Article
Oncology
Mary Dillhoff, Timothy M. Pawlik
Summary: Multiple randomized trials have shown that extended lymphadenectomy does not improve overall survival for patients with pancreatic cancer, but is associated with increased postoperative complications, operating room time, and length of hospital stay.
ANNALS OF SURGICAL ONCOLOGY
(2021)
Article
Surgery
Markus K. Diener, Andre L. Mihaljevic, Oliver Strobel, Martin Loos, Thomas Schmidt, Martin Schneider, Christoph Berchtold, Arianeb Mehrabi, Beat P. Mueller-Stich, Kuirong Jiang, John P. Neoptolemos, Thilo Hackert, Yi Miao, Markus W. Buechler
Summary: Periarterial divestment is a technique to clear periarterial soft tissue around peripancreatic visceral arteries during pancreatic surgery, which can prevent the need for arterial resection in borderline and locally advanced pancreatic cancer. It, together with other resection strategies like artery first maneuver and mesenterico-portal venous bypass first, enables tumor resection in locally advanced pancreatic cancer.
Article
Oncology
Hiroyuki Ishida, Toshiro Ogura, Amane Takahashi, Ryoichi Miyamoto, Shinichi Matsudaira, Katsumi Amikura, Minoru Tanabe, Yoshiyuki Kawashima
Summary: This study explored the importance of lymph node dissection for left-sided pancreatic cancer based on tumor location, showing that dissection of the non-PLN region can be avoided in patients with DPT >= 20 mm. Non-PLN metastasis was associated with a poorer prognosis compared to only-PLN metastasis.
ANNALS OF SURGICAL ONCOLOGY
(2022)
Article
Oncology
Mihoko Yamada, Teiichi Sugiura, Yukiyasu Okamura, Takaaki Ito, Yusuke Yamamoto, Ryo Ashida, Katsuhisa Ohgi, Takeshi Aramaki, Masahiro Endo, Katsuhiko Uesaka
Summary: The study found that the prognosis of pancreatic cancer patients without lymph node metastasis (pN0-PC) is not satisfactory, and the survival rate of patients with multiple risk factors is similar to that of patients with lymph node metastasis.
ANNALS OF SURGICAL ONCOLOGY
(2021)
Article
Radiology, Nuclear Medicine & Medical Imaging
Yun Bian, Zhilin Zheng, Xu Fang, Hui Jiang, Mengmeng Zhu, Jieyu Yu, Haiyan Zhao, Ling Zhang, Jiawen Yao, Le Lu, Jianping Lu, Chengwei Shao
Summary: In this study, an automated preoperative artificial intelligence algorithm was developed and validated for the segmentation of tumor and lymph nodes in patients with pancreatic ductal adenocarcinoma (PDAC) using CT imaging. The performance of the algorithm was compared to radiologists and clinical models, and it was found that the AI model outperformed the other models in predicting lymph node metastasis. The AI model-predicted positive LN metastasis was also associated with worse survival.
Review
Oncology
Sergio Pedrazzoli
Summary: This review examines various aspects of pancreatic surgery, including standardized postoperative complication reporting, lymphadenectomy extent in pancreaticoduodenectomy, and the impact of mesopancreas excision. The review highlights the lack of standardization in reporting follow-up period, definition of pancreatic fistula-related morbidity and mortality, and complete reporting of complications. It also discusses the ongoing debate on the extent of lymphadenectomy and the benefits of mesopancreas excision.
SURGICAL ONCOLOGY-OXFORD
(2022)
Article
Oncology
Taisuke Imamura, Yusuke Yamamoto, Teiichi Sugiura, Yukiyasu Okamura, Takaaki Ito, Ryo Ashida, Katsuhisa Ohgi, Katsuhiko Uesaka
Summary: The study suggests that lymph node dissection based on tumor location can improve treatment outcomes and reduce the risk of lymph node recurrence for patients with pancreatic cancer.
ANNALS OF SURGICAL ONCOLOGY
(2021)
Article
Surgery
Jing Wang, Shao-Cheng Lyu, Ji-Qiao Zhu, Xian-Liang Li, Ren Lang, Qiang He
Summary: This study compared the morbidity and mortality rates of patients with pancreatic head cancer undergoing standard lymphadenectomy versus extended lymphadenectomy. The results suggest that extended lymphadenectomy may improve long-term survival in patients with borderline resectable pancreatic head cancer.
Article
Surgery
Hironori Shiozaki, Yoshihiro Shirai, Machi Suka, Ryoga Hamura, Takashi Horiuchi, Jungo Yasuda, Kenei Furukawa, Shinji Onda, Takeshi Gocho, Toru Ikegami
Summary: This study found that for resectable pancreatic cancer patients without LN enlargement around the SMA, performing LN and nerve plexus dissection around the SMA did not prolong disease-free survival and overall survival. However, it significantly increased the frequency of severe diarrhea.
LANGENBECKS ARCHIVES OF SURGERY
(2021)
Article
Oncology
Ziyun Shen, Haoda Chen, Shiwei Zhao, Yuchen Ji, Yiran Zhou, Yuanchi Weng, Jun Zhang, Xiaxing Deng, Chenghong Peng, Weishen Wang, Baiyong Shen
Summary: This study suggests that the addition of paraaortic dissection (PAD) during pancreaticoduodenectomy does not improve the prognosis of patients with resectable pancreatic cancer and may lead to an increased risk of infection. However, further investigation is needed for accurate preoperative assessment and appropriate treatment strategy for patients with metastatic para-aortic lymph node (PALN+), due to the poor prognosis.
ANNALS OF SURGICAL ONCOLOGY
(2023)
Article
Oncology
Ziyun Shen, Haoda Chen, Shiwei Zhao, Yuchen Ji, Yiran Zhou, Yuanchi Weng, Jun Zhang, Xiaxing Deng, Chenghong Peng, Weishen Wang, Baiyong Shen
Summary: This study suggests that the addition of paraaortic dissection (PAD) during pancreaticoduodenectomy does not improve the prognosis of patients with resectable pancreatic cancer and may lead to an increased risk of infection. However, accurate preoperative assessment and appropriate treatment strategies for patients with metastatic para-aortic lymph node (PALN+) need further investigation due to the poor prognosis.
ANNALS OF SURGICAL ONCOLOGY
(2023)
Article
Surgery
Ammar A. Javed, Ding Ding, Erum Baig, Michael J. Wright, Jonathan A. Teinor, Daniyal Mansoor, Elizabeth Thompson, Ralph H. Hruban, Amol Narang, William R. Burns, Richard A. Burkhart, Kelly Lafaro, Matthew J. Weiss, John L. Cameron, Christopher L. Wolfgang, Jin He
Summary: This study aimed to evaluate the optimal number of examined lymph nodes in patients with neoadjuvantly treated PDAC, finding that 22 examined lymph nodes were associated with improved recurrence free survival (RFS), resulting in optimal nodal staging for N0 patients.
WORLD JOURNAL OF SURGERY
(2022)
Article
Surgery
Andrew M. Fleming, Leah E. Hendrick, Evan S. Glazer, Andrew J. Murphy, Paxton Dickson, David Shibata, Danny Yakoub, Jeremiah L. Deneve
Summary: This study evaluated the prognostic features of pancreatic carcinosarcoma through analysis of multiple datasets. The results showed that tumor size, metastatic disease, and relapse were associated with decreased survival, while resection + chemotherapy, lymph node examination, and treatment at an academic center were associated with improved overall survival. These findings are important for understanding the incidence and treatment strategies of pancreatic carcinosarcoma.
Article
Surgery
Yoichi Miyata, Naoto Yonamine, Ibuki Fujinuma, Takazumi Tsunenari, Yasuhiro Takihata, Toshimitsu Iwasaki, Takahiro Einama, Hironori Tsujimoto, Hideki Ueno, Junji Yamamoto, Yoji Kishi
Summary: Metastases to LN#14 in pancreatic head cancer patients significantly affect prognosis, with LN#14 + group having worse overall survival compared to LN#14 - group.
WORLD JOURNAL OF SURGERY
(2021)
Article
Gastroenterology & Hepatology
Yusuke Kazami, Atsushi Oba, Yoshihiro Ono, Takafumi Sato, Yosuke Inoue, Akio Saiura, Yu Takahashi, Hiromichi Ito
Summary: Occult metastasis to PALNs is common in patients with potentially resectable PC. The prognostic impact depends on the treatment strategy, with PALN metastasis having no impact on recurrence and survival after neoadjuvant therapy for borderline or unresectable tumors, while it is associated with early recurrence and shorter survival after upfront resection for resectable tumors.
Article
Oncology
Laura Maggino, Giuseppe Malleo, Stefano Crippa, Giulio Belfiori, Sara Nobile, Giulia Gasparini, Gabriella Lionetto, Claudio Luchini, Paola Mattiolo, Marco Schiavo-Lena, Claudio Doglioni, Aldo Scarpa, Claudio Bassi, Massimo Falconi, Roberto Salvia
Summary: This study investigated the incidence and pattern of recurrence in patients with initially resectable and borderline resectable pancreatic ductal adenocarcinoma who received post-neoadjuvant pancreatectomy. The results showed that preoperative tumor size <20 mm, normal posttreatment CA19.9 and Delta CA19.9 > 50% were associated with longer recurrence-free survival (RFS) in these patients.
ANNALS OF SURGICAL ONCOLOGY
(2023)
Editorial Material
Oncology
Laura Maggino, Giuseppe Malleo, Stefano Crippa, Massimo Falconi, Roberto Salvia
ANNALS OF SURGICAL ONCOLOGY
(2023)
Article
Surgery
Syed S. Raza, Anisa Nutu, Sarah Powell-Brett, Alessio Marchetti, Giampaolo Perri, Amanda Carvalheiro Boteon, James Hodson, Nikolaos Chatzizacharias, Bobby Dasari, John Isaac, Manual Abradelo, Ravi Marudanayagam, Darius F. Mirza, J. Keith Roberts, Giovanni Marchegiani, Roberto Salvia, Robert P. Sutcliffe
Summary: This study aimed to identify early postoperative variables that may predict the severity of postoperative pancreatic fistula. The study found that male sex, drain fluid amylase level on postoperative day 3, c-reactive protein level on postoperative day 3, and albumin level on postoperative day 3 were significant predictors of clinically relevant postoperative pancreatic fistula.
Article
Pathology
Claudio Luchini, Paola Mattiolo, Olca Basturk, Andrea Mafficini, Kerem Ozcan, Rita T. Lawlor, Seung-Mo Hong, Lodewijk A. Brosens, Giovanni Marchegiani, Antonio Pea, Erminia Manfrin, Giuseppe Sciacca, Federica Zampieri, Rita Polati, Riccardo De Robertis, Michele Milella, Mirko D'Onofrio, Giuseppe Malleo, Roberto Salvia, Volkan Adsay, Aldo Scarpa
Summary: Acinar cystic transformation (ACT) of the pancreas is a poorly understood and rare entity among pancreatic cystic lesions. This study aims to clarify its real nature by describing the clinicopathological features and molecular profile of a cohort of 25 patients with pancreatic ACT. The findings suggest that ACT is a benign entity potentially arising from diverse conditions/backgrounds, but the presence of driver mutations raises the possibility of long-term surveillance for these patients.
AMERICAN JOURNAL OF SURGICAL PATHOLOGY
(2023)
Article
Surgery
Elisa Bannone, Giovanni Marchegiani, Giulia Angela Zamboni, Bogdan Mihai Maris, Lorenzo Costa, Giuseppa Procida, Pier Giuseppe Vacca, Mirko D'Onofrio, Giancarlo Mansueto, Enrique De-Madaria, Roberto Salvia, Claudio Bassi
Summary: This study systematically investigates the early radiologic, biochemical, and clinical features of postpancreatectomy acute pancreatitis. The results show that patients with postoperative serum hyperamylasemia and postpancreatectomy acute pancreatitis have lower apparent diffusion coefficient values at diffusion-weighted magnetic resonance imaging, but no macroscopic features consistent with acute pancreatitis. Subsequent imaging reveals that patients with radiologic features of acute pancreatitis have worse outcomes and all patients with radiologic features also have postoperative serum hyperamylasemia. The findings pave the way for the transfer of treatment strategies for acute pancreatitis into managing postpancreatectomy acute pancreatitis.
Review
Surgery
Tamir N. Sholklapper, Jorge Ballon, Aref S. Sayegh, Anibal La Riva, Laura C. Perez, Sherry Huang, Michael Eppler, Gregg Nelson, Giovanni Marchegiani, Robert Hinchliffe, Luca Gordini, Marc Furrer, Michael J. Brenner, Salome Dell-Kuster, Chandra Shekhar Biyani, Nader Francis, Haytham M. A. Kaafarani, Matthias Siepe, Des Winter, Julie A. Sosa, Francesco Bandello, Robert Siemens, Jochen Walz, Alberto Briganti, Christian Gratzke, Andre L. Abreu, Mihir M. Desai, Rene Sotelo, Riaz Agha, Keith D. Lillemoe, Steven Wexner, Gary S. Collins, Inderbir Gill, Giovanni E. Cacciamani
Summary: This study assesses the prevalence and typology of perioperative adverse event reporting guidelines among surgery and anesthesiology journals. Results show that 46.5% of the queried journals recommend surgical adverse event reporting. Journals in the surgery, urology, and anesthesia categories are most likely to recommend reporting; those in the top SJR quartiles and based in Western Europe, North America, and the Middle East are also more likely to recommend.
INTERNATIONAL JOURNAL OF SURGERY
(2023)
Editorial Material
Gastroenterology & Hepatology
Giampaolo Perri, Giovanni Marchegiani
Review
Gastroenterology & Hepatology
Tommaso Pollini, Giovanni Marchegiani, Antonio Facciorusso, Alberto Balduzzi, Marco Biancotto, Claudio Bassi, Ajay Maker, Roberto Salvia
Summary: Mucinous Cystic Neoplasms (MCN) of the pancreas have a 16.1% rate of malignancy, with studies published before 2012 having a higher rate compared to recent studies. Larger size and presence of mural nodules are associated with an increased risk of malignant MCN.
Article
Surgery
Ugo Boggi, Greta F. Donisi, Niccolo F. Napoli, Stefano Partelli, Alessandro Esposito, Giovanni Ferrari, Giovanni Butturini, Luca Morelli, Mohammad Abu Hilal, Massimo Viola, Fabrizio Di Benedetto, Roberto Troisi, Marco Vivarelli, Elio Jovine, Alessandro Ferrero, Umberto Bracale, Sergio Alfieri, Riccardo Casadei, Giorgio Ercolani, Luca Moraldi, Carlo Molino, Raffaele Dalla Valle, Giuseppe Ettorre, Riccardo L. Memeo, Giacomo Zanus, Andrea Belli, Salvatore Gruttadauria, Alberto Brolese, Andrea Coratti, Gianluca Garulli, Renato Romagnoli, Marco Massani, Felice Borghi, Giulio Belli, Roberto Coppola, Massimo Falconi, Roberto Salvia, Alessandro Zerbi, IGOMPIS registry
Summary: This retrospective analysis of the IGOMIPS registry in Italy examined 1191 minimally invasive pancreatic resections with various procedures. The study found that robotic assistance improved surgical outcomes and reduced complications. High-volume centers and standardized pathology were also associated with better results. Further research is needed to fully understand the implementation of MIPR in Italy.
UPDATES IN SURGERY
(2023)
Article
Health Care Sciences & Services
Veronica Marinelli, Maria Angela Mazzi, Michela Rimondini, Olivia Purnima Danzi, Deborah Bonamini, Claudio Bassi, Roberto Salvia, Lidia Del Piccolo
Summary: Pancreatic cancer is a highly lethal malignancy and surgical resection is the only treatment option. However, preoperative anxiety significantly affects patients' quality of life and surgical outcomes. This observational study aimed to identify the socio-demographic, clinical, and psychological characteristics that contribute to preoperative anxiety and concerns in pancreatic cancer patients. The findings suggest that high anxiety levels are associated with more preoperative concerns, particularly related to surgical aspects. Depressive symptoms and trait anxiety were identified as risk factors for preoperative anxiety. Screening for psychological characteristics and providing support can help prevent the development of preoperative anxiety and surgery worries.
Article
Health Care Sciences & Services
Maarten Korrel, Leia R. Jones, Jony van Hilst, Gianpaolo Balzano, Bergthor Bjornsson, Ugo Boggi, Svein Olav Bratlie, Olivier R. Busch, Giovanni Butturini, Giovanni Capretti, Riccardo Casadei, Bjorn Edwin, Anouk M. L. H. Emmen, Alessandro Esposito, Massimo Falconi, Bas Groot Koerkamp, Tobias Keck, Ruben H. J. de Kleine, Dyre B. Kleive, Arto Kokkola, Daan J. Lips, Sanne Lof, Misha D. P. Luyer, Alberto Manzoni, Ravi Marudanayagam, Matteo de Pastena, Nicolo Pecorelli, John N. Primrose, Claudio Ricci, Roberto Salvia, Per Sandstrom, Frederique L. I. M. Vissers, Ulrich F. Wellner, Alessandro Zerbi, Marcel G. W. Dijkgraaf, Marc G. Besselink, Mohammad Abu Hilal
Summary: This is a non-inferiority trial comparing open distal pancreatectomy (ODP) with minimally invasive distal pancreatectomy (MIDP) in patients with resectable pancreatic cancer. The results show that MIDP is not inferior to ODP in terms of radical resection rates, and the postoperative outcomes and survival rates are comparable as well.
LANCET REGIONAL HEALTH-EUROPE
(2023)
Article
Surgery
Giovanni Marchegiani, Giampaolo Perri, Federico Reich, Giuseppa Procida, Elisa Bannone, Roberto Salvia, Claudio Bassi
BRITISH JOURNAL OF SURGERY
(2023)
Article
Surgery
Roberto Salvia, Anna Burelli, Angelica Nepi, Andrea Caravati, Claudia Tomelleri, Tommaso Dall'Olio, Fabio Casciani, Stefano Francesco Crino, Giampaolo Perri, Giovanni Marchegiani
Summary: This study aimed to reappraise diagnostic errors in patients undergoing surgery for presumed pancreatic cystic neoplasms. The study found that misdiagnosis and mismatch rates were still high, and some diagnostic errors had clinical relevance. New diagnostic tools are needed to improve the accuracy of diagnosing high-risk lesions.
Article
Surgery
Alberto Balduzzi, Boris V. Janssen, Matteo De Pastena, Tommaso Pollini, Giovanni Marchegiani, Henk Marquering, Jaap Stoker, Inez Verpalen, Claudio Bassi, Marc G. Besselink, Roberto Salvia
BRITISH JOURNAL OF SURGERY
(2023)
Article
Oncology
Eran van Veldhuisen, Sjors Klompmaker, Quisette P. Janssen, Mohammed Abu Hilal, Adnan Alseidi, Alberto Balduzzi, Gianpaolo Balzano, Claudio Bassi, Frederik Berrevoet, Morgan Bonds, Olivier R. Busch, Giovanni Butturini, Kevin C. Conlon, Isabella M. Frigerio, Giuseppe K. Fusai, Johan Gagniere, Oonagh Griffin, Thilo Hackert, Asif Halimi, Tobias Keck, Joerg Kleeff, Ulla Klaiber, Knut J. Labori, Mickael Lesurtel, Giuseppe Malleo, Marco V. Marino, I. Quintus Molenaar, Michael B. Mortensen, Andrej Nikov, Michele Pagnanelli, Rupaly Pande, Per Pfeiffer, Daniel Pietrasz, Elena Rangelova, Keith J. Roberts, Antonio Sa Cunha, Roberto Salvia, Oliver Strobel, Timo Tarvainen, Johanna W. Wilmink, Bas Groot Koerkamp, Marc G. Besselink
Summary: This study aimed to evaluate the outcome of pancreatectomy after preoperative FOLFIRINOX chemotherapy, and found that this treatment is associated with favorable outcomes for patients with BRPC and LAPC. However, the number of preoperative chemotherapy cycles and the use of adjuvant chemotherapy are not related to survival rate.
ANNALS OF SURGICAL ONCOLOGY
(2023)
