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Utrecht, Netherlands

Aalbers A.M.,Reinier Of Graaf Group | Aarts M.J.,Netherlands Cancer Registry | Krol A.D.G.,Leiden University | Marijnen C.A.M.,Leiden University | Posthuma E.F.M.,Reinier Of Graaf Group
Netherlands Journal of Medicine | Year: 2016

Background: Chronic lymphocytic leukaemia (CLL) is a common haematological malignancy that mainly occurs in the elderly population. Patients frequently have comorbidities compromising the use of old and new systemic therapies. Methods and results: We report the prevalence of comorbidities in patients with CLL as present in the southern region of the Netherlands Cancer Registry. Comorbid conditions were present in 67% of the male and 63% of the female patients, and became more common with increasing age. Furthermore, we describe the beneficial local and abscopal effects of splenic irradiation in four patients with CLL who were not suitable for systemic chemoimmunotherapy because of severe comorbidities, or who were unwilling to undergo systemic therapy. Conclusion: Our results show that, although an old tool, splenic irradiation should not be forgotten as a potentially effective palliative treatment option in frail patients with symptomatic CLL. © Van Zuiden Communications B.V. All rights reserved. Source


Van Rongen I.,Albert Schweitzer Hospital | Damhuis R.A.M.,Netherlands Cancer Registry | Van Der Hoeven J.A.B.,Albert Schweitzer Hospital | Plaisier P.W.,Albert Schweitzer Hospital
Acta Chirurgica Belgica | Year: 2013

Background: Cancer of the transverse colon is rare and postoperative mortality tends to be high. Standard surgical treatment involves either extended hemicolectomy or transverse colectomy, depending on the location of the tumour. The aim of the present study was to compare postoperative mortality and five-year survival between these types of surgery. Methods: For this observational study, data on patients with a tumour of the transverse colon, treated by open resection in the Dordrecht Hospital from 1989 through 2003, were derived from the database of the regional cancer registry. Information on type of resection, tumour stage, complications, postoperative mortality (30-day) and survival was abstracted from the medical files. Patients with multi-organ surgery, (sub)total colectomy or stage IV disease were excluded from the analysis, leaving a total series of 103 patients. Results: Transverse colectomy comprised one third of operations, predominantly involving partial resections. Postoperative mortality was 6% (2/34) after transverse colectomy and 7% (5/69) after extended hemicolectomy. Fiveyear survival was slightly higher for the hemicolectomy group (61% versus 50%), but this difference did not reach statistical significance (p = 0.34). Conclusion: Our results confirm the high postoperative risk after surgery for cancer of the transverse colon and show that this risk does not depend on the type of surgery. Considering the satisfactory results after partial transverse colectomy, segmental resections may be considered as an option for the treatment of localised tumours of the transverse colon. Source


Van Den Hoven I.,Maxima Medical Center | Voogd A.C.,Netherlands Cancer Registry | Voogd A.C.,Maastricht University | Roumen R.M.H.,Maxima Medical Center | Roumen R.M.H.,Maastricht University
Clinical Breast Cancer | Year: 2015

The various pitfalls that exist in using predictive systems for sentinel node-positive breast cancer are described, to give insight into the background and building stones of these systems. The aim of this article was to make clinicians aware of these pitfalls before using them in the clinical decision-making process in individual patients with positive sentinel nodes. Besides these pitfalls, the implications concerning the results of the Z0011 trial as presented by Giuliano et al (Giuliano AE, et al. Locoregional recurrence after sentinel lymph node dissection with or without axillary dissection in patients with sentinel lymph node metastases: The American College of Surgeons Oncology Group Z0011 randomized trial. Ann Surg 2010; 252:426-32, discussion 432-3) are addressed, and we point out some important issues for debate, before implementation of the conclusions of that practice-changing trial into daily clinical breast cancer practice. © 2015 Elsevier Inc. All rights reserved. Source


Aarts M.J.,Netherlands Cancer Registry | Aerts J.G.,Amphia Hospital | Aerts J.G.,Erasmus Medical Center | Van Den Borne B.E.,Catharina Hospital | And 4 more authors.
Clinical Lung Cancer | Year: 2015

Introduction We evaluated the trends in the prevalence of comorbidity and its prognostic impact in a cohort of unselected patients with small-cell lung cancer (SCLC). Patients and Methods All patients (n = 4142) diagnosed with SCLC from 1995 to 2012 were identified from the population-based Netherlands Cancer Registry in the Eindhoven region. Results The prevalence of comorbidity increased from 55% in 1995 to 1998 to 76% in 2011 to 2012 and multimorbidity (ie, ≥ 2 concomitant diseases) from 23% to 51%. The prevalence of a comorbidity increased with age. Among the men, hypertension, cardiac disease, and diabetes, in particular, became more common (increased from 11% to 35%, from 19% to 36%, and from 7% to 18%, respectively). In the women, the rate of pulmonary disease, hypertension, and cardiac disease increased the most (increased from 18% to 30%, from 12% to 28%, and from 11% to 24%, respectively). Multimorbidity was associated with a slightly increased hazard of death, independent of treatment in those with limited-stage SCLC (hazard ratio [HR] for ≥ 2 comorbidities vs. no comorbidities, 1.2; 95% confidence interval [CI], 1.0-1.4). The prognostic effects of multimorbidity resulted from treatment in those with extensive-stage SCLC (HR for ≥ 2 comorbidities vs. no comorbidities, final model, 1.2; 95% CI, 1.0-1.2). The prognostic impact of the specific comorbidities varied, with digestive disease reducing the hazard and cardiac disease increasing the hazard in those with limited-stage SCLC (HR for digestive disease vs. no digestive disease, 0.7 [95% CI, 0.5-0.9], and HR for cardiac vs. no cardiac disease, 1.2 [95% CI, 1.0-1.3]). Also, cardiac and cerebrovascular disease increased the hazard in those with extensive-stage SCLC (HR 1.2 [95% CI, 1.0-1.3] and HR 1.3 [95% CI, 1.1-1.6], respectively). Conclusion Comorbidity among patients with SCLC is very common and has been increasing. Multimorbidity was associated with a slightly increased hazard of death in those with limited-stage SCLC, independent of treatment. However, the prognostic effects in those with advanced-stage SCLC resulted from treatment. Digestive disease favorably affected survival and cardiac disease negatively affected the prognosis for those with limited-stage SCLC, and cardiac and cerebrovascular diseases had a negative prognostic effect for those with extensive-stage SCLC. With the burden of comorbidities in patients with SCLC increasing, more attention to individualized treatment approaches is needed. © 2015 Elsevier Inc. All rights reserved. Source


Hollestein L.M.,Erasmus Medical Center | de Vries E.,Erasmus Medical Center | Aarts M.J.,Comprehensive Cancer Center South | Schroten C.,Netherlands Cancer Registry | Nijsten T.E.C.,Erasmus Medical Center
Journal of the American Academy of Dermatology | Year: 2014

Background: Keratinocyte cancer is the most common cancer among Caucasians. Objective: We sought to study time trends of the burden of disease attributable to keratinocyte cancer in The Netherlands. Methods: Data of all patients with newly diagnosed keratinocyte cancer (ie, squamous cell carcinoma and basal cell carcinoma) were obtained from the population-based Netherlands Cancer Registry and the Eindhoven Cancer Registry (1989-2008). Population structure, mortality data, and life expectancy data were extracted from Statistics Netherlands. The disability-adjusted life-years (DALY) was the sum of the years of life lived with disability and the years of life lost. Results: The world standardized rate of keratinocyte cancer has doubled and was 103 and 94 per 100,000 person-years for males and females in 2004 to 2008, respectively. DALYs as a result of basal cell carcinoma increased by 124% and DALYs as a result of squamous cell carcinoma increased by 66% from 1989 to 1993. Keratinocyte cancer accounted for a total loss of 19,913 DALYs (15,369 years of life lived with disability and 4544 years of life lost) between 2004 and 2008. Limitations: Only the first keratinocyte cancer was included in this study. Conclusion: Keratinocyte cancer is a large burden to the Dutch society. Because incidence rates of keratinocyte cancer continue to increase, the management becomes even more challenging. © 2014 American Academy of Dermatology, Inc. Source

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