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49 results on '"van Melick, H."'

9. Is cribriform pattern in prostate biopsy a risk factor for metastatic disease on 68Ga-PSMA-11 PET/CT?

Author

Heetman, J. G., Versteeg, R., Wever, L., Paulino Pereira, L. J., Soeterik, T. F. W., Lavalaye, J., de Bruin, P. C., van den Bergh, R. C. N., and van Melick, H. H. E.

Subjects
DISEASE risk factors, PROSTATE biopsy, PROSTATE cancer, COMPUTED tomography
Abstract

Introduction: Cribriform growth pattern (CP) in prostate cancer (PCa) has been associated with different unfavourable oncological outcomes. This study addresses if CP in prostate biopsies is an independent risk factor for metastatic disease on PSMA PET/CT. Methods: Treatment-naive patients with ISUP GG ≥ 2 staged with 68Ga-PSMA-11 PET/CT diagnosed from 2020 to 2021 were retrospectively enrolled. To test if CP in biopsies was an independent risk factor for metastatic disease on 68Ga-PSMA PET/CT, regression analyses were performed. Secondary analyses were performed in different subgroups. Results: A total of 401 patients were included. CP was reported in 252 (63%) patients. CP in biopsies was not an independent risk factor for metastatic disease on the 68Ga-PSMA PET/CT (p = 0.14). ISUP grade group (GG) 4 (p = 0.006), GG 5 (p = 0.003), higher PSA level groups per 10 ng/ml until > 50 (p-value between 0.02 and > 0.001) and clinical EPE (p > 0.001) were all independent risk factors. In the subgroups with GG 2 (n = 99), GG 3 (n = 110), intermediate-risk group (n = 129) or the high-risk group (n = 272), CP in biopsies was also not an independent risk factor for metastatic disease on 68Ga-PSMA PET/CT. If the EAU guideline recommendation for performing metastatic screening was applied as threshold for PSMA PET/CT imaging, in 9(2%) patients, metastatic disease was missed, and 18% fewer PSMA PET/CT would have been performed. Conclusion: This retrospective study found that CP in biopsies was not an independent risk factor for metastatic disease on 68Ga-PSMA PET/CT. [ABSTRACT FROM AUTHOR]

Published
2023
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10. Circulating tumour cells to drive the use of neoadjuvant chemotherapy in patients with muscle-invasive bladder cancer

Author

Beije, N., de Kruijff, I. E., de Jong, J. J., Klaver, S. O., de Vries, P., Jacobs, R. A.L., Somford, D. M., te Slaa, E., van der Heijden, A. G., Alfred Witjes, J., Fossion, L. M.C.L., Boevé, E. R., van der Hoeven, J., van Melick, H. H.E., Wijburg, C. J., Bickerstaffe, H., Martens, J. W.M., de Wit, R., Kraan, J., Sleijfer, S., Boormans, J. L., Beije, N., de Kruijff, I. E., de Jong, J. J., Klaver, S. O., de Vries, P., Jacobs, R. A.L., Somford, D. M., te Slaa, E., van der Heijden, A. G., Alfred Witjes, J., Fossion, L. M.C.L., Boevé, E. R., van der Hoeven, J., van Melick, H. H.E., Wijburg, C. J., Bickerstaffe, H., Martens, J. W.M., de Wit, R., Kraan, J., Sleijfer, S., and Boormans, J. L.

Abstract

Background: Guidelines recommend neoadjuvant chemotherapy (NAC) for the treatment of nonmetastatic muscle-invasive bladder cancer (MIBC). NAC is, however, underutilized in practice because of its associated limited overall survival (OS) benefit and significant treatment-related toxicity. We hypothesized that the absence of circulating tumour cells (CTCs) identifies MIBC patients with such a favourable prognosis that NAC may be withheld. Patients and methods: The CirGuidance study was an open-label, multicentre trial that included patients with clinical stage T2-T4aN0-N1M0 MIBC, scheduled for radical cystectomy. CTC-negative patients (no CTCs detectable using the CELLSEARCH system) underwent radical surgery without NAC; CTC-positive patients (≥1 detectable CTCs) were advised to receive NAC, followed by radical surgery. The primary endpoint was the 2-year OS in the CTC-negative group with a prespecified criterion for trial success of ≥75% (95% confidence interval (CI) ±5%). Results: A total of 273 patients were enrolled. Median age was 69 years; median follow-up was 36 months. The primary endpoint of 2-year OS in the CTC-negative group was 69.5% (N = 203; 95% CI 62.6%-75.5%). Two-year OS was 58.2% in the CTC-positive group (N = 70; 95% CI 45.5%-68.9%). CTC-positive patients had a higher rate of cancer-related mortality [hazard ratio (HR) 1.61, 95% CI 1.05-2.45, P = 0.03] and disease relapse (HR 1.87, 95% CI 1.28-2.73, P = 0.001) than CTC-negative patients. Explorative analyses suggested that CTC-positive patients who had received NAC (n = 22) survived longer than CTC-positive patients who had not (n = 48). Conclusion: The absence of CTCs in MIBC patients was associated with improved cancer-related mortality and a lower risk of disease relapse after cystectomy; however, their absence alone does not justify to withhold NAC. Exploratory analyses suggested that CTC-positive MIBC patients might derive more benefit from NAC. Trial registration: Netherlands Trial Register

Published
2022

11. Interrater agreement of contouring of the neurovascular bundles and internal pudendal arteries in neurovascular-sparing magnetic resonance-guided radiotherapy for localized prostate cancer

Author

Onderzoek Radiotherapie, Cancer, Urologie Onderzoek, MS Radiologie, MS Radiotherapie, MS Urologische Oncologie, Urologie Medisch volwassenen, Trialbureau Beeld, Klinische Fysica RT, Teunissen, F. R., Wortel, R. C., Wessels, F. J., Claes, A., van de Pol, S. M.G., Rasing, M. J.A., Meijer, R. P., van Melick, H. H.E., de Boer, J. C.J., Verkooijen, H. M., van der Voort van Zyp, J. R.N., Onderzoek Radiotherapie, Cancer, Urologie Onderzoek, MS Radiologie, MS Radiotherapie, MS Urologische Oncologie, Urologie Medisch volwassenen, Trialbureau Beeld, Klinische Fysica RT, Teunissen, F. R., Wortel, R. C., Wessels, F. J., Claes, A., van de Pol, S. M.G., Rasing, M. J.A., Meijer, R. P., van Melick, H. H.E., de Boer, J. C.J., Verkooijen, H. M., and van der Voort van Zyp, J. R.N.

Published
2022

14. Interrater agreement in contouring the neurovascular bundle and internal pudendal artery for MRgRT

Author

Onderzoek Radiotherapie, Cancer, Urologie Onderzoek, MS Radiologie, MS Radiotherapie, Klinische Fysica RT, MS Urologische Oncologie, Trialbureau Beeld, Teunissen, F., Wortel, R., Wessels, F., van de Pol, S., Rasing, M., Claes, A., de Boer, J., Meijer, R., van Melick, H., Verkooijen, H., van Zyp, J. van der Voort, Onderzoek Radiotherapie, Cancer, Urologie Onderzoek, MS Radiologie, MS Radiotherapie, Klinische Fysica RT, MS Urologische Oncologie, Trialbureau Beeld, Teunissen, F., Wortel, R., Wessels, F., van de Pol, S., Rasing, M., Claes, A., de Boer, J., Meijer, R., van Melick, H., Verkooijen, H., and van Zyp, J. van der Voort

Published
2021

15. Feasibility of neurovascular sparing MR-guided adaptive radiotherapy for prostate cancer

Author

Onderzoek Radiotherapie, Cancer, Urologie Onderzoek, Klinische Fysica RT, MS Urologische Oncologie, Trialbureau Beeld, MS Radiotherapie, Teunissen, F., Wortel, R., Hes, J., Willigenburg, T., de Boer, J., Meijer, R., van Melick, H., Verkooijen, H., van Zyp, J. van der Voort, Onderzoek Radiotherapie, Cancer, Urologie Onderzoek, Klinische Fysica RT, MS Urologische Oncologie, Trialbureau Beeld, MS Radiotherapie, Teunissen, F., Wortel, R., Hes, J., Willigenburg, T., de Boer, J., Meijer, R., van Melick, H., Verkooijen, H., and van Zyp, J. van der Voort

Published
2021

16. New national and regional bryophyte records, 66

Author

Ellis, L. T., primary, Alataş, M., additional, Aleffi, M., additional, Álvaro Alba, W. R., additional, Becerra Infante, D. A., additional, Cárdenas Espinosa, K. A., additional, Aziz, Md N., additional, Bakalin, V. A., additional, Bergamo Decarli, G., additional, Boiko, M., additional, Zagorodniuk, N., additional, Boiko, L. M., additional, Borovichev, E. A., additional, Brusa, G., additional, Cano, M. J., additional, Jiménez, J. A., additional, Choi, S. S., additional, Draper, I., additional, Lara, F., additional, Dunlin, M. V., additional, Enroth, J., additional, Ezer, T., additional, Fedosov, V. E., additional, Fuertes, E., additional, Garilleti, R., additional, Albertos, B., additional, Gradstein, S. R., additional, Graulich, A., additional, Hugonnot, V., additional, Hyun, C. W., additional, Kırmacı, M., additional, Filiz, F., additional, Çatak, U., additional, Konstantinova, N. A., additional, Savchenko, A. N., additional, Kropik, M., additional, Kučera, J., additional, Kürschner, H., additional, Yu. Kuzmina, E., additional, Liksakova, N. S., additional, Maity, D., additional, Martin, P., additional, McIntosh, T. T., additional, van Melick, H. M. H., additional, Moncada, B., additional, Németh, Cs., additional, O’Leary, S. V., additional, Peñaloza-Bojacá, G. F., additional, Maciel-Silva, S. A., additional, Poponessi, S., additional, Cogoni, A., additional, Porley, R. D., additional, Potemkin, A. D., additional, Puglisi, M., additional, Sciandrello, S., additional, Rawat, K. K., additional, Sahu, V., additional, Paul, R. R., additional, Ryan, M., additional, Saha, P., additional, Salas, D. S., additional, Segarra-Moragues, J. G., additional, Sguazzin, F., additional, Shafigullina, N. R., additional, Shevock, J. R., additional, Ștefănuţ, S., additional, Uygur, A., additional, Karaman Erkul, S., additional, Ursavaş, S., additional, Özen, A., additional, Zechmeister, H. G., additional, and Zander, R. H., additional

Published
2021
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17. Treatment of High-grade Non–muscle-invasive Bladder Carcinoma by Standard Number and Dose of BCG Instillations Versus Reduced Number and Standard Dose of BCG Instillations: Results of the European Association of Urology Research Foundation Randomised Phase III Clinical Trial “NIMBUS”

Author

MS Urologische Oncologie, Cancer, Urologie Medisch volwassenen, Grimm, Marc Oliver, van der Heijden, A. G., Colombel, Marc, Muilwijk, Tim, Martínez-Piñeiro, Luis, Babjuk, Marko M., Türkeri, Levent N., Palou, Joan, Patel, Anup, Bjartell, Anders S., Caris, Christien, Schipper, Raymond G., Witjes, Wim P.J., Horstmann, Jörg, Machtens, Stefan, Mumperow, Eberhard, Ghazal, Andreas Al, Pulte, Thomas, Stephan-Odenthal, Michael, Gakis, Georgios, Kramer, Mario, Zaak, Dirk, Schmitz-Dräger, Bernd, Schreier, Holger, Lehmann, Jan, Werner, Torsten, Klier, Jörg, Marin, Jan, Rulf, Wolfgang, Hellmis, Eva, Schneider, Andreas, Spiegelhalder, Wirth, Manfred, Klotz, Theodor, Suttmann, Henrik, Siebels, Michael, Rodemer, Gerd, Rudolph, Robert, Zillmann, Roger, de Bruin, M., Bos, S., van Moorselaar, R., de Reijke, T., Boormans, J., Wijsman, B., van Melick, H. H.E., van Boven, E., Meijer, R. P., Vergunst, H., te Slaa, E., Leliveld-Kors, A. M., Ruffion, Alain, Pfister, Christian, Roupret, Morgan, Irani, Jacques, Stoica, Gabriel, Van Bruwaene, Siska, Ameye, Filip, Arentsen, Harm, Joniau, Steven, Beardo, Pastora, MS Urologische Oncologie, Cancer, Urologie Medisch volwassenen, Grimm, Marc Oliver, van der Heijden, A. G., Colombel, Marc, Muilwijk, Tim, Martínez-Piñeiro, Luis, Babjuk, Marko M., Türkeri, Levent N., Palou, Joan, Patel, Anup, Bjartell, Anders S., Caris, Christien, Schipper, Raymond G., Witjes, Wim P.J., Horstmann, Jörg, Machtens, Stefan, Mumperow, Eberhard, Ghazal, Andreas Al, Pulte, Thomas, Stephan-Odenthal, Michael, Gakis, Georgios, Kramer, Mario, Zaak, Dirk, Schmitz-Dräger, Bernd, Schreier, Holger, Lehmann, Jan, Werner, Torsten, Klier, Jörg, Marin, Jan, Rulf, Wolfgang, Hellmis, Eva, Schneider, Andreas, Spiegelhalder, Wirth, Manfred, Klotz, Theodor, Suttmann, Henrik, Siebels, Michael, Rodemer, Gerd, Rudolph, Robert, Zillmann, Roger, de Bruin, M., Bos, S., van Moorselaar, R., de Reijke, T., Boormans, J., Wijsman, B., van Melick, H. H.E., van Boven, E., Meijer, R. P., Vergunst, H., te Slaa, E., Leliveld-Kors, A. M., Ruffion, Alain, Pfister, Christian, Roupret, Morgan, Irani, Jacques, Stoica, Gabriel, Van Bruwaene, Siska, Ameye, Filip, Arentsen, Harm, Joniau, Steven, and Beardo, Pastora

Published
2020

18. Prospective Validation of Gallium-68 Prostate Specific Membrane Antigen-Positron Emission Tomography/Computerized Tomography for Primary Staging of Prostate Cancer

Author

Researchgr. Nucleaire Geneeskunde, MS Urologische Oncologie, Urologie Medisch volwassenen, Cancer, CMM Groep Coffer, Child Health, Regenerative Medicine and Stem Cells, MS Radiologie, Unit Opleiding Aios, van Kalmthout, L W M, van Melick, H H E, Lavalaye, J, Meijer, R P, Kooistra, A, de Klerk, J M H, Braat, A J A T, Kaldeway, H P, de Keizer, B, Lam, M G E H, Researchgr. Nucleaire Geneeskunde, MS Urologische Oncologie, Urologie Medisch volwassenen, Cancer, CMM Groep Coffer, Child Health, Regenerative Medicine and Stem Cells, MS Radiologie, Unit Opleiding Aios, van Kalmthout, L W M, van Melick, H H E, Lavalaye, J, Meijer, R P, Kooistra, A, de Klerk, J M H, Braat, A J A T, Kaldeway, H P, de Keizer, B, and Lam, M G E H

Published
2020

21. Adjuvant recMAGE-A3 Immunotherapy After Cystectomy for Muscle-invasive Bladder Cancer: Lessons Learned from the Phase 2 MAGNOLIA Clinical Trial

Author

Mulders, Peter F. A., Martinez-Pineiro, Luis, Heidenreich, Axel, Babjuk, Marko, Colombel, Marc, Colombo, Renzo, Radziszewski, Piotr, Korneyev, Igor, Surcel, Cristian, Yakovlevi, Pavel, Witjes, J. Alfred, Caris, Christien, Schipper, Raymond, Witjes, Wim P. J., Villers, A., Malavaud, B., Rouboud, G., Grimm, M. O., Retz, M., Wagenlehner, F., Stenzl, A., Olbert, P., Niegisch, G., Hakenberg, O., Goebell, P., Wirth, M., Bolenz, C., Tubaro, A., Selli, C., Porena, M., Kerst, M., van Melick, H., Antoniewicz, A., Chlosta, P., Palou, J., Ponce Diaz-Reixa, J., Alonso Dorrego, J. M., Llorente, C., Fernandez-Gomez, J., Alvarez Maestro, M., Alvarez-Ossorio, J. L., Sanchez Chapado, M., Ribal, M., Guix, M., Bellmunt, J., Villacampa, F., Schraml, J., Zachoval, R., Sinescu, I, Stoica, L., Sakalo, V, Matveev, V, Alekseev, B., Komyakov, B., Van den Steen, Peter, Mulders, Peter F. A., Martinez-Pineiro, Luis, Heidenreich, Axel, Babjuk, Marko, Colombel, Marc, Colombo, Renzo, Radziszewski, Piotr, Korneyev, Igor, Surcel, Cristian, Yakovlevi, Pavel, Witjes, J. Alfred, Caris, Christien, Schipper, Raymond, Witjes, Wim P. J., Villers, A., Malavaud, B., Rouboud, G., Grimm, M. O., Retz, M., Wagenlehner, F., Stenzl, A., Olbert, P., Niegisch, G., Hakenberg, O., Goebell, P., Wirth, M., Bolenz, C., Tubaro, A., Selli, C., Porena, M., Kerst, M., van Melick, H., Antoniewicz, A., Chlosta, P., Palou, J., Ponce Diaz-Reixa, J., Alonso Dorrego, J. M., Llorente, C., Fernandez-Gomez, J., Alvarez Maestro, M., Alvarez-Ossorio, J. L., Sanchez Chapado, M., Ribal, M., Guix, M., Bellmunt, J., Villacampa, F., Schraml, J., Zachoval, R., Sinescu, I, Stoica, L., Sakalo, V, Matveev, V, Alekseev, B., Komyakov, B., and Van den Steen, Peter

Published
2019

22. De FUTURE trial; een multicenter RCT naar MRI-geleide prostaatbiopten: Vergelijking van drie technieken van target biopten en vergelijking met systematische biopten

Author

MS Urologische Oncologie, Wegelin, O., Exterkate, L., Barentsz, J. O., van der Leest, M. G., Kelder, J. C., Kummer, J. A., Vreuls, W., de Bruin, P. C., de Vocht, T. F., Nuininga, J. E., Bosch, J. L.H.R., Somford, D. M., van Melick, H. H.E., MS Urologische Oncologie, Wegelin, O., Exterkate, L., Barentsz, J. O., van der Leest, M. G., Kelder, J. C., Kummer, J. A., Vreuls, W., de Bruin, P. C., de Vocht, T. F., Nuininga, J. E., Bosch, J. L.H.R., Somford, D. M., and van Melick, H. H.E.

Published
2019

24. New national and regional bryophyte records, 58

Author

Ellis, L. T., primary, Afonina, O. M., additional, Doroshina, G. Ya., additional, Agudelo, C., additional, Andriamiarisoa, R. L., additional, Asthana, A. K., additional, Gupta, D., additional, Gupta, R., additional, Rawat, K. K., additional, Sahu, V., additional, Aymerich, P., additional, Bednarek-Ochyra, H., additional, Brugués, M., additional, Ruiz, E., additional, Sáez, L., additional, Callaghan, D. A., additional, Caspari, S., additional, Drapela, P., additional, Dugarova, O. D., additional, Tubanova, D. Ya., additional, Erzberger, P., additional, Flores, J. R., additional, Suárez, G. M., additional, Fedosov, V. E., additional, Gospodinov, G., additional, Gradstein, S. R., additional, Reeb, C., additional, Jukonienė, I., additional, Subkaitė, M., additional, Kučera, J., additional, Lee, G. E., additional, Lombo, Y. J., additional, Suarez, K. Y., additional, Lebouvier, M., additional, Majumdar, S., additional, Müller, F., additional, Nagy, J., additional, Norhazrina, N., additional, Papp, B., additional, Plášek, V., additional, Pócs, T., additional, Puglisi, M., additional, Schäfer-Verwimp, A., additional, Shirzadian, S., additional, Singh, D. K., additional, Ştefănuţ, S., additional, Torzewski, K., additional, van Melick, H., additional, Wolski, G. J., additional, and Zander, R. H., additional

Published
2019
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25. Reduce bladder cancer recurrence in patients treated for upper urinary tract urothelial carcinoma: The REBACARE-trial

Author

UMC Utrecht, Cancer, Urologie Medisch volwassenen, MS Urologische Oncologie, van Doeveren, T., van Leeuwen, P. J., Aben, K. K.H., van der Aa, M., Barendrecht, M., Boevé, E. R., Cornel, E. B., van der Heijden, A. G., Hendricksen, K., Hirdes, W., Kooistra, A., Kroon, B. K., Leliveld, A. M., Meijer, R. P., van Melick, H., Merks, B., de Reijke, T. M., de Vries, P., Wymenga, L. F.A., Wijsman, B., Boormans, J. L., UMC Utrecht, Cancer, Urologie Medisch volwassenen, MS Urologische Oncologie, van Doeveren, T., van Leeuwen, P. J., Aben, K. K.H., van der Aa, M., Barendrecht, M., Boevé, E. R., Cornel, E. B., van der Heijden, A. G., Hendricksen, K., Hirdes, W., Kooistra, A., Kroon, B. K., Leliveld, A. M., Meijer, R. P., van Melick, H., Merks, B., de Reijke, T. M., de Vries, P., Wymenga, L. F.A., Wijsman, B., and Boormans, J. L.

Published
2018

26. Effect of a decision aid for lower urinary tract symptoms due to benign prostatic hyperplasia on informed and value congruent decision making: A prospective study with a historical control group

Author

Van Der Wijden, F., primary, De Angst, I., additional, Cuypers, M., additional, De Vries, M., additional, Lamers, R., additional, Van Melick, H., additional, De Beij, J., additional, Oerlemans, D., additional, Van De Beek, C., additional, and Kil, P., additional

Published
2018
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30. Surgical safety of immediate versus deferred cytoreductive nephrectomy (CN) in patients with synchronous metastatic renal cell carcinoma (mRCC) receiving sunitinib. Data from the EORTC randomized trial 30073 SURTIME

Author

Bex, A., primary, Mulders, P., additional, Jewett, M., additional, Wagstaff, J., additional, Van Velthoven, R., additional, Laguna, P., additional, Wood, L., additional, Van Melick, H., additional, Soetekouw, P., additional, Lattouf, J., additional, Powles, T., additional, De Jong, I., additional, Rottey, S., additional, Tombal, B., additional, Marreaud, S., additional, Collette, S., additional, Collette, L., additional, and Haanen, J., additional

Published
2018
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40. 1 - Surgical safety of immediate versus deferred cytoreductive nephrectomy (CN) in patients with synchronous metastatic renal cell carcinoma (mRCC) receiving sunitinib. Data from the EORTC randomized trial 30073 SURTIME

Author

Bex, A., Mulders, P., Jewett, M., Wagstaff, J., Van Velthoven, R., Laguna, P., Wood, L., Van Melick, H., Soetekouw, P., Lattouf, J., Powles, T., De Jong, I., Rottey, S., Tombal, B., Marreaud, S., Collette, S., Collette, L., and Haanen, J.

Published
2018
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45. In vivo Raman spectroscopy for bladder cancer detection using a superficial Raman probe compared to a nonsuperficial Raman probe.

Author

Stomp-Agenant M, van Dijk T, R Onur A, Grimbergen M, van Melick H, Jonges T, Bosch R, and van Swol C

Subjects
Humans, Principal Component Analysis, Sensitivity and Specificity, Spectrum Analysis, Raman methods, Urinary Bladder pathology, Carcinoma, Transitional Cell, Urinary Bladder Neoplasms diagnosis, Urinary Bladder Neoplasms pathology
Abstract

Raman spectroscopy is promising as a noninvasive tool for cancer diagnosis. A superficial Raman probe might improve the classification of bladder cancer, because information is gained solely from the diseased tissue and irrelevant information from deeper layers is omitted. We compared Raman measurements of a superficial to a nonsuperficial probe, in bladder cancer diagnosis. Two-hundred sixteen Raman measurements and biopsies were taken in vivo from at least one suspicious and one unsuspicious bladder location in 104 patients. A Raman classification model was constructed based on histopathology, using a principal-component fed linear-discriminant-analysis and leave-one-person-out cross-validation. The diagnostic ability measured in area under the receiver operating characteristics curve was 0.95 and 0.80, the sensitivity was 90% and 85% and the specificity was 87% and 88% for the superficial and the nonsuperficial probe, respectively. We found inflammation to be a confounder and additionally we found a gradual transition from benign to low-grade to high-grade urothelial carcinoma. Raman spectroscopy provides additional information to histopathology and the diagnostic value using a superficial probe., (© 2022 The Authors. Journal of Biophotonics published by Wiley-VCH GmbH.)

Published
2022
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46. Circulating tumour cells to drive the use of neoadjuvant chemotherapy in patients with muscle-invasive bladder cancer.

Author

Beije N, de Kruijff IE, de Jong JJ, Klaver SO, de Vries P, Jacobs RAL, Somford DM, Te Slaa E, van der Heijden AG, Alfred Witjes J, Fossion LMCL, Boevé ER, van der Hoeven J, van Melick HHE, Wijburg CJ, Bickerstaffe H, Martens JWM, de Wit R, Kraan J, Sleijfer S, and Boormans JL

Subjects
Aged, Female, Humans, Male, Muscles pathology, Neoadjuvant Therapy, Recurrence, Neoplastic Cells, Circulating, Urinary Bladder Neoplasms drug therapy, Urinary Bladder Neoplasms pathology
Abstract

Background: Guidelines recommend neoadjuvant chemotherapy (NAC) for the treatment of nonmetastatic muscle-invasive bladder cancer (MIBC). NAC is, however, underutilized in practice because of its associated limited overall survival (OS) benefit and significant treatment-related toxicity. We hypothesized that the absence of circulating tumour cells (CTCs) identifies MIBC patients with such a favourable prognosis that NAC may be withheld., Patients and Methods: The CirGuidance study was an open-label, multicentre trial that included patients with clinical stage T2-T4aN0-N1M0 MIBC, scheduled for radical cystectomy. CTC-negative patients (no CTCs detectable using the CELLSEARCH system) underwent radical surgery without NAC; CTC-positive patients (≥1 detectable CTCs) were advised to receive NAC, followed by radical surgery. The primary endpoint was the 2-year OS in the CTC-negative group with a prespecified criterion for trial success of ≥75% (95% confidence interval (CI) ±5%)., Results: A total of 273 patients were enrolled. Median age was 69 years; median follow-up was 36 months. The primary endpoint of 2-year OS in the CTC-negative group was 69.5% (N = 203; 95% CI 62.6%-75.5%). Two-year OS was 58.2% in the CTC-positive group (N = 70; 95% CI 45.5%-68.9%). CTC-positive patients had a higher rate of cancer-related mortality [hazard ratio (HR) 1.61, 95% CI 1.05-2.45, P = 0.03] and disease relapse (HR 1.87, 95% CI 1.28-2.73, P = 0.001) than CTC-negative patients. Explorative analyses suggested that CTC-positive patients who had received NAC (n = 22) survived longer than CTC-positive patients who had not (n = 48)., Conclusion: The absence of CTCs in MIBC patients was associated with improved cancer-related mortality and a lower risk of disease relapse after cystectomy; however, their absence alone does not justify to withhold NAC. Exploratory analyses suggested that CTC-positive MIBC patients might derive more benefit from NAC., Trial Registration: Netherlands Trial Register NL3954; https://www.trialregister.nl/trial/3954., Competing Interests: Diclosure JWMM and SS report a research agreement with Menarini, unrelated to the currently submitted manuscript. JLB reports consultancy work for MSD, Janssen, ISMAR Health Care, Eight Medical, BMS and AMBU (all paid to the Erasmus MC) and a research agreement with Decipher. All other authors declare no conflict of interest., (Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Published
2022
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47. Interrater agreement of contouring of the neurovascular bundles and internal pudendal arteries in neurovascular-sparing magnetic resonance-guided radiotherapy for localized prostate cancer.

Author

Teunissen FR, Wortel RC, Wessels FJ, Claes A, van de Pol SMG, Rasing MJA, Meijer RP, van Melick HHE, de Boer JCJ, Verkooijen HM, and van der Voort van Zyp JRN

Abstract

Background and Purpose: Radiation damage to neural and vascular tissue, such as the neurovascular bundles (NVBs) and internal pudendal arteries (IPAs), during radiotherapy for prostate cancer (PCa) may cause erectile dysfunction. Neurovascular-sparing magnetic resonance-guided adaptive radiotherapy (MRgRT) aims to preserve erectile function after treatment. However, the NVBs and IPAs are not routinely contoured in current radiotherapy practice. Before neurovascular-sparing MRgRT for PCa can be implemented, the interrater agreement of the contouring of the NVBs and IPAs on pre-treatment MRI needs to be assessed., Materials and Methods: Four radiation oncologists independently contoured the prostate, NVB, and IPA in an unselected consecutive series of 15 PCa patients, on pre-treatment MRI. Dice similarity coefficients (DSCs) for pairwise interrater agreement of contours were calculated. Additionally, the DCS of a subset of the inferior half of the NVB contours (i.e. approximately prostate midgland to apex level) was calculated., Results: Median overall interrater DSC for the left and right NVB was 0.60 (IQR: 0.54 - 0.68) and 0.61 (IQR: 0.53 - 0.69) respectively and for the left and right IPA 0.59 (IQR: 0.53 - 0.64) and 0.59 (IQR: 0.52 - 0.64) respectively. Median overall interrater DSC for the inferior half of the left NVB was 0.67 (IQR: 0.58 - 0.74) and 0.67 (IQR: 0.61 - 0.71) for the right NVB., Conclusion: We found that the interrater agreement for the contouring of the NVB and IPA improved with enhancement of the MRI sequence as well as further training of the raters. The agreement was best in the subset of the inferior half of the NVB, where a good agreement is clinically most relevant for neurovascular-sparing MRgRT for PCa., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: HV receives research funding from Elekta. The remaining authors declare no potential competing interests., (© 2021 The Author(s).)

Published
2021
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49. AUTHOR REPLY.

Author

Soeterik TFW, van Melick HHE, Dijksman LM, Biesma DH, Witjes JA, and van Basten JPA

Published
2021
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