Annals of surgery
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To describe the evolution of management strategies for neuroendocrine liver metastases (NE LM) and trends in patient outcomes over the preceding 3 decades. ⋯ Improved imaging modalities and modifications in specific therapies as components of multimodal treatment concepts are concordant with significantly improved survival outcomes in NELM over 30 years. The use of multimodal therapy improved overall survival in patients with NE LM. Future studies should determine optimal treatment selection and sequencing, and role of novel biomarkers to guide these.
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To examine the optimal method of assessing response to neoadjuvant therapy (NAT) in operable pancreatic ductal adenocarcinoma (PDAC) patients. ⋯ CA19-9 response to NAT alone is not enough to identify long-term post-resection PDAC survivors. The co-existence of CA19-9 and major pathologic response was predictive of the most optimal survival outcome.
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To investigate the incidence and risk factors of portomesenteric venous thrombosis (PVT) after pancreatic cancer surgery with portomesenteric venous resection (PVR). ⋯ Early PVT after pancreatectomy with PVR is rare. Late PVT is associated with neoadjuvant radiotherapy and local recurrence. These findings may inform risk assessment in pancreatic cancer patients undergoing PVR.
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To develop and validate a signature to precisely predict prognosis in pancreatic ductal adenocarcinoma (PDAC) undergoing resection and adjuvant chemotherapy. ⋯ The ChemoResist signature could precisely predict survival in PDAC undergoing resection and chemotherapy, and its predictive value surpassed TNM stage and other clinicopathologic factors. Moreover, the ChemoResist classifier could assist with identifying patients who would more likely benefit from adjuvant chemotherapy.
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To compare early patency and outcomes of single outflow (SOT) and double outflow (DOT) reconstruction in right lobe living donor liver transplantation (RtLDLT) in a multicenter open-labelled randomized controlled trial. ⋯ SOT has better early neoMHV patency than DOT and may be associated with better early survival.