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Article ; Online: The Implementation of Minimally Invasive Surgery in the Treatment of Esophageal Cancer: A Step Toward Better Outcomes?

Triantafyllou, Tania / van der Sluis, Pieter / Skipworth, Richard / Wijnhoven, Bas P L

2022 Volume 10, Issue 2, Page(s) 337–349

Abstract: Esophagectomy is considered the cornerstone of the radical treatment of esophageal cancer. In the past decades, minimally invasive techniques including robot-assisted approaches have become popular. The aim of minimally invasive surgery is to reduce the ... ...

Abstract	Esophagectomy is considered the cornerstone of the radical treatment of esophageal cancer. In the past decades, minimally invasive techniques including robot-assisted approaches have become popular. The aim of minimally invasive surgery is to reduce the surgical trauma, resulting in faster recovery, reduction in complications, and better quality of life after surgery. Secondly, a more precise dissection may lead to better oncological outcomes. As such, minimally invasive esophagectomy is now seen by many as the standard surgical approach. However, evidence supporting this viewpoint is limited. This narrative review summarizes recent prospectively designed studies on minimally invasive esophagectomy.
Language	English
Publishing date	2022-08-10
Publishing country	New Zealand
Document type	Journal Article ; Review
ZDB-ID	2848647-X
ISSN	2366-1089 ; 2366-1070
ISSN (online)	2366-1089
ISSN	2366-1070
DOI	10.1007/s40487-022-00206-3
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Article: Pain management after robot-assisted minimally invasive esophagectomy.

Rosner, Ann Kristin / van der Sluis, Pieter C / Meyer, Lena / Wittenmeier, Eva / Engelhard, Kristin / Grimminger, Peter P / Griemert, Eva-Verena

Heliyon

2023 Volume 9, Issue 3, Page(s) e13842

Abstract: Background: Adequate pain control after open esophagectomy is associated with reduced complications, earlier recovery and higher patient satisfaction. While further developing surgical procedures like robot-assisted minimally invasive esophagectomy ( ... ...

Abstract	Background: Adequate pain control after open esophagectomy is associated with reduced complications, earlier recovery and higher patient satisfaction. While further developing surgical procedures like robot-assisted minimally invasive esophagectomy (RAMIE) it is relevant to adapt postoperative pain management. The primary question of this observational survey was whether one of the two standard treatments, thoracic epidural analgesia (TEA) or intravenous patient-controlled analgesia (PCA), is superior for pain control after RAMIE as the optimal pain management for these patients still remains unclear. Use of additional analgesics, changes in forced expiratory volume in 1 s (FEV1), postoperative complications and duration of intensive care and hospital stay were also analyzed. Methods: This prospective observational pilot study analyzed 50 patients undergoing RAMIE (postoperative PCA with piritramide or TEA using bupivacaine; each n = 25). Patient reported pain using the numeric rating scale score and differences in FEV1 using a micro spirometer were measured at postoperative day 1, 3 and 7. Additional data of secondary endpoints were collected from patient charts. Results: Key demographics, comorbidity, clinical and operative variables were equivalently distributed. Patients receiving TEA had lower pain scores and a longer-lasting pain relief. Moreover, TEA was an independent predictive variable for reduced length of hospital stay (HR -3.560 (95% CI: -6.838 to -0.282), p = 0.034). Conclusions: Although RAMIE leads to reduced surgical trauma, a less invasive pain therapy with PCA appears to be inferior compared to TEA in case of sufficient postoperative analgesia and length of hospital stay. According to the results of this observational pilot study analgesia with TEA provided better and longer-lasting pain relief compared to PCA. Further randomized controlled trials should be conducted to evaluate the optimal postoperative analgesic treatment for RAMIE.
Language	English
Publishing date	2023-02-17
Publishing country	England
Document type	Journal Article
ZDB-ID	2835763-2
ISSN	2405-8440
ISSN	2405-8440
DOI	10.1016/j.heliyon.2023.e13842
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Article ; Online: Pain management after robot-assisted minimally invasive esophagectomy

Rosner, Ann Kristin / van der Sluis, Pieter C. / Meyer, Lena / Wittenmeier, Eva / Engelhard, Kristin / Grimminger, Peter P. / Griemert, Eva-Verena

Heliyon. 2023 Mar., v. 9, no. 3 p.e13842-

2023

Abstract: Adequate pain control after open esophagectomy is associated with reduced complications, earlier recovery and higher patient satisfaction. While further developing surgical procedures like robot-assisted minimally invasive esophagectomy (RAMIE) it is ... ...

Abstract	Adequate pain control after open esophagectomy is associated with reduced complications, earlier recovery and higher patient satisfaction. While further developing surgical procedures like robot-assisted minimally invasive esophagectomy (RAMIE) it is relevant to adapt postoperative pain management. The primary question of this observational survey was whether one of the two standard treatments, thoracic epidural analgesia (TEA) or intravenous patient-controlled analgesia (PCA), is superior for pain control after RAMIE as the optimal pain management for these patients still remains unclear. Use of additional analgesics, changes in forced expiratory volume in 1 s (FEV1), postoperative complications and duration of intensive care and hospital stay were also analyzed. This prospective observational pilot study analyzed 50 patients undergoing RAMIE (postoperative PCA with piritramide or TEA using bupivacaine; each n = 25). Patient reported pain using the numeric rating scale score and differences in FEV1 using a micro spirometer were measured at postoperative day 1, 3 and 7. Additional data of secondary endpoints were collected from patient charts. Key demographics, comorbidity, clinical and operative variables were equivalently distributed. Patients receiving TEA had lower pain scores and a longer-lasting pain relief. Moreover, TEA was an independent predictive variable for reduced length of hospital stay (HR -3.560 (95% CI: −6.838 to −0.282), p = 0.034). Although RAMIE leads to reduced surgical trauma, a less invasive pain therapy with PCA appears to be inferior compared to TEA in case of sufficient postoperative analgesia and length of hospital stay. According to the results of this observational pilot study analgesia with TEA provided better and longer-lasting pain relief compared to PCA. Further randomized controlled trials should be conducted to evaluate the optimal postoperative analgesic treatment for RAMIE.
Keywords	analgesia ; analgesics ; comorbidity ; demographic statistics ; hospitals ; intravenous injection ; pain ; patients ; ramie ; surveys ; Robotic surgery ; Esophagectomy ; Patient-controlled analgesia ; Epidural anesthesia ; Pain-management
Language	English
Dates of publication	2023-03
Publishing place	Elsevier Ltd
Document type	Article ; Online
Note	Use and reproduction
ZDB-ID	2835763-2
ISSN	2405-8440
ISSN	2405-8440
DOI	10.1016/j.heliyon.2023.e13842
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Article: Outcomes after Surgical Treatment of Oesophagogastric Cancer with Synchronous Liver Metastases: A Multicentre Retrospective Cohort Study.

van Hootegem, Sander J M / de Pasqual, Carlo A / Giacopuzzi, Simone / Van Daele, Elke / Vanommeslaeghe, Hanne / Moons, Johnny / Nafteux, Philippe / van der Sluis, Pieter C / Lagarde, Sjoerd M / Wijnhoven, Bas P L

Cancers

2024 Volume 16, Issue 4

Abstract: Approximately 10-12% of patients with oesophageal or gastric cancer (OGC) present with oligometastatic disease at diagnosis. It remains unclear if there is a role for radical surgery in these patients. We aimed to assess the outcomes of OGC patients who ... ...

Abstract	Approximately 10-12% of patients with oesophageal or gastric cancer (OGC) present with oligometastatic disease at diagnosis. It remains unclear if there is a role for radical surgery in these patients. We aimed to assess the outcomes of OGC patients who underwent simultaneous treatment for the primary tumour and synchronous liver metastases. Patients with OGC who underwent surgical treatment between 2008 and 2020 for the primary tumour and up to five synchronous liver metastases aiming for complete tumour removal or ablation (i.e., no residual tumour) were identified from four institutional databases. The primary outcome was overall survival (OS), calculated with the Kaplan-Meier method. Secondary outcomes were disease-free survival and postoperative outcomes. Thirty-one patients were included, with complete follow-up data for 30 patients. Twenty-six patients (84%) received neoadjuvant therapy followed by response evaluation. Median OS was 21 months [IQR 9-36] with 2- and 5-year survival rates of 43% and 30%, respectively. While disease recurred in 80% of patients (20 of 25 patients) after radical resection, patients with a solitary liver metastasis had a median OS of 34 months. The number of liver metastases was a prognostic factor for OS (solitary metastasis aHR 0.330;
Language	English
Publishing date	2024-02-16
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers16040797
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Article ; Online: Intraperitoneal chemotherapy for peritoneal metastases of gastric origin: a systematic review and meta-analysis.

Guchelaar, Niels A D / Nasserinejad, Kazem / Mostert, Bianca / Koolen, Stijn L W / van der Sluis, Pieter C / Lagarde, Sjoerd M / Wijnhoven, Bas P L / Mathijssen, Ron H J / Noordman, Bo J

The British journal of surgery

2024 Volume 111, Issue 5

Abstract: Background: Gastric cancer with peritoneal metastases is associated with a dismal prognosis. Normothermic catheter-based intraperitoneal chemotherapy and normothermic pressurized intraperitoneal aerosol chemotherapy (PIPAC) are methods to deliver ... ...

Abstract	Background: Gastric cancer with peritoneal metastases is associated with a dismal prognosis. Normothermic catheter-based intraperitoneal chemotherapy and normothermic pressurized intraperitoneal aerosol chemotherapy (PIPAC) are methods to deliver chemotherapy intraperitoneally leading to higher intraperitoneal concentrations of cytotoxic drugs compared to intravenous administration. We reviewed the effectiveness and safety of different methods of palliative intraperitoneal chemotherapy. Methods: Embase, MEDLINE, Web of Science and Cochrane were searched for articles studying the use of repeated administration of palliative intraperitoneal chemotherapy in patients with gastric cancer and peritoneal metastases, published up to January 2024. The primary outcome was overall survival. Results: Twenty-three studies were included, representing a total of 999 patients. The pooled median overall survival was 14.5 months. The pooled hazard ratio of the two RCTs using intraperitoneal paclitaxel and docetaxel favoured the intraperitoneal chemotherapy arm. The median overall survival of intraperitoneal paclitaxel, intraperitoneal docetaxel and PIPAC with cisplatin and doxorubicin were respectively 18.4 months, 13.2 months and 9.0 months. All treatment methods had a relatively safe toxicity profile. Conversion surgery after completion of intraperitoneal therapy was performed in 16% of the patients. Conclusions: Repeated intraperitoneal chemotherapy, regardless of method of administration, is safe for patients with gastric cancer and peritoneal metastases. Conversion surgery after completion of the intraperitoneal chemotherapy is possible in a subset of patients.
MeSH term(s)	Humans ; Peritoneal Neoplasms/secondary ; Peritoneal Neoplasms/drug therapy ; Peritoneal Neoplasms/mortality ; Stomach Neoplasms/drug therapy ; Stomach Neoplasms/pathology ; Docetaxel/administration & dosage ; Antineoplastic Agents/administration & dosage ; Antineoplastic Agents/therapeutic use ; Infusions, Parenteral ; Palliative Care/methods ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Antineoplastic Combined Chemotherapy Protocols/administration & dosage ; Paclitaxel/administration & dosage
Chemical Substances	Docetaxel (15H5577CQD) ; Antineoplastic Agents ; Paclitaxel (P88XT4IS4D)
Language	English
Publishing date	2024-05-09
Publishing country	England
Document type	Journal Article ; Systematic Review ; Meta-Analysis
ZDB-ID	2985-3
ISSN	1365-2168 ; 0263-1202 ; 0007-1323 ; 1355-7688
ISSN (online)	1365-2168
ISSN	0263-1202 ; 0007-1323 ; 1355-7688
DOI	10.1093/bjs/znae116
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Article ; Online: Pathological response to neoadjuvant chemoradiotherapy for oesophageal squamous cell carcinoma in Eastern versus Western countries: meta-analysis.

Gao, Xing / Overtoom, Hidde C G / Eyck, Ben M / Huang, Shi-Han / Nieboer, Daan / van der Sluis, Pieter C / Lagarde, Sjoerd M / Wijnhoven, Bas P L / Chao, Yin-Kai / van Lanschot, Jan J B

The British journal of surgery

2024 Volume 111, Issue 5

Abstract: Objective: Locally advanced oesophageal squamous cell carcinoma can be treated with neoadjuvant chemoradiotherapy or chemotherapy followed by oesophagectomy. Discrepancies in pathological response rates have been reported between studies from Eastern ... ...

Abstract	Objective: Locally advanced oesophageal squamous cell carcinoma can be treated with neoadjuvant chemoradiotherapy or chemotherapy followed by oesophagectomy. Discrepancies in pathological response rates have been reported between studies from Eastern versus Western countries. The aim of this study was to compare the pathological response to neoadjuvant chemoradiotherapy in Eastern versus Western countries. Methods: Databases were searched until November 2022 for studies reporting pCR rates after neoadjuvant chemoradiotherapy for oesophageal squamous cell carcinoma. Multi-level meta-analyses were performed to pool pCR rates separately for cohorts from studies performed in centres in the Sinosphere (East) or in Europe and the Anglosphere (West). Results: For neoadjuvant chemoradiotherapy, 51 Eastern cohorts (5636 patients) and 20 Western cohorts (3039 patients) were included. Studies from Eastern countries included more men, younger patients, more proximal tumours, and more cT4 and cN+ disease. Patients in the West were more often treated with high-dose radiotherapy, whereas patients in the East were more often treated with a platinum + fluoropyrimidine regimen. The pooled pCR rate after neoadjuvant chemoradiotherapy was 31.7% (95% c.i. 29.5% to 34.1%) in Eastern cohorts versus 40.4% (95% c.i. 35.0% to 45.9%) in Western cohorts (fixed-effect P = 0.003). For cohorts with similar cTNM stages, pooled pCR rates for the East and the West were 32.5% and 41.9% respectively (fixed-effect P = 0.003). Conclusion: The pathological response to neoadjuvant chemoradiotherapy is less favourable in patients treated in Eastern countries compared with Western countries. Despite efforts to investigate accounting factors, the discrepancy in pCR rate cannot be entirely explained by differences in patient, tumour, or treatment characteristics.
MeSH term(s)	Humans ; Esophageal Neoplasms/therapy ; Esophageal Neoplasms/pathology ; Neoadjuvant Therapy ; Esophageal Squamous Cell Carcinoma/therapy ; Esophageal Squamous Cell Carcinoma/pathology ; Esophagectomy ; Chemoradiotherapy, Adjuvant ; Chemoradiotherapy ; Europe ; Treatment Outcome
Language	English
Publishing date	2024-05-09
Publishing country	England
Document type	Journal Article ; Meta-Analysis ; Comparative Study
ZDB-ID	2985-3
ISSN	1365-2168 ; 0263-1202 ; 0007-1323 ; 1355-7688
ISSN (online)	1365-2168
ISSN	0263-1202 ; 0007-1323 ; 1355-7688
DOI	10.1093/bjs/znae083
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Article ; Online: Postoperative C-reactive Protein: Focus on Patients After Esophagectomy and Clear Guidance for Daily Praxis: Reply.

Grimminger, Peter Philipp / van der Sluis, Pieter Christiaan / Fetzner, Ulrich Klaus

The Annals of thoracic surgery

2020 Volume 110, Issue 3, Page(s) 1098

MeSH term(s)	C-Reactive Protein/analysis ; Esophageal Neoplasms/surgery ; Esophagectomy ; Humans ; Intraoperative Complications ; Postoperative Period
Chemical Substances	C-Reactive Protein (9007-41-4)
Language	English
Publishing date	2020-04-24
Publishing country	Netherlands
Document type	Letter ; Comment
ZDB-ID	211007-6
ISSN	1552-6259 ; 0003-4975
ISSN (online)	1552-6259
ISSN	0003-4975
DOI	10.1016/j.athoracsur.2020.03.060
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Article ; Online: Robot assisted minimally invasive esophagectomy (RAMIE) for esophageal cancer.

van der Sluis, Pieter Christiaan / van Hillegersberg, Richard

Best practice & research. Clinical gastroenterology

2018 Volume 36-37, Page(s) 81–83

Abstract: Worldwide, the standard treatment for locally advanced esophageal cancer with curative intent is perioperative chemotherapy or preoperative chemoradiotherapy followed by open transthoracic esophagectomy (OTE) with gastric conduit reconstruction. ... ...

Abstract	Worldwide, the standard treatment for locally advanced esophageal cancer with curative intent is perioperative chemotherapy or preoperative chemoradiotherapy followed by open transthoracic esophagectomy (OTE) with gastric conduit reconstruction. Minimally invasive esophagectomy (MIE) was developed to improve the postoperative outcome by reducing the surgical trauma, with comparable short-term oncologic results. However, MIE is a highly complex procedure associated with a long learning curve. In 2003, robot-assisted minimally invasive thoraco-laparoscopic esophagectomy (RAMIE) was developed to overcome the technical limitations of MIE. Robotic surgery benefits from a stable 3-dimensional, magnified view and articulated instruments enabling precise dissection with 7 degrees of freedom of movement. In this review, the development of RAMIE within our hospital is described using a 5-stage development process for the assessment of surgical innovation (IDEAL).
MeSH term(s)	Esophageal Neoplasms/surgery ; Esophagectomy/instrumentation ; Esophagectomy/methods ; Humans ; Laparoscopy/instrumentation ; Laparoscopy/methods ; Learning Curve ; Minimally Invasive Surgical Procedures/instrumentation ; Minimally Invasive Surgical Procedures/methods ; Robotics/instrumentation ; Robotics/methods ; Treatment Outcome
Language	English
Publishing date	2018-11-29
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2048181-0
ISSN	1532-1916 ; 1521-6918
ISSN (online)	1532-1916
ISSN	1521-6918
DOI	10.1016/j.bpg.2018.11.004
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Article ; Online: MalnutritiOn assessment with biOelectrical impedaNce analysis in gastRic cancer patIentS undergoing multimodaltrEatment (MOONRISE)-Study protocol for a single-arm multicenter cross-sectional longitudinal study.

Pelc, Zuzanna / Sędłak, Katarzyna / Mlak, Radosław / Chawrylak, Katarzyna / Mielniczek, Katarzyna / Leśniewska, Magdalena / Skórzewska, Magdalena / Kwietniewska, Magdalena / Paśnik, Iwona / Gęca, Katarzyna / van der Sluis, Pieter / Banasiewicz, Tomasz / Pędziwiatr, Michał / Polkowski, Wojciech P / Pawlik, Timothy M / Małecka-Massalska, Teresa / Rawicz-Pruszyński, Karol

PloS one

2024 Volume 19, Issue 2, Page(s) e0297583

Abstract: European data suggests that over 30% of gastric cancer (GC) patients are diagnosed with sarcopenia before surgery, while unintentional weight loss occurs in approximately 30% of patients following gastrectomy. Preoperative sarcopenia significantly ... ...

Abstract	European data suggests that over 30% of gastric cancer (GC) patients are diagnosed with sarcopenia before surgery, while unintentional weight loss occurs in approximately 30% of patients following gastrectomy. Preoperative sarcopenia significantly increases the risk of major postoperative complications, and preoperative body weight loss remains a superior predictor of outcome and an independent prognostic factor for overall survival (OS) in patients with GC. A standardized approach of nutritional risk screening of GC patients is yet to be established. Therefore, the MOONRISE study aims to prospectively analyze the changes in nutritional status and body composition at each stage of multimodal treatment among GC patients from five Western expert centers. Specifically, we seek to assess the association between nutritional status and body composition on tumor response following neoadjuvant chemotherapy (NAC). Secondary outcomes of the study are treatment toxicity, postoperative complications, quality of life (QoL), and OS. Patients with locally advanced gastric adenocarcinoma scheduled for multimodal treatment will be included in the study. Four consecutive nutritional status assessments will be performed throughout the treatment. The following study was registered in ClinicalTrials.gov (Identifier: NCT05723718) and will be conducted in accordance with the STROBE statement. The anticipated duration of the study is 12-24 months, depending on the recruitment status. Results of this study will reveal whether nutritional status and body composition assessment based on BIA will become a validated and objective tool to support clinical decisions in GC patients undergoing multimodal treatment.
MeSH term(s)	Humans ; Stomach Neoplasms/pathology ; Quality of Life ; Sarcopenia/etiology ; Longitudinal Studies ; Electric Impedance ; Cross-Sectional Studies ; Malnutrition/diagnosis ; Nutritional Status ; Postoperative Complications/etiology ; Gastrectomy/adverse effects ; Multicenter Studies as Topic
Language	English
Publishing date	2024-02-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0297583
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Article: Perioperative Chemotherapy for Gastro-Esophageal or Gastric Cancer: Anthracyclin Triplets versus FLOT.

Geerts, Julie F M / van der Zijden, Charlène J / van der Sluis, Pieter C / Spaander, Manon C W / Nieuwenhuijzen, Grard A P / Rosman, Camiel / van Laarhoven, Hanneke W M / Verhoeven, Rob H A / Wijnhoven, Bas P L / Lagarde, Sjoerd M / Mostert, Bianca

Cancers

2024 Volume 16, Issue 7

Abstract: Background: ...

Abstract	Background:
Language	English
Publishing date	2024-03-26
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers16071291
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