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Article ; Online: Tumor-positive peritoneal cytology in patients with gastric cancer is associated with poor outcome: A nationwide study.

Van Der Sluis, Karen / Taylor, Steven N / Kodach, Liudmila L / van Dieren, Jolanda M / de Hingh, Ignace H J T / Wijnhoven, Bas P L / Verhoeven, Rob H A / Vollebergh, Marieke A / van Sandick, Johanna W

European journal of cancer (Oxford, England : 1990)

2024 Volume 199, Page(s) 113541

Abstract: Background: The clinical significance of tumor-positive peritoneal cytology (CYT+) in gastric cancer (GC) patients is unclear. This nationwide cohort study aimed to i) assess the frequency of cytological analysis at staging laparoscopy; ii) determine ... ...

Abstract	Background: The clinical significance of tumor-positive peritoneal cytology (CYT+) in gastric cancer (GC) patients is unclear. This nationwide cohort study aimed to i) assess the frequency of cytological analysis at staging laparoscopy; ii) determine the prevalence of CYT+GC; and iii) compare overall survival (OS) in CYT+ patients versus those with (PM+) and those without (PM-) macroscopic peritoneal disease. Methods: All patients diagnosed with cT1-4, cN0-2 and M0 or synchronous PM GC between 2016-2021 were identified in the Netherlands Cancer Registry database and linked to the nationwide pathology database. Results: A total of 4397 patients was included, of which 40 % underwent cytological assessment following staging laparoscopy (863/1745). The prevalence of CYT+ was 8 %. A total of 69 patients had CYT+(1.6 %), 789 (17.9 %) had PM+ and 3539 (80.5 %) had PM- disease. Hazard ratio for OS in CYT+ versus PM+ was 0.86 (95 %CI 0.64-1.17, p-value=0.338), and in PM- versus PM+0.43 (95 %CI 0.38-0.49, p-value<0.001). No survival difference was found between systemic chemotherapy versus surgical resection in CYT+ patients. Discussion: In this nationwide study, OS for gastric cancer patients with CYT+ was equally unfavorable as for those with PM+ and significantly worse as compared to those with PM-. The optimal treatment strategy has yet to be established.
MeSH term(s)	Humans ; Stomach Neoplasms/pathology ; Cohort Studies ; Cytology ; Peritoneal Lavage ; Neoplasm Staging ; Prognosis
Language	English
Publishing date	2024-01-15
Publishing country	England
Document type	Journal Article
ZDB-ID	82061-1
ISSN	1879-0852 ; 0277-5379 ; 0959-8049 ; 0964-1947
ISSN (online)	1879-0852
ISSN	0277-5379 ; 0959-8049 ; 0964-1947
DOI	10.1016/j.ejca.2024.113541
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Zs.A 456: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Treatment of haemorrhoids: rubber band ligation or sclerotherapy (THROS)? Study protocol for a multicentre, non-inferiority, randomised controlled trial.

van Oostendorp, J Y / Sluckin, T C / Han-Geurts, I J M / van Dieren, S / Schouten, R

Trials

2023 Volume 24, Issue 1, Page(s) 374

Abstract: Introduction: Haemorrhoidal disease (HD) is a common condition with significant epidemiologic and economic implications. While it is possible to treat symptomatic grade 1-2 haemorrhoids with rubber band ligation (RBL) or sclerotherapy (SCL), the ... ...

Abstract	Introduction: Haemorrhoidal disease (HD) is a common condition with significant epidemiologic and economic implications. While it is possible to treat symptomatic grade 1-2 haemorrhoids with rubber band ligation (RBL) or sclerotherapy (SCL), the effectiveness of these treatments compatible with current standards has not yet been investigated with a randomised controlled trial. The hypothesis is that SCL is not inferior to RBL in terms of symptom reduction (patient-related outcome measures (PROMs)), patient experience, complications or recurrence rate. Methods and analysis: This protocol describes the methodology of a non-inferiority, multicentre, randomised controlled trial comparing rubber band ligation and sclerotherapy for symptomatic grade 1-2 haemorrhoids in adults (> 18 years). Patients are preferably randomised between the two treatment arms. However, patients with a strong preference for one of the treatments and refuse randomisation are eligible for the registration arm. Patients either receive 4 cc Aethoxysklerol 3% SCL or 3 × RBL. The primary outcome measures are symptom reduction by means of PROMs, recurrence and complication rates. Secondary outcome measures are patient experience, number of treatments and days of sick leave from work. Data are collected at 4 different time points. Discussion: The THROS trial is the first large multicentre randomised trial to study the difference in effectivity between RBL and SCL for the treatment of grade 1-2 HD. It will provide information as to which treatment method (RBL or SCL) is the most effective, gives fewer complications and is experienced by the patient as the best option. Ethics and dissemination: The study protocol has been approved by the Medical Ethics Review Committee of the Amsterdam University Medical Centers, location AMC (nr. 2020_053). The gathered data and results will be submitted for publication in peer-reviewed journals and spread to coloproctological associations and guidelines. Trial registration: Dutch Trial Register NL8377 . Registered on 12-02-2020.
MeSH term(s)	Adult ; Humans ; Hemorrhoids/diagnosis ; Hemorrhoids/therapy ; Sclerotherapy/adverse effects ; Hemorrhoidectomy ; Ligation/methods ; Clinical Protocols ; Randomized Controlled Trials as Topic ; Multicenter Studies as Topic
Language	English
Publishing date	2023-06-03
Publishing country	England
Document type	Clinical Trial Protocol ; Journal Article
ZDB-ID	2040523-6
ISSN	1745-6215 ; 1468-6694 ; 1745-6215
ISSN (online)	1745-6215
ISSN	1468-6694 ; 1745-6215
DOI	10.1186/s13063-023-07400-2
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Article ; Online: Value of Size and Malignant Features of Lateral Lymph Nodes in Risk Stratification at Lateral Local Recurrence of Rectal Cancer: A National Cohort Study.

van Geffen, Eline G M / Sluckin, Tania C / Hazen, Sanne-Marije J A / Horsthuis, Karin / Beets-Tan, Regina G H / van Dieren, Susan / Marijnen, Corrie A M / Tanis, Pieter J / Kusters, Miranda

Journal of the National Comprehensive Cancer Network : JNCCN

2024 Volume 22, Issue 1, Page(s) 17–25

Abstract: Background: Patients with rectal cancer who have enlarged lateral lymph nodes (LLNs) have an increased risk of lateral local recurrence (LLR). However, little is known about prognostic implications of malignant features (internal heterogeneity, ... ...

Abstract	Background: Patients with rectal cancer who have enlarged lateral lymph nodes (LLNs) have an increased risk of lateral local recurrence (LLR). However, little is known about prognostic implications of malignant features (internal heterogeneity, irregular margins, loss of fatty hilum, and round shape) on MRI and number of enlarged LLNs, in addition to LLN size. Methods: Of the 3,057 patients with rectal cancer included in this national, retrospective, cross-sectional cohort study, 284 with a cT3-4 tumor located ≤8 cm from the anorectal junction who received neoadjuvant treatment and who had visible LLNs on MRI were selected. Imaging was reassessed by trained radiologists. LLNs were categorized based on size. Influence of malignant features and the number of LLNs on LLR was investigated. Results: Of 284 patients with at least 1 visible LLN, 122 (43%) had an enlarged node (≥7.0 mm) and 157 (55%) had malignant features. Of the 122 patients with enlarged nodes, 25 had multiple (≥2). In patients with a single enlarged node (n=97), a single malignant feature was associated with a 4-year LLR rate of 0% and multiple malignant features was associated with a rate of 17% (P=.060). In the group with multiple malignant features, their disappearance on restaging was associated with an LLR rate of 13% compared with an LLR rate of 20% for persistent malignant features (P=.532). The presence of intermediate-size LLNs (5.0-6.9 mm) with at least 1 malignant feature was associated with a 4-year LLR rate of 8%; the 4-year LLR rate was 13% when the malignant features persisted on restaging MRI (P=.409). Patients with multiple enlarged LLNs had a 4-year LLR rate of 28% compared with 11% for those with a single enlarged LLN (P=.059). Conclusions: The presence of multiple enlarged LLNs (≥7.0 mm), as well as multiple malignant features in an enlarged node contribute to the risk of developing an LLR. These radiologic features can be used for clinical decision-making regarding the potential benefit of LLN dissection.
MeSH term(s)	Humans ; Cohort Studies ; Retrospective Studies ; Cross-Sectional Studies ; Lymph Nodes/pathology ; Rectal Neoplasms/diagnostic imaging ; Rectal Neoplasms/epidemiology ; Rectal Neoplasms/therapy ; Risk Assessment ; Lymph Node Excision/methods ; Neoplasm Recurrence, Local/epidemiology ; Neoplasm Recurrence, Local/pathology ; Neoplasm Staging
Language	English
Publishing date	2024-02-23
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2250759-0
ISSN	1540-1413 ; 1540-1405
ISSN (online)	1540-1413
ISSN	1540-1405
DOI	10.6004/jnccn.2023.7081
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Article ; Online: Improving diagnostic accuracy of identifying gastric cancer patients with peritoneal metastases: tumor-guided cell-free DNA analysis of peritoneal fluid.

van der Sluis, Karen / van Sandick, Johanna W / Vollebergh, Marieke A / van Dieren, Jolanda M / Hugen, Niek / Hartemink, Koen J / Veenhof, Alexander A F A / Verhoeven, Els / van den Berg, José G / Snaebjornsson, Petur / Noe, Michael / van Wezel, Tom / Boelens, Mirjam C / Kodach, Liudmila L

Oncogene

2024

Abstract: Detection of peritoneal dissemination (PD) in gastric cancer (GC) patients remains challenging. The feasibility of tumor-guided cell-free DNA (cfDNA) detection in prospectively collected peritoneal fluid (ascites and peritoneal lavage) was investigated ... ...

Abstract	Detection of peritoneal dissemination (PD) in gastric cancer (GC) patients remains challenging. The feasibility of tumor-guided cell-free DNA (cfDNA) detection in prospectively collected peritoneal fluid (ascites and peritoneal lavage) was investigated and compared to conventional cytology in 28 patients. Besides conventional cytology, next generation sequencing was performed on primary tumor DNA and cell-free DNA from peritoneal fluid. Patients were retrospectively grouped into: a positive group (with PD) and a negative group (without PD). Detectable mutations were found in the primary tumor of 68% (n = 19). Sensitivity of PD detection by tumor-guided cfDNA analysis was 91%, compared to 64% by conventional cytology. Within the positive group (n = 11), tumor-guided cfDNA was detected in all patients with ascites samples (4/4, 100%) and in 86% (6/7) of the lavage samples, opposed to 4/4 (100%) patients with ascites and 43% (3/7) with lavage by conventional cytology. Within the negative group (n = 8), conventional cytology was negative for all samples. In two patients, tumor-guided cfDNA was detected in peritoneal lavage fluid. Interestingly, these 2 patients developed PD within 6 months, suggesting a prognostic value of tumor-guided cfDNA detection. This study showed that tumor-guided cfDNA detection in peritoneal fluids of GC patients is feasible and superior to conventional cytology in detecting PD.
Language	English
Publishing date	2024-04-23
Publishing country	England
Document type	Journal Article
ZDB-ID	639046-8
ISSN	1476-5594 ; 0950-9232
ISSN (online)	1476-5594
ISSN	0950-9232
DOI	10.1038/s41388-024-03034-z
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Zs.A 2218: Show issues

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Article: Optimizing patient selection for stereotactic ablative radiotherapy in patients with locally advanced pancreatic cancer after initial chemotherapy - a single center prospective cohort.

Doppenberg, D / Lagerwaard, F J / van Dieren, S / Meijerink, M R / van der Vliet, J J / Besselink, M G / van Tienhoven, G / Versteijne, E / Slotman, B J / Wilmink, J W / Kazemier, G / Bruynzeel, A M E

Frontiers in oncology

2023 Volume 13, Page(s) 1149961

Abstract: Background: The role of stereotactic ablative radiation therapy (SABR) as local treatment option after chemotherapy for locally advanced pancreatic cancer (LAPC) is evolving. However adequate patient selection criteria for SABR in patients with LAPC are ...

Abstract	Background: The role of stereotactic ablative radiation therapy (SABR) as local treatment option after chemotherapy for locally advanced pancreatic cancer (LAPC) is evolving. However adequate patient selection criteria for SABR in patients with LAPC are lacking. Methods: A prospective institutional database collected data of patients with LAPC treated with chemotherapy, mainly FOLFIRINOX, followed by SABR, which was delivered using magnetic resonance guided radiotherapy, 40 Gy in 5 fractions within two weeks. Primary endpoint was overall survival (OS). Cox regression analyses were performed to identify predictors for OS. Results: Overall, 74 patients were included, median age 66 years, 45.9% had a KPS score of ≥90. Median OS was 19.6 months from diagnosis and 12.1 months from start of SABR. Local control was 90% at one year. Multivariable Cox regression analyses identified KPS ≥90, age <70, and absence of pain prior to SABR as independent favorable predictors for OS. The rate of grade ≥3 fatigue and late gastro-intestinal toxicity was 2.7%. Conclusions: SABR is a well-tolerated treatment in patients with unresectable LAPC following chemotherapy, with better outcomes when applied in patients with higher performance score, age <70 years and absence of pain. Future randomized trials will have to confirm these findings.
Language	English
Publishing date	2023-05-31
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2649216-7
ISSN	2234-943X
ISSN	2234-943X
DOI	10.3389/fonc.2023.1149961
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Article: Clinical Prediction Models for Recurrence in Patients with Resectable Grade 1 and 2 Sporadic Non-Functional Pancreatic Neuroendocrine Tumors: A Systematic Review.

Chen, Jeffrey W / Heidsma, Charlotte M / Engelsman, Anton F / Kabaktepe, Ertunç / van Dieren, Susan / Falconi, Massimo / Besselink, Marc G / Nieveen van Dijkum, Els J M

Cancers

2023 Volume 15, Issue 5

Abstract: Recurrence after resection in patients with non-functional pancreatic neuroendocrine tumors (NF-pNET) has a considerable impact on overall survival. Accurate risk stratification will tailor optimal follow-up strategies. This systematic review assessed ... ...

Abstract	Recurrence after resection in patients with non-functional pancreatic neuroendocrine tumors (NF-pNET) has a considerable impact on overall survival. Accurate risk stratification will tailor optimal follow-up strategies. This systematic review assessed available prediction models, including their quality. This systematic review followed PRISMA and CHARMS guidelines. PubMed, Embase, and the Cochrane Library were searched up to December 2022 for studies that developed, updated, or validated prediction models for recurrence in resectable grade 1 or 2 NF-pNET. Studies were critically appraised. After screening 1883 studies, 14 studies with 3583 patients were included: 13 original prediction models and 1 prediction model validation. Four models were developed for preoperative and nine for postoperative use. Six models were presented as scoring systems, five as nomograms, and two as staging systems. The
Language	English
Publishing date	2023-02-28
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers15051525
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Article ; Online: Impact of family visit restrictions due to COVID-19 policy on patient outcomes: A cohort study.

Bloemberg, Daphne / Musters, Selma C W / Wal-Huisman, Hanneke van der / Dieren, Susan van / Nieveen van Dijkum, Els J M / Eskes, Anne M

Journal of advanced nursing

2022 Volume 78, Issue 12, Page(s) 4042–4053

Abstract: Aim: To investigate the impact of family visit restrictions during the COVID-19 pandemic on deliriums, falls, pneumonia, pressure ulcers and readmissions among surgical inpatients with gastrointestinal (oncologic) diseases.: Design: Cohort study.: ... ...

Abstract	Aim: To investigate the impact of family visit restrictions during the COVID-19 pandemic on deliriums, falls, pneumonia, pressure ulcers and readmissions among surgical inpatients with gastrointestinal (oncologic) diseases. Design: Cohort study. Methods: This study was conducted among adult inpatients undergoing gastrointestinal surgery in two academic hospitals. During the COVID-19 outbreak in 2020, over a 10-week period, one cohort was subjected to family visit restrictions. Per patient, one person per day was allowed to visit for a maximum of 30 min. This cohort was compared with another cohort in which patients were not subjected to such restrictions during a 10-week period in 2019. Logistic regression analyses were used to investigate the impact of the restrictions on deliriums, falls, pneumonia, pressure ulcers and readmissions. Results: In total, 287 patients were included in the 2020 cohort and 243 in the 2019 cohort. No differences were observed in the cohorts with respect to baseline characteristics. Logistic regression analyses showed no significant differences in deliriums, falls, pneumonia, pressure ulcers and readmissions between the cohorts. Conclusion: We cautiously conclude that the family visit restrictions during the COVID-19 pandemic did not contribute to deliriums, falls, pneumonia, pressure ulcers or readmissions in surgical patients with gastrointestinal (oncologic) diseases. Impact: COVID-19 influenced family-centred care due to family visit restrictions. Nurses need to continue monitoring outcomes known to be sensitive to family-centred care to gain insight into the effects of visit restrictions and share the results in order to include nurses' perspectives in COVID-19-decision-making. Re-implementing of family visit restrictions should be carefully considered in policy-making.
MeSH term(s)	Adult ; Humans ; COVID-19/epidemiology ; Cohort Studies ; Pressure Ulcer/epidemiology ; Pandemics ; Pneumonia/epidemiology ; Policy
Language	English
Publishing date	2022-06-14
Publishing country	England
Document type	Journal Article
ZDB-ID	197634-5
ISSN	1365-2648 ; 0309-2402
ISSN (online)	1365-2648
ISSN	0309-2402
DOI	10.1111/jan.15325
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Article ; Online: Rubber band ligation versus haemorrhoidectomy for the treatment of grade II-III haemorrhoids: a systematic review and meta-analysis of randomised controlled trials.

Dekker, L / Han-Geurts, I J M / Rørvik, H D / van Dieren, S / Bemelman, W A

Techniques in coloproctology

2021 Volume 25, Issue 6, Page(s) 663–674

Abstract: Background: The aim of this study was to review clinical outcome of haemorrhoidectomy and rubber band ligation in grade II-III haemorrhoids.: Methods: A systematic review was conducted. Medline, Embase, Cochrane Library, Clinicaltrials.gov, and the ... ...

Abstract	Background: The aim of this study was to review clinical outcome of haemorrhoidectomy and rubber band ligation in grade II-III haemorrhoids. Methods: A systematic review was conducted. Medline, Embase, Cochrane Library, Clinicaltrials.gov, and the WHO International Trial Registry Platform were searched, from inception until May 2018, to identify randomised clinical trials comparing rubber band ligation with haemorrhoidectomy for grade II-III haemorrhoids. The primary outcome was control of symptoms. Secondary outcomes included postoperative pain, postoperative complications, anal continence, patient satisfaction, quality of life and healthcare costs were assessed. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Results: Three hundred and twenty-four studies were identified. Eight trials met the inclusion criteria. All trials were of moderate methodological quality. Outcome measures were diverse and not clearly defined. Control of symptoms was better following haemorrhoidectomy. Patients had less pain after rubber band ligation. There were more complications (bleeding, urinary retention, anal incontinence/stenosis) in the haemorrhoidectomy group. Patient satisfaction was equal in both groups. There were no data on quality of life and healthcare costs except that in one study patients resumed work more early after rubber band ligation. Conclusions: Haemorrhoidectomy seems to provide better symptom control but at the cost of more pain and complications. However, due to the poor quality of the studies analysed/it is not possible to determine which of the two procedures provides the best treatment for grade II-III haemorrhoids. Further studies focusing on clearly defined outcome measurements taking patients perspective and economic impact into consideration are required.
MeSH term(s)	Fecal Incontinence/etiology ; Hemorrhoidectomy/adverse effects ; Hemorrhoids/surgery ; Humans ; Ligation ; Quality of Life ; Randomized Controlled Trials as Topic
Language	English
Publishing date	2021-03-08
Publishing country	Italy
Document type	Journal Article ; Meta-Analysis ; Review ; Systematic Review
ZDB-ID	2083309-X
ISSN	1128-045X ; 1123-6337
ISSN (online)	1128-045X
ISSN	1123-6337
DOI	10.1007/s10151-021-02430-x
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Article ; Online: Cost Analysis of Volar Plate Fixation Versus Plaster Cast Immobilization for Intra-Articular Distal Radial Fractures.

Selles, C A / Mulders, M A M / van Dieren, S / Goslings, J C / Schep, N W L

The Journal of bone and joint surgery. American volume

2021 Volume 103, Issue 21, Page(s) 1970–1976

Abstract: Background: The aim of this study was to compare the cost-effectiveness and cost-utility between plaster cast immobilization and volar plate fixation for acceptably reduced intra-articular distal radial fractures.: Methods: A cost-effectiveness ... ...

Abstract	Background: The aim of this study was to compare the cost-effectiveness and cost-utility between plaster cast immobilization and volar plate fixation for acceptably reduced intra-articular distal radial fractures. Methods: A cost-effectiveness analysis was conducted as part of a randomized controlled trial comparing operative (volar plate fixation) with nonoperative (plaster cast immobilization) treatment in patients between 18 and 75 years old with an acceptably reduced intra-articular distal radial fracture. Health-care utilization and use of resources per patient were documented prospectively and included direct medical costs, direct non-medical costs, and indirect costs. All analyses were performed according to the intention-to-treat principle. Results: The mean total cost per patient was $291 (95% bias-corrected and accelerated confidence interval [bcaCI] = -$1,286 to $1,572) higher in the operative group compared with the nonoperative group. The mean total number of quality-adjusted life-years (QALYs) gained at 12 months was significantly higher in the operative group than in the nonoperative group (mean difference = 0.15; 95% bcaCI = 0.056 to 0.243). The difference in the cost per QALY (incremental cost-effectiveness ratio [ICER]) was $2,008 (95% bcaCI = -$9,608 to $18,222) for the operative group compared with the nonoperative group, which means that operative treatment is more effective but also more expensive. Subgroup analysis including only patients with a paid job showed that the ICER was -$3,500 per QALY for the operative group with a paid job compared with the nonoperative group with a paid job, meaning that operative treatment is more effective and less expensive for patients with a paid job. Conclusions: The difference in QALYs gained for the operatively treated group was equivalent to an additional 55 days of perfect health per year. In adult patients with an acceptably reduced intra-articular distal radial fracture, operative treatment is a cost-effective intervention, especially in patients with paid employment. Operative treatment is slightly more expensive than nonoperative treatment but provides better functional results and a better quality of life. Level of evidence: Economic and Decision Analysis Level I. See Instructions for Authors for a complete description of levels of evidence.
MeSH term(s)	Adolescent ; Adult ; Aged ; Bone Plates/economics ; Casts, Surgical/economics ; Casts, Surgical/statistics & numerical data ; Cost-Benefit Analysis ; Female ; Follow-Up Studies ; Fracture Fixation, Internal/economics ; Fracture Fixation, Internal/statistics & numerical data ; Hand Strength/physiology ; Health Care Costs/statistics & numerical data ; Humans ; Intra-Articular Fractures/diagnosis ; Intra-Articular Fractures/economics ; Intra-Articular Fractures/physiopathology ; Intra-Articular Fractures/therapy ; Male ; Middle Aged ; Patient Acceptance of Health Care/statistics & numerical data ; Prospective Studies ; Quality-Adjusted Life Years ; Radius Fractures/diagnosis ; Radius Fractures/economics ; Radius Fractures/physiopathology ; Radius Fractures/therapy ; Range of Motion, Articular ; Treatment Outcome ; Wrist Injuries/diagnosis ; Wrist Injuries/economics ; Wrist Injuries/physiopathology ; Wrist Injuries/therapy ; Wrist Joint/diagnostic imaging ; Young Adult
Language	English
Publishing date	2021-09-13
Publishing country	United States
Document type	Comparative Study ; Journal Article ; Multicenter Study ; Randomized Controlled Trial
ZDB-ID	220625-0
ISSN	1535-1386 ; 0021-9355
ISSN (online)	1535-1386
ISSN	0021-9355
DOI	10.2106/JBJS.20.01345
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Uk I Zs.58/1: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)
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Article ; Online: The effect of preoperative body mass index on short-term outcome after esophagectomy for cancer: A nationwide propensity score-matched analysis.

Gooszen, Jan A H / Eshuis, Wietse J / Blom, Rachel L G M / van Dieren, Susan / Gisbertz, Suzanne S / van Berge Henegouwen, Mark I

Surgery

2022 Volume 172, Issue 1, Page(s) 137–144

Abstract: ... body mass index categories (<18.5 kg/m: Results: Of the patients, 2,598 were included (underweight = 70, normal ...

Abstract	Background: The true influence of body mass index on the outcome of esophageal cancer surgery is unclear. The aim of this study was to determine the relation between preoperative body mass index and clinical and oncological outcomes of esophagectomy for cancer in a patient cohort from the Dutch nationwide audit. Methods: All patients who underwent esophagectomy for cancer between January 2011 and 2016 were identified in the Dutch Upper Gastrointestinal Cancer Audit. Patients were divided into 4 body mass index categories (<18.5 kg/m Results: Of the patients, 2,598 were included (underweight = 70, normal weight = 1,097, overweight = 1,007, and obese = 424). Before propensity score-matched analysis, underweight patients had a significantly longer hospital stay, more chyle leakage, underwent more re-operations, and had a higher in-hospital/30-day mortality compared to the other weight groups. After propensity score-matched analysis, 560 patients were included: 62 were underweight, 180 were normal weight, 165 were overweight, and 153 were obese. Length of hospital stay, chyle leakage, necrosis of the reconstruction, re-interventions, re-operations, re-admittance to the intensive care unit/medium care unit, and in-hospital/30-day mortality were seen most in the underweight group. No differences were seen in intraoperative complications and oncological outcomes. Conclusion: Underweight patients are more prone for the development of postoperative complications after esophagectomy. Physicians and dieticians should be aware of the impact of underweight on postoperative outcome. Future studies should focus on nutritional status and the effect of preoperative correction of body weight.
MeSH term(s)	Body Mass Index ; Esophageal Neoplasms ; Esophagectomy/adverse effects ; Humans ; Obesity/complications ; Overweight/complications ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Postoperative Complications/surgery ; Propensity Score ; Retrospective Studies ; Thinness/complications
Language	English
Publishing date	2022-02-13
Publishing country	United States
Document type	Journal Article
ZDB-ID	202467-6
ISSN	1532-7361 ; 0039-6060
ISSN (online)	1532-7361
ISSN	0039-6060
DOI	10.1016/j.surg.2022.01.003
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In stock of ZB MED Cologne/Königswinter

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In stock of ZB MED Cologne/Königswinter

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In stock of ZB MED Cologne/Königswinter

Order via subito