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  1. Article: Adherence to guideline recommendations for Barrett's esophagus (BE) surveillance endoscopies: Effects of dedicated BE endoscopy lists.

    Beaufort, I N / Milne, A N / Alderlieste, Y A / Baars, J E / Bos, P R / Burger, J P W / van Heel, N C M / Ledeboer, M / Lieverse, R J / van de Meeberg, P C / Meeuse, J J / Naber, A H J / Pullens, H J M / Scheffer, R C H / Sikkema, M / Verbeek, R E / Verhagen, M A M T / van de Vrie, W / Willems, M /
    Weusten, B L A M

    Endoscopy international open

    2023  Volume 11, Issue 10, Page(s) E952–E962

    Abstract: Background and study ... ...

    Abstract Background and study aims
    Language English
    Publishing date 2023-10-11
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2761052-4
    ISSN 2196-9736 ; 2364-3722
    ISSN (online) 2196-9736
    ISSN 2364-3722
    DOI 10.1055/a-2125-0161
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: A Combined microRNA and Chemokine Profile in Urine to Identify Rejection After Kidney Transplantation.

    Gielis, Els M / Anholts, Jacqueline D H / van Beelen, Els / Haasnoot, Geert W / De Fijter, Hans W / Bajema, Ingeborg / Heidt, Sebastiaan / van de Vrie, Mathijs / Hilbrands, Luuk B / Mallat, Marko J K / Ledeganck, Kristien J / Claas, Frans H J / Eikmans, Michael

    Transplantation direct

    2021  Volume 7, Issue 7, Page(s) e711

    Abstract: There is an unmet need for noninvasive tools for diagnosis of rejection after kidney transplantation. The aim of this study was to determine the discriminative value of a combined cellular and molecular biomarker platform in urine for the detection of ... ...

    Abstract There is an unmet need for noninvasive tools for diagnosis of rejection after kidney transplantation. The aim of this study was to determine the discriminative value of a combined cellular and molecular biomarker platform in urine for the detection of rejection.
    Methods: First, microRNA (miR) molecules were screened in transplant biopsies and urine sediments of patients with acute rejection and patients without rejection and stable graft function. Second, the expression of 15 selected miRs was quantified in an independent set of 115 urine sediments of patients with rejection and 55 urine sediments of patients without histological signs of rejection on protocol biopsy. Additionally, CXCL-9 and CXCL-10 protein levels were quantified in the urine supernatant.
    Results: Levels of miR-155-5p (5.7-fold), miR-126-3p (4.2-fold), miR-21-5p (3.7-fold), miR-25-3p (2.5-fold), and miR-615-3p (0.4-fold) were significantly different between rejection and no-rejection urine sediments. CXCL-9 and CXCL-10 levels were significantly elevated in urine from recipients with rejection. In a multivariable model (sensitivity: 89.1%, specificity: 75.6%, area under the curve: 0.94,
    Conclusions: A combined urinary microRNA and chemokine profile discriminates kidney transplant rejection from stable graft conditions.
    Language English
    Publishing date 2021-06-10
    Publishing country United States
    Document type Journal Article
    ISSN 2373-8731
    ISSN 2373-8731
    DOI 10.1097/TXD.0000000000001169
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Conference proceedings: POOLING BARRETT’S ESOPHAGUS (BE) SURVEILLANCE ENDOSCOPIES ON DEDICATED BE ENDOSCOPY LISTS IMPROVES ADHERENCE TO THE FOUR-QUADRANT RANDOM (4QR) BIOPSY PROTOCOL

    Beaufort, I. / Meeuse, J. / van de Meeberg, P. / Alderlieste, Y. / Verbeek, R. / Sikkema, M. / Scheffer, B. / Naber, T. / Ledeboer, M. / Pullens, P. / van de Vrie, W. / Willems, M. / Lieverse, R. / Verhagen, M. / Baars, J. / van Heel, N. / Bos, P. / Burger, J. / Weusten, B.

    Endoscopy

    2022  Volume 54, Issue S 01

    Event/congress ESGE Days 2022, Prague, Czech Republic, 2022-04-28
    Language English
    Publishing date 2022-04-01
    Publisher Georg Thieme Verlag KG
    Publishing place Stuttgart ; New York
    Document type Article ; Conference proceedings
    ZDB-ID 80120-3
    ISSN 1438-8812 ; 0013-726X
    ISSN (online) 1438-8812
    ISSN 0013-726X
    DOI 10.1055/s-0042-1744643
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  4. Article ; Online: Can serum human epididymis protein 4 (HE4) support the decision to refer a patient with an ovarian mass to an oncology hospital?

    Lof, P / van de Vrie, R / Korse, C M / van Gent, M D J M / Mom, C H / Rosier-van Dunné, F M F / van Baal, W M / Verhoeve, H R / Hermsen, B B J / Verbruggen, M B / Hemelaar, M / van de Swaluw, A M G / Knipscheer, H C / Huirne, J A F / Westenberg, S M / van der Noort, V / Amant, F / van den Broek, D / Lok, C A R

    Gynecologic oncology

    2022  Volume 166, Issue 2, Page(s) 284–291

    Abstract: Introduction: The value of serum human epididymis protein 4 (HE4) in guiding referral decisions in patients with an ovarian mass remains unclear, because the majority of studies investigating HE4 were performed in oncology hospitals. However, the ... ...

    Abstract Introduction: The value of serum human epididymis protein 4 (HE4) in guiding referral decisions in patients with an ovarian mass remains unclear, because the majority of studies investigating HE4 were performed in oncology hospitals. However, the decision to refer is made at general hospitals with a low ovarian cancer prevalence. We assessed accuracies of HE4 in differentiating benign or borderline from malignant tumors in patients presenting with an ovarian mass at general hospitals.
    Method: Patients with an ovarian mass were prospectively included between 2017 and 2021 in nine general hospitals. HE4 and CA125 were preoperatively measured and the risk of malignancy index (RMI) was calculated. Histological diagnosis was the reference standard.
    Results: We included 316 patients, of whom 195 had a benign, 39 had a borderline and 82 had a malignant ovarian mass. HE4 had the highest AUC of 0.80 (95%CI 0.74-0.86), followed by RMI (0.71, 95%CI 0.64-0.78) and CA125 (0.69, 95%CI 0.62-0.75). Clinical setting significantly influenced biomarker performances. Applying age-dependent cut-off values for HE4 resulted in a better performance than one cut-off. Addition of HE4 to RMI resulted in a 32% decrease of unnecessary referred patients, while the number of correctly referred patients remained the same.
    Conclusion: HE4 is superior to RMI in predicting malignancy in patients with an ovarian mass from general hospitals. The addition of HE4 to the RMI improved HE4 alone. Although, there is still room for improvement, HE4 can guide referral decisions in patients with an ovarian mass to an oncology hospital.
    MeSH term(s) Algorithms ; Biomarkers, Tumor ; CA-125 Antigen ; Female ; Hospitals ; Humans ; Ovarian Neoplasms/pathology ; Proteins/metabolism ; WAP Four-Disulfide Core Domain Protein 2/analysis
    Chemical Substances Biomarkers, Tumor ; CA-125 Antigen ; Proteins ; WAP Four-Disulfide Core Domain Protein 2 ; WFDC2 protein, human
    Language English
    Publishing date 2022-06-08
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 801461-9
    ISSN 1095-6859 ; 0090-8258
    ISSN (online) 1095-6859
    ISSN 0090-8258
    DOI 10.1016/j.ygyno.2022.05.025
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Multiple elevated red spots in a woman with nausea, altered stools, and weight loss.

    Maas, Kathlene S J S M / van de Vrie, Wim / Kuizinga, Marti C

    Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association

    2014  Volume 12, Issue 1, Page(s) e1

    MeSH term(s) Aged ; Antigens, CD/analysis ; Antigens, CD1/analysis ; Antigens, Differentiation, Myelomonocytic/analysis ; CD4 Antigens/analysis ; Capsule Endoscopy ; Colposcopy ; Diarrhea/diagnosis ; Diarrhea/etiology ; Female ; Gastrointestinal Diseases/complications ; Gastrointestinal Diseases/diagnosis ; Gastrointestinal Diseases/pathology ; Histiocytosis, Langerhans-Cell/complications ; Histiocytosis, Langerhans-Cell/diagnosis ; Histiocytosis, Langerhans-Cell/pathology ; Histocytochemistry ; Humans ; Immunohistochemistry ; Microscopy ; Nausea/diagnosis ; Nausea/etiology ; S100 Proteins/analysis ; Weight Loss
    Chemical Substances Antigens, CD ; Antigens, CD1 ; Antigens, Differentiation, Myelomonocytic ; CD1a antigen ; CD4 Antigens ; CD68 antigen, human ; S100 Proteins
    Language English
    Publishing date 2014-01
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 2119789-1
    ISSN 1542-7714 ; 1542-3565
    ISSN (online) 1542-7714
    ISSN 1542-3565
    DOI 10.1016/j.cgh.2013.05.022
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Pre-operative prediction of residual disease after interval cytoreduction for epithelial ovarian cancer using HE4.

    Lof, Pien / van de Vrie, Roelien / Korse, Catharina M / van Driel, Willemien J / van Gent, Mignon D J M / Karlsen, Mona A / Amant, Frederic / Lok, Christianne A R

    International journal of gynecological cancer : official journal of the International Gynecological Cancer Society

    2019  Volume 29, Issue 8, Page(s) 1304–1310

    Abstract: Background: Presence of residual disease after cytoreductive surgery is an important negative prognostic factor for patients with advanced stage epithelial ovarian cancer. Surgery is of limited benefit when the diameter of residual disease is >1 cm. ... ...

    Abstract Background: Presence of residual disease after cytoreductive surgery is an important negative prognostic factor for patients with advanced stage epithelial ovarian cancer. Surgery is of limited benefit when the diameter of residual disease is >1 cm. Residual disease is difficult to predict before surgery. The multivariate model Cancer Ovarii Non-invasive Assessment of Treatment Strategy (CONATS) index, based on serum biomarker HE4, age, and World Health Organization performance status, predicted no visible residual disease in patients undergoing primary cytoreductive surgery with an area under the curve (AUC) of 0.85. The AUC of predicting residual disease >1 cm was not reported, although this can be of importance for pre-operative decision making, especially in fragile patients. We tested this model for predicting residual disease >1 cm in patients undergoing interval cytoreduction.
    Methods: We retrospectively included patients with advanced epithelial ovarian cancer who underwent interval cytoreduction between January 2010 and December 2017 in two tertiary centers in the Netherlands. HE4 was measured with electrochemiluminescence in pre-operative samples. The CONATS index was used to predict residual disease. AUCs were calculated to predict residual disease >1 cm.
    Results: A total of 273 patients were included. Mean (SD) age was 64 (11) years. Median number of cycles of neoadjuvant chemotherapy was 3 (range 3-6) and the most common regimen used consisted of carboplatin and paclitaxel. Before interval cytoreduction, 19 patients (7%) showed complete response to chemotherapy, 251 patients (92%) showed partial response, and 3 patients (1%) showed stable disease at imaging. Following surgery, 232 patients (85%) had residual disease ≤1 cm and 41 patients (15%) had residual disease >1 cm. The AUC was 0.80 for predicting residual disease >1 cm. In patients ≥70 years of age the AUC was 0.82.
    Conclusion: The CONATS index predicts surgical outcome after interval cytoreduction and is useful in counseling patients about the chance of whether an optimal interval cytoreduction can be achieved. This could be especially helpful in counseling elderly patients in whom surgery has a high risk of complications.
    MeSH term(s) Aged ; Biomarkers, Tumor/blood ; Carcinoma, Ovarian Epithelial/blood ; Carcinoma, Ovarian Epithelial/drug therapy ; Carcinoma, Ovarian Epithelial/pathology ; Carcinoma, Ovarian Epithelial/surgery ; Chemotherapy, Adjuvant ; Cytoreduction Surgical Procedures/methods ; Female ; Humans ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm, Residual/blood ; Neoplasm, Residual/pathology ; Ovarian Neoplasms/blood ; Ovarian Neoplasms/drug therapy ; Ovarian Neoplasms/pathology ; Ovarian Neoplasms/surgery ; Predictive Value of Tests ; Retrospective Studies ; WAP Four-Disulfide Core Domain Protein 2/metabolism
    Chemical Substances Biomarkers, Tumor ; WAP Four-Disulfide Core Domain Protein 2 ; WFDC2 protein, human
    Language English
    Publishing date 2019-09-11
    Publishing country England
    Document type Journal Article ; Multicenter Study
    ZDB-ID 1070385-8
    ISSN 1525-1438 ; 1048-891X
    ISSN (online) 1525-1438
    ISSN 1048-891X
    DOI 10.1136/ijgc-2019-000581
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Urinary MicroRNA as Biomarker in Renal Transplantation.

    van de Vrie, M / Deegens, J K / Eikmans, M / van der Vlag, J / Hilbrands, L B

    American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons

    2016  Volume 17, Issue 5, Page(s) 1160–1166

    Abstract: Urine represents a noninvasive source in which proteins and nucleic acids can be assessed. Such analytes may function as biomarkers to monitor kidney graft pathology at every desired frequency, thereby providing a time window to prevent graft damage by ... ...

    Abstract Urine represents a noninvasive source in which proteins and nucleic acids can be assessed. Such analytes may function as biomarkers to monitor kidney graft pathology at every desired frequency, thereby providing a time window to prevent graft damage by therapeutic intervention. Recently, several proteins have been measured in urine as markers of graft injury. However, the specificity is limited, and measuring urinary proteins generally lacks the potential to predict early kidney graft damage. Currently, urinary mRNA and microRNA are being investigated to evaluate the prognostic value of changes in gene expression during the initial stages of graft damage. At such time point, a change in treatment regimen and dosage is expected to have maximum potency to minimize future decline in graft function. Both mRNA and microRNAs have shown promising results in both detection and prediction of graft injury. An advantage of microRNAs compared to mRNA molecules is their stability, a characteristic that is beneficial when working with urine samples. In this review, we provide the current state of urinary biomarkers in renal transplantation, with a focus on urinary microRNA. In addition, we discuss the methods used to study urinary microRNA expression.
    MeSH term(s) Biomarkers/urine ; Graft Rejection/diagnosis ; Graft Rejection/etiology ; Graft Rejection/urine ; Humans ; Kidney Transplantation/adverse effects ; MicroRNAs/genetics ; MicroRNAs/urine ; Urinalysis
    Chemical Substances Biomarkers ; MicroRNAs
    Language English
    Publishing date 2016-11-10
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2060594-8
    ISSN 1600-6143 ; 1600-6135
    ISSN (online) 1600-6143
    ISSN 1600-6135
    DOI 10.1111/ajt.14082
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Adherence to guideline recommendations for Barrett's esophagus (BE) surveillance endoscopies: Effects of dedicated BE endoscopy lists

    Beaufort, I.N. / Milne, A.N. / Alderlieste, Y.A. / Baars, J.E. / Bos, P.R. / Burger, J.P.W. / van Heel, N.C.M. / Ledeboer, M. / Lieverse, R.J. / van de Meeberg, P.C. / Meeuse, J.J. / Naber, A.H.J. / Pullens, H.J.M. / Scheffer, R.C.H. / Sikkema, M. / Verbeek, R.E. / Verhagen, M.A.M.T. / van de Vrie, W. / Willems, M. /
    Weusten, B.L.A.M.

    Endoscopy International Open

    2023  Volume 11, Issue 10, Page(s) E952–E962

    Abstract: Background and study aims: For non-dysplastic Barrett’s Esophagus (BE) patients, guidelines recommend endoscopic surveillance every 3 to 5 years with four-quadrant random biopsies every 2 cm of BE length. Adherence to these guidelines is low in clinical ...

    Abstract Background and study aims: For non-dysplastic Barrett’s Esophagus (BE) patients, guidelines recommend endoscopic surveillance every 3 to 5 years with four-quadrant random biopsies every 2 cm of BE length. Adherence to these guidelines is low in clinical practice. Pooling BE surveillance endoscopies on dedicated endoscopy lists performed by dedicated endoscopists could possibly enhance guideline adherence, detection of visible lesions, and dysplasia detection rates (DDRs).
    Patients and methods: Data were used from the ACID-study (Netherlands Trial Registry NL8214), a prospective trial of BE surveillance in the Netherlands. BE patients with known or previously treated dysplasia were excluded. Guideline adherence, detection of visible lesions, and DDRs were compared for patients on dedicated and general endoscopy lists.
    Results: A total of 1,244 patients were included, 318 on dedicated lists and 926 on general lists. Endoscopies on dedicated lists showed significantly higher adherence to the random biopsy protocol (85% vs. 66%, P <0.01) and recommended surveillance intervals (60% vs. 47%, P <0.01) compared to general lists. Detection of visible lesions (8.8% vs. 8.1%, P =0.79) and DDRs were not significantly different (6.9% and 6.6%, P =0.94). None (0.0%) of the patients scheduled on dedicated lists and 10 (1.1%) on general lists were diagnosed with esophageal adenocarcinoma ( P =0.07). In multivariable analysis, dedicated lists were significantly associated with biopsy protocol adherence and adherence to surveillance interval recommendations with odds ratios of 4.45 (95% confidence interval [CI] 2.07–9.57) and 1.64 (95% CI 1.03–2.61), respectively.
    Conclusions: Dedicated endoscopy lists are associated with better adherence to the random biopsy protocol and surveillance interval recommendations.
    Keywords Endoscopy Upper GI Tract ; Reflux disease ; Barrett's and adenocarcinoma ; Diagnosis and imaging (inc chromoendoscopy, NBI, iSCAN, FICE, CLE)
    Language English
    Publishing date 2023-10-01
    Publisher Georg Thieme Verlag KG
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 2761052-4
    ISSN 2196-9736 ; 2364-3722 ; 2196-9736
    ISSN (online) 2196-9736
    ISSN 2364-3722 ; 2196-9736
    DOI 10.1055/a-2125-0161
    Database Thieme publisher's database

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  9. Article ; Online: Patient selection for urgent endoscopic retrograde cholangio-pancreatography by endoscopic ultrasound in predicted severe acute biliary pancreatitis (APEC-2): a multicentre prospective study.

    Hallensleben, Nora D / Stassen, Pauline M C / Schepers, Nicolien J / Besselink, Marc G / Anten, Marie-Paule G F / Bakker, Olaf J / Bollen, Thomas L / da Costa, David W / van Dijk, Sven M / van Dullemen, Hendrik M / Dijkgraaf, Marcel G W / van Eijck, Brechje / van Eijck, Casper H J / Erkelens, Willemien / Erler, Nicole S / Fockens, Paul / van Geenen, Erwin-Jan M / van Grinsven, Janneke / Hazen, Wouter L /
    Hollemans, Robbert A / van Hooft, Jeanin E / Jansen, Jeroen M / Kubben, Frank J G M / Kuiken, Sjoerd D / Poen, Alexander C / Quispel, Rutger / de Ridder, Rogier J / Römkens, Tessa E H / Schoon, Erik J / Schwartz, Matthijs P / Seerden, Tom C J / Smeets, Xavier J N M / Spanier, B W Marcel / Tan, Adriaan C I T L / Thijs, Willem J / Timmer, Robin / Umans, Devica S / Venneman, Niels G / Verdonk, Robert C / Vleggaar, Frank P / van de Vrie, Wim / van Wanrooij, Roy L J / Witteman, Ben J / van Santvoort, Hjalmar C / Bouwense, Stefan A W / Bruno, Marco J

    Gut

    2023  Volume 72, Issue 8, Page(s) 1534–1542

    Abstract: Objective: Routine urgent endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic biliary sphincterotomy (ES) does not improve outcome in patients with predicted severe acute biliary pancreatitis. Improved patient selection for ERCP by ... ...

    Abstract Objective: Routine urgent endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic biliary sphincterotomy (ES) does not improve outcome in patients with predicted severe acute biliary pancreatitis. Improved patient selection for ERCP by means of endoscopic ultrasonography (EUS) for stone/sludge detection may challenge these findings.
    Design: A multicentre, prospective cohort study included patients with predicted severe acute biliary pancreatitis without cholangitis. Patients underwent urgent EUS, followed by ERCP with ES in case of common bile duct stones/sludge, within 24 hours after hospital presentation and within 72 hours after symptom onset. The primary endpoint was a composite of major complications or mortality within 6 months after inclusion. The historical control group was the conservative treatment arm (n=113) of the randomised APEC trial (Acute biliary Pancreatitis: urgent ERCP with sphincterotomy versus conservative treatment, patient inclusion 2013-2017) applying the same study design.
    Results: Overall, 83 patients underwent urgent EUS at a median of 21 hours (IQR 17-23) after hospital presentation and at a median of 29 hours (IQR 23-41) after start of symptoms. Gallstones/sludge in the bile ducts were detected by EUS in 48/83 patients (58%), all of whom underwent immediate ERCP with ES. The primary endpoint occurred in 34/83 patients (41%) in the urgent EUS-guided ERCP group. This was not different from the 44% rate (50/113 patients) in the historical conservative treatment group (risk ratio (RR) 0.93, 95% CI 0.67 to 1.29; p=0.65). Sensitivity analysis to correct for baseline differences using a logistic regression model also showed no significant beneficial effect of the intervention on the primary outcome (adjusted OR 1.03, 95% CI 0.56 to 1.90, p=0.92).
    Conclusion: In patients with predicted severe acute biliary pancreatitis without cholangitis, urgent EUS-guided ERCP with ES did not reduce the composite endpoint of major complications or mortality, as compared with conservative treatment in a historical control group.
    Trial registration number: ISRCTN15545919.
    MeSH term(s) Humans ; Cholangiopancreatography, Endoscopic Retrograde/adverse effects ; Prospective Studies ; Endosonography/adverse effects ; Patient Selection ; Sewage ; Sphincterotomy, Endoscopic/adverse effects ; Pancreatitis/diagnosis ; Gallstones/complications ; Gallstones/diagnostic imaging ; Gallstones/surgery ; Cholangitis/complications ; Acute Disease
    Chemical Substances 2-((2-aminoethylamino)carbonylethylphenylethylamino)-5'-N-ethylcarboxamidoadenosine (126828-50-0) ; Sewage
    Language English
    Publishing date 2023-02-27
    Publishing country England
    Document type Multicenter Study ; Journal Article
    ZDB-ID 80128-8
    ISSN 1468-3288 ; 0017-5749
    ISSN (online) 1468-3288
    ISSN 0017-5749
    DOI 10.1136/gutjnl-2022-328258
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: The FIGO Stage IVA Versus IVB of Ovarian Cancer: Prognostic Value and Predictive Value for Neoadjuvant Chemotherapy.

    Tajik, Parvin / van de Vrie, Roelien / Zafarmand, Mohammad H / Coens, Corneel / Buist, Marrije R / Vergote, Ignace / Bossuyt, Patrick M M / Kenter, Gemma G

    International journal of gynecological cancer : official journal of the International Gynecological Cancer Society

    2018  Volume 28, Issue 3, Page(s) 453–458

    Abstract: Objective: The revised version of the International Federation of Gynaecology and Obstetrics (FIGO) staging system (2014) for epithelial ovarian cancer includes a number of changes. One of these is the division of stage IV into 2 subgroups. Data on the ... ...

    Abstract Objective: The revised version of the International Federation of Gynaecology and Obstetrics (FIGO) staging system (2014) for epithelial ovarian cancer includes a number of changes. One of these is the division of stage IV into 2 subgroups. Data on the prognostic and predictive significance of this classification are scarce. The effect of neoadjuvant chemotherapy (NACT) versus primary debulking surgery (PDS) in relation to the subclassification of FIGO stage IV is also unknown.
    Methods: We used data of the EORTC 55971 trial, in which 670 patients with previous stage IIIC or IV epithelial ovarian cancer were randomly assigned to PDS or NACT; 160 patients had previous stage IV. Information on previous FIGO staging and presence of pleural effusion with positive cytology were used to classify tumors as either stage IVA or IVB. We tested the association between stage IVA/IVB and survival to evaluate the prognostic value and interactions between stage, treatment, and survival to evaluate the predictive performance.
    Results: Among the 160 participants with previous stage IV disease, 103 (64%) were categorized as stage IVA and 57 (36%) as stage IVB tumors. Median overall survival was 24 months in FIGO stage IVA and 31 months in stage IVB patients (P = 0.044). Stage IVB patients treated with NACT had 9 months longer median overall survival compared with IVB patients undergoing PDS (P = 0.025), whereas in IVA patients, no significant difference was observed (24 vs 26 months, P = 0.48).
    Conclusions: The reclassification of FIGO stage IV into stage IVA or IVB was not prognostic as expected. Compared with stage IVA patients, stage IVB patients have a better overall survival and may benefit more from NACT.
    MeSH term(s) Aged ; Carcinoma, Ovarian Epithelial/drug therapy ; Carcinoma, Ovarian Epithelial/pathology ; Carcinoma, Ovarian Epithelial/surgery ; Chemotherapy, Adjuvant ; Cytoreduction Surgical Procedures ; Female ; Humans ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm Staging ; Predictive Value of Tests ; Prognosis ; Randomized Controlled Trials as Topic ; Survival Rate
    Language English
    Publishing date 2018-01-08
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 1070385-8
    ISSN 1525-1438 ; 1048-891X
    ISSN (online) 1525-1438
    ISSN 1048-891X
    DOI 10.1097/IGC.0000000000001186
    Database MEDical Literature Analysis and Retrieval System OnLINE

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