Publications by authors named "Leerdam M"

Background: Female Lynch syndrome carriers have an increased risk of developing endometrial cancer. Regardless, research on endometrial carcinoma tumorigenesis is scarce and no uniform, evidence-based gynaecological management guidelines exist. We therefore described gynaecological surveillance and surgery outcomes in a nation-wide Lynch syndrome cohort.

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Objectives: To prevent colorectal cancer (CRC), most patients with familial adenomatous polyposis (FAP) undergo (procto)colectomy with ileorectal anastomosis (IRA) or ileal pouch-anal anastomosis (IPAA). After surgery, these patients remain at risk of developing cancer in the remnant rectum or rectal cuff/pouch. We aimed to compare the long-term risk of cancer following IRA or IPAA in FAP.

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Upper age limits are currently fixed for all fecal immunochemical test (FIT)-based colorectal cancer (CRC) screening programs. A risk-stratified upper age limit may be beneficial. Therefore, we assessed differences in interval CRC risk among individuals who had reached the upper age limit of screening (75 years).

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Sarcopenia is a muscle disease that occur across a lifetime. It is commonly described in the aging population but can occur earlier in life in patients with cancer. Previous studies demonstrated sarcopenia is highly prevalent in patients with gastroenteropancreatic neuroendocrine tumours (GEP-NETs).

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Testicular cancer survivors (TCS) treated with platinum-based chemotherapy have increased cancer risk. Platinum retention in healthy tissue may contribute to carcinogenesis. We assessed total platinum concentrations in plasma, urine, and normal colonic mucosa samples in TCS treated with cisplatin.

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Background: Individuals carrying a germline CDKN2A pathogenic variant (PV) are at a high risk of developing pancreatic ductal adenocarcinoma. Risk stratification could allow tailored surveillance.

Objective: To develop a Fine-Gray prediction model for the risk of PDAC in carriers of a CDKN2A PV.

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Article Synopsis
  • * A study analyzed 200 individuals with Lynch syndrome to assess the effectiveness of faecal VOCs, both alone and in combination with FIT, in identifying relevant colorectal neoplasia before and after colonoscopy.
  • * Results indicated high sensitivity and negative predictive values for detecting colorectal cancer and advanced adenomas using VOC analysis, suggesting that faecal VOCs could guide optimal colonoscopy intervals and improve patient monitoring following polypectomy.
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Background And Aims: This study aimed to provide evidence on the harm-to-benefit ratio of fecal immunochemical test (FIT)-based colorectal cancer (CRC) screening by previous fecal hemoglobin (f-Hb) concentrations, as reflected in the number needed to screen (NNS) and number needed to scope (NNSc).

Methods: Participants in up to 4 FIT screening rounds of the Dutch CRC screening program were included. The main outcomes of this study were the NNS and NNSc to detect 1 CRC and/or advanced neoplasia (AN) in screening rounds 2, 3, or 4, conditional on previous f-Hb concentrations.

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Background And Aims: Patients with screen-detected colorectal cancer (CRC) have a better stage-specific overall survival than non-screen-detected CRC. Currently, it is unknown if recurrence rates differ between screen-detected and non-screen-detected CRCs, and whether this could explain the observed difference in overall survival. Therefore, we aimed to assess the disease-free survival (DFS) rates in screen-detected and non-screen-detected CRCs and if recurrence affects overall survival.

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Article Synopsis
  • Researchers found that changes in a specific part of the p53 gene, called p53β, might be important in causing some types of cancer.
  • They discovered a special change (stop-lost variant) in this gene in four families with a history of certain cancers like colorectal, breast, and thyroid cancer.
  • This change affects how p53β works and can increase cancer risk, showing that we need to look closely at all parts of the p53 gene to better understand cancer and who might be at risk.
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Mismatch repair deficiency (dMMR) is found in approximately 15% of non-metastatic colon cancers (CCs) and is characterized by a defective DNA mismatch repair system, resulting in hypermutated and highly immunogenic tumors. Although patients with dMMR CC have limited benefit from chemotherapy, these tumors have been shown to respond exceptionally well to neoadjuvant anti-PD-1 plus anti-CTLA-4, with high rates of pathologic responses. Here, based on data from melanoma studies, we postulated a high efficacy and favorable toxicity profile of anti-PD-1 plus anti-LAG-3.

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  • Colonoscopy surveillance for colorectal cancer (CRC) can be burdensome for patients, and stool tests might help reduce the need for colonoscopies by identifying individuals at higher risk.
  • This study involved 3453 participants aged 50-75 who completed multiple stool tests and colonoscopies to assess the accuracy of these methods for detecting advanced neoplasia.
  • Results indicated that stool-based strategies could effectively reduce colonoscopy frequency by 15%-41% while being safer and more cost-effective, particularly with fecal immunochemical tests (FITs), although multitarget stool DNA testing was found to be more expensive.
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  • The study evaluates strategies for colorectal cancer (CRC) surveillance in individuals with familial CRC risk, comparing different methods of colonoscopy and fecal testing.
  • The optimal strategy identified is a combination of 10-yearly colonoscopy and 2-yearly FIT from ages 40 to 80, which enhances life quality and reduces costs.
  • This approach not only prevents more CRC deaths but also significantly decreases the number of colonoscopies required compared to current guidelines.
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Article Synopsis
  • Colonoscopy surveillance for individuals with Lynch syndrome is challenging, and colorectal cancers can still occur despite regular screenings.
  • A study evaluated the efficacy of fecal immunochemical tests (FIT) to determine the best intervals for colonoscopy by measuring specific thresholds of hemoglobin in stool samples.
  • Results indicated that using a lower FIT threshold (2.5 μg Hb/g) increased the detection rate of relevant neoplasia, with even better specificity seen at a threshold of 4.1 μg Hb/g, suggesting that FIT could potentially allow many Lynch syndrome patients to delay unnecessary colonoscopies while still effectively identifying those at risk for advanced neoplasia.
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Background & Aims: Desmoid tumors (DT) are an important cause of morbidity and mortality in patients with familial adenomatous polyposis (FAP). DT development might be related to the type and approach of colectomy. We aimed to compare DT development after colectomy with ileorectal anastomosis (IRA) and proctocolectomy with ileal pouch-anal anastomosis (IPAA).

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Background: Mismatch repair-deficient (dMMR) tumors can be found in 10 to 15% of patients with nonmetastatic colon cancer. In these patients, the efficacy of chemotherapy is limited. The use of neoadjuvant immunotherapy has shown promising results, but data from studies of this approach are limited.

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Individuals with a germline CDKN2A pathogenic variant (PV) have a highly increased life time risk of melanoma and pancreatic cancer. This cross-sectional study assessed the attitudes among toward genetic testing, family planning, and preimplantation genetic testing (PGT) in confirmed CDKN2A PV carriers and individuals with a 50% risk of the PV (at-risk carriers) using of a one-time questionnaire.A total of 537 individuals were screened for eligibility, of whom 208 of 366 (57%) confirmed carriers (56% female, median age 54 years [IQR 46-63]) and 39 of 171 (23%) at-risk carriers (59% female, median age of 26 years [IQR 22-32]) participated in the study.

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Two independent exome sequencing initiatives aimed to identify new genes involved in the predisposition to nonpolyposis colorectal cancer led to the identification of heterozygous loss-of-function variants in NPAT, a gene that encodes a cyclin E/CDK2 effector required for S phase entry and a coactivator of histone transcription, in two families with multiple members affected with colorectal cancer. Enrichment of loss-of-function and predicted deleterious NPAT variants was identified in familial/early-onset colorectal cancer patients compared to non-cancer gnomAD individuals, further supporting the association with the disease. Previous studies in Drosophila models showed that NPAT abrogation results in chromosomal instability, increase of double strand breaks, and induction of tumour formation.

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Pancreatic cancer has a dismal prognosis in the general population. However, early detection and treatment of disease in high-risk individuals can improve survival, as patients with localized disease and especially patients with lesions smaller than 10 mm show greatly improved 5-year survival rates. To achieve early detection through MRI surveillance programs, optimization of imaging is required.

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Background & Aims: Changes in body composition and metabolic factors may serve as biomarkers for the early detection of pancreatic ductal adenocarcinoma (PDAC). The aim of this study was to capture the longitudinal changes in body composition and metabolic factors before diagnosis of PDAC.

Methods: We performed a retrospective cohort study in which all patients (≥18 years) diagnosed with PDAC from 2002 to 2021 were identified.

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