Search

Your search keyword '"Seldenrijk, C.A."' showing total 29 results
Start Over Author "Seldenrijk, C.A."
29 results on '"Seldenrijk, C.A."'

2. Associations of non-pedunculated T1 colorectal adenocarcinoma outcome with consensus molecular subtypes, immunoscore, and microsatellite status: a multicenter case-cohort study

Author

Haasnoot, K.J.C., Backes, Y., Moons, L.M.G., Kranenburg, O., Trinh, A., Vermeulen, L., Noe, M., Tuynman, J.B., Lent, A.U.G. van, Ginneken, R. van, Seldenrijk, C.A., Raicu, M.G., Trumpi, K., Ubink, I., Milne, A.N., Boonstra, J.J., Groen, J.N., Schwartz, M.P., Wolfhagen, F.H.J., Geesing, J.M.J., Borg, F. ter, Brosens, L.A.A., Bergeijk, J. van, Spanier, B.W.M., Cappel, W.H.D.T.N., Kessels, K., Seerden, T.C.J., Vleggaar, F.P., Offerhaus, G.J.A., Siersema, P.D., Elias, S.G., Lacle, M.M., Dutch T1 CRC Working Grp, Internal medicine, Amsterdam Gastroenterology Endocrinology Metabolism, Surgery, and CCA - Cancer biology and immunology

Subjects
Male, 0301 basic medicine, Oncology, medicine.medical_specialty, Pathology, Time Factors, Adenocarcinoma, Lower risk, Pathology and Forensic Medicine, 03 medical and health sciences, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], 0302 clinical medicine, Predictive Value of Tests, Internal medicine, Biomarkers, Tumor, medicine, Tumours of the digestive tract Radboud Institute for Molecular Life Sciences [Radboudumc 14], Humans, Genetic Predisposition to Disease, Colorectal adenocarcinoma, Lymph node, Aged, Neoplasm Staging, Netherlands, Tissue microarray, business.industry, Hazard ratio, Microsatellite instability, Middle Aged, medicine.disease, Immunohistochemistry, digestive system diseases, DNA Repair Enzymes, Phenotype, Treatment Outcome, 030104 developmental biology, medicine.anatomical_structure, Tissue Array Analysis, Case-Control Studies, 030220 oncology & carcinogenesis, Microsatellite, Female, Microsatellite Instability, Neoplasm Recurrence, Local, Colorectal Neoplasms, business, Cohort study
Abstract

Contains fulltext : 229364.pdf (Publisher’s version ) (Closed access) Advanced colorectal cancer (CRC) consensus molecular subtype 4 (CMS4) or CRC with a low immunoscore is associated with shorter survival times. Non-metastatic CRC with microsatellite instability (MSI) is associated with a lower risk of recurrence. We evaluated outcome (lymph node metastases [LNM] or cancer recurrence) in these tumor subtypes in patients with surgically-removed non-pedunculated T1 CRC by performing a multicenter case-cohort study. We included all patients in 13 hospitals in the Netherlands from 2000-2014 (n = 651). We randomly selected a subgroup of patients (n = 223) and all patients with LNM or recurrence (n = 63), and median follow-up of 44 months. We centrally reviewed tumor-slides, and constructed and immunostained tissue microarrays determining MSI, CMS (MSI/CMS1, CMS2/3, or CMS4), and immunoscore (I-low/I-high). We used weighted Cox proportional hazard models to evaluate the association of MSI, CMS, and immunoscore with LNM or recurrence, adjusting for conventional histologic risk factors. In the randomly selected subgroup of patients, 7.1% of tumors were MSI/CMS1, 91.0% CMS2/3, 1.8% CMS4, and 25% I-low. In the case-cohort, patients with CMS4 tumors had an increased risk for LNM or recurrence compared with patients with tumors of other CMSs (adjusted hazard ratio [HR], 3.97; 95% CI, 1.12-14.06; P = 0.03). Albeit not significant, tumors with MSI had a lower risk for LNM or recurrence than other tumor subtypes (adjusted HR, 0.52; 95% CI, 0.12-2.30; P = 0.39), whereas tumors with a low immunoscore had an increased risk for LNM or recurrence (adjusted HR, 1.30; 95% CI, 0.68-2.48; P = 0.43). In conclusion, in a case-cohort study of patients with non-pedunculated T1 CRC, MSI, and immunoscore were not significantly associated with adverse outcome after surgery. CMS4 substantially increased the risk of adverse outcome. However, CMS4 is rare in T1 CRCs, limiting its value for determining the risk in patients.

Published
2020
Full Text
View/download PDF

3. Significant variation in histopathological assessment of endoscopic resections for Barrett's neoplasia suggests need for consensus reporting: propositions for improvement

Author

Wel, M.J.C. van der, Klaver, E., Pouw, R.E., Brosens, L.A.A., Biermann, K., Doukas, M., Huysentruyt, C., Karrenbeld, A., Kate, F.J. ten, Kats-Ugurlu, G., Laan, J. van der, Lijnschoten, I. Van, Moll, F.C.P., Offerhaus, G.J.A., Ooms, A., Seldenrijk, C.A., Visser, M. de, Tijssen, J.G., Meijer, S.L., Bergman, J., Wel, M.J.C. van der, Klaver, E., Pouw, R.E., Brosens, L.A.A., Biermann, K., Doukas, M., Huysentruyt, C., Karrenbeld, A., Kate, F.J. ten, Kats-Ugurlu, G., Laan, J. van der, Lijnschoten, I. Van, Moll, F.C.P., Offerhaus, G.J.A., Ooms, A., Seldenrijk, C.A., Visser, M. de, Tijssen, J.G., Meijer, S.L., and Bergman, J.

Abstract

Item does not contain fulltext, Endoscopic resection (ER) is an important diagnostic step in management of patients with early Barrett's esophagus (BE) neoplasia. Based on ER specimens, an accurate histological diagnosis can be made, which guides further treatment. Based on depth of tumor invasion, differentiation grade, lymphovascular invasion, and margin status, the risk of lymph node metastases and local recurrence is judged to be low enough to justify endoscopic management, or high enough to warrant invasive surgical esophagectomy. Adequate assessment of these histological risk factors is therefore of the utmost importance. Aim of this study was to assess pathologist concordance on these histological features on ER specimens and evaluate causes of discrepancy. Of 62 challenging ER cases, one representative H&E slide and matching desmin and endothelial marker were digitalized and independently assessed by 13 dedicated GI pathologists from 8 Dutch BE expert centers, using an online assessment module. For each histological feature, concordance and discordance were calculated. Clinically relevant discordances were observed for all criteria. Grouping depth of invasion categories according to expanded endoscopic treatment criteria (T1a and T1sm1 vs. T1sm2/3), ≥1 pathologist was discrepant in 21% of cases, increasing to 45% when grouping diagnoses according to the traditional T1a versus T1b classification. For differentiation grade, lymphovascular invasion, and margin status, discordances were substantial with 27%, 42%, and 32% of cases having ≥1 discrepant pathologist, respectively. In conclusion, histological assessment of ER specimens of early BE cancer by dedicated GI pathologists shows significant discordances for all relevant histological features. We present propositions to improve definitions of diagnostic criteria.

Published
2021

4. Extension of early esophageal squamous cell neoplasia into ducts and submucosal glands and the role of endoscopic ablation therapy

Author

Overwater, A., Munster, S.N. van, Offerhaus, G.J.A., Seldenrijk, C.A., Raicu, G.M., Koch, A.D., Bergman, J., Pouw, R.E., Brosens, L.A.A., Jansen, M., Weusten, B., Overwater, A., Munster, S.N. van, Offerhaus, G.J.A., Seldenrijk, C.A., Raicu, G.M., Koch, A.D., Bergman, J., Pouw, R.E., Brosens, L.A.A., Jansen, M., and Weusten, B.

Abstract

Item does not contain fulltext, BACKGROUND AND AIMS: Early esophageal squamous cell neoplasia (ESCN) is preferably treated with en-bloc endoscopic resection. Ablation might be an alternative for flat ESCN, but ESCN extension along the epithelial lining of ducts and submucosal glands (SMGs) might jeopardize ablation efficacy. Clinical studies suggest that local recurrence might arise from such buried ESCN niches after ablation. We studied human endoscopic resection specimens of ESCN to quantify ESCN extension into ducts/SMGs and performed a prospective porcine study to evaluate the depth of radiofrequency ablation (RFA) and CryoBalloon ablation (CBA) into ducts/SMGs. METHODS: Endoscopic submucosal dissection specimens of flat-type ESCN from a Japanese (n = 65) and Dutch cohort (n = 14) were evaluated for presence and neoplastic involvement of ducts/SMGs. Twenty-seven pigs were treated with circumferential RFA (c-RFA; n = 4), focal CBA (n = 20), and focal RFA (n = 3) with 4, 60, and 9 treatment areas, respectively. After prespecified survival periods (0 hours, 8 hours, 2 days, 5 days, and 28 days), treatment areas were evaluated for uniformity and depth of ablation and affected SMGs. RESULTS: Neoplastic extension in ducts/SMGs was observed in most lesions: 58% (38/65) in the Japanese and 64% (9/14) in the Dutch cohort. In the animal study, 33% of SMGs (95% confidence interval, 28-50) were not affected after c-RFA, although the overlying epithelium was ablated. Focal RFA and CBA resulted in uniform ablations with effective treatment of all SMGs. CONCLUSIONS: ESCN extends into ducts/SMGs in most patients. In an animal model, focal RFA and CBA effectively ablated SMGs, whereas c-RFA inadequately ablated SMGs. Given this potential reason for recurrence, endoscopic resection should remain the standard of care.

Published
2021

5. Lymphovascular invasion quantification could improve risk prediction of lymph node metastases in patients with submucosal (T1b) esophageal adenocarcinoma

Author

Ven, S.E.M. van de, Suzuki, L., Gotink, A.W., Kate, F.J. ten, Nieboer, D., Weusten, B., Brosens, L.A.A., Hillegersberg, R. van, Herrero, L. Alvarez, Seldenrijk, C.A., Alkhalaf, A., Moll, F.C.P., Curvers, W., Lijnschoten, I.G. van, Tang, T.J., Valk, H. van der, Nagengast, W.B., Kats-Ugurlu, G., Plukker, J.T., Houben, M, Laan, J.S. van der, Pouw, R.E., Bergman, J., Meijer, S.L., Henegouwen, M.I. van Berge, Wijnhoven, B.P., Jonge, P.J.F. de, Doukas, M., Bruno, M.J., Biermann, K., Koch, A.D., Ven, S.E.M. van de, Suzuki, L., Gotink, A.W., Kate, F.J. ten, Nieboer, D., Weusten, B., Brosens, L.A.A., Hillegersberg, R. van, Herrero, L. Alvarez, Seldenrijk, C.A., Alkhalaf, A., Moll, F.C.P., Curvers, W., Lijnschoten, I.G. van, Tang, T.J., Valk, H. van der, Nagengast, W.B., Kats-Ugurlu, G., Plukker, J.T., Houben, M, Laan, J.S. van der, Pouw, R.E., Bergman, J., Meijer, S.L., Henegouwen, M.I. van Berge, Wijnhoven, B.P., Jonge, P.J.F. de, Doukas, M., Bruno, M.J., Biermann, K., and Koch, A.D.

Abstract

Item does not contain fulltext, AIM: To quantify lymphovascular invasion (LVI) and to assess the prognostic value in patients with pT1b esophageal adenocarcinoma. METHODS: In this nationwide, retrospective cohort study, patients were included if they were treated with surgery or endoscopic resection for pT1b esophageal adenocarcinoma. Primary endpoint was the presence of metastases, lymph node metastases, or distant metastases, in surgical resection specimens or during follow-up. A prediction model to identify risk factors for metastases was developed and internally validated. RESULTS: 248 patients were included. LVI was distributed as follows: no LVI (n = 196; 79.0%), 1 LVI focus (n = 16; 6.5%), 2-3 LVI foci (n = 21; 8.5%) and ≥4 LVI foci (n = 15; 6.0%). Seventy-eight patients had metastases. The risk of metastases was increased for tumors with 2-3 LVI foci [subdistribution hazard ratio (SHR) 3.39, 95% confidence interval (CI) 2.10-5.47] and ≥4 LVI foci (SHR 3.81, 95% CI 2.37-6.10). The prediction model demonstrated a good discriminative ability (c-statistic 0.81). CONCLUSION: The risk of metastases is higher when more LVI foci are present. Quantification of LVI could be useful for a more precise risk estimation of metastases. This model needs to be externally validated before implementation into clinical practice.

Published
2021

6. Axial slicing versus bivalving in the pathological examination of pancreatoduodenectomy specimens (APOLLO): a multicentre randomized controlled trial

Author

Roessel, S. van, Soer, E.C., Dieren, S. van, Koens, L., Velthuysen, M.L. van, Doukas, M., Groot Koerkamp, B., Sarasqueta, A.F., Bronkhorst, C.M., Raicu, G.M., Kuijpers, K.C., Seldenrijk, C.A., Santvoort, H.C. van, Molenaar, I.Q., Post, R.S. van der, Stommel, M.W.J., Busch, O.R., Besselink, M.G.H., Brosens, L.A.A., Verheij, J., Roessel, S. van, Soer, E.C., Dieren, S. van, Koens, L., Velthuysen, M.L. van, Doukas, M., Groot Koerkamp, B., Sarasqueta, A.F., Bronkhorst, C.M., Raicu, G.M., Kuijpers, K.C., Seldenrijk, C.A., Santvoort, H.C. van, Molenaar, I.Q., Post, R.S. van der, Stommel, M.W.J., Busch, O.R., Besselink, M.G.H., Brosens, L.A.A., and Verheij, J.

Abstract

Item does not contain fulltext, BACKGROUND: In pancreatoduodenectomy specimens, dissection method may affect the assessment of primary tumour origin (i.e. pancreatic, distal bile duct or ampullary adenocarcinoma), which is primarily determined macroscopically. This is the first study to prospectively compare the two commonly used techniques, i.e. axial slicing and bivalving. METHODS: In four centres, a randomized controlled trial was performed in specimens of patients with a suspected (pre)malignant tumour in the pancreatic head. Primary outcome measure was the level of certainty (scale 0-100) regarding tumour origin by four independent gastrointestinal pathologists based on macroscopic assessment. Secondary outcomes were inter-observer agreement and R1 rate. RESULTS: In total, 128 pancreatoduodenectomy specimens were randomized. The level of certainty in determining the primary tumour origin did not differ between axial slicing and bivalving (mean score 72 [sd 13] vs. 68 [sd 16], p = 0.21), nor did inter-observer agreement, both being moderate (kappa 0.45 vs. 0.47). In pancreatic cancer specimens, R1 rate (60% vs. 55%, p = 0.71) and the number of harvested lymph nodes (median 16 vs. 17, p = 0.58) were similar. CONCLUSION: This study demonstrated no differences in determining the tumour origin between axial slicing and bivalving. Both techniques performed similarly regarding inter-observer agreement, R1 rate, and lymph node harvest.

Published
2021

7. T-cellular immune reactions (in macrophage inhibition factor assay) against Mycobacterium paratuberculosis, Mycobacterium kansasii, Mycobacterium tuberculosis, Mycobacterium avium in patients with chronic inflammatory bowel disease

Author

Seldenrijk, C.A., Drexhage, H.A., Meuwissen, S.G.M., and Meijer, C.J.L.M.

Subjects
Crohn's disease -- Physiological aspects, Intestine, Small -- Inflammation, Mycobacterium avium, Mycobacterial infections -- Complications, Mycobacterium tuberculosis, Crohn's disease -- Causes of, Health
Abstract

Crohn's disease, or regional ileitis, is an inflammatory condition of the intestine characterized by diarrhea, abdominal pain, anemia, weight loss, and symptoms of bowel obstruction. The cause of Crohn's disease is not known, but it has been suggested that infestation with mycobacteria (the type of bacterial parasite which causes tuberculosis and leprosy) may be a causal factor. Johne's disease, a similar condition in cattle, is known to be caused by infection with Mycobacterium paratuberculosis. To evaluate the possibility that an inappropriate immune response (either exaggerated or suppressed) to M. paratuberculosis, or to a similar bacterial parasite, might be involved in Crohn's disease, a study was performed involving 35 patients with Crohn's disease, 28 patients with ulcerative colitis (a similar inflammatory condition affecting the colon, which is not thought to result from bacterial infection), and 25 healthy control subjects. Subjects were injected with inactivated M. paratuberculosis, Mycobacterium kansasii, Mycobacterium tuberculosis, and Mycobacterium avium; the response of the immune system was evaluated. There were no differences in the percentages of patients in the three groups showing various types of responses to each of the bacterial antigens. This suggests that an altered response to one of these bacteria is not responsible for Crohn's disease. In addition, many of the control subjects showed mycobacterial activation of the immune system (indicating prior or current infestation), suggesting that individuals can be exposed to these bacteria with no adverse effects. (Consumer Summary produced by Reliance Medical Information, Inc.)

Published
1990

9. Prognostic value of estrogen receptor alpha and progesterone receptor conversion in distant breast cancer metastases

Author

Hoefnagel, L.D.C., Moelans, C.B., Meijer, S.L., van Slooten, H.J., Wesseling, P., Wesseling, J., Westenend, PJ, Bart, J., Seldenrijk, C.A., Nagtegaal, I.D., Oudejans, J., van der Valk, P., van Gils, C.H., van der Wall, E.E., van Diest, P.J., Pathology, and CCA - Disease profiling

Subjects
Translational research [ONCOL 3], Translational research Tissue engineering and pathology [ONCOL 3]
Abstract

Contains fulltext : 109187pub.pdf (Publisher’s version ) (Closed access) BACKGROUND: Changes in the receptor profile of primary breast cancers to their metastases (receptor conversion) have been described for the estrogen receptor alpha (ERalpha) and progesterone receptor (PR). The purpose of this study was to evaluate the impact of receptor conversion for ERalpha and PR on survival in a large group of distant non-bone breast cancer metastases. METHODS: Receptor conversion was studied by immunohistochemistry in a group of 233 metastatic breast cancer patients. Kaplan-Meier overall survival curves were plotted, and differences between the curves were analyzed by log-rank analysis. The additional prognostic value of conversion to established prognosticators was studied by Cox regression. RESULTS: Overall survival of patients showing conversion from positive to negative ERalpha or PR, or from negative to positive ERalpha or PR, or remaining receptor negative was comparable, and significantly worse than patients remaining receptor positive. ERalpha or PR receptor conversion from positive in the primary breast tumor to negative in distant metastases has independent negative prognostic value. CONCLUSIONS: ERalpha or PR receptor conversion from positive in the primary breast cancer to negative in distant metastases has negative prognostic value. Cancer 2012. (c) 2012 American Cancer Society.

Published
2012
Full Text
View/download PDF

10. Tumoren van long, pleura en mediastinum

Author

Schramel, F.M.N.H., Postmus, P.E., Thunnissen, F.B.J.M., Vanderschueren, R.G.J.R.A., Seldenrijk, C.A., Pulmonary medicine, Pathology, and CCA - Innovative therapy

Published
2010

11. The Microanatomic Location of Metastatic Breast Cancer in Sentinel Lymph Nodes Predicts Nonsentinel Lymph Node Involvement

Author

Deurzen, C.H.M. van, Seldenrijk, C.A., Koelemij, R., Hillegersberg, R. van, Hobbelink, M.G.G., and Diest, P.J. van

Subjects
Geneeskunde, Axillary lymph node metastases, Breast cancer, Sentinel node, Morphometry
Abstract

Background: The majority of sentinel node (SN) positive breast cancer patients do not have additional non-SN involvement and may not benefit from axillary lymph node dissection (ALND). Previous studies in melanoma have suggested that microanatomic localization of SN metastases may predict non-SN involvement. The present study was designed to assess whether these criteria might also be used to be more restrictive in selecting breast cancer patients who would benefit from an ALND. Methods: A consecutive series of 357 patients with invasive breast cancer and a tumorpositive axillary SN, followed by an ALND, was reviewed. Microanatomic SN tumor features (subcapsular, combined subcapsular and parenchymal, parenchymal, extensive localization, multifocality, and the penetrative depth from the SN capsule) were evaluated for their predictive value for non-SN involvement. Results: Non-SN metastases were found in 136/357 cases (38%). Microanatomic location and penetrative depth of SN metastases were significant predictors for non-SN involvement (

Published
2008

12. Dendritic cells and scavenger macrophages in chronic inflammatory bowel disease

Author

Seldenrijk, C.A., Drexhage, H.A., Meuwissen, S.G.M., Pals, S.T., and Meijer, C.J.L.M.

Subjects
Ulcerative colitis, Macrophages -- Identification and classification, Phagocytes -- Identification and classification, Health
Abstract

The gut walls in ten cases of chronic inflammatory bowel disease, including cases of Crohn's disease and ulcerative colitis (inflammation of the mucous of the colon), were studied. Two opposite types of mononuclear phagocytes were identified: scavenger macrophages with blunted projections, and dendritic cells with long dendritic cytoplasmic projections. (Phagocytes are cells which are able to ingest and thereby destroy bacteria, cell debris and other substances.) Dendritic cells were usually found in lymphoid tissue in deep layers of the gut wall. Antigen handling and stimulation of the immune response seem to take place at dendritic cell sites. Scavenger macrophages, on the other hand, were noted in more superficial locations. Ingestion and degradation of foreign material takes place at these spots.

Published
1989

13. Prognostic value of estrogen receptor alpha and progesterone receptor conversion in distant breast cancer metastases

Author

Hoefnagel, L.D., Moelans, C.B., Meijer, S.L., van Slooten, H.J., Wesseling, P., Wesseling, J., Westenend, P.J., Bart, J., Seldenrijk, C.A., Nagtegaal, I.D., Oudejans, J., van der Valk, P., Gils, C.H. van, van der Wall, E., van Diest, P.J., Hoefnagel, L.D., Moelans, C.B., Meijer, S.L., van Slooten, H.J., Wesseling, P., Wesseling, J., Westenend, P.J., Bart, J., Seldenrijk, C.A., Nagtegaal, I.D., Oudejans, J., van der Valk, P., Gils, C.H. van, van der Wall, E., and van Diest, P.J.

Abstract

Contains fulltext : 109187pub.pdf (publisher's version ) (Closed access), BACKGROUND: Changes in the receptor profile of primary breast cancers to their metastases (receptor conversion) have been described for the estrogen receptor alpha (ERalpha) and progesterone receptor (PR). The purpose of this study was to evaluate the impact of receptor conversion for ERalpha and PR on survival in a large group of distant non-bone breast cancer metastases. METHODS: Receptor conversion was studied by immunohistochemistry in a group of 233 metastatic breast cancer patients. Kaplan-Meier overall survival curves were plotted, and differences between the curves were analyzed by log-rank analysis. The additional prognostic value of conversion to established prognosticators was studied by Cox regression. RESULTS: Overall survival of patients showing conversion from positive to negative ERalpha or PR, or from negative to positive ERalpha or PR, or remaining receptor negative was comparable, and significantly worse than patients remaining receptor positive. ERalpha or PR receptor conversion from positive in the primary breast tumor to negative in distant metastases has independent negative prognostic value. CONCLUSIONS: ERalpha or PR receptor conversion from positive in the primary breast cancer to negative in distant metastases has negative prognostic value. Cancer 2012. (c) 2012 American Cancer Society.

Published
2012

14. Receptor conversion in distant breast cancer metastases.

Author

Hoefnagel, L.D., Vijver, M.J. van de, Slooten, H.J. van, Wesseling, P., Wesseling, J., Westenend, P.J., Bart, J., Seldenrijk, C.A., Nagtegaal, I.D., Oudejans, J.J., Valk, P. van der, Groep, P. van der, Vries, E.G. de, Wall, E. van der, Diest, P.J. van, Hoefnagel, L.D., Vijver, M.J. van de, Slooten, H.J. van, Wesseling, P., Wesseling, J., Westenend, P.J., Bart, J., Seldenrijk, C.A., Nagtegaal, I.D., Oudejans, J.J., Valk, P. van der, Groep, P. van der, Vries, E.G. de, Wall, E. van der, and Diest, P.J. van

Abstract

Contains fulltext : 89478.pdf (publisher's version ) (Open Access)

Published
2010

21. Vasculitis due to gemcitabine

Author

Voorburg, A.M.C.J., primary, van Beek, F.T., additional, Slee, P.H.Th.J., additional, Seldenrijk, C.A., additional, and Schramel, F.M.N.H., additional

Published
2002
Full Text
View/download PDF

23. Predictive value of tumor load in breast cancer sentinel lymph nodes for second echelon lymph node metastases

Author

van Deurzen, C.H.M, van Hillegersberg, R., Hobbelink, M.G.G., Seldenrijk, C.A., Koelemij, R., and van Diest, P.J.

Abstract

Background: The need for routine axillary lymph node dissection (ALND) in patients with invasive breast cancer and low-volume sentinel node (SN) involvement is questionable. Accurate prediction of second echelon lymph node involvement could identify those patients most likely to benefit from ALND.Methods: A consecutive series of 317 patients with invasive breast cancer and a tumor positive axillary SN followed by ALND was reviewed. Clinicopathologic features of the primary tumor and the SN were assessed as possible predictors of second echelon lymph node involvement.Results: Second echelon metastases were found in 116317 cases (36.6%). Frequency of second echelon lymph node involvement in patients with isolated tumor cells (ITC, N23), micro- (N101) and macrometastases (N193) was 13%, 20% and 48%, respectively (p<0.001). Based on the area % of SN occupied by tumor no subgroup of patients could be selected with less than 20% second echelon lymph node involvement. However, none of the patients with SN ITC or micrometastases and a primary tumor size ≤1 cm (N12, 3.8%) had second echelon lymph node involvement.Conclusions: Accurately measured SN tumor load predicts second echelon lymph node involvement. However, even in patients with ITC, the second echelon lymph nodes are involved in 13% justifying ALND.

Published
2007

24. Primary thyroid lymphoma

Author

Honing, M.L.H, Seldenrijk, C.A, and de Maat, C.E.M

Abstract

A 71-year-old woman presented with a rapidly growing goitre which was diagnosed as chronic autoimmune thyroiditis. Despite treatment with levothyroxine, she developed progressive airway obstruction. Biopsy revealed a primary thyroid lymphoma which was successfully treated with radiotherapy.

Published
1998
Full Text
View/download PDF

25. Kikuchi's histiocytic necrotizing lymphadenitis

Author

Veth, G., Seldenrijk, C.A., and de Maat, C.E.M.

Abstract

Kikuchi's lymphadenitis was first recognized almost 25 years ago in Japan as a histopathologically specific reactive lymphadenitis without clear clinical correlates. The benign self-limiting clinical course and the notorious danger of misdiagnosis as malignant lymphoma together make it important to recognize this lymph node reaction type. We describe 2 typical case histories—young women with a cervical localisation.

Published
1997
Full Text
View/download PDF

28. Liver cirrhosis due to methotrexate in a patient with rheumatoid arthritis

Author

ter Borg, E.J., Seldenrijk, C.A., and Timmer, R.

Abstract

A 49-year-old female with rheumatoid arthritis developed liver cirrhosis after a cumulative dosage of 6 g methotrexate (MTX). There were mild liver enzyme abnormalities, decreased liver synthesis function and possible signs of portal hypertension. After stopping MTX all laboratory abnormalities disappeared except for a mild thrombocytopenia. Risk factors and guidelines for monitoring liver toxicity during MTX treatment in rheumatoid arthritis are discussed.

Published
1996
Full Text
View/download PDF

29. Low volume metastases in breast cancer sentinel nodes: A diagnostic and therapeutic challenge

Author

van Deurzen, C.H.M., van Diest, Paul J., Tjan-Heijnen, V.C.G., Seldenrijk, C.A., and University Utrecht

Abstract

A SN biopsy is an accurate method to assess nodal status in breast cancer patients and has largely replaced the traditional axillary lymph node dissection (ALND) as an initial staging procedure. The clinical scenarios for the use of a SN biopsy are expanding. We reviewed the literature regarding the role of a SN biopsy in patients with ductal carcinoma in situ (DCIS) and following neoadjuvant chemotherapy. We concluded that it could be considered on an individual basis, but we think there is insufficient evidence to recommend this as a standard procedure in these patients. Selective targeting of the SN with extensive pathological assessment increased the detection rate of small metastases with unknown clinical significance. This phenomenon is reflected by the International Union Against Cancer (UICC) system and by the 6th edition of the American Joint Committee on Cancer (AJCC) Cancer Staging Manual, which defined metastases in three categories based on size: isolated tumor cells (ITC) (?0.2 mm), micrometastases (> 0.2- ? 2 mm) and macrometastases (> 2 mm). Although patients with ITC are staged as N0, there is no generally accepted approach regarding local control in this group. The published literature reported an overall pooled risk of higher echelon lymph node involvement (further denoted as non-SNs) of 12.3% after finding ITC in the SN. Because the majority of patients with SN ITC had non-SN macrometastases, there might be an indication for an ALND for those patients with SN ITC without other indications for adjuvant systemic therapy. A substantial proportion of patients with SN involvement do not have non-SN involvement. We assessed the predictive value of the SN tumor load (defined as the area% of the SN involved by tumor) and its micro-anatomic location, for non-SN involvement. Based on these features however, we could not select a subgroup of patients without non-SN involvement. Previous studies suggested that small epithelial deposits in lymph nodes may represent mechanically displaced benign or malignant epithelial cells, rather than true metastases. We therefore assessed the malignant potential of ITC by nuclear morphometry and immunohistochemistry. The results of these analyses suggest that some of these deposits represent benign or degenerated malignant epithelium lacking outgrowth potential. Since the distinction between ITC, micro-and macrometastases directly affects therapeutic decisions making, it is important to have a reproducible pathological staging method that provides a prognostic separation. We compared some refinements of the current definitions and offer suggestions regarding its use in lobular breast carcinoma patients. The unknown prognostic relevance of micrometastases and ITC leads to different opinions regarding adjuvant therapy. We evaluated the prognostic relevance of these metastases and the impact of adjuvant systemic therapy in a large nationwide Dutch cohort study and demonstrated a negative prognostic impact of both ITC and micrometastases in early stage breast cancer patients not receiving adjuvant systemic therapy. Furthermore, disease recurrence was reduced in patients treated with adjuvant systemic therapy. Of particular interest was that the impact of ITC was similar to the impact or micrometastases.

Published
2009

Catalog

Books, media, physical & digital resources
See catalog results