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Pancreatic Neoplasms: HELP
Articles by Selene Manfrè
Based on 5 articles published since 2009
(Why 5 articles?)
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Between 2009 and 2019, S. Manfrè wrote the following 5 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Review Endoscopic ultrasonography for diagnosis and staging of pancreatic adenocarcinoma: key messages for clinicians. 2014

De Angelis, C / Manfrè, S F / Pellicano, R. ·Department of Gastroenterology and Hepatology Endoscopy and Endosonography Center Molinette Hospital, University of Turin, Turin, Italy - eusdeang@hotmail.com or eusdeang@yahoo.it. ·Minerva Med · Pubmed #24727876.

ABSTRACT: Endoscopic ultrasound (EUS) is a technique that combines the potential of endoscopy, which enables the visual examination of the mucosal surface of any gastrointestinal (GI) tract, with ultrasonography. Despite diagnostic and therapeutic advance, pancreatic cancer (PC), in particular ductal adenocarcinoma, remains the most deadly of all GI malignancies, with a 5-years survival rate less than 1.8%. Moreover its incidence appears to be increasing and most patients present with advanced cancer either locally or with metastatic spread. Thus, all efforts must be oriented towards the need of an early diagnosis and to reliably identify patients who really can benefit from major surgical interventions. To date the most accurate imaging techniques for PC diagnosis and staging remain contrast-enhanced computed tomography and EUS. While the former should be the first choice in patients with suspected PC, EUS has the highest accuracy in detecting small lesions, in assessing tumor size and lymph nodes involvement. The possibility to obtain samples from suspicious lesions or lymph nodes, by means of EUS-guided fine-needle aspiration, makes this procedure an ideal staging modality for PC. Since an accurate preoperative evaluation is essential to choose the correct management strategy, EUS role is crucial.

2 Article International Intraductal Papillary Mucinous Neoplasms Registry: Long-Term Results Based on the New Guidelines. 2017

Moris, Maria / Raimondo, Massimo / Woodward, Timothy A / Skinner, Verna J / Arcidiacono, Paolo G / Petrone, Maria C / De Angelis, Claudio / Manfrè, Selene / Carrara, Silvia / Jovani, Manol / Fusaroli, Pietro / Wallace, Michael B. ·From the *Department of Gastroenterology and †Clinical Studies Unit, Mayo Clinic, Jacksonville, FL; ‡Department of Gastroenterology, San Raffaele Scientific Institute, Milan; §Department of Gastroenterology, Azienda Universitario-Ospedaliera San Giovanni Battista, Turin; ∥Department of Gastroenterology, Humanitas Research Hospital, Milan; and ¶Department of Gastroenterology, University of Bologna/Hospital of Imola, Italy. ·Pancreas · Pubmed #28099263.

ABSTRACT: OBJECTIVE: The aim of this study was to analyze the outcomes of a long-term intraductal papillary mucinous neoplasm (IPMN) registry and evaluate new guidelines. METHODS: A prospectively maintained IPMN registry involving 6 centers in Europe and the United States was used to collect the data. Patients with more than 1-year follow-up and no malignancy diagnosed within the first 3 months of surveillance were included. RESULTS: From 1999 to 2014, 620 patients were included. The median follow-up time was 3 years. Thirty-seven (6%) patients developed malignancy with a median time from IPMN diagnosis to malignancy of 10.3 months. The 1-, 5-, and 10-year actuarial rates of disease-free survival were 97%, 93%, and 92% respectively. Four hundred thirty-one patients met criteria for low-risk branch duct IPMN consisting of cyst size less than 3 cm, with no solid component or main duct dilation. Eight malignancies were diagnosed in this subgroup, all of them within the first 5 years. From this subcohort, 112 patients had a follow-up time of more than 5 years, and no malignancy was diagnosed. CONCLUSIONS: In IPMN lesions with low-risk features at baseline, the risk of progression to malignancy after the first 5 years of follow-up was minimal. Furthermore, the main cyst characteristics remained unchanged during their surveillance.

3 Article Diagnostic Accuracy of Endoscopic Ultrasound-Guided Fine-Needle Aspiration Cytology, Carcinoembryonic Antigen, and Amylase in Intraductal Papillary Mucinous Neoplasm. 2016

Moris, Maria / Raimondo, Massimo / Woodward, Timothy A / Skinner, Verna / Arcidiacono, Paolo G / Petrone, Maria C / De Angelis, Claudio / Manfrè, Selene / Fusaroli, Pietro / Asbun, Horacio / Stauffer, John / Wallace, Michael B. ·From the *Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL; †Programa de Doctorat en Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain; ‡San Raffaele Scientific Institute, Milano, Italy; §Azienda Universitario-Ospedaliera San Giovanni Battista, Torino, Italy; ∥University of Bologna/Hospital of Imola, Imola, Italy; and ¶Department of Surgery, Mayo Clinic, Jacksonville, FL. ·Pancreas · Pubmed #26646270.

ABSTRACT: OBJECTIVES: The aim of this study was to determine the accuracy of cytology, carcinoembryonic antigen (CEA), and amylase levels in the preoperative diagnosis of intraductal papillary mucinous neoplasms (IPMNs). METHODS: An international registry was started in 2005 and included patients with clinically suspected IPMNs. Those who underwent surgery and had preoperative endoscopic ultrasonography fine-needle aspiration were selected for the study. RESULTS: One hundred eighty patients were included. Cytological analysis for neoplastic cells in IPMNs showed high specificity (87.8%) but low sensitivity (39.4%). The median CEA level was 525.5 ng/mL (n = 78) in IPMNs versus 9.7 ng/mL in nonmucinous cysts (n = 6), showing an area under the receiver operating characteristic curve (AUC) of 0.87. The optimal cutoff CEA value for distinguishing IPMN from nonmucinous cysts was 129 ng/mL. At this level, the sensitivity was 76.9%, and specificity was 83.3%, yielding a positive predictive value of 95.9% and a negative predictive value of 41.9%. Carcinoembryonic antigen was a poor predictor of neoplasia in IPMNs (AUC = 0.55). Amylase did not distinguish IPMNs from mucinous cystadenomas (MCAs) (median, 3759 U/L [n = 28 IPMNs] and 497 U/L [n = 3 MCAs], AUC = 0.65). CONCLUSIONS: Cytology has a limited role because of its lack of sensitivity. Carcinoembryonic antigen modestly differentiated between mucinous and nonmucinous lesions. Amylase did not distinguish IPMNs versus MCAs.

4 Article Risk factors for malignant progression of intraductal papillary mucinous neoplasms. 2015

Moris, Maria / Raimondo, Massimo / Woodward, Timothy A / Skinner, Verna / Arcidiacono, Paolo G / Petrone, Maria C / De Angelis, Claudio / Manfrè, Selene / Fusaroli, Pietro / Wallace, Michael B. ·Mayo Clinic, Jacksonville, FL, USA; Programa de Doctorat en Medicina de la Universitat Autònoma de Barcelona, Barcelona, Spain. · Mayo Clinic, Jacksonville, FL, USA. · San Raffaele Scientific Institute, Milano, Italy. · Azienda Universitario-Ospedaliera San Giovanni Battista, Torino, Italy. · University of Bologna/Hospital of Imola, Imola, Italy. · Mayo Clinic, Jacksonville, FL, USA. Electronic address: Wallace.michael@mayo.edu. ·Dig Liver Dis · Pubmed #25869552.

ABSTRACT: BACKGROUND: Intraductal papillary mucinous neoplasms of the pancreas are increasingly diagnosed. Due to their malignant potential, greater understanding of their nature is required. AIMS: Define risk factors for malignancy in intraductal papillary mucinous neoplasms. METHODS: An international, multicentre study was performed in Europe and the United States. Clinical databases were reviewed for patients with intraductal papillary mucinous neoplasms diagnosis. RESULTS: Of 1126 patients, 84 were diagnosed with invasive carcinoma/high-grade dysplasia and were compared to the rest of the cohort. Multivariate logistic analysis showed a statistically significant association between cancer/high-grade dysplasia and the variables smoking history (OR 1.9, 95% CI [1.1-3.1]), body mass index (OR 1.1, 95% CI [1-1.1]), symptoms (OR 3.4, 95% CI [1.9-6]), jaundice (OR 0.1, 95% CI [0-0.3]), and steatorrhea (OR 0.3, 95% CI [0.1-0.8]). Univariate analysis showed no association between malignancy and the cyst number/location (p=0.3 and p=0.5, respectively) although a strong association was shown for cyst size (p<0.001). The presence and size of nodules (p<0.01) and main duct involvement (p<0.001) were also strongly related with malignancy. CONCLUSION: The presence of jaundice and steatorrhea, smoking, high body mass index, and imaging features such as cyst size, main duct involvement, and the presence and size of mural nodules are associated with high-grade neoplasia in intraductal papillary mucinous neoplasms.

5 Article Hegemony and cost-effectiveness of endoscopic ultrasound (EUS) in the field of gastroenteropancreatic-neuroendocrine tumors (GEP-NETs). 2014

De Angelis, C / Manfrè, S F / Bruno, M / Pellicano, R. ·Department of Gastroenterology and Hepatology Molinette Hospital, Turin, Italy - eusdeang@hotmail.com. ·Minerva Med · Pubmed #25325565.

ABSTRACT: Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are a group of neoplasms arising from the diffuse neuroendocrine system of the gastrointestinal (GI) tract. They often represent a diagnostic challenge because of their little dimensions, the deep localization into the retroperitoneum or in extramucosal sites, the possibility to be multilocated and the heterogeneous patterns of presentation. Endoscopic ultrasound (EUS) is a cost-effective technique that enables to look very definitely at a suspicious mass and at the surrounding area both within the GI wall and in the pancreas, allowing to precisely assess T and N stage. Under EUS-guidance it is possible to obtain tissue samples in order to reach a definitive diagnosis and to establish the tumor grade. In the therapeutic field, EUS is crucial to assess the safety and the feasibility of resective endoscopic techniques for the GI-wall NETs and it can guide local ablative techniques for pancreatic NETs. After treatment, EUS can be successfully useful to assess complete endoscopic resection and to follow-up resected or ablated patients. It is so evident that EUS has a role in the whole route of NETs management, from diagnosis, evaluation, grading and staging assessment, to therapy and consequent follow-up.