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1. Gastric neuroendocrine tumors: 20‐Year experience in a reference center

Author

Ravizza, D, Giunta, M, Sala, I, Bagnardi, V, Tamayo, D, de Roberto, G, Trovato, C, Bravi, I, Soru, P, Maregatti, M, Pisa, E, Bertani, E, Bonomo, G, Spada, F, Nicola, F, Ravizza, Davide, Giunta, Mariangela, Sala, Isabella, Bagnardi, Vincenzo, Tamayo, Darina, de Roberto, Giuseppe, Trovato, Cristina, Bravi, Ivana, Soru, Pietro, Maregatti, Margherita, Pisa, Eleonora, Bertani, Emilio, Bonomo, Guido, Spada, Francesca, Nicola, Fazio, Ravizza, D, Giunta, M, Sala, I, Bagnardi, V, Tamayo, D, de Roberto, G, Trovato, C, Bravi, I, Soru, P, Maregatti, M, Pisa, E, Bertani, E, Bonomo, G, Spada, F, Nicola, F, Ravizza, Davide, Giunta, Mariangela, Sala, Isabella, Bagnardi, Vincenzo, Tamayo, Darina, de Roberto, Giuseppe, Trovato, Cristina, Bravi, Ivana, Soru, Pietro, Maregatti, Margherita, Pisa, Eleonora, Bertani, Emilio, Bonomo, Guido, Spada, Francesca, and Nicola, Fazio

Abstract

Few studies have been published on the long-term outcomes of patients with gastric neuroendocrine tumors (gNETs). We analyzed their management over a two-decade period, focusing on endoscopic and clinical outcomes. Clinical, laboratory, endoscopic, surgical, and histopathological data from Types 1 and 3 gNETs histologically diagnosed between March 2000 and December 2021 at the European Institute of Oncology (IEO, Milan) were retrospectively collected. Sixty-nine patients were included (60 Type 1, 9 Type 3): 53 (77%) were treated endoscopically, 6 (9%) surgically, and 10 (14%) did not receive any treatment. Overall, 293 lesions were removed endoscopically: 74% by forceps, 20% by endoscopic mucosal resection (EMR), and 5% by endoscopic submucosal dissection (ESD). No differences were observed between EMR and ESD in terms of complete resection rate (p value = .50) and complications rate (p value = .084). The median follow-up period was 5.8 years (range: 0.3-20.5), during which no gNET-related deaths were observed. Metachronous gNETs developed in 60% of patients with Type 1 gNET. Six patients with lymph node metastases (LNM) were younger (p value = .006) and had larger lesions (p value <.001) than patients without LNM. Most Type 1 gNETs were successfully excised using forceps, with EMR and ESD being equally effective. The presence of incomplete resection was not associated with a worse prognosis, which remains excellent in this highly recurrent disease. Younger age and a size ≥10 mm were associated with an increased risk of LNM. CLINICAL TRIAL REGISTRATION: Project code UID 2854.

Published
2024

4. Pharmacokinetics of oral mannitol for bowel preparation for colonoscopy

Author

Fiori, G., Spada, Cristiano, Soru, P., Tontini, G. E., Bravi, I., Cesana, Bruno Mario, Cesaro, Paola, Manes, G., Orsatti, A., Prada, A., Quadarella, Alessandro, Schettino, M., Spina, L., Trovato, C., Carnovali, M., Vecchi, M., Cavallaro, Fabio, Codazzi, M., De Nucci, G., De Roberto, G., Devani, M., Di Paolo, D., Elli, L., Hinkel, C., Jakobs, R., Janke, D., Lombardo, V., Lovera, Mauro, Radaelli, F., Ravizza, D., Uebel, P., Valats, J. C., Vollmar, J., Zimmermann, Thomas Alexander, Ciprandi, Guido, Spada C. (ORCID:0000-0002-5692-0960), Cesana B. M., Cesaro P., Quadarella A., Cavallaro F., Lovera M., Zimmermann T., Ciprandi G., Fiori, G., Spada, Cristiano, Soru, P., Tontini, G. E., Bravi, I., Cesana, Bruno Mario, Cesaro, Paola, Manes, G., Orsatti, A., Prada, A., Quadarella, Alessandro, Schettino, M., Spina, L., Trovato, C., Carnovali, M., Vecchi, M., Cavallaro, Fabio, Codazzi, M., De Nucci, G., De Roberto, G., Devani, M., Di Paolo, D., Elli, L., Hinkel, C., Jakobs, R., Janke, D., Lombardo, V., Lovera, Mauro, Radaelli, F., Ravizza, D., Uebel, P., Valats, J. C., Vollmar, J., Zimmermann, Thomas Alexander, Ciprandi, Guido, Spada C. (ORCID:0000-0002-5692-0960), Cesana B. M., Cesaro P., Quadarella A., Cavallaro F., Lovera M., Zimmermann T., and Ciprandi G.

Abstract

This study aimed to define the pharmacokinetics (PKs) of oral mannitol used as an osmotic laxative for bowel preparation for colonoscopy. The PKs of oral mannitol was evaluated in a substudy as part of a phase II dose-finding, international, multicenter, randomized, parallel-group, endoscopist-blinded study. Patients were randomly assigned to take 50, 100, or 150 g mannitol. Venous blood samples were drawn at baseline (T0), 1 h (T1), 2 h (T2), 4 h (T4), and 8 h (T8) after completion of mannitol self-administration. The mean mannitol plasma concentrations (mg/ml) were dose-dependent with a consistent difference among doses. The mean maximum concentration (Cmax) ± SD was 0.63 ± 0.15, 1.02 ± 0.28, and 1.36 ± 0.39 mg/ml, in the three dosage groups, respectively. The mean area under the curve from zero to infinity (AUC0−∞) was 2.667 ± 0.668, 4.992 ± 1.706, and 7.403 ± 3.472 mg/ml*h in the 50, 100, and 150 g mannitol dose groups, respectively. Bioavailability was similar in the three dose groups and was just over 20% (0.243 ± 0.073, 0.209 ± 0.081, and 0.228 ± 0.093 in the 50, 100, and 150 g mannitol dose groups, respectively). The present study showed that the bioavailability of oral mannitol is just over 20% and is similar for the three tested doses (50, 100, and 150 g). The linear increase in Cmax, AUC0−t8, and AUC0−∞ must be considered when choosing the oral mannitol dose for bowel preparation to avoid its systemic osmotic effects.

Published
2022

6. Preoperative versus postoperative docetaxel–cisplatin–fluorouracil (TCF) chemotherapy in locally advanced resectable gastric carcinoma: 10-year follow-up of the SAKK 43/99 phase III trial†

Author

Fazio, N., Biffi, R., Maibach, R., Hayoz, S., Thierstein, S., Brauchli, P., Bernhard, J., Stupp, R., Andreoni, B., Renne, G., Crosta, C., Morant, R., Chiappa, A., Luca, F., Zampino, M. G., Huber, O., Goldhirsch, A., de Braud, F., Roth, A. D., Pace, U., Cenciarelli, S., Pozzi, S., Bertani, E., Mura, S., Lorizzo, K., Di Meglio, G., Ravizza, D., Boselli, S., Matter, M., Richter, M., Monfardini, S., Dittrich, C., Häfner, M., and Clemens, M.

Published
2016
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21. Breakthrough during recombinant interferon alfa therapy in patients with chronic hepatitis C virus infection: prevalence, etiology, and management

Author

Roffi, L, Mels, G, Antonelli, G, Bellati, G, Panizzuti, F, Pozzi, M, Ravizza, D, Angeli, G, Dianzani, F., PIPERNO, ALBERTO, Roffi, L, Mels, G, Antonelli, G, Bellati, G, Panizzuti, F, Piperno, A, Pozzi, M, Ravizza, D, Angeli, G, and Dianzani, F

Subjects
Adult, Male, Adolescent, Antibodie, Interferon-alpha, Alanine Transaminase, Recombinant Protein, Middle Aged, Hepatitis C, Antibodies, Recombinant Proteins, Treatment Outcome, Recurrence, Chronic Disease, Prevalence, Humans, Female, Human, Aged
Abstract

Recombinant interferon alfa (r-IFN alpha 2) has been shown to normalize the aminotransferase levels in approximately 50% of patients with chronic hepatitis C virus (HCV). Few patients experience a relapse during the treatment, in spite of a complete initial response (breakthrough). We studied 191 HCV Ab-positive patients with histologically proven chronic hepatitis. All of them were treated with r-IFN alpha 2 (3 MU three times a week). A complete response was seen in 54.4%. However, 12 of 104 responders experienced a breakthrough. At the time of breakthrough, neutralizing IFN antibodies were positive in 6 of 12 patients. Binding IFN antibodies were positive in all of these 12 patients. Continued treatment with r-IFN alpha 2, even at higher doses, did not restore the previous response in any patient. All of them were then switched to natural lymphoblastoid IFN, and this rapidly restored a complete response in all of the patients.

Published
1995

34. A massive gastric xanthomatosis

Author

De Roberto, G., primary, Ravizza, D., additional, Fiori, G., additional, Trovato, C., additional, Maffini, F., additional, Tamayo, D., additional, and Crosta, C., additional

Published
2009
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40. Results of sub-nanosecond laser-conditioning of KD 2 PO 4 crystals

Author

Adams, J. J., primary, Jarboe, J. A., additional, Carr, C. W., additional, Feit, M. D., additional, Hackel, R. P., additional, Halpin, J. M., additional, Honig, J., additional, Lane, L. A., additional, Luthi, R. L., additional, Peterson, J. E., additional, Ravizza, D. L., additional, Ravizza, F., additional, Rubenchik, A. M., additional, Sell, W. D., additional, Vickers, J. L., additional, Weiland, T. L., additional, Wennberg, T. J., additional, Willard, D. A., additional, and Yeoman, M. F., additional

Published
2006
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44. Frequency and outcomes of rectal ulcers during argon plasma coagulation for chronic radiation-induced proctopathy

Author

Ravizza, D., Fiori, G., Trovato, C., and Crosta, C.

Abstract

Background: Argon plasma coagulation is suitable for treating hemorrhagic GI tract lesions. This study evaluated the frequency and clinical outcomes of complications arising during use of argon plasma coagulation to treat chronic radiation-induced proctopathy. Methods: This uncontrolled prospective study included 27 consecutive patients. Fever and any rectal symptoms or signs were assessed by telephone with a structured questionnaire. Patients with symptoms underwent endoscopy; follow-up examination was performed when rectal complications developed. Results: Fifty-nine therapeutic sessions were performed (mean 2 per patient; mean interval between sessions, 72.5 days); mean follow-up was 11.5 months. The treatment reduced the mean bleeding severity score from 2.8 to 0.5 (p<0.001). Two patients (7%) experienced fever and anal pain, and 14 (52%) developed rectal ulcers but remained asymptomatic; ulcer detection never precluded further treatment. Ulcer healing was assessed in 7 patients after a mean of 141 days; no strictures were observed. Conclusions: The frequency of complications during argon plasma coagulation for radiation-induced proctopathy was high in the present series (59%), the most frequent untoward event being the development of rectal ulcers in asymptomatic patients. However, given the benign outcome, these lesions do not necessitate discontinuation of treatment or additional monitoring.

Published
2003
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47. Iatrogenic gastroduodenal ulcers during hepatic intra-arterial chemotherapy

Author

Ravizza, D., Fazio, N., Crosta, C., Fiori, G., Orsi, F., Grasso, R., Medici, M., Gianluigi FERRETTI, and Braud, F.

Subjects
Male, Antimetabolites, Antineoplastic, Peptic Ulcer, Antibiotics, Antineoplastic, Mitomycin, Iatrogenic Disease, Liver Neoplasms, Antineoplastic Agents, Middle Aged, Cohort Studies, Humans, Infusions, Intra-Arterial, Female, Endoscopy, Digestive System, Fluorouracil, Cisplatin, Aged, Retrospective Studies
Abstract

Various percentages of iatrogenic gastroduodenal ulcers during hepatic intra-arterial chemotherapy have been reported in the literature. The aim of this study was to analyze a homogeneous cohort of patients in order to evaluate the evolution and management of this complication.We retrospectively reviewed the clinical charts of 80 patients with primary or metastatic liver tumors who received 186 hepatic arterial infusion chemotherapy courses of 5-fluorouracil, cisplatin and mitomycin-C. All of the patients complaining of upper gastrointestinal symptoms during or after hepatic arterial infusion underwent esophagogastroduodenoscopy.Esophagogastroduodenoscopy was performed in 14 patients, all of whom had gastroduodenal ulcers. Two of ten investigated patients were Helicobacter pylori positive. All of the patients were treated with a proton pump inhibitor and five also received major analgesics. All of the ulcers healed without complications. Six patients did not continue with hepatic arterial infusion for reasons other than ulcers. Eight patients received a subsequent hepatic intra-arterial chemotherapy course, five despite the persistence of an active ulcer.Iatrogenic gastroduodenal ulcers are probably due to ischemia and the direct toxicity of the anticancer agents. They are Helicobacter pylori independent and do not represent an absolute contraindication for the continuation of hepatic intra-arterial chemotherapy.

48. On impact and volcanism across the Cretaceous-Paleogene boundary

Author

Hull, P. M., Bornemann, A., Penman, D., Henehan, M. J., Norris, R. D., Wilson, P. A., Blum, P., Alegret, L., Batenburg, S., Bown, P. R., Bralower, T. J., Cournede, C., Deutsch, A., Donner, B., Friedrich, O., Jehle, S., Kim, H., Kroon, D., Lippert, P., Loroch, D., Moebius, I., Moriya, K., Peppe, D. J., Ravizza, D. E., Röhl, U., Schueth, J. D., Sepúlveda, J., Sexton, P., Sibert, E., Śliwińska, K. K., Summons, R. E., Thomas, E., Westerhold, T., Whiteside, T. J., Yamaguchi, T., Zachos, J. C., Hull, P. M., Bornemann, A., Penman, D., Henehan, M. J., Norris, R. D., Wilson, P. A., Blum, P., Alegret, L., Batenburg, S., Bown, P. R., Bralower, T. J., Cournede, C., Deutsch, A., Donner, B., Friedrich, O., Jehle, S., Kim, H., Kroon, D., Lippert, P., Loroch, D., Moebius, I., Moriya, K., Peppe, D. J., Ravizza, D. E., Röhl, U., Schueth, J. D., Sepúlveda, J., Sexton, P., Sibert, E., Śliwińska, K. K., Summons, R. E., Thomas, E., Westerhold, T., Whiteside, T. J., Yamaguchi, T., and Zachos, J. C.

Abstract

The cause of the end-Cretaceous mass extinction is vigorously debated, owing to the occurrence of a very large bolide impact and flood basalt volcanism near the boundary. Disentangling their relative importance is complicated by uncertainty regarding kill mechanisms and the relative timing of volcanogenic outgassing, impact, and extinction. We used carbon cycle modeling and paleotemperature records to constrain the timing of volcanogenic outgassing. We found support for major outgassing beginning and ending distinctly before the impact, with only the impact coinciding with mass extinction and biologically amplified carbon cycle change. Our models show that these extinction-related carbon cycle changes would have allowed the ocean to absorb massive amounts of carbon dioxide, thus limiting the global warming otherwise expected from postextinction volcanism.

49. On impact and volcanism across the Cretaceous-Paleogene boundary

Author

Hull, P. M., Bornemann, A., Penman, D., Henehan, M. J., Norris, R. D., Wilson, P. A., Blum, P., Alegret, L., Batenburg, S., Bown, P. R., Bralower, T. J., Cournede, C., Deutsch, A., Donner, B., Friedrich, O., Jehle, S., Kim, H., Kroon, D., Lippert, P., Loroch, D., Moebius, I., Moriya, K., Peppe, D. J., Ravizza, D. E., Röhl, U., Schueth, J. D., Sepúlveda, J., Sexton, P., Sibert, E., Śliwińska, K. K., Summons, R. E., Thomas, E., Westerhold, T., Whiteside, T. J., Yamaguchi, T., Zachos, J. C., Hull, P. M., Bornemann, A., Penman, D., Henehan, M. J., Norris, R. D., Wilson, P. A., Blum, P., Alegret, L., Batenburg, S., Bown, P. R., Bralower, T. J., Cournede, C., Deutsch, A., Donner, B., Friedrich, O., Jehle, S., Kim, H., Kroon, D., Lippert, P., Loroch, D., Moebius, I., Moriya, K., Peppe, D. J., Ravizza, D. E., Röhl, U., Schueth, J. D., Sepúlveda, J., Sexton, P., Sibert, E., Śliwińska, K. K., Summons, R. E., Thomas, E., Westerhold, T., Whiteside, T. J., Yamaguchi, T., and Zachos, J. C.

Abstract

The cause of the end-Cretaceous mass extinction is vigorously debated, owing to the occurrence of a very large bolide impact and flood basalt volcanism near the boundary. Disentangling their relative importance is complicated by uncertainty regarding kill mechanisms and the relative timing of volcanogenic outgassing, impact, and extinction. We used carbon cycle modeling and paleotemperature records to constrain the timing of volcanogenic outgassing. We found support for major outgassing beginning and ending distinctly before the impact, with only the impact coinciding with mass extinction and biologically amplified carbon cycle change. Our models show that these extinction-related carbon cycle changes would have allowed the ocean to absorb massive amounts of carbon dioxide, thus limiting the global warming otherwise expected from postextinction volcanism.

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