Publications by authors named "Wijnen M"

Background: The 5-year prognosis of non-high-risk neuroblastomas is generally good (>90%). However, a proportion of patients show progression and succumb to their disease. We aimed to identify molecular aberrations (not incorporated in the current risk stratification) associated with overall survival (OS) and/or event-free survival (EFS) in patients diagnosed with non-high-risk neuroblastoma.

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Background And Aim: In this retrospective single center cohort study, we report the surgical outcomes of nephron-sparing surgery (NSS) for Wilms' tumor (WT) patients since centralization of pediatric oncology care in the Netherlands, and implementation of technological advancements. Therewith we describe the influence of experience and innovations for this type of surgery.

Methods: We retrospectively assessed all NSS procedures from January 1st 2015 until January 1st 2024 for patients who underwent surgery for a renal tumor at the Princess Máxima Center for Pediatric Oncology.

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A defect in the canonical Wnt-β-catenin pathway may lead to reduced bone strength and increased fracture risk. Sclerostin is a key inhibitor of this pathway by binding to low-density lipoprotein (LDL) receptor-related protein , thereby reducing bone formation. The effectiveness of romosozumab, a human monoclonal antibody that binds sclerostin and prevents this inhibitory effect, has been questioned in patients with inactivating genetic variants in or .

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Purpose: Participation in everyday life activities is important for the development of children and is an important topic in rehabilitation practices. This qualitative study aimed to unveil the perspectives and experiences of teenagers with vision impairments (VIs) or motor impairments (MIs) regarding their participation in leisure activities.

Materials And Methods: 13 teenagers with VIs and 12 teenagers with MIs (age range: 11-15 years) participated in this study.

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Article Synopsis
  • This study investigates the effectiveness of highly-conformal image-guided radiotherapy (IGRT) for patients with high-risk neuroblastoma (HR-NBL), focusing on locoregional control outcomes.
  • The research involved 77 patients treated between 2015-2022, analyzing various factors such as the size of residual lesions and their impact on locoregional failure rates.
  • Results showed a low five-year locoregional failure rate of 7.8%, indicating that IGRT with reduced margins and dose boosts for larger residual lesions is effective in managing HR-NBL.
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Objectives: The International Society of Paediatric Oncology-Renal Tumour Study Group (SIOP-RTSG) discourages invasive procedures to determine the histology of paediatric renal neoplasms at diagnosis. Therefore, the histological subtype of Wilms' tumours (WT) is unknown at the start of neoadjuvant chemotherapy. MR-DWI shows potential value as a non-invasive biomarker through apparent diffusion coefficients (ADCs).

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Surgery is a crucial component of pediatric cancer treatment, but conventional methods may lack precision. Image-guided surgery, including fluorescent and radioguided techniques, offers promise for enhancing tumor localization and facilitating precise resection. Intraoperative molecular imaging utilizes agents like indocyanine green to direct surgeons to occult deposits of tumor and to delineate tumor margins.

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  • - The study explored the effectiveness of taurolidine-citrate(-heparin) lock solutions (TCHL) in preventing central-line-associated bloodstream infections (CLABSI) in pediatric oncology patients, with a trial conducted from 2020 to 2023.
  • - A total of 462 patients using central venous access devices were split into two groups: one using TCHL and the other using heparin-only locks (HL), with follow-ups for 90 days post-insertion.
  • - Results showed no significant difference in the incidence of CLABSI between the TCHL and HL groups, with slightly fewer infections in the TCHL group, but adverse events occurred more often in that group.
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Background: Hemoglobinopathies, the most common inherited blood disorder, are frequently underdiagnosed. Early identification of carriers is important for genetic counseling of couples at risk. The aim of this study was to develop and validate a novel machine learning model on a multicenter data set, covering a wide spectrum of hemoglobinopathies based on routine complete blood count (CBC) testing.

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  • Achieving complete tumor removal is difficult, but can be enhanced using real-time fluorescence-guided surgery with specially designed molecular probes.
  • The traditional process of identifying and testing these probes is lengthy and complicated by the variation within tumors and between different patients.
  • To address these challenges, researchers created a multispectral real-time 3D imaging platform that uses organoid technology to better mimic the diversity in patient tumors and how probes bind to healthy tissue.
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  • Taurolidine lock solutions (TL) may prevent bloodstream infections but can interfere with blood culture results if not fully aspirated before testing.
  • Various lock solutions were tested for their impact on microbial detection in blood culture vials, with taurolidine showing a significant delay in detecting microbial growth.
  • The findings emphasize the necessity of removing TLs from central venous catheters prior to collecting blood cultures to avoid misleading results.
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Background: Surgical treatment of pediatric chest wall tumors requires accurate surgical planning and tumor localization to achieve radical resections while sparing as much healthy tissue as possible. Augmented Reality (AR) could facilitate surgical decision making by improving anatomical understanding and intraoperative tumor localization. We present our clinical experience with the use of an AR system for intraoperative tumor localization during chest wall resections.

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Background: Patient-specific 3D models of neuroblastoma and relevant anatomy are useful tools for surgical planning. However, these models do not represent the heterogenous biology of neuroblastoma. This heterogeneity is visualized with the ADC and I-MIGB-SPECT-CT imaging.

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  • The study aimed to evaluate the use of CLABSI criteria by the CDC in pediatric oncology patients with central venous catheters.
  • A total of 84 bacteremia episodes were analyzed, with 40% classified as CLABSIs and 60% as non-CLABSIs, showing a significant disagreement (13%) among medical experts on these classifications.
  • The findings suggest that modifying the MBI-LCBI criteria to include Pseudomonas aeruginosa and mucositis might enhance the accuracy of diagnosing bloodstream infections in this population.
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Background: To compare paediatric oncologic vascular access ports located on the anterior thoracic wall to ports on the lower lateral thoracic wall, in terms of perceived port-related hindrance and scar-quality.

Methods: A cross-sectional survey study including paediatric oncology patients (≥8-<19 yrs), caregivers (in patients <8 yrs), survivors (>22 yrs with only anterior ports) and nurses of the Princess Máxima Center, the Netherlands, was performed. The survey consisted of questions regarding satisfaction, hindrance during daily life, and port position preference.

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Pediatric patients with high-risk neuroblastoma have poor survival rates and urgently need more effective treatment options with less side effects. Since novel and improved immunotherapies may fill this need, we dissect the immunoregulatory interactions in neuroblastoma by single-cell RNA-sequencing of 24 tumors (10 pre- and 14 post-chemotherapy, including 5 pairs) to identify strategies for optimizing immunotherapy efficacy. Neuroblastomas are infiltrated by natural killer (NK), T and B cells, and immunosuppressive myeloid populations.

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Purpose: Resection of pediatric osteosarcoma in the extremities with soft tissue involvement presents surgical challenges due to difficult visualization and palpation of the tumor. Therefore, an adequate image-guided surgery (IGS) system is required for more accurate tumor resection. The use of a 3D model in combination with intraoperative tracked ultrasound (iUS) may enhance surgical decision making.

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Fluorescence-guided surgery (FGS), based on fluorescent tracers binding to tumor-specific biomarkers, could assist surgeons to achieve complete tumor resections. This study evaluated potential biomarkers for FGS in pediatric Ewing sarcoma (ES). Immunohistochemistry (IHC) was performed to assess CD99, CXCR4, CD117, NPY-R-Y1, and IGF-1R expression in ES biopsies and resection specimens.

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Background: Fluorescence-guided surgery (FGS) with indocyanine green (ICG) is increasingly applied in pediatric surgical oncology. However, FGS has been mostly reported in case studies of liver or renal tumors. Applying novel technologies in pediatric surgical oncology is more challenging than in adult surgical oncology due to differences in tumor histology, biology, and fewer cases.

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Wilms tumor is a common pediatric solid tumor. To evaluate tumor response to chemotherapy and decide whether nephron-sparing surgery is possible, tumor volume measurements based on magnetic resonance imaging (MRI) are important. Currently, radiological volume measurements are based on measuring tumor dimensions in three directions.

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Article Synopsis
  • * A total of 462 paediatric oncology patients will be part of a randomised controlled trial comparing taurolidine-citrate-heparin locks to standard heparin-only locks, with a primary focus on the incidence of CLABSI within a maximum follow-up of 90 days.
  • * The research is ethically approved, and results will be published in a peer-reviewed journal, with data accessible upon request after the main results are published.
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To reduce the burden of chronic diseases on society and individuals, European countries implemented chronic Disease Management Programs (DMPs) that focus on the management of a single chronic disease. However, due to the fact that the scientific evidence that DMPs reduce the burden of chronic diseases is not convincing, patients with multimorbidity may receive overlapping or conflicting treatment advice, and a single disease approach may be conflicting with the core competencies of primary care. In addition, in the Netherlands, care is shifting from DMPs to person-centred integrated care (PC-IC) approaches.

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Background: Standard sentinel lymph node procedure (SNP) in pediatric cancer consists of a preoperative injection with technetium nanocolloid in combination with an optional intraoperative injection with blue dye. However, blue dye has disadvantages, and the detection rate is low, with only 60% of sentinel lymph nodes (SLNs) staining blue. In adult oncology, fluorescence imaging using indocyanine green (ICG) has been shown to be a safe and accurate method for visual detection of SLNs, with a higher sensitivity (up to 97%) compared with blue dye.

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Introduction: In the Netherlands pediatric oncological care for solid tumours is concentrated in one centre since November 2014. One of the most frequently diagnosed solid non-brain tumours in children is the neuroblastoma. Results of surgical treatment of neuroblastoma since the start of this centralization are presented and compared to a historic cohort.

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