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Naves DD, Reuling EMBP, Dickhoff C, Kortman PC, Broeckaert MAM, Plaisier PW, Daniels JMA, Thunnissen E, Radonic T. In-depth analysis of immunohistochemistry concordance in biopsy-resection pairs of bronchial carcinoids. Ann Diagn Pathol 2023; 67:152181. [PMID: 37598464 DOI: 10.1016/j.anndiagpath.2023.152181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 07/16/2023] [Indexed: 08/22/2023]
Abstract
Primary diagnosis of bronchial carcinoids (BC) is always made on biopsies and additional immunohistochemistry (IHC) is often necessary. In the present study we investigated the concordance of common diagnostic (synaptophysin, chromogranin, CD56 and INSM-1) and potential prognostic (OTP, CD44, Rb and p16) IHC markers between the preoperative biopsies and resections of in total 64 BCs, 26 typical (41 %) and 38 atypical (59 %) carcinoid tumors. Synaptophysin and chromogranin had 100 % concordance in all resected carcinoids and paired diagnostic biopsies. Synaptophysin was not affected by variable expression in biopsies compared to chromogranin, CD56 and INSM-1. Notably, INSM-1 IHC was false negative in 8 % of biopsies. Of the novel and potential prognostic markers, only CD44 showed 100 % concordance between biopsies and resections, while OTP showed two (4 %) false negative results in paired biopsies. While Rb IHC was false negative in 8 % of biopsies, no strong and diffuse pattern of p16 expression was observed. In this study, most false negative IHC results (85 %, 22/26) were observed in small flexible biopsies. Taken together, our data suggest excellent concordance of synaptophysin and CD44 on the preoperative biopsy samples, while other neuroendocrine markers, Rb and OTP should be interpreted with caution, especially in small biopsies.
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Affiliation(s)
- Dwayne D Naves
- Department of Pathology, Amsterdam University Medical Center, VU University Amsterdam, Cancer Center Amsterdam, Amsterdam, the Netherlands
| | - Ellen M B P Reuling
- Department of Surgery, Amsterdam University Medical Center, VU University Amsterdam, Amsterdam, the Netherlands; Department of Surgery, Albert Schweitzer Hospital, Dordrecht, the Netherlands
| | - Chris Dickhoff
- Department of Surgery, Amsterdam University Medical Center, VU University Amsterdam, Amsterdam, the Netherlands; Department of Cardiothoracic Surgery, Amsterdam University Medical Center, VU University Amsterdam, Amsterdam, the Netherlands
| | - Pim C Kortman
- Department of Pathology, Amsterdam University Medical Center, VU University Amsterdam, Cancer Center Amsterdam, Amsterdam, the Netherlands
| | - Mark A M Broeckaert
- Department of Pathology, Amsterdam University Medical Center, VU University Amsterdam, Cancer Center Amsterdam, Amsterdam, the Netherlands
| | - Peter W Plaisier
- Department of Surgery, Albert Schweitzer Hospital, Dordrecht, the Netherlands
| | - Johannes M A Daniels
- Department of Pulmonary Diseases, Amsterdam University Medical Center, VU University Amsterdam, Amsterdam, the Netherlands
| | - Erik Thunnissen
- Department of Pathology, Amsterdam University Medical Center, VU University Amsterdam, Cancer Center Amsterdam, Amsterdam, the Netherlands
| | - Teodora Radonic
- Department of Pathology, Amsterdam University Medical Center, VU University Amsterdam, Cancer Center Amsterdam, Amsterdam, the Netherlands.
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Kamminga NCW, Wakkee M, De Bruin RJ, van der Veldt AAM, Joosse A, Reeder SWI, Plaisier PW, Nijsten T, Lugtenberg M. Oncological healthcare providers' perspectives on appropriate melanoma survivorship care: a qualitative focus group study. BMC Cancer 2023; 23:278. [PMID: 36973713 PMCID: PMC10042579 DOI: 10.1186/s12885-023-10759-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 03/21/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND The increasing group of melanoma survivors reports multiple unmet needs regarding survivorship care (SSC). To optimise melanoma SSC, it is crucial to take into account the perspectives of oncological healthcare providers (HCPs) in addition to those of patients. The aim of this study is to gain an in-depth understanding of HCPs' perspectives on appropriate melanoma SSC. METHODS Four online focus groups were conducted with mixed samples of oncological HCPs (dermatologists, surgeons, oncologists, oncological nurse practitioners, support counsellors and general practitioners) (total n = 23). A topic guide was used to structure the discussions, focusing on perspectives on both SSC and survivorship care plans (SCPs). All focus groups were recorded, transcribed verbatim, and subjected to an elaborate thematic content analysis. RESULTS Regarding SSC, HCPs considered the current offer minimal and stressed the need for broader personalised SSC from diagnosis onwards. Although hardly anyone was familiar with SCPs, they perceived various potential benefits of SCPs, such as an increase in the patients' self-management and providing HCPs with an up-to-date overview of the patient's situation. Perceived preconditions for successful implementation included adequate personalisation, integration in the electronic health record and ensuring adequate funding to activate and provide timely updates. CONCLUSIONS According to HCPs there is considerable room for improvement in terms of melanoma SSC. SCPs can assist in offering personalised and broader i.e., including psychosocial SSC. Aside from personalisation, efforts should be focused on SCPs' integration in clinical practice, and their long-term maintenance.
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Affiliation(s)
- Nadia C W Kamminga
- Department of Dermatology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Marlies Wakkee
- Department of Dermatology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Rianne J De Bruin
- Department of Dermatology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Astrid A M van der Veldt
- Department of Medical Oncology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Radiology & Nuclear Medicine, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Arjen Joosse
- Department of Medical Oncology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Suzan W I Reeder
- Department of Dermatology, Albert Schweitzer Hospital, Dordrecht, The Netherlands
| | - Peter W Plaisier
- Department of Surgical Oncology, Albert Schweitzer Hospital, Dordrecht, The Netherlands
| | - Tamar Nijsten
- Department of Dermatology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Marjolein Lugtenberg
- Department of Dermatology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands.
- Department Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands.
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Reuling EMBP, Naves DD, Kortman PC, Broeckaert MAM, Plaisier PW, Dickhoff C, Daniels JMA, Radonic T. A Multimodal Biomarker Predicts Dissemination of Bronchial Carcinoid. Cancers (Basel) 2022; 14:cancers14133234. [PMID: 35805004 PMCID: PMC9265109 DOI: 10.3390/cancers14133234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 06/22/2022] [Accepted: 06/26/2022] [Indexed: 11/30/2022] Open
Abstract
Background: Curatively treated bronchial carcinoid tumors have a relatively low metastatic potential. Gradation into typical (TC) and atypical carcinoid (AC) is limited in terms of prognostic value, resulting in yearly follow-up of all patients. We examined the additional prognostic value of novel immunohistochemical (IHC) markers to current gradation of carcinoids. Methods: A retrospective single-institution cohort study was performed on 171 patients with pathologically diagnosed bronchial carcinoid (median follow-up: 66 months). The risk of developing distant metastases based on histopathological characteristics (Ki-67, p16, Rb, OTP, CD44, and tumor diameter) was evaluated using multivariate regression analysis and the Kaplan−Meier method. Results: Of 171 patients, seven (4%) had disseminated disease at presentation, and 164 (96%) received curative-intent treatment with either endobronchial treatment (EBT) (n = 61, 36%) or surgery (n = 103, 60%). Among the 164 patients, 13 developed metastases at follow-up of 81 months (IQR 45−162). Univariate analysis showed that Ki-67, mitotic index, OTP, CD44, and tumor diameter were associated with development of distant metastases. Multivariate analysis showed that mitotic count, Ki-67, and OTP were independent risk factors for development of distant metastases. Using a 5% cutoff for Ki-67, Kaplan−Meier analysis showed that the risk of distant metastasis development was significantly associated with the number of risk predictors (AC, Ki-67 ≥ 5%, and loss of OTP or CD44) (p < 0.0001). Six out of seven patients (86%) with all three positive risk factors developed distant metastasis. Conclusions: Mitotic count, proliferation index, and OTP IHC were independent predictors of dissemination at follow-up. In addition to the widely used carcinoid classification, a comprehensive analysis of histopathological variables including Ki-67, OTP, and CD44 could assist in the determination of distant metastasis risks of bronchial carcinoids.
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Affiliation(s)
- Ellen M. B. P. Reuling
- Department of Surgery, Amsterdam University Medical Center, VUMC, University Amsterdam, 1081 HV Amsterdam, The Netherlands; (E.M.B.P.R.); (C.D.)
- Department of Surgery, Albert Schweitzer Hospital, 3318 AT Dordrecht, The Netherlands;
| | - Dwayne D. Naves
- Department of Pathology, Amsterdam University Medical Center, VUMC, University Amsterdam, 1081 HV Amsterdam, The Netherlands; (D.D.N.); (P.C.K.); (M.A.M.B.)
| | - Pim C. Kortman
- Department of Pathology, Amsterdam University Medical Center, VUMC, University Amsterdam, 1081 HV Amsterdam, The Netherlands; (D.D.N.); (P.C.K.); (M.A.M.B.)
| | - Mark A. M. Broeckaert
- Department of Pathology, Amsterdam University Medical Center, VUMC, University Amsterdam, 1081 HV Amsterdam, The Netherlands; (D.D.N.); (P.C.K.); (M.A.M.B.)
| | - Peter W. Plaisier
- Department of Surgery, Albert Schweitzer Hospital, 3318 AT Dordrecht, The Netherlands;
| | - Chris Dickhoff
- Department of Surgery, Amsterdam University Medical Center, VUMC, University Amsterdam, 1081 HV Amsterdam, The Netherlands; (E.M.B.P.R.); (C.D.)
- Department of Cardiothoracic Surgery, Amsterdam University Medical Center, VUMC, University Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Johannes M. A. Daniels
- Department of Pulmonary Diseases, Amsterdam University Medical Center, VUMC, University Amsterdam, 1081 HV Amsterdam, The Netherlands;
| | - Teodora Radonic
- Department of Pathology, Amsterdam University Medical Center, VUMC, University Amsterdam, 1081 HV Amsterdam, The Netherlands; (D.D.N.); (P.C.K.); (M.A.M.B.)
- Cancer Center Amsterdam, Amsterdam University Medical Center, VUMC, University Amsterdam, 1081 HV Amsterdam, The Netherlands
- Correspondence:
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Hoek VT, Edomskis PP, Stark PW, Lambrichts DPV, Draaisma WA, Consten ECJ, Lange JF, Bemelman WA, Hop WC, Opmeer BC, Reitsma JB, Scholte RA, Waltmann EWH, Legemate A, Bartelsman JF, Meijer DW, de Brouwer M, van Dalen J, Durbridge M, Geerdink M, Ilbrink GJ, Mehmedovic S, Middelhoek P, Boom MJ, Consten ECJ, van der Bilt JDW, van Olden GDJ, Stam MAW, Verweij MS, Vennix S, Musters GD, Swank HA, Boermeester MA, Busch ORC, Buskens CJ, El-Massoudi Y, Kluit AB, van Rossem CC, Schijven MP, Tanis PJ, Unlu C, van Dieren S, Gerhards MF, Karsten TM, de Nes LC, Rijna H, van Wagensveld BA, Koff eman GI, Steller EP, Tuynman JB, Bruin SC, van der Peet DL, Blanken-Peeters CFJM, Cense HA, Jutte E, Crolla RMPH, van der Schelling GP, van Zeeland M, de Graaf EJR, Groenendijk RPR, Karsten TM, Vermaas M, Schouten O, de Vries MR, Prins HA, Lips DJ, Bosker RJI, van der Hoeven JAB, Diks J, Plaisier PW, Kruyt PM, Sietses C, Stommel MWJ, Nienhuijs SW, de Hingh IHJT, Luyer MDP, van Montfort G, Ponten EH, Smulders JF, van Duyn EB, Klaase JM, Swank DJ, Ottow RT, Stockmann HBAC, Vermeulen J, Vuylsteke RJCLM, Belgers HJ, Fransen S, von Meijenfeldt EM, Sosef MN, van Geloven AAW, Hendriks ER, ter Horst B, Leeuwenburgh MMN, van Ruler O, Vogten JM, Vriens EJC, Westerterp M, Eijsbouts QAJ, Bentohami A, Bijlsma TS, de Korte N, Nio D, Govaert MJPM, Joosten JJA, Tollenaar RAEM, Stassen LPS, Wiezer MJ, Hazebroek EJ, Smits AB, van Westreenen HL, Lange JF, Brandt A, Nijboer WN, Mulder IM, Toorenvliet BR, Weidema WF, Coene PPLO, Mannaerts GHH, den Hartog D, de Vos RJ, Zengerink JF, Hoofwijk AGM, Hulsewé KWE, Melenhorst J, Stoot JHMB, Steup WH, Huijstee PJ, Merkus JWS, Wever JJ, Maring JK, Heisterkamp J, van Grevenstein WMU, Vriens MR, Besselink MGH, Borel Rinkes IHM, Witkamp AJ, Slooter GD, Konsten JLM, Engel AF, Pierik EGJM, Frakking TG, van Geldere D, Patijn GA, D’Hoore BAJL, de Buck AVO, Miserez M, Terrasson I, Wolthuis A, di Saverio S, de Blasiis MG. Laparoscopic peritoneal lavage versus sigmoidectomy for perforated diverticulitis with purulent peritonitis: three-year follow-up of the randomised LOLA trial. Surg Endosc 2022; 36:7764-7774. [PMID: 35606544 PMCID: PMC9485102 DOI: 10.1007/s00464-022-09326-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 05/01/2022] [Indexed: 10/31/2022]
Abstract
Abstract
Background
This study aimed to compare laparoscopic lavage and sigmoidectomy as treatment for perforated diverticulitis with purulent peritonitis during a 36 month follow-up of the LOLA trial.
Methods
Within the LOLA arm of the international, multicentre LADIES trial, patients with perforated diverticulitis with purulent peritonitis were randomised between laparoscopic lavage and sigmoidectomy. Outcomes were collected up to 36 months. The primary outcome of the present study was cumulative morbidity and mortality. Secondary outcomes included reoperations (including stoma reversals), stoma rates, and sigmoidectomy rates in the lavage group.
Results
Long-term follow-up was recorded in 77 of the 88 originally included patients, 39 were randomised to sigmoidectomy (51%) and 38 to laparoscopic lavage (49%). After 36 months, overall cumulative morbidity (sigmoidectomy 28/39 (72%) versus lavage 32/38 (84%), p = 0·272) and mortality (sigmoidectomy 7/39 (18%) versus lavage 6/38 (16%), p = 1·000) did not differ. The number of patients who underwent a reoperation was significantly lower for lavage compared to sigmoidectomy (sigmoidectomy 27/39 (69%) versus lavage 17/38 (45%), p = 0·039). After 36 months, patients alive with stoma in situ was lower in the lavage group (proportion calculated from the Kaplan–Meier life table, sigmoidectomy 17% vs lavage 11%, log-rank p = 0·0268). Eventually, 17 of 38 (45%) patients allocated to lavage underwent sigmoidectomy.
Conclusion
Long-term outcomes showed that laparoscopic lavage was associated with less patients who underwent reoperations and lower stoma rates in patients alive after 36 months compared to sigmoidectomy. No differences were found in terms of cumulative morbidity or mortality. Patient selection should be improved to reduce risk for short-term complications after which lavage could still be a valuable treatment option.
Graphical abstract
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Reuling EMBP, Naves DD, Daniels JMA, Dickhoff C, Kortman PC, Broeckaert MAMB, Plaisier PW, Thunnissen E, Radonic T. Correction to: Diagnosis of atypical carcinoid can be made on biopsies > 4 mm2 and is accurate. Virchows Arch 2022; 480:595. [PMID: 35129676 PMCID: PMC8989927 DOI: 10.1007/s00428-022-03294-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Ellen M B P Reuling
- Department of Surgery, Amsterdam University Medical Center, VU University Amsterdam, Amsterdam, the Netherlands
- Department of Surgery, Albert Schweitzer Hospital, Albert Schweitzerplaats 25, 3318 AT, Dordrecht, the Netherlands
| | - Dwayne D Naves
- Department of Pathology, Amsterdam University Medical Center, VU University Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands
| | - Johannes M A Daniels
- Department of Pulmonary Diseases, Amsterdam University Medical Center, VU University Amsterdam, Amsterdam, the Netherlands
| | - Chris Dickhoff
- Department of Surgery, Amsterdam University Medical Center, VU University Amsterdam, Amsterdam, the Netherlands
- Department of Cardiothoracic Surgery, Amsterdam University Medical Center, VU University Amsterdam, Amsterdam, the Netherlands
| | - Pim C Kortman
- Department of Pathology, Amsterdam University Medical Center, VU University Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands
| | - Mark A M B Broeckaert
- Department of Pathology, Amsterdam University Medical Center, VU University Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands
| | - Peter W Plaisier
- Department of Surgery, Albert Schweitzer Hospital, Albert Schweitzerplaats 25, 3318 AT, Dordrecht, the Netherlands
| | - Erik Thunnissen
- Department of Pathology, Amsterdam University Medical Center, VU University Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands
| | - Teodora Radonic
- Department of Pathology, Amsterdam University Medical Center, VU University Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands.
- Cancer Centre Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands.
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Greidanus MA, de Rijk AE, de Boer AGEM, Bos MEMM, Plaisier PW, Smeenk RM, Frings-Dresen MHW, Tamminga SJ. A randomised feasibility trial of an employer-based intervention for enhancing successful return to work of cancer survivors (MiLES intervention). BMC Public Health 2021; 21:1433. [PMID: 34289828 PMCID: PMC8293550 DOI: 10.1186/s12889-021-11357-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 06/16/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Employers express a need for support during sickness absence and return to work (RTW) of cancer survivors. Therefore, a web-based intervention (MiLES) targeted at employers with the objective of enhancing cancer survivors' successful RTW has been developed. This study aimed to assess feasibility of a future definitive randomised controlled trial (RCT) on the effectiveness of the MiLES intervention. Also preliminary results on the effectiveness of the MiLES intervention were obtained. METHODS A randomised feasibility trial of 6 months was undertaken with cancer survivors aged 18-63 years, diagnosed with cancer < 2 years earlier, currently in paid employment, and sick-listed < 1 year. Participants were randomised to an intervention group, with their employer receiving the MiLES intervention, or to a waiting-list control group (2:1). Feasibility of a future definitive RCT was determined on the basis of predefined criteria related to method and protocol-related uncertainties (e.g. reach, retention, appropriateness). The primary effect measure (i.e. successful RTW) and secondary effect measures (e.g. quality of working life) were assessed at baseline and 3 and 6 months thereafter. RESULTS Thirty-five cancer survivors were included via medical specialists (4% of the initially invited group) and open invitations, and thereafter randomised to the intervention (n = 24) or control group (n = 11). Most participants were female (97%) with breast cancer (80%) and a permanent employment contract (94%). All predefined criteria for feasibility of a future definitive RCT were achieved, except that concerning the study's reach (90 participants). After 6 months, 92% of the intervention group and 100% of the control group returned to work (RR: 0.92, 95% CI: 0.81-1.03); no difference were found with regard to secondary effect measures. CONCLUSIONS With the current design a future definitive RCT on the effectiveness of the MiLES intervention on successful RTW of cancer survivors is not feasible, since recruitment of survivors fell short of the predefined minimum for feasibility. There was selection bias towards survivors at low risk of adverse work outcomes, which reduced generalisability of the outcomes. An alternative study design is needed to study effectiveness of the MiLES intervention. TRIAL REGISTRATION The study has been registered in the Dutch Trial Register ( NL6758/NTR7627 ).
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Affiliation(s)
- M A Greidanus
- Department Public and Occupational Health/ Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
| | - A E de Rijk
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Duboisdomein 30, Maastricht, The Netherlands
| | - A G E M de Boer
- Department Public and Occupational Health/ Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - M E M M Bos
- Department of Medical Oncology, Erasmus Medical Center, Doctor Molewaterplein 40, Rotterdam, The Netherlands
| | - P W Plaisier
- Department of Surgery, Albert Schweitzer Hospital, Albert Schweitzerplaats 25, Dordrecht, The Netherlands
| | - R M Smeenk
- Department of Surgery, Albert Schweitzer Hospital, Albert Schweitzerplaats 25, Dordrecht, The Netherlands
| | - M H W Frings-Dresen
- Department Public and Occupational Health/ Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - S J Tamminga
- Department Public and Occupational Health/ Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
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Leeneman B, Blommestein HM, Coupé VMH, Hendriks MP, Kruit WHJ, Plaisier PW, van Ruth S, Ten Tije AJ, Wouters MWJM, Franken MG, Uyl-de Groot CA. Real-world healthcare costs of localized and regionally advanced cutaneous melanoma in the Netherlands. Melanoma Res 2021; 31:249-257. [PMID: 33871398 DOI: 10.1097/cmr.0000000000000732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The aim of this study was to provide insight into real-world healthcare costs of patients initially diagnosed with localized or regionally advanced melanoma in three Dutch hospitals between 2003 and 2011. Patients were stratified according to their stage at diagnosis and recurrence status. Costs were calculated by applying unit costs to individual patient resource use and reported for the full disease course, the initial treatment episode, and treatment episodes for disease recurrence (stratified by type of recurrence). We included 198 patients with localized melanoma and 98 patients with regionally advanced melanoma. Total costs were much higher for patients with disease recurrence than for patients without disease recurrence: €20 007 versus €3032 for patients with localized melanoma and €19 519 versus €5951 for patients with regionally advanced melanoma. This was owing to the costs of disease recurrence because the costs of the initial treatment were comparable between patients with and without disease recurrence. Costs of disease recurrence were dependent on the type of recurrence: €4414, €4604, €8129 and €10 393 for a local recurrence, intralymphatic metastases, regional lymph node metastases and distant metastases, respectively. In conclusion, healthcare costs of patients with localized and regionally advanced melanoma were rather low for the initial treatment. Costs became, however, more substantial in case of disease recurrence. In the context of a rapidly changing treatment paradigm, it remains crucial to monitor treatment outcomes as well as healthcare expenditures.
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Affiliation(s)
- Brenda Leeneman
- Department of Health Technology Assessment, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam
| | - Hedwig M Blommestein
- Department of Health Technology Assessment, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam
| | - Veerle M H Coupé
- Department of Epidemiology and Biostatistics, Amsterdam UMC, Amsterdam
| | | | - Wim H J Kruit
- Department for Medical Oncology, Erasmus MC Cancer Institute, Rotterdam
| | - Peter W Plaisier
- Department of Surgical Oncology, Albert Schweitzer Hospital, Dordrecht
| | | | | | | | - Margreet G Franken
- Department of Health Technology Assessment, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam
- Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Carin A Uyl-de Groot
- Department of Health Technology Assessment, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam
- Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, The Netherlands
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Tamminga SJ, Verbeek JHAM, Bos MMEM, Fons G, Kitzen JJEM, Plaisier PW, Frings-Dresen MHW, de Boer AGEM. Two-Year Follow-Up of a Multi-centre Randomized Controlled Trial to Study Effectiveness of a Hospital-Based Work Support Intervention for Cancer Patients. J Occup Rehabil 2019; 29:701-710. [PMID: 30778742 PMCID: PMC6838305 DOI: 10.1007/s10926-019-09831-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Purpose Purpose is to: (1) study effectiveness of the hospital-based work support intervention for cancer patients at two years of follow-up compared to usual care and (2) identify which early factors predict time to return-to-work (RTW). Methods In this multi-center randomised controlled trial (RCT), 106 (self-)employed cancer patients were randomized to an intervention group or control group and provided 2 years of follow-up data. The intervention group received patient education and work-related support at the hospital. Primary outcome was RTW (rate and time) and quality of life (SF-36), and secondary outcomes were, work ability (WAI), and work functioning (WLQ). Univariate Cox regression analyses were performed to study which early factors predict time to full RTW. Results Participants were diagnosed with breast (61%), gynaecological cancer (35%), or other type of cancer (4%). RTW rates were 84% and 90% for intervention versus control group. They were high compared to national register-based studies. No differences between groups were found on any of the outcomes. Receiving chemotherapy (HR = 2.43, 95% CI 1.59-3.73 p < 0.001), low level of education (HR = 1.65, 95% CI 1.076-2.52 p = 0.02) and low work ability (HR = 1.09 [95% CI 1.04-1.17] p = 0.02) were associated with longer time to full RTW. Conclusions We found high RTW rates compared to national register-based studies and we found no differences between groups. Future studies should therefore focus on reaching the group at risk, which consist of patients who receive chemotherapy, have a low level of education and have a low work ability at diagnosis. TRIAL REGISTRATION: Netherlands Trial Registry (NTR) (http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1658): NTR1658.
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Affiliation(s)
- S J Tamminga
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - J H A M Verbeek
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Finnish Institute of Occupational Health, Kuopio, Finland
| | - M M E M Bos
- Department of Internal Medicine, Reinier de Graaf Groep, Delft, The Netherlands
| | - G Fons
- Department of Gynaecology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - J J E M Kitzen
- Department of Internal Medicine, Albert Schweitzer Hospital, Dordrecht, The Netherlands
| | - P W Plaisier
- Department of Surgery, Albert Schweitzer Hospital, Dordrecht, The Netherlands
| | - M H W Frings-Dresen
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - A G E M de Boer
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
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Leeneman B, Franken MG, Coupé VM, Hendriks MP, Kruit W, Plaisier PW, van Ruth S, Verstijnen JA, Wouters MW, Blommestein HM, Uyl – de Groot CA. Stage-specific disease recurrence and survival in localized and regionally advanced cutaneous melanoma. Eur J Surg Oncol 2019; 45:825-831. [DOI: 10.1016/j.ejso.2019.01.225] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 12/20/2018] [Accepted: 01/31/2019] [Indexed: 10/27/2022] Open
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10
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Reuling EMBP, Dickhoff C, Plaisier PW, Bonjer HJ, Daniels JMA. Endobronchial and surgical treatment of pulmonary carcinoid tumors: A systematic literature review. Lung Cancer 2019; 134:85-95. [PMID: 31320001 DOI: 10.1016/j.lungcan.2019.04.016] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 03/31/2019] [Accepted: 04/08/2019] [Indexed: 12/26/2022]
Abstract
The treatment of pulmonary carcinoid has changed over the last decades. Although surgical resection is still the gold standard, minimally invasive endobronchial procedures have emerged as a parenchyma sparing alternative for tumors located in the central airways. This review was performed to identify the optimal treatment strategy for pulmonary carcinoid, with a particular focus on the feasibility and outcome of parenchyma sparing techniques versus surgical resection. A systematic review of the literature was carried out using MEDLINE, Embase and the Cochrane databases, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement. Two separate searches of publications in endobronchial and surgical treatment in patients with pulmonary carcinoid, were performed. Outcomes were overall survival, disease free survival, recurrence rate, complications, quality of life, and healthcare costs. Combining the two main searches for endobronchial therapy and surgical therapy yielded 3111 records. Finally, 43 studies concerning surgical treatment and 9 studies related to endobronchial treatment for pulmonary carcinoid were included. Assessment of included studies showed that lymph node involvement, histological grade, tumor location and tumor diameter were identified as poor prognostic factors and seem to be important for patients with pulmonary carcinoid. For patients with a more favorable prognosis, tumor location and tumor diameter are important factors that can help decide on the optimal treatment strategy. Centrally located small intraluminal pulmonary carcinoids, without signs of metastasis can be treated with minimally invasive alternatives such as endobronchial treatment or parenchyma sparing surgical resection. Patients with parenchyma sparing resections should be followed with long term follow up to exclude recurrence of disease. In a multidisciplinary setting, it should be determined whether individual patients are eligible for parenchyma sparing procedures or anatomical resection. Overall evidence is of low quality and future studies should focus on prospective trials in the treatment of pulmonary carcinoid.
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Affiliation(s)
- E M B P Reuling
- Department of Surgery, Cancer Center Amsterdam, Amsterdam University Medical Center, De Boelelaan, 1117, 1081 HV, Amsterdam, the Netherlands; Department of Surgery, Albert Schweitzer Hospital, Albert Schweitzerplaats 25, 3318 AT Dordrecht, the Netherlands.
| | - C Dickhoff
- Department of Surgery, Cancer Center Amsterdam, Amsterdam University Medical Center, De Boelelaan, 1117, 1081 HV, Amsterdam, the Netherlands; Department of Cardiothoracic Surgery, Cancer Center Amsterdam, Amsterdam University Medical Center, De Boelelaan, 1117, 1081 HV, Amsterdam, the Netherlands
| | - P W Plaisier
- Department of Surgery, Albert Schweitzer Hospital, Albert Schweitzerplaats 25, 3318 AT Dordrecht, the Netherlands
| | - H J Bonjer
- Department of Surgery, Cancer Center Amsterdam, Amsterdam University Medical Center, De Boelelaan, 1117, 1081 HV, Amsterdam, the Netherlands
| | - J M A Daniels
- Department of Pulmonary Diseases, Cancer Center Amsterdam, Amsterdam University Medical Center, De Boelelaan, 1117, 1081 HV, Amsterdam, the Netherlands
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11
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Atema V, van Leeuwen M, Kieffer JM, Oldenburg HSA, van Beurden M, Gerritsma MA, Kuenen MA, Plaisier PW, Lopes Cardozo AMF, van Riet YEA, Heuff G, Rijna H, van der Meij S, Noorda EM, Timmers GJ, Vrouenraets BC, Bollen M, van der Veen H, Bijker N, Hunter MS, Aaronson NK. Efficacy of Internet-Based Cognitive Behavioral Therapy for Treatment-Induced Menopausal Symptoms in Breast Cancer Survivors: Results of a Randomized Controlled Trial. J Clin Oncol 2019; 37:809-822. [PMID: 30763176 DOI: 10.1200/jco.18.00655] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE We evaluated the effect of Internet-based cognitive behavioral therapy (iCBT), with or without therapist support, on the perceived impact of hot flushes and night sweats (HF/NS) and overall levels of menopausal symptoms (primary outcomes), sleep quality, HF/NS frequency, sexual functioning, psychological distress, and health-related quality of life in breast cancer survivors with treatment-induced menopausal symptoms. PATIENTS AND METHODS We randomly assigned 254 breast cancer survivors to a therapist-guided or a self-managed iCBT group or to a waiting list control group. The 6-week iCBT program included psycho-education, behavior monitoring, and cognitive restructuring. Questionnaires were administered at baseline and at 10 weeks and 24 weeks postrandomization. We used mixed-effects models to compare the intervention groups with the control group over time. Significance was set at P < .01. An effect size (ES) of .20 was considered small, .50 moderate and clinically significant, and .80 large. RESULTS Compared with the control group, the guided and self-managed iCBT groups reported a significant decrease in the perceived impact of HF/NS (ES, .63 and .56, respectively; both P < .001) and improvement in sleep quality (ES, .57 and .41; both P < .001). The guided group also reported significant improvement in overall levels of menopausal symptoms (ES, .33; P = .003), and NS frequency (ES, .64; P < .001). At longer-term follow-up (24 weeks), the effects remained significant, with a smaller ES for the guided group on perceived impact of HF/NS and sleep quality and for the self-managed group on overall levels of menopausal symptoms. Additional longer-term effects for both intervention groups were found for hot flush frequency. CONCLUSION iCBT, with or without therapist support, has clinically significant, salutary effects on the perceived impact and frequency of HF/NS, overall levels of menopausal symptoms, and sleep quality.
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Affiliation(s)
- Vera Atema
- 1 The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | | | | | | | | | | | | | | | | | | | - Gijsbert Heuff
- 5 Spaarne Gasthuis Hoofddorp, Hoofddorp, the Netherlands
| | - Herman Rijna
- 6 Spaarne Gasthuis Haarlem, Haarlem, the Netherlands
| | | | | | | | | | - Matthé Bollen
- 11 Medical Centre Zuiderzee, Lelystad, the Netherlands
| | | | - Nina Bijker
- 13 Amsterdam UMC, Amsterdam, the Netherlands
| | | | - Neil K Aaronson
- 1 The Netherlands Cancer Institute, Amsterdam, the Netherlands
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12
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Hummel SB, van Lankveld JJDM, Oldenburg HSA, Hahn DEE, Kieffer JM, Gerritsma MA, Kuenen MA, Bijker N, Borgstein PJ, Heuff G, Lopes Cardozo AMF, Plaisier PW, Rijna H, van der Meij S, van Dulken EJ, Vrouenraets BC, Broomans E, Aaronson NK. Sexual Functioning and Relationship Satisfaction of Partners of Breast Cancer Survivors Who Receive Internet-Based Sex Therapy. J Sex Marital Ther 2018; 45:91-102. [PMID: 30040589 DOI: 10.1080/0092623x.2018.1488325] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 05/17/2018] [Accepted: 05/31/2018] [Indexed: 06/08/2023]
Abstract
As part of a larger, randomized controlled trial, we evaluated longitudinally the sexual functioning and relationship satisfaction of 69 partners of breast cancer (BC) survivors who received Internet-based cognitive behavioral therapy (CBT) for sexual dysfunction. The findings suggest that Internet-based CBT positively affects the partners' immediate post-CBT and longer-term overall sexual satisfaction, sexual intimacy, and sexual relationship satisfaction. No sustained changes in other areas of sexual functioning were observed. Our CBT program was focused primarily on the sexual health of the BC survivors. We recommend that future programs include more psychoeducational and behavioral elements targeted at the partners.
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Affiliation(s)
- Susanna B Hummel
- a Division of Psychosocial Research and Epidemiology , The Netherlands Cancer Institute , Amsterdam , The Netherlands
| | - Jacques J D M van Lankveld
- b Faculty of Psychology and Educational Sciences , Open University of The Netherlands , Heerlen , The Netherlands
| | - Hester S A Oldenburg
- c Department of Surgical Oncology , The Netherlands Cancer Institute , Amsterdam , The Netherlands
| | - Daniela E E Hahn
- d Department of Quality of Life , The Netherlands Cancer Institute , Amsterdam , The Netherlands
- e Family Cancer Clinic , The Netherlands Cancer Institute , Amsterdam , The Netherlands
| | - Jacobien M Kieffer
- a Division of Psychosocial Research and Epidemiology , The Netherlands Cancer Institute , Amsterdam , The Netherlands
| | - Miranda A Gerritsma
- a Division of Psychosocial Research and Epidemiology , The Netherlands Cancer Institute , Amsterdam , The Netherlands
| | - Marianne A Kuenen
- a Division of Psychosocial Research and Epidemiology , The Netherlands Cancer Institute , Amsterdam , The Netherlands
| | - Nina Bijker
- f Department of Radiotherapy , Academic Medical Center , Amsterdam , The Netherlands
| | - Paul J Borgstein
- g Department of Surgical Oncology , Onze Lieve Vrouwe Gasthuis, Location East , Amsterdam , The Netherlands
| | - Gijsbert Heuff
- h Department of Surgical Oncology , Spaarne Gasthuis Hoofddorp , Hoofddorp , The Netherlands
| | | | - Peter W Plaisier
- j Department of General Surgery , Albert Schweitzer Hospital , Dordrecht , The Netherlands
| | - Herman Rijna
- k Department of Surgical Oncology , Spaarne Gasthuis Haarlem , Haarlem , The Netherlands
| | - Suzan van der Meij
- l Department of Surgical Oncology , Flevo Hospital , Almere , The Netherlands
| | - Eric J van Dulken
- m Department of Surgical Oncology , Medical Center Slotervaart , Amsterdam , The Netherlands
| | - Bart C Vrouenraets
- n Department of Surgery , Onze Lieve Vrouwe Gasthuis, Location West , Amsterdam , The Netherlands
| | - Eva Broomans
- o Department of Adult Care , Virenze Institute of Mental Health Care , Utrecht , The Netherlands
- p PsyQ Institute of Mental Health Care , Almere , The Netherlands
| | - Neil K Aaronson
- a Division of Psychosocial Research and Epidemiology , The Netherlands Cancer Institute , Amsterdam , The Netherlands
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13
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Reuling EMBP, Dickhoff C, Plaisier PW, Coupé VMH, Mazairac AHA, Lely RJ, Bonjer HJ, Daniels JMA. Author's Reply. Respiration 2018; 96:205. [PMID: 29953996 DOI: 10.1159/000489985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Ellen M B P Reuling
- Department of Surgery, VU University Medical Center, Amsterdam, the Netherlands
| | - Chris Dickhoff
- Department of Surgery, VU University Medical Center, Amsterdam, the Netherlands
| | - Peter W Plaisier
- Department of Surgery, Albert Schweitzer Hospital, Dordrecht, the Netherlands
| | - Veerle M H Coupé
- Department of Epidemiology and Statistics, VU University Medical Center, Amsterdam, the Netherlands
| | - Albert H A Mazairac
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, the Netherlands
| | - Rutger J Lely
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, the Netherlands
| | - H Jaap Bonjer
- Department of Surgery, VU University Medical Center, Amsterdam, the Netherlands
| | - Johannes M A Daniels
- Department of Pulmonary Diseases, VU University Medical Center, Amsterdam, the Netherlands
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14
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Hummel SB, van Lankveld JJDM, Oldenburg HSA, Hahn DEE, Kieffer JM, Gerritsma MA, Kuenen MA, Bijker N, Borgstein PJ, Heuff G, Cardozo AMFL, Plaisier PW, Rijna H, van der Meij S, van Dulken EJ, Vrouenraets BC, Broomans E, Aaronson NK. Internet-Based Cognitive Behavioral Therapy Realizes Long-Term Improvement in the Sexual Functioning and Body Image of Breast Cancer Survivors. J Sex Marital Ther 2018; 44:485-496. [PMID: 29297781 DOI: 10.1080/0092623x.2017.1408047] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The study aim was to evaluate the long-term efficacy of Internet-based cognitive behavioral therapy (CBT) for sexual dysfunctions in 84 breast cancer survivors. The positive effects of the intervention on overall sexual functioning, sexual desire, sexual arousal, vaginal lubrication, discomfort during sex, sexual distress, and body image observed immediately posttreatment were maintained at three- and nine-month follow-ups. Although sexual pleasure decreased during follow-up, it did not return to baseline levels. Our findings provide evidence that Internet-based CBT has a sustained, positive effect on sexual functioning and body image of breast cancer survivors with a sexual dysfunction.
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Affiliation(s)
- Susanna B Hummel
- a Division of Psychosocial Research and Epidemiology , The Netherlands Cancer Institute , Amsterdam , The Netherlands
| | - Jacques J D M van Lankveld
- b Faculty of Psychology and Educational Sciences , Open University of The Netherlands , Heerlen , The Netherlands
| | - Hester S A Oldenburg
- c Department of Surgical Oncology , The Netherlands Cancer Institute , Amsterdam , The Netherlands
| | - Daniela E E Hahn
- d Department of Psychosocial Counseling , The Netherlands Cancer Institute , Amsterdam , The Netherlands
- e Family Cancer Clinic , The Netherlands Cancer Institute , Amsterdam , The Netherlands
| | - Jacobien M Kieffer
- a Division of Psychosocial Research and Epidemiology , The Netherlands Cancer Institute , Amsterdam , The Netherlands
| | - Miranda A Gerritsma
- a Division of Psychosocial Research and Epidemiology , The Netherlands Cancer Institute , Amsterdam , The Netherlands
| | - Marianne A Kuenen
- a Division of Psychosocial Research and Epidemiology , The Netherlands Cancer Institute , Amsterdam , The Netherlands
| | - Nina Bijker
- f Department of Radiotherapy , Academic Medical Center , Amsterdam , The Netherlands
| | - Paul J Borgstein
- g Department of Surgical Oncology , Onze Lieve Vrouwe Gasthuis Location East , Amsterdam , The Netherlands
| | - Gijsbert Heuff
- h Department of Surgical Oncology , Spaarne Gasthuis Hoofddorp , Hoofddorp , The Netherlands
| | | | - Peter W Plaisier
- j Department of General Surgery , Albert Schweitzer Hospital , Dordrecht , The Netherlands
| | - Herman Rijna
- k Department of Surgical Oncology , Spaarne Gasthuis Haarlem , Haarlem , The Netherlands
| | - Suzan van der Meij
- l Department of Surgical Oncology , Flevo Hospital , Almere , The Netherlands
| | - Eric J van Dulken
- m Department of Surgical Oncology , Medical Center Slotervaart , Amsterdam , The Netherlands
| | - Bart C Vrouenraets
- n Department of Surgery , Onze Lieve Vrouwe Gasthuis Location West , Amsterdam , The Netherlands
| | - Eva Broomans
- o Department of Adult Care , Virenze Institute of Mental Health Care , Utrecht , The Netherlands
- p PsyQ Institute of Mental Health Care , Almere , The Netherlands
| | - Neil K Aaronson
- a Division of Psychosocial Research and Epidemiology , The Netherlands Cancer Institute , Amsterdam , The Netherlands
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15
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Reuling EMBP, Dickhoff C, Plaisier PW, Coupé VMH, Mazairac AHA, Lely RJ, Bonjer HJ, Daniels JMA. Endobronchial Treatment for Bronchial Carcinoid: Patient Selection and Predictors of Outcome. Respiration 2018; 95:220-227. [PMID: 29433123 DOI: 10.1159/000484984] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Accepted: 11/06/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Traditionally, surgical resection is the preferred treatment for typical carcinoids and atypical carcinoids located in the lungs. Recently however, several studies have shown excellent long-term outcome after endobronchial treatment of carcinoid tumors located in the central airways. This study investigates clinical and radiological features as predictors of successful endobronchial treatment in patients with a bronchial carcinoid tumor. OBJECTIVES To identify clinical and radiological features predictive of successful endobronchial treatment in patients with bronchial carcinoid. METHODS This analysis was performed in a cohort of patients with typical and atypical bronchial carcinoid referred for endobronchial treatment. Several patient characteristics, radiological features, and histological grade (typical or atypical carcinoid) were tested as predictors of successful endobronchial treatment. RESULTS One hundred and twenty-five patients with a diagnosis of bronchial carcinoid underwent endobronchial treatment. On multivariate analysis, a tumor diameter <15 mm (odds ratio 0.09; 95% confidence interval 0.02-0.5; p = <0.01) and purely intraluminal growth on computer tomography (CT scan) (odds ratio, 9.1; 95% confidence interval 1.8-45.8; p = <0.01) were predictive of radical endobronchial treatment. The success rate for intraluminal tumors with a diameter <20 mm was 72%. CONCLUSIONS Purely intraluminal disease and tumor diameter on CT scan seem to be independent predictors for successful endobronchial treatment in patients with bronchial carcinoid. Based on these data, patients with purely intraluminal carcinoid tumors with a diameter <20 mm on CT scan are good candidates for endobronchial treatment, regardless of histological grade. In contrast, all patients with a tumor diameter ≥20 mm should be directly referred for surgery.
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Affiliation(s)
- Ellen M B P Reuling
- Department of Surgery, VU University Medical Center, Amsterdam, the Netherlands.,Department of Surgery, Albert Schweitzer Hospital, Dordrecht, the Netherlands
| | - Chris Dickhoff
- Department of Surgery, VU University Medical Center, Amsterdam, the Netherlands.,Department of Cardiothoracic Surgery, VU University Medical Center, Amsterdam, the Netherlands
| | - Peter W Plaisier
- Department of Surgery, Albert Schweitzer Hospital, Dordrecht, the Netherlands
| | - Veerle M H Coupé
- Department of Epidemiology and Statistics, VU University Medical Center, Amsterdam, the Netherlands
| | - Albert H A Mazairac
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, the Netherlands
| | - Rutger J Lely
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, the Netherlands
| | - H Jaap Bonjer
- Department of Surgery, VU University Medical Center, Amsterdam, the Netherlands
| | - Johannes M A Daniels
- Department of Pulmonary Diseases, VU University Medical Center, Amsterdam, the Netherlands
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16
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Hummel SB, van Lankveld JJDM, Oldenburg HSA, Hahn DEE, Kieffer JM, Gerritsma MA, Kuenen MA, Bijker N, Borgstein PJ, Heuff G, Lopes Cardozo AMF, Plaisier PW, Rijna H, van der Meij S, van Dulken EJ, Vrouenraets BC, Broomans E, Aaronson NK. Efficacy of Internet-Based Cognitive Behavioral Therapy in Improving Sexual Functioning of Breast Cancer Survivors: Results of a Randomized Controlled Trial. J Clin Oncol 2017; 35:1328-1340. [PMID: 28240966 DOI: 10.1200/jco.2016.69.6021] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose We evaluated the effect of Internet-based cognitive behavioral therapy (CBT) on sexual functioning and relationship intimacy (primary outcomes) and body image, menopausal symptoms, marital functioning, psychological distress, and health-related quality of life (secondary outcomes) in breast cancer survivors (BCSs) with a DSM-IV diagnosis of a sexual dysfunction. Patients and Methods We randomly assigned 169 BCSs to either Internet-based CBT or a waiting-list control group. The CBT consisted of weekly therapist-guided sessions, with a maximum duration of 24 weeks. Self-report questionnaires were completed by the intervention group at baseline (T0), midtherapy (T1), and post-therapy (T2) and at equivalent times by the control group. We used a mixed-effect modeling approach to compare the groups over time. Results Compared with the control group, the intervention group showed a significant improvement over time in overall sexual functioning (effect size for T2 [EST2] = .43; P = .031), which was reflected in an increase in sexual desire (EST1 = .48 and EST2 = .72; P < .001), sexual arousal (EST2 = .50; P = .008), and vaginal lubrication (EST2 = .46; P = .013). The intervention group reported more improvement over time in sexual pleasure (EST1 = .32 and EST2 = .62; P = .001), less discomfort during sex (EST1 = .49 and EST2 = .66; P = .001), and less sexual distress (EST2 = .59; P = .002) compared with the control group. The intervention group reported greater improvement in body image (EST2 = .45; P = .009) and fewer menopausal symptoms (EST1 = .39; P = .007) than the control group. No significant effects were observed for orgasmic function, sexual satisfaction, intercourse frequency, relationship intimacy, marital functioning, psychological distress, or health-related quality of life. Conclusion Internet-based CBT has salutary effects on sexual functioning, body image, and menopausal symptoms in BCSs with a sexual dysfunction.
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Affiliation(s)
- Susanna B Hummel
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Jacques J D M van Lankveld
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Hester S A Oldenburg
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Daniela E E Hahn
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Jacobien M Kieffer
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Miranda A Gerritsma
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Marianne A Kuenen
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Nina Bijker
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Paul J Borgstein
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Gijsbert Heuff
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Alexander M F Lopes Cardozo
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Peter W Plaisier
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Herman Rijna
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Suzan van der Meij
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Eric J van Dulken
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Bart C Vrouenraets
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Eva Broomans
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Neil K Aaronson
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
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Buisman FE, van Gelder L, Menke-Pluijmers MBE, Bisschops BHC, Plaisier PW, Westenend PJ. Non-primary breast malignancies: a single institution's experience of a diagnostic challenge with important therapeutic consequences-a retrospective study. World J Surg Oncol 2016; 14:166. [PMID: 27337944 PMCID: PMC4918012 DOI: 10.1186/s12957-016-0915-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 06/15/2016] [Indexed: 11/25/2022] Open
Abstract
Background Breast cancer is a common malignancy, but metastases to the breast of extramammary malignancies are very rare. Treatment and prognosis are different. The aim of the study is to report the incidence of lymphomas and metastases to the breast of extramammary malignancies in our 30-year archive. Methods The pathology database of a single institute was reviewed for all breast neoplasms which were coded in our system as a metastasis in the period 1985–2014. Metastatic tumors from primary breast carcinoma were excluded. Results A total of 47 patients were included (7 men/40 women, mean age 63 years). The majority originated from lymphoma (n = 18) and primary melanoma (n = 11). Other primary tumor sites included the ovary (n = 6), lung (n = 6), colon (n = 3), kidney (n = 1), stomach (n = 1), and chorion (n = 1). In 24/47 patients (51 %), metastasis was the first sign of the specific malignant disease. In seven patients (15 %) surgery was performed, the diagnosis of metastatic disease was adjusted in four patients (9 %) postoperatively. Conclusions It is important to distinguish lymphomas and metastases to the breast from common primary breast carcinoma for proper treatment and prognosis. Therefore, we emphasize the need for a histological or cytopathological diagnosis before any treatment is commenced. The pathologist plays a key role in considering the diagnosis of metastasis if the histological features are unusual for a primary breast carcinoma. The pathologist should therefore be properly informed by the clinical physician although lymphomas and metastases to the breast are the first presentation of malignant disease in half the cases.
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Affiliation(s)
- Florian E Buisman
- Department of Surgery, Albert Schweitzer Hospital, Dordrecht, The Netherlands. .,Department of Surgery, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
| | - Linda van Gelder
- Department of Surgery, Albert Schweitzer Hospital, Dordrecht, The Netherlands
| | | | - Bob H C Bisschops
- Department of Radiology, Albert Schweitzer Hospital, Dordrecht, The Netherlands
| | - Peter W Plaisier
- Department of Surgery, Albert Schweitzer Hospital, Dordrecht, The Netherlands
| | - Pieter J Westenend
- Laboratory of Pathology, Albert Schweitzer Hospital, Dordrecht, The Netherlands
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18
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van Gelder L, Bisschops RHC, Menke-Pluymers MBE, Westenend PJ, Plaisier PW. Magnetic resonance imaging in patients with unilateral bloody nipple discharge; useful when conventional diagnostics are negative? World J Surg 2015; 39:184-6. [PMID: 25123174 DOI: 10.1007/s00268-014-2701-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Unilateral bloody nipple discharge (UBND) is mostly caused by benign conditions such as papilloma or ductal ectasia. However, in 7-33 % of all nipple discharge, it is caused by breast cancer. Conventional diagnostic imaging like mammography (MMG) and ultrasonography (US) is performed to exclude malignancy. Preliminary investigations of breast magnetic resonance imaging (MRI) assume that it has additional value. With an increasing availability of MRI, it is of clinical importance to evaluate this. We evaluated the additional diagnostic value of MRI in patients with UBND in the absence of a palpable mass, with normal conventional imaging. METHODS All women with UBND in the period November 2007-July 2012 were included. In addition to the standard work-up (patient's history, physical examination, MMG, and US), MRI was performed. Data from these examinations and treatment were collected retrospectively. RESULTS A total of 111 women (mean age 52 years; range 23-80) were included. In nine (8 %) patients, malignancy was suspected on MRI while conventional imaging was normal. In eight (89 %) of these patients, histology was obtained, two by core biopsy and six by terminal duct excision. Benign conditions were found in six patients (86 %) and a (pre-) malignant lesion in two patients. In both cases, it concerned a ductal carcinoma in situ, which was treated with breast-conserving therapy. Moreover, in two cases of (pre)malignancy, the MRI was interpreted as negative. CONCLUSION In patients with UBND who show no signs of a malignancy on conventional diagnostic examinations, the added value of a breast MRI is limited, since a malignancy can be demonstrated in <2 %.
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Affiliation(s)
- L van Gelder
- Department of Surgery, Albert Schweitzer Hospital, Albert Schweitzerplaats 25, 3318 AT, Dordrecht, The Netherlands,
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19
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Leeneman B, Franken MG, Blommestein HM, van Gils CWM, van der Meijde E, Wouters MWJM, Plaisier PW, Kruit WHJ, van Ruth S, Ten Tije AJ, Hendriks MP, Coupe VMH, Uyl-de Groot CA. The Importance of Long-Term Surveillance of Stage IB Melanomas: Unexpectedly Low Survival Subsequent to Recurrence. Value Health 2014; 17:A618-A619. [PMID: 27202168 DOI: 10.1016/j.jval.2014.08.2187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- B Leeneman
- Erasmus University, Rotterdam, The Netherlands
| | - M G Franken
- Erasmus University, Rotterdam, The Netherlands
| | | | | | | | - M W J M Wouters
- Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | - P W Plaisier
- Albert Schweitzer Hospital, Dordrecht, The Netherlands
| | - W H J Kruit
- Erasmus Medical Center, Rotterdam, The Netherlands
| | - S van Ruth
- Tergooi Hospital, Hilversum, The Netherlands
| | | | - M P Hendriks
- Medical Center Alkmaar, Alkmaar, The Netherlands
| | - V M H Coupe
- VU University Medical Center, Amsterdam, The Netherlands
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Damhuis RA, Maat AP, Plaisier PW. Performance indicators for lung cancer surgery in the Netherlands. Eur J Cardiothorac Surg 2014; 47:897-903; discussion 903-4. [PMID: 25187534 DOI: 10.1093/ejcts/ezu329] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Accepted: 07/22/2014] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES In the Netherlands, surgery for lung cancer is traditionally performed in low-volume hospitals. To assess the need for centralization, we examined early outcome measures and compared results between hospitals and with other European countries. METHODS Data on patient, tumour and treatment characteristics were retrieved from the Netherlands Cancer Registry. Results were tabulated for 30-day postoperative mortality (POM), major morbidity rate (intrathoracic empyema, bronchopleural fistula or rethoracotomy) and pneumonectomy proportion. Hospital variation was projected using funnel graphs in which the results for individual hospitals are plotted against volume. RESULTS The study comprised a series of 9579 patients with primary non-small cell lung cancer, diagnosed from 2005 through 2010 and operated in 79 different hospitals. The POM was 2.7% on average and age, gender, period and type of surgery were determined as prognostic factors. Multivariable analysis did not reveal an association with hospital volume (P = 0.34). The POM was higher for operations on Fridays (4.0%) or during weekends (6.8%). Major morbidity was observed after 8.3% of operations and was more frequent after bilobectomy (11.6%) or right pneumonectomy (22%). The pneumonectomy proportion decreased from 18% in 2005 to 11% in 2010. Funnel plots revealed a limited number of significant outliers, despite combining data over a 6-year period. CONCLUSIONS Results for the Netherlands were similar to those from other European countries. Hospital volume was not associated with early outcome indicators. Quality assessment at the hospital level remains a major challenge given the low frequency of adverse events and the impediments of chance variation.
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Affiliation(s)
- Ronald A Damhuis
- Department of Registry and Research, Comprehensive Cancer Centre the Netherlands, Rotterdam, Netherlands
| | - Alex P Maat
- Department of Cardiothoracic Surgery, Erasmus Medical Centre, Rotterdam, Netherlands
| | - Peter W Plaisier
- Department of General Surgery, Albert Schweitzer Hospital, Dordrecht, Netherlands
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Abstract
An incarcerated inguinal hernia is a common diagnosis, since the risk of an inguinal hernia incarcerating or strangulating is around 0.3-3%. An acute rupture of the adductor longus tendon is rarely seen and mostly affects (semi-) professional sportsmen. We present a case of a patient with an assumed incarcerated inguinal hernia which turned out to be a proximal adductor longus tendon rupture. If patients without a history of inguinal hernia present themselves with acute groin pain after suddenly exorotating the upper leg, a rupture of the adductor longus tendon should be considered. Both surgical and non-surgical treatment can be performed.
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Affiliation(s)
- Bas R J Aerts
- Department of Surgery, Albert Schweitzer Hospital, Dordrecht, The Netherlands
| | - Peter W Plaisier
- Department of Surgery, Albert Schweitzer Hospital, Dordrecht, The Netherlands
| | - Tijs S C Jakma
- Department of Surgery, Albert Schweitzer Hospital, Dordrecht, The Netherlands.
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22
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Tamminga SJ, Verbeek JHAM, Bos MMEM, Fons G, Kitzen JJEM, Plaisier PW, Frings-Dresen MHW, de Boer AGEM. Effectiveness of a hospital-based work support intervention for female cancer patients - a multi-centre randomised controlled trial. PLoS One 2013; 8:e63271. [PMID: 23717406 PMCID: PMC3661555 DOI: 10.1371/journal.pone.0063271] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Accepted: 04/02/2013] [Indexed: 12/24/2022] Open
Abstract
Objective One key aspect of cancer survivorship is return-to-work. Unfortunately, many cancer survivors face problems upon their return-to-work. For that reason, we developed a hospital-based work support intervention aimed at enhancing return-to-work. We studied effectiveness of the intervention compared to usual care for female cancer patients in a multi-centre randomised controlled trial. Methods Breast and gynaecological cancer patients who were treated with curative intent and had paid work were randomised to the intervention group (n = 65) or control group (n = 68). The intervention involved patient education and support at the hospital and improvement of communication between treating and occupational physicians. In addition, we asked patient's occupational physician to organise a meeting with the patient and the supervisor to make a concrete gradual return-to-work plan. Outcomes at 12 months of follow-up included rate and time until return-to-work (full or partial), quality of life, work ability, work functioning, and lost productivity costs. Time until return-to-work was analyzed with Kaplan-Meier survival analysis. Results Return-to-work rates were 86% and 83% (p = 0.6) for the intervention group and control group when excluding 8 patients who died or with a life expectancy of months at follow-up. Median time from initial sick leave to partial return-to-work was 194 days (range 14–435) versus 192 days (range 82–465) (p = 0.90) with a hazard ratio of 1.03 (95% CI 0.64–1.6). Quality of life and work ability improved statistically over time but did not differ statistically between groups. Work functioning and costs did not differ statistically between groups. Conclusion The intervention was easily implemented into usual psycho-oncological care and showed high return-to-work rates. We failed to show any differences between groups on return-to-work outcomes and quality of life scores. Further research is needed to study which aspects of the intervention are useful and which elements need improvement. Trial Registration Nederlands Trial Register (NTR) 1658
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Affiliation(s)
- Sietske J Tamminga
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
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van Rongen I, Damhuis RAM, van der Hoeven JAB, Plaisier PW. Comparison of extended hemicolectomy versus transverse colectomy in patients with cancer of the transverse colon. Acta Chir Belg 2013; 113:107-111. [PMID: 23741929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Cancer of the transverse colon is rare and postoperative mortality tends to be high. Standard surgical treatment involves either extended hemicolectomy or transverse colectomy, depending on the location of the tumour. The aim of the present study was to compare postoperative mortality and five-year survival between these types of surgery. METHODS For this observational study, data on patients with a tumour of the transverse colon, treated by open resection in the Dordrecht Hospital from 1989 through 2003, were derived from the database of the regional cancer registry. Information on type of resection, tumour stage, complications, postoperative mortality (30-day) and survival was abstracted from the medical files. Patients with multi-organ surgery, (sub)total colectomy or stage IV disease were excluded from the analysis, leaving a total series of 103 patients. RESULTS Transverse colectomy comprised one third of operations, predominantly involving partial resections. Postoperative mortality was 6% (2/34) after transverse colectomy and 7% (5/69) after extended hemicolectomy. Five-year survival was slightly higher for the hemicolectomy group (61% versus 50%), but this difference did not reach statistical significance (p = 0.34). CONCLUSION Our results confirm the high postoperative risk after surgery for cancer of the transverse colon and show that this risk does not depend on the type of surgery. Considering the satisfactory results after partial transverse colectomy, segmental resections may be considered as an option for the treatment of localised tumours of the transverse colon.
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Affiliation(s)
- I van Rongen
- Department of Surgery, Albert Schweitzer Hospital, Dordrecht, The Netherlands
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Tamminga SJ, de Boer AGEM, Bos MMEM, Fons G, Kitzen JJEM, Plaisier PW, Verbeek JHAM, Frings-Dresen MHW. A hospital-based work support intervention to enhance the return to work of cancer patients: a process evaluation. J Occup Rehabil 2012; 22:565-78. [PMID: 22699884 PMCID: PMC3484279 DOI: 10.1007/s10926-012-9372-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
PURPOSE To perform a process evaluation of a hospital-based work support intervention for cancer patients aimed at enhancing return to work and quality of life. The intervention involves the delivery of patient education and support at the hospital and involves the improvement of the communication between the treating physician and the occupational physician. In addition, the research team asked patient's occupational physician to organise a meeting with the patient and the supervisor to make a concrete gradual return-to-work plan. METHODS Eligible were cancer patients treated with curative intent and who have paid work. Data were collected from patients assigned to the intervention group (N = 65) and from nurses who delivered the patient education and support at the hospital (N = 4) by means of questionnaires, nurses' reports, and checklists. Data were quantitatively and qualitatively analysed. RESULTS A total of 47 % of all eligible patients participated. Nurses delivered the patient education and support in 85 % of the cases according to the protocol. In 100 % of the cases at least one letter was sent to the occupational physician. In 10 % of the cases the meeting with the patient, the occupational physician and the supervisor took place. Patients found the intervention in general very useful and nurses found the intervention feasible to deliver. CONCLUSIONS We found that a hospital- based work support intervention was easily accepted in usual psycho-oncological care but that it proved difficult to involve the occupational physician. Patients were highly satisfied and nurses found the intervention feasible.
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Affiliation(s)
- S J Tamminga
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, PO Box 22700, 1100 DE, Amsterdam, The Netherlands.
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Duijts SF, van Beurden M, Oldenburg HS, Hunter MS, Kieffer JM, Stuiver MM, Gerritsma MA, Menke-Pluymers MB, Plaisier PW, Rijna H, Lopes Cardozo AM, Timmers G, van der Meij S, van der Veen H, Bijker N, de Widt-Levert LM, Geenen MM, Heuff G, van Dulken EJ, Boven E, Aaronson NK. Efficacy of Cognitive Behavioral Therapy and Physical Exercise in Alleviating Treatment-Induced Menopausal Symptoms in Patients With Breast Cancer: Results of a Randomized, Controlled, Multicenter Trial. J Clin Oncol 2012; 30:4124-33. [PMID: 23045575 DOI: 10.1200/jco.2012.41.8525] [Citation(s) in RCA: 150] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Purpose The purpose of our study was to evaluate the effect of cognitive behavioral therapy (CBT), physical exercise (PE), and of these two interventions combined (CBT/PE) on menopausal symptoms (primary outcome), body image, sexual functioning, psychological well-being, and health-related quality of life (secondary outcomes) in patients with breast cancer experiencing treatment-induced menopause. Patients and Methods Patients with breast cancer reporting treatment-induced menopausal symptoms (N = 422) were randomly assigned to CBT (n = 109), PE (n = 104), CBT/PE (n = 106), or to a waiting list control group (n = 103). Self-report questionnaires were completed at baseline, 12 weeks, and 6 months. Multilevel procedures were used to compare the intervention groups with the control group over time. Results Compared with the control group, the intervention groups had a significant decrease in levels of endocrine symptoms (Functional Assessment of Cancer Therapy–Endocrine Symptoms; P < .001; effect size, 0.31-0.52) and urinary symptoms (Bristol Female Lower Urinary Tract Symptoms Questionnaire; P = .002; effect size, 0.29-0.33), and they showed an improvement in physical functioning (36-Item Short Form Health Survey physical functioning subscale; P = .002; effect size, 0.37-0.46). The groups that included CBT also showed a significant decrease in the perceived burden of hot flashes and night sweats (problem rating scale of the Hot Flush Rating Scale; P < .001; effect size, 0.39-0.56) and an increase in sexual activity (Sexual Activity Questionnaire habit subscale; P = .027; effect size, 0.65). Most of these effects were observed at both the 12-week and 6-month follow-ups. Conclusion CBT and PE can have salutary effects on endocrine symptoms and, to a lesser degree, on sexuality and physical functioning of patients with breast cancer experiencing treatment-induced menopause. Future work is needed to improve the design and the planning of these interventions to improve program adherence.
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Affiliation(s)
- Saskia F.A. Duijts
- Saskia F.A. Duijts, Jacobien M. Kieffer, Miranda A. Gerritsma, Neil K. Aaronson, the Netherlands Cancer Institute; Marc van Beurden, Hester S.A. Oldenburg, Martijn M. Stuiver, Antoni van Leeuwenhoek Hospital; Nina Bijker, Academic Medical Center; Maud M. Geenen, Sint Lucas Andreas Hospital; Eric J. van Dulken, Slotervaart Hospital; Epie Boven, Vrije Universiteit Medical Center, Amsterdam; Marian B.E. Menke-Pluymers, Erasmus Medical Center, Rotterdam; Peter W. Plaisier, Albert Schweitzer Hospital,
| | - Marc van Beurden
- Saskia F.A. Duijts, Jacobien M. Kieffer, Miranda A. Gerritsma, Neil K. Aaronson, the Netherlands Cancer Institute; Marc van Beurden, Hester S.A. Oldenburg, Martijn M. Stuiver, Antoni van Leeuwenhoek Hospital; Nina Bijker, Academic Medical Center; Maud M. Geenen, Sint Lucas Andreas Hospital; Eric J. van Dulken, Slotervaart Hospital; Epie Boven, Vrije Universiteit Medical Center, Amsterdam; Marian B.E. Menke-Pluymers, Erasmus Medical Center, Rotterdam; Peter W. Plaisier, Albert Schweitzer Hospital,
| | - Hester S.A. Oldenburg
- Saskia F.A. Duijts, Jacobien M. Kieffer, Miranda A. Gerritsma, Neil K. Aaronson, the Netherlands Cancer Institute; Marc van Beurden, Hester S.A. Oldenburg, Martijn M. Stuiver, Antoni van Leeuwenhoek Hospital; Nina Bijker, Academic Medical Center; Maud M. Geenen, Sint Lucas Andreas Hospital; Eric J. van Dulken, Slotervaart Hospital; Epie Boven, Vrije Universiteit Medical Center, Amsterdam; Marian B.E. Menke-Pluymers, Erasmus Medical Center, Rotterdam; Peter W. Plaisier, Albert Schweitzer Hospital,
| | - Myra S. Hunter
- Saskia F.A. Duijts, Jacobien M. Kieffer, Miranda A. Gerritsma, Neil K. Aaronson, the Netherlands Cancer Institute; Marc van Beurden, Hester S.A. Oldenburg, Martijn M. Stuiver, Antoni van Leeuwenhoek Hospital; Nina Bijker, Academic Medical Center; Maud M. Geenen, Sint Lucas Andreas Hospital; Eric J. van Dulken, Slotervaart Hospital; Epie Boven, Vrije Universiteit Medical Center, Amsterdam; Marian B.E. Menke-Pluymers, Erasmus Medical Center, Rotterdam; Peter W. Plaisier, Albert Schweitzer Hospital,
| | - Jacobien M. Kieffer
- Saskia F.A. Duijts, Jacobien M. Kieffer, Miranda A. Gerritsma, Neil K. Aaronson, the Netherlands Cancer Institute; Marc van Beurden, Hester S.A. Oldenburg, Martijn M. Stuiver, Antoni van Leeuwenhoek Hospital; Nina Bijker, Academic Medical Center; Maud M. Geenen, Sint Lucas Andreas Hospital; Eric J. van Dulken, Slotervaart Hospital; Epie Boven, Vrije Universiteit Medical Center, Amsterdam; Marian B.E. Menke-Pluymers, Erasmus Medical Center, Rotterdam; Peter W. Plaisier, Albert Schweitzer Hospital,
| | - Martijn M. Stuiver
- Saskia F.A. Duijts, Jacobien M. Kieffer, Miranda A. Gerritsma, Neil K. Aaronson, the Netherlands Cancer Institute; Marc van Beurden, Hester S.A. Oldenburg, Martijn M. Stuiver, Antoni van Leeuwenhoek Hospital; Nina Bijker, Academic Medical Center; Maud M. Geenen, Sint Lucas Andreas Hospital; Eric J. van Dulken, Slotervaart Hospital; Epie Boven, Vrije Universiteit Medical Center, Amsterdam; Marian B.E. Menke-Pluymers, Erasmus Medical Center, Rotterdam; Peter W. Plaisier, Albert Schweitzer Hospital,
| | - Miranda A. Gerritsma
- Saskia F.A. Duijts, Jacobien M. Kieffer, Miranda A. Gerritsma, Neil K. Aaronson, the Netherlands Cancer Institute; Marc van Beurden, Hester S.A. Oldenburg, Martijn M. Stuiver, Antoni van Leeuwenhoek Hospital; Nina Bijker, Academic Medical Center; Maud M. Geenen, Sint Lucas Andreas Hospital; Eric J. van Dulken, Slotervaart Hospital; Epie Boven, Vrije Universiteit Medical Center, Amsterdam; Marian B.E. Menke-Pluymers, Erasmus Medical Center, Rotterdam; Peter W. Plaisier, Albert Schweitzer Hospital,
| | - Marian B.E. Menke-Pluymers
- Saskia F.A. Duijts, Jacobien M. Kieffer, Miranda A. Gerritsma, Neil K. Aaronson, the Netherlands Cancer Institute; Marc van Beurden, Hester S.A. Oldenburg, Martijn M. Stuiver, Antoni van Leeuwenhoek Hospital; Nina Bijker, Academic Medical Center; Maud M. Geenen, Sint Lucas Andreas Hospital; Eric J. van Dulken, Slotervaart Hospital; Epie Boven, Vrije Universiteit Medical Center, Amsterdam; Marian B.E. Menke-Pluymers, Erasmus Medical Center, Rotterdam; Peter W. Plaisier, Albert Schweitzer Hospital,
| | - Peter W. Plaisier
- Saskia F.A. Duijts, Jacobien M. Kieffer, Miranda A. Gerritsma, Neil K. Aaronson, the Netherlands Cancer Institute; Marc van Beurden, Hester S.A. Oldenburg, Martijn M. Stuiver, Antoni van Leeuwenhoek Hospital; Nina Bijker, Academic Medical Center; Maud M. Geenen, Sint Lucas Andreas Hospital; Eric J. van Dulken, Slotervaart Hospital; Epie Boven, Vrije Universiteit Medical Center, Amsterdam; Marian B.E. Menke-Pluymers, Erasmus Medical Center, Rotterdam; Peter W. Plaisier, Albert Schweitzer Hospital,
| | - Herman Rijna
- Saskia F.A. Duijts, Jacobien M. Kieffer, Miranda A. Gerritsma, Neil K. Aaronson, the Netherlands Cancer Institute; Marc van Beurden, Hester S.A. Oldenburg, Martijn M. Stuiver, Antoni van Leeuwenhoek Hospital; Nina Bijker, Academic Medical Center; Maud M. Geenen, Sint Lucas Andreas Hospital; Eric J. van Dulken, Slotervaart Hospital; Epie Boven, Vrije Universiteit Medical Center, Amsterdam; Marian B.E. Menke-Pluymers, Erasmus Medical Center, Rotterdam; Peter W. Plaisier, Albert Schweitzer Hospital,
| | - Alexander M.F. Lopes Cardozo
- Saskia F.A. Duijts, Jacobien M. Kieffer, Miranda A. Gerritsma, Neil K. Aaronson, the Netherlands Cancer Institute; Marc van Beurden, Hester S.A. Oldenburg, Martijn M. Stuiver, Antoni van Leeuwenhoek Hospital; Nina Bijker, Academic Medical Center; Maud M. Geenen, Sint Lucas Andreas Hospital; Eric J. van Dulken, Slotervaart Hospital; Epie Boven, Vrije Universiteit Medical Center, Amsterdam; Marian B.E. Menke-Pluymers, Erasmus Medical Center, Rotterdam; Peter W. Plaisier, Albert Schweitzer Hospital,
| | - Gertjan Timmers
- Saskia F.A. Duijts, Jacobien M. Kieffer, Miranda A. Gerritsma, Neil K. Aaronson, the Netherlands Cancer Institute; Marc van Beurden, Hester S.A. Oldenburg, Martijn M. Stuiver, Antoni van Leeuwenhoek Hospital; Nina Bijker, Academic Medical Center; Maud M. Geenen, Sint Lucas Andreas Hospital; Eric J. van Dulken, Slotervaart Hospital; Epie Boven, Vrije Universiteit Medical Center, Amsterdam; Marian B.E. Menke-Pluymers, Erasmus Medical Center, Rotterdam; Peter W. Plaisier, Albert Schweitzer Hospital,
| | - Suzan van der Meij
- Saskia F.A. Duijts, Jacobien M. Kieffer, Miranda A. Gerritsma, Neil K. Aaronson, the Netherlands Cancer Institute; Marc van Beurden, Hester S.A. Oldenburg, Martijn M. Stuiver, Antoni van Leeuwenhoek Hospital; Nina Bijker, Academic Medical Center; Maud M. Geenen, Sint Lucas Andreas Hospital; Eric J. van Dulken, Slotervaart Hospital; Epie Boven, Vrije Universiteit Medical Center, Amsterdam; Marian B.E. Menke-Pluymers, Erasmus Medical Center, Rotterdam; Peter W. Plaisier, Albert Schweitzer Hospital,
| | - Henk van der Veen
- Saskia F.A. Duijts, Jacobien M. Kieffer, Miranda A. Gerritsma, Neil K. Aaronson, the Netherlands Cancer Institute; Marc van Beurden, Hester S.A. Oldenburg, Martijn M. Stuiver, Antoni van Leeuwenhoek Hospital; Nina Bijker, Academic Medical Center; Maud M. Geenen, Sint Lucas Andreas Hospital; Eric J. van Dulken, Slotervaart Hospital; Epie Boven, Vrije Universiteit Medical Center, Amsterdam; Marian B.E. Menke-Pluymers, Erasmus Medical Center, Rotterdam; Peter W. Plaisier, Albert Schweitzer Hospital,
| | - Nina Bijker
- Saskia F.A. Duijts, Jacobien M. Kieffer, Miranda A. Gerritsma, Neil K. Aaronson, the Netherlands Cancer Institute; Marc van Beurden, Hester S.A. Oldenburg, Martijn M. Stuiver, Antoni van Leeuwenhoek Hospital; Nina Bijker, Academic Medical Center; Maud M. Geenen, Sint Lucas Andreas Hospital; Eric J. van Dulken, Slotervaart Hospital; Epie Boven, Vrije Universiteit Medical Center, Amsterdam; Marian B.E. Menke-Pluymers, Erasmus Medical Center, Rotterdam; Peter W. Plaisier, Albert Schweitzer Hospital,
| | - Louise M. de Widt-Levert
- Saskia F.A. Duijts, Jacobien M. Kieffer, Miranda A. Gerritsma, Neil K. Aaronson, the Netherlands Cancer Institute; Marc van Beurden, Hester S.A. Oldenburg, Martijn M. Stuiver, Antoni van Leeuwenhoek Hospital; Nina Bijker, Academic Medical Center; Maud M. Geenen, Sint Lucas Andreas Hospital; Eric J. van Dulken, Slotervaart Hospital; Epie Boven, Vrije Universiteit Medical Center, Amsterdam; Marian B.E. Menke-Pluymers, Erasmus Medical Center, Rotterdam; Peter W. Plaisier, Albert Schweitzer Hospital,
| | - Maud M. Geenen
- Saskia F.A. Duijts, Jacobien M. Kieffer, Miranda A. Gerritsma, Neil K. Aaronson, the Netherlands Cancer Institute; Marc van Beurden, Hester S.A. Oldenburg, Martijn M. Stuiver, Antoni van Leeuwenhoek Hospital; Nina Bijker, Academic Medical Center; Maud M. Geenen, Sint Lucas Andreas Hospital; Eric J. van Dulken, Slotervaart Hospital; Epie Boven, Vrije Universiteit Medical Center, Amsterdam; Marian B.E. Menke-Pluymers, Erasmus Medical Center, Rotterdam; Peter W. Plaisier, Albert Schweitzer Hospital,
| | - Gijsbert Heuff
- Saskia F.A. Duijts, Jacobien M. Kieffer, Miranda A. Gerritsma, Neil K. Aaronson, the Netherlands Cancer Institute; Marc van Beurden, Hester S.A. Oldenburg, Martijn M. Stuiver, Antoni van Leeuwenhoek Hospital; Nina Bijker, Academic Medical Center; Maud M. Geenen, Sint Lucas Andreas Hospital; Eric J. van Dulken, Slotervaart Hospital; Epie Boven, Vrije Universiteit Medical Center, Amsterdam; Marian B.E. Menke-Pluymers, Erasmus Medical Center, Rotterdam; Peter W. Plaisier, Albert Schweitzer Hospital,
| | - Eric J. van Dulken
- Saskia F.A. Duijts, Jacobien M. Kieffer, Miranda A. Gerritsma, Neil K. Aaronson, the Netherlands Cancer Institute; Marc van Beurden, Hester S.A. Oldenburg, Martijn M. Stuiver, Antoni van Leeuwenhoek Hospital; Nina Bijker, Academic Medical Center; Maud M. Geenen, Sint Lucas Andreas Hospital; Eric J. van Dulken, Slotervaart Hospital; Epie Boven, Vrije Universiteit Medical Center, Amsterdam; Marian B.E. Menke-Pluymers, Erasmus Medical Center, Rotterdam; Peter W. Plaisier, Albert Schweitzer Hospital,
| | - Epie Boven
- Saskia F.A. Duijts, Jacobien M. Kieffer, Miranda A. Gerritsma, Neil K. Aaronson, the Netherlands Cancer Institute; Marc van Beurden, Hester S.A. Oldenburg, Martijn M. Stuiver, Antoni van Leeuwenhoek Hospital; Nina Bijker, Academic Medical Center; Maud M. Geenen, Sint Lucas Andreas Hospital; Eric J. van Dulken, Slotervaart Hospital; Epie Boven, Vrije Universiteit Medical Center, Amsterdam; Marian B.E. Menke-Pluymers, Erasmus Medical Center, Rotterdam; Peter W. Plaisier, Albert Schweitzer Hospital,
| | - Neil K. Aaronson
- Saskia F.A. Duijts, Jacobien M. Kieffer, Miranda A. Gerritsma, Neil K. Aaronson, the Netherlands Cancer Institute; Marc van Beurden, Hester S.A. Oldenburg, Martijn M. Stuiver, Antoni van Leeuwenhoek Hospital; Nina Bijker, Academic Medical Center; Maud M. Geenen, Sint Lucas Andreas Hospital; Eric J. van Dulken, Slotervaart Hospital; Epie Boven, Vrije Universiteit Medical Center, Amsterdam; Marian B.E. Menke-Pluymers, Erasmus Medical Center, Rotterdam; Peter W. Plaisier, Albert Schweitzer Hospital,
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Smeenk RM, Plaisier PW, van der Hoeven JAB, Hesp WLEM. Outcome of surgery for colovesical and colovaginal fistulas of diverticular origin in 40 patients. J Gastrointest Surg 2012; 16:1559-65. [PMID: 22653331 DOI: 10.1007/s11605-012-1919-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2012] [Accepted: 05/15/2012] [Indexed: 02/08/2023]
Abstract
INTRODUCTION According to literature, colonic resection with a primary anastomosis and no defunctioning ileostomy is a safe treatment for colovesical or colovaginal fistula of diverticular origin. This study investigates the outcome of surgery for this patient group in a regional hospital. METHODS Patients were obtained from a prospective database in the period 2004-2011. Several variables were investigated for their relation with surgical outcome. RESULTS A colovesical (n = 35) or colovaginal (n = 5) fistula was diagnosed in 18 men and 22 women. The mean age was 69 years (range, 45-90). A rectosigmoid resection with primary anastomosis was performed in 32 patients. Fourteen patients received a defunctioning ileostomy. Eight patients were treated with a Hartmann procedure. Overall 30-day treatment-related morbidity and mortality was 48 and 8 %, respectively. Major morbidity, because of anastomotic leakage, was mainly observed in the primary anastomosis group without a defunctioning ileostomy. Morbidity and mortality were associated with high body mass index, diabetes, use of corticosteroids, and American Society of Anesthesiologists classification, though not significantly. CONCLUSIONS One should be liberal in the use of a defunctioning ileostomy in case of a primary anastomosis after colonic resection for a diverticular fistula, in order to prevent high morbidity rates due to anastomotic leakage.
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Affiliation(s)
- R M Smeenk
- Department of Surgery, Albert Schweitzer Hospital, Albert Schweitzerplaats 25, 3318 AT Dordrecht, The Netherlands
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27
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Damhuis RAM, Wijnhoven BPL, Plaisier PW, Kirkels WJ, Kranse R, van Lanschot JJ. Comparison of 30-day, 90-day and in-hospital postoperative mortality for eight different cancer types. Br J Surg 2012; 99:1149-54. [PMID: 22718521 DOI: 10.1002/bjs.8813] [Citation(s) in RCA: 118] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2012] [Indexed: 01/29/2023]
Abstract
BACKGROUND Various definitions are used to calculate postoperative mortality. As variation hampers comparability between reports, a study was performed to evaluate the impact of using different definitions for several types of cancer surgery. METHODS Population-based data for the period 1997-2008 were retrieved from the Rotterdam Cancer Registry for resectional surgery of oesophageal, gastric, colonic, rectal, breast, lung, renal and bladder cancer. Postoperative deaths were tabulated as 30-day, in-hospital or 90-day mortality. Postdischarge deaths were defined as those occurring after discharge from hospital but within 30 days. RESULTS This study included 40,474 patients. Thirty-day mortality rates were highest after gastric (8·8 per cent) and colonic (6·0 per cent) surgery, and lowest after breast (0·2 per cent) and renal (2·0 per cent) procedures. For most tumour types, the difference between 30-day and in-hospital rates was less than 1 per cent. For bladder and oesophageal cancer, however, the in-hospital mortality rate was considerably higher at 5·1 per cent (+1·3 per cent) and 7·3 per cent (+2·8 per cent) respectively. For gastric, colonic and lung cancer, 1·0 per cent of patients died after discharge. For gastric, lung and bladder cancer, more than 3 per cent of patients died between discharge and 90 days. CONCLUSION The 30-day definition is recommended as an international standard because it includes the great majority of surgery-related deaths and is not subject to discharge procedures. The 90-day definition, however, captures mortality from multiple causes; although this may be of less interest to surgeons, the data may be valuable when providing information to patients before surgery.
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Affiliation(s)
- R A M Damhuis
- Comprehensive Cancer Centre the Netherlands, Utrecht, The Netherlands.
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Jakma TSC, Vijfhuize S, Vegt PA, Plaisier PW, Oostenbroek RJ, Punt BJ. Hip fracture surgery and performance indicators: an analysis of 941 patients operated in a large teaching hospital. Eur J Trauma Emerg Surg 2012; 38:49-52. [PMID: 26815673 DOI: 10.1007/s00068-011-0120-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Accepted: 05/21/2011] [Indexed: 11/24/2022]
Abstract
BACKGROUND In the Netherlands, two performance indicators for the treatment of hip fracture patients have been recently implemented. Both indicators state that surgery within 24 h after admission improves the outcome with regard to 1-year mortality and the amount of re-operations within 1 year. To determine the value of these performance indicators, we conducted a retrospective analysis of 941 hip fracture patients. METHODS In the period from January 2003 to December 2006, a total of 941 consecutive hip fracture patients were included in this study. We determined the amount of re-operations and the mortality at 1 year after surgery. From June 2005 to December 2006, we could determine whether patients were operated on within 24 h after admission. In this group of 379 patients, we determined if there were differences in the 1-year mortality and the number of re-operations at 1 year with regard to the time window in which these patients were operated on (<24 h or >24 h). RESULTS Our overall mortality rate at 1 year is 21% (202 patients) and the amount of re-operations within 1 year is 8% (77 procedures). In our subgroup analysis, we found no significant difference in mortality or re-operations if patients were operated on within 24 h or not (number needed to treat of 59 and -31, respectively). CONCLUSION We conclude that hip fracture surgery within 24 h does not provide significantly better results in terms of 1-year mortality and the amount of re-operations within 1 year.
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Affiliation(s)
- T S C Jakma
- Department of Surgery, Albert Schweitzer Hospital, P.O. Box 444, 3300 AK, Dordrecht, The Netherlands
| | - S Vijfhuize
- Department of Surgery, Albert Schweitzer Hospital, P.O. Box 444, 3300 AK, Dordrecht, The Netherlands
| | - P A Vegt
- Department of Surgery, Albert Schweitzer Hospital, P.O. Box 444, 3300 AK, Dordrecht, The Netherlands
| | - P W Plaisier
- Department of Surgery, Albert Schweitzer Hospital, P.O. Box 444, 3300 AK, Dordrecht, The Netherlands
| | - R J Oostenbroek
- Department of Surgery, Albert Schweitzer Hospital, P.O. Box 444, 3300 AK, Dordrecht, The Netherlands
| | - B J Punt
- Department of Surgery, Albert Schweitzer Hospital, P.O. Box 444, 3300 AK, Dordrecht, The Netherlands.
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Post ICJH, van Ingen G, Hendriks TR, Plaisier PW. [A 73-year-old man with a Merkel cell carcinoma]. Ned Tijdschr Geneeskd 2010; 154:A1974. [PMID: 21029484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
A 73-year-old man had a firm node on his right upper arm, which was caused by a Merkel cell carcinoma (MCC). The diagnosis was made on the basis of characteristic histopathological findings and a surgical excision with wide margins followed. Twenty months later a considerable swelling manifested in the right armpit due to a metastasis. During a CT scan of the thorax and abdomen, 2 suspicious abnormalities were seen in the mesenterial adipose tissue of the left lower abdomen and left perirenal adipose tissue. A tissue sample of the last abnormality taken under CT guidance confirmed this to be a metastasis of the MCC. The patient was irradiated but chose not to have chemotherapy. He died 2 years after the diagnosis. Merkel cell carcinoma is a rare and aggressive malignant skin neoplasm. Early recognition facilitates cure of the disease. Treatment is multidisciplinary, but surgery, either alone or in combination with radiotherapy, forms the basis of treating both the localised and regionalized forms of the disease. Chemotherapy may be used in case of disseminated disease and has a reasonable, albeit temporary, effect. The 10-year survival rate varies from 20-70%, dependent on the stage of the disease.
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Affiliation(s)
- Ivo C J H Post
- Albert Schweitzer Ziekenhuis, Afd. Heelkunde, Dordrecht, the Netherlands
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Kuipers IMT, Oostenbroek RJ, Storm RK, Menke-Pluymers MBE, Westenend PJ, Plaisier PW. [Suppose a mammary carcinoma is absent from the surgical specimen]. Ned Tijdschr Geneeskd 2009; 153:A3. [PMID: 19900338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
In three women aged 53, 51, and 42 respectively, who were treated by breast-conserving surgery for mammary carcinoma, the cancer was not found in the surgical specimen. For both patient and treating physician it is rather worrying when there is no good explanation for the fact that a histologically proven breast cancer cannot be detected in the surgical specimen without neoadjuvant therapy having been given. It is important to revise the needle biopsies, to exclude mix up of patient materials, to totally include the resected specimen in the pathological examination and to perform addition imaging of the remaining breast, preferably with MRI. An explanation may be that biopsy has removed such an amount of tumour tissue that the remains are not found. If no flaws are apparent, adjuvant radiotherapy and further adjuvant therapy on indication suffices.
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Abstract
Urachus fistulas are rare, especially in adulthood. In grown-ups urachus fistulas are usually a reflection of Crohn's disease. We present a patient in whom an urachus fistula was the first presentation of diverticulitis of the sigmoid colon. The need for proper preoperative diagnostic imaging is discussed.
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Affiliation(s)
- C Dickhoff
- Department of Surgery, Albert Schweitzer Hospital, Dordrecht, The Netherlands
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Brandenburg JJI, de Jong VM, Oostenbroek RJ, Westenend PJ, Frenay HME, Hesp WLEM, Plaisier PW. [Splenectomy in a large general hospital: often caused by iatrogenic injury, often causing multiple complications; poor adherence to post-operative guidelines for vaccination and prophylaxis]. Ned Tijdschr Geneeskd 2008; 152:1164-1168. [PMID: 18549143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE To assess the indications, complications and mortality associated with splenectomy in a large general hospital, and to evaluate adherence to guidelines for postoperative vaccination and prophylactic antibiotics. DESIGN Retrospective, descriptive. METHOD Data were collected on 106 patients who underwent splenectomy between 1999 and 2004. Indications for surgery, complications, duration of hospitalisation, and vaccination status were investigated retrospectively. Patients were contacted by telephone for a structured interview regarding vaccination and antibiotic prophylaxis. RESULTS Of the 95 patients with sufficient data for analysis, 41 underwent elective surgery and 54 underwent non-elective surgery, including 37 who required splenectomy due to iatrogenic injury. Posteroperative complications arose in 45 patients, including 23 who developed serious complications. 10 patients died due to complications, including 7 who died within one month after the procedure. Vaccination coverage for the entire group was 58%. CONCLUSION In this large general hospital, splenectomy was often performed due to iatrogenic injury and was associated with a relatively high complication rate. Adherence to guidelines on vaccination and prophylactic antibiotics could be improved.
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Affiliation(s)
- J J I Brandenburg
- Albert Schweitzer Ziekenhuis, afd. Heelkunde, Postbus 444, 3300 AK Dordrecht
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van der Zwaal P, van den Berg IR, Plaisier PW, Tutein Nolthenius RP. Mesh fixation using staples in Lichtenstein's inguinal hernioplasty: fewer complications and fewer recurrences. Hernia 2008; 12:391-4. [PMID: 18286350 DOI: 10.1007/s10029-008-0353-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2007] [Accepted: 01/30/2008] [Indexed: 10/22/2022]
Abstract
BACKGROUND Fixation of the mesh in Lichtenstein's inguinal hernioplasty is traditionally performed with polypropylene sutures. A modification of this technique uses staples for securing of the mesh. METHOD A retrospective comparative study of 149 elective repairs of a primary inguinal hernia was performed: a control group of 67 patients undergoing mesh fixation using sutures and a study group of 82 patients undergoing staple fixation. Operating time, recurrence, postoperative pain, complications and costs were studied. RESULTS Seven recurrences (11%) occurred in the polypropylene group as compared to one recurrence (1%) in the staple group (P < 0.01). There was a trend of fewer complications in the staple group. Operative time and long-term postoperative pain did not differ significantly between the two groups. The costs per surgery for mesh fixation and skin closure were euro 11.13 for the suture group and euro 24.35 for the staple group. CONCLUSION Staple fixation of the mesh in Lichtenstein's inguinal hernioplasty can be considered equal to traditional fixation with sutures with regard to operating time and postoperative pain. However, staple fixation seems to show fewer recurrences and fewer complications.
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Affiliation(s)
- P van der Zwaal
- Department of Surgery, Albert Schweitzer Hospital, 3300 AK, Dordrecht, The Netherlands
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Peters NHGM, Borel Rinkes IHM, Mali WPTM, van den Bosch MAAJ, Storm RK, Plaisier PW, de Boer E, van Overbeeke AJ, Peeters PHM. Breast MRI in nonpalpable breast lesions: a randomized trial with diagnostic and therapeutic outcome - MONET - study. Trials 2007; 8:40. [PMID: 18045470 PMCID: PMC2222222 DOI: 10.1186/1745-6215-8-40] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2007] [Accepted: 11/28/2007] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND In recent years there has been an increasing interest in MRI as a non-invasive diagnostic modality for the work-up of suspicious breast lesions. The additional value of Breast MRI lies mainly in its capacity to detect multicentric and multifocal disease, to detect invasive components in ductal carcinoma in situ lesions and to depict the tumor in a 3-dimensional image. Breast MRI therefore has the potential to improve the diagnosis and provide better preoperative staging and possibly surgical care in patients with breast cancer. The aim of our study is to assess whether performing contrast enhanced Breast MRI can reduce the number of surgical procedures due to better preoperative staging and whether a subgroup of women with suspicious nonpalpable breast lesions can be identified in which the combination of mammography, ultrasound and state-of-the-art contrast-enhanced Breast MRI can provide a definite diagnosis. METHODS/DESIGN The MONET - study (MR mammography Of Nonpalpable BrEast Tumors) is a randomized controlled trial with diagnostic and therapeutic endpoints. We aim to include 500 patients with nonpalpable suspicious breast lesions who are referred for biopsy. With this number of patients, the expected 12% reduction in surgical procedures due to more accurate preoperative staging with Breast MRI can be detected with a high power (90%). The secondary outcome is the positive and negative predictive value of contrast enhanced Breast MRI. If the predictive values are deemed sufficiently close to those for large core biopsy then the latter, invasive, procedure could possibly be avoided in some women. The rationale, study design and the baseline characteristics of the first 100 included patients are described. TRIAL REGISTRATION Study protocol number NCT00302120.
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Affiliation(s)
- Nicky HGM Peters
- Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, E01.132 3584 CX Utrecht, The Netherlands
| | - Inne HM Borel Rinkes
- Department of Surgical Oncology, University Medical Center Utrecht, Heidelberglaan 100, G04.228 3584 CX Utrecht, The Netherlands
| | - Willem PTM Mali
- Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, E01.132 3584 CX Utrecht, The Netherlands
| | - Maurice AAJ van den Bosch
- Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, E01.132 3584 CX Utrecht, The Netherlands
| | - Remmert K Storm
- Department of Radiology, Albert Schweitzer Ziekenhuis, van der Steenhovenplein 1 3300 AK Dordrecht, The Netherlands
| | - Peter W Plaisier
- Department of Surgery, Albert Schweitzer Ziekenhuis, van der Steenhovenplein 1 3300 AK Dordrecht, The Netherlands
| | - Erwin de Boer
- Department of Radiology, Meander Medisch Centrum, lokatie Lichtenberg, Utrechtseweg 1603813 ES Amersfoort, The Netherlands
| | - Adriaan J van Overbeeke
- Department of Surgery, Meander Medisch Centrum, lokatie Lichtenberg, Utrechtseweg 1603813 ES Amersfoort, The Netherlands
| | - Petra HM Peeters
- Clinical epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Heidelberglaan 100, STR 6.131 3584 CX Utrecht, The Netherlands
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Schönhuth CP, Bosman HG, van der Valk PHM, Krijnen JLM, Plaisier PW. Open biopsy: the ultimate test for pulmonary embolism. Neth J Med 2007; 65:267-9. [PMID: 17656814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Affiliation(s)
- C P Schönhuth
- Department of Surgery, Albert Schweitzer Hospital, Dordrecht, the Netherlands
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Larsen M, Polat F, Stook FP, Oostenbroek RJ, Plaisier PW, Hesp WLEM. Satisfaction and complications in post-bariatric surgery abdominoplasty patients. Acta Chir Plast 2007; 49:95-98. [PMID: 18306644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND Bariatric surgery is an expanding field, with subsequent increases in the number of patients seeking additional corrective procedures including abdominoplasty. Complication rates and body image changes may be different from the general population seeking corrective procedures. METHODS We performed a retrospective study by questionnaire and chart-based review of the patients who underwent laparoscopic adjustable gastric banding (LAGB) and abdominoplasty at our hospital between 1995 and 2004. Outcome variables included minor and major complications and satisfaction with body image and functional outcome. RESULTS Patients who returned the completed questionnaire were included in the study (n = 25). The most prevalent complications were seroma formation (25%) and wound infections requiring antibiotics (13%). Hygiene, mobility and general functional capacity improved in 68%, 72%, and 80%, respectively. Body satisfaction and body mass index (BMI) did not markedly change, while self-efficacy improved after abdominoplasty. CONCLUSION Abdominoplasty is a safe and effective method of body contour correction in patients with massive weight loss after bariatric surgery. However, a BMI as close to the ideal as possible is necessary for the complication rate to approach that of the general population undergoing abdominoplasty. Patients should be made aware of the difference in body image changes after abdominoplasty as compared to post-LAGB, as well as the trend towards an unchanged BMI.
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Affiliation(s)
- M Larsen
- Departments of Surgery, Albert Schweitzer Hospital, Dordrecht, The Netherlands
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van Veen RN, van Wessem KJP, Halm JA, Simons MP, Plaisier PW, Jeekel J, Lange JF. Patent processus vaginalis in the adult as a risk factor for the occurrence of indirect inguinal hernia. Surg Endosc 2006; 21:202-5. [PMID: 17122977 DOI: 10.1007/s00464-006-0012-9] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2006] [Accepted: 05/31/2006] [Indexed: 11/26/2022]
Abstract
BACKGROUND Inguinal hernias are a common entity with nearly 31,000 repairs annually in The Netherlands and over 800,000 in the USA. The aim of the present study is to determine whether a laparoscopically diagnosed patent processus vaginalis (PPV) is a risk factor for the development of groin hernia. METHODS The study population was originally composed of 599 consecutive cases (189 male, 32%) of laparoscopic transperitoneal surgery for different indications performed in 4 teaching hospitals in The Netherlands between November 1998 and February 2002. During laparoscopy, the deep inguinal ring was inspected bilaterally. The PPV group was compared with the obliterative processus vaginalis (OPV) group. RESULTS After a mean follow-up of 5.5 years, the studied population consisted of 337 cases (94 male, 28%). In this study 12% of the studied population appeared to have PPV in adult life. The percentage PPV of our study group is much higher than the percentage of hernia repairs performed in the Dutch population. A greater proportion (12%) of hernia repairs in the PPV group was found as compared with the OPV group (3%). The chance of developing an inguinal hernia within 5.3 years is four times higher in the group with PPV. No significant correlation between age and the prevalence of PPV was observed. CONCLUSION This study demonstrates that PPV is an etiologic factor and a risk factor for acquiring an indirect inguinal hernia in adults.
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Affiliation(s)
- R N van Veen
- Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Post Office Box 2040, Dr. Molewaterplein 40, 3000, CA, Rotterdam, The Netherlands
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38
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Damhuis RAM, Schütte PR, Varin OCM, van den Berg PM, Heinhuis R, Plaisier PW. Poor results after surgery for bronchioloalveolar carcinoma. Eur J Surg Oncol 2006; 32:573-6. [PMID: 16580808 DOI: 10.1016/j.ejso.2006.02.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2005] [Accepted: 02/08/2006] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Bronchioloalveolar carcinoma (BAC) is suggested to be less aggressive than other types of lung cancer. To assess the option of treatment modification, actual outcome data were studied and compared with results for other types of lung cancer. METHOD Retrospective analysis of all consecutive patients who underwent resection for stage I lung cancer in our hospital. For 18 BAC cases, histological specimens were re-evaluated and in three cases diagnosis was revised. RESULTS In the period 1989 through 2000, 15 patients with BAC and 260 patients with other tumour types underwent surgery in our hospital. Five-year survival rates were 24 and 53%, respectively, (p = 0.01). CONCLUSIONS Given the poor results after standard surgery, parenchyma-sparing operations do not seem justified in patients with invasive BAC.
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Abstract
We present the case of a 44-year-old man who presented with nausea, vomiting and acute pain in the right groin. On physical examination an irreducible mass was palpated in the right inguinal region. Ultrasound suggested an inguinal hernia sac with bowel contents. Subsequent right inguinal exploration revealed only unspecified necrotizing tissue, but no hernia sac or bowel contents were identified. Two days later laparotomy was required since the inguinal wound produced faecal discharge. The sigmoid appeared to be necrotic and perforated, and was subsequently resected. Histology revealed a perforated adenocarcinoma without lymph node involvement. Incarcerated inguinal hernias containing an adenocarcinoma of the colon are rare, but should be considered in patients presenting with an irreducible palpable mass in the inguinal region. Moreover, a carcinoma of the sigmoid may invade the right inguinal region. An intestinal perforation to skin-level in this population is even rarer and is associated with high morbidity and mortality rates.
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Affiliation(s)
- J L Boormans
- Department of Surgery, Albert Schweitzer Hospital, P.O. Box 444, NL-3300, AK, Dordrecht, The Netherlands
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Steunebrink M, Schnater JM, Storm RK, van Ingen G, Vegt PA, Plaisier PW. Bilateral axillary metastases of occult breast carcinoma: report of a case with a review of the literature. Breast 2005; 14:165-8. [PMID: 15767189 DOI: 10.1016/j.breast.2004.06.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2004] [Revised: 06/02/2004] [Accepted: 06/03/2004] [Indexed: 02/06/2023] Open
Abstract
The case of a 47-year-old premenopausal woman is presented in whom axillary lymph node metastases occurred on both sides 3 years apart although no primary tumor was detectable in either breast is presented. An overview of the literature on this rare entity is given. Patients with occult breast carcinoma with axillary lymph node metastases should have a complete physical examination, radiologic analysis (mammography, ultrasonography, and MRI of both breasts) and screening for disseminated disease. If there is no evidence of a primary tumor and metastases other than in the axilla, an axillary dissection should be carried out. In addition, the patient should be offered the choice of irradiation of the breast or mastectomy. Postoperatively, patients should receive appropriate systemic therapy tailored to their age, menopausal status, and receptor status.
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Affiliation(s)
- M Steunebrink
- Department of Surgery, Albert Schweitzer Hospital, P.O. Box 444, 3300AK Dordrecht, The Netherlands
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41
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van Rossen MEE, Westenend PJ, Plaisier PW. Response to "Breast metastases from colorectal carcinoma" by R. Mihai et al. The Breast 2004; 13, 155-8. Breast 2005; 14:80-1; author reply 82. [PMID: 15695089 DOI: 10.1016/j.breast.2004.08.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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42
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Govaert GAM, Plaisier PW. [Diagnostic image (237). A man with a swelling on his left buttock. Bednar tumor]. Ned Tijdschr Geneeskd 2005; 149:983. [PMID: 15903039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
A 42-year-old man was referred because of a pigmented dermatofibrosarcoma protuberans, a so-called Bednar tumour, on his left buttock. It was radically excised.
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Affiliation(s)
- G A M Govaert
- Albert Schweitzer Ziekenhuis, locatie Dordwijk, afd Chirurgie, 3300 AK Dordrecht
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43
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Govaert GAM, Oostenbroek RJ, Plaisier PW. Prolonged skin staining after intradermal use of patent blue in sentinel lymph node biopsy for breast cancer. Eur J Surg Oncol 2005; 31:373-5. [PMID: 15837042 DOI: 10.1016/j.ejso.2004.12.009] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2004] [Revised: 11/25/2004] [Accepted: 12/06/2004] [Indexed: 10/25/2022] Open
Abstract
AIMS To investigate the duration of staining of the skin after intradermal injection of patent blue during sentinel lymph node biopsy (SLNB) for breast cancer. METHODS The clinical data of 33 consecutive patients who underwent a SLNB in combination with breast conserving therapy (BCT) in our hospital were retrospectively reviewed. Also, patients were interviewed at intervals of 3 months until the blue staining of their skin had disappeared. RESULTS At mean follow-up of 18 months (range: 12-28) patent blue was visible at the site of injection after 3, 6, 9 and 12 months in 70, 64, 44 and 41% of the patients, respectively. CONCLUSIONS Use of the intradermal injection technique of patent blue during sentinel lymph node biopsy in BCT may result in remarkably long discolouring of the skin at the site of injection.
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Affiliation(s)
- G A M Govaert
- Department of Surgery, Albert Schweitzer Hospital, P.O. Box 444, NL-3300 AK Dordrecht, The Netherlands
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44
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de Jong VM, Plaisier PW. [Diagnostic image (212). A man with severe abdominal pain]. Ned Tijdschr Geneeskd 2004; 148:2128. [PMID: 15553357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
A 36-year-old man presented with acute abdominal pain due to occlusion of the superior mesenteric artery associated with intestinal rotation caused by an upper abdominal postoperative adhesion.
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Affiliation(s)
- V M de Jong
- Albert Schweitzer Ziekenhuis, afd. Heelkunde, Postbus 444, 3300 AK Dordrecht
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45
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de Leeuw M, Oostenbroek RJ, Pijpers L, Plaisier PW. [Two patients with a non-palpable, subcutaneously implanted contraceptive]. Ned Tijdschr Geneeskd 2004; 148:1785-8. [PMID: 15495943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
Two women, 33 and 31 years of age, were referred to a surgeon for the removal of a previously implanted hormonal contraceptive after the general practitioner had attempted this without success. However, no foreign body could be detected in either patient by surgery, echography and MRI and by X-ray, echography and MRI, respectively. They were then referred to a gynaecologist. In the first patient, a low level of etonogestrel confirmed that there was no contraceptive in her body. Subcutaneous contraceptives are sometimes implanted incorrectly. If the rod is not palpable at the site of insertion, then the etonogestrel level should be determined first of all. If the hormone level indicates that a rod is indeed present, then echography or MRI may be considered to localise it before resorting to surgical exploration. Many problems can be prevented by proper implantation.
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Affiliation(s)
- M de Leeuw
- Afd. Chirurgie, Albert Schweitzer Ziekenhuis, Postbus 444, 3300 AK Dordrecht
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46
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Schnater JM, Eland RE, van der Straaten F, Plaisier PW. Lung cancer presenting as a giant tumor of the thoracic wall. Eur J Cardiothorac Surg 2004; 25:1122-3. [PMID: 15145020 DOI: 10.1016/j.ejcts.2004.01.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2003] [Revised: 01/24/2004] [Accepted: 01/28/2004] [Indexed: 11/24/2022] Open
Affiliation(s)
- J Marco Schnater
- Department of Surgery, Albert Schweitzer Hospital, NL-3300 AK Dordrecht, The Netherlands
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47
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Leenhouts PA, Zeebregts CJ, Plaisier PW, Gerritsen JJ. [Symptoms of cholelithiasis following cholecystectomy; possibly a second gallbladder]. Ned Tijdschr Geneeskd 2004; 148:190-3. [PMID: 14974313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Three patients with cholelithiasis were found to possess a duplicate gallbladder. A 48-year-old woman continued to have symptoms one year after cholecystectomy, a 69-year-old woman had symptoms even though her gallbladder had been removed 40 years before, and in a 29-year-old woman a second gallbladder was found during cholecystectomy. In all three patients, the second gallbladder was removed as well, after which they recovered. The differential diagnosis of persistent symptoms following cholecystectomy should also consider the possible presence of an accessory gallbladder.
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Affiliation(s)
- P A Leenhouts
- Medisch Spectrum Twente, afd. Heelkunde, Postbus 50.000, 7500 KA Enschede
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48
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Schnater JM, Plaisier PW, van den Berg PM, Schütte PR. A remarkable outcome after video-assisted thoracoscopic resection of a giant bulla. Interact Cardiovasc Thorac Surg 2003; 2:589-91. [PMID: 17670130 DOI: 10.1016/s1569-9293(03)00169-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
A 56-year-old woman visited our hospital for mild exertional dyspnea. Radiological investigations revealed a giant bulla of the left lung that was treated with video-assisted thoracoscopic bullectomy. The result of treatment was a better stamina, and, more strikingly, a major change of voice.
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Affiliation(s)
- J Marco Schnater
- Department of Surgery, Albert Schweitzer Hospital, P.O. Box 444, NL-3300 AK Dordrecht, The Netherlands
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Plaisier PW, Mulder HJ, Schouwink JH, de Smit P. Cervical mediastinoscopy in The Netherlands: past or present? A retrospective analysis of 218 procedures. Neth J Med 2003; 61:253-6. [PMID: 14628960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
BACKGROUND Cervical mediastinoscopy (CM) has been considered the gold standard for the evaluation of mediastinal lymph nodes in the staging of non-small cell lung cancer (NSCLC) for many years. Recent publications on the value of PET scanning might reduce the use of CM in the near future. The aim of this study was to analyse the data of our CM procedures for their reliability and contribution in the assessment of mediastinal lymph nodes. METHODS In the period 1995-1999, 219 patients underwent CM. Data were available on 218 procedures and were analysed retrospectively. CM was performed in 162 men and 56 women with a median age of 56 years [range 29 to 80 years]. RESULTS Median hospitalisation time was three days. There was no mortality and morbidity was 6%. In 96% of procedures representative lymphoid tissue was obtained. In 24%, biopsies contained malignancy. CONCLUSIONS CM is a relatively safe procedure with a high diagnostic yield. As long as PET scanning remains available at a limited level, CM remains the gold standard in The Netherlands for patients with apparently operable NSCLC.
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Affiliation(s)
- P W Plaisier
- Department of General Surgery, Medisch Spectrum Twente, Enschede.
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50
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van Wessem KJP, Simons MP, Plaisier PW, Lange JF. The etiology of indirect inguinal hernias: congenital and/or acquired? Hernia 2003; 7:76-9. [PMID: 12820028 DOI: 10.1007/s10029-002-0108-7] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2002] [Accepted: 11/14/2002] [Indexed: 11/26/2022]
Abstract
The development of indirect inguinal hernias in infants is caused by a patent processus vaginalis (PPV). Consequently, this type of hernia is cured by simple herniotomy. In adults, however, herniotomy alone is accompanied by a high recurrence rate. This indicates that additional factors play a part in the development of indirect inguinal hernias in adults. The aim of this study was to determine the etiology of the development of an indirect hernia in adult life. Also, the prevalence of a PPV without clinical evidence of a hernia was determined and related to age. From November 1998 until February 2002, 599 patients from four different teaching hospitals, who underwent abdominal laparoscopy for various pathologies, were included. During laparoscopy, the deep inguinal ring was bilaterally inspected. Patients undergoing laparoscopy for inguinal hernia repair were excluded. Mean age was 45 years (range 8-89 years). Thirty-two percent (189/599) were male. Twelve percent (71/599) had PPV, all without clinical symptoms. Fifty-five percent (39/71) with PPV were male (P<0.0001). Fifty-nine percent (42/71) with PPV were right-sided, 29% (21/71) with PPV were left sided, and 12% (8/71) were bilateral (P=0.01). The prevalence of PPV in patients under 20 years was 22%. Of those between 20 and 30 years of age, 6% had PPV. Of those between 30 and 50 years, 24 patients (11%) had PPV. Of patients over 50 years, 33 (14%) had PPV. No significant differences between ages were observed. It is concluded that asymptomatic patent processus vaginalis frequently exists in adult life. The prevalence of PPV does not increase significantly with age. Assuming that indirect hernias start with asymptomatic peritoneal protrusion that can be observed laparoscopically, the incidence of PPV, like the incidence of adult indirect hernias, should increase in case of acquired etiology. Such an increase of incidence with age was not confirmed by our results. It is concluded that the etiology of indirect inguinal hernia in adults, as in infants, is congenital.
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Affiliation(s)
- K J P van Wessem
- Department of General Surgery, Medical Center Rijnmond-Zuid, Location Clara, Olympiaweg 350, 3078 HT, Rotterdam, The Netherlands.
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