Andreola, S., additional, Bonfanti, G., additional, Gallino, G., additional, Vitellaro, M., additional, and Battaglia, L., additional
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- 2001
- Full Text
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24. Management of Dietary Habits and Diarrhea in Fap Individuals: A Mediterranean Low-Inflammatory Dietary Intervention
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Ciniselli Chiara Maura, Bruno Eleonora, Oliverio Andreina, Baldassari Ivan, Pastori Marta, Signoroni Stefano, Vitellaro Marco, Ricci Maria Teresa, Milione Massimo, Cattaneo Laura, Gariboldi Manuela, Mancini Andrea, Rivoltini Licia, Morelli Daniele, Pasanisi Patrizia, and Verderio Paolo
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FAP individuals ,Mediterranean low-inflammatory diet ,dietary questionnaires ,dietary adherence ,diarrheal discharges ,Nutrition. Foods and food supply ,TX341-641 - Abstract
Background: A total colectomy and a frequent life-long endoscopic surveillance are guaranteed to patients with Familial Adenomatous Polyposis (FAP) to reduce their risk of duodenal and rectal stump cancers. However, after surgery, individuals with FAP suffer from an increased number of diarrheal discharges that force them to dietary restrictions. A non-randomized pilot study was conducted to assess whether a three-month low-inflammatory Mediterranean dietary intervention reduces gastro-intestinal markers of inflammation in FAP individuals. The aim of the present work is to evaluate the participant’s adherence to the proposed dietary recommendations and the change in their number of diarrheal discharges. Methods: 26 FAP individuals aged >18 years, who underwent a total colectomy with ileo-rectal anastomosis and were involved in the surveillance program at the Fondazione IRCCS Istituto Nazionale Tumori of Milan, were included in the present analysis. Results: FAP individuals significantly reduced the Not recommended foods (p-value: 0.002) and increased the consumption of the Recommended ones (p-value: 0.075). The adherence to the proposed dietary recommendations was accompanied by a significant decrease in the number of diarrheal discharges (p-value: 0.008). Conclusions: This study suggests that adhering to a low-inflammatory Mediterranean diet has a potential protective effect on the number of diarrheal discharges in FAP individuals.
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- 2021
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25. Total rectal resection and colo-anal anastomosis for low rectal tumours: comparative results in a group of young and old patients
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Leo, E., primary, Audisio, R.A., additional, Belli, F., additional, Vitellaro, M., additional, Baldini, M.T., additional, Mascheroni, L., additional, Patuzzo, R., additional, Rigillo, G., additional, Rebuffoni, G., additional, Filiberti, A., additional, Navarria, P., additional, and Andreola, S., additional
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- 1994
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26. Total rectal resection, colo-anal anastomosis and “J” reservoir in lower third rectal cancer
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Leo, E., primary, Belli, F., additional, Vitellaro, M., additional, Baldini, M.T., additional, Furlan, L., additional, Gallino, F., additional, and Palazzo, R., additional
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- 1994
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27. 123I-IBZM scan in cutaneous melanoma
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Maffioli, L. S., primary, Mascheroni, L., additional, Castellani, M. R., additional, Baldini, M. T., additional, Mongioj, V., additional, Gasparini, M., additional, Vitellaro, M., additional, and Buraggi, G. L., additional
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- 1993
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28. Omission of bone scan and skeletal X-ray in primary melanoma staging
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Mascheroni, L, primary, Vitellaro, M., additional, and Potepan, P., additional
- Published
- 1993
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29. Total rectal resection, colo-anal anastomosis and “J” reservoir in lower third rectal cancer
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Leo, E, primary, Belli, F, additional, Vitellaro, M, additional, Baldini, MT, additional, Mascheroal, L, additional, and Giovanazzi, R, additional
- Published
- 1993
- Full Text
- View/download PDF
30. Videoassisted thoracoscopic extended thymectomy
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Novellino, L, Spinelli, L, PIAZZINI ALBANI, A, Vitellaro, M, and Palazzini, Giorgio
31. Total rectal resection, colo-endoanal anastomosis and colic reservoir for cancer of the lower third of the rectum
- Author
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Leo, E., Filiberto Belli, Baldini, M. T., Vitellaro, M., Santoro, N., Mascheroni, L., Andreola, S., Bellomi, M., Rebuffoni, G., Zucali, R., Audisio, R., and Filiberti, A.
32. The art of decision-making in surgery. To what extent does economics influence choice?
- Author
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Vannelli, A., Battaglia, L., Poiasina, E., Belli, F., Bonfanti, G., Gianfrancesco Gallino, Vitellaro, M., Dosso, S., and Leo, E.
33. Simultaneous idiopathic segmental infarction of the great omentum and acute appendicitis: a rare association
- Author
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Rampa Mario, Poiasina Elia, Gallino Gianfrancesco, Bonfanti Giuliano, Vannelli Alberto, Belli Filiberto, Battaglia Luigi, Vitellaro Marco, and Leo Ermanno
- Subjects
Surgery ,RD1-811 ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
Abstract Idiopathic segmental infarction of the greater omentum is an uncommon cause of acute abdomen. The etiology is still unclear and the symptoms mimic acute appendicitis. Its presentation simultaneously with acute appendicitis is still more infrequent. We present a case of a 47-year old woman without significant previous medical history, admitted with an acute abdomen, in which the clinical diagnosis was acute appendicitis and in whom an infarcted segment of right side of the greater omentum was also found at laparotomy. As the etiology is unknown, we highlighted some of the possible theories, and emphasize the importance of omental infarction even in the presence of acute appendicitis as a coincident intraperitoneal pathological condition.
- Published
- 2008
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34. 123I-IBZM scan in cutaneous melanoma.
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Maffioli, L. S., Mascheroni, L., Castellani, M. R., Baldini, M. T., Mongioj, V., Gasparini, M., Vitellaro, M., and Buraggi, G. L.
- Published
- 1993
- Full Text
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35. Laparoscopic treatment of residual stones after cholecystectomy.
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Novellino, L., Longoni, M., Vitellaro, M., Spinelli, L., Casati, A., Andretta, M., Faillace, G., Albani, A. Piazzini, Perrucchini, G., and Campanati, L.
- Published
- 1996
36. Laparoscopic treatment of mine bile duct stones.
- Author
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Novellino, L., Longoni, M., Vitellaro, M., Spinelli, L., Casati, A., Andretta, M., Faillace, G., Albani, A. Piazzini, Perrucchini, G., and Campanati, L.
- Published
- 1996
37. Definition and management of colorectal polyposis not associated with APC/MUTYH germline pathogenic variants: AIFEG consensus statement
- Author
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Emanuele Damiano Luca Urso, Maurizio Ponz de Leon, Marco Vitellaro, Guglielmo Niccolò Piozzi, Quoc Riccardo Bao, Aline Martayan, Andrea Remo, Vittoria Stigliano, Cristina Oliani, Emanuela Lucci Cordisco, Salvatore Pucciarelli, Guglielmina Nadia Ranzani, Alessandra Viel, Francesca Adami, Elisa Alducci, Lucia Amadori, Valentina Arcangeli, Luisa Balestrino, Daniela Barana, Lucio Bertario, Bernardo Bonanni, Stefania Boni, Pierluigi Bullian, Fiorella Carbonardi, Ileana Carnevali, Paola Castelli, Francesco Celotto, Giulia Cini, Gino Crivellari, Duilio Della Libera, Anastasia Dell'elice, Maria Digennaro, Alessandra D'urso, Antonella Fabretto, Daniele Fanale, Irene Feroce, Daniela Furlan, Paola Ghiorzo, Mara Giacché, Milena Gusella, Barbara Liserre, Isabella Mammi, Stefania Massuras, Daniela Mazzà, Eleonora Mollica, Alberto Morabito, Giorgia Nardo, Flavia Palermo, Elena Panizza, Margherita Patruno, Monica Pedroni, Valeria Grazia Maria Pensotti, Guglielmo Niccolo Piozzi, Simonetta Pozzi, Silvia Presi, Marta Puzzono, Mila Ravegnani, Maria Teresa Ricci, Luca Roncucci, Giovanni Battsita Rossi, Elena Maria Sala, Lupe Sanchez Mete, Daniele Sandonà, Stefania Sciallero, Davide Serrano, Stefano Signoroni, Francesca Spina, Monica Taborelli, Gianluca Tedaldi, Maria Grazia Tibiletti, Silvia Tognazzo, Gianluca Tolva, Cristina Maria Concetta Trovato, Daniela Turchetti, Dora Varvara, Caterina Vivanet, Stefania Zovato, Raffaella Alessia Zuppardo, Urso E.D.L., Ponz de Leon M., Vitellaro M., Piozzi G.N., Bao Q.R., Martayan A., Remo A., Stigliano V., Oliani C., Lucci Cordisco E., Pucciarelli S., Ranzani G.N., Viel A., Adami F., Alducci E., Amadori L., Arcangeli V., Balestrino L., Barana D., Bertario L., Bonanni B., Boni S., Bullian P., Carbonardi F., Carnevali I., Castelli P., Celotto F., Cini G., Crivellari G., Libera D.D., Dell'elice A., Digennaro M., D'urso A., Fabretto A., Fanale D., Feroce I., Furlan D., Ghiorzo P., Giacche M., Gusella M., Liserre B., Mammi I., Massuras S., Mazza D., Mollica E., Morabito A., Nardo G., Palermo F., Panizza E., Patruno M., Pedroni M., Pensotti V.G.M., Pozzi S., Presi S., Puzzono M., Ravegnani M., Ricci M.T., Roncucci L., Rossi G.B., Sala E.M., Mete L.S., Sandona D., Sciallero S., Serrano D., Signoroni S., Spina F., Taborelli M., Tedaldi G., Tibiletti M.G., Tognazzo S., Tolva G., Trovato C.M.C., Turchetti D., Varvara D., Vivanet C., Zovato S., and Zuppardo R.A.
- Subjects
Oncology ,medicine.medical_specialty ,Gastrointestinal tumors ,Colorectal cancer ,Surgical Management ,Colorectal polyposis ,Germline ,03 medical and health sciences ,Cancer Genetic ,0302 clinical medicine ,MUTYH ,Internal medicine ,medicine ,Cancer Genetics ,Polyposis coli ,Hepatology ,Pathogenic mutation ,business.industry ,Colorectal polyposis not associated with APC/MUTYH mutation ,Polyposis management guideline ,Gastroenterology ,Expert consensus ,Endoscopic surveillance ,medicine.disease ,Consensus development conference ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,business - Abstract
An expert consensus panel convened by the Italian Association for Inherited and Familial Gastrointestinal Tumors (Associazione Italiana per lo Studio della Familiarita ed Ereditarieta 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).
- Published
- 2021
38. Familial adenomatosis polyposis-related desmoid tumours treated with low-dose chemotherapy: Results from an international, multi-institutional, retrospective analysis
- Author
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Antonella Brunello, Robin L. Jones, Marianna Silletta, Nadia Hindi, Margherita Nannini, Peter Hohenberger, Mariella Spalato Ceruso, Marco Vitellaro, Javier Martin-Broto, Angelo Paolo Dei Tos, Chiara Colombo, Giuseppe Badalamenti, Daniele Santini, Giuseppe Tonini, Spyridon Gennatas, Bruno Vincenzi, Alessandro Gronchi, Salvatore Provenzano, Toni Ibrahim, Elena Palassini, Silvia Stacchiotti, Silvia Gasperoni, Andrea Napolitano, Napolitano A., Provenzano S., Colombo C., Vitellaro M., Brunello A., Badalamenti G., Nannini M., Ibrahim T., Hohenberger P., Gasperoni S., Gennatas S., Jones R.L., Hindi N., Martin-Broto J., Spalato Ceruso M., Silletta M., Dei Tos A.P., Gronchi A., Stacchiotti S., Santini D., Tonini G., Palassini E., and Vincenzi B.
- Subjects
Adult ,familial adenomatosis polyposi ,Cancer Research ,medicine.medical_specialty ,Vinca ,Adolescent ,Vinca alkaloids ,desmoid ,medicine.medical_treatment ,Population ,Vinorelbine ,chemotherapy ,Gastroenterology ,methotrexate ,vinca alkaloids ,Young Adult ,familial adenomatosis polyposis ,Low-dose chemotherapy ,Internal medicine ,medicine ,Humans ,Chemotherapy ,Child ,education ,Desmoid ,Survival analysis ,Retrospective Studies ,education.field_of_study ,biology ,business.industry ,Familial adenomatosis polyposis ,biology.organism_classification ,medicine.disease ,Methotrexate ,Adenomatous Polyposis Coli ,Oncology ,Female ,Sarcoma ,business ,Progressive disease ,medicine.drug - Abstract
[Introduction] Desmoid tumour (DT) is a locally aggressive fibroblastic proliferative disease representing the most common extraintestinal manifestation of familial adenomatosis polyposis (FAP). As data on the activity of chemotherapy in these patients are limited, we examined the outcomes of patients treated with low-dose methotrexate (MTX)+vinca alkaloids (vinorelbine or vinblastine)., [Patients and methods] We retrospectively reviewed clinical and outcome data from all patients with confirmed FAP-associated DTs treated with weekly MTX+vinca alkaloids in seven European sarcoma reference centres between January 2000 and December 2018. Radiological responses were assessed using RECIST V.1.0 and V.1.1. The Kaplan-Meier method associated to the log-rank test was used to estimate and compare survival curves., [Results] We identified 37 patients (median age 29 years, range 7–44). According to RECIST, 20/37 (54.1%) patients achieved partial response (PR), 15/37 (40.5%) patients had stable disease and 2/37 (5.4%) had progressive disease as best response. Overall, the median progression-free survival (PFS) was 6.5 years (range, 0.3–12.1 years). In the subset of patients achieving PR as best response, the median PFS was not reached. In a subset of 11 patients with progressive disease offered MTX+vinca alkaloids rechallenge (after chemotherapy withdrawal following prolonged disease control), the disease control rate was 100%, resulting in a median PFS after rechallenge of 5.8 years., [Conclusions] This is the largest series on the activity of low-dose chemotherapy in patients with FAP-related DT. In this population, MTX+vinca alkaloids is an active combination, as already reported in patients with sporadic DT.
- Published
- 2020
39. Cancer-associated foam cells hamper protective T cell immunity and favor tumor progression in human colon carcinogenesis.
- Author
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Daveri E, Vergani B, Lalli L, Ferrero G, Casiraghi E, Cova A, Zorza M, Huber V, Gariboldi M, Pasanisi P, Guarrera S, Morelli D, Arienti F, Vitellaro M, Corsetto PA, Rizzo AM, Stroscia M, Frati P, Lagano V, Cattaneo L, Sabella G, Leone BE, Milione M, Sorrentino L, and Rivoltini L
- Subjects
- Humans, Male, Female, Aged, Middle Aged, Tumor Microenvironment, Colonic Neoplasms immunology, Colonic Neoplasms pathology, Carcinogenesis immunology, Disease Progression
- Abstract
Background: Colorectal cancer (CRC) remains a significant healthcare burden worldwide, characterized by a complex interplay between obesity and chronic inflammation. While the relationship between CRC, obesity and altered lipid metabolism is not fully understood, there are evidences suggesting a link between them. In this study, we hypothesized that dysregulated lipid metabolism contributes to local accumulation of foam cells (FC) in CRC, which in turn disrupts antitumor immunosurveillance., Methods: Tumor infiltrating FC and CD8
+ were quantified by digital pathology in patients affected by T2-T4 CRC with any N stage undergoing radical upfront surgery (n=65) and correlated with patients' clinical outcomes. Multiparametric high-resolution flow cytometry analysis and bulk RNAseq of CRC tissue were conducted to evaluate the phenotype and transcriptomic program of immune cell infiltrate in relation to FC accumulation. The immunosuppressive effects of FC and mechanistic studies on FC-associated transforming growth factor-beta (TGF-β) and anti-PD-L1 inhibition were explored using an in-vitro human model of lipid-engulfed macrophages., Results: FC (large CD68+ Bodipy+ macrophages) accumulated at the tumor margin in CRC samples. FChigh tumors exhibited reduced CD8+ T cells and increased regulatory T cells (Tregs). Functional transcriptional profiling depicted an immunosuppressed milieu characterized by reduced interferon gamma, memory CD8+ T cells, and activated macrophages mirrored by increased T-cell exhaustion and Treg enrichment. Furthermore, FChigh tumor phenotype was independent of standard clinical factors but correlated with high body mass index (BMI) and plasma saturated fatty acid levels. In CD8low tumors, the FChigh phenotype was associated with a 3-year disease-free survival rate of 8.6% compared with 28.7% of FClow (p=0.001). In-vitro studies demonstrated that FC significantly impact on CD8 proliferation in TFG-β dependent manner, while inhibition of TGF-β FC-related factors restored antitumor immunity., Conclusions: FC exert immunosuppressive activity through a TGF-β-related pathway, resulting in a CD8-excluded microenvironment and identifying immunosuppressed tumors with worse prognosis in patients with primary CRC. FC association with patient BMI and dyslipidemia might explain the link of CRC with obesity, and offers novel therapeutic and preventive perspectives in this specific clinical setting., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)- Published
- 2024
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40. Effect of powered circular stapler in colorectal anastomosis after left-sided colic resection: systematic review and meta-analysis.
- Author
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Scardino A, Riva CG, Sorrentino L, Lauricella S, Aiolfi A, Rottoli M, Bonitta G, Vitellaro M, Bonavina L, Bona D, Kelly M, and Rausa E
- Subjects
- Humans, Rectum surgery, Reoperation, Surgical Stapling adverse effects, Publication Bias, Anastomosis, Surgical adverse effects, Surgical Staplers, Colon surgery, Anastomotic Leak etiology
- Abstract
Purpose: Anastomotic leak (AL) remains the most important complication after left-sided colic anastomoses and technical complications during anastomotic construction are responsible of higher leakage incidence. Powered circular stapler (PCS) in colorectal surgery has been introduced in order to reduce technical errors and post-operative complications due to the manual circular stapler (MCS)., Methods: A systematic review and meta-analysis were performed. An electronic systematic search was performed using Web of Science, PubMed, and Embase of studies comparing PCS and MCS. The incidence of AL, anastomotic bleeding (AB), conversion, and reoperation were assessed. PROSPERO Registration Number: CRD42024512644., Results: Five observational studies were eligible for inclusion reporting on 2379 patients. The estimated pooled Risk Ratios for AL and AB rates following PCS were significantly lower than those observed with MCS (0.44 and 0.23, respectively; both with p < 0.01). Conversion and reoperation rate did not show any significant difference: 0.41 (95% CI 0.09-1.88; p = 0.25) and 0.78 (95% CI 0.33-1.84; p = 0.57); respectively., Conclusion: The use of PCS demonstrates a lower incidence of AL and AB compared to MCS but does not exhibit a discernible influence on reintervention or conversion rates. The call for future randomized clinical trials aims to definitively clarify these issues and contribute to further advancements in refining surgical strategies for left-sided colonic resection., (© 2024. The Author(s).)
- Published
- 2024
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41. Pathological Characteristics, Management, and Prognosis of Rectal Neuroendocrine Tumors: A Retrospective Study from a Tertiary Hospital.
- Author
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Cavalcoli F, Rausa E, Ferrari D, Rosa R, Maccauro M, Pusceddu S, Sabella G, Cantù P, Vitellaro M, Coppa J, and Mazzaferro V
- Abstract
Background: Rectal neuroendocrine tumors (rNENs) are rare, constituting 1-2% of rectal tumors, and are often asymptomatic, leading to challenges in early diagnosis. Current management guidelines recommend endoscopic resection for small lesions and surgical intervention for larger or high-risk tumors. This study aims to retrospectively analyze the pathological characteristics, management, and prognosis of rNEN patients., Methods: Data from the Neuroendocrine Tumor Registry at a tertiary hospital in Milan, Italy from 2005 to 2023 were retrospectively analyzed. Patient demographics, disease characteristics, pathology findings, treatment details, and surveillance data were collected. Statistical analyses included descriptive statistics, multivariable binary logistic regression, and Kaplan-Meier survival analysis., Results: Forty-five patients were included, 53.3% male with a mean age of 57.5 years. Most patients were asymptomatic, with incidental diagnosis during colonoscopy. Endoscopic excision was the primary treatment modality (77.8%), with surgical resection reserved for incomplete or inappropriate endoscopic resections. Disease progression occurred in 13 patients (28.9%), with tumor-related mortality of 22.2%. Kaplan-Meier analysis showed 5- and 10-year survival rates of 68.8% and 59.1%, respectively, with corresponding progression-free survival rates of 72.8% and 54.0%. Tumor stage was significantly associated with disease progression on multivariable analysis (OR = 7.230, p = 0.039)., Conclusions: This study highlights the heterogeneous presentation and prognosis of rNENs, with a substantial proportion diagnosed incidentally. Endoscopic management was predominantly utilized, aligning with current guidelines for localized tumors. Tumor stage emerged as a significant predictor of disease progression, emphasizing the importance of accurate staging for optimal management. Further research is warranted to refine management protocols and validate these findings.
- Published
- 2024
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42. Current Management of Desmoid Tumors: A Review.
- Author
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Kasper B, Baldini EH, Bonvalot S, Callegaro D, Cardona K, Colombo C, Corradini N, Crago AM, Dei Tos AP, Dileo P, Elnekave E, Erinjeri JP, Navid F, Farma JM, Ferrari A, Fiore M, Gladdy RA, Gounder M, Haas RL, Husson O, Kurtz JE, Lazar AJ, Orbach D, Penel N, Ratan R, Raut CP, Roland CL, Schut AW, Sparber-Sauer M, Strauss DC, Van der Graaf WTA, Vitellaro M, Weiss AR, and Gronchi A
- Subjects
- Humans, Fibromatosis, Aggressive therapy, Fibromatosis, Aggressive pathology, Fibromatosis, Aggressive drug therapy
- Abstract
Importance: Desmoid tumor (DT) is a rare and locally aggressive monoclonal, fibroblastic proliferation characterized by a variable and often unpredictable clinical course. Previously, surgery was the standard primary treatment modality; however, within the past decade, a paradigm shift toward less-invasive management has been introduced and an effort to harmonize the strategy among clinicians has been made. To update the 2020 global evidence-based consensus guideline on the management of patients with DT, the Desmoid Tumor Working Group convened a 1-day consensus meeting in Milan, Italy, on June 30, 2023, under the auspices of the European Reference Network on Rare Adult Solid Cancers and Sarcoma Patient Advocacy Global Network, the Desmoid Foundation Italy, and the Desmoid Tumor Research Foundation. The meeting brought together over 90 adult and pediatric sarcoma experts from different disciplines as well as patients and patient advocates from around the world., Observations: The 2023 update of the global evidence-based consensus guideline focused on the positioning of local therapies alongside surgery and radiotherapy in the treatment algorithm as well as the positioning of the newest class of medical agents, such as γ-secretase inhibitors. Literature searches of MEDLINE and Embase databases were performed for English-language randomized clinical trials (RCTs) of systemic therapies to obtain data to support the consensus recommendations. Of the 18 full-text articles retrieved, only 4 articles met the inclusion criteria. The 2023 consensus guideline is informed by a number of new aspects, including data for local ablative therapies such as cryotherapy; other indications for surgery; and the γ-secretase inhibitor nirogacestat, the first representative of the newest class of medical agents and first approved drug for DT. Management of DT is complex and should be carried out exclusively in designated DT referral centers equipped with a multidisciplinary tumor board. Selection of the appropriate strategy should consider DT-related symptoms, associated risks, tumor location, disease morbidities, available treatment options, and preferences of individual patients., Conclusions and Relevance: The therapeutic armamentarium of DT therapy is continually expanding. It is imperative to carefully select the management strategy for each patient with DT to optimize tumor control and enhance quality of life.
- Published
- 2024
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43. Current management of familial adenomatous polyposis.
- Author
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Lauricella S, Rausa E, Pellegrini I, Ricci MT, Signoroni S, Palassini E, Cavalcoli F, Pasanisi P, Colombo C, and Vitellaro M
- Subjects
- Humans, Postoperative Complications prevention & control, Postoperative Complications etiology, Patient Care Team, Precision Medicine, Phenotype, Genotype, Fibromatosis, Aggressive therapy, Fibromatosis, Aggressive pathology, Adenomatous Polyposis Coli therapy, Adenomatous Polyposis Coli surgery, Quality of Life, Colectomy
- Abstract
Introduction: APC-associated polyposis is a rare hereditary disorder characterized by the development of multiple adenomas in the digestive tract. Individuals with APC-associated polyposis need to be managed by specialized multidisciplinary teams in dedicated centers., Areas Covered: The study aimed to review the literature on Familial adenomatous polyposis (FAP) to provide an update on diagnostic and surgical management while focusing on strategies to minimize the risk of desmoid-type fibromatosis, cancer in anorectal remnant, and postoperative complications. FAP individuals require a comprehensive approach that includes diagnosis, surveillance, preventive surgery, and addressing specific extracolonic concerns such as duodenal and desmoid tumors. Management should be personalized considering all factors: genotype, phenotype, and personal needs. Total colectomy and ileo-rectal anastomosis have been shown to yield superior QoL results when compared to Restorative Procto colectomy and ileopouch-anal anastomosis with acceptable oncological risk of developing cancer in the rectal stump if patients rigorously adhere to lifelong endoscopic surveillance. Additionally, a low-inflammatory diet may prevent adenomas and cancer by modulating systemic and tissue inflammatory indices., Expert Opinion: FAP management requires a multidisciplinary and personalized approach. Integrating genetic advances, innovative surveillance techniques, and emerging therapeutic modalities will contribute to improving outcomes and quality of life for FAP individuals.
- Published
- 2024
- Full Text
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44. Detection of (pre)cancerous colorectal lesions in Lynch syndrome patients by microsatellite instability liquid biopsy.
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Boeri M, Signoroni S, Ciniselli CM, Gariboldi M, Zanutto S, Rausa E, Segale M, Zanghì A, Ricci MT, Verderio P, Sozzi G, and Vitellaro M
- Subjects
- Humans, Liquid Biopsy methods, Female, Male, Middle Aged, Aged, Adult, Retrospective Studies, Precancerous Conditions genetics, Precancerous Conditions pathology, Precancerous Conditions diagnosis, Colorectal Neoplasms genetics, Colorectal Neoplasms pathology, Colorectal Neoplasms diagnosis, Biomarkers, Tumor genetics, Colorectal Neoplasms, Hereditary Nonpolyposis genetics, Colorectal Neoplasms, Hereditary Nonpolyposis diagnosis, Colorectal Neoplasms, Hereditary Nonpolyposis pathology, Microsatellite Instability
- Abstract
Lynch syndrome (LS) is an inherited condition characterized by an increased risk of developing cancer, in particular colorectal cancer (CRC). Microsatellite instability (MSI) is the main feature of (pre)cancerous lesions occurring in LS patients. Close endoscopic surveillance is the only option available to reduce CRC morbidity and mortality. However, it may fail to intercept interval cancers and patients' compliance to such an invasive procedure may decrease over the years. The development of a minimally invasive test able to detect (pre)cancerous colorectal lesions, could thus help tailor surveillance programs in LS patients. Taking advantage of an endoscopic surveillance program, we retrospectively assessed the instability of five microsatellites (BAT26, BAT25, NR24, NR21, and Mono27) in liquid biopsies collected at baseline and possibly at two further endoscopic rounds. For this purpose, we tested a new multiplex drop-off digital polymerase chain reaction (dPCR) assay, reaching mutant allele frequencies (MAFs) as low as 0.01%. Overall, 78 plasma samples at the three time-points from 18 patients with baseline (pre)cancerous lesions and 18 controls were available for molecular analysis. At baseline, the MAFs of BAT26, BAT25 and NR24 were significantly higher in samples of patients with lesions but did not differ with respect to the grade of dysplasia or any other clinico-pathological characteristics. When all markers were combined to determine MSI in blood, this test was able to discriminate lesion-bearing patients with an AUC of 0.80 (95%CI: 0.66; 0.94)., (© 2024. The Author(s).)
- Published
- 2024
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45. Current Management of Acute Severe Ulcerative Colitis: New Insights on the Surgical Approaches.
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Lauricella S, Brucchi F, Cavalcoli F, Rausa E, Cassini D, Miccini M, Vitellaro M, Cirocchi R, and Costa G
- Abstract
Acute severe ulcerative colitis (ASUC) is a life-threatening medical emergency with considerable morbidity. Despite recent advances in medical IBD therapy, colectomy rates for ASUC remain high. A scoping review of published articles on ASUC was performed. We collected data, such as general information of the disease, diagnosis and initial assessment, and available medical and surgical treatments focusing on technical aspects of surgical approaches. The most relevant articles were considered in this scoping review. The management of ASUC is challenging; currently, personalized treatment for it is unavailable. Sequential medical therapy should be administrated, preferably in high-volume IBD centers with close patient monitoring and indication for surgery in those cases with persistent symptoms despite medical treatment, complications, and clinical worsening. A total colectomy with end ileostomy is typically performed in the acute setting. Managing rectal stump is challenging, and all individual and technical aspects should be considered. Conversely, when performing elective colectomy for ASUC, a staged surgical procedure is usually preferred, thus optimizing the patients' status preoperatively and minimizing postoperative complications. The minimally invasive approach should be selected whenever technically feasible. Robotic versus laparoscopic ileal pouch-anal anastomosis (IPAA) has shown similar outcomes in terms of safety and postoperative morbidity. The transanal approach to ileal pouch-anal anastomosis (Ta-IPAA) is a recent technique for creating an ileal pouch-anal anastomosis via a transanal route. Early experiences suggest comparable short- and medium-term functional results of the transanal technique to those of traditional approaches. However, there is a need for additional comparative outcomes data and a better understanding of the ideal training and implementation pathways for this procedure. This manuscript predominantly explores the surgical treatment of ASUC. Additionally, it provides an overview of currently available medical treatment options that the surgeon should reasonably consider in a multidisciplinary setting.
- Published
- 2024
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46. Modulation of faecal miRNAs highlights the preventive effects of a Mediterranean low-inflammatory dietary intervention.
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Illescas O, Ferrero G, Belfiore A, Pardini B, Tarallo S, Ciniselli CM, Noci S, Daveri E, Signoroni S, Cattaneo L, Mancini A, Morelli D, Milione M, Cordero F, Rivoltini L, Verderio P, Pasanisi P, Vitellaro M, Naccarati A, and Gariboldi M
- Subjects
- Humans, Inflammation genetics, Inflammation prevention & control, Leukocyte L1 Antigen Complex, Pilot Projects, MicroRNAs genetics, Neoplasms
- Abstract
Background: Dietary interventions have been proposed as therapeutic approaches for several diseases, including cancer. A low-inflammatory Mediterranean dietary intervention, conducted as a pilot study in subjects with Familial Adenomatous Polyposis (FAP), reduced markers of local and systemic inflammation. We aim to determine whether this diet may modulate faecal microRNA (miRNA) and gene expression in the gut., Methods: Changes in the faecal miRNome were evaluated by small RNA sequencing at baseline (T0), after the three-month intervention (T1), and after an additional three months (T2). Changes in the transcriptome of healthy rectal mucosa and adenomas were evaluated by RNA sequencing at T0 and T2. The identification of validated miRNA-gene interactions and functional analysis of miRNA targets were performed using in silico approaches., Results: Twenty-seven subjects were included in this study. It was observed that the diet modulated 29 faecal miRNAs (p < 0.01; |log2 Fold Change|>1), and this modulation persisted for three months after the intervention. Levels of miR-3612-3p and miR-941 correlated with the adherence to the diet, miR-3670 and miR-4252-5p with faecal calprotectin, and miR-3670 and miR-6867 with serum calprotectin. Seventy genes were differentially expressed between adenoma and normal tissue, and most were different before the dietary intervention but reached similar levels after the diet. Functional enrichment analysis identified the proinflammatory ERK1/2, cell cycle regulation, and nutrient response pathways as commonly regulated by the modulated miRNAs and genes., Conclusions: Faecal miRNAs modulated by the dietary intervention target genes that participate in inflammation. Changes in levels of miRNAs and genes with oncogenic and tumour suppressor functions further support the potential cancer-preventive effect of the low-inflammatory Mediterranean diet., Clinical Trial Number Registration: NCT04552405, Registered in ClinicalTrials.gov., Competing Interests: Conflicts of interest No relevant conflicts of interest exist for all the authors. No funding sources had a role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and the decision to submit the manuscript for publication., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
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- 2024
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47. De novo germline pathogenic variant in Lynch Syndrome: A rare event or the tip of the iceberg?
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Brignola C, Volorio S, De Vecchi G, Zaffaroni D, Dall'Olio V, Mariette F, Sardella D, Capra F, Signoroni S, Rausa E, Vitellaro M, Pensotti V, and Ricci MT
- Subjects
- Female, Humans, Adult, Germ-Line Mutation, Mutation, Genetic Counseling, Germ Cells pathology, MutL Protein Homolog 1 genetics, DNA Mismatch Repair, Colorectal Neoplasms, Hereditary Nonpolyposis genetics
- Abstract
Lynch Syndrome is an autosomal dominant cancer predisposition syndrome caused by germline pathogenic variants or epimutation in one of the DNA mismatch repair genes. De novo pathogenic variants in mismatch repair genes have been described as a rare event in Lynch Syndrome (1-5%), although the prevalence of de novo pathogenic variants in Lynch Syndrome is probably underestimated. The de novo pathogenic variant was identified in a 26-year-old woman diagnosed with an adenocarcinoma of the caecum with mismatch repair protein deficiency at immunohistochemistry and a synchronous neuroendocrine tumor of the appendix with normal expression of mismatch repair proteins. DNA testing revealed deletion of exon 6 of the MLH1 gene. It appeared to be a de novo event, as the deletion was not detected in the patient's parents. The presence of a mosaicism in the patient was excluded and haplotype analysis demonstrated the paternal origin of the chromosome harboring the deletion. The de novo deletion probably originated either from a very early postzygotic or a single prezygotic mutational event, or from a gonadal mosaicism. In conclusion, the identification of de novo pathogenic variants is crucial to allow proper genetic counseling and appropriate management of the patient's family., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
- Published
- 2024
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48. Association between Pancreatoblastoma and Familial Adenomatous Polyposis: Review of the Literature with an Additional Case.
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Remo A, Negro S, Bao RQ, d'Angelo E, Alaggio R, Crivellari G, Mammi I, Intini R, Bergamo F, Fassan M, Agostini M, Vitellaro M, Pucciarelli S, and Urso EDL
- Subjects
- Adult, Humans, Germ-Line Mutation, Adenomatous Polyposis Coli genetics, Pancreatic Neoplasms epidemiology, Pancreatic Neoplasms genetics
- 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 APC germline pathogenic variants (GPVs)., 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.
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- 2023
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49. Quality of life after prophylactic surgery for colorectal adenomatous polyposis.
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Rausa E, Ciniselli CM, Signoroni S, Boer LS, Oldhoff L, Dijk L, Van Luijk F, Ricci MT, Ghidoli C, Duroni V, Brignola C, Borreani C, Alfieri S, Apolone G, Verderio P, and Vitellaro M
- Subjects
- Humans, Quality of Life, Colectomy, Adenomatous Polyposis Coli surgery, Adenomatous Polyposis Coli pathology, Colorectal Neoplasms prevention & control, Colorectal Neoplasms surgery, Proctocolectomy, Restorative
- Abstract
Purpose: Colorectal adenomatous polyposis is characterized by the onset of tens to thousands of adenomas in the colorectal epithelium and, if not treated, leads to a lifetime increased risk of developing colorectal cancer compared to the general population. Thus, prophylactic surgery is recommended. This study aims to investigate the quality of life of colorectal adenomatous polyposis patients following prophylactic surgery and indirectly compares these findings with those of healthy adults of the normative sample., Methods: All patients who underwent prophylactic surgery for polyposis and were in follow-up at the hereditary digestive tract tumors outpatient department of our institute were eligible for the study. The Short Form-36 questionnaire and 21 ad hoc items were used at the time of clinical evaluation., Results: A total of 102 patients were enrolled. For the SF-36 domains, mean values ranged from 64.18 for vitality to 88.49 for physical functioning, with the highest variability for role-physical limitations; the minimum value of functioning was reached for role-physical limitations, role-emotional limitations, and social functioning. The maximum value of functioning was reached for role-emotional limitations (73.96%) and role-physical limitations (60.42%). In total, 48.96% and 90.63% of patients reported no fecal or urinary incontinence episodes, respectively; 69.79% of patients did not have problems in work/school resumption or the personal sexual sphere., Conclusion: Quality of life following prophylactic surgery for these patients seems to be good when indirectly compared to HP-normative samples'. Young adult patients appear to quickly manage and adapt to changes in bowel functioning. A minority of patients may experience social and sexual issues., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
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- 2023
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50. Delphi Initiative for Early-Onset Colorectal Cancer (DIRECt) International Management Guidelines.
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Cavestro GM, Mannucci A, Balaguer F, Hampel H, Kupfer SS, Repici A, Sartore-Bianchi A, Seppälä TT, Valentini V, Boland CR, Brand RE, Buffart TE, Burke CA, Caccialanza R, Cannizzaro R, Cascinu S, Cercek A, Crosbie EJ, Danese S, Dekker E, Daca-Alvarez M, Deni F, Dominguez-Valentin M, Eng C, Goel A, Guillem JG, Houwen BBSL, Kahi C, Kalady MF, Kastrinos F, Kühn F, Laghi L, Latchford A, Liska D, Lynch P, Malesci A, Mauri G, Meldolesi E, Møller P, Monahan KJ, Möslein G, Murphy CC, Nass K, Ng K, Oliani C, Papaleo E, Patel SG, Puzzono M, Remo A, Ricciardiello L, Ripamonti CI, Siena S, Singh SK, Stadler ZK, Stanich PP, Syngal S, Turi S, Urso ED, Valle L, Vanni VS, Vilar E, Vitellaro M, You YN, Yurgelun MB, Zuppardo RA, and Stoffel EM
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- Humans, Genetic Testing, Endoscopy, Colorectal Neoplasms diagnosis
- Abstract
Background & Aims: Patients with early-onset colorectal cancer (eoCRC) are managed according to guidelines that are not age-specific. A multidisciplinary international group (DIRECt), composed of 69 experts, was convened to develop the first evidence-based consensus recommendations for eoCRC., Methods: After reviewing the published literature, a Delphi methodology was used to draft and respond to clinically relevant questions. Each statement underwent 3 rounds of voting and reached a consensus level of agreement of ≥80%., Results: The DIRECt group produced 31 statements in 7 areas of interest: diagnosis, risk factors, genetics, pathology-oncology, endoscopy, therapy, and supportive care. There was strong consensus that all individuals younger than 50 should undergo CRC risk stratification and prompt symptom assessment. All newly diagnosed eoCRC patients should receive germline genetic testing, ideally before surgery. On the basis of current evidence, endoscopic, surgical, and oncologic treatment of eoCRC should not differ from later-onset CRC, except for individuals with pathogenic or likely pathogenic germline variants. The evidence on chemotherapy is not sufficient to recommend changes to established therapeutic protocols. Fertility preservation and sexual health are important to address in eoCRC survivors. The DIRECt group highlighted areas with knowledge gaps that should be prioritized in future research efforts, including age at first screening for the general population, use of fecal immunochemical tests, chemotherapy, endoscopic therapy, and post-treatment surveillance for eoCRC patients., Conclusions: The DIRECt group produced the first consensus recommendations on eoCRC. All statements should be considered together with the accompanying comments and literature reviews. We highlighted areas where research should be prioritized. These guidelines represent a useful tool for clinicians caring for patients with eoCRC., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)
- Published
- 2023
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