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1. Defining Major Surgery: A Delphi Consensus Among European Surgical Association (ESA) Members

Author

Martin, D., Mantziari, S., Demartines, N., Hubner, M., Bismuth, H., Sarr, M. G., Strasberg, S. M., Wexner, S. D., Adham, M., Altomare, D. F., Andersson, R., Bechstein, W., Biondo, S., Bockhorn, M., Bonavina, L., Rituerto, D. C., Clavien, P. -A., De Manzini, N., Decker, G., Dejong, C. H., Dervenis, C., Farges, O., Figueras, J., Fingerhut, A. L., Friess, H., Glehen, O., Gnant, M., Gutschow, C., Hahnloser, D., Hamberger, B., Hamming, J. F., Holscher, A. H., Izbicki, J. R., Jonas, S., Karamarkovic, A., Kehlet, H., Leppaniemi, A. K., Lerut, J., Line, P. -D., Lodge, J. P. A., Meakins, J. L., Montorsi, M., Nafteux, P., Naredi, P., Olah, A., Panis, Y., Pardo, F., Parks, R. W., Pedrazzoli, S., Pessaux, P., Marques, H. P., Poggioli, G., Popescu, I., Puolakkainen, P. A., Ramia Angel, J. M., Rasanen, J., Reynolds, J. V., Rosati, R., Saeger, H. -D., Schneeberger, S., Schneider, P. M., Soreide, K., Stippel, D., Toso, C., Tuech, J. -J., Tukiainen, E. J., Van Hillegersberg, R., Wijnhoven, B., Winter, D. C., Zaninotto, G., Surgery, Martin, D., Mantziari, S., Demartines, N., Hubner, M., Bismuth, H., Sarr, M. G., Strasberg, S. M., Wexner, S. D., Adham, M., Altomare, D. F., Andersson, R., Bechstein, W., Biondo, S., Bockhorn, M., Bonavina, L., Rituerto, D. C., Clavien, P. -A., De Manzini, N., Decker, G., Dejong, C. H., Dervenis, C., Farges, O., Figueras, J., Fingerhut, A. L., Friess, H., Glehen, O., Gnant, M., Gutschow, C., Hahnloser, D., Hamberger, B., Hamming, J. F., Holscher, A. H., Izbicki, J. R., Jonas, S., Karamarkovic, A., Kehlet, H., Leppaniemi, A. K., Lerut, J., Line, P. -D., Lodge, J. P. A., Meakins, J. L., Montorsi, M., Nafteux, P., Naredi, P., Olah, A., Panis, Y., Pardo, F., Parks, R. W., Pedrazzoli, S., Pessaux, P., Marques, H. P., Poggioli, G., Popescu, I., Puolakkainen, P. A., Ramia Angel, J. M., Rasanen, J., Reynolds, J. V., Rosati, R., Saeger, H. -D., Schneeberger, S., Schneider, P. M., Soreide, K., Stippel, D., Toso, C., Tuech, J. -J., Tukiainen, E. J., Van Hillegersberg, R., Wijnhoven, B., Winter, D. C., Zaninotto, G., Martin D., Mantziari S., Demartines N., Hubner M., Bismuth H., Sarr M.G., Strasberg S.M., Wexner S.D., Adham M., Altomare D.F., Andersson R., Bechstein W., Biondo S., Bockhorn M., Bonavina L., Rituerto D.C., Clavien P.-A., De Manzini N., Decker G., Dejong C.H., Dervenis C., Farges O., Figueras J., Fingerhut A.L., Friess H., Glehen O., Gnant M., Gutschow C., Hahnloser D., Hamberger B., Hamming J.F., Holscher A.H., Izbicki J.R., Jonas S., Karamarkovic A., Kehlet H., Leppaniemi A.K., Lerut J., Line P.-D., Lodge J.P.A., Meakins J.L., Montorsi M., Nafteux P., Naredi P., Olah A., Panis Y., Pardo F., Parks R.W., Pedrazzoli S., Pessaux P., Marques H.P., Poggioli G., Popescu I., Puolakkainen P.A., Ramia Angel J.M., Rasanen J., Reynolds J.V., Rosati R., Saeger H.-D., Schneeberger S., Schneider P.M., Soreide K., Stippel D., Toso C., Tuech J.-J., Tukiainen E.J., Van Hillegersberg R., Wijnhoven B., Winter D.C., Zaninotto G., ESA Study Group, Sarr, M.G., Strasberg, S.M., Wexner, S.D., Altomare, D.F., Rituerto, D.C., Clavien, P.A., Dejong, C.H., Fingerhut, A.L., Hamming, J.F., Hölscher, A.H., Izbicki, J.R., Leppäniemi, A.K., Line, P.D., Lodge, JPA, Meakins, J.L., Oláh, A., Parks, R.W., Marques, H.P., Puolakkainen, P.A., Ramia Angel, J.M., Reynolds, J.V., Saeger, H.D., Schneider, P.M., Søreide, K., Tuech, J.J., Tukiainen, E.J., Winter, D.C., Institut de Recherche sur les Maladies Virales et Hépatiques (IVH), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), University of Zurich, Demartines, Nicolas, and Toso, Christian

Subjects
Male, medicine.medical_specialty, Blood transfusion, Consensus, Delphi Technique, medicine.medical_treatment, Delphi method, 610 Medicine & health, Consensu, Likert scale, 03 medical and health sciences, Surgeon, 0302 clinical medicine, Aged, Europe, Humans, Middle Aged, Societies, Medical, Surgeons, Surgical Procedures, Operative/methods, Medical, major surgery, Delphi consensus definition, medicine, Operative / methods, 10217 Clinic for Visceral and Transplantation Surgery, Surgical Procedures, ddc:617, business.industry, Perioperative, Vascular surgery, 2746 Surgery, 3. Good health, Cardiac surgery, Surgery, Cardiothoracic surgery, 030220 oncology & carcinogenesis, Surgical Procedures, Operative, 030211 gastroenterology & hepatology, Societies, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Abdominal surgery, Human
Abstract

Background: Major surgery is a term frequently used but poorly defined. The aim of the present study was to reach a consensus in the definition of major surgery within a panel of expert surgeons from the European Surgical Association (ESA). Methods: A 3-round Delphi process was performed. All ESA members were invited to participate in the expert panel. In round 1, experts were inquired by open- and closed-ended questions on potential criteria to define major surgery. Results were analyzed and presented back anonymously to the panel within next rounds. Closed-ended questions in round 2 and 3 were either binary or statements to be rated on a Likert scale ranging from 1 (strong disagreement) to 5 (strong agreement). Participants were sent 3 reminders at 2-week intervals for each round. 70% of agreement was considered to indicate consensus. Results: Out of 305 ESA members, 67 (22%) answered all the 3 rounds. Significant comorbidities were the only preoperative factor retained to define major surgery (78%). Vascular clampage or organ ischemia (92%), high intraoperative blood loss (90%), high noradrenalin requirements (77%), long operative time (73%) and perioperative blood transfusion (70%) were procedure-related factors that reached consensus. Regarding postoperative factors, systemic inflammatory response (76%) and the need for intensive or intermediate care (88%) reached consensus. Consequences of major surgery were high morbidity (>30% overall) and mortality (>2%). Conclusion: ESA experts defined major surgery according to extent and complexity of the procedure, its pathophysiological consequences and consecutive clinical outcomes.

Published
2020

2. Definitions and treatment of oligometastatic oesophagogastric cancer according to multidisciplinary tumour boards in Europe

Author

Kroese, T.E. van Hillegersberg, R. Schoppmann, S. Deseyne, P.R.A.J. Nafteux, P. Obermannova, R. Nordsmark, M. Pfeiffer, P. Hawkings, M.A. Smyth, E. Markar, S. Hanna, G.B. Cheong, E. Chaudry, A. Elme, A. Adenis, A. Piessen, G. Gani, C. Bruns, C.J. Moehler, M. Liakakos, T. Reynolds, J. Morganti, A. Rosati, R. Castoro, C. D'Ugo, D. Roviello, F. Bencivenga, M. de Manzoni, G. Jeene, P. van Sandick, J.W. Muijs, C. Slingerland, M. Nieuwenhuijzen, G. Wijnhoven, B. Beerepoot, L.V. Kolodziejczyk, P. Polkowski, W.P. Alsina, M. Pera, M. Kanonnikoff, T.F. Nilsson, M. Guckenberger, M. Monig, S. Wagner, D. Wyrwicz, L. Berbee, M. Gockel, I. Lordick, F. Griffiths, E.A. Verheij, M. van Rossum, P.S.N. van Laarhoven, H.W.M. Rosman, C. Rütten, H. Gootjes, E.C. Vonken, F.E.M. van Dieren, J.M. Vollebergh, M.A. van der Sangen, M. Creemers, G.-J. Zander, T. Schlößer, H. Cascinu, S. Mazza, E. Nicoletti, R. Damascelli, A. Slim, N. Passoni, P. Cossu, A. Puccetti, F. Barbieri, L. Fanti, L. Azzolini, F. Ventoruzzo, F. Szczepanik, A. Visa, L. Reig, A. Roques, T. Harrison, M. Ciseł, B. Pikuła, A. Skórzewska, M. Vanommeslaeghe, H. Van Daele, E. Pattyn, P. Geboes, K. Callebout, E. Ribeiro, S. van Duijvendijk, P. Tromp, C. Sosef, M. Warmerdam, F. Heisterkamp, J. Vera, A. Jordá, E. López-Mozos, F. Fernandez-Moreno, M.C. Barrios-Carvajal, M. Huerta, M. de Steur, W. Lips, I. Diez, M. Castro, S. O'Neill, R. Holyoake, D. Hacker, U. Denecke, T. Kuhnt, T. Hoffmeister, A. Kluge, R. Bostel, T. Grimminger, P. Jedlička, V. Křístek, J. Pospíšil, P. Mourregot, A. Maurin, C. Starling, N. Chong, I. OMEC working group

Abstract

Background: Consensus about the definition and treatment of oligometastatic oesophagogastric cancer is lacking. Objective: To assess the definition and treatment of oligometastatic oesophagogastric cancer across multidisciplinary tumour boards (MDTs) in Europe. Material and methods: European expert centers (n = 49) were requested to discuss 15 real-life cases in their MDT with at least a medical, surgical, and radiation oncologist present. The cases varied in terms of location and number of metastases, histology, timing of detection (i.e. synchronous versus metachronous), primary tumour treatment status, and response to systemic therapy. The primary outcome was the agreement in the definition of oligometastatic disease at diagnosis and after systemic therapy. The secondary outcome was the agreement in treatment strategies. Treatment strategies for oligometastatic disease were categorised into upfront local treatment (i.e. metastasectomy or stereotactic radiotherapy), systemic therapy followed by restaging to consider local treatment or systemic therapy alone. The agreement across MDTs was scored to be either absent/poor (

Published
2022

4. Intragraft donor-specific anti-HLA antibodies in phenotypes of chronic lung allograft dysfunction

Author

Sacreas, Annelore, Taupin, Jean-Luc, Emonds, Marie-Paule, Daniels, Liesbeth, Van Raemdonck, Dirk E, Vos, Robin, Verleden, Geert M, Vanaudenaerde, Bart M, Roux, Antoine, Verleden, Stijn E, De Leyn, P, Nafteux, P, Decaluwe, H, Van Veer, H, Ceulemans, LJ, Depypere, L, Van Herck, Anke, Kaes, Janne, Heigl, Tobias, Ordies, Sofie, De Sadeleer, Laurens J, Vanstapel, Arno, Neyrinck, Arne P, Schaevers, Veronique, Dupont, Lieven J, Yserbyt, Jonas, Godinas, Laurent, Van Veer, Coosemans Hans, Nafteux, Philippe, Decaluwe, Herbert, and Leuven Lung Transplant Grp

Subjects
Pulmonary and Respiratory Medicine, Adult, Lung Diseases, Male, medicine.medical_treatment, Bronchiolitis obliterans, Human leukocyte antigen, 030204 cardiovascular system & hematology, 030230 surgery, Antibodies, Serology, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Postoperative Complications, Antigen, HLA Antigens, medicine, Lung transplantation, Humans, Bronchiolitis Obliterans, Leuven Lung Transplant Group, Retrospective Studies, Lung, biology, business.industry, Middle Aged, medicine.disease, Allografts, Tissue Donors, medicine.anatomical_structure, Phenotype, Immunology, Chronic Disease, biology.protein, Female, Human medicine, Antibody, business, Explant culture, Lung Transplantation
Abstract

IntroductionCirculating anti-human leukocyte antigen (HLA) serum donor-specific antibodies (sDSAs) increase the risk of chronic lung allograft dysfunction (CLAD) and mortality. Discrepancies between serological and pathological/clinical findings are common. Therefore, we aimed to assess the presence of tissue-bound graft DSAs (gDSAs) in CLAD explant tissue compared with sDSAs.MethodsTissue cores, obtained from explant lungs of unused donors (n=10) and patients with bronchiolitis obliterans syndrome (BOS; n=18) and restrictive allograft syndrome (RAS; n=18), were scanned with micro-computed tomography before elution of antibodies. Total IgG levels were measuredviaELISA. Anti-HLA class I and II IgG gDSAs were identified using Luminex single antigen beads and compared with DSAs found in serum samples.ResultsOverall, mean fluorescence intensity was higher in RAS eluates compared with BOS and controls (p+/gDSA+and two patients were sDSA−/gDSA+. In RAS, four patients were sDSA+/gDSA+, one patient was sDSA+/gDSA−and five patients were sDSA−/gDSA+. Serum and graft results combined, DSAs were more prevalent in RAS compared with BOS (56%versus22%; p=0.04). There was spatial variability in gDSA detection in one BOS patient and three RAS patients, who were all sDSA−. Total graft IgG levels were higher in RAS than BOS (p+versusgDSA−(p=0.0008), but not in sDSA+versussDSA−(p=0.33). In RAS, total IgG levels correlated with fibrosis (r= −0.39; p=0.02).ConclusionsThis study underlines the potential of gDSA assessment as complementary information to sDSA findings. The relevance and applications of gDSAs need further investigation.

Published
2019

5. Does selective pleural irradiation of malignant pleural mesothelioma allow radiation dose escalation?

Author

Botticella, A., Defraene, G., Nackaerts, K., Deroose, C., Coolen, J., Nafteux, P., Vanstraelen, B., Joosten, S., Michiels, L. A. W., Peeters, S., De Ruysscher, D., Promovendi PHPC, RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, Promovendi ODB, and Radiotherapie

Subjects
Elective pleural irradiation, Malignant pleural mesothelioma, Selective pleural irradiation, GUIDELINES, PHASE-III, THERAPY, Lungsparing VMAT, INTENSITY-MODULATED RADIOTHERAPY, CISPLATIN, PLEURECTOMY/DECORTICATION, PATTERNS, SURVIVAL, Nonsurgical treatments, FAILURE, LUNG
Abstract

Background After lung-sparing radiotherapy for malignant pleural mesothelioma (MPM), local failure at sites of previous gross disease represents the dominant form of failure. Our aim is to investigate if selective irradiation of the gross pleural disease only can allow dose escalation. Materials and methods In all, 12 consecutive stage I-IV MPM patients (6 left-sided and 6 right-sided) were retrospectively identified and included. A magnetic resonance imaging-based pleural gross tumor volume (GTV) was contoured. Two sets of planning target volumes (PTV) were generated for each patient: (1) a "selective" PTV (S-PTV), originating from a 5-mm isotropic expansion from the GTV and (2) an "elective" PTV (E-PTV), originating from a 5-mm isotropic expansion from the whole ipsilateral pleural space. Two sets of volumetric modulated arc therapy (VMAT) treatment plans were generated: a "selective" pleural irradiation plan (SPI plan) and an "elective" pleural irradiation plan (EPI plan, planned with a simultaneous integrated boost technique [SIB]). Results In the SPI plans, the average median dose to the S-PTV was 53.6Gy (range 41-63.6Gy). In 4 of 12 pa-tients, it was possible to escalate the dose to the S-PTV to > 58Gy. In the EPI plans, the average median doses to the E-PTV and to the S-PTV were 48.6Gy (range 38.5-58.7) and 49Gy (range 38.6-59.5Gy), respectively. No significant dose escalation was achievable. Conclusion The omission of the elective irradiation of the whole ipsilateral pleural space allowed dose escalation from 49Gy to more than 58Gy in 4 of 12 chemonaive MPM patients. This strategy may form the basis for nonsurgical radical combined modality treatment of MPM.

Published
2017

11. De divertikel van Zenker

Author

null LERUT T, null CEULEMANS P, null COOSEMANS W, null DECKER G, null DE LEYN P, null NAFTEUX P, null VAN RAEMDONCK D, and null DEJAEGER E

Subjects
General Medicine
Published
2005

13. Recurrence pattern in patients with a pathologically complete response after neoadjuvant chemoradiotherapy and surgery for oesophageal cancer

Author

Hagen, Pieter, Wijnhoven, Bas, Nafteux, P, Moons, J, Haustermans, K, De Hertogh, G, van Lanschot, Jan, Lerut, T, and Surgery

Subjects
SDG 3 - Good Health and Well-being
Abstract

Background: Little is known about recurrence patterns in patients with a pathologically complete response (pCR) or an incomplete response after neoadjuvant chemoradiotherapy (CRT) followed by resection for oesophageal cancer. This study was performed to determine the pattern of recurrence in patients with a pCR after neoadjuvant CRT followed by surgery. Methods: All patients who received neoadjuvant CRT followed by oesophagectomy between 1993 and 2009 were identified from a database, and categorized according to pathological tumour response. Recurrences were classified as locoregional or distant. Results: One hundred and eighty-eight patients were included. Median potential follow-up was 71.6 months. A pCR was achieved in 62 (33.0 per cent) of 188 patients. Recurrence developed in 24 (39 per cent) of 62 patients with a pCR and 70 (55.6 per cent) of 126 without a pCR (P = 0.044). Locoregional recurrence with or without synchronous distant metastases occurred in eight patients (13 per cent) in the pCR group and 31 (24.6 per cent) in the non-pCR group (P = 0.095). Locoregional recurrences without synchronous distant metastases occurred four (6 per cent) and ten (7.9 per cent) patients respectively (P = 0.945). The overall 5-year survival rate was significantly higher in the pCR group than in the non-pCR group (52 versus 33.9 per cent respectively; P = 0.019). Conclusion: Of patients with a pCR, 13 per cent still developed a locoregional recurrence. Although pCR is more favourable for survival, it is not synonymous with cure or complete locoregional disease control. Copyright (C) 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

Published
2013

14. Technical Advances in Mediastinal Surgery

Author

Bodner, J, Cohen, J, Coosemans, W, D'Amico, T, D'Andrilli, A, Daiel, V, Decaluwè, H, Decker, G, De Leyn, P, Go, T, Ippolito, E, Komanapalli, C, Krasna, M, Lerut, T, Macchiarini, P, Mancini, F, Mineo, Tc, Nafteux, P, Calvin, S, Pompeo, E, Van Raemdonck, D, Rendina, E, Sukumar, M, Tacconi, F, Venuta, F, Weissenbacher, A, Wright, C, Yim, A, and Zielinski, M

Subjects
Settore MED/21 - Chirurgia Toracica
Published
2010

15. Technical advances in mediastinal surgery. Preface

Author

Bodner, J, Cohen, J, Coosemans, W, D'Amico, T, D'Andrilli, A, Daiel, V, Decaluwè, H, Decker, G, De Leyn, P, Go, T, Ippolito, E, Komanapalli, C, Krasna, M, Lerut, T, Macchiarini, P, Mancini, F, Mineo, Tc, Nafteux, P, Calvin, S, Pompeo, E, Van Raemdonck, D, Rendina, E, Sukumar, M, Tacconi, F, Venuta, F, Weissenbacher, A, Wright, C, Yim, A, and Zielinski, M

Subjects
Mediastinoscopy, Settore MED/21 - Chirurgia Toracica
Published
2010

20. Definitions and treatment of oligometastatic oesophagogastric cancer according to multidisciplinary tumour boards in Europe

Author

Tiuri E. Kroese, Richard van Hillegersberg, Sebastian Schoppmann, Pieter R.A.J. Deseyne, Philippe Nafteux, Radka Obermannova, Marianne Nordsmark, Per Pfeiffer, Maria A. Hawkins, Elizabeth Smyth, Sheraz Markar, George B. Hanna, Edward Cheong, Asif Chaudry, Anneli Elme, Antoine Adenis, Guillaume Piessen, Cihan Gani, Christiane J. Bruns, Markus Moehler, Theodore Liakakos, John Reynolds, Alessio Morganti, Riccardo Rosati, Carlo Castoro, Domenico D'Ugo, Franco Roviello, Maria Bencivenga, Giovanni de Manzoni, Paul Jeene, Johanna W. van Sandick, Christel Muijs, Marije Slingerland, Grard Nieuwenhuijzen, Bas Wijnhoven, Laurens V. Beerepoot, Piotr Kolodziejczyk, Wojciech P. Polkowski, Maria Alsina, Manuel Pera, Tania F. Kanonnikoff, Magnus Nilsson, Matthias Guckenberger, Stefan Monig, Dorethea Wagner, Lucjan Wyrwicz, Maaike Berbee, Ines Gockel, Florian Lordick, Ewen A. Griffiths, Marcel Verheij, Peter S.N. van Rossum, Hanneke W.M. van Laarhoven, Camiel Rosman, Heide Rütten, Elske C. Gootjes, Francine E.M. Vonken, Jolanda M. van Dieren, Marieke A. Vollebergh, Maurice van der Sangen, Geert-Jan Creemers, Thomas Zander, Hans Schlößer, Stefano Cascinu, Elena Mazza, Roberto Nicoletti, Anna Damascelli, Najla Slim, Paolo Passoni, Andrea Cossu, Francesco Puccetti, Lavinia Barbieri, Lorella Fanti, Francesco Azzolini, Federico Ventoruzzo, Antoni Szczepanik, Laura Visa, Anna Reig, Tom Roques, Mark Harrison, Bogumiła Ciseł, Agnieszka Pikuła, Magdalena Skórzewska, Hanne Vanommeslaeghe, Elke Van Daele, Piet Pattyn, Karen Geboes, Eduard Callebout, Suzane Ribeiro, Peter van Duijvendijk, Cathrien Tromp, Meindert Sosef, Fabienne Warmerdam, Joos Heisterkamp, Almudena Vera, Esther Jordá, Fernando López-Mozos, Maria C. Fernandez-Moreno, Maria Barrios-Carvajal, Marisol Huerta, Wobbe de Steur, Irene Lips, Marc Diez, Sandra Castro, Robert O'Neill, Daniel Holyoake, Ulrich Hacker, Timm Denecke, Thomas Kuhnt, Albrecht Hoffmeister, Regine Kluge, Tilman Bostel, Peter Grimminger, Václav Jedlička, Jan Křístek, Petr Pospíšil, Anne Mourregot, Clotilde Maurin, Naureen Starling, Irene Chong, Institut Català de la Salut, [Kroese TE] Department of Surgery, Utrecht University Medical Center, Utrecht University, Utrecht, the Netherlands. Department of Radiation Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands. [van Hillegersberg R] Department of Surgery, Utrecht University Medical Center, Utrecht University, Utrecht, the Netherlands. [Schoppmann S] Department of Surgery, Medical University of Vienna, Vienna University, Vienna, Austria. [Deseyne PRAJ] Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium. [Nafteux P] Department of Surgery, KU Leuven, Leuven University, Leuven, Belgium. [Obermannova R] Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute and Faculty of Medicine, Masaryk University Brno, Brno, Czech Republic. [Alsina M] Servei d’Oncologia Mèdica, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain, Vall d'Hebron Barcelona Hospital Campus, Radiotherapie, MUMC+: MA Radiotherapie OC (9), RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, Damage and Repair in Cancer Development and Cancer Treatment (DARE), Radiation Oncology, AII - Cancer immunology, CCA - Cancer biology and immunology, Internal medicine, Surgery, Kroese, T. E., van Hillegersberg, R., Schoppmann, S., Deseyne, P. R. A. J., Nafteux, P., Obermannova, R., Nordsmark, M., Pfeiffer, P., Hawkings, M. A., Smyth, E., Markar, S., Hanna, G. B., Cheong, E., Chaudry, A., Elme, A., Adenis, A., Piessen, G., Gani, C., Bruns, C. J., Moehler, M., Liakakos, T., Reynolds, J., Morganti, A., Rosati, R., Castoro, C., D'Ugo, D., Roviello, F., Bencivenga, M., de Manzoni, G., Jeene, P., van Sandick, J. W., Muijs, C., Slingerland, M., Nieuwenhuijzen, G., Wijnhoven, B., Beerepoot, L. V., Kolodziejczyk, P., Polkowski, W. P., Alsina, M., Pera, M., Kanonnikoff, T. F., Nilsson, M., Guckenberger, M., Monig, S., Wagner, D., Wyrwicz, L., Berbee, M., Gockel, I., Lordick, F., Griffiths, E. A., Verheij, M., van Rossum, P. S. N., van Laarhoven, H. W. M., Rosman, C., Rutten, H., Gootjes, E. C., Vonken, F. E. M., van Dieren, J. M., Vollebergh, M. A., van der Sangen, M., Creemers, G. -J., Zander, T., Schlosser, H., Cascinu, S., Mazza, E., Nicoletti, R., Damascelli, A., Slim, N., Passoni, P., Cossu, A., Puccetti, F., Barbieri, L., Fanti, L., Azzolini, F., Ventoruzzo, F., Szczepanik, A., Visa, L., Reig, A., Roques, T., Harrison, M., Cisel, B., Pikula, A., Skorzewska, M., Vanommeslaeghe, H., Van Daele, E., Pattyn, P., Geboes, K., Callebout, E., Ribeiro, S., van Duijvendijk, P., Tromp, C., Sosef, M., Warmerdam, F., Heisterkamp, J., Vera, A., Jorda, E., Lopez-Mozos, F., Fernandez-Moreno, M. C., Barrios-Carvajal, M., Huerta, M., de Steur, W., Lips, I., Diez, M., Castro, S., O'Neill, R., Holyoake, D., Hacker, U., Denecke, T., Kuhnt, T., Hoffmeister, A., Kluge, R., Bostel, T., Grimminger, P., Jedlicka, V., Kristek, J., Pospisil, P., Mourregot, A., Maurin, C., Starling, N., Chong, I., Oncology, CCA - Imaging and biomarkers, CCA - Cancer Treatment and Quality of Life, and AGEM - Amsterdam Gastroenterology Endocrinology Metabolism

Subjects
Cancer Research, neoplasias::neoplasias por localización::neoplasias del sistema digestivo::neoplasias gastrointestinales::neoplasias gástricas [ENFERMEDADES], Neoplasm metastasis, Radiosurgery, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], SDG 3 - Good Health and Well-being, Metàstasi, Neoplasms, Medicine and Health Sciences, Humans, Mastectomia, Oligometastasis, SURGICAL RESECTION, Metastasectomy, Neoplasms::Neoplastic Processes::Neoplasm Metastasis [DISEASES], Aparell digestiu - Càncer - Cirurgia, CHEMOTHERAPY, Europe, Surgical Procedures, Operative::Metastasectomy [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], intervenciones quirúrgicas::metastasectomía [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], Oncology, neoplasias::procesos neoplásicos::metástasis neoplásica [ENFERMEDADES], JUNCTION, Gastric neoplasm, SURVIVAL, Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Gastrointestinal Neoplasms::Stomach Neoplasms [DISEASES], Lymph Nodes, Oesophageal neoplasm
Abstract

Oesophageal neoplasm; Oligometastasis; Radiosurgery Neoplàsia esofàgica; Oligometàstasi; Radiocirurgia Neoplasia esofágica; Oligometástasis; Radiocirugía Background Consensus about the definition and treatment of oligometastatic oesophagogastric cancer is lacking. Objective To assess the definition and treatment of oligometastatic oesophagogastric cancer across multidisciplinary tumour boards (MDTs) in Europe. Material and methods European expert centers (n = 49) were requested to discuss 15 real-life cases in their MDT with at least a medical, surgical, and radiation oncologist present. The cases varied in terms of location and number of metastases, histology, timing of detection (i.e. synchronous versus metachronous), primary tumour treatment status, and response to systemic therapy. The primary outcome was the agreement in the definition of oligometastatic disease at diagnosis and after systemic therapy. The secondary outcome was the agreement in treatment strategies. Treatment strategies for oligometastatic disease were categorised into upfront local treatment (i.e. metastasectomy or stereotactic radiotherapy), systemic therapy followed by restaging to consider local treatment or systemic therapy alone. The agreement across MDTs was scored to be either absent/poor (

Published
2022

21. Study protocol for the OligoMetastatic Esophagogastric Cancer (OMEC) project

Author

Tiuri E. Kroese, Peter S.N. van Rossum, Magnus Nilsson, Florian Lordick, Elizabeth C. Smyth, Riccardo Rosati, Philippe Nafteux, Domenico D'Ugo, M. Asif Chaudry, Wojciech Polkowkski, Franco Roviello, Ines Gockel, Piotr Kolodziejczyk, Karin Haustermans, Matthias Guckenberger, Marianne Nordsmark, Maria A. Hawkins, Andres Cervantes, Tania Fleitas, Eric van Cutsem, Markus Moehler, Anna D. Wagner, Hanneke W.M. van Laarhoven, Richard van Hillegersberg, Kroese, Te, van Rossum, Psn, Nilsson, M, Lordick, F, Smyth, Ec, Rosati, R, Nafteux, P, D'Ugo, D, Chaudry, Ma, Polkowkski, W, Roviello, F, Gockel, I, Kolodziejczyk, P, Haustermans, K, Guckenberger, M, Nordsmark, M, Hawkins, Ma, Cervantes, A, Fleitas, T, van Cutsem, E, Moehler, M, Wagner, Ad, van Laarhoven, Hwm, and van Hillegersberg, R

Subjects
Oligometastasis, Radiotherapy, Oncology, Esophageal cancer, Metastasectomy, Surgery, General Medicine, Gastric cancer
Abstract

BACKGROUND: A uniform definition and treatment for oligometastatic esophagogastric cancer is currently lacking. However, a comprehensive definition of oligometastatic esophagogastric cancer is necessary to initiate studies on local treatment strategies (e.g. metastasectomy or stereotactic radiotherapy) and new systemic therapy agents in this group of patients. For this purpose, the OligoMetastatic Esophagogastric Cancer (OMEC) project was established. The OMEC-project aims to develop a multidisciplinary European consensus statement on the definition, diagnosis, and treatment for oligometastatic esophagogastric cancer and provide a framework for prospective studies to improve outcomes of these patients. METHODS: The OMEC-project consists of five studies, including 1) a systematic review on definitions and outcomes of oligometastatic esophagogastric cancer; 2) real-life clinical scenario discussions in multidisciplinary expert teams to determine the variation in the definition and treatment strategies; 3) Delphi consensus process through a starting meeting, two Delphi questionnaire rounds, and a consensus meeting; 4) publication of a multidisciplinary European consensus statement; and 5) a prospective clinical trial in patients with oligometastatic esophagogastric cancer. DISCUSSION: The OMEC project aims to establish a multidisciplinary European consensus statement for oligometastatic esophagogastric cancer and aims to initiate a prospective clinical trial to improve outcomes for these patients. Recommendations from OMEC can be used to update the relevant guidelines on treatment for patients with (oligometastatic) esophagogastric cancer. ispartof: EJSO vol:49 issue:1 pages:21-28 ispartof: location:England status: published

Published
2022

22. Distribution of lymph node metastases in esophageal carcinoma [TIGER study]: Study protocol of a multinational observational study

Author

Jari Räsänen, Sybren L. Meijer, Flávio D. Sabino, Maarten C.C.M. Hulshof, E R C Hagens, Philip Linden, Shailesh P. Puntambekar, Marcel G. W. Dijkgraaf, Riccardo Rosati, Suzanne S. Gisbertz, M Griffin, Grard A. P. Nieuwenhuijzen, Roel J. Bennink, Philippe Nafteux, Miguel A. Cuesta, Paul Wilkerson, Arnulf H. Hölscher, Carlo Castoro, Jacques J. Bergman, Madhan Kumar Kuppusamy, Hisahiro Matsubara, Haiquan Chen, John V. Reynolds, Richard van Hillegersberg, Thomas N. Walsh, Haruhiro Inoue, Peter P. Grimminger, K Moorthy, Piet Pattyn, Banafsche Mearadji, Mark I. van Berge Henegouwen, Yuji Tachimori, Christophe Mariette, Gail E. Darling, Sjoerd M. Lagarde, Johanna W. van Sandick, Magnus Nilsson, Donald L. van der Peet, Joris J. Scheepers, Camiel Rosman, Sudish Murthy, Wolfgang Schröder, Jouke T. Annema, Joos Heisterkamp, Hanneke W. M. van Laarhoven, C S Pramesh, Shin-ichi Kosugi, M. Asif Chaudry, Bruno Sgromo, Manuel Pera, Meindert N. Sosef, Paul M. Schneider, Edward Cheong, Sandro Mattioli, Wayne L. Hofstetter, Luigi Bonavina, Josep Garcia, Olga Tucker, Simon Law, Giovanni de Manzoni, K. Robert Shen, Surgery, AGEM - Digestive immunity, CCA - Cancer Treatment and quality of life, III kirurgian klinikka, HUS Helsinki and Uusimaa Hospital District, Hagens, E. R. C., Van Berge Henegouwen, M. I., Van Sandick, J. W., Cuesta, M. A., Van Der Peet, D. L., Heisterkamp, J., Nieuwenhuijzen, G. A. P., Rosman, C., Scheepers, J. J. G., Sosef, M. N., Van Hillegersberg, R., Lagarde, S. M., Nilsson, M., Rasanen, J., Nafteux, P., Pattyn, P., Holscher, A. H., Schroder, W., Schneider, P. M., Mariette, C., Castoro, C., Bonavina, L., Rosati, R., De Manzoni, G., Mattioli, S., Garcia, J. R., Pera, M., Griffin, M., Wilkerson, P., Chaudry, M. A., Sgromo, B., Tucker, O., Cheong, E., Moorthy, K., Walsh, T. N., Reynolds, J., Tachimori, Y., Inoue, H., Matsubara, H., Kosugi, S. -I., Chen, H., Law, S. Y. K., Pramesh, C. S., Puntambekar, S. P., Murthy, S., Linden, P., Hofstetter, W. L., Kuppusamy, M. K., Shen, K. R., Darling, G. E., Sabino, F. D., Grimminger, P. P., Meijer, S. L., Bergman, J. J. G. H. M., Hulshof, M. C. C. M., Van Laarhoven, H. W. M., Mearadji, B., Bennink, R. J., Annema, J. T., Dijkgraaf, M. G. W., Gisbertz, S. S., Graduate School, AGEM - Endocrinology, metabolism and nutrition, AGEM - Re-generation and cancer of the digestive system, CCA - Cancer Treatment and Quality of Life, Pathology, Gastroenterology and Hepatology, Radiotherapy, Oncology, Radiology and Nuclear Medicine, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Pulmonology, CCA - Imaging and biomarkers, Epidemiology and Data Science, and APH - Methodology

Subjects
0301 basic medicine, Cancer Research, Esophageal Neoplasms, IMPACT, medicine.medical_treatment, Esophageal cancer, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], Study Protocol, 0302 clinical medicine, Medicine and Health Sciences, DISSECTION, Lymph node, Neoadjuvant therapy, Prognosis, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, CANCER, Primary tumor, Neoadjuvant Therapy, 3. Good health, medicine.anatomical_structure, Oncology, Esophagectomy, Lymphatic Metastasis, 030220 oncology & carcinogenesis, Carcinoma, Squamous Cell, Adenocarcinoma, Esophagogastric Junction, Lymph, Radiology, SPREAD, Life Sciences & Biomedicine, SQUAMOUS-CELL, medicine.medical_specialty, 3122 Cancers, lcsh:RC254-282, Disease-Free Survival, 03 medical and health sciences, Lymph node metastase, Genetics, medicine, Humans, Neoplasm Staging, Science & Technology, business.industry, ADENOCARCINOMA, Lymphadenectomy, medicine.disease, PATTERN, 030104 developmental biology, Lymph Node Excision, Lymph Nodes, business, Lymph node metastases, Follow-Up Studies
Abstract

Contains fulltext : 215779.pdf (Publisher’s version ) (Open Access) BACKGROUND: An important parameter for survival in patients with esophageal carcinoma is lymph node status. The distribution of lymph node metastases depends on tumor characteristics such as tumor location, histology, invasion depth, and on neoadjuvant treatment. The exact distribution is unknown. Neoadjuvant treatment and surgical strategy depends on the distribution pattern of nodal metastases but consensus on the extent of lymphadenectomy has not been reached. The aim of this study is to determine the distribution of lymph node metastases in patients with resectable esophageal or gastro-esophageal junction carcinoma in whom a transthoracic esophagectomy with a 2- or 3-field lymphadenectomy is performed. This can be the foundation for a uniform worldwide staging system and establishment of the optimal surgical strategy for esophageal cancer patients. METHODS: The TIGER study is an international observational cohort study with 50 participating centers. Patients with a resectable esophageal or gastro-esophageal junction carcinoma in whom a transthoracic esophagectomy with a 2- or 3-field lymphadenectomy is performed in participating centers will be included. All lymph node stations will be excised and separately individually analyzed by pathological examination. The aim is to include 5000 patients. The primary endpoint is the distribution of lymph node metastases in esophageal and esophago-gastric junction carcinoma specimens following transthoracic esophagectomy with at least 2-field lymphadenectomy in relation to tumor histology, tumor location, invasion depth, number of lymph nodes and lymph node metastases, pre-operative diagnostics, neo-adjuvant therapy and (disease free) survival. DISCUSSION: The TIGER study will provide a roadmap of the location of lymph node metastases in relation to tumor histology, tumor location, invasion depth, number of lymph nodes and lymph node metastases, pre-operative diagnostics, neo-adjuvant therapy and survival. Patient-tailored treatment can be developed based on these results, such as the optimal radiation field and extent of lymphadenectomy based on the primary tumor characteristics. TRIAL REGISTRATION: NCT03222895 , date of registration: July 19th, 2017.

Published
2019

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