133 results on '"Liem, Mike S L"'
Search Results
2. Robotic Versus Laparoscopic Liver Resection: A Nationwide Propensity Score Matched Analysis
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Pilz da Cunha, Gabriela, Sijberden, Jasper P., van Dieren, Susan, Gobardhan, Paul, Lips, Daan J., Terkivatan, Türkan, Marsman, Hendrik A., Patijn, Gijs A., Leclercq, Wouter K. G., Bosscha, Koop, Mieog, J. Sven D., van den Boezem, Peter B., Vermaas, Maarten, Kok, Niels F. M., Belt, Eric J. T., de Boer, Marieke T., Derksen, Wouter J. M., Torrenga, Hans, Verheijen, Paul M., Oosterling, Steven J., Rijken, Arjen M., Coolsen, Marielle M. E., Liem, Mike S. L., Tran, T.C. Khé, Gerhards, Michael F., Nieuwenhuijs, Vincent, Abu Hilal, Mohammad, Besselink, Marc G., van Dam, Ronald M., Hagendoorn, Jeroen, and Swijnenburg, Rutger-Jan more...
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- 2024
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3. Nutritional support in pancreatic cancer patients and its effect on nutritional status: an observational regional HPB network study investigating current practice
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Wijma, Allard G., Hogenbirk, Rianne N. M., Driessens, Heleen, Kluifhooft, Daniëlle A., Jellema-Betten, Ellen S., Tjalsma-de Vries, Marlies, Liem, Mike S. L., Nieuwenhuijs, Vincent B., Manusama, Eric M., Hoogwater, Frederik J. H., Nijkamp, Maarten W., Beijer, Sandra, and Klaase, Joost M. more...
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- 2024
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4. Practice variation and outcomes of minimally invasive minor liver resections in patients with colorectal liver metastases: a population-based study
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de Graaff, Michelle R., Klaase, Joost M., de Kleine, Ruben, Elfrink, Arthur K. E., Swijnenburg, Rutger-Jan, M. Zonderhuis, Babs, D. Mieog, J. Sven, Derksen, Wouter J. M., Hagendoorn, Jeroen, van den Boezem, Peter B., Rijken, Arjen M., Gobardhan, Paul D., Marsman, Hendrik A., Liem, Mike S. L., Leclercq, Wouter K. G., van Heek, Tjarda N. T., Pantijn, Gijs A., Bosscha, Koop, Belt, Eric J. T., Vermaas, Maarten, Torrenga, Hans, Manusama, Eric R., van den Tol, Petrousjka, Oosterling, Steven J., den Dulk, Marcel, Grünhagen, Dirk J., and Kok, Niels F. M. more...
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- 2023
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5. Deep learning models for automatic tumor segmentation and total tumor volume assessment in patients with colorectal liver metastases
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Wesdorp, Nina J., Zeeuw, J. Michiel, Postma, Sam C. J., Roor, Joran, van Waesberghe, Jan Hein T. M., van den Bergh, Janneke E., Nota, Irene M., Moos, Shira, Kemna, Ruby, Vadakkumpadan, Fijoy, Ambrozic, Courtney, van Dieren, Susan, van Amerongen, Martinus J., Chapelle, Thiery, Engelbrecht, Marc R. W., Gerhards, Michael F., Grunhagen, Dirk, van Gulik, Thomas M., Hermans, John J., de Jong, Koert P., Klaase, Joost M., Liem, Mike S. L., van Lienden, Krijn P., Molenaar, I. Quintus, Patijn, Gijs A., Rijken, Arjen M., Ruers, Theo M., Verhoef, Cornelis, de Wilt, Johannes H. W., Marquering, Henk A., Stoker, Jaap, Swijnenburg, Rutger-Jan, Punt, Cornelis J. A., Huiskens, Joost, and Kazemier, Geert more...
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- 2023
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6. Intersurgeon Variability in Local Treatment Planning for Patients with Initially Unresectable Colorectal Cancer Liver Metastases: Analysis of the Liver Expert Panel of the Dutch Colorectal Cancer Group
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Bond, Marinde J. G., Kuiper, Babette I., Bolhuis, Karen, Komurcu, Aysun, van Amerongen, Martinus J., Chapelle, Thiery, Dejong, Cornelis H. C., Engelbrecht, Marc R. W., Gerhards, Michael F., Grünhagen, Dirk J., van Gulik, Thomas, Hermans, John J., de Jong, Koert P., Klaase, Joost M., Kok, Niels F. M., Leclercq, Wouter K. G., Liem, Mike S. L., van Lienden, Krijn P., Molenaar, I. Quintus, Neumann, Ulf P., Patijn, Gijs A., Rijken, Arjen M., Ruers, Theo M., Verhoef, Cornelis, de Wilt, Johannes H. W., Kazemier, Geert, May, Anne M., Punt, Cornelis J. A., and Swijnenburg, Rutger-Jan more...
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- 2023
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7. A scoring system for predicting malignancy in intraductal papillary mucinous neoplasms of the pancreas: a multicenter EUROPEAN validation
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Manuel-Vázquez, Alba, Balakrishnan, Anita, Agami, Paul, Andersson, Bodil, Berrevoet, Frederik, Besselink, Marc G., Boggi, Ugo, Caputo, Damiano, Carabias, Alberto, Carrion-Alvarez, Lucia, Franco, Carmen Cepeda, Coppola, Alessandro, Dasari, Bobby V. M., Diaz-Mercedes, Sherley, Feretis, Michail, Fondevila, Constantino, Fusai, Giuseppe Kito, Garcea, Giuseppe, Gonzabay, Victor, Bravo, Miguel Ángel Gómez, Gorris, Myrte, Hendrikx, Bart, Hidalgo-Salinas, Camila, Kadam, Prashant, Karavias, Dimitrios, Kauffmann, Emanuele, Kourdouli, Amar, La Vaccara, Vincenzo, van Laarhoven, Stijn, Leighton, James, Liem, Mike S. L., Machairas, Nikolaos, Magouliotis, Dimitris, Mahmoud, Adel, Marino, Marco V., Massani, Marco, Requena, Paola Melgar, Mentor, Keno, Napoli, Niccolò, Nijhuis, Jorieke H. T., Nikov, Andrej, Nistri, Cristina, Nunes, Victor, Ruiz, Eduardo Ortiz, Pandanaboyana, Sanjay, Saborido, Baltasar Pérez, Pohnán, Radek, Popa, Mariuca, Pérez, Belinda Sánchez, Bueno, Francisco Sánchez, Serrablo, Alejandro, Serradilla-Martín, Mario, Skipworth, James R. A., Soreide, Kjetil, Symeonidis, Dimitris, Zacharoulis, Dimitris, Zelga, Piotr, Aliseda, Daniel, Santiago, María Jesús Castro, Mancilla, Carlos Fernández, Fragua, Raquel Latorre, Hughes, Daniel Llwyd, Llorente, Carmen Payá, Lesurtel, Mickaël, Gallagher, Tom, and Ramia, José Manuel more...
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- 2022
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8. First-Line Systemic Treatment for Initially Unresectable Colorectal Liver Metastases: Post Hoc Analysis of the CAIRO5 Randomized Clinical Trial.
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Bond, Marinde J. G., Bolhuis, Karen, Loosveld, Olaf J. L., de Groot, Jan Willem B., Droogendijk, Helga, Helgason, Helgi H., Hendriks, Mathijs P., Klaase, Joost M., Kazemier, Geert, Liem, Mike S. L., Rijken, Arjen M., Verhoef, Cornelis, de Wilt, Johannes H.W., de Jong, Koert P., Gerhards, Michael F., van Amerongen, Martinus J., Engelbrecht, Marc R.W., van Lienden, Krijn P., Hermans, John J., and Molenaar, I. Quintus more...
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- 2025
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9. Routine Imaging or Symptomatic Follow-Up After Resection of Pancreatic Adenocarcinoma
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Andel, Paul C. M., van Goor, Iris W. J. M., Augustinus, Simone, Berrevoet, Frederik, Besselink, Marc G., Bhojwani, Rajesh, Boggi, Ugo, Bouwense, Stefan A. W., Cirkel, Geert A., van Dam, Jacob L., Djanani, Angela, Dorcaratto, Dimitri, Dreyer, Stephan, den Dulk, Marcel, Frigerio, Isabella, Ghorbani, Poya, Goetz, Mara R., Groot Koerkamp, Bas, Gryspeerdt, Filip, Hidalgo Salinas, Camila, Intven, Martijn, Izbicki, Jakob R., Jorba Martin, Rosa, Kauffmann, Emanuele F., Klug, Reinhold, Liem, Mike S. L., Luyer, Misha D. P., Maglione, Manuel, Martin-Perez, Elena, Meerdink, Mark, de Meijer, Vincent E., Nieuwenhuijs, Vincent B., Nikov, Andrej, Nunes, Vitor, Pando, Elizabeth, Radenkovic, Dejan, Roeyen, Geert, Sanchez-Bueno, Francisco, Serrablo, Alejandro, Sparrelid, Ernesto, Tepetes, Konstantinos, Thakkar, Rohan G., Tzimas, George N., Verdonk, Robert C., ten Winkel, Meike, Zerbi, Alessandro, Groot, Vincent P., Molenaar, I. Quintus, Daamen, Lois A., and van Santvoort, Hjalmar C. more...
- Abstract
IMPORTANCE: International guidelines lack consistency in their recommendations regarding routine imaging in the follow-up after pancreatic resection for pancreatic ductal adenocarcinoma (PDAC). Consequently, follow-up strategies differ between centers worldwide. OBJECTIVE: To compare clinical outcomes, including recurrence-focused treatment and survival, in patients with PDAC recurrence who received symptomatic follow-up or routine imaging after pancreatic resection in international centers affiliated with the European-African Hepato-Pancreato-Biliary Association (E-AHPBA). DESIGN, SETTING, AND PARTICIPANTS: This was a prospective, international, cross-sectional study. Patients from a total of 33 E-AHPBA centers from 13 countries were included between 2020 and 2021. According to the predefined study protocol, patients who underwent PDAC resection and were diagnosed with disease recurrence were prospectively included. Patients were stratified according to postoperative follow-up strategy: symptomatic follow-up (ie, without routine imaging) or routine imaging. EXPOSURES: Symptomatic follow-up or routine imaging in patients who underwent PDAC resection. MAIN OUTCOMES AND MEASURES: Overall survival (OS) was estimated with Kaplan-Meier curves and compared using the log-rank test. To adjust for potential confounders, multivariable logistic regression was used to evaluate the association between follow-up strategy and recurrence-focused treatment. Multivariable Cox proportional hazard analysis was used to study the independent association between follow-up strategy and OS. RESULTS: Overall, 333 patients (mean [SD] age, 65 [11] years; 184 male [55%]) with PDAC recurrence were included. Median (IQR) follow-up at time of analysis 2 years after inclusion of the last patient was 40 (30-58) months. Of the total cohort, 98 patients (29%) received symptomatic follow-up, and 235 patients (71%) received routine imaging. OS was 23 months (95% CI, 19-29 months) vs 28 months (95% CI, 24-30 months) in the groups who received symptomatic follow-up vs routine imaging, respectively (P = .01). Routine imaging was associated with receiving recurrence-focused treatment (adjusted odds ratio, 2.57; 95% CI, 1.22-5.41; P = .01) and prolonged OS (adjusted hazard ratio, 0.75; 95% CI, 0.56-.99; P = .04). CONCLUSION AND RELEVANCE: In this international, prospective, cross-sectional study, routine follow-up imaging after pancreatic resection for PDAC was independently associated with receiving recurrence-focused treatment and prolonged OS. more...
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- 2025
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10. Hospital variation and outcomes after repeat hepatic resection for colorectal liver metastases: a nationwide cohort study
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MS CGO, Cancer, de Graaff, Michelle R, Klaase, Joost M, den Dulk, Marcel, Te Riele, Wouter W, Hagendoorn, Jeroen, van Heek, N Tjarda, Vermaas, M, Belt, Eric J Th, Bosscha, Koop, Slooter, Gerrit D, Leclercq, Wouter K G, Liem, Mike S L, Mieog, J Sven D, Swijnenburg, Rutger-Jan, van Dam, Ronald M, Verhoef, Cees, Kuhlmann, Koert, van Duijvendijk, Peter, Gerhards, Michael F, Gobardhan, Paul, van den Boezem, Peter, Manusama, Eric R, Grünhagen, Dirk J, Kok, Niels F M, Dutch Hepato Biliary Audit Group, Collaborators, MS CGO, Cancer, de Graaff, Michelle R, Klaase, Joost M, den Dulk, Marcel, Te Riele, Wouter W, Hagendoorn, Jeroen, van Heek, N Tjarda, Vermaas, M, Belt, Eric J Th, Bosscha, Koop, Slooter, Gerrit D, Leclercq, Wouter K G, Liem, Mike S L, Mieog, J Sven D, Swijnenburg, Rutger-Jan, van Dam, Ronald M, Verhoef, Cees, Kuhlmann, Koert, van Duijvendijk, Peter, Gerhards, Michael F, Gobardhan, Paul, van den Boezem, Peter, Manusama, Eric R, Grünhagen, Dirk J, Kok, Niels F M, and Dutch Hepato Biliary Audit Group, Collaborators more...
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- 2024
11. Outcomes of liver surgery: A decade of mandatory nationwide auditing in the Netherlands
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MS CGO, Cancer, de Graaff, Michelle R, Klaase, Joost M, Dulk, Marcel den, Buis, C I, Derksen, Wouter J M, Hagendoorn, Jeroen, Leclercq, Wouter K G, Liem, Mike S L, Hartgrink, Henk H, Swijnenburg, Rutger-Jan, Vermaas, M, Belt, Eric J Th, Bosscha, Koop, Verhoef, Cees, Olde Damink, Steven, Kuhlmann, Koert, Marsman, H M, Ayez, Ninos, van Duijvendijk, Peter, van den Boezem, Peter, Manusama, Eric R, Grünhagen, Dirk J, Kok, Niels F M, Dutch Hepato Biliary Audit Group, Collaborators, MS CGO, Cancer, de Graaff, Michelle R, Klaase, Joost M, Dulk, Marcel den, Buis, C I, Derksen, Wouter J M, Hagendoorn, Jeroen, Leclercq, Wouter K G, Liem, Mike S L, Hartgrink, Henk H, Swijnenburg, Rutger-Jan, Vermaas, M, Belt, Eric J Th, Bosscha, Koop, Verhoef, Cees, Olde Damink, Steven, Kuhlmann, Koert, Marsman, H M, Ayez, Ninos, van Duijvendijk, Peter, van den Boezem, Peter, Manusama, Eric R, Grünhagen, Dirk J, Kok, Niels F M, and Dutch Hepato Biliary Audit Group, Collaborators more...
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- 2024
12. The Value of Biological and Conditional Factors for Staging of Patients with Resectable Pancreatic Cancer Undergoing Upfront Resection: A Nationwide Analysis
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MS CGO, Cancer, Onderzoek Radiotherapie, Pathologie Pathologen staf, MS Medische Oncologie, MS Radiotherapie, Trialbureau Beeld, MS HOD, Schouten, Thijs J, van Goor, Iris W J M, Dorland, Galina A, Besselink, Marc G, Bonsing, Bert A, Bosscha, Koop, Brosens, Lodewijk A A, Busch, Olivier R, Cirkel, Geert A, van Dam, Ronald M, Festen, Sebastiaan, Groot Koerkamp, Bas, van der Harst, Erwin, de Hingh, Ignace H J T, Intven, Martijn P W, Kazemier, Geert, Liem, Mike S L, van Lienden, Krijn P, Los, Maartje, de Meijer, Vincent E, Patijn, Gijs A, Schreinemakers, Jennifer M J, Stommel, Martijn W J, van Tienhoven, Geert Jan, Verdonk, Robert C, Verkooijen, Helena M, van Santvoort, Hjalmar C, Molenaar, I Quintus, Daamen, Lois A, Dutch Pancreatic Cancer Group, MS CGO, Cancer, Onderzoek Radiotherapie, Pathologie Pathologen staf, MS Medische Oncologie, MS Radiotherapie, Trialbureau Beeld, MS HOD, Schouten, Thijs J, van Goor, Iris W J M, Dorland, Galina A, Besselink, Marc G, Bonsing, Bert A, Bosscha, Koop, Brosens, Lodewijk A A, Busch, Olivier R, Cirkel, Geert A, van Dam, Ronald M, Festen, Sebastiaan, Groot Koerkamp, Bas, van der Harst, Erwin, de Hingh, Ignace H J T, Intven, Martijn P W, Kazemier, Geert, Liem, Mike S L, van Lienden, Krijn P, Los, Maartje, de Meijer, Vincent E, Patijn, Gijs A, Schreinemakers, Jennifer M J, Stommel, Martijn W J, van Tienhoven, Geert Jan, Verdonk, Robert C, Verkooijen, Helena M, van Santvoort, Hjalmar C, Molenaar, I Quintus, Daamen, Lois A, and Dutch Pancreatic Cancer Group more...
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- 2024
13. Risk factors for surgery-related muscle quantity and muscle quality loss and their impact on outcome
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van Wijk, Laura, van Duinhoven, Stijn, Liem, Mike S. L., Bouman, Donald E., Viddeleer, Alain R., and Klaase, Joost M.
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- 2021
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14. The Prognostic Value of Total Tumor Volume Response Compared With RECIST1.1 in Patients With Initially Unresectable Colorectal Liver Metastases Undergoing Systemic Treatment
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Wesdorp, Nina J., Bolhuis, Karen, Roor, Joran, van Waesberghe, Jan-Hein T. M., van Dieren, Susan, van Amerongen, Martin J., Chapelle, Thiery, Dejong, Cornelis H. C., Engelbrecht, Marc R. W., Gerhards, Michael F., Grunhagen, Dirk, van Gulik, Thomas M., Hermans, John J., de Jong, Koert P., Klaase, Joost M., Liem, Mike S. L., van Lienden, Krijn P., Molenaar, I. Quintus, Patijn, Gijs A., Rijken, Arjen M., Ruers, Theo M., Verhoef, Cornelis, de Wilt, Johannes H. W., Swijnenburg, Rutger-Jan, Punt, Cornelis J. A., Huiskens, Joost, and Kazemier, Geert more...
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- 2021
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15. Short-Term Outcomes of Secondary Liver Surgery for Initially Unresectable Colorectal Liver Metastases Following Modern Induction Systemic Therapy in the Dutch CAIRO5 Trial
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Bolhuis, Karen, Grosheide, Lodi, Wesdorp, Nina J., Komurcu, Aysun, Chapelle, Thiery, Dejong, Cornelis H. C., Gerhards, Michael F., Grünhagen, Dirk J., van Gulik, Thomas M., Huiskens, Joost, De Jong, Koert P., Kazemier, Geert, Klaase, Joost M., Liem, Mike S. L., Molenaar, I. Quintus, Patijn, Gijs A., Rijken, Arjen M., Ruers, Theo M., Verhoef, Cornelis, de Wilt, Johannes H. W., Punt, Cornelis J. A., and Swijnenburg, Rutger-Jan more...
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- 2021
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16. Axillary metastases after port site recurrences of gallbladder carcinoma: a case report
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Nijhuis, Jorieke J. H. T., Bosscher, M. R. Frederiek, and Liem, Mike S. L.
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- 2020
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17. First-line systemic treatment strategies in patients with initially unresectable colorectal cancer liver metastases (CAIRO5): an open-label, multicentre, randomised, controlled, phase 3 study from the Dutch Colorectal Cancer Group
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Bond, Marinde J G, primary, Bolhuis, Karen, additional, Loosveld, Olaf J L, additional, de Groot, Jan Willem B, additional, Droogendijk, Helga, additional, Helgason, Helgi H, additional, Hendriks, Mathijs P, additional, Klaase, Joost M, additional, Kazemier, Geert, additional, Liem, Mike S L, additional, Rijken, Arjen M, additional, Verhoef, Cornelis, additional, de Wilt, Johannes H W, additional, de Jong, Koert P, additional, Gerhards, Michael F, additional, van Amerongen, Martinus J, additional, Engelbrecht, Marc R W, additional, van Lienden, Krijn P, additional, Molenaar, I Quintus, additional, de Valk, Bart, additional, Haberkorn, Brigitte C M, additional, Kerver, Emile D, additional, Erdkamp, Frans, additional, van Alphen, Robbert J, additional, Mathijssen-van Stein, Daniëlle, additional, Komurcu, Aysun, additional, Lopez-Yurda, Marta, additional, Swijnenburg, Rutger-Jan, additional, Punt, Cornelis J A, additional, Van Gulik, Thomas, additional, Huiskens, Joost, additional, Van Tinteren, Harm, additional, Dejong, Cornelis H.C., additional, Grünhagen, Dirk J., additional, Patijn, Gijs A., additional, Ruers, Theo J.M., additional, Chapelle, Thiery, additional, Hermans, John J., additional, Leclercq, Wouter K.G., additional, Valkenburg-van Iersel, Liselot B.J., additional, Grootscholten, Cecile, additional, Van Dodewaard-de Jong, Joyce M., additional, Vincent, Jeroen, additional, Houtsma, Danny, additional, Los, Maartje, additional, Den Boer, Marien, additional, Trajkovic-Vidakovic, Marija, additional, Van Voorthuizen, Theo, additional, Koopman, Miriam, additional, Vestjens, Johanneke H.M.J.V., additional, Torrenga, Hans, additional, Mekenkamp, Leonie J., additional, Veldhuis, Gerrit Jan, additional, Polee, Marco B., additional, Dohmen, Serge E., additional, Schut, Heidi, additional, Vulink, Annelie J.E., additional, Van Halteren, Henk K., additional, Oulad Hadj, Jamal, additional, Schiphorst, Pieter-Paul J.B.M., additional, and Hoekstra, Ronald, additional more...
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- 2023
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18. Textbook Outcome: Nationwide Analysis of a Novel Quality Measure in Pancreatic Surgery
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van Roessel, Stijn, Mackay, Tara M., van Dieren, Susan, van der Schelling, George P., Nieuwenhuijs, Vincent B., Bosscha, Koop, van der Harst, Edwin, van Dam, Ronald M., Liem, Mike S. L., Festen, Sebastiaan, Stommel, Martijn W. J., Roos, Daphne, Wit, Fennie, Molenaar, I. Quintus, de Meijer, Vincent E., Kazemier, Geert, de Hingh, Ignace H. J. T., van Santvoort, Hjalmar C., Bonsing, Bert A., Busch, Olivier R., Groot Koerkamp, Bas, and Besselink, Marc G. more...
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- 2020
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19. Impact of complications after resection of pancreatic cancer on disease recurrence and survival, and mediation effect of adjuvant chemotherapy:nationwide, observational cohort study
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Henry, Anne Claire, van Dongen, Jelle C, van Goor, Iris W J M, Smits, F Jasmijn, Nagelhout, Anne, Besselink, Marc G, Busch, Olivier R, Bonsing, Bert A, Bosscha, Koop, van Dam, Ronald M, Festen, Sebastiaan, Groot Koerkamp, Bas, van der Harst, Erwin, de Hingh, Ignace H, van der Kolk, Marion, Liem, Mike S L, de Meijer, Vincent E, Patijn, Gijs A, Roos, Daphne, Schreinemakers, Jennifer M, Wit, Fennie, Daamen, Lois A, van Santvoort, Hjalmar C, Molenaar, I Quintus, van Eijck, Casper H J, Henry, Anne Claire, van Dongen, Jelle C, van Goor, Iris W J M, Smits, F Jasmijn, Nagelhout, Anne, Besselink, Marc G, Busch, Olivier R, Bonsing, Bert A, Bosscha, Koop, van Dam, Ronald M, Festen, Sebastiaan, Groot Koerkamp, Bas, van der Harst, Erwin, de Hingh, Ignace H, van der Kolk, Marion, Liem, Mike S L, de Meijer, Vincent E, Patijn, Gijs A, Roos, Daphne, Schreinemakers, Jennifer M, Wit, Fennie, Daamen, Lois A, van Santvoort, Hjalmar C, Molenaar, I Quintus, and van Eijck, Casper H J more...
- Abstract
Background: The causal pathway between complications after pancreatic cancer resection and impaired long-term survival remains unknown. The aim of this study was to investigate the impact of complications after pancreatic cancer resection on disease-free interval and overall survival, with adjuvant chemotherapy as a mediator. Methods: This observational study included all patients undergoing pancreatic cancer resection in the Netherlands (2014-2017). Clinical data were extracted from the prospective Dutch Pancreatic Cancer Audit. Recurrence and survival data were collected additionally. In causal mediation analysis, direct and indirect effect estimates via adjuvant chemotherapy were calculated. Results: In total, 1071 patients were included. Major complications (hazards ratio 1.22 (95 per cent c.i. 1.04 to 1.43); P = 0.015 and hazards ratio 1.25 (95 per cent c.i. 1.08 to 1.46); P = 0.003) and organ failure (hazards ratio 1.86 (95 per cent c.i. 1.32 to 2.62); P < 0.001 and hazards ratio 1.89 (95 per cent c.i. 1.36 to 2.63); P < 0.001) were associated with shorter disease-free interval and overall survival respectively. The effects of major complications and organ failure on disease-free interval (-1.71 (95 per cent c.i. -2.27 to -1.05) and -3.05 (95 per cent c.i. -4.03 to -1.80) respectively) and overall survival (-1.92 (95 per cent c.i. -2.60 to -1.16) and -3.49 (95 per cent c.i. -4.84 to -2.03) respectively) were mediated by adjuvant chemotherapy. Additionally, organ failure directly affected disease-free interval (-5.38 (95 per cent c.i. -9.27 to -1.94)) and overall survival (-6.32 (95 per cent c.i. -10.43 to -1.99)). In subgroup analyses, the association was found in patients undergoing pancreaticoduodenectomy, but not in patients undergoing distal pancreatectomy. Conclusion: Major complications, including organ failure, negatively impact survival in patients after pancreatic cancer resection, largely mediated by adjuvant chemotherapy. Prevention or adeq more...
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- 2023
20. Fistula Risk Score for Auditing Pancreatoduodenectomy:The Auditing FRS
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van Dongen, Jelle C, van Dam, Jacob L, Besselink, Marc G, Bonsing, Bert A, Bosscha, Koop, Busch, Olivier R, van Dam, Ronald M, Festen, Sebastiaan, van der Harst, Erwin, de Hingh, Ignace H, Kazemier, Geert, Liem, Mike S L, de Meijer, Vincent E, Mieog, J Sven D, Molenaar, I Q, Patijn, Gijs A, van Santvoort, Hjalmar C, Wijsman, Jan H, Stommel, Martijn W J, Wit, Fennie, De Wilde, Roeland F, van Eijck, Casper H J, Groot Koerkamp, Bas, van Dongen, Jelle C, van Dam, Jacob L, Besselink, Marc G, Bonsing, Bert A, Bosscha, Koop, Busch, Olivier R, van Dam, Ronald M, Festen, Sebastiaan, van der Harst, Erwin, de Hingh, Ignace H, Kazemier, Geert, Liem, Mike S L, de Meijer, Vincent E, Mieog, J Sven D, Molenaar, I Q, Patijn, Gijs A, van Santvoort, Hjalmar C, Wijsman, Jan H, Stommel, Martijn W J, Wit, Fennie, De Wilde, Roeland F, van Eijck, Casper H J, and Groot Koerkamp, Bas more...
- Abstract
OBJECTIVE: To develop a fistula risk score for auditing, to be able to compare postoperative pancreatic fistula (POPF) after pancreatoduodenectomy among hospitals.BACKGROUND: For proper comparisons of outcomes in surgical audits, case-mix variation should be accounted for.METHODS: This study included consecutive patients after pancreatoduodenectomy from the mandatory nationwide Dutch Pancreatic Cancer Audit. Derivation of the score was performed with the data from 2014 to 2018 and validation with 2019 to 2020 data. The primary endpoint of the study was POPF (grade B or C). Multivariable logistic regression analysis was performed for case-mix adjustment of known risk factors.RESULTS: In the derivation cohort, 3271 patients were included, of whom 479 (14.6%) developed POPF. Male sex [odds ratio (OR)=1.34; 95% confidence interval (CI): 1.09-1.66], higher body mass index (OR=1.07; 95% CI: 1.05-1.10), a final diagnosis other than pancreatic ductal adenocarcinoma/pancreatitis (OR=2.41; 95% CI: 1.90-3.06), and a smaller duct diameter (OR=1.43/mm decrease; 95% CI: 1.32-1.55) were independently associated with POPF. Diabetes mellitus (OR=0.73; 95% CI: 0.55-0.98) was independently associated with a decreased risk of POPF. Model discrimination was good with a C-statistic of 0.73 in the derivation cohort and 0.75 in the validation cohort (n=913). Hospitals differed in particular in the proportion of pancreatic ductal adenocarcinoma/pancreatitis patients, ranging from 36.0% to 58.1%. The observed POPF risk per center ranged from 2.9% to 25.4%. The expected POPF rate based on the 5 risk factors ranged from 11.6% to 18.0% among hospitals.CONCLUSIONS: The auditing fistula risk score was successful in case-mix adjustment and enables fair comparisons of POPF rates among hospitals. more...
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- 2023
21. Pancreatectomy with arterial resection for periampullary cancer:outcomes after planned or unplanned events in a nationwide, multicentre cohort
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Stoop, Thomas F, Mackay, Tara M, Brada, Lilly J H, van der Harst, Erwin, Daams, Freek, Land, Freek R van 't, Kazemier, Geert, Patijn, Gijs A, van Santvoort, Hjalmar C, de Hingh, Ignace H, Bosscha, Koop, Seelen, Leonard W F, Nijkamp, Maarten W, Stommel, Martijn W J, Liem, Mike S L, Busch, Olivier R, Coene, Peter-Paul L O, van Dam, Ronald M, de Wilde, Roeland F, Mieog, J Sven D, Quintus Molenaar, I, Besselink, Marc G, van Eijck, Casper H J, Stoop, Thomas F, Mackay, Tara M, Brada, Lilly J H, van der Harst, Erwin, Daams, Freek, Land, Freek R van 't, Kazemier, Geert, Patijn, Gijs A, van Santvoort, Hjalmar C, de Hingh, Ignace H, Bosscha, Koop, Seelen, Leonard W F, Nijkamp, Maarten W, Stommel, Martijn W J, Liem, Mike S L, Busch, Olivier R, Coene, Peter-Paul L O, van Dam, Ronald M, de Wilde, Roeland F, Mieog, J Sven D, Quintus Molenaar, I, Besselink, Marc G, and van Eijck, Casper H J more...
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- 2023
22. Early Recurrence After Resection of Locally Advanced Pancreatic Cancer Following Induction Therapy: An International Multicenter Study
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Seelen, Leonard W F, Floortje van Oosten, A, Brada, Lilly J H, Groot, Vincent P, Daamen, Lois A, Walma, Marieke S, van der Lek, Bastiaan F, Liem, Mike S L, Patijn, Gijs A, Stommel, Martijn W J, van Dam, Ronald M, Koerkamp, Bas Groot, Busch, Olivier R, de Hingh, Ignace H J T, van Eijck, Casper H J, Besselink, Marc G, Burkhart, Richard A, Borel Rinkes, Inne H M, Wolfgang, Christopher L, Molenaar, I Quintus, He, Jin, van Santvoort, Hjalmar C, Seelen, Leonard W F, Floortje van Oosten, A, Brada, Lilly J H, Groot, Vincent P, Daamen, Lois A, Walma, Marieke S, van der Lek, Bastiaan F, Liem, Mike S L, Patijn, Gijs A, Stommel, Martijn W J, van Dam, Ronald M, Koerkamp, Bas Groot, Busch, Olivier R, de Hingh, Ignace H J T, van Eijck, Casper H J, Besselink, Marc G, Burkhart, Richard A, Borel Rinkes, Inne H M, Wolfgang, Christopher L, Molenaar, I Quintus, He, Jin, and van Santvoort, Hjalmar C more...
- Abstract
Objective: To establish an evidence-based cutoff and predictors for early recurrence in patients with resected locally advanced pancreatic cancer (LAPC). Background: It is unclear how many and which patients develop early recurrence after LAPC resection. Surgery in these patients is probably of little benefit. Methods: We analyzed all consecutive patients undergoing resection of LAPC after induction chemotherapy who were included in prospective databases in The Netherlands (2015-2019) and the Johns Hopkins Hospital (2016-2018). The optimal definition for "early recurrence"was determined by the post-recurrence survival (PRS). Patients were compared for overall survival (OS). Predictors for early recurrence were evaluated using logistic regression analysis. Results: Overall, 168 patients were included. After a median follow-up of 28 months, recurrence was observed in 118 patients (70.2%). The optimal cutoff for recurrence-free survival to differentiate between early (n=52) and late recurrence (n=66) was 6 months (P<0.001). OS was 8.4 months [95% confidence interval (CI): 7.3-9.6] in the early recurrence group (n=52) versus 31.1 months (95% CI: 25.7-36.4) in the late/no recurrence group (n=116) (P<0.001). A preoperative predictor for early recurrence was postinduction therapy carbohydrate antigen (CA) 19-9≥100 U/mL [odds ratio (OR)=4.15, 95% CI: 1.75-9.84, P=0.001]. Postoperative predictors were poor tumor differentiation (OR=4.67, 95% CI: 1.83-11.90, P=0.001) and no adjuvant chemotherapy (OR=6.04, 95% CI: 2.43-16.55, P<0.001). Conclusions: Early recurrence was observed in one third of patients after LAPC resection and was associated with poor survival. Patients with post-induction therapy CA 19-9 ≥100 U/mL, poor tumor differentiation and no adjuvant therapy were especially at risk. This information is valuable for patient counseling before and after resection of LAPC. more...
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- 2023
23. A nationwide assessment of hepatocellular adenoma resection:Indications and pathological discordance
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Haring, Martijn P D, Elfrink, Arthur K E, Oudmaijer, Christiaan A J, Andel, Paul C M, Furumaya, Alicia, de Jong, Nenke, Willems, Colin J J M, Huits, Thijs, Sijmons, Julie M L, Belt, Eric J T, Bosscha, Koop, Consten, Esther C J, Coolsen, Mariëlle M E, van Duijvendijk, Peter, Erdmann, Joris I, Gobardhan, Paul, de Haas, Robbert J, van Heek, Tjarda, Lam, Hwai-Ding, Leclercq, Wouter K G, Liem, Mike S L, Marsman, Hendrik A, Patijn, Gijs A, Terkivatan, Türkan, Zonderhuis, Babs M, Molenaar, Izaak Quintus, Te Riele, Wouter W, Hagendoorn, Jeroen, Schaapherder, Alexander F M, IJzermans, Jan N M, Buis, Carlijn I, Klaase, Joost M, de Jong, Koert P, de Meijer, Vincent E, Haring, Martijn P D, Elfrink, Arthur K E, Oudmaijer, Christiaan A J, Andel, Paul C M, Furumaya, Alicia, de Jong, Nenke, Willems, Colin J J M, Huits, Thijs, Sijmons, Julie M L, Belt, Eric J T, Bosscha, Koop, Consten, Esther C J, Coolsen, Mariëlle M E, van Duijvendijk, Peter, Erdmann, Joris I, Gobardhan, Paul, de Haas, Robbert J, van Heek, Tjarda, Lam, Hwai-Ding, Leclercq, Wouter K G, Liem, Mike S L, Marsman, Hendrik A, Patijn, Gijs A, Terkivatan, Türkan, Zonderhuis, Babs M, Molenaar, Izaak Quintus, Te Riele, Wouter W, Hagendoorn, Jeroen, Schaapherder, Alexander F M, IJzermans, Jan N M, Buis, Carlijn I, Klaase, Joost M, de Jong, Koert P, and de Meijer, Vincent E more...
- Abstract
Hepatocellular adenomas (HCAs) are benign liver tumors associated with bleeding or malignant transformation. Data on the indication for surgery are scarce. We analyzed indications and outcome of patients operated for HCAs < 50 mm compared to HCAs ≥ 50 mm. Changes in final postoperative diagnosis were assessed. We performed a retrospective study that included patients who underwent resection for (suspected) HCAs in the Netherlands from 2014 to 2019. Indication for resection was analyzed and stratified for small (<50 mm) and large (≥50 mm) tumors. Logistic regression analysis was performed on factors influencing change in tumor diagnosis. Out of 222 patients who underwent surgery, 44 (20%) patients had a tumor <50 mm. Median age was 46 (interquartile range [IQR], 33-56) years in patients with small tumors and 37 (IQR, 31-46) years in patients with large tumors (p = 0.016). Patients with small tumors were more frequently men (21% vs. 5%, p = 0.002). Main indications for resection in patients with small tumors were suspicion of (pre)malignancy (55%), (previous) bleeding (14%), and male sex (11%). Patients with large tumors received operations because of tumor size >50 mm (52%), suspicion of (pre)malignancy (28%), and (previous) bleeding (5.1%). No difference was observed in HCA-subtype distribution between small and large tumors. Ninety-six (43%) patients had a postoperative change in diagnosis. Independent risk factors for change in diagnosis were tumor size <50 mm (adjusted odds ratio [aOR], 3.4; p < 0.01), male sex (aOR, 3.7; p = 0.03), and lack of hepatobiliary contrast-enhanced magnetic resonance imaging (CE-MRI) (aOR, 1.8; p = 0.04). Resection for small (suspected) HCAs was mainly indicated by suspicion of (pre)malignancy, whereas for large (suspected) HCAs, tumor size was the most prevalent indication. Male sex, tumor size <50 mm, and lack of hepatobiliary CE-MRI were independent risk factors for postoperative change in tumor diagnosis. more...
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- 2023
24. ASO Visual Abstract: Intersurgeon Variability in Local Treatment Planning for Patients with Initially Unresectable Colorectal Cancer Liver Metastases-Analysis of the Liver Expert Panel of the Dutch Colorectal Cancer Group
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Epi Kanker Team B, Cancer, MS CGO, Epi Kanker, JC onderzoeksprogramma Kanker, Bond, Marinde J G, Kuiper, Babette I, Bolhuis, Karen, Komurcu, Aysun, van Amerongen, Martinus J, Chapelle, Thiery, Dejong, Cornelis H C, Engelbrecht, Marc R W, Gerhards, Michael F, Grünhagen, Dirk J, van Gulik, Thomas, Hermans, John J, de Jong, Koert P, Klaase, Joost M, Kok, Niels F M, Leclercq, Wouter K G, Liem, Mike S L, van Lienden, Krijn P, Quintus Molenaar, I, Neumann, Ulf P, Patijn, Gijs A, Rijken, Arjen M, Ruers, Theo M, Verhoef, Cornelis, de Wilt, Johannes H W, Kazemier, Geert, May, Anne M, Punt, Cornelis J A, Swijnenburg, Rutger-Jan, Epi Kanker Team B, Cancer, MS CGO, Epi Kanker, JC onderzoeksprogramma Kanker, Bond, Marinde J G, Kuiper, Babette I, Bolhuis, Karen, Komurcu, Aysun, van Amerongen, Martinus J, Chapelle, Thiery, Dejong, Cornelis H C, Engelbrecht, Marc R W, Gerhards, Michael F, Grünhagen, Dirk J, van Gulik, Thomas, Hermans, John J, de Jong, Koert P, Klaase, Joost M, Kok, Niels F M, Leclercq, Wouter K G, Liem, Mike S L, van Lienden, Krijn P, Quintus Molenaar, I, Neumann, Ulf P, Patijn, Gijs A, Rijken, Arjen M, Ruers, Theo M, Verhoef, Cornelis, de Wilt, Johannes H W, Kazemier, Geert, May, Anne M, Punt, Cornelis J A, and Swijnenburg, Rutger-Jan more...
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- 2023
25. Intersurgeon Variability in Local Treatment Planning for Patients with Initially Unresectable Colorectal Cancer Liver Metastases: Analysis of the Liver Expert Panel of the Dutch Colorectal Cancer Group
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Epi Kanker Team B, Cancer, MS CGO, Epi Kanker, JC onderzoeksprogramma Kanker, Bond, Marinde J G, Kuiper, Babette I, Bolhuis, Karen, Komurcu, Aysun, van Amerongen, Martinus J, Chapelle, Thiery, Dejong, Cornelis H C, Engelbrecht, Marc R W, Gerhards, Michael F, Grünhagen, Dirk J, van Gulik, Thomas, Hermans, John J, de Jong, Koert P, Klaase, Joost M, Kok, Niels F M, Leclercq, Wouter K G, Liem, Mike S L, van Lienden, Krijn P, Molenaar, I Quintus, Neumann, Ulf P, Patijn, Gijs A, Rijken, Arjen M, Ruers, Theo M, Verhoef, Cornelis, de Wilt, Johannes H W, Kazemier, Geert, May, Anne M, Punt, Cornelis J A, Swijnenburg, Rutger-Jan, Epi Kanker Team B, Cancer, MS CGO, Epi Kanker, JC onderzoeksprogramma Kanker, Bond, Marinde J G, Kuiper, Babette I, Bolhuis, Karen, Komurcu, Aysun, van Amerongen, Martinus J, Chapelle, Thiery, Dejong, Cornelis H C, Engelbrecht, Marc R W, Gerhards, Michael F, Grünhagen, Dirk J, van Gulik, Thomas, Hermans, John J, de Jong, Koert P, Klaase, Joost M, Kok, Niels F M, Leclercq, Wouter K G, Liem, Mike S L, van Lienden, Krijn P, Molenaar, I Quintus, Neumann, Ulf P, Patijn, Gijs A, Rijken, Arjen M, Ruers, Theo M, Verhoef, Cornelis, de Wilt, Johannes H W, Kazemier, Geert, May, Anne M, Punt, Cornelis J A, and Swijnenburg, Rutger-Jan more...
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- 2023
26. Early Recurrence After Resection of Locally Advanced Pancreatic Cancer Following Induction Therapy: An International Multicenter Study
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Cancer, MS CGO, Regenerative Medicine and Stem Cells, MS HOD, Seelen, Leonard W F, Floortje van Oosten, A, Brada, Lilly J H, Groot, Vincent P, Daamen, Lois A, Walma, Marieke S, van der Lek, Bastiaan F, Liem, Mike S L, Patijn, Gijs A, Stommel, Martijn W J, van Dam, Ronald M, Koerkamp, Bas Groot, Busch, Olivier R, de Hingh, Ignace H J T, van Eijck, Casper H J, Besselink, Marc G, Burkhart, Richard A, Borel Rinkes, Inne H M, Wolfgang, Christopher L, Molenaar, I Quintus, He, Jin, van Santvoort, Hjalmar C, Cancer, MS CGO, Regenerative Medicine and Stem Cells, MS HOD, Seelen, Leonard W F, Floortje van Oosten, A, Brada, Lilly J H, Groot, Vincent P, Daamen, Lois A, Walma, Marieke S, van der Lek, Bastiaan F, Liem, Mike S L, Patijn, Gijs A, Stommel, Martijn W J, van Dam, Ronald M, Koerkamp, Bas Groot, Busch, Olivier R, de Hingh, Ignace H J T, van Eijck, Casper H J, Besselink, Marc G, Burkhart, Richard A, Borel Rinkes, Inne H M, Wolfgang, Christopher L, Molenaar, I Quintus, He, Jin, and van Santvoort, Hjalmar C more...
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- 2023
27. Risk Models for Developing Pancreatic Fistula After Pancreatoduodenectomy: Validation in a Nationwide Prospective Cohort.
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Schouten, Thijs J., Henry, Anne Claire, Smits, Francina J., Besselink, Marc G., Bonsing, Bert A., Bosscha, Koop, Busch, Olivier R., van Dam, Ronald M., van Eijck, Casper H., Festen, Sebastiaan, Koerkamp, Bas Groot, van der Harst, Erwin, de Hingh, Ignace H. J. T., Kazemier, Geert, Liem, Mike S. L., de Meijer, Vincent E., Patijn, Gijs A., Roos, Daphne, Schreinemakers, Jennifer M. J., and Stommel, Martijn W. J. more...
- Abstract
Objective: To evaluate the performance of published fistula risk models by external validation, and to identify independent risk factors for postoperative pancreatic fistula (POPF). Background: Multiple risk models have been developed to predict POPF after pancreatoduodenectomy. External validation in high-quality prospective cohorts is, however, lacking or only performed for individual models. Methods: A post hoc analysis of data from the stepped-wedge cluster cluster-randomized Care After Pancreatic Resection According to an Algorithm for Early Detection and Minimally Invasive Management of Pancreatic Fistula versus Current Practice (PORSCH) trial was performed. Included were all patients undergoing pancreatoduodenectomy in the Netherlands (January 2018--November 2019). Risk models on POPF were identified by a systematic literature search. Model performance was evaluated by calculating the area under the receiver operating curves (AUC) and calibration plots. Multivariable logistic regression was performed to identify independent risk factors associated with clinically relevant POPF. Results: Overall, 1358 patients undergoing pancreatoduodenectomy were included, of whom 341 patients (25%) developed clinically relevant POPF. Fourteen risk models for POPF were evaluated, with AUCs ranging from 0.62 to 0.70. The updated alternative fistula risk score had an AUC of 0.70 (95% confidence intervals [CI]: 0.69--0.72). The alternative fistula risk score demonstrated an AUC of 0.70 (95% CI: 0.689--0.71), whilst an AUC of 0.70 (95% CI: 0.699--0.71) was also found for the model by Petrova and colleagues. Soft pancreatic texture, pathology other than pancreatic ductal adenocarcinoma or chronic pancreatitis, small pancreatic duct diameter, higher body mass index, minimally invasive resection and male sex were identified as independent predictors of POPF. Conclusion: Published risk models predicting clinically relevant POPF after pancreatoduodenectomy have a moderate predictive accuracy. Their clinical applicability to identify high-risk patients and guide treatment strategies is therefore questionable. [ABSTRACT FROM AUTHOR] more...
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- 2023
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28. ASO Visual Abstract: Intersurgeon Variability in Local Treatment Planning for Patients with Initially Unresectable Colorectal Cancer Liver Metastases—Analysis of the Liver Expert Panel of the Dutch Colorectal Cancer Group
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Bond, Marinde J. G., primary, Kuiper, Babette I., additional, Bolhuis, Karen, additional, Komurcu, Aysun, additional, van Amerongen, Martinus J., additional, Chapelle, Thiery, additional, Dejong, Cornelis H. C., additional, Engelbrecht, Marc R. W., additional, Gerhards, Michael F., additional, Grünhagen, Dirk J., additional, van Gulik, Thomas, additional, Hermans, John J., additional, de Jong, Koert P., additional, Klaase, Joost M., additional, Kok, Niels F. M., additional, Leclercq, Wouter K. G., additional, Liem, Mike S. L., additional, van Lienden, Krijn P., additional, Quintus Molenaar, I., additional, Neumann, Ulf P., additional, Patijn, Gijs A., additional, Rijken, Arjen M., additional, Ruers, Theo M., additional, Verhoef, Cornelis, additional, de Wilt, Johannes H. W., additional, Kazemier, Geert, additional, May, Anne M., additional, Punt, Cornelis J. A., additional, and Swijnenburg, Rutger-Jan, additional more...
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- 2023
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29. Impact of complications after resection of pancreatic cancer on disease recurrence and survival, and mediation effect of adjuvant chemotherapy: nationwide, observational cohort study
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Henry, Anne Claire, primary, van Dongen, Jelle C, additional, van Goor, Iris W J M, additional, Smits, F Jasmijn, additional, Nagelhout, Anne, additional, Besselink, Marc G, additional, Busch, Olivier R, additional, Bonsing, Bert A, additional, Bosscha, Koop, additional, van Dam, Ronald M, additional, Festen, Sebastiaan, additional, Groot Koerkamp, Bas, additional, van der Harst, Erwin, additional, de Hingh, Ignace H, additional, van der Kolk, Marion, additional, Liem, Mike S L, additional, de Meijer, Vincent E, additional, Patijn, Gijs A, additional, Roos, Daphne, additional, Schreinemakers, Jennifer M, additional, Wit, Fennie, additional, Daamen, Lois A, additional, van Santvoort, Hjalmar C, additional, Molenaar, I Quintus, additional, and van Eijck, Casper H J, additional more...
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- 2023
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30. Fistula Risk Score for Auditing Pancreatoduodenectomy: The Auditing FRS
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van Dongen, Jelle C, van Dam, Jacob L, Besselink, Marc G, Bonsing, Bert A, Bosscha, Koop, Busch, Olivier R, van Dam, Ronald M, Festen, Sebastiaan, van der Harst, Erwin, de Hingh, Ignace H, Kazemier, Geert, Liem, Mike S L, de Meijer, Vincent E, Mieog, J Sven D, Molenaar, I Q, Patijn, Gijs A, van Santvoort, Hjalmar C, Wijsman, Jan H, Stommel, Martijn W J, Wit, Fennie, De Wilde, Roeland F, van Eijck, Casper H J, Groot Koerkamp, Bas, Surgery, MUMC+: MA Heelkunde (9), RS: NUTRIM - R2 - Liver and digestive health, and RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy more...
- Subjects
SDG 3 - Good Health and Well-being - Abstract
OBJECTIVE: To develop a fistula risk score for auditing, to be able to compare postoperative pancreatic fistula (POPF) after pancreatoduodenectomy among hospitals. BACKGROUND: For proper comparisons of outcomes in surgical audits, case-mix variation should be accounted for. METHODS: This study included consecutive patients after pancreatoduodenectomy from the mandatory nationwide Dutch Pancreatic Cancer Audit. Derivation of the score was performed with the data from 2014 to 2018 and validation with 2019 to 2020 data. The primary endpoint of the study was POPF (grade B or C). Multivariable logistic regression analysis was performed for case-mix adjustment of known risk factors. RESULTS: In the derivation cohort, 3271 patients were included, of whom 479 (14.6%) developed POPF. Male sex [odds ratio (OR)=1.34; 95% confidence interval (CI): 1.09-1.66], higher body mass index (OR=1.07; 95% CI: 1.05-1.10), a final diagnosis other than pancreatic ductal adenocarcinoma/pancreatitis (OR=2.41; 95% CI: 1.90-3.06), and a smaller duct diameter (OR=1.43/mm decrease; 95% CI: 1.32-1.55) were independently associated with POPF. Diabetes mellitus (OR=0.73; 95% CI: 0.55-0.98) was independently associated with a decreased risk of POPF. Model discrimination was good with a C-statistic of 0.73 in the derivation cohort and 0.75 in the validation cohort (n=913). Hospitals differed in particular in the proportion of pancreatic ductal adenocarcinoma/pancreatitis patients, ranging from 36.0% to 58.1%. The observed POPF risk per center ranged from 2.9% to 25.4%. The expected POPF rate based on the 5 risk factors ranged from 11.6% to 18.0% among hospitals. CONCLUSIONS: The auditing fistula risk score was successful in case-mix adjustment and enables fair comparisons of POPF rates among hospitals. more...
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- 2022
31. Pancreatectomy with arterial resection for periampullary cancer: outcomes after planned or unplanned events in a nationwide, multicentre cohort.
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Stoop, Thomas F., Mackay, Tara M., Brada, Lilly J. H., van der Harst, Erwin, Daams, Freek, van 't Land, Freek R., Kazemier, Geert, Patijn, Gijs A., van Santvoort, Hjalmar C., de Hingh, Ignace H., Bosscha, Koop, Seelen, Leonard W. F., Nijkamp, Maarten W., Stommel, Martijn W. J., Liem, Mike S. L., Busch, Olivier R., Coene, Peter-Paul L. O., van Dam, Ronald M., de Wilde, Roeland F., and Mieog, J. Sven D. more...
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ONCOLOGIC surgery ,CANCER prognosis ,PANCREATECTOMY - Published
- 2023
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32. Improved preoperative aerobic fitness following a home-based bimodal prehabilitation programme in high-risk patients scheduled for liver or pancreatic resection
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van Wijk, Laura, primary, Bongers, Bart C, additional, Berkel, Annefleur E M, additional, Buis, Carlijn I, additional, Reudink, Muriël, additional, Liem, Mike S L, additional, Slooter, Gerrit D, additional, van Meeteren, Nico L U, additional, and Klaase, Joost M, additional more...
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- 2022
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33. Interobserver Variability in CT-based Morphologic Tumor Response Assessment of Colorectal Liver Metastases
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Wesdorp, Nina J, Kemna, Ruby, Bolhuis, Karen, van Waesberghe, Jan H T M, Nota, Irene M G C, Struik, Femke, Oulad Abdennabi, Ikrame, Phoa, Saffire S K S, van Dieren, Susan, van Amerongen, Martinus J, Chapelle, Thiery, Dejong, Cornelis H C, Engelbrecht, Marc R W, Gerhards, Michael F, Grünhagen, Dirk, van Gulik, Thomas M, Hermans, John J, de Jong, Koert P, Klaase, Joost M, Liem, Mike S L, van Lienden, Krijn P, Molenaar, I Quintus, Patijn, Gijs A, Rijken, Arjen M, Ruers, Theo M, Verhoef, Cornelis, de Wilt, Johannes H W, Swijnenburg, Rutger-Jan, Punt, Cornelis J A, Huiskens, Joost, Stoker, Jaap, Kazemier, Geert, Surgery, MUMC+: MA Heelkunde (9), RS: NUTRIM - R2 - Liver and digestive health, Internal medicine, Radiology and nuclear medicine, AGEM - Re-generation and cancer of the digestive system, VU University medical center, CCA - Imaging and biomarkers, Radiology & Nuclear Medicine, Graduate School, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Radiology and Nuclear Medicine, AGEM - Digestive immunity, APH - Methodology, Oncology, Groningen Institute for Organ Transplantation (GIOT), Guided Treatment in Optimal Selected Cancer Patients (GUTS), and Value, Affordability and Sustainability (VALUE) more...
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Colorectal Neoplasms/diagnostic imaging ,Male ,Tumor Response ,Abdomen/Gastrointestinal ,Tomography, X-Ray Computed/methods ,Observer Performance ,Metastases ,Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14] ,Liver Neoplasms/diagnostic imaging ,Humans ,Prospective Studies ,Tomography ,Original Research ,Computer. Automation ,Observer Variation ,Liver Neoplasms ,General Medicine ,Middle Aged ,X-Ray Computed/methods ,Liver ,Oncology ,Female ,Human medicine ,Colorectal Neoplasms ,Tomography, X-Ray Computed ,Rare cancers Radboud Institute for Health Sciences [Radboudumc 9] ,CT - Abstract
Item does not contain fulltext Purpose To evaluate interobserver variability in the morphologic tumor response assessment of colorectal liver metastases (CRLM) managed with systemic therapy and to assess the relation of morphologic response with gene mutation status, targeted therapy, and Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 measurements. Materials and Methods Participants with initially unresectable CRLM receiving different systemic therapy regimens from the randomized, controlled CAIRO5 trial (NCT02162563) were included in this prospective imaging study. Three radiologists independently assessed morphologic tumor response on baseline and first follow-up CT scans according to previously published criteria. Two additional radiologists evaluated disagreement cases. Interobserver agreement was calculated by using Fleiss κ. On the basis of the majority of individual radiologic assessments, the final morphologic tumor response was determined. Finally, the relation of morphologic tumor response and clinical prognostic parameters was assessed. Results In total, 153 participants (median age, 63 years [IQR, 56-71]; 101 men) with 306 CT scans comprising 2192 CRLM were included. Morphologic assessment performed by the three radiologists yielded 86 (56%) agreement cases and 67 (44%) disagreement cases (including four major disagreement cases). Overall interobserver agreement between the panel radiologists on morphology groups and morphologic response categories was moderate (κ = 0.53, 95% CI: 0.48, 0.58 and κ = 0.54, 95% CI: 0.47, 0.60). Optimal morphologic response was particularly observed in patients treated with bevacizumab (P = .001) and in patients with RAS/BRAF mutation (P = .04). No evidence of a relationship between RECIST 1.1 and morphologic response was found (P = .61). Conclusion Morphologic tumor response assessment following systemic therapy in participants with CRLM demonstrated considerable interobserver variability. Keywords: Tumor Response, Observer Performance, CT, Liver, Metastases, Oncology, Abdomen/Gastrointestinal Clinical trial registration no. NCT02162563 Supplemental material is available for this article. © RSNA, 2022. more...
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- 2022
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34. Defining Textbook Outcome in liver surgery and assessment of hospital variation:A nationwide population-based study
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de Graaff, Michelle R, Elfrink, Arthur K E, Buis, Carlijn I, Swijnenburg, Rutger-Jan, Erdmann, Joris I, Kazemier, Geert, Verhoef, Cornelis, Mieog, J Sven D, Derksen, Wouter J M, van den Boezem, Peter B, Ayez, Ninos, Liem, Mike S L, Leclercq, Wouter K G, Kuhlmann, Koert F D, Marsman, Hendrik A, van Duijvendijk, Peter, Kok, Niels F M, Klaase, Joost M, Dejong, Cornelis H C, Grünhagen, Dirk J, den Dulk, Marcel, de Graaff, Michelle R, Elfrink, Arthur K E, Buis, Carlijn I, Swijnenburg, Rutger-Jan, Erdmann, Joris I, Kazemier, Geert, Verhoef, Cornelis, Mieog, J Sven D, Derksen, Wouter J M, van den Boezem, Peter B, Ayez, Ninos, Liem, Mike S L, Leclercq, Wouter K G, Kuhlmann, Koert F D, Marsman, Hendrik A, van Duijvendijk, Peter, Kok, Niels F M, Klaase, Joost M, Dejong, Cornelis H C, Grünhagen, Dirk J, and den Dulk, Marcel more...
- Abstract
Introduction: Textbook outcome (TO) is a composite outcome measure covering the surgical care process in a single outcome measure. TO has an advantage over single outcome parameters with low event rates, which have less discriminating impact to detect differences between hospitals. This study aimed to assess factors associated with TO, and evaluate hospital and network variation after case-mix correction in TO rates for liver surgery. Methods: This was a population-based retrospective study of all patients who underwent liver resection for malignancy in the Netherlands in 2019 and 2020. TO was defined as absence of severe postoperative complications, mortality, prolonged length of hospital stay, and readmission, and obtaining adequate resection margins. Multivariable logistic regression was used for case-mix adjustment. Results: 2376 patients were included. TO was accomplished in 1380 (80%) patients with colorectal liver metastases, in 192 (76%) patients with other liver metastases, in 183 (74%) patients with hepatocellular carcinoma and 86 (51%) patients with biliary cancers. Factors associated with lower TO rates for CRLM included ASA score ≥3 (aOR 0.70, CI 0.51–0.95 p = 0.02), extrahepatic disease (aOR 0.64, CI 0.44–0.95, p = 0.02), tumour size >55 mm on preoperative imaging (aOR 0.56, CI 0.34–0.94, p = 0.02), Charlson Comorbidity Index ≥2 (aOR 0.73, CI 0.54–0.98, p = 0.04), and major liver resection (aOR 0.50, CI 0.36–0.69, p < 0.001). After case-mix correction, no significant hospital or oncological network variation was observed. Conclusion: TO differs between indications for liver resection and can be used to assess between hospital and network differences. more...
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- 2022
35. Practice variation and outcomes of minimally invasive minorliver resections in patients with colorectal liver metastases: a population-based study
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de Graaff, Michelle R., Klaase, Joost M., de Kleine, Ruben, Elfrink, Arthur K. E., Swijnenburg, Rutger-Jan, M. Zonderhuis, Babs, D. Mieog, J. Sven, Derksen, Wouter J. M., Hagendoorn, Jeroen, van den Boezem, Peter B., Rijken, Arjen M., Gobardhan, Paul D., Marsman, Hendrik A., Liem, Mike S. L., Leclercq, Wouter K. G., van Heek, Tjarda N. T., Pantijn, Gijs A., Bosscha, Koop, Belt, Eric J. T., Vermaas, Maarten, Torrenga, Hans, Manusama, Eric R., van den Tol, Petrousjka, Oosterling, Steven J., den Dulk, Marcel, Grünhagen, Dirk J., and Kok, Niels F. M. more...
- Abstract
Introduction: In 2017, the Southampton guideline stated that minimally invasive liver resections (MILR) should considered standard practice for minor liver resections. This study aimed to assess recent implementation rates of minor MILR, factors associated with performing MILR, hospital variation, and outcomes in patients with colorectal liver metastases (CRLM). Methods: This population-based study included all patients who underwent minor liver resection for CRLM in the Netherlands between 2014 and 2021. Factors associated with MILR and nationwide hospital variation were assessed using multilevel multivariable logistic regression. Propensity-score matching (PSM) was applied to compare outcomes between minor MILR and minor open liver resections. Overall survival (OS) was assessed with Kaplan–Meier analysis on patients operated until 2018. Results: Of 4,488 patients included, 1,695 (37.8%) underwent MILR. PSM resulted in 1,338 patients in each group. Implementation of MILR increased to 51.2% in 2021. Factors associated with not performing MILR included treatment with preoperative chemotherapy (aOR 0.61 CI:0.50–0.75, p< 0.001), treatment in a tertiary referral hospital (aOR 0.57 CI:0.50–0.67, p< 0.001), and larger diameter and number of CRLM. Significant hospital variation was observed in use of MILR (7.5% to 93.0%). After case-mix correction, six hospitals performed fewer, and six hospitals performed more MILRs than expected. In the PSM cohort, MILR was associated with a decrease in blood loss (aOR 0.99 CI:0.99–0.99, p< 0.01), cardiac complications (aOR 0.29, CI:0.10–0.70, p= 0.009), IC admissions (aOR 0.66, CI:0.50–0.89, p= 0.005), and shorter hospital stay (aOR CI:0.94–0.99, p< 0.01). Five-year OS rates for MILR and OLR were 53.7% versus 48.6%, p= 0.21. Conclusion: Although uptake of MILR is increasing in the Netherlands, significant hospital variation remains. MILR benefits short-term outcomes, while overall survival is comparable to open liver surgery. Graphical abstract:
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- 2023
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36. Implementation and first results of a mandatory, nationwide audit on liver surgery
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van der Werf, Leonie R., Kok, Niels F. M., Buis, Carlijn I., Grünhagen, Dirk J., Hoogwater, Frederik J. H., Swijnenburg, Rutger Jan, Dulk, Marcel den, Dejong, Kees C. H. C., Klaase, Joost M., de Boer, Marieke T., Besselink, Marc G. H., van Gullik, Thomas M., Hagendoorn, Jeroen, van Hillegersberg, Richard, Liem, Mike S. L., Molenaar, I. Quintus, Patijn, Gijs A., Porte, Robert J., te Riele, Wouter W., van Santvoort, Hjalmar C., Verhoef, Kees, Burgmans, Marc C., van Delden, Otto M., van der Leij, Christiaan, Meijerink, Martijn R., Moelker, Adriaan, Prevoo, Warner, Surgery, AGEM - Digestive immunity, AGEM - Re-generation and cancer of the digestive system, CCA - Cancer Treatment and Quality of Life, Radiology and Nuclear Medicine, ACS - Amsterdam Cardiovascular Sciences, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Other Research, MUMC+: MA Heelkunde (9), RS: NUTRIM - R2 - Liver and digestive health, RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, CCA - Cancer Treatment and quality of life, Radiology and nuclear medicine, Groningen Institute for Organ Transplantation (GIOT), and Value, Affordability and Sustainability (VALUE) more...
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Male ,Liver surgery ,medicine.medical_specialty ,RESECTION ,ENHANCED RECOVERY ,MEDLINE ,Audit ,030230 surgery ,Liver resections ,MORBIDITY ,03 medical and health sciences ,0302 clinical medicine ,Interquartile range ,Hepatectomy ,Humans ,Medicine ,Registries ,Neoplasm Metastasis ,Aged ,Netherlands ,Quality Indicators, Health Care ,Retrospective Studies ,Clinical Audit ,Hepatology ,business.industry ,General surgery ,Liver Neoplasms ,Gastroenterology ,Outcome measures ,Retrospective cohort study ,CHEMOTHERAPY ,Middle Aged ,CANCER ,METASTASES ,Population Surveillance ,030220 oncology & carcinogenesis ,Female ,Colorectal Neoplasms ,business ,Complication ,Follow-Up Studies - Abstract
Background: The Dutch Hepato Biliary Audit (DHBA) was initiated in 2013 to assess the national quality of liver surgery. This study aimed to describe the initiation and implementation of this audit along with an overview of the results and future perspectives.Methods: Registry of patients undergoing liver surgery for all primary and secondary liver tumors in the DHBA is mandatory. Weekly, benchmarked information on process and outcome measures is reported to surgical teams. In this study, the first results of patients with colorectal liver metastases were presented, including results of data verification.Results: Between 2014 and 2017, 6241 procedures were registered, including 4261 (68%) resections for colorectal liver metastases. For minor- and major liver resections for colorectal liver metastases, the median [interquartile range] hospital stay was 6 [4-8] and 8 [6-12] days, respectively. A postoperative complicated course (complication leading to >14 days of hospital stay, reintervention or death) occurred in 26% and 43% and the 30-day/in-hospital mortality was 1% and 4%, respectively. The completeness of data was 97%. In 3.6% of patients, a complicated postoperative course was erroneously omitted.Conclusion: Nationwide implementation of the DHBA has been successful. This was the first step in creating a complete evaluation of the quality of liver surgery. more...
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- 2019
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37. Survival Benefit Associated With Resection of Locally Advanced Pancreatic Cancer After Upfront FOLFIRINOX Versus FOLFIRINOX Only
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Brada, Lilly J. H., primary, Daamen, Lois A., additional, Magermans, Lisa G., additional, Walma, Marieke S., additional, Latifi, Diba, additional, van Dam, Ronald M., additional, de Hingh, Ignace H., additional, Liem, Mike S. L., additional, de Meijer, Vincent E., additional, Patijn, Gijs A., additional, Festen, Sebastiaan, additional, Stommel, Martijn W. J., additional, Bosscha, Koop, additional, Polée, Marco B., additional, Nio, Yung C., additional, Wessels, Frank J., additional, de Vries, Jan J. J., additional, van Lienden, Krijn P., additional, Bruijnen, Rutger C., additional, Busch, Olivier R., additional, Koerkamp, Bas Groot, additional, van Eijck, Casper, additional, Molenaar, Quintus I., additional, Wilmink, Hanneke J. W., additional, van Santvoort, Hjalmar C., additional, and Besselink, Marc G., additional more...
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- 2021
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38. Hospital variation in combined liver resection and thermal ablation for colorectal liver metastases and impact on short-term postoperative outcomes:a nationwide population-based study
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Elfrink, Arthur K E, Nieuwenhuizen, Sanne, van den Tol, M Petrousjka, Burgmans, Mark C, Prevoo, Warner, Coolsen, Marielle M E, van den Boezem, Peter B, van Delden, Otto M, Hagendoorn, Jeroen, Patijn, Gijs A, Leclercq, Wouter K G, Liem, Mike S L, Rijken, Arjen M, Verhoef, Cornelis, Kuhlmann, Koert F D, Ruiter, Simeon J S, Grünhagen, Dirk J, Klaase, Joost M, Kok, Niels F M, Meijerink, Martijn R, Swijnenburg, Rutger-Jan, Elfrink, Arthur K E, Nieuwenhuizen, Sanne, van den Tol, M Petrousjka, Burgmans, Mark C, Prevoo, Warner, Coolsen, Marielle M E, van den Boezem, Peter B, van Delden, Otto M, Hagendoorn, Jeroen, Patijn, Gijs A, Leclercq, Wouter K G, Liem, Mike S L, Rijken, Arjen M, Verhoef, Cornelis, Kuhlmann, Koert F D, Ruiter, Simeon J S, Grünhagen, Dirk J, Klaase, Joost M, Kok, Niels F M, Meijerink, Martijn R, and Swijnenburg, Rutger-Jan more...
- Abstract
BACKGROUND: Combining resection and thermal ablation can improve short-term postoperative outcomes in patients with colorectal liver metastases (CRLM). This study assessed nationwide hospital variation and short-term postoperative outcomes after combined resection and ablation.METHODS: In this population-based study, all CRLM patients who underwent resection in the Netherlands between 2014 and 2018 were included. After propensity score matching for age, ASA-score, Charlson-score, diameter of largest CRLM, number of CRLM and earlier resection, postoperative outcomes were compared. Postoperative complicated course (PCC) was defined as discharge after 14 days or a major complication or death within 30 days of surgery.RESULTS: Of 4639 included patients, 3697 (80%) underwent resection and 942 (20%) resection and ablation. Unadjusted percentage of patients who underwent resection and ablation per hospital ranged between 4 and 44%. Hospital variation persisted after case-mix correction. After matching, 734 patients remained in each group. Hospital stay (median 6 vs. 7 days, p = 0.011), PCC (11% vs. 14.7%, p = 0.043) and 30-day mortality (0.7% vs. 2.3%, p = 0.018) were lower in the resection and ablation group. Differences faded in multivariable logistic regression due to inclusion of major hepatectomy.CONCLUSION: Significant hospital variation was observed in the Netherlands. Short-term postoperative outcomes were better after combined resection and ablation, attributed to avoiding complications associated with major hepatectomy. more...
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- 2021
39. Study protocol of a single-arm pre-post study to assess the preliminary effectiveness and feasibility of a home-based bimodal prehabilitation program on preoperative aerobic fitness in high-risk patients scheduled for liver or pancreatic resection
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Berkel, Annefleur E. M., primary, Wijk, Laura Van, additional, Bongers, Bart C., additional, Palen, Job Van Der, additional, Buis, Carlijn I., additional, Reudink, Muriel, additional, Liem, Mike S. L., additional, Slooter, Gerrit D., additional, Van Meeteren, Nico L. U., additional, and Klaase, Joost M., additional more...
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- 2020
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40. Textbook Outcome Nationwide Analysis of a Novel Quality Measure in Pancreatic Surgery
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MS CGO, Cancer, van Roessel, Stun, Mackay, Tara M., van Dieren, Susan, van der Schelling, George P., Nieuwenhutjs, Vincent B., Bosscha, Koop, van der Harst, Edwin, van Dam, Ronald M., Liem, Mike S. L., Festen, Sebastiaan, Stommel, Martijn W. J., Roos, Daphne, Wit, Fennie, Molenaar, I. Quintus, de Meijer, Vincent E., Kazemier, Geert, de Hingh, Ignace H. J. T., van Santvoort, Hjalmar C., Bonsing, Bert A., Busch, Olivier R., Koerkamp, Bas Groot, Besselink, Marc G., MS CGO, Cancer, van Roessel, Stun, Mackay, Tara M., van Dieren, Susan, van der Schelling, George P., Nieuwenhutjs, Vincent B., Bosscha, Koop, van der Harst, Edwin, van Dam, Ronald M., Liem, Mike S. L., Festen, Sebastiaan, Stommel, Martijn W. J., Roos, Daphne, Wit, Fennie, Molenaar, I. Quintus, de Meijer, Vincent E., Kazemier, Geert, de Hingh, Ignace H. J. T., van Santvoort, Hjalmar C., Bonsing, Bert A., Busch, Olivier R., Koerkamp, Bas Groot, and Besselink, Marc G. more...
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- 2020
41. Magnetic resonance imaging of Achilles tendon xanthomas in familial hypercholesterolemia
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Liem, Mike S. L., Leuven, Jan A. Gevers, Bloem, Johan L., and Schipper, Jaap
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- 1992
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42. Textbook Outcome
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van Roessel, Stijn, primary, Mackay, Tara M., additional, van Dieren, Susan, additional, van der Schelling, George P., additional, Nieuwenhuijs, Vincent B., additional, Bosscha, Koop, additional, van der Harst, Edwin, additional, van Dam, Ronald M., additional, Liem, Mike S. L., additional, Festen, Sebastiaan, additional, Stommel, Martijn W. J., additional, Roos, Daphne, additional, Wit, Fennie, additional, Molenaar, I. Quintus, additional, de Meijer, Vincent E., additional, Kazemier, Geert, additional, de Hingh, Ignace H. J. T., additional, van Santvoort, Hjalmar C., additional, Bonsing, Bert A., additional, Busch, Olivier R., additional, Groot Koerkamp, Bas, additional, and Besselink, Marc G., additional more...
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- 2020
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43. Does Hypercarbia Develop Faster During Laparoscopic Herniorrhaphy Than During Laparoscopic Cholecystectomy? Assessment with Continuous Blood Gas Monitoring
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Liem, Mike S. L., Kallewaard, Jan-Willem, de Smet, Anne Marie G. A., and van Vroonhoven, Theo J. M. V.
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- 1995
44. Base Deficit-Based Predictive Modeling of Outcome in Trauma Patients Admitted to Intensive Care Units in Dutch Trauma Centers
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Kroezen, Frank, primary, Bijlsma, Taco S., additional, Liem, Mike S. L., additional, Meeuwis, J Dik, additional, and Leenen, Luke P. H., additional
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- 2007
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45. Recurrences After Conventional Anterior and Laparoscopic Inguinal Hernia Repair
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Liem, Mike S. L., primary, van Duyn, Eino B., additional, van der Graaf, Yolanda, additional, and van Vroonhoven, Theo J. M. V., additional
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- 2003
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46. Cost-Effectiveness of Extraperitoneal Laparoscopic Inguinal Hernia Repair: A Randomized Comparison With Conventional Herniorrhaphy
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Liem, Mike S. L., primary, Halsema, Joanna A. M., additional, van der Graaf, Yolanda, additional, Schrijvers, Augustinus J. P., additional, and van Vroonhoven, Theo J. M. V., additional
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- 1997
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47. Does Hypercarbia Develop Faster During Laparoscopic Herniorrhaphy than During Laparoscopic Cholecystectomy? Assessment with Continuous Blood Gas Monitoring
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LIEM, MIKE S. L., primary, KALLEWAARD, JAN-WILLEM, additional, DE SMET, ANNE MARIE G. A., additional, and VAN VROONHOVEN, THEO J. M. V., additional
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- 1996
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48. Risk Factors for Inguinal Hernia in Women: A Case-Control Study.
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Liem, Mike S. L., van der Graaf, Yolanda, Zwart, Reinder C., Geurts, Ingrid, and van Vroonhoven, Theo J. M. V.
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INGUINAL hernia ,SMOKING ,NUTRITION disorders ,PREGNANCY ,APPENDECTOMY - Abstract
Potential risk factors for inguinal hernia in women were investigated and the relative importance of these factors was quantified. In women, symptomatic but nonpalpable hernias often remain undiagnosed. However, knowledge on this subject only concerns hernia and operation characteristics, which have been obtained by review of case series. Virtually nothing is known about risk factors for inguinal hernia. The authors performed a hospital-based case-control study of 89 female patients with an incident inguinal hernia and 176 agematched female controls. Activity since birth with two validated questionnaires was measured and smoking habits, medical and operation history, Quetelet index (kg/m2, and history of pregnancies and deliveries were recorded. Response for cases was 81% and for controls 73%. Total physical activity was not associated with inguinal hernia (univariate odds ratio (OR) = 0.8, 95% confidence interval (Cl) 0.6–1.1), but high present sports activities was associated with less inguinal hernia (multivariate OR = 0.2, 95% Cl 0.1–0.7). Obesity (Quetelet index >30) was also protective for inguinal hernia (OR = 0.2, 95% Cl 0.04–1.0). Independent risk factors were positive family history (OR – 4.3, 95% Cl 1.9–9.7) and obstipation (OR – 2.5, 95% Cl 1.0–6.7). In particular, smoking, appendectomy, other abdominal operations, and multiple deliveries were not associated with inguinal hernia in females. The protective effect of present sports activity may be explained by optimizing the resistance of the abdominal musculature protecting the relatively small inguinal weak spot in the female. The individual predisposition for inguinal hernia may be quantified by these risk factors, and, with this in mind, the authors advise that further evaluation might be needed for the patient with unexplained inguinal pain. [ABSTRACT FROM AUTHOR] more...
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- 1997
49. Risk factors and outcomes of conversions in robotic and laparoscopic liver resections: A nationwide analysis.
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Pilz da Cunha G, Sijberden JP, Gobardhan P, Lips DJ, Terkivatan T, Marsman HA, Patijn GA, Leclercq WKG, Bosscha K, Mieog JSD, van den Boezem PB, Vermaas M, Kok NFM, Belt EJT, de Boer MT, Derksen WJM, Torrenga H, Verheijen PM, Oosterling SJ, de Graaff MR, Rijken AM, Coolsen MME, Liem MSL, Tran TCK, Gerhards MF, Nieuwenhuijs V, van Dieren S, Abu Hilal M, Besselink MG, van Dam RM, Hagendoorn J, and Swijnenburg RJ more...
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- Humans, Female, Male, Middle Aged, Retrospective Studies, Aged, Risk Factors, Netherlands epidemiology, Postoperative Complications epidemiology, Postoperative Complications etiology, Length of Stay statistics & numerical data, Propensity Score, Blood Loss, Surgical statistics & numerical data, Treatment Outcome, Liver Diseases surgery, Hepatectomy methods, Hepatectomy adverse effects, Robotic Surgical Procedures adverse effects, Robotic Surgical Procedures statistics & numerical data, Laparoscopy adverse effects, Laparoscopy methods, Conversion to Open Surgery statistics & numerical data
- Abstract
Background: Unfavorable intraoperative findings or incidents during minimally invasive liver surgery may necessitate conversion to open surgery. This study aimed to identify predictors for conversion in minimally invasive liver surgery and gain insight into outcomes following conversions., Methods: This nationwide, retrospective cohort study compared converted and non-converted minimally invasive liver surgery procedures using data from 20 centers in the Dutch Hepatobiliary Audit (2014-2022). Propensity score matching was applied. Subgroup analyses of converted robotic liver resection versus laparoscopic liver resection and emergency versus non-emergency conversions were performed. Predictors for conversions were identified using backward stepwise multivariable logistic regression., Results: Of 3,530 patients undergoing minimally invasive liver surgery (792 robotic liver resection, 2,738 laparoscopic liver resection), 408 (11.6%) were converted (4.9% robotic liver resection, 13.5% laparoscopic liver resection). Conversion was associated with increased blood loss (580 mL [interquartile range 250-1,200] vs 200 mL [interquartile range 50-500], P < .001), major blood loss (≥500 mL, 58.8% vs 26.7%, P < .001), intensive care admission (19.0% vs 8.4%, P = .005), overall morbidity (38.9% vs 21.0%, P < .001), severe morbidity (17.9% vs 9.6%, P = .002), and a longer hospital stay (6 days [interquartile range 5-8] vs 4 days [interquartile range 2-5], P < .001) but not mortality (2.2% vs 1.2%, P = .387). Emergency conversions had increased intraoperative blood loss (1,500 mL [interquartile range 700-2,800] vs 525 mL [interquartile range 208-1,000], P < .001), major blood loss (87.5% vs 59.3%, P = .005), and intensive care admission (27.9% vs 10.6%, P = .029), compared with non-emergency conversions. Robotic liver resection was linked to lower conversion risk, whereas American Society of Anesthesiologists grade ≥3, larger lesion size, concurrent ablation, technically major, and anatomically major resections were risk factors., Conclusion: Both emergency and non-emergency conversions negatively impact perioperative outcomes in minimally invasive liver surgery. Robotic liver resection reduces conversion risk compared to laparoscopic liver resection., Competing Interests: Conflict of Interest/Disclosure RJS, MGB, DL, HAM, MFG, and JH are proctors for Intuitive Surgical (Intuitive Surgical Inc, Sunnyvale, CA, USA). MGB received grants from Medtronic, Ethicon, and Intuitive Surgical for investigator-initiated randomized trials. The other authors have no conflicts of interest or financial ties to disclose., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.) more...
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- 2025
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50. The use of indocyanine green fluorescence imaging in preventing postoperative bile leakage of the hepaticojejunostomy in robot-assisted pancreatic surgery.
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Gijsen AF, de Vries RPH, Vaassen HGM, Geelkerken RH, Liem MSL, and Lips DJ
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- Humans, Male, Female, Aged, Middle Aged, Retrospective Studies, Bile, Jejunostomy adverse effects, Treatment Outcome, Predictive Value of Tests, Coloring Agents, Aged, 80 and over, Indocyanine Green administration & dosage, Robotic Surgical Procedures adverse effects, Anastomotic Leak prevention & control, Anastomotic Leak etiology, Optical Imaging, Pancreaticoduodenectomy adverse effects
- Abstract
Background: Postoperative bile leakage (POBL) due to insufficiency of the hepaticojejunostomy (HJ) after pancreatico-duodenectomy (PD) is associated with high morbidity and mortality. The aim of this cohort study was to determine the clinical relevance of ICG in detecting and preventing POBL of the HJ in robotic minimal invasive pancreatic surgery (R-MIPS)., Methods: All consecutive robot- and ICG-assisted HJ-anastomoses between 2019 and 2022 were included. Biliary leakage was objectified with near infrared technology. Only clinically relevant POBL were considered in this study., Results: Sixty patients who underwent a PD between 2019 and 2022 were included. In ten patients, fluorescence imaging revealed an intra-operative hepaticojejunostomy insufficiency (HJI). Five of these patients developed POBL despite revision but preventing POBL in five patients. Detection of HJI with ICG predicted POBL with a sensitivity and specificity of 41.6% and 89.6% respectively. There was a significant higher chance of developing a POBL if the hepatic duct diameter was less than 5 mm (relative risk = 4.68 (p = 0.0345)), or if an intra-operative HJI was detected (relative risk = 3.57 (p = 0.009))., Conclusion: ICG is a simple and useful tool for detecting intra-operative bile leakage. This study shows that bile illumination with ICG in R-MIPS could prevent postoperative bile leakage., Competing Interests: Conflict of interest None to declare., (Copyright © 2024 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.) more...
- Published
- 2024
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