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Advanced small-bowel well-differentiated neuroendocrine tumours:An international survey of practice on 3rd-line treatment

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World Journal of Gastroenterology 2021年第10期27卷 976-989页

作者： Angela Lamarca Mauro Cives louis de mestier Joakim Crona Francesca Spada KjellÖberg Marianne Pavel Teresa Alonso-Gordoa department of Medical Oncology European Neuroendocrine Tumor Society Centre of ExcellenceThe Christie NHS Foundation TrustUniversity of ManchesterManchester M204BXUnited Kingdom department of Biomedical Sciences and Human Oncology University of Bari Aldo MoroBari 70121Italy department of Gastroenterology and Pancreatology European Neuroendocrine Tumor Society Center of ExcellenceParis-Diderot UniversityClichy 75006France department of Medical Sciences Uppsala UniversityUppsala SE-75185Sweden Gastrointestinal Medical Oncology and Neuroendocrine Tumors Unit European Institute of OncologyMilan 20141Italy department of Endocrine Oncology Uppsala University HospitalUppsala SE-75185Sweden department of Endocrinology Universitatsklinikum ErlangenErlangen 91054Germany Medical Oncology department The Ramón y Cajal Health Research InstituteAlcaláUniversityUniversity Hospital Ramon y CajalMadrid 28034Spain

BACKGROUND Somatostatin analogues are an established first-line therapy for well differentiated small bowel neuroendocrine tumours(Wd-SBNETs),while and peptide receptor radionuclide therapy(PRRT)is frequently used as a second-line *** treatment selection of third-line treatment remains challenging due to the limited prospective data currently available on the best therapeutic *** To understand current practice and rationale for decision-making by physicians in the 3rd-line setting by building an online *** Weighted average(WA)of likelihood of usage between responders(1 very unlikely;4 very likely)was used to reflect the relevance of factors *** Replies from representatives of 28 centers were received(5/8/2020-21/9/2020);medical oncologist(53.6%),gastroenterologist(17.9%);United Kingdom(21.4%),Spain(17.9%),Italy(14.3%).Majority from European Neuroendocrine Tumor Society(ENETS)Centres of Excellence(57.1%),who followed ENETS guidelines(82.1%).Generally speaking,3rd-line treatment for Wd-SBNETs was:everolimus(EVE)(66.7%),PRRT(18.5%),liver embolization(LE)(7.4%)and interferon-alpha(IFN)(3.7%);chemotherapy(0%);decision was based on clinical trial data(59.3%),or personal experience(22.2%).EVE was most likely used if Ki-67den(WA 2.77/4);temozolomide or streptozocin was used with capecitabine or 5-fluorouracil(5-FU)(57.7%),FOLFOX(5-FU combined with oxaliplatin)(23.1%).LE was selected if presence of CS(WA 3.24/4)or Ki-67<10%(WA 2.8/4),after progression to other treatments(WA 2.8/4).IFN was rarely used(WA 1.3/4).CONCLUSION Everolimus was the most frequently used therapeutic option in the t

关键词： Neuroendocrine tumour Small bowel Survey Third-line Advanced Practice

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Role of endoscopic ultrasound in the screening and follow-up of high-risk individuals for familial pancreatic cancer

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World Journal of Gastroenterology 2019年第34期25卷 5082-5096页

作者： Diane Lorenzo Vinciane Rebours Frédérique Maire Maxime Palazzo Jean-Michel Gonzalez Marie-Pierre Vullierme Alain Aubert Pascal Hammel Philippe Lévy louis de mestier Pancreatology department Beaujon HospitalAssistance Publique-Hopitaux de ParisClichyand Paris Diderot UniversityParis 75013France INSERM UMR1149Paris 92110France departement of Gastroenterology Aix Marseille university-APHM-Hopital NordMarseille 13000France Radiology department Beaujon HospitalAssistance Publique-Hopitaux de ParisClichyand Paris Diderot UniversityParis 92110France Oncology department Beaujon HospitalAssistance Publique-Hopitaux de ParisClichyand Paris Diderot UniversityParis 92110France

Managing familial pancreatic cancer(FPC)is challenging for gastroenterologists,surgeons and ***-risk individuals(HRI)for pancreatic cancer(PC)(FPC or with germline mutations)are a heterogeneous group of subjects with a theoretical lifetime cumulative risk of PC over 5%.Screening is mainly based on annual magnetic resonance imaging(MRI)and endoscopic ultrasound(EUS).The goal of screening is to identify early-stage operable cancers or high-risk precancerous lesions(pancreatic intraepithelial neoplasia or intraductal papillary mucinous neoplasms with high-grade dysplasia).In the literature,target lesions are identified in 2%-5%of HRI who undergo *** appears to provide better identification of small solid lesions(0%-46%of HRI)and chronicpancreatitis-like parenchymal changes(14%-77%of HRI),while MRI is probably the best modality to identify small cystic lesions(13%-49%of HRI).There are no specific studies in HRI on the use of contrast-enhanced harmonic *** can also be used to obtain tissue ***,there is still limited evidence on the accuracy of imaging procedures used for screening or agreement on which patients to *** cost-effectiveness of screening is also *** new EUS-related techniques,such as searching for DNA abnormalities or protein markers in pancreatic fluid,appear to be promising.

关键词： Endoscopic ultrasound Familial pancreatic cancer Fine-needle aspiration Intraductal papillary mucinous neoplasm Pancreatic cancer Pancreatic intraepithelial neoplasia Pancreatic cancer screening guidelines

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Primary tumor resection in colorectal cancer with unresectable synchronous metastases: A review

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世界胃肠肿瘤学杂志：英文版（电子版） 2014年第6期6卷 156-169页

作者： louis de mestier Gilles Manceau Cindy Neuzillet Jean Baptiste Bachet Jean Philippe Spano Reza Kianmanesh Jean Christophe Vaillant Olivier Bouché Laurent Han-noun Mehdi Karoui department of Gastroenterology and Digestive Oncology Robert-DebréUniversity Hospital Assistance Publique-Hopitaux de Paris Pitié-Salpêtrière HospitalDepartment of Digestive and Hepato-Pancreato-Biliary SurgeryUniversity Institute of Cancerology(ParisⅥ)Pierre and Marie Curie University Assistance Publique-Hopitaux de Paris Depart-ment of Gastroenterology and PancreatologyBeaujon University Hospital Assistance Publique-Hopitaux de Paris Pitié-Salpêtrière HospitalDepartment of GastroenterologyUniversity Institute of Cancerology(ParisⅥ)Pierre and Marie Curie University Assistance Publique-Hopitaux de Paris Pitié-Salpêtrière HospitalDepartment of Medical OncologyUniversity Institute of Cancerology(ParisⅥ)Pierre and Marie Curie University department of Digestive and Endocrine Sur-gery Robert-DebréUniversity Hospital

At the time of diagnosis, 25% of patients with colorectal cancer(CRC) present with synchronous metastases, which are unresectable in the majority of patients. Whether primary tumor resection(PTR) followed by chemotherapy or immediate chemotherapy without PTR is the best therapeutic option in patients with asymptomatic CRC and unresectable metastases is a major issue, although unanswered to date. The aim of this study was to review all published data on whether PTR should be performed in patients with CRC and unresectable synchronous metastases. All aspects of the management of CRC were taken into account, es-pecially prognostic factors in patients with CRC and un-resectable metastases. The impact of PTR on survival and quality of life were reviewed, in addition to the characteristics of patients that could benefit from PTR and the possible underlying mechanisms. The risks of both approaches are reported. As no randomized study has been performed to date, we finally discussed how a therapeutic strategy's trial should be designed to pro-vide answer to this issue.

关键词： Colorectal cancer Colorectal surgery Chemotherapy Colorectal primary tumor Survival Livermetastases

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