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Pancreatic Neoplasms: HELP
Articles by Massimiliano Tuveri
Based on 5 articles published since 2010
(Why 5 articles?)
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Between 2010 and 2020, Massimiliano Tuveri wrote the following 5 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Review Screening/surveillance programs for pancreatic cancer in familial high-risk individuals: A systematic review and proportion meta-analysis of screening results. 2018

Paiella, Salvatore / Salvia, Roberto / De Pastena, Matteo / Pollini, Tommaso / Casetti, Luca / Landoni, Luca / Esposito, Alessandro / Marchegiani, Giovanni / Malleo, Giuseppe / De Marchi, Giulia / Scarpa, Aldo / D'Onofrio, Mirko / De Robertis, Riccardo / Pan, Teresa Lucia / Maggino, Laura / Andrianello, Stefano / Secchettin, Erica / Bonamini, Deborah / Melisi, Davide / Tuveri, Massimiliano / Bassi, Claudio. ·General and Pancreatic Surgery Department, Pancreas Institute, University and Hospital Trust of Verona, Verona, Italy. Electronic address: salvatore.paiella@univr.it. · General and Pancreatic Surgery Department, Pancreas Institute, University and Hospital Trust of Verona, Verona, Italy. · Gastroenterology B Unit, Pancreas Institute, University and Hospital Trust of Verona, Verona, Italy. · Department of Pathology and Diagnostics, University and Hospital Trust of Verona, Verona, Italy; ARC-NET Research Center, University and Hospital Trust of Verona, Verona, Italy. · Department of Radiology, Pancreas Institute, University and Hospital Trust of Verona, Verona, Italy. · Department of Radiology, Casa di Cura Pederzoli Hospital, Peschiera del Garda, Italy. · Oncology Unit, Pancreas Institute, University and Hospital Trust of Verona, Verona, Italy. ·Pancreatology · Pubmed #29709409.

ABSTRACT: BACKGROUND/OBJECTIVES: Screening/surveillance programs for pancreatic cancer (PC) in familial high-risk individuals (FPC-HRI) have been widely reported, but their merits remain unclear. The data reported so far are heterogeneous-especially in terms of screening yield. We performed a systematic review and meta-analysis of currently available data coming from screening/surveillance programs to evaluate the proportion of screening goal achievement (SGA), overall surgery and unnecessary surgery. METHODS: We searched MEDLINE, Embase, PubMed and the Cochrane Library database from January 2000 to December 2016to identify studies reporting results of screening/surveillance programs including cohorts of FPC-HRI. The main outcome measures were weighted proportion of SGA, overall surgery, and unnecessary surgery among the FPC-HRI cohort, using a random effects model. SGA was defined as any diagnosis of resectable PC, PanIN3, or high-grade dysplasia intraductal papillary mucinous neoplasm (HGD-IPMN). Unnecessary surgery was defined as any other final pathology. RESULTS: In a meta-analysis of 16 studies reporting on 1551 FPC-HRI cases, 30 subjects (1.82%), received a diagnosis of PC, PanIN3 or HGD-IPMNs. The pooled proportion of SGA was 1.4%(95% CI 0.8-2, p < 0.001, I CONCLUSIONS: The weighted proportion of SGA of screening/surveillance programs published thus far is excellent. However, the probability of receiving surgery during the screening/surveillance program is non-negligible, and unnecessary surgery is a potential negative outcome.

2 Article Reinforced stapler versus ultrasonic dissector for pancreatic transection and stump closure for distal pancreatectomy: A propensity matched analysis. 2019

Pulvirenti, Alessandra / Landoni, Luca / Borin, Alex / De Pastena, Matteo / Fontana, Martina / Pea, Antonio / Esposito, Alessandro / Casetti, Luca / Tuveri, Massimiliano / Paiella, Salvatore / Marchegiani, Giovanni / Malleo, Giuseppe / Salvia, Roberto / Bassi, Claudio. ·Unit of General and Pancreatic Surgery, University of Verona Hospital Trust, Italy. · Unit of General and Pancreatic Surgery, University of Verona Hospital Trust, Italy. Electronic address: Roberto.salvia@univr.it. ·Surgery · Pubmed #30975498.

ABSTRACT: BACKGROUND: Postoperative pancreatic fistula is the primary contributor to morbidity after distal pancreatectomy. To date, no techniques used for the transection and closure of the pancreatic stump have shown clear superiority over the others. This study aimed to compare the rate of postoperative pancreatic fistula after pancreatic transection conducted with a reinforced stapler versus an ultrasonic dissector after a distal pancreatectomy. METHOD: Prospectively collected data of consecutive patients who underwent distal pancreatectomy from 2014 to 2017 were reviewed retrospectively. We included distal pancreatectomies in which pancreatic transection was performed by reinforced stapler or ultrasonic dissector; we excluded extended distal pancreatectomies. To overcome the absence of randomization, we conducted a propensity matching analysis according to risk factors for postoperative pancreatic fistula. RESULTS: Overall, 200 patients met the inclusion criteria. The reinforced stapler was employed in 108 patients and the ultrasonic dissector in 92 cases. After one-to-one propensity matching, 92 patients were selected from each group. The matched reinforced stapler and ultrasonic dissector cohort had no differences in baselines characteristics except for the mini-invasive approach, which was more common in the ultrasonic dissector group (34% vs 51%, P = .025). Overall, 48 patients (26%) developed a postoperative pancreatic fistula, 46 (25%) a grade B postoperative pancreatic fistula, and 2 (1%) a grade C postoperative pancreatic fistula. In the reinforced stapler group, the rate of postoperative pancreatic fistula was 12% (n = 11) and in the ultrasonic dissector group 40% (n = 37) with a P < .001. CONCLUSION: The results of this study suggest that the use of reinforced stapler for pancreatic transection decreases the risk of postoperative pancreatic fistula. A randomized trial is required to confirm these preliminary data.

3 Article Central pancreatectomy for benign or low-grade malignant pancreatic lesions - A single-center retrospective analysis of 116 cases. 2019

Paiella, Salvatore / De Pastena, Matteo / Faustini, Federico / Landoni, Luca / Pollini, Tommaso / Bonamini, Deborah / Giuliani, Tommaso / Bassi, Claudio / Esposito, Alessandro / Tuveri, Massimiliano / Salvia, Roberto. ·General and Pancreatic Surgery Unit, Pancreas Institute, University of Verona Hospital Trust, Policlinico GB Rossi, Piazzale L.A. Scuro, 10, 37134, Verona, Italy. Electronic address: Salvatore.paiella@univr.it. · General and Pancreatic Surgery Unit, Pancreas Institute, University of Verona Hospital Trust, Policlinico GB Rossi, Piazzale L.A. Scuro, 10, 37134, Verona, Italy. ·Eur J Surg Oncol · Pubmed #30527222.

ABSTRACT: BACKGROUND: Central pancreatectomy (CP) is a parenchyma-sparing surgery for benign or low-grade malignant pancreatic tumors. This study aimed to evaluate the safety of the procedure and to analyze the long-term pancreatic function. The age-specific incidence ratio (IR) was calculated based on the incidence of diabetes mellitus in the general Italian population of Italy. MATERIALS AND METHODS: Patients submitted to CP from January 1990 to December 2017 at the Department of General and Pancreatic Surgery of the Pancreas Institute of Verona, Italy, were evaluated. RESULTS: The final population was composed of 116 patients. There was a clear prevalence of females (74.1%), the mean age was 48 ± 15 years and the main indication for surgery was a pancreatic neuroendocrine tumor (45.7%). A pancreojejunal anastomosis was performed more frequently than a pancreogastric anastomosis (78.4% vs 11.6%). The mean length of stay was 20 ± 33 days. The overall abdominal complications rate was 62%. The frequency of clinically relevant postoperative pancreatic fistula (grades B and C) was 26.7%. The mortality rate was 0%. The rate of R1-resection was 0.8%, as was the recurrence rate. After a mean follow-up of 12.8 years ±6.5, 6 patients developed new-onset diabetes (NODM, 7.5%), and the IR was 1.36 (95%CI 0.49-2.96). CONCLUSIONS: CP is associated with high rates of abdominal complications, however, considering the amount of the normal pancreas that was spared, it might be indicated for selected benign or low-malignancy pancreatic tumors. CP patients have the same incidence of diabetes than the general population.

4 Article The Evolution of Surgical Strategies for Pancreatic Neuroendocrine Tumors (Pan-NENs): Time-trend and Outcome Analysis From 587 Consecutive Resections at a High-volume Institution. 2019

Landoni, Luca / Marchegiani, Giovanni / Pollini, Tommaso / Cingarlini, Sara / D'Onofrio, Mirko / Capelli, Paola / De Robertis, Riccardo / Davì, Maria V / Amodio, Antonio / Impellizzeri, Harmony / Malpaga, Anna / Miotto, Marco / Boninsegna, Letizia / Crepaz, Lorenzo / Nessi, Chiara / Zingaretti, Caterina C / Paiella, Salvatore / Esposito, Alessandro / Casetti, Luca / Malleo, Giuseppe / Tuveri, Massimiliano / Butturini, Giovanni / Salvia, Roberto / Scarpa, Aldo / Falconi, Massimo / Bassi, Claudio. ·General and Pancreatic Surgery Department, The Pancreas Institute-University of Verona Hospital Trust, Verona, Italy. · Department of Oncology, The Pancreas Institute-University of Verona Hospital Trust, Verona, Italy. · Department of Radiology, The Pancreas Institute-University of Verona Hospital Trust, Verona, Italy. · Department of Pathology, The Pancreas Institute-University of Verona Hospital Trust, Verona, Italy. · Department of Radiology, Pederzoli Hospital, Peschiera del Garda, Verona, Italy. · Department of Medicine, The Pancreas Institute-University of Verona Hospital Trust, Verona, Italy. · Division of Surgery, Ospedale "Sacro Cuore-Don Calabria", Negrar (VR), Italy. · Department of Surgery, Pederzoli Hospital, Peschiera del Garda, Verona, Italy. · Pancreatic Surgery Unit, Pancreas Translational & Clinical Research Center, San Raffaele Scientific Institute, "Vita-Salute" University, Milan, Italy. ·Ann Surg · Pubmed #29189384.

ABSTRACT: OBJECTIVE: The objective of the present analysis is 2-fold: first, to define the evolution of time trends on the surgical approach to pancreatic neuroendocrine neoplasms (Pan-NENs); second, to perform a complete analysis of the predictors of oncologic outcome. BACKGROUND: Reflecting their rarity and heterogeneity, Pan-NENs represent a clinical dilemma. In particular, there is a scarcity of data regarding their long-term follow-up after surgical resection. METHODS: From the Institutional Pan-NEN database, 587 resected cases from 1990 to 2015 were extracted. The time span was arbitrarily divided into 3 discrete clusters enabling a balanced comparison between patient groups. Analyses for predictors of recurrence and survival were performed, together with conditional survival analyses. RESULTS: Among the 587 resected Pan-NENs, 75% were nonfunctioning tumors, and 5% were syndrome-associated tumors. The mean age was 54 years (±14 years), and 51% of the patients were female. The median tumor size was 20 mm (range 4 to 140), 62% were G1, 32% were G2, and 4% were G3 tumors. Time trends analysis revealed that the number of resected Pan-NENs constantly increased, while the size (from 25 to 20 mm) and G1 proportion (from 65% to 49%) decreased during the study period. After a mean follow-up of 75 months, recurrence analysis revealed that nonfunctioning tumors, tumor grade, N1 status, and vascular invasion were all independent predictors of recurrence. Regardless of size, G1 nonfunctioning tumors with no nodal involvement and vascular invasion had a negligible risk of recurrence at 5 years. CONCLUSIONS: Pan-NENs have been increasingly diagnosed and resected during the last 3 decades, revealing reliable predictors of outcome. Functioning and nodal status, tumor grade, and vascular invasion accurately predict survival and recurrence with resulting implications for patient follow-up.

5 Article Pancreaticoduodenectomy in patients ≥ 75 years of age: Are there any differences with other age ranges in oncological and surgical outcomes? Results from a tertiary referral center. 2017

Paiella, Salvatore / De Pastena, Matteo / Pollini, Tommaso / Zancan, Giovanni / Ciprani, Debora / De Marchi, Giulia / Landoni, Luca / Esposito, Alessandro / Casetti, Luca / Malleo, Giuseppe / Marchegiani, Giovanni / Tuveri, Massimiliano / Marrano, Enrico / Maggino, Laura / Secchettin, Erica / Bonamini, Deborah / Bassi, Claudio / Salvia, Roberto. ·Salvatore Paiella, Matteo De Pastena, Tommaso Pollini, Giovanni Zancan, Debora Ciprani, Luca Landoni, Alessandro Esposito, Luca Casetti, Giuseppe Malleo, Giovanni Marchegiani, Massimiliano Tuveri, Enrico Marrano, Laura Maggino, Erica Secchettin, Deborah Bonamini, Claudio Bassi, Roberto Salvia, General and Pancreatic Surgery Department, Pancreas Institute, University and Hospital Trust of Verona, 37134 Verona, Italy. ·World J Gastroenterol · Pubmed #28533664.

ABSTRACT: AIM: To compare surgical and oncological outcomes after pancreaticoduodenectomy (PD) in patients ≥ 75 years of age with two younger cohorts of patients. METHODS: The prospectively maintained Institutional database of pancreatic resection was queried for patients aged ≥ 75 years (late elderly, LE) submitted to PD for any disease from January 2010 to June 2015. We compared clinical, demographic and pathological features and survival outcomes of LE patients with 2 exact matched cohorts of younger patients [≥ 40 to 64 years of age (adults, A) and ≥ 65 to 74 years of age (young elderly, YE)] submitted to PD, according to selected variables. RESULTS: The final LE population, as well as the control groups, were made of 96 subjects. Up to 71% of patients was operated on for a periampullary malignancy and pancreatic cancer (PDAC) accounted for 79% of them. Intraoperative data (estimated blood loss and duration of surgery) did not differ among the groups. The overall complication rate was 65.6%, 61.5% and 58.3% for LE, YE and A patients, respectively, CONCLUSION: Age is not a contraindication for PD. A careful selection of LE patients allows to obtain good surgical and oncological results.