{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T03:32:41Z","timestamp":1764905561698},"reference-count":34,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2015,3,25]],"date-time":"2015-03-25T00:00:00Z","timestamp":1427241600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2015,3,25]],"date-time":"2015-03-25T00:00:00Z","timestamp":1427241600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2015,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Pancreatic neuroendocrine tumors (PNET) locally advanced may lead to significant local symptoms especially segmental portal hypertension (SPH) with risk of bleeding. The aim of our study was to evaluate the role of SPH on the PNET management in an expert center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Forty\u2010two patients treated for locally advanced PNET with SPH between January 1984 and December 2012 were retrospectively analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median age was 55 years (25\u201375). The median tumor size was 7.5\u00a0cm (3\u201320). Thirty four (80.9 %) patients were metastatic mainly in the liver (<jats:italic>n<\/jats:italic> = 33, 79 %) with a frequent (<jats:italic>n<\/jats:italic> = 16, 38.1 %) involvement &gt;20 %. The surgery was impossible because of SPH in 7 (16.6 %) cases. Pancreatic resection was performed in 28 (66.7 %) cases by distal pancreatectomy. Neoadjuvant chemotherapy (<jats:italic>n<\/jats:italic> = 24, 57 %) had no impact on SPH with no modification of collateral circulation. Among operated on patients, complete macroscopic resection was obtained in 19 (67.8 %) patients. The mortality and severe morbidity rate was respectively 3.6 and 18 %. Five year overall survival (OS) was similar in operated and no operated patients. (61 %; <jats:italic>p<\/jats:italic> = 0.64). The 5\u2010year OS was 77.9 or 55.4 % in patients who underwent a complete or incomplete macroscopic resection of primary and metastases, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>PNET resection associated with SPH is feasible with a low morbimortality. SPH was not improved by chemotherapy. Prolonged survival was observed after complete macroscopic resection.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-015-3030-8","type":"journal-article","created":{"date-parts":[[2015,3,24]],"date-time":"2015-03-24T19:30:41Z","timestamp":1427225441000},"page":"1974-1980","update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Therapeutic Strategies for Advanced Pancreatic Neuroendocrine Tumors with Segmental Portal Hypertension"],"prefix":"10.1002","volume":"39","author":[{"given":"F.","family":"Dumont","sequence":"first","affiliation":[{"name":"Department of Surgical Oncology Gustave Roussy Cancer Campus 114 rue Edouard Vaillant 94805 Villejuif Cedex France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y.","family":"Goudard","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology Gustave Roussy Cancer Campus 114 rue Edouard Vaillant 94805 Villejuif Cedex France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Caramella","sequence":"additional","affiliation":[{"name":"Department of Radiology Gustave Roussy Cancer Campus Villejuif France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Go\u00e9r\u00e9","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology Gustave Roussy Cancer Campus 114 rue Edouard Vaillant 94805 Villejuif Cedex France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Baudin","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Gustave Roussy Cancer Campus Villejuif France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Elias","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology Gustave Roussy Cancer Campus 114 rue Edouard Vaillant 94805 Villejuif Cedex France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,3,25]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11605\u2010009\u20101115\u20100"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.35.1817"},{"key":"e_1_2_6_4_2","first-page":"1175","article-title":"Nonfunctioning islet cell carcinoma of the pancreas","volume":"114","author":"Evans DB","year":"1993","journal-title":"Surgery"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1067\/msy.2001.118367"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s002680010224"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10620\u2010006\u20109307\u2010x"},{"key":"e_1_2_6_8_2","first-page":"444","article-title":"Splenic mass and isolated gastric varices: a rare presentation of a neuroendocrine tumor of the pancreas","volume":"11","author":"Shah SA","year":"2010","journal-title":"JOP"},{"key":"e_1_2_6_9_2","first-page":"6","article-title":"Multi\u2010visceral resection of pancreatic VIPoma in a patient with sinistral portal hypertension","volume":"28","author":"Joyce DL","year":"2008","journal-title":"World J Surg Oncol"},{"key":"e_1_2_6_10_2","first-page":"670","article-title":"Sinistral portal hypertension\u07dda case report","volume":"7","author":"Singhal D","year":"2006","journal-title":"JOP"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00326127"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1159\/000328392"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1159\/000335587"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00428\u2010006\u20100250\u20101"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2009.02.017"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000133083.54934.ae"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2005.05.001"},{"key":"e_1_2_6_18_2","first-page":"276","article-title":"Aggressive multi\u2010visceral pancreatic resections for locally advanced neuroendocrine tumours. 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