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Abstracts of the 22
nd
National Congress of Digestive Diseases / Digestive and Liver Disease 48S2 (2016) e67–e231
and TRG response to CRT treatment that could be used to select
optimal therapy in rectal cancer patients.
OC.04.8
PROGNOSTIC ROLE OF 25-HYDROXYVITAMIN D IN PATIENTS
WITH LIVER METASTASES FROM COLORECTAL CANCER TREATED
WITH RADIOFREQUENCY ABLATION
Facciorusso A.*
1
, Del Prete V.
1
, Crucinio N.
1
, Barone M.
2
,
Muscatiello N.
1
1
University of Foggia, Foggia, Italy,
2
University of Bari, Bari, Italy
Background and aim:
Vitamin D is implicated in the etiology of
several neoplastic diseases but its relationship with colorectal
cancer survival is still unclear. Aim of this study was to determine
whether vitamin D levels influence survival outcomes in colorectal
cancer liver metastases (CLM) patients treated with percutaneous
radiofrequency ablation (RFA).
Material and methods:
We measured 25(OH)D3 levels in 143
patients with 215 CLMs who underwent RFA between 1999 and
2011 at our Institution. The influence of 25(OH)D3 levels on
overall survival (OS) and time to recurrence (TTR) was evaluated in
univariate and multivariate Cox analyses.
Results:
Median age was 68 years (range 41-85) and median number
of nodules was 2 (1-3) with a median maximum diameter of 26 mm
(10-48). Median OS was 44 months (36-62) and survival rate (SR)
was 91.4%, 46.5% and 42.2% at 1, 4 and 5 years in the whole cohort.
Median OS was 65 months (52-74) if 25(OH)D3 > 20 ng/mL and
34 months (24-41) if ≤ 20 ng/mL, (p<0.001). In the whole cohort,
median TTR was 34 months (26-47) with a recurrence-free survival
(RFS) rate of 79.4%, 37.7% and 27.4% at 1, 4 and 5 years. TTR was 50
months (36-62) in the case of 25(OH)D3 > 20 ng/mL and 24 months
(20-32) if ≤ 20 ng/mL (p<0.001). Nodule size and 25(OH)D3 resulted
as significant predictors of both OS and TTR in multivariate analysis.
Conclusions:
Our study provides support for the use of 25(OH)D3 as
a new predictor of outcome for CLM patients.
OC.04.9
SURVEILLANCE PROTOCOL FOR ABDOMINAL DESMOID TUMOURS
IN FAMILIAL ADENOMATOUS POLYPOSIS (FAP): EXPERIENCE OF A
REGIONAL REFERRAL CENTRE
Sanchez Mete L.*, Caterino M., Ferraresi V., Martayan A., Anti M.,
Stigliano V.
Regina Elena National Cancer Institute, Rome, Italy
Background and aim:
Desmoid tumours (DTs) are benign prolifera
tions of stromal cells, rare in the general population and common
in patients with Familial Adenomatous Polyposis (FAP) who have
undergone prophylactic colectomy. In 10% of the cases DTs show
a locally aggressive and rapid growth and are a main cause of
death after prophylactic colectomy in FAP patients. Nevertheless
International Guidelines have not defined a surveillance protocol
yet.
Aims of the present study were: to define a surveillance protocol
and to evaluate the best diagnostic tool between MRI and CT; to
identify DTs with aggressive behaviour.
Material and methods:
From January 2010 to September 2015
patients who referred to the “Regional Referral Centre for FAP of
Lazio Region” with a proven diagnosis of FAP were enrolled in the
study. All patients underwent contrast-enhanced (CE) abdominal CT
and MRI at least 1 year after prophilactic colectomy. Patients with
DTs and without intestinal obstruction and ureteral compression
received follow up examination after 6-12 months or alternatively
after 2-3 months. Patients without DTs underwent follow up
examination after 3 years. DTs growth assessment was performed
by using RECIST criteria 1.1. The “average monthly growth rate” was
also evaluated.
Results:
75 patients (40M/35F) were enrolled in the study. DTs were
detected in 13/75 (17.3%) cases (7M/6F): 3 abdominal wall DTs (AWD)
and 10 intrabdominal DTs (IAD). The average age at diagnosis was
31.6 years (range 19-53), the average time of onset after colectomy
was 19.8 months (range 9-34). In 4/13 cases (30.7%) the IAD showed
an aggressive behaviour (asymptomatic intestinal obstruction and
ureteral compression seen at imaging in 3 cases and symptomatic
intestinal perforation in one case). The “average monthly growth
rate” was 0.58 cm (range 0,47 cm-0,75 cm) for an average follow up
of 11 months (range 4-20 months). The highest value was detected
in the unique symptomatic case. CT was better than MRI for imaging
IAD in 13 vs 9 cases.
Conclusions:
The proposed surveillance protocol allowed to detect
early asymptomatic intestinal obstruction and ureteral compression
in 3 cases improving clinical management. CT had a better
diagnostic output than MRI and could play an important role for
the first diagnosis OF DTs. The evaluation of the “average monthly
growth rate” could allow the identification of IAD with aggressive
behaviour, improving, thus, the clinical management.
OC.05 Esophagus
OC.05.1
PROLONGED INTRA-ESOPHAGEAL PH PROFILE AND ESOPHAGEAL
MOTILITY IN CHILDREN WITH EOSINOPHILIC ESOPHAGITIS
Rossi P.*, Isoldi S., Mallardo S., Oliva S., Biscione G., Rossetti D.,
Lucarelli S., Cucchiara S.
policlinico Umberto I, Roma, Italy
Background and aim:
Patients (pts) with eosinophilic esophagitis
(EoE), a chronic immune-mediated disorder, may exhibit symptoms
of disturbed food transit (i.e. dysphagia, impaction) or mimicking
gastro-oesophageal reflux (GOR). We aimed at characterizing in
EoE pts the intra-esophageal pH pattern with 24-h multichannel
intraluminal impedance (MII-pH) as well as the esophageal motility
with high-resolution manometry (EHRM)
Material and methods:
during a 30 month period we studied 57
patients (pts), median age 11 years (range: 7-16): 25 with EoE,
diagnosed according to widely agreed criteria (JPGN 2014;58:107-
18; ESPGHAN guidelines) and 32 with GOR disease (GORD). All
underwent esophagogastro-duodenoscopy, MII-pH and EHRM. The
pH-MII and data analysis were done according to ESPGHAN EURO-