Publications by authors named "Butturini G"
Importance: The effect of adjuvant chemotherapy following resection of pancreatic adenocarcinoma after preoperative (m)FOLFIRINOX (combination leucovorin calcium [folinic acid], fluorouracil, irinotecan hydrochloride, and oxaliplatin in full or modified dosing) chemotherapy on overall survival (OS) is unclear because current studies do not account for the number of cycles of preoperative chemotherapy and adjuvant chemotherapy regimen.
Objective: To investigate the association of adjuvant chemotherapy following resection of pancreatic adenocarcinoma after preoperative (m)FOLFIRINOX with OS, taking into account the number of cycles of preoperative chemotherapy and adjuvant chemotherapy regimen.
Design, Setting, And Participants: This retrospective cohort study included patients with localized pancreatic adenocarcinoma treated with 2 to 11 cycles of preoperative (m)FOLFIRINOX followed by resection across 48 centers in 20 countries from 2010 to 2018.
Purpose: To assess the association between neoadjuvant therapy and overall survival (OS) in patients with left-sided resectable pancreatic cancer (RPC) compared to upfront surgery.
Background: Left-sided pancreatic cancer is associated with worse OS compared to right-sided pancreatic cancer. Although neoadjuvant therapy is currently seen as not effective in patients with RPC, current randomized trials included mostly patients with right-sided RPC.
Objective: To validate the ISGPS complexity grading system for minimally invasive pancreaticoduodenectomy (MIPD).
Background: Although concerns about patient safety persist, MIPD is gaining popularity. The ISGPS recently introduced a difficulty grading system to improve patient selection by aligning procedural complexity with surgeon and center expertise.
Objective: To build a Bayesian approach-based model to predict the success of surgical exploration post-neoadjuvant treatment.
Background: Pancreatic cancer (PDAC) is best treated with radical surgery and chemotherapy, offering the greatest chance of survival. Surgery after neoadjuvant treatment (NAT) is indicated in the absence of progression, knowing the limits in accurately predicting resectability with traditional radiology.
Pancreatic cancer has an increasing incidence and prevalence trend. Its prognosis is negatively affected by poor/altered nutritional status. Therefore, nutritional interventions play a critical/pivotal role at any stage.
View Article and Find Full Text PDFPurpose: There is debate about the optimal management of borderline resectable (bRe) and resectable (Re) pancreatic ductal adenocarcinoma (PDAC). Both preclinical and clinical evidence showed that carbon ion radiotherapy (CIRT) produces superior control on radioresistant histologies compared to conventional photon beam radiotherapy (RT). However, so far there is a lack of data concerning the integration of CIRT in a multimodal approach with chemotherapy and surgery for bRe/Re.
View Article and Find Full Text PDFArticle Synopsis
- The study surveyed Italian pancreatic surgeons to assess their use of intraperitoneal prophylactic drains (IPDs) during distal pancreatectomy (DP) and to understand their regrets associated with drain decisions.
- Out of 106 respondents, 59.4% used at least one drain, but only a small percentage changed their strategies based on patient risk categories for postoperative pancreatic complications.
- Results showed that the median regret for not using an IPD when it would have been beneficial was high (80), while regret for using it unnecessarily was low (2.5), indicating a clear preference for cautious management in high-risk patients.
Background: The impact of chemoradiotherapy on pathologic response, resection margin, and survival benefit is still debated. The aim of this study was to compare the rate of pathologic complete response (pCR) in surgical resection following neoadjuvant chemotherapy vs. chemoradiotherapy, and secondarily, to compare the rate of R0 resection and Overall Survival (OS).
View Article and Find Full Text PDFBackground: Resection of non-functioning pancreatic neuroendocrine tumours (NF-PanNETs) is curative in most patients. The potential benefits of neoadjuvant treatments have, however, never been explored. The primary aim of this study was to evaluate the safety of neoadjuvant 177Lu-labelled DOTA0-octreotate (177Lu-DOTATATE) followed by surgery in patients with NF-PanNETs.
View Article and Find Full Text PDFThis study aims to review existing literature on the effect of oral nutritional supplements (ONSs) during chemotherapy in older cancer patients. Electronic databases were searched for relevant studies up to March 2024. The risk of bias in the included studies was evaluated using the Cochrane tool.
View Article and Find Full Text PDFBackground: This study analyzed the Quality of Life (QoL) and cost-effectiveness of laparoscopic (LDP) versus robotic distal pancreatectomy (RDP).
Methods: Consecutive patients submitted to LDP or RDP from 2010 to 2020 in four high-volume Italian centers were included, with a minimum of 12 months of postoperative follow-up were included. QoL was evaluated using the EORTC QLQ-C30 and EQ-5D questionnaires, self-reported by patients.
Objective: The ISGPS aims to develop a universally accepted complexity and experience grading system to guide the safe implementation of robotic and laparoscopic minimally-invasive pancreatoduodenectomy (MIPD).
Background: Despite the perceived advantages of MIPD, its global adoption has been slow due to the inherent complexity of the procedure and challenges to acquiring surgical experience. Its wider adoption must be undertaken with an emphasis towards appropriate patient selection according to adequate surgeon and center experience.
Background: Although minimally invasive distal pancreatectomy (MIDP) is considered a standard approach it still presents a non-negligible rate of conversion to open that is mainly related to some difficulty factors, as obesity. The aim of this study is to analyze the preoperative factors associated with conversion in obese patients with MIDP.
Methods: In this multicenter study, all obese patients who underwent MIDP at 18 international expert centers were included.
Article Synopsis
- Postoperative fluid collections occur frequently after distal pancreatectomy, with a 30-day prevalence of 68% among 133 patients studied.
- Factors linked to clinically relevant collections include early postoperative pancreatic fistula, pancreatitis, and larger collection size (>50 mm).
- Elevated serum hyperamylasemia is a significant indicator for predicting these fluid collections after surgery.
Article Synopsis
- The PUECOF study seeks expert consensus on the best organizational practices for Pancreas Units, involving 30 surgical leaders across 14 countries in a Delphi survey.
- *Surgeons emphasize the importance of multidisciplinary meetings, leadership development, and measurable outcomes, while viewing clinical professionals and patients as key stakeholders.
- *Although the technical aspects of pancreatic surgery will remain unchanged, Pancreas Units could enhance surgeons' workflows, professional growth, and collaborative opportunities, ultimately improving patient outcomes.
Article Synopsis
- A survey was conducted with surgeons to explore their use of intraperitoneal prophylactic drains (IPDs) during pancreaticoduodenectomy (PD), revealing varying practices and significant levels of regret associated with the decision to use or omit drains.
- The results showed that most surgeons (97.2%) used IPDs, with a high median regret score (84) for omitting the drain but much lower for using it (10).
- The study suggested that for low-risk patients, omitting IPDs could be a viable option, and the acceptance of this practice varies based on factors like surgical technique and perceptions of risk assessment.
Article Synopsis
- The REDISCOVER consensus conference focused on creating guidelines for the perioperative care of patients with borderline-resectable and locally advanced pancreatic ductal adenocarcinoma (PDAC).
- Using a structured methodology and expert consensus, the conference developed 34 recommendations on various aspects of surgical care, patient selection, and management of pancreatic cancer.
- Despite the low evidence quality for most recommendations, participants highlighted the importance of establishing an international registry to enhance understanding and care for this patient group.
Background: Intermittent treatment with tyrosine kinase inhibitors (TKIs) is an option for elderly chronic myeloid leukemia (CML) patients who are often candidates for life-long treatment.
Materials And Methods: The Italian phase III multicentric randomized Optimize TKIs Multiple Approaches (OPTkIMA) study aimed to evaluate if a progressive de-escalation of TKIs is able to maintain the molecular remission (MR) and to improve Health-Related Quality of Life (HRQoL) in CML elderly patients.
Results: A total of 215 patients in stable MR/MR were randomized to receive an intermittent TKI schedule 1 month ON-1 month OFF for 3 years (FIXED arm; n = 111) vs.
Article Synopsis
- Neuroendocrine neoplasms (NENs) are rare tumors, and existing databases like SEER are outdated due to recent advancements in diagnostics and treatments, prompting the need for updated information.
- In 2019, the Italian Association for Neuroendocrine Tumors (Itanet) launched a nationwide database to collect data on gastroenteropancreatic NENs from 37 Italian centers, focusing on details like age, diagnostics, tumor stage, and treatments.
- By October 2023, the database has recorded data from 1,600 patients, with plans to reach 3,600 by the end of 2025, aiming to improve understanding of GEP-NENs and enhance patient
Background: Upfront surgery followed by postoperative treatment is a commonly adopted treatment for resectable pancreatic ductal adenocarcinoma (rPDAC). However, the risk of positive surgical margins, the poor recovery that often impairs postoperative treatments, and the risk of recurrence might limit the outcome of this strategy. This study evaluated the safety and the activity of liposomal irinotecan 50 mg/m + 5-fluorouracil 2400 mg/m + leucovorin 400 mg/m + oxaliplatin 60 mg/m (NALIRIFOX) in the perioperative treatment of patients with rPDAC.
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