Local recurrence following breast-conserving treatment in women aged 40 years or younger: trends in risk and the impact on prognosis in a population-based cohort of 1143 patients.

Aim: To evaluate trends in the risk of local recurrences after breast-conserving treatment (BCT) and to examine the impact of local recurrence (LR) on distant relapse-free survival in a large, population-based cohort of women aged ≤40 years with early-stage breast cancer.

Methods: All women (n=1143) aged ≤40 years with early-stage (pT1-2/cT1-2, N0-2, M0) breast cancer who underwent BCT in the south of the Netherlands between 1988 and 2010 were included. BCT consisted of local excision of the tumour followed by irradiation of the breast.

The standardised mortality ratio is unreliable for assessing quality of care in rectal cancer.

Background: The standardised mortality ratio (SMR) for rectal or anal cancer was above average in a large tertiary referral centre for locally advanced rectal cancer in the Netherlands. The aim of this study was to investigate whether the increased SMR was indeed related to poor quality of care or whether it could be explained by inadequate adjustment for case-mix factors.

Methods: Between 2006 and 2008, 381 patients were admitted for rectal or anal cancer.

Comparison of the sentinel node procedure between patients with multifocal and unifocal breast cancer in the EORTC 10981-22023 AMAROS Trial: identification rate and nodal outcome.

Introduction: Multifocal breast cancer is associated with a higher risk of nodal involvement compared to unifocal breast cancer and the drainage pattern from multifocal localisations may be different. For this reason, the value of the sentinel node biopsy (SNB) procedure for this indication is debated. The aim of the current analysis was to evaluate the sentinel node identification rate and nodal involvement in patients with a multifocal tumour in the EORTC 10981-22023 AMAROS trial.

Rising incidence, no change in survival and decreasing mortality from thyroid cancer in The Netherlands since 1989.

The incidence of thyroid cancer (TC) is increasing worldwide, partly due to increased detection. We therefore assessed combined trends in incidence, survival and mortality of the various types of TC in The Netherlands between 1989 and 2009. We included all patients ≥15 years with TC, diagnosed in the period 1989-2009 and recorded in The Netherlands Cancer Registry (n=8021).

Removable and repositionable covered metal self-expandable stents for leaks after upper gastrointestinal surgery: experiences in a tertiary referral hospital.

Background: Anastomotic leakages are severe complications of upper gastrointestinal surgery with serious morbidity and mortality. Until recently, only abscess drainage was possible. Since 2007, removable and repositionable covered metal self-expandable stents (RReCoMSeS) have been used in our hospital to cover leaks.

Patterns and determinants of surgical management of screen detected breast cancer in the South-East Netherlands.

Introduction: Patients with screen detected breast cancer tend to have small, non-palpable tumours with favourable characteristics for breast conserving surgery (BCS). The aims of this study were to analyse patterns in surgical management in patients with screen detected breast cancer and to determine factors predictive of the need for a re-operation after BCS (re-excision or secondary mastectomy).

Methods: Patient data were retrieved from the population based Eindhoven Cancer Registry, which covers 14 hospitals in de south of the Netherlands.

Repeat sentinel node biopsy in patients with locally recurrent breast cancer: a systematic review and meta-analysis of the literature.

Axillary staging in patients with locally recurrent breast cancer is important for obtaining locoregional control and predicting prognosis. The aim of the present study is to determine technical feasibility, validity, aberrant drainage patterns and clinical consequences of performing repeat sentinel node biopsy (SNB) in these patients. We performed a systematic review and meta-analysis of the literature and included all studies on repeat SNB in locally recurrent breast cancer.

Intraoperative radiotherapy and cytoreductive surgery with hyperthermic intraperitoneal chemotherapy. Five consecutive case reports of locally advanced rectal cancer with synchronous peritoneal carcinomatosis.

Purpose: Treatment of rectal cancer has markedly improved since the introduction of neoadjuvant strategies and better surgical techniques. However, treatment remains troublesome for patients with locally advanced rectal cancer (LARC) or with peritoneal carcinomatosis (PC). Patients presenting with LARC may now benefit from the integration of intra-operative radiotherapy (IORT) into multimodality treatment.

Dynamic article: Vaginal and perineal reconstruction using rectus abdominis myocutaneous flap in surgery for locally advanced rectum carcinoma and locally recurrent rectum carcinoma.

Background: Surgery for locally advanced and recurrent rectal carcinoma sometimes requires partial resection of the perineum and/or vagina necessitating subsequent reconstruction.

Objective: The aim of this study was to describe the surgical and functional outcomes of reconstructing the vagina and/or the perineum by using the vertical rectus abdominis myocutaneous flap and to evaluate the health status of patients who received reconstruction.

Design: This is a retrospective cohort study.

Quality of life of older rectal cancer patients is not impaired by a permanent stoma.

Background: The current study was undertaken to investigate the impact of a stoma on the HRQL with a special focus on age.

Materials And Methods: Using the Eindhoven Cancer Registry, rectal cancer patients diagnosed between 1998 and 2007 in 4 hospitals were identified. All patients underwent TME surgery.

Development of a disease-specific health-related quality of life questionnaire (THYCA-QoL) for thyroid cancer survivors.

Background: To date, no valid instrument is available that focuses on specific health-related quality of life (HRQoL) issues that affect thyroid cancer survivors. The objective of this study was to develop and pretest a thyroid cancer specific HRQoL questionnaire that can be used in addition to the more general European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30).

Material And Methods: Potentially relevant issues were identified by a systematic literature review, a focus group meeting, and an issue list completed by six health care professionals (HCP) and 18 thyroid cancer survivors.

Detection of local recurrence following breast-conserving treatment in young women with early breast cancer: optimization of long-term follow-up strategies.

The detection of a local recurrence (LR) in young women with breast cancer after breast-conserving treatment (BCT) was investigated to compare the impact of different long-term follow-up strategies. Between 1988 and 2005, 937 women aged ≤40 years were treated with BCT for early-stage breast cancer in the southern part of the Netherlands. Up to October 2009, 152 had developed an isolated LR.

Influence of comorbidity and age on 1-, 2-, and 3-month postoperative mortality rates in gastrointestinal cancer patients.

Background: Studies on the impact of comorbidity and age on postoperative outcome after gastrointestinal tumor resection are scarce. In this study we investigated the impact of comorbidity and age on 30-, 60-, and 90-day mortality after resection of esophageal, gastric, periampullary, colon, and rectal cancer.

Methods: The study included 8,583 patients recorded in the population-based Netherlands Cancer Registry, regions Eindhoven (Eindhoven Cancer Registry) and Mid and South Limburg, who underwent resection for cancer stage I-III.

Increased resection rates and survival among patients aged 75 years and older with esophageal cancer: a Dutch nationwide population-based study.

Background: The incidence of esophageal cancer has grown over the recent decades and 30% of esophageal cancer patients are now 75 years or older at the time of diagnosis. The aim of this study was to evaluate trends in management and survival of patients aged 75 years or older with esophageal cancer.

Methods: In the Netherlands cancer registry, we identified all patients aged 75 years or older who were diagnosed with esophageal cancer between 1989 and 2008.

Sentinel Node and Recurrent Breast Cancer (SNARB): results of a nationwide registration study.

Background: Knowledge of regional lymph node involvement is important in patients with recurrent breast cancer for obtaining better locoregional control and predicting prognosis. To determine technical feasibility, validity, aberrant drainage rates, and clinical consequences of performing repeat sentinel node biopsy (SNB) in patients with locally recurrent breast cancer we conducted the "Sentinel Node and Recurrent Breast Cancer (SNARB)" study.

Methods: A total of 150 patients with locally recurrent breast cancer underwent lymphatic mapping and SNB.

Preoperative chemoradiotherapy for esophageal or junctional cancer.

Background: The role of neoadjuvant chemoradiotherapy in the treatment of patients with esophageal or esophagogastric-junction cancer is not well established. We compared chemoradiotherapy followed by surgery with surgery alone in this patient population.

Methods: We randomly assigned patients with resectable tumors to receive surgery alone or weekly administration of carboplatin (doses titrated to achieve an area under the curve of 2 mg per milliliter per minute) and paclitaxel (50 mg per square meter of body-surface area) for 5 weeks and concurrent radiotherapy (41.

Axillary and systemic treatment of patients with breast cancer and micrometastatic disease or isolated tumor cells in the sentinel lymph node.

Background: After introduction of sentinel node biopsy (SNB) in patients with breast cancer a higher proportion of micrometastases and isolated tumor cells are being detected. Prognostic impact and clinical relevance of this minimal nodal involvement is under debate and substantial variation in the use of axillary surgery and/or systemic adjuvant treatment could be expected.

Methods: Data from the population-based Eindhoven Cancer Registry were used on all (n = 9038) women who underwent SNB for invasive breast cancer from 1996 to 2008 and medical files were studied to determine the role of minimal nodal involvement in the decision to use adjuvant systemic treatment.

The effect of socioeconomic status on staging and treatment decisions in esophageal cancer.

Background: Optimal treatment choice for patients with esophageal cancer (EC) is complex and largely determined by tumor characteristics, comorbidity, and age.

Goals: This study describes the role of patient characteristics, among which is socioeconomic status (SES), in EC treatment.

Study: Patients diagnosed with primary EC between 1990 and 2008 in the southern part of the Netherlands were identified using the Eindhoven Cancer Registry.

An abnormal screening mammogram causes more anxiety than a palpable lump in benign breast disease.

Being recalled for further diagnostic procedures after an abnormal screening mammogram (ASM) can evoke a high state anxiety with lowered quality of life (QoL). We examined whether these adverse psychological consequences are found in all women with benign breast disease (BBD) or are particular to women referred after ASM. In addition, the influence of the anxiety as a personality characteristic (trait anxiety) was studied.

Increased incidence and survival for oesophageal cancer but not for gastric cardia cancer in the Netherlands.

Introduction: A worldwide increasing incidence is seen for oesophageal adenocarcinoma, but not for oesophageal squamous cell carcinoma (SCC) and gastric cardia adenocarcinoma. Purposes of the current study were to evaluate the changing incidence rates of oesophageal and gastric cardia cancer, and to assess survival trends.

Patients And Methods: Patients diagnosed with oesophageal adenocarcinoma (N=12,195) or SCC (N=9046), or gastric cardia adenocarcinoma (N=9900) between 1989 and 2008 in the Netherlands were included.

Acute cholecystitis in high risk surgical patients: percutaneous cholecystostomy versus laparoscopic cholecystectomy (CHOCOLATE trial): study protocol for a randomized controlled trial.

Background: Laparoscopic cholecystectomy in acute calculous cholecystitis in high risk patients can lead to significant morbidity and mortality. Percutaneous cholecystostomy may be an alternative treatment option but the current literature does not provide the surgical community with evidence based advice.

Methods/design: The CHOCOLATE trial is a randomised controlled, parallel-group, superiority multicenter trial.

Patent blue staining as a method to improve lymph node detection in rectal cancer following neoadjuvant treatment.

Introduction: Lymph node involvement is one of the most important prognostic factors in rectal cancer. After neoadjuvant treatment the number of retrieved lymph nodes is often reported to be low which impairs reliable tumour staging. This study examines the effect of patent blue staining on the number of harvested lymph nodes and evaluates whether a higher number of retrieved lymph nodes is of prognostic significance.

Perineal hernia repair after abdominoperineal rectal excision.

Background: A perineal hernia can severely disable everyday activities. Its repair is a surgical challenge, and guidance by the literature is limited. The series described so far are small or encompass a long period in which even nonmesh techniques were used.

Lymphatic mapping after previous breast surgery.

Background: To assess the feasibility of lymphatic mapping and determine the lymphatic drainage pathways in patients previously treated with breast conserving therapy (BCT).

Methods: We included patients without current breast cancer that previously received BCT with sentinel node biopsy (SNB) and/or axillary lymph node dissection (ALND) for primary breast cancer. The study population consisted of 44 patients and was divided into two groups according to previous surgical treatment of the axilla: 22 patients after previous SNB and 22 patients after previous ALND.