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Your search keyword '"Elisabeth J.M. Nieveen Van Dijkum"' showing total 3 results
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3 results on '"Elisabeth J.M. Nieveen Van Dijkum"'

1. Sporadic nonfunctional pancreatic neuroendocrine tumors: Risk of lymph node metastases and aggressiveness according to tumor size: A multicenter international study

Author

Julie Perinel, Gennaro Nappo, Alessandro Zerbi, Charlotte M. Heidsma, Elisabeth J.M. Nieveen van Dijkum, Ho Seong Han, Yoo-Seok Yoon, Sohei Satoi, Ihsan Ekin Demir, Helmut Friess, Yogesh Vashist, Jakob Izbicki, Alexandra Charlotte Muller, Beat Gloor, Marta Sandini, Luca Gianotti, Fabien Subtil, Mustapha Adham, Surgery, CCA - Cancer Treatment and Quality of Life, and AGEM - Amsterdam Gastroenterology Endocrinology Metabolism

Subjects
Pancreatic Neoplasms, Neuroendocrine Tumors, Pancreatectomy, Lymphatic Metastasis, Humans, Surgery, 610 Medicine & health, Retrospective Studies
Abstract

Background: Although the correlation between tumor size and aggressiveness is clearly established in sporadic nonfunctional pancreatic neuroendocrine tumors, the management of tumors ≤2 cm remains debated. In recent guidelines, the cut-off size to operate ranged from 1 to 2 cm. The aim of this retrospective study was to report the rate of lymph nodes metastases in resected sporadic nonfunctional pancreatic neuroendocrine tumors, according to tumor size and, second, to identify risk factors of lymph node metastases and disease-free survival. Methods: Resected sporadic nonfunctional pancreatic neuroendocrine tumors from 9 international expert centers were included (1999–2017). Functional pancreatic neuroendocrine tumors, genetic syndromes, and R2 resection were excluded. Aggressiveness was defined as microvascular invasion, perineural invasion, lymph node metastases, G3 grading, distant metastases, and/or recurrence. Results: Overall, 495 resected sporadic nonfunctional pancreatic neuroendocrine tumors were included. For tumors up to 5 cm, the risk of lymph node metastases was increased by 1.73 for every 1 cm increase in size (odds ratio = 1.73; 95% confidence interval = 1.46–2.03). Tumor size >2 cm (P < .001), perineural invasion (P = .002), microvascular invasion (P < .001), and distant metastases (P = .008) were independently associated with lymph node metastases. Tumor size >2 cm (P = .003), R1 status (P = .004), lymph node metastases (P < .001), and World Health Organization grade 3 (P = .002) were independently associated with disease-free survival. Aggressiveness rate was 13.1% in tumors ≤1 cm and 29% in tumors between 1.1 and 2 cm. Conclusion: In resected sporadic nonfunctional pancreatic neuroendocrine tumors, the risk of lymph node metastases is correlated to tumor size. Considering that sporadic nonfunctional pancreatic neuroendocrine tumors between 1.1 and 2 cm had a higher risk of lymph node metastases and recurrence compared to tumors ≤1 cm, the decision to perform surgery in this subgroup of patients should be individualized in surgically fit patients.

Published
2022
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2. Watchful waiting for small non-functional pancreatic neuroendocrine tumours

Author

CM (Charlotte) Heidsma, Anton F. Engelsman, Susan Van Dieren, Martijn W.J. Stommel, I. H.J.T. de Hingh, MR Vriens, L Hol, S Festen, Leonie J. Mekenkamp, Frederik J.H. Hoogwater, F Daams, Heinz Josef Klümpen, Marc G. Besselink, C.H.J. (Casper) van Eijck, Elisabeth J.M. Nieveen Van Dijkum, CM (Charlotte) Heidsma, Anton F. Engelsman, Susan Van Dieren, Martijn W.J. Stommel, I. H.J.T. de Hingh, MR Vriens, L Hol, S Festen, Leonie J. Mekenkamp, Frederik J.H. Hoogwater, F Daams, Heinz Josef Klümpen, Marc G. Besselink, C.H.J. (Casper) van Eijck, and Elisabeth J.M. Nieveen Van Dijkum

Published
2021
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3. Reliability and Agreement of Radiological and Pathological Tumor Size in Patients with Multiple Endocrine Neoplasia Type 1-Related Pancreatic Neuroendocrine Tumors

Author

Dirk Jan van Beek, Helena M. Verkooijen, Sjoerd Nell, B. A. Bonsing, C.H.J. (Casper) van Eijck, Harry van Goor, Frederik J.H. Hoogwater, Elisabeth J.M. Nieveen Van Dijkum, Geert Kazemier, Cornelis H.C. Dejong, Lodewijk A.A. Brosens, Frank J. Wessels, Inne H.M. Borel Rinkes, Gerlof D. Valk, Menno R. Vriens, Dirk Jan van Beek, Helena M. Verkooijen, Sjoerd Nell, B. A. Bonsing, C.H.J. (Casper) van Eijck, Harry van Goor, Frederik J.H. Hoogwater, Elisabeth J.M. Nieveen Van Dijkum, Geert Kazemier, Cornelis H.C. Dejong, Lodewijk A.A. Brosens, Frank J. Wessels, Inne H.M. Borel Rinkes, Gerlof D. Valk, and Menno R. Vriens

Abstract

Background: Pancreatic neuroendocrine tumors (pNETs) have a high prevalence in patients with multiple endocrine neoplasia type 1 (MEN1) and are the leading cause of death. Tumor size is still regarded as the main prognostic factor and therefore used for surgical decision-making. We assessed reliability and agreement of radiological and pathological tumor size in a population-based cohort of patients with MEN1-related pNETs. Methods: Patients were selected from the Dutch MEN1 database if they had undergone a resection for a pNET between 2003 and 2018. Radiological (MRI, CT, and endoscopic ultrasonography [EUS]) and pathological tumor size were collected from patient records. Measures of agreement (Bland-Altman plots with limits of agreement [LoA] and absolute agreement) and reliability (intraclass correlation coefficients [ICC] and unweighted kappa) were calculated for continuous and categorized (< or ≥2 cm) pNET size. Results: In 73 included patients, the median radiological and pathological tumor sizes measured were 22 (3-160) and 21 (4-200) mm, respectively. Mean bias between radiological and pathological tumor size was -0.2 mm and LoA ranged from -12.9 to 12.6 mm. For the subgroups of MRI, CT, and EUS, LoA of radiological and pathological tumor size ranged from -9.6 to 10.9, -15.9 to 15.8, and -13.9 to 11.0, respectively. ICCs for the overall cohort, MRI, CT, and EUS were 0.80, 0.86, 0.75, and 0.76, respectively. Based on the 2 cm criterion, agreement was 81.5%; hence, 12 patients (18.5%) were classified differently between imaging and pathology. Absolute agreement and kappa values of MRI, CT, and EUS were 88.6, 85.7, and 75.0%, and 0.77, 0.71, and 0.50, respectively. Conclusion: Within a population-based cohort, MEN1-related pNET size was not systematically over- or underestimated on preoperative imaging. Based on agreement and reliability measures, MRI is the preferred imaging modality.

Published
2021
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