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2. Corrigendum to “Evolution of pancreatectomy with en bloc venous resection for pancreatic cancer in Italy. Retrospective cohort study on 425 cases in 10 pancreatic referral units” (International Journal of Surgery (2018) 55 (103–109), (S174391911830774X), (10.1016/j.ijsu.2018.05.025))

Author

Nigri, G, Petrucciani, N, Pinna, A, Ravaioli, M, Jovine, E, Minni, F, Grazi, G, Chirletti, P, Balzano, G, Ferla, F, De Carlis, L, Tisone, G, Napoli, N, Boggi, U, Ramacciato, G, Nigri G., Petrucciani N., Pinna A. D., Ravaioli M., Jovine E., Minni F., Grazi G. L., Chirletti P., Balzano G., Ferla F., De Carlis L., Tisone G., Napoli N., Boggi U., Ramacciato G., Nigri, G, Petrucciani, N, Pinna, A, Ravaioli, M, Jovine, E, Minni, F, Grazi, G, Chirletti, P, Balzano, G, Ferla, F, De Carlis, L, Tisone, G, Napoli, N, Boggi, U, Ramacciato, G, Nigri G., Petrucciani N., Pinna A. D., Ravaioli M., Jovine E., Minni F., Grazi G. L., Chirletti P., Balzano G., Ferla F., De Carlis L., Tisone G., Napoli N., Boggi U., and Ramacciato G.

Abstract

The authors regret that the affiliation for Gian Luca Grazi was incorrect and should appear as above. The authors would like to apologise for any inconvenience caused.

Published
2019

3. Corrigendum to “Evolution of pancreatectomy with en bloc venous resection for pancreatic cancer in Italy. Retrospective cohort study on 425 cases in 10 pancreatic referral units” (International Journal of Surgery (2018) 55 (103–109), (S174391911830774X), (10.1016/j.ijsu.2018.05.025))

Author

Nigri G., Nigri, G, Petrucciani, N, Pinna, A, Ravaioli, M, Jovine, E, Minni, F, Grazi, G, Chirletti, P, Balzano, G, Ferla, F, De Carlis, L, Tisone, G, Napoli, N, Boggi, U, Ramacciato, G, Nigri G., Petrucciani N., Pinna A. D., Ravaioli M., Jovine E., Minni F., Grazi G. L., Chirletti P., Balzano G., Ferla F., De Carlis L., Tisone G., Napoli N., Boggi U., Ramacciato G., Nigri G., Nigri, G, Petrucciani, N, Pinna, A, Ravaioli, M, Jovine, E, Minni, F, Grazi, G, Chirletti, P, Balzano, G, Ferla, F, De Carlis, L, Tisone, G, Napoli, N, Boggi, U, Ramacciato, G, Nigri G., Petrucciani N., Pinna A. D., Ravaioli M., Jovine E., Minni F., Grazi G. L., Chirletti P., Balzano G., Ferla F., De Carlis L., Tisone G., Napoli N., Boggi U., and Ramacciato G.

Abstract

The authors regret that the affiliation for Gian Luca Grazi was incorrect and should appear as above. The authors would like to apologise for any inconvenience caused.

Published
2019

9. Evolution of pancreatectomy with en bloc venous resection for pancreatic cancer in Italy. Retrospective cohort study on 425 cases in 10 pancreatic referral units

Author

Nigri, G, Petrucciani, N, Pinna, A, Ravaioli, M, Jovine, E, Minni, F, Grazi, G, Chirletti, P, Balzano, G, Ferla, F, De Carlis, L, Tisone, G, Napoli, N, Boggi, U, Ramacciato, G, Pinna, AD, Grazi, GL, Nigri, G, Petrucciani, N, Pinna, A, Ravaioli, M, Jovine, E, Minni, F, Grazi, G, Chirletti, P, Balzano, G, Ferla, F, De Carlis, L, Tisone, G, Napoli, N, Boggi, U, Ramacciato, G, Pinna, AD, and Grazi, GL

Abstract

Introduction: The aim of this study is to analyze the evolution of pancreatectomy with venous resection in 10 referral Italian centers in the last 25 years. Methods: A multicenter database of 425 patients submitted to pancreatectomy with venous resection between 1991 and 2015 was retrospectively analyzed. Patients were classified in 5 periods: 1 (1991–1995); 2 (1996–2000); 3 (2001–2005); 4 (2006–2010); 5 (2011–2015). Indications and outcomes were compared according to the period of surgery. Results: Nineteen patients were operated in period 1, 28 in period 2, 91 in period 3, 140 in period 4, and 147 in period 5. Use of neoadjuvant therapy increased from 0% in period 1 and 2–12.1% in period 5. Postoperative complications ranged from 46.3% to 67.8%, and mortality from 5.3% to 9.2%. Median survival progressively increased, from 6 months in period 1–16 months in period 2, 24 months in period 3 and 4 and 35 months in period 5 (p = 0.004). Period, venous and nodal invasion were significant prognostic factors for survival. Conclusion: Management and outcomes of pancreatectomy with venous resection have evolved in the last 25 years in Italy. Improvement in patients’ multidisciplinary management has lead to significant improvement of median survival.

Published
2018

11. OC.03.7 ENDOSCOPIC ULTRASOUND-GUIDED ABLATION WITH HYBRIDTHERM PROBE IN ADDITION TO CHEMOTHERAPY VERSUS CHEMOTHERAPY ALONE FOR THE TREATMENT OF LOCALLY ADVANCED OR BORDERLINE RESECTABLE PANCREATIC CANCER: A PHASE II RANDOMIZED CONTROLLED TRIAL

Author

Testoni, S.G.G., Petrone, M.C., Reni, M., Rossi, G., Barbera, M., Nicoletti, V., Gusmini, S., Balzano, G., Linzenbold, W., Enderle, M., Della–Torre, E., De Cobelli, F., Doglioni, C., Falconi, M., Capurso, G., and Arcidiacono, P.G.

Published
2021
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13. Relaparotomy for a pancreatic fistula after a pancreaticoduodenectomy: A comparison of different surgical strategies

Author

Balzano, G, Pecorelli, N, Piemonti, L, Ariotti, R, Carvello, M, Nano, R, Braga, M, Staudacher, C, Balzano G, Pecorelli N, PIEMONTI , LORENZO, Ariotti R, Carvello M, Nano R, BRAGA, MARCO, Staudacher C., Balzano, G, Pecorelli, N, Piemonti, L, Ariotti, R, Carvello, M, Nano, R, Braga, M, Staudacher, C, Balzano G, Pecorelli N, PIEMONTI , LORENZO, Ariotti R, Carvello M, Nano R, BRAGA, MARCO, and Staudacher C.

Abstract

Introduction A relaparotomy for a pancreatic fistula (PF) after a pancreaticoduodenectomy (PD) is a formidable operation, and the appropriate treatment of anastomotic leakage is under debate. The objective of this study was to compare the outcomes of different strategies in managing the pancreatic remnant during a relaparotomy for PF after a PD. Methods In this retrospective study on prospectively collected data, 669 PD were performed between 2004 and 2011. The study group comprised 31 patients requiring a relaparotomy, because of delayed haemorrhage (n = 19) or sepsis (n = 12). The pancreatic stump was treated either using pancreas-preserving techniques (simple drainage or duct occlusion) or completion of a pancreatectomy (CP). In 2008, autologous islet transplantation (AIT) was introduced for endocrine tissue rescue of CP. Results The mortality rate, blood loss and transfusion requirement were similar for all techniques. Patients undergoing a CP required a further relaparotomy less frequently than patients with pancreas preservation (7% versus 59%, P < 0.01), and the intensive care unit (ICU) stay was reduced after CP (P = 0.058). PF persisted at discharge in 66% of patients after pancreas-preserving techniques. AIT was associated with CP in 7 patients, of whom one died post-operatively. Long-term graft function was maintained in four out of six surviving patients, with one insulin-independent patient at 36 months after transplantation. Conclusions When a PF requires a relaparotomy, CP has become our favoured technique. AIT can reduce the metabolic impact of the procedure.

Published
2014

35. Nab-paclitaxel plus gemcitabine with or without capecitabine and cisplatin in metastatic pancreatic adenocarcinoma (PACT-19): a randomised phase 2 trial

Author

Chiara Pircher, Marta Chiaravalli, U. Peretti, Massimo Falconi, Michele Reni, Silvia Romi, Roberto Nicoletti, M. Macchini, Elena Gritti, Diletta Barone, Silvia Zanon, Luca Gianni, Claudio Doglioni, Elena Mazza, Gianpaolo Balzano, Reni, M., Zanon, S., Peretti, U., Chiaravalli, M., Barone, D., Pircher, C., Balzano, G., Macchini, M., Romi, S., Gritti, E., Mazza, E., Nicoletti, R., Doglioni, C., Falconi, M., and Gianni, L.

Subjects
Adult, Male, 0301 basic medicine, medicine.medical_specialty, Neutropenia, Paclitaxel, FOLFIRINOX, medicine.medical_treatment, Population, Deoxycytidine, Gastroenterology, Capecitabine, 03 medical and health sciences, 0302 clinical medicine, Albumins, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, medicine, Humans, Progression-free survival, Karnofsky Performance Status, Neoplasm Metastasis, education, Fatigue, Aged, Neoplasm Staging, education.field_of_study, Chemotherapy, Hepatology, business.industry, Anemia, Combination chemotherapy, Middle Aged, Gemcitabine, Progression-Free Survival, Pancreatic Neoplasms, Regimen, 030104 developmental biology, 030220 oncology & carcinogenesis, Female, Cisplatin, business, Carcinoma, Pancreatic Ductal, medicine.drug
Abstract

Summary Background Current treatment for metastatic pancreatic ductal adenocarcinoma includes combination chemotherapy, such as FOLFIRINOX or nab-paclitaxel plus gemcitabine. We investigated the activity of a novel four-drug regimen, consisting of cisplatin, nab-paclitaxel, capecitabine, and gemcitabine, compared with nab-paclitaxel plus gemcitabine, in the PACT-19 trial. Methods This single-centre, randomised, open-label, phase 2 trial was done in San Raffaele Hospital in Italy. We enrolled patients aged 18–75 years with pathologically confirmed stage IV pancreatic ductal adenocarcinoma who had received no previous chemotherapy and had Karnofsky performance status of at least 70. Patients were randomly assigned (1:1) by computer-generated permutated block randomisation (block size of four) stratified by baseline concentration of carbohydrate antigen 19-9 to PAXG (cisplatin 30 mg/m 2 , nab-paclitaxel 150 mg/m 2 , and gemcitabine 800 mg/m 2 on days 1 and 15 and oral capecitabine 1250 mg/m 2 on days 1–28 every 4 weeks), or nab-paclitaxel and gemcitabine alone (nab-paclitaxel 125 mg/m 2 and gemcitabine 1000 mg/m 2 on days 1, 8, and 15 every 4 weeks). The primary endpoint was the proportion of patients who were progression-free at 6 months, analysed in the intention-to-treat population. Data cutoff was on March 31, 2018. The safety population included all patients who received at least one dose of study treatment. This trial is registered with ClinicalTrials.gov, number NCT01730222, and is now closed. Findings Between April 22, 2014, and May 30, 2016, we randomly assigned 83 patients to treatment: 42 patients to PAXG and 41 patients to nab-paclitaxel plus gemcitabine. At 6 months, 31 (74%, 95% CI 58–86) of 42 patients in the PAXG group were alive and free from disease progression compared with 19 (46%, 31–63) of 41 patients in the nab-paclitaxel plus gemcitabine group. The most frequent grade 3 adverse events were neutropenia (12 [29%] of 42 in the PAXG group vs 14 [34%] of 41 in the nab-paclitaxel plus gemcitabine group), anaemia (nine [21%] vs nine [22%]), and fatigue (seven [17%] vs seven [17%]). The most common grade 4 adverse event was neutropenia (five [12%] in the PAXG group vs two [5%] in the nab-paclitaxel plus gemcitabine group). Two (5%) treatment-related deaths occurred in the nab-paclitaxel plus gemcitabine group compared with none in the PAXG group. Interpretation Despite the small sample size, our findings suggest that the PAXG regimen warrants further investigation in a phase 3 trial in patients with metastatic pancreatic ductal adenocarcinoma. Funding Celgene.

Published
2018

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