9 results on '"Vergeldt TFM"'
Search Results
2. Vulvar cancer in hidradenitis suppurativa.
- Author
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Vergeldt TFM, Driessen RJB, Bulten J, Nijhuis THJ, and de Hullu JA
- Abstract
Background: Hidradenitis suppurativa (HS) is a debilitating disorder characterized by chronic inflammation in intertriginous areas. Malignant transformation to squamous cell carcinoma (SCC) is rare and is mostly diagnosed in the perianal area in men. The clinical behavior of SCC in HS can be aggressive, with local invasion and distant metastases.Case descriptions.We describe two cases of vulvar SCC in HS. The first demonstrates a 75 year old woman with a severe undertreated HS for over 30 years, who presented with a widespread vulvar cancer with lymphangitis carcinomatosa and inguinal and pelvic lymphadenopathy within several weeks after first suspicion of a malignancy. She died shortly after diagnosis. The second case describes a 61 year old woman diagnosed with HS 7 years ago, who presented with a rapidly progressive vulvar cancer with suspicion for ingrowth in the anal sphincter, vagina and levator ani muscle with inguinal and pelvic lymphadenopathy. She received radical chemoradiation with a complete response on imaging, but had a local recurrence within 2 months after finishing treatment. A posterior exenteration was performed but 5 months after surgery she had a second recurrence in the vulvar scar and pelvic floor muscles with possible bone metastases. She received palliative chemotherapy., Conclusion: Vulvar SCC in an area of HS is a rare condition which is difficult to diagnose. It can have an aggressive course with rapid progression and a high frequency of metastases at presentation. Early surgical excision of HS to diagnose occult malignant transformation, appropriate imaging to establish the extent of the disease and an aggressive treatment plan without any delays are recommended., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Rieke Driessen reports grants and personal fees from Galderma, Novartis, Abbvie, Janssen and Leo Pharma, outside the submitted work. Fees were paid directly to the institution. The other authors have nothing to disclose., (© 2022 The Authors.)
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- 2022
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3. Salvage surgery for patients with residual disease after chemoradiation therapy for locally advanced cervical cancer: A systematic review on indication, complications, and survival.
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van Kol KGG, Ebisch RMF, Piek JMJ, Zusterzeel PLM, Vergeldt TFM, and Bekkers RLM
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- Chemoradiotherapy methods, Disease-Free Survival, Female, Humans, Neoadjuvant Therapy methods, Neoplasm Staging, Neoplasm, Residual mortality, Neoplasm, Residual therapy, Radiotherapy, Adjuvant methods, Uterine Cervical Neoplasms pathology, Salvage Therapy statistics & numerical data, Uterine Cervical Neoplasms mortality, Uterine Cervical Neoplasms therapy
- Abstract
Introduction: Standard treatment for locally advanced cervical cancer is chemoradiation therapy. Treatment with chemoradiation therapy harbors a risk of local residual disease, which can be curatively treated with salvage surgery, but the risk of complications following surgical procedures in radiated tissue is not negligible. The presence of residual disease can be radiologically and/or histologically diagnosed. The objective of this study is to describe studies that report on salvage surgery for patients with locally advanced cervical cancer after primary treatment with chemoradiation therapy. Therefore, we assessed the method of determining the presence of residual disease, the risk of complications, and the survival rate after salvage surgery., Material and Methods: PubMed, EMBASE, and the Cochrane database were searched from inception up to 6 March 2020. Titles and abstracts were independently assessed by two researchers. Studies were eligible for inclusion when patients had locally advanced cervical cancer with radiologically suspected or histologically confirmed residual disease after chemoradiation therapy, diagnosed with a CT, MRI, or PET-CT scan, or biopsy. Information on complications after salvage surgery and survival outcomes had to be reported. Methodological quality of the articles was independently assessed by two researchers with the Newcastle-Ottawa scale., Results: Of the 2963 screened articles, six studies were included, representing 220 women. A total of 175 patients were treated with salvage surgery, of whom 27%-100% had residual disease on the surgery specimen. Of the 161 patients treated with salvage surgery based on positive biopsy results, 72%-100% showed residual disease on the surgery specimen. Of the 44 patients treated with salvage surgery based on suspected residual disease on radiology, 27%-48% showed residual disease on the salvage surgery specimen. A total of 105 complications were registered in 175 patients treated with salvage surgery. The overall survival rate after salvage surgery was 69% (mean follow-up period of 24.9 months)., Conclusions: It is necessary to confirm residual disease by biopsy before performing salvage surgery in patients with locally advanced cervical cancer primarily treated with chemoradiation therapy. Salvage surgery only based on radiologically suspected residual disease should be avoided to prevent unnecessary surgery and complications., (© 2021 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).)
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- 2021
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4. Association between levator ani avulsion and urinary incontinence in women: A systematic review and meta-analysis.
- Author
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Smeets CFA, Vergeldt TFM, Notten KJB, Martens FMJ, and van Kuijk SMJ
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- Female, Humans, Pregnancy, Delivery, Obstetric adverse effects, Pelvic Floor physiology, Urinary Incontinence, Stress epidemiology
- Abstract
Background: Urinary incontinence is a bothersome symptom. Although the relationship between stress urinary incontinence (SUI) and vaginal delivery is established, the pathology underlying SUI after vaginal birth remains to be elucidated., Objectives: To determine whether levator ani muscle avulsion predisposes for SUI in women., Search Strategy: Pubmed and Embase were searched for terms and their variations "levator ani muscle avulsion" and "urinary incontinence", from inception until 5 November 2019., Selection Criteria: Inclusion criterion: studies describing the relationship between urinary incontinence and levator ani muscle avulsion in women at least 1 year after delivery. Exclusion criterion: studies only analyzing the urethral sphincter or hiatus dimensions., Data Collection and Analysis: Odds ratios were used and if not available, were calculated as means of data synthesis, adjusted odds ratios if presented by the study, random-effects model to compute a pooled estimate., Results: Seven studies were included, accounting for 2388 women. Comparing women with and without levator ani muscle avulsion, the overall odds ratio for SUI is 0.87 (95% confidence interval 0.56-1.34), and after adjustment for possible confounders was 0.72 (95% confidence interval 0.40-1.30)., Conclusion: There is no relationship between levator ani muscle avulsion and SUI in women., (© 2020 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.)
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- 2021
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5. Optimizing the treatment algorithm for sentinel lymph node mapping in endometrial cancer.
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Pijnenborg JMA, Reijnen C, Vergeldt TFM, and Zusterzeel PLM
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- Female, Humans, Lymphatic Metastasis pathology, Sentinel Lymph Node pathology, Algorithms, Endometrial Neoplasms pathology, Lymphatic Metastasis diagnosis, Neoplasm Staging methods, Sentinel Lymph Node Biopsy
- Abstract
The incidence of endometrial cancer, the most common gynecological malignancy, is increasing as life expectancy and obesity both rise. Lymph node status is the most important predictor for outcome, yet routine lymphadenectomy does not confer a survival benefit and is associated with substantial surgical morbidity. In the last decade, sentinel lymph node (SLN) mapping has emerged as a feasible and accurate alternative to full lymphadenectomy. Yet, SLN has introduced a distinction between micro- and macrometastasis, and the entity of non-SLN involvement with their attendant impact on outcome. Included among the raised issues is the question of whether positive sentinel nodes should be followed by pelvic and/or para-aortic lymphadenectomy dependent on the presence of macrometastasis at frozen section or other criteria. Moreover, the proper adjuvant treatment for individual cases with micrometastasis and/or isolated tumor cells is unclear. Recently published data on this topic are summarized in order to optimize the current treatment algorithm as it relates to the results of SLN assessment in endometrial cancer., (Copyright © 2020 The Author(s). Published by Elsevier Inc. All rights reserved.)
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- 2020
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6. Does three-dimensional anatomy improve student understanding?
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Triepels CPR, Smeets CFA, Notten KJB, Kruitwagen RFPM, Futterer JJ, Vergeldt TFM, and Van Kuijk SMJ
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- Humans, Anatomy education, Computer Simulation, Education, Medical methods, Imaging, Three-Dimensional, Models, Anatomic, Simulation Training methods
- Abstract
We aim to provide an overview of the various digital three-dimensional visualizations used for learning anatomy and to assess whether these improve medical students' understanding of anatomy compared to traditional learning methods. Furthermore, we evaluate the attitudes of the users of three-dimensional visualizations. We included articles that compared advanced newer three-dimensional anatomy visualization methods (i.e., virtual reality, augmented reality, and computer-based three-dimensional visualizations) to traditional methods that have been used for a long time (i.e., cadaver and textbooks) with regard to users' understanding of anatomy. Of the 1,148 articles identified, 21 articles reported data on the effectiveness of using three-dimensional visualization methods compared to two-dimensional methods. Twelve articles found that three-dimensional visualization is a significantly more effective learning method compared to traditional methods, whereas nine articles did not find that three-dimensional visualization was a significantly more effective method. In general, based on these articles, medical students prefer to use three-dimensional visualizations to learn anatomy. In most of the articles, using three-dimensional visualization was shown to be a more effective method to gain anatomical knowledge compared to traditional methods. Besides that, students are motivated and interested in using these new visualization methods for learning anatomical structures. Clin. Anat. 32:25-33, 2019. © 2019 Wiley Periodicals, Inc., (© 2019 The Authors. Clinical Anatomy published by Wiley Periodicals, Inc. on behalf of American Association of Clinical Anatomists.)
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- 2020
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7. Abdominal radical trachelectomy versus chemotherapy followed by vaginal radical trachelectomy in stage 1B2 (FIGO 2018) cervical cancer. A systematic review on fertility and recurrence rates.
- Author
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van Kol KGG, Vergeldt TFM, and Bekkers RLM
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- Chemotherapy, Adjuvant, Cohort Studies, Female, Humans, Neoadjuvant Therapy, Neoplasm Recurrence, Local pathology, Neoplasm Staging, Pregnancy, Pregnancy Rate, Retrospective Studies, Trachelectomy methods, Uterine Cervical Neoplasms pathology, Uterine Cervical Neoplasms physiopathology, Fertility physiology, Neoplasm Recurrence, Local diagnosis, Uterine Cervical Neoplasms drug therapy, Uterine Cervical Neoplasms surgery
- Abstract
Introduction: There is currently no standard of care for women with cervical cancer stage IB2 (FIGO 2018, ≥2 cm and <4 cm in greatest dimension) who wish to preserve their fertility. Generally, two approaches are offered. Option 1: neoadjuvant platinum-based chemotherapy (NACT) to reduce the tumor size to ≤ 2 cm, followed by Vaginal Radical Trachelectomy (VRT) with Pelvic Lymph Node Dissection (PLND) either before chemotherapy or at the time of VRT. Option 2: Abdominal Radical Trachelectomy (ART) with PLND., Objective: To compare rates of fertility, pregnancy, life births as well as recurrence for women with cervical cancer stage IB2 treated with either NACT followed by VRT, or ART., Methods: A systematic review was performed using the PubMed database. Articles reporting the search term 'trachelectomy' as text word or as Medical Subject Headings (MeSH) were identified., Results: Ten studies were identified with a total of 338 patients. After NACT followed by VRT 39% of the women tried to conceive, 70% of these women got pregnant, of which 63% resulted in a life birth. The overall recurrence and death rate were 10% and 2.9% respectively. After ART 40% of the women tried to conceive, 21% of these women got pregnant, which resulted in a life birth rate of 42%. Recurrence and death rate after ART were 6.9%, and 3.4% respectively., Conclusion: Women with cervical cancer stage IB2 and a wish to preserve fertility treated with NACT followed by VRT have a significantly higher chance of pregnancy than women treated with ART, with comparative oncological results., (Copyright © 2019 Elsevier Inc. All rights reserved.)
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- 2019
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8. Diagnostic Accuracy and Clinical Implications of Translabial Ultrasound for the Assessment of Levator Ani Defects and Levator Ani Biometry in Women With Pelvic Organ Prolapse: A Systematic Review.
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Notten KJB, Vergeldt TFM, van Kuijk SMJ, Weemhoff M, and Roovers JWR
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- Cross-Sectional Studies, Female, Humans, Magnetic Resonance Imaging, Observational Studies as Topic, Pelvic Floor pathology, Predictive Value of Tests, Prospective Studies, Recurrence, Retrospective Studies, Risk Factors, Imaging, Three-Dimensional methods, Pelvic Floor diagnostic imaging, Pelvic Organ Prolapse diagnosis, Ultrasonography methods
- Abstract
Objective: The aim of this study was to assess the diagnostic accuracy and clinical implications of translabial 3-dimensional (3D) ultrasound for the assessment of levator ani defects and biometry in women with pelvic organ prolapse (POP)., Methods: We performed a systematic literature search through computerized databases including MEDLINE (via PubMed), EMBASE (via OvidSP), and the Cochrane Library using both medical subject headings and text terms from January 1, 2003, to December 25, 2015.We included articles that reported on POP status and diagnostic accuracy measurements with translabial 3D ultrasound or transperineal ultrasound for the detection of levator ani defects or for measuring pelvic floor biometry, that is, levator ani hiatus, or reported on the clinical relevance of using translabial 3D ultrasound for levator ani defects or measuring pelvic floor biometry in women with POP., Results: Thirty-one articles were selected in accordance with parts of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines that can be applied to studies of diagnostic accuracy. Twenty-two articles (71%) are coauthored by 1 expert in this field. Detecting levator ani defects with translabial 3D ultrasound compared with magnetic resonance imaging showed a moderate to good agreement, whereas measuring hiatal biometry on translabial 3D ultrasound compared with magnetic resonance imaging showed a moderate to very good agreement.The interobserver agreement for diagnosing levator ani defects and measuring the levator hiatal area showed a moderate to very good agreement. Furthermore, levator ani defects increase the risk of cystocele and uterine prolapse, and levator ani defects are associated with recurrent POP.Finally, a larger hiatus was associated with POP and recurrent POP., Conclusions: Translabial 3D ultrasound is reproducible for diagnosing levator ani defects and ballooning hiatus. Both levator ani defects and a larger hiatal area are, in a selected population of patients with pelvic floor dysfunction, associated with POP and recurrent POP. More research is needed concerning external validation because most data in this article are coauthored by 1 expert in this field.
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- 2017
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9. Recurrence risk is associated with preoperatively advanced prolapse stage: Is there a difference between women with stage 2 and those with stage 3 or 4 cystocele?
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Vergeldt TFM, Notten KJB, Kluivers KB, and Weemhoff M
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- Adult, Aged, Aged, 80 and over, Cystocele surgery, Female, Gynecologic Surgical Procedures, Humans, Middle Aged, Netherlands epidemiology, Prospective Studies, Recurrence, Cystocele epidemiology
- Abstract
Introduction and Hypothesis: Pelvic organ prolapse (POP) recurrence after surgery is a major problem. POP that is more advanced preoperatively is associated with a higher risk of recurrence postoperatively. We hypothesized that women with a stage 2 cystocele differ from those with a stage 3 or 4 cystocele. The aim of this study was to compare the baseline characteristics of women with mild and those with more advanced cystocele., Methods: Patients had participated in one of two multicenter prospective cohort studies on women undergoing conventional anterior colporrhaphy without previous POP surgery. This was a secondary analysis of these data. Women with a preoperative cystocele stage 2 were compared with women with a stage 3 or 4 cystocele. Logistic regression models were employed to calculate odds ratios (OR) and 95% confidence intervals (CI)., Results: Two hundred and sixty-nine women were assessed, of whom 132 (49.1%) had an advanced cystocele. Only older age was significantly associated with advanced cystocele preoperatively, with an OR of 1.07 (95% CI 1.04-1.10). There were no significant differences between women with advanced or stage 2 cystocele in body mass index, vaginal deliveries, assisted delivery, positive family history of POP, concurrent rectocele, concurrent uterine of vaginal vault prolapse, major levator ani muscle defects, or levator hiatal area., Conclusions: Women with advanced cystocele were significantly older than women with stage 2 cystocele. This raises the question whether it would be favorable to perform POP surgery in an earlier stage, i.e., at a younger age, in order to prevent POP recurrence.
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- 2017
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