iiinova — where your digital self keeps evolving

Julie Hallet, MD MSc @halletjulie.bsky.social · 10/08/2025

💥Bone mets in SI-NETs – more common than you think! 🦴25% on PET-CT 😌14% pain, 4% fracture ⏳Stage IV pts with 🦴 mets ⬇️ median survival vs without 📊>5 lesions has ⬇️ survival What's the best strategy for bone treatments in #NETs? 💭 ow.ly/GB2N50WCokB #NETSky #OncSky #MedSky #SurgSky

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Julie Hallet, MD MSc @halletjulie.bsky.social · 08/08/2025

💭Guess what day it is? #NETs OR 🦓 with Dr Meloche-Dumas She’s focusing on NETs during surg onc fellowship. The NETs field needs more dedicated surgeons like her - watch out for what’s to come! So fun to create tailored multidisciplinary NETs rotations with UofT SurgOnc #NETsky #SurgSky #MedSky

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Julie Hallet, MD MSc @halletjulie.bsky.social · 24/07/2025

🎙️New data for management of #HCC What is new? What is in the works? Review this & more with Adam Yopp, Amit Singhal & Katie Kelley in new #SurgOncToday podcast 🎧 from @socsurgonc.bsky.social A real masterclass in perioperative care for HCC 🔝 #HPBsky #SurgSky #medsky #oncsky

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Julie Hallet, MD MSc @halletjulie.bsky.social · 29/06/2025

What will my life look like after surgery? The STAYHOME tool can help with this question for older adults for cancer surgery: 🏡 individualized risk of staying home at 6 & 12 months 😷 uses preop info ✅ good discrimination & well calibrated 📝 in JAMASurgery lnkd.in/gTtRgj_e #SurgSky #OncSky

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Julie Hallet, MD MSc @halletjulie.bsky.social · 29/06/2025

That was the last OR day with Dr Acher! Always bittersweet to see fellows go 🥹 So proud of the highly skilled, brilliant, whip-smart surgeon she is 🌟 @wiscsurgery.bsky.social, you're lucky to have her! Now, we can always dream of getting her on social media 🙃 @uoftsurgery.bsky.social

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Julie Hallet, MD MSc @halletjulie.bsky.social · 28/05/2025

Stable OR teams contribute to better outcomes🤝✨ Each additional case done by same anesthesiologist-surgeon team 👉 ⬇️ major morbidity 🔓‼ Opportunity is knocking: ⬆️outcomes by re-organizing teams How do we do it? 🆕📝 tinyurl.com/yx44pm96 #SurgSky #MedSky #HPBSky

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Julie Hallet, MD MSc @halletjulie.bsky.social · 17/05/2025

PRRT before surgery in #NETs? ☢️🦓 Maybe? 💭 Think about why, how to measure success, potential risks 🤔 Some key reasons to consider the approach by Jess Maxwell @mdanderson.bsky.social 👇🏻 @nanets.bsky.social #NETsky #HPBSky #SurgSky @enets.bsky.social @socsurgonc.bsky.social

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Julie Hallet, MD MSc @halletjulie.bsky.social · 17/05/2025

#NETs in LA ⭐️🎥🌴 Reminder to debulk NETs liver metastases by Alexandra Gangi 🤩 @cedarssinai.bsky.social ➡️ mortality in NETs happens in the liver - treat it ⛔️ No to anatomic resection! 👉🏻 enucleate! #NETsky #HPBSky #SurgSky #OncSky @nanets.bsky.social

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Julie Hallet, MD MSc @halletjulie.bsky.social · 15/05/2025

Perioperative management essentials for carcinoid syndrome 🎞️👀 sneak peek of 🗺️ international expert consensus recommendations at @essonews.bsky.social #NETs webinar today 🔹Assess for 🖤disease 🔹Identify & treat crisis fast 🔹Don't rely on octreotide! Thanks for the invite! #NETSky #HPBSky #SurgSky

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Julie Hallet, MD MSc @halletjulie.bsky.social · 12/05/2025

Symptoms & QoL are key in #NETs care New tools🧰 from @ascocancer.bsky.social for symtpom management in well-diff GEP-NETs ☑️carcinoid syndrome, heart disease, crisis & functional PNETs ☑️surgery, liver-directed therapy & systemic 🔗📝https://ascopubs.org/doi/10.1200/OP-25-00133 #NETSky #OncSky

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Julie Hallet, MD MSc @halletjulie.bsky.social · 09/05/2025

Want to know more about surgery & functioning NETs?🤨 Join @essonews.bsky.social on May 14! 🔥Will include preview of international expert consensus recommendations for periop management of carcinoid crisis🦓🌎 Register 👇🏻👇🏻 #NETSky #SurgSky #OncSky #HPBSky

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Julie Hallet, MD MSc @halletjulie.bsky.social · 25/04/2025

Are current wait time targets optimal? Strong work by Adom Bondzi-Simpson #AmerSurg25: wait time & survival in #CRC 🚫 diff OS if surgery <28d (traditional target) ⬆️OS if surgery <45d (new) Time to reconsider wait times to optimize cancer outcome vs resources? ⚖️🤔 📸cred @swexner.bsky.social

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Julie Hallet, MD MSc @halletjulie.bsky.social · 22/04/2025

The scrub cap is back for some team spirit in the OR 🏥 #StanleyCupPlayoffs #GoHabsGo Bring back the cup where it belongs! 🔵⚪️🔴 🇨🇦

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Julie Hallet, MD MSc @halletjulie.bsky.social · 03/04/2025

🚨 Debulking of #NETs liver metastases 🦓 What? Why? When? How? The 😈 is in the details Get details in 🆕 #SurgOncToday podcast🎙️with Jessica Maxwell & Alexandra Gangi: patient selection, preop preparation & technical approach open.spotify.com/episode/2n7z... #NETSky #HPBSky #SurgSky #OncSky

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Julie Hallet, MD MSc @halletjulie.bsky.social · 02/04/2025

🚨 #AHPBA2025 recap🎙️ Missed the meeting? Spent time at the beach🏖️? Too many sessions to pick from? Get your update in 🆕 #SurgOncToday with Ryan Ellis & Michael Lidsky: HAIP⛽️, locally advanced PDAC, PNETs, NSQIP & more! open.spotify.com/episode/3AJT... #SurgSky #HPBSky @socsurgonc.bsky.social

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Julie Hallet, MD MSc @halletjulie.bsky.social · 29/03/2025

Congrats Adom Bondzi-Simpson & Tiago Ribeiro on #SSO2025 presentations and awards 👏🏻👏🏻 Outstanding representation of UofT surgery and well deserved recognition of your work! 🎉 #SurgSky

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Julie Hallet, MD MSc @halletjulie.bsky.social · 27/03/2025

Reunited with some favourite #SurgOnc colleagues and friends under the Florida ☀️ for #SSO2025 Starting with board meeting - lots accomplished under Ron DeMatteo's presidency and more to come under Russ Berman's leadership 💪🆙 @socsurgonc.bsky.social #SurgSky #MedSky #HPBSky #OncSky

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Julie Hallet, MD MSc @halletjulie.bsky.social · 24/03/2025

Surgical ergonomics & human factors are joining forces in Toronto next week! Join the Society of Surgical Ergonomics and HF/ES for cocktail hour: 📆March 31, 2025 ⏰6:30pm 📍Miller Tavern (Yonge street) See you there!

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Julie Hallet, MD MSc @halletjulie.bsky.social · 23/03/2025

That was fun #AHPBA2025! ☀️🌴🌊 Thanks Flavio Rocha & AHPBA team for a great meeting! ⏭️ now to #SSO2025 #HPBsky #SurgSky

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Julie Hallet, MD MSc @halletjulie.bsky.social · 14/03/2025

MIS for liver resection - Should we? Why? How? 🤔💭 🎙️Dissecting the data & tips for uptake with the author of the first lap liver trial A Fretland and robotic expert L Melstrom in #SurgOncToday 🎧 #Hpbsky #SurgSky @socsurgonc.bsky.social podcasts.apple.com/ca/podcast/sur…

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Julie Hallet, MD MSc @halletjulie.bsky.social · 12/03/2025

Fun work day with good music! 🎶🎸 Nothing better than music in the OR and a happy anesthesiologist - both make work better 😄

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Julie Hallet, MD MSc @halletjulie.bsky.social · 06/03/2025

Because you can resect does not mean you should Not all NETs are the same Stefano Partelli introducing biological unresectability for PNETs at #ENETS25 👉🏻 identifying futile surgery & when preop therapy will help We have 💊options - let’s figure out how to combine with surgery! #NETsky #Medsky

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Julie Hallet, MD MSc @halletjulie.bsky.social · 06/03/2025

🔥 from #ENETS25 - 🇨🇦 science on a big stage!💪🏻 @iacovosmichael.bsky.social using NETs organoids (my NET babies!) to test new Rx mechanisms ▪️apoptosis machinery active in G1/2 NETs ▪️BH3-mimetics + lutathera work in lab 👉🏻 New therapy to trial? #NETsky #oncSky @nanets.bsky.social

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Julie Hallet, MD MSc @halletjulie.bsky.social · 16/02/2025

What's better than combiing Valentine's day 💖, #NETs 🦓 & Mexico 🇲🇽🌮? 😃 That's a wrap on a successful 1st @nanets.bsky.socia meeting in Latin America - thanks for the welcome in CDMX! Congrats Jaydira Del Rivero & Ismael Dominguez for coordinating!!

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Julie Hallet, MD MSc @halletjulie.bsky.social · 14/02/2025

What to do with carcinoid crisis? 🦓 A frequent concern for patients with #NETs having surgery We put together an international 🌎🌍🌏 multidisciplinary expert consensus statement 📢 Now open for feedback! Sign-up here 🔗 surveymonkey.com/r/periopcarc... 📆 Open until March 3rd!

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Julie Hallet, MD MSc @halletjulie.bsky.social · 12/02/2025

🆕📝Self-injury after cancer dx - does it matter? A severe sequelae of distress 😣 In 3⃣ in every 1⃣0⃣0⃣0⃣ pts ⚠️Associated with ⬆️46% hazards of deaths A critical outcome: how to better screen & care? Need more than💊 to⬆️survival 🔗https://tinyurl.com/53tmspcn More👇🏻 #MedSky #OncSky

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Julie Hallet, MD MSc @halletjulie.bsky.social · 04/02/2025

In pain/discomfort after OR: get yourself anti-fatigue mats! RCT H&N surgery >3h - mat 🆚 not ⬇️ discomfort & pain in lower extremity, shoulders, neck & back 😀 Immediately postop and 24h after Simple and it works! 📝 pubmed.ncbi.nlm.nih.gov/39882505/

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Julie Hallet, MD MSc @halletjulie.bsky.social · 30/01/2025

Fun times in Milan 🇮🇹- visiting 🍷🍝, catching up with friends, making new ones, and a little time to talk #ergonomics. Thanks everyone for the welcome! #HPBSky #SurgSky

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Julie Hallet, MD MSc @halletjulie.bsky.social · 13/01/2025

Thrilled to announce the launch of CUTNETs 🦓 🔪, a surgical collaborative for NETs care and research! Together, we aim to unite expertise and resources in NETs surgery to ⬆️ outcomes 🇨🇦🇮🇹🇺🇸🇲🇽🇬🇧🇳🇴🇸🇪🇫🇷🇦🇹🇩🇪🇳🇱 More in Lancet Gastro Hep letter with Stefano Partelli & Massimo Falconi 🔗 tinyurl.com/yc2w7vba

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Julie Hallet, MD MSc @halletjulie.bsky.social · 10/01/2025

Decision to transfuse🩸in surgery impacts outcomes Point-of-care Hgb often used but is it accurate? 🕵️‍♂️Prospective study by @chamogui.bsky.social 🧪1735 samples Wide variation in p-o-c Hgb ➡️ large difference vs lab ⚠️Risk of transfusion errors - lowest with HemoCue 6% tinyurl.com/2mh7dwu4

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Julie Hallet, MD MSc @halletjulie.bsky.social · 10/01/2025

📸 day at research treat for Dr Coburn, Dr Eskander & my labs A day to celebrate incredible teamwork by those talented investigators & students 🤩 Very grateful to work with them, build off diverse perspectives, skillsets and methodologies to improve cancer care 🆙 #NETSky #HPBSky #SurgSky #OncSky

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Julie Hallet, MD MSc @halletjulie.bsky.social · 10/01/2025

Combination therapy for #NETs Phase 2 RCT #LuCAPtrial of radiosensitizer Cape 👥72 advanced G1/2 GEP-NET ☢️RLT (177Lu-Dotatate) alone 🆚 RLT + Cape No difference ORR, PFS or OS🫤 Should we look at different population? different radiosensitizer? tinyurl.com/mr3ujhr9 #NETSky #HPBSky #OncSky

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Julie Hallet, MD MSc @halletjulie.bsky.social · 04/01/2025

What do we know about NETs in kids? Lots of consultations to NETologists, but little data 🆕info from registry 🇩🇰 x 25 yrs 👥220 👉🏻 >90% appendix 📊 incidence 6.8/1 million Only 2% genetic Excellent prognosis😁 What does it mean for Rx & surveillance? pubmed.ncbi.nlm.nih.gov/39579111/

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Julie Hallet, MD MSc @halletjulie.bsky.social · 21/12/2024

My🔝10📝of2⃣0⃣2⃣4⃣ - the end NEOLUPANET @bjsurgery.bsky.social ☢️Neoadj PRRT in high-risk PNETs Single arm study ✅60% response ✅M&M profile not altered Fave one - prospective periop data in NETs surgery!🎉 Surgeons can do it! What's in for 2025? tinyurl.com/2abu5ny9 #NETSky #HPBSky #MedSky #SurgSky

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Julie Hallet, MD MSc @halletjulie.bsky.social · 20/12/2024

My🔝10📝of2⃣0⃣2⃣4⃣(cont'd) HELIX in @JAMA_current RCT - TXA vs placebo for hepatectomy No difference in 🩸 transfusions but ⬆️ in complications ❌ no more TXA for liver resection in 2025? t.co/tJlyac4AZV #HPBSky #SurgSky #MedSky @ihpba.bsky.social

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Julie Hallet, MD MSc @halletjulie.bsky.social · 19/12/2024

My🔝 10 📝 of 2⃣0⃣2⃣4⃣ (cont'd) NETTER 2 in @TheLancet RCT - ☢️ PRRT vs long-acting SSA in G2/3 advanced GEP-NETs ⬆️ PFS by >12 months median HR 0.28 (0.18–0.42) Across all sub-groups 💥 New standard of care for 2025? 🦓 www.thelancet.com/journals/lan...

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Julie Hallet, MD MSc @halletjulie.bsky.social · 18/12/2024

My🔝10📝of2⃣0⃣2⃣4⃣(cont'd) Contemporary management of periop carcinoid crisis ▪️Octreotide does not help ▫️Relying on octreotide as 1st line treatment can delay crisis ▪️Start with pressors when crisis occurs 🌎 expert consensus coming in 2025!🦓 link.springer.com/article/10.1...

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Julie Hallet, MD MSc @halletjulie.bsky.social · 17/12/2024

My🔝10📝of2⃣0⃣2⃣4⃣(cont'd) PRICE-2🩸 RCT - hypovolemic phlebotomy vs usual care for hepatectomy ⬇️🩸transfusions from 16 to 8%, and NNT 11 Will it be implemented in 2025? tinyurl.com/2npc5u7b #SurgSky #HPBSky #LiverSky #MedSky @chamogui.bsky.social @ihpba.bsky.social @eahpba.bsky.social

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Julie Hallet, MD MSc @halletjulie.bsky.social · 16/12/2024

My🔝10📝of2⃣0⃣2⃣4⃣(cont'd) CAMINO trial 👣🥾 @TheLancetOncol RCT of MRI gadoxetic acid for CRLM vs not Change in management 1⃣in 3⃣ pts with MRI Gadoxetic acid MRI should be standard of care - any barriers to this? 💭 tinyurl.com/mr8phxsy #SurgSky #HPBSky #MedSky @marcbesselink.bsky.social

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Julie Hallet, MD MSc @halletjulie.bsky.social · 15/12/2024

My🔝10📝of2⃣0⃣2⃣4⃣(cont'd) Guidance on biomarkers🧬 for #NETs🦓 @JAMAOnc by @nanets.bsky. ▪️Few are treatment-informing ▫️Most need further research, including NGS, TMB, NETPET score Which markers do #NETologists currently use?🤔 jamanetwork.com/journals/jam... #OncSky #MedSky #NETSKy #SurgSky #PBsky

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Julie Hallet, MD MSc @halletjulie.bsky.social · 14/12/2024

My 🔝 10 📝 of 2⃣0⃣2⃣4⃣ (cont'd) Cytoreduction for liver & peritoneal SB-NETs mets OS, PFS and symptom-free survival ↔️ liver only ⬆️ outcomes with ⬆️ % cytoreduction Which patients to select for this approach? 🧐 tinyurl.com/ywja97mz #SurgSky #MedSky #NETSky @nanets.bsky.social @oncothor.bsky.social

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Julie Hallet, MD MSc @halletjulie.bsky.social · 13/12/2024

📢Attention HPB friends and liver lovers! Yes, the liver emoji has finally arrived (thanks apple intelligence) 🎉🥳 Now, the real challenge: figuring out how to share it & not be a sticker outside of iMessage - any help welcome! 🤔 #MedSky #SurgSky #LiverSky #HPBSky

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Julie Hallet, MD MSc @halletjulie.bsky.social · 13/12/2024

My🔝10📝of2⃣0⃣2⃣4⃣(cont'd) Treatment of pancreas #NETs👉https://tinyurl.com/43mny6mr in @bjsopen.bsky.social 1⃣ of 3⃣ PNETs potentially over-treated ⚠️25% overtreated have unnecessary morbidity! We can harm patients - careful with surgery indications😬 #SurgSky #HPBSky #NETSky

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Julie Hallet, MD MSc @halletjulie.bsky.social · 13/12/2024

End of year content continues!🎊 2⃣0⃣2⃣4⃣ HPB Wrapped by SSO with Cecilia Ethun & Sajid Khan Top 10 studies🌟 - in this episode 🔟AMPLIFY 9⃣Adjuvant therapy for IPMN-PDAC 8⃣HELIX 7⃣CAMINO 6⃣PANDAS Which one had the most impact #HPBSky? 🎧 tinyurl.com/5c5yj5ye #SurgSky #MedSky #OncSky

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Julie Hallet, MD MSc @halletjulie.bsky.social · 12/12/2024

How good is social media to disseminate info about #NETs? Review of 168 TikTok & BiliBili 🎥 on PNETs ⬆️⬆️⬆️x 2020 Low educational value👉 no change over time Should it 📺 be used for information & education? What is medical community role?🤔 formative.jmir.org/2024/1/e60033 #NETSky #SurgSky #MedSky

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Julie Hallet, MD MSc @halletjulie.bsky.social · 12/12/2024

✨The end of 2⃣0⃣2⃣4⃣ nears; over the next days, 🔝10 papers that have changed my practice & shaped research Start with anatomy review of SMA 👉https://tinyurl.com/mr3kdkxz Branch 1 & 2 perfuse mean 195cm small intestine ➡️Many proximal #NETs mesenteric masses can be resected #SurgSky #NETSky #HPBSky

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Julie Hallet, MD MSc @halletjulie.bsky.social · 11/12/2024

🔑 concepts in #NETs surgery Mesenteric nodal disease classification👉🏻4 levels 4⃣ - unresectable 1⃣2⃣3⃣ - need tailored mesentery resection to spare bowel ✅Resectable if can salvage >=2 proximal SMA branches 📝 tinyurl.com/2w952fjv #NETSky #HPBSky #SurgSky #OncSky

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Julie Hallet, MD MSc @halletjulie.bsky.social · 08/12/2024

It’s a wrap on the 10th CommNETs workshop 🦓🏝️ So much energy and momentum to advance research and care for #NETs 🇦🇺🇳🇿🇨🇦 Going home to get working! #OncSky #MedSky #NETSky

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Julie Hallet, MD MSc @halletjulie.bsky.social · 07/12/2024

The state of #NETs organoids as seen by their creator @iacovosmichael.bsky.social They work! Now: spare them or kill them with 💊? Who will win? 🤺 #NETsSky #MedSky #OncSky

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