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Pancreatic Neoplasms: HELP
Articles by Marco LA Torre
Based on 11 articles published since 2008
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Between 2008 and 2019, M. La Torre wrote the following 11 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Editorial What's new in oncologic pancreatic surgery. 2011

Ziparo, V / La Torre, M. · ·G Chir · Pubmed #22018213.

ABSTRACT: -- No abstract --

2 Review Hospital volume, margin status, and long-term survival after pancreaticoduodenectomy for pancreatic adenocarcinoma. 2012

La Torre, Marco / Nigri, Giuseppe / Ferrari, Linda / Cosenza, Giulia / Ravaioli, Matteo / Ramacciato, Giovanni. ·Department of Hepato-Biliary and Pancreatic Surgery, Sant'Andrea Hospital, Faculty of Medicine and Psychology University of Rome La Sapienza, Rome, Italy. marco.latorre@uniroma1.it ·Am Surg · Pubmed #22369834.

ABSTRACT: An association between hospital surgical volume and short- and long-term outcomes after pancreatic surgery has been demonstrated. Identification of specific factors contributing to this relationship is difficult. In this study, the authors evaluated if margin status can be identified as a measure of surgical quality, affecting overall survival, as a function of hospital pancreaticoduodenectomy volume. A systematic review of the literature was performed. Two models for analysis were created, dividing the 18 studies identified into quartiles and two quantiles based on the average annual hospital pancreatectomy volume. Regression modeling and analysis of variance were used to find an association between hospital volume, margin status, and survival. Increasing hospital volume was associated with a significantly increased negative margin status rate: 55 per cent for low-volume, 72 per cent for medium-volume, 74.3 per cent for high-volume, and 75.7 per cent for very high-volume centers (P = 0.008). The negative margin status rates were 64 per cent and 75.1 per cent for volume centers with less and more than 12 pancreaticoduodenectomies/year, respectively (P = 0.04). Low-volume centers negatively affected both margin positive resection and 5-year survival rates, compared with high-volume centers. Margin status rate after pancreaticoduodenectomy could, therefore, be considered a measure of quality for selection of hospitals dedicated to pancreatic surgery.

3 Clinical Trial Safety of a new biological adhesive after pancreatic resection. 2012

Cavallini, M / La Torre, M / Ferri, M / Vitale, V / Mercantini, P / Dente, M / Ziparo, V. ·Surgical Department of Clinical Sciences, Biomedical Technologies and Translational Medicine, Sant'Andrea Hospital, Faculty of Medicine and Psychology University, "La Sapienza" University, Rome, Italy. ·Minerva Chir · Pubmed #23232478.

ABSTRACT: AIM: Pancreatic fistula (PF) represents the main complication (10%-29%) after pancreatic surgery. Soft pancreatic texture with a not dilated pancreatic duct represent the major risk factors for PF. Mortality after pancreaticoduodenectomy (PD) is reported in several large series to be <5%. PF and local sepsis are the main causes of delayed arterial hemorrage with a high mortality rate (14-38%). Therefore, any effort should be implemented in order to reduce the incidence of PF. METHODS: In the present study we have extended the use of the biological adhesive Bioglue® to coat pancreatic resection surface after distal pancreasectomy (DP, N.=5) and pancreatico-jejunostomy (PJ) after PD (N.=18) in a RESULTS: Operative mortality was observed in 2 instances: one case after PJ leakage (1/18, 5.5%) and one case after DP not related to PF (1/5, 20%). PF has been documented in 7/23 (30,4%) after pancreatic resection, and in all cases after PD. In 3 cases PF has been successfully treated conservatively by NPO and octreotide. 2 patients required radiological percutaneous transhepatic biliary drainage and 2 patients required surgical drainage of multiple intrabdominal collections and radiological PTBD. CONCLUSION: On the basis of these observations Bioglue® can be safely utilized to coat pancreatic surface after DP and pancreatico-jejunostomy after PD. This experience warrants further larger controlled studies of the potential value of Bioglue® in reducing the incidence of PF after major pancreatic surgery.

4 Article An Alternative Surgery for an Atypical Kind of Grade C Postoperative Pancreatic Fistula Following Pancreaticoduodenectomy. 2017

Virgilio, Edoardo / LA Torre, Marco / Cavallini, Marco. ·Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology "Sapienza", St. Andrea Hospital, Rome, Italy aresedo1992@yahoo.it edoardo.virgilio@uniroma1.it. · Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology "Sapienza", St. Andrea Hospital, Rome, Italy. ·Anticancer Res · Pubmed #28551674.

ABSTRACT: BACKGROUND/AIM: Grade C postoperative pancreatic fistula (POPF) is a life-threatening complication of pancreaticoduodenectomy (PD), with its surgical management remaining under debate. Occasionally, POPF is associated with a compromised anastomotic Roux-limb. Our series focused to this sort of grade C mixed fistula. PATIENTS AND METHODS: Between April 2004 and March 2014, 5 out of 12 patients with grade C POPF were classified as grade C mixed POPFs. Surgery consisted of associating resection of the anastomotic jejunal segment with resection and closure of the pancreatic stump. RESULTS: Four patients suffered from a grade C mixed POPF discharging into a single dehiscent site; 1 patient was found with two dehiscent points in all (pancreatic anastomosis and jejunal rim). For all of them, the described surgical procedure resulted in complete recovery. CONCLUSION: For grade C pancreatico-digestive POPF, resecting anastomotic jejunal segment during dismantling of the pancreatico-digestive anastomosis appears a very promising surgical technique.

5 Article Early onset pancreatic cancer: risk factors, presentation and outcome. 2015

Piciucchi, Matteo / Capurso, Gabriele / Valente, Roberto / Larghi, Alberto / Archibugi, Livia / Signoretti, Marianna / Stigliano, Serena / Zerboni, Giulia / Barucca, Viola / La Torre, Marco / Cavallini, Marco / Costamagna, Guido / Marchetti, Paolo / Ziparo, Vincenzo / Delle Fave, Gianfranco. ·Digestive and Liver Disease Unit, S. Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy. · Endoscopy Division, Gemelli Hospital, Faculty of Medicine and Surgery, Catholic University of Rome, Italy. · Oncology Department, S. Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy. · General Surgery Unit, S. Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy. · Digestive and Liver Disease Unit, S. Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy. Electronic address: gianfranco.dellefave@uniroma1.it. ·Pancreatology · Pubmed #25708929.

ABSTRACT: BACKGROUND: About 10% of pancreatic cancer patients are aged ≤50 at diagnosis and defined as Early Onset Pancreatic Cancer (EOPC). There is limited information regarding risk factors for EOPC occurrence and their outcome. AIM: To investigate risk factors, presentation features and outcome of EOPC patients. METHODS: Consecutive, histologically confirmed, pancreatic cancer patients enrolled. Data regarding environmental and genetic risk factors, clinical and pathological information, treatment and survival were recorded. EOPC patients (aged ≤50 at diagnosis) were compared to older subjects. RESULTS: Twenty-five of 293 patients (8.5%) had EOPC. There was no difference regarding sex distribution, medical conditions and alcohol intake between EOPC and older subjects. EOPC patients were more frequently current smokers (56% vs 28% p = 0.001) and started smoking at a significantly lower mean age (19.8 years, 95%CI 16.7-22.9) as compared to older patients (26.1, 95%CI 24.2-28) (p = 0.001). Current smoking (OR 7.5; 95%CI 1.8-30; p = 0.004) and age at smoking initiation (OR 0.8 for every increasing year; 95%CI 0.7-0.9; p = 0.01) were significant and independent risk factors for diagnosis of EOPC. There were no differences regarding genetic syndromes and pancreatic cancer family history. EOCP presented less frequently with jaundice (16% vs 44%, p = 0.006) and had a higher rate of unresectable disease, albeit not significantly (84% vs 68%, p = 0.1). EOPC patients were more frequently fit for surgery or chemotherapy than their counterpart, resulting in similar stage-specific survival probability. CONCLUSION: EOPC seems related to active and early smoking but not to familial syndromes. Young patients display aggressive disease but not worse outcome.

6 Article Prognostic assessment of different lymph node staging methods for pancreatic cancer with R0 resection: pN staging, lymph node ratio, log odds of positive lymph nodes. 2014

La Torre, Marco / Nigri, Giuseppe / Petrucciani, Niccolò / Cavallini, Marco / Aurello, Paolo / Cosenza, Giulia / Balducci, Genoveffa / Ziparo, Vincenzo / Ramacciato, Giovanni. ·Department of General Surgery, Surgical Department of Clinical Sciences, Biomedical Technologies and Translational Medicine, Faculty of Medicine and Psychology, University of Rome "La Sapienza", St. Andrea Hospital, Via di Grottarossa, 1035-39, 00189 Rome, Italy. Electronic address: marco.latorre@uniroma1.it. · Department of Hepato-Biliary and Pancreatic Surgery, Surgical Department of Clinical Sciences, Biomedical Technologies and Translational Medicine, Faculty of Medicine and Psychology, University of Rome "La Sapienza", St. Andrea Hospital, Via di Grottarossa, 1035-39, 00189 Rome, Italy. · Department of General Surgery, Surgical Department of Clinical Sciences, Biomedical Technologies and Translational Medicine, Faculty of Medicine and Psychology, University of Rome "La Sapienza", St. Andrea Hospital, Via di Grottarossa, 1035-39, 00189 Rome, Italy. ·Pancreatology · Pubmed #25062879.

ABSTRACT: BACKGROUND AND AIMS: Survival after surgical resection of pancreatic adenocarcinoma is poor. Several prognostic factors such as the status of the resection margin, lymph node status, or tumour grading have been identified. The aims of the present study were to evaluate and compare the prognostic assessment of different lymph nodes staging methods: standard lymph node (pN) staging, metastatic lymph node ratio (LNR), and log odds of positive lymph nodes (LODDS) in pancreatic cancer after pancreatic resection. MATERIALS AND METHODS: Data were retrospectively collected from 143 patients who had undergone R0 pancreatic resection for pancreatic ductal adenocarcinoma. Survival curves (Kaplan-Meier and Cox proportional hazard models), accuracy, and homogeneity of the 3 methods (LNR, LODDS, and pN) were compared to evaluate the prognostic effects. RESULTS: Multivariate analysis demonstrated that LODDS and LNR were an independent prognostic factors, but not pN classification. The scatter plots of the relationship between LODDS and the LNR suggested that the LODDS stage had power to divide patients with the same ratio of node metastasis into different groups. For patients in each of the pN or LNR classifications, significant differences in survival could be observed among patients in different LODDS stages. CONCLUSION: LODDS and LNR are more powerful predictors of survival than the lymph node status in patients undergoing pancreatic resection for ductal adenocarcinoma. LODDS allows better prognostic stratification comparing LNR in node negative patients.

7 Article Is a preoperative assessment of the early recurrence of pancreatic cancer possible after complete surgical resection? 2014

La Torre, Marco / Nigri, Giuseppe / Lo Conte, Annalisa / Mazzuca, Federica / Tierno, Simone Maria / Salaj, Adelona / Marchetti, Paolo / Ziparo, Vincenzo / Ramacciato, Giovanni. ·Department of General Surgery, Biomedical Technologies and Translational Medicine, St. Andrea Hospital, University of Rome La Sapienza Faculty of Medicine and Psychology, Rome, Italy. · Department of Hepato-Biliary and Pancreatic Surgery, Biomedical Technologies and Translational Medicine, St. Andrea Hospital, University of Rome La Sapienza Faculty of Medicine and Psychology, Rome, Italy. · Department of Oncology, Biomedical Technologies and Translational Medicine, St. Andrea Hospital, University of Rome La Sapienza Faculty of Medicine and Psychology, Rome, Italy. ·Gut Liver · Pubmed #24516708.

ABSTRACT: BACKGROUND/AIMS: The prognosis of pancreatic adenocarcinoma (PAC) is poor. The serum carbohydrate antigen 19-9 (CA 19-9) level has been identified as a prognostic indicator of recurrence and reduced overall survival. The aim of this study was to identify preoperative prognostic factors and to create a prognostic model able to assess the early recurrence risk for patients with resectable PAC. METHODS: A series of 177 patients with PAC treated surgically at the St. Andrea Hospital of Rome between January 2003 and December 2011 were reviewed retrospectively. Univariate and multivariate analyses were utilized to identify preoperative prognostic indicators. RESULTS: A preoperative CA 19-9 level >228 U/mL, tumor size >3.1 cm, and the presence of pathological preoperative lymph nodes statistically correlated with early recurrence. Together, these three factors predicted the possibility of an early recurrence with 90.4% accuracy. The combination of these three preoperative conditions was identified as an independent parameter for early recurrence based on multivariate analysis (p=0.0314; hazard ratio, 3.9811; 95% confidence interval, 1.1745 to 15.3245). CONCLUSIONS: PAC patient candidates for surgical resection should undergo an assessment of early recurrence risk to avoid unnecessary and ineffective resection and to identify patients for whom palliative or alternative treatment may be the treatment of choice.

8 Article Malnutrition and pancreatic surgery: prevalence and outcomes. 2013

La Torre, Marco / Ziparo, Vincenzo / Nigri, Giuseppe / Cavallini, Marco / Balducci, Genoveffa / Ramacciato, Giovanni. ·Department of General Surgery, University of Rome La Sapienza, St. Andrea Hospital, Via di Grottarossa, Rome, Italy. marco.latorre@uniroma1.it ·J Surg Oncol · Pubmed #23280557.

ABSTRACT: BACKGROUND: Pancreatic surgery is associated with severe postoperative morbidity. Identification of patients at high risk may provide a way to allocate resources objectively and focus care on those patients in greater need. The Authors evaluate the prevalence of malnutrition and its effect on the postoperative morbidity of patients undergoing pancreatic surgery for malignant tumors. METHODS: Data were collected from 143 patients who had undergone pancreatic resection for cancer. Prevalence of malnutrition was evaluated by several validated screening tools and correlated to the incidence of surgical site infection, overall morbidity, mortality, and hospital stay. RESULTS: Overall, 88% of patients were at medium-high risk of malnutrition. Patients at high risk of malnutrition presented a fourfold longer postoperative hospitalization period and a higher morbidity rate (53.2%) than those patients at low risk of malnutrition. Malnutrition, evaluated by MUST and NRI, was an independent predictor of overall morbidity using multivariate analysis (P = 0.00145, HR = 2.6581, 95% CI = 1.3589-8.5698, and P = 0.07129, HR = 1.9953, 95% CI = 0.9723-13.548, respectively). CONCLUSION: Malnutrition is a relevant predictor of post-operative morbidity and mortality after pancreatic surgery. Patients underwent pancreatic resection for malignant tumors are usually malnourished. Preoperative malnutrition screening is mandatory in order to assess the risk and to treat the malnutrition.

9 Article The glasgow prognostic score as a predictor of survival in patients with potentially resectable pancreatic adenocarcinoma. 2012

La Torre, Marco / Nigri, Giuseppe / Cavallini, Marco / Mercantini, Paolo / Ziparo, Vincenzo / Ramacciato, Giovanni. ·Department of General Surgery, University of Rome La Sapienza, Rome, Italy. marco.latorre@uniroma1.it ·Ann Surg Oncol · Pubmed #22488099.

ABSTRACT: BACKGROUND: Survival rates after resection of pancreatic adenocarcinoma are poor; however, several tumor-related prognostic factors have been identified. There is increasing evidence that additional patient-related prognostic factors, such as ongoing systemic inflammatory response, are associated with poor outcomes in patients with common solid tumors. The purpose of this study was to evaluate the prognostic significance of the modified glasgow prognostic score (mGPS) in resected pancreatic ductal adenocarcinoma. METHODS: Data were collected from 101 patients who had undergone pancreatic resection for ductal adenocarcinoma. Tumor and host factors were analyzed by Kaplan-Meier and Cox proportional hazard models to evaluate their potential prognostic effects. RESULTS: An elevated mGPS was associated with lower overall survival rate after pancreatic resection. The median actuarial survival rate for patients with an mGPS of 0, 1, or 2 was 37.2, 11.5, and 7.3, respectively (p = 0.0001). The Cox proportional hazards model, including all the parameters statistically significant at univariate analysis, demonstrated that mGPS, lymph node ratio (LNR), and positive resection margins were independent negative prognostic factors CONCLUSIONS: Margin involvement, LNR, and the preoperative mGPS were identified as independent predictors of survival in patients undergoing potentially curative pancreatic resection. Based on the present results and existing validation literature, the mGPS should be included in the routine assessment of patients with pancreatic cancer to better stratify patients for entry into therapeutic trials.

10 Article Role of the lymph node ratio in pancreatic ductal adenocarcinoma. Impact on patient stratification and prognosis. 2011

La Torre, Marco / Cavallini, Marco / Ramacciato, Giovanni / Cosenza, Giulia / Rossi Del Monte, Simone / Nigri, Giuseppe / Ferri, Mario / Mercantini, Paolo / Ziparo, Vincenzo. ·Department of General Surgery, Ospedale S. Andrea, Seconda Facoltà di Medicina e Chirurgia, Sapienza University of Rome, Italy. marco.latorre@uniroma1.it ·J Surg Oncol · Pubmed #21713779.

ABSTRACT: BACKGROUND: Survival after resection of pancreatic adenocarcinoma is poor. Several prognostic factors such as the status of the resection margin, lymph node status, or tumor grading have been identified. Aim of the study was to evaluate the prognostic significance of the lymph node ratio (LNR) for resected pancreatic ductal adenocarcinoma. MATERIALS AND METHODS: Data were collected from 101 patients who had undergone pancreatoduodenectomy for pancreatic ductal adenocarcinoma. Patients were divided into four groups according to the absolute LNR (0, 0-0.199, 0.2-0.399, >0.4). Kaplan-Meier and Cox proportional hazard models were used to evaluate the prognostic effect. RESULTS: The actuarial 3- and 5-year survival rates were 32 and 17%, respectively. The median survival was 19 months. Patients with LNR 0/0-0.199/0.2-0.399/>0.4 survived 40.2/30.5/18.1, and 13.6 months, respectively (P = 0.001). At the multivariate analysis, lymph node status was not found to be a significant prognostic factor; on the contrary LNR >0.2 (P = 0.007), positive resection margin (P = 0.001), and grading (P = 0.05) were significantly related to survival. CONCLUSION: LNR is a more powerful predictor of survival than the lymph node status in patients undergoing pancreaticoduodenectomy for ductal adenocarcinoma.

11 Minor A novel approach in surgical palliation for unresectable pancreatic cancer with untreatable chronic pain: radiofrequency ablation of pancreatic mass and celiac plexus. 2010

Cavallini, Marco / La Torre, Marco / Citone, Michele / Rossi, Michele / Rebonato, Alberto / Nava, Andrea Kazemi / Ferrari, Linda / Salvi, Pier Federico / Ziparo, Vincenzo. · ·Am Surg · Pubmed #21513624.

ABSTRACT: -- No abstract --