Publications by authors named "Alida van der Steeg"

Background: The 5-year prognosis of non-high-risk neuroblastomas is generally good (>90%). However, a proportion of patients show progression and succumb to their disease. We aimed to identify molecular aberrations (not incorporated in the current risk stratification) associated with overall survival (OS) and/or event-free survival (EFS) in patients diagnosed with non-high-risk neuroblastoma.

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Background And Aim: In this retrospective single center cohort study, we report the surgical outcomes of nephron-sparing surgery (NSS) for Wilms' tumor (WT) patients since centralization of pediatric oncology care in the Netherlands, and implementation of technological advancements. Therewith we describe the influence of experience and innovations for this type of surgery.

Methods: We retrospectively assessed all NSS procedures from January 1st 2015 until January 1st 2024 for patients who underwent surgery for a renal tumor at the Princess Máxima Center for Pediatric Oncology.

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Article Synopsis
  • This study investigates the effectiveness of highly-conformal image-guided radiotherapy (IGRT) for patients with high-risk neuroblastoma (HR-NBL), focusing on locoregional control outcomes.
  • The research involved 77 patients treated between 2015-2022, analyzing various factors such as the size of residual lesions and their impact on locoregional failure rates.
  • Results showed a low five-year locoregional failure rate of 7.8%, indicating that IGRT with reduced margins and dose boosts for larger residual lesions is effective in managing HR-NBL.
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Objectives: The International Society of Paediatric Oncology-Renal Tumour Study Group (SIOP-RTSG) discourages invasive procedures to determine the histology of paediatric renal neoplasms at diagnosis. Therefore, the histological subtype of Wilms' tumours (WT) is unknown at the start of neoadjuvant chemotherapy. MR-DWI shows potential value as a non-invasive biomarker through apparent diffusion coefficients (ADCs).

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Background: Infertility is an important late effect of childhood cancer treatment. Ovarian tissue cryopreservation (OTC) is established as a safe procedure to preserve gonadal tissue in (pre)pubertal girls with cancer at high risk for infertility. However, it is unclear whether elective laparoscopic OTC can also be performed safely in infants <1 year with cancer.

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  • Achieving complete tumor removal is difficult, but can be enhanced using real-time fluorescence-guided surgery with specially designed molecular probes.
  • The traditional process of identifying and testing these probes is lengthy and complicated by the variation within tumors and between different patients.
  • To address these challenges, researchers created a multispectral real-time 3D imaging platform that uses organoid technology to better mimic the diversity in patient tumors and how probes bind to healthy tissue.
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Background: Surgical treatment of pediatric chest wall tumors requires accurate surgical planning and tumor localization to achieve radical resections while sparing as much healthy tissue as possible. Augmented Reality (AR) could facilitate surgical decision making by improving anatomical understanding and intraoperative tumor localization. We present our clinical experience with the use of an AR system for intraoperative tumor localization during chest wall resections.

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Background: Patient-specific 3D models of neuroblastoma and relevant anatomy are useful tools for surgical planning. However, these models do not represent the heterogenous biology of neuroblastoma. This heterogeneity is visualized with the ADC and I-MIGB-SPECT-CT imaging.

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  • The study aimed to evaluate the use of CLABSI criteria by the CDC in pediatric oncology patients with central venous catheters.
  • A total of 84 bacteremia episodes were analyzed, with 40% classified as CLABSIs and 60% as non-CLABSIs, showing a significant disagreement (13%) among medical experts on these classifications.
  • The findings suggest that modifying the MBI-LCBI criteria to include Pseudomonas aeruginosa and mucositis might enhance the accuracy of diagnosing bloodstream infections in this population.
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Background: The aim was to determine whether salvage treatment with systemic antibiotics is a safe and effective strategy for Enterobacterales bloodstream infections (BSI) in pediatric oncology patients with a central venous catheter (CVC).

Methods: A retrospective study was performed on oncology and stem cell recipient patients with a CVC and blood culture with Enterobacterales , at the Princess Máxima Centre for Pediatric Oncology, Utrecht, the Netherlands. Analyses were performed for all BSI and for episodes meeting central line-associated bloodstream infection (CLABSI) criteria.

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Fluorescence-guided surgery (FGS), based on fluorescent tracers binding to tumor-specific biomarkers, could assist surgeons to achieve complete tumor resections. This study evaluated potential biomarkers for FGS in pediatric Ewing sarcoma (ES). Immunohistochemistry (IHC) was performed to assess CD99, CXCR4, CD117, NPY-R-Y1, and IGF-1R expression in ES biopsies and resection specimens.

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Background: Small-cell carcinoma of the ovary, hypercalcemic type (SCCOHT) is a rare aggressive ovarian malignancy mainly affecting children, adolescents, and young adults. Since the discovery of mutations in the SMARCA4 gene in 2014, SCCOHT has become the subject of extensive investigation. However, international uniform treatment guidelines for SCCOHT are lacking and the outcome remains poor.

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Wilms tumor is a common pediatric solid tumor. To evaluate tumor response to chemotherapy and decide whether nephron-sparing surgery is possible, tumor volume measurements based on magnetic resonance imaging (MRI) are important. Currently, radiological volume measurements are based on measuring tumor dimensions in three directions.

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Article Synopsis
  • * A total of 462 paediatric oncology patients will be part of a randomised controlled trial comparing taurolidine-citrate-heparin locks to standard heparin-only locks, with a primary focus on the incidence of CLABSI within a maximum follow-up of 90 days.
  • * The research is ethically approved, and results will be published in a peer-reviewed journal, with data accessible upon request after the main results are published.
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Surgery is one of the cornerstones of Wilms tumor treatment. In this article, we present technical advancements that are finding their way into the armamentarium of pediatric cancer surgeons. We discuss the current approaches, challenges, opportunities, and future directions of minimally invasive surgery (laparoscopic and robotics), image-guided surgery, and fluorescence-guided surgery.

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Background: Standard sentinel lymph node procedure (SNP) in pediatric cancer consists of a preoperative injection with technetium nanocolloid in combination with an optional intraoperative injection with blue dye. However, blue dye has disadvantages, and the detection rate is low, with only 60% of sentinel lymph nodes (SLNs) staining blue. In adult oncology, fluorescence imaging using indocyanine green (ICG) has been shown to be a safe and accurate method for visual detection of SLNs, with a higher sensitivity (up to 97%) compared with blue dye.

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Introduction: In the Netherlands pediatric oncological care for solid tumours is concentrated in one centre since November 2014. One of the most frequently diagnosed solid non-brain tumours in children is the neuroblastoma. Results of surgical treatment of neuroblastoma since the start of this centralization are presented and compared to a historic cohort.

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Background: Pediatric renal tumors are often heterogeneous lesions with variable regions of distinct histopathology. Direct comparison between in vivo imaging and ex vivo histopathology might be useful for identification of discriminating imaging features.

Objective: This feasibility study explored the use of a patient-specific three-dimensional (3D)-printed cutting guide to ensure correct alignment (orientation and slice thickness) between magnetic resonance imaging (MRI) and histopathology.

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Article Synopsis
  • - This study aimed to identify the best type of central venous catheter (CVC) for pediatric patients with Hodgkin lymphoma by examining complications associated with different types during a retrospective analysis from 2015 to 2021.
  • - Out of 98 patients, common complications included local infections/irritations, malfunctions, and central venous thrombosis (CVT), with single lumen peripherally inserted central catheters (PICCs) showing a significantly higher risk of complications compared to totally implantable venous access ports (TIVAPs).
  • - The study recommends using TIVAPs over PICCs for pediatric HL patients, particularly if they have risk factors for CVT, and suggests further research on the use
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Introduction: Six to eight children are diagnosed with a malignant liver tumour yearly in the Netherlands. The majority of these tumours are hepatoblastoma (HB) and hepatocellular carcinoma (HCC), for which radical resection, often in combination with chemotherapy, is the only curative treatment option. We investigated the surgical outcome of children with a malignant liver tumour in a consecutive cohort in the Netherlands.

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Introduction: Familial occurrence of Hirschsprung's disease may have a positive effect on patients' ability to cope with the disease. The aim was to compare long-term bowel function and generic quality of life between patients with familial and non-familial Hirschsprung's disease.

Methods: This was a nationwide, cross-sectional study in which we included all 830 Hirschsprung patients of 8 years and older who had undergone surgery between 1957 and 2015.

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Background: Outcome of patients operated for anorectal malformation (ARM) type rectovestibular fistula (RVF) is generally considered to be good. However, large multi-center studies are scarce, mostly describing pooled outcome of different ARM-types, in adult patients. Therefore, counseling parents concerning the bowel function at early age is challenging.

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Article Synopsis
  • Survival rates for children with Wilms tumor (WT) are high, but complications can lead to unplanned admissions to pediatric intensive care units (PICU).
  • A study in the Netherlands tracked 175 WT patients and identified 50 unplanned PICU admissions, revealing that younger age and more intensive treatments were linked to these admissions.
  • Follow-up showed higher instances of hypertension and chronic kidney disease in the unplanned PICU group, highlighting the need for careful monitoring during and after treatment.
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Nephron-sparing surgery (NSS) in Wilms tumor (WT) patients is a surgically challenging procedure used in highly selective cases only. Virtual resections can be used for preoperative planning of NSS to estimate the remnant renal volume (RRV) and to virtually mimic radical tumor resection. In this single-center evaluation study, virtual resection for NSS planning and the user experience were evaluated.

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