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Pancreatic Neoplasms: HELP
Articles by Giulio Belfiori
Based on 7 articles published since 2010
(Why 7 articles?)
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Between 2010 and 2020, Giulio Belfiori wrote the following 7 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Review Nerves and Pancreatic Cancer: New Insights into a Dangerous Relationship. 2019

Gasparini, Giulia / Pellegatta, Marta / Crippa, Stefano / Lena, Marco Schiavo / Belfiori, Giulio / Doglioni, Claudio / Taveggia, Carla / Falconi, Massimo. ·Pancreas Translational & Clinical Research Center, Division of Experimental Oncology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy. gasparini.giulia@hsr.it. · Axo-Glial Interaction Unit, INSPE, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy. gasparini.giulia@hsr.it. · Axo-Glial Interaction Unit, INSPE, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy. pellegatta.marta@hsr.it. · Pancreas Translational & Clinical Research Center, Division of Experimental Oncology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy. crippa1.stefano@hsr.it. · Vita Salute San Raffaele University, 20132 Milan, Italy. crippa1.stefano@hsr.it. · Pathology Unit, Division of Experimental Oncology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy. schiavolena.marco@hsr.it. · Pancreas Translational & Clinical Research Center, Division of Experimental Oncology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy. belfiori.giulio@hsr.it. · Vita Salute San Raffaele University, 20132 Milan, Italy. doglioni.claudio@hsr.it. · Pathology Unit, Division of Experimental Oncology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy. doglioni.claudio@hsr.it. · Axo-Glial Interaction Unit, INSPE, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy. taveggia.carla@hsr.it. · Pancreas Translational & Clinical Research Center, Division of Experimental Oncology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy. falconi.massimo@hsr.it. · Vita Salute San Raffaele University, 20132 Milan, Italy. falconi.massimo@hsr.it. ·Cancers (Basel) · Pubmed #31248001.

ABSTRACT: Perineural invasion (PNI) is defined as the presence of neoplastic cells along nerves and/or within the different layers of nervous fibers: epineural, perineural and endoneural spaces. In pancreatic cancer-particularly in pancreatic ductal adenocarcinoma (PDAC)-PNI has a prevalence between 70 and 100%, surpassing any other solid tumor. PNI has been detected in the early stages of pancreatic cancer and has been associated with pain, increased tumor recurrence and diminished overall survival. Such an early, invasive and recurrent phenomenon is probably crucial for tumor growth and metastasis. PNI is a still not a uniformly characterized event; usually it is described only dichotomously ("present" or "absent"). Recently, a more detailed scoring system for PNI has been proposed, though not specific for pancreatic cancer. Previous studies have implicated several molecules and pathways in PNI, among which are secreted neurotrophins, chemokines and inflammatory cells. However, the mechanisms underlying PNI are poorly understood and several aspects are actively being investigated. In this review, we will discuss the main molecules and signaling pathways implicated in PNI and their roles in the PDAC.

2 Review Management of neuroendocrine carcinomas of the pancreas (WHO G3): A tailored approach between proliferation and morphology. 2016

Crippa, Stefano / Partelli, Stefano / Belfiori, Giulio / Palucci, Marco / Muffatti, Francesca / Adamenko, Olga / Cardinali, Luca / Doglioni, Claudio / Zamboni, Giuseppe / Falconi, Massimo. ·Stefano Crippa, Stefano Partelli, Marco Palucci, Francesca Muffatti, Olga Adamenko, Massimo Falconi, Division of Pancreatic Surgery, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute, Vita e Salute University, 20132 Milan, Italy. ·World J Gastroenterol · Pubmed #28018101.

ABSTRACT: Neuroendocrine carcinomas (NEC) of the pancreas are defined by a mitotic count > 20 mitoses/10 high power fields and/or Ki67 index > 20%, and included all the tumors previously classified as poorly differentiated endocrine carcinomas. These latter are aggressive malignancies with a high propensity for distant metastases and poor prognosis, and they can be further divided into small- and large-cell subtypes. However in the NEC category are included also neuroendocrine tumors with a well differentiated morphology but ki67 index > 20%. This category is associated with better prognosis and does not significantly respond to cisplatin-based chemotherapy, which represents the gold standard therapeutic approach for poorly differentiated NEC. In this review, the differences between well differentiated and poorly differentiated NEC are discussed considering both pathology, imaging features, treatment and prognostic implications. Diagnostic and therapeutic flowcharts are proposed. The need for a revision of current classification system is stressed being well differentiated NEC a more indolent disease compared to poorly differentiated tumors.

3 Article Positive neck margin at frozen section analysis is a significant predictor of tumour recurrence and poor survival after pancreatodudenectomy for pancreatic cancer. 2020

Crippa, Stefano / Guarneri, Giovanni / Belfiori, Giulio / Partelli, Stefano / Pagnanelli, Michele / Gasparini, Giulia / Balzano, Gianpaolo / Lena, Marco Schiavo / Rubini, Corrado / Doglioni, Claudio / Zamboni, Giuseppe / Falconi, Massimo. ·Division of Pancreatic Surgery, Pancreas Translational & Clinical Research Center, Università Vita Salute, IRCCS San Raffaele Scientific Institute, Milan, Italy. · Department of Pathology, Università Vita Salute, IRCCS San Raffaele Scientific Institute, Milan, Italy. · Department of Pathology, Università Politecnica Delle Marche, Ospedali Riuniti, Ancona, Italy. · Department of Pathology, Ospedale Sacro Cuore-Don Calabria, Negrar, Italy. · Division of Pancreatic Surgery, Pancreas Translational & Clinical Research Center, Università Vita Salute, IRCCS San Raffaele Scientific Institute, Milan, Italy. Electronic address: falconi.massimo@hsr.it. ·Eur J Surg Oncol · Pubmed #32098733.

ABSTRACT: BACKGROUND: The possible benefit of frozen section (FS) analysis during (PD) for pancreatic ductal adenocarcinoma (PDAC) and of additional resection up to total pancreatectomy (TP) is debated. Aim of this work is to evaluate the prognostic role of positive FS analysis after PD for PDAC. METHODS: Multicentric retrospective analysis on prospective databases of three institutions. Based on FS analysis patients were classified as FS negative/FS positive. All positive FS patients underwent extended PD (EPD) or TP. Postoperative outcomes, disease-free (DFS) and disease-specific survival (DSS) were evaluated. RESULTS: Of 371 patients, 58 (16%) had positive FS. This resulted in 313 (84%) SPD (standard pancreatoduodenectomy), 22 (6%) EPD and 36 (10%) TP. Postoperative mortality was higher in patients undergoing TP (11% compared to 4.5% in EPD and 1% in SPD; p = 0.01). 26% of patients underwent neoadjuvant therapy, and it did not decrease the rate of positive FS. Systemic/local relapse rates were 59% and 41% in negative FS group, and 78% and 22% in positive FS group (p = 0.031). Median DFS and DSS were 20 and 37 months in negative FS group, and 12 and 23 months in positive FS patients (p = 0.001). Independent predictors of recurrence were G3, N1/N2 status and positive FS. R1 resection, G3, N1/N2 status, perineural invasion and positive FS were independent predictors of DSS. CONCLUSIONS: Positive FS analysis is a poor prognostic factor after PD for PDAC. It is significantly associated with a high rate of R1 resection at final histology, PDAC recurrence and poor survival.

4 Article Postoperative Outcomes and Functional Recovery After Preoperative Combination Chemotherapy for Pancreatic Cancer: A Propensity Score-Matched Study. 2019

Pecorelli, Nicolò / Pagnanelli, Michele / Cinelli, Lorenzo / Di Salvo, Francesca / Partelli, Stefano / Crippa, Stefano / Tamburrino, Domenico / Castoldi, Renato / Belfiori, Giulio / Reni, Michele / Falconi, Massimo / Balzano, Gianpaolo. ·Division of Pancreatic Surgery, Pancreas Translational & Clinical Research Center, San Raffaele Scientific Institute, Milan, Italy. · Vita-Salute San Raffaele University, Milan, Italy. · Department of Medical Oncology, San Raffaele Scientific Institute, Milan, Italy. ·Front Oncol · Pubmed #31850203.

ABSTRACT:

5 Article Minimally Invasive Versus Open Treatment for Benign Sporadic Insulinoma Comparison of Short-Term and Long-Term Outcomes. 2018

Belfiori, Giulio / Wiese, Dominik / Partelli, Stefano / Wächter, Sabine / Maurer, Elisabeth / Crippa, Stefano / Falconi, Massimo / Bartsch, Detlef K. ·Pancreatic Surgery Unit, Pancreas Translational and Clinical Research Center, Vita-Salute San Raffaele University, Milan, Italy. giulio_belfiori@live.it. · Department of Visceral, Thoracic and Vascular Surgery, Philipps University Marburg, 35041, Baldingerstrasse, Marburg, Germany. · Pancreatic Surgery Unit, Pancreas Translational and Clinical Research Center, Vita-Salute San Raffaele University, Milan, Italy. ·World J Surg · Pubmed #29691623.

ABSTRACT: BACKGROUND: Benign insulinoma is the most common functioning neuroendocrine tumor of the pancreas, and its incidence is estimated at 0.4%. The treatment of choice is organ-preserving resection. The aim of this study was to compare short-term and long-term outcomes of minimally invasive laparoscopic or robotic enucleation (MIC-EN) and open enucleation (O-EN) for sporadic benign insulinoma. METHODS: A retrospective bi-institutional analysis of 71 patients who underwent an enucleation for sporadic benign insulinoma between 2003 and 2016 was performed. Patients were analyzed according to intention-to-treat principle. RESULTS: Fifteen (21%) patients underwent MIC-EN (three robotic and 12 laparoscopic) and 56 (79%) patients O-EN. In all MIC-EN patients, the insulinoma was localized by preoperative imaging compared to only 62.5% (35 of 56) patients in the O-EN group (p = 0.005). Three of the MIC-EN patients (20%) with insulinomas in the pancreatic head had to undergo a conversion. Excluding conversions, MIC-EN procedures were shorter (145 vs 180, p = 0.036) compared to O-EN surgery. Late complications and pathological data did not differ between groups, excluding margin status R1 MIC-EN (26.7%) compared to O-EN (10.7%, p = 0.115). After a median follow-up of 75 (range 1-151) months, all patients were alive, but four (5.6%) patients (one after MIC-EN and three after O-EN) developed a functional recurrence. No patient with a R1 resection had a disease recurrence. CONCLUSIONS: MIC-EN for benign sporadic insulinoma is a safe procedure with at least similar short-term and long-term postoperative outcomes as the open technique. Thus, preoperatively localized benign insulinoma should be approached laparoscopically, if technically feasible.

6 Article SUVmax after (18)fluoro-deoxyglucose positron emission tomography/computed tomography: A tool to define treatment strategies in pancreatic cancer. 2018

Pergolini, Ilaria / Crippa, Stefano / Salgarello, Matteo / Belfiori, Giulio / Partelli, Stefano / Ruffo, Giacomo / Pucci, Alessandro / Zamboni, Giuseppe / Falconi, Massimo. ·Department of Surgery, Universita' Politecnica delle Marche, Ancona, Italy. · Pancreatic Surgery Unit, Pancreas Translational & Clinical Research Center, IRCCS San Raffaele Scientific Institute, Milan, Italy. · Department of Nuclear Medicine, Ospedale Sacro Cuore-Don Calabria, Negrar, Italy. · Department of Surgery, Ospedale Sacro Cuore-Don Calabria, Negrar, Italy. · Department of Pathology, Ospedale Sacro Cuore-Don Calabria, Negrar, Italy. · Pancreatic Surgery Unit, Pancreas Translational & Clinical Research Center, IRCCS San Raffaele Scientific Institute, Milan, Italy. Electronic address: falconi.massimo@hsr.it. ·Dig Liver Dis · Pubmed #29017830.

ABSTRACT: BACKGROUND: (18)fluoro-deoxyglucose positron emission tomography/computed tomography (18FDG-PET/CT) might be a useful tool in the management of pancreatic ductal adenocarcinoma (PDAC). AIMS: The aim of this study was to analyze maximum standard uptake value (SUVmax) after 18FDG-PET/CT as predictor of survival outcomes and method to determine treatment strategies. METHODS: A consecutive series of patients who underwent preoperative 18FDG-PET/CT and subsequent resection for PDAC were retrospectively reviewed. Patients who underwent neoadjuvant chemotherapy were excluded. RESULTS: 46 patients were included in the analysis. Median follow-up was 27 months (4-67). Patients who recurred within 12 months showed a significantly higher preoperative median SUVmax (8.1 vs 6.1, p=0.039). Receiver operating characteristics (ROC) curves for disease-free survival (DFS) and disease-specific survival (DSS) identified SUVmax of 6.0 as optimal cut-off. Multivariate analysis showed that SUVmax ≥ 6.0 was an independent predictor of poor DFS (HR 2.288, p=0.024) and DSS (HR 4.875, p<0.001). The combination of SUVmax ≥6.0 with CA19.9 ≥200U/ml was significantly associated with survival outcomes in comparison to patients without concordantly elevated values. CONCLUSION: SUVmax ≥6.0 is an independent predictor of DFS and DSS in resected PDAC. 18FDG-PET/CT might be considered in the preoperative evaluation of patients with pancreatic cancer.

7 Article A preoperative score to predict early death after pancreatic cancer resection. 2017

Balzano, Gianpaolo / Dugnani, Erica / Crippa, Stefano / Scavini, Marina / Pasquale, Valentina / Aleotti, Francesca / Liberati, Daniela / Gandolfi, Alessandra / Belfiori, Giulio / Reni, Michele / Doglioni, Claudio / Ruffo, Giacomo / Marmorale, Cristina / Falconi, Massimo / Piemonti, Lorenzo. ·Pancreatic Surgery Unit, Pancreas Translational & Clinical Research Center, Milan, Italy. · Diabetes Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy. · Department of Medical Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy. · Department of Pathology, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy. · Division of General Surgery, Sacro Cuore Don Calabria Hospital, Verona, Italy. · Department of Surgery, Polytechnic University of Marche Region, Ancona, Italy. · Pancreatic Surgery Unit, Pancreas Translational & Clinical Research Center, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy. · Diabetes Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy. Electronic address: piemonti.lorenzo@hsr.it. ·Dig Liver Dis · Pubmed #28734776.

ABSTRACT: BACKGROUND: This study aimed to develop and validate a preoperative prognostic model for death within one year post-surgery in patients with resectable pancreatic ductal adenocarcinoma (PDAC). METHODS: A derivation cohort study of 296 patients who underwent surgical resection of PDAC was prospectively enrolled in an observational study. Preoperative predictors of one year mortality were used to develop a risk score which was then validated in an external cohort of 182 patients with resectable PDAC. RESULTS: Seventy-eight out of 296 patients (26%) died within the first year. Preoperative independent predictors of one year mortality were: nutritional status (Geriatric Nutritional Risk Index, OR 2.23, 1.14-4.38; p=0.02), American Society of Anaesthesiologists' score (OR 2.56, 1.1-5.98; p=0.03), abdominal or back pain at presentation (OR 2.51, 1.05-5.9; p=0.038) and non metastatic liver disease as comorbidity (OR 4.5, 1.05-19.3; p=0.043). A score ranging from 0 to 7 points was developed. In the validation cohort, the model was able to predict early mortality (OR 7.1, 3.9-12.7; p<0.0001), with a predictive ability of 53.5% (Nagelkerke R CONCLUSIONS: Our new simple risk score proved reliable in forecasting one year mortality in patients with resectable PDAC.