10 results on '"Kelly A.E. Sinx"'
Search Results
2. Optical Coherence Tomography for Noninvasive Diagnosis and Subtyping of Basal Cell Carcinoma
- Author
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Eva van Loo, Klara Mosterd, Patty J. Nelemans, Véronique Winnepenninckx, Nicole W.J. Kelleners-Smeets, Erwin H.J. Tonk, Kelly A.E. Sinx, MUMC+: MA AIOS Dermatologie (9), Dermatologie, RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, MUMC+: MA Dermatologie (9), Pathologie, MUMC+: DA Pat Pathologie (9), RS: GROW - R2 - Basic and Translational Cancer Biology, Epidemiologie, and RS: CAPHRI - R5 - Optimising Patient Care
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0301 basic medicine ,Male ,medicine.medical_specialty ,Skin Neoplasms ,Physical examination ,Dermatology ,Biochemistry ,Sensitivity and Specificity ,Lesion ,03 medical and health sciences ,0302 clinical medicine ,Optical coherence tomography ,Biopsy ,OPERATING CHARACTERISTIC CURVES ,medicine ,Humans ,Basal cell carcinoma ,Prospective Studies ,Prospective cohort study ,Molecular Biology ,Aged ,Aged, 80 and over ,integumentary system ,medicine.diagnostic_test ,Receiver operating characteristic ,business.industry ,Cell Biology ,Gold standard (test) ,Middle Aged ,medicine.disease ,030104 developmental biology ,Carcinoma, Basal Cell ,030220 oncology & carcinogenesis ,Female ,Radiology ,medicine.symptom ,business ,Tomography, Optical Coherence - Abstract
Noninvasive diagnostic strategies such as optical coherence tomography (OCT) enable detailed examination of skin tissue architecture and have potential for identification and subtyping of basal cell carcinoma (BCC). To evaluate the additional diagnostic value of OCT, a prospective cohort study was performed in 182 patients with 250 lesions suspected for non-melanoma skin premalignancies requiring a biopsy. Accuracy of BCC diagnosis and subtype on the basis of clinical examination (CE) of patients was compared with that on the basis of OCT scans in conjunction with clinical images of lesions (cOCT). Confidence levels were recorded on a 5-point scale, where score 0 indicated absence of BCC and scores 1-4 indicated increasing suspicion of BCC. Diagnostic performance parameters were compared using histopathologic diagnosis as gold standard. The patient-based area under the receiver operating characteristic curve (AUC) increased from 85.6% for CE to 91.2% for cOCT (P = 0.061) and the lesion-based AUC from 82.7% to 91.3% (P
- Published
- 2020
3. Surgery versus combined treatment with curettage and imiquimod for nodular basal cell carcinoma: One-year results of a noninferiority, randomized, controlled trial
- Author
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Kelly A.E. Sinx, Nicole W.J. Kelleners-Smeets, Klara Mosterd, Aimee H.M.M. Arits, Véronique Winnepenninckx, Patty J. Nelemans, Dermatologie, MUMC+: MA AIOS Dermatologie (9), RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, Epidemiologie, RS: CAPHRI - R5 - Optimising Patient Care, MUMC+: MA Dermatologie (9), Pathologie, MUMC+: DA Pat Pathologie (9), and RS: GROW - R2 - Basic and Translational Cancer Biology
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medicine.medical_specialty ,surgical excision ,medicine.medical_treatment ,Nodular basal cell carcinoma ,Imiquimod ,Dermatology ,law.invention ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,basal cell carcinoma ,Randomized controlled trial ,law ,medicine ,Clinical endpoint ,Basal cell carcinoma ,5-PERCENT IMIQUIMOD ,therapy ,skin cancer ,treatment ,business.industry ,EFFICACY ,medicine.disease ,Confidence interval ,Curettage ,Surgery ,030220 oncology & carcinogenesis ,imiquimod cream ,nonmelanoma skin cancer ,Skin cancer ,business ,CREAM ,medicine.drug - Abstract
Purpose: Nodular basal cell carcinoma (nBCC) is mostly treated with surgical excision. Interest in minimally invasive treatment of these low-risk tumors is increasing. We assessed the effectiveness of nBCC treatment with curettage and imiquimod cream compared with surgical excision.Methods: Patients with nBCC included in this randomized, controlled noninferiority trial were randomly assigned to either a curettage and imiquimod cream group or a surgical excision group. The primary endpoint was the proportion of patients free from treatment failure 1 year after the end of treatment. A prespecified noninferiority margin of 8% was used. A modified intention-to-treat and a per-protocol analysis was performed (ClinicalTrials.gov identifier NCT02242929).Results: One hundred forty-five patients were randomized: 73 to the curettage and imiquimod cream group and 72 to the surgical excision group. The proportion of patients free of recurrence after 12 months was 86.3% (63/73) for the curettage and imiquimod group and 100% (72/72) for the surgical excision group. The difference in efficacy was -13.7% (95% confidence interval -21.6% to -5.8%; 1-sided P =.0004) favoring surgical excision.Conclusion: Noninferiority of curettage and imiquimod cream cannot be concluded. Given the still high efficacy of curettage and imiquimod cream and the indolent growth pattern of nBCC, curettage and imiquimod could still be a valuable treatment option with the possibility to prevent overuse of excisions. However, it cannot replace surgical excision.
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- 2020
4. Patient preferences for curettage followed by imiquimod 5% cream vs. surgical excision for the treatment of non‐facial nodular basal cell carcinoma: a discrete choice experiment
- Author
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Kelly A.E. Sinx, B A Essers, D de Coster, Klara Mosterd, RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, Dermatologie, MUMC+: MA AIOS Dermatologie (9), MUMC+: MA Dermatologie (9), RS: CAPHRI - R2 - Creating Value-Based Health Care, and MUMC+: KIO Kemta (9)
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Imiquimod 5% cream ,medicine.medical_specialty ,Skin Neoplasms ,SURGERY ,medicine.medical_treatment ,Nodular basal cell carcinoma ,Antineoplastic Agents ,Discrete choice experiment ,Dermatology ,Curettage ,PHOTODYNAMIC THERAPY ,medicine ,Humans ,Basal cell carcinoma ,Imiquimod ,business.industry ,Patient Preference ,medicine.disease ,Patient preference ,Surgery ,Treatment Outcome ,Infectious Diseases ,Carcinoma, Basal Cell ,Aminoquinolines ,Surgical excision ,business - Published
- 2021
5. Update on Hedgehog Pathway Inhibitor Therapy for Patients with Basal Cell Naevus Syndrome or High-frequency Basal Cell Carcinoma
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Babette J.A. Verkouteren, Kelly A.E. Sinx, Marie G.H.C. Reinders, Maureen J.B. Aarts, and Klara Mosterd
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Dermatology ,General Medicine - Abstract
Some patients with basal cell carcinoma develop a large number of basal cell carcinomas during their lives. The most common underlying genetic disease that causes multiple basal cell carcinomas is basal cell naevus syndrome. Basal cell naevus syndrome is caused by a germline mutation in patched-1 (PTCH1), a tumour suppressor gene of the hedgehog signalling pathway. However, in a significant portion of patients with multiple basal cell carcinomas, no underlying genetic cause is found. Nevertheless, these patients can experience a treatment burden comparable to that of patients with basal cell naevus syndrome. They are referred to as high-frequency basal cell carcinoma patients. Hedgehog pathway inhibitors were the first group of targeted therapy for basal cell carcinomas. This study reviews the literature on hedgehog pathway inhibitor therapy for patients with basal cell naevus syndrome or high-frequency basal cell carcinoma, to provide an overview on efficacy, safety, dosing regimens, tumour resistance and reoccurrence, and health-related quality of life.
- Published
- 2022
6. Cumulative Sum Analysis for the Learning Curve of Optical Coherence Tomography Assisted Diagnosis of Basal Cell Carcinoma
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Patty J. Nelemans, Klara Mosterd, Nicole W.J. Kelleners-Smeets, Eva van Loo, Sandra Schuh, Julia Welzel, Kelly A.E. Sinx, MUMC+: MA Dermatologie (9), RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, MUMC+: MA AIOS Dermatologie (9), Dermatologie, Epidemiologie, and RS: CAPHRI - R5 - Optimising Patient Care
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medicine.medical_specialty ,Skin Neoplasms ,ACCURACY ,non-invasive ,Word error rate ,diagnostic ,Optical coherence tomography ,basal cell carcinoma ,medicine ,lcsh:Dermatology ,Humans ,Basal cell carcinoma ,ddc:610 ,Reference standards ,EUS ,optical coherence tomography ,medicine.diagnostic_test ,business.industry ,Non invasive ,General Medicine ,lcsh:RL1-803 ,medicine.disease ,COMPETENCE ,TRENDS ,cumulative sum analysis ,TRAINEES ,Learning curve ,Carcinoma, Basal Cell ,Positive test result ,Radiology ,SENSITIVITY ,business ,DERMATOLOGY ,Learning Curve ,Tomography, Optical Coherence - Abstract
The amount of training needed to correctly interpret optical coherence tomography scans of the skin is undefined. The aim of this study was to illustrate how cumulative sum charts can be used to determine how many optical coherence tomography scans novice assessors should evaluate in order to obtain competence in diagnosing basal cell carcinoma. Four hundred lesions suspected for non-melanoma skin cancer were evaluated by optical coherence tomography in combination with clinical photographs, using a 5-point confidence scale. The diagnostic error rate (sum of false-negative and false-positive optical coherence tomography results/total number of cases) was used to evaluate performance, with histopathological diagnosis as the reference standard. Acceptable and unacceptable error rates were set at 16% and 25%, respectively. Adequate performance was reached after assessing 183-311 scans, dependent on the cut-off for a positive test result. In conclusion, cumulative sum analysis is useful to monitor the progress of optical coherence tomography trainees. The caseload necessary for training is substantial.
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- 2020
7. Vismodegib-resistant basal cell carcinomas in basal cell nevus syndrome: Clinical approach and genetic analysis
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Kelly A.E. Sinx, Ernst-Jan M. Speel, Virrie van Zutven, Michel van Geel, P.M. Steijlen, Renske Janssen, Guido M.J.M. Roemen, Klara Mosterd, Dermatologie, RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, MUMC+: MA Dermatologie (9), Promovendi ODB, RS: GROW - R2 - Basic and Translational Cancer Biology, Pathologie, MUMC+: MA AIOS Dermatologie (9), MUMC+: MA Dermatologie (3), and MUMC+: DA KG Lab Centraal Lab (9)
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0301 basic medicine ,Patched ,SHH, sonic hedgehog pathway ,Basal Cell Nevus Syndrome ,Vismodegib ,Case Report ,Dermatology ,smMIP, single-molecule molecular inversion probes ,03 medical and health sciences ,hedgehog pathway ,0302 clinical medicine ,Germline mutation ,basal cell carcinoma ,vismodegib ,medicine ,Basal cell carcinoma ,laBCC, locally advanced BCC ,basal cell nevus syndrome ,BCC, basal cell carcinoma ,business.industry ,mBCC, metastatic BCC ,medicine.disease ,tumor resistance ,Hedgehog signaling pathway ,030104 developmental biology ,PTCH1 ,030220 oncology & carcinogenesis ,Cancer research ,business ,Smoothened ,BCNS, basal cell nevus syndrome ,medicine.drug - Abstract
Basal cell nevus syndrome (BCNS, Gorlin syndrome) is a rare inherited disorder characterized by the development of multiple basal cell carcinomas (BCCs), odontogenic keratocysts, and palmar pits.1 BCC development is caused by sonic hedgehog pathway (SHH) activation caused by mutations in tumor suppressor gene patched 1 (PTCH1) or activating mutations in the oncogene smoothened (SMO).2 Because patients with BCNS carry a germ-line mutation in PTCH1, one additional somatic mutation (second hit) results in BCC development at a young age. In 2012, the US Food and Drug Administration approved vismodegib for treatment of locally advanced BCC (laBCC) or metastatic BCC (mBCC). Vismodegib prevents activation of the SHH pathway by binding and inhibiting the SMO protein.3 Vismodegib resistance, mainly caused by SMO mutations, is an important problem seen in laBCC or mBCC in patients with and without BCNS.4, 5 Vismodegib resistance in smaller BCCs, which are far more frequent in BCNS patients, is only described once.6 Here, vismodegib resistance of those smaller BCCs in a BCNS patient is genetically explained, and a clinical treatment approach is given.
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- 2018
8. Reply to
- Author
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Kelly A.E. Sinx, Klara Mosterd, Dermatologie, MUMC+: MA AIOS Dermatologie (9), RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, and MUMC+: MA Dermatologie (9)
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medicine.medical_specialty ,Imiquimod ,Skin Neoplasms ,business.industry ,medicine.medical_treatment ,Nodular basal cell carcinoma ,Dermatology ,Curettage ,Surgery ,law.invention ,Text mining ,Combined treatment ,Randomized controlled trial ,Carcinoma, Basal Cell ,law ,medicine ,Humans ,business ,medicine.drug - Published
- 2021
9. Commentary on 'Long-Term Follow-Up Results of Topical Imiquimod Treatment in Basal Cell Carcinoma'
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Kelly A.E. Sinx, Nicole W.J. Kelleners-Smeets, Maud H.E. Jansen, Klara Mosterd, Promovendi ODB, MUMC+: MA AIOS Dermatologie (9), RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, Dermatologie, and MUMC+: MA Dermatologie (9)
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medicine.medical_specialty ,Skin Neoplasms ,Long term follow up ,SURGERY ,Administration, Topical ,Imiquimod ,Dermatology ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Carcinoma ,medicine ,Humans ,Basal cell ,Basal cell carcinoma ,business.industry ,Follow up studies ,Retrospective cohort study ,General Medicine ,medicine.disease ,humanities ,Carcinoma, Basal Cell ,030220 oncology & carcinogenesis ,Aminoquinolines ,TRIAL ,Topical imiquimod ,business ,medicine.drug ,Follow-Up Studies - Abstract
The article “Long-Term Follow-Up Results of Topical Imiquimod Treatment in Basal Cell Carcinoma” of Professor Bostanci and colleagues1 addresses an interesting topic that the authors would like to discuss further. In this retrospective study, Bostanci and colleagues treated 24 basal cell carcinomas
- Published
- 2018
10. Senior Commentary to 'Long-Term Follow-Up Results of Topical Imiquimod Treatment in Basal Cell Carcinoma'
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Maud H.E. Jansen, Kelly A.E. Sinx, Nicole W.J. Kelleners-Smeets, and Klara Mosterd
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Surgery ,Dermatology ,General Medicine - Published
- 2018
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