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1. Efficacy of a nurse-led sexual rehabilitation intervention for women with gynaecological cancers receiving radiotherapy: results of a randomised trial

Author

Suvaal, Isabelle, Hummel, Susanna B., Mens, Jan-Willem M., Tuijnman-Raasveld, Charlotte C., Tsonaka, Roula, Velema, Laura A., Westerveld, Henrike, Cnossen, Jeltsje S., Snyers, An, Jürgenliemk-Schulz, Ina M., Lutgens, Ludy C. H. W., Beukema, Jannet C., Haverkort, Marie A. D., Nowee, Marlies E., Nout, Remi A., de Kroon, Cor D., van den Hout, Wilbert B., Creutzberg, Carien L., van Doorn, Helena C., and ter Kuile, Moniek M.

Published
2024
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2. Automated causal inference in application to randomized controlled clinical trials

Author

Wu, Jiqing, Horeweg, Nanda, de Bruyn, Marco, Nout, Remi A., Jürgenliemk-Schulz, Ina M., Lutgens, Ludy C. H. W., Jobsen, Jan J., van der Steen-Banasik, Elzbieta M., Nijman, Hans W., Smit, Vincent T. H. B. M., Bosse, Tjalling, Creutzberg, Carien L., and Koelzer, Viktor H.

Subjects
Statistics - Methodology, Computer Science - Artificial Intelligence, Computer Science - Machine Learning
Abstract

Randomized controlled trials (RCTs) are considered as the gold standard for testing causal hypotheses in the clinical domain. However, the investigation of prognostic variables of patient outcome in a hypothesized cause-effect route is not feasible using standard statistical methods. Here, we propose a new automated causal inference method (AutoCI) built upon the invariant causal prediction (ICP) framework for the causal re-interpretation of clinical trial data. Compared to existing methods, we show that the proposed AutoCI allows to efficiently determine the causal variables with a clear differentiation on two real-world RCTs of endometrial cancer patients with mature outcome and extensive clinicopathological and molecular data. This is achieved via suppressing the causal probability of non-causal variables by a wide margin. In ablation studies, we further demonstrate that the assignment of causal probabilities by AutoCI remain consistent in the presence of confounders. In conclusion, these results confirm the robustness and feasibility of AutoCI for future applications in real-world clinical analysis., Comment: Submitted to Nature Machine Intelligence. The code is publicly available via https://github.com/CTPLab/AutoCI

Published
2022

3. Prognostic impact and causality of age on oncological outcomes in women with endometrial cancer: a multimethod analysis of the randomised PORTEC-1, PORTEC-2, and PORTEC-3 trials

Author

Wakkerman, Famke C, Wu, Jiqing, Putter, Hein, Jürgenliemk-Schulz, Ina M, Jobsen, Jan J, Lutgens, Ludy C H W, Haverkort, Marie A D, de Jong, Marianne A, Mens, Jan Willem M, Wortman, Bastiaan G, Nout, Remi A, Léon-Castillo, Alicia, Powell, Melanie E, Mileshkin, Linda R, Katsaros, Dionyssios, Alfieri, Joanne, Leary, Alexandra, Singh, Naveena, de Boer, Stephanie M, Nijman, Hans W, Smit, Vincent T H B M, Bosse, Tjalling, Koelzer, Viktor H, Creutzberg, Carien L, and Horeweg, Nanda

Published
2024
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4. Molecular and Clinicopathologic Characterization of Mismatch Repair-Deficient Endometrial Carcinoma Not Related to MLH1 Promoter Hypermethylation

Author

Kaya, Merve, Post, Cathalijne C.B., Tops, Carli M., Nielsen, Maartje, Crosbie, Emma J., Leary, Alexandra, Mileshkin, Linda R., Han, Kathy, Bessette, Paul, de Boer, Stephanie M., Jürgenliemk-Schulz, Ina M., Lutgens, Ludy, Jobsen, Jan J., Haverkort, Marie A.D., Nout, Remi A., Kroep, Judith, Creutzberg, Carien L., Smit, Vincent T.H.B.M., Horeweg, Nanda, van Wezel, Tom, and Bosse, Tjalling

Published
2024
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5. Nine Recommendations for Decision Aid Implementation from the Clinician Perspective

Author

Ankolekar, Anshu, Vanneste, Ben G. L., Gurp, Esther Bloemen-van, van Roermund, Joep, Berlanga, Adriana, Roumen, Cheryl, van Limbergen, Evert, Lutgens, Ludy, Marcelissen, Tom, Lambin, Philippe, Dekker, Andre, and Fijten, Rianne

Subjects
Computer Science - Computers and Society, J.3
Abstract

Background: Shared decision-making (SDM) aims to empower patients to take an active role in their treatment choices, supported by clinicians and patient decision aids (PDAs). The purpose of this study is to explore barriers and possible facilitators to SDM and a PDA in the prostate cancer trajectory. In the process we identify possible actions that organizations and individuals can take to support implementation in practice. Methods: We use the Ottawa Model of Research Use as a framework to determine the barriers and facilitators to SDM and PDAs from the perspective of clinicians. Semi-structured interviews were conducted with urologists (n=4), radiation oncologists (n=3), and oncology nurses (n=2), focusing on the current decision-making process experienced by these stakeholders. Questions included their attitudes towards SDM and PDAs, barriers to implementation and possible strategies to overcome them. Results: Time pressure and patient characteristics were cited as major barriers by 55% of the clinicians we interviewed. Structural factors such as external quotas for certain treatment procedures were also considered as barriers by 44% of the clinicians. Facilitating factors involved organizational changes to em-bed PDAs in the treatment trajectory, training in using PDAs as a tool for SDM, and clinician motivation by disseminating positive clinical outcomes. Our findings also suggest a role for external stakeholders such as healthcare insurers in creating economic incentives to facilitate implementation. Conclusion: Our findings highlight the importance of a multi-faceted implementation strategy to support SDM. While clinician motivation and patient activation are essential, structural/economic barriers may hamper implementation. Action must also be taken at the administrative and policy levels to foster a collaborative environment for SDM and, in the process, for PDAs.

Published
2020

6. Association of persistent morbidity after radiotherapy with quality of life in locally advanced cervical cancer survivors

Author

Spampinato, Sofia, Tanderup, Kari, Lindegaard, Jacob C., Schmid, Maximilian P., Sturdza, Alina, Segedin, Barbara, Jürgenliemk-Schulz, Ina M., De Leeuw, Astrid, Bruheim, Kjersti, Mahantshetty, Umesh, Chargari, Cyrus, Rai, Bhavana, Cooper, Rachel, van der Steen-Banasik, Elzbieta, Sundset, Marit, Wiebe, Ericka, Villafranca, Elena, Van Limbergen, Erik, Pieters, Bradley R., Tee Tan, Li, Lutgens, Ludy C.H.W., Hoskin, Peter, Smet, Stéphanie, Pötter, Richard, Nout, Remi, Chopra, Supriya, and Kirchheiner, Kathrin

Published
2023
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8. Interpretable deep learning model to predict the molecular classification of endometrial cancer from haematoxylin and eosin-stained whole-slide images: a combined analysis of the PORTEC randomised trials and clinical cohorts

Author

Fremond, Sarah, Andani, Sonali, Barkey Wolf, Jurriaan, Dijkstra, Jouke, Melsbach, Sinéad, Jobsen, Jan J, Brinkhuis, Mariel, Roothaan, Suzan, Jurgenliemk-Schulz, Ina, Lutgens, Ludy C H W, Nout, Remi A, van der Steen-Banasik, Elzbieta M, de Boer, Stephanie M, Powell, Melanie E, Singh, Naveena, Mileshkin, Linda R, Mackay, Helen J, Leary, Alexandra, Nijman, Hans W, Smit, Vincent T H B M, Creutzberg, Carien L, Horeweg, Nanda, Koelzer, Viktor H, and Bosse, Tjalling

Published
2023
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10. Prediction of recurrence risk in endometrial cancer with multimodal deep learning

Author

Volinsky-Fremond, Sarah, primary, Horeweg, Nanda, additional, Andani, Sonali, additional, Barkey Wolf, Jurriaan, additional, Lafarge, Maxime W., additional, de Kroon, Cor D., additional, Ørtoft, Gitte, additional, Høgdall, Estrid, additional, Dijkstra, Jouke, additional, Jobsen, Jan J., additional, Lutgens, Ludy C. H. W., additional, Powell, Melanie E., additional, Mileshkin, Linda R., additional, Mackay, Helen, additional, Leary, Alexandra, additional, Katsaros, Dionyssios, additional, Nijman, Hans W., additional, de Boer, Stephanie M., additional, Nout, Remi A., additional, de Bruyn, Marco, additional, Church, David, additional, Smit, Vincent T. H. B. M., additional, Creutzberg, Carien L., additional, Koelzer, Viktor H., additional, and Bosse, Tjalling, additional

Published
2024
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12. Patients' and clinicians' preferences in adjuvant treatment for high-risk endometrial cancer: Implications for shared decision making

Author

Post, Cathalijne C.B., Mens, Jan Willem M., Haverkort, Marie A.D., Koppe, Friederike, Jürgenliemk-Schulz, Ina M., Snyers, An, Roeloffzen, Ellen M.A., Schaake, Eva E., Slot, Annerie, Stam, Tanja C., Beukema, Jannet C., van den Berg, Hetty A., Lutgens, Ludy C.H.W., Nijman, Hans W., de Kroon, Cornelis D., Kroep, Judith R., Stiggelbout, Anne M., and Creutzberg, Carien L.

Published
2021
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13. MRI-guided adaptive brachytherapy in locally advanced cervical cancer (EMBRACE-I): a multicentre prospective cohort study

Author

Chargari, Cyrus, Dumas, Isabelle, Lowe, Gerry, Swamidas, Jamema, Hudej, Robert, Paulsen Hellebust, Taran, Menon, Geetha, Oinam, Arun S., Bownes, Peter, Christiaens, Melissa, De Brabandere, Marisol, Janssen, Hilde, Oosterveld, Bernard, Koedooder, Kees, Langeland Marthinsen, Anne Beate, Sundset, Marit, Whitney, Diane, Ketelaars, Martijn, Lutgens, Ludy C.H.W., Reinniers, Brigitte, Mora, Itxa, Villafranca, Elena, Antal, Gergely, Hadjiev, Janaki, Bachand, Francois, Batchelar, Deidre, Erickson, Beth, Rownd, Jason, Jacobson, Geraldine, Kim, Yusung, Anttila, Maarit, Palmgren, Jan-Erik, An, Jusheng, Assenholt, Marianne Sanggaard, Banerjee, Susovan, Bentzen, Sören, Berger, Thomas, Dankulchai, Pittaya, Diendorfer, Tamara, Dilworth, Ian, Dimopoulos, Johannes, Dörr, Elke, Ecker, Stefan, Federico, Mario, Fidarova, Elena, Fortin, Israel, Georg, Petra, Gora, Joanna, Hegazy, Neamat, Jastaniyah, Noha, Jensen, Nina Boje Kibsgaard, Liederer, Thomas, Majercakova, Katarina, Misimovic, Dragan, Motisi, Laura, Najjari Jamal, Dina, Nkiwane, Karen, Schwartz-Vittrup, Anders, Serban, Monica, Smet, Stephanie, Spampinato, Sofia, Trnkova, Petra, Valgma, Margit, Westerveld, Henrike, Wong, Joyce Siu Yu, Yoshida, Kenji, Pötter, Richard, Tanderup, Kari, Schmid, Maximilian Paul, Jürgenliemk-Schulz, Ina, Haie-Meder, Christine, Fokdal, Lars Ulrik, Sturdza, Alina Emiliana, Hoskin, Peter, Mahantshetty, Umesh, Segedin, Barbara, Bruheim, Kjersti, Huang, Fleur, Rai, Bhavana, Cooper, Rachel, van der Steen-Banasik, Elzbieta, Van Limbergen, Erik, Pieters, Bradley Rumwell, Tan, Li-Tee, Nout, Remi Abubakar, De Leeuw, Astrid Agatha Catharina, Ristl, Robin, Petric, Primoz, Nesvacil, Nicole, Kirchheiner, Kathrin, Kirisits, Christian, and Lindegaard, Jacob Christian

Published
2021
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14. Molecular and Clinicopathologic Characterization of Mismatch Repair-Deficient Endometrial Carcinoma Not Related to MLH1 Promoter Hypermethylation

Author

MS Radiotherapie, Cancer, Kaya, Merve, Post, Cathalijne C.B., Tops, Carli M., Nielsen, Maartje, Crosbie, Emma J., Leary, Alexandra, Mileshkin, Linda R., Han, Kathy, Bessette, Paul, de Boer, Stephanie M., Jürgenliemk-Schulz, Ina M., Lutgens, Ludy, Jobsen, Jan J., Haverkort, Marie A.D., Nout, Remi A., Kroep, Judith, Creutzberg, Carien L., Smit, Vincent T.H.B.M., Horeweg, Nanda, van Wezel, Tom, Bosse, Tjalling, MS Radiotherapie, Cancer, Kaya, Merve, Post, Cathalijne C.B., Tops, Carli M., Nielsen, Maartje, Crosbie, Emma J., Leary, Alexandra, Mileshkin, Linda R., Han, Kathy, Bessette, Paul, de Boer, Stephanie M., Jürgenliemk-Schulz, Ina M., Lutgens, Ludy, Jobsen, Jan J., Haverkort, Marie A.D., Nout, Remi A., Kroep, Judith, Creutzberg, Carien L., Smit, Vincent T.H.B.M., Horeweg, Nanda, van Wezel, Tom, and Bosse, Tjalling

Published
2024

15. Prognostic impact and causality of age on oncological outcomes in women with endometrial cancer: a multimethod analysis of the randomised PORTEC-1, PORTEC-2, and PORTEC-3 trials

Author

MS Radiotherapie, Cancer, Wakkerman, Famke C., Wu, Jiqing, Putter, Hein, Jürgenliemk-Schulz, Ina M., Jobsen, Jan J., Lutgens, Ludy C.H.W., Haverkort, Marie A.D., de Jong, Marianne A., Mens, Jan Willem M., Wortman, Bastiaan G., Nout, Remi A., Léon-Castillo, Alicia, Powell, Melanie E., Mileshkin, Linda R., Katsaros, Dionyssios, Alfieri, Joanne, Leary, Alexandra, Singh, Naveena, de Boer, Stephanie M., Nijman, Hans W., Smit, Vincent T.H.B.M., Bosse, Tjalling, Koelzer, Viktor H., Creutzberg, Carien L., Horeweg, Nanda, MS Radiotherapie, Cancer, Wakkerman, Famke C., Wu, Jiqing, Putter, Hein, Jürgenliemk-Schulz, Ina M., Jobsen, Jan J., Lutgens, Ludy C.H.W., Haverkort, Marie A.D., de Jong, Marianne A., Mens, Jan Willem M., Wortman, Bastiaan G., Nout, Remi A., Léon-Castillo, Alicia, Powell, Melanie E., Mileshkin, Linda R., Katsaros, Dionyssios, Alfieri, Joanne, Leary, Alexandra, Singh, Naveena, de Boer, Stephanie M., Nijman, Hans W., Smit, Vincent T.H.B.M., Bosse, Tjalling, Koelzer, Viktor H., Creutzberg, Carien L., and Horeweg, Nanda

Published
2024

16. Prediction of recurrence risk in endometrial cancer with multimodal deep learning

Author

Volinsky-Fremond, Sarah, Horeweg, Nanda, Andani, Sonali, Barkey Wolf, Jurriaan, Lafarge, Maxime W., de Kroon, Cor D., Ørtoft, Gitte, Høgdall, Estrid, Dijkstra, Jouke, Jobsen, Jan J., Lutgens, Ludy C.H.W., Powell, Melanie E., Mileshkin, Linda R., Mackay, Helen, Leary, Alexandra, Katsaros, Dionyssios, Nijman, Hans W., de Boer, Stephanie M., Nout, Remi A., de Bruyn, Marco, Church, David, Smit, Vincent T.H.B.M., Creutzberg, Carien L., Koelzer, Viktor H., Bosse, Tjalling, Volinsky-Fremond, Sarah, Horeweg, Nanda, Andani, Sonali, Barkey Wolf, Jurriaan, Lafarge, Maxime W., de Kroon, Cor D., Ørtoft, Gitte, Høgdall, Estrid, Dijkstra, Jouke, Jobsen, Jan J., Lutgens, Ludy C.H.W., Powell, Melanie E., Mileshkin, Linda R., Mackay, Helen, Leary, Alexandra, Katsaros, Dionyssios, Nijman, Hans W., de Boer, Stephanie M., Nout, Remi A., de Bruyn, Marco, Church, David, Smit, Vincent T.H.B.M., Creutzberg, Carien L., Koelzer, Viktor H., and Bosse, Tjalling

Abstract

Predicting distant recurrence of endometrial cancer (EC) is crucial for personalized adjuvant treatment. The current gold standard of combined pathological and molecular profiling is costly, hampering implementation. Here we developed HECTOR (histopathology-based endometrial cancer tailored outcome risk), a multimodal deep learning prognostic model using hematoxylin and eosin-stained, whole-slide images and tumor stage as input, on 2,072 patients from eight EC cohorts including the PORTEC-1/-2/-3 randomized trials. HECTOR demonstrated C-indices in internal (n = 353) and two external (n = 160 and n = 151) test sets of 0.789, 0.828 and 0.815, respectively, outperforming the current gold standard, and identified patients with markedly different outcomes (10-year distant recurrence-free probabilities of 97.0%, 77.7% and 58.1% for HECTOR low-, intermediate- and high-risk groups, respectively, by Kaplan–Meier analysis). HECTOR also predicted adjuvant chemotherapy benefit better than current methods. Morphological and genomic feature extraction identified correlates of HECTOR risk groups, some with therapeutic potential. HECTOR improves on the current gold standard and may help delivery of personalized treatment in EC.

Published
2024

17. Efficacy of a nurse-led sexual rehabilitation intervention for women with gynaecological cancers receiving radiotherapy: results of a randomised trial

Author

MS Radiotherapie, Cancer, Suvaal, Isabelle, Hummel, Susanna B., Mens, Jan Willem M., Tuijnman-Raasveld, Charlotte C., Tsonaka, Roula, Velema, Laura A., Westerveld, Henrike, Cnossen, Jeltsje S., Snyers, An, Jürgenliemk-Schulz, Ina M., Lutgens, Ludy C.H.W., Beukema, Jannet C., Haverkort, Marie A.D., Nowee, Marlies E., Nout, Remi A., de Kroon, Cor D., van den Hout, Wilbert B., Creutzberg, Carien L., van Doorn, Helena C., ter Kuile, Moniek M., MS Radiotherapie, Cancer, Suvaal, Isabelle, Hummel, Susanna B., Mens, Jan Willem M., Tuijnman-Raasveld, Charlotte C., Tsonaka, Roula, Velema, Laura A., Westerveld, Henrike, Cnossen, Jeltsje S., Snyers, An, Jürgenliemk-Schulz, Ina M., Lutgens, Ludy C.H.W., Beukema, Jannet C., Haverkort, Marie A.D., Nowee, Marlies E., Nout, Remi A., de Kroon, Cor D., van den Hout, Wilbert B., Creutzberg, Carien L., van Doorn, Helena C., and ter Kuile, Moniek M.

Published
2024

18. Efficacy of a nurse-led sexual rehabilitation intervention for women with gynaecological cancers receiving radiotherapy:results of a randomised trial

Author

Suvaal, Isabelle, Hummel, Susanna B., Mens, Jan Willem M., Tuijnman-Raasveld, Charlotte C., Tsonaka, Roula, Velema, Laura A., Westerveld, Henrike, Cnossen, Jeltsje S., Snyers, An, Jürgenliemk-Schulz, Ina M., Lutgens, Ludy C.H.W., Beukema, Jannet C., Haverkort, Marie A.D., Nowee, Marlies E., Nout, Remi A., de Kroon, Cor D., van den Hout, Wilbert B., Creutzberg, Carien L., van Doorn, Helena C., ter Kuile, Moniek M., Suvaal, Isabelle, Hummel, Susanna B., Mens, Jan Willem M., Tuijnman-Raasveld, Charlotte C., Tsonaka, Roula, Velema, Laura A., Westerveld, Henrike, Cnossen, Jeltsje S., Snyers, An, Jürgenliemk-Schulz, Ina M., Lutgens, Ludy C.H.W., Beukema, Jannet C., Haverkort, Marie A.D., Nowee, Marlies E., Nout, Remi A., de Kroon, Cor D., van den Hout, Wilbert B., Creutzberg, Carien L., van Doorn, Helena C., and ter Kuile, Moniek M.

Abstract

Background: The multicentre randomised SPARC trial evaluated the efficacy of a nurse-led sexual rehabilitation intervention on sexual functioning, distress, dilator use, and vaginal symptoms after radiotherapy for gynaecological cancers. Methods: Eligible women were randomised to the rehabilitation intervention or care-as-usual. Four intervention sessions were scheduled over 12 months, with concurrent validated questionnaires and clinical assessments. Primary outcome was the Female Sexual Function Index (FSFI). A generalised-mixed-effects model compared groups over time. Results: In total, 229 women were included (n = 112 intervention; n = 117 care-as-usual). No differences in FSFI total scores were found between groups at any timepoint (P = 0.37), with 12-month scores of 22.57 (intervention) versus 21.76 (care-as-usual). The intervention did not significantly improve dilator use, reduce sexual distress or vaginal symptoms compared to care-as-usual. At 12 months, both groups had minimal physician-reported vaginal stenosis; 70% of women were sexually active and reported no or mild vaginal symptoms. After radiotherapy and brachytherapy, 85% (intervention) versus 75% (care-as-usual) of participants reported dilation twice weekly. Discussion: Sexual rehabilitation for women treated with combined (chemo)radiotherapy and brachytherapy improved before and during the SPARC trial, which likely contributed to comparable study groups. Best practice involves a sexual rehabilitation appointment 1 month post-radiotherapy, including patient information, with dilator guidance, preferably by a trained nurse, and follow-up during the first year after treatment. Clinical trial registration: NCT03611517.

Published
2024

19. Age-Related Differences in Patient Preferences for Adjuvant Chemotherapy for High-Risk Endometrial Cancer

Author

Wakkerman, Famke C., primary, Post, Cathalijne C.B., additional, Mens, Jan-Willem M., additional, Jurgenliemk-Schulz, Ina, additional, Koppe, Friederike, additional, Haverkort, Marie A.D., additional, Roeloffzen, Ellen M.A., additional, Snyers, An, additional, de Jong, Marianne A.A., additional, Schaake, Eva E., additional, Beukema, Jannet C., additional, Cnossen, Jeltsje S., additional, Kiderlen, Mandy, additional, Lutgens, Ludy CHW, additional, Nijman, Hans W., additional, D de Kroon, Cornelis, additional, Kroep, Judith R., additional, Pieterse, Arwen H., additional, Creutzberg, Carien L., additional, and Horeweg, Nanda, additional

Published
2024
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21. HECTOR: multimodal deep learning predicts recurrence risk in endometrial cancer.

Author

Fremond-Volinsky, Sarah, primary, Horeweg, Nanda, additional, Andani, Sonali, additional, Barkey Wolf, Jurriaan, additional, Lafarge, Maxime W, additional, de Kroon, Cor, additional, Ortoft, Gitte, additional, Hogdall, Estrid, additional, Dijkstra, Jouke, additional, Jobsen, Jan J, additional, Lutgens, Ludy CHW, additional, Powell, Melanie E, additional, Mileshkin, Linda R, additional, Mackay, Helen, additional, Leary, Alexandra, additional, Katsaros, Dionyssios, additional, Nijman, Hans W, additional, de Boer, Stephanie M, additional, Nout, Remi A, additional, de Bruyn, Marco, additional, Church, David, additional, Smit, Vincent THBM, additional, Creutzberg, Carien L, additional, Koelzer, Viktor H, additional, and Bosse, Tjalling, additional

Published
2023
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22. Prognostic impact and causality of age on oncological outcomes in women with endometrial cancer: a multimethod analysis of the randomised PORTEC-1, -2 and -3 trials

Author

Wakkerman, Famke Charlotte, primary, Wu, Jiqing, additional, Putter, Hein, additional, Jurgenliemk-Schulz, Ina M., additional, Jobsen, Jan J., additional, Lutgens, Ludy C.H.W., additional, Haverkort, Marie A.D., additional, de Jong, Marianne, additional, Mens, Jan Willem M., additional, Wortman, Bastiaan G., additional, Nout, Remi A., additional, Leon-Castillo, Alicia, additional, Powell, Melanie E., additional, Mileshkin, Linda R., additional, Katsaros, Dionyssios, additional, Alfieri, Joanne, additional, Leary, Alexandra, additional, Singh, Naveena, additional, de Boer, Stephanie M., additional, Nijman, Hans W., additional, Smit, Vincent T.H.B.M., additional, Bosse, Tjalling, additional, Koelzer, Viktor H., additional, Creutzberg, Carien L., additional, and Horeweg, Nanda, additional

Published
2023
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23. Adjuvant chemoradiotherapy versus radiotherapy alone for women with high-risk endometrial cancer (PORTEC-3): final results of an international, open-label, multicentre, randomised, phase 3 trial

Author

McCormack, Mary, Whitmarsh, Karen, Allerton, Rozenn, Gregory, Deborah, Symonds, Paul, Hoskin, Peter J., Adusumalli, Madhavi, Anand, Anjana, Wade, Robert, Stewart, Alexandra, Taylor, Wendy, Kruitwagen, Roy F.P.M., Hollema, Harry, Pras, Elizabeth, Snyers, An, Stalpers, Lukas, Jobsen, Jan J., Slot, Annerie, Mens, Jan-Willem M., Stam, Tanja C., Van Triest, Baukelien, Van der Steen - Banasik, Elzbieta M., De Winter, Karin A.J., Quinn, Michael A., Kolodziej, Ilka, Pyman, Jan, Johnson, Carol, Capp, Anne, Fossati, Roldano, Gribaudo, Sergio, Lissoni, Andrea A., Ferrero, Annamaria, Artioli, Grazia, Davidson, Cathy, McLachlin, C. Meg, Ghatage, Prafull, Rittenberg, Paula V.C., Souhami, Luis, Thomas, Gillian, Duvillard, Pierre, Berton-Rigaud, Dominique, Tubiana-Mathieu, Nicole, de Boer, Stephanie M, Powell, Melanie E, Mileshkin, Linda, Katsaros, Dionyssios, Bessette, Paul, Haie-Meder, Christine, Ottevanger, Petronella B, Ledermann, Jonathan A, Khaw, Pearly, Colombo, Alessandro, Fyles, Anthony, Baron, Marie-Helene, Jürgenliemk-Schulz, Ina M, Kitchener, Henry C, Nijman, Hans W, Wilson, Godfrey, Brooks, Susan, Carinelli, Silvestro, Provencher, Diane, Hanzen, Chantal, Lutgens, Ludy C H W, Smit, Vincent T H B M, Singh, Naveena, Do, Viet, D'Amico, Romerai, Nout, Remi A, Feeney, Amanda, Verhoeven-Adema, Karen W, Putter, Hein, and Creutzberg, Carien L

Published
2018
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24. 919: Randomised trial of nurse-led sexual rehabilitation after radiotherapy for gynaecological cancers

Author

Suvaal, Isabelle, Hummel, Lisanne B., Mens, Jan-Willem M., Tuijnman-Raasveld, Charlotte C., Tsonaka, Roula, Velema, Laura A., Westerveld, Henrike, Cnossen, Jeltsje, Snyers, An, Jürgenliemk-Schulz, Ina M., Lutgens, Ludy C.H.W., Beukema, Jannet C., Haverkort, Dorien, Nowee, Marlies E., de Kroon, Cor D., van den Hout, Wilbert B., Creutzberg, Carien L., van Doorn, Lena E., and Kuile, Moniek M. ter

Published
2024
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25. 3408: Ten-year results of the PORTEC-3 trial: adjuvant therapy for women with high-risk endometrial cancer

Author

Post, Cathalijne C B, de Boer, Stephanie M., Powell, Melanie E., Mileshkin, Linda, Katsaros, Dionyssios, Bessette, Paul, Leary, Alexandra, Ottevanger, Nelleke P., McCormack, Mary, Khaw, Pearly, D’Amico, Romerai, Fyles, Anthony, Chargari, Cyrus, Kitchener, Henry C., Nijman, Hans W., Lutgens, Ludy, Jürgenliemk-Schulz, Ina M., Nout, Remi A., Putter, Hein, Horeweg, Nanda, Bosse, Tjalling, and Creutzberg, Carien L.

Published
2024
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26. Clinical Behavior and Molecular Landscape of Stage I p53-abnormal Low-Grade Endometrioid Endometrial Carcinomas

Author

Jamieson, Amy, primary, Vermij, Lisa, additional, Kramer, Claire J.H., additional, Jobsen, Jan J., additional, Jürgenliemk-Schulz, Ina, additional, Lutgens, Ludy, additional, Mens, Jan Willem, additional, Haverkort, Marie A.D., additional, Slot, Annerie, additional, Nout, Remi A., additional, Oosting, Jan, additional, Carlson, Joseph, additional, Howitt, Brooke E., additional, Ip, Philip P.C., additional, Lax, Sigurd F., additional, McCluggage, W. Glenn, additional, Singh, Naveena, additional, McAlpine, Jessica N., additional, Creutzberg, Carien L., additional, Horeweg, Nanda, additional, Gilks, C. Blake, additional, and Bosse, Tjalling, additional

Published
2023
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27. A unified strategy to focal brachytherapy incorporating transperineal biopsy, image fusion, and real-time implantation with and without rectal spacer simulated in prostate phantoms.

Author

Vanneste, Ben G. L., Skouteris, Basile, Pinheiro, Luis Campos, Voncken, Robert, Van Limbergen, Evert J., Lutgens, Ludy, Fonteyne, Valérie, Van Praet, Charles, Lumen, Nicolaas, Sheu, Rendi, Stock, Richard, and Stone, Nelson N.

Subjects
ENDORECTAL ultrasonography, LOW dose rate brachytherapy, IMAGE fusion, RADIOISOTOPE brachytherapy, PROSTATE cancer, PROSTATE, RETENTION of urine, MAGNETIC resonance imaging, BIOPSY
Abstract

Purpose: To develop an approach to the diagnosis and treatment of prostate cancer using one platform for fusion biopsy, followed by focal gland ablation utilizing permanent prostate brachytherapy with and without a rectal spacer. Material and methods: Prostate phantoms containing multiparametric magnetic resonance imaging (mpMRI) regions of interest (ROI) underwent fusion biopsy, followed by image co-registration of positive sites to a treatment planning brachytherapy program. A partial hemi-ablation and both posterior lobes using a Mick applicator and linked stranded seeds were simulated. Dummy sources were modeled as iodine-125 (125I) with a prescribed dose of at least 210 Gy to gross tumor (GTV) and clinical target volume (CTV), as defined by mpMRI visible ROI and surrounding negative biopsy sites. Computer tomograms (CT) were performed post-implant prior to and after rectal spacer insertion. Different prostate and rectal constraints were compared with and without the spacer. Results: The intra-operative focal volumes of CTV ranged from 6.2 to 14.9 cc (mean, 11.3 cc), and the ratio of focal volume/whole prostate volume ranged between 0.19 and 0.42 (mean, 0.31). The intra- and post-operative mean focal D90 of GTV, CTV, and for the entire prostate gland was 265 Gy and 235 Gy, 214 Gy and 213 Gy, and 66.1 Gy and 57 Gy, respectively. On average, 13 mm separation was achieved between the prostate and the rectum (range, 12-14 mm) on post-operative CT. The mean doses in Gy to 2 cc of the rectum (D2cc) without spacer vs. with spacer were 39.8 Gy vs. 32.6 Gy, respectively. Conclusions: Doses above 200 Gy and the implantation of seeds in clinically significant region for focal therapy in phantoms are feasible. All rectal dosimetric parameters improved for the spacer implants, as compared with the nonspacer implants. Further validation of this concept is warranted in clinical trials. [ABSTRACT FROM AUTHOR]

Published
2024
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28. QPOLE: A Quick, Simple, and Cheap Alternative for POLE Sequencing in Endometrial Cancer by Multiplex Genotyping Quantitative Polymerase Chain Reaction

Author

Van den Heerik, Anne Sophie V.M., primary, Ter Haar, Natalja T., additional, Vermij, Lisa, additional, Jobsen, Jan J., additional, Brinkhuis, Mariel, additional, Roothaan, Suzan M., additional, Leon-Castillo, Alicia, additional, Ortoft, Gitte, additional, Hogdall, Estrid, additional, Hogdall, Claus, additional, Van Wezel, Tom, additional, Lutgens, Ludy C.H.W., additional, Haverkort, Marie A.D., additional, Khattra, Jas, additional, McAlpine, Jessica N., additional, Creutzberg, Carien L., additional, Smit, Vincent T.H.B.M., additional, Gilks, C. Blake, additional, Horeweg, Nanda, additional, and Bosse, Tjalling, additional

Published
2023
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29. Abstract 5695: Deep learning risk prediction model of distant recurrence from H&E endometrial cancer slides

Author

Fremond, Sarah, primary, Andani, Sonali, additional, Wolf, Jurriaan Barkey, additional, Ørtoft, Gitte, additional, Høgdall, Estrid, additional, Dijkstra, Jouke, additional, Jobsen, Jan J., additional, Jürgenliemk-Schulz, Ina M., additional, Lutgens, Ludy CHW, additional, Powell, Melanie E., additional, Singh, Naveena, additional, Mileshkin, Linda R., additional, Mackay, Helen J., additional, Leary, Alexandra, additional, Katsaros, Dionyssios, additional, Nijman, Hans W., additional, de Boer, Stephanie M., additional, Nout, Remi A., additional, Smit, Vincent T.H.B.M, additional, Creutzberg, Carien L., additional, Horeweg, Nanda, additional, Koelzer, Viktor H., additional, and Bosse, Tjalling, additional

Published
2023
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30. Data from Prognostic Integrated Image-Based Immune and Molecular Profiling in Early-Stage Endometrial Cancer

Author

Horeweg, Nanda, primary, de Bruyn, Marco, primary, Nout, Remi A., primary, Stelloo, Ellen, primary, Kedzierska, Katarzyna, primary, León-Castillo, Alicia, primary, Plat, Annechien, primary, Mertz, Kirsten D., primary, Osse, Michelle, primary, Jürgenliemk-Schulz, Ina M., primary, Lutgens, Ludy C.H.W., primary, Jobsen, Jan J., primary, van der Steen-Banasik, Elzbieta M., primary, Smit, Vincent T., primary, Creutzberg, Carien L., primary, Bosse, Tjalling, primary, Nijman, Hans W., primary, Koelzer, Viktor H., primary, and Church, David N., primary

Published
2023
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31. Supplementary Data from Prognostic Integrated Image-Based Immune and Molecular Profiling in Early-Stage Endometrial Cancer

Author

Horeweg, Nanda, primary, de Bruyn, Marco, primary, Nout, Remi A., primary, Stelloo, Ellen, primary, Kedzierska, Katarzyna, primary, León-Castillo, Alicia, primary, Plat, Annechien, primary, Mertz, Kirsten D., primary, Osse, Michelle, primary, Jürgenliemk-Schulz, Ina M., primary, Lutgens, Ludy C.H.W., primary, Jobsen, Jan J., primary, van der Steen-Banasik, Elzbieta M., primary, Smit, Vincent T., primary, Creutzberg, Carien L., primary, Bosse, Tjalling, primary, Nijman, Hans W., primary, Koelzer, Viktor H., primary, and Church, David N., primary

Published
2023
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32. QPOLE:A Quick, Simple, and Cheap Alternative for POLE Sequencing in Endometrial Cancer by Multiplex Genotyping Quantitative Polymerase Chain Reaction

Author

Van den Heerik, Anne Sophie V.M., Ter Haar, Natalja T., Vermij, Lisa, Jobsen, Jan J., Brinkhuis, Mariel, Roothaan, Suzan M., Leon-Castillo, Alicia, Ortoft, Gitte, Hogdall, Estrid, Hogdall, Claus, Van Wezel, Tom, Lutgens, Ludy C.H.W., Haverkort, Marie A.D., Khattra, Jas, McAlpine, Jessica N., Creutzberg, Carien L., Smit, Vincent T.H.B.M., Gilks, C. Blake, Horeweg, Nanda, Bosse, Tjalling, Van den Heerik, Anne Sophie V.M., Ter Haar, Natalja T., Vermij, Lisa, Jobsen, Jan J., Brinkhuis, Mariel, Roothaan, Suzan M., Leon-Castillo, Alicia, Ortoft, Gitte, Hogdall, Estrid, Hogdall, Claus, Van Wezel, Tom, Lutgens, Ludy C.H.W., Haverkort, Marie A.D., Khattra, Jas, McAlpine, Jessica N., Creutzberg, Carien L., Smit, Vincent T.H.B.M., Gilks, C. Blake, Horeweg, Nanda, and Bosse, Tjalling

Abstract

PURPOSE: Detection of 11 pathogenic variants in the POLE gene in endometrial cancer (EC) is critically important to identify women with a good prognosis and reduce overtreatment. Currently, POLE status is determined by DNA sequencing, which can be expensive, relatively time-consuming, and unavailable in hospitals without specialized equipment and personnel. This may hamper the implementation of POLE-testing in clinical practice. To overcome this, we developed and validated a rapid, low-cost POLE hotspot test by a quantitative polymerase chain reaction (qPCR) assay, QPOLE. MATERIALS AND METHODS: Primer and fluorescence-labeled 5'-nuclease probe sequences of the 11 established pathogenic POLE mutations were designed. Three assays, QPOLE-frequent for the most common mutations and QPOLE-rare-1 and QPOLE-rare-2 for the rare variants, were developed and optimized using DNA extracted from formalin-fixed paraffin-embedded tumor tissues. The simplicity of the design enables POLE status assessment within 4-6 hours after DNA isolation. An interlaboratory external validation study was performed to determine the practical feasibility of this assay. RESULTS: Cutoffs for POLE wild-type, POLE-mutant, equivocal, and failed results were predefined on the basis of a subset of POLE mutants and POLE wild-types for the internal and external validation. For equivocal cases, additional DNA sequencing is recommended. Performance in 282 EC cases, of which 99 were POLE-mutated, demonstrated an overall accuracy of 98.6% (95% CI, 97.2 to 99.9), a sensitivity of 95.2% (95% CI, 90.7 to 99.8), and a specificity of 100%. After DNA sequencing of 8.8% equivocal cases, the final sensitivity and specificity were 96.0% (95% CI, 92.1 to 99.8) and 100%. External validation confirmed feasibility and accuracy. CONCLUSION: QPOLE is a qPCR assay that is a quick, simple, and reliable alternative for DNA sequencing. QPOLE detects all pathogenic variants in the exonuclease domain of the POLE gene. QPOLE will

Published
2023

33. Clinical Behavior and Molecular Landscape of Stage I p53-Abnormal Low-Grade Endometrioid Endometrial Carcinomas

Author

Jamieson, Amy, Vermij, Lisa, Kramer, Claire J.H., Jobsen, Jan J., Jürgemlienk-Schulz, Ina, Lutgens, Ludy, Mens, Jan Willem, Haverkort, Marie A.D., Slot, Annerie, Nout, Remi A., Oosting, Jan, Carlson, Joseph, Howitt, Brooke E., Ip, Philip P.C., Lax, Sigurd F., McCluggage, W. Glenn, Singh, Naveena, McAlpine, Jessica N., Creutzberg, Carien L., Horeweg, Nanda, Gilks, C. Blake, Bosse, Tjalling, Jamieson, Amy, Vermij, Lisa, Kramer, Claire J.H., Jobsen, Jan J., Jürgemlienk-Schulz, Ina, Lutgens, Ludy, Mens, Jan Willem, Haverkort, Marie A.D., Slot, Annerie, Nout, Remi A., Oosting, Jan, Carlson, Joseph, Howitt, Brooke E., Ip, Philip P.C., Lax, Sigurd F., McCluggage, W. Glenn, Singh, Naveena, McAlpine, Jessica N., Creutzberg, Carien L., Horeweg, Nanda, Gilks, C. Blake, and Bosse, Tjalling

Abstract

PURPOSE: The clinical significance of the p53-abnormal (p53abn) molecular subtype in stage I low-grade endometrioid endometrial carcinoma (EEC) is debated. We aimed to review pathologic and molecular characteristics, and outcomes of stage I low-grade p53abn EEC in a large international cohort. EXPERIMENTAL DESIGN: Previously diagnosed stage I p53abn EC (POLE-wild-type, mismatch repair-proficient) low-grade EEC from Canadian retrospective cohorts and PORTEC-1&2 trials were included. Pathology review was performed by six expert gynecologic pathologists blinded to p53 status. IHC profiling, next-generation sequencing, and shallow whole-genome sequencing was performed. Kaplan-Meier method was used for survival analysis. RESULTS: We identified 55 stage I p53abn low-grade EEC among 3,387 cases (2.5%). On pathology review, 17 cases (31%) were not diagnosed as low-grade EEC by any pathologists, whereas 26 cases (47%) were diagnosed as low-grade EEC by at least three pathologists. The IHC and molecular profile of the latter cases were consistent with low-grade EEC morphology (ER/PR positivity, patchy p16 expression, PIK3CA and PTEN mutations) but they also showed features of p53abn EC (TP53 mutations, many copy-number alterations). These cases had a clinically relevant risk of disease recurrence (5-year recurrence-free survival 77%), with pelvic and/or distant recurrences observed in 12% of the patients. CONCLUSIONS:A subset of p53abn EC is morphologically low-grade EEC and exhibit genomic instability. Even for stage I disease, p53abn low-grade EEC are at substantial risk of disease recurrence. These findings highlight the clinical relevance of universal p53-testing, even in low-grade EEC, to identify women at increased risk of recurrence.

Published
2023

34. Clinical Behavior and Molecular Landscape of Stage I p53-Abnormal Low-Grade Endometrioid Endometrial Carcinomas

Author

MS Radiotherapie, Cancer, Jamieson, Amy, Vermij, Lisa, Kramer, Claire J H, Jobsen, Jan J, Jürgemlienk-Schulz, Ina, Lutgens, Ludy, Mens, Jan Willem, Haverkort, Marie A D, Slot, Annerie, Nout, Remi A, Oosting, Jan, Carlson, Joseph, Howitt, Brooke E, Ip, Philip P C, Lax, Sigurd F, McCluggage, W Glenn, Singh, Naveena, McAlpine, Jessica N, Creutzberg, Carien L, Horeweg, Nanda, Gilks, C Blake, Bosse, Tjalling, MS Radiotherapie, Cancer, Jamieson, Amy, Vermij, Lisa, Kramer, Claire J H, Jobsen, Jan J, Jürgemlienk-Schulz, Ina, Lutgens, Ludy, Mens, Jan Willem, Haverkort, Marie A D, Slot, Annerie, Nout, Remi A, Oosting, Jan, Carlson, Joseph, Howitt, Brooke E, Ip, Philip P C, Lax, Sigurd F, McCluggage, W Glenn, Singh, Naveena, McAlpine, Jessica N, Creutzberg, Carien L, Horeweg, Nanda, Gilks, C Blake, and Bosse, Tjalling

Published
2023

35. Interpretable deep learning model to predict the molecular classification of endometrial cancer from haematoxylin and eosin-stained whole-slide images: a combined analysis of the PORTEC randomised trials and clinical cohorts

Author

MS Radiotherapie, Cancer, Fremond, Sarah, Andani, Sonali, Barkey Wolf, Jurriaan, Dijkstra, Jouke, Melsbach, Sinéad, Jobsen, Jan J., Brinkhuis, Mariel, Roothaan, Suzan, Jurgenliemk-Schulz, Ina, Lutgens, Ludy C.H.W., Nout, Remi A., van der Steen-Banasik, Elzbieta M., de Boer, Stephanie M., Powell, Melanie E., Singh, Naveena, Mileshkin, Linda R., Mackay, Helen J., Leary, Alexandra, Nijman, Hans W., Smit, Vincent T.H.B.M., Creutzberg, Carien L., Horeweg, Nanda, Koelzer, Viktor H., Bosse, Tjalling, MS Radiotherapie, Cancer, Fremond, Sarah, Andani, Sonali, Barkey Wolf, Jurriaan, Dijkstra, Jouke, Melsbach, Sinéad, Jobsen, Jan J., Brinkhuis, Mariel, Roothaan, Suzan, Jurgenliemk-Schulz, Ina, Lutgens, Ludy C.H.W., Nout, Remi A., van der Steen-Banasik, Elzbieta M., de Boer, Stephanie M., Powell, Melanie E., Singh, Naveena, Mileshkin, Linda R., Mackay, Helen J., Leary, Alexandra, Nijman, Hans W., Smit, Vincent T.H.B.M., Creutzberg, Carien L., Horeweg, Nanda, Koelzer, Viktor H., and Bosse, Tjalling

Published
2023

37. Supplementary Table S5 from Improved Risk Assessment by Integrating Molecular and Clinicopathological Factors in Early-stage Endometrial Cancer—Combined Analysis of the PORTEC Cohorts

Author

Stelloo, Ellen, primary, Nout, Remi A., primary, Osse, Elisabeth M., primary, Jürgenliemk-Schulz, Ina J., primary, Jobsen, Jan J., primary, Lutgens, Ludy C., primary, van der Steen-Banasik, Elzbieta M., primary, Nijman, Hans W., primary, Putter, Hein, primary, Bosse, Tjalling, primary, Creutzberg, Carien L., primary, and Smit, Vincent T.H.B.M., primary

Published
2023
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39. Evaluation of hyaluronic acid gel dissolution with hyaluronidase in an in-vitro prostate cancer model

Author

Vanneste, Ben G L, Lutgens, Ludy, Van Limbergen, Evert J, Radiotherapie, RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, and MUMC+: MA Radiotherapie OC (9)

Subjects
Medical physics. Medical radiology. Nuclear medicine, In-vitro, Oncology, Hyaluronic acid, R895-920, Technical Note, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Hyaluronidase, Radiology, Nuclear Medicine and imaging, Prostate cancer radiotherapy, INJECTION, RC254-282, Rectum spacer
Abstract

Highlights • Hyaluronic acid (HA) is an implantable rectum spacer used to decrease rectal radiation dose in prostate cancer radiotherapy. • Hyaluronidase (HAS) is an enzyme that degrades HA, when wrongly positioned. • A ratio of HA:HAS of 1:2 has already a decrease of half of volume on the 2nd day., Aim To determine a dose response relationship of disintegration of a hyaluronic acid (HA) and hyaluronidase (HAS) used in prostate cancer radiotherapy. Materials and methods Five in-vitro models are applicated with 3 ml (ml) HA. For dissolution varying doses of HAS were used: 6 ml, 3 ml, 1.5 ml, and 0 ml. One ml contains 150 International Units (IU). Each HAS was added with saline till the complementary amount of 6 ml. One phantom was solely implanted with a HA 3 ml acting as a control. Length, width and height were measured on different time points: 1st day 4 times, 2nd day 3 times, third day 2 times, and then once daily during one week, with a final measurement 2 weeks after implantation. The experiments were performed in duplicate to exclude variations and confirm the results. Results The fastest dissolution was observed with the highest concentration of HAS, already observed at the first time point 2 h after implantation, with volume decrease of 50% on the second day, and less than 1 ml residue (33%) on day 4. The 2 other concentrations of HAS also showed a volume decrease, with less than 2 ml (66%) on day 4. All the applied quantities of HAS are observed with a residue of less than 1 ml after 7 days. After 14 days the control phantom and the saline filled one remains on steady state volume (3 ml). Conclusions A dose response was observed by HAS injection: highest volumes of HAS dissolute most swiftly. Using a ratio of HA:HAS of 1:2 results in a decrease to half of initial volume within 24 h. This is of special interest when used in clinical practice following erroneous positioning, and dissolution is urgently needed.

Published
2022

40. 2022-RA-925-ESGO Development of adjuvant treatment decision support tool for endometrial cancer patients by pooled analysis of data from 2000 women included in the PORTEC-1–3 trials and a prospective cohort study

Author

Vermij, Lisa, primary, Putter, Hein, additional, Jobsen, Jan, additional, Powell, Melanie, additional, de Boer, Stephanie, additional, Leary, Alexandra, additional, Bessette, Paul, additional, Mileshkin, Linda, additional, Lutgens, Ludy, additional, Jürgenliemk-Schulz, Ina, additional, Slot, Annerie, additional, van der Steen-Banasik, Elzbieta, additional, Nout, Remi, additional, Smit, Vincent, additional, Steyerberg, Ewout, additional, Creutzberg, Carien, additional, Bosse, Tjalling, additional, and Horeweg, Nanda, additional

Published
2022
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41. 2022-RA-825-ESGO The impact of age on prognosis in women with endometrial cancer: a pooled analysis of the PORTEC-1, -2 and -3 randomised trials

Author

Wakkerman, Famke Charlotte, primary, De Boer, Stephanie M, additional, Powell, Melanie E, additional, Leary, Alexandra, additional, Fyles, Anthony, additional, Mileshkin, Linda R, additional, Singh, Naveena, additional, Nout, Remi A, additional, Jürgenliemk-Schulz, Ina M, additional, Jobsen, Jan J, additional, Lutgens, Ludy CHW, additional, van der Steen-Banasik, Elsbieta M, additional, Mens, Jan-Willem M, additional, Slot, Annerie, additional, Nijman, Hans W, additional, Smit, Vincent THBM, additional, Bosse, Tjalling, additional, Creutzberg, Carien L, additional, and Horeweg, Nanda, additional

Published
2022
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42. 2022-RA-450-ESGO Benefit of adjuvant radiotherapy depends on molecular class of early-stage endometrial cancer

Author

Horeweg, Nanda, primary, Nout, Remi A, additional, Stelloo, Ellen, additional, Lutgens, Ludy CHW, additional, Jobsen, Jan J, additional, Jürgenliemk-Schulz, Ina M, additional, van der Steen-Banasik, Elsbieta M, additional, Mens, Jan-Willem M, additional, Slot, Annerie, additional, Smit, Vincent THBM, additional, Bosse, Tjalling, additional, and Creutzberg, Carien L, additional

Published
2022
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43. 2022-RA-809-ESGO Underlying causes and prognosis of mismatch repair deficiency in endometrial cancer other thanMLH1promoter hypermethylation

Author

Kaya, Merve, primary, Post, Cathalijne, additional, Tops, Carli M, additional, Stelloo, Ellen, additional, Nielsen, Maartje, additional, Powell, Melanie E, additional, Leary, Alexandra, additional, Mileshkin, Linda R, additional, Bessette, Paul, additional, de Boer, Stephanie M, additional, Jürgenliemk-Schulz, Ina M, additional, Lutgens, Ludy, additional, Jobsen, Jan J, additional, van der Steen-Banasik, Elzbieta M, additional, Nout, Remi A, additional, Horeweg, Nanda, additional, van Wezel, Tom, additional, Smit, Vincent, additional, Creutzberg, Carien L, additional, and Bosse, Tjalling, additional

Published
2022
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44. 2022-RA-648-ESGO Interpretable deep learning provides clues for prognostic refinement of the molecular endometrial cancer classification

Author

Fremond, Sarah, primary, Andani, Sonali, additional, Wolf, Jurriaan Barkey, additional, Dijkstra, Jouke, additional, Jobsen, Jan, additional, Jürgenliemk-Schulz, Ina, additional, Lutgens, Ludy, additional, Nout, Remi, additional, van der Steen-Banasik, Elzbieta, additional, de Boer, Stephanie, additional, Powell, Melanie, additional, Singh, Naveena, additional, Mileshkin, Linda, additional, Mackay, Helen, additional, Leary, Alexandra, additional, Nijman, Hans, additional, Creutzberg, Carien, additional, Horeweg, Nanda, additional, Koelzer, Viktor Hendrik, additional, and Bosse, Tjalling, additional

Published
2022
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45. Molecular Classification Predicts Response to Radiotherapy in the Randomized PORTEC-1 and PORTEC-2 Trials for Early-Stage Endometrioid Endometrial Cancer.

Author

Horeweg, Nanda, Nout, Remi A., Jürgenliemk-Schulz, Ina M., Lutgens, Ludy C.H.W., Jobsen, Jan J., Haverkort, Marie A.D., Mens, Jan Willem M., Slot, Annerie, Wortman, Bastiaan G., de Boer, Stephanie M., Stelloo, Ellen, Verhoeven-Adema, Karen W., Putter, Hein, Smit, Vincent T.H.B.M., Bosse, Tjalling, Creutzberg, Carien L., Creutzberg, C.L., Koper, P.C.M., van Putten, W.L.J., and Dercksen, R.

Published
2023
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46. Defining Substantial Lymphovascular Space Invasion in Endometrial Cancer

Author

Peters, Elke E.M., León-Castillo, Alicia, Smit, Vincent T.H.B.M., Boennelycke, Marie, Hogdall, Estrid, Hogdall, Claus, Creutzberg, Carien, Jürgenliemk-Schulz, Ina M., Jobsen, Jan J., Mens, Jan Willem M., Lutgens, Ludy C.H.W., Van Der Steen-Banasik, Elzbieta M., Ortoft, Gitte, Bosse, Tjalling, Nout, Remi, Peters, Elke E.M., León-Castillo, Alicia, Smit, Vincent T.H.B.M., Boennelycke, Marie, Hogdall, Estrid, Hogdall, Claus, Creutzberg, Carien, Jürgenliemk-Schulz, Ina M., Jobsen, Jan J., Mens, Jan Willem M., Lutgens, Ludy C.H.W., Van Der Steen-Banasik, Elzbieta M., Ortoft, Gitte, Bosse, Tjalling, and Nout, Remi

Abstract

Lymphovascular space invasion (LVSI) occurs in a minority of endometrial cancer (EC) cases, and the extent of LVSI is an important risk factor for recurrence and/or metastases. Our aim was to improve the reproducibility of measuring clinically meaningful LVSI by performing a quantitative analysis of the correlation between LVSI and the risk of pelvic lymph node recurrence in EC. EC samples from PORTEC-1 and PORTEC-2 trials were retrieved and used to collect quantitative data, including the number of LVSI-positive vessels per H&E-stained slide. Using a predefined threshold for clinical relevance, the risk of pelvic lymph node recurrence risk was calculated (Kaplan-Meier method, with Cox regression) using a stepwise adjustment for the number of LVSI-positive vessels. This analysis was then repeated in the Danish Gynecological Cancer Database (DGCD) cohort. Among patients in PORTEC-1 and PORTEC-2 trials who did not receive external beam radiotherapy, the 5-yr pelvic lymph node recurrence risk was 3.3%, 6.7% (P=0.51), and 26.3% (P<0.001), respectively when 0, 1 to 3, or ≥4 vessels had LVSI involvement; similar results were obtained for the DGCD cohort. Furthermore, both the average number of tumor cells in the largest embolus and the number of LVSI-positive H&E slides differed significantly between focal LVSI and substantial LVSI. On the basis of these results, we propose a numeric threshold (≥4 LVSI-involved vessels in at least one H&E slide) for defining clinically relevant LVSI in EC, thereby adding supportive data to the semiquantitative approach. This will help guide gynecologic pathologists to differentiate between focal and substantial LVSI, especially in borderline cases.

Published
2022

47. Radiation Therapy Techniques and Treatment-Related Toxicity in the PORTEC-3 Trial:Comparison of 3-Dimensional Conformal Radiation Therapy Versus Intensity-Modulated Radiation Therapy

Author

Wortman, Bastiaan G., Post, Cathalijne C. B., Powell, Melanie E., Khaw, Pearly, Fyles, Anthony, D'Amico, Romerai, Haie-Meder, Christine, Jurgenliemk-Schulz, Ina M., McCormack, Mary, Do, Viet, Katsaros, Dionyssios, Bessette, Paul, Baron, Marie Helene, Nout, Remi A., Whitmarsh, Karen, Mileshkin, Linda, Lutgens, Ludy C. H. W., Kitchener, Henry C., Brooks, Susan, Nijman, Hans W., Astreinidou, Eleftheria, Putter, Hein, Creutzberg, Carien L., de Boer, Stephanie M., Wortman, Bastiaan G., Post, Cathalijne C. B., Powell, Melanie E., Khaw, Pearly, Fyles, Anthony, D'Amico, Romerai, Haie-Meder, Christine, Jurgenliemk-Schulz, Ina M., McCormack, Mary, Do, Viet, Katsaros, Dionyssios, Bessette, Paul, Baron, Marie Helene, Nout, Remi A., Whitmarsh, Karen, Mileshkin, Linda, Lutgens, Ludy C. H. W., Kitchener, Henry C., Brooks, Susan, Nijman, Hans W., Astreinidou, Eleftheria, Putter, Hein, Creutzberg, Carien L., and de Boer, Stephanie M.

Abstract

Purpose: Radiation therapy techniques have developed from 3-dimensional conformal radiation therapy (3DCRT) to intensity modulated radiation therapy (IMRT), with better sparing of the surrounding normal tissues. The current analysis aimed to investigate whether IMRT, compared to 3DCRT, resulted in fewer adverse events (AEs) and patient-reported symptoms in the randomized PORTEC-3 trial for high-risk endometrial cancer. Methods and Materials: Data on AEs and patient-reported quality of life (QoL) of the PORTEC-3 trial were available for analysis. Physician-reported AEs were graded using Common Terminology Criteria for Adverse Events v3.0. QoL was assessed by the European Organisation for Research and Treatment of Cancer QLQC30, CX24, and OV28 questionnaires. Data were compared between 3DCRT and IMRT. A P value of ≤ .01 was considered statistically significant due to the risk of multiple testing. For QoL, combined scores 1 to 2 (“not at all” and “a little”) versus 3 to 4 (“quite a bit” and “very much”) were compared between the techniques. Results: Of 658 evaluable patients, 559 received 3DCRT and 99 IMRT. Median follow-up was 74.6 months. During treatment no significant differences were observed, with a trend for more grade ≥3 AEs, mostly hematologic and gastrointestinal, after 3DCRT (37.7% vs 26.3%, P = .03). During follow-up, 15.4% (vs 4%) had grade ≥2 diarrhea, and 26.1% (vs 13.1%) had grade ≥2 hematologic AEs after 3DCRT (vs IMRT) (both P < .01). Among 574 (87%) patients evaluable for QoL, 494 received 3DCRT and 80 IMRT. During treatment, 37.5% (vs 28.6%) reported diarrhea after 3DCRT (vs IMRT) (P = .125); 22.1% (versus 10.0%) bowel urgency (P = 0039), and 18.2% and 8.6% abdominal cramps (P = .058). Other QoL scores showed no differences. Conclusions: IMRT resulted in fewer grade ≥3 AEs during treatment and significantly lower rates of grade ≥2 diarrhea and hematologic AEs during follow-up. Trends toward fewer patient-reported bowel urgency and abdominal cr

Published
2022

48. Defining Substantial Lymphovascular Space Invasion in Endometrial Cancer

Author

MS Radiotherapie, Cancer, Peters, Elke E.M., León-Castillo, Alicia, Smit, Vincent T.H.B.M., Boennelycke, Marie, Hogdall, Estrid, Hogdall, Claus, Creutzberg, Carien, Jürgenliemk-Schulz, Ina M., Jobsen, Jan J., Mens, Jan Willem M., Lutgens, Ludy C.H.W., Van Der Steen-Banasik, Elzbieta M., Ortoft, Gitte, Bosse, Tjalling, Nout, Remi, MS Radiotherapie, Cancer, Peters, Elke E.M., León-Castillo, Alicia, Smit, Vincent T.H.B.M., Boennelycke, Marie, Hogdall, Estrid, Hogdall, Claus, Creutzberg, Carien, Jürgenliemk-Schulz, Ina M., Jobsen, Jan J., Mens, Jan Willem M., Lutgens, Ludy C.H.W., Van Der Steen-Banasik, Elzbieta M., Ortoft, Gitte, Bosse, Tjalling, and Nout, Remi

Published
2022

49. Radiation Therapy Techniques and Treatment-Related Toxicity in the PORTEC-3 Trial: Comparison of 3-Dimensional Conformal Radiation Therapy Versus Intensity-Modulated Radiation Therapy

Author

MS Radiotherapie, Cancer, Wortman, Bastiaan G., Post, Cathalijne C.B., Powell, Melanie E., Khaw, Pearly, Fyles, Anthony, D'Amico, Romerai, Haie-Meder, Christine, Jürgenliemk-Schulz, Ina M., McCormack, Mary, Do, Viet, Katsaros, Dionyssios, Bessette, Paul, Baron, Marie Hélène, Nout, Remi A., Whitmarsh, Karen, Mileshkin, Linda, Lutgens, Ludy C.H.W., Kitchener, Henry C., Brooks, Susan, Nijman, Hans W., Astreinidou, Eleftheria, Putter, Hein, Creutzberg, Carien L., de Boer, Stephanie M., MS Radiotherapie, Cancer, Wortman, Bastiaan G., Post, Cathalijne C.B., Powell, Melanie E., Khaw, Pearly, Fyles, Anthony, D'Amico, Romerai, Haie-Meder, Christine, Jürgenliemk-Schulz, Ina M., McCormack, Mary, Do, Viet, Katsaros, Dionyssios, Bessette, Paul, Baron, Marie Hélène, Nout, Remi A., Whitmarsh, Karen, Mileshkin, Linda, Lutgens, Ludy C.H.W., Kitchener, Henry C., Brooks, Susan, Nijman, Hans W., Astreinidou, Eleftheria, Putter, Hein, Creutzberg, Carien L., and de Boer, Stephanie M.

Published
2022

50. Risk Factors for Late Persistent Fatigue After Chemoradiotherapy in Patients With Locally Advanced Cervical Cancer: An Analysis From the EMBRACE-I Study

Author

MS Radiotherapie, Cancer, Smet, Stéphanie, Spampinato, Sofia, Pötter, Richard, Jürgenliemk-Schulz, Ina M., Nout, Remi A., Chargari, Cyrus, Mahantshetty, Umesh, Sturdza, Alina, Segedin, Barbara, Bruheim, Kjersti, Hoskin, Peter, Rai, Bhavana, Huang, Fleur, Cooper, Rachel, Van der Steen-Banasik, Elzbieta, Sundset, Marit, Van Limbergen, Erik, Tan, Li Tee, Lutgens, Ludy C.H.W., Villafranca, Elena, Pieters, Bradley R., Tanderup, Kari, Kirchheiner, Kathrin, MS Radiotherapie, Cancer, Smet, Stéphanie, Spampinato, Sofia, Pötter, Richard, Jürgenliemk-Schulz, Ina M., Nout, Remi A., Chargari, Cyrus, Mahantshetty, Umesh, Sturdza, Alina, Segedin, Barbara, Bruheim, Kjersti, Hoskin, Peter, Rai, Bhavana, Huang, Fleur, Cooper, Rachel, Van der Steen-Banasik, Elzbieta, Sundset, Marit, Van Limbergen, Erik, Tan, Li Tee, Lutgens, Ludy C.H.W., Villafranca, Elena, Pieters, Bradley R., Tanderup, Kari, and Kirchheiner, Kathrin

Published
2022

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