Publications by authors named "Heidi Kusters-Vandevelde"

Objective: The prognostic relevance of hormonal biomarkers in endometrial cancer (EC) has been well-established. A refined three-tiered risk model for estrogen receptor (ER)/progesterone receptor (PR) expression was shown to improve prognostication. This has not been evaluated in relation to the molecular subgroups.

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Objective: To evaluate the effectiveness of extended (e-PLND) and super-extended pelvic lymph node dissection (se-PLND) during robot-assisted radical prostatectomy (RARP) by examining lymph node (LN) yield, complications, LN metastasis, and biochemical recurrence (BCR) incidence.

Methods: Between January 2016 and January 2020, 354 consecutive patients with > 5% risk of lymph node involvement (LNI), as predicted by the Memorial Sloan Kettering Cancer Center nomogram, underwent RARP with (s)e-PLND at a high-volume center. The e-PLND involved removing fibrofatty lymphatic tissue around the obturator fossa, internal iliac region, and external iliac vessels.

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Prostate-specific membrane antigen (PSMA)-targeted radioguided surgery (RGS) aims to optimize the peroperative detection and removal of PSMA-avid lymph node (LN) metastases (LNMs) and has been described in patients with recurrent prostate cancer (PCa). In newly diagnosed PCa patients undergoing pelvic LN dissections, PSMA RGS could guide the urologist toward PSMA-expressing LNMs as identified on preoperative F-PSMA PET/CT imaging. The objective was to evaluate the safety and feasibility of In-PSMA RGS in primary PCa patients with one or more suggestive LNs on preoperative F-PSMA PET/CT.

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Article Synopsis
  • * This study explored the use of AI to assist in diagnosing endometrial biopsies, aiming to improve workflow for pathologists by training AI on real-world images rather than selectively chosen ones.
  • * While interrater reliability among pathologists was moderate, AI showed potential for distinguishing benign from (pre)malignant tissues, though it still faces challenges in accurately categorizing specific diagnoses.
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Objectives: Two advanced imaging modalities used to detect lymph node (LN) metastases in prostate cancer patients are prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography and ultrasmall superparamagnetic iron oxide (USPIO)-enhanced magnetic resonance imaging (MRI). As these modalities use different targets, a subnodal comparison is needed to interpret both their correspondence and their differences. The aim of this explorative study was to compare ex vivo 111 In-PSMA μSPECT images with high-resolution 7 T USPIO μMR images and histopathology of resected LN specimens from prostate cancer patients to assess the degree of correspondence at subnodal level.

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  • - This study focuses on the use of fluorine-18 (F)-PSMA-1007 PET/CT imaging to evaluate prostate cancer (PCa) lesions, emphasizing its overexpression in PCa and the need for better diagnostic methods.
  • - Researchers enrolled treatment-naïve patients with confirmed intermediate-to-high-risk PCa and found a significant correlation between the maximum standardized uptake value (SUVmax) on PSMA PET/CT and the severity of the cancer, measured by the International Society of Urological Pathology (ISUP) grade group and immune reactive score.
  • - The findings suggest that F-PSMA-1007 PET/CT could effectively characterize the severity of intraprostatic PCa lesions, potentially improving
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Background: Accurate local staging is critical for treatment planning and prognosis in prostate cancer (PCa). Although multiparametric magnetic resonance imaging (mpMRI) has high specificity for detection of extraprostatic extension (EPE) and seminal vesicle invasion (SVI), its sensitivity remains limited. F-PSMA-1007 positron emission tomography/computed tomography (PET/CT) may be more accurate in determining T stage.

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  • Patients with high-grade endometrial carcinoma (EC) have a higher likelihood of tumor spread and lymph node metastasis (LNM), with preoperative imaging and CA125 levels aiding in their assessment.
  • A study involving 333 high-grade EC patients found that elevated CA125 levels significantly correlated with advanced disease stages and poorer survival outcomes.
  • Logistic regression analysis indicated that elevated CA125, non-endometrioid histology, deep myometrial invasion, and cervical involvement are strong predictors of LNM, while CT findings alone were less predictive.
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Background: Uterine clear cell carcinoma (CCC) consists of either pure clear cell histology but can also display other histological components (mixed uterine CCCs). In this study, the molecular and immunohistochemical background of pure and mixed uterine CCC was compared. Secondly, it was evaluated whether histological classification and molecular background affected clinical outcome.

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Importance: Patients with low-grade (ie, grade 1-2) endometrial cancer (EC) are characterized by their favorable prognosis compared with patients with high-grade (ie, grade 3) EC. With the implementation of molecular profiling, the prognostic relevance of tumor grading might lose attention. As most patients present with low-grade EC and have an excellent outcome, the value of molecular profiling for these patients is unclear.

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Objective: Ovarian cancer is known for its poor prognosis, which is mainly due to the lack of early symptoms and adequate screening options. In this study we evaluated whether mutational analysis in cervicovaginal and endometrial samples could assist in the detection of ovarian cancer.

Methods: In this prospective multicenter study, we included patients surgically treated for either (suspicion of) ovarian cancer or for a benign gynecological condition (control group).

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In recent years, clinical use of novel advanced imaging modalities in prostate cancer detection, staging, and therapy has intensified and is currently reforming clinical guidelines. In the future, advanced imaging technologies will continue to develop and become even more accurate, which will offer new opportunities for improving patient selection, surgical treatment, and radiotherapy, with the potential to guide prostate cancer therapy.

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Background: Whereas neoadjuvant cisplatin-based chemotherapy (NAC) followed by a radical cystectomy remains the standard treatment for patients with muscle-invasive bladder cancer (MIBC), increasing evidence suggests that checkpoint inhibitors, either alone or in combination with chemotherapy, are effective in the (neo)adjuvant setting. The major aim of this study was to improve our understanding of the immune-modulating effects of NAC in MIBC.

Methods: Tumor tissue of 81 patients was used, including 60 patients treated with NAC and 21 patients undergoing upfront cystectomy.

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Article Synopsis
  • F-PSMA-1007 is a radiotracer for prostate cancer staging that lacks large validation studies for its diagnostic accuracy compared to traditional methods like histopathology.
  • A trial evaluated 99 men with intermediate to high-risk prostate cancer, measuring the sensitivity and specificity of F-PSMA-1007 PET/CT against lymph node dissection results.
  • The results indicated high specificity (89.9%) but moderate sensitivity (53.3%), suggesting that while it’s effective for certain detections, it shouldn’t replace extensive surgical procedures for accurate staging.
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Detection of lymph node (LN) metastases in prostate cancer (PCa) is pivotal for accurate staging and determining treatment options. To date, the reference standard for nodal staging is histopathological examination of all harvested surgical specimens from extended pelvic LN dissections. However, this is a labor-intensive process, and small metastatic foci can be missed due to sampling effects.

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An increasing number of pathology laboratories are now fully digitised, using whole slide imaging (WSI) for routine diagnostics. WSI paves the road to use artificial intelligence (AI) that will play an increasing role in computer-aided diagnosis (CAD). In melanocytic skin lesions, the presence of a dermal mitosis may be an important clue for an intermediate or a malignant lesion and may indicate worse prognosis.

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There is no consensus on the cutoff for positivity of estrogen receptor (ER) and progesterone receptor (PR) in endometrial cancer (EC). Therefore, we determined the cutoff value for ER and PR expression with the strongest prognostic impact on the outcome. Immunohistochemical expression of ER and PR was scored as a percentage of positive EC cell nuclei.

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Background: Prediction of side-specific extraprostatic extension (EPE) is crucial in selecting patients for nerve-sparing radical prostatectomy (RP).

Objective: To develop and externally validate nomograms including multiparametric magnetic resonance imaging (mpMRI) information to predict side-specific EPE.

Design, Setting, And Participants: A retrospective analysis of 1870 consecutive prostate cancer patients who underwent robot-assisted RP from 2014 to 2018 at three institutions.

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Background: Bayesian networks (BNs) are machine-learning-based computational models that visualize causal relationships and provide insight into the processes underlying disease progression, closely resembling clinical decision-making. Preoperative identification of patients at risk for lymph node metastasis (LNM) is challenging in endometrial cancer, and although several biomarkers are related to LNM, none of them are incorporated in clinical practice. The aim of this study was to develop and externally validate a preoperative BN to predict LNM and outcome in endometrial cancer patients.

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Objective: Uterine serous carcinoma (USC) is presumed to arise from endometrial intra-epithelial carcinoma (EIC), whereas tubo-ovarian high-grade serous carcinomas have similar precursor lesions in the Fallopian tube, i.e. serous tubal intra-epithelial carcinoma (STIC).

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Introduction: To establish oncological safe nerve-sparing robot-assisted radical prostatectomy, accurate assessment of extraprostatic extension (EPE) is critical. A recently developed nomogram including magnetic resonance imaging parameters accurately predicted side-specific EPE in the development cohort. The aim of this study is to assess this model's performance in an external patient population.

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Synchronous primary endometrial and ovarian cancers (SEOs) represent 10% of all endometrial and ovarian cancers and are assumed to develop as independent entities. We investigated the clonal relationship between endometrial and ovarian carcinomas in a large cohort classified as SEOs or metastatic disease (MD). The molecular profiles were compared to The Cancer Genome Atlas (TCGA) data to explore primary origin.

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Endometrial carcinoma (EC) is traditionally diagnosed by a histopathological assessment of an endometrial biopsy, leaving up to 30% of patients undiagnosed due to technical failure or an inadequate amount of tissue. The aim of the current study is to assess whether mutational analysis of cervical cytology or pipelle endometrial biopsies improves the diagnostic accuracy of traditional histopathological diagnosis of EC. This prospective multicentre cohort study included patients surgically treated for EC or a benign gynaecological condition (control group).

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A 46-year-old woman presents to her general practitioner with a painless swelling of her right index finger, which developed spontaneously one year ago and is slowly growing since. Histopathological investigation shows a superficial acralfibromyxoma: a rare benign soft tissue tumour that occurs mostly on the digits and predominantly in men at a mean age at diagnosis of 48 years. Complete excision is important to prevent local recurrence.

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