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Surgery for metastatic pancreatic neuroendocrine tumors: a narrative review

Hepatobiliary Surgery and Nutrition 2023年第1期12卷 69-83页

作者： Jelani K.Williams Jason L.Schwarz xavier m.keutgen Division of General Surgery and Surgical Oncology Department of SurgeryUniversity of Chicago MedicineChicagoILUSA

Background and Objective:Pancreatic neuroendocrine tumors(PanNETs)are derived from the islet cells of the pancreas and have been increasing in *** of these tumors are nonfunctional although some can secrete hormones and lead to hormone-specific clinical *** is the mainstay of treatment for localized tumors,however,surgical resection is controversial in metastatic *** narrative review seeks to summarize the current literature surrounding surgery,specifically in the controversial area of metastatic PanNETs,review current treatment paradigms,and understand the benefits of surgery in this group of ***:Authors searched Pubmed using the terms“surgery pancreatic neuroendocrine tumor”,“metastatic neuroendocrine tumor”,and“liver debulking neuroendocrine tumor”from January 1990 to June *** English language publications were *** Content and Findings:There is no consensus among the leading specialty organizations regarding surgery for metastatic *** considering surgery for metastatic PanNETs,tumor grade and morphology,location of the primary tumor,extra-hepatic or extra-abdominal disease,as well as liver tumor burden and metastatic distribution should be *** the liver is the most common site of metastasis and liver failure is the most common cause of death in patients with hepatic metastases,attention is centered here on debulking and other ablative *** transplantation is rarely used for hepatic metastases but could be beneficial in a small subset of *** studies have demonstrated improvement in survival and symptoms after surgery for metastatic disease,but the lack of prospective randomized control trials significantly limits analysis of surgical benefits in patients with metastatic ***:Surgery is the standard of care for localized PanNETs,while it remains controversial in metastatic *** studies have shown a survival and symptomatic be

关键词： Pancreatic neuroendocrine tumors(PanNETs) liver tumor burden hepatic metastasis liver debulking DOTATATE

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Prognostic criteria for postoperative mortality in 170 patients undergoing major right hepatectomy

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Hepatobiliary & Pancreatic Diseases International 2012年第5期11卷 507-512页

作者： Filippo Filicori xavier m keutgen matteo Zanello Giorgio Ercolani Salomone Di Saverio Federico Sacchetti Antonio Daniele Pinna Gian Luca Grazi General Surgery and Transplant Unit Department of General Surgery and Organ TransplantationUniversity of BolognaVia Massarenti 940138 BolognaItaly Department of Surgery New York Presbyterian Hospital Weill Cornell Medical College Department of Surgery New York Presbyterian HospitalWeill Cornell Medical College Department of Emergency Surgery Maggiore HospitalL.go Nigrisoli 240133 BolognaItaly Hepato-Biliary Surgery Unit Istituto Nazionale Tumori Regina ElenaVia Elio Chianesi5300144 RomaItaly

BACKGROUND: Postoperative hepatic failure is a dreadful complication after major hepatectomy and carries high morbidity and mortality rates. In this study, we assessed the accuracy of the 50/50 criteria (bilirubin >2.9 mg/dL and international normalized ratio >1.7 on postoperative day 5) and the mullen criteria (bilirubin peak >7 mg/dL on postoperative days 1-7) in predicting death from hepatic failure in patients undergoing right hepatectomy only. In addition, we identified prognostic factors linked to intra-hospital morbidity and mortality in these patients. mETHODS: One hundred seventy consecutive patients underwent major right hepatectomy at a tertiary medical center from 2000 to 2008. Nineteen (11.2%) patients suffered from liver cirrhosis. Univariate and multivariate analyses were performed to identify predictors of intra-hospital mortality, morbidity and death from hepatic failure. RESULTS: The intra-hospital mortality was 6.5% (11/170). Of the six patients who died from hepatic failure, one was positive for the 50/50 criteria, but all six patients were positive for the mullen criteria. multivariate analysis showed that male gender, hepatitis C (HCV), hepatocellular carcinoma, postoperative bilirubin >7 mg/dL and ALTm hepatic failure in the postoperative period. Age >65 years, HCV, reoperation, andrenal failure were significant predictors of overall intra-hospital mortality on multivariate analysis. CONCLUSIONS: The mullen criteria were more accurate than the 50/50 criteria in predicting death from hepatic failure in patients undergoing right hepatectomy. A bilirubin peak >7 mg/dL in the postoperative period, HCV positivity, hepatocellular carcinoma, and an ALT level m hepatic failure in our patient population.

关键词： hepatectomy liver diseases liver failure postoperative complications prothrombin time bilirubin

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metastatic well-differentiated pancreatic neuroendocrine tumors to the liver: a narrative review of systemic and surgical management

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Journal of Pancreatology 2021年第2期4卷 82-89页

作者： Tanaz Vaghaiwalla Kelvin memeh Chih-Yi Liao xavier m.keutgen Department of Surgery Division of General SurgeryUniversity of Tennessee Graduate School of MedicineKnoxvilleTN b Department of Surgery Division of Surgical OncologyEndocrine Surgery Research ProgramUniversity of Chicago Medicine Department of medicine Section of Hematology and OncologyUniversity of Chicago MedicineChicagoILUSA

Pancreatic neuroendocrine tumors(PNETs)are a rare group of neoplasms originating from the endocrine *** are classified as functional or non-functional *** are more often diagnosed at a higher stage with distant metastases or advanced locoregional *** majority of individuals with hepatic metastases will ultimately die of liver failure;therefore,the treatment of liver tumor burden is critical to providing a survival *** surgical resection remains the only chance of cure for disease confined to the pancreas or for locoregional disease,the treatment of advanced or metastatic PNETs is more complex and often requires a multimodal *** review focuses on treatment options for well and moderately differentiated PNETs with metastatic disease to the *** include surgery,liver-directed therapies including ablative and intra-arterial therapies,and systemic therapies such as somatostatin analogues,targeted therapies,chemotherapy,and peptide receptor radionuclide *** an individualized treatment strategy requires careful assessment of liver tumor burden and predicted biological *** surgical resection of hepatic metastases secondary to PNET primary tumors is associated with improved survival in multiple retrospective *** goals of treatment for metastatic disease include prolonging overall survival and progression free survival,improving quality of life,and control of symptoms.

关键词： Hepatic cytoreduction metastatic disease Pancreatic neuroendocrine tumor Peptide receptor radionuclide therapy Review

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Surgical treatment of non-functioning pancreatic neuroendocrine tumors:current controversies and challenges

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Journal of Pancreatology 2020年第2期3卷 51-58页

作者： memeh Kelvin O. Vaghaiwalla Tanaz keutgen xavier m. Section of Endocrine Surgery Division of General Surgery and Surgical OncologyDepartment of SurgeryThe University of Chicago MedicineChicagoILUSA

There has been a rising trend in the incidence and prevalence of non-functioning pancreatic neuroendocrine tumors(NFPanNETs).While a significant number of the newly diagnosed NFPanNETs are asymptomatic,a majority of patients will present with liver metastasis(Lm)at the time of *** resection remains the only curative treatment,especially for localized *** a majority of small NFPanNETs are indolent,some are *** heterogeneity in tumor biology presents the surgeon with the unique challenge of determining which patient will benefit from surgery,given the morbidity of pancreatic *** has been a recent push for a more aggressive approach to the care of these patients,given the emergence of data supporting such ***,the risk of over or under treatment has generated immense debate amongst experts in the *** heterogeneity of current practice guidelines and institutional practices around the world is a reflection of the disparate opinion on the management of *** this review,we set out to examine the evidence regarding some of the most controversial and challenging aspects of the surgical treatment of *** evaluate the following questions;should patients with small NFPanNETs≤2 cm in size be resected;should patients with metastatic NFPanNETs undergo surgical debulking,and should there be resection of the primary tumor in the setting of non-resectable metastatic disease?Although there are currently no Level 1 data to answer these questions conclusively,we believe that the current literature supports a more aggressive approach to the management of NFPanNET.

关键词： Carcinoid tumors Enucleation Liver debulking Neuroendocrine cancer Neuroendocrine tumor Pancreatic enucleation Pancreatic tumor PRRT Somatostatin analog

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Hepatocyte cryopreservation:Is it time to change the strategy?

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World Journal of Gastroenterology 2010年第1期16卷 1-14页

作者： xavier Stéphenne mustapha Najimi Etienne m Sokal Catholic University of Louvain and St Luc Clinics Paediatric Department(HPED)PEDI unitLaboratory of Paediatric Hepatology and Cell Therapy

Liver cell transplantation presents clinical benefit in patients with inborn errors of metabolism as an alternative,or at least as a bridge,to orthotopic liver *** success of such a therapeutic approach remains limited by the quality of the transplanted *** remains the best option for long-term storage of hepatocytes,providing a permanent and sufficient cell ***, isolated adult hepatocytes are poorly resistant to such a process,with a significant alteration both at the morphological and functional ***,the aim of the current review is to discuss the state of the art regarding widely-used hepatocyte cryopreservation protocols,as well as the assays performed to analyse the post-thawing cell quality both in vitro and in vivo. The majority of studies agree upon the poor quality and efficiency of cryopreserved/thawed hepatocytes as compared to freshly isolated *** ice formation or exposure to hyperosmotic solutionsremains the main phenomenon of cryopreservation process,and its effects on cell quality and cell death induction will be *** increased knowledge and understanding of the cryopreservation process will lead to research strategies to improve the viability and the quality of the cell suspensions after *** strategies,such as vitrification,will be discussed with respect to their potential to significantly improve the quality of cell suspensions dedicated to liver cell-based therapies.

关键词： Hepatocyte Cryopreservation Quality mitochondria Intracellular ice formation

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Determining indoor air quality and identifying the origin of odour episodes in indoor environments

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Journal of Environmental Sciences 2009年第3期21卷 333-339页

作者： Eva Gallego xavier Roca Jose Francisco Perales xavier Guardino Environmental Centre Laboratory Polytechnic University of Catalonia (LCMA-UPC) Avda Diagonal 647 E 08028 Barcelona Spain National Centre of Work Conditions (INSHT) Dulcet 2-10 E 08034 Barcelona Spain

A methodology for identifying volatile organic compounds （VOCs） and determining air quality of indoor air has been developed. The air samples are collected using pump samplers by the inhabitants when they perceive odorous and/or discomfort episodes. Glass multi-sorbent tubes are connected to the pump samplers for the retention of VOC. The analysis is performed by automatic thermal desorption （ATD） coupled with gas chromatography-mass spectrometry （GC/mS）. This methodology can be applied in cases of sick building syndrome （SBS） evaluation, in which building occupants experience a series of varied symptoms that appear to be linked to time spent in the building. Chemical pollutants concentrations （e.g., VOC） have been described to contribute to SBS. To exemplify the methodology, a qualitative determination and an evaluation of existing VOC were performed in a dwelling where the occupants experienced the SBS symptoms. Higher total VOC （TVOC） levels were detected during episodes in indoor air （1.33 ±1.53 mg/m^3） compared to outdoor air （0.71± 0.46 mg/m^3）. The concentrations of individual VOCs, such as ethanol, acetone, isopropanol, 1-butanol, acetic acid, acetonitrile and 1-methoxy-2-propanol, were also higher than the expected for a standard dwelling. The external source of VOC was found to be an undeclared activity of storage and manipulation of solvents located at the bottom of a contiguous building.

关键词： indoor air thermal desorption TVOC VOC sick building syndrome

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multiple ecological strategies explain the distribution of exotic and native C_(4) grasses in heterogeneous early successional sites in Hawai’i

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Journal of Plant Ecology 2017年第3期10卷 426-439页

作者： Rafael de Oliveira xavier Carla m.D’Antonio Ecology and Conservation Lab Department of HydrobiologyFederal University of São CarlosWashington Luís Highwaykm 235São CarlosSão Paulo 13565-905Brazil Environmental Studies Program 4312-L Bren University of CaliforniaSanta BarbaraCA 93106USA

Aims Biotic homogenization results in novel communities contain-ing multiple exotic *** attributes that contribute to the dominance of invaders and increase invasibility of communities have been identified,but rarely have factors governing the domi-nance of co-occurring invaders been *** we assess the presence and performance of five exotic and one native C_(4) grass species across local(microsite)and more broad-scale variation in fire history,soil age,altitude and *** ask whether species show preferences for the same conditions,whether all are constrained by poor soil development,and how their performance changes when alone versus *** addition to providing information useful to managers who want to control some of these species,such information can help to predict how distributions might change with climate change methods We measured percent cover and plant height of each grass species in 64 plots in each of 15 sites,located in young volcanic substrates across environmental gradients in Hawai’i Volcanoes National Park,Hawai’i,*** varied in fire history and soil age,across altitu-dinal and precipitation *** estimated microsite heteroge-neity by measuring rock cover and soil depth,where each species was present and in plots as a *** analyzed effects of pos-sible controlling variables using chi-square tests and Generalized Additive mixed *** Findings Two species(Schizachyrium condensatum and Hyparrhenia rufa)were absent in shallow soil,restricted to more mesic sites and showed increasing performance with soil *** contrast,two other species(Andropogon virginicus and melinis repens)tended to occur in shal-low soil with high rock cover across a wide range of *** addi-tional species(melinis minutiflora)was weakly affected by soil depth and was the dominant at higher elevation(more mesic)and on burned sites,especially in old *** species was largely absent from lower elevation si

关键词： elevation gradient fire invasive species melinis minutiflora soil depth

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Effect of pre-and post-wildfire management practices on plant recovery after a wildfire in Northeast Iberian Peninsula

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Journal of Forestry Research 2020年第5期31卷 1647-1661页

作者： marcos Francos Paulo Pereira xavier Ubeda GRAm(Grup de Recerca Ambiental mediterrania) Department of GeographyUniversity of BarcelonaMontalegre608001 BarcelonaSpain Environmental management Centre Mykolas Romeris UniversityVilniusLithuania

Fire and pre-or post-fire management practices shape the distribution and richness of plant ***,the effects of pre-and post-fire management on vegetation recovery were studied at different times,up to 18 months after a *** months after a 2015 wildfire,18 study plots were established(three 4-m^2 plots for each treatment),vegetation regrowth was monitored and vegetal species richness(S),evenness(IT),density(D),diversity(H0)and maximum diversity(Hmax)after 2,10 and 18 *** treatments were(1)control,unaffected by 2015 wildfire;(2)no treatment(NT),burned in 2015 wildfire and not managed;(3)managed in 2005 and burned in 2015(m05B);(4)managed in 2015,2 months before wildfire(m15B);(5)cut and manual removal after the 2015 wildfire(CR);(6)cut and no trunk removal randomly deposited on topsoil after the 2015 wildfire(CL).All the treatments were carried out in a Pinus halepensis miller *** 10 and 18 months after the wildfire,vegetation recovery was greater in NT,CR and CL plots than in m05B and m15B the *** 18 months after the wildfire,Brachypodium retusum(Pers.)*** Rosmarinus officinalis *** still dominant,especially in m15B,corroborating the belief that pre-fire treatment reduced ecosystem resilience and vegetal recovery compared to the NT and post-fire managed *** was significantly lower 10 months after wildfire in control plots,and IT was significantly higher in that inventory than previously in *** months after the wildfire,H0 was significantly lower in *** months post-wildfire,Hmax was significantly lower in the control *** months after the wildfire,Hmax,was significantly higher in CR,CL and m05B than in the control and m15B ***,pre-fire management was detrimental to post-fire vegetation recovery,while manual post-fire management proved beneficial.

关键词： Forest management Vegetation recovery Diversity Richness Evenness

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A hot future for cool materials

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Frontiers in Energy 2023年第4期17卷 447-449页

作者： xavier mOYA Neil D.mATHUR Department of materials Science University of CambridgeCambridge CB3 0FSUK

The ewidespreadneed to pump heat necessitates simprovements that will increase energy efficiency and,more generally,reduce eenvironmental *** discussed at the recent Calorics 2022 Conference,heat-pump devices based on... 详细信息

关键词： magnetocaloric electrocaloric mechanoca-loric elastocaloric barocaloric

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Effect of Homogenizing Procedures on the Properties of Reaction Sialon Suspension

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厦门大学学报（自然科学版） 2002年第S1期41卷 132-133页

作者： xavier Venceslau Kexin Chen José m F Ferreira Department of Ceramics and Glass Engineering CICECO University of AveiroDepartment of Ceramics and Glass EngineeringCICECO University of AveiroDepartment of Ceramics and Glass EngineeringCICECO University of Aveiro PortugalPortugalPortugal

Homogeneous, high concentrated ceramic suspensions wi th low viscosity are the key controlling factors for the production of ceramic c omponents through colloidal processing. A well-dispersed suspension can be obta ined by choosing suitable dispersant, solvent, particle size distribution etc. B esides these factors, the homogenizing procedure is also a key step. In this paper, reaction sialon suspensions were prepared using 3-wt% KD1 as dis persant in organic media composed of 60-vol% methyletheylketone and 40-vol% et hanol. Different homogenizing procedures have been used and compared, including planetary milling, low energy ball milling and ultrasonic disaggregation. The ef fects of different homogenizing routes and mixing times on the rheology and stab ility of suspensions, and on the microstructure of slip casting green bodies, ha ve been studied. The varying dispersion efficiencies observed could be attribute d to differences in deagglomeration degrees achieved and in adsorption amount of dispersant onto the surface of reaction sialon powders.

关键词： Effect of Homogenizing Procedures on the Properties of Reaction Sialon Suspension

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