Publications by authors named "Bangma C"

Unlabelled: For men with prostate cancer (PCa) within the European Randomized Study of Screening for Prostate Cancer (ERSPC), the cause of death is determined by a Cause of Death Committee (CODC) that evaluates all medical records using a fixed algorithm. The aim of this study was to compare the classification of PCa-specific mortality (PCSM) between the CODC and Statistics Netherlands. We calculated the sensitivity (PCSM agreement divided by total PCSM deaths according to the CODC) and specificity (agreement for other-cause mortality [OCM] divided by total OCM deaths according to the CODC) using the last 21-yr follow-up data from ERSPC Rotterdam.

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Background: High-risk non-muscle invasive bladder cancer (HR-NMIBC) patients require long-term surveillance with cystoscopies, cytology and upper tract imaging. Previously, we developed a genomic urine assay for surveillance of HR-NMIBC patients with high sensitivity and anticipatory value.

Objective: We aimed to validate the performance of the assay in an unselected prospectively collected cohort of HR-NMIBC patients under surveillance.

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Article Synopsis
  • Early detection of hereditary urological cancers, such as prostate, bladder, renal, and testicular carcinomas, can significantly impact patient diagnosis and treatment decisions, potentially affecting both them and their families.
  • Routine screening for family cancer histories should be standard practice in clinical settings to identify those at risk of hereditary cancers.
  • Patients who may be at risk have the option to be referred for genetic counseling or to undergo genetic testing after discussing it with their urologist.
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Aims: To investigate the surgical margin status in patients with prostate cancer who underwent robot-assisted radical prostatectomy (RARP) with intraoperative neurovascular structure-adjacent frozen-section analysis (NeuroSAFE) and evaluate differences compared to patients who underwent radical prostatectomy without NeuroSAFE.

Patients And Methods: Between September 2018 and January 2021, 962 patients underwent centralized RARP with NeuroSAFE. A secondary resection was performed in case of a positive surgical margin (PSM) on intraoperative frozen section (IFS) analysis to convert a PSM into a negative surgical margin (NSM).

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Background And Objective: There is no consensus on de-escalation of monitoring during active surveillance (AS) for prostate cancer (PCa). Our objective was to determine clinical criteria that can be used in decisions to reduce the intensity of AS monitoring.

Methods: The global prospective AS cohort from the Global Action Plan prostate cancer AS consortium was retrospectively analyzed.

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Article Synopsis
  • Active surveillance (AS) is a safe and acceptable treatment strategy for men with low- and intermediate-risk prostate cancer, showing a high overall survival (OS) rate of 84.1% and metastasis-free survival (MFS) exceeding 99% over a follow-up period of more than 6 years.
  • The study analyzed clinical data from nearly 27,000 men across 15 countries, revealing that while there was no significant change in overall survival rates over time, metastasis-free survival rates improved notably.
  • Treatment changes were primarily driven by anxiety or tumor progression, with the most common radical treatment being surgery, which resulted in 90% of men remaining free from biochemical recurrence after 5 years.
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  • The study aimed to see how the Prostate Health Index (PHI) affects clinical decisions for men with PSA levels between 4-10 ng/mL and normal digital rectal exams in Hong Kong public hospitals from 2016 to 2017.
  • Of 2828 patients followed for 2 years, 82% showed low PHI risk scores (under 35), leading 83% of those with elevated PSA to choose against biopsy, while higher PHI scores correlated with increased detection of high-grade prostate cancer.
  • The conclusion suggests that using PHI in clinical decisions helped reduce unnecessary biopsies and improved the detection of significant prostate cancer compared to traditional PSA methods.
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Objective: To evaluate whether a subgroup of men can be identified that would benefit more from screening than others.

Materials And Methods: This retrospective cohort study was based on three European Randomised Study of Screening for Prostate Cancer (ERSPC) centres, Finland, the Netherlands and Sweden. We identified 126 827 men aged 55-69 years in the study who were followed for maximum of 16 years after randomisation.

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Value-based payment aims to shift the focus from traditional volume-driven arrangements to a system that rewards providers for the quality and value of care delivered. Previous research has shown that it is difficult for providers to change their medical and organizational practices to adopt value-based payment, but the role of actors in these reforms has remained underexposed. This paper unravels the motives of non-clinical and clinical professionals to maintain institutionalized payment practices when faced with value-based payment.

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Aims: Knowledge on survival probabilities is essential for determining optimal treatment strategies. We studied overall survival and associated prognostic factors in Dutch patients with localised prostate cancer (PCa) selected for external beam radiotherapy.

Materials And Methods: For this single-centre retrospective cohort study, we identified all T1-T3 PCa patients (aged 55-80 years) in the radiotherapy planning database with a start date between January 2006 and December 2013, treated with 72-78 Gy in 2 Gy fractions to the prostate ± seminal vesicles (n = 1536).

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Background: The European Association of Urology guidelines recommend a risk-based strategy for prostate cancer screening based on the first prostate-specific antigen (PSA) level and age.

Objective: To analyze the impact of the first PSA level on prostate cancer (PCa) detection and PCa-specific mortality (PCSM) in a population-based screening trial (repeat screening every 2-4 yr).

Design, Setting, And Participants: We evaluated 25589 men aged 55-59 yr, 16898 men aged 60-64 yr, and 12936 men aged 65-69 yr who attended at least one screening visit in the European Randomized Study of Screening for Prostate Cancer (ERSPC) trial (screening arm: repeat PSA testing every 2-4 yr and biopsy in cases with elevated PSA; control arm: no active screening offered) during 16-yr follow-up (FU).

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Background: Nerve-sparing (NS) radical prostatectomy (RP) results in better functional outcomes. Intraoperative neurovascular structure-adjacent frozen section examination (NeuroSAFE) significantly increases the frequency of NS surgery. The effect of NeuroSAFE on postoperative erectile function (EF) and continence is not yet clear.

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Background: Our objective was to assess the accuracy of transabdominal ultrasound (TAUS) measured prostate volume in the primary care setting with transrectal ultrasound (TRUS) measured prostate volume by the urologist as the reference test. Furthermore, our objective was to assess whether risk-stratification using TAUS prostate volume by the primary care physician could reduce unnecessary referrals to the urologist.

Methods: Men in two Dutch primary care offices with a prostate cancer (PCa) screening request received a digital rectal examination (DRE), prostate specific-antigen (PSA), and TAUS prostate volume measurement by the general practitioner, followed by Rotterdam Prostate Cancer Risk Calculator (RPCRC) risk assessment.

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Article Synopsis
  • * A panel of 39 Dutch experts used a modified Delphi method to discuss and vote on the appropriateness of testing, reaching consensus on only 44% of their questions.
  • * Key findings suggest that patients with a family history might benefit from certain types of genetic testing, but limitations include a lack of scientific evidence for some recommendations and a limited number of specialists involved in the discussions.
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Background: This meta-analysis aimed to evaluate the effectiveness of intensive follow-up after curative intent treatment for five common solid tumours, in terms of survival and treatment of recurrences.

Methods: A systematic literature search was conducted, identifying comparative studies on follow-up for colorectal, lung, breast, upper gastro-intestinal and prostate cancer. Outcomes of interest were overall survival (OS), cancer specific survival (CSS), and treatment of recurrences.

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Background: Active surveillance (AS) is a management option for men diagnosed with low-risk prostate cancer. Opinions differ on whether it is safe to include young men (≤60 yr) or men with intermediate-risk disease.

Objective: To assess whether reasons for discontinuation, treatment choice after AS, and adverse pathology at radical prostatectomy (RP; N1, or ≥GG3, or ≥pT3) differ for men ≤60 yr or those with European Association of Urology (EAU) intermediate-risk disease from those for men >60 yr or those with EAU low-risk disease.

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Objectives: To investigate the impact of intra-operative neurovascular structure-adjacent frozen-section examination (NeuroSAFE) on the rate of nerve-sparing surgery (NSS) and oncological outcome in a large radical prostatectomy (RP) cohort.

Patients And Methods: Between January 2016 and December 2020, 1756 prostate cancer patients underwent robot-assisted RP, of whom 959 (55%) underwent this with NeuroSAFE and 797 (45%) without (control cohort). In cases where NeuroSAFE showed tumour in the margin, a secondary resection was performed.

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Article Synopsis
  • European Association of Urology guidelines suggest a risk-adjusted biopsy approach for detecting prostate cancer in men who haven't had a biopsy before, but the effectiveness of different strategies is still uncertain.
  • This study compared the effectiveness of two pathways: a risk-based ultrasound-directed approach and a magnetic resonance imaging (MRI)-directed approach in biopsy-naïve men suspected of having prostate cancer.
  • Results showed that both methods detected similar rates of significant cancers, but the ultrasound approach found more low-grade cancers, whereas the MRI method was more effective in avoiding unnecessary biopsies.
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Background: The optimal interval for repeat biopsy during active surveillance (AS) for prostate cancer is yet to be defined. This study examined whether risk of upgrading (to grade group ≥ 2) or risk of converting to treatment varied according to intensity of repeat biopsy using data from the GAP3 consortium's global AS database.

Materials And Methods: Intensity of surveillance biopsy schedules was categorized according to centers' protocols: (a) Prostate Cancer Research International Active Surveillance project (PRIAS) protocols with biopsies at years 1, 4, and 7 (10 centers; 7532 men); (b) biennial biopsies, that is, every other year (8 centers; 4365 men); and (c) annual biopsy schedules (4 centers; 1602 men).

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The computer-aided analysis of prostate multiparametric MRI (mpMRI) could improve significant-prostate-cancer (PCa) detection. Various deep-learning- and radiomics-based methods for significant-PCa segmentation or classification have been reported in the literature. To be able to assess the generalizability of the performance of these methods, using various external data sets is crucial.

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Background: Identification of intervention-related deaths is important for an accurate assessment of the ratio of benefit to harm in screening trials.

Objective: To investigate intervention-related deaths by study arm in the European Randomized Study of Prostate Cancer Screening (ERSPC).

Design Setting And Participants: ERSPC is a multicenter trial initiated in the 1990s to investigate whether screening on the basis of prostate-specific antigen (PSA) can decrease prostate cancer mortality.

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Purpose: External Beam Radiotherapy (EBRT) techniques dramatically changed over the years. This may have affected the risk of radiation-induced second primary cancers (SPC), due to increased irradiated low dose volumes and scatter radiation. We investigated whether patterns of SPC after EBRT have changed over the years in prostate cancer (PCa) survivors.

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