125 results on '"Plaisier PW"'
Search Results
2. Preoperative breast MRI in management of patients with needle biopsy-proven ductal carcinoma in situ (DCIS)
- Author
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Bekkum, S, ter Braak, BPM, Plaisier, PW, van Rosmalen, Joost, Menke-Pluijmers, MB, Westenend, PJ, Bekkum, S, ter Braak, BPM, Plaisier, PW, van Rosmalen, Joost, Menke-Pluijmers, MB, and Westenend, PJ
- Published
- 2020
3. Stage-specific disease recurrence and survival in localized and regionally advanced cutaneous melanoma
- Author
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Leeneman, Brenda, Franken, Margreet, Coupe, VMH, Hendriks, MP, Kruit, Wim, Plaisier, PW, van Ruth, S, Verstijnen, J, Wouters, M, Blommestein, Hedwig, Groot, Carin, Leeneman, Brenda, Franken, Margreet, Coupe, VMH, Hendriks, MP, Kruit, Wim, Plaisier, PW, van Ruth, S, Verstijnen, J, Wouters, M, Blommestein, Hedwig, and Groot, Carin
- Published
- 2019
4. Laparoscopic peritoneal lavage or sigmoidectomy for perforated diverticulitis with purulent peritonitis: a multicentre, parallel-group, randomised, open-label trial
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Vennix, S, Musters, Gd, Mulder, Im, Swank, Ha, Consten, Ec, Belgers, Eh, van Geloven AA, Gerhards, Mf, Govaert, Mj, van Grevenstein WM, Hoofwijk, Ag, Kruyt, Pm, Nienhuijs, Sw, Boermeester, Ma, Vermeulen, J, van Dieren, S, Lange, Jf, Bemelman, Wa, Collaborators (138) Hop WC, Ladies trial colloborators., Opmeer, Bc, Reitsma, Jb, Scholte, Ra, Waltmann, Ew, Legemate, Da, Bartelsman, Jf, Meijer, Dw, de Brouwer, M, van Dalen, J, Durbridge, M, Geerdink, M, Ilbrink, Gj, Mehmedovic, S, Middelhoek, P, Boom, Mj, van der Bilt JD, van Olden GD, Stam, Ma, Verweij, Ms, Busch, Or, Buskens, Cj, El-Massoudi, Y, Kluit, Ab, van Rossem CC, Schijven, Mp, Tanis, Pj, Unlu, C, Karsten, Tm, de Nes LC, Rijna, H, van Wagensveld BA, Koffeman, Gi, Steller, Ep, Tuynman, Jb, Bruin, Sc, van der Peet DL, Blanken-Peeters, Cf, Cense, Ha, Jutte, E, Crolla, Rm, van der Schelling GP, van Zeeland, M, de Graaf EJ, Groenendijk, Rp, Vermaas, M, Schouten, O, de Vries MR, Prins, Ha, Lips, Dj, Bosker, Rj, van der Hoeven JA, Diks, J, Plaisier, Pw, Sietses, C, Stommel, Mw, de Hingh IH, Luyer, Md, van Montfort, G, Ponten, Eh, Smulders, Jf, van Duyn EB, Klaase, Jm, Swank, Dj, Ottow, Rt, Stockmann, Hb, Vuylsteke, Jc, Belgers, Hj, Fransen, S, von Meijenfeldt EM, Sosef, Mn, Hendriks, Er, ter Horst, B, Leeuwenburgh, Mm, van Ruler, O, Vogten, Jm, Vriens, Ej, Westerterp, M, Eijsbouts, Qa, Bentohami, A, Bijlsma, Ts, de Korte, N, Nio, D, Joosten, Jj, Tollenaar, Ra, Stassen, Lp, Wiezer, Mj, Hazebroek, Ej, Smits, Ab, van Westreenen HL, Brandt, A, Nijboer, Wn, Toorenvliet, Br, Weidema, Wf, Coene, Pp, Mannaerts, Gh, den Hartog, D, de Vos RJ, Zengerink, Jf, Hulsewé, Kw, Melenhorst, J, Stoot, Jh, Steup, Wh, Huijstee, Pj, Merkus, Jw, Wever, Jj, Maring, Jk, Heisterkamp, J, Vriens, Mr, Besselink, Mg, Borel Rinkes IH, Witkamp, Aj, Slooter, Gd, Konsten, Jl, Engel, Af, Pierik, Eg, Frakking, Tg, van Geldere, D, Patijn, Ga, D'Hoore, Aj, de Buck van Overstraeten, A, Miserez, M, Terrasson, I, Wolthuis, A, Di Saverio, S, De Blasiis, Mg., Surgery, Immunology, Other departments, AII - Amsterdam institute for Infection and Immunity, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, APH - Amsterdam Public Health, Clinical Research Unit, ACS - Amsterdam Cardiovascular Sciences, 02 Surgical specialisms, Gastroenterology and Hepatology, Graduate School, and CCA -Cancer Center Amsterdam
- Subjects
Male ,medicine.medical_specialty ,Colon ,Sigmoid ,Peritonitis ,Research Support ,law.invention ,Diverticulitis, Colonic ,Stoma ,Colonic ,Sigmoidectomy ,Randomized controlled trial ,law ,Colon, Sigmoid ,Journal Article ,medicine ,Clinical endpoint ,Humans ,Comparative Study ,Peritoneal Lavage ,Non-U.S. Gov't ,Laparoscopy ,Diverticulitis ,medicine.diagnostic_test ,business.industry ,Research Support, Non-U.S. Gov't ,Sigmoidoscopy ,General Medicine ,Middle Aged ,medicine.disease ,Surgery ,Multicenter Study ,Treatment Outcome ,Reconstructive and regenerative medicine Radboud Institute for Molecular Life Sciences [Radboudumc 10] ,Intestinal Perforation ,Randomized Controlled Trial ,Female ,business - Abstract
Item does not contain fulltext BACKGROUND: Case series suggest that laparoscopic peritoneal lavage might be a promising alternative to sigmoidectomy in patients with perforated diverticulitis. We aimed to assess the superiority of laparoscopic lavage compared with sigmoidectomy in patients with purulent perforated diverticulitis, with respect to overall long-term morbidity and mortality. METHODS: We did a multicentre, parallel-group, randomised, open-label trial in 34 teaching hospitals and eight academic hospitals in Belgium, Italy, and the Netherlands (the Ladies trial). The Ladies trial is split into two groups: the LOLA group comparing laparoscopic lavage with sigmoidectomy and the DIVA group comparing Hartmann's procedure with sigmoidectomy plus primary anastomosis. The DIVA section of this trial is still underway but here we report the results of the LOLA section. Patients with purulent perforated diverticulitis were enrolled for LOLA, excluding patients with faecal peritonitis, aged older than 85 years, with high-dose steroid use (>/=20 mg daily), and haemodynamic instability. Patients were randomly assigned (2:1:1; stratified by age [/=60 years]) using secure online computer randomisation to laparoscopic lavage, Hartmann's procedure, or primary anastomosis in a parallel design after diagnostic laparoscopy. Patients were analysed according to a modified intention-to-treat principle and were followed up after the index operation at least once in the outpatient setting and after sigmoidoscopy and stoma reversal, according to local protocols. The primary endpoint was a composite endpoint of major morbidity and mortality within 12 months. This trial is registered with ClinicalTrials.gov, number NCT01317485. FINDINGS: Between July 1, 2010, and Feb 22, 2013, 90 patients were randomly assigned in the LOLA section of the Ladies trial when the study was terminated by the data and safety monitoring board because of an increased event rate in the lavage group. Two patients were excluded for protocol violations. The primary endpoint occurred in 30 (67%) of 45 patients in the lavage group and 25 (60%) of 42 patients in the sigmoidectomy group (odds ratio 1.28, 95% CI 0.54-3.03, p=0.58). By 12 months, four patients had died after lavage and six patients had died after sigmoidectomy (p=0.43). INTERPRETATION: Laparoscopic lavage is not superior to sigmoidectomy for the treatment of purulent perforated diverticulitis. FUNDING: Netherlands Organisation for Health Research and Development.
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- 2015
5. Operation Compared with Watchful Waiting in Elderly Male Inguinal Hernia Patients: A Review and Data Analysis INCA Trialists Collaboration
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Wijsmuller, Arthur, Ramshorst, GH, Bosch, Joke, Hunink, Myriam, Kleinrensink, Gert-jan, Jeekel, J (Hans), Lange, Johan, Berendes, T, Boelens, O, Bouvy, N, van den Broek, RWFR, Burger, PJW, Dawson, Imro, Deelman, T, van Erp, WFM, van Geffen, EV, Go, P, van Goor, H, de Haan, J, Haers, P, Halm, Jens, van der Harst, E (Erwin), Heres, P, Hompes, D, van den Hout, N, Juttmann, JW, van Kempen, Bob, Keyzer-Dekker, CMG, Knook, M, Lange, Don, Lont, HE (Harold), Mastboom, W, Miserez, M, Mulier, K, de Muynck, RJ, Oomen, J, Oostenbroek, RJ, Postema, RR, Poyck, PPC, Plaisier, PW, Rath, HJ, Rakic, S, de Rooij, PD, Roumen, R, Ruurda, J, Scheltinga, M, Schoenmaeckers, EJP, Schmitz, R, Schreurs, HWH, Schreinemacher, M, Simons, MP, Smulders, F, Susa, D, Staal, E, Stigter, H, Swank, D, Ugahary, F, Verbeek, P, Wijffels, R, Zijsling, B, Surgery, Radiology & Nuclear Medicine, Neurosciences, Pathology, Pediatric Surgery, and Internal Medicine
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- 2011
6. Suppose a mammary carcinoma is absent from the surgical specimen
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Kuipers, IM, Oostenbroek, RJ, Storm, RK (Remmert), Pluijmers, MBE, Westenend, PJ (Pieter), Plaisier, PW, Erasmus MC other, Surgery, Pathology, and Internal Medicine
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- 2009
7. Critical limb ischemia after accidental subcutaneous infusion of sulprostone
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Plaisier Pw, Fred K. Lotgering, I.Leng Tan, and Yvonne W.C.M. de Koning
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Adult ,Fetal Membranes, Premature Rupture ,medicine.medical_specialty ,Vasodilator Agents ,medicine.medical_treatment ,Ischemia ,Dinoprostone ,chemistry.chemical_compound ,Obstetric Labor, Premature ,Pregnancy ,medicine ,Humans ,Iloprost ,Chemotherapy ,business.industry ,Vascular disease ,Postpartum Hemorrhage ,Obstetrics and Gynecology ,Vasospasm ,Critical limb ischemia ,medicine.disease ,Surgery ,Diabetes, Gestational ,Reproductive Medicine ,chemistry ,Anesthesia ,Arm ,Female ,medicine.symptom ,business ,Complication ,Sulprostone ,medicine.drug - Abstract
A 34-year-old patient was treated with constant intravenous infusion of sulprostone because of postpartum hemorrhage from a hypotonic uterus. The arm in which sulprostone had been infused was painful 23 h after infusion. A day later, the arm was found to be blueish, edematous and extremely painful as a result of arterial spasm. The vasospasm was probably caused by accidental subcutaneous infusion of sulprostone as a result of a displaced intravenous catheter. A diagnosis of critical limb ischemia was made. Treatment with the prostacyclin-analogue iloprost resulted in full recovery. Critical limb ischemia as a serious complication of sulprostone has not been previously reported.
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- 1995
8. Liver fibrosis after extracorporeal shock-wave lithotripsy of gallbladder stones
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Plaisier Pw, R. L. Van Der Hul, Hajo A. Bruining, J. F. Hamming, and R. Den Toom
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Adult ,Liver Cirrhosis ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Gallbladder ,Gallstones ,Hepatology ,Lithotripsy ,medicine.disease ,Extracorporeal shock wave lithotripsy ,Extracorporeal ,Surgery ,medicine.anatomical_structure ,Cholelithiasis ,Fibrosis ,Internal medicine ,Humans ,Medicine ,Female ,Cholecystectomy ,business - Abstract
We encountered significant liver fibrosis in a healthy young patient undergoing laparoscopic cholecystectomy for symptomatic gallstone disease. Twelve months prior to cholecystectomy the patient underwent multiple extracorporeal shock-wave lithotripsy (ESWL) sessions with adjuvant oral bile-acid therapy. Since the site of fibrosis corresponded clearly to the shock-wave transmission path, which was in accordance with animal studies, it was concluded that this liver fibrosis was a side effect of biliary ESWL. Based on these findings and the literature, we conclude that further assessment of the long-term safety of ESWL is still warranted, especially in patients undergoing multiple ESWL sessions.
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- 1994
9. Thoracoscopic repair of a Bochdalek hernia in an adult
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Plaisier Pw, Schütte Pr, and Willemse P
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Adult ,Hernia, Diaphragmatic ,Male ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Thoracoscopy ,Congenital diaphragmatic hernia ,medicine.disease ,digestive system diseases ,Surgery ,Bochdalek hernia ,stomatognathic diseases ,surgical procedures, operative ,medicine ,Humans ,Hernia ,business ,Laparoscopy - Abstract
Bochdalek hernia is a rare congenital diaphragmatic hernia in adults. In most cases, there are no symptoms. Rarely, it requires surgical intervention. In cases with pain or visceral strangulation, laparatomy or laparoscopy are both possible. We present the case of an adult with a Bochdalek hernia. He was operated on via a thoracoscopic approach and had an uneventful recovery. We recommend the thoracoscopic approach as an alternative to open or laparoscopic approach in cases of noncomplicated Bochdalek's hernia.
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- 2002
10. Routine testing of liver function after biliary-enteric anastomosis has no clinical relevance
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Plaisier, PW, Hul, RL, Lameris, JS, Oei, HY, Terpstra, OT (Onno), Other departments, Surgery, and Radiology & Nuclear Medicine
- Abstract
Patients who had a biliary-enteric anastomosis often have elevated liver function tests. The aim of this study was to investigate whether elevated liver function tests are associated with recurrent episodes of cholangitis. Thirty-two patients, who received a biliary-enteric anatomosis for benign biliary disease were evaluated. Follow-up consisted of the patient's history, physical examination, determination of liver function tests, ultrasonography and hepatobiliary scintigraphy using 99mTc-HIDA. Median duration of follow-up was 45 months (range: 1-192) and liver function tests were elevated in 22 patients (69%) at some time during follow-up. Dilated intrahepatic ducts were found in 3 of 30 patients (10%), all of whom had elevated liver function tests at follow-up. Delayed passage from the liver was observed using scintigraphy in 10 (31%) of the patients. Seven patients (22%) experienced one episode of cholangitis and none experienced more than one episode. Multivariate analysis showed that male sex was an independent risk factor for elevated liver function tests (odds ratio: 10.9; P < 0.05). For cholangitis, no risk factors could be identified. It is concluded that elevated liver function tests are relatively common after a biliary-enteric anastomosis for benign biliary tract disease and are not predictive of the occurrence of cholangitis. We, therefore, recommend omitting routine laboratory screening for elevated liver function tests in the follow-up of a biliary-enteric anastomosis
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- 2001
11. Vertraagde miltruptuur
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Plaisier, PW, de Witte, MT, Tutein Nolthenius, RP, Lameris, JS, Vogels, LMM, Internal Medicine, Radiology & Nuclear Medicine, and Surgery
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- 2000
12. Letter to the Editor: 'Incidence of contralateral occult inguinal hernia found at the time of laparoscopic trans-abdominal pre-peritoneal (TAPP) repair' by Griffin et al. (Hernia 14:345-349, 2010)
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van Wessem, KJP, Plaisier, PW, Lange, Johan, van Wessem, KJP, Plaisier, PW, and Lange, Johan
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- 2010
13. Upper gastrointestinal endoscopy at four intensive care units in one hospital: frequency and indication
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van Buuren Hr, Bruining Ha, Plaisier Pw, Internal Medicine, and Surgery
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Endoscopy, Gastrointestinal ,Enteral Nutrition ,Intensive care ,Medicine ,Humans ,Aged ,Netherlands ,Retrospective Studies ,Aged, 80 and over ,Hepatology ,medicine.diagnostic_test ,business.industry ,Esophageal disease ,Gastroenterology ,Postoperative complication ,Emergency department ,Middle Aged ,medicine.disease ,Surgery ,Endoscopy ,Intensive Care Units ,Therapeutic endoscopy ,Female ,Gastritis ,medicine.symptom ,business ,Varices ,Gastrointestinal Hemorrhage - Abstract
Objective To investigate the frequency, indication and results of upper gastrointestinal endoscopy (UGIE) at four different intensive care units (ICUs) in one hospital. Design Retrospective analysis. Setting Rotterdam Erasmus University Hospital, The Netherlands. Participants One hundred and ninety-nine male and 102 female patients; mean age, 58.3 years (range, 14-91 years). Interventions Four hundred and eleven UGIEs. Main outcome measures and results UGIE was primarily diagnostic and therapeutic in 55% and 45% of patients, respectively. Seventy-three per cent of the diagnostic UGIEs were performed for localization of a haemorrhage and 70% of the therapeutic UGIEs for placement of feeding tubes. The causes of haemorrhage were varices, duodenal ulcer and oesophagitis in 26, 22 and 14% of cases, respectively. As co-incidental findings, oesophagitis, gastritis and gastric ulcer were seen in, respectively, 18, 8 and 7% of cases. The vast majority of UGIEs (81%) were performed at the surgical and medical ICUs. At the medical ICU, upper gastrointestinal haemorrhage (UGIH) usually was the ICU admission diagnosis, and usually concerned varices (56%). At the surgical ICU, UGIH was usually not the ICU admission diagnosis but a postoperative complication, and usually concerned oesophagitis (25%) or a duodenal or gastric ulcer (25 and 13%, respectively). Of all ICU patients, surgical patients were most prone to have co-incidental abnormalities of the digestive tract at UGIE (63%). Conclusions UGIE is a frequent diagnostic and therapeutic procedure in patients admitted to the ICU, particularly at the surgical and medical ICU. Diagnostic and therapeutic endoscopy are most frequently performed for assessment of bleeding and placement of feeding tubes, respectively. Oesophagitis is a surprisingly common finding, both as a co-incidental diagnosis as well as the cause of bleeding, especially after surgery.
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- 1998
14. An analysis of upper GI endoscopy done for patients in surgical intensive care: high incidence of, and morbity from reflux oesophagitus
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Plaisier, PW, van Buuren, Henk, Bruining, HA, Surgery, and Internal Medicine
- Published
- 1997
15. Extracorporeal shock-wave lithotripsy of pancreatic duct stones: immediate and long-term results
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Plaisier Pw, H. A. Bruining, Johannes Jeekel, R. L. Van Der Hul, R. Den Toom, and Onno T. Terpstra
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Adult ,Male ,medicine.medical_specialty ,Abdominal pain ,Pancreatic disease ,medicine.medical_treatment ,Lithotripsy ,Extracorporeal ,Calculi ,Chronic calcifying pancreatitis ,medicine ,Humans ,Pancreatic duct ,business.industry ,Gastroenterology ,Pancreatic Ducts ,Endoscopy ,Middle Aged ,medicine.disease ,Extracorporeal shock wave lithotripsy ,Surgery ,medicine.anatomical_structure ,Treatment Outcome ,Pancreatitis ,Female ,medicine.symptom ,business ,Follow-Up Studies - Abstract
To study the efficacy of extracorporeal shock-wave lithotripsy (ESWL) of pancreatic duct stones, seventeen patients (mean age: 42 years) with recurrent attacks of abdominal pain as a result of chronic calcifying pancreatitis were treated with this method. In all cases, endoscopic removal of the stones proved impossible. When there was fragmentation, the remaining calculi and fragments either evacuated spontaneously, or attempts were made to extract them endoscopically, followed by flushing. In 13 patients (76%), fragmentation of stones was achieved, and 11 of these patients had dramatic pain relief directly after ESWL (65%). However, complete ductal clearance of stones was achieved in only seven patients (41%); at the last follow-up (12-59 months after ESWL, mean: 30 months), all seven were free of symptoms. Of the six patients with stone fragmentation without ductal clearance, three were operated on because of recurrent complaints. The only complication due to the procedure was an exacerbation of pancreatitis in one patient, which was treated conservatively. If pancreatic stones cannot be removed endoscopically, ESWL seems to be preferable to surgery, which may still be performed in case of failure. It seems important to achieve ductal clearance and not merely stone disintegration in order to obtain the desired long-term clinical effects.
- Published
- 1994
16. Current role of extracorporeal shockwave therapy in surgery
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R. L. Van Der Hul, Plaisier Pw, Onno T. Terpstra, and H. A. Bruining
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medicine.medical_specialty ,medicine.medical_treatment ,Urinary system ,Gallstones ,Lithotripsy ,Calculi ,Fractures, Bone ,Cholelithiasis ,Neoplasms ,medicine ,Humans ,Thrombus ,Pancreatic duct ,Salivary Gland Calculi ,Common bile duct ,business.industry ,Gallbladder ,Pancreatic Ducts ,Pancreatic Diseases ,Thrombosis ,Ablation ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Extracorporeal shockwave therapy ,business - Abstract
In urology the introduction of extracorporeal shockwave therapy brought a revolutionary change to the management of urinary calculi. This inspired the introduction of shockwave therapy in several fields of surgery; it has been applied as a potential alternative to several operative procedures but is still experimental. So far, the major application of shockwave therapy has been lithotripsy of stones in the gallbladder, common bile duct, pancreatic duct and salivary gland ducts. Other applications are in the non-operative management of bone healing disturbances and in the inhibition of tumour growth. Steps towards selective thrombus ablation and pretreatment of heavily calcified arteries have also been made. In this review, the applications of extracorporeal shockwave therapy in several areas of surgery are discussed. It is concluded that, for selected patients, shockwave treatment may serve as a useful addition to the surgical armamentarium.
- Published
- 1994
17. UNEXPECTED DIFFICULTIES IN RANDOMIZING PATIENTS IN A SURGICAL TRIAL - A PROSPECTIVE-STUDY COMPARING EXTRACORPOREAL SHOCK-WAVE LITHOTRIPSY WITH OPEN CHOLECYSTECTOMY
- Author
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PLAISIER, PW, BERGER, MY, VANDERHUL, RL, NIJS, HGT, DENTOOM, R, TERPSTRA, OT, BRUINING, HA, Damage and Repair in Cancer Development and Cancer Treatment (DARE), and Life Course Epidemiology (LCE)
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STANDARD ,DESIGN ,GALLSTONES ,LAPAROSCOPIC CHOLECYSTECTOMY ,GALLBLADDER STONES ,PREFERENCES ,CLINICAL-TRIALS - Abstract
Shortly after extracorporeal shock wave lithotripsy (ESWL) was introduced as a promising new treatment modality for gallstone disease, a randomized controlled study was performed to assess the cost-effectiveness of ESWL compared to open cholecystectomy, the gold standard. During the performance of this study it was found that during a 3-year intake period only 8.3% (37 of 448) of the patients could be entered into the trial. Three factors were identified that hampered patient accrual: (1) restricted eligibility for ESWL, (and thus for the study), which could not have been predicted on the data provided in the literature; (2) the introduction of laparoscopic cholecystectomy; and (3) strong patient preference, inhibiting randomization. All three mechanisms could not have been predicted during the design phase of the study. It is concluded that it is not always feasible to conduct a randomized study in surgery due to unforeseen circumstances. Entering patients into surgical trials is difficult in quickly evolving fields of surgery, such as the management of gallstone disease. Acquiring informed consent is also difficult when treatment characteristics are divergent. A randomized controlled study on the effects of laparoscopic cholecystectomy will therefore probably never be performed.
- Published
- 1994
18. Detection and management of common bile duct stones in the era of laparoscopic cholecystectomy
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Plaisier Pw, J. F. Hamming, R. L. Van Der Hul, M. van Blankenstein, and H. A. Bruining
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Adult ,Male ,medicine.medical_specialty ,Gallstones ,Sphincterotomy, Endoscopic ,Predictive Value of Tests ,Recurrence ,Lithotripsy ,Preoperative Care ,Medicine ,Humans ,Laparoscopic cholecystectomy ,Aged ,Aged, 80 and over ,Intraoperative Care ,Common bile duct ,business.industry ,General surgery ,Gastroenterology ,Middle Aged ,Surgery ,medicine.anatomical_structure ,Treatment Outcome ,Cholecystectomy, Laparoscopic ,Choledochostomy ,Female ,Morbidity ,business ,human activities ,Cholangiography - Abstract
(1993). Review: Detection and Management of Common Bile Duct Stones in the Era of Laparoscopic Cholecystectomy. Scandinavian Journal of Gastroenterology: Vol. 28, No. 11, pp. 929-933.
- Published
- 1993
19. The value of ultrasound in the follow-up of patients treated with biliary lithotripsy. Implications for monitoring patients after nonsurgical therapy of gallbladder stones
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Nijs Hg, R. Den Toom, R. L. Van Der Hul, Onno T. Terpstra, Plaisier Pw, Johan S. Laméris, H. E. Schütte, and K. Brakel
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Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Lithotripsy ,Gallbladder Stone ,Cholelithiasis ,medicine ,Humans ,Aged ,Retrospective Studies ,Ultrasonography ,Aged, 80 and over ,business.industry ,Gallbladder ,Ultrasound ,Gastroenterology ,Similar time ,Gallstones ,Biliary lithotripsy ,Middle Aged ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Biliary tract ,Female ,business - Abstract
To establish the value of ultrasound (US) in the follow-up of patients treated with extracorporeal shockwave lithotripsy (ESWL), the results of 484 US examinations of 87 patients were analyzed and related to the results of ESWL. Reliability of US in assessing efficacy was investigated by comparing consecutive US examinations. Unreliable US results were found in 36 patients (41%); in 7 patients US failed to demonstrate fragments. In nine patients (10%) unreliable US findings contributed to delayed retreatment with ESWL. To prevent errors in treatment regimen, verification of US findings is advised in case no fragments or fragments5 mm are found. In 22 patients (25%) US findings appeared indicative of hampered stone migration. Only 2 of these 22 patients (9.1%) became free of stones, compared with 32 of the remaining 65 patients (49.3%) (p0.01), even though both groups had similar initial stone characteristics and similar time of follow-up. US findings such as a contracted gallbladder or a common bile duct7 mm therefore indicate poor efficacy of ESWL.
- Published
- 1993
20. Dissolution of gallstones
- Author
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Onno T. Terpstra, Plaisier Pw, and Henk Vergunst
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Methyl Ethers ,medicine.medical_specialty ,medicine.medical_treatment ,Chenodeoxycholic Acid ,Glycerides ,Cholelithiasis ,Cyclohexenes ,medicine ,Humans ,Edetic Acid ,business.industry ,Terpenes ,General surgery ,Ursodeoxycholic Acid ,Gastroenterology ,General Medicine ,Gallstones ,medicine.disease ,Biochemistry ,Solvents ,Cholecystectomy ,Caprylates ,business ,Monooctanoin ,Limonene ,Ethers - Abstract
Gallstones represent a major health problem in western society. For symptomatic gallstones, cholecystectomy is the gold standard. A considerable number of patients, however, cannot tolerate or are unwilling to undergo surgery and anaesthesia. For these patients, dissolution therapy, administered either systemically ('oral dissolution') or directly into the gallbladder ('contact dissolution'), might be preferable. In this review, the possibilities and limitations of dissolution therapy are discussed. It is concluded that dissolution is a good alternative in selected symptomatic patients and that it is useful as adjuvant therapy after lithotripsy (ESWL) of gall-bladder stones.
- Published
- 1993
21. Extracorporeal shock wave lithotripsy as a troubleshooter for a Dormia basket impacted in the common bile duct
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Plaisier Pw, Henk R. van Buuren, G.A.J. Johan Nix, René L. van der Hul, and Hajo A. Bruining
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medicine.medical_specialty ,medicine.anatomical_structure ,Common bile duct ,business.industry ,medicine.medical_treatment ,Gastroenterology ,Medicine ,Radiology, Nuclear Medicine and imaging ,Dormia basket ,business ,Extracorporeal shock wave lithotripsy ,Surgery - Published
- 1994
22. Extracorporeal Shock Wave Lithotripsy for Recurrent Common Bile Duct Stones
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R. L. Van Der Hul, H. A. Bruining, and Plaisier Pw
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Male ,medicine.medical_specialty ,Common bile duct ,business.industry ,medicine.medical_treatment ,Gastroenterology ,Gallstones ,Extracorporeal shock wave lithotripsy ,Surgery ,medicine.anatomical_structure ,Recurrence ,Lithotripsy ,medicine ,Humans ,business ,Cholangiography ,Aged - Published
- 1994
23. Cholecystectomy and bowel function
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Plaisier Pw
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Diarrhea ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Gastroenterology ,Context (language use) ,Colonic Diseases, Functional ,Postcholecystectomy diarrhoea ,Internal medicine ,medicine ,Humans ,Cholecystectomy ,Bowel function ,Letters to the Editor ,business - Abstract
Editor,—I read with great interest the article by Hearing et al ( Gut1999;45:889–894 [OpenUrl][1][PubMed][2] ) on the effect of cholecystectomy on bowel function. In this elegant publication, however, the authors mistakenly assume that published estimates of the prevalence of postcholecystectomy diarrhoea derive from retrospective or uncontrolled data only. In this context I would like to draw attention to earlier … [1]: {openurl}?query=rft.jtitle%253DThe%2BAmerican%2Bjournal%2Bof%2Bgastroenterology%26rft.stitle%253DAm%2BJ%2BGastroenterol%26rft.aulast%253DPlaisier%26rft.auinit1%253DP.%2BW.%26rft.volume%253D89%26rft.issue%253D5%26rft.spage%253D739%26rft.epage%253D744%26rft.atitle%253DThe%2Bcourse%2Bof%2Bbiliary%2Band%2Bgastrointestinal%2Bsymptoms%2Bafter%2Btreatment%2Bof%2Buncomplicated%2Bsymptomatic%2Bgallstones%253A%2Bresults%2Bof%2Ba%2Brandomized%2Bstudy%2Bcomparing%2Bextracorporeal%2Bshock%2Bwave%2Blithotripsy%2Bwith%2Bconventional%2Bcholecystectomy.%26rft_id%253Dinfo%253Apmid%252F8172149%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=8172149&link_type=MED&atom=%2Fgutjnl%2F48%2F2%2F283.1.atom
- Published
- 2001
24. Mesh fixation using staples in Lichtenstein's inguinal hernioplasty: fewer complications and fewer recurrences.
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van der Zwaal P, van den Berg IR, Plaisier PW, Tutein Nolthenius RP, van der Zwaal, P, van den Berg, I R, Plaisier, P W, and Tutein Nolthenius, R P
- Abstract
Background: Fixation of the mesh in Lichtenstein's inguinal hernioplasty is traditionally performed with polypropylene sutures. A modification of this technique uses staples for securing of the mesh.Method: A retrospective comparative study of 149 elective repairs of a primary inguinal hernia was performed: a control group of 67 patients undergoing mesh fixation using sutures and a study group of 82 patients undergoing staple fixation. Operating time, recurrence, postoperative pain, complications and costs were studied.Results: Seven recurrences (11%) occurred in the polypropylene group as compared to one recurrence (1%) in the staple group (P < 0.01). There was a trend of fewer complications in the staple group. Operative time and long-term postoperative pain did not differ significantly between the two groups. The costs per surgery for mesh fixation and skin closure were euro 11.13 for the suture group and euro 24.35 for the staple group.Conclusion: Staple fixation of the mesh in Lichtenstein's inguinal hernioplasty can be considered equal to traditional fixation with sutures with regard to operating time and postoperative pain. However, staple fixation seems to show fewer recurrences and fewer complications. [ABSTRACT FROM AUTHOR]- Published
- 2008
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25. Quality control in laparoscopic cholecystectomy: operation notes, video or photo print?
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Plaisier, PW, Pauwels, The Late MMS, and Lange, JF
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- *
CHOLECYSTECTOMY , *LAPAROSCOPIC surgery , *GALLBLADDER surgery , *LAPAROSCOPY , *QUALITY control - Abstract
Background In 1995 the concept of a 'critical view of safety' (CVS) in Calot's triangle was introduced to prevent bile duct injury in laparoscopic cholecystectomy. The aim of this study was to determine the most reliable method for recording CVS. Methods Operation notes, video images and photo prints from 50 consecutive elective non-converted laparoscopic cholecystectomies were analysed. Results Operation notes alone did not suffice to record CVS. As an adjunct, video proved superior to photo print with regard to quality. Nevertheless, photo prints were practically and logistically much easier to produce than video. Moreover, when good quality images were achieved, photo print recorded CVS more conclusively than video. Discussion Operation notes, video and photo print are complementary, and the combination records CVS conclusively in nearly every case. [ABSTRACT FROM AUTHOR]
- Published
- 2001
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26. Letter to the editor: "Incidence of contralateral occult inguinal hernia found at the time of laparoscopic trans-abdominal pre-peritoneal (TAPP) repair" by Griffin et al. (Hernia 14:345-349, 2010).
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van Wessem KJ, Plaisier PW, Lange JF, van Wessem, K J P, Plaisier, P W, and Lange, J F
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- 2010
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27. Surg Endosc 2008;22:1620-1624. Biochemical predictors of common bile duct (CBD) stones.
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Plaisier PW, van der Hul RL, Plaisier, Peter W, and van der Hul, René L
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- 2009
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28. Determinants of postoperative mortality after cancer surgery
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Damhuis, Ronald, van Lanschot, Jan, Plaisier, PW, Wijnhoven, Bas, and Medical Oncology
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SDG 3 - Good Health and Well-being - Published
- 2013
29. Do Large Language Model Chatbots perform better than established patient information resources in answering patient questions? A comparative study on melanoma.
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Kamminga NC, Kievits JE, Plaisier PW, Burgers JS, van der Veldt AM, van den Brand JAGJ, Mulder M, Wakkee M, Lugtenberg M, and Nijsten T
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Background: Large Language Models (LLMs) have a potential role in providing adequate patient information., Objectives: To compare the quality of LLMs' responses with established Dutch patient information resources (PIRs) in answering patient questions regarding melanoma., Methods: Responses from ChatGPT versions 3.5 and 4.0, Gemini, and three leading Dutch melanoma PIRs to 50 melanoma-specific questions were examined at baseline and for LLMs again after eight months. Outcomes included (medical) accuracy, completeness, personalisation, readability, and additionally reproducibility for LLMs. Comparative analyses were performed within LLMs and PIRs using Friedman's ANOVA, and between best-performing LLMs and gold-standard PIR using Wilcoxon Signed Ranks test., Results: Within LLMs, ChatGPT-3.5 demonstrated the highest accuracy (p=0.009). Gemini performed best in completeness (p<0.001), personalisation (p=0.007), and readability (p<0.001). PIRs were consistent in accuracy and completeness, with the general practitioner's website excelling in personalisation (p=0.013) and readability (p<0.001). The best-performing LLMs outperformed the gold-standard PIR on all criteria except accuracy. Over time, response reproducibility decreased for all LLMs, showing variability across outcomes., Conclusions: Although LLMs show potential in providing highly personalised and complete responses to patient questions regarding melanoma, improving and safeguarding accuracy, reproducibility and accessibility is crucial before they can replace or complement conventional PIRs.This study compared the quality of responses from Large Language Models (LLMs) with established Dutch patient information resources (PIRs) for melanoma-related patient questions. Results showed LLMs provided highly personalised and complete answers, often surpassing PIRs. However, improving and safeguarding accuracy, reproducibility and accessibility is crucial before they can replace or complement conventional PIRs., (© The Author(s) 2024. Published by Oxford University Press on behalf of British Association of Dermatologists.)
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- 2024
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30. In-depth analysis of immunohistochemistry concordance in biopsy-resection pairs of bronchial carcinoids.
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Naves DD, Reuling EMBP, Dickhoff C, Kortman PC, Broeckaert MAM, Plaisier PW, Daniels JMA, Thunnissen E, and Radonic T
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- Humans, Synaptophysin metabolism, Chromogranins, Biomarkers, Tumor metabolism, Immunohistochemistry, Biopsy, Carcinoid Tumor diagnosis, Carcinoid Tumor surgery, Lung Neoplasms pathology
- Abstract
Primary diagnosis of bronchial carcinoids (BC) is always made on biopsies and additional immunohistochemistry (IHC) is often necessary. In the present study we investigated the concordance of common diagnostic (synaptophysin, chromogranin, CD56 and INSM-1) and potential prognostic (OTP, CD44, Rb and p16) IHC markers between the preoperative biopsies and resections of in total 64 BCs, 26 typical (41 %) and 38 atypical (59 %) carcinoid tumors. Synaptophysin and chromogranin had 100 % concordance in all resected carcinoids and paired diagnostic biopsies. Synaptophysin was not affected by variable expression in biopsies compared to chromogranin, CD56 and INSM-1. Notably, INSM-1 IHC was false negative in 8 % of biopsies. Of the novel and potential prognostic markers, only CD44 showed 100 % concordance between biopsies and resections, while OTP showed two (4 %) false negative results in paired biopsies. While Rb IHC was false negative in 8 % of biopsies, no strong and diffuse pattern of p16 expression was observed. In this study, most false negative IHC results (85 %, 22/26) were observed in small flexible biopsies. Taken together, our data suggest excellent concordance of synaptophysin and CD44 on the preoperative biopsy samples, while other neuroendocrine markers, Rb and OTP should be interpreted with caution, especially in small biopsies., Competing Interests: Declaration of competing interest The authors declare no competing interests., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)
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- 2023
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31. Oncological healthcare providers' perspectives on appropriate melanoma survivorship care: a qualitative focus group study.
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Kamminga NCW, Wakkee M, De Bruin RJ, van der Veldt AAM, Joosse A, Reeder SWI, Plaisier PW, Nijsten T, and Lugtenberg M
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- Humans, Focus Groups, Patient Care Planning, Health Personnel, Survivorship, Melanoma therapy
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Background: The increasing group of melanoma survivors reports multiple unmet needs regarding survivorship care (SSC). To optimise melanoma SSC, it is crucial to take into account the perspectives of oncological healthcare providers (HCPs) in addition to those of patients. The aim of this study is to gain an in-depth understanding of HCPs' perspectives on appropriate melanoma SSC., Methods: Four online focus groups were conducted with mixed samples of oncological HCPs (dermatologists, surgeons, oncologists, oncological nurse practitioners, support counsellors and general practitioners) (total n = 23). A topic guide was used to structure the discussions, focusing on perspectives on both SSC and survivorship care plans (SCPs). All focus groups were recorded, transcribed verbatim, and subjected to an elaborate thematic content analysis., Results: Regarding SSC, HCPs considered the current offer minimal and stressed the need for broader personalised SSC from diagnosis onwards. Although hardly anyone was familiar with SCPs, they perceived various potential benefits of SCPs, such as an increase in the patients' self-management and providing HCPs with an up-to-date overview of the patient's situation. Perceived preconditions for successful implementation included adequate personalisation, integration in the electronic health record and ensuring adequate funding to activate and provide timely updates., Conclusions: According to HCPs there is considerable room for improvement in terms of melanoma SSC. SCPs can assist in offering personalised and broader i.e., including psychosocial SSC. Aside from personalisation, efforts should be focused on SCPs' integration in clinical practice, and their long-term maintenance., (© 2023. The Author(s).)
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- 2023
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32. A Multimodal Biomarker Predicts Dissemination of Bronchial Carcinoid.
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Reuling EMBP, Naves DD, Kortman PC, Broeckaert MAM, Plaisier PW, Dickhoff C, Daniels JMA, and Radonic T
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Background: Curatively treated bronchial carcinoid tumors have a relatively low metastatic potential. Gradation into typical (TC) and atypical carcinoid (AC) is limited in terms of prognostic value, resulting in yearly follow-up of all patients. We examined the additional prognostic value of novel immunohistochemical (IHC) markers to current gradation of carcinoids. Methods: A retrospective single-institution cohort study was performed on 171 patients with pathologically diagnosed bronchial carcinoid (median follow-up: 66 months). The risk of developing distant metastases based on histopathological characteristics (Ki-67, p16, Rb, OTP, CD44, and tumor diameter) was evaluated using multivariate regression analysis and the Kaplan−Meier method. Results: Of 171 patients, seven (4%) had disseminated disease at presentation, and 164 (96%) received curative-intent treatment with either endobronchial treatment (EBT) (n = 61, 36%) or surgery (n = 103, 60%). Among the 164 patients, 13 developed metastases at follow-up of 81 months (IQR 45−162). Univariate analysis showed that Ki-67, mitotic index, OTP, CD44, and tumor diameter were associated with development of distant metastases. Multivariate analysis showed that mitotic count, Ki-67, and OTP were independent risk factors for development of distant metastases. Using a 5% cutoff for Ki-67, Kaplan−Meier analysis showed that the risk of distant metastasis development was significantly associated with the number of risk predictors (AC, Ki-67 ≥ 5%, and loss of OTP or CD44) (p < 0.0001). Six out of seven patients (86%) with all three positive risk factors developed distant metastasis. Conclusions: Mitotic count, proliferation index, and OTP IHC were independent predictors of dissemination at follow-up. In addition to the widely used carcinoid classification, a comprehensive analysis of histopathological variables including Ki-67, OTP, and CD44 could assist in the determination of distant metastasis risks of bronchial carcinoids.
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- 2022
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33. Diagnosis of atypical carcinoid can be made on biopsies > 4 mm 2 and is accurate.
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Reuling EMBP, Naves DD, Daniels JMA, Dickhoff C, Kortman PC, Broeckaert MAMB, Plaisier PW, Thunnissen E, and Radonic T
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- Biopsy, Humans, Ki-67 Antigen, Carcinoid Tumor diagnosis, Carcinoid Tumor pathology, Lung Neoplasms pathology, Neuroendocrine Tumors pathology
- Abstract
In the 2021 WHO thoracic tumors, gradation of lung carcinoids in biopsies is discouraged. We hypothesized that atypical carcinoid (AC) could be reliably diagnosed in larger preoperative biopsies. Biopsy-resection paired specimens of carcinoid patients were included, and definitive diagnosis was based on the resection specimen according to the WHO 2021 classification. A total of 64 biopsy-resection pairs (26 typical carcinoid (TC) (41%) and 38 AC (59%)) were analyzed. In 35 patients (55%), tumor classification between the biopsy and resection specimen was concordant (26 TC, 9 AC). The discordance in the remaining 29 biopsies (45%, 29 TC, 0 AC) was caused by misclassification of AC as TC. In biopsies measuring < 4 mm
2 , 15/15 AC (100%) were misclassified compared to 14/23 AC (61%) of biopsies ≥ 4 mm2 . Categorical concordance of Ki-67 in biopsy-resection pairs at threshold of 5% was 68%. Ki-67 in the biopsy was not of additional value to discriminate between TC and AC, irrespective of the biopsy size. Atypical carcinoid is frequently missed in small bronchial biopsies (< 4 mm2 ). If the carcinoid classification is clinically relevant, a cumulative biopsy size of at least 4 mm2 should be considered. Our study provides strong arguments to make the diagnosis of AC in case of sufficient mitosis for AC on a biopsy and keep the diagnosis "carcinoid NOS" for carcinoids with ≤ 1 mitosis per 2 mm2 . Ki-67 has a good concordance but was not discriminative for definitive diagnosis., (© 2022. The Author(s).)- Published
- 2022
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34. Correction to: Diagnosis of atypical carcinoid can be made on biopsies > 4 mm 2 and is accurate.
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Reuling EMBP, Naves DD, Daniels JMA, Dickhoff C, Kortman PC, Broeckaert MAMB, Plaisier PW, Thunnissen E, and Radonic T
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- 2022
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35. Morbidity and extent of surgical resection of carcinoid tumors after endobronchial treatment.
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Reuling EMBP, Naves DD, Hartemink KJ, van der Heijden EHFM, Plaisier PW, Verhagen AFTM, Daniels JMA, and Dickhoff C
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- Adult, Bronchial Neoplasms diagnostic imaging, Bronchial Neoplasms pathology, Carcinoid Tumor diagnostic imaging, Carcinoid Tumor pathology, Female, Humans, Male, Middle Aged, Pneumonectomy, Postoperative Complications, Bronchial Neoplasms surgery, Carcinoid Tumor surgery
- Abstract
Objectives: This study assessed whether endobronchial therapy (EBT) for bronchial carcinoid, if not curative, reduces the extent of the surgical resection and whether EBT is associated with increased surgical morbidity., Material and Methods: Analysis was performed in a cohort of patients with bronchial carcinoid who have undergone surgical resection. A group that underwent EBT before the surgery (S + EBT) was compared with a group where no EBT was performed (S-EBT). Postoperative complications were also compared between both groups., Results: A total of 254 patients treated for a bronchial carcinoid tumor between 2003 and 2019 were screened for inclusion. A total of 65 surgically treated patients were included, of whom 41 (63%) underwent EBT prior to surgery. In 5 out of 41 patients (12%) from the S + EBT group, less parenchyma was resected versus 2 out of 24 (8%) from the S-EBT group (OR 1.528, 95% CI 0.273-8.562, p = 1.000). Two patients from the S + EBT group (5%) underwent lobectomy instead of sleeve lobectomy versus 0 from the S-EBT group (OR 1.051, 95% CI 0.981-1.127, p = 0.527). Comparing complications between the S + EBT and S-EBT group did not result in increased postoperative surgical morbidity (15% S + EBT, 24% S-EBT)., Conclusion: EBT, if not curative, does not reduce the extent of the subsequent surgical resection. Therefore, if curative EBT is not anticipated, patients should directly be referred for surgery. If curative EBT seems feasible, it should be attempted not only because surgical resection can be prevented, but also because failure of EBT is not associated with excess surgical morbidity., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2021
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36. A randomised feasibility trial of an employer-based intervention for enhancing successful return to work of cancer survivors (MiLES intervention).
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Greidanus MA, de Rijk AE, de Boer AGEM, Bos MEMM, Plaisier PW, Smeenk RM, Frings-Dresen MHW, and Tamminga SJ
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- Employment, Feasibility Studies, Female, Humans, Return to Work, Sick Leave, Breast Neoplasms, Cancer Survivors
- Abstract
Background: Employers express a need for support during sickness absence and return to work (RTW) of cancer survivors. Therefore, a web-based intervention (MiLES) targeted at employers with the objective of enhancing cancer survivors' successful RTW has been developed. This study aimed to assess feasibility of a future definitive randomised controlled trial (RCT) on the effectiveness of the MiLES intervention. Also preliminary results on the effectiveness of the MiLES intervention were obtained., Methods: A randomised feasibility trial of 6 months was undertaken with cancer survivors aged 18-63 years, diagnosed with cancer < 2 years earlier, currently in paid employment, and sick-listed < 1 year. Participants were randomised to an intervention group, with their employer receiving the MiLES intervention, or to a waiting-list control group (2:1). Feasibility of a future definitive RCT was determined on the basis of predefined criteria related to method and protocol-related uncertainties (e.g. reach, retention, appropriateness). The primary effect measure (i.e. successful RTW) and secondary effect measures (e.g. quality of working life) were assessed at baseline and 3 and 6 months thereafter., Results: Thirty-five cancer survivors were included via medical specialists (4% of the initially invited group) and open invitations, and thereafter randomised to the intervention (n = 24) or control group (n = 11). Most participants were female (97%) with breast cancer (80%) and a permanent employment contract (94%). All predefined criteria for feasibility of a future definitive RCT were achieved, except that concerning the study's reach (90 participants). After 6 months, 92% of the intervention group and 100% of the control group returned to work (RR: 0.92, 95% CI: 0.81-1.03); no difference were found with regard to secondary effect measures., Conclusions: With the current design a future definitive RCT on the effectiveness of the MiLES intervention on successful RTW of cancer survivors is not feasible, since recruitment of survivors fell short of the predefined minimum for feasibility. There was selection bias towards survivors at low risk of adverse work outcomes, which reduced generalisability of the outcomes. An alternative study design is needed to study effectiveness of the MiLES intervention., Trial Registration: The study has been registered in the Dutch Trial Register ( NL6758/NTR7627 )., (© 2021. The Author(s).)
- Published
- 2021
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37. Real-world healthcare costs of localized and regionally advanced cutaneous melanoma in the Netherlands.
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Leeneman B, Blommestein HM, Coupé VMH, Hendriks MP, Kruit WHJ, Plaisier PW, van Ruth S, Ten Tije AJ, Wouters MWJM, Franken MG, and Uyl-de Groot CA
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- Female, Humans, Male, Melanoma epidemiology, Netherlands, Retrospective Studies, Skin Neoplasms epidemiology, Melanoma, Cutaneous Malignant, Health Care Costs standards, Melanoma economics, Skin Neoplasms economics
- Abstract
The aim of this study was to provide insight into real-world healthcare costs of patients initially diagnosed with localized or regionally advanced melanoma in three Dutch hospitals between 2003 and 2011. Patients were stratified according to their stage at diagnosis and recurrence status. Costs were calculated by applying unit costs to individual patient resource use and reported for the full disease course, the initial treatment episode, and treatment episodes for disease recurrence (stratified by type of recurrence). We included 198 patients with localized melanoma and 98 patients with regionally advanced melanoma. Total costs were much higher for patients with disease recurrence than for patients without disease recurrence: €20 007 versus €3032 for patients with localized melanoma and €19 519 versus €5951 for patients with regionally advanced melanoma. This was owing to the costs of disease recurrence because the costs of the initial treatment were comparable between patients with and without disease recurrence. Costs of disease recurrence were dependent on the type of recurrence: €4414, €4604, €8129 and €10 393 for a local recurrence, intralymphatic metastases, regional lymph node metastases and distant metastases, respectively. In conclusion, healthcare costs of patients with localized and regionally advanced melanoma were rather low for the initial treatment. Costs became, however, more substantial in case of disease recurrence. In the context of a rapidly changing treatment paradigm, it remains crucial to monitor treatment outcomes as well as healthcare expenditures., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)
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- 2021
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38. The Dilemma After an Unforeseen Positive Sentinel Node in Primary Breast Cancer: Is Completion Axillary Dissection Necessary?
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van Bekkum S, Kraima AC, Westenend PJ, Plaisier PW, and Menke-Pluijmers MBE
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- Aged, Axilla surgery, Breast Neoplasms pathology, Female, Humans, Lymph Node Excision, Middle Aged, Retrospective Studies, Sentinel Lymph Node Biopsy, Axilla pathology, Breast Neoplasms surgery, Lymphatic Metastasis pathology
- Abstract
Background: In the majority of cases, the sentinel node is the only positive node in the axilla and completion ALND (cALND) is a futile procedure. However, refraining from cALND will lead to less accurate staging and, possibly, undertreatment. To help resolve this dilemma, we examined the clinical value of cALND in staging and determining adjuvant treatment., Methods: In a retrospective cohort, all consecutive patients over a five-year period with primary breast cancer who received ALND were identified and grouped based on timing of ALND. Total nodal yield and positive lymph nodes were defined and factors with possible impact identified. In the case of cALND, N-status upstaging and possible impact on adjuvant treatment were studied in detail., Results: A total of 280 patients were selected of whom 204 underwent primary ALND (pALND) and 76 cALND. pALND resulted in a significantly higher total nodal yield and more positive nodes when compared to cALND (p = 0.003, and p < 0.001, respectively). Neoadjuvant chemotherapy (NAC) had no effect on total nodal yield (p = 0.413), but resulted in fewer positive nodes (p < 0.001). Due to the results of cALND, only 11 patients (14%) had upstaging of N-status. All these patients were advised more extensive adjuvant radiotherapy., Conclusion: In the majority of patients, cALND does not lead to upstaging. cALND should be performed only after a careful discussion with the patient about the pros and cons of this procedure, and most probably only in the presence of multiple risk factors for axillary disease in the absence of systemic therapy.
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- 2020
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39. Preoperative breast MRI in management of patients with needle biopsy-proven ductal carcinoma in situ (DCIS).
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van Bekkum S, Ter Braak BPM, Plaisier PW, van Rosmalen J, Menke-Pluijmers MBE, and Westenend PJ
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- Aged, Biopsy, Large-Core Needle, Breast Neoplasms pathology, Breast Neoplasms surgery, Carcinoma, Ductal, Breast pathology, Carcinoma, Ductal, Breast surgery, Carcinoma, Intraductal, Noninfiltrating pathology, Carcinoma, Intraductal, Noninfiltrating surgery, Female, Humans, Magnetic Resonance Imaging, Mastectomy, Mastectomy, Segmental, Middle Aged, Neoplasm Invasiveness, Netherlands, Patient Selection, Preoperative Care, Risk Assessment, Sensitivity and Specificity, Sentinel Lymph Node Biopsy methods, Breast Neoplasms diagnostic imaging, Carcinoma, Ductal, Breast diagnostic imaging, Carcinoma, Intraductal, Noninfiltrating diagnosis, Diagnostic Errors
- Abstract
Background: In 20-25% of patients with biopsy-proven DCIS underestimation occurs. Sentinel lymph node biopsy (SLNB) is offered to patients with biopsy-proven ductal carcinoma in situ (DCIS) and a high risk of occult invasive cancer. However, assessment of high risk is controversial. We aimed to improve selection of patients for SLNB with preoperative breast magnetic resonance imaging (MRI)., Methods: In this prospective observational study, MRI was offered to all subsequent patients with a biopsy-proven DCIS admitted to a large Dutch teaching hospital between April 2012 and March 2017. MRI images were analysed for signs of invasive cancer and the results were compared with the pathologic results after surgical treatment. The diagnostic accuracy of additional MRI in detecting occult invasive cancer was determined., Results: Of 211 patients eligible for additional MRI analysis, 149 underwent breast MRI. The majority (67%) received breast-conserving therapy, and the underestimation rate was 20%. Subsequent to MRI analysis, 20 additional invasive diagnostic procedures were performed. Occult invasive cancer was suspected on MRI in 46 patients (31%) and was confirmed in 18 (12%). In this study, breast MRI had a sensitivity of 67%, a specificity of 77%, and a true negative rate of 91%., Conclusion: Preoperative breast MRI cannot reliably predict the presence of invasive cancer in patients with biopsy proven DCIS. Therefore, it cannot be used to in the selection of patients for a SLNB., Competing Interests: Declaration of competing interest The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article., (Copyright © 2020 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.)
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- 2020
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40. Two-Year Follow-Up of a Multi-centre Randomized Controlled Trial to Study Effectiveness of a Hospital-Based Work Support Intervention for Cancer Patients.
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Tamminga SJ, Verbeek JHAM, Bos MMEM, Fons G, Kitzen JJEM, Plaisier PW, Frings-Dresen MHW, and de Boer AGEM
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- Adult, Female, Follow-Up Studies, Humans, Male, Middle Aged, Physical Functional Performance, Program Evaluation, Proportional Hazards Models, Quality of Life, Return to Work psychology, Time Factors, Neoplasms rehabilitation, Return to Work statistics & numerical data
- Abstract
Purpose Purpose is to: (1) study effectiveness of the hospital-based work support intervention for cancer patients at two years of follow-up compared to usual care and (2) identify which early factors predict time to return-to-work (RTW). Methods In this multi-center randomised controlled trial (RCT), 106 (self-)employed cancer patients were randomized to an intervention group or control group and provided 2 years of follow-up data. The intervention group received patient education and work-related support at the hospital. Primary outcome was RTW (rate and time) and quality of life (SF-36), and secondary outcomes were, work ability (WAI), and work functioning (WLQ). Univariate Cox regression analyses were performed to study which early factors predict time to full RTW. Results Participants were diagnosed with breast (61%), gynaecological cancer (35%), or other type of cancer (4%). RTW rates were 84% and 90% for intervention versus control group. They were high compared to national register-based studies. No differences between groups were found on any of the outcomes. Receiving chemotherapy (HR = 2.43, 95% CI 1.59-3.73 p < 0.001), low level of education (HR = 1.65, 95% CI 1.076-2.52 p = 0.02) and low work ability (HR = 1.09 [95% CI 1.04-1.17] p = 0.02) were associated with longer time to full RTW. Conclusions We found high RTW rates compared to national register-based studies and we found no differences between groups. Future studies should therefore focus on reaching the group at risk, which consist of patients who receive chemotherapy, have a low level of education and have a low work ability at diagnosis. TRIAL REGISTRATION: Netherlands Trial Registry (NTR) (http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1658): NTR1658.
- Published
- 2019
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41. Endobronchial and surgical treatment of pulmonary carcinoid tumors: A systematic literature review.
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Reuling EMBP, Dickhoff C, Plaisier PW, Bonjer HJ, and Daniels JMA
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- Carcinoid Tumor diagnosis, Carcinoid Tumor mortality, Health Care Costs, Humans, Lung Neoplasms diagnosis, Lung Neoplasms mortality, Organ Sparing Treatments methods, Postoperative Complications, Prognosis, Quality of Life, Recurrence, Treatment Outcome, Bronchoscopy methods, Carcinoid Tumor surgery, Lung Neoplasms surgery, Pneumonectomy methods
- Abstract
The treatment of pulmonary carcinoid has changed over the last decades. Although surgical resection is still the gold standard, minimally invasive endobronchial procedures have emerged as a parenchyma sparing alternative for tumors located in the central airways. This review was performed to identify the optimal treatment strategy for pulmonary carcinoid, with a particular focus on the feasibility and outcome of parenchyma sparing techniques versus surgical resection. A systematic review of the literature was carried out using MEDLINE, Embase and the Cochrane databases, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement. Two separate searches of publications in endobronchial and surgical treatment in patients with pulmonary carcinoid, were performed. Outcomes were overall survival, disease free survival, recurrence rate, complications, quality of life, and healthcare costs. Combining the two main searches for endobronchial therapy and surgical therapy yielded 3111 records. Finally, 43 studies concerning surgical treatment and 9 studies related to endobronchial treatment for pulmonary carcinoid were included. Assessment of included studies showed that lymph node involvement, histological grade, tumor location and tumor diameter were identified as poor prognostic factors and seem to be important for patients with pulmonary carcinoid. For patients with a more favorable prognosis, tumor location and tumor diameter are important factors that can help decide on the optimal treatment strategy. Centrally located small intraluminal pulmonary carcinoids, without signs of metastasis can be treated with minimally invasive alternatives such as endobronchial treatment or parenchyma sparing surgical resection. Patients with parenchyma sparing resections should be followed with long term follow up to exclude recurrence of disease. In a multidisciplinary setting, it should be determined whether individual patients are eligible for parenchyma sparing procedures or anatomical resection. Overall evidence is of low quality and future studies should focus on prospective trials in the treatment of pulmonary carcinoid., (Copyright © 2019 The Authors. Published by Elsevier B.V. All rights reserved.)
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- 2019
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42. Stage-specific disease recurrence and survival in localized and regionally advanced cutaneous melanoma.
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Leeneman B, Franken MG, Coupé VMH, Hendriks MP, Kruit W, Plaisier PW, van Ruth S, Verstijnen JAMC, Wouters MWJM, Blommestein HM, and Uyl-de Groot CA
- Subjects
- Adult, Aged, Female, Humans, Male, Melanoma surgery, Middle Aged, Neoplasm Recurrence, Local surgery, Neoplasm Staging, Retrospective Studies, Survival Rate, Melanoma pathology, Neoplasm Recurrence, Local pathology, Skin Neoplasms pathology
- Abstract
Objective: To investigate stage-specific survival from diagnosis, stage-specific disease recurrence, and post-recurrence survival in patients diagnosed with localized and regionally advanced cutaneous melanoma., Methods: A retrospective, observational cohort study was conducted in six Dutch hospitals. We included patients with a first diagnosis of stage I, II, or III melanoma between January 2003 and December 2011. Descriptive statistics were used to summarize time to first recurrence and type of first recurrence. Overall survival (OS) from diagnosis and post-recurrence OS were assessed using the Kaplan-Meier method., Results: A total of 3,093 patients had a first diagnosis of stage I (n = 2,299), II (n = 565), or III (n = 229) melanoma. Median OS was not yet reached for patients with stage I, 9.5 years for patients with stage II, and 6.8 years for patients with stage III. Fifty-seven patients (8%) with stage IB, 137 patients (29%) with stage II, and 81 patients (47%) with stage III developed disease recurrence. Median time to first recurrence was 2.8, 1.5, and 1.0 years for patients with stage IB, II, and III, respectively. Most patients (79%) developed regional lymph node or distant metastases as first recurrence. Median post-recurrence OS was 2.8, 3.9, and 0.5 years for patients with intralymphatic, regional lymph node, and distant metastases, respectively., Conclusion: A substantial number of patients developed disease recurrence. Of these patients, a considerably high proportion developed distant metastases which had a great impact on survival. Identifying disease recurrence at its earliest stage is crucial because metastatic melanoma remains incurable for most patients., (Copyright © 2019 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.)
- Published
- 2019
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43. Efficacy of Internet-Based Cognitive Behavioral Therapy for Treatment-Induced Menopausal Symptoms in Breast Cancer Survivors: Results of a Randomized Controlled Trial.
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Atema V, van Leeuwen M, Kieffer JM, Oldenburg HSA, van Beurden M, Gerritsma MA, Kuenen MA, Plaisier PW, Lopes Cardozo AMF, van Riet YEA, Heuff G, Rijna H, van der Meij S, Noorda EM, Timmers GJ, Vrouenraets BC, Bollen M, van der Veen H, Bijker N, Hunter MS, and Aaronson NK
- Subjects
- Adult, Female, Hot Flashes etiology, Hot Flashes therapy, Humans, Middle Aged, Neoadjuvant Therapy adverse effects, Outcome Assessment, Health Care methods, Outcome Assessment, Health Care statistics & numerical data, Pilot Projects, Sleep Wake Disorders etiology, Sleep Wake Disorders therapy, Surveys and Questionnaires, Sweating, Breast Neoplasms therapy, Cancer Survivors, Cognitive Behavioral Therapy methods, Internet, Psychotherapy, Group methods
- Abstract
Purpose: We evaluated the effect of Internet-based cognitive behavioral therapy (iCBT), with or without therapist support, on the perceived impact of hot flushes and night sweats (HF/NS) and overall levels of menopausal symptoms (primary outcomes), sleep quality, HF/NS frequency, sexual functioning, psychological distress, and health-related quality of life in breast cancer survivors with treatment-induced menopausal symptoms., Patients and Methods: We randomly assigned 254 breast cancer survivors to a therapist-guided or a self-managed iCBT group or to a waiting list control group. The 6-week iCBT program included psycho-education, behavior monitoring, and cognitive restructuring. Questionnaires were administered at baseline and at 10 weeks and 24 weeks postrandomization. We used mixed-effects models to compare the intervention groups with the control group over time. Significance was set at P < .01. An effect size (ES) of .20 was considered small, .50 moderate and clinically significant, and .80 large., Results: Compared with the control group, the guided and self-managed iCBT groups reported a significant decrease in the perceived impact of HF/NS (ES, .63 and .56, respectively; both P < .001) and improvement in sleep quality (ES, .57 and .41; both P < .001). The guided group also reported significant improvement in overall levels of menopausal symptoms (ES, .33; P = .003), and NS frequency (ES, .64; P < .001). At longer-term follow-up (24 weeks), the effects remained significant, with a smaller ES for the guided group on perceived impact of HF/NS and sleep quality and for the self-managed group on overall levels of menopausal symptoms. Additional longer-term effects for both intervention groups were found for hot flush frequency., Conclusion: iCBT, with or without therapist support, has clinically significant, salutary effects on the perceived impact and frequency of HF/NS, overall levels of menopausal symptoms, and sleep quality.
- Published
- 2019
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44. Sexual Functioning and Relationship Satisfaction of Partners of Breast Cancer Survivors Who Receive Internet-Based Sex Therapy.
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Hummel SB, van Lankveld JJDM, Oldenburg HSA, Hahn DEE, Kieffer JM, Gerritsma MA, Kuenen MA, Bijker N, Borgstein PJ, Heuff G, Lopes Cardozo AMF, Plaisier PW, Rijna H, van der Meij S, van Dulken EJ, Vrouenraets BC, Broomans E, and Aaronson NK
- Subjects
- Adult, Breast Neoplasms therapy, Cancer Survivors psychology, Female, Humans, Internet, Male, Middle Aged, Breast Neoplasms psychology, Cognitive Behavioral Therapy methods, Personal Satisfaction, Sexual Partners psychology, Therapy, Computer-Assisted methods
- Abstract
As part of a larger, randomized controlled trial, we evaluated longitudinally the sexual functioning and relationship satisfaction of 69 partners of breast cancer (BC) survivors who received Internet-based cognitive behavioral therapy (CBT) for sexual dysfunction. The findings suggest that Internet-based CBT positively affects the partners' immediate post-CBT and longer-term overall sexual satisfaction, sexual intimacy, and sexual relationship satisfaction. No sustained changes in other areas of sexual functioning were observed. Our CBT program was focused primarily on the sexual health of the BC survivors. We recommend that future programs include more psychoeducational and behavioral elements targeted at the partners.
- Published
- 2019
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45. Endobronchial Treatment for Bronchial Carcinoid: Patient Selection and Predictors of Outcome.
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Reuling EMBP, Dickhoff C, Plaisier PW, Coupé VMH, Mazairac AHA, Lely RJ, Bonjer HJ, and Daniels JMA
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- Adolescent, Adult, Aged, Aged, 80 and over, Bronchial Neoplasms mortality, Carcinoid Tumor mortality, Female, Humans, Male, Middle Aged, Netherlands epidemiology, Retrospective Studies, Young Adult, Bronchial Neoplasms surgery, Bronchoscopy statistics & numerical data, Carcinoid Tumor surgery
- Abstract
Background: Traditionally, surgical resection is the preferred treatment for typical carcinoids and atypical carcinoids located in the lungs. Recently however, several studies have shown excellent long-term outcome after endobronchial treatment of carcinoid tumors located in the central airways. This study investigates clinical and radiological features as predictors of successful endobronchial treatment in patients with a bronchial carcinoid tumor., Objectives: To identify clinical and radiological features predictive of successful endobronchial treatment in patients with bronchial carcinoid., Methods: This analysis was performed in a cohort of patients with typical and atypical bronchial carcinoid referred for endobronchial treatment. Several patient characteristics, radiological features, and histological grade (typical or atypical carcinoid) were tested as predictors of successful endobronchial treatment., Results: One hundred and twenty-five patients with a diagnosis of bronchial carcinoid underwent endobronchial treatment. On multivariate analysis, a tumor diameter <15 mm (odds ratio 0.09; 95% confidence interval 0.02-0.5; p = <0.01) and purely intraluminal growth on computer tomography (CT scan) (odds ratio, 9.1; 95% confidence interval 1.8-45.8; p = <0.01) were predictive of radical endobronchial treatment. The success rate for intraluminal tumors with a diameter <20 mm was 72%., Conclusions: Purely intraluminal disease and tumor diameter on CT scan seem to be independent predictors for successful endobronchial treatment in patients with bronchial carcinoid. Based on these data, patients with purely intraluminal carcinoid tumors with a diameter <20 mm on CT scan are good candidates for endobronchial treatment, regardless of histological grade. In contrast, all patients with a tumor diameter ≥20 mm should be directly referred for surgery., (© 2018 S. Karger AG, Basel.)
- Published
- 2018
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46. Author's Reply.
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Reuling EMBP, Dickhoff C, Plaisier PW, Coupé VMH, Mazairac AHA, Lely RJ, Bonjer HJ, and Daniels JMA
- Published
- 2018
- Full Text
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47. Internet-Based Cognitive Behavioral Therapy Realizes Long-Term Improvement in the Sexual Functioning and Body Image of Breast Cancer Survivors.
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Hummel SB, van Lankveld JJDM, Oldenburg HSA, Hahn DEE, Kieffer JM, Gerritsma MA, Kuenen MA, Bijker N, Borgstein PJ, Heuff G, Cardozo AMFL, Plaisier PW, Rijna H, van der Meij S, van Dulken EJ, Vrouenraets BC, Broomans E, and Aaronson NK
- Subjects
- Adult, Body Image, Female, Humans, Middle Aged, Sexual Behavior, Sexual Dysfunction, Physiological etiology, Sexual Dysfunction, Physiological psychology, Sexual Dysfunctions, Psychological etiology, Sexual Dysfunctions, Psychological psychology, Surveys and Questionnaires, Treatment Outcome, Cancer Survivors psychology, Cognitive Behavioral Therapy methods, Libido, Sexual Dysfunction, Physiological therapy, Sexual Dysfunctions, Psychological therapy
- Abstract
The study aim was to evaluate the long-term efficacy of Internet-based cognitive behavioral therapy (CBT) for sexual dysfunctions in 84 breast cancer survivors. The positive effects of the intervention on overall sexual functioning, sexual desire, sexual arousal, vaginal lubrication, discomfort during sex, sexual distress, and body image observed immediately posttreatment were maintained at three- and nine-month follow-ups. Although sexual pleasure decreased during follow-up, it did not return to baseline levels. Our findings provide evidence that Internet-based CBT has a sustained, positive effect on sexual functioning and body image of breast cancer survivors with a sexual dysfunction.
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- 2018
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48. Efficacy of Internet-Based Cognitive Behavioral Therapy in Improving Sexual Functioning of Breast Cancer Survivors: Results of a Randomized Controlled Trial.
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Hummel SB, van Lankveld JJDM, Oldenburg HSA, Hahn DEE, Kieffer JM, Gerritsma MA, Kuenen MA, Bijker N, Borgstein PJ, Heuff G, Lopes Cardozo AMF, Plaisier PW, Rijna H, van der Meij S, van Dulken EJ, Vrouenraets BC, Broomans E, and Aaronson NK
- Subjects
- Breast Neoplasms physiopathology, Breast Neoplasms psychology, Female, Humans, Middle Aged, Self Report, Sexual Behavior physiology, Sexual Behavior psychology, Sexual Dysfunction, Physiological psychology, Survivors, Waiting Lists, Breast Neoplasms therapy, Cognitive Behavioral Therapy methods, Internet, Sexual Dysfunction, Physiological therapy, Therapy, Computer-Assisted methods
- Abstract
Purpose We evaluated the effect of Internet-based cognitive behavioral therapy (CBT) on sexual functioning and relationship intimacy (primary outcomes) and body image, menopausal symptoms, marital functioning, psychological distress, and health-related quality of life (secondary outcomes) in breast cancer survivors (BCSs) with a DSM-IV diagnosis of a sexual dysfunction. Patients and Methods We randomly assigned 169 BCSs to either Internet-based CBT or a waiting-list control group. The CBT consisted of weekly therapist-guided sessions, with a maximum duration of 24 weeks. Self-report questionnaires were completed by the intervention group at baseline (T0), midtherapy (T1), and post-therapy (T2) and at equivalent times by the control group. We used a mixed-effect modeling approach to compare the groups over time. Results Compared with the control group, the intervention group showed a significant improvement over time in overall sexual functioning (effect size for T2 [ES
T2 ] = .43; P = .031), which was reflected in an increase in sexual desire (EST1 = .48 and EST2 = .72; P < .001), sexual arousal (EST2 = .50; P = .008), and vaginal lubrication (EST2 = .46; P = .013). The intervention group reported more improvement over time in sexual pleasure (EST1 = .32 and EST2 = .62; P = .001), less discomfort during sex (EST1 = .49 and EST2 = .66; P = .001), and less sexual distress (EST2 = .59; P = .002) compared with the control group. The intervention group reported greater improvement in body image (EST2 = .45; P = .009) and fewer menopausal symptoms (EST1 = .39; P = .007) than the control group. No significant effects were observed for orgasmic function, sexual satisfaction, intercourse frequency, relationship intimacy, marital functioning, psychological distress, or health-related quality of life. Conclusion Internet-based CBT has salutary effects on sexual functioning, body image, and menopausal symptoms in BCSs with a sexual dysfunction.- Published
- 2017
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49. Non-primary breast malignancies: a single institution's experience of a diagnostic challenge with important therapeutic consequences-a retrospective study.
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Buisman FE, van Gelder L, Menke-Pluijmers MB, Bisschops BH, Plaisier PW, and Westenend PJ
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- Adult, Aged, Aged, 80 and over, Breast Neoplasms surgery, Female, Follow-Up Studies, Humans, Male, Middle Aged, Neoplasm Staging, Neoplasms surgery, Prognosis, Retrospective Studies, Breast Neoplasms secondary, Neoplasms pathology
- Abstract
Background: Breast cancer is a common malignancy, but metastases to the breast of extramammary malignancies are very rare. Treatment and prognosis are different. The aim of the study is to report the incidence of lymphomas and metastases to the breast of extramammary malignancies in our 30-year archive., Methods: The pathology database of a single institute was reviewed for all breast neoplasms which were coded in our system as a metastasis in the period 1985-2014. Metastatic tumors from primary breast carcinoma were excluded., Results: A total of 47 patients were included (7 men/40 women, mean age 63 years). The majority originated from lymphoma (n = 18) and primary melanoma (n = 11). Other primary tumor sites included the ovary (n = 6), lung (n = 6), colon (n = 3), kidney (n = 1), stomach (n = 1), and chorion (n = 1). In 24/47 patients (51 %), metastasis was the first sign of the specific malignant disease. In seven patients (15 %) surgery was performed, the diagnosis of metastatic disease was adjusted in four patients (9 %) postoperatively., Conclusions: It is important to distinguish lymphomas and metastases to the breast from common primary breast carcinoma for proper treatment and prognosis. Therefore, we emphasize the need for a histological or cytopathological diagnosis before any treatment is commenced. The pathologist plays a key role in considering the diagnosis of metastasis if the histological features are unusual for a primary breast carcinoma. The pathologist should therefore be properly informed by the clinical physician although lymphomas and metastases to the breast are the first presentation of malignant disease in half the cases.
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- 2016
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50. Performance indicators for lung cancer surgery in the Netherlands.
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Damhuis RA, Maat AP, and Plaisier PW
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- Adolescent, Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Morbidity trends, Netherlands epidemiology, Retrospective Studies, Survival Rate trends, Young Adult, Carcinoma, Non-Small-Cell Lung surgery, Lung Neoplasms surgery, Pneumonectomy standards, Postoperative Complications epidemiology, Quality Indicators, Health Care
- Abstract
Objectives: In the Netherlands, surgery for lung cancer is traditionally performed in low-volume hospitals. To assess the need for centralization, we examined early outcome measures and compared results between hospitals and with other European countries., Methods: Data on patient, tumour and treatment characteristics were retrieved from the Netherlands Cancer Registry. Results were tabulated for 30-day postoperative mortality (POM), major morbidity rate (intrathoracic empyema, bronchopleural fistula or rethoracotomy) and pneumonectomy proportion. Hospital variation was projected using funnel graphs in which the results for individual hospitals are plotted against volume., Results: The study comprised a series of 9579 patients with primary non-small cell lung cancer, diagnosed from 2005 through 2010 and operated in 79 different hospitals. The POM was 2.7% on average and age, gender, period and type of surgery were determined as prognostic factors. Multivariable analysis did not reveal an association with hospital volume (P = 0.34). The POM was higher for operations on Fridays (4.0%) or during weekends (6.8%). Major morbidity was observed after 8.3% of operations and was more frequent after bilobectomy (11.6%) or right pneumonectomy (22%). The pneumonectomy proportion decreased from 18% in 2005 to 11% in 2010. Funnel plots revealed a limited number of significant outliers, despite combining data over a 6-year period., Conclusions: Results for the Netherlands were similar to those from other European countries. Hospital volume was not associated with early outcome indicators. Quality assessment at the hospital level remains a major challenge given the low frequency of adverse events and the impediments of chance variation., (© The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)
- Published
- 2015
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