Ermanno Ancona - Academia.edu (original) (raw)
Papers by Ermanno Ancona
Digestive and Liver Disease, 2000
The endoscopic palliation with metal stents has proved to be a simple, well-tolerated and lasting... more The endoscopic palliation with metal stents has proved to be a simple, well-tolerated and lasting method. We present here our resuhs regarding the safetv and efficacv of self-emandine metal stems. Methods: from
Diseases of the Esophagus, 1988
Perforation of the esophagus is considered to be one of the most dangerous esophageal diseases wi... more Perforation of the esophagus is considered to be one of the most dangerous esophageal diseases with regard to morbidity and mortality. In the majority of the cases the perforation has an iatrogenic cause, and this explains why many different treatments are proposed in the medical literature to reduce the death rate.
Clinical Cancer Research, Feb 1, 2011
Purpose: Targeting the tumor vasculature by vascular disrupting agents (VDAs) has shown therapeut... more Purpose: Targeting the tumor vasculature by vascular disrupting agents (VDAs) has shown therapeutic activity in mouse models. In most cases, however, VDA efficacy is substantially compromised by the inability of these drugs to completely kill tumor cells located at the periphery of the tumor mass. In this study, we investigated anti-tumor effects of L19mTNFa, a fusion protein composed of L19 (scFv), specific for the angiogenesis-associated ED-B containing fibronectin isoform, and murine TNFa, in xenograft models of esophageal cancer. Experimental design: We evaluated ED-B expression in esophageal cancer samples. Subsequently, we generated subcutaneous xenografts from primary tumors, treated them with the L19mTNFa scFv, and determined effects on tumor vasculature, viability and proliferation, and VEGF expression and infiltration by hematopoietic cells. To overcome tumor resistance, L19mTNFa scFv was combined with vandetanib, a tyrosine kinase inhibitor of VEGF receptor, epidermal growth factor receptor, and RET signaling. Results: ED-B was broadly expressed by esophageal cancer cell lines, as well as xenografts and primary surgical samples of esophageal cancer. Administration of L19mTNFa acutely damaged tumor vasculature and increased necrosis, indicating a VDA-like activity of this immunoconjugate. This event was followed, however, by rapid tumor growth recovery associated with increased expression of VEGF and recruitment of CD11bþGr1þ myeloid cells into tumors. Combination of L19mTNFa with vandetanib severely impaired vascular functions in tumors, leading to a reduction of cell proliferation and increased necrosis, without apparent signs of toxicity. Conclusion: These findings indicate that a combination of vascular damaging agents with antiangiogenic drugs could represent a promising therapeutic strategy for esophageal cancer. Clin Cancer Res; 17(3); 447-58. Ó2010 AACR.
Annali italiani di chirurgia
From 1990 to 1995, 187 patients underwent esophagectomy and esophagogastrostomy with the anastomo... more From 1990 to 1995, 187 patients underwent esophagectomy and esophagogastrostomy with the anastomosis performed inside the chest using a circular stapler. Twenty-three patients (12.3%) developed an anastomotic stricture. The incidence of anastomotic stricture was inversely related to the diameter of the stapler. Also concomitant cardiovascular diseases, morpho-functional disorders of the tubulized stomach (possible related to duodeno-gastric reflux) and neoadjuvant chemotherapy were recognized as significant risks factors. Endoscopic dilations were safe and effective in the treatment of anastomotic strictures.
Annali italiani di chirurgia
Recently, it has been demonstrated that the surgical treatment of gastro-esophageal reflux diseas... more Recently, it has been demonstrated that the surgical treatment of gastro-esophageal reflux disease is superior to the medical treatment. Further, the surgical treatment gained new popularity because of the introduction and diffusion of laparoscopic techniques. A careful definition of gastro-esophageal reflux disease, based on the underlying pathophysiological abnormality (i.e.: an increased exposure of the distal esophagus to the refluxed acid juice), and a proper selection of patients candidate to surgery must however be maintained, together with a proper surgical technique, in order to achieve satisfactory results. In this paper, the authors outline in this paper the general principles of anti-reflux surgery and review the most recent results obtained with Nissen fundoplication as well as with other antireflux procedures. They describe in detail the surgical technique of the Nissen fundoplication ("Floppy" Nissen) by a laparoscopic approach. They review their experience ...
Diseases of the Esophagus, 1988
Antireflux operations are widely employed for relief of gastroesophageal reflux (GER) unresponsiv... more Antireflux operations are widely employed for relief of gastroesophageal reflux (GER) unresponsive to medical treatment. Whatever the adopted surgical technique is, long-term follow-up studies reveal that 10%–15% of patients still complain of symptoms which may or may not be related to the recurrence of GER [1]. Postlethwait [2] reports 9% of poor results after antireflux surgery on 4805 collected cases.
Scandinavian Journal of Gastroenterology, 1989
Oesophageal motility and lower oesophageal sphincter (LOS) competence were investigated in 13 pat... more Oesophageal motility and lower oesophageal sphincter (LOS) competence were investigated in 13 patients with progressive systemic sclerosis (PSS) and in 16 patients with localized scleroderma (LS) by means of oesophageal manometry and 24-h pH monitoring of the distal oesophagus. Results were compared with those of a control group consisting of asymptomatic volunteers. Marked abnormalities in oesophageal motility and in acid exposure in the distal oesophagus were observed in PSS patients only. The mean resting pressure of the LOS was 10.1 +/- 1.5 mmHg in PSS, 21.4 +/- 1.1 mmHg in LS, and 23.8 +/- 2.0 mmHg in asymptomatic controls. Overall sphincter length was 24.1 +/- 3.4 mm in PSS, 31.1 +/- 1.6 mm in LS, and 39.0 +/- 2.0 mm in the control group. Spincter abdominal length was 12.1 +/- 2 mm, 15.4 +/- 1 mm, and 25.0 +/- 1 mm, respectively. The amplitude and duration of oesophageal waves were markedly reduced at 5, 10, and 15 cm above the LOS in PSS patients, with only the upper part of their gullet being spared. An abnormal acid exposure in the distal oesophagus was observed in 84.6% of PSS patients, whereas only 18.2% (2 of 11) of pH-tested LS patients had an abnormal 24-h pH test. These data show that a marked oesophageal involvement is present only in the systemic form of scleroderma. Oesophageal tests may be useful for a circumstantial diagnosis whenever the diagnosis of PSS is uncertain; however, their use does not seem to be justified as routine in patients with LS.
Oncology Reports, 1995
The epidermal growth factor receptor (EGFr) and the erbB2 protein (p185) concentrations were asse... more The epidermal growth factor receptor (EGFr) and the erbB2 protein (p185) concentrations were assessed in 31 esophageal cancer specimens and in the corresponding normal mucosa, in order to investigate the possible links with the main clinical and pathological parameters. Detectable and high affinity EGFr was found in 27/31 cancer and in 18/31 normal tissue samples. EGFr concentrations were not significantly different between cancer and normal tissue, although a trend toward higher levels in cancer was found. No relationships were found with histologic type, tumor bulk, lymph node status, pathologic stage, ploidy and type of surgical resection. A significant negative correlation between EGFr levels and overall survival was found. Detectable levels of p185 were found in all the tissues examined, but the expression was higher in adenocarcinoma than in squamous cell carcinoma samples. The EGFr role in malignant transformation still has to be established, but the determination could be of clinical use. As for p185, its role in the onset of esophageal cancer could be confined to the subgroup of the adenocarcinomas.
Digestive Surgery, 1984
Prolonged pH monitoring of the distal oesophagus is considered the most sensitive test for detect... more Prolonged pH monitoring of the distal oesophagus is considered the most sensitive test for detecting gastro-oesophageal reflux (GOR). Local patterns of GOR are needed because of its large diffusion in countries with different dietetic and behavioural habits and the use of the test in ...
British Journal of Cancer, Jan 18, 2011
BACKGROUND: Preoperative chemoradiotherapy (CRT) improves the survival of patients with oesophage... more BACKGROUND: Preoperative chemoradiotherapy (CRT) improves the survival of patients with oesophageal cancer when compared with surgery alone. METHODS: We conducted a phase II, multicenter trial of FOLFOX-4 and cetuximab in patients with locally advanced oesophageal cancer (LAEC) followed by daily radiotherapy (180 cGy fractions to 5040 cGy) with concurrent weekly cetuximab. Cytokines levels potentially related to cetuximab efficacy were assessed using multiplex-bead assays and enzyme-linked immunosorbent assay at baseline, at week 8 and at week 17. Primary end point was complete pathological response rate (pCR). RESULTS: In all, 41 patients were enroled. Among 30 patients who underwent surgery, a pCR was observed in 8 patients corresponding to a rate of 27%. The most frequent grade 3/4 toxicity was skin (30%) and neutropenia (30%). The 36-month survival rates were 85 and 52% in patients with pathological CR or PR vs 38 and 33% in patients with SD or PD. CONCLUSIONS: Incorporating cetuximab into a preoperative regimen for LAEC is feasible; no correlation between cytokines changes and patient outcome was observed. Positron emission tomography/computed tomography study even if influenced by the small number of patients appears to be able to predict patients outcome both as early and late metabolic response.
Minimally Invasive Therapy & Allied Technologies, 2019
Journal of Hepatology, 1992
Wolfgang Pabst Verlag Scientific Publishers, 1992
Digestive and Liver Disease, 2000
The endoscopic palliation with metal stents has proved to be a simple, well-tolerated and lasting... more The endoscopic palliation with metal stents has proved to be a simple, well-tolerated and lasting method. We present here our resuhs regarding the safetv and efficacv of self-emandine metal stems. Methods: from
Diseases of the Esophagus, 1988
Perforation of the esophagus is considered to be one of the most dangerous esophageal diseases wi... more Perforation of the esophagus is considered to be one of the most dangerous esophageal diseases with regard to morbidity and mortality. In the majority of the cases the perforation has an iatrogenic cause, and this explains why many different treatments are proposed in the medical literature to reduce the death rate.
Clinical Cancer Research, Feb 1, 2011
Purpose: Targeting the tumor vasculature by vascular disrupting agents (VDAs) has shown therapeut... more Purpose: Targeting the tumor vasculature by vascular disrupting agents (VDAs) has shown therapeutic activity in mouse models. In most cases, however, VDA efficacy is substantially compromised by the inability of these drugs to completely kill tumor cells located at the periphery of the tumor mass. In this study, we investigated anti-tumor effects of L19mTNFa, a fusion protein composed of L19 (scFv), specific for the angiogenesis-associated ED-B containing fibronectin isoform, and murine TNFa, in xenograft models of esophageal cancer. Experimental design: We evaluated ED-B expression in esophageal cancer samples. Subsequently, we generated subcutaneous xenografts from primary tumors, treated them with the L19mTNFa scFv, and determined effects on tumor vasculature, viability and proliferation, and VEGF expression and infiltration by hematopoietic cells. To overcome tumor resistance, L19mTNFa scFv was combined with vandetanib, a tyrosine kinase inhibitor of VEGF receptor, epidermal growth factor receptor, and RET signaling. Results: ED-B was broadly expressed by esophageal cancer cell lines, as well as xenografts and primary surgical samples of esophageal cancer. Administration of L19mTNFa acutely damaged tumor vasculature and increased necrosis, indicating a VDA-like activity of this immunoconjugate. This event was followed, however, by rapid tumor growth recovery associated with increased expression of VEGF and recruitment of CD11bþGr1þ myeloid cells into tumors. Combination of L19mTNFa with vandetanib severely impaired vascular functions in tumors, leading to a reduction of cell proliferation and increased necrosis, without apparent signs of toxicity. Conclusion: These findings indicate that a combination of vascular damaging agents with antiangiogenic drugs could represent a promising therapeutic strategy for esophageal cancer. Clin Cancer Res; 17(3); 447-58. Ó2010 AACR.
Annali italiani di chirurgia
From 1990 to 1995, 187 patients underwent esophagectomy and esophagogastrostomy with the anastomo... more From 1990 to 1995, 187 patients underwent esophagectomy and esophagogastrostomy with the anastomosis performed inside the chest using a circular stapler. Twenty-three patients (12.3%) developed an anastomotic stricture. The incidence of anastomotic stricture was inversely related to the diameter of the stapler. Also concomitant cardiovascular diseases, morpho-functional disorders of the tubulized stomach (possible related to duodeno-gastric reflux) and neoadjuvant chemotherapy were recognized as significant risks factors. Endoscopic dilations were safe and effective in the treatment of anastomotic strictures.
Annali italiani di chirurgia
Recently, it has been demonstrated that the surgical treatment of gastro-esophageal reflux diseas... more Recently, it has been demonstrated that the surgical treatment of gastro-esophageal reflux disease is superior to the medical treatment. Further, the surgical treatment gained new popularity because of the introduction and diffusion of laparoscopic techniques. A careful definition of gastro-esophageal reflux disease, based on the underlying pathophysiological abnormality (i.e.: an increased exposure of the distal esophagus to the refluxed acid juice), and a proper selection of patients candidate to surgery must however be maintained, together with a proper surgical technique, in order to achieve satisfactory results. In this paper, the authors outline in this paper the general principles of anti-reflux surgery and review the most recent results obtained with Nissen fundoplication as well as with other antireflux procedures. They describe in detail the surgical technique of the Nissen fundoplication ("Floppy" Nissen) by a laparoscopic approach. They review their experience ...
Diseases of the Esophagus, 1988
Antireflux operations are widely employed for relief of gastroesophageal reflux (GER) unresponsiv... more Antireflux operations are widely employed for relief of gastroesophageal reflux (GER) unresponsive to medical treatment. Whatever the adopted surgical technique is, long-term follow-up studies reveal that 10%–15% of patients still complain of symptoms which may or may not be related to the recurrence of GER [1]. Postlethwait [2] reports 9% of poor results after antireflux surgery on 4805 collected cases.
Scandinavian Journal of Gastroenterology, 1989
Oesophageal motility and lower oesophageal sphincter (LOS) competence were investigated in 13 pat... more Oesophageal motility and lower oesophageal sphincter (LOS) competence were investigated in 13 patients with progressive systemic sclerosis (PSS) and in 16 patients with localized scleroderma (LS) by means of oesophageal manometry and 24-h pH monitoring of the distal oesophagus. Results were compared with those of a control group consisting of asymptomatic volunteers. Marked abnormalities in oesophageal motility and in acid exposure in the distal oesophagus were observed in PSS patients only. The mean resting pressure of the LOS was 10.1 +/- 1.5 mmHg in PSS, 21.4 +/- 1.1 mmHg in LS, and 23.8 +/- 2.0 mmHg in asymptomatic controls. Overall sphincter length was 24.1 +/- 3.4 mm in PSS, 31.1 +/- 1.6 mm in LS, and 39.0 +/- 2.0 mm in the control group. Spincter abdominal length was 12.1 +/- 2 mm, 15.4 +/- 1 mm, and 25.0 +/- 1 mm, respectively. The amplitude and duration of oesophageal waves were markedly reduced at 5, 10, and 15 cm above the LOS in PSS patients, with only the upper part of their gullet being spared. An abnormal acid exposure in the distal oesophagus was observed in 84.6% of PSS patients, whereas only 18.2% (2 of 11) of pH-tested LS patients had an abnormal 24-h pH test. These data show that a marked oesophageal involvement is present only in the systemic form of scleroderma. Oesophageal tests may be useful for a circumstantial diagnosis whenever the diagnosis of PSS is uncertain; however, their use does not seem to be justified as routine in patients with LS.
Oncology Reports, 1995
The epidermal growth factor receptor (EGFr) and the erbB2 protein (p185) concentrations were asse... more The epidermal growth factor receptor (EGFr) and the erbB2 protein (p185) concentrations were assessed in 31 esophageal cancer specimens and in the corresponding normal mucosa, in order to investigate the possible links with the main clinical and pathological parameters. Detectable and high affinity EGFr was found in 27/31 cancer and in 18/31 normal tissue samples. EGFr concentrations were not significantly different between cancer and normal tissue, although a trend toward higher levels in cancer was found. No relationships were found with histologic type, tumor bulk, lymph node status, pathologic stage, ploidy and type of surgical resection. A significant negative correlation between EGFr levels and overall survival was found. Detectable levels of p185 were found in all the tissues examined, but the expression was higher in adenocarcinoma than in squamous cell carcinoma samples. The EGFr role in malignant transformation still has to be established, but the determination could be of clinical use. As for p185, its role in the onset of esophageal cancer could be confined to the subgroup of the adenocarcinomas.
Digestive Surgery, 1984
Prolonged pH monitoring of the distal oesophagus is considered the most sensitive test for detect... more Prolonged pH monitoring of the distal oesophagus is considered the most sensitive test for detecting gastro-oesophageal reflux (GOR). Local patterns of GOR are needed because of its large diffusion in countries with different dietetic and behavioural habits and the use of the test in ...
British Journal of Cancer, Jan 18, 2011
BACKGROUND: Preoperative chemoradiotherapy (CRT) improves the survival of patients with oesophage... more BACKGROUND: Preoperative chemoradiotherapy (CRT) improves the survival of patients with oesophageal cancer when compared with surgery alone. METHODS: We conducted a phase II, multicenter trial of FOLFOX-4 and cetuximab in patients with locally advanced oesophageal cancer (LAEC) followed by daily radiotherapy (180 cGy fractions to 5040 cGy) with concurrent weekly cetuximab. Cytokines levels potentially related to cetuximab efficacy were assessed using multiplex-bead assays and enzyme-linked immunosorbent assay at baseline, at week 8 and at week 17. Primary end point was complete pathological response rate (pCR). RESULTS: In all, 41 patients were enroled. Among 30 patients who underwent surgery, a pCR was observed in 8 patients corresponding to a rate of 27%. The most frequent grade 3/4 toxicity was skin (30%) and neutropenia (30%). The 36-month survival rates were 85 and 52% in patients with pathological CR or PR vs 38 and 33% in patients with SD or PD. CONCLUSIONS: Incorporating cetuximab into a preoperative regimen for LAEC is feasible; no correlation between cytokines changes and patient outcome was observed. Positron emission tomography/computed tomography study even if influenced by the small number of patients appears to be able to predict patients outcome both as early and late metabolic response.
Minimally Invasive Therapy & Allied Technologies, 2019
Journal of Hepatology, 1992
Wolfgang Pabst Verlag Scientific Publishers, 1992