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Aim This study aimed to evaluated prognostic factors of patients with GEP-NETs after primary tumor resection comparing pancreatic and gastro-enteric locations. Methods Patients undergone surgery for primary GEP-NETs between 01/2000 and 03/2012 were considered. All specimens were reclassified according to the WHO 2010 scheme. Results A total of 83 patients were considered: 37 pancreatic NETs (pNET) and 46 gastroenteric NETs (GE-NET). The two groups were similar in terms of age, sex and tumors size. A higher rate of patients with pNETs had Ki67 score ≥3 (64.8% vs. 39%, p = 0.027) while the rates of Mitotic Index ≥2x10HPF (62% pNET vs. 50% GE-NET, p = 0.374) and diagnosis of neuroendocrine carcinoma NEC (16.2% pNET vs. 17.3% GE-NET, p = 0.100) were similar. The rates of distant metastases (GE-NETs 30.4% vs. p-NETs 29.7%, p = 0.944) and liver metastases (19.5% GE-NET vs. 27% pNET, p = 0.421) were comparable. Radical resection was achieved in a similar proportion in both groups [33 patients (89.1%) pNET vs. 36 (78.2%) GE-NET, p = 0.393]. After a median follow-up of 47.1 months overall 3, 5 and 10-years survival rates of whole patients were 88.1%, 81.2% and 76.7%. There was not difference on 5-years overall survival between pNET (81.4%) and GE-NET (81%, p = 0.901). At multivariate analysis age ≥70 [OR 4.177 (CI 95% 1.26–13.8), p = 0.019] and NEC [OR 5.932 (CI 95% 1.81–19.40), p < 0.001] were negative prognostic factors of survival. Conclusion Overall survival of GEP-NET after resection of primary tumors seems to be correlated to patient's age and WHO 2010 staging system but not to primary tumor site. [ABSTRACT FROM AUTHOR]

Objectives Patients with T3-4 gallbladder cancers (GBCs) often require extended surgical procedures, and up to 30% of patients have N2 metastases. This study investigated which patients with T3-4 GBC benefit from resection. Methods Consecutive patients (n = 78) with T3-4 GBC who underwent resection between 1990 and 2011 were analysed (38 before 2003, 40 in 2003-2011). Forty patients required common bile duct (CBD) resection, 10 pancreatoduodenectomy, 4 right colectomy and 2 gastric resection. Fifty-two (67%) patients had LN metastases, including 22 with N2 metastases. Results The in-hospital mortality rate was 8%, 11% before 2003 vs. 5% in 2003-2011. The morbidity rate (47%) remained stable during the study. Undergoing liver and pancreatic resection did not increase severe morbidity (0%) or mortality (10%). Sixty-seven (86%) patients had R0 resection. The 5-year survival rate was 17% (median follow-up, 65 months). Survival improved after 2002 (26% vs. 9%, p = 0.04). R1 patients had poor 3-year survival (0% vs. 32%, p = 0.001). N+ patients also had low survival (5-year survival, 10% vs. 32% in N0, p = 0.019), but N1 and N2 patients had similar outcomes. CBD resection and major hepatectomy did not worsen prognosis. Patients requiring pancreatoduodenectomy, gastric or colonic resection had 0% 3-year survival (p = 0.036 in multivariate analysis). Conclusions Resection of T3-4 GBC is worthwhile only if R0 surgery is achievable. Outcomes improved in most recent years. N2 metastases should not preclude surgery. Good results are possible even with CBD resection or major hepatectomy, while benefits from surgery are doubtful if pancreatoduodenectomy or other organ resection is needed. [ABSTRACT FROM AUTHOR]

B Background: b To assess the efficacy of intraoperative ultrasound (IOUS) compared with liver-specific magnetic resonance imaging (MRI) in patients with colorectal liver metastases (CRLM). Performance of IOUS and MRI was compared on patients by patients analysis. [Extracted from the article]

B Background: b Surgical management of colorectal liver metastasis (CRLM) has changed dramatically with the diffusion of parenchymal sparing liver resection (LR). 568 minor LRs were considered and categorized into 2 groups according to the date of LR: Group A (2005-2010, 271 LRs) and Group B (2011-2015, 297 LRs). [Extracted from the article]

B Background: b Hepatic resection is the treatment of choice for patients with colorectal liver metastases but 75- 85% of patients are unresectable at diagnosis. Right hepatectomy is now frequently performed laparoscopically, but it may be challenging in the setting of two stage hepatectomy, after left liver clearance and portal vein ligation. [Extracted from the article]

B Background: b Hepatic resection is the treatment of choice for patients with colorectal liver metastases but 75-85% of patients are unresectable at diagnosis. B Results: b The video shows the case of a patient with 3 liver metastases scheduled for a laparoscopic right hepatectomy and atypical resection of segment 4a, after neoadjuvant chemotherapy. [Extracted from the article]

B Background: b Post-hepatectomy liver failure (PHLF), one of the most common complications after liver surgery, is associated with an increased risk of in-hospital mortality. ICG and FRLV should be used to estimate the risk of PHLF and our new clinical tool might be considered in the decision-making process to select those patients referred to liver resection. [Extracted from the article]

B Background: b The ALICE model (based on serum albumin and indocyanine retention rate) was shown to be an effective and simple method for predicting postoperative long and short-term outcomes in eastern HCC patients. The median overall survival in the patients with ALICE grade 1, grade 2 and grade 3 were significant different both in the whole population (95, 67, and 15 months) and in Child A patients (95, 68 and 23 months). [Extracted from the article]