Publications by authors named "Roeland F De Wilde"
Liver transplantation (LT) is one of the most effective treatments for hepatocellular carcinoma (HCC) in cirrhotic livers. Neoadjuvant bridging treatment in patients qualifying and listed for LT is advised but is still debatable owing to the low level of evidence. The aim of this study was to perform a systematic review to assess the prognostic value of bridging therapy, in terms of radiological and histopathological examination outcomes, for survival after LT.
View Article and Find Full Text PDFPurpose/objectives: To evaluate if stereotactic body radiotherapy (SBRT) for hepatocellular carcinoma (HCC) has a durable effect on tumor control and can be delivered safely.
Materials/methods: Patients included in this retrospective study have been treated at our institution from January 2008 to December 2022. Eligibility criteria were diagnosis of HCC, BCLC stage 0-A-B, non-cirrhotic liver or liver with cirrhosis Child-Pugh class A, and a maximum of three lesions with a cumulative diameter of ≤ 6 cm.
Objective: The impact of the coronavirus disease 2019 (COVID-19) on hepatocellular carcinoma (HCC) care is unclear. This study reports on HCC patterns during the COVID-19 pandemic in the Netherlands.
Methods: Patients diagnosed with HCC between 2017 and 2020 were identified from the Netherlands Cancer Registration.
ASO Visual Abstract: Surgical Outcome After Distal Pancreatectomy With and Without Portomesenteric Venous Resection in Patients with Pancreatic Adenocarcinoma : A Transatlantic Evaluation of Patients in North America, Germany, Sweden, and The Netherlands (GAPASURG).
Ann Surg Oncol
December 2024
Background: Patients with localized (that is non-metastatic) pancreatic ductal adenocarcinoma with an inadequate response or toxicity to first-line chemotherapy may benefit from chemotherapy switch. The aim was to explore the available data on the use and effect of chemotherapy switch, as reported in the literature.
Methods: A systematic search was conducted in Embase, MEDLINE (Ovid), the Web of Science, Cochrane, and Google Scholar on 1 December 2023.
Article Synopsis
- Periampullary cancer poses a significant risk for older patients, with surgical resection being a high-risk yet potentially curative option.
- A study on patients aged 70 and older found that 75% were frail, which influenced treatment decisions; frail patients were more likely to choose nonsurgical options and had a higher incidence of postoperative complications.
- The findings suggest that comprehensive geriatric assessment (CGA) can improve treatment planning and care for older patients undergoing pancreatic surgery, particularly by highlighting the risks associated with frailty.
Article Synopsis
- Robotic pancreatoduodenectomy is gaining popularity globally, with positive outcomes reported, but more large-scale studies are needed to assess the impact of the learning curve on these results.* -
- An extensive study was conducted involving 2,186 patients from 18 centers in 8 countries, analyzing the learning curve and its effects on feasibility (operative time and blood loss) and proficiency (complications and morbidity).* -
- Findings revealed that a significant reduction in major morbidity occurred after 90 procedures, with improved outcomes across the board, while mortality rates remained steady throughout different experience levels among centers.*
Article Synopsis
- Isolated pancreatic injuries from blunt trauma are rare and can't always be detected just through symptoms; a CT scan is essential for diagnosis.
- A 16-year-old patient presented with abdominal pain days after a minor scooter accident, and a CT scan later revealed a complete pancreatic transection, leading to surgery and complications.
- All trauma cases should be assessed carefully for potential abdominal injuries, emphasizing the need for imaging, as seemingly harmless conditions can hide serious injuries.
Surgical Outcome After Distal Pancreatectomy With and Without Portomesenteric Venous Resection in Patients with Pancreatic Adenocarcinoma: A Transatlantic Evaluation of Patients in North America, Germany, Sweden, and The Netherlands (GAPASURG).
Ann Surg Oncol
November 2024
Background: Pancreatic adenocarcinoma located in the pancreatic body might require a portomesenteric venous resection (PVR), but data regarding surgical risks after distal pancreatectomy (DP) with PVR are sparse. Insight into additional surgical risks of DP-PVR could support preoperative counseling and intraoperative decision making. This study aimed to provide insight into the surgical outcome of DP-PVR, including its potential risk elevation over standard DP.
View Article and Find Full Text PDFInterobserver Variability in the International Study Group for Pancreatic Surgery (ISGPS)-Defined Complications After Pancreatoduodenectomy: An International Cross-Sectional Multicenter Study.
Ann Surg
November 2024
Objective: To determine the interobserver variability for complications of pancreatoduodenectomy as defined by the International Study Group for Pancreatic Surgery (ISGPS) and others.
Background: Good interobserver variability for the definitions of surgical complications is of major importance in comparing surgical outcomes between and within centers. However, data on interobserver variability for pancreatoduodenectomy-specific complications are lacking.
Article Synopsis
- - The study compares the outcomes of robot-assisted and laparoscopic pancreatoduodenectomy across 50 European centers, focusing on major morbidity and mortality rates among patients from 2009 to 2020.
- - The results show no significant differences in major morbidity and 30-day mortality rates between the two surgical methods, but robot-assisted surgery had lower conversion rates and better lymph node retrieval.
- - Laparoscopic pancreatoduodenectomy had advantages like shorter operation times and lower rates of postoperative pancreatic complications, suggesting it may be the preferable approach in certain aspects.
Article Synopsis
- International guidelines suggest that monitoring minimally invasive pancreatic surgery (MIPS) is important, but there is a lack of data, particularly on minimally invasive distal pancreatectomy (MIDP).
- This study analyzed data from 1672 patients in 83 European centers to compare robot-assisted distal pancreatectomy (RDP) and laparoscopic distal pancreatectomy (LDP), focusing on intraoperative events, major morbidity, and mortality.
- Findings showed RDP had fewer intraoperative complications but longer surgery times compared to LDP; both procedures had low mortality rates, with LDP still being the more common approach despite the rising use of RDP.
Background: Hepatic arterial infusion pump (HAIP) chemotherapy is an effective treatment for patients with unresectable intrahepatic cholangiocarcinoma (iCCA). HAIP chemotherapy requires a catheter inserted in the gastroduodenal artery and a subcutaneous pump. The catheter can be placed using an open or robotic approach.
View Article and Find Full Text PDFArticle Synopsis
- A nationwide study in the Netherlands aimed to compare the outcomes of robotic pancreatoduodenectomy and open pancreatoduodenectomy, focusing on safety and effectiveness across various centers from 2014 to 2021.
- The research included data from 701 patients who underwent robotic procedures and 4447 who had open surgery, with a focus on major complications and mortality rates.
- While robotic surgery had a longer operating time, it resulted in less blood loss, fewer infections, and shorter hospital stays, but it did not show significant differences in major complications or mortality compared to open surgery after matching the patient groups.
Article Synopsis
- The REDISCOVER consensus conference focused on creating guidelines for the perioperative care of patients with borderline-resectable and locally advanced pancreatic ductal adenocarcinoma (PDAC).
- Using a structured methodology and expert consensus, the conference developed 34 recommendations on various aspects of surgical care, patient selection, and management of pancreatic cancer.
- Despite the low evidence quality for most recommendations, participants highlighted the importance of establishing an international registry to enhance understanding and care for this patient group.
Article Synopsis
- There is a lack of international studies on the outcomes of minimally invasive pancreatoduodenectomy (MIPD), prompting the establishment of the European Registry for Minimally Invasive Pancreatic Surgery (E-MIPS) to monitor these procedures in Europe.
- An analysis of 1,336 patients from 45 centers across 14 European countries indicated significant outcomes, including a major morbidity rate of 41.2% and a 30-day/in-hospital mortality rate of 4.5%.
- Findings revealed that robot-assisted MIPD (R-MIPD) is becoming more popular than laparoscopic MIPD (L-MIPD), with better outcomes in terms of major morbidity and lower rates of complications when performed
Background: Several international high-volume centers have reported good outcomes after resection of locally advanced pancreatic cancer (LAPC) following chemo(radio)therapy, but it is unclear how this translates to nationwide clinical practice and outcome. This study aims to assess the nationwide use and outcome of resection of LAPC following induction chemo(radio)therapy.
Patients And Methods: A multicenter retrospective study including all patients who underwent resection for LAPC following chemo(radio)therapy in all 16 Dutch pancreatic surgery centers (2014-2020), registered in the mandatory Dutch Pancreatic Cancer Audit.
Objective: To assess nationwide surgical outcome after pancreatoduodenectomy (PD) in patients at very high risk for postoperative pancreatic fistula (POPF), categorized as ISGPS-D.
Summary Background Data: Morbidity and mortality after ISGPS-D PD is perceived so high that a recent randomized trial advocated prophylactic total pancreatectomy (TP) as alternative aiming to lower this risk. However, current outcomes of ISGPS-D PD remain unknown as large nationwide series are lacking.
Pancreatic ductal adenocarcinoma (PDAC) remains one of the deadliest solid tumors and is resistant to immunotherapy. B cells play an essential role in PDAC progression and immune responses, both locally and systemically. Moreover, increasing evidence suggests that microbial compositions inside the tumor, as well as in the oral cavity and the gut, are important factors in shaping the PDAC immune landscape.
View Article and Find Full Text PDFThe landscape regarding the treatment possibilities for patients with locally advanced pancreatic cancer (LAPC) has changed over the last decade. The introduction of modern multi-agent chemotherapeutic regimens (i.e.
View Article and Find Full Text PDFLiver transplantation is the most successful treatment for limited-stage HCC. The waiting time for liver transplantation (LT) can be a critical factor affecting the oncological prognosis and outcome of patients with HCC. Efficient strategies to optimize waiting time are essential to maximize the benefits of LT and to reduce the harm of delay in transplantation.
View Article and Find Full Text PDFBackground: Due to centralization of pancreatic surgery, patients with pancreatic cancer are treated in pancreatic cancer networks, composed of referring hospitals (Spokes) and an expert center (Hub). This study aimed to investigate I) how pancreatic cancer networks are organized and II) evaluated by involved clinicians.
Methods: Two online surveys were sent out between January-May 2022.
Objective: This nationwide multicenter study aimed to define clinically relevant thresholds of relative serum CA19-9 response after 2 months of induction chemotherapy in patients with locally advanced pancreatic cancer (LAPC).
Background: CA19-9 is seen as leading biomarker for response evaluation in patients with LAPC, but early clinically useful cut-offs are lacking.
Methods: All consecutive patients with LAPC after 4 cycles (m)FOLFIRINOX or 2 cycles gemcitabine-nab-paclitaxel induction chemotherapy (±radiotherapy) with CA19-9 ≥5 U/mL at baseline were analyzed (2015-2019).
Objective: This study aims at establishing benchmark values for best achievable outcomes following open major anatomic hepatectomy for liver tumors of all dignities.
Background: Outcomes after open major hepatectomies vary widely lacking reference values for comparisons among centers, indications, types of resections, and minimally invasive procedures.
Methods: A standard benchmark methodology was used covering consecutive patients, who underwent open major anatomic hepatectomy from 44 high-volume liver centers from 5 continents over a 5-year period (2016-2020).