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Susanna Cirera, Sophia G Moesgaard, Nora E Zois, Nathja Ravn, Jens P Goetze, Signe E Cremer, Tom Teerlink, Páll S Leifsson, Jesper L Honge, J Michael Hasenkam, and Lisbeth H Olsen

disease (MMVD), leading to adaptive remodeling, enlargement, and subsequent dysfunction of the left ventricle (1) . Severe MR may need surgery, and if left untreated, it can cause heart failure or serious arrhythmia. In the USA, about 18 000 patients

Open access

Lisette van Alewijk, Kirsten Davidse, Karlijn Pellikaan, Judith van Eck, Anita C S Hokken-Koelega, Theo C J Sas, Sabine Hannema, Aart J van der Lely, and Laura C G de Graaff

undergo surgery, I know how to change my hydrocortisone dosage 2 8 4 6 10 3 1 1 3 4 1 2 3 0 3 17 P =0.23 P =0.29 I know what can happen if I do not change the hydrocortisone dosage in these situations 4 5 4

Open access

Shruti Khare, Anurag R Lila, Hiren Patt, Chaitanya Yerawar, Manjunath Goroshi, Tushar Bandgar, and Nalini S Shah

treatment was defined as resistance. In resistant patients, maximum dose of cabergoline used was 7 mg/week and if still unresponsive, second line therapies were offered. Second line management includes trans-sphenoidal surgery (TSS) by a single experienced

Open access

Carole Morin, Keo-Morakort Benedetto, Agathe Deville, Laurent Milot, Aurélie Theillaumas, Valerie Hervieu, Mathieu Pioche, Gilles Poncet, Julien Forestier, Laurent François, Francoise Borson-Chazot, Mustapha Adham, Catherine Lombard-Bohas, and Thomas Walter

Purpose: To improve neuroendocrine neoplasm (NEN) management, the European Neuroendocrine Tumor Society (ENETS) recognised 62 Centers of Excellence (CoE). This retrospective study compares conformity of patients’ initial management within vs outside an ENETS CoE with clinical practice guidelines (CPGs).

Methods: Patients diagnosed with a NEN between August 2018 and July 2020 and presented in the Lyon-CoE Multidisciplinary Tumour Board (MDT) were included. Factors potentially associated with conformity of initial management (work-up and first treatment) to CPG underwent univariate and multivariate analyses.

Results: Among the 615 included patients, 170 (27.6%) were initially managed in the CoE and 445 (72.4%) were only presented at the CoE-MDT. Patients in the CoE group more often had intestinal or pancreatic primaries, metastatic disease (61.8% vs 33%), hereditary syndrome and a functioning tumour. Work-up conformity was 37.1% in the CoE (vs 29.9%, p=0.09); this was 95.8% for the first treatment (vs 88.7%, p=0.01). After multivariate analysis, CPG conformity was significantly higher for patients managed in the CoE, for younger patients, for those having a grade 1-2 tumour, and a genetic syndrome. Pancreatic and small intestinal (SI) NET surgeries performed in the CoE had higher splenic preservation rate during left pancreatectomy, better detection of multiple tumours in SI surgeries, and higher number of resected lymph nodes.

Conclusions: Given the widespread observance of CPG, not all patients require management in the CoE. Referral should be considered for more complex cases such as metastatic diseases, G2 tumours or carcinoid syndromes. Finally, we should encourage centralization of NET surgery.

Open access

Jiaxin Luo, Weili Yin, Qiuxia Lin, Juqing Wu, Pan Chen, Yuanna Ling, Jing Wang, Zhen Li, Liqin Pan, Yanying Chen, Wei Ouyang, and Huijuan Feng

surgery, radioiodine therapy (RAIT), external beam radiation therapy (EBRT), and bisphosphonate therapy ( 11 ). The American Thyroid Association noted that although radioiodine (I-131) is less likely to cure bone metastases, patients with positive I-131

Open access

Anping Su, Yanping Gong, Wenshuang Wu, Rixiang Gong, Zhihui Li, and Jingqiang Zhu

Introduction Total thyroidectomy with central neck dissection has been adopted in many specialized endocrine surgery units for the treatment of papillary thyroid carcinoma (PTC) ( 1 , 2 , 3 ). However, central neck dissection, especially

Open access

Logan Mills, Panagiotis Drymousis, Yogesh Vashist, Christoph Burdelski, Andreas Prachalias, Parthi Srinivasan, Krishna Menon, Corina Cotoi, Saboor Khan, Judith Cave, Thomas Armstrong, Martin O Weickert, Jakob Izbicki, Joerg Schrader, Andreja Frilling, John K Ramage, and Raj Srirajaskanthan

tumours ( 1 , 11 ). Variation and controversy exist as to the specific criteria used to select patients for surveillance, and as to the best strategy for using imaging for surveillance. The case for surgery in all non-functional tumours ≤2 cm does not

Open access

Wei Sun, Boyuan Zheng, Zhihong Wang, Wenwu Dong, Yuan Qin, and Hao Zhang

receive PCLND ( 9 ). In addition, dynamic observation of central lymph nodes is considered safe and should be performed for all patients with PTC before and during surgery to ensure that they are free from central neck metastasis ( 10 ). However, other

Open access

Dirk-Jan van Beek, Rachel S van Leeuwaarde, Carolina R C Pieterman, Menno R Vriens, Gerlof D Valk, and the DutchMEN Study Group

complications of surgery (e.g. hypoparathyroidism after (sub)total parathyroidectomy) and survival of dp-NETs as important topics since these affect quality of life. In a process of informed shared decision-making, research questions and study aims were

Open access

Stephanie E Baldeweg, Mark Vanderpump, Will Drake, Narendra Reddy, Andrew Markey, Gordon T Plant, Michael Powell, Saurabh Sinha, John Wass, and the Society for Endocrinology Clinical Committee

, major surgery, especially coronary artery bypass grafting, dynamic testing of the pituitary gland, anticoagulation therapy, coagulopathies, pregnancy and head trauma. Differential diagnosis SAH due to ruptured intracranial aneurysm or