المؤلفون: Maud T. A. Strous, Ragna L. A. van der Linden, Audrey L. H. M. Gubbels, Timothy K. E. Faes, Koop Bosscha, Carolien M. Bronkhorst, Maryska L. G. Janssen-Heijnen, Adriaan P. de Bruïne, F. Jeroen Vogelaar

المصدر: Molecular Medicine, Vol 29, Iss 1, Pp 1-10 (2023)

مصطلحات موضوعية: Colon cancer, Node negative, Tumour-stroma ratio, TSR, MSI, BRAF, Therapeutics. Pharmacology, RM1-950, Biochemistry, QD415-436

الوصف: Abstract Background Within the group of node-negative colon cancer patients, presumed to have a good prognosis, a significant percentage of patients develops cancer-recurrence. Current high-risk features prove inadequate to select these particular high-risk patients. In the process of tailor-made care and shared decision-making the need to identify these patients grows. In this study we investigate the value of adding molecular markers and the tumour-stroma ratio (TSR) to conventional histological tumour staging methods to improve the selection of high risk patients. Methods We retrospectively analysed 201 patients diagnosed with TNM-stage I-II colon cancer and treated by complete oncological resection between November 1st 2002 and December 31st 2012 at the Jeroen Bosch Hospital. Conventional histological tumour staging, BRAF mutations, KRAS mutations, MSI status and TSR were determined. Differences between groups based on TSR and mutation status, in disease free survival were analysed using Cox-Regression analyses. Results Poorly differentiated histology (p = 0.002), high-TSR (p = 0.033), BRAF-mutation (p = 0.008) and MSI (p = 0.011) were identified as significant risk factors for cancer recurrence. The risk of recurrence increased in the presence of both a BRAF-mutation and high-TSR compared to the absence of both factors or presence of only one factor (HR = 3.66 BRAF-mt/TSR-low (p = 0.006), HR 2.82 BRAF-wt/TSR-high (p = 0.015), HR = 4.39 BRAF-mt/TSR-high (p = 0.023)). This was also seen in tumours with MSI and high-TSR (HR = 2.46 MSS/TSR-high (p = 0.041), HR = 3.31 MSI/TSR-high (p = 0.045). Conclusion Judging by the higher HR for the combination of the prognostic factors TSR and BRAF compared to the HRs of these prognostic factors individually, the prognostication for disease free survival can be improved by determining both TSR and BRAF instead of BRAF alone, as is done in current daily practise. In this study MSI also shows additional value to TSR in the prognostication of disease free survival. Adopting TSR into daily diagnostics will be of additional value next to currently used molecular markers in risk stratification of patients with node negative colon cancer and is therefore advised.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1528-3658Test

الوصول الحر: https://doaj.org/article/dc351e63cafa456ca98c82a4c3d37b81Test

المؤلفون: Marieke Walma, Laura Maggino, F. Jasmijn Smits, Alicia S. Borggreve, Lois A. Daamen, Vincent P. Groot, Fabio Casciani, Vincent E. de Meijer, Frank J. Wessels, George P. van der Schelling, Vincent B. Nieuwenhuijs, Koop Bosscha, Erwin van der Harst, Ronald van Dam, Mike S. Liem, Sebastiaan Festen, Martijn W. J. Stommel, Daphne Roos, Fennie Wit, Ignace H. de Hingh, Bert A. Bonsing, Olivier R. Busch, Bas Groot Koerkamp, Geert Kazemier, Marc G. Besselink, Roberto Salvia, Giuseppe Malleo, I. Quintus Molenaar, Hjalmar C. van Santvoort

المصدر: Journal of Clinical Medicine, Vol 13, Iss 6, p 1679 (2024)

مصطلحات موضوعية: pancreatic cancer, occult metastases, prediction model, Medicine

الوصف: Occult metastases are detected in 10–15% of patients during exploratory laparotomy for pancreatic cancer. This study developed and externally validated a model to predict occult metastases in patients with potentially resectable pancreatic cancer. Model development was performed within the Dutch Pancreatic Cancer Audit, including all patients operated for pancreatic cancer (January 2013–December 2017). Multivariable logistic regression analysis based on the Akaike Information Criteria was performed with intraoperative pathologically proven metastases as the outcome. The model was externally validated with a cohort from the University Hospital of Verona (January 2013–December 2017). For model development, 2262 patients were included of whom 235 (10%) had occult metastases, located in the liver (n = 143, 61%), peritoneum (n = 73, 31%), or both (n = 19, 8%). The model included age (OR 1.02, 95% CI 1.00–1.03), BMI (OR 0.96, 95% CI 0.93–0.99), preoperative nutritional support (OR 1.73, 95% CI 1.01–2.74), tumor diameter (OR 1.60, 95% CI 1.04–2.45), tumor composition (solid vs. cystic) (OR 2.33, 95% CI 1.20–4.35), and indeterminate lesions on preoperative imaging (OR 4.01, 95% CI 2.16–7.43). External validation showed poor discrimination with a C-statistic of 0.56. Although some predictor variables were significantly associated with occult metastases, the model performed insufficiently at external validation.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/2077-0383/13/6/1679Test; https://doaj.org/toc/2077-0383Test

الوصول الحر: https://doaj.org/article/09bd235be44f4ef785712079fb333204Test

المؤلفون: Anouk S. Schuit, Karen Holtmaat, Veerle M. H. Coupé, Simone E. J. Eerenstein, Josée M. Zijlstra, Corien Eeltink, Annemarie Becker-Commissaris, Lia van Zuylen, Myra E. van Linde, C. Willemien Menke-van der Houven van Oordt, Dirkje W. Sommeijer, Nol Verbeek, Koop Bosscha, Rishi Nandoe Tewarie, Robert-Jan Sedee, Remco de Bree, Alexander de Graeff, Filip de Vos, Pim Cuijpers, Irma M. Verdonck-de Leeuw, Femke Jansen

المصدر: Current Oncology, Vol 29, Iss 9, Pp 6186-6202 (2022)

مصطلحات موضوعية: palliative care, eHealth, cost-utility analysis, cost evaluation, incurable cancer, quality of life, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282

الوصف: Evidence on the cost-effectiveness of eHealth in palliative care is scarce. Oncokompas, a fully automated behavioral intervention technology, aims to support self-management in cancer patients. This study aimed to assess the cost-utility of the eHealth application Oncokompas among incurably ill cancer patients, compared to care as usual. In this randomized controlled trial, patients were randomized into the intervention group (access to Oncokompas) or the waiting-list control group (access after three months). Healthcare costs, productivity losses, and health status were measured at baseline and three months. Intervention costs were also taken into account. Non-parametric bootstrapping with 5000 replications was used to obtain 95% confidence intervals around the incremental costs and quality-adjusted life years (QALYs). A probabilistic approach was used because of the skewness of cost data. Altogether, 138 patients completed the baseline questionnaire and were randomly assigned to the intervention group (69) or the control group (69). In the base case analysis, mean total costs and mean total effects were non-significantly lower in the intervention group (−€806 and −0.01 QALYs). The probability that the intervention was more effective and less costly was 4%, whereas the probability of being less effective and less costly was 74%. Among patients with incurable cancer, Oncokompas does not impact incremental costs and seems slightly less effective in terms of QALYs, compared to care as usual. Future research on the costs of eHealth in palliative cancer care is warranted to assess the generalizability of the findings of this study.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/1718-7729/29/9/486Test; https://doaj.org/toc/1198-0052Test; https://doaj.org/toc/1718-7729Test

الوصول الحر: https://doaj.org/article/3a47e0cbe6194f9ca1f1a13d7602a847Test

المؤلفون: Martijn P. D. Haring, Arthur K. E. Elfrink, Christiaan A. J. Oudmaijer, Paul C. M. Andel, Alicia Furumaya, Nenke de Jong, Colin J. J. M. Willems, Thijs Huits, Julie M. L. Sijmons, Eric J. T. Belt, Koop Bosscha, Esther C. J. Consten, Mariëlle M. E. Coolsen, Peter van Duijvendijk, Joris I. Erdmann, Paul Gobardhan, Robbert J. de Haas, Tjarda van Heek, Hwai‐Ding Lam, Wouter K. G. Leclercq, Mike S. L. Liem, Hendrik A. Marsman, Gijs A. Patijn, Türkan Terkivatan, Babs M. Zonderhuis, Izaak Quintus Molenaar, Wouter W. te Riele, Jeroen Hagendoorn, Alexander F. M. Schaapherder, Jan N. M. IJzermans, Carlijn I. Buis, Joost M. Klaase, Koert P. de Jong, Vincent E. de Meijer

المصدر: Hepatology Communications, Vol 7, Iss 1, Pp e2110-e2110 (2023)

مصطلحات موضوعية: Diseases of the digestive system. Gastroenterology, RC799-869

الوصف: Hepatocellular adenomas (HCAs) are benign liver tumors associated with bleeding or malignant transformation. Data on the indication for surgery are scarce. We analyzed indications and outcome of patients operated for HCAs 50 mm (52%), suspicion of (pre)malignancy (28%), and (previous) bleeding (5.1%). No difference was observed in HCA‐subtype distribution between small and large tumors. Ninety‐six (43%) patients had a postoperative change in diagnosis. Independent risk factors for change in diagnosis were tumor size

وصف الملف: electronic resource

العلاقة: http://journals.lww.com/10.1002/hep4.2110Test; https://doaj.org/toc/2471-254XTest

الوصول الحر: https://doaj.org/article/5bc6211f44f94829bfd770f0d4b780d4Test

المؤلفون: Anouk S. Schuit, Karen Holtmaat, Birgit I. Lissenberg-Witte, Simone E.J. Eerenstein, Josée M. Zijlstra, Corien Eeltink, Annemarie Becker-Commissaris, Lia van Zuylen, Myra E. van Linde, C. Willemien Menke-van der Houven van Oordt, Dirkje W. Sommeijer, Nol Verbeek, Koop Bosscha, Rishi Nandoe Tewarie, Robert-Jan Sedee, Remco de Bree, Alexander de Graeff, Filip de Vos, Pim Cuijpers, Irma M. Verdonck-de Leeuw

المصدر: The Lancet Regional Health. Europe, Vol 18, Iss , Pp 100390- (2022)

مصطلحات موضوعية: eHealth, Palliative care, Supportive care, Incurable cancer, Psychosocial oncology, Public aspects of medicine, RA1-1270

الوصف: Summary: Background: Many patients with incurable cancer have symptoms affecting their health-related quality of life. The eHealth application ‘Oncokompas’ supports patients to take an active role in managing their palliative care needs, to reduce symptoms and improve health-related quality of life (HRQOL). This randomized controlled trial was conducted to determine the efficacy of Oncokompas compared to care as usual among incurably ill cancer patients with a life expectancy of more than three months. Methods: Patients were recruited in six hospitals in the Netherlands. Eligible patients were randomly assigned to the intervention (direct access to Oncokompas) or the control group (access to Oncokompas after three months). The primary outcome measure was patient activation (i.e., patients’ knowledge, skills and confidence for self-management). Secondary outcomes were general self-efficacy and HRQOL. Measures were assessed at baseline, two weeks after randomization, and three months after the baseline measurement. Linear mixed models were used to compare longitudinal changes between both groups from baseline to the three-month follow-up. Findings: In total, 219 patients were eligible of which 138 patients completed the baseline questionnaire (response rate 63%), and were randomized to the intervention (69) or control group (69). There were no significant differences between the intervention and control group over time in patient activation (estimated difference in change T0-T2; 1·8 (90% CI: -1·0 to 4·7)), neither in general self-efficacy and HRQOL. Of the patients in the intervention group who activated their account, 74% used Oncokompas as intended. The course of patient activation, general self-efficacy, and HRQOL was not significantly different between patients who used Oncokompas as intended versus those who did not. Interpretation: Among incurably ill cancer patients with a life expectancy of more than three months and recruited in the hospital setting, Oncokompas did not significantly improve patient activation, self-efficacy, or HRQOL. Funding: ZonMw, Netherlands Organization for Health Research and Development (844001105).

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S2666776222000837Test; https://doaj.org/toc/2666-7762Test

الوصول الحر: https://doaj.org/article/b6ec120edb344bab9bf1cdde7c9ebeb7Test

المؤلفون: Floris M. Thunnissen, Bernhard W. Schreurs, Carmen S. S. Latenstein, Marjan J. Meinders, Eddy M. Adang, Glyn Elwyn, Doeke Boersma, Bas Bosmans, Koop Bosscha, Bastiaan L. Ginsel, Eric J. Hazebroek, Jeroen J. Nieuwenhuis, Maarten Staarink, Dries Verhallen, Marc L. Wagener, Femke Atsma, Philip R. de Reuver

المصدر: BMC Medical Informatics and Decision Making, Vol 21, Iss 1, Pp 1-10 (2021)

مصطلحات موضوعية: Shared decision-making, Decision aids, Cholecystolithiasis, Inguinal hernia, Knee osteoarthritis, Hip osteoarthritis, Computer applications to medicine. Medical informatics, R858-859.7

الوصف: Abstract Background Inguinal hernia repair, gallbladder removal, and knee- and hip replacements are the most commonly performed surgical procedures, but all are subject to practice variation and variable patient-reported outcomes. Shared decision-making (SDM) has the potential to reduce surgery rates and increase patient satisfaction. This study aims to evaluate the effectiveness of an SDM strategy with online decision aids for surgical and orthopaedic practice in terms of impact on surgery rates, patient-reported outcomes, and cost-effectiveness. Methods The E-valuAID-study is designed as a multicentre, non-randomized stepped-wedge study in patients with an inguinal hernia, gallstones, knee or hip osteoarthritis in six surgical and six orthopaedic departments. The primary outcome is the surgery rate before and after implementation of the SDM strategy. Secondary outcomes are patient-reported outcomes and cost-effectiveness. Patients in the usual care cluster prior to implementation of the SDM strategy will be treated in accordance with the best available clinical evidence, physician’s knowledge and preference and the patient’s preference. The intervention consists of the implementation of the SDM strategy and provision of disease-specific online decision aids. Decision aids will be provided to the patients before the consultation in which treatment decision is made. During this consultation, treatment preferences are discussed, and the final treatment decision is confirmed. Surgery rates will be extracted from hospital files. Secondary outcomes will be evaluated using questionnaires, at baseline, 3 and 6 months. Discussion The E-valuAID-study will examine the cost-effectiveness of an SDM strategy with online decision aids in patients with an inguinal hernia, gallstones, knee or hip osteoarthritis. This study will show whether decision aids reduce operation rates while improving patient-reported outcomes. We hypothesize that the SDM strategy will lead to lower surgery rates, better patient-reported outcomes, and be cost-effective. Trial registration: The Netherlands Trial Register, Trial NL8318, registered 22 January 2020. URL: https://www.trialregister.nl/trial/8318Test .

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1472-6947Test

الوصول الحر: https://doaj.org/article/e1874e5b78d54e11b8a810d02dc273f2Test

المؤلفون: Hein Putter, Koos Burggraaf, Alexander L Vahrmeijer, J Sven D Mieog, Alexander L. Vahrmeijer, Ruben P J Meijer, Robin A Faber, Okker D Bijlstra, Jeffrey P B M Braak, Elma Meershoek-Klein Kranenbarg, Denise E Hilling, Ruben P.J. Meijer, Robin A. Faber, Okker D. Bijlstra, Jeffrey P.B.M. Braak, E. Meershoek-Klein Kranenbarg, J Hein Putter, Sven D. Mieog, E Denise, Hilling Tjeerd S. Aukema, I.M Coen, Johanne G. Bloemen, Annelies Bodegom, Fran Boersma, Koop Bosscha, Mark A.M. Brouwers, Esther C.J. Consten, Pascal G. Doornebosch, Dashti Faraj, Paul D. Gobardhan, Fabian .A. Holman, Tessa Kauwenbergh, Andreas W.K.S. Marinelli, Peter A. Neijenhuis, Koen C.M.J. Peeters, Daan J. Sikkenk, Laurents P.S. Stassen, Willem-Hans Steup, Maxime J.M. van der Valk, Bob J. van Wely, Lissa Wullaert

المصدر: BMJ Open, Vol 12, Iss 4 (2022)

مصطلحات موضوعية: Medicine

وصف الملف: electronic resource

العلاقة: https://bmjopen.bmj.com/content/12/4/e051144.fullTest; https://doaj.org/toc/2044-6055Test

الوصول الحر: https://doaj.org/article/14edae49e0734a728c1124af7464c499Test

المؤلفون: F. Jasmijn Smits, Anne Claire Henry, Casper H. van Eijck, Marc G. Besselink, Olivier R. Busch, Mark Arntz, Thomas L. Bollen, Otto M. van Delden, Daniel van den Heuvel, Christiaan van der Leij, Krijn P. van Lienden, Adriaan Moelker, Bert A. Bonsing, Inne H. M. Borel Rinkes, Koop Bosscha, R. M. van Dam, Sebastiaan Festen, B. Groot Koerkamp, Erwin van der Harst, Ignace H. de Hingh, Geert Kazemier, Mike Liem, B. Marion van der Kolk, Vincent E. de Meijer, Gijs A. Patijn, Daphne Roos, Jennifer M. Schreinemakers, Fennie Wit, C. Henri van Werkhoven, I. Quintus Molenaar, Hjalmar C. van Santvoort, for the Dutch Pancreatic Cancer Group

المصدر: Trials, Vol 21, Iss 1, Pp 1-16 (2020)

مصطلحات موضوعية: Medicine (General), R5-920

الوصف: Abstract Background Pancreatic resection is a major abdominal operation with 50% risk of postoperative complications. A common complication is pancreatic fistula, which may have severe clinical consequences such as postoperative bleeding, organ failure and death. The objective of this study is to investigate whether implementation of an algorithm for early detection and minimally invasive management of pancreatic fistula may improve outcomes after pancreatic resection. Methods This is a nationwide stepped-wedge, cluster-randomized, superiority trial, designed in adherence to the Consolidated Standards of Reporting Trials (CONSORT) guidelines. During a period of 22 months, all Dutch centers performing pancreatic surgery will cross over in a randomized order from current practice to best practice according to the algorithm. This evidence-based and consensus-based algorithm will provide daily multilevel advice on the management of patients after pancreatic resection (i.e. indication for abdominal imaging, antibiotic treatment, percutaneous drainage and removal of abdominal drains). The algorithm is designed to aid early detection and minimally invasive step-up management of postoperative pancreatic fistula. Outcomes of current practice will be compared with outcomes after implementation of the algorithm. The primary outcome is a composite of major complications (i.e. post-pancreatectomy bleeding, new-onset organ failure and death) and will be measured in a sample size of at least 1600 patients undergoing pancreatic resection. Secondary endpoints include the individual components of the primary endpoint and other clinical outcomes, healthcare resource utilization and costs analysis. Follow up will be up to 90 days after pancreatic resection. Discussion It is hypothesized that a structured nationwide implementation of a dedicated algorithm for early detection and minimally invasive step-up management of postoperative pancreatic fistula will reduce the risk of major complications and death after pancreatic resection, as compared to current practice. Trial registration Netherlands Trial Register: NL 6671 . Registered on 16 December 2017.

وصف الملف: electronic resource

العلاقة: http://link.springer.com/article/10.1186/s13063-020-4167-9Test; https://doaj.org/toc/1745-6215Test

الوصول الحر: https://doaj.org/article/2c3622f1841e47eeb63fad385131042dTest

المؤلفون: Thijs de Rooij, Jony van Hilst, Koop Bosscha, Marcel G. Dijkgraaf, Michael F. Gerhards, Bas Groot Koerkamp, Jeroen Hagendoorn, Ignace H. de Hingh, Tom M. Karsten, Daan J. Lips, Misha D. Luyer, I. Quintus Molenaar, Hjalmar C. van Santvoort, T. C. Khé Tran, Olivier R. Busch, Sebastiaan Festen, Marc G. Besselink, for the Dutch Pancreatic Cancer Group

المصدر: Trials, Vol 19, Iss 1, Pp 1-10 (2018)

مصطلحات موضوعية: Minimally invasive, Laparoscopic, Pancreatoduodenectomy, Whipple, Robot-assisted, Medicine (General), R5-920

الوصف: Abstract Background Data from observational studies suggest that minimally invasive pancreatoduodenectomy (MIPD) is superior to open pancreatoduodenectomy regarding intraoperative blood loss, postoperative morbidity, and length of hospital stay, without increasing total costs. However, several case-matched studies failed to demonstrate superiority of MIPD, and large registry studies from the USA even suggested increased mortality for MIPDs performed in low-volume (

وصف الملف: electronic resource

العلاقة: http://link.springer.com/article/10.1186/s13063-017-2423-4Test; https://doaj.org/toc/1745-6215Test

الوصول الحر: https://doaj.org/article/fd58c7e85c7842c7ac3476cd947a786cTest

المؤلفون: Fleur van der Sijde, Marjolein Y. V. Homs, Marlies L. van Bekkum, Thierry P. P. van den Bosch, Koop Bosscha, Marc G. Besselink, Bert A. Bonsing, Jan Willem B. de Groot, Thomas M. Karsten, Bas Groot Koerkamp, Brigitte C. M. Haberkorn, Saskia A. C. Luelmo, Leonie J. M. Mekenkamp, Dana A. M. Mustafa, Johanna W. Wilmink, Casper H. J. van Eijck, Eveline E. Vietsch, on behalf of the Dutch Pancreatic Cancer Group

المصدر: International Journal of Molecular Sciences, Vol 22, Iss 20, p 10902 (2021)

مصطلحات موضوعية: pancreatic cancer, FOLFIRINOX, predictive biomarker, miR-373, miR-194, Biology (General), QH301-705.5, Chemistry, QD1-999

الوصف: In this study, we explored the predictive value of serum microRNA (miRNA) expression for early tumor progression during FOLFIRINOX chemotherapy and its association with overall survival (OS) in patients with pancreatic ductal adenocarcinoma (PDAC). A total of 132 PDAC patients of all disease stages were included in this study, of whom 25% showed progressive disease during FOLFIRINOX according to the RECIST criteria. MiRNA expression was analyzed in serum collected before the start and after one cycle of chemotherapy. In the discovery cohort (n = 12), a 352-miRNA RT-qPCR panel was used. In the validation cohorts (total n = 120), miRNA expression was detected using individual RT-qPCR miRNA primers. Before the start of FOLFIRINOX, serum miR-373-3p expression was higher in patients with progressive disease compared to patients with disease control after FOLFIRINOX (Log2 fold difference (FD) 0.88, p = 0.006). MiR-194-5p expression after one cycle of FOLFIRINOX was lower in patients with progressive disease (Log2 FD −0.29, p = 0.044). Both miRNAs were predictors of early tumor progression in a multivariable model including disease stage and baseline CA19-9 level (miR-373-3p odds ratio (OR) 3.99, 95% CI 1.10–14.49; miR-194-5p OR 0.91, 95% CI 0.83–0.99). MiR-373-3p and miR-194-5p did not show an association with OS after adjustment for disease stage, baseline CA19-9, and chemotherapy response. In conclusion, high serum miR-373-3p before the start and low serum miR-194-5p after one cycle are associated with early tumor progression during FOLFIRINOX.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/1422-0067/22/20/10902Test; https://doaj.org/toc/1661-6596Test; https://doaj.org/toc/1422-0067Test

الوصول الحر: https://doaj.org/article/ea7f7eb76eff430cb27d55f8e5ca125aTest