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Pancreatic Neoplasms: HELP
Articles by Rita Conigliaro
Based on 6 articles published since 2010
(Why 6 articles?)
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Between 2010 and 2020, Rita Conigliaro wrote the following 6 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Clinical Trial SpyGlass single-operator peroral cholangioscopy in the evaluation of indeterminate biliary lesions: a single-center, prospective, cohort study. 2013

Manta, Raffaele / Frazzoni, Marzio / Conigliaro, Rita / Maccio, Livia / Melotti, Gianlugi / Dabizzi, Emanuele / Bertani, Helga / Manno, Mauro / Castellani, Danilo / Villanacci, Vincenzo / Bassotti, Gabrio. ·Gastroenterologia ed Endoscopia Digestiva, Nuovo Ospedale S. Agostino, Viale Giardini 1355, 41100 Modena, Italy. r.manta@libero.it ·Surg Endosc · Pubmed #23233008.

ABSTRACT: BACKGROUND: SpyGlass single-operator peroral cholangioscopy appears to be a promising technique to overcome some limitations of conventional peroral cholangioscopy. We aimed to prospectively evaluate the SpyGlass system in a cohort of patients with indeterminate biliary lesions. METHODS: Patients with indeterminate strictures or filling defects at endoscopic retrograde cholangiopancreatography (ERCP) were consecutively enrolled. After SpyGlass visual evaluation, targeted biopsies were taken with the SpyBite and histopathological assessment was made by two experienced gastrointestinal pathologists. SpyBite-targeted biopsy results were evaluated by assessing agreement with surgical specimens and by evaluation of final, clinical follow-up-based diagnosis. RESULTS: Fifty-two patients participated in the study. In 7 cases, definite diagnosis (stones, varices) was made by SpyGlass endoscopic evaluation. In 42 of the remaining 45 cases, material suitable for histopathology assessment was provided by the SpyBite. Overall, a definite diagnosis was made in 49 (7 + 42; 94 %) cases. Agreement of SpyBite biopsy results with surgical specimen diagnosis was found in 38/42 (90 %) cases; sensitivity, specificity, and positive and negative predictive values were 88, 94, 96, and 85 %, respectively. Procedure-related complications consisted of one case of mild cholangitis and one case of mild pancreatitis. CONCLUSIONS: In our series, the SpyGlass system allowed adequate biopsy sampling and definite diagnosis with high accuracy in the vast majority of patients with indeterminate biliary lesions. Its use was associated with a low complication rate. Further refinements of the technique are warranted, but the SpyGlass system has the potential to become a diagnostic standard for the assessment of indeterminate biliary lesions.

2 Article Technique, safety, and feasibility of EUS-guided radiofrequency ablation in unresectable pancreatic cancer. 2018

Scopelliti, Filippo / Pea, Antonio / Conigliaro, Rita / Butturini, Giovanni / Frigerio, Isabella / Regi, Paolo / Giardino, Alessandro / Bertani, Helga / Paini, Marina / Pederzoli, Paolo / Girelli, Roberto. ·Department of Hepato-Pancreato-Biliary Surgery, Pederzoli Hospital, via Monte Baldo 24, 37019, Peschiera del Garda, VR, Italy. fscopelliti@ospedalepederzoli.it. · Department of Pancreatic Surgery, University of Verona, Verona, Italy. · Gastroenterology and Digestive Endoscopy Unit, Baggiovara Hospital, Modena, Italy. · Department of Hepato-Pancreato-Biliary Surgery, Pederzoli Hospital, via Monte Baldo 24, 37019, Peschiera del Garda, VR, Italy. · Department of General Surgery, Pederzoli Hospital, Peschiera del Garda, Italy. ·Surg Endosc · Pubmed #29766302.

ABSTRACT: BACKGROUND AND AIMS: Radiofrequency ablation (RFA) is a well-recognized local ablative technique applied in the treatment of different solid tumors. Intraoperative RFA has been used for non-metastatic unresectable pancreatic ductal adenocarcinoma (PDAC), showing increased overall survival in retrospective studies. A novel RFA probe has recently been developed, allowing RFA under endoscopic ultrasound (EUS) guidance. Aim of the present study was to assess the feasibility and safety of EUS-guided RFA for unresectable PDACs. METHODS: Patients with unresectable non-metastatic PDAC were included in the study following neoadjuvant chemotherapy. EUS-guided RFA was performed using a novel monopolar 18-gauge electrode with a sharp conical 1 cm tip for energy delivery. Pre- and post-procedural clinical and radiological data were prospectively collected. RESULTS: Ten consecutive patients with unresectable PDAC were enrolled. The procedure was successful in all cases and no major adverse events were observed. A delineated hypodense ablated area within the tumor was observed at the 30-day CT scan in all cases. CONCLUSIONS: EUS-guided RFA is a feasible and safe minimally invasive procedure for patients with unresectable PDAC. Further studies are warranted to demonstrate the impact of EUS-guided RFA on disease progression and overall survival.

3 Article Covered versus uncovered self-expandable metal stent for palliation of primary malignant extrahepatic biliary strictures: a randomized multicenter study. 2018

Conio, Massimo / Mangiavillano, Benedetto / Caruso, Angelo / Filiberti, Rosa Angela / Baron, Todd H / De Luca, Luca / Signorelli, Sergio / Crespi, Mattia / Marini, Mario / Ravelli, Paolo / Conigliaro, Rita / De Ceglie, Antonella. ·Gastroenterology Department, General Hospital, Sanremo (IM). · Gastroenterology and Digestive Endoscopy Department, Azienda Ospedaliera Universitaria di Modena, Sant'Agostino Estense Hospital, Baggiovara (MO). · Clinical Epidemiology Unit, Ospedale Policlinico San Martino, Genova, Italy. · Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. · Gastroenterology and Digestive Endoscopy Unit, Ospedali Riuniti Marche Nord, Pesaro. · Gastroenterology and Gastrointestinal Endoscopy Unit, ASST, Papa Giovanni XXIII, Bergamo, Italy. · Gastroenterology and Operative Endoscopy Unit, Santa Maria Alle Scotte Hospital, Siena, Italy. ·Gastrointest Endosc · Pubmed #29653120.

ABSTRACT: BACKGROUND AND AIMS: Self-expandable metal stents (SEMSs) are used to relieve malignant biliary obstructions. We aimed to compare stent patency, the adverse events rate, and overall survival of covered versus uncovered self-conformable metal stents in patients with primary malignant extrahepatic biliary strictures, not eligible for surgery. METHODS: This is a multicenter randomized trial analyzing 158 patients with inoperable distal malignant biliary obstruction conducted in 5 Italian referral centers between December 2014 and October 2016. Seventy-eight patients were randomized to receive a fully covered SEMS (FCSEMS), and 80 patients received uncovered SEMSs (USEMSs). Data from 148 (72 FCSEMSs and 76 USEMSs) of 158 patients were analyzed. RESULTS: Median time of stent patency was lower for FCSEMSs (240 days vs 541 days for USEMSs; P = .031). Adverse events occurred with 19 FCSEMSs (26.4%) and 10 USEMSs (13.2%); P = .061. The main causes of FCSEMS dysfunction were migration (7% vs 0% in the USEMS group) and early occlusion mainly because of sludge or overgrowth; late stent occlusion because of tumor ingrowth occurred in 13.2% of patients in the USEMS group. There were no significant differences either in levels of conjugated bilirubin improvement or in overall survival between the FCSEMS and USEMS groups. Median survival was 134 days in the FCSEMS group and 112 days in the USEMS group (P = .23). CONCLUSION: The number of stent-related adverse events was higher, although not significantly, among patients in the FCSEMS group. FCSEMSs had a significantly higher rate of migration than USEMSs, and stent occlusion occurred earlier. A significant difference in the patency rate was observed in favor of the USEMS group. (Clinical trial registration number: NCT02102984.).

4 Article Pre-operative Diagnosis of Pancreatic Neuroendocrine Tumors with Endoscopic Ultrasonography and Computed Tomography in a Large Series. 2016

Manta, Raffaele / Nardi, Elisabetta / Pagano, Nico / Ricci, Claudio / Sica, Mariano / Castellani, Danilo / Bertani, Helga / Piccoli, Micaela / Mullineris, Barbara / Tringali, Alberto / Marini, Francesco / Germani, Ugo / Villanacci, Vincenzo / Casadei, Riccardo / Mutignani, Massimiliano / Conigliaro, Rita / Bassotti, Gabrio / Zullo, Angelo. ·Gastroenterology and Digestive Endoscopy Unit, Nuovo Ospedale Civile Sant'Agostino-Estense, Baggiovara-Modena, Italy. r.manta@libero.it. · Gastroenterology Section, Department of Medicine, University of Perugia School of Medicine, Perugia, Italy. · Department of Internal Medicine and Surgery (DIMEC), University of Bologna, Sant'Orsola-Malpighi Hospital, Bologna, Italy. · Gastroenterology and Digestive Endoscopy Unit, Nuovo Ospedale Civile Sant'Agostino-Estense, Baggiovara-Modena, Italy. · Department of General Surgery, Nuovo Ospedale Civile Sant'Agostino-Estense, Baggiovara-Modena, Italy. · Endoscopy Unit, Niguarda Ca-Granda Hospital, Milan, Italy. · Gastroenterology Unit, Ospedali Riuniti Ancona, Italy. · Pathology Unit Spedali Civili, Brescia, Italy. · Gastroenterology and Digestive Endoscopy, Nuovo Regina Margherita Hospital, Rome, Italy. ·J Gastrointestin Liver Dis · Pubmed #27689195.

ABSTRACT: BACKGROUND AND AIMS: Diagnosis of pancreatic neuroendocrine tumors (p-NETs) is frequently challenging. We describe a large series of patients with p-NETs in whom both pre-operative Computed Tomography (CT) and Endoscopic Ultrasonography (EUS) were performed. METHODS: This was a retrospective analysis of prospectively collected sporadic p-NET cases. All patients underwent both standard multidetector CT study and EUS with fine-needle aspiration (FNA). The final histological diagnosis was achieved on a post-surgical specimen. Chromogranin A (CgA) levels were measured. RESULTS: A total of 80 patients (mean age: 58 +/- 14.2 years; males: 42) were enrolled. The diameter of functioning was significantly lower than that of non-functioning p-NETs (11.2 +/- 8.5 mm vs 19.8 +/- 12.2 mm; P = 0.0004). The CgA levels were more frequently elevated in non-functioning than functioning pNET patients (71.4% vs 46.9%; P = 0.049). Overall, the CT study detected the lesion in 51 (63.7%) cases, being negative in 26 (68.4%) patients with a tumor Data of this large case series would suggest that the EUS should be included in the diagnostic work-up in all patients with a suspected p-NET, even when the CT study was negative for a primary lesion in the pancreas.

5 Article A multimodal, one-session endoscopic approach for management of patients with advanced pancreatic cancer. 2016

Manta, Raffaele / Conigliaro, Rita / Mangiafico, Santi / Forti, Edoardo / Bertani, Helga / Frazzoni, Marzio / Galloro, Giuseppe / Mutignani, Massimiliano / Zullo, Angelo. ·Interventional Digestive Endoscopy, "Niguarda Ca' Granda" Hospital, Milan, Italy. · Gastroenterology and Digestive Endoscopy Unit, "Nuovo Civile Sant'Agostino - Estense" Hospital, Baggiovara, Modena, Italy. · Department of Clinical Medicine and Surgery, Surgical Digestive Endoscopy Unit, Federico II University, Naples, Italy. · Gastroenterology and Digestive Endoscopy, "Nuovo Regina Margherita" Hospital, Rome, Italy. angelozullo66@yahoo.it. ·Surg Endosc · Pubmed #26194252.

ABSTRACT: BACKGROUND: A number of patients with inoperable pancreatic cancer may concurrently complain of pain, biliary obstruction, and duodenal stenosis. Endoscopic palliative treatments and opioid therapy are generally performed in these patients. The study aimed to assess the efficacy and safety of a multimodal 'one-Session Three Endoscopic Procedures' (one-STEP) to simultaneously treat cholestasis, restore duodenal transit, and achieve pain relief in selected patients with advanced pancreatic cancer. METHODS: Selected patients diagnosed with an advanced pancreatic cancer presenting with biliary obstruction, duodenal stenosis, and severe pain treated with the one-STEP were considered. The one-STEP endoscopic approach included biliary and duodenal stenting, and EUS-guided celiac plexus neurolysis. The technical success rate, complications, pain relief, and opioid use at follow-up were assessed. RESULTS: A total of 15 patients were treated. The one-STEP was successful in 13 (87 %) cases, while it failed in two patients due to the impossibility of dilating the neoplastic mass for creating a fistula. No endoscopy-related complications occurred. The median of pain intensity was 8 (range 7-10) at entry and significantly decreased to 2 (range 2-4) 72 h following celiac plexus neurolysis. At follow-up (median survival 4 months; range 3-8), only 3 (20 %) needed of narcotic treatment in the last period. CONCLUSIONS: The multimodal one-STEP is an effective and safe endoscopic approach for palliative treatment of biliary and duodenal stenosis, and for relieving chronic pain in patients with advanced pancreatic cancer.

6 Article Ki-67 cytological index can distinguish well-differentiated from poorly differentiated pancreatic neuroendocrine tumors: a comparative cytohistological study of 53 cases. 2014

Carlinfante, Gabriele / Baccarini, Paola / Berretti, Debora / Cassetti, Tiziana / Cavina, Maurizio / Conigliaro, Rita / De Pellegrin, Alessandro / Di Tommaso, Luca / Fabbri, Carlo / Fornelli, Adele / Frasoldati, Andrea / Gardini, Giorgio / Losi, Luisa / Maccio, Livia / Manta, Raffaele / Pagano, Nico / Sassatelli, Romano / Serra, Silvia / Camellini, Lorenzo. ·Department of Pathology, Arcispedale Santa Maria Nuova-IRCCS, Viale Risorgimento 80, 42123, Reggio Emilia, Italy, carlinfante.gabriele@asmn.re.it. ·Virchows Arch · Pubmed #24807732.

ABSTRACT: The Ki-67 labeling index has been found to bear prognostic significance in gastrointestinal neuroendocrine tumors (NETs), and it was recently incorporated in NET histological grading. Nevertheless, a reliable preoperative determination of NET grading could be useful in clinical practice. The aim of this study is to compare the results of Ki-67 labeling index, as measured on cytological samples and on surgical specimens of patients with pancreatic NETs (P-NETs). We also investigated whether concordance might be improved, using a 5 % (instead of 2 %) cutoff value for defining G2 tumors. We retrospectively identified 48 consecutive patients with 53 P-NETs, from our five institutions, and we measured Ki-67 labeling index on their cytological samples and surgical specimens. The traditional 2 % and the alternative 5 % cutoff values were used to classify G2 tumors. The concordance rate between cytological and histological grading was 46/53 (86.8 %; weighted κ statistic 0.77; 95 % confidence interval (95 % CI) 0.60-0.94). No cases of cytological G1-G2 NETs were upgraded to G3 neuroendocrine carcinoma (NEC) at histological grading. Cytology was found to be highly specific in the diagnosis of both G2 (94.1 %; 95 % CI 80.3-99.3) and G3 tumors (100.0 %; 95 % CI 92.8-100), but the sensitivity was poor for G2 NETs (66.7 %; 95 % CI 38.4-88.2) and high for the prediction of G3 NECs (100 %; 95 % CI 39.8-100.0). When the 5 % cutoff value was adopted, concordance rate was 49/53 (92.4 %; weighted κ 0.82; 95 % CI 0.64-1.00). In conclusion, Ki-67 cytological expression can distinguish well-differentiated (both G1 and G2) from poorly differentiated P-NETs, and it may be useful for their preoperative classification.