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  1. Article: Letter in reply: increase of sentinel lymph node melanoma staging in The Netherlands; still room and need for further improvement.

    Deckers, Eric A / Wj Louwman, Marieke / Kruijff, Schelto / Hoekstra, Harald J

    Melanoma management

    2020  Volume 8, Issue 1, Page(s) MMT53

    Language English
    Publishing date 2020-11-23
    Publishing country England
    Document type Journal Article
    ISSN 2045-0885
    ISSN 2045-0885
    DOI 10.2217/mmt-2020-0021
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Increase of sentinel lymph node melanoma staging in The Netherlands; still room and need for further improvement.

    Deckers, Eric A / Louwman, Marieke Wj / Kruijff, Schelto / Hoekstra, Harald J

    Melanoma management

    2020  Volume 7, Issue 1, Page(s) MMT38

    Abstract: Aim: To investigate implementation of the seventh American Joint Committee on Cancer melanoma staging with sentinel lymph node biopsy (SLNB) and associations with socioeconomic status (SES).: Patients & methods: Data from The Netherlands Cancer ... ...

    Abstract Aim: To investigate implementation of the seventh American Joint Committee on Cancer melanoma staging with sentinel lymph node biopsy (SLNB) and associations with socioeconomic status (SES).
    Patients & methods: Data from The Netherlands Cancer Registry on patient and tumor characteristics were analyzed for all stage IB-II melanoma cases diagnosed 2010-2016, along with SES data from The Netherlands Institute for Social Research.
    Results: The proportion of SLNB-staged patients increased from 40% to 65% (p < 0.001). Multivariate analysis showed that being female, elderly, or having head-and-neck disease reduced the likelihood of SLNB staging.
    Conclusion: SLNB staging increased by 25% during the study period but lagged among elderly patients and those with head-and-neck melanoma. In The Netherlands, SES no longer affects SLNB staging performance.
    Language English
    Publishing date 2020-03-30
    Publishing country England
    Document type Journal Article
    ISSN 2045-0885
    ISSN 2045-0885
    DOI 10.2217/mmt-2019-0018
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  3. Article ; Online: ASO Author Reflections: Stage-Adjusted Reduced Follow-Up of Melanoma Patients is Justified and Cost Effective, Until Biomarkers to Predict Prognosis Have Been Identified.

    Francken, Anne Brecht / Hoekstra-Weebers, Josette E H M / Deckers, Eric / Hoekstra, Harald J

    Annals of surgical oncology

    2019  Volume 27, Issue 5, Page(s) 1418–1419

    MeSH term(s) Biomarkers ; Cost-Benefit Analysis ; Health Care Costs ; Humans ; Melanoma/economics ; Melanoma/therapy ; Prognosis ; Skin Neoplasms/economics ; Skin Neoplasms/therapy
    Chemical Substances Biomarkers
    Language English
    Publishing date 2019-09-03
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1200469-8
    ISSN 1534-4681 ; 1068-9265
    ISSN (online) 1534-4681
    ISSN 1068-9265
    DOI 10.1245/s10434-019-07611-5
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    Zs.A 4042: Show issues Location:
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  4. Article ; Online: Obesity is not associated with disease-free interval, melanoma-specific survival, or overall survival in patients with clinical stage IB-II melanoma after SLNB.

    Deckers, Eric A / Kruijff, Schelto / Bastiaannet, Esther / van Ginkel, Robert J / Hoekstra-Weebers, Josette E H M / Hoekstra, Harald J

    Journal of surgical oncology

    2021  Volume 124, Issue 4, Page(s) 655–664

    Abstract: Background and objectives: Clinicopathologic characteristics have prognostic value in clinical stage IB-II patients with melanoma. Little is known about the prognostic value of obesity that has been associated with an increased risk for several cancer ... ...

    Abstract Background and objectives: Clinicopathologic characteristics have prognostic value in clinical stage IB-II patients with melanoma. Little is known about the prognostic value of obesity that has been associated with an increased risk for several cancer types and worsened prognosis after diagnosis. This study aims to examine effects of obesity on outcome in patients with clinical stage IB-II melanoma.
    Methods: Prospectively recorded data of patients with clinical stage IB-II melanoma who underwent sentinel lymph node biopsy (SLNB) between 1995 and 2018 at the University Medical Center of Groningen were collected from medical files and retrospectively analyzed. Cox-regression analyses were used to determine associations between obesity (body mass index> 30), tumor (location, histology, Breslow-thickness, ulceration, mitotic rate, SLN-status) and patient-related variables (gender, age, and social-economic-status [SES]) and disease-free interval (DFI), melanoma-specific survival (MSS), and overall survival (OS).
    Results: Of the 715 patients, 355 (49.7%) were women, median age was 55 (range 18.6-89) years, 149 (20.8%) were obese. Obesity did not significantly affect DFI (adjusted hazard ratio [HR] = 1.40; 95% confidence interval [CI] = 0.98-2.00; p = 0.06), MSS (adjusted HR = 1.48;95%CI = 0.97-2.25; p = 0.07), and OS (adjusted HR = 1.25; 95% CI = 0.85-1.85; p = 0.25). Increased age, arm location, increased Breslow-thickness, ulceration, increased mitotic rate, and positive SLN-status were significantly associated with decreased DFI, MSS, and OS. Histology, sex, and SES were not associated.
    Conclusion: Obesity was not associated with DFI, MSS, or OS in patients with clinical stage IB-II melanoma who underwent SLNB.
    MeSH term(s) Adolescent ; Adult ; Aged ; Aged, 80 and over ; Body Mass Index ; Female ; Follow-Up Studies ; Humans ; Male ; Melanoma/etiology ; Melanoma/mortality ; Melanoma/pathology ; Melanoma/surgery ; Middle Aged ; Obesity/complications ; Prognosis ; Prospective Studies ; Retrospective Studies ; Sentinel Lymph Node Biopsy/mortality ; Survival Rate ; Young Adult
    Language English
    Publishing date 2021-06-04
    Publishing country United States
    Document type Journal Article
    ZDB-ID 82063-5
    ISSN 1096-9098 ; 0022-4790
    ISSN (online) 1096-9098
    ISSN 0022-4790
    DOI 10.1002/jso.26555
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    Zs.A 706: Show issues Location:
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  5. Article ; Online: Follow-up Schedule for Patients With Sentinel Node-negative Cutaneous Melanoma (The MELFO Study): An International Phase III Randomized Clinical Trial.

    Moncrieff, Marc D / Bastiaannet, Esther / Underwood, Beverly / Francken, Anne Brecht / Garioch, Jennifer / Damude, Samantha / Heaton, Martin / Deckers, Eric A / Patel, Nakul / Hoekstra-Weebers, Josette E / Hoekstra, Harald J

    Annals of surgery

    2022  Volume 276, Issue 4, Page(s) e208–e216

    Abstract: Objectives and design: The MELFO (MELanoma FOllow-up) study is an international phase III randomized controlled trial comparing an experimental low-intensity schedule against current national guidelines.: Background: Evidence-based guidelines for the ...

    Abstract Objectives and design: The MELFO (MELanoma FOllow-up) study is an international phase III randomized controlled trial comparing an experimental low-intensity schedule against current national guidelines.
    Background: Evidence-based guidelines for the follow-up of sentinel node-negative melanoma patients are lacking.
    Methods: Overall, 388 adult patients diagnosed with sentinel node-negative primary melanoma patients were randomized in cancer centers in the Netherlands and United Kingdom between 2006 and 2016. The conventional schedule group (control: n=196) was reviewed as per current national guidelines. The experimental schedule group (n=192) was reviewed in a reduced-frequency schedule. Quality of life was the primary outcome measurement. Detection rates and survival outcomes were recorded. Patient satisfaction rates and compliance with allocated schedules were compared.
    Results: At 5 years, both arms expressed high satisfaction with their regimens (>97%). This study found no significant group effect on any patient-reported outcome measure scores between the follow-up protocols. In total, 75/388 (19.4%) patients recurred, with no difference in incidence found between the 2 arms (hazard ratio=0.87, 95% confidence interval: 0.54-1.39, P =0.57). Self-examination was the method of detection for 25 experimental patients and 32 control patients (75.8% vs. 76.2%; P =0.41). This study found no difference in any survival outcomes between the 2 study arms (disease-free survival: hazard ratio=1.00, 95% confidence interval: 0.49-2.07, P =0.99).
    Conclusions: A reduced-intensity, American Joint Committee on Cancer (AJCC) stage-adjusted follow-up schedule for sentinel node-negative melanoma patients is a safe strategy, and patient self-examination is effective for recurrence detection with no evidence of diagnostic delay. Patients' acceptance is very high.
    MeSH term(s) Adult ; Delayed Diagnosis ; Follow-Up Studies ; Humans ; Melanoma/pathology ; Neoplasm Staging ; Quality of Life ; Sentinel Lymph Node Biopsy ; Skin Neoplasms/pathology ; Melanoma, Cutaneous Malignant
    Language English
    Publishing date 2022-07-22
    Publishing country United States
    Document type Clinical Trial, Phase III ; Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
    ZDB-ID 340-2
    ISSN 1528-1140 ; 0003-4932
    ISSN (online) 1528-1140
    ISSN 0003-4932
    DOI 10.1097/SLA.0000000000005621
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    Uk I Zs.35/1: Show issues Location:
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  6. Article: Posterior retroperitoneoscopic resection of recurrent nonseminomatous tumor mass: a case report of the surgical procedure.

    Öztürk, Çiğdem / Hoekstra, Harald J / Hemmer, Patrick H J / Gietema, Jourik A / Kruijff, Schelto

    Journal of surgical case reports

    2020  Volume 2020, Issue 7, Page(s) rjaa122

    Abstract: Treatment of stage II-IV nonseminomatous testicular germ cell tumors (NSTGCTs) consists of cisplatin-based combination chemotherapy and, when present, resection of residual retroperitoneal tumor mass (RRTM) by conventional laparotomy or laparoscopy. In ... ...

    Abstract Treatment of stage II-IV nonseminomatous testicular germ cell tumors (NSTGCTs) consists of cisplatin-based combination chemotherapy and, when present, resection of residual retroperitoneal tumor mass (RRTM) by conventional laparotomy or laparoscopy. In case of a retroperitoneal recurrence, a second conventional or laparoscopic procedure may be challenging. A case of late relapse after prior conventional resection of a RRTM and tailor-made surgical management with a posterior retroperitoneoscopic resection (PRR) is reported. A posterior retroperitoneoscopic RRTM resection was performed in a 26-year-old male with a history of stage IIC NSTGCT, presenting with a late left-sided retroperitoneal relapse, 6 years after initial treatment. Postoperative course was uneventful and at 1-year follow-up the patient had no evidence of disease. Reoperative surgery by a minimal invasive retroperitoneoscopic approach should be considered as an alternative for patients with a recurrent retroperitoneal tumor mass of a NSTGCT.
    Language English
    Publishing date 2020-07-08
    Publishing country England
    Document type Case Reports
    ISSN 2042-8812
    ISSN 2042-8812
    DOI 10.1093/jscr/rjaa122
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  7. Article ; Online: The MelFo Study UK: Effects of a Reduced-Frequency, Stage-Adjusted Follow-Up Schedule for Cutaneous Melanoma 1B to 2C Patients After 3-Years.

    Moncrieff, Marc D / Underwood, Beverly / Garioch, Jennifer J / Heaton, Martin / Patel, Nakul / Bastiaannet, Esther / Hoekstra-Weebers, Josette E H M / Hoekstra, Harald J

    Annals of surgical oncology

    2020  Volume 27, Issue 11, Page(s) 4109–4119

    Abstract: Background: Evidence-based guidelines for follow-up treatment of American Joint Committee on Cancer (AJCC) stages 1B to 2C melanoma patients are lacking. The MELanoma FOllow-up study is an international phase 3 randomized trial, and the 3-year interim ... ...

    Abstract Background: Evidence-based guidelines for follow-up treatment of American Joint Committee on Cancer (AJCC) stages 1B to 2C melanoma patients are lacking. The MELanoma FOllow-up study is an international phase 3 randomized trial, and the 3-year interim data were recently reported from the Netherlands. The study was undertaken concurrently with a British cohort for comparison and validation of the Dutch study.
    Methods: The study enrolled and stratified 207 patients by AJCC stage. The conventional schedule group (CSG; n = 103) cohort was reviewed as per UK guidelines. The experimental schedule group (ESG; n = 104) cohort was reviewed in a reduced-frequency nurse-led, consultant-supervised clinic. Quality of life (QoL) was measured at baseline (T1), a 1 year (T2), and at 3 years (T3) using the State-Trait Anxiety Inventory, the Cancer Worry Scale, the Impact-of-Event Scale, and the Mental and Physical Component scales (PCS/MCS) of the RAND-36.
    Results: Of the 207 QoL questionnaires, 170 (82.1%) were completed at T3. Both cohorts expressed high satisfaction (> 93%) with their regimens. At T3, no significant group effect was found on any patient-reported outcome measures scores, indicating no QoL difference between the follow-up protocols. Recurrence had developed in 33 patients Conventional follow-up (CFU), 16 [15.5%]; Experimental follow-up (EFU), 17 [16.3%]. Self-examination was the method of detection for 12 ESG patients (70.6%) and 11 CSG patients (68.8%). The melanoma-specific survival was identical.
    Conclusion: The UK 3-year data were consistent with the previous Dutch report. The reduced follow-up strategy was shown to be safe, with significant resource usage benefits for national cancer services. Patient anxiety levels were not increased by a less-intensive follow-up regimen, and acceptance was high. The study data indicate that patient self-examination is very effective for recurrence detection.
    MeSH term(s) Aged ; Clinical Trials, Phase III as Topic ; Female ; Follow-Up Studies ; Humans ; Male ; Melanoma/diagnosis ; Melanoma/pathology ; Middle Aged ; Neoplasm Recurrence, Local/diagnosis ; Neoplasm Recurrence, Local/pathology ; Neoplasm Staging ; Quality of Life ; Randomized Controlled Trials as Topic ; Skin Neoplasms/diagnosis ; Skin Neoplasms/pathology
    Language English
    Publishing date 2020-07-04
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1200469-8
    ISSN 1534-4681 ; 1068-9265
    ISSN (online) 1534-4681
    ISSN 1068-9265
    DOI 10.1245/s10434-020-08758-2
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    Zs.A 4042: Show issues Location:
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  8. Article ; Online: Schildwachtklierbiopsie moet bij melanoom.

    Nieweg, Omgo E / Hoekstra, Harald J

    Nederlands tijdschrift voor geneeskunde

    2014  Volume 158, Page(s) A8194

    Abstract: Sentinel lymph node biopsy provides melanoma patients with important prognostic information and improves staging and regional tumour control, while the morbidity is limited and the subsequent quality of life is good. The most important result of the only ...

    Title translation Sentinel lymph node biopsy necessary in melanoma patients.
    Abstract Sentinel lymph node biopsy provides melanoma patients with important prognostic information and improves staging and regional tumour control, while the morbidity is limited and the subsequent quality of life is good. The most important result of the only randomised study is the improved ten-year melanoma-specific survival in node-positive patients with an intermediate thickness melanoma. We recommend sentinel lymph node biopsy as a standard diagnostic procedure for these patients. Sentinel lymph node biopsy can be considered in patients with a thinner or thicker melanoma.
    MeSH term(s) Humans ; Lymphatic Metastasis ; Melanoma/diagnosis ; Melanoma/mortality ; Melanoma/pathology ; Prognosis ; Sentinel Lymph Node Biopsy ; Skin Neoplasms/diagnosis ; Skin Neoplasms/mortality ; Skin Neoplasms/pathology ; Survival Analysis
    Language Dutch
    Publishing date 2014
    Publishing country Netherlands
    Document type English Abstract ; Journal Article
    ZDB-ID 82073-8
    ISSN 1876-8784 ; 0028-2162
    ISSN (online) 1876-8784
    ISSN 0028-2162
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    Ua VI Zs.18: Show issues Location:
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  9. Article ; Online: Isolated limb perfusion of soft tissue sarcomas: a comprehensive review of literature.

    Seinen, Jojanneke M / Hoekstra, Harald J

    Cancer treatment reviews

    2013  Volume 39, Issue 6, Page(s) 569–577

    Abstract: Patients with primary irresectable, locally advanced soft tissue sarcomas of the limbs form a challenging group for the treating physician. Multimodality treatment is necessary to guarantee optimal limb salvage and survival rates. Since the introduction ... ...

    Abstract Patients with primary irresectable, locally advanced soft tissue sarcomas of the limbs form a challenging group for the treating physician. Multimodality treatment is necessary to guarantee optimal limb salvage and survival rates. Since the introduction of isolated limb perfusion in the late fifties, several treatment regimens have been proposed. Isolated perfusion with melphalan and TNF-α, as part of a multimodality treatment, is regarded as the current best treatment option today. Ongoing studies are investigating potential benefit of other doses, new chemotherapeutic agents and new techniques in perfusion and radiotherapy. This article provides a historical overview of published literature and insight in upcoming treatment techniques.
    MeSH term(s) Antineoplastic Combined Chemotherapy Protocols/administration & dosage ; Chemotherapy, Cancer, Regional Perfusion/methods ; Extremities ; Humans ; Soft Tissue Neoplasms/drug therapy
    Language English
    Publishing date 2013-10
    Publishing country Netherlands
    Document type Journal Article ; Review
    ZDB-ID 125102-8
    ISSN 1532-1967 ; 0305-7372
    ISSN (online) 1532-1967
    ISSN 0305-7372
    DOI 10.1016/j.ctrv.2012.10.005
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    Zs.A 1022: Show issues Location:
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    Zs.MO 611: Show issues

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  10. Article ; Online: Laparoscopic Resection of Residual Retroperitoneal Tumor Mass in Advanced Nonseminomatous Testicular Germ Cell Tumors; a Feasible and Safe Oncological Procedure.

    Öztürk, Çiğdem / Been, Lukas B / van Ginkel, Robert J / Gietema, Jourik A / Hoekstra, Harald J

    Scientific reports

    2019  Volume 9, Issue 1, Page(s) 15837

    Abstract: Ten-year oncological experience of the University Medical Center Groningen with conventional laparotomy (C-RRRTM) and laparoscopy (L-RRRTM) is described concerning resection of residual retroperitoneal tumor masses (RRTM) in a large series of patients ... ...

    Abstract Ten-year oncological experience of the University Medical Center Groningen with conventional laparotomy (C-RRRTM) and laparoscopy (L-RRRTM) is described concerning resection of residual retroperitoneal tumor masses (RRTM) in a large series of patients with advanced nonseminomatous testicular germ cell tumors (NSTGCT). 150 consecutive patients with disseminated NSTGCT required adjunctive surgery after combination chemotherapy. L-RRRTM was scheduled in 89 and C-RRRTM in 61 patients. Median residual tumor diameter was 20 mm in the L-RRRTM versus 42 mm in the C-RRRTM group (p < 0.001). Conversion rate was 15% in the L-RRRTM group. Perioperative complications occurred in 5 patients (6%) in the L-RRRTM and 7 (12%, NS) in the C-RRRTM group. Median duration of L-RRRTM was 156 minutes vs. 221 minutes for C-RRRTM (p < 0.001). 17/89 patients in the L-RRRTM group had postoperative complications versus 18/61 patients in the C-RRRTM group (NS). Median postoperative stay in the L-RRRTM group was 2 vs. 6 days in the C-RRRTM group (p < 0.001). During a median follow-up of 79 months, 27 patients had recurrences: 8 (9%) in the L-RRRTM group and 19 (31%) in the C-RRRTM group (p < 0.001). Laparoscopic resection of RRTM for advanced NSTGCT is feasible and an oncologically safe option in appropriately selected patients.
    MeSH term(s) Adolescent ; Adult ; Aged ; Humans ; Laparoscopy ; Laparotomy ; Male ; Middle Aged ; Neoplasm Recurrence, Local/epidemiology ; Neoplasm Recurrence, Local/pathology ; Neoplasm Recurrence, Local/surgery ; Neoplasm, Residual ; Neoplasms, Germ Cell and Embryonal/epidemiology ; Neoplasms, Germ Cell and Embryonal/pathology ; Neoplasms, Germ Cell and Embryonal/surgery ; Retroperitoneal Neoplasms/epidemiology ; Retroperitoneal Neoplasms/pathology ; Retroperitoneal Neoplasms/secondary ; Retroperitoneal Neoplasms/surgery ; Retrospective Studies ; Testicular Neoplasms/epidemiology ; Testicular Neoplasms/pathology ; Testicular Neoplasms/surgery ; Time Factors
    Language English
    Publishing date 2019-11-01
    Publishing country England
    Document type Journal Article
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-019-52109-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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