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Stoop TF, Theijse RT, Seelen LWF, Groot Koerkamp B, van Eijck CHJ, Wolfgang CL, van Tienhoven G, van Santvoort HC, Molenaar IQ, Wilmink JW, Del Chiaro M, Katz MHG, Hackert T, Besselink MG. Preoperative chemotherapy, radiotherapy and surgical decision-making in patients with borderline resectable and locally advanced pancreatic cancer. Nat Rev Gastroenterol Hepatol 2024; 21:101-124. [PMID: 38036745 DOI: 10.1038/s41575-023-00856-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/05/2023] [Indexed: 12/02/2023]
Abstract
Surgical resection combined with systemic chemotherapy is the cornerstone of treatment for patients with localized pancreatic cancer. Upfront surgery is considered suboptimal in cases with extensive vascular involvement, which can be classified as either borderline resectable pancreatic cancer or locally advanced pancreatic cancer. In these patients, FOLFIRINOX or gemcitabine plus nab-paclitaxel chemotherapy is currently used as preoperative chemotherapy and is eventually combined with radiotherapy. Thus, more patients might reach 5-year overall survival. Patient selection for chemotherapy, radiotherapy and subsequent surgery is based on anatomical, biological and conditional parameters. Current guidelines and clinical practices vary considerably regarding preoperative chemotherapy and radiotherapy, response evaluation, and indications for surgery. In this Review, we provide an overview of the clinical evidence regarding disease staging, preoperative therapy, response evaluation and surgery in patients with borderline resectable pancreatic cancer or locally advanced pancreatic cancer. In addition, a clinical work-up is proposed based on the available evidence and guidelines. We identify knowledge gaps and outline a proposed research agenda.
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Affiliation(s)
- Thomas F Stoop
- Amsterdam UMC, location University of Amsterdam, Department of Surgery, Amsterdam, Netherlands
- Cancer Center Amsterdam, Amsterdam, Netherlands
- Division of Surgical Oncology, Department of Surgery, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - Rutger T Theijse
- Amsterdam UMC, location University of Amsterdam, Department of Surgery, Amsterdam, Netherlands
- Cancer Center Amsterdam, Amsterdam, Netherlands
| | - Leonard W F Seelen
- Department of Surgery, Regional Academic Cancer Center Utrecht, University Medical Center Utrecht and St. Antonius Hospital Nieuwegein, Utrecht, Netherlands
| | - Bas Groot Koerkamp
- Department of Surgery, Erasmus MC Cancer Institute, Erasmus Medical Center, Rotterdam, Netherlands
| | - Casper H J van Eijck
- Department of Surgery, Erasmus MC Cancer Institute, Erasmus Medical Center, Rotterdam, Netherlands
| | - Christopher L Wolfgang
- Division of Surgical Oncology, Department of Surgery, New York University Medical Center, New York City, NY, USA
| | - Geertjan van Tienhoven
- Cancer Center Amsterdam, Amsterdam, Netherlands
- Amsterdam UMC, location University of Amsterdam, Department of Radiation Oncology, Amsterdam, Netherlands
| | - Hjalmar C van Santvoort
- Department of Surgery, Regional Academic Cancer Center Utrecht, University Medical Center Utrecht and St. Antonius Hospital Nieuwegein, Utrecht, Netherlands
| | - I Quintus Molenaar
- Department of Surgery, Regional Academic Cancer Center Utrecht, University Medical Center Utrecht and St. Antonius Hospital Nieuwegein, Utrecht, Netherlands
| | - Johanna W Wilmink
- Cancer Center Amsterdam, Amsterdam, Netherlands
- Amsterdam UMC, location University of Amsterdam, Department of Medical Oncology, Amsterdam, Netherlands
| | - Marco Del Chiaro
- Division of Surgical Oncology, Department of Surgery, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - Matthew H G Katz
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Thilo Hackert
- Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
- Department of General, Visceral and Thoracic Surgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Marc G Besselink
- Amsterdam UMC, location University of Amsterdam, Department of Surgery, Amsterdam, Netherlands.
- Cancer Center Amsterdam, Amsterdam, Netherlands.
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3
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Donisi G, Nappo G, Pacilli M, Capretti GL, Spaggiari P, Sollai M, Bozzarelli S, Zerbi A. Pathologic tumor response to neoadjuvant therapy in resected pancreatic cancer: does it affect prognosis? Updates Surg 2023; 75:1497-1508. [PMID: 37578734 DOI: 10.1007/s13304-023-01628-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 08/04/2023] [Indexed: 08/15/2023]
Abstract
Neoadjuvant therapy (NAT) + surgical resection for pancreatic cancer (PC) has gained consensus in recent years. Pathological response (PR) is generally assessed according to the College of American Pathologists grading system, ranging from 0 (complete response) to 3 (no response). The aim of our study is to evaluate the PR in a series of resections for PC after NAT and its prognostic implication. 112 patients undergone NAT and resection for PC between 2011 and 2020 were retrospectively evaluated. PR was 0/1, 2 and 3 in 18 (15%), 79 (61%) and 29 (24%) cases, respectively. Chemotherapy regimens different from FOLFIRINOX and gemcitabine + nab-paclitaxel (OR 11.61 (2.53-53.36), p = 0.002) and lymphovascular invasion (OR 11.28 (1.89-67.23), p = 0.008) were associated to PR-3. Median follow-up was 25.8 (3.6-130.5) months. For PR-0/1, PR-2 and PR-3, median DFS was 45.8, 11.5, 4.6 months (p < 0.0001), respectively, while median OS was not reached, 27.1 and 17.5 months (p = 0.0006), respectively. At univariate analysis, PR-0/1 was significantly associated to better DFS and OS (HR 0.33 (0.17-0.67), p = 0.002; HR 0.20 (0.07-0.54), p = 0.002, respectively). At multivariate analysis, pancreaticoduodenectomy (HR 0.50 (0.30-0.84), p = 0.009), LNR (HR 27.14 (1.21-608.9), p = 0.038) and lymphovascular invasion (HR 1.99 (1.06-3.76), p = 0.033) were independently associated to DFS; pre-treatment CA 19.9 value (HR 1.00 (1.00-1.00), p = 0.025), post-treatment resectability status (HR 0.51 (0.28-0.95), p = 0.035), pancreaticoduodenectomy (HR 0.56 (0.32-0.99), p = 0.050), severe morbidity (2.99 (1.22-7.55), p = 0.017), LNR (HR 56.8 (2.08-1548.3), p = 0.017), lymphovascular invasion (HR 2.18 (1.08-4.37), p = 0.029) were independently associated to OS. PR did not reach statistical significance at multivariate analysis. A favorable PR is observed only in a limited number of cases. The prognostic role of PR, despite being promising, remains unclear and further multicentric studies are needed.
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Affiliation(s)
- G Donisi
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Milan, Pieve Emanuele, Italy
- Pancreatic Surgery Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - G Nappo
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Milan, Pieve Emanuele, Italy.
- Pancreatic Surgery Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Milan, Rozzano, Italy.
| | - M Pacilli
- Pancreatic Surgery Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - G L Capretti
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Milan, Pieve Emanuele, Italy
- Pancreatic Surgery Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - P Spaggiari
- Department of Pathology, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - M Sollai
- Department of Pathology, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - S Bozzarelli
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - A Zerbi
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Milan, Pieve Emanuele, Italy
- Pancreatic Surgery Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Milan, Rozzano, Italy
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4
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Wang H, Zhou X, Li C, Yan S, Feng C, He J, Li Z, Tu C. The emerging role of pyroptosis in pediatric cancers: from mechanism to therapy. J Hematol Oncol 2022; 15:140. [PMID: 36209102 PMCID: PMC9547461 DOI: 10.1186/s13045-022-01365-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 10/04/2022] [Indexed: 11/18/2022] Open
Abstract
Pediatric cancers are the driving cause of death for children and adolescents. Due to safety requirements and considerations, treatment strategies and drugs for pediatric cancers have been so far scarcely studied. It is well known that tumor cells tend to progressively evade cell death pathways, which is known as apoptosis resistance, one of the hallmarks of cancer, dominating tumor drug resistance. Recently, treatments targeting nonapoptotic cell death have drawn great attention. Pyroptosis, a newly specialized form of cell death, acts as a critical physiological regulator in inflammatory reaction, cell development, tissue homeostasis and stress response. The action in different forms of pyroptosis is of great significance in the therapy of pediatric cancers. Pyroptosis could be induced and consequently modulate tumorigenesis, progression, and metastasis if treated with local or systemic therapies. However, excessive or uncontrolled cell death might lead to tissue damage, acute inflammation, or even cytokine release syndrome, which facilitates tumor progression or recurrence. Herein, we aimed to describe the molecular mechanisms of pyroptosis, to highlight and discuss the challenges and opportunities for activating pyroptosis pathways through various oncologic therapies in multiple pediatric neoplasms, including osteosarcoma, neuroblastoma, leukemia, lymphoma, and brain tumors.
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Affiliation(s)
- Hua Wang
- Department of Orthopaedics, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.,Xiangya School of Medicine, Central South University, Changsha, 410011, Hunan, China
| | - Xiaowen Zhou
- Department of Orthopaedics, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.,Xiangya School of Medicine, Central South University, Changsha, 410011, Hunan, China
| | - Chenbei Li
- Department of Orthopaedics, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.,Hunan Key Laboratory of Tumor Models and Individualized Medicine, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Shuxiang Yan
- Xiangya School of Medicine, Central South University, Changsha, 410011, Hunan, China
| | - Chengyao Feng
- Department of Orthopaedics, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.,Hunan Key Laboratory of Tumor Models and Individualized Medicine, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Jieyu He
- Department of Geriatrics, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Zhihong Li
- Department of Orthopaedics, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China. .,Hunan Key Laboratory of Tumor Models and Individualized Medicine, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
| | - Chao Tu
- Department of Orthopaedics, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China. .,Hunan Key Laboratory of Tumor Models and Individualized Medicine, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
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5
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Versteijne E, van Dam JL, Besselink MG, Groot Koerkamp B, Homs MYV, Wilmink JW, van Eijck CH, van Tienhoven G. Reply to W. Attaallah, A. Jain et al, and P. Mroczkowski et al. J Clin Oncol 2022; 40:3348-3351. [PMID: 35737926 DOI: 10.1200/jco.22.00875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Eva Versteijne
- Eva Versteijne, MD, PhD, Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Radiation Oncology, Amsterdam, the Netherlands, Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands; Jacob L. van Dam, MD, Erasmus MC Cancer Institute, Department of Surgery, Rotterdam, the Netherlands; Marc G. Besselink, MD, PhD, Amsterdam UMC Location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands, Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands; Bas Groot Koerkamp, MD, PhD, Erasmus MC Cancer Institute, Department of Surgery, Rotterdam, the Netherlands; Marjolein Y.V. Homs, MD, PhD, Erasmus MC Cancer Institute, Department of Medical Oncology, Rotterdam, the Netherlands; Johanna W. Wilmink, MD, PhD, Amsterdam UMC Location University of Amsterdam, Department of Medical Oncology, Amsterdam, the Netherlands, Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands; Casper H. van Eijck, MD, PhD, Erasmus MC Cancer Institute, Department of Surgery, Rotterdam, the Netherlands; and Geertjan van Tienhoven, MD, PhD, Amsterdam UMC Location University of Amsterdam, Department of Radiation Oncology, Amsterdam, the Netherlands, Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands
| | - Jacob L van Dam
- Eva Versteijne, MD, PhD, Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Radiation Oncology, Amsterdam, the Netherlands, Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands; Jacob L. van Dam, MD, Erasmus MC Cancer Institute, Department of Surgery, Rotterdam, the Netherlands; Marc G. Besselink, MD, PhD, Amsterdam UMC Location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands, Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands; Bas Groot Koerkamp, MD, PhD, Erasmus MC Cancer Institute, Department of Surgery, Rotterdam, the Netherlands; Marjolein Y.V. Homs, MD, PhD, Erasmus MC Cancer Institute, Department of Medical Oncology, Rotterdam, the Netherlands; Johanna W. Wilmink, MD, PhD, Amsterdam UMC Location University of Amsterdam, Department of Medical Oncology, Amsterdam, the Netherlands, Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands; Casper H. van Eijck, MD, PhD, Erasmus MC Cancer Institute, Department of Surgery, Rotterdam, the Netherlands; and Geertjan van Tienhoven, MD, PhD, Amsterdam UMC Location University of Amsterdam, Department of Radiation Oncology, Amsterdam, the Netherlands, Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands
| | - Marc G Besselink
- Eva Versteijne, MD, PhD, Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Radiation Oncology, Amsterdam, the Netherlands, Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands; Jacob L. van Dam, MD, Erasmus MC Cancer Institute, Department of Surgery, Rotterdam, the Netherlands; Marc G. Besselink, MD, PhD, Amsterdam UMC Location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands, Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands; Bas Groot Koerkamp, MD, PhD, Erasmus MC Cancer Institute, Department of Surgery, Rotterdam, the Netherlands; Marjolein Y.V. Homs, MD, PhD, Erasmus MC Cancer Institute, Department of Medical Oncology, Rotterdam, the Netherlands; Johanna W. Wilmink, MD, PhD, Amsterdam UMC Location University of Amsterdam, Department of Medical Oncology, Amsterdam, the Netherlands, Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands; Casper H. van Eijck, MD, PhD, Erasmus MC Cancer Institute, Department of Surgery, Rotterdam, the Netherlands; and Geertjan van Tienhoven, MD, PhD, Amsterdam UMC Location University of Amsterdam, Department of Radiation Oncology, Amsterdam, the Netherlands, Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands
| | - Bas Groot Koerkamp
- Eva Versteijne, MD, PhD, Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Radiation Oncology, Amsterdam, the Netherlands, Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands; Jacob L. van Dam, MD, Erasmus MC Cancer Institute, Department of Surgery, Rotterdam, the Netherlands; Marc G. Besselink, MD, PhD, Amsterdam UMC Location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands, Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands; Bas Groot Koerkamp, MD, PhD, Erasmus MC Cancer Institute, Department of Surgery, Rotterdam, the Netherlands; Marjolein Y.V. Homs, MD, PhD, Erasmus MC Cancer Institute, Department of Medical Oncology, Rotterdam, the Netherlands; Johanna W. Wilmink, MD, PhD, Amsterdam UMC Location University of Amsterdam, Department of Medical Oncology, Amsterdam, the Netherlands, Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands; Casper H. van Eijck, MD, PhD, Erasmus MC Cancer Institute, Department of Surgery, Rotterdam, the Netherlands; and Geertjan van Tienhoven, MD, PhD, Amsterdam UMC Location University of Amsterdam, Department of Radiation Oncology, Amsterdam, the Netherlands, Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands
| | - Marjolein Y V Homs
- Eva Versteijne, MD, PhD, Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Radiation Oncology, Amsterdam, the Netherlands, Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands; Jacob L. van Dam, MD, Erasmus MC Cancer Institute, Department of Surgery, Rotterdam, the Netherlands; Marc G. Besselink, MD, PhD, Amsterdam UMC Location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands, Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands; Bas Groot Koerkamp, MD, PhD, Erasmus MC Cancer Institute, Department of Surgery, Rotterdam, the Netherlands; Marjolein Y.V. Homs, MD, PhD, Erasmus MC Cancer Institute, Department of Medical Oncology, Rotterdam, the Netherlands; Johanna W. Wilmink, MD, PhD, Amsterdam UMC Location University of Amsterdam, Department of Medical Oncology, Amsterdam, the Netherlands, Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands; Casper H. van Eijck, MD, PhD, Erasmus MC Cancer Institute, Department of Surgery, Rotterdam, the Netherlands; and Geertjan van Tienhoven, MD, PhD, Amsterdam UMC Location University of Amsterdam, Department of Radiation Oncology, Amsterdam, the Netherlands, Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands
| | - Johanna W Wilmink
- Eva Versteijne, MD, PhD, Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Radiation Oncology, Amsterdam, the Netherlands, Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands; Jacob L. van Dam, MD, Erasmus MC Cancer Institute, Department of Surgery, Rotterdam, the Netherlands; Marc G. Besselink, MD, PhD, Amsterdam UMC Location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands, Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands; Bas Groot Koerkamp, MD, PhD, Erasmus MC Cancer Institute, Department of Surgery, Rotterdam, the Netherlands; Marjolein Y.V. Homs, MD, PhD, Erasmus MC Cancer Institute, Department of Medical Oncology, Rotterdam, the Netherlands; Johanna W. Wilmink, MD, PhD, Amsterdam UMC Location University of Amsterdam, Department of Medical Oncology, Amsterdam, the Netherlands, Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands; Casper H. van Eijck, MD, PhD, Erasmus MC Cancer Institute, Department of Surgery, Rotterdam, the Netherlands; and Geertjan van Tienhoven, MD, PhD, Amsterdam UMC Location University of Amsterdam, Department of Radiation Oncology, Amsterdam, the Netherlands, Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands
| | - Casper H van Eijck
- Eva Versteijne, MD, PhD, Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Radiation Oncology, Amsterdam, the Netherlands, Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands; Jacob L. van Dam, MD, Erasmus MC Cancer Institute, Department of Surgery, Rotterdam, the Netherlands; Marc G. Besselink, MD, PhD, Amsterdam UMC Location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands, Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands; Bas Groot Koerkamp, MD, PhD, Erasmus MC Cancer Institute, Department of Surgery, Rotterdam, the Netherlands; Marjolein Y.V. Homs, MD, PhD, Erasmus MC Cancer Institute, Department of Medical Oncology, Rotterdam, the Netherlands; Johanna W. Wilmink, MD, PhD, Amsterdam UMC Location University of Amsterdam, Department of Medical Oncology, Amsterdam, the Netherlands, Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands; Casper H. van Eijck, MD, PhD, Erasmus MC Cancer Institute, Department of Surgery, Rotterdam, the Netherlands; and Geertjan van Tienhoven, MD, PhD, Amsterdam UMC Location University of Amsterdam, Department of Radiation Oncology, Amsterdam, the Netherlands, Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands
| | - Geertjan van Tienhoven
- Eva Versteijne, MD, PhD, Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Radiation Oncology, Amsterdam, the Netherlands, Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands; Jacob L. van Dam, MD, Erasmus MC Cancer Institute, Department of Surgery, Rotterdam, the Netherlands; Marc G. Besselink, MD, PhD, Amsterdam UMC Location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands, Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands; Bas Groot Koerkamp, MD, PhD, Erasmus MC Cancer Institute, Department of Surgery, Rotterdam, the Netherlands; Marjolein Y.V. Homs, MD, PhD, Erasmus MC Cancer Institute, Department of Medical Oncology, Rotterdam, the Netherlands; Johanna W. Wilmink, MD, PhD, Amsterdam UMC Location University of Amsterdam, Department of Medical Oncology, Amsterdam, the Netherlands, Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands; Casper H. van Eijck, MD, PhD, Erasmus MC Cancer Institute, Department of Surgery, Rotterdam, the Netherlands; and Geertjan van Tienhoven, MD, PhD, Amsterdam UMC Location University of Amsterdam, Department of Radiation Oncology, Amsterdam, the Netherlands, Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands
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