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p.ncreatic neuroendocrine tumors:Are tumors smaller than 2 cm truly indolent?

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World Journal of Gastrointestinal Oncology 2024年第5期16卷 1756-1762页

作者： Sergio Hoyos p.blo p.sada-Moreno Natalia Guzman-Arango Romario Chanci-Drago Jaime Chavez Alvaro Andrés-Duarte Santiago Salazar-Ochoa Hep.tobilary and Liver transplant Unit Hospital Pablo Tobon Uribe and Gastrohepathology Group Universidad de AntioquiaMedellin 050034AntioquiaColombia department of general surgery Universidad Pontificia BolivarianaMedellín 050034AntioquiaColombia

BACKGROUND p.ncreatic neuroendocrine tumors(p.ETs)are relatively rare but rank as the second most common p.ncreatic *** can be functional,causing early metabolic disturbances due to hormone secretion,or non-functional and diagnosed later based on tumor size-related *** diagnoses of p.ETs under 2 cm in size have sp.rked debates about their management;some p.actitioners advocate for surgical removal and others suggest observation due to the tumors’lower p.tential for ***,it is unclear whether managing these small tumors exp.ctantly is truly *** To evaluate p.or p.ognostic factors in p.ETs based on tumor size(>2 cm orp.tients with p.ETs who underwent surgical resection between 2006 and 2019 at a high-comp.exity reference hosp.tal in Medellín,*** assess p.tient survival,quarterly follow-up. were conducted during the first year after surgery,followed by semi-annual con-sultations at the hosp.tal's hep.tobiliary surgery *** variables were described using absolute and relative frequencies,and quantitative variables were exp.essed using measures of central tendency and their corresp.nding measures of *** The p.esence of lymp. node involvement,neural involvement,and lymp.ovascular invasion were all associated with an increased risk of mortality,with hazard ratios of 5.68(95%CI:1.26–25.61,p.0.024),6.44(95%CI:1.43–28.93,p.0.015),and 24.87(95%CI:2.98–207.19,p.0.003),*** involvement and lymp.ovascular invasion were p.esent in tumors smaller than 2 cm in diameter and those larger than 2 cm in *** recurrence rates between the two tumor group. were furthermore similar:18.2%for tumors smaller than 2 cm and 21.4%for tumors larger than 2 *** survival was additionally comp.rable between the two tumor *** Tumor size does not dictate p.ognosis;lymp. node and lymp.ovascular involvement a

关键词： Neuroendocrine tumor p.ncreatic neop.asm p.ncreas p.ncreatic neuroendocrine neop.asm p.ncreatic neuroendocrine tumors

Metformin and p.ncreatic neuroendocrine tumors:A systematic review and meta-analysis

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World Journal of Gastroenterology 2024年第7期30卷 759-769页

作者： Maja Cigrovski Berkovic Alessandro Cop.ola Vibor Sesa Anna Mrzljak Quirino Lai department for Sp.rt and Exercise Medicine Faculty of Kinesiology University of ZagrebZagreb 10000Croatia department of surgery Sapienza University of RomeRome 00185Italy department of Gastroenterology and Hep.tology Liver Transplant CenterUniversity Hospital Centre ZagrebZagreb 10000Croatia department of Medicine School of MedicineZagreb 10000Croatia general surgery and Organ transplantation Unit Department of SurgerySapienza University of RomeRome 00018Italy

BACKGROUND Most p.tients with advanced p.ncreatic neuroendocrine tumors(p.ETs)die due to tumor ***,identifying new therap.es with low toxicity and good tolerability to use concomitantly with the established p.ET treatment is *** this p.rsp.ctive,metformin is emerging as a molecule of *** studies have described metformin,a widely used agent for the treatment of p.tients with typ. 2 diabetes mellitus(T2DM),to be effective in modulating different tumor-related events,including cancer incidence,recurrence and survival by inhibiting mTOR *** systematic review evaluates the role of T2DM and metformin in the insurgence and p.st-treatment outcomes in p.tients with *** To systematically analyze and summarize evidence related to the diagnostic and p.ognostic value of T2DM and metformin for p.edicting the insurgence and p.sttreatment outcomes of *** A systematic review of the p.blished literature was undertaken,focusing on the role of T2DM and metformin in insurgence and p.ognosis of p.ET,measured through outcomes of tumor-free survival(TFS),overall survival and p.ogression free *** A total of 13 studies(5674 p.tients)were included in this *** of 809 p.ET cases from five retrosp.ctive studies(low study heterogeneity with I^(2)=0%)confirms the correlation between T2DM and insurgence of p.ET(OR=2.13,95%CI=1.56-4.55;p.0.001).The p.oled data from 1174 p.ET p.tients showed the correlation between T2DM and p.st-treatment TFS in p.ET p.tients(hazard ratio=1.84,95%CI=0.78-2.90;p.0.001).The study heterogeneity was intermediate,with I^(2)=51%.A few studies limited the p.ssibility of p.rforming p.oled analysis in the setting of metformin;therefore,results were heterogeneous,with no statistical relevance to the use of this drug in the diagnosis and p.ognosis of *** T2DM rep.esents a risk factor for the insurgence of p.ET and is a significant p.edictor of p.or p.st-treatment TFS

关键词： p.ncreatic neuroendocrine tumors Typ. 2 diabetes mellitus p.ognosis Treatment Metformin

Transient recep.or p.tential channels as p.edictive marker and p.tential indicator of chemoresistance in colon cancer

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Oncology Research 2024年第1期32卷 227-239页

作者： WEI HU THOMAS WARTMANN MARCO STRECKER ARISTOTELIS p.RRAKIS ROLAND CRONER ARp.D SZALLASI WENJIE SHI ULF D.KAHLERT The Fourth Clinical Medical College of Yangzhou University Nantong Rich HospitalNantongChina Molecular and Exp.rimental surgery Clinic for General-Visceral-Vascular and Transplant SurgeryFaculty of Medicine and University Hospital MagdeburgOtto-von-Guericke UniversityMagdeburgGermany department of p.thology and Exp.rimental Cancer Research Semmelweis UniversityBudapestHungary

Transient recep.or p.tential(TRp.channels are strongly associated with colon cancer develop.ent and *** study leveraged a multivariate Cox regression model on p.blicly available datasets to construct a TRp.channels-associated gene signature,with further validation of signature in real world samp.es from our hosp.tal treated p.tient ***-Meier(K-M)survival analysis and receiver op.rating characteristic(ROC)curves were emp.oyed to evaluate this gene signature’s p.edictive accuracy and robustness in both training and testing cohorts,***,the study utilized the CIBERSORT algorithm and single-samp.e gene set enrichment analysis to exp.ore the signature’s immune infiltration landscap. and underlying functional *** sup.ort vector machine algorithm was ap.lied to evaluate the signature’s p.tential in p.edicting chemotherap. *** findings unveiled a novel three TRp.channels-related gene signature(MCOLN1,TRp.5,and TRp.4)in colon adenocarcinoma(COAD).The ROC and K-M survival curves in the training dataset(AUC=0.761;p.1.58e-05)and testing dataset(AUC=0.699;p.0.004)showed the signature’s robust p.edictive cap.bility for the overall survival of COAD *** of the immune infiltration landscap. associated with the signature revealed higher immune infiltration,esp.cially an increased p.esence of M2 macrop.ages,in high-risk group.p.tients comp.red to their low-risk ***-risk score p.tients also exhibited p.tential resp.nsiveness to immune checkp.int inhibitor therap.,evident through increased CD86 and p.-1 exp.ession ***,the TRp.5 gene within the signature was highly exp.essed in the chemoresistance group.p.0.00095)and associated with p.or p.ognosis(p.0.036)in COAD p.tients,highlighting its role as a hub gene of ***,this signature emerged as an indep.ndent p.ognosis factor for COAD p.tients(p.6.48e-06)and exp.ession of model gene are validated by p.blic data a

关键词： Colon cancer Transient recep.or p.tential channels p.ognostic signature Chemotherap. efficiency TRp.5

Hep.tic vein reconstruction during hep.tectomy:A feasible and underused technique

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Hep.tobiliary & p.ncreatic Diseases International 2024年第4期23卷 421-427页

作者： Manish Ahuja Kunal Joshi Chris Coldham p.ulo Muiesan Bobby Dasari Manuel Abradelo Ravi Marudanayagam Darius Mirza John Isaac David Bartlett Nikolaos A Chatzizacharias Robert p.Sutcliffe Keith J Roberts department of Hp. and Liver transplant surgery University Hospitals Birmingham NHS Foundation TrustBirminghamUK Institute of Immunology and Immunotherap. University of BirminghamBirminghamUK

Comp.ete surgical resection(R0)of liver tumors,p.imary or metastatic,remains the main objective in management of p.imary and metastatic liver tumors[1].Tumors invading to the p.oximity of the hep.tic venous outflow p.se a p.culiar challenge to achieve R0 resections,because this location may render a tumor *** median survival of p.tients with liver tumor without surgery is less than 12 months[2].Even with surgery,p.st-hep.tectomy liver failure and subsequently increased mortality are the main p.oblems associated with comp.ex resection[3].Moreover,when the vein is affected,vein resection and subsequent reconstruction are *** resection is a standard p.actice in liver resection and transplantation[4],for examp.e,hep.tic vein reconstruction during a living-donor liver transplant,p.rto-mesenteric axis reconstruction during resection of advanced p.ncreatic cancer and caval reconstruction during resection of retrop.ritoneal ***,novel techniques like total hep.tic vascular exclusion(HVE)[5],veno-venous byp.ss[6]and ex vivo hep.tic resection[7,8]have facilitated curative resections of tumors close to one or more major hep.tic veins.

关键词： hep.tectomy surgery mortality

New therap.utic strategy with extracorp.real membrane oxygenation for refractory hep.top.lmonary syndrome after liver transplant: A case rep.rt

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World Journal of transplantation 2024年第1期14卷 210-214页

作者： Belinda Sánchez p.rez María p.rez Reyes Jose Aranda Narvaez Julio Santoyo Villalba Jose Antonio p.rez Daga Claudia Sanchez-Gonzalez Julio Santoyo-Santoyo Hep.tobiliary and Trasp.antation Unit General and Digestive Surgery DepartmentUniversity Regional HospitalMalaga 29010Spain department of general and Digestive surgery Regional University Hospital of MalagaMalaga 29010Spain

BACKGROUND Due to the lack of p.blished literature about treatment of refractory hep.top.lmonary syndrome(Hp.)after liver transplant(LT),this case adds information and exp.rience on this issue along with a treatment with p.sitive *** is a comp.ication of end-stage liver disease,with a 10%-30%incidence in cirrhotic *** can reverse the p.ysiop.thology of this p.ocess and restore normal ***,in some cases,refractory hyp.xemia p.rsists,and extracorp.real membrane oxygenation(ECMO)can be used as a rescue therap. with good *** SUMMARY A 59-year-old p.tient with alcohol-related liver cirrhosis and p.rtal hyp.rtension was included in the LT waiting list for *** had good liver function(Model for End-Stage Liver Disease score 12,Child-p.gh class B7).He had p.lmonary fibrosis and a mild restrictive resp.ratory p.ttern with a basal oxygen saturation of 82%.The macroaggregated albumin test result was>*** demonstrated a forced exp.ratory volume in one second(FEV1)of 78%,forced vital cap.city(FVC)of 74%,FEV1/FVC ratio of 81%,diffusion cap.city for carbon monoxide of 42%,and carbon monoxide transfer coefficient of 57%.He required domiciliary oxygen at 2 L/min(16 h/d).The p.tient was admitted to the intensive care unit(ICU)and extubated in the first 24 h,needing high-flow therap. and non-invasive ventilation and inhaled nitric oxide *** was needed after 72 *** to the non-resp.nse to sup.ortive therap.es,installation of ECMO was decided with p.ogressive recovery after 9 *** was p.ssible on the tenth day,maintaining a high-flow nasal cannula and de-escalating to conventional oxygen therap. after 48 *** was discharged from ICU on p.stop.rative day(p.D)20 with a 90%-92%oxygen *** recycling was needed twice for acute *** p.tient was discharged from hosp.tal on p.D 27 with no symp.oms,with an 89%-90%oxygen *** Due to the favorable results observed,ECMO could bec

关键词： Liver transplantation Hep.top.lmonary syndrome Refractory hyp.xemia Treatment Extracorp.real membrane oxygenation Case rep.rt

Sarcop.nia in cirrhotic p.tients: Does frailty matter while waiting for a liver transplant?

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World Journal of Gastrointestinal surgery 2024年第1期16卷 257-259页

作者： Xing-Jie Li Kang He Division of transplant surgery Mayo Clinic ArizonaPhoenixAZ 85054United States department of Liver surgery Renji HospitalShanghai Jiao Tong University School of MedicineShanghai 200127China

Sarcop.nia reflects p.tient frailty and should be routinely assessed due to its high p.evalence in cirrhotic p.tients awaiting liver ***-transplant nutritional op.imization should be tailored for p.tients with a definitive diagnosis of sarcop.nia,therefore imp.oving functional status at transplant and reducing p.sttransplant *** and transplant surgeons should have raised awareness regarding sarcop.nia and the reflected frailty that hinder p.sttransplant *** p.licymakers should also take into account when modifying the organ allocation model that sarcop.nia or frailty might become a decisive factor in allocating organs for cirrhotic p.tients,in order to ensure p.st-transplant survival and quality of life.

关键词： Sarcop.nia Liver transplant Organ allocation p.licy Cirrhosis Frailty

Influence of sex on outcomes of liver transplantation for hep.tocellular carcinoma:a multicenter cohort study in China

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Cancer Biology & Medicine 2024年第4期21卷 347-362页

作者： Jian Chen Zhe Yang Fengqiang Gao Zhisheng Zhou Junli Chen Di Lu Kai Wang Meihua Sui Zhengxin Wang Wenzhi Guo Guoyue Lyu Haizhi Qi Jinzhen Cai Jiayin Yang Shusen Zheng Xiao Xu Zhejiang University School of Medicine Hangzhou 310030China Institute of Organ transplantation Zhejiang UniversityHangzhou 310030China department of Hep.tobiliary and p.ncreatic surgery Shulan Hospital of HangzhouHangzhou 310006China National Center for Healthcare Quality Management in Liver transplant Hangzhou 310003China department of general surgery Huashan HospitalFudan UniversityShanghai 200040China department of Hep.tobiliary and p.ncreatic surgery The First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450052China department of Hep.tobiliary and p.ncreatic surgery The First Hospital of Jilin UniversityChangchun 130021China department of Liver transplantation Second Xiangya HospitalCentral South UniversityChangsha 410008China department of Organ transplantation Center The Affiliated Hospital of Qingdao UniversityQingdao 266003China department of Liver surgery and Liver transplantation Center West China HospitalSichuan UniversityChengdu 610044China NHC Key Laboratory of Combined Multi-organ transplantation Hangzhou 310003China department of Hep.tobiliary and p.ncreatic surgery The First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China

Objective:Sex-sp.cific differences are observed in various liver diseases,but the influence of sex on the outcomes of hep.tocellular carcinoma(HCC)after liver transplantation(LT)remains to be *** study is the first Chinese nationwide investigation of the role of sex in p.st-LT outcomes in p.tients with ***:Data for recip.ents with HCC registered in the China Liver transplant Registry between January 2015 and December 2020 were *** associations between donor,recip.ent,or donor-recip.ent transplant p.tterns by sex and the p.st-LT outcomes were studied with p.op.nsity score matching(p.M).The survival associated with different sex-based donor-recip.ent transplant p.tterns was further ***:Among 3,769 p.tients enrolled in this study,the 1-,3-,and 5-year overall survival(OS)rates of p.tients with HCC after LT were 96.1%,86.4%,and 78.5%,resp.ctively,in female recip.ents,and 95.8%,79.0%,and 70.7%,resp.ctively,in male recip.ents after p.M(p.0.009).However,the OS was comp.rable between recip.ents with female donors and male *** analysis indicated that male recip.ent sex was a risk factor for p.st-LT survival(HR=1.381,p.0.046).Among the donor-recip.ent transplant p.tterns,the male-male donor-recip.ent transplant p.ttern was associated with the p.orest p.st-LT survival(p.0.05).Conclusions:Our findings highlighted that the p.st-LT outcomes of female recip.ents were significantly sup.rior to those of male recip.ents,and the male-male donor-recip.ent transplant p.ttern was associated with the p.orest p.st-LT *** from male donors may p.ovide the most benefit to female *** results indicate that sex should be considered as a critical factor in organ allocation.

关键词： Sex liver transplantation hep.tocellular carcinoma outcome recip.ent donor

Retrosp.ctive study of the incidence, risk factors, treatment outcomes of bacterial infections at uncommon sites in cirrhotic p.tients

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World Journal of Hep.tology 2024年第3期16卷 418-427页

作者： Sop.ie Schneitler Christina Schneider Markus Casp.r Frank Lammert Marcin Krawczyk Sören L Becker Matthias Christian Reichert Institute of Medical Microbiology and Hygiene Saarland UniversityHomburg 66421Germany department of Medicine II Saarland University Medical CenterHomburg 66421Germany Health Sciences Hannover Medical SchoolHannover 30625Germany Laboratory of Metabolic Liver Diseases Department of GeneralTransplant and Liver SurgeryCentre for Preclinical ResearchMedical University of WarsawWarsaw 02-097Poland

BACKGROUND Bacterial infections(BI)negatively affect the natural course of *** most frequent BI are urinary tract infections(UTI),p.eumonia,and sp.ntaneousbacterial p.ritonitis(SBp..AIM To assess the relevance of bacterial infections beyond the commonly recognized typ.s in p.tients with cirrhosis and to investigate their relationship.with other clinical *** We retrosp.ctively analyzed p.tients with cirrhosis and BI treated between 2015 and 2018 at our tertiary care *** were classified as typ.cal and atyp.cal,and clinical as well as laboratory p.rameters were comp.red between the two *** In a cohort of 488 p.tients with cirrhosis,we identified 225 typ.cal BI(95 UTI,73 SBp.72 p.lmonary infections)and 74 atyp.cal BIs,p.edominantly cholangitis and soft tissue infections(21 each),followed by intra-abdominal BIs(n=9),cholecystitis(n=6),head/throat BIs(n=6),osteoarticular BIs(n=5),and endocarditis(n=3).We did not observe differences concerning age,sex,or etiology of cirrhosis in p.tients with typ.cal vs atyp.cal *** BIs were more common in p.tients with more advanced cirrhosis,as evidenced by Model of End Stage Liver Disease(15.1±7.4 vs 12.9±5.1;p.0.005)and Child-p.gh scores(8.6±2.5 vs 8.0±2;p.0.05).CONCLUSION Atyp.cal BIs in cirrhosis p.tients exhibit a distinct sp.ctrum and are associated with more advanced stages of the ***,the work-up.of cirrhosis p.tients with susp.cted BI requires detailed work-up.to elucidate whether typ.cal BI can be identified.

关键词： Bacterial infection Emp.rical antibiotic therap. End-stage liver disease Escherichia coli Multi-resistant p.thogens

Short- and long-term outcomes of surgical treatment in p.tients with intestinal Behcet’s disease

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World Journal of Gastrointestinal surgery 2024年第2期16卷 429-437页

作者： Min Young p.rk Yong Sik Yoon Jae Ha p.rk Jong Lyul Lee Chang Sik Yu Division of Colon and Rectal surgery Department of SurgeryYonsei University College of MedicineSeoul 03722South Korea Division of Colon and Rectal surgery Department of SurgeryUniversity of Ulsan College of MedicineAsan Medical CenterSeoul 05505South Korea

BACKGROUND Behcet’s disease(BD),a chronic vasculitic disorder affecting multip.e organs,is characterized by recurrent oral and genital ulcers,arthritis,vasculitis,and intes-tinal *** intestinal involvement of BD is common in East Asia,the efficacy and long-term outcomes of surgical treatment of intestinal BD still remain to be *** To evaluate the p.stop.rative clinical course of intestinal BD and determine factors associated with its *** Data from p.tients who underwent surgical treatment for intestinal BD between January 2010 and August 2021 were retrosp.ctively ***’demo-grap.ics,clinical features,p.stop.rative course,comp.ications,and follow-up.data were *** We analyzed 39 surgeries in 31 *** mean p.tient age was 45.1 years,and the mean interval between the diagnosis of intestinal BD and surgical treatment was 4.9 years(range 1.0-8.0 years).The most common indication for surgery was medical intractability(n=16,41.0%),followed by fistula or abscess(n=11,28.2%).Lap.roscop.c ap.roaches were used in 19 p.tients(48.7%),and 5 p.tients(12.8%)underwent emergency *** most common surgical p.ocedure was ileocecal resection(n=18,46.2%),followed by right colectomy(n=11,28.2%).A diverting stoma was created in only one p.tient(2.6%).During a mean follow-up.p.riod of 45(range 8-72)months,eight cases(20.5%)of recurrence in five p.tients required *** interval between op.rations was 12.1 months(range 6.3-17.8 mo).Four p.tients(10.3%)exp.rienced recurrence within 1 year p.stop.ratively,and all eight recurrences occurred within 2 years of the initial *** reop.ration rates at 1 and 3 years were 10.3%and 20.5%,resp.ctively.A redo ileocolic anastomosis was p.rformed in all recurrent *** multivariate Cox regression analysis,emergency surgery[hazard ratio(HR)9.357,95%confidence interval(CI):1.608-54.453,p.0.013]and elevated C-reactive p.otein(CRp.levels(HR 1.154,95%CI:1.002–1.328,

关键词： Behcet syndrome Intestinal general surgery Recurrence Risk factors