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2. Outcomes of gynecologic cancer surgery during the COVID-19 pandemic: an international, multicenter, prospective CovidSurg-Gynecologic Oncology Cancer study
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Nepogodiev, Dmitri, Siaw-Acheampong, Kwabena, Benson, Ruth A., Bywater, Edward, Chaudhry, Daoud, Dawson, Brett E., Evans, Jonathan P., Glasbey, James C., Gujjuri, Rohan R., Heritage, Emily, Jones, Conor S., Kamarajah, Sivesh K., Khatri, Chetan, Khaw, Rachel A., Keatley, James M., Knight, Andrew, Lawday, Samuel, Li, Elizabeth, Mann, Harvinder S., Marson, Ella J., McLean, Kenneth A., Mckay, Siobhan C., Mills, Emily C., Pellino, Gianluca, Picciochi, Maria, Taylor, Elliott H., Tiwari, Abhinav, Simoes, Joana FF., Trout, Isobel M., Venn, Mary L., Wilkin, Richard JW., Bhangu, Aneel, Abbott, Tom EF., Abukhalaf, Sadi, Adamina, Michel, Ademuyiwa, Adesoji O., Agarwal, Arnav, Akkulak, Murat, Alameer, Ehab, Alderson, Derek, Alakaloko, Felix, Albertsmeier, Markus, Alser, Osaid, Alshaar, Muhammad, Alshryda, Sattar, Arnaud, Alexis P., Augestad, Knut Magne, Ayasra, Faris, Azevedo, José, Bankhead-Kendall, Brittany K., Barlow, Emma, Beard, David, Blanco-Colino, Ruth, Brar, Amanpreet, Minaya-Bravo, Ana, Breen, Kerry A., Bretherton, Chris, Buarque, Igor Lima, Burke, Joshua, Caruana, Edward J., Chaar, Mohammad, Chakrabortee, Sohini, Christensen, Peter, Cox, Daniel, Cukier, Moises, Cunha, Miguel F., Davidson, Giana H., Desai, Anant, Di Saverio, Salomone, Drake, Thomas M., Edwards, John G., Elhadi, Muhammed, Emile, Sameh, Farik, Shebani, Fiore, Marco, Fitzgerald, J Edward, Ford, Samuel, Garmanova, Tatiana, Gallo, Gaetano, Ghosh, Dhruva, Ataíde Gomes, Gustavo Mendonça, Grecinos, Gustavo, Griffiths, Ewen A., Gruendl, Magdalena, Halkias, Constantine, Harrison, Ewen M., Hisham, Intisar, Hutchinson, Peter J., Hwang, Shelley, Isik, Arda, Jenkinson, Michael D., Jonker, Pascal, MA Kaafarani, Haytham, Keller, Debby, Kolias, Angelos, Kruijff, Schelto, Lawani, Ismail, Lederhuber, Hans, Leventoglu, Sezai, Litvin, Andrey, Loehrer, Andrew, Löffler, Markus W., Lorena, Maria Aguilera, Modolo, Maria Marta, Major, Piotr, Martin, Janet, Mashbari, Hassan N., Mazingi, Dennis, Metallidis, Symeon, Mohan, Helen M., Moore, Rachel, Moszkowicz, David, Moug, Susan, Ng-Kamstra, Joshua S., Maimbo, Mayaba, Negoi, Ionut, Niquen, Milagros, Ntirenganya, Faustin, Olivos, Maricarmen, Oussama, Kacimi, Outani, Oumaima, Parreno-Sacdalanm, Marie Dione, Pata, Francesco, Perez Rivera, Carlos Jose, Pinkney, Thomas D., van der Plas, Willemijn, Pockney, Peter, Qureshi, Ahmad, Radenkovic, Dejan, Ramos-De la Medina, Antonio, Richards, Toby, Roberts, Keith, Roslani, April C., Rutegård, Martin, Segura-Sampedro, Juan José, Santos, Irène, Satoi, Sohei, Sayyed, Raza, Schache, Andrew, Schnitzbauer, Andreas A., Seyi-Olajide, Justina O., Sharma, Neil, Shaw, Catherine A., Shaw, Richard, Shu, Sebastian, Soreide, Kjetil, Spinelli, Antonino, Stewart, Grant D., Sund, Malin, Sundar, Sudha, Tabiri, Stephen, Townend, Philip, Tsoulfas, Georgios, van Ramshorst, Gabrielle H., Vidya, Raghavan, Vimalachandran, Dale, Warren, Oliver J., Wedderburn, Duane, Wright, Naomi, Booth, Lesley, Barker, Neil, Cooke, Shirley, Doré, Suzanne, Horwood, Nigel, Runigamugabo, Emmy, Weir, Carrie Tierney, Dajti I, Albania, C, Allemand, LA, Boccalatte, M, Figari, M, Lamm, J, Larrañaga, C, Marchitelli, F, Noll, D, Odetto, M, Perrotta, J, Saadi, L, Zamora, Ballester, A.M., KE, Tapper, N, Zeff, JI, Valenzuela, C, Alurralde, J, Anastasio, Perez de Nucci A, Apas, EL, Caram, D, Eskinazi, JP, Mendoza, M, Usandivaras, R, Badra, A, Esteban, JS, García, PM, García, JI, Gerchunoff, Lucchini, S.M., NIgra, M.A., L, Vargas, T, Hovhannisyan, A, Stepanyan, CE, Vasey, EGR, Watson, C, Ip, J, Kealey, CSH, Lim, S, Sengupta, S, Ward, E, Wong, T, Gould, R, Gourlay, B, Griffiths, S, Gananadha, M, McLaren, J, Cecire, N, Joshi, S, Salindera, A, Sutherland, JH, Ahn, G, Charlton, S, Chen, N, Gauri, R, Hayhurst, S, Jang, F, Jia, C, Mulligan, W, Yang, G, Ye, H, Zhang, M, Ballal, D, Gibson, D, Hayne, H, McMillan, J, Moss, MJ, Pugliese, T, Richards, YTN, Seow, A, Thian, P, Viswambaram, UG, Vo, J, Bennetts, T, Bright, Brooke-Smith, M., R, Fong, B, Gricks, L, Huang, YH, Lam, A, Nathan, Ong, B.S., E, Ooi, M, Szpytma, D, Watson, K, Bagraith, S, Caird, E, Chan, C, Dawson, D, Ho, N, Hui, S, Izwan, E, Jeyarajan, S, Jordan, R, Liang, A, Lim, GJ, Nolan, A, Oar, D, Parker, H, Puhalla, A, Quennell, L, Rutherford, C, Sommerville, P, Townend, Papen M, Von, M, Wullschleger, AC, Dawson, A, Drane, A, Blatt, D, Cope, N, Egoroff, M, Fenton, J, Gani, N, Lott, P, Pockney, N, Shugg, M, Elliott, D, Phung, D, Phan, D, Townend, C, Bong, J, Gundara, A, Frankel, S, Bowman, GR, Guerra, N, Gerns, S, McGeorge, A, Riddell, M, Roberts, N, Rukin, J, Bolt, K, Buddingh, Dudi-Venkata, N.N., S, Jog, HM, Kroon, T, Sammour, R, Smith, C, Stranz, M, Batstone, K, Lah, W, McGahan, D, Mitchell, A, Morton, A, Pearce, G, Sheahan, B, Swinson, A, Waldron, P, Walker, N, Alam, S, Banting, L, Chong, P, Choong, S, Clatworthy, D, Foley, A, Fox, MW, Hii, B, Knowles, J, Mack, M, Read, A, Rowcroft, G, Wright, EWY, Lun, M, Lanner, J, Burtscher, Trivik-Barrientos, F., I, Königsrainer, M, Bauer, C, Freyschlag, M, Kafka, F, Messner, D, Öfner, I, Tsibulak, S, Holawe, M, Zimmermann, K, Emmanuel, M, Grechenig, R, Gruber, M, Harald, L, Öhlberger, J, Presl, A, Wimmer, İ, Namazov, E, Samadov, D, Barker, R, Boyce, S, Corbin, A, Doyle, A, Eastmond, R, Gill, A, Haynes, S, Millar, M, O’Shea, G, Padmore, N, Paquette, E, Phillips, John S, St., K, Walkes, J, Abeloos, Backer T, De, Ceulaer J, De, C, Dick, Diez-Fraile, A., P, Lamoral, C, Spaas, W, Ceelen, P, Pattyn, D, Van de putte, Nieuwenhove Y, Van, Ramshorst G, Van, Willaert, W., Bazzett-Matabele, L., SP, Chiyapo, Ramogola-Masire, D., G, Ramontshonyana, A, Seiphetlheng, P, Vuylsteke, EA, Abdallah, Júnior S, Aguiar, G, Baiocchi, GB, Carvalho, FJF, Coimbra, LP, Kowalski, F, Makdissi, N, Marques, T, Marques, Santos S, Soares Dos, Gonçalves B, Tirapelli, JG, Vartanian, Reis R, Dos, P, Camara, Lima RK, De, Giustina E, Della, PV, Hoffmann, A, Gatti, C, Nardi, R, Oliva, L, Nacif, Ferro C, Carvalho, Ataíde G, Gomes Mendonça, Buarque I, Lima, A, Lira dos Santos Leite, Pol-Fachin, L., Bezerra T, Santos, Ramos da Silva A, Maylson, de Araújo Silvestre D, Windson, Barros A, Vieira, L, Campbell, Cicco R, De, I, Cecconello, P, Gregorio, Lima L, Pontual, Junior U, Ribeiro, FR, Takeda, RM, Terra, Teixeira M, Faccini, Kulcsar, M.A.V., LL, Matos, KS, Nunes, G, Laporte, M, Salem, Awada J, Barakat, TR, Ijichi, NJ, Kim, A, Marreiro, B, Muller, R, Nunes, B, Bodanese, ER, Eidt, JC, Isoton, Vieira da Cunha M, Lemos, de Sampaio L, Regina, C, Vendrame, M, Zeni, JA, Zortéa, MR, Zortéa, M, Sokolov, B, Kidane, S, Srinathan, A, Munro, L, Helyer, D, McKeen, M, Boutros, NG, Caminsky, G, Ghitulescu, G, Jamjoum, J, Moon, J, Pelletier, T, Vanounou, S, Wong, D, Cheng, SD, MacNeil, J, Martin, S, Dumitra, A, Kouyoumdjian, S, Schmid, J, Spicer, A, Agarwal, A, Brar, J, Dada, A, Dare, U, Hameed, F, Osman, B, Johnston, C, Russell, G, Groot, A, Persad, H, Pham, M, Wood, M, Ko, L, Rajendran, S, Demyttenaere, R, Garfinkle, C, Brown, A, Karimuddin, N, Lee, J, Liu, Kia T, Madani, Phang, P.T., M, Raval, K, Tom, Abou-Khalil, J., A, Martel, C, Nessim, J, Stevenson, Riyami S, Al, K, Bali, D, Bigam, K, Dajani, A, Dell, MM, Modolo, Nieto P, Ramirez, R, Sepulveda, A, Molero, A, Bolbaran, I, Ruiz, F, Heredia, F, Bellolio, N, Besser, E, Grasset, JO, Guaman, M, Inzunza, MJ, Irarrázaval, C, Jarry, Martinic M, Quintana, Altamirano C, Riquoir, Manqui CA, Romero, Esquide M, Ruiz, Añazco C, Vargas, A, Almeciga, A, Fletcher, A, Merchan, T, Quijano, D, Sanabria, Arias-Amézquita, F., C, Cétares, Murgueitio N, Cortes, Gomez-Mayorga, J.L., Herrera-Almario, G., J, Rodriguez, P, Iglesias, LO, Puentes, JA, Calvache, Orozco-Chamorro, C.M., DA, Rojas, Sánchez-Gómez, A., M, Abadia, J, Acosta, Aristizabal J, Angel, A, Bonilla, L, Caicedo, Quiroz PH, Calderon, Bonilla S, Cervera, S, Diaz, H, Facundo, Mora M, Garcia, O, Guevara, L, Guzman, Mora DR, Herrera, Ramirez LJ, Jimenez, C, Lehmann, E, Manrique, I, Mariño, M, Medina, Morales RE, Pinilla, A, Puerto, Horta J, Puerto, M, Quintero, Ferro M, Rey, A, Saénz, D, Santana, W, Serrano, O, Suescun, Sanchez LM, Trujillo, Cuasquen BG, Velasquez, Quevedo J , Bogota, Mendoza, G, Bačić, D, Karlović, D, Kršul, M, Zelić, I, Luksic, M, Mamic, I, Bacic, B, Bakmaz, I, Ćoza, E, Dijan, Z, Katusic, J, Mihanovic, D, Morović, I, Rakvin, H, Almezghwi, K, Arslan, H, Besim, A, Özant, N, Özçay, K, Frantzeskou, N, Gouvas, G, Kokkinos, P, Papatheodorou, I, Pozotou, O, Stavrinidou, A, Yiallourou, L, Martinek, M, Skrovina, M, Straka, I, Szubota, M, Peteja, J, Žatecký, V, Javurkova, J, Klat, S, Antony, T, Avlund, KD, Berg, M, Borre, P, Christensen, MC, Elkjær, A, Ernst, SK, Fensman, M, Haldrup, JL, Harbjerg, LH, Iversen, Jensen, P.T., TD, Jeppesen, DW, Kjaer, HØ, Kristensen, N, Lund, Axelsen S, Maigaard, M, Mekhael, N, Mikic, EB, Ostenfeld, AL, Ebbehøj, P, Krarup, N, Schlesinger, H, Smith, S, Batista, A, Crespo, PJ, Díaz, R, Rivas, Rodriguez-Abreu, J., N, Tactuk, Kassas M, El, W, Omar, A, Tawheed, M, Talaat, A, Abdelsamed, AY, Azzam, H, Salem, A, Seleim, A, Abdelmajeed, M, Abdou, NE, Abosamak, Sayed M, A.L., F, Ashoush, R, Atta, E, Elazzazy, M, Elnemr, Hewalla ME, Elsayed, I, Elsherbini, E, Essam, M, Ewedah, I, Ghallab, E, Hassan, M, Ibrahim, M, Metwalli, M, Mourad, Qatora, M.S., M, Ragab, A, Sabry, H, Saifeldin, A, Samih, Abdelaal A, Samir, S, Shehata, K, Shenit, D, Attia, N, Kamal, N, Osman, Abbas, A.M., Elazeem HAS, Abd, Abd-Elkariem, A.Y., MM, Abdelkarem, S, Alaa, M, Ashraf, A, Ayman, MG, Azizeldine, H, Elkhayat, Mashhour A, Emad, M, Gaber, HM, Hamza, I, Hawal, HF, Hetta, Ali A, K., S, M.elghazaly, MM, Mohammed, FA, Monib, Nageh, M.A., A, Saad, MM, Saad, M, Shahine, EA, Yousof, A, Youssef, El-Deeb, M., M, Fawzy, G, Ghaly, M, Ibraheem, A, Eldaly, E, Esmail, M, ElFiky, A, Nabil, M, Alrahawy, A, Sakr, H, Soliman, H, Soltan, G, Amira, I, Sallam, M, Sherief, A, Sherif, A, Abdelrahman, H, Aboulkassem, R, Hamdy, A, Morsi, G, Sherif, H, Abdeldayem, Salama I, Abdelkader, M, Balabel, Y, Fayed, AE, Sherif, R, Elmorsi, S, Emile, B, Refky, S, Abd-elsalam, H, Badr, M, Elbahnasawy, M, Elzoghby, M, Essa, Badr S, Gamal, A, Ghoneim, O, Hamad, M, Hamada, M, Hammad, A, Hawila, Morsy, M.S., S, Salman, S, Sarsik, K, Bekele, JH, Kauppila, E, Sarjanoja, O, Helminen, H, Huhta, C, Beyrne, L, Jouffret, L, Lugans, Marie-Macron, L., E, Chouillard, Simone B, De, F, Fredon, A, Roux, J, Bettoni, S, Dakpé, B, Devauchelle, N, Lavagen, S, Testelin, S, Boucher, R, Breheret, A, Gueutier, A, Kahn, Kün-Darbois, J., A, Barrabe, Z, Lakkis, A, Louvrier, S, Manfredelli, P, Mathieu, A, Chebaro, V, Drubay, M, El amrani, C, Eveno, K, Lecolle, G, Legault, L, Martin, G, Piessen, FR, Pruvot, S, Truant, P, Zerbib, Q, Ballouhey, B, Barrat, L, Fourcade, J, Laloze, H, Salle, A, Taibi, J, Tricard, J, Usseglio, D, Bergeat, A, Merdrignac, Roy B, Le, LO, Perotto, A, Scalabre, H, Gornes, C, Vaysse, K, Vergriete, A, Aimé, A, Ezanno, B, Malgras, AP, Arnaud, E, Fustec, V, Lavoue, C, Tesson, P, Bouche, S, Tzedakis, E, Cotte, O, Glehen, J, Lifante, L, Bendjemar, H, Braham, L, Charre, Arbi N, El, L, Morel-chevillet, A, Police, V, Villefranque, E, Volpin, A, D’Urso, E, Felli, D, Mutter, P, Pessaux, B, Seeliger, Y, Barbé, J, Bardet, E, Barret, R, Berry, G, Boddaert, S, Bonnet, E, Brian, N, Cathala, X, Cathelineau, C, Denet, D, Fuks, D, Gossot, M, Grigoroiu, A, Laforest, Levy-Zauberman, Y., Louis-Sylvestre, C., P, Macek, A, Mombet, A, Moumen, G, Pourcher, F, Rozet, Salas R, Sanchez, A, Seguin-givelet, E, Tribillon, V, Crenn, Vergie S, De, E, Duchalais, F, Espitalier, C, Ferron, H, Fragnaud, O, Malard, N, Regenet, J, Rigaud, Y, Varenne, D, Waast, U, Bork, M, Distler, J, Fritzmann, J, Kirchberg, C, Praetorius, C, Riediger, J, Weitz, T, Welsch, P, Wimberger, K, Beyer, C, Kamphues, J, Lauscher, FN, Loch, C, Schineis, M, Albertsmeier, M, Angele, A, Kappenberger, H, Niess, T, Schiergens, J, Werner, R, Becker, J, Jonescheit, J, Doerner, R, Seiberth, I, Pergolini, D, Reim, J, Herzberg, H, Honarpisheh, T, Strate, C, Boeker, I, Hakami, J, Mall, P, Liokatis, W, Smolka, N, Vassos, Mannheim, K, Nowak, T, Reinhard, F, Hölzle, A, Modabber, P, Winnand, M, Anthuber, E, Shiban, B, Sommer, F, Sommer, S, Wolf, H, Howaldt, M, Knitschke, P, Kauffmann, S, Wolfer, J, Kleeff, K, Lorenz, C, Michalski, U, Ronellenfitsch, Saale, Schneider R., E, Bertolani, A, Königsrainer, MW, Löffler, M, Quante, C, Steidle, L, Überrück, C, Yurttas, CS, Betz, J, Bewarder, A, Böttcher, S, Burg, C, Busch, M, Dreimann, KH, Frosch, M, Gosau, A, Heuer, J, Izbicki, TO, Klatte, D, Koenig, N, Moeckelmann, C, Nitschke, D, Perez, M, Priemel, A, Reiter, R, Smeets, U, Speth, M, Stangenberg, S, Thole, FG, Uzunoglu, L, Viezens, T, Vollkommer, N, Zeller, MJ, Battista, K, Gillen, A, Hasenburg, S, Krajnak, VC, Linz, R, Schwab, Amo-Antwi, K., A, Appiah-kubi, T, Konney, A, Tawiah, S, Boatey, A, Issaka, Korsah, M.A., M, Sheriff, K, Angelou, D, Haidopoulos, A, Rodolakis, P, Antonakis, K, Bramis, L, Chardalias, I, Contis, N, Dafnios, D, Dellaportas, G, Fragulidis, A, Gklavas, M, Konstadoulakis, N, Memos, I, Papaconstantinou, A, Polydorou, T, Theodosopoulos, A, Vezakis, MI, Antonopoulou, DK, Manatakis, N, Tasis, N, Arkadopoulos, N, Danias, P, Economopoulou, M, Frountzas, P, Kokoropoulos, A, Larentzakis, N, Michalopoulos, C, Nastos, S, Parasyris, E, Pikoulis, J, Selmani, T, Sidiropoulos, P, Vassiliu, K, Bouchagier, S, Klimopoulos, D, Paspaliari, G, Stylianidis, D, Akrivou, K, Baxevanidou, K, Bouliaris, P, Chatzikomnitsa, G, Delinasios, C, Doudakmanis, M, Efthimiou, A, Giaglaras, C, Kalfountzos, C, Kolla, G, Koukoulis, K, Zervas, S, Zourntou, I, Baloyiannis, A, Diamantis, E, Gkrinia, J, Hajiioannou, C, Korais, O, Koukoura, K, Perivoliotis, A, Saratziotis, C, Skoulakis, D, Symeonidis, K, Tepetes, G, Tzovaras, D, Zacharoulis, V, Alexoudi, K, Antoniades, I, Astreidis, P, Christidis, D, Deligiannidis, T, Grivas, O, Ioannidis, I, Kalaitsidou, L, Loutzidou, A, Mantevas, D, Michailidou, E, Nikolaidou, S, Papadopoulou, K, Paraskevopoulos, S, Politis, A, Stavroglou, D, Tatsis, I, Tilaveridis, K, Vahtsevanos, G, Venetis, I, Karaitianos, T, Tsirlis, K, Dinas, Margioula-Siarkou, C., S, Petousis, E, Baili, A, Charalabopoulos, T, Liakakos, D, Schizas, E, Spartalis, A, Syllaios, C, Zografos, C, Anthoulakis, Christou, C.D., V, Papadopoulos, A, Tooulias, D, Tsolakidis, G, Tsoulfas, D, Zouzoulas, E, Athanasakis, E, Chrysos, I, Tsiaoussis, S, Xenaki, E, Xynos, Duarte A, Barrios, Muralles I, Lopez, MJ, Lowey, AL, Portilla, G, Recinos, JYK, Chan, Chan, S.M., CCN, Chong, K, Futaba, Ho, M.F., SF, Hon, RWH, Lau, TWC, Mak, CF, Ng, CSH, Ng, KKC, Ng, SSM, Ng, AYB, Teoh, JY, Teoh, CC, Foo, B, Banky, N, Suszták, S, Misra, P, Pareek, JR, Vishnoi, S, Ambre, V, Balasubiramaniyan, P, Chappity, I, Chaudhary, L, Colney, MK, Das, M, Imaduddin, A, Jain, SK, Jena, M, Kar, S, Mandal, A, Mishra, SS, Mishra, TS, Mishra, JK, Mitra, Y, Mittal, DK, Muduly, P, Nayak, PK, Parida, P, Pradhan, DK, Rajan, E, Rebba, DK, Samal, A, Singh, M, Sultania, SP, Agarwal, A, Agrawal, RK, Arora, J, 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M, Mohammed, G, Tahhan, V, Valtzoglou, N, Blencowe, P, Eskander, K, Gash, L, Gourbault, M, Hanna, TA, Maccabe, B, Main, J, Olivier, C, Newton, S, Roswadowski, N, Ryan, E, Teh, D, West, H, Al-omishy, M, Baig, H, Bates, Taranto G, Di, K, Dickson, N, Dunne, C, Gill, D, Howe, D, Jeevan, A, Khajuria, Martin-Ucar, A., K, McEvoy, P, Naredla, S, Robertson, M, Sait, DR, Sarma, S, Shanbhag, T, Shortland, S, Simmonds, J, Skillman, N, Tewari, G, Walton, Akhtar, M.A., A, Brunt, J, McIntyre, K, Milne, MM, Rashid, A, Sgrò, KE, Stewart, A, Turnbull, Abou-Foul, A.K., G, Gossedge, S, O’Donnell, F, Oldfield, S, Thomson, Gonzalez M, Aguilar, S, Talukder, C, Boyle, D, Fernando, K, Gallagher, A, Laird, D, Tham, M, Bath, P, Basnyat, H, Davis, P, Montauban, A, Shrestha, K, Agarwal, T, Arif, C, Magee, T, Nambirajan, S, Powell, R, Vinayagam, I, Flindall, A, Hanson, V, Mahendran, S, Green, M, Lim, L, MacDonald, V, Miu, L, Onos, K, Sheridan, R, Young, F, Alam, O, Griffiths, C, Houlden, VS, Kolli, AK, Lala, S, Leeson, R, Peevor, Z, Seymour, E, Consorti, R, Gonzalez, R, Grolman, Kwan-Feinberg, R., T, Liu, O, Merzlikin, Francisco, San, A, Brown, Z, Cooper, S, Hirji, J, Jolissaint, D, Mahvi, B, Okafor, CP, Raut, V, Roxo, A, Salim, S, Bessen, L, Chen, L, Dagrosa, K, Fay, C, Fleischer, R, Hasson, E, Henderson, M, Leech, A, Loehrer, C, Markey, J, Paydarfar, K, Rosenkranz, K, Telma, N, Tocci, Wilkinson-Ryan, I., M, Bokenkamp, K, Brown, D, Fleming, C, Heron, C, Hill, H, Kay, E, Leede, K, McElhinney, KA, Olson, EC, Osterberg, C, Riley, P, Srikanth, J, Barbour, D, Blazer, GA, DiLalla, O, Fayanju, ES, Hwang, R, Kahmke, H, Kazaure, A, Lazarides, W, Lee, M, Lidsky, C, Menendez, D, Moris, J, Plichta, MC, Pradhan, L, Puscas, HE, Rice, D, Rocke, L, Rosenberger, R, Scheri, Smith, B.D., Stang, M.T., L, Tolnitch, K, Turnage, J, Visgauss, FS, Walton, T, Watts, S, Zani, J, Farma, K, Cardona, MC, Russell, J, Clark, D, Kwon, N, Goel, J, Kronenfeld, B, Bigelow, E, Etchill, Gabre-Kidan, A., H, Jenny, A, Kent, MR, Ladd, C, Long, H, Malapati, A, Margalit, S, Rapaport, J, Rose, K, Stevens, L, Tsai, D, Vervoort, P, Yesantharao, A, Dehal, D, Klaristenfeld, K, Huynh, H, Kaafarani, L, Naar, M, Qadan, L, Brown, I, Ganly, JE, Mullinax, N, Alpert, C, Gillezeau, Miles DDS MD, F.A.C.S.B.A., E, Taioli, DE, Cha, E, Gleeson, C, Horn, U, Sarpel, N, Gusani, J, Hazelton, J, Maines, JS, Oh, A, Ssentongo, P, Ssentongo, A, Bhama, K, Colling, M, Najarian, M, Azam, A, Choudhry, W, Marx, Y, Abedin, G, Arzumanov, R, Chokshi, S, Gabrilovich, N, Glass, E, Kalyoussef, Parvin-Nejad, F.P., D, Roden, J, Stein, Suarez-Ligon, A., G, Tsui, K, Zhao, J, Fleming, A, Fuson, J, Gigliotti, A, Ovaitt, Y, Ying, MK, Abel, V, Andaya, K, Bigay, Boeck, M.A., H, Chern, C, Corvera, El-Sayed, I., A, Glencer, P, Ha, Hamilton, B.C.S., C, Heaton, K, Hirose, Jablons, D.M., KS, Kirkwood, LZ, Kornblith, JR, Kratz, RH, Lee, PN, Miller, EK, Nakakura, Nunez-Garcia, B., RJ, O’Donnell, D, Ozgediz, P, Park, B, Robinson, A, Sarin, B, Sheu, MG, Varma, KC, Wai, R, Wustrack, MJ, Xu, M, Zimel, D, CA) Beswick, J, Goddard, J, Manor, J, Song, Springs/Loveland, Denver/Colorado, A, Cioci, W, Pavlis, K, Rakoczy, G, Ruiz, R, Saberi, T, Fullmer, C, Gaskill, N, Gross, K, Kiong, CL, Roland, SN, Zafar, M, Abdallah, A, Abouassi, E, Aigbivbalu, M, Almasri, J, Eid, B, George, G, Kulkarni, H, Marwan, M, Mehdi, Andrés M, San, J, Sundaresan, SG, Aoun, VS, Ban, HH, Batjer, K, Bosler, J, Caruso, B, Sumer, D, Abbott, A, Acher, T, Aiken, J, Barrett, E, Foley, PB, Schwartz, AT, Hawkins, A, Maiga, NM, Ruzgar, M, Sion, S, Ullrich, J, Laufer, S, Scasso, Al-Naggar, H., Al-Shehari, M., A, Almassaudi, M, Alsayadi, R, Alsayadi, M, Nahshal, S, Shream, S, AL-Ameri, M, Aldawbali, Fotopoulou, Christina, Khan, Tabassum, Bracinik, Juraj, Glasbey, James, Abu-Rustum, Nadeem, Chiva, Luis, Fagotti, Anna, Fujiwara, Keiichi, Ghebre, Rahel, Gutelkin, Murat, Konney, Thomas O., Ng, Joseph, Pareja, Rene, Kottayasamy Seenivasagam, Rajkumar, Sehouli, Jalid, Surappa, Shylasree T.S., and Leung, Elaine
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- 2022
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3. Intraoperative Imaging Techniques to Improve Surgical Resection Margins of Oropharyngeal Squamous Cell Cancer: A Comprehensive Review of Current Literature.
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Kleijn, B.J. de, Heldens, G.T.N., Herruer, J.M., Sier, C.F.M., Piazza, C., Bree, R. de, Guntinas-Lichius, O., Kowalski, L.P., der Poorten, V. Van, Rodrigo, J.P., Zidar, N., Nathan, Carl, Tsang, R.K.Y., Golusinski, P., Shaha, A.R., Ferlito, A., Takes, R.P., Kleijn, B.J. de, Heldens, G.T.N., Herruer, J.M., Sier, C.F.M., Piazza, C., Bree, R. de, Guntinas-Lichius, O., Kowalski, L.P., der Poorten, V. Van, Rodrigo, J.P., Zidar, N., Nathan, Carl, Tsang, R.K.Y., Golusinski, P., Shaha, A.R., Ferlito, A., and Takes, R.P.
- Abstract
Item does not contain fulltext, Inadequate resection margins in head and neck squamous cell carcinoma surgery necessitate adjuvant therapies such as re-resection and radiotherapy with or without chemotherapy and imply increasing morbidity and worse prognosis. On the other hand, taking larger margins by extending the resection also leads to avoidable increased morbidity. Oropharyngeal squamous cell carcinomas (OPSCCs) are often difficult to access; resections are limited by anatomy and functionality and thus carry an increased risk for close or positive margins. Therefore, there is a need to improve intraoperative assessment of resection margins. Several intraoperative techniques are available, but these often lead to prolonged operative time and are only suitable for a subgroup of patients. In recent years, new diagnostic tools have been the subject of investigation. This study reviews the available literature on intraoperative techniques to improve resection margins for OPSCCs. A literature search was performed in Embase, PubMed, and Cochrane. Narrow band imaging (NBI), high-resolution microendoscopic imaging, confocal laser endomicroscopy, frozen section analysis (FSA), ultrasound (US), computed tomography scan (CT), (auto) fluorescence imaging (FI), and augmented reality (AR) have all been used for OPSCC. NBI, FSA, and US are most commonly used and increase the rate of negative margins. Other techniques will become available in the future, of which fluorescence imaging has high potential for use with OPSCC.
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- 2023
4. Neutrophil to Lymphocyte Ratio in Oropharyngeal Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis.
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Rodrigo, J.P., Sánchez-Canteli, M., Triantafyllou, A., Bree, R. de, Mäkitie, A.A., Franchi, A., Hellquist, H., Saba, N.F., Stenman, G., Takes, R.P., Valero, C., Zidar, N., Ferlito, A., Rodrigo, J.P., Sánchez-Canteli, M., Triantafyllou, A., Bree, R. de, Mäkitie, A.A., Franchi, A., Hellquist, H., Saba, N.F., Stenman, G., Takes, R.P., Valero, C., Zidar, N., and Ferlito, A.
- Abstract
Item does not contain fulltext, Neutrophil-to-lymphocyte ratio (NLR) has been associated with survival in various cancers, including head and neck cancer. However, there is limited information on its role in oropharyngeal squamous cell carcinomas (OPSCC) according to HPV status. This prompted the present meta-analysis. Studies were selected when the prognostic value of NLR prior to treatment was evaluated in OPSCC patients, the cutoff value of NLR was available, and the prognostic value of NLR was evaluated by time-to-event survival analysis. A total of 14 out of 492 articles, including 7647 patients, were analyzed. The results showed a worse prognosis for the patients with a high NLR: The combined hazard ratios (HR) for overall survival (OS) in patients with an elevated NLR was 1.56 (95% confidence interval (CI) 1.21-2.02; p = 0.0006), for disease-free survival was 1.52 (95% CI 1.34-1.73; p < 0.00001), and for recurrence-free survival was 1.86 (95% CI 1.50-2.30; p < 0.00001). This worse prognosis of high NLR was exclusive of HPV-positive patients: HR for OS in the HPV-positive subgroup was 4.05 (95% CI 1.90-8.62 (p = 0.0003), and in the HPV-negative subgroup 0.92 (95% CI 0.47-1.80; p = 0.82). The prognosis of NLR was not influenced by treatment: The HR for OS for patients treated with radiotherapy/chemoradiotherapy (RT/CRT) was 1.48 (95% CI 1.09-2.01; p = 0.01), and for patients treated with surgery (±RT/CRT) was 1.72 (95% CI 1.08-2.72; p = 0.02). In conclusion, an elevated NLR relates to worse outcomes in patients with HPV-positive OPSCC.
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- 2023
5. Management of Older Patients with Head and Neck Cancer: A Comprehensive Review.
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Matos, L.L., Sanabria, A., Robbins, K.T., Halmos, G.B., Strojan, P., Ng, W.T., Takes, R.P., Angelos, P., Piazza, C., Bree, R. de, Ronen, O., Guntinas-Lichius, O., Eisbruch, A., Zafereo, M., Mäkitie, A.A., Shaha, A.R., Coca-Pelaz, A., Rinaldo, A., Saba, N.F., Cohen, O., Lopez, F., Rodrigo, J.P., Silver, C.E., Strandberg, T.E., Kowalski, L.P., Ferlito, A., Matos, L.L., Sanabria, A., Robbins, K.T., Halmos, G.B., Strojan, P., Ng, W.T., Takes, R.P., Angelos, P., Piazza, C., Bree, R. de, Ronen, O., Guntinas-Lichius, O., Eisbruch, A., Zafereo, M., Mäkitie, A.A., Shaha, A.R., Coca-Pelaz, A., Rinaldo, A., Saba, N.F., Cohen, O., Lopez, F., Rodrigo, J.P., Silver, C.E., Strandberg, T.E., Kowalski, L.P., and Ferlito, A.
- Abstract
Item does not contain fulltext, The projected increase in life expectancy over the next few decades is expected to result in a rise in age-related diseases, including cancer. Head and neck cancer (HNC) is a worldwide health problem with high rates of morbidity and mortality. In this report, we have critically reviewed the literature reporting the management of older patients with HNC. Older adults are more prone to complications and toxicities secondary to HNC treatment, especially those patients who are frail or have comorbidities. Thus, this population should be screened prior to treatment for such predispositions to maximize medical management of comorbidities. Chronologic age itself is not a reason for choosing less intensive treatment for older HNC patients. Whenever possible, also older patients should be treated according to the best standard of care, as nonstandard approaches may result in increased treatment failure rates and mortality. The treatment plan is best established by a multidisciplinary tumor board with shared decision-making with patients and family. Treatment modifications should be considered for those patients who have severe comorbidities, evidence of frailty (low performance status), or low performance status or those who refuse the recommendations of the tumor board.
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- 2023
6. Hypoxia and tumor microenvironment in head and neck squamous cell carcinoma
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Bree, R. de, Willems, S.M., Swartz, Justin Egidius, Bree, R. de, Willems, S.M., and Swartz, Justin Egidius
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- 2023
7. Radiomics in Hypopharyngeal Cancer Management: A State-of-the-Art Review.
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Chiesa-Estomba, C.M., Mayo-Yanez, M., Guntinas-Lichius, O., Vander-Poorten, V., Takes, R.P., Bree, R. de, Halmos, G.B., Saba, N.F., Nuyts, S., Ferlito, A., Chiesa-Estomba, C.M., Mayo-Yanez, M., Guntinas-Lichius, O., Vander-Poorten, V., Takes, R.P., Bree, R. de, Halmos, G.B., Saba, N.F., Nuyts, S., and Ferlito, A.
- Abstract
Contains fulltext : 291571.pdf (Publisher’s version ) (Open Access), (1) Background: Hypopharyngeal squamous cell carcinomas usually present with locally advanced disease and a correspondingly poor prognosis. Currently, efforts are being made to improve tumor characterization and provide insightful information for outcome prediction. Radiomics is an emerging area of study that involves the conversion of medical images into mineable data; these data are then used to extract quantitative features based on shape, intensity, texture, and other parameters; (2) Methods: A systematic review of the peer-reviewed literature was conducted; (3) Results: A total of 437 manuscripts were identified. Fifteen manuscripts met the inclusion criteria. The main targets described were the evaluation of textural features to determine tumor-programmed death-ligand 1 expression; a surrogate for microvessel density and heterogeneity of perfusion; patient stratification into groups at high and low risk of progression; prediction of early recurrence, 1-year locoregional failure and survival outcome, including progression-free survival and overall survival, in patients with locally advanced HPSCC; thyroid cartilage invasion, early disease progression, recurrence, induction chemotherapy response, treatment response, and prognosis; and (4) Conclusions: our findings suggest that radiomics represents a potentially useful tool in the diagnostic workup as well as during the treatment and follow-up of patients with HPSCC. Large prospective studies are essential to validate this technology in these patients.
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- 2023
8. Lymph Node Metastases from Non-Melanoma Skin Cancer of the Head and Neck.
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Civantos, F., Helmen, Z.M., Bradley, P.J., Coca-Pelaz, A., Bree, R. de, Guntinas-Lichius, O., Kowalski, L.P., López, F., Mäkitie, A.A., Rinaldo, A., Robbins, K.T., Rodrigo, J.P., Takes, R.P., Ferlito, A., Civantos, F., Helmen, Z.M., Bradley, P.J., Coca-Pelaz, A., Bree, R. de, Guntinas-Lichius, O., Kowalski, L.P., López, F., Mäkitie, A.A., Rinaldo, A., Robbins, K.T., Rodrigo, J.P., Takes, R.P., and Ferlito, A.
- Abstract
Contains fulltext : 296333.pdf (Publisher’s version ) (Open Access), Non-melanoma skin cancer (NMSC) represents the most common malignancy in the world, comprising exceedingly common lesions such as basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC) and rare lesions such as Merkel cell carcinoma. Risk factors are widely recognized and include ultraviolet (UV) light exposure, radiation exposure, immunosuppression, and many others. As a whole, survival and functional outcomes are favorable, but each histopathological subtype of NMSC behaves differently. Treatment regimens for the primary site usually include wide surgical excision and neck dissection in cases of clinically involved metastatic lymph nodes. The elective management of draining nodal basins, however, is a contested topic. Nearly all subtypes, excluding BCC, have a significant risk of lymphatic metastases, and have been studied with regard to sentinel lymph node biopsy (SLNB) and elective neck dissection. To date, no studies have definitively established a true single standard of care, as exists for melanoma, for any of the NMSCs. As a result, the authors have sought to summarize the current literature and identify indications and management options for the management of the cervical lymphatics for each major subtype of NMSC. Further research remains critically necessary in order to develop complete treatment algorithms.
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- 2023
9. Survival Outcomes in T3 Laryngeal Cancers: Primary Total Laryngectomy vs. Concurrent Chemoradiation or Radiation Therapy-A Meta-Analysis.
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Rao, K.N., Pai, P.S., Dange, P., Kowalski, L.P., Strojan, P., Mäkitie, A.A., Guntinas-Lichius, O., Robbins, K.T., Rodrigo, J.P., Eisbruch, A., Takes, R.P., Bree, R. de, Coca-Pelaz, A., Piazza, C., Chiesa-Estomba, C., López, F., Saba, N.F., Rinaldo, A., Ferlito, A., Rao, K.N., Pai, P.S., Dange, P., Kowalski, L.P., Strojan, P., Mäkitie, A.A., Guntinas-Lichius, O., Robbins, K.T., Rodrigo, J.P., Eisbruch, A., Takes, R.P., Bree, R. de, Coca-Pelaz, A., Piazza, C., Chiesa-Estomba, C., López, F., Saba, N.F., Rinaldo, A., and Ferlito, A.
- Abstract
Contains fulltext : 296046.pdf (Publisher’s version ) (Open Access), BACKGROUND: The management of cT3 laryngeal cancers remains controversial, with studies recommending surgical or non-surgical approaches. Despite the many papers that have been published on the subject, there is a lack of studies showing which treatment has better results in terms of survival. OBJECTIVE: To determine the difference in survival outcomes following total laryngectomy (TL), concurrent chemoradiation (CRT) or radiation therapy (RT) alone in T3 laryngeal cancers. METHODS: Search of PubMed, Scopus, and Google Scholar databases from 1995 to 2023 employing specific keywords and Boolean operators to retrieve relevant articles. Statistical analysis was conducted using a random-effects model, and heterogeneity was evaluated using the Q-test and I(2) statistic. Funnel plot asymmetry was assessed using rank correlation and regression tests. RESULTS: The qualitative data synthesis comprised 10,940 patients from 16 included studies. TL was performed in 2149 (19.4%), CRT in 6723 (61.5%), RT in 295 (2.7%), while non-surgical treatment was not specified in 1773 (16.2%) patients. The pooled 2-year overall survival (OS) rates were TL = 73%, CRT = 74.7%, RT = 57.9%, 3-year OS rates were TL = 64.3%, CRT = 62.9%, RT = 52.4%, and 5-year OS rates were TL = 54.2%, CRT = 52.7%, RT = 40.8%. There was a significant heterogeneity in the included studies. There was no statistically significant difference in 2-year OS (logOR= -0.88 (95% confidence interval (CI): -1.99 to 0.23), p = 0.12), 3-year OS (logOR = -0.6 (95% CI: -1.34 to 0.15), p = 0.11), and 5-year OS (logOR = -0.54 (95% CI: -1.29 to 0.21), p = 0.16) between TL and CRT. Instead, there was significant difference in 2-year OS (logOR= -1.2383 (95% CI: -2.1679 to -0.3087), p = 0.009), 3-year OS (-1.1262 (95% CI: -1.6166 to -0.6358), p < 0.001), and 5-year OS (-0.99 (95% CI: -1.44 to -0.53)), p < 0.001) between TL and RT alone. CONCLUSIONS AND SIGNIFICANCE: TL followed with adjuvant (chemo)radiation on indication and CRT with
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- 2023
10. Swallowing after Oral Oncological Treatment: A Five-Year Prospective Study.
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Speksnijder, C.M., Ortiz-Comino, L., Haan, A.F.J. de, Fernández-Lao, C., Bree, R. de, Merkx, M.A.W., Speksnijder, C.M., Ortiz-Comino, L., Haan, A.F.J. de, Fernández-Lao, C., Bree, R. de, and Merkx, M.A.W.
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Contains fulltext : 296330.pdf (Publisher’s version ) (Open Access), BACKGROUND: Swallowing rehabilitation in curative treated patients with oral cancer is still a challenge. Different factors may influence these patients' swallowing function. The aim of this study was to identify factors associated with swallowing function up to 5 years after cancer treatment. METHODS: Swallowing duration and frequency of 5 mL water and 15 mL applesauce were measured in 123 patients treated for oral cancer. Mixed model analyses were performed to identify associated factors. RESULTS: Age influenced all measured swallowing outcomes. Assessment moment, gender, tumor location, maximum tongue force, and tactile sensory function of the tongue were associated with both water and applesauce swallowing duration, tumor classification was associated with water swallowing duration, and alcohol consumption was associated with applesauce swallowing duration. Assessment moment, cancer treatment, maximum tongue force, and tactile sensory function of the tongue were associated with water and applesauce swallowing frequency. CONCLUSION: Patients who are older at diagnosis, women, and patients who regularly consume alcohol before their treatment may have poorer swallow functioning after curative oral cancer treatment. Patients that fit these criteria should have their swallowing evaluated during clinical follow-ups and sent to swallowing therapy when needed. During this therapy, optimizing tongue function needs attention to maintain an optimal swallowing function.
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- 2023
11. Changes in Sexuality and Sexual Dysfunction over Time in the First Two Years after Treatment of Head and Neck Cancer.
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Stone, M.A., Lissenberg-Witte, Birgit I., Bree, R. de, Hardillo, J.A., Lamers, F., Langendijk, J.A., Leemans, C.Rene, Takes, R.P., Jansen, F., Verdonck-de Leeuw, I.M., Stone, M.A., Lissenberg-Witte, Birgit I., Bree, R. de, Hardillo, J.A., Lamers, F., Langendijk, J.A., Leemans, C.Rene, Takes, R.P., Jansen, F., and Verdonck-de Leeuw, I.M.
- Abstract
Item does not contain fulltext, The aim of this study was to investigate changes in sexuality and sexual dysfunction in head and neck cancer (HNC) patients in the first two years after treatment, in relation to the type of treatment. Data were used of 588 HNC patients participating in the prospective NETherlands Quality of life and Biomedical Cohort Study (NET-QUBIC) from diagnosis to 3, 6, 12 and 24 months after treatment. Primary outcome measures were the International Index of Erectile Function (IIEF) and the Female Sexual Function Index (FSFI). The total scores of the IIEF and FSFI were dichotomized into sexual (dys)function. In men, type of treatment was significantly associated with change in erectile function, orgasm, satisfaction with intercourse, and overall satisfaction. In women, type of treatment was significantly associated with change in desire, arousal, and orgasm. There were significant differences between treatment groups in change in dysfunctional sexuality. A deterioration in sexuality and sexual dysfunction from baseline to 3 months after treatment was observed especially in patients treated with chemoradiation. Changes in sexuality and sexual dysfunction in HNC patients were related to treatment, with an acute negative effect of chemoradiation. This effect on the various domains of sexuality seems to differ between men and women.
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- 2023
12. Validation of automated positive cell and region detection of immunohistochemically stained laryngeal tumor tissue using digital image analysis
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Smits, H.J.M., Swartz, J.E., Philippens, M.E., Bree, R. de, Kaanders, J.H.A.M., Koppes, S.A., Breimer, G.E., and Willems, S.M.
- Subjects
All institutes and research themes of the Radboud University Medical Center ,Validation ,Positive cell detection ,Health Informatics ,Positive region detection ,Computational pathology ,Biomarker analysis ,Rare cancers Radboud Institute for Health Sciences [Radboudumc 9] ,Computer Science Applications ,Pathology and Forensic Medicine - Abstract
Contains fulltext : 291203.pdf (Publisher’s version ) (Open Access) OBJECTIVES: This study aimed to validate a digital image analysis (DIA) workflow for automatic positive cell detection and positive region delineation for immunohistochemical hypoxia markers with a nuclear (hypoxia-inducible factor 1α [HIF-1α]) and a cytoplasmic (pimonidazole [PIMO]) staining pattern. MATERIALS AND METHODS: 101 tissue fragments from 44 laryngeal tumor biopsies were immunohistochemically stained for HIF-1α and PIMO. QuPath was used to determine the percentage of positive cells and to delineate positive regions automatically. For HIF-1α, only cells with strong staining were considered positive. Three dedicated head and neck pathologists scored the percentage of positive cells using three categories (0: 33%;). The pathologists also delineated the positive regions on 14 corresponding PIMO and HIF-1α-stained fragments. The consensus between observers was used as the reference standard and was compared to the automatic delineation. RESULTS: Agreement between categorical positivity scores was 76.2% and 65.4% for PIMO and HIF-1α, respectively. In all cases of disagreement in HIF-1α fragments, the DIA underestimated the percentage of positive cells. As for the region detection, the DIA correctly detected most positive regions on PIMO fragments (false positive area=3.1%, false negative area=0.7%). In HIF-1α, the DIA missed some positive regions (false positive area=1.3%, false negative area=9.7%). CONCLUSIONS: Positive cell and region detection on biopsy material is feasible, but further optimization is needed before unsupervised use. Validation at varying DAB staining intensities is hampered by lack of reliability of the gold standard (i.e., visual human interpretation). Nevertheless, the DIA method has the potential to be used as a tool to assist pathologists in the analysis of IHC staining.
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- 2023
13. Development and external validation of a prediction model for tube feeding dependency for at least four weeks during chemoradiotherapy for head and neck cancer
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Willemsen, A., Kok, Annemieke, Baijens, Laura W. J., Boer, Jan Paul de, Bree, R. de, Devriese, Lot A., Driessen, C.M.L., Herpen, C.M.L. van, Kaanders, J.H.A.M., Terhaard, Chris H. J., Hoeben, Ann, Willemsen, A., Kok, Annemieke, Baijens, Laura W. J., Boer, Jan Paul de, Bree, R. de, Devriese, Lot A., Driessen, C.M.L., Herpen, C.M.L. van, Kaanders, J.H.A.M., Terhaard, Chris H. J., and Hoeben, Ann
- Abstract
Item does not contain fulltext
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- 2022
14. Fewer head and neck cancer diagnoses and faster treatment initiation during COVID-19 in 2020: A nationwide population-based analysis
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Schoonbeek, R.C., Jel, D.V.C. de, Dijk, B.A. van, Willems, S.M., Bloemena, E., Hoebers, F.J., Meerten, E. van, Verbist, B.M., Smeele, L.E., Halmos, G.B., Merkx, M.A.W., Siesling, S., Bree, R. de, Takes, R.P., Schoonbeek, R.C., Jel, D.V.C. de, Dijk, B.A. van, Willems, S.M., Bloemena, E., Hoebers, F.J., Meerten, E. van, Verbist, B.M., Smeele, L.E., Halmos, G.B., Merkx, M.A.W., Siesling, S., Bree, R. de, and Takes, R.P.
- Abstract
Item does not contain fulltext, BACKGROUND: Inevitably, the emergence of COVID-19 has impacted non-COVID care. Because timely diagnosis and treatment are essential, especially for patients with head and neck cancer (HNC) with fast-growing tumours in a functionally and aesthetically important area, we wished to quantify the impact of the COVID-19 pandemic on HNC care in the Netherlands. MATERIAL AND METHODS: This population-based study covered all, in total 8468, newly diagnosed primary HNC cases in the Netherlands in 2018, 2019 and 2020. We compared incidence, patient and tumour characteristics, primary treatment characteristics, and time-to-treatment in the first COVID-19 year 2020 with corresponding periods in 2018 and 2019 (i.e. pre-COVID). RESULTS: The incidence of HNC was nearly 25% less during the first wave (n = 433) than in 2019 (n = 595) and 2018 (n = 598). In April and May 2020, the incidence of oral cavity and laryngeal carcinomas was significantly lower than in pre-COVID years. There were no shifts in tumour stage or alterations in initial treatment modalities. Regardless of the first treatment modality and specific period, the median number of days between first visit to a HNC centre and start of treatment was significantly shorter during the COVID-19 year (26-28 days) than pre-COVID (31-32 days, p < 0.001). CONCLUSION: The incidence of HNC during the Netherlands' first COVID-19 wave was significantly lower than expected. The expected increase in incidence during the remainder of 2020 was not observed. Despite the overloaded healthcare system, the standard treatment for HNC patients could be delivered within a shorter time interval.
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- 2022
15. Oral Squamous Cell Carcinoma of the Maxilla: On the way to patient-specific care
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Bree, R. de, Cann, E.M. van, Slieker, Fons Joeri Bernard, Bree, R. de, Cann, E.M. van, and Slieker, Fons Joeri Bernard
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- 2022
16. Managing Cachexia in Head and Neck Cancer: a Systematic Scoping Review
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Mäkitie, A.A., Alabi, R.O., Orell, H., Youssef, O., Almangush, A., Homma, A., Takes, R.P., López, F., Bree, R. de, Rodrigo, J.P., Ferlito, A., Mäkitie, A.A., Alabi, R.O., Orell, H., Youssef, O., Almangush, A., Homma, A., Takes, R.P., López, F., Bree, R. de, Rodrigo, J.P., and Ferlito, A.
- Abstract
Item does not contain fulltext, INTRODUCTION: Patients with head and neck cancer (HNC) are usually confronted with functional changes due to the malignancy itself or its treatment. These factors typically affect important structures involved in speech, breathing, chewing, swallowing, and saliva production. Consequently, the intake of food will be limited, which further contributes to loss of body weight and muscle mass, anorexia, malnutrition, fatigue, and anemia. This multifactorial condition can ultimately lead to cancer cachexia syndrome. This study aims to examine the treatment of cachexia in HNC patients. METHODS: We systematically searched OvidMedline, PubMed, Scopus, and Web of Science for articles examining the treatment of cachexia in HNC. RESULTS: A total of nine studies were found, and these suggested interventions including nutritional, pharmacologic, therapeutic exercise, and multimodal approaches. The nutritional intervention includes essential components such as dietary counseling, oral nutritional supplements, and medical nutritional support. Individualized nutritional interventions include oral, enteral (feeding tubes i.e., percutaneous endoscopic gastrostomy [PEG], nasogastric tube [NGT]) and parenteral nutrition. The pharmacologic interventions aim at increasing the appetite and weight of cachectic patients. Therapeutic exercise and increased physical activity can help to enhance the synthesis of muscle protein, reducing inflammation and the catabolic effects of cachexia syndrome. CONCLUSION: Owing to the multifactorial nature of this syndrome, it is expected that the management approach should be multi-interventional. Early implementation of these interventions may help to improve survival and quality of health and life of cachectic HNC patients.
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- 2022
17. Response to 'Head and neck cancer diagnoses and faster treatment initiation during COVID-19: Correspondence'
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Schoonbeek, R.C., Jel, D.V.C. de, Dijk, B.A. van, Willems, S.M., Bloemena, E., Hoebers, F.J., Meerten, E. van, Verbist, B.M., Smeele, L.E., Halmos, G.B., Merkx, M.A.W., Siesling, S., Bree, R. de, Takes, R.P., Schoonbeek, R.C., Jel, D.V.C. de, Dijk, B.A. van, Willems, S.M., Bloemena, E., Hoebers, F.J., Meerten, E. van, Verbist, B.M., Smeele, L.E., Halmos, G.B., Merkx, M.A.W., Siesling, S., Bree, R. de, and Takes, R.P.
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Item does not contain fulltext
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- 2022
18. Benign Peripheral Non-cranial Nerve Sheath Tumors of the Neck
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Suárez, C., López, F., Rodrigo, J.P., Mendenhall, W.M., Bree, R. de, Mäkitie, A.A., Poorten, V. Van der, Takes, R.P., Bondi, S., Kowalski, L.P., Shaha, A.R., Fernández-Alvarez, V., Gutiérrez, J.C., Zidar, N., Chiesa-Estomba, C., Strojan, P., Sanabria, A., Rinaldo, A., Ferlito, A., Suárez, C., López, F., Rodrigo, J.P., Mendenhall, W.M., Bree, R. de, Mäkitie, A.A., Poorten, V. Van der, Takes, R.P., Bondi, S., Kowalski, L.P., Shaha, A.R., Fernández-Alvarez, V., Gutiérrez, J.C., Zidar, N., Chiesa-Estomba, C., Strojan, P., Sanabria, A., Rinaldo, A., and Ferlito, A.
- Abstract
Item does not contain fulltext, Benign peripheral non-cranial nerve sheath tumors are rare lesions, including both schwannomas and neurofibromas. These tumors arise from Schwann cells, and may originate from any peripheral, cranial, or autonomic nerve. Most of them are localized and sporadic but multifocal systemic forms can occur. Cervical sympathetic chain, brachial plexus, cervical plexus and spinal roots and nerves are the major nerve systems commonly affected. Dumbbell-shaped intra- and extradural tumors occur most commonly in the cervical spine, as well as purely extradural and paravertebral tumors. The management of these tumors has improved greatly owing to the developments in imaging techniques and surgical innovations such as endoscopically assisted approaches and robotic surgery. Microsurgical intracapsular excision of the tumor helped by the use of intraoperative fluorescent dyes and intraoperative neurophysiological monitoring minimize postoperative neural deficit, since most schwannomas are encapsulated. Most tumors can be removed with a low rate of complications and recurrence. Radiotherapy should be considered for growing lesions that are not amenable to surgery. In asymptomatic patients, observation and serial scans is an option for elderly infirm patients.
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- 2022
19. Neck and Shoulder Morbidity in Patients with Oral Cancer and Clinically Negative Node Neck Status: A Comparison between the Elective Neck Dissection and Sentinel Lymph Node Biopsy Strategies
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Hinte, G.J. van, Withagen, Koen P.A., Bree, R. de, Speksnijder, C.M., Hinte, G.J. van, Withagen, Koen P.A., Bree, R. de, and Speksnijder, C.M.
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Item does not contain fulltext
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- 2022
20. Correlation and colocalization of HIF-1alpha and pimonidazole staining for hypoxia in laryngeal squamous cell carcinomas: A digital, single-cell-based analysis
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Swartz, J.E., Smits, H.J.M., Philippens, M.E., Bree, R. de, Kaanders, J.H.A.M., Willems, S.M., Swartz, J.E., Smits, H.J.M., Philippens, M.E., Bree, R. de, Kaanders, J.H.A.M., and Willems, S.M.
- Abstract
Contains fulltext : 251419.pdf (Publisher’s version ) (Open Access), OBJECTIVE: Tumor hypoxia results in worse local control and patient survival. We performed a digital, single-cell-based analysis to compare two biomarkers for hypoxia (hypoxia-inducible factor 1-alpha [HIF-1alpha] and pimonidazole [PIMO]) and their effect on outcome in laryngeal cancer patients treated with accelerated radiotherapy with or without carbogen breathing and nicotinamide (AR versus ARCON). MATERIALS AND METHODS: Immunohistochemical staining was performed for HIF-1alpha and PIMO in consecutive sections of 44 laryngeal cancer patients randomized between AR and ARCON. HIF-1alpha expression and PIMO-binding were correlated using digital image analysis in QuPath. High-density areas for each biomarker were automatically annotated and staining overlap was analyzed. Kaplan-Meier survival analyses for local control, regional control and disease-free survival were performed to predict a response benefit of ARCON over AR alone for each biomarker. RESULTS: 106 Tissue fragments of 44 patients were analyzed. A weak, significant positive correlation was observed between HIF-1alpha and PIMO positivity on fragment level, but not on patient level. A moderate strength correlation (r = 0.705, p < 0.001) was observed between the number of high-density staining areas for both biomarkers. Staining overlap was poor. HIF-1alpha expression, PIMO-binding or a combination could not predict a response benefit of ARCON over AR. CONCLUSION: Digital image analysis to compare positive cell fractions and staining overlap between two hypoxia biomarkers using open-source software is feasible. Our results highlight that there are distinct differences between HIF-1alpha and PIMO as hypoxia biomarkers and therefore suggest co-existence of different forms of hypoxia within a single tumor.
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- 2022
21. Measurement of Sarcopenia in Head and Neck Cancer Patients and Its Association With Frailty
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Bree, R. de, Meerkerk, C.D.A., Halmos, G.B., Mäkitie, A.A., Homma, A., Rodrigo, J.P., López, F., Takes, R.P., Vermorken, J.B., Ferlito, A., Bree, R. de, Meerkerk, C.D.A., Halmos, G.B., Mäkitie, A.A., Homma, A., Rodrigo, J.P., López, F., Takes, R.P., Vermorken, J.B., and Ferlito, A.
- Abstract
Contains fulltext : 251734.pdf (Publisher’s version ) (Open Access), In head and neck cancer (HNC) there is a need for more personalized treatment based on risk assessment for treatment related adverse events (i.e. toxicities and complications), expected survival and quality of life. Sarcopenia, defined as a condition characterized by loss of skeletal muscle mass and function, can predict adverse outcomes in HNC patients. A review of the literature on the measurement of sarcopenia in head and neck cancer patients and its association with frailty was performed. Skeletal muscle mass (SMM) measurement only is often used to determine if sarcopenia is present or not. SMM is most often assessed by measuring skeletal muscle cross-sectional area on CT or MRI at the level of the third lumbar vertebra. As abdominal scans are not always available in HNC patients, measurement of SMM at the third cervical vertebra has been developed and is frequently used. Frailty is often defined as an age-related cumulative decline across multiple physiologic systems, with impaired homeostatic reserve and a reduced capacity of the organism to withstand stress, leading to increased risk of adverse health outcomes. There is no international standard measure of frailty and there are multiple measures of frailty. Both sarcopenia and frailty can predict adverse outcomes and can be used to identify vulnerable patients, select treatment options, adjust treatments, improve patient counselling, improve preoperative nutritional status and anticipate early on complications, length of hospital stay and discharge. Depending on the definitions used for sarcopenia and frailty, there is more or less overlap between both conditions. However, it has yet to be determined if sarcopenia and frailty can be used interchangeably or that they have additional value and should be used in combination to optimize individualized treatment in HNC patients.
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- 2022
22. Diagnostic test accuracy of sentinel lymph node biopsy in squamous cell carcinoma of the oropharynx, larynx, and hypopharynx: A systematic review and meta-analysis
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Bosch, S van den, Czerwinski, M., Govers, T., Takes, R.P., Bree, R. de, Al-Mamgani, A., Hannink, G., Kaanders, J.H.A.M., Bosch, S van den, Czerwinski, M., Govers, T., Takes, R.P., Bree, R. de, Al-Mamgani, A., Hannink, G., and Kaanders, J.H.A.M.
- Abstract
Contains fulltext : 283429.pdf (Publisher’s version ) (Open Access), The aim of this meta-analysis was to determine the diagnostic test accuracy of sentinel lymph node biopsy (SLNB) in patients with oropharyngeal, laryngeal, and hypopharyngeal squamous cell carcinoma (SCC). For this purpose, MEDLINE, EMBASE, and Web of Science were searched from inception to March 8, 2022. Included were studies evaluating diagnostic test accuracy of SLNB to identify cervical lymph node metastases with elective neck dissection or follow-up as reference. A bivariate generalized linear mixed model approach was used for the meta-analysis. Nineteen studies were eligible, evaluating 377 cases in total. The pooled estimates of sensitivity and negative predictive value were 0.93 (95% CI: 0.86-0.96) and 0.97 (95% CI: 0.94-0.98), respectively. The excellent accuracy of SLNB justifies a place in the diagnostic workup of patients with larynx and pharynx SCC. Randomized trials are required to demonstrate oncologic safety and benefits on treatment related morbidity and quality of life when omitting elective neck treatment based on SLNB.
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- 2022
23. Skeletal muscle mass in head and neck cancer patients: Radiological assessment and association with clinical outcome
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Bree, R. de, Devriese, L.A., Bril, Sandra Isabella, Bree, R. de, Devriese, L.A., and Bril, Sandra Isabella
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- 2021
24. The eHealth self-management application 'Oncokompas' that supports cancer survivors to improve health-related quality of life and reduce symptoms: which groups benefit most?
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Hout, A van den, Holtmaat, K., Jansen, F., Lissenberg-Witte, Birgit I., Uden-Kraan, C.F. van, Nieuwenhuijzen, G.A., Hardillo, J.A., Jong, R.J. de, Tiren-Verbeet, N.L., Sommeijer, D.W., Heer, K. de, Schaar, C.G., Sedee, R.J., Bosscha, K., Brekel, M.W. van den, Petersen, J.F., Westerman, M., Honings, J., Takes, R.P., Houtenbos, I., Broek, W.T. van den, Bree, R. de, Jansen, P., Eerenstein, S.E., Leemans, C.Rene, Zijlstra, J.M., Cuijpers, P., Poll-Franse, L.V. van de, Verdonck-de Leeuw, I.M., Hout, A van den, Holtmaat, K., Jansen, F., Lissenberg-Witte, Birgit I., Uden-Kraan, C.F. van, Nieuwenhuijzen, G.A., Hardillo, J.A., Jong, R.J. de, Tiren-Verbeet, N.L., Sommeijer, D.W., Heer, K. de, Schaar, C.G., Sedee, R.J., Bosscha, K., Brekel, M.W. van den, Petersen, J.F., Westerman, M., Honings, J., Takes, R.P., Houtenbos, I., Broek, W.T. van den, Bree, R. de, Jansen, P., Eerenstein, S.E., Leemans, C.Rene, Zijlstra, J.M., Cuijpers, P., Poll-Franse, L.V. van de, and Verdonck-de Leeuw, I.M.
- Abstract
Contains fulltext : 231712.pdf (Publisher’s version ) (Open Access), BACKGROUND: Oncokompas is a web-based self-management application that supports cancer survivors to monitor their health-related quality of life (HRQOL) and symptoms, and to obtain personalised feedback and tailored options for supportive care. In a large randomised controlled trial among survivors of head and neck cancer, colorectal cancer, and breast cancer and (non-)Hodgkin lymphoma, Oncokompas proved to improve HRQOL, and to reduce several tumour-specific symptoms. Effect sizes were however small, and no effect was observed on the primary outcome patient activation. Therefore, this study aims to explore which subgroups of cancer survivors may especially benefit from Oncokompas. MATERIALS AND METHODS: Cancer survivors (n = 625) were randomly assigned to the intervention group (access to Oncokompas, n = 320) or control group (6 months waiting list, n = 305). Outcome measures were HRQOL, tumour-specific symptoms, and patient activation. Potential moderators included socio-demographic (sex, age, marital status, education, employment), clinical (tumour type, stage, time since diagnosis, treatment modality, comorbidities), and personal factors (self-efficacy, personal control, health literacy, Internet use), and patient activation, mental adjustment to cancer, HRQOL, symptoms, and need for supportive care, measured at baseline. Linear mixed models were performed to investigate potential moderators. RESULTS: The intervention effect on HRQOL was the largest among cancer survivors with low to moderate self-efficacy, and among those with high personal control and those with high health literacy scores. Cancer survivors with higher baseline symptom scores benefitted more on head and neck (pain in the mouth, social eating, swallowing, coughing, trismus), and colorectal cancer (weight) specific symptoms. DISCUSSION: Oncokompas seems most effective in reducing symptoms in head and neck cancer and colorectal cancer survivors who report a higher burden of tumour-specific sympto
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- 2021
25. What is the role of sentinel lymph node biopsy in the management of oral cancer in 2020?
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Bree, R. de, Keizer, B. de, Civantos, F.J., Takes, R.P., Rodrigo, J.P., Hernandez-Prera, J.C., Halmos, G.B., Rinaldo, A., Ferlito, A., Bree, R. de, Keizer, B. de, Civantos, F.J., Takes, R.P., Rodrigo, J.P., Hernandez-Prera, J.C., Halmos, G.B., Rinaldo, A., and Ferlito, A.
- Abstract
Contains fulltext : 237775.pdf (Publisher’s version ) (Open Access), Approximately 70-80% of patients with cT1-2N0 oral squamous cell carcinoma (OSCC) ultimately prove to have no cancer in the cervical lymphatics on final pathology after selective neck dissection. As a result, sentinel lymph node biopsy (SLNB) has been adopted during the last decade as a diagnostic staging method to intelligently identify patients who would benefit from formal selective lymphadenectomy or neck irradiation. While not yet universally accepted, SLNB is now incorporated in many national guidelines. SLNB offers a less invasive alternative to elective neck dissection (END), and has some advantages and disadvantages. SLNB can assess the individual drainage pattern and, with step serial sectioning and immunohistochemistry (IHC), can enable the accurate detection of micrometastases and isolated tumor cells (ITCs). Staging of the neck is improved relative to END with routine histopathological examination. The improvements in staging are particularly notable for the contralateral neck and the pretreated neck. However, for floor of mouth (FOM) tumors, occult metastases are frequently missed by SLNB due to the proximity of activity from the primary site to the lymphatics (the shine through phenomenon). For FOM cancers, it is advised to perform either elective neck dissection or superselective neck dissection of the preglandular triangle of level I. New tracers and techniques under development may improve the diagnostic accuracy of SLNB for early-stage OSCC, particularly for FOM tumors. Treatment of the neck (either neck dissection or radiotherapy), although limited to levels I-IV, remains mandatory for any positive category of metastasis (macrometastasis, micrometastasis, or ITCs). Recently, the updated EANM practical guidelines for SLN localization in OSCC and the surgical consensus guidelines on SLNB in patients with OSCC were published. In this review, the current evidence and results of SLNB in early OSCC are presented.
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- 2021
26. Contralateral Regional Recurrence in Lateralized or Paramedian Early-Stage Oral Cancer Undergoing Sentinel Lymph Node Biopsy-Comparison to a Historic Elective Neck Dissection Cohort
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Mahieu, Rutger, Toom, Inne J. den, Boeve, Koos, Lobeek, D., Bloemena, Elisabeth, Donswijk, Maarten L., Takes, R.P., Witjes, M.J., Bree, R. de, Mahieu, Rutger, Toom, Inne J. den, Boeve, Koos, Lobeek, D., Bloemena, Elisabeth, Donswijk, Maarten L., Takes, R.P., Witjes, M.J., and Bree, R. de
- Abstract
Contains fulltext : 233466.pdf (Publisher’s version ) (Open Access)
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- 2021
27. Cost-utility of an eHealth application 'Oncokompas' that supports cancer survivors in self-management: results of a randomised controlled trial
- Author
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Hout, A van den, Jansen, F., Uden-Kraan, C.F. van, Coupé, V.M., Holtmaat, K., Nieuwenhuijzen, G.A., Hardillo, J.A., Jong, R.J. de, Tiren-Verbeet, N.L., Sommeijer, D.W., Heer, K. de, Schaar, C.G., Sedee, R.J., Bosscha, K., Brekel, M.W. van den, Petersen, J.F., Westerman, M., Honings, J., Takes, R.P., Houtenbos, I., Broek, W.T. van den, Bree, R. de, Jansen, P., Eerenstein, S.E., Leemans, C.Rene, Zijlstra, J.M., Cuijpers, P., Poll-Franse, L.V. van de, Verdonck-de Leeuw, I.M., Hout, A van den, Jansen, F., Uden-Kraan, C.F. van, Coupé, V.M., Holtmaat, K., Nieuwenhuijzen, G.A., Hardillo, J.A., Jong, R.J. de, Tiren-Verbeet, N.L., Sommeijer, D.W., Heer, K. de, Schaar, C.G., Sedee, R.J., Bosscha, K., Brekel, M.W. van den, Petersen, J.F., Westerman, M., Honings, J., Takes, R.P., Houtenbos, I., Broek, W.T. van den, Bree, R. de, Jansen, P., Eerenstein, S.E., Leemans, C.Rene, Zijlstra, J.M., Cuijpers, P., Poll-Franse, L.V. van de, and Verdonck-de Leeuw, I.M.
- Abstract
Contains fulltext : 231658.pdf (Publisher’s version ) (Open Access), PURPOSE: The eHealth self-management application 'Oncokompas' was developed to support cancer survivors in monitoring health-related quality of life (HRQOL) and symptoms, and obtaining personalized feedback and options for supportive care. The aim of this study was to assess the cost-utility of Oncokompas compared with care as usual (CAU) among cancer survivors. METHODS: Survivors were randomly allocated to the intervention or control group. Direct (non-)medical, indirect non-medical costs, and HRQOL were measured at 3- and 6-month follow-up, using iMTA Medical Consumption and Productivity Costs and the EuroQol-5D questionnaires. Mean cumulative costs and quality-adjusted life-years (QALYs) were compared between both groups. RESULTS: In total, 625 survivors were randomized into intervention (n = 320) or control group (n = 305). Base case analysis showed that incremental costs from a societal perspective were - €163 (95% CI, - 665 to 326), and incremental QALYs were 0.0017 (95% CI, - 0.0121 to 0.0155) in the intervention group compared with those in the control group. The probability that, compared with CAU, Oncokompas is more effective was 60%, less costly 73%, and both more effective and less costly 47%. Sensitivity analyses showed that incremental costs vary between - €40 and €69, and incremental QALYs vary between - 0.0023 and - 0.0057. CONCLUSION: Oncokompas is likely to be equally effective on utilities, and not more expensive than CAU, and will therefore contribute to sustainable cancer survivorship care in a (cost-)effective manner. IMPLICATIONS FOR CANCER SURVIVORS: Oncokompas seems to improve HRQOL and reduces the burden of several tumour-specific symptoms, while costs from a societal perspective are similar to CAU.
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- 2021
28. Contemporary management of the neck in nasopharyngeal carcinoma
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Ng, W.T., Tsang, R.K.Y., Beitler, J.J., Bree, R. de, Coca-Pelaz, A., Eisbruch, A., Guntinas-Lichius, O., Lee, A.W.C., Mäkitie, A.A., Mendenhall, W.M., Nuyts, S., Rinaldo, A., Robbins, K.T., Rodrigo, J.P., Silver, C.E., Simo, R., Smee, R., Strojan, P., Takes, R.P., Ferlito, A., Ng, W.T., Tsang, R.K.Y., Beitler, J.J., Bree, R. de, Coca-Pelaz, A., Eisbruch, A., Guntinas-Lichius, O., Lee, A.W.C., Mäkitie, A.A., Mendenhall, W.M., Nuyts, S., Rinaldo, A., Robbins, K.T., Rodrigo, J.P., Silver, C.E., Simo, R., Smee, R., Strojan, P., Takes, R.P., and Ferlito, A.
- Abstract
Item does not contain fulltext, Up to 85% of the patients with nasopharyngeal carcinoma present with regional nodal metastasis. Although excellent nodal control is achieved with radiotherapy, a thorough understanding of the current TNM staging criteria and pattern of nodal spread is essential to optimize target delineation and minimize unnecessary irradiation to adjacent normal tissue. Selective nodal irradiation with sparing of the lower neck and submandibular region according to individual nodal risk is now emerging as the preferred treatment option. There has also been continual refinement in staging classification by incorporating relevant adverse nodal features. As for the uncommon occurrence of recurrent nodal metastasis after radiotherapy, surgery remains the standard of care.
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- 2021
29. Current Trends and Controversies in the Management of Warthin Tumor of the Parotid Gland
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Quer, M., Hernandez-Prera, J.C., Silver, C.E., Casasayas, M., Simo, R., Poorten, V. Van der, Guntinas-Lichius, O., Bradley, P.J., Tong-Ng, W., Rodrigo, J.P., Mäkitie, A.A., Rinaldo, A., Kowalski, L.P., Sanabria, A., Bree, R. de, Takes, R.P., López, F., Olsen, K.D., Shaha, A.R., Ferlito, A., Quer, M., Hernandez-Prera, J.C., Silver, C.E., Casasayas, M., Simo, R., Poorten, V. Van der, Guntinas-Lichius, O., Bradley, P.J., Tong-Ng, W., Rodrigo, J.P., Mäkitie, A.A., Rinaldo, A., Kowalski, L.P., Sanabria, A., Bree, R. de, Takes, R.P., López, F., Olsen, K.D., Shaha, A.R., and Ferlito, A.
- Abstract
Contains fulltext : 237728.pdf (Publisher’s version ) (Open Access), PURPOSE: To review the current options in the management of Warthin tumors (WTs) and to propose a working management protocol. METHODS: A systematic literature search was conducted using PubMed and ScienceDirect database. A total of 141 publications were selected and have been included in this review. Publications were selected based on relevance, scientific evidence, and actuality. RESULTS: The importance of parotid WTs is increasing due to its rising incidence in many countries, becoming the most frequently encountered benign parotid tumor in certain parts of the world. In the past, all WTs were treated with surgery, but because of their slow growth rate, often minimal clinical symptoms, and the advanced age of many patients, active observation has gradually become more widely used. In order to decide on active surveillance, the diagnosis of WT must be reliable, and clinical, imaging, and cytological data should be concordant. There are four clear indications for upfront surgery: uncertain diagnosis; cosmetic problems; clinical complaints, such as pain, ulceration, or recurrent infection; and the patient's wish to have the tumor removed. In the remaining cases, surgery can be elective. Active surveillance is often suggested as the first approach, with surgery being considered if the tumor progresses and/or causes clinical complaints. The extent of surgery is another controversial topic, and the current trend is to minimize the resection using partial parotidectomies and extracapsular dissections when possible. Recently, non-surgical options such as microwave ablation, radiofrequency ablation, and ultrasound-guided ethanol sclerotherapy have been proposed for selected cases. CONCLUSIONS: The management of WT is gradually shifting from superficial or total parotidectomy to more conservative approaches, with more limited resections, and to active surveillance in an increasing number of patients. Additionally, non-surgical treatments are emerging, but their role needs
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- 2021
30. Laryngectomy: complications & survival
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Bree, R. de, Tijink, B.M., Pézier, Thomas Francis Robert, Bree, R. de, Tijink, B.M., and Pézier, Thomas Francis Robert
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- 2021
31. Sarcopenia in head and neck cancer: Towards personalized medicine
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Bree, R. de, Devriese, L.A., Chargi, Najiba, Bree, R. de, Devriese, L.A., and Chargi, Najiba
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- 2021
32. Cost-utility and cost-effectiveness of a guided self-help head and neck exercise program for patients treated with total laryngectomy: Results of a multi-center randomized controlled trial
- Author
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Jansen, F., Coupé, V.M., Eerenstein, S.E., Cnossen, I.C., Uden-Kraan, C.F. van, Bree, R. de, Doornaert, P., Halmos, G.B., Hardillo, J.A., Hinte, G.J. van, Honings, J., Leemans, C.Rene, Verdonck-de Leeuw, I.M., Jansen, F., Coupé, V.M., Eerenstein, S.E., Cnossen, I.C., Uden-Kraan, C.F. van, Bree, R. de, Doornaert, P., Halmos, G.B., Hardillo, J.A., Hinte, G.J. van, Honings, J., Leemans, C.Rene, and Verdonck-de Leeuw, I.M.
- Abstract
Contains fulltext : 234952.pdf (Publisher’s version ) (Open Access), OBJECTIVES: The guided self-help exercise program called In Tune without Cords (ITwC) is effective in improving swallowing problems and communication among patients treated with a total laryngectomy (TL). This study investigated the cost-utility and cost-effectiveness of ITwC. MATERIALS AND METHODS: Patients within 5 years after TL were included in this randomized controlled trial. Patients in the intervention group (n = 46) received access to the self-help exercise program with flexibility, range-of-motion and lymphedema exercises, and a self-care education program. Patients in the control group (n = 46) received access to the self-care education program only. Healthcare utilization (iMCQ), productivity losses (iPCQ), health status (EQ-5D-3L, EORTC QLU-C10D) and swallowing problems (SwalQol) were measured at baseline, 3- and 6-months follow-up. Hospital costs were extracted from medical files. Mean total costs and effects (quality-adjusted life-years (QALYs) or SwalQol score) were compared with regression analyses using bias-corrected accelerated bootstrapping. RESULTS: Mean total costs were non-significantly lower (-€685) and QALYs were significantly higher (+0.06) in the intervention compared to the control group. The probability that the intervention is less costly and more effective was 73%. Sensitivity analyses with adjustment for baseline costs and EQ-5D scores showed non-significantly higher costs (+€119 to +€364) and QALYs (+0.02 to +0.03). A sensitivity analysis using the QLU-C10D to calculate QALYs showed higher costs (+€741) and lower QALYs (-0.01) and an analysis that used the SwalQol showed higher costs (+€232) and higher effects (improvement of 6 points on a 0-100 scale). CONCLUSION: ITwC is likely to be effective, but possibly at higher expenses. TRIAL REGISTRATION: NTR5255.
- Published
- 2021
33. COVID-19 pandemic: Effects and evidence-based recommendations for otolaryngology and head and neck surgery practice.
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Kowalski, L.P., Sanabria, A., Ridge, J.A., Ng, W.T., Bree, R. de, Rinaldo, A., Takes, R.P., Mäkitie, A.A., Carvalho, A.L., Bradford, C.R., Paleri, V., Hartl, D.M., Poorten, V. Van der, Nixon, I.J., Piazza, C., Lacy, P.D., Rodrigo, J.P., Guntinas-Lichius, O., Mendenhall, W.M., D'Cruz, A., Lee, A.W.C., Ferlito, A., Kowalski, L.P., Sanabria, A., Ridge, J.A., Ng, W.T., Bree, R. de, Rinaldo, A., Takes, R.P., Mäkitie, A.A., Carvalho, A.L., Bradford, C.R., Paleri, V., Hartl, D.M., Poorten, V. Van der, Nixon, I.J., Piazza, C., Lacy, P.D., Rodrigo, J.P., Guntinas-Lichius, O., Mendenhall, W.M., D'Cruz, A., Lee, A.W.C., and Ferlito, A.
- Abstract
1 juni 2020, Contains fulltext : 220043.pdf (Publisher’s version ) (Closed access), The 2019 novel coronavirus disease (COVID-19) is a highly contagious zoonosis produced by SARS-CoV-2 that is spread human-to-human by respiratory secretions. It was declared by the WHO as a public health emergency. The most susceptible populations, needing mechanical ventilation, are the elderly and people with associated comorbidities. There is an important risk of contagion for anesthetists, dentists, head and neck surgeons, maxillofacial surgeons, ophthalmologists, and otolaryngologists. Health workers represent between 3.8% and 20% of the infected population; some 15% will develop severe complaints and among them, many will lose their lives. A large number of patients do not have overt signs and symptoms (fever/respiratory), yet pose a real risk to surgeons (who should know this fact and must therefore apply respiratory protective strategies for all patients they encounter). All interventions that have the potential to aerosolize aerodigestive secretions should be avoided or used only when mandatory. Health workers who are: pregnant, over 55 to 65 years of age, with a history of chronic diseases (uncontrolled hypertension, diabetes mellitus, chronic obstructive pulmonary diseases, and all clinical scenarios where immunosuppression is feasible, including that induced to treat chronic inflammatory conditions and organ transplants) should avoid the clinical attention of a potentially infected patient. Health care facilities should prioritize urgent and emergency visits and procedures until the present condition stabilizes; truly elective care should cease and discussed on a case-by-case basis for patients with cancer. For those who are working with COVID-19 infected patients' isolation is compulsory in the following settings: (a) unprotected close contact with COVID-19 pneumonia patients; (b) onset of fever, cough, shortness of breath, and other symptoms (gastrointestinal complaints, anosmia, and dysgeusia have been reported in a minority of cases). For any care or
- Published
- 2020
34. Metastatic Squamous Cell Carcinoma to the Cervical Lymph Nodes From an Unknown Primary Cancer: Management in the HPV Era
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Civantos, F.J., Vermorken, J.B., Shah, J.P., Rinaldo, A., Suárez, C., Kowalski, L.P., Rodrigo, J.P., Olsen, K., Strojan, P., Mäkitie, A.A., Takes, R.P., Bree, R. de, Corry, J., Paleri, V., Shaha, A.R., Hartl, D.M., Mendenhall, W., Piazza, C., Hinni, M., Robbins, K.T., Tong, N.W., Sanabria, A., Coca-Pelaz, A., Langendijk, J.A., Hernandez-Prera, J., Ferlito, A., Civantos, F.J., Vermorken, J.B., Shah, J.P., Rinaldo, A., Suárez, C., Kowalski, L.P., Rodrigo, J.P., Olsen, K., Strojan, P., Mäkitie, A.A., Takes, R.P., Bree, R. de, Corry, J., Paleri, V., Shaha, A.R., Hartl, D.M., Mendenhall, W., Piazza, C., Hinni, M., Robbins, K.T., Tong, N.W., Sanabria, A., Coca-Pelaz, A., Langendijk, J.A., Hernandez-Prera, J., and Ferlito, A.
- Abstract
Contains fulltext : 229895.pdf (publisher's version ) (Open Access), BACKGROUND: Patients with metastases in the lymph nodes of the neck and no obvious primary tumor, neck cancer with unknown primary (NCUP), represent a management challenge. A majority of patients have metastatic squamous cell carcinoma (SCC), although other histologies do occur. METHODS: We comprehensively reviewed the literature, compared available guidelines, and conferred with an international team of experts. RESULTS: Positron emission tomography-computed tomography (PET-CT) and fine needle aspiration (FNA) under ultrasound guidance increase accuracy of diagnosis. Immunohistochemistry (IHC), determination of human papilloma virus (HPV) status, by p16 staining or by in situ hybridization (ISH), and next-generation gene sequencing can guide us regarding probable primary sites and tumor biology. Narrow Band Imaging (NBI) has been introduced for the early detection of subtle mucosal lesions. Direct laryngoscopy (DL) and tonsillectomy have long been procedures used in the search for a primary site. More recently, TransOral Robotic Surgery (TORS) or Transoral LASER Microsurgery (TLM) have been introduced for lingual tonsillectomy. CONCLUSIONS: New technologies have been developed which can better detect, diagnose, and treat occult primary tumors. Decisions regarding therapy are based on the primary tumor site (if discovered) and N stage. Options include neck dissection with or without postoperative adjuvant therapy, primary irradiation, or combined chemotherapy with irradiation. The preferred treatment of patients whose primary remains unidentified is controversial.
- Published
- 2020
35. Incidence of Occult Lymph Node Metastasis in Primary Larynx Squamous Cell Carcinoma, by Subsite, T Classification and Neck Level: A Systematic Review.
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Sanabria, A., Shah, J.P., Medina, J.E., Olsen, K.D., Robbins, K.T., Silver, C.E., Rodrigo, J.P., Suárez, C., Coca-Pelaz, A., Shaha, A.R., Mäkitie, A.A., Rinaldo, A., Bree, R. de, Strojan, P., Hamoir, M., Takes, R.P., Sjögren, E.V., Cannon, T., Kowalski, L.P., Ferlito, A., Sanabria, A., Shah, J.P., Medina, J.E., Olsen, K.D., Robbins, K.T., Silver, C.E., Rodrigo, J.P., Suárez, C., Coca-Pelaz, A., Shaha, A.R., Mäkitie, A.A., Rinaldo, A., Bree, R. de, Strojan, P., Hamoir, M., Takes, R.P., Sjögren, E.V., Cannon, T., Kowalski, L.P., and Ferlito, A.
- Abstract
Contains fulltext : 220094.pdf (publisher's version ) (Open Access), BACKGROUND: Larynx cancer is a common site for tumors of the upper aerodigestive tract. In cases with a clinically negative neck, the indications for an elective neck treatment are still debated. The objective is to define the prevalence of occult metastasis based on the subsite of the primary tumor, T classification and neck node levels involved. METHODS: All studies included provided the rate of occult metastases in cN0 larynx squamous cell carcinoma patients. The main outcome was the incidence of occult metastasis. The pooled incidence was calculated with random effects analysis. RESULTS: 36 studies with 3803 patients fulfilled the criteria. The incidence of lymph node metastases for supraglottic and glottic tumors was 19.9% (95% CI 16.4-23.4) and 8.0% (95% CI 2.7-13.3), respectively. The incidence of occult metastasis for level I, level IV and level V was 2.4% (95% CI 0-6.1%), 2.0% (95% CI 0.9-3.1) and 0.4% (95% CI 0-1.0%), respectively. For all tumors, the incidence for sublevel IIB was 0.5% (95% CI 0-1.3). CONCLUSIONS: The incidence of occult lymph node metastasis is higher in supraglottic and T3-4 tumors. Level I and V and sublevel IIB should not be routinely included in the elective neck treatment of cN0 laryngeal cancer and, in addition, level IV should not be routinely included in cases of supraglottic tumors.
- Published
- 2020
36. Elective Neck Dissection or Sentinel Lymph Node Biopsy in Early Stage Oral Cavity Cancer Patients: The Dutch Experience
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Toom, Inne J. den, Boeve, Koos, Lobeek, D., Bloemena, Elisabeth, Donswijk, Maarten L., Keizer, Bart de, Takes, R.P., Witjes, M.J., Bree, R. de, Toom, Inne J. den, Boeve, Koos, Lobeek, D., Bloemena, Elisabeth, Donswijk, Maarten L., Keizer, Bart de, Takes, R.P., Witjes, M.J., and Bree, R. de
- Abstract
Contains fulltext : 221533.pdf (publisher's version ) (Open Access)
- Published
- 2020
37. The risk of second primary tumors in head and neck cancer: A systematic review
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Coca-Pelaz, A., Rodrigo, J.P., Suarez, C., Nixon, I.J., Makitie, A., Sanabria, A., Quer, M., Strojan, P., Bradford, C.R., Kowalski, L.P., Shaha, A.R., Bree, R. de, Hartl, D.M., Rinaldo, A., Takes, R.P., Ferlito, A., Coca-Pelaz, A., Rodrigo, J.P., Suarez, C., Nixon, I.J., Makitie, A., Sanabria, A., Quer, M., Strojan, P., Bradford, C.R., Kowalski, L.P., Shaha, A.R., Bree, R. de, Hartl, D.M., Rinaldo, A., Takes, R.P., and Ferlito, A.
- Abstract
Contains fulltext : 219913.pdf (Publisher’s version ) (Closed access), BACKGROUND: Second primary tumors (SPTs) are a common cause of reduced life expectancy in patients treated for head and neck cancer (HNC). This phenomenon forms an area to be addressed during posttreatment follow-up. METHODS: We conducted a systematic review of literature following PRISMA guidelines, from 1979 to 2019, to investigate incidence of SPTs, synchronous, and metachronous, in HNC population. RESULTS: Our review includes data of 456 130 patients from 61 articles. With a minimum follow-up of 22 months, mean incidence of SPTs was 13.2% (95% CI: 11.56-14.84): 5.3% (95% CI: 4.24-6.36) for synchronous SPTs and 9.4% (95% CI: 7.9-10.9) for metachronous SPTs. The most frequent site for SPTs was head and neck area, followed by the lungs and esophagus. CONCLUSION: Although with wide variations between studies, the rate of SPTs in HNC patients is high. Given the impact in the prognosis, we must develop strategies for the early diagnosis of SPTs.
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- 2020
38. Sentinel lymph node biopsy in oral cavity cancer: Towards personalized diagnostics
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Bree, R. de, Willems, S., Keizer, B. de, Toom, Inne Janick den, Bree, R. de, Willems, S., Keizer, B. de, and Toom, Inne Janick den
- Published
- 2020
39. Effectiveness of a guided self-help exercise program tailored to patients treated with total laryngectomy: Results of a multi-center randomized controlled trial
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Jansen, F., Eerenstein, Simone E.J., Cnossen, I.C., Lissenberg-Witte, Birgit I., Bree, R. de, Doornaert, P., Hinte, G.J. van, Honings, J., Leemans, C.R., Verdonck-de Leeuw, Irma M., Jansen, F., Eerenstein, Simone E.J., Cnossen, I.C., Lissenberg-Witte, Birgit I., Bree, R. de, Doornaert, P., Hinte, G.J. van, Honings, J., Leemans, C.R., and Verdonck-de Leeuw, Irma M.
- Abstract
Contains fulltext : 217781.pdf (Publisher’s version ) (Open Access)
- Published
- 2020
40. Contemporary management of primary parapharyngeal space tumors
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Lopez, F., Suarez, C., Poorten, V. Van der, Makitie, A., Nixon, I.J., Strojan, P., Hanna, E.Y., Rodrigo, J.P., Bree, R. de, Quer, M., Takes, R.P., Bradford, C.R., Shaha, A.R., Sanabria, A., Rinaldo, A., Ferlito, A., Lopez, F., Suarez, C., Poorten, V. Van der, Makitie, A., Nixon, I.J., Strojan, P., Hanna, E.Y., Rodrigo, J.P., Bree, R. de, Quer, M., Takes, R.P., Bradford, C.R., Shaha, A.R., Sanabria, A., Rinaldo, A., and Ferlito, A.
- Abstract
Contains fulltext : 203151.pdf (publisher's version ) (Closed access), The parapharyngeal space is a complex anatomical area. Primary parapharyngeal tumors are rare tumors and 80% of them are benign. A variety of tumor types can develop in this location; most common are salivary gland neoplasm and neurogenic tumors. The management of these tumors has improved greatly owing to the developments in imaging techniques, surgery, and radiotherapy. Most tumors can be removed with a low rate of complications and recurrence. The transcervical approach is the most frequently used. In some cases, minimally invasive approaches may be used alone or in combination with a limited transcervical route, allowing large tumors to be removed by reducing morbidity of expanded approaches. An adequate knowledge of the anatomy and a careful surgical plan is essential to tailor management according to the patient and the tumor. The purpose of the present review was to update current aspects of knowledge related to this more challenging area of tumor occurrence.
- Published
- 2019
41. Surgical margins in head and neck cancer: Intra- and postoperative considerations
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Robbins, K. Thomas, Triantafyllou, A., Suarez, C., Lopez, F., Hunt, J.L., Strojan, P., Williams, M.D., Braakhuis, B.J., Bree, R. de, Hinni, M.L., Kowalski, L.P., Rinaldo, A., Rodrigo, J.P., Poorten, V. Van der, Nixon, I.J., Takes, R.P., Silver, C.E., Ferlito, A., Robbins, K. Thomas, Triantafyllou, A., Suarez, C., Lopez, F., Hunt, J.L., Strojan, P., Williams, M.D., Braakhuis, B.J., Bree, R. de, Hinni, M.L., Kowalski, L.P., Rinaldo, A., Rodrigo, J.P., Poorten, V. Van der, Nixon, I.J., Takes, R.P., Silver, C.E., and Ferlito, A.
- Abstract
Contains fulltext : 203203.pdf (publisher's version ) (Closed access), OBJECTIVE: To provide a perspective on the significance of recent reports for optimizing cancer free surgical margins that have challenged standard practices. METHODS: We conducted a review of the recent literature (2012-2018) using the keywords surgical margin analysis, frozen and paraffin section techniques, head and neck cancer, spectroscopy and molecular markers. RESULTS: Of significance are the reports indicating superiority of tumor specimen directed sampling of margins compared to patient directed (tumor bed) sampling for frozen section control of oral cancers. With reference to optimal distance between tumor and the surgical margin, recent reports recommended cutoffs less than 5mm. Employment of new technologies such as light spectroscopy and molecular analysis of tissues, provide opportunities for a "real time" assessment of surgical margins. CONCLUSIONS: The commonly practiced method of patient directed margin sampling involving previous studies raises concern over conclusions made regarding the efficacy of frozen section margin control. The recent studies that challenge the optimal distance for clear surgical margins are retrospective and address patient cohorts with inherently confounding factors. The use of novel ancillary techniques require further refinements, clinical trial validation, and justification based on the additional resources.
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- 2019
42. Prognostic and predictive factors in recurrent and/or metastatic head and neck squamous cell carcinoma: A review of the literature
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Bossi, P., Alfieri, S., Strojan, P., Takes, R.P., Lopez, F., Makitie, A., Saba, N.F., Rodrigo, J.P., Bradford, C., Suarez, C., Zafereo, M., Forastiere, A.A., Vermorken, J.B., Quer, M., Sanabria, A., Simo, R., Bree, R. de, Rinaldo, A., Ferlito, A., Bossi, P., Alfieri, S., Strojan, P., Takes, R.P., Lopez, F., Makitie, A., Saba, N.F., Rodrigo, J.P., Bradford, C., Suarez, C., Zafereo, M., Forastiere, A.A., Vermorken, J.B., Quer, M., Sanabria, A., Simo, R., Bree, R. de, Rinaldo, A., and Ferlito, A.
- Abstract
Item does not contain fulltext, The pattern of clinical behaviour and response to treatment of recurrent and/or metastatic head and neck squamous cell carcinoma is heterogeneous. Treatment strategies that can be employed vary from potentially curative salvage surgery and re-irradiation to palliative systemic therapies and best supportive care. The advent of new therapeutic options, in terms of more sophisticated surgical approaches and techniques, highly conformal and precise radiation techniques and immunotherapy may offer improved control of disease and longer survival. Moreover, the epidemiological changes during the last decades, including the increase of human papilloma virus-related oropharyngeal primary tumors, are also reflected in the recurrent and metastatic setting. In this complex context the identification of predictive and prognostic factors is urgently needed to tailor treatment, to increase its efficacy, and to avoid unnecessary toxicities. A better knowledge of prognosis may also help the patients and caregivers in decision making on the optimal choice of care. The purpose of our review is to highlight the current evidence and shortcomings in this field.
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- 2019
43. Elective neck dissection in oral squamous cell carcinoma: Past, present and future
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Bree, R. de, Takes, R.P., Shah, J.P., Hamoir, M., Kowalski, L.P., Robbins, K.T., Rodrigo, J.P., Sanabria, A., Medina, J.E., Rinaldo, A., Shaha, A.R., Silver, C., Suarez, C., Bernal-Sprekelsen, M., Ferlito, A., Bree, R. de, Takes, R.P., Shah, J.P., Hamoir, M., Kowalski, L.P., Robbins, K.T., Rodrigo, J.P., Sanabria, A., Medina, J.E., Rinaldo, A., Shaha, A.R., Silver, C., Suarez, C., Bernal-Sprekelsen, M., and Ferlito, A.
- Abstract
Contains fulltext : 203158.pdf (publisher's version ) (Open Access), In 1994 a decision analysis, based on the literature and utility ratings for outcome by a panel of experienced head and neck physicians, was presented which showed a threshold probability of occult metastases of 20% to recommend elective treatment of the neck. It was stated that recommendations for the management of the cN0 neck are not immutable and should be reconfigured to determine the optimal management based on different sets of underlying assumptions. Although much has changed and is published in the almost 25years after its publication, up to date this figure is still mentioned in the context of decisions on treatment of the clinically negative (cN0) neck. Therefore, we critically reviewed the developments in diagnostics and therapy and modeling approaches in the context of decisions on treatment of the cN0 neck. However, the results of studies on treatment of the cN0 neck cannot be translated to other settings due to significant differences in relevant variables such as population, culture, diagnostic work-up, follow-up, costs, institutional preferences and other factors. Moreover, patients may have personal preferences and may weigh oncologic outcomes versus morbidity and quality of life differently. Therefore, instead of trying to establish "the" best strategy for the cN0 neck or "the" optimal cut-off point for elective neck treatment, the approach to optimize the management of the cN0 neck would be to develop and implement models and decision support systems that can serve to optimize choices depending on individual, institutional, population and other relevant variables.
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- 2019
44. The role of age in treatment-related adverse events in patients with head and neck cancer: A systematic review
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Coca-Pelaz, A., Halmos, G.B., Strojan, P., Bree, R. de, Bossi, P., Bradford, C.R., Rinaldo, A., Poorten, V. Van der, Sanabria, A., Takes, R.P., Ferlito, A., Coca-Pelaz, A., Halmos, G.B., Strojan, P., Bree, R. de, Bossi, P., Bradford, C.R., Rinaldo, A., Poorten, V. Van der, Sanabria, A., Takes, R.P., and Ferlito, A.
- Abstract
Item does not contain fulltext, Head and neck squamous cell carcinoma (HNSCC) is often diagnosed in advanced stage and therefore requires aggressive, multimodal treatment. Elderly patients are often excluded from standard therapy regimens purely based on age. This clinical review aims to collect all published data in the literature on treatment modality selection in elderly patients and on age-related adverse events following treatment of HNSCC. We performed a literature search for articles on the treatment of HNSCC in elderly patients. Most of the articles were retrospective studies with the consequent limitations. It can be concluded that age is not an absolute contraindication for intensive treatment and comorbidity is an important predictor of outcome, but not the only one. Despite the existence of multiple tools for pretreatment evaluation, there are not consistent data on their use.
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- 2019
45. Recurrent and second primary squamous cell carcinoma of the head and neck: when and how to reirradiate
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Strojan, P., Corry, J., Eisbruch, A., Vermorken, J.B., Mendenhall, W.M., Lee, A.W., Haigentz, M., Jr., Beitler, J.J., Bree, R. de, Takes, R.P., Paleri, V., Kelly, C.G., Genden, E.M., Bradford, C.R., Harrison, L.B., Rinaldo, A., Ferlito, A., Otolaryngology / Head & Neck Surgery, and CCA - Innovative therapy
- Subjects
Rare cancers Radboud Institute for Health Sciences [Radboudumc 9] - Abstract
Item does not contain fulltext BACKGROUND: Local and/or regional recurrence and metachronous primary tumor arising in a previously irradiated area are rather frequent events in patients with head and neck squamous cell carcinoma (HNSCC). Re-treatment is associated with an increased risk of serious toxicity and impaired quality of life (QOL) with an uncertain survival advantage. METHODS: We analyzed the literature on the efficacy and toxicity of photon/electron-based external beam reirradiation for previously irradiated patients with HNSCC of non-nasopharyngeal origin. Studies were grouped according to the radiotherapy technique used for reirradiation. Patient selection criteria, target volume identification method, tumor dose, fractionation schedule, systemic therapy administration, and toxicities were reviewed. RESULTS: In addition to disease-related factors, current comorbidities and preexisting organ dysfunction must be considered when selecting patients for reirradiation. As morbidity from re-treatment may be considerable and differ depending on which mode of re-treatment is used, it is important to give patients information on potential morbidity outcomes so that an informed choice can be made within a shared decision-making context. With improved dose distribution and adequate imaging support, including positron emission tomography-CT, modern radiotherapy techniques may improve local control and reduce toxicity of reirradiation. A reirradiation dose of >/=60 Gy and a volume encompassing the gross tumor with up to a 5-mm margin are recommended. Concomitant administration of systemic therapeutics and reirradiation is likely to be of similar benefit as observed in large randomized studies of upfront therapy. CONCLUSION: Reirradiation, administered either with or without concurrent systemic therapy, is feasible and tolerable in properly selected patients with recurrent or a new primary tumor in a previously irradiated area of the head and neck, offering a meaningful survival (in the range of 10% to 30% at 2 years). Whenever feasible, salvage surgery is the method of choice for curative intent; patients at high-risk for local recurrence should be advised that postoperative reirradiation is expected to increase locoregional control at the expense of higher toxicity and without survival advantage compared to salvage surgery without reirradiation. (c) 2014 Wiley Periodicals, Inc. Head Neck 37: 134-150, 2015.
- Published
- 2015
46. Detection of Distant Metastases in Head and Neck Cancer: Changing Landscape
- Author
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Bree, R. de, Senft, A., Coca-Pelaz, A., Kowalski, L., Lopez, F., Mendenhall, W., Quer, M., Rinaldo, A., Shaha, A.R., Strojan, P., Takes, R.P., Silver, C.E., Leemans, C.R., Ferlito, A., Bree, R. de, Senft, A., Coca-Pelaz, A., Kowalski, L., Lopez, F., Mendenhall, W., Quer, M., Rinaldo, A., Shaha, A.R., Strojan, P., Takes, R.P., Silver, C.E., Leemans, C.R., and Ferlito, A.
- Abstract
Contains fulltext : 191230.pdf (publisher's version ) (Closed access), As head and neck squamous cell carcinoma (HNSCC) patients with distant metastases (DM) were generally treated only palliatively, the value of screening for DM was usually limited to attempts to avoid extensive locoregional treatment when DM were present pretreatment. Recently, the concept of treating oligometastases, e.g., by metastatectomy or stereotactic body radiotherapy, has been reintroduced for HNSCC and may cause a change in the treatment paradigm. Although whole body (18)F-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) combined with computed tomography (CT; WB-FDG-PET/CT) is still the mainstay diagnostic technique, there is a growing body of evidence supporting implementation of whole body magnetic resonance imaging (WB-MRI) as an important diagnostic technique for screening for DM. Also, FDG-PET/MRI may become a valuable technique for the detection of DM in HNSCC patients. Because the yield of examinations for detection of DM is too low to warrant routine screening of all HNSCC patients, only patients with high risk factors should be selected for intense screening for DM. Clinical and histopathological risk factors are mainly related to the extent of lymph node metastases. Risk for development of DM may also be assessed by molecular characterization of the primary tumor using genomic and proteomic technologies and radiomics. More research is needed to develop a new protocol for screening for DM after introduction of the concept of treating oligometastases in HNSCC.
- Published
- 2018
47. Overcoming wound complications in head and neck salvage surgery
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Kwon, D., Genden, E.M., Bree, R. de, Rodrigo, J.P., Rinaldo, A., Sanabria, A., Rapidis, A.D., Takes, R.P., Ferlito, A., Kwon, D., Genden, E.M., Bree, R. de, Rodrigo, J.P., Rinaldo, A., Sanabria, A., Rapidis, A.D., Takes, R.P., and Ferlito, A.
- Abstract
Contains fulltext : 196793.pdf (publisher's version ) (Closed access), BACKGROUND: Loco-regional treatment failure after radiotherapy with or without chemotherapy and/or prior surgery represents a significant portion of head and neck cancer patients. Due to a wide array of biological interactions, these patients have a significantly increased risk of complications related to wound healing. METHODS: Review of the current literature was performed for wound healing pathophysiology, head and neck salvage surgery, and wound therapy. RESULTS: The biology of altered wound healing in the face of previous surgery and chemoradiotherapy is well described in the literature. This is reflected in multiple clinical studies demonstrating increased rates of wound healing complications in salvage surgery, most commonly in the context of previous irradiation. Despite these disadvantages, multiple studies have described strategies to optimize healing outcomes. The literature supports preoperative optimization of known wound healing factors, adjunctive wound care modalities, and microvascular free tissue transfer for salvage surgery defects and wounds. CONCLUSION: Previously treated head and neck patients requiring salvage surgery have had a variety of disadvantages related to wound healing. Recognition and treatment of these factors can help to reverse adverse tissue conditions. A well-informed approach to salvage surgery with utilization of free vascularized or pedicled tissue transfer as well as optimizing wound healing factors is essential to obtaining favorable outcomes.
- Published
- 2018
48. Sacrifice and extracranial reconstruction of the common or internal carotid artery in advanced head and neck carcinoma: Review and meta-analysis
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Back, L.J.J., Aro, K., Tapiovaara, L., Vikatmaa, P., Bree, R. de, Fernandez-Alvarez, V., Kowalski, L.P., Nixon, I.J., Rinaldo, A., Rodrigo, J.P., Robbins, K.T., Silver, C.E., Snyderman, C.H., Suarez, C., Takes, R.P., Ferlito, A., Back, L.J.J., Aro, K., Tapiovaara, L., Vikatmaa, P., Bree, R. de, Fernandez-Alvarez, V., Kowalski, L.P., Nixon, I.J., Rinaldo, A., Rodrigo, J.P., Robbins, K.T., Silver, C.E., Snyderman, C.H., Suarez, C., Takes, R.P., and Ferlito, A.
- Abstract
Contains fulltext : 193460.pdf (publisher's version ) (Closed access), BACKGROUND: Sacrifice and reconstruction of the carotid artery in cases of head and neck carcinoma with invasion of the common or internal carotid artery is debated. METHODS: We conducted a systematic search of electronic databases and provide a review and meta-analysis. RESULTS: Of the 72 articles identified, 24 met the inclusion criteria resulting in the inclusion of 357 patients. The overall perioperative 30-day mortality was 3.6% (13/357). Permanent cerebrovascular complications occurred in 3.6% (13/357). Carotid blowout episodes were encountered in 1.4% (5/357). The meta-regression analysis showed a significant difference in 1-year overall survival between reports published from 1981-1999 (37.0%) and 2001-2016 (65.4%; P = .02). CONCLUSION: This review provides evidence that sacrifice with extracranial reconstruction of common or internal carotid artery in selected patients with head and neck carcinoma may improve survival with acceptable complication rates. However, all of the published literature is retrospective involving selected series and, therefore, precludes determining the absolute effectiveness of the surgery.
- Published
- 2018
49. Head and Neck Cancer: A Review of the Impact of Treatment Delay on Outcome
- Author
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Coca-Pelaz, A., Takes, R.P., Hutcheson, K., Saba, N.F., Haigentz, M., Jr., Bradford, C.R., Bree, R. de, Strojan, P., Lund, V.J., Mendenhall, W.M., Nixon, I.J., Quer, M., Rinaldo, A., Ferlito, A., Coca-Pelaz, A., Takes, R.P., Hutcheson, K., Saba, N.F., Haigentz, M., Jr., Bradford, C.R., Bree, R. de, Strojan, P., Lund, V.J., Mendenhall, W.M., Nixon, I.J., Quer, M., Rinaldo, A., and Ferlito, A.
- Abstract
Contains fulltext : 191238.pdf (publisher's version ) (Closed access), Delay between the initial symptoms, diagnosis, and the definitive treatment of head and neck cancers is associated with tumor progression and upstaging. These delays may lead to poor outcomes and may mandate more aggressive treatments with unnecessary morbidity and even mortality. The multidisciplinary team approach for the treatment of patients with head and neck cancers has improved organization of standard clinical guidelines, but this development has yet to translate into a demonstrable impact on survival. We review the association between waiting times (time between diagnosis and initiation of treatment) and clinical outcomes in patients with head and neck squamous cell carcinoma (HNSCC).
- Published
- 2018
50. Prognostic value of lymph node ratio in head and neck squamous cell carcinoma
- Author
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Talmi, Y.P., Takes, R.P., Alon, E.E., Nixon, I.J., Lopez, F., Bree, R. de, Rodrigo, J.P., Shaha, A.R., Halmos, G.B., Rinaldo, A., Ferlito, A., Talmi, Y.P., Takes, R.P., Alon, E.E., Nixon, I.J., Lopez, F., Bree, R. de, Rodrigo, J.P., Shaha, A.R., Halmos, G.B., Rinaldo, A., and Ferlito, A.
- Abstract
Contains fulltext : 193448.pdf (publisher's version ) (Closed access), BACKGROUND: Lymph node ratio (LNR) is increasingly reported as a potential prognostic tool. The purpose of this review was to analyze the available literature on the prognostic significance of LNR in head and neck squamous cell carcinoma (HNSCC). METHODS: A PubMed internet search was performed and articles meeting selection criteria were reviewed. RESULTS: Twenty-eight studies were identified in the literature dealing with the prognostic value of LNR. The published results are variable with a range of cutoff values of LNR associated with prognosis (overall survival [OS] and/or disease-specific survival [DSS]) between 0.02 and 0.20, with an average of 0.09. CONCLUSION: The LNR is reported to be of value in assessing prognosis in the patients with HNSCC. Although it is easy to calculate and could be considered in the staging of these patients, the currently available evidence in the literature does not yet provide a solid base for implementation.
- Published
- 2018
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