Publications by authors named "Koen M A Dreijerink"

Medullary thyroid cancer (MTC) is a rare cancer with variable disease course. To enable optimal care, centralization and consensus guidelines are essential. This study describes trends in the incidence, organization of care, surgical treatment, and outcomes of MTC over 30 years in the Netherlands.

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  • A study examined the prevalence and risk factors of acne in transgender men undergoing gender-affirming masculinizing testosterone therapy (GATT) from 2010 to 2019, involving 323 participants.
  • The findings revealed that the prevalence of moderate to severe acne increased significantly from 11.8% to 39.1% within the first year of GATT.
  • Key risk factors for developing moderate/severe acne included having a body mass index (BMI) over 25, being younger (ages 18-25), higher testosterone levels, and pre-existing acne, suggesting important considerations for healthcare providers when counseling patients.
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  • Glucagonomas are special tumors in the pancreas that cause a syndrome and were studied in six patients to understand their features better.
  • These tumors were mostly large and showed a common skin symptom called necrolytic migratory erythema in all patients.
  • The tumors had specific changes in their genes and were linked to serious aggressive behavior, which means they can spread or grow badly in some patients.
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Introduction: Recommendations for resection technique of duodenal neuroendocrine neoplasms (D-NEN) with a size between 10 and 20 mm are lacking. The primary aim was to compare overall survival (OS) and progression-free survival (PFS) after endoscopic resection (ER) with surgical resection (SR). The secondary aim was to assess the incidence and clinical variables correlated with OS.

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Objective: Hereditary pheochromocytoma (hPCC) commonly develops bilaterally, causing adrenal insufficiency when standard treatment, radical adrenalectomy (RA), is performed. Partial adrenalectomy (PA) aims to preserve adrenal function, but with higher recurrence rates. This study compares outcomes of PA versus RA in hPCC.

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Context: Breast development is an important outcome for trans women receiving gender affirming hormone therapy (GAHT). Limited breast development has been reported, possibly because of testosterone exposure during puberty. The impact of puberty suppression (PS) on breast development is unclear.

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Objective: This study describes the effects of introducing a protocol omitting preoperative α-blockade dose-escalation (de-escalation) in a prospective patient group.

Background: The decline of mortality and morbidity associated with pheochromocytoma resection is frequently attributed to the introduction of preoperative α-blockade. Current protocols require preoperative α-blockade dose-escalation and multiple-day hospital admissions.

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Three-dimensional (3D) imaging techniques are promising new tools for measuring breast volume, for example in gender-affirming therapy. Transgender individuals can be treated with gender-affirming hormone therapy (GAHT). A robust method for monitoring breast volume changes is critical to be able to study the effects of feminizing GAHT.

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Entrustable Professional Activities (EPAs) are an important tool to support individualisation of medical training in a competency-based setting and are increasingly implemented in the clinical speciality training for endocrinologist. This study aims to assess interrater agreement and factors that potentially impact EPA scores. Five known factors that affect entrustment decisions in health profesions training (capability, integrity, reliability, humility, agency) were used in this study.

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  • The study investigates the impact of adding oral progesterone to traditional gender-affirming hormone therapy (GAHT) with estradiol in transgender women on breast volume post surgery.
  • It employs a randomized controlled trial design, where 90 participants are divided into six groups receiving varying doses of estradiol and progesterone for 12 months.
  • Key measurements include changes in breast volume using 3D imaging, alongside assessments of safety, mood, sleep, and sexual pleasure.
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  • Stage IV adrenocortical carcinoma (mACC) has a historically poor prognosis, but results from a 2012 trial led to the recommendation of the first-line treatment EDP-M, which includes multiple chemotherapy agents.
  • Analysis of data from 167 mACC patients in the Netherlands showed that while EDP-M appeared to improve overall survival (OS) numerically, the results were not statistically significant; patients receiving mitotane alone had the best long-term survival rates.
  • Overall survival for mACC patients in the Netherlands has improved since 2014, with factors like palliative adrenalectomy and local treatment contributing to better outcomes, but EDP-M did not show a significant impact on OS.
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  • Hormone treatment (HT) is essential for gender-affirming care, but guidelines often overlook the needs of nonbinary and genderqueer (NBGQ) individuals compared to binary transgender (BT) people.
  • A study involving 602 applicants found that NBGQ individuals were less likely to receive conventional HT and more likely to receive tailored HT than BT individuals, with significant differences in treatment outcomes.
  • The study highlights the need for individualized endocrine counseling for NBGQ individuals and calls for more qualitative and prospective research to develop customized HT regimens.
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Background: The impact of multifocality and bilaterality on recurrence in patients with low-risk papillary thyroid cancer (PTC) is relevant when considering patients for a de-escalated treatment strategy: hemithyroidectomy instead of total thyroidectomy followed with or without radioactive iodine. This study aims to analyze contralateral tumor probability in patients treated for low-risk PTC and assess multifocality and bilaterality as possible predictors for recurrence.

Methods: Patients with low-risk PTC treated with total thyroidectomy followed with or without radioactive iodine in the Netherlands between 2005 and 2015 were included in this study.

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Summary: A 31-year-old woman with complete androgen insensitivity syndrome (CAIS) experienced breast volume fluctuations during biphasic hormone replacement therapy consisting of estradiol and cyclical dydrogesterone, a progestin. 3D breast volume measurements showed a 100 cc volume (17%) difference between estradiol monotherapy and combined estradiol and dydrogesterone treatment. Progestogen-dependent breast volume changes have not been reported in the literature.

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Background: Development of skin cancer, in particular melanoma, has been linked to sex hormones. We aimed to determine the incidence of skin cancer in transgender individuals receiving gender-affirming hormone treatment (GAHT).

Methods: In this nationwide retrospective cohort study, clinical information of participants who visited our clinic between (the years) 1972 and 2018 and received GAHT was integrated with national pathology and cancer statistics data in order to assess skin cancer incidence.

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Insulinomas are rare functional pancreatic neuroendocrine tumors. While most insulinomas are indolent and cured after surgery, 10-15% of cases show aggressive or malignant tumor behavior and metastasize locally or to distant organs. Patients with metastatic insulinoma survive significantly shorter.

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Background: Loss-of-function mutations of the multiple endocrine neoplasia type 1 (MEN1) gene are causal to the MEN1 tumor syndrome, but they are also commonly found in sporadic pancreatic neuroendocrine tumors and other types of cancers. The MEN1 gene product, menin, is involved in transcriptional and chromatin regulation, most prominently as an integral component of KMT2A/MLL1 and KMT2B/MLL2 containing COMPASS-like histone H3K4 methyltransferase complexes. In a mutually exclusive fashion, menin also interacts with the JunD subunit of the AP-1 and ATF/CREB transcription factors.

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Background: Clinical pathways are care plans established to describe essential steps in the care of patients with a specific clinical problem. They translate (inter)national guidelines into local applicable protocols and clinical practice. The purpose of this article is to establish a multidisciplinary integrated care pathway for specialists and allied health care professionals in caring for individuals with von Hippel-Lindau (VHL) disease.

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We aimed to develop a disease-specific adrenocortical carcinoma (ACC) health-related quality of life (HRQoL) questionnaire (ACC-QOL) and assess HRQoL in a population-based cohort of patients with ACC. Development was in line with European Organization for Research and Treatment of Cancer (EORTC) guidelines, though not an EORTC product. In phase I and II, we identified 90 potential HRQoL issues using literature and focus groups, which were reduced to 39 by healthcare professionals.

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  • Neuroendocrine carcinomas (NEC) share histological and clinical features but have distinct chromatin landscapes, indicating a common epigenetic program.
  • Focused on neuroendocrine prostate cancer (NEPC), the study identifies two major subtypes based on specific neuronal transcription factors, ASCL1 and NEUROD1, which show differing genetic and epigenetic profiles.
  • In clinical samples, these subtypes coexist within the same tumor, highlighting the complexity and heterogeneity of NEPC and suggesting that effective treatment may require targeting multiple tumor populations simultaneously.
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Patients with multiple endocrine neoplasia 1 syndrome (MEN1) often develop multifocal duodenopancreatic neuroendocrine tumors (dpNETs). Nonfunctional pancreatic neuroendocrine tumors (PanNETs) and duodenal gastrinomas are the most frequent origins of metastasis. Current guidelines recommend surgery based on tumor functionality, size ≥2 cm, grade or presence of lymph node metastases.

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