المؤلفون: Elisabeth Maurer, I Fülber, K Holzer, Jerena Manoharan, Ioannis Mintziras, Detlef K. Bartsch, Christian Vorländer, Jochen Schabram, Sabine Wächter

المصدر: European Archives of Oto-Rhino-Laryngology. 277:1507-1514

مصطلحات موضوعية: Oncology, medicine.medical_specialty, medicine.medical_treatment, Thyroid Carcinoma, Anaplastic, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Carcinoma, Humans, Thyroid Neoplasms, Anaplastic thyroid cancer, Stage (cooking), 030223 otorhinolaryngology, Retrospective Studies, Chemotherapy, business.industry, Thyroidectomy, General Medicine, Prognosis, medicine.disease, Debulking, Treatment Outcome, Otorhinolaryngology, 030220 oncology & carcinogenesis, Lymphadenectomy, business

الوصف: The prognosis of anaplastic thyroid cancer (ATC) is poor. Despite various attempts to modify common treatment modalities, including surgery, external beam radiation (EBRT) and chemotherapy (CTX), no standardized treatment is yet established. This study aimed to analyze the changing trends of treatment concepts and associated overall survival (OS) over the last two decades. A retrospective analysis was conducted on 42 patients with histologically confirmed ATC. The outcome measures included the evaluation of clinical characteristics and treatments performed with regard to OS. Median OS for all tumor stages was 6 (range 1 week–79) months, 6.5 months for stage IVA/B and 4 months for stage IVC carcinoma patients. Twenty-one patients with stage IVA/B carcinomas underwent curative treatment, including thyroidectomy with lymphadenectomy (TTX plus LAD, n = 11) or multimodal treatment with TTX plus LAD and EBRT plus/minus CTX (n = 10). The median OS of patients with stage IVA/B carcinomas was significantly prolonged after multimodal treatment than after surgery alone (25 vs. 3 months, p = 0.04). Fifteen of 18 patients with stage IVC carcinomas received palliative, 3 patients multimodal treatment. The median OS of stage IVC patients after trimodal therapy was not significantly longer than after debulking procedures (6 vs. 7 months, p = 0.25). In the time period 1999–2009, only 4 (21%) patients received multimodal treatment compared to 9 (39%) in the period from 2009 to 2019, but this did not result in a significantly prolonged survival in the latter period (8.5 vs. 15 months, p = 0.61). Concurrent radio- and/or chemotherapy in combination with surgery seems to result in improved survival in stage IVA/B ATC, whereas this is not the case in patients with stage IVC tumors. Novel treatment regimens are urgently needed to improve the dismal prognosis of ATC.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9f672ed82b2f17cfe20d7d4b671d6643Test
https://doi.org/10.1007/s00405-020-05853-8Test

المؤلفون: Elisabeth Maurer, Carmen Bollmann, Jerena Manoharan, Sabine Wächter, Detlef K. Bartsch, Ioannis Mintziras, Max B. Albers

المصدر: Clinical Endocrinology. 92:63-70

مصطلحات موضوعية: Adult, Male, endocrine system, medicine.medical_specialty, Adolescent, endocrine system diseases, Hypoparathyroidism, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Total parathyroidectomy, Urology, 030209 endocrinology & metabolism, Transplantation, Autologous, Subtotal Parathyroidectomy, Young Adult, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Endocrinology, Internal medicine, Multiple Endocrine Neoplasia Type 1, medicine, Humans, MEN1, Multiple endocrine neoplasia, Aged, Retrospective Studies, Parathyroidectomy, business.industry, Middle Aged, Hyperparathyroidism, Primary, Thymectomy, medicine.disease, Autotransplantation, 030220 oncology & carcinogenesis, Female, business, Primary hyperparathyroidism

الوصف: Importance Guidelines advocate subtotal parathyroidectomy (SPTX) or total parathyroidectomy with autotransplantation (TPTX) with bilateral cervical thymectomy for primary hyperparathyroidism (pHPT) associated with multiple endocrine neoplasia type 1 (MEN1). However, both procedures are associated with a significant risk of permanent hypoparathyroidism. Objective The aim of the current study was to compare long-term results of either single gland excision (SGE, 1-2 glands), SPTX and TPTX for the treatment of MEN1-associated pHPT. Design and setting Data of genetically confirmed MEN1 patients who underwent surgery for pHPT between 1987 and 2017 were retrieved from a prospective database and were retrospectively analysed. Results Eighty-nine MEN1 patients underwent either TPTX (n = 38, 42.7%), SPTX (n = 23, 25.8%) or SGE (n = 28, 31.5%). The rate of disease persistence after initial surgery was 2.6%, 0% and 14.2% in the TPTX, SPTX and SGE groups, respectively. After median follow-up of 112 (range 7-411) months, the rate of recurrent pHPT was significantly higher in the SGE group (n = 19, 21.3%) compared with the TPTX (n = 4, 4.4%, P = .001) and the SPTX (n = 9, 10.1%, P = .03) groups. Analysis of the recurrence-free time among the surgical groups revealed a significant difference (P = .036). The median time to recurrence was significantly shorter after SGE (101, range 3-301 months) than after SPTX (139, range 28-278 months, P = .018) and TPTX (204, range 75-396 months, P = .049). Twelve (32%) patients who underwent TPTX developed permanent hypoparathyroidism compared with only 4 (17%, P = .06) in the SPTX and 0 in the SGE group (P = .001). Conclusion Given the high rate of postoperative permanent hypoparathyroidism after TPTX and SPTX, SGE is a valid option for the treatment of MEN1-associated pHPT.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e04de3ee7d08d2c8f6420051cf0f289dTest
https://doi.org/10.1111/cen.14112Test

المؤلفون: Jerena Manoharan, Carmen Bollmann, K Holzer, Max B. Albers, Detlef K. Bartsch, Maximilian P. Chlosta

المصدر: World journal of surgery. 43(2)

مصطلحات موضوعية: Adult, Male, Reoperation, medicine.medical_specialty, Time Factors, Duodenum, medicine.medical_treatment, 03 medical and health sciences, 0302 clinical medicine, Pancreatectomy, Duodenal Neoplasms, medicine, Multiple Endocrine Neoplasia Type 1, Humans, Prospective Studies, VIPoma, Retrospective Studies, business.industry, Perioperative, Vascular surgery, Middle Aged, medicine.disease, Surgery, Pancreatic Neoplasms, Cardiothoracic surgery, 030220 oncology & carcinogenesis, Pancreatic Vipoma, 030211 gastroenterology & hepatology, Lymphadenectomy, Female, business, Abdominal surgery

الوصف: To evaluate the outcome of duodenopancreatic reoperations in patients with multiple endocrine neoplasia type 1 (MEN1). MEN1 patients who underwent reoperations for duodenopancreatic neuroendocrine neoplasms (dpNENs) were retrieved from a prospective database and retrospectively analyzed. Twelve of 101 MEN1 patients underwent up to three reoperations, resulting in a total of 18 reoperations for dpNEN recurrence. Patients initially underwent either formal pancreatic resections (n = 7), enucleations (n = 3), or duodenotomy with lymphadenectomy for either NF-pNEN (seven patients), Zollinger–Ellison syndrome (ZES, three patients), organic hyperinsulinism (one patient) or VIPoma (one patient). Six patients had malignant dpNENs with lymph node (n = 5) and/or liver metastases (n = 2). The indication of reoperations was NF-pNEN (five patients), ZES (five patients), organic hyperinsulinism (one patient), and recurrent VIPoma (one patient). Median time to first reoperation was 67.5 (range 6–251) months. Five patients required a second duodenopancreatic reoperation for 60–384 months after initial surgery, and one patient underwent a third reoperation after 249 months. The rate of complications (Clavien–Dindo ≥3) was 28%. Four patients required completion pancreatectomy. Six patients developed pancreoprivic diabetes. After a median follow-up of 18 (6–34) years after initial surgery, ten of 12 patients are alive, one died of metastatic pancreatic VIPoma, and one died of metastatic thymic NEN. Reoperations are frequently necessary for dpNEN in MEN1 patients, but are not associated with an increased perioperative morbidity in specialized centers. Organ-sparing resections should be preferred as initial duodenopancreatic procedures to maintain pancreatic function and avoid completion pancreatectomy.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e382f69d42f825f9d615131d33bf9061Test
https://pubmed.ncbi.nlm.nih.gov/30288555Test

المؤلفون: Carmen Bollmann, Jerena Manoharan, Emily P. Slater, Volker Fendrich, Friedhelm Raue, Detlef K. Bartsch, Caroline L. Lopez, Max B. Albers

المصدر: World journal of surgery. 41(8)

مصطلحات موضوعية: Male, endocrine system, medicine.medical_specialty, Pediatrics, endocrine system diseases, Adolescent, 030209 endocrinology & metabolism, 030230 surgery, Asymptomatic, 03 medical and health sciences, 0302 clinical medicine, Pituitary adenoma, medicine, Multiple Endocrine Neoplasia Type 1, Humans, Pituitary Neoplasms, Prospective Studies, Prospective cohort study, Child, Retrospective Studies, Gynecology, business.industry, Retrospective cohort study, Vascular surgery, medicine.disease, Annual Screening, Pancreatic Neoplasms, Cardiothoracic surgery, Surgery, Female, Insulinoma, medicine.symptom, business, Abdominal surgery

الوصف: Recent clinical practice guidelines recommend that routine screening of MEN1 mutation carriers should start at the age of 5 years. The occurrence of clinically relevant MEN1 organ manifestations in children (≤18 years) was evaluated. Two prospective collected databases of MEN1 patients (n = 166) who underwent annual screening were retrospectively analyzed for organ manifestations in MEN1 patients ≤18 years. The follow-up was based on the most recent screening examination until December 2015. Twenty [11 females, 9 males, (12%)] of 166 MEN1 patients were diagnosed with at least one organ manifestation at age ≤18 years. The most frequent manifestation was mild asymptomatic pHPT (n = 9, 45%, age range 8–18 years). Eight (40%) young patients had pNENs (three non-functioning pNENs, five insulinomas, age range 9–18 years). All five insulinomas were diagnosed based on hypoglycemic symptoms. The other organ manifestations were asymptomatic pituitary adenomas in six patients (30%, age range 15–18 years) and a bronchial carcinoid in one 15-year-old patient. Only six (30%) patients ≤18 years had clinically relevant organ manifestations. Symptomatic or severe manifestations in MEN1 patients rarely occur below the age of 16 years. With regard to psychological burden and cost-effectiveness, routine screening of asymptomatic MEN1 patients should be postponed at least until the age of 16 years.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::dfe0051f4b2ecd6ef658e76cf6b89028Test
https://pubmed.ncbi.nlm.nih.gov/28321559Test

المؤلفون: Volker Fendrich, Jens Waldmann, Caroline L. Lopez, Detlef K. Bartsch, Carmen Bollmann, Max B. Albers, Jerena Manoharan

المصدر: 133. Kongress der Deutschen Gesellschaft für Chirurgie; 20160426-20160429; Berlin; DOC16dgch493 /20160421/

مصطلحات موضوعية: Adult, Male, congenital, hereditary, and neonatal diseases and abnormalities, endocrine system, medicine.medical_specialty, endocrine system diseases, Adolescent, medicine.medical_treatment, Urology, Neuroendocrine tumors, 03 medical and health sciences, Pancreatic Fistula, Young Adult, 0302 clinical medicine, Pancreatectomy, Postoperative Complications, Robotic Surgical Procedures, medicine, Multiple Endocrine Neoplasia Type 1, Humans, Minimally Invasive Surgical Procedures, MEN1, Multiple endocrine neoplasia, Child, Insulinoma, Retrospective Studies, business.industry, 610 Medical sciences, Medicine, Vascular surgery, Middle Aged, medicine.disease, Surgery, Pancreatic Neoplasms, Neuroendocrine Tumors, Treatment Outcome, ddc: 610, Pancreatic fistula, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Female, Laparoscopy, business, Abdominal surgery

الوصف: Background: The role of minimally invasive pancreatic surgery for pancreatic neuroendocrine neoplasms (pNENs) in patients with multiple endocrine neoplasia type 1 (MEN1) is not well defined. The aim of this study was to compare the outcome of minimally invasive versus open pancreatic resections in patients[for full text, please go to the a.m. URL]
133. Kongress der Deutschen Gesellschaft für Chirurgie

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::be32ac3e90494b7eba06b93e70807713Test
https://pubmed.ncbi.nlm.nih.gov/26956903Test