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3. Identification of spatially-resolved markers of malignant transformation in Intraductal Papillary Mucinous Neoplasms

Author

Agostini, Antonio, Piro, Geny, Inzani, Frediano, Quero, Giuseppe, Esposito, Annachiara, Caggiano, Alessia, Priori, Lorenzo, Larghi, Alberto, Alfieri, Sergio, Casolino, Raffaella, Scaglione, Giulia, Tondolo, Vincenzo, Cammarota, Giovanni, Ianiro, Gianluca, Corbo, Vincenzo, Biankin, Andrew V., Tortora, Giampaolo, and Carbone, Carmine

Published
2024
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8. A single-center prospective analysis of the impact of glucose metabolism on pancreatic fistula onset after pancreaticoduodenectomy for periampullary tumors

Author

Quero, Giuseppe, Laterza, Vito, Di Giuseppe, Gianfranco, Lucinato, Chiara, Massimiani, Giuseppe, Nista, Enrico Celestino, Sionne, Francesco, Biffoni, Beatrice, Brunetti, Michela, Rosa, Fausto, De Sio, Davide, Ciccarelli, Gea, Fiorillo, Claudio, Menghi, Roberta, Langellotti, Lodovica, Soldovieri, Laura, Gasbarrini, Antonio, Pontecorvi, Alfredo, Giaccari, Andrea, Alfieri, Sergio, Tondolo, Vincenzo, and Mezza, Teresa

Published
2024
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10. Talniflumate abrogates mucin immune suppressive barrier improving efficacy of gemcitabine and nab-paclitaxel treatment in pancreatic cancer

Author

Agostini, Antonio, Guerriero, Ilaria, Piro, Geny, Quero, Giuseppe, Roberto, Luca, Esposito, Annachiara, Caggiano, Alessia, Priori, Lorenzo, Scaglione, Giulia, De Sanctis, Francesco, Sistigu, Antonella, Musella, Martina, Larghi, Alberto, Rizzatti, Gianenrico, Lucchetti, Donatella, Alfieri, Sergio, Sgambato, Alessandro, Bria, Emilio, Bizzozero, Laura, Arena, Sabrina, Ugel, Stefano, Corbo, Vincenzo, Tortora, Giampaolo, and Carbone, Carmine

Published
2023
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11. Reduced incretin effect precedes diabetes development following duodenopancreatectomy in individuals without diabetes

Author

Di Giuseppe, Gianfranco, Soldovieri, Laura, Ciccarelli, Gea, Ferraro, Pietro Manuel, Quero, Giuseppe, Cinti, Francesca, Capece, Umberto, Moffa, Simona, Nista, Enrico Celestino, Gasbarrini, Antonio, Mari, Andrea, Alfieri, Sergio, Tondolo, Vincenzo, Pontecorvi, Alfredo, Holst, Jens Juul, Giaccari, Andrea, and Mezza, Teresa

Subjects
Dextrose, Glucose, Prediabetic state, Health care industry
Abstract

To the Editor: The incretin effect (IE) is a key factor regulating [beta] cell functional response and affecting the dynamics of insulin secretion (1). The main actors in the IE [...]

Published
2024

12. An alternative splicing signature defines the basal-like phenotype and predicts worse clinical outcome in pancreatic cancer

Author

Ruta, Veronica, Naro, Chiara, Pieraccioli, Marco, Leccese, Adriana, Archibugi, Livia, Cesari, Eleonora, Panzeri, Valentina, Allgöwer, Chantal, Arcidiacono, Paolo Giorgio, Falconi, Massimo, Carbone, Carmine, Tortora, Giampaolo, Borrelli, Federica, Attili, Fabia, Spada, Cristiano, Quero, Giuseppe, Alfieri, Sergio, Doglioni, Claudio, Kleger, Alexander, Capurso, Gabriele, and Sette, Claudio

Published
2024
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13. Intra-islet insulin synthesis defects are associated with endoplasmic reticulum stress and loss of beta cell identity in human diabetes

Author

Brusco, Noemi, Sebastiani, Guido, Di Giuseppe, Gianfranco, Licata, Giada, Grieco, Giuseppina E., Fignani, Daniela, Nigi, Laura, Formichi, Caterina, Aiello, Elena, Auddino, Stefano, Quero, Giuseppe, Cefalo, Chiara M. A., Cinti, Francesca, Mari, Andrea, Ferraro, Pietro M., Pontecorvi, Alfredo, Alfieri, Sergio, Giaccari, Andrea, Dotta, Francesco, and Mezza, Teresa

Published
2023
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19. Multicentric validation of EndoDigest: a computer vision platform for video documentation of the critical view of safety in laparoscopic cholecystectomy

Author

Mascagni, Pietro, Alapatt, Deepak, Laracca, Giovanni Guglielmo, Guerriero, Ludovica, Spota, Andrea, Fiorillo, Claudio, Vardazaryan, Armine, Quero, Giuseppe, Alfieri, Sergio, Baldari, Ludovica, Cassinotti, Elisa, Boni, Luigi, Cuccurullo, Diego, Costamagna, Guido, Dallemagne, Bernard, and Padoy, Nicolas

Published
2022
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23. Endoscopic full-thickness resection vs. endoscopic submucosal dissection of residual/recurrent colonic lesions on scars: a retrospective Italian and Japanese comparative study

Author

Barbaro, Federico, Papparella, Luigi Giovanni, Chiappetta, Michele Francesco, Ciuffini, Cristina, Fukuchi, Takehide, Hamanaka, Jun, Quero, Giuseppe, Pecere, Silvia, Gibiino, Giulia, Petruzziello, Lucio, Maeda, Shin, Hirasawa, Kingo, Costamagna, Guido, Quero, Giuseppe (ORCID:0000-0002-0001-9479), Costamagna, Guido (ORCID:0000-0002-8100-2731), Barbaro, Federico, Papparella, Luigi Giovanni, Chiappetta, Michele Francesco, Ciuffini, Cristina, Fukuchi, Takehide, Hamanaka, Jun, Quero, Giuseppe, Pecere, Silvia, Gibiino, Giulia, Petruzziello, Lucio, Maeda, Shin, Hirasawa, Kingo, Costamagna, Guido, Quero, Giuseppe (ORCID:0000-0002-0001-9479), and Costamagna, Guido (ORCID:0000-0002-8100-2731)

Abstract

Background and aimsEndoscopic treatment of recurrent/residual colonic lesions on scars is a challenging procedure. In this setting, endoscopic submucosal dissection (ESD) is considered the first choice, despite a significant rate of complications. Endoscopic full-thickness resection (eFTR) has been shown to be well-tolerated and effective for these lesions. The aim of this study is to conduct a comparison of outcomes for resection of such lesions between ESD and eFTR in an Italian and a Japanese referral center.MethodsFrom January 2018 to July 2020, we retrospectively enrolled patients with residual/recurrent colonic lesions, 20 treated by eFTR in Italy and 43 treated by ESD in Japan. The primary outcome was to compare the two techniques in terms of en-bloc and R0-resection rates, whereas complications, time of procedure, and outcomes at 3-month follow-up were evaluated as secondary outcomes.ResultsR0 resection rate was not significantly different between the two groups [18/20 (90%) and 41/43 (95%); P= 0.66]. En-bloc resection was 100% in both groups. No significant difference was found in the procedure time (54 min vs. 61 min; P= 0.9). There was a higher perforation rate in the ESD group [11/43 (26%) vs. 0/20 (0%); P= 0.01]. At the 3-month follow-up, two lesions relapsed in the eFTR cohort and none in the ESD cohort (P= 0.1).ConclusioneFTR is a safer, as effective and equally time-consuming technique compared with ESD for the treatment of residual/recurrent colonic lesions on scars and could become an alternative therapeutic option for such lesions.

Published
2024

24. Endoscopic Contrast-Enhanced Ultrasound and Fine-Needle Aspiration or Biopsy for the Diagnosis of Pancreatic Solid Lesions: A Systematic Review and Meta-Analysis

Author

Esposto, Giorgio, Massimiani, Giuseppe, Galasso, Linda, Santini, Paolo, Borriello, Raffaele, Mignini, Irene, Ainora, Maria Elena, Nicoletti, Alberto, Zileri Dal Verme, Lorenzo, Gasbarrini, Antonio, Alfieri, Sergio, Quero, Giuseppe, Zocco, Maria Assunta, Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Alfieri, Sergio (ORCID:0000-0002-0404-724X), Quero, Giuseppe (ORCID:0000-0002-0001-9479), Zocco, Maria Assunta (ORCID:0000-0002-0814-9542), Esposto, Giorgio, Massimiani, Giuseppe, Galasso, Linda, Santini, Paolo, Borriello, Raffaele, Mignini, Irene, Ainora, Maria Elena, Nicoletti, Alberto, Zileri Dal Verme, Lorenzo, Gasbarrini, Antonio, Alfieri, Sergio, Quero, Giuseppe, Zocco, Maria Assunta, Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Alfieri, Sergio (ORCID:0000-0002-0404-724X), Quero, Giuseppe (ORCID:0000-0002-0001-9479), and Zocco, Maria Assunta (ORCID:0000-0002-0814-9542)

Abstract

Simple Summary We conducted a systematic search of the literature to explore if endoscopic contrast-enhanced ultrasound (ECEUS) could improve the diagnostic success of pancreatic solid lesion biopsy or fine needle aspiration. The analysis that we conducted on 1.178 patients showed a slight trend of more diagnoses and the greater efficacy of a single pass in patients who underwent contrast-guided pancreatic sampling, although this finding did not reach statistical significance. We believe that our analysis provides a useful insight for clinical practice and could aid future investigations on this topic.Abstract Introduction: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) and endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) are currently recommended for the pathologic diagnosis of pancreatic solid lesions (PSLs). The application of contrast-enhanced endoscopic ultrasound (ECEUS) could aid the endoscopist during an FNA and/or FNB procedure. CEUS is indeed able to better differentiate the pathologic tissue from the surrounding healthy pancreatic parenchyma and to detect necrotic areas and vessels. Objectives: Our objective was to evaluate if ECEUS could reduce the number of needle passes and side effects and increase the diagnostic efficacy of FNA and/or FNB. Methods: A comprehensive literature search of clinical studies was performed to explore if ECEUS-FNA or FNB could increase diagnostic accuracy and reduce the number of needle passes and adverse effects compared to standard EUS-FNA or FNB. In accordance with the study protocol, a qualitative and quantitative analysis of the evidence was planned. Results: The proportion of established diagnoses of ECEUS was 90.9% compared to 88.3% of EUS, with no statistically significant difference (p = 0.14). The diagnosis was made through a single step in 70.9% of ECEUS patients and in 65.3% of EUS patients, without statistical significance (p = 0.24). The incidence of adverse reactions was substantially co

Published
2024

28. Quantitative assessment of the impact of COVID-19 pandemic on pancreatic surgery: an Italian multicenter analysis of 1423 cases from 10 tertiary referral centers

Author

Quero, Giuseppe, Pecorelli, Nicolò, Paiella, Salvatore, Fiorillo, Claudio, Petrone, Maria Chiara, Rosa, Fausto, Capretti, Giovanni, Laterza, Vito, Kauffmann, Emanuele, Nobile, Sara, Butturini, Giovanni, Ferrari, Giovanni, Coratti, Andrea, Casadei, Riccardo, Mazzaferro, Vincenzo, Boggi, Ugo, Zerbi, Alessandro, Salvia, Roberto, Falconi, Massimo, and Alfieri, Sergio

Published
2022
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29. Pancreaticoduodenectomy in octogenarians: The importance of “biological age” on clinical outcomes

Author

Quero, Giuseppe, Pecorelli, Nicolò, Paiella, Salvatore, Fiorillo, Claudio, Petrone, Maria Chiara, Capretti, Giovanni, Laterza, Vito, De Sio, Davide, Menghi, Roberta, Kauffmann, Emanuele, Nobile, Sara, Butturini, Giovanni, Ferrari, Giovanni, Rosa, Fausto, Coratti, Andrea, Casadei, Riccardo, Mazzaferro, Vincenzo, Boggi, Ugo, Zerbi, Alessandro, Salvia, Roberto, Falconi, Massimo, and Alfieri, Sergio

Published
2022
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30. The Diagnosis of Wilkie's Syndrome Associated with Nutcracker Syndrome: A Case Report and Literature Review.

Author

Abenavoli, Ludovico, Imoletti, Felice, Quero, Giuseppe, Bottino, Valentina, Facciolo, Viviana, Scarlata, Giuseppe Guido Maria, Luzza, Francesco, and Laganà, Domenico

Subjects
SUPERIOR mesenteric artery syndrome, NUTCRACKER syndrome, LITERATURE reviews, RENAL veins, MESENTERIC artery
Abstract

Superior mesenteric artery (SMA) syndrome or Wilkie's syndrome is a vascular compression disorder that causes the abnormal compression of the third portion of the duodenum by the SMA. It has a low incidence rate, which is higher in young women, and is rarely associated with the Nutcracker phenomenon: a condition of the compression of the left renal vein between the SMA and the aorta, which manifests as pain in the left flank and pelvis. Here, we report on the case of a 54-year-old woman with a history of repeated episodes of abdominal pain caused by the Nutcracker syndrome and Wilkie's syndrome. [ABSTRACT FROM AUTHOR]

Published
2024
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32. Robotic versus laparoscopic right colectomy for nonmetastatic pT4 colon cancer: A European multicentre propensity score‐matched analysis.

Author

de'Angelis, Nicola, Schena, Carlo Alberto, Espin‐Basany, Eloy, Piccoli, Micaela, Alfieri, Sergio, Aisoni, Filippo, Coccolini, Federico, Frontali, Alice, Kraft, Miquel, Lakkis, Zaher, Le Roy, Bertrand, Luzzi, Andrea Pierre, Milone, Marco, Pattacini, Gianmaria Casoni, Pellino, Gianluca, Petri, Roberto, Piozzi, Guglielmo Niccolò, Quero, Giuseppe, Ris, Frederic, and Winter, Des C.

Subjects
MINIMALLY invasive procedures, COLON cancer, PROPENSITY score matching, SURGICAL complications, SURGICAL robots, COLECTOMY
Abstract

Aim: Minimally invasive surgery has been increasingly adopted for locally advanced colon cancer. However, evidence comparing robotic (RRC) versus laparoscopic right colectomy (LRC) for nonmetastatic pT4 cancers is lacking. Methods: This was a multicentre propensity score‐matched (PSM) study of a cohort of consecutive patients with pT4 right colon cancer treated with RRC or LRC. The two surgical approaches were compared in terms of R0, number of lymph nodes harvested, intra‐ and postoperative complication rates, overall (OS), and disease‐free survival (DFS). Results: Among a total of 200 patients, 39 RRC were compared with 78 PS‐matched LRC patients. The R0 rate was similar between RRC and LRC (92.3% vs. 96.2%, respectively; p = 0.399), as was the odds of retrieving 12 or more lymph nodes (97.4% vs. 96.2%; p = 1). No significant difference was noted for the mean operating time (192.9 min vs. 198.3 min; p = 0.750). However, RRC was associated with fewer conversions to laparotomy (5.1% vs. 20.5%; p = 0.032), less blood loss (36.9 vs. 95.2 mL; p < 0.0001), fewer postoperative complications (17.9% vs. 41%; p = 0.013), a shorter time to flatus (2 vs. 2.8 days; p = 0.009), and a shorter hospital stay (6.4 vs. 9.5 days; p < 0.0001) compared with LRC. These results were confirmed even when converted procedures were excluded from the analysis. The 1‐, 3‐ and 5‐year OS (p = 0.757) and DFS (p = 0.321) did not significantly differ between RRC and LRC. Conclusion: Adequate oncological outcomes are observed for RRC and LRC performed for pT4 right colon cancer. However, RRC is associated with lower conversion rates and improved short‐term postoperative outcomes. [ABSTRACT FROM AUTHOR]

Published
2024
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36. Endoscopic Contrast-Enhanced Ultrasound and Fine-Needle Aspiration or Biopsy for the Diagnosis of Pancreatic Solid Lesions: A Systematic Review and Meta-Analysis

Author

Esposto, Giorgio, primary, Massimiani, Giuseppe, additional, Galasso, Linda, additional, Santini, Paolo, additional, Borriello, Raffaele, additional, Mignini, Irene, additional, Ainora, Maria Elena, additional, Nicoletti, Alberto, additional, Zileri Dal Verme, Lorenzo, additional, Gasbarrini, Antonio, additional, Alfieri, Sergio, additional, Quero, Giuseppe, additional, and Zocco, Maria Assunta, additional

Published
2024
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37. Reduced incretin effect precedes diabetes development following duodenopancreatectomy in subjects without diabetes

Author

Di Giuseppe, Gianfranco, primary, Soldovieri, Laura, additional, Ciccarelli, Gea, additional, Ferraro, Pietro Manuel, additional, Quero, Giuseppe, additional, Cinti, Francesca, additional, Capece, Umberto, additional, Moffa, Simona, additional, Nista, Enrico Celestino, additional, Gasbarrini, Antonio, additional, Mari, Andrea, additional, Alfieri, Sergio, additional, Tondolo, Vincenzo, additional, Pontecorvi, Alfredo, additional, Holst, Jens Juul, additional, Giaccari, Andrea, additional, and Mezza, Teresa, additional

Published
2024
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44. Propensity score-matched comparison of short- and long-term outcomes between surgery and endoscopic submucosal dissection (ESD) for intestinal type early gastric cancer (EGC) of the middle and lower third of the stomach: a European tertiary referral center experience

Author

Quero, Giuseppe, Fiorillo, Claudio, Longo, Fabio, Laterza, Vito, Rosa, Fausto, Cina, Caterina, Menghi, Roberta, Tortorelli, Antonio Pio, Barbaro, Federico, Pecere, Silvia, Petruzziello, Lucio, Costamagna, Guido, and Alfieri, Sergio

Published
2021
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45. Advancing Diabetes Research: a novel islet isolation method from living donors.

Author

Di Piazza, Eleonora, Todi, Laura, Di Giuseppe, Gianfranco, Soldovieri, Laura, Ciccarelli, Gea, Brunetti, Michela, Quero, Giuseppe, Alfieri, Sergio, Tondolo, Vincenzo, Pontecorvi, Alfredo, Giaccari, Andrea, Pani, Giovambattista, Mezza, Teresa, Gianfranco Di Giuseppe, Laura Soldovieri, Gea Ciccarelli, Michela Brunetti, Giuseppe Quero (ORCID:0000-0002-0001-9479), Sergio Alfieri (ORCID:0000-0002-0404-724X), Vincenzo Tondolo (ORCID:0000-0003-0256-3766), Alfredo Pontecorvi (ORCID:0000-0003-0570-6865), Andrea Giaccari (ORCID:0000-0002-7462-7792), Giovambattista Pani (ORCID:0000-0001-7133-8728), Teresa Mezza (ORCID:0000-0001-5407-9576), Di Piazza, Eleonora, Todi, Laura, Di Giuseppe, Gianfranco, Soldovieri, Laura, Ciccarelli, Gea, Brunetti, Michela, Quero, Giuseppe, Alfieri, Sergio, Tondolo, Vincenzo, Pontecorvi, Alfredo, Giaccari, Andrea, Pani, Giovambattista, Mezza, Teresa, Gianfranco Di Giuseppe, Laura Soldovieri, Gea Ciccarelli, Michela Brunetti, Giuseppe Quero (ORCID:0000-0002-0001-9479), Sergio Alfieri (ORCID:0000-0002-0404-724X), Vincenzo Tondolo (ORCID:0000-0003-0256-3766), Alfredo Pontecorvi (ORCID:0000-0003-0570-6865), Andrea Giaccari (ORCID:0000-0002-7462-7792), Giovambattista Pani (ORCID:0000-0001-7133-8728), and Teresa Mezza (ORCID:0000-0001-5407-9576)

Abstract

Pancreatic islet isolation is critical for type 2 diabetes research. Although -omics approaches have shed light on islet molecular profiles, inconsistencies persist; on the other side, functional studies are essential, but they require reliable and standardized isolation methods. Here, we propose a simplified protocol applied to very small-sized samples collected from partially pancreatecto-mized living donors. Islet isolation was performed digesting tissue specimens collected during surgery within a collagenase P solution, followed by a Lympholyte density gradient separation; finally, functional assays and a staining with dithizone were carried out. Isolated pancreatic islets exhibited functional responses to glucose and arginine stimulation mirroring donors' metabolic profiles, with insulin secretion significantly decreasing in diabetic islets compared to non-diabetic islets; conversely, proinsulin secretion showed an increasing trend from non-diabetic to diabetic islets. This novel islet isolation method from living patients undergoing partial pancreatectomy offers a valuable opportunity for targeted study of islet physiology, with the primary advantage of being time-effective and successfully preserving islet viability and functionality. It enables the generation of islet preparations closely reflecting donors’ clinical profiles, simplifying the isola-tion process and eliminating the need for a Ricordi chamber. Thus, this method holds promises for advancing our understanding of diabetes and for new personalized pharmacological approaches.

Published
2024

46. Understanding the Conundrum of Pancreatic Cancer in the Omics Sciences Era.

Author

Nicoletti, Alberto, Paratore, Mattia, Vitale, Federica, Negri, Marcantonio, Quero, Giuseppe, Esposto, Giorgio, Mignini, Irene, Alfieri, Sergio, Gasbarrini, Antonio, Zocco, Maria Assunta, and Zileri Dal Verme, Lorenzo

Subjects
PANCREATIC cancer, AMINO acid metabolism, METABOLOMICS, METABOLIC reprogramming, PHARMACOGENOMICS, IMAGE analysis, TUMOR microenvironment
Abstract

Pancreatic cancer (PC) is an increasing cause of cancer-related death, with a dismal prognosis caused by its aggressive biology, the lack of clinical symptoms in the early phases of the disease, and the inefficacy of treatments. PC is characterized by a complex tumor microenvironment. The interaction of its cellular components plays a crucial role in tumor development and progression, contributing to the alteration of metabolism and cellular hyperproliferation, as well as to metastatic evolution and abnormal tumor-associated immunity. Furthermore, in response to intrinsic oncogenic alterations and the influence of the tumor microenvironment, cancer cells undergo a complex oncogene-directed metabolic reprogramming that includes changes in glucose utilization, lipid and amino acid metabolism, redox balance, and activation of recycling and scavenging pathways. The advent of omics sciences is revolutionizing the comprehension of the pathogenetic conundrum of pancreatic carcinogenesis. In particular, metabolomics and genomics has led to a more precise classification of PC into subtypes that show different biological behaviors and responses to treatments. The identification of molecular targets through the pharmacogenomic approach may help to personalize treatments. Novel specific biomarkers have been discovered using proteomics and metabolomics analyses. Radiomics allows for an earlier diagnosis through the computational analysis of imaging. However, the complexity, high expertise required, and costs of the omics approach are the main limitations for its use in clinical practice at present. In addition, the studies of extracellular vesicles (EVs), the use of organoids, the understanding of host–microbiota interactions, and more recently the advent of artificial intelligence are helping to make further steps towards precision and personalized medicine. This present review summarizes the main evidence for the application of omics sciences to the study of PC and the identification of future perspectives. [ABSTRACT FROM AUTHOR]

Published
2024
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47. Resection Margin Status and Long-Term Outcomes after Pancreaticoduodenectomy for Ductal Adenocarcinoma: A Tertiary Referral Center Analysis.

Author

Quero, Giuseppe, De Sio, Davide, Fiorillo, Claudio, Lucinato, Chiara, Panza, Edoardo, Biffoni, Beatrice, Langellotti, Lodovica, Laterza, Vito, Scaglione, Giulia, Taglioni, Flavia, Massimiani, Giuseppe, Menghi, Roberta, Rosa, Fausto, Mezza, Teresa, Alfieri, Sergio, and Tondolo, Vincenzo

Subjects
*ADENOCARCINOMA, *LYMPH nodes, *TREATMENT effectiveness, *RETROSPECTIVE studies, *MULTIVARIATE analysis, *TERTIARY care, *DESCRIPTIVE statistics, *PANCREATIC tumors, *PANCREATICODUODENECTOMY, *SURGICAL margin, *ODDS ratio, *DUCTAL carcinoma, *PROGRESSION-free survival, *CANCER patient psychology, *COMPARATIVE studies, *CONFIDENCE intervals, *MEDICAL referrals, *OVERALL survival
Abstract

Simple Summary: This study investigates the impact of resection margin (R) status on overall survival (OS) and disease-free survival (DFS) in patients undergoing pancreaticoduodenectomy (PD) for pancreatic ductal adenocarcinoma (PDAC). A retrospective analysis of 167 PD cases from 2012 to 2023 revealed that 62.8% achieved negative margins (R0), while 37.1% had positive margins (R1). Patients with R1 status had significantly lower OS (23 vs. 36 months, p = 0.003) and DFS (10 vs. 18 months, p = 0.004) compared to R0 patients. Multivariate analysis identified R1 status and positive lymph nodes (N+) as independent factors adversely affecting both OS and DFS. Specifically, among patients with N+ disease, R1 status was associated with a notably decreased DFS (10 vs. 16 months, p = 0.05). The study concludes that achieving R0 status during PD is crucial for improved long-term outcomes, emphasizing the importance of radical surgery, especially in patients with lymph node involvement. The influencing role of resection margin (R) status on long-term outcomes, namely overall (OS) and disease-free survival (DFS), after pancreaticoduodenectomy (PD) for pancreatic ductal adenocarcinoma (PDAC) is not still clear. The aim of this study is to evaluate the prognostic impact of R status after PD and to define tumor characteristics associated with a positive resection margin (R1). All PDs for PDAC performed between 2012 and 2023 were retrospectively enrolled. The effect of R status, patient clinico-demographic features, and tumor features on OS and DFS were assessed. One-hundred and sixty-seven patients who underwent PD for PDAC were included in the study. R0 was achieved in 105 cases (62.8%), while R1 was evidenced in 62 patients (37.1%). R1 was associated with a decreased OS (23 (13–38) months) as compared to R0 (36 (21–53) months) (p = 0.003). Similarly, DFS was shorter in R1 patients (10 (6–25) months) as compared to the R0 cohort (18 (9–70) months) (p = 0.004), with a consequent higher recurrence rate in cases of R1 (74.2% vs. 64.8% in the R0 group; p = 0.04). In the multivariate analysis, R1 and positive lymph nodes (N+) were the only independent influencing factors for OS (OR: 1.6; 95% CI: 1–2.5; p = 0.03 and OR: 1.7; 95% CI: 1–2.8; p = 0.04) and DFS (OR: 1.5; 95% CI: 1–2.1; p = 0.04 and OR: 1.8; 95% CI: 1.1–2.7; p = 0.009). Among 111 patients with N+ disease, R1 was associated with a significantly decreased DFS (10 (8–11) months) as compared to R0N+ patients (16 (11–21) months) (p = 0.05). In conclusion, the achievement of a negative resection margin is associated with survival benefits, particularly in cases of N1 disease. In addition, R0 was recognized as an independent prognostic feature for both OS and DFS. This further outlines the relevant role of radical surgery on long-term outcomes. [ABSTRACT FROM AUTHOR]

Published
2024
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50. Second-line chemotherapy in elderly patients with advanced pancreatic cancer: A mono-institutional retrospective experience.

Author

Trovato, Giovanni, primary, Bensi, Maria, additional, Beccia, Viria, additional, Spring, Alexia, additional, Barone, Diletta, additional, Ceccarelli, Anna, additional, Perazzo, Serena, additional, Messina, Gloria, additional, Chiofalo, Laura, additional, Bagalà, Cinzia, additional, Quero, Giuseppe, additional, Alfieri, Sergio, additional, Tortora, Giampaolo, additional, and Salvatore, Lisa, additional

Published
2024
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