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Article ; Online: State of the art and future directions in the systemic treatment of medullary thyroid cancer.

Jager, Eline C / Broekman, K Esther / Kruijff, Schelto / Links, Thera P

2021 Volume 34, Issue 1, Page(s) 1–8

Abstract: Purpose of review: Systemic treatment is the only therapeutic option for patients with progressive, metastatic medullary thyroid cancer (MTC). Since the discovery of the rearranged during transfection (RET) proto-oncogene (100% hereditary, 60-90% ... ...

Abstract	Purpose of review: Systemic treatment is the only therapeutic option for patients with progressive, metastatic medullary thyroid cancer (MTC). Since the discovery of the rearranged during transfection (RET) proto-oncogene (100% hereditary, 60-90% sporadic MTC), research has focused on finding effective systemic therapies to target this mutation. This review surveys recent findings. Recent findings: Multikinase inhibitors are systemic agents targeting angiogenesis, inhibiting growth of tumor cells and cells in the tumor environment and healthy endothelium. In the phase III EXAM and ZETA trials, cabozantinib and vandetanib showed progression-free survival benefit, without evidence of prolonged overall survival. Selpercatinib and pralsetinib are kinase inhibitors with high specificity for RET; phase I and II studies showed overall response rates of 73% and 71% in first line, and 69% and 60% in second line treatment, respectively. Although resistance mechanisms to mutation-driven therapy will be a challenge in the future, phase III studies are ongoing and neo-adjuvant therapy with selpercatinib is being studied. Summary: The development of selective RET-inhibitors has expanded the therapeutic arsenal to control tumor growth in progressive MTC, with fewer adverse effects than multikinase inhibitors. Future studies should confirm their effectiveness, study neo-adjuvant strategies, and tackle resistance to these inhibitors, ultimately to improve patient outcomes.
MeSH term(s)	Carcinoma, Medullary/congenital ; Carcinoma, Neuroendocrine/drug therapy ; Carcinoma, Neuroendocrine/genetics ; Humans ; Multiple Endocrine Neoplasia Type 2a ; Proto-Oncogene Proteins c-ret/genetics ; Proto-Oncogene Proteins c-ret/therapeutic use ; Thyroid Neoplasms/drug therapy ; Thyroid Neoplasms/genetics
Chemical Substances	Proto-Oncogene Proteins c-ret (EC 2.7.10.1)
Language	English
Publishing date	2021-10-14
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1049384-0
ISSN	1531-703X ; 1040-8746
ISSN (online)	1531-703X
ISSN	1040-8746
DOI	10.1097/CCO.0000000000000798
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Article: Surgery-Related Muscle Loss after Pancreatic Resection and Its Association with Postoperative Nutritional Intake.

Hogenbirk, Rianne N M / Hentzen, Judith E K R / van der Plas, Willemijn Y / Campmans-Kuijpers, Marjo J E / Kruijff, Schelto / Klaase, Joost M

Cancers

2023 Volume 15, Issue 3

Abstract: To study the occurrence of surgery-related muscle loss (SRML) and its association with in-hospital nutritional intake, we conducted a prospective observational cohort study including patients who underwent pancreatic surgery because of (suspected) ... ...

Abstract	To study the occurrence of surgery-related muscle loss (SRML) and its association with in-hospital nutritional intake, we conducted a prospective observational cohort study including patients who underwent pancreatic surgery because of (suspected) malignant diseases. Muscle diameter was measured by using bedside ultrasound 1 day prior to surgery and 7 days postoperatively. Clinically relevant SRML was defined as ≥10% muscle diameter loss in minimally one arm and leg muscle within 1 week after surgery. Protein and caloric intake was measured by nutritional diaries. The primary endpoint included the number of patients with SRML. Secondary endpoints included the association between SRML and postoperative nutritional intake. Of the 63 included patients (60.3% men; age 67.1 ± 10.2 years), a total of 24 patients (38.1%) showed SRML. No differences were observed in severe complication rate or length of hospital stay between patients with and without SRML. During the first postoperative week, patients with clinically relevant SRML experienced more days without any nutritional intake compared with the non-SRML group (1 [0-4] versus 0 [0-1] days,
Language	English
Publishing date	2023-02-03
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers15030969
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Article ; Online: Empowering Tomorrow's Cancer Specialists: Evaluating the Co-creation and Impact of Malawi's First Surgical Oncology Summerschool.

van Egmond, Remco / van Kesteren, Jurre / Kaomba, Lucy / Philipo, Godfrey Sama / Borgstein, Eric / Rinkes, Inne Borel / Rijken, Marcus / Kruijff, Schelto / Stortelder, Eva

Journal of cancer education : the official journal of the American Association for Cancer Education

2024

Abstract: Annually more than 1 million newly diagnosed cancer cases and 500,000 cancer-related deaths occur in Sub Saharan Africa (SSA). By 2030, the cancer burden in Africa is expected to double accompanied by low survival rates. Surgery remains the primary ... ...

Abstract	Annually more than 1 million newly diagnosed cancer cases and 500,000 cancer-related deaths occur in Sub Saharan Africa (SSA). By 2030, the cancer burden in Africa is expected to double accompanied by low survival rates. Surgery remains the primary treatment for solid tumours especially where other treatment modalities are lacking. However, in SSA, surgical residents lack sufficient training in cancer treatment. In 2022, Malawian and Dutch specialists co-designed a training course focusing on oncologic diseases and potential treatment options tailored to the Malawian context. The aim of this study was to describe the co-creation process of a surgical oncology education activity in a low resource setting, at the same time attempting to evaluate the effectiveness of this training program. The course design was guided and evaluated conform Kirkpatrick's requirements for an effective training program. Pre-and post-course questionnaires were conducted to evaluate the effectiveness. Thirty-five surgical and gynaecological residents from Malawi participated in the course. Eighty-six percent of respondents (n = 24/28) were highly satisfied at the end of the course. After a 2-month follow-up, 84% (n = 16/19) frequently applied the newly acquired knowledge, and 74% (n = 14/19) reported to have changed their patient care. The course costs were approximately 119 EUR per attendee per day. This course generally received generally positively feedback, had high satisfaction rates, and enhanced knowledge and confidence in the surgical treatment of cancer. Its effectiveness should be further evaluated using the same co-creation model in different settings. Integrating oncology into the regular curriculum of surgical residents is recommended.
Language	English
Publishing date	2024-02-09
Publishing country	England
Document type	Journal Article
ZDB-ID	632898-2
ISSN	1543-0154 ; 0885-8195 ; 1543-1154
ISSN (online)	1543-0154
ISSN	0885-8195 ; 1543-1154
DOI	10.1007/s13187-024-02400-5
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Zs.A 2185: Show issues

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Article ; Online: Actual physical activity after major abdominal cancer surgery: Far from optimal.

Hogenbirk, Rianne N M / Wijma, Allard G / van der Plas, Willemijn Y / Hentzen, Judith E K R / de Bock, Geertruida H / van der Schans, Cees P / Kruijff, Schelto / Klaase, Joost M

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology

2024 Volume 50, Issue 2, Page(s) 107949

Abstract: Background: Enhanced recovery after surgery protocols emphasize the importance of early postoperative mobilization. However, literature quantifying actual physical activity after major abdominal cancer surgery is scarce and inconclusive.: Material and ...

Abstract	Background: Enhanced recovery after surgery protocols emphasize the importance of early postoperative mobilization. However, literature quantifying actual physical activity after major abdominal cancer surgery is scarce and inconclusive. Material and methods: A single-center prospective cohort study was conducted at the University Medical Center Groningen from 2019 to 2021. Patients' postoperative physical activity was measured using an accelerometer, with the primary aim of assessing daily physical activity. Secondary aims were identifying patient-related factors associated with low physical activity and studying the consequences of low physical activity in terms of complication rate and length of hospital stay. Results: 143 patients included (48 % male; mean age 65 years), 38.5 %, 24.5 %, 19.6 %, and 14 % underwent pancreatic, hepatic, colorectal, or cytoreductive surgery with hyperthermic intraperitoneal chemotherapy, respectively. Median daily step count was low; from median 71 steps on the first to 918 steps on the seventh postoperative day. An association between physical activity and age (OR 3.597, p = 0.013), preoperative weight loss ≥10 % (OR 4.984, p = 0.004), Eastern Cooperative Oncology Group performance status ≥2 (OR 4.016, p = 0.001), midline laparotomy (OR 2.851, p = 0.025), and operation duration (OR 1.003, p = 0.044) was found. An association was observed between physical activity and the occurrence of complications (OR 3.197, p = 0.039) and prolonged hospital stay (β 4.068, p = 0.013). Conclusion: Postoperative physical activity is low in patients undergoing major abdominal cancer surgery and is linked to postoperative outcomes. Although physical activity should be encouraged in all patients, patient-specific risk factors were identified that can aid early recognition of patients at risk of low physical activity.
MeSH term(s)	Humans ; Male ; Aged ; Female ; Prospective Studies ; Exercise ; Abdominal Neoplasms/surgery ; Pancreas ; Risk Factors ; Postoperative Complications/epidemiology ; Length of Stay
Language	English
Publishing date	2024-01-06
Publishing country	England
Document type	Journal Article
ZDB-ID	632519-1
ISSN	1532-2157 ; 0748-7983
ISSN (online)	1532-2157
ISSN	0748-7983
DOI	10.1016/j.ejso.2024.107949
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Zs.A 1149: 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)
Zs.MO 549: Show issues

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Article ; Online: Pre-Transplant Hyperparathyroidism and Graft or Patient Outcomes After Kidney Transplantation.

Rodrigues, Fernanda Guedes / Van Der Plas, Willemijn Y / Sotomayor, Camilo German / Van Der Vaart, Amarens / Kremer, Daan / Pol, Robert A / Kruijff, Schelto / Heilberg, Ita Pfeferman / Bakker, Stephan J L / De Borst, Martin H

Transplant international : official journal of the European Society for Organ Transplantation

2024 Volume 37, Page(s) 11916

Abstract: The impact of pre-transplant parathyroid hormone (PTH) levels on early or long-term kidney function after kidney transplantation is subject of debate. We assessed whether severe hyperparathyroidism is associated with delayed graft function (DGF), death- ... ...

Abstract	The impact of pre-transplant parathyroid hormone (PTH) levels on early or long-term kidney function after kidney transplantation is subject of debate. We assessed whether severe hyperparathyroidism is associated with delayed graft function (DGF), death-censored graft failure (DCGF), or all-cause mortality. In this single-center cohort study, we studied the relationship between PTH and other parameters related to bone and mineral metabolism, including serum alkaline phosphatase (ALP) at time of transplantation with the subsequent risk of DGF, DCGF and all-cause mortality using multivariable logistic and Cox regression analyses. In 1,576 kidney transplant recipients (51.6 ± 14.0 years, 57.3% male), severe hyperparathyroidism characterized by pre-transplant PTH ≥771 pg/mL (>9 times the upper limit) was present in 121 patients. During 5.2 [0.2-30.0] years follow-up, 278 (15.7%) patients developed DGF, 150 (9.9%) DCGF and 432 (28.6%) died. A higher pre-transplant PTH was not associated with DGF (HR 1.06 [0.90-1.25]), DCGF (HR 0.98 [0.87-1.13]), or all-cause mortality (HR 1.02 [0.93-1.11]). Results were consistent in sensitivity analyses. The same applied to other parameters related to bone and mineral metabolism, including ALP. Severe pre-transplant hyperparathyroidism was not associated with an increased risk of DGF, DCGF or all-cause mortality, not supporting the need of correction before kidney transplantation to improve graft or patient survival.
MeSH term(s)	Humans ; Male ; Female ; Kidney Transplantation/adverse effects ; Cohort Studies ; Hyperparathyroidism/complications ; Parathyroid Hormone ; Minerals ; Graft Survival ; Risk Factors ; Delayed Graft Function/etiology ; Graft Rejection ; Retrospective Studies
Chemical Substances	Parathyroid Hormone ; Minerals
Language	English
Publishing date	2024-02-07
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	639435-8
ISSN	1432-2277 ; 0934-0874
ISSN (online)	1432-2277
ISSN	0934-0874
DOI	10.3389/ti.2024.11916
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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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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
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Article ; Online: The increased need for palliative cancer care in Sub-Saharan Africa.

van der Plas, Willemijn Y / Benjamens, Stan / Kruijff, Schelto

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology

2020 Volume 46, Issue 7, Page(s) 1373–1376

Abstract: Although palliative care as a discipline in high income countries is maturing, it is still somewhat in its infancy in sub-Saharan Africa, an area where this type of care is needed the most: more than 80% of people in urgent need of palliative care live ... ...

Abstract	Although palliative care as a discipline in high income countries is maturing, it is still somewhat in its infancy in sub-Saharan Africa, an area where this type of care is needed the most: more than 80% of people in urgent need of palliative care live in low- and middle-income countries (LMICs). We will describe why the development of palliative care in LMICs is increasingly essential, and how it is currently still underdeveloped. In this manuscript, we discuss the challenges in organizing palliative care in LMICs in regard to the four WHO palliative care pillars: policy, education, medication, and implementation. We will illustrate how several Sub-Saharan African countries are increasingly able to provide palliative care analyzed in terms of these pillars. Ultimately, scientific research and cost-effectiveness analyses of well-developed palliative programs, should encourage both local and international governments and authorities to provide more capital and human recourses for palliative care in the future.
MeSH term(s)	Africa South of the Sahara ; Analgesics/supply & distribution ; Developing Countries ; Education, Medical ; Education, Nursing ; Health Policy ; Health Services Needs and Demand/organization & administration ; Humans ; Palliative Care/organization & administration ; Program Development
Chemical Substances	Analgesics
Language	English
Publishing date	2020-03-27
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	632519-1
ISSN	1532-2157 ; 0748-7983
ISSN (online)	1532-2157
ISSN	0748-7983
DOI	10.1016/j.ejso.2020.03.212
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Article ; Online: Palliative cancer care in Malawi.

Bates, Maya Jane / Kwaitana, Duncan / van der Plas, Willemijn Y / Benjamens, Stan / Kruijff, Schelto

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology

2021 Volume 48, Issue 2, Page(s) 472

MeSH term(s)	Humans ; Malawi/epidemiology ; Neoplasms/therapy ; Palliative Care
Language	English
Publishing date	2021-11-12
Publishing country	England
Document type	Letter ; Comment
ZDB-ID	632519-1
ISSN	1532-2157 ; 0748-7983
ISSN (online)	1532-2157
ISSN	0748-7983
DOI	10.1016/j.ejso.2021.11.006
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Article ; Online: The immediate impact of the coronavirus disease 2019 (COVID-19) pandemic on burn-out, work-engagement, and surgical training in the Netherlands.

Poelmann, Floris B / Koëter, Tijmen / Steinkamp, Pieter J / Vriens, Menno R / Verhoeven, Bas / Kruijff, Schelto

Surgery

2021 Volume 170, Issue 3, Page(s) 719–726

Abstract: Background: The coronavirus disease 2019 pandemic led to major changes in health care and education options for all health care employees. The aim of this study is to achieve insight into coronavirus disease-care participation of surgical residents in ... ...

Abstract	Background: The coronavirus disease 2019 pandemic led to major changes in health care and education options for all health care employees. The aim of this study is to achieve insight into coronavirus disease-care participation of surgical residents in the Netherlands, the impact of coronavirus disease 2019 on the experienced quality of surgical training, and the influence on Burn-out and Work Engagement compared with the non-coronavirus disease 2019 period in January 2020. Methods: In this study, we have conducted 2 digital surveys immediately before and 2 months after the start of the coronavirus disease 2019 pandemic. We surveyed a validated Dutch questionnaire 'Utrecht Burn-out Scale,' derived from the Maslach Burn-out Inventory, and also collected the 'Utrecht Work Engagement Scale' measuring work engagement. Additionally, we describe the coronavirus disease-care participation of surgical residents, the impact on how they experienced the quality of their surgical training, and the influence on 'Burn-out and Work Engagement' compared with the pre-coronavirus disease 2019 period for surgical residents in the Netherlands. Results: In January 2020, a total of 317 residents completed the online survey, and in April 2020, a total of 313 residents completed the online survey. Of the responders, 48.6%, in April, participated in coronavirus disease-care in both the coronavirus disease ward as well as the coronavirus disease intensive care unit. Residents experienced that the coronavirus disease 2019 influenced their surgical training in 85.2% of responders. In only 5% of the residents did the pandemic not affect the exposure to surgical training in the operating theater. More burn-out symptoms were noted amongst coronavirus disease ward deployed residents versus no coronavirus disease ward deployment, (16.0% vs 7.6%, P = .06). The Work-Engagement questionnaire showed a significantly lower work engagement score of 4.2 for residents who were deployed in a coronavirus disease-care intensive care unit versus a score of 4.6 for residents scheduled in a coronavirus disease ward (P = .02). Conclusion: This study shows a significant impact of the first months of the coronavirus disease 2019 pandemic on the Dutch surgical trainee program, with a major redistribution of residents with a decrease of surgical exposure and education. We emphasize the need for adequate guidance of all surgical residents and potentially lengthening the surgical training program.
MeSH term(s)	Adult ; Burnout, Professional/epidemiology ; COVID-19 ; Female ; Humans ; Internship and Residency ; Male ; Netherlands/epidemiology ; Surgeons/education ; Surgeons/psychology ; Surgeons/statistics & numerical data ; Surveys and Questionnaires ; Work Engagement
Language	English
Publishing date	2021-03-05
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.2021.02.061
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