Publications by authors named "Gaspersz M"
Background: The patients with unresectable perihilar cholangiocarcinoma require biliary drainage to relieve symptoms and allow for palliative systemic chemotherapy. The aim of this study was to establish the success, complication, and mortality rates of the initial biliary drainage in patients with unresectable perihilar cholangiocarcinoma at presentation.
Methods: In this retrospective multicenter study, patients with unresectable perihilar cholangiocarcinoma who underwent initial endoscopic or percutaneous transhepatic biliary drainage between 2002 and 2014 were included.
Objective: This study investigated the patterns, predictors, and survival of recurrent disease following esophageal cancer surgery.
Background: Survival of recurrent esophageal cancer is usually poor, with limited prospects of remission.
Methods: This nationwide cohort study included patients with distal esophageal and gastroesophageal junction adenocarcinoma and squamous cell carcinoma after curatively intended esophagectomy in 2007 to 2016 (follow-up until January 2020).
Article Synopsis
- This study analyzed trends in the treatment and outcomes for patients with distal esophageal and gastro-esophageal junction cancers in the Netherlands from 2007 to 2016.
- It found that the use of transthoracic esophagectomy, neo-adjuvant treatments, and minimally invasive surgery significantly increased during this period.
- Postoperative results improved, with lower complication rates, higher success in tumor removal, better lymph node retrieval, and longer survival times for patients.
Background: During the COVID-19 pandemic, a decrease in the number of patients presenting with acute appendicitis was observed. It is unclear whether this caused a shift towards more complicated cases of acute appendicitis. We compared a cohort of patients diagnosed with acute appendicitis during the 2020 COVID-19 pandemic with a 2019 control cohort.
View Article and Find Full Text PDFBackground: Liver transplantation (LT) has been performed in a select group of patients presenting with unresectable or primary sclerosing cholangitis (PSC)-associated perihilar cholangiocarcinoma (pCCA) in the Mayo Clinic with a reported 5-year overall survival (OS) of 53% on intention-to-treat analysis. The objective of this study was to estimate eligibility for LT in a cohort of pCCA patients in two tertiary referral centers.
Methods: Patients diagnosed with pCCA between 2002 and 2014 were included from two tertiary referral centers in the Netherlands.
Background & Aims: The presence of hepatocellular adenoma (HCA) in pregnant women requires special consideration, as it has been reported to carry the risk of growth and clinically significant haemorrhage. In this prospective study we assessed aspects of growth of HCA <5 cm during pregnancy.
Methods: This was a multicentre prospective cohort study in pregnant women with suspected HCA <5 cm on imaging.
Background: The aim was to compare the prognostic accuracy of cross-sectional imaging of the 7th and 8th editions of the American Joint Committee on Cancer(AJCC) staging system for perihilar cholangiocarcinoma(PHC).
Methods: All patients with PHC between 2002 and 2014 were included. Imaging at the time of presentation was reassessed and clinical tumor-node-metastasis (cTNM) stage was determined according to the 7th and 8th editions of the AJCC staging system.
Background: Patients with resectable perihilar cholangiocarcinoma (PHC) on imaging have a substantial risk of metastatic or locally advanced disease, incomplete (R1) resection, and 90-day mortality. Our aim was to develop a preoperative prognostic model to predict surgical success, defined as a complete (R0) resection without 90-day mortality, in patients with resectable PHC on imaging.
Study Design: Patients with PHC who underwent exploratory laparotomy in three tertiary referral centers were identified.
Article Synopsis
- Low skeletal muscle mass is linked to poorer outcomes after surgery for perihilar cholangiocarcinoma (PHC), and this study aimed to assess the impact of muscle mass and density on overall survival (OS) in PHC patients.
- Data from 233 patients diagnosed with PHC between 2002 and 2014 were analyzed, comparing OS based on muscle mass and density measured via CT scans.
- The results indicated that while low skeletal muscle mass did not significantly affect OS, low muscle density was associated with a higher risk of early death within the first 6 months after diagnosis.
Article Synopsis
- Biliary tract cancer (BTC) has poor prognosis and is commonly treated palliatively with gemcitabine and cisplatin since the ABC-02 trial in 2010, which set the standard of care.
- This study evaluated the effectiveness and safety of this treatment approach in real-world patients, comparing those who met the ABC-02 trial criteria to those who did not, along with a group receiving supportive care.
- Results showed that both chemotherapy groups had similar overall and progression-free survival rates, indicating that gemcitabine and cisplatin are effective for a broader range of BTC patients than previously recognized.
A model including sarcopenia surpasses the MELD score in predicting waiting list mortality in cirrhotic liver transplant candidates: A competing risk analysis in a national cohort.
J Hepatol
April 2018
Article Synopsis
- Sarcopenia (low skeletal muscle mass) increases the risk of waiting list mortality in frail liver transplant patients, especially those with low MELD scores.
- A study examined patients with cirrhosis from the Eurotransplant registry, finding that those with sarcopenia had significantly shorter waiting list survival.
- While the MELD-Sarcopenia score was validated, it only slightly improved predictive performance compared to the original MELD score, suggesting its limited value in mortality prediction.
Background: When a liver lesion diagnosed as focal nodular hyperplasia (FNH) increases in size, it may cause doubt about the initial diagnosis. In many cases, additional investigations will follow to exclude hepatocellular adenoma or malignancy. This retrospective cohort study addresses the implications of growth of FNH for clinical management.
View Article and Find Full Text PDFArticle Synopsis
- Scientists are working on new ways to grow liver cancer cells in the lab to understand them better.
- They created special mini-livers called organoids that behave like real liver tissue, keeping important features of the original cancer.
- These organoids can help researchers find new treatments and better understand how liver cancer works.
Article Synopsis
- Low skeletal muscle mass in cancer patients is linked to worse postoperative outcomes and higher healthcare costs, prompting investigation in a Western-European healthcare context.
- The study analyzed data from 452 patients who underwent abdominal surgeries for various cancers, revealing that 45.6% had sarcopenia and those with low muscle mass incurred €2,183 more in hospital costs.
- Ultimately, low skeletal muscle mass was associated with an independent increase in costs of approximately €4,061 per patient, highlighting the need for strategies to address muscle wasting to potentially lower hospital expenses.
Background: Although several classifications of perihilar cholangiocarcinoma (PHC) include vascular involvement, its prognostic value has not been investigated. Our aim was to assess the prognostic value of unilateral and main/bilateral involvement of the portal vein (PV) and hepatic artery (HA) on imaging in patients with PHC.
Methods: All patients with PHC between 2002 and 2014 were included regardless of stage or management.
Background: Hepatocellular adenoma (HCA) is a benign liver tumour that may be complicated by bleeding or malignant transformation. Present guidelines advise cessation of oral contraceptives and surgical resection if the lesion is still larger than 5 cm at 6 months after diagnosis. The aim of this study was to evaluate whether this 6-month interval is sufficient to expect regression of a large HCA to 5 cm or smaller.
View Article and Find Full Text PDFBackground: Conditional survival is the life expectancy from a point in time for a patient who has survived a specific period after presentation. The aim of the study was to estimate conditional survival for patients with unresectable perihilar cholangiocarcinoma.
Methods: Patients with unresectable perihilar cholangiocarcinoma from two academic hospitals in the Netherlands between 2002 and 2012 were assessed.
Inflammatory and multiple hepatocellular adenoma are associated with a higher BMI.
Eur J Gastroenterol Hepatol
October 2017
Aim: To identify patient and lesion characteristics associated with the occurrence of single or multiple hepatocellular adenoma (HCA).
Patients And Methods: Using a tertiary centre database, we retrospectively collected information on patient and lesion characteristics, management and follow-up of all patients with HCA included between 2001 and 2016. Patients were classified into three groups; patients with a single HCA, 2-9 HCA and at least 10 HCA.
Background & Aims: Ligand binding to inhibitory receptors on immune cells, such as programmed cell death 1 (PD-1) and cytotoxic T-lymphocyte associated protein 4 (CTLA4), down-regulates the T-cell-mediated immune response (called immune checkpoints). Antibodies that block these receptors increase antitumor immunity in patients with melanoma, non-small-cell lung cancer, and renal cell cancer. Tumor-infiltrating CD4 and CD8 T cells in patients with hepatocellular carcinoma (HCC) have been found to be functionally compromised.
View Article and Find Full Text PDFBackground: The aim of this study was to compare patients with PHC with lymph node metastases (LN+) who underwent a resection with patients who did not undergo resection because of locally advanced disease at exploratory laparotomy.
Methods: Consecutive LN+ patients who underwent a resection for PHC in 12 centers were compared with patients who did not undergo resection because of locally advanced disease at exploratory laparotomy in 2 centers.
Results: In the resected cohort of 119 patients, the median overall survival (OS) was 19 months and the estimated 1-, 3- and 5-year OS was 69%, 27% and 13%, respectively.
Background & Aims: Most systems for staging perihilar cholangiocarcinoma (PHC) have been developed for the minority of patients with resectable disease. The recently developed Mayo Clinic system for staging PHC requires only clinical and radiologic variables, but has not yet been validated. We performed a retrospective study to validate the Mayo Clinic staging system.
View Article and Find Full Text PDFBackground & Aims: Hepatocellular adenoma (HCA) is a rare benign liver tumor, which typically develops in women in their reproductive phase and is associated with the use of oral contraceptives. The aim of this study was to evaluate whether follow-up of HCA can be safely terminated after the occurrence of menopause. Secondary, we studied the impact of the diagnosis HCA on health-related quality of life (HRQoL).
View Article and Find Full Text PDFThe latest European Society of Cardiology (ESC) guidelines on myocardial revascularisation are reviewed. The nearly 300 recommendations make it difficult to apply them in their totality. The authors would propose 20-30 recommendations per guideline based on sound clinical evidence.
View Article and Find Full Text PDFBackground: Short- and long-term data showed that drug-eluting stents (DES) significantly decreased target vessel revascularization (TVR) and major adverse cardiac event (MACE) rates compared to bare-metal stents (BMS). However, conflicting long-term data remain for patients with ST-segment elevation myocardial infarction (STEMI).
Objective: Our aim was to assess the 6-year clinical outcome of all patients undergoing primary percutaneous coronary intervention (PPCI) for a de novo lesion with exclusive use of BMS, sirolimus-eluting stents (SES) and paclitaxel-eluting stents (PES).