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| 1 | Aggressive behaviour of solid-pseudopapillary tumor of the pancreas in adults:A case report and review of the literature显示文摘Solid-pseudopapillary tumor (SPT) is a rare neoplasm of the pancreas that usually occurs in young females. It is generally considered a low-grade malignant tumor that can remain asymptomatic for several years. The occurrence of infiltrating varieties of SPT is around 10%-15%. Between 1986 and 2006, 282 cystic tumors of the pancreas were observed. Among them a SPT was diagnosed in 8 patients (2.8%) with only one infiltrating variety. This was diagnosed in a 49-year-old female 13 years after the sonographic evidence of a small pancreatic cystic lesion interpreted as a pseudocyst. The tumor invaded a long segment of the portal- mesenteric vein confluence, and was removed with a total pancreatectomy, resection of the portal vein and reconstruction with the internal jugular vein. Histological examination confirmed the R-0 resection of the primary SPT, although a vascular invasion was demonstrated. The postoperative course was uneventful, but 32 mo after surgery the patient experienced diffuse liver metastases. Chemotherapy with different drugs was started. The patient is alive and symptom-free, with stable disease, 75 mo after surgery. Twenty-five patients with invasion of the portal vein and/or of mesenteric vessels were retrieved from the literature, 16 recent patients with tumor relapse after potentially curative resection were also retrieved. The best treatment remains a radical resection whenever possible, even in locally advanced or metastatic disease. The role of chemotherapy, and/or radiotherapy, is still to be defined. | Cosimo Sperti Mattia Berselli Claudio Pasquali Davide Pastorelli Sergio Pedrazzoli | 2008 | World Journal of Gastroenterology2008，14，6： | 44 |
| 2 | Parenchyma-sparing pancreatectomies for benign or border-line tumors of the pancreas显示文摘Standard pancreatic resections, such as pancreaticoduodenectomy, distal pancreatectomy, or total pancreatectomy, result in an important loss of normal pancreatic parenchyma and may cause impairment of exocrine and endocrine function. Whilst these procedures are mandatory for malignant tumors, they seem to be too extensive for benign or border-line tumors, especially in patients with a long life expectancy. In recent years, there has been a growing interest in parenchyma-sparing pancreatic surgery with the aim of achieving better functional results without compromising oncological radicality in patients with benign, border-line or low-grade malignant tumors. Several limited resections have been introduced for isolated or multiple pancreatic lesions, depending on the location of the tumor: central pancreatectomy, duodenum-preserving pancreatic head resection with or without segmental duodenectomy, inferior head resection, dorsal pancreatectomy, excavation of the pancreatic head, middle-preserving pancreatectomy, and other multiple segmental resections. All these procedures are technically feasible in experienced hands,with very low mortality, although with high morbidity rate when compared to standard procedures. Pancreatic endocrine and exocrine function is better preserved with good quality of life in most of the patients, and tumor recurrence is uncommon. Careful patient selection and expertise in pancreatic surgery are crucial to achieve the best results. | Cosimo Sperti Valentina Beltrame Anna Caterina Milanetto Margherita Moro Sergio Pedrazzoli | 2010 | World Journal of Gastrointestinal Oncology2010，2，6： | 11 |
| 3 | Metastatic tumors to the pancreas: The role of surgery显示文摘Pancreatic metastases from other primary malignancies are a rare entity. By far, the most common primary cancer site resulting in an isolated pancreatic metastasis is the kidney, followed by colorectal cancer, melanoma, breast cancer, lung carcinoma and sarcoma. Only few data on the surgical outcome of pancreatic resections performed for metastases from other primary tumor have been published, and there are no guidelines to address the surgical treatment for these patients. In this study, we performed a review of the published literature, focusing on the early and long-term results of surgery for the most frequent primary tumors metastasizing to the pancreas. Results for the Literature's analysis show that in last years an increasing number of surgical resections have been performed in selected patients with limited pancreatic disease. Pancreatic resection for metastatic disease can be performed with acceptable mortality and morbidity rates. The usefulness of pancreatic resection is mainly linked to the biology of the primary tumor metastasizing to the pancreas. The benefit of metastasectomy in terms of patient survival has been observed for metastases from renal cell cancer, while for other primary tumors, such as lung and breast cancers, the role of surgery is mainly palliative. | Cosimo Sperti Lucia Moletta Giuseppe Patanè | 2014 | World Journal of Gastrointestinal Oncology2014，6，10： | 8 |
| 4 | Totally robotic vs 3D laparoscopic colectomy: A single centers preliminary experience显示文摘AIM: to compare robotic and three-dimensional(3D) laparoscopic colectomy based on the literature and our preliminary experience.METHODS: This retrospective observational study compared operative measures and postoperative outcomes between laparoscopic 3D and robotic colectomy for cancer. From September 2013 to September 2014,24 robotic colectomies and 23 3D laparoscopic colectomy were performed at our Department. Data were analyzed and reported both by approach and by colectomy side. Robotic left colectomy(RL) vs laparoscopic 3D left colectomy(LL 3D) and Robotic right colectomy(RR) vs laparoscopic 3D(LR 3D). Rectal cancer procedures were not included.RESULTS: There were 18 RR and 11 LR 3D,6 RL and 12 LL 3D. As regards LR 3D,extracorporeal anastomosis(EA) was performed in 7 patients and intracorporeal anastomosis(IA) in 4; the RR group included 14 IA and 4 EA. There was no mortality. Median operative time was higher for the robotic group while conversion rate(12.5% vs 13%) and lymph nodes removed(14 vs 13) were similar for both. First flatus time was 1 d for RR and 2 d the other patient groups. Oral intake was resumed in 1 d by LR and in 2 d by the other patients(P = 0.012). Overall cost was €4950 and €1950 for RL and LL 3D,and €4450 and €1450 for RR and LR 3D,respectively. CONCLUSION: There were no differences betweenRR and LR 3D,except that IA was easier with RR,and probably contributed with the learning curve to the longer operative time recorded. Both techniques offer similar advantages for the patient with significantly different costs. In left colectomies robotic colectomy provided better outcomes,especially in resections approaching the rectum. | Mario Guerrieri Roberto Campagnacci Pierluigi Sperti Giulio Belfiori Rosaria Gesuita Roberto Ghiselli | 2015 | World Journal of Gastroenterology2015，21，46： | 5 |
| 5 | Para-aortic node involvement is not an independent predictor of survival after resection for pancreatic cancer显示文摘AIM To analyze the importance of para-aortic node status in a series of patients who underwent pancreaticoduodenectomy(PD)in a single Institution.METHODS Between January 2000 and December 2012,151patients underwent PD with para-aortic node dissection for pancreatic adenocarcinoma in our Institution.Patients were divided into two groups:patients with negative PALNs(PALNs-),and patients with metastatic PALNs(PALNs+).Pathologic factors,including stage,nodal status,number of positive nodes and lymph node ratio,invasion of para-aortic nodes,tumor’s grading,and radicality of resection were studied by univariate and multivariate analysis.Survival curves were constructed with Kaplan-Meier method and compared with Log-rank test:significance was considered as P<0.05.RESULTS A total of 107 patients(74%)had nodal metastases.Median number of pathologically assessed lymph nodes was 26(range 14-63).Twenty-five patients(16.5%) had para-aortic lymph node involvement.Thirty-three patients(23%)underwent R1 pancreatic resection.Onehundred forty-one patients recurred and died for tumor recurrence,one is alive with recurrence,and 9 are alive and free of disease.Overall survival was significantly influenced by grading(P=0.0001),radicality of resection(P=0.001),stage(P=0.03),lymph node status(P=0.04),para-aortic nodes metastases(P=0.02).Multivariate analysis showed that grading was an independent prognostic factor for overall survival(P=0.0001),while grading(P=0.0001)and radicality of resection(P=0.01)were prognostic parameters for disease-free survival.Number of metastatic nodes,node ratio,and para-aortic nodes involvement were not independent predictors of disease-free and overall survival.CONCLUSION In this experience,lymph node status and para-aortic node metastases were associated with poor survival at univariate analysis,but they were not independent prognostic factors. | Cosimo Sperti Mario Gruppo Stella Blandamura Michele Valmasoni Gioia Pozza Nicola Passuello Valentina Beltrame Lucia Moletta | 2017 | World Journal of Gastroenterology2017，23，24： | 5 |
| 6 | Pancreatic resection in very elderly patients:A critical analysis of existing evidence显示文摘The aging of the population results in a rise of number of elderly patients(aged 80 years and older) with pancreatic or periampullary cancer, and more pancreatectomies could eventually be performed in such complex patients. However, early and long-term results after pancreatic resection in octogenarians are still controversial, and may trouble the surgeon when approaching this type of population. Evaluation of reported experiences shows that for almost all Authors, pancreatectomy can be performed safely in elderly population, although overall morbidity and mortality rates were 34.9% and 13.2% respectively, with a mean length of hospital stay of 18 d. These features appear higher in older patients compared to the younger counterpart. Less than 50% of patients underwent adjuvant therapy after operation. Long-term survival is reported not significantly different in aged 80 years and older patients, with a median overall survival time of 17.6 mo. The quality of life after pancreatic resection is only sporadically evaluated but, when considered, it highlights the need of health facility service after operation for these 'frail' patients. Prospective studies on the quality of life of pancreatectomized octogenarians are welcome. Proper selection of patients, geriatric assessment with multidisciplinary approach, centralization of pancreatic surgery in high-volume centres and rehabilitation programs after surgery appear to be crucial points in order to improve surgical treatments of pancreatic tumors in very elderly patients. | Cosimo Sperti Lucia Moletta Gioia Pozza | 2017 | World Journal of Gastrointestinal Oncology2017，9，1： | 2 |
| 7 | Asymptomatic Colorectal Cancer with Un-Resectable Liver Metastases: Immediate Colorectal Resection or Up-Front Systemic Chemotherapy?显示文摘 | Andrea Muratore MD Daria Zorzi MD Hedayat Bouzari MD Marco Amisano MD Paolo Massucco MD Elisa Sperti MD Lorenzo Capussotti MD | 2007 | Annals of Surgical Oncology2007，，2： | 2 |
| 8 | Decreased total lymphocyte counts in pancreatic cancer:an index of adverse outcome显示文摘 | Fogar P Sperti C Basso D | 2006 | Pancreas2006，32，1： | 1 |
| 9 | Median pancreatectomy for tumors of the neck and body of the pancreas 显示文摘 | Sperti C Pasquali C Feronartor A | 2000 | J Am Coil Surg2000，190，6： | 1 |
| 10 | Survival after resection for ductual adenocarcinoma of the pancreas显示文摘 | Sperti C Pasquali C Piccoli A | 1996 | Br J Surg1996，83，5： | 1 |
| 11 | Randomized controlled trial of duration of analgesia following intravenous or rectal acetaminophen after adenotonsillectomy in children显示文摘 | Capici F Ingelmo PM Davidson A Sacchi CA Milan B Sperti LR | 2008 | Br J Anaesth2008，100，2： | 1 |
| 12 | Distal pancreatectomy for body-tail pancreatic cancer:is there a role for celiac axis resection显示文摘 | Sperti C Berselli M Pedrazzoli S | 2010 | Pancreatology2010，10，4： | 1 |
| 13 | Pancreatic resection for metastatic tumors to the pancreas显示文摘 | Sperti C Pasquali C Liessi G | 2003 | J Surg Oncol2003，83，： | 1 |
| 14 | Recurrence after resection for ductal adenocarcinoma of the pancreas 显示文摘 | Sperti C Pasquali C Piccoli A | 1997 | World J Surg1997，21，2： | 1 |
| 15 | Serum tumors markers and cyst fluid analysis are useful for the diagnosis of the pancreatic tumours显示文摘 | Sperti C Pasqalic Guolo P | 1996 | Cancer1996，78，2： | 1 |
| 16 | Macrocystic serous cystadenoma of the pancreas: clinicopathologic features in seven cases显示文摘 | Sperti C Pasquali C Perasole A | 2000 | Int J Pancreatol2000，28，1： | 1 |
| 17 | The Ag-NOR proteins and transcription and duplication of ribosomal genes in mammalian cell nucleoli显示文摘 | A. Pession F. Farabegoli D. Treré F. Novello L. Montanaro S. Sperti F. Rambelli M. Derenzini | 1991 | Chromosoma1991，，4： | 1 |
| 18 | Neuroendocrine tumor imaging: can SF-fluorodeoxyglucose positron emission tomog- raphy detect tumors with poor prognosis and aggressive behav- ior? 显示文摘 | Pasquali C Rubello D Sperti C | 1998 | World J Surg1998，22，6： | 1 |
| 19 | Median pancreatectomy for tumors of the neck and body of the pancreas 显示文摘 | Sperti C Pasquali C Ferronato A | 2000 | J Am Coll Surg2000，190，6： | 1 |
| 20 | Asymptomatic Colorectal Cancer with Un-Resectable Liver Metastases: Immediate Colorectal Resection or Up-Front Systemic Chemotherapy?显示文摘 | Andrea Muratore Daria Zorzi Hedayat Bouzari Marco Amisano Paolo Massucco Elisa Sperti Lorenzo Capussotti | 2007 | Annals of Surgical Oncology2007，，2： | 1 |
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