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2. Omentum preservation versus complete omentectomy in gastrectomy for gastric cancer (OMEGA trial): study protocol for a randomized controlled trial.

Author

Keywani, K., Eshuis, W. J., Borgstein, A. B. J., van Det, M. J., van Duijvendijk, P., van Etten, B., Grimminger, P. P., Heisterkamp, J., Lagarde, S. M., Luyer, M. D. P., Markar, S. R., Meijer, S. L., Pierie, J. P. E. N., Roviello, F., Ruurda, J. P., van Sandick, J. W., Sosef, M., Witteman, B. P. L., de Steur, W. O., and Lissenberg-Witte, B. I.

Subjects
STOMACH cancer, OVERALL survival, BOWEL obstructions, RANDOMIZED controlled trials, PROGRESSION-free survival
Abstract

Background: Potentially curative therapy for locally advanced gastric cancer consists of gastrectomy, usually in combination with perioperative chemotherapy. An oncological resection includes a radical (R0) gastrectomy and modified D2 lymphadenectomy; generally, a total omentectomy is also performed, to ensure the removal of possible microscopic disease. However, the omentum functions as a regulator of regional immune responses to prevent infections and prevents adhesions which could lead to bowel obstructions. Evidence supporting a survival benefit of routine complete omentectomy during gastrectomy is lacking. Methods: OMEGA is a randomized controlled, open, parallel, non-inferiority, multicenter trial. Eligible patients are operable (ASA < 4) and have resectable (≦ cT4aN3bM0) primary gastric cancer. Patients will be 1:1 randomized between (sub)total gastrectomy with omentum preservation distal of the gastroepiploic vessels versus complete omentectomy. For a power of 80%, the target sample size is 654 patients. The primary objective is to investigate whether omentum preservation in gastrectomy for cancer is non-inferior to complete omentectomy in terms of 3-year overall survival. Secondary endpoints include intra- and postoperative outcomes, such as blood loss, operative time, hospital stay, readmission rate, quality of life, disease-free survival, and cost-effectiveness. Discussion: The OMEGA trial investigates if omentum preservation during gastrectomy for gastric cancer is non-inferior to complete omentectomy in terms of 3-year overall survival, with non-inferiority being determined based on results from both the intention-to-treat and the per-protocol analyses. The OMEGA trial will elucidate whether routine complete omentectomy could be omitted, potentially reducing overtreatment. Trial registration: ClinicalTrials.gov NCT05180864. Registered on 6th January 2022. [ABSTRACT FROM AUTHOR]

Published
2024
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3. Impact of nationwide centralization of oesophageal, gastric, and pancreatic surgery on travel distance and experienced burden in the Netherlands

Author

Arts Assistenten CTC, MS CGO, Cancer, MS HOD, Luijten, J. C.H.B.M., Nieuwenhuijzen, G. A.P., Sosef, M. N., de Hingh, I. H.J.T., Rosman, C., Ruurda, J. P., van Duijvendijk, P., Heisterkamp, J., de Steur, W. O., van Laarhoven, H. W.M., Besselink, M. G., Groot Koerkamp, B., van Santvoort, H. C., Lemmens, V. E.P., Vissers, P. A.J., Arts Assistenten CTC, MS CGO, Cancer, MS HOD, Luijten, J. C.H.B.M., Nieuwenhuijzen, G. A.P., Sosef, M. N., de Hingh, I. H.J.T., Rosman, C., Ruurda, J. P., van Duijvendijk, P., Heisterkamp, J., de Steur, W. O., van Laarhoven, H. W.M., Besselink, M. G., Groot Koerkamp, B., van Santvoort, H. C., Lemmens, V. E.P., and Vissers, P. A.J.

Published
2022

4. 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

5. 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

6. Impact of nationwide centralization of oesophageal, gastric, and pancreatic surgery on travel distance and experienced burden in the Netherlands.

Author

Luijten JCHBM, Nieuwenhuijzen GAP, Sosef MN, de Hingh IHJT, Rosman C, Ruurda JP, van Duijvendijk P, Heisterkamp J, de Steur WO, van Laarhoven HWM, Besselink MG, Groot Koerkamp B, van Santvoort HC, Lemmens VEP, and Vissers PAJ

Subjects
Age Factors, Aged, Female, Health Expenditures, Hospital Planning, Hospitals, Hospitals, High-Volume, Hospitals, Low-Volume, Humans, Logistic Models, Male, Middle Aged, Multivariate Analysis, Netherlands, Referral and Consultation, Surveys and Questionnaires, Cost of Illness, Digestive System Surgical Procedures, Esophageal Neoplasms surgery, Health Services Accessibility, Pancreatic Neoplasms surgery, Stomach Neoplasms surgery, Surgical Oncology organization & administration, Travel
Abstract

Background: This study aims to assess the impact of nationwide centralization of surgery on travel distance and travel burden among patients with oesophageal, gastric, and pancreatic cancer according to age in the Netherlands. As centralization of care increases to improve postoperative outcomes, travel distance and experienced burden might increase., Materials and Methods: All patients who underwent surgery between 2006 and 2017 for oesophageal, gastric and pancreatic cancer in the Netherlands were included. Travel distance between patient's home address and hospital of surgery in kilometres was calculated. Questionnaires were used to assess experienced travel burden in a subpopulation (n = 239). Multivariable ordinal logistic regression models were constructed to identify predictors for longer travel distance., Results: Over 23,838 patients were included, in whom median travel distance for surgical care increased for oesophageal cancer (n = 9217) from 18 to 28 km, for gastric cancer (n = 6743) from 9 to 26 km, and for pancreatic cancer (n = 7878) from 18 to 25 km (all p < 0.0001). Multivariable analyses showed an increase in travel distance for all cancer types over time. In general, patients experienced a physical and social burden, and higher financial costs, due to traveling extra kilometres. Patients aged >70 years travelled less often independently (56% versus 68%), as compared to patients aged ≤70 years., Conclusion: With nationwide centralization, travel distance increased for patients undergoing oesophageal, gastric, and pancreatic cancer surgery. Younger patients travelled longer distances and experienced a lower travel burden, as compared to elderly patients. Nevertheless, on a global scale, travel distances in the Netherlands remain limited., Competing Interests: Declaration of competing interest None declared., (Copyright © 2021 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.)

Published
2022
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