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Amsterdam-Zuidoost, Netherlands

Kruijff S.,University of Groningen | Bastiaannet E.,Leiden University | Francken A.B.,Isala Clinics | Schaapveld M.,NKI AVL | And 2 more authors.
British Journal of Cancer | Year: 2012

Background: Melanoma incidence has increased rapidly in the last decades, and predictions show a continuing increase in the years to come. The aim of this study was to assess trends in melanoma incidence, Breslow thickness (BT), and melanoma survival among young and elderly patients in the Netherlands.Methods: Patients diagnosed with invasive melanoma between 1994 and 2008 were selected from the Netherlands Cancer Registry. Incidence (per 100 000) over time was calculated for young (≥ 65 years) and elderly patients (≥ 65 years). Distribution of BT for young and elderly males and females was assessed. Regression analysis of the log-transformed BT was used to assess changes over time. Relative survival was calculated as the ratio of observed survival to expected survival.Results:Overall, 40 880 patients were included (42.3% male and 57.7% female). Melanoma incidence increased more rapidly among the elderly (5.4% estimated annual percentage change (EAPC), P<0.0001) than among younger patients (3.9% EAPC, P<0.0001). The overall BT declined significantly over time (P<0.001). Among younger patients, BT decreased for almost all locations. Among elderly males, BT decreased for melanomas in the head and neck region (P<0.001) and trunk (P<0.001), but did not decrease significantly for the other regions. Among elderly females, BT only decreased for melanomas at the trunk (P<0.01). The relative survival of elderly patients was worse compared with that of younger patients (P<0.001).Conclusion:Melanoma incidence increases more rapidly for elderly than for younger patients and the decline in BT is less prominent among elderly patients than among young patients. Campaigns in the Netherlands should focus more on early melanoma detection in the elderly. © 2012 Cancer Research UK All rights reserved. Source


Vencken P.M.L.H.,Erasmus Medical Center | Reitsma W.,University of Groningen | Kriege M.,Erasmus Medical Center | Mourits M.J.E.,University of Groningen | And 12 more authors.
Annals of Oncology | Year: 2013

Background: Recent studies suggested an improved overall survival (OS) for BRCA2- versus BRCA1-associated epithelial ovarian cancer (EOC), whereas the impact of chemotherapy is not yet clear. In a nationwide cohort, we examined the results of primary treatment, progression-free survival (PFS), treatment-free interval (TFI), and OS of BRCA1 versus BRCA2 EOC patients. Methods: Two hundred and forty-five BRCA1- and 99 BRCA2-associated EOC patients were identified through all Dutch university hospitals. Analyses were carried out with the Pearson's Chi-square test, Kaplan-Meier, and Cox regression methods. Results: BRCA1 patients were younger at EOC diagnosis than BRCA2 patients (51 versus 55 years; P < 0.001), without differences regarding histology, tumor grade, and International Federation of Gynecology and Obstetrics (FIGO) stage. Complete response rates after primary treatment, including chemotherapy, did not differ between BRCA1 (86%) and BRCA2 patients (90%). BRCA1 versus BRCA2 patients had a shorter PFS (median 2.2 versus 3.9 years, respectively; P = 0.006), TFI (median 1.7 versus 2.8 years; P = 0.009), and OS (median 6.0 versus 9.7 years; P = 0.04). Differences could not be explained by age at diagnosis, FIGO stage or type of treatment. Conclusions: PFS and OS were substantially longer in BRCA2- than in BRCA1-associated EOC patients. While response rates after primary treatment were similarly high in both groups, TFI, as surrogate for chemosensitivity, was significantly longer in BRCA2 patients. © The Author 2013.Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. Source


Ariese-Beldman K.,NKI AVL | Hulshoff L.,NKI AVL | Jansen R.,Onze Lieve Vrouwe Gasthuis | van der Voort P.H.J.,Onze Lieve Vrouwe Gasthuis
Netherlands Journal of Critical Care | Year: 2013

In this case report we present a 64-year old female patient who was admitted to our intensive care unit (ICU) with an abdominal sepsis six days after a laparotomy and a hyperthermic intraperitoneal chemotherapy (HIPEC)-procedure. During her ICU admission she developed a pneumonia and sepsis. Bronchoalveolar lavage (BAL) was positive for Aspergillus species and an unknown fungus species. Despite maximum treatment for invasive aspergillosis, the patient died after being on the ICU for 29 days. Evaluation of the unknown species in the BAL showed Trichoderma. This case reports focuses on the clinical relevance of finding the Trichoderma species in the BAL. In addition, we provide a literature overview concerning Trichoderma species infections. Source


Haloua M.H.,VU University Amsterdam | Volders J.H.,VU University Amsterdam | Krekel N.M.A.,VU University Amsterdam | Lopes Cardozo A.M.F.,Medical Center Alkmaar | And 8 more authors.
Annals of Surgical Oncology | Year: 2016

Background: Ultrasound-guided breast-conserving surgery (USS) results in a significant reduction in both margin involvement and excision volumes (COBALT trial). Objective: The aim of the present study was to determine whether USS also leads to improvements in cosmetic outcome and patient satisfaction when compared with standard palpation-guided surgery (PGS). Methods: A total of 134 patients with T1–T2 invasive breast cancer were included in the COBALT trial (NTR2579) and randomized to either USS (65 patients) or PGS (69 patients). Cosmetic outcomes were assessed by a three-member panel using computerized software Breast Cancer Conservative Treatment cosmetic results (BCCT.core) and by patient self-evaluation, including patient satisfaction. Time points for follow-up were 3, 6, and 12 months after surgery. Overall cosmetic outcome and patient satisfaction were scored on a 4-point Likert scale (excellent, good, fair, or poor), and outcomes were analyzed using a multilevel, mixed effect, proportional odds model for ordinal responses. Results: Ultrasound-guided breast-conserving surgery achieved better cosmetic outcomes, with 20 % excellence overall and only 6 % rated as poor, whereas 14 % of PGS outcomes were rated excellent and 13 % as poor. USS also had consistently lower odds for worse cosmetic outcomes (odds ratio 0.55, p = 0.067) than PGS. The chance of having a worse outcome was significantly increased by a larger lumpectomy volume (ptrend = 0.002); a volume >40 cc showed odds 2.78-fold higher for a worse outcome than a volume ≤40 cc. USS resulted in higher patient satisfaction compared with PGS. Conclusion: Ultrasound-guided breast-conserving surgery achieved better overall cosmetic outcomes and patient satisfaction than PGS. Lumpectomy volumes >40 cc resulted in significantly worse cosmetic outcomes. © 2015, The Author(s). Source


Wessels R.,NKI AVL | De Bruin D.M.,AMC UvA | Relyveld G.N.,NKI AVL | Faber D.J.,AMC UvA | And 5 more authors.
Journal of the European Academy of Dermatology and Venereology | Year: 2015

Background Cutaneous melanomas are diagnosed worldwide in 231 130 patients per year. The sensitivity and specificity of melanoma diagnosis expresses the need for an additional diagnostic method. Optical coherence tomography (OCT) has shown that it allows morphological (qualitative) description of image features and quantitative analysis of pathology related light scattering by means of the attenuation coefficient (μoct). Objective We hypothesize that OCT images of nevi will differ qualitatively and quantitatively from melanomas. Methods Forty lesions from 33 consecutive patients were imaged with OCT. After data acquisition, excision was performed. Epidermal layer thickness was measured and values of μoct were extracted from 200 OCT images of pigmented lesions. Results Morphologically, absence of the lower border of the lesion was characteristic for melanoma (P = 0.02). Also, the μoct was different between benign and malignant lesions (P = 0.02). There were no differences in epidermal layer thickness of benign lesions and melanoma. Conclusion Although this preliminary study comprised a small number of patients, quantitative analysis of OCT images in pigmented skin lesions give valuable additional information about lesions characteristics. When using the attenuation coefficient, it might be possible to distinguish between benign lesions and melanomas. © 2014 European Academy of Dermatology and Venereology. Source

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