Publications by authors named "H L Van Westreenen"
ASO Author Reflections: Pushing the Boundaries of Local Excision: How Does the Risk of Lymph Node Metastases Compare to Those Associated with Major Surgery in T2 Colon Cancer Patients?
Ann Surg Oncol
February 2025
Background: Similar to T1 colon cancer (CC), risk stratification may guide T2 CC treatment and reduce unnecessary major surgery. In this study, prediction models were developed that could identify T2 CC patients with a lower risk of lymph node metastasis (LNM) for whom (intensive) follow-up after local treatment could be considered.
Methods: A nationwide cohort study was performed involving pT2 CC patients who underwent surgery between 2012 and 2020, using data from the Dutch ColoRectal Audit, which were linked to the Nationwide Pathology Databank.
Article Synopsis
- There is evidence suggesting that using stents or decompressing stomas before surgery for left-sided obstructive colon cancer (LSOCC) is safer than emergency surgery, particularly for patients aged 70 and older.
- A study analyzing data from 2012 to 2020 showed a decrease in emergency resections, from 79.7% to 54.7%, with an increase in safer approaches like resection after stent or stoma.
- Despite a national trend towards safer surgical methods, some hospitals still performed over 75% emergency resections, leading to higher mortality rates, emphasizing the need to follow updated guidelines for elderly patients.
Background: The LIMERIC study has proven that colonoscopy-assisted laparoscopic wedge resection effectively and safely removes benign colonic lesions unsuitable for endoscopic removal, thereby avoiding the need for major surgery.
Objective: To evaluate the impact of colonoscopy-assisted laparoscopic wedge on health-related quality of life of patients who participated in the LIMERIC study.
Design: Prospective multicenter study.