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155 results on '"Horsthuis, Karin"'

2. MRI in addition to CT in patients scheduled for local therapy of colorectal liver metastases (CAMINO): an international, multicentre, prospective, diagnostic accuracy trial

Author

Ayez, Ninos, Bnà, Claudio, van den Boom, Rivka, Lambregts, Doenja J.M., Liefers, Gerrit-Jan, de Meyere, Celine, Draaisma, Werner A., Gerhards, Michael F., Imani, Farshad, Ruers, Theo .J.M., Liem, Mike S.L., Serafino, Gian Piero, van Beek, Hermen C., van der Hoeven, Joost A.B., Veeken, Cornelis J., Zonderhuis, Babs M., Görgec, Burak, Hansen, Ingrid S, Kemmerich, Gunter, Syversveen, Trygve, Abu Hilal, Mohammed, Belt, Eric J T, Bosscha, Koop, Burgmans, Mark C, Cappendijk, Vincent C, D'Hondt, Mathieu, Edwin, Bjørn, van Erkel, Arian R, Gielkens, Hugo A J, Grünhagen, Dirk J, Gobardhan, Paul D, Hartgrink, Henk H, Horsthuis, Karin, Klompenhouwer, Elisabeth G, Kok, Niels F M, Kint, Peter A M, Kuhlmann, Koert, Leclercq, Wouter K G, Lips, Daan J, Lutin, Bart, Maas, Monique, Marsman, Hendrik A, Meijerink, Martijn, Meyer, Yannick, Morone, Mario, Peringa, Jan, Sijberden, Jasper P, van Delden, Otto M, van den Bergh, Janneke E, Vanhooymissen, Inge J S, Vermaas, Maarten, Willemssen, François E J A, Dijkgraaf, Marcel G W, Bossuyt, Patrick M, Swijnenburg, Rutger-Jan, Fretland, Åsmund A, Verhoef, Cornelis, Besselink, Marc G, and Stoker, Jaap

Published
2024
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3. Evaluation of National Surgical Practice for Lateral Lymph Nodes in Rectal Cancer in an Untrained Setting

Author

Sluckin, Tania C., Hazen, Sanne-Marije J. A., Horsthuis, Karin, Beets-Tan, Regina G. H., Aalbers, Arend G. J., Beets, Geerard L., Boerma, Evert-Jan G., Borstlap, Jaap, van Breest Smallenburg, Vivian, Burger, Jacobus W. A., Crolla, Rogier M. P. H., Daniëls-Gooszen, Alette W., Davids, Paul H. P., Dunker, Michalda S., Fabry, Hans F. J., Furnée, Edgar J. B., van Gils, Renza A. H., de Haas, Robbert J., Hoogendoorn, Stefan, van Koeverden, Sebastiaan, de Korte, Fleur I., Oosterling, Steven J., Peeters, Koen C. M. J., Posma, Lisanne A. E., Pultrum, Bareld B., Rothbarth, Joost, Rutten, Harm J. T., Schasfoort, Renske A., Schreurs, Wilhelmina H., Simons, Petra C. G., Smits, Anke B., Talsma, Aaldert K., The, G. Y. Mireille, van Tilborg, Fiek, Tuynman, Jurriaan B., Vanhooymissen, Inge J. S., van de Ven, Anthony W. H., Verdaasdonk, Emiel G. G., Vermaas, Maarten, Vliegen, Roy F. A., Vogelaar, F. Jeroen, de Vries, Marianne, Vroemen, Joy C., van Vugt, Sebastiaan T., Westerterp, Marinke, van Westreenen, Henderik L., de Wilt, Johannes H. W., van der Zaag, Edwin S., Zimmerman, David D. E., Marijnen, Corrie A. M., Tanis, Pieter J., and Kusters, Miranda

Published
2023
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4. ASO Visual Abstract: Evaluation of National Surgical Practice for Lateral Lymph Nodes in Rectal Cancer in an Untrained Setting

Author

Sluckin, Tania C., Hazen, Sanne-Marije J. A., Horsthuis, Karin, Beets-Tan, Regina G. H., Aalbers, Arend G. J., Beets, Geerard L., Boerma, Evert-Jan G., Borstlap, Jaap, van Breest Smallenburg, Vivian, Burger, Jacobus W. A., Crolla, Rogier M. P. H., Daniëls-Gooszen, Alette W., Davids, Paul H. P., Dunker, Michalda S., Fabry, Hans F. J., Furnée, Edgar J. B., van Gils, Renza A. H., de Haas, Robbert J., Hoogendoorn, Stefan, van Koeverden, Sebastiaan, de Korte, Fleur I., Oosterling, Steven J., Peeters, Koen C. M. J., Posma, Lisanne A. E., Pultrum, Bareld B., Rothbarth, Joost, Rutten, Harm J. T., Schasfoort, Renske A., Schreurs, Wilhelmina H., Simons, Petra C. G., Smits, Anke B., Talsma, Aaldert K., The, G. Y. Mireille, van Tilborg, Fiek, Tuynman, Jurriaan B., Vanhooymissen, Inge J., van de Ven, Anthony W. H., Verdaasdonk, Emiel G. G., Vermaas, Maarten, Vliegen, Roy F. A., Vogelaar, F. Jeroen, de Vries, Marianne, Vroemen, Joy C., van Vugt, Sebastiaan T., Westerterp, Marinke, van Westreenen, Henderik L., de Wilt, Johannes H. W., van der Zaag, Edwin S., Zimmerman, David D. E., Marijnen, Corrie A. M., Tanis, Pieter J., and Kusters, Miranda

Published
2023
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9. THU-112-YI Quantitative magnetic resonance cholangiopancreatography provides additional prognostic value in prediction of transplant-free survival in primary sclerosing cholangitis

Author

Middelburg, Tim, primary, Mol, Bregje, additional, Young, Liam, additional, Ferreira, Carlos, additional, Davis, Tom, additional, Horsthuis, Karin, additional, de Boer, Ynto, additional, van der Meer, Adriaan J., additional, de Vries, Annemarie, additional, Dwarkasing, Roy, additional, Bogaards, Johannes, additional, Nederveen, Aart, additional, Stoker, Jaap, additional, and Ponsioen, Cyriel, additional

Published
2024
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10. Abandonment of Routine Radiotherapy for Nonlocally Advanced Rectal Cancer and Oncological Outcomes

Author

Hazen, Sanne Marije J.A., Sluckin, Tania C., Intven, Martijn P.W., Beets, Geerard L., Beets-Tan, Regina G.H., Borstlap, Wernard A.A., Buffart, Tineke E., Buijsen, Jeroen, Burger, Jacobus W.A., Van Dieren, Susan, Furnée, Edgar J.B., Geijsen, E. Debby, Hompes, Roel, Horsthuis, Karin, Leijtens, Jeroen W.A., Maas, Monique, Melenhorst, Jarno, Nederend, Joost, Peeters, Koen C.M.J., Rozema, Tom, Tuynman, Jurriaan B., Verhoef, Cornelis, De Vries, Marianne, Van Westreenen, Henderik L., De Wilt, Johannes H.W., Zimmerman, David D.E., Marijnen, Corrie A.M., Tanis, Pieter J., Kusters, Miranda, Hazen, Sanne Marije J.A., Sluckin, Tania C., Intven, Martijn P.W., Beets, Geerard L., Beets-Tan, Regina G.H., Borstlap, Wernard A.A., Buffart, Tineke E., Buijsen, Jeroen, Burger, Jacobus W.A., Van Dieren, Susan, Furnée, Edgar J.B., Geijsen, E. Debby, Hompes, Roel, Horsthuis, Karin, Leijtens, Jeroen W.A., Maas, Monique, Melenhorst, Jarno, Nederend, Joost, Peeters, Koen C.M.J., Rozema, Tom, Tuynman, Jurriaan B., Verhoef, Cornelis, De Vries, Marianne, Van Westreenen, Henderik L., De Wilt, Johannes H.W., Zimmerman, David D.E., Marijnen, Corrie A.M., Tanis, Pieter J., and Kusters, Miranda

Abstract

Importance: Neoadjuvant short-course radiotherapy was routinely applied for nonlocally advanced rectal cancer (cT1-3N0-1M0 with >1 mm distance to the mesorectal fascia) in the Netherlands following the Dutch total mesorectal excision trial. This policy has shifted toward selective application after guideline revision in 2014. Objective: To determine the association of decreased use of neoadjuvant radiotherapy with cancer-related outcomes and overall survival at a national level. Design, Setting, and Participants: This multicenter, population-based, nationwide cross-sectional cohort study analyzed Dutch patients with rectal cancer who were treated in 2011 with a 4-year follow-up. A similar study was performed in 2021, analyzing all patients that were surgically treated in 2016. From these cohorts, all patients with cT1-3N0-1M0 rectal cancer and radiologically unthreatened mesorectal fascia were included in the current study. The data of the 2011 cohort were collected between May and October 2015, and the data of the 2016 cohort were collected between October 2020 and November 2021. The data were analyzed between May and October 2022. Main Outcomes and Measures: The main outcomes were 4-year local recurrence and overall survival rates. Results: Among the 2011 and 2016 cohorts, 1199 (mean [SD] age, 68 [11] years; 430 women [36%]) of 2095 patients (57.2%) and 1576 (mean [SD] age, 68 [10] years; 547 women [35%]) of 3057 patients (51.6%) had cT1-3N0-1M0 rectal cancer and were included, with proportions of neoadjuvant radiotherapy of 87% (2011) and 37% (2016). Four-year local recurrence rates were 5.8% and 5.5%, respectively (P =.99). Compared with the 2011 cohort, 4-year overall survival was significantly higher in the 2016 cohort (79.6% vs 86.4%; P <.001), with lower non-cancer-related mortality (13.8% vs 6.3%; P <.001). Conclusions and Relevance: The results of this cross-sectional study suggest that an absolute 50% reduction in radiotherapy use for nonlocally

Published
2024

11. Impact of the new rectal cancer definition on multimodality treatment and interhospital variability: Results from a nationwide cross-sectional study

Author

Heelkunde Opleiding, MS Radiologie, Cancer, MS CGO, MS Radiotherapie, Pathologie Groep Brosens, Hazen, Sanne Marije J.A., Sluckin, Tania C., Horsthuis, Karin, Lambregts, Doenja M.J., Beets-Tan, Regina G.H., Hompes, Roel, Buffart, Tineke E., Marijnen, Corrie A.M., Tanis, Pieter J., Kusters, Miranda, the Dutch Snapshot Research Group, Heelkunde Opleiding, MS Radiologie, Cancer, MS CGO, MS Radiotherapie, Pathologie Groep Brosens, Hazen, Sanne Marije J.A., Sluckin, Tania C., Horsthuis, Karin, Lambregts, Doenja M.J., Beets-Tan, Regina G.H., Hompes, Roel, Buffart, Tineke E., Marijnen, Corrie A.M., Tanis, Pieter J., Kusters, Miranda, and the Dutch Snapshot Research Group

Published
2024

12. Impact of the new rectal cancer definition on multimodality treatment and interhospital variability:Results from a nationwide cross-sectional study

Author

Hazen, Sanne Marije J.A., Sluckin, Tania C., Horsthuis, Karin, Lambregts, Doenja M.J., Beets-Tan, Regina G.H., Hompes, Roel, Buffart, Tineke E., Marijnen, Corrie A.M., Tanis, Pieter J., Kusters, Miranda, Hazen, Sanne Marije J.A., Sluckin, Tania C., Horsthuis, Karin, Lambregts, Doenja M.J., Beets-Tan, Regina G.H., Hompes, Roel, Buffart, Tineke E., Marijnen, Corrie A.M., Tanis, Pieter J., and Kusters, Miranda

Abstract

Aim: This study aimed to determine the consequences of the new definition of rectal cancer for decision-making in multidisciplinary team meetings (MDT). The new definition of rectal cancer, the lower border of the tumour is located below the sigmoid take-off (STO), was implemented in the Dutch guideline in 2019 after an international Delphi consensus meeting to reduce interhospital variations. Method: All patients with rectal cancer according to the local MDT, who underwent resection in 2016 in the Netherlands were eligible for this nationwide collaborative cross-sectional study. MRI-images were rereviewed, and the tumours were classified as above or on/below the STO. Results: This study registered 3107 of the eligible 3178 patients (98%), of which 2784 patients had an evaluable MRI. In 314 patients, the tumour was located above the STO (11%), with interhospital variation between 0% and 36%. Based on TN-stage, 175 reclassified patients with colon cancer (6%) would have received different treatment (e.g., omitting neoadjuvant radiotherapy, candidate for adjuvant chemotherapy). Tumour location above the STO was independently associated with lower risk of 4-year locoregional recurrence (HR 0.529; p = 0.030) and higher 4-year overall survival (HR 0.732; p = 0.037) compared to location under the STO. Conclusion: By using the STO, 11% of the prior MDT-based diagnosis of rectal cancer were redefined as sigmoid cancer, with potential implications for multimodality treatment and prognostic value. Given the substantial interhospital variation in proportion of redefined cancers, the use of the STO will contribute to standardisation and comparability of outcomes in both daily practice and trial settings.

Published
2024

13. Prognostic Implications of Lateral Lymph Nodes in Rectal Cancer:A Population-Based Cross-sectional Study with Standardized Radiological Evaluation after Dedicated Training

Author

Sluckin, Tania C., Van Geffen, Eline G.M., Hazen, Sanne Marije J.A., Horsthuis, Karin, Beets-Tan, Regina G.H., Marijnen, Corrie A.M., Tanis, Pieter J., Kusters, Miranda, Sluckin, Tania C., Van Geffen, Eline G.M., Hazen, Sanne Marije J.A., Horsthuis, Karin, Beets-Tan, Regina G.H., Marijnen, Corrie A.M., Tanis, Pieter J., and Kusters, Miranda

Abstract

BACKGROUND: There is an ongoing discussion regarding the prognostic implications of the presence, short-axis diameter, and location of lateral lymph nodes. OBJECTIVE: To analyze lateral lymph node characteristics, the role of downsizing on restaging MRI, and associated local recurrence rates for patients with cT3-4 rectal cancer after MRI re-review and training. DESIGN: Retrospective population-based cross-sectional study. SETTINGS: This collaborative project was led by local investigators from surgery and radiology departments in 60 Dutch hospitals. PATIENTS: A total of 3057 patients underwent rectal cancer surgery in 2016: 1109 had a cT3-4 tumor located ≤8 cm from the anorectal junction, of whom 891 received neoadjuvant therapy. MAIN OUTCOME MEASURES: Local recurrence and (ipsi) lateral local recurrence rates. RESULTS: Re-review identified 314 patients (35%) with visible lateral lymph nodes. Of these, 30 patients had either only long-stretched obturator (n = 13) or external iliac (n = 17) nodes, and both did not lead to any lateral local recurrences. The presence of internal iliac/obturator lateral lymph nodes (n = 284) resulted in 4-year local recurrence and lateral local recurrence rates of 16.4% and 8.8%, respectively. Enlarged (≥7 mm) lateral lymph nodes (n = 122) resulted in higher 4-year local recurrence (20.8%, 13.1%, 0%; p <.001) and lateral local recurrence (14.7%, 4.4%, 0%; p < 0.001) rates compared to smaller and no lateral lymph nodes, respectively. Visible lateral lymph nodes (HR 1.8 [1.1-2.8]) and enlarged lateral lymph nodes (HR 1.9 [1.1-3.5]) were independently associated with local recurrence in multivariable analysis. Enlarged lateral lymph nodes with malignant features had higher 4-year lateral local recurrence rates of 17.0%. Downsizing had no impact on lateral local recurrence rates. Enlarged lateral lymph nodes were found to be associated with higher univariate 4-year distant metastasis rates (36.4% vs 24.4%; p = 0.021), but this was

Published
2024

14. Prognostic significance of MRI-detected extramural venous invasion according to grade and response to neo-adjuvant treatment in locally advanced rectal cancer A national cohort study after radiologic training and reassessment

Author

Geffen, Eline G.M.van, Nederend, Joost, Sluckin, Tania C., Hazen, Sanne Marije J.A., Horsthuis, Karin, Beets-Tan, Regina G.H., Marijnen, Corrie A.M., Tanis, Pieter J., Kusters, Miranda, Geffen, Eline G.M.van, Nederend, Joost, Sluckin, Tania C., Hazen, Sanne Marije J.A., Horsthuis, Karin, Beets-Tan, Regina G.H., Marijnen, Corrie A.M., Tanis, Pieter J., and Kusters, Miranda

Abstract

Background: Detection of grade 3–4 extra mural venous invasion (mrEMVI) on magnetic resonance imaging (MRI) is associated with an increased distant metastases (DM)-rate. This study aimed to determine the impact of different grades of mrEMVI and their disappearance after neoadjuvant therapy.Methods: A Dutch national retrospective cross-sectional study was conducted, including patients who underwent resection for rectal cancer in 2016 from 60/69 hospitals performing rectal surgery. Patients with a cT3-4 tumour ≤8 cm from the anorectal junction were selected and their MRI-scans were reassessed by trained abdominal radiologists. Positive mrEMVI grades (3 and 4) were analyzed in regard to 4-year local recurrence (LR), DM, disease-free survival (DFS) and overall survival (OS). Results: The 1213 included patients had a median follow-up of 48 months (IQR 30–54). Positive mrEMVI was present in 324 patients (27%); 161 had grade 3 and 163 had grade 4. A higher mrEMVI stage (grade 4 vs grade 3 vs no mrEMVI) increased LR-risk (21% vs 18% vs 7%, <0.001) and DM-risk (49% vs 30% vs 21%, p < 0.001) and decreased DFS (42% vs 55% vs 69%, p < 0.001) and OS (62% vs 76% vs 81%, p < 0.001), which remained independently associated in multivariable analysis. When mrEMVI had disappeared on restaging MRI, DM-rate was comparable to initial absence of mrEMVI (both 26%), whereas LR-rate remained high (22% vs 9%, p = 0.006). Conclusion: The negative oncological impact of mrEMVI on recurrence and survival rates was dependent on grading. Disappearance of mrEMVI on restaging MRI decreased the risk of DM, but not of LR.

Published
2024

15. Prognostic significance of MRI-detected extramural venous invasion according to grade and response to neo-adjuvant treatment in locally advanced rectal cancer A national cohort study after radiologic training and reassessment

Author

Geffen, Eline G.M. van, primary, Nederend, Joost, additional, Sluckin, Tania C., additional, Hazen, Sanne-Marije J.A., additional, Horsthuis, Karin, additional, Beets-Tan, Regina G.H., additional, Marijnen, Corrie A.M., additional, Tanis, Pieter J., additional, Kusters, Miranda, additional, Aalbers, Arend G.J., additional, van Aalten, Susanna M., additional, Amelung, Femke J., additional, Ankersmit, Marjolein, additional, Antonisse, Imogeen E., additional, Ashruf, Jesse F., additional, Aukema, Tjeerd S., additional, Avenarius, Henk, additional, Bahadoer, Renu R., additional, Bakers, Frans C.H., additional, Bakker, Ilsalien S., additional, Bangert, Fleur, additional, Barendse, Renée M., additional, Beekhuis, Heleen M.D., additional, Beets, Geerard L., additional, Bemelman, Willem A., additional, Berbée, Maaike, additional, de Bie, Shira H., additional, Bisschops, Robert H.C., additional, Blok, Robin D., additional, van Bockel, Liselotte W., additional, Boer, Anniek H., additional, den Boer, Frank C., additional, Boerma, Evert-Jan G., additional, Boogerd, Leonora S.F., additional, Borstlap, Jaap, additional, Borstlap, Wernard A.A., additional, Bouwman, Johanna E., additional, Braak, Sicco J., additional, Braat, Manon N.G.J.A., additional, Bradshaw, Jennifer, additional, Brandsma, Amarins T.A., additional, van Breest Smallenburg, Vivian, additional, van den Broek, Wim T., additional, van der Burg, Sjirk W., additional, Burger, Jacobus W.A., additional, Burghgraef, Thijs A., additional, ten Cate, David W.G., additional, Ceha, Heleen M., additional, Cnossen, Jeltsje S., additional, Coebergh van den Braak, Robert R.J., additional, Consten, Esther C.J., additional, Corver, Maaike, additional, Crolla, Rogier M.P.H., additional, Curutchet, Sam, additional, Daniëls-Gooszen, Alette W., additional, Davids, Paul H.P., additional, Dekker, Emmelie N., additional, Dekker, Jan Willem T., additional, Demirkiran, Ahmet, additional, Derksen, Tyche, additional, Diederik, Arjen L., additional, Dinaux, Anne M., additional, Dogan, Kemal, additional, van Dop, Ilse M., additional, Droogh-de Greve, Kitty E., additional, Duijsens, Hanneke M.H., additional, Dunker, Michalda S., additional, Duyck, Johan, additional, van Duyn, Eino B., additional, van Egdom, Laurentine S.E., additional, Eijlers, Bram, additional, El-Massoudi, Youssef, additional, van Elderen, Saskia, additional, Emmen, Anouk M.L.H., additional, Engelbrecht, Marc, additional, van Erp, Anne C., additional, van Essen, Jeroen A., additional, Fabry, Hans F.J., additional, Fassaert, Thomas, additional, Feitsma, Eline A., additional, Feshtali, Shirin S., additional, Frietman, Bas, additional, Furnée, Edgar J.B., additional, van Geel, Anne M., additional, Geijsen, Elisabeth D., additional, van Geloven, Anna A.W., additional, Gerhards, Michael F., additional, Gielkens, Hugo, additional, van Gils, Renza A.H., additional, Goense, Lucas, additional, Govaert, Marc J.P.M., additional, van Grevenstein, Wilhelmina M.U., additional, Joline de Groof, E., additional, de Groot, Irene, additional, de Haas, Robbert J., additional, Hakkenbrak, Nadia A.G., additional, den Hartogh, Mariska D., additional, Heesink, Vera, additional, Heikens, Joost T., additional, Hendriksen, Ellen M., additional, van den Hoek, Sjoerd, additional, van der Hoeven, Erik J.R.J., additional, Hoff, Christiaan, additional, Hogewoning, Anna, additional, Hogewoning, Cornelis R.C., additional, Hoogendoorn, Stefan, additional, van Hoorn, Francois, additional, van der Hul, René L., additional, van Hulst, Rieke, additional, Imani, Farshad, additional, Inberg, Bas, additional, Intven, Martijn P.W., additional, Janssen, Pedro, additional, de Jong, Chris E.J., additional, Jonkers, Jacoline, additional, Jou-Valencia, Daniela, additional, Keizers, Bas, additional, Ketelaers, Stijn H.J., additional, Knöps, Eva, additional, van Koeverden, Sebastiaan, additional, Kok, Sylvia, additional, Kolderman, Stephanie E.M., additional, de Korte, Fleur I., additional, Kortekaas, Robert T.J., additional, Korving, Julie C., additional, Koster, Ingrid M., additional, Krdzalic, Jasenko, additional, Krielen, Pepijn, additional, Kroese, Leonard F., additional, Krul, Eveline J.T., additional, Lahuis, Derk H.H., additional, Lamme, Bas, additional, van Landeghem, An A.G., additional, Leijtens, Jeroen W.A., additional, Leseman-Hoogenboom, Mathilde M., additional, de Lijster, Manou S., additional, Marsman, Martijn S., additional, Martens, MilouH., additional, Masselink, Ilse, additional, van der Meij, Wout, additional, Meijnen, Philip, additional, Melenhorst, Jarno, additional, de Mey, Dietrich J.L., additional, Moelker-Galuzina, Julia, additional, Morsink, Linda, additional, Mulder, Erik J., additional, Muller, Karin, additional, Musters, Gijsbert D., additional, Neijenhuis, Peter A., additional, de Nes, Lindsey C.F., additional, Nielen, M., additional, van den Nieuwboer, Jan B.J., additional, Nieuwenhuis, Jonanne F., additional, Nonner, Joost, additional, Noordman, Bo J., additional, Nordkamp, Stefi, additional, Olthof, Pim B., additional, Oosterling, Steven J., additional, Ootes, Daan, additional, Oppedijk, Vera, additional, Ott, Pieter, additional, Paulusma, Ida, additional, Peeters, Koen C.M.J., additional, Pereboom, Ilona T.A., additional, Peringa, Jan, additional, Pironet, Zoë, additional, Plate, Joost D.J., additional, Polat, Fatih, additional, Poodt, Ingrid G.M., additional, Posma, Lisanne A.E., additional, Prette, Jeroen F., additional, Pultrum, Bareld B., additional, Qaderi, Seyed M., additional, van Rees, Jan M., additional, Renger, Rutger-Jan, additional, Rombouts, Anouk J.M., additional, Roosen, Lodewijk J., additional, Roskott-ten Brinke, Ellen A., additional, Rothbarth, Joost, additional, Rouw, Dennis B., additional, Rozema, Tom, additional, Rütten, Heidi, additional, Rutten, Harm J.T., additional, van der Sande, Marit E., additional, Schaafsma, Boudewijn E., additional, Schasfoort, Renske A., additional, Scheurkogel, Merel M., additional, Schouten van der Velden, Arjan P., additional, Schreurs, Wilhelmina H., additional, Schuivens, Puck M.E., additional, Sietses, Colin, additional, Simons, Petra C.G., additional, Slob, Marjan J., additional, Slooter, Gerrit D., additional, van der Sluis, Martsje, additional, Smalbroek, Bo P., additional, Smits, Anke B., additional, Spillenaar-Bilgen, Ernst J., additional, Spruit, Patty H., additional, Stam, Tanja C., additional, Stoker, Jaap, additional, Talsma, Aaldert K., additional, Temmink, Sofieke J.D., additional, The, G.Y. Mireille, additional, Tielbeek, Jeroen A.W., additional, van Tilborg, Aukje A.J.M., additional, van Tilborg, Fiek, additional, van Trier, Dorothée, additional, Tuynman, Jurriaan B., additional, van der Valk, Maxime J.M., additional, Vanhooymissen, Inge J.S., additional, Vasbinder, G. Boudewijn C., additional, Veeken, Cornelis J., additional, Velema, Laura A., additional, van de Ven, Anthony W.H., additional, Verdaasdonk, Emiel G.G., additional, Verduin, Wouter M., additional, Verhagen, Tim, additional, Verheijen, Paul M., additional, Vermaas, Maarten, additional, Verrijssen, An-Sofie E., additional, Verschuur, Anna V.D., additional, Schaik, Harmke Verwoerd-van, additional, Vliegen, Roy F.A., additional, Voets, Sophie, additional, Vogelaar, F. Jeroen, additional, Vogelij, Clementine L.A., additional, Vos-Westerman, Johanna, additional, de Vries, Marianne, additional, Vroemen, Joy C., additional, van Vugt, Bas S.T., additional, Wegdam, Johannes A., additional, van Wely, Bob J., additional, Westerterp, Marinke, additional, van Westerveld, Paul P., additional, van Westreenen, Henderik L., additional, Wijma, Allard G., additional, de Wilt, Johannes H.W., additional, de Wit, Bart W.K., additional, Wit, Fennie, additional, Woensdregt, Karlijn, additional, van Woerden, Victor, additional, van der Wolf, Floor S.W., additional, van der Wolk, Sander, additional, Wybenga, Johannes M., additional, van der Zaag, Edwin S., additional, Zamaray, Bobby, additional, Zandvoort, Herman J.A., additional, van der Zee, Dennis, additional, Zeilstra, Annette P., additional, Zheng, Kang J., additional, Zimmerman, David D.E., additional, and Zorgdrager, Marcel, additional

Published
2024
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16. Impact of the new rectal cancer definition on multimodality treatment and interhospital variability: Results from a nationwide cross‐sectional study.

Author

Hazen, Sanne‐Marije J. A., Sluckin, Tania C., Horsthuis, Karin, Lambregts, Doenja M. J., Beets‐Tan, Regina G. H., Hompes, Roel, Buffart, Tineke E., Marijnen, Corrie A. M., Tanis, Pieter J., Kusters, Miranda, Aalbers, Arend G. J., van Aalten, Susanna M., Amelung, Femke J., Ankersmit, Marjolein, Antonisse, Imogeen E., Ashruf, Jesse F., Aukema, Tjeerd S., Avenarius, Henk, Bahadoer, Renu R., and Bakers, Frans C. H.

Subjects
RECTAL cancer, COLON cancer, DELPHI method, CROSS-sectional method, PROGNOSIS
Abstract

Aim: This study aimed to determine the consequences of the new definition of rectal cancer for decision‐making in multidisciplinary team meetings (MDT). The new definition of rectal cancer, the lower border of the tumour is located below the sigmoid take‐off (STO), was implemented in the Dutch guideline in 2019 after an international Delphi consensus meeting to reduce interhospital variations. Method: All patients with rectal cancer according to the local MDT, who underwent resection in 2016 in the Netherlands were eligible for this nationwide collaborative cross‐sectional study. MRI‐images were rereviewed, and the tumours were classified as above or on/below the STO. Results: This study registered 3107 of the eligible 3178 patients (98%), of which 2784 patients had an evaluable MRI. In 314 patients, the tumour was located above the STO (11%), with interhospital variation between 0% and 36%. Based on TN‐stage, 175 reclassified patients with colon cancer (6%) would have received different treatment (e.g., omitting neoadjuvant radiotherapy, candidate for adjuvant chemotherapy). Tumour location above the STO was independently associated with lower risk of 4‐year locoregional recurrence (HR 0.529; p = 0.030) and higher 4‐year overall survival (HR 0.732; p = 0.037) compared to location under the STO. Conclusion: By using the STO, 11% of the prior MDT‐based diagnosis of rectal cancer were redefined as sigmoid cancer, with potential implications for multimodality treatment and prognostic value. Given the substantial interhospital variation in proportion of redefined cancers, the use of the STO will contribute to standardisation and comparability of outcomes in both daily practice and trial settings. [ABSTRACT FROM AUTHOR]

Published
2024
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17. MRI in addition to CT in patients scheduled for local therapy of colorectal liver metastases (CAMINO): an international, multicentre, prospective, diagnostic accuracy trial

Author

Görgec, Burak, primary, Hansen, Ingrid S, additional, Kemmerich, Gunter, additional, Syversveen, Trygve, additional, Abu Hilal, Mohammed, additional, Belt, Eric J T, additional, Bosscha, Koop, additional, Burgmans, Mark C, additional, Cappendijk, Vincent C, additional, D'Hondt, Mathieu, additional, Edwin, Bjørn, additional, van Erkel, Arian R, additional, Gielkens, Hugo A J, additional, Grünhagen, Dirk J, additional, Gobardhan, Paul D, additional, Hartgrink, Henk H, additional, Horsthuis, Karin, additional, Klompenhouwer, Elisabeth G, additional, Kok, Niels F M, additional, Kint, Peter A M, additional, Kuhlmann, Koert, additional, Leclercq, Wouter K G, additional, Lips, Daan J, additional, Lutin, Bart, additional, Maas, Monique, additional, Marsman, Hendrik A, additional, Meijerink, Martijn, additional, Meyer, Yannick, additional, Morone, Mario, additional, Peringa, Jan, additional, Sijberden, Jasper P, additional, van Delden, Otto M, additional, van den Bergh, Janneke E, additional, Vanhooymissen, Inge J S, additional, Vermaas, Maarten, additional, Willemssen, François E J A, additional, Dijkgraaf, Marcel G W, additional, Bossuyt, Patrick M, additional, Swijnenburg, Rutger-Jan, additional, Fretland, Åsmund A, additional, Verhoef, Cornelis, additional, Besselink, Marc G, additional, Stoker, Jaap, additional, Ayez, Ninos, additional, Bnà, Claudio, additional, van den Boom, Rivka, additional, Lambregts, Doenja J.M., additional, Liefers, Gerrit-Jan, additional, de Meyere, Celine, additional, Draaisma, Werner A., additional, Gerhards, Michael F., additional, Imani, Farshad, additional, Ruers, Theo .J.M., additional, Liem, Mike S.L., additional, Serafino, Gian Piero, additional, van Beek, Hermen C., additional, van der Hoeven, Joost A.B., additional, Veeken, Cornelis J., additional, and Zonderhuis, Babs M., additional

Published
2023
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19. A Deep Learning Framework with Explainability for the Prediction of Lateral Locoregional Recurrences in Rectal Cancer Patients with Suspicious Lateral Lymph Nodes

Author

Sluckin, Tania C., primary, Hekhuis, Marije, additional, Kol, Sabrine Q., additional, Nederend, Joost, additional, Horsthuis, Karin, additional, Beets-Tan, Regina G. H., additional, Beets, Geerard L., additional, Burger, Jacobus W. A., additional, Tuynman, Jurriaan B., additional, Rutten, Harm J. T., additional, Kusters, Miranda, additional, and Benson, Sean, additional

Published
2023
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20. Abandonment of Routine Radiotherapy for Nonlocally Advanced Rectal Cancer and Oncological Outcomes.

Author

Hazen, Sanne-Marije J. A., Sluckin, Tania C., Intven, Martijn P. W., Beets, Geerard L., Beets-Tan, Regina G. H., Borstlap, Wernard A. A., Buffart, Tineke E., Buijsen, Jeroen, Burger, Jacobus W. A., van Dieren, Susan, Furnée, Edgar J. B., Geijsen, E. Debby, Hompes, Roel, Horsthuis, Karin, Leijtens, Jeroen W. A., Maas, Monique, Melenhorst, Jarno, Nederend, Joost, Peeters, Koen C. M. J., and Rozema, Tom

Published
2024
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23. Evaluation of the implementation of the sigmoid take-off landmark in the Netherlands

Author

Hazen, Sanne Marije J.A., Sluckin, Tania C., Horsthuis, Karin, Lambregts, Doenja M.J., Beets-Tan, Regina G.H., Tanis, Pieter J., Kusters, Miranda, Hazen, Sanne Marije J.A., Sluckin, Tania C., Horsthuis, Karin, Lambregts, Doenja M.J., Beets-Tan, Regina G.H., Tanis, Pieter J., and Kusters, Miranda

Abstract

Aim: The sigmoid take-off (STO), the point on imaging where the sigmoid sweeps ventral from the sacrum, was chosen as the definition of the rectum during an international Delphi consensus meeting and has been incorporated into the Dutch guidelines since October 2019. The aim of this study was to evaluate the implementation of this landmark 1 year after the guideline implementation and to perform a quality assessment of the STO training. Method: Dutch radiologists, surgeons, surgical residents, interns, PhD students and physician assistants were asked to complete a survey and classify 20 tumours on MRI as ‘below’, ‘on’ or ‘above’ the STO. Outcomes were agreement with the expert reference, inter-rater variability and accuracy before and after the training. Results: Eighty-six collaborators participated. Six radiologists (32%) and 11 surgeons (73%) used the STO as the standard landmark to distinguish between rectal and sigmoidal tumours during multidisciplinary meetings. Overall agreement with the expert reference improved from 53% to 70% (p < 0.001) after the training. The positive predictive value for diagnosing rectal tumours was high before and after the training (92% vs. 90%); the negative predictive value for diagnosing sigmoidal tumours improved from 39% to 63%. Conclusion: Approximately half of the represented hospitals have implemented the new definition of rectal cancer 1 year after the implementation of the Dutch national guidelines. Overall baseline agreement with the expert reference and accuracy for the tumours around the STO was low, but improved significantly after training. These results highlight the added value of training in implementation of radiological landmarks to ensure unambiguous assessment.

Published
2022

24. Lateral Lymph Nodes in Rectal Cancer:Do we all Think the Same? A Review of Multidisciplinary Obstacles and Treatment Recommendations

Author

Sluckin, Tania C., Couwenberg, Alice M., Lambregts, Doenja M.J., Hazen, Sanne Marije J.A., Horsthuis, Karin, Meijnen, Philip, Beets-Tan, Regina G.H., Tanis, Pieter J., Marijnen, Corrie A.M., Kusters, Miranda, Sluckin, Tania C., Couwenberg, Alice M., Lambregts, Doenja M.J., Hazen, Sanne Marije J.A., Horsthuis, Karin, Meijnen, Philip, Beets-Tan, Regina G.H., Tanis, Pieter J., Marijnen, Corrie A.M., and Kusters, Miranda

Abstract

Lateral lymph nodes in low, locally advanced, rectal cancer have proven implications for local recurrence rates, which increase drastically in the presence of persistently enlarged lateral lymph nodes. These clinical implications warrant a thorough understanding of lateral nodal disease with awareness and knowledge from all three specialties involved – radiology, radiation oncology, and surgery – to ensure proper treatment. Relevant literature for each specialty, including all current guidelines and perspectives, were examined. Variations in definitions and treatment paradigms were evaluated. There is still no consensus for the standardized treatment of lateral nodal disease. Each discipline works according to their own available evidence, but relevant data are scarce. Current international guidelines and standard recommendations for the diagnostics and treatment of lateral lymph nodes are lacking. This results in differing perspectives and interpretations between the disciplines which can lead to challenging communication in an area where multidisciplinary collaboration is essential. This review addresses this by presenting the current evidence, perspectives and practices of each specialty and makes suggestions for each phase of the diagnostic and treatment process for patients with lateral nodal disease. By doing this, steps are taken toward achieving international consensus, and multidisciplinary collaboration.

Published
2022

26. Fibrosis and MAGNIFI-CD Activity Index at Magnetic Resonance Imaging to Predict Treatment Outcome in Perianal Fistulizing Crohn’s Disease Patients

Author

van Rijn, Kyra L, primary, Meima-van Praag, Elise M, additional, Bossuyt, Patrick M, additional, D’Haens, Geert R, additional, Gecse, Krisztina B, additional, Horsthuis, Karin, additional, Snijder, Harmanna J, additional, Tielbeek, Jeroen A W, additional, Buskens, Christianne J, additional, and Stoker, Jaap, additional

Published
2021
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31. Fibrosis and MAGNIFI-CD Activity Index at Magnetic Resonance Imaging to Predict Treatment Outcome in Perianal Fistulizing Crohn's Disease Patients.

Author

Rijn, Kyra L van, Praag, Elise M Meima-van, Bossuyt, Patrick M, D'Haens, Geert R, Gecse, Krisztina B, Horsthuis, Karin, Snijder, Harmanna J, Tielbeek, Jeroen A W, Buskens, Christianne J, and Stoker, Jaap

Abstract

Background and Aims Characteristic magnetic resonance imaging [MRI] features associated with long-term perianal fistula closure are still being discussed. This study evaluated the predictive value of degree of fibrosis and disease activity (MAGNIFI-CD index) at MRI for long-term clinical closure of Crohn's perianal fistulas. Methods Crohn's disease [CD] patients treated with surgical closure following anti-tumour necrosis factor [anti-TNF] induction or anti-TNF alone for high perianal fistulas as part of a patient preference randomized controlled trial [PISA-II] between 2013 and 2020 with a post-treatment MRI and long-term clinical follow-up data were retrospectively included. Two radiologists scored the degree of fibrosis and MAGNIFI-CD index at pre- and post-treatment MRI. The accuracy of post-treatment MRI findings in predicting long-term clinical closure [12 months after the MRI] was evaluated using receiver operating characteristics [ROC] analysis. Results Fifty patients were included: 31 female, median age 33 years (interquartile range [IQR] 26–45). Fourteen patients showed a 100% fibrotic fistula at post-treatment MRI, all of which had long-term clinical closure. Median MAGNIFI-CD index at post-treatment MRI was 0 [IQR 0–5] in 25 patients with long-term clinical closure and 16 [IQR 10-20] in 25 patients without. ROC analysis showed an area under the curve of 0.90 (95% confidence interval [CI] 0.82–0.99) for degree of fibrosis and 0.95 [95% CI 0.89–1.00] for the MAGNIFI-CD index, with a Youden cut-off point of 6 [91% specificity, 87% sensitivity]. Conclusions Degree of fibrosis and MAGNIFI-CD index at post-treatment MRI are accurate in predicting long-term clinical closure and seem valuable in follow-up of perianal CD. A completely fibrotic tract at MRI is a robust indicator for long-term fistula closure. EudraCT 2013-002932-25 and 2018-002064-15 [ABSTRACT FROM AUTHOR]

Published
2022
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36. Evaluation of the implementation of the sigmoid take‐off landmark in the Netherlands.

Author

Hazen, Sanne‐Marije J. A., Sluckin, Tania C., Horsthuis, Karin, Lambregts, Doenja M. J., Beets‐Tan, Regina G. H., Tanis, Pieter J., Kusters, Miranda, Dinaux, Anne M., Lamme, Bas, Musters, Gijsbert D., Bangert, Fleur, Knöps, Eva, Temmink, Sofieke, Kint, Peter A. M., Coebergh van den Braak, Robert R. J., Schuivens, Puck M. E., Bemelman, Willem A., Borstlap, Wernard A. A., Haasnoot, Pieter J., and Hompes, Roel

Subjects
PHYSICIAN assistant students, RECTAL cancer, DOCTORAL students
Abstract

Aim: The sigmoid take‐off (STO), the point on imaging where the sigmoid sweeps ventral from the sacrum, was chosen as the definition of the rectum during an international Delphi consensus meeting and has been incorporated into the Dutch guidelines since October 2019. The aim of this study was to evaluate the implementation of this landmark 1 year after the guideline implementation and to perform a quality assessment of the STO training. Method: Dutch radiologists, surgeons, surgical residents, interns, PhD students and physician assistants were asked to complete a survey and classify 20 tumours on MRI as 'below', 'on' or 'above' the STO. Outcomes were agreement with the expert reference, inter‐rater variability and accuracy before and after the training. Results: Eighty‐six collaborators participated. Six radiologists (32%) and 11 surgeons (73%) used the STO as the standard landmark to distinguish between rectal and sigmoidal tumours during multidisciplinary meetings. Overall agreement with the expert reference improved from 53% to 70% (p < 0.001) after the training. The positive predictive value for diagnosing rectal tumours was high before and after the training (92% vs. 90%); the negative predictive value for diagnosing sigmoidal tumours improved from 39% to 63%. Conclusion: Approximately half of the represented hospitals have implemented the new definition of rectal cancer 1 year after the implementation of the Dutch national guidelines. Overall baseline agreement with the expert reference and accuracy for the tumours around the STO was low, but improved significantly after training. These results highlight the added value of training in implementation of radiological landmarks to ensure unambiguous assessment. [ABSTRACT FROM AUTHOR]

Published
2022
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40. Fasted and fed small bowel motility patterns at cine‐MRI in chronic intestinal pseudo‐obstruction.

Author

Rijn, Kyra L., Bredenoord, Albert J., Smout, André J. P. M., Bouma, Gerd, Tielbeek, Jeroen A. W., Horsthuis, Karin, Stoker, Jaap, and Jonge, Catharina S.

Subjects
SMALL intestine, INTESTINES, MAGNETIC resonance imaging, ADULTS
Abstract

Background: Chronic intestinal pseudo‐obstruction (CIPO) is a severe intestinal motility disorder of which the pathophysiology is largely unknown. This study aimed at gaining insight in fasted and fed small bowel motility in CIPO patients using cine‐MRI with caloric stimulation. Methods: Eight adult patients with manometrically confirmed CIPO were prospectively included. Patients underwent a cine‐MRI protocol after an overnight fast, comprising fasting‐state scans and scans after ingestion of a meal (Nutridrink, 300 kcal). Small bowel motility was quantified resulting in a motility score in arbitrary units (AU) and visually assessed by three radiologists. Findings were compared with those in 16 healthy volunteers. Key Results: Motility scores (median, IQR) in CIPO patients were 0.21 (0.15–0.30) in the fasting state and 0.23 (0.15–0.27) directly postprandially. In healthy volunteers, corresponding motility scores were 0.15 (0.13–0.18) and 0.22 (0.19–0.25), respectively. The postprandial change in motility score was +1% (−19 to +21%) in CIPO and +39% (+23 to +50%) in healthy volunteers (p = 0.001*). Visual analysis revealed increased small bowel contractility in four, normal in two, and decreased in two CIPO patients. Conclusions & Inferences: Surprisingly, we found hyperactive small bowel motility in half of the CIPO patients, suggestive of uncoordinated motility. A wide variation in motility patterns was observed, both higher, lower, and comparable contractility compared with healthy subjects. No clear postprandial activation was seen in patients. Cine‐MRI helps to gain insight in this complex disease and can potentially impact treatment decisions in the future. [ABSTRACT FROM AUTHOR]

Published
2021
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41. Comparison of contrast-enhanced and diffusion-weighted MRI in assessment of the terminal ileum in Crohn’s disease patients

Author

Puylaert, Carl A.J. (author), Tielbeek, Jeroen A.W. (author), Schüffler, Peter J. (author), Nio, C. Yung (author), Horsthuis, Karin (author), Mearadji, Banafsche (author), Ponsioen, Cyriel Y. (author), Vos, F.M. (author), Stoker, Jaap (author), Puylaert, Carl A.J. (author), Tielbeek, Jeroen A.W. (author), Schüffler, Peter J. (author), Nio, C. Yung (author), Horsthuis, Karin (author), Mearadji, Banafsche (author), Ponsioen, Cyriel Y. (author), Vos, F.M. (author), and Stoker, Jaap (author)

Abstract

Purpose: The purpose of the study was to compare the performance of contrast-enhanced (CE)-MRI and diffusion-weighted imaging (DW)-MRI in grading Crohn’s disease activity of the terminal ileum. Methods: Three readers evaluated CE-MRI, DW-MRI, and their combinations (CE/DW-MRI and DW/CE-MRI, depending on which protocol was used at the start of evaluation). Disease severity grading scores were correlated to the Crohn’s Disease Endoscopic Index of Severity (CDEIS). Diagnostic accuracy, severity grading, and levels of confidence were compared between imaging protocols and interobserver agreement was calculated. Results: Sixty-one patients were included (30 female, median age 36). Diagnostic accuracy for active disease for CE-MRI, DW-MRI, CE/DW-MRI, and DW/CE-MRI ranged between 0.82 and 0.85, 0.75 and 0.83, 0.79 and 0.84, and 0.74 and 0.82, respectively. Severity grading correlation to CDEIS ranged between 0.70 and 0.74, 0.66 and 0.70, 0.69 and 0.75, and 0.67 and 0.74, respectively. For each reader, CE-MRI values were consistently higher than DW-MRI, albeit not significantly. Confidence levels for all readers were significantly higher for CE-MRI compared to DW-MRI (P < 0.001). Further increased confidence was seen when using combined imaging protocols. Conclusions: There was no significant difference of CE-MRI and DW-MRI in determining disease activity, but the higher confidence levels may favor CE-MRI. DW-MRI is a good alternative in cases with relative contraindications for the use of intravenous contrast medium., ImPhys/Quantitative Imaging

Published
2018
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43. The effects of a decrease in neoadjuvant radiotherapy on clinical nature and oncological outcomes of locally recurrent rectal cancer: results from a national cross-sectional cohort study.

Author

Van Geffen, Eline, Judith Langhout, M.A., Sanne-Marije Hazen, J.A., Tania Sluckin, C., Beets, Geerard, Regina Beets-Tan, G.H., Wernard Borstlap, A.A., Horsthuis, Karin, Corrie Marijnen, A.M., Pieter Tanis, J., and Kusters, Miranda

Subjects
RECTAL cancer, CROSS-sectional method, COHORT analysis, RADIOTHERAPY
Published
2024
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45. Tu1213 Reproducibility of Magnetic Resonance Enterography Assessment of Disease Activity in Crohn's Disease Using Central Readers

Author

Ordás, Ingrid, primary, Rimola, Jordi, additional, Zou, Guangyong, additional, Santillan, Cynthia, additional, Horsthuis, Karin, additional, Taylor, Stuart A., additional, Panes, Julian, additional, Khanna, Reena, additional, Stoker, Jaap, additional, Stitt, Larry, additional, D'Haens, Geert R., additional, Sandborn, William, additional, Feagan, Brian G., additional, Vandervoort, Margaret K., additional, and Levesque, Barrett G., additional

Published
2015
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47. Computed Tomography Pulmonary Angiography in Acute Pulmonary Embolism

Author

Wittenberg, Rianne, primary, Peters, Joost F., additional, van den Berk, Inge A.H., additional, Freling, Nicole J.M., additional, Lely, Rutger, additional, de Hoop, Bartjan, additional, Horsthuis, Karin, additional, Ravesloot, Cécile J., additional, Weber, Michael, additional, Prokop, W. Mathias, additional, and Schaefer-Prokop, Cornelia M., additional

Published
2013
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49. Coverage of Lateral Lymph Nodes in Rectal Cancer Patients with Routine Radiation Therapy Practice and Associated Locoregional Recurrence Rates.

Author

Sluckin, Tania C., Hazen, Sanne-Marije J.A., Horsthuis, Karin, Beets-Tan, Regina G.H., Antonisse, Imogeen E., Berbée, Maaike, van Bockel, Liselotte W., Boer, Anniek H., Ceha, Heleen M., Cnossen, Jeltsje S., Geijsen, Elisabeth D., den Hartogh, Mariska D., Hendriksen, Ellen M., Intven, Martijn P.W., Leseman-Hoogenboom, Mathilde M., Meijnen, Philip, Muller, Karin, Oppedijk, Vera, Rozema, Tom, and Rütten, Heidi

Subjects
*RECTAL cancer, *LYMPH node cancer, *RADIOTHERAPY treatment planning, *RADIOTHERAPY, *CANCER patients, *SENTINEL lymph nodes, *MAGNETIC resonance imaging
Abstract

Involved internal iliac and obturator lateral lymph nodes (LLNs) are a known risk factor for the occurrence of ipsilateral local recurrences (LLR) in rectal cancer. This study examined coverage of LLNs with routine radiation therapy practice in the Netherlands and associated LLR rates. Patients with a primary tumor ≤8 cm of the anorectal junction, cT3-4 stage, and at least 1 internal iliac or obturator LLN with short axis ≥5 mm who received neoadjuvant (chemo)radiation therapy, were selected from a national, cross-sectional study of patients with rectal cancer treated in the Netherlands in 2016. Magnetic resonance images and radiation therapy treatment plans were reviewed regarding segmented LLNs as gross tumor volume (GTV), location of LLNs within clinical target volume (CTV), and received proportion of the planned radiation therapy dose. A total of 223 out of 3057 patients with at least 1 LLN ≥5 mm were selected. Of those, 180 (80.7%) LLNs were inside the CTV, of which 60 (33.3%) were segmented as GTV. Overall, 202 LLNs (90.6%) received ≥95% of the planned dose. Four-year LLR rates were not significantly higher for LLNs situated outside the CTV compared with those inside (4.0% vs 12.5%, P =.092) or when receiving <95% versus ≥95% of the planned radiation therapy dose (7.1% vs 11.3%, P =.843), respectively. Two of 7 patients who received a dose escalation of 60 Gy developed an LLR (4-year LLR rate of 28.6%). This evaluation of routine radiation therapy practice showed that adequate coverage of LLNs was still associated with considerable 4-year LLR rates. Techniques resulting in better local control for patients with involved LLNs need to be explored further. [ABSTRACT FROM AUTHOR]

Published
2023
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