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Pancreatic Neoplasms: HELP
Articles by Domenico Galasso
Based on 7 articles published since 2008
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Between 2008 and 2019, D. Galasso wrote the following 7 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Review Pancreatic cancer: diagnosis and endoscopic staging. 2010

Galasso, D / Carnuccio, A / Larghi, A. ·Digestive Endoscopy Unit, Catholic University of the Sacred Heart, Rome, Italy. ·Eur Rev Med Pharmacol Sci · Pubmed #20496552.

ABSTRACT: Early diagnosis and appropriate staging of pancreatic adenocarcinoma is of vital importance to possibly detect this otherwise lethal disease at a curable phase and to stratify patients who would benefit the most from surgical resection. The availability of endoscopic ultrasound (EUS) with its unique capability of obtaining refine images of the pancreas has represented a major breakthrough in the management of these difficult tasks. Furthermore, the ability to perform fine needle aspiration (FNA) under real time EUS guidance has offered the possibility to reach a definite diagnosis which has a major impact on the decision making process in the care of patients with both resectable and unresecectable pancreatic cancer. In parallel to the widespread importance of diagnostic EUS, the therapeutic applications of EUS are increasing and may further expand the role of this procedure in the management of pancreatic cancer. This article focuses on the current role of EUS and EUS-FNA in the diagnosis and staging of solid pancreatic lesions in different clinical scenarios, including those individuals at a high risk of developing pancreatic cancer and who may be candidates for a EUS-based screening and surveillance program. Data on the emerging therapeutic role of EUS for pancreatic cancer treatment will also be reviewed.

2 Review Endoscopic ultrasound in the evaluation of pancreaticobiliary disorders. 2010

Larghi, A / Petrone, M C / Galasso, D / Arcidiacono, P G. ·Digestive Endoscopy Unit, Catholic University, Rome, Italy. albertolarghi@yahoo.it ·Dig Liver Dis · Pubmed #19665951.

ABSTRACT: The close proximity of the endoscopic ultrasound probe to the pancreas coupled with the ability to perform fine needle aspiration has made endoscopic ultrasound an extremely important technique for the evaluation of both benign and malignant pancreaticobiliary disorders. In parallel to the widespread importance of diagnostic endoscopic ultrasound, the therapeutic and interventional applications of this procedure are expanding and may become a major breakthrough in the management of pancreaticobiliary diseases. This article focuses on the utility and recent advances of endoscopic ultrasound in the diagnostic evaluation pancreaticobiliary disorders and analyses the data of well established interventional procedures such as celiac plexus neurolysis and pseudocyst drainage. Moreover, the more innovative procedures, such endoscopic ultrasound-guided biliary and pancreatic ducts access and drainage and the experimental use of direct endoscopic ultrasound-guided therapy of both solid and cystic pancreatic lesions will also be reviewed.

3 Clinical Trial Ki-67 grading of nonfunctioning pancreatic neuroendocrine tumors on histologic samples obtained by EUS-guided fine-needle tissue acquisition: a prospective study. 2012

Larghi, Alberto / Capurso, Gabriele / Carnuccio, Antonella / Ricci, Riccardo / Alfieri, Sergio / Galasso, Domenico / Lugli, Francesca / Bianchi, Antonio / Panzuto, Francesco / De Marinis, Laura / Falconi, Massimo / Delle Fave, Gianfranco / Doglietto, Giovanni Battista / Costamagna, Guido / Rindi, Guido. ·Digestive Endoscopy Unit, Divisionof Digestive and Liver Disease, Catholic University, Rome, Italy. albertolarghi@yahoo.it ·Gastrointest Endosc · Pubmed #22898415.

ABSTRACT: BACKGROUND: Preoperative determination of Ki-67 expression, an important prognostic factor for grading nonfunctioning pancreatic endocrine tumors (NF-PETs), remains an important clinical challenge. OBJECTIVE: To prospectively evaluate the feasibility, yield, and clinical impact of EUS-guided fine-needle tissue acquisition (EUS-FNTA) with a large-gauge needle to obtain tissue samples for histologic diagnosis and Ki-67 analysis in patients with suspected NF-PETs. DESIGN: Prospective cohort study. SETTING: Tertiary-care academic medical center. PATIENTS: Consecutive patients with a single pancreatic lesion suspicious for NF-PET on imaging. INTERVENTION: EUS-FNTA with a 19-gauge needle. MAIN OUTCOME MEASUREMENTS: Feasibility and yield of EUS-FNTA for diagnosis and Ki-67 expression determination. RESULTS: Thirty patients (mean [± SD] age 55.7 ± 14.9 years), with a mean (± SD) lesion size of 16.9 ± 6.1 mm were enrolled. EUS-FNTA was successfully performed without complications in all patients, with a mean (± SD) of 2.7 ± 0.5 passes per patient. Adequate samples for histologic examination were obtained in 28 of the 30 patients (93.3%). Ki-67 determination could be performed in 26 of these 28 patients (92.9%, 86.6% overall), 12 of whom underwent surgical resection. Preoperative and postoperative Ki-67 proliferation indexes were concordant in 10 patients (83.3%), whereas 2 patients were upstaged from G1 to G2 or downstaged from G2 to G1, respectively. LIMITATIONS: Single center study with a single operator. CONCLUSION: In patients with suspected nonfunctioning low-grade to intermediate-grade pancreatic neuroendocrine tumors (p-NETs), retrieval of tissue specimens with EUS-FNTA by using a 19-gauge needle is safe, feasible, and highly accurate for both diagnosis and Ki-67 determination. A Ki-67 proliferative index acquired through this technique might be of great help for further therapeutic decisions.

4 Article EUS-guided radiofrequency ablation for management of pancreatic insulinoma by using a novel needle electrode (with videos). 2016

Lakhtakia, Sundeep / Ramchandani, Mohan / Galasso, Domenico / Gupta, Rajesh / Venugopal, Sushma / Kalpala, Rakesh / Reddy, D Nageshwar. ·Asian Institute of Gastroenterology, Hyderabad, India. · Digestive Endoscopy Unit, A. Gemelli Hospital, Catholic University of Sacred Heart, Rome, Italy. · Maimonides Medical Center, Brooklyn, New York, USA. ·Gastrointest Endosc · Pubmed #26394384.

ABSTRACT: BACKGROUND AND AIMS: Insulinomas are one of the most common functional pancreatic neuroendocrine tumors. Surgical removal is the standard of care. Patients unfit for or refusing surgery need an alternative nonsurgical method to alleviate symptoms. EUS has been used to localize, aspirate, and tattoo insulinomas and to inject alcohol for local ablation. This study is aimed at assessing the feasibility of EUS-guided radiofrequency ablation (EUS-RFA) for managing patients with a symptomatic insulinoma by using a novel EUS-RFA needle electrode. METHODS: The EUS-RFA system used consists of a prototype 19-gauge needle electrode, generator, and internal cooling system. EUS-guided RFA is performed under real-time visualization at 50 W to ablate pancreatic insulinomas. RESULTS: In this observational human case series from a tertiary care center, 3 patients with a symptomatic pancreatic insulinoma, not eligible for surgery, underwent EUS-RFA by using an internally cooled prototype needle electrode. All had rapid symptom relief with biochemical improvement and remained symptom free at 11 to 12 months of follow-up. There were no procedure-related adverse events. CONCLUSIONS: EUS-RFA with the novel device can be considered in select patients with a symptomatic pancreatic insulinoma based on preliminary findings of a beneficial effect without adverse events. Assessment of the safety profile requires larger prospective trials.

5 Article Performance of the forward-viewing linear echoendoscope for fine-needle aspiration of solid and cystic lesions throughout the gastrointestinal tract: a large single-center experience. 2014

Larghi, Alberto / Fuccio, Lorenzo / Attili, Fabia / Rossi, Ester Diana / Napoleone, Matteo / Galasso, Domenico / Fadda, Guido / Costamagna, Guido. ·Digestive Endoscopy Unit, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168, Rome, Italy, albertolarghi@yahoo.it. ·Surg Endosc · Pubmed #24414459.

ABSTRACT: BACKGROUND: A newly developed forward-viewing linear echoendoscope (FV-EUS) has recently become available. To date, however, only scanty data on the performance of the FV-EUS scope for fine-needle aspiration (FNA) of lesions throughout the gastrointestinal (GI) tract are available. This study aimed to evaluate the technical performance of the FV-EUS scope for FNA of solid and cystic lesions located throughout the GI tract in a large cohort of patients referred to a tertiary care center. METHODS: All patients who underwent endoscopic ultrasound (EUS)-guided FNA using the FV-EUS scope between January 2007 and December 2008 were included in this retrospective study. The performance of the FV-EUS scope for FNA was evaluated. RESULTS: During the study period, 285 patients with solid or cystic lesions throughout the GI tract underwent the procedure with the FV-EUS scope. A total of 300 FNAs were attempted, 6 (2%) of which could not be performed. Of the 294 successful EUS-FNA procedures, 130 (44.2%) were performed using a 22-gauge needle, 89 (30.3%) using a 25-gauge needle, and 75 (25.5%) using a 19-gauge needle. In all 67 cases of pancreatic cyst or dilated pancreatic duct, a specimen for cystic fluid analysis or cytologic examination could be obtained. Among the remaining 217 patients with solid lesion, a definitive diagnosis could be established for 211 patients (97.2%). The FV-EUS scope had a sensitivity of 74.7% (95% confidence interval [CI] 68.1-80.6%), a specificity of 100% (95% CI 89.9-100%), a positive likelihood ratio of infinity, and a negative likelihood ratio of 0.251 (95% CI 0.196-0.323). CONCLUSIONS: The FV-EUS scope is highly effective for FNA of solid and cystic lesions throughout the GI tract. Prospective studies comparing the FV-EUS scope and a curved linear scope are needed.

6 Article Endoscopic ultrasound-guided fine-needle aspiration with liquid-based cytologic preparation in the diagnosis of primary pancreatic lymphoma. 2010

Rossi, Esther Diana / Larghi, Alberto / Verna, Elizabeth C / Martini, Maurizio / Galasso, Domenico / Carnuccio, Antonella / Larocca, Luigi Maria / Costamagna, Guido / Fadda, Guido. ·Department of Pathology, Catholic University, Rome, Italy. ·Pancreas · Pubmed #20944491.

ABSTRACT: OBJECTIVES: The diagnosis subtyping of lymphoma on specimens collected by endoscopic ultrasound fine-needle aspiration (EUS-FNA) can be extremely difficult. When a cytopathologist is available for the on-site evaluation, the diagnosis may be achieved by applying flow cytometric techniques. We describe our experience with immunocytochemistry (ICC) and molecular biology studies applied on EUS-FNA specimens processed with a liquid-based cytologic (LBC) preparation for the diagnosis of primary pancreatic lymphoma (PPL). METHODS: Three patients with a pancreatic mass underwent EUS-FNA. The collected specimens were processed with the ThinPrep method for the cytologic diagnosis and eventual additional investigations. RESULTS: A morphologic picture consistent with PPL was found on the LBC specimens of the 3 patients. Subsequent ICC and molecular biology studies for immunoglobulin heavy chain gene rearrangement established the diagnosis of pancreatic large B-cell non-Hodgkin lymphoma in 2 patients and a non-Hodgkin lymphoma with plasmoblastic/immunoblastic differentiation in the remaining one. CONCLUSIONS: An LBC preparation can be used to diagnose and subtype PPL by applying ICC and molecular biology techniques to specimens collected with EUS-FNA. This method can be an additional processing method for EUS-FNA specimens in centers where on-site cytopathologist expertise is not available.

7 Article Concomitant intraductal papillary mucinous neoplasm and pancreatic endocrine tumour: Report of two cases and review of the literature. 2009

Larghi, A / Stobinski, M / Galasso, D / Lecca, P G / Costamagna, G. ·Digestive Endoscopy Unit, Catholic University, Rome, Italy. albertolarghi@yahoo.it ·Dig Liver Dis · Pubmed #19223252.

ABSTRACT: It has been suggested that the occurrence of intraductal papillary mucinous neoplasms in association with pancreatic endocrine tumours is more frequent than expected [Goh BK, Ooi LL, Kumarasinghe MP, Tan YM, Cheow PC, Chow PK, et al. Clinicopathological features of patients with concomitant intraductal papillary mucinous neoplasm of the pancreas and pancreatic endocrine neoplasm. Pancreatology 2006;6:520-6]. Up to now, 10 patients with concomitant intraductal papillary mucinous neoplasms and pancreatic endocrine tumours have been reported [Goh BK, Ooi LL, Kumarasinghe MP, Tan YM, Cheow PC, Chow PK, et al. Clinicopathological features of patients with concomitant intraductal papillary mucinous neoplasm of the pancreas and pancreatic endocrine neoplasm. Pancreatology 2006;6:520-6; Zhao X, Stabile BE, Mo J, Wang J, French SW. Nesidioblastosis coexisting with islet cell tumor and intraductal papillary mucinous hyperplasia. Arch Pathol Lab Med 2001;125:1344-7; Marrache F, Cazals-Hatem D, Kianmanesh R, Palazzo L, Couvelard A, O'Toole D, et al. Endocrine tumor and intraductal papillary mucinous neoplasm of the pancreas: a fortuitous association? Pancreas 2005;31:79-83]. In most cases the synchronous existence of both tumours was incidentally discovered after the examination of the surgical specimen. We report two additional patients with intraductal papillary mucinous neoplasms and pancreatic endocrine tumours, in whom both tumours were diagnosed before surgery.