37 results on '"Oonk, Maaike H. M."'
Search Results
2. Vulvar cancer and vulvar premalignancies
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de Hullu, Joanne A., van der Avoort, Irene A. M., Oonk, Maaike H. M., van Poelgeest, Mariette I. E., Steegers, Eric A.P., editor, de Groot, Christianne J.M., editor, Hilders, Carina G.J.M., editor, Hoek, Annemieke, editor, Jaddoe, Vincent W.V., editor, Schoenmakers, Sam, editor, and Zweemer, Ronald P., editor
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- 2024
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3. Sentinel lymph node procedure in patients with recurrent vulvar squamous cell carcinoma: a proposed protocol for a multicentre observational study
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van Doorn, Helena C., Oonk, Maaike H. M., Fons, Guus, Gaarenstroom, Katja N., de Hullu, Joanne, van Rosmalen, Joost, and van Beekhuizen, Heleen J.
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- 2022
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4. Post-discharge Telemonitoring of Physical Activity, Vital Signs, and Patient-Reported Symptoms in Older Patients Undergoing Cancer Surgery
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Jonker, Leonie T., Lahr, Maarten M. H., Oonk, Maaike H. M., de Bock, Geertruida H., and van Leeuwen, Barbara L.
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- 2021
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5. Vulvar cancer and vulvar premalignancies
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de Hullu, Joanne A., van der Avoort, Irene A. M., Oonk, Maaike H. M., van Poelgeest, Mariette I. E., Steegers, Eric A.P., editor, Fauser, Bart C.J.M., editor, Hilders, Carina G.J.M., editor, Jaddoe, Vincent W.V., editor, Massuger, Leon F.A.G., editor, van der Post, Joris A.M., editor, and Schoenmakers, Sam, editor
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- 2019
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6. Vulvar Carcinoma: Diagnosis, Staging, and Treatment
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Pouwer, Anne-Floor W., te Grootenhuis, Nienke C., Oonk, Maaike H. M., de Hullu, Joanne A., and Bornstein, Jacob, editor
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- 2019
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7. Incidence of inguinofemoral lymph node metastases at the first local recurrence of vulvar cancer: a Dutch nationwide study
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Pleunis, Noortje, primary, Pouwer, Anne-Floor W., additional, Oonk, Maaike H. M., additional, van Doorn, Helena C., additional, Tjiong, Ming Y., additional, van der Velden, Jacobus, additional, Zijlmans, Henry, additional, van Poelgeest, Mariette I. E., additional, van Dorst, Eleonora B., additional, Slangen, Brigitte F. M., additional, Verhoef, Lia C. G., additional, Pijnenborg, Johanna M. A., additional, and de Hullu, Joanne A., additional
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- 2023
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8. European Society of Gynaecological Oncology Guidelines for the Management of Patients with Vulvar Cancer - Update 2023
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Oonk, Maaike H M, primary, Planchamp, François, additional, Baldwin, Peter, additional, Mahner, Sven, additional, Mirza, Mansoor Raza, additional, Fischerová, Daniela, additional, Creutzberg, Carien L, additional, Guillot, Eugénie, additional, Garganese, Giorgia, additional, Lax, Sigurd, additional, Redondo, Andres, additional, Sturdza, Alina, additional, Taylor, Alexandra, additional, Ulrikh, Elena, additional, Vandecaveye, Vincent, additional, van der Zee, Ate, additional, Wölber, Linn, additional, Zach, Diana, additional, Zannoni, Gian Franco, additional, and Zapardiel, Ignacio, additional
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- 2023
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9. The OncoLifeS data-biobank for oncology: a comprehensive repository of clinical data, biological samples, and the patient’s perspective
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Sidorenkov, Grigory, Nagel, Janny, Meijer, Coby, Duker, Jacko J., Groen, Harry J. M., Halmos, Gyorgy B., Oonk, Maaike H. M., Oostergo, Rene J., van der Vegt, Bert, Witjes, Max J. H., Nijland, Marcel, Havenga, Klaas, Maduro, John H., Gietema, Jourik A., and de Bock, Gertruida H.
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- 2019
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10. Sentinel Node Biopsy—Does It Help in the Management of Vulvar Cancer?
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Oonk, Maaike H. M., van der Zee, Ate G. J., Speiser, Paul, Ledermann, Jonathan A., editor, Creutzberg, Carien L., editor, and Quinn, Michael A., editor
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- 2014
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11. Challenges and controversies patients and (health care) professionals experience in managing vaginal, vulvar, penile or anal cancer: The SILENCE study
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van Dongen, Jessy, primary, de Heus, Eline, additional, Eickholt, Lauren, additional, Schrieks, Marga, additional, Zantingh, Ilaniek, additional, Brouwer, Oscar R., additional, Oonk, Maaike H. M., additional, Grotenhuis, Brechtje A., additional, Ezendam, Nicole P. M., additional, and Duijts, Saskia F. A., additional
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- 2022
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12. History and Updates of the GROINSS-V Studies
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Wagner, Marise M., primary, van der Zee, Ate G. J., additional, and Oonk, Maaike H. M., additional
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- 2022
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13. Radiotherapy Versus Inguinofemoral Lymphadenectomy as Treatment for Vulvar Cancer Patients With Micrometastases in the Sentinel Node: Results of GROINSS-V II
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Oonk, Maaike H. M., primary, Slomovitz, Brian, additional, Baldwin, Peter J. W., additional, van Doorn, Helena C., additional, van der Velden, Jacobus, additional, de Hullu, Joanne A., additional, Gaarenstroom, Katja N., additional, Slangen, Brigitte F. M., additional, Vergote, Ignace, additional, Brännström, Mats, additional, van Dorst, Eleonora B. L., additional, van Driel, Willemien J., additional, Hermans, Ralph H., additional, Nunns, David, additional, Widschwendter, Martin, additional, Nugent, David, additional, Holland, Cathrine M., additional, Sharma, Aarti, additional, DiSilvestro, Paul A., additional, Mannel, Robert, additional, Boll, Dorry, additional, Cibula, David, additional, Covens, Al, additional, Provencher, Diane, additional, Runnebaum, Ingo B., additional, Luesley, David, additional, Ellis, Patricia, additional, Duncan, Timothy J., additional, Tjiong, Ming Y., additional, Cruickshank, Derek J., additional, Kjølhede, Preben, additional, Levenback, Charles F., additional, Bouda, Jiri, additional, Kieser, Katharina E., additional, Palle, Connie, additional, Spirtos, Nicola M., additional, O'Malley, David M., additional, Leitao, Mario M., additional, Geller, Melissa A., additional, Dhar, Kalyan, additional, Asher, Viren, additional, Tamussino, Karl, additional, Tobias, Daniel H., additional, Borgfeldt, Christer, additional, Lea, Jayanthi S., additional, Bailey, Jo, additional, Lood, Margareta, additional, Eyjolfsdottir, Brynhildur, additional, Attard-Montalto, Stephen, additional, Tewari, Krishnansu S., additional, Manchanda, Ranjit, additional, Jensen, Pernille T., additional, Persson, Par, additional, Van Le, Linda, additional, Putter, Hein, additional, de Bock, Geertruida H., additional, Monk, Bradley J., additional, Creutzberg, Carien L., additional, and van der Zee, Ate G. J., additional
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- 2021
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14. Sentinel Node Biopsy—Does It Help in the Management of Vulvar Cancer?
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Oonk, Maaike H. M., primary, van der Zee, Ate G. J., additional, and Speiser, Paul, additional
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- 2013
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15. The value of follow-up in patients treated for carcinoma of the vulva
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Oonk, Maaike H. M., Hullu, Joanne A. De, Hollema, Harry, Mourits, Marian J. E., Pras, Elisabeth, Wymenga, Anke N. M., and Zee, Ate G. J. Van Der
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Vulva -- Research ,Vulvar cancer -- Care and treatment ,Vulvar cancer -- Research ,Genital cancer -- Care and treatment ,Genital cancer -- Research ,Health - Published
- 2003
16. European Society of Gynaecological Oncology Guidelines for the Management of Patients With Vulvar Cancer.
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Oonk, Maaike H. M., Planchamp, François, Baldwin, Peter, Bidzinski, Mariusz, Brännström, Mats, Landoni, Fabio, Mahner, Sven, Mahantshetty, Umesh, Mirza, Mansoor, Petersen, Cordula, Querleu, Denis, Regauer, Sigrid, Rob, Lukas, Rouzier, Roman, Ulrikh, Elena, van der Velden, Jacobus, Vergote, Ignace, Woelber, Linn, and van der Zee, Ate G. J.
- Abstract
Objective: The aim of this study was to develop clinically relevant and evidence-based guidelines as part of European Society of Gynaecological Oncology's mission to improve the quality of care for women with gynecologic cancers across Europe. Methods: The European Society of Gynaecological Oncology Council nominated an international development group made of practicing clinicians who provide care to patients with vulvar cancer and have demonstrated leadership and interest in the management of patients with vulvar cancer (18 experts across Europe). To ensure that the statements are evidence based, the current literature identified from a systematic search has been reviewed and critically appraised. In the absence of any clear scientific evidence, judgment was based on the professional experience and consensus of the development group (expert agreement). The guidelines are thus based on the best available evidence and expert agreement. Prior to publication, the guidelines were reviewed by 181 international reviewers including patient representatives independent from the development group. Results: The guidelines cover diagnosis and referral, preoperative investigations, surgical management (local treatment, groin treatment including sentinel lymph node procedure, reconstructive surgery), radiation therapy, chemoradiation, systemic treatment, treatment of recurrent disease (vulvar recurrence, groin recurrence, distant metastases), and follow-up. [ABSTRACT FROM AUTHOR]
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- 2017
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17. Sentinel lymph node biopsy in the management of gynecologic cancer.
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Cibula, David, Oonk, Maaike H. M., and Abu-Rustum, Nadeem R.
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- 2015
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18. The value of routine follow-up in patients treated for carcinoma of the vulva
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Oonk, Maaike H. M., primary, de Hullu, Joanne A., additional, Hollema, Harry, additional, Mourits, Marian J. E., additional, Pras, Elisabeth, additional, Wymenga, Anke N. M., additional, and van der Zee, Ate G. J., additional
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- 2003
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19. Modern management of vulvar cancer.
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de Hullu, Joanne A, Oonk, Maaike H M, and van der Zee, Ate G J
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- 2004
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20. Update on the Sentinel Node Procedure in Vulvar Cancer.
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van der Kolk WL, Bart J, van der Zee AJG, and Oonk MHM
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- Female, Humans, Lymphatic Metastasis pathology, Prospective Studies, Neoplasm Staging, Sentinel Lymph Node Biopsy methods, Lymph Node Excision adverse effects, Lymph Node Excision methods, Lymph Nodes surgery, Lymph Nodes pathology, Vulvar Neoplasms surgery, Carcinoma, Squamous Cell pathology
- Abstract
Early-stage vulvar cancer is managed by a local excision of the primary tumor and, if indicated, a sentinel node (SN) biopsy to assess the need for further groin treatment. With the SN procedure, many patients can be treated less radically and will experience less complications and morbidity compared with an inguinofemoral lymphadenectomy (IFL). Still, the SN procedure can be further optimized. Different tracers for detecting the SN are being investigated, aiming to optimize detection rates and decrease the burden of the procedure and short-term complications. Until now, no standardized protocols exist for the pathologic workup of the SN, possibly leading to discrepancies in detection of metastases between institutes using different methods. New techniques, such as one-step nucleic amplification, seem to have potential in accurately detecting metastases in other cancers, but have not yet been investigated in vulvar squamous cell carcinoma (VSCC). Furthermore, several studies have investigated the possibility to broaden the indications for the SN procedure, such as its use in recurrent disease, larger tumors, or multifocal tumors. Although these studies show encouraging results, cohorts are small and further studies are needed. Prospective studies are currently investigating these subgroups. Lastly, several studies investigated optimization of groin treatment of patients with a metastatic SN. Inguinofemoral radiotherapy is a good alternative to IFL in patients with micrometastases in the SN, with comparable efficacy and less treatment-related morbidity. Reduction of the radicality of groin treatment is also possible in other ways, such as omitting contralateral IFL in patients with lateralized tumors and a unilateral metastatic SN. In conclusion, the SN procedure is an established procedure in early-stage VSCC, although optimization of the technique, pathologic workup, indications, and treatment in the setting of metastatic disease are the subject of ongoing research.
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- 2024
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21. Autologous lipoaspirate as a new treatment of vulvar lichen sclerosus: A review on literature.
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van der Sluis N, Scheers ECAH, Krenning G, van der Lei B, Oonk MHM, and van Dongen JA
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- Female, Humans, Pain, Skin pathology, Lichen Sclerosus et Atrophicus pathology, Lichen Sclerosus et Atrophicus therapy, Vulvar Lichen Sclerosus pathology, Vulvar Lichen Sclerosus therapy, Vulvar Neoplasms pathology
- Abstract
Lichen sclerosus (LS) is a chronic inflammatory dermatosis that mostly affects the genital and anal skin areas. Symptoms may vary from pruritis and pain to sexual dysfunction; however, LS can also be asymptomatic. LS occurs at all ages and in both sexes. Approximately 5% of all women affected by vulvar LS will develop vulvar squamous cell carcinoma. Topical treatment is safe but less effective resulting in chronic course in most patients, who suffer from persistent itching and pain. In severe cases of therapy-resistant LS, there is no adequate treatment. Fat grafting is a novel regenerative therapy to reduce dermal fibrosis. The therapeutic effect of adipose tissue grafts for LS is already investigated in various pioneering studies. This review provides an overview of these studies and the putative mechanisms-of-action of fat grafting to treat LS., (© 2022 The Authors. Experimental Dermatology published by John Wiley & Sons Ltd.)
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- 2022
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22. Perioperative telemonitoring of older adults with cancer: Can we connect them all?
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Jonker LT, Lahr MMH, Festen S, Oonk MHM, de Bock GH, and van Leeuwen BL
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- Aged, Female, Humans, Internet, Prospective Studies, Retrospective Studies, Health Literacy, Neoplasms, Telemedicine
- Abstract
Objectives: Although the increasing cancer incidence in older patients is widely recognised, older patients remain underrepresented in clinical cancer trials and eHealth studies. The aim of this research is to identify technological and patient-related barriers to inclusion of this population in a clinical eHealth study., Material and Methods: This is a retrospective analysis of a prospective cohort study with older patients (≥ 65 years) undergoing cancer-related surgery, who were identified for a perioperative telemonitoring study. Reasons for ineligibility and refusal had been prospectively registered. Characteristics and postoperative outcomes were compared between participants and non-participants., Results: Between May 2018 and March 2020, 151 patients were assessed for eligibility, resulting in 65 participants and 86 non-participants. The main reason for ineligibility was lack of internet access at home (n = 16), while main reasons for refusal were perceived high mental burden (n = 46) and insufficient digital skills (n = 12). Compared with participants, non-participants were significantly older (mean age 75 vs. 73, p = 0.01); more often female (64% vs. 35%, p = 0.00), unmarried (42% vs. 8%, p = 0.01) living alone (38% vs. 19%, p = 0.02); had a higher ASA classification (43% vs. 19%, p = 0.00); often had polypharmacy (67% vs. 43%, p = 0.00); and were more often discharged to skilled nursing facilities (0% vs. 15%, p = 0.00)., Conclusion: Our results confirm the underrepresentation of older female patients with little support from a partner and higher comorbidity. We should be aware of technological and patient-related barriers to including older adults with cancer, in order to avoid further dividing patients with low and high digital health literacy., Competing Interests: Declaration of Competing Interest LTJ: no conflicts of interest to declare; MMH: no conflicts of interest to declare; SF: no conflicts of interest to declare; MHMO: no conflicts of interest to declare; GHdB: no conflicts of interest to declare; BLvL: no conflicts of interest to declare., (Copyright © 2020 Elsevier Inc. All rights reserved.)
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- 2020
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23. Vulvar Paget disease: A national retrospective cohort study.
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van der Linden M, Oonk MHM, van Doorn HC, Bulten J, van Dorst EBL, Fons G, Lok CAR, van Poelgeest MIE, Slangen BMF, Massuger LFAG, and de Hullu JA
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- Adult, Aged, Aged, 80 and over, Antineoplastic Agents therapeutic use, Disease-Free Survival, Female, Humans, Imiquimod therapeutic use, Kaplan-Meier Estimate, Lymphatic Metastasis, Middle Aged, Neoplasm Invasiveness, Netherlands, Retrospective Studies, Survival Rate, Vulvectomy, Neoplasm Recurrence, Local pathology, Paget Disease, Extramammary secondary, Paget Disease, Extramammary therapy, Vulvar Neoplasms pathology, Vulvar Neoplasms therapy
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Background: Vulvar Paget disease (VPD) is a rare skin disorder that is considered premalignant., Objective: To assess the clinical course, treatment schedules, and effect of invasion and treatment on recurrence and survival in patients with VPD., Methods: Data on women with VPD were retrieved from the medical files and pathology reports in all Dutch tertiary university medical centers. Disease-free survival and 5-year disease-specific survival were estimated by using Kaplan-Meier curves., Results: Data on 113 patients whose VPD was diagnosed between 1991 and 2016 were analyzed; 77% had noninvasive VPD. Most of the women (65%) underwent a surgical procedure. Recurrences were reported in 40%. Of the women with noninvasive VPD, 8% developed invasion. There were no disease-specific deaths reported in the women with noninvasive VPD. The 5-year disease-specific survival rate was greater than 98% in noninvasive and microinvasive VPD, but significantly worse in invasive VPD (50% [P < .0005])., Limitations: The main limitations of this study are its retrospective character and the fact that original pathology samples were not available for reassessment., Conclusions: VPD is extremely rare, and the recurrence rates are high. Most patients have noninvasive VPD, which does not affect survival and should be considered a chronic disorder with limited invasive potential. In cases of invasive disease, survival decreases significantly., (Copyright © 2018 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)
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- 2019
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24. Determinants of health-related quality of life in elderly ovarian cancer patients: The role of frailty and dependence.
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de Arruda FN, Oonk MHM, Mourits MJE, de Graeff P, Jalving M, and de Bock GH
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- Activities of Daily Living, Aged, Fatigue etiology, Female, Health Status, Humans, Sleep Initiation and Maintenance Disorders etiology, Carcinoma, Ovarian Epithelial complications, Frailty complications, Ovarian Neoplasms complications, Quality of Life
- Abstract
Objective: To investigate the impact of frailty and dependence on health-related quality of life (HRQOL) in elderly women diagnosed with epithelial ovarian cancer (EOC)., Methods: Data was gathered from a prospectively collected data biobank, OncoLifeS (Oncological Life Study) at the University Medical Center of Groningen. Women with a diagnosis of EOC, ≥65 years of age, with baseline assessment available from January 2016 to May 2018 were included. HRQOL was determined using the EORTC QLQ-C30 yielding scores on Global Health Status, five functional scales, three symptom scales, and six single items. The summary score was also calculated. Frailty was measured using the Groningen Frailty Indicator (GFI), and dependence using the Instrumental Activities of Daily Living (IADL). To evaluate the impact of frailty and dependence on HRQOL, linear regression was performed. Analyses were adjusted for age and tumor stage., Results: 84 patients were included. Median age was 71 years (IQR: 68-75), 78% had advanced stage and 81% serous histology. Overall, the median global health status was 67 (IQR: 50-83). HRQOL scales with lowest scores were: role functioning (median: 66.7; IQR: 33-100), fatigue (median: 33.3; IQR: 22-56) and insomnia (median: 33.3; IQR: 0-67). Being frail was associated with worse functioning on all HRQOL scales and higher symptom scores (p = .001). Conversely, being independent was associated with better functioning on all HRQOL scales and lower symptom scores. These associations remained significant after adjusting for age and tumor stage., Conclusion: In women ≥65 years, diagnosed with EOC, frailty and dependence are associated to reduced HRQOL. These associations remain significant adjusting for age and stage., (Copyright © 2019 Elsevier Inc. All rights reserved.)
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- 2019
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25. Quality of Life and Sexual Functioning After Vulvar Reconstruction With the Lotus Petal Flap.
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Hellinga J, Te Grootenhuis NC, Werker PMN, de Bock GH, van der Zee AGJ, Oonk MHM, and Stenekes MW
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- Aged, Cross-Sectional Studies, Female, Humans, Quality of Life, Sexual Behavior psychology, Vulvar Neoplasms physiopathology, Vulvar Neoplasms psychology, Perineum surgery, Plastic Surgery Procedures methods, Sexual Behavior physiology, Surgical Flaps, Vulva surgery, Vulvar Neoplasms surgery
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Objective: Resection of (pre) malignant lesions in the vulvoperineal area may result in large defects that cannot be closed primarily. The lotus petal flap technique is widely used for reconstruction. The aim of this study was to evaluate both quality of life (QoL) and sexual functioning of patients who underwent the lotus petal flap procedure, because no data are available on this topic., Methods: A cross-sectional study was performed on all eligible patients (N = 38) who underwent the lotus petal flap procedure between 2005 and 2016. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30, Female Sexual Function Index, and Body Image Scale were used to evaluate QoL and sexual functioning. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 and Female Sexual Function Index scores were compared with scores of age-matched healthy women., Results: Twenty-six patients (68%) responded. The mean (SD) age was 65.5 (16.3) years, and the median follow-up time was 38.5 months (range 16-141 months). Quality of life scores were lower compared with healthy women in the domains physical, role, and social functioning. Sexual activity rates were comparable with healthy women; however, sexual functioning was worse. Although patients were satisfied about their sexual life, pain was reported., Conclusions: Patients who underwent vulvar reconstructive surgery with lotus petal flaps seem to have a lower QoL compared with healthy women. Patients report more pain during sexual activity but are satisfied about their sexual functioning. These results should be included in preoperative counseling and follow-up of future patients eligible for vulvar reconstruction with a lotus petal flap.
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- 2018
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26. Prognostic factors for local recurrence of squamous cell carcinoma of the vulva: A systematic review.
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Te Grootenhuis NC, Pouwer AW, de Bock GH, Hollema H, Bulten J, van der Zee AGJ, de Hullu JA, and Oonk MHM
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- Carcinoma, Squamous Cell epidemiology, Carcinoma, Squamous Cell pathology, Female, Groin, Gynecologic Surgical Procedures, Humans, Lymphatic Metastasis, Margins of Excision, Neoplasm Grading, Neoplasm Invasiveness, Neoplasm Staging, Papillomavirus Infections epidemiology, Prognosis, Risk Factors, Vulvar Lichen Sclerosus epidemiology, Vulvar Neoplasms epidemiology, Vulvar Neoplasms pathology, Carcinoma, Squamous Cell surgery, Lymph Nodes pathology, Neoplasm Recurrence, Local epidemiology, Vulvar Neoplasms surgery
- Abstract
Background: In patients treated for early-stage squamous cell vulvar carcinoma local recurrence is reported in up to 40% after ten years. Knowledge on prognostic factors related to local recurrences should be helpful to select high risk patients and/or to develop strategies to prevent local recurrences., Objective: This systematic review aims to evaluate the current knowledge on the incidence of local recurrences in vulvar carcinoma related to clinicopathologic and cell biologic variables., Data Sources: Relevant studies were identified by an extensive online electronic search in July 2017., Study Eligibility Criteria: Studies reporting prognostic factors specific for local recurrences of vulvar carcinoma were included., Study Appraisal and Synthesis Methods: Two review authors independently performed data selection, extraction and assessment of study quality. The risk difference was calculated for each prognostic factor when described in two or more studies., Results: Twenty-two studies were included; most of all were retrospective and mainly reported pathologic prognostic factors. Our review indicates an estimated annual local recurrence rate of 4% without plateauing. The prognostic relevance for local recurrence of vulvar carcinoma of all analyzed variables remains equivocal, including pathologic tumor free margin distance <8mm, presence of lichen sclerosus, groin lymph node metastases and a variety of primary tumor characteristics (grade of differentiation, tumor size, tumor focality, depth of invasion, lymphovascular space invasion, tumor localization and presence of human papillomavirus)., Conclusions: Current quality of data on prognostic factors for local recurrences in vulvar carcinoma patients does not allow evidence-based clinical decision making. Further research on prognostic factors, applying state of the art methodology is needed to identify high-risk patients and to develop alternative primary and secondary prevention strategies., (Copyright © 2017 Elsevier Inc. All rights reserved.)
- Published
- 2018
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27. CD103 defines intraepithelial CD8+ PD1+ tumour-infiltrating lymphocytes of prognostic significance in endometrial adenocarcinoma.
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Workel HH, Komdeur FL, Wouters MC, Plat A, Klip HG, Eggink FA, Wisman GB, Arts HJ, Oonk MH, Mourits MJ, Yigit R, Versluis M, Duiker EW, Hollema H, de Bruyn M, and Nijman HW
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- Adenocarcinoma therapy, Adult, Aged, Endometrial Neoplasms therapy, Female, Humans, Integrins metabolism, Middle Aged, Phenotype, Prognosis, T-Lymphocyte Subsets immunology, Adenocarcinoma immunology, Antigens, CD metabolism, CD8-Positive T-Lymphocytes immunology, Endometrial Neoplasms immunology, Integrin alpha Chains metabolism, Lymphocytes, Tumor-Infiltrating immunology
- Abstract
Introduction: Intraepithelial CD8+ tumour-infiltrating T-lymphocytes (TIL) are associated with a prolonged survival in endometrial cancer (EC). By contrast, stromal infiltration of CD8+ TIL does not confer prognostic benefit. A single marker to discriminate these populations would therefore be of interest for rapid assessment of the tumour immune contexture, ex vivo analysis of intraepithelial and stromal T-cells on a functional level and/or adoptive T-cell transfer. Here we determined whether CD103, the αE subunit of the αEβ7integrin, can be used to specifically discriminate the epithelial and stromal CD8+ TIL populations in EC., Methods: CD103+ TIL were quantified in a cohort of 305 EC patients by immunohistochemistry. Localization of CD103+ cells and co-expression of CD103 with CD3, CD8, CD16 and FoxP3 were assessed by immunofluorescence. Further phenotyping of CD103+ cells was performed by flow cytometry on primary endometrial tumour digests., Results: CD8+CD103+ cells were preferentially located in endometrial tumour epithelium, whereas CD8+CD103- cells were located in stroma. CD103+ lymphocytes were predominantly CD3+CD8+ T-cells and expressed PD1. The presence of a high CD103+ cell infiltration was associated with an improved prognosis in patients with endometrial adenocarcinoma (p = 0.035). Moreover, this beneficial effect was particularly evident in high-risk adenocarcinoma patients (p = 0.031)., Conclusions: Because of the restricted expression on intraepithelial CD8+ T-cells, CD103 may be a suitable biomarker for rapid assessment of immune infiltration of epithelial cancers. Furthermore, this intraepithelial tumour-reactive subset might be an interesting T-cell subset for adoptive T-cell transfer and/or target for checkpoint inhibition therapy., (Copyright © 2016 Elsevier Ltd. All rights reserved.)
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- 2016
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28. Prognostic value and clinicopathologic characteristics of L1 cell adhesion molecule (L1CAM) in a large series of vulvar squamous cell carcinomas.
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Trietsch MD, Oonk MH, Hawinkels LJ, Bor R, van Eendenburg JD, Ivanova Z, Peters AA, Nijman HW, Gaarenstroom KN, and Bosse T
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- Aged, Carcinoma, Squamous Cell metabolism, Female, Humans, Neoplasm Recurrence, Local metabolism, Prognosis, Survival Rate, Vulvar Neoplasms metabolism, Biomarkers, Tumor metabolism, Carcinoma, Squamous Cell pathology, Neoplasm Recurrence, Local pathology, Neural Cell Adhesion Molecule L1 metabolism, Vulvar Neoplasms pathology
- Abstract
Background: Vulvar cancer treatment is mostly curative, but also has high morbidity rates. In a search for markers that can identify patients at risk of metastases, we investigated the prognostic value of L1-cell adhesion molecule (L1CAM) in large series of vulvar squamous cell carcinomas (VSCCs). L1CAM promotes cell motility and is an emerging prognostic factor for metastasis in many cancer subtypes., Results: L1CAM expression was observed at the invasive front or in spray-patterned parts of 17% of the tumours. L1CAM-positive tumours expressed vimentin more often, but L1CAM expression was not associated with TP53 or CTNNB1 mutations. Five-year survival was worse for patients with L1CAM expression (overall survival 46.1% vs 63.6%, P=.014, disease specific survival 63.8% vs 80.0%, P=.018). Multivariate analysis indicates L1CAM expression as an independent prognostic marker (HR 2.9, 95% CI 1.10-7.68). An in vitro spheroid invasion assay showed decreased invasion of L1CAM-expressing VSCC spindle cells after treatment with L1CAM-neutralising antibodies., Methods: Paraffin-embedded tumour tissue from two cohorts (N=103 and 245) of primary VSCCs were stained for L1CAM, vimentin and E-cadherin. Patients of the first cohort were tested for human papilloma virus infection and sequenced for TP53 and CTNNB1 (β-catenin) mutations. The expression of L1CAM was correlated to clinical characteristics and patient survival., Conclusion: This is the first study to show high L1CAM-expression at the infiltrating margin of VSCC's. L1CAM-expressing VSCCs had a significantly worse prognosis compared to L1CAM-negative tumours. The highest expression was observed in spindle-shaped cells, where it might be correlated to their invasive capacity., Competing Interests: The authors declare no conflicts of interest.
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- 2016
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29. Repeat sentinel lymph node procedure in patients with recurrent vulvar squamous cell carcinoma is feasible.
- Author
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van Doorn HC, van Beekhuizen HJ, Gaarenstroom KN, van der Velden J, van der Zee AG, Oonk MH, and de Hullu JA
- Subjects
- Adult, Aged, Aged, 80 and over, Carcinoma, Squamous Cell surgery, Feasibility Studies, Female, Follow-Up Studies, Groin, Humans, Lymphatic Metastasis, Middle Aged, Reoperation, Retrospective Studies, Vulvar Neoplasms surgery, Carcinoma, Squamous Cell secondary, Neoplasm Recurrence, Local pathology, Sentinel Lymph Node Biopsy, Vulvar Neoplasms pathology
- Abstract
Objective: Standard treatment of primary T1 squamous cell carcinoma (SCC) of the vulva <4cm consists of wide local excision (WLE) and sentinel lymph node (SLN) procedure of the groin(s). In case of a local recurrence WLE and inguino femoral lymphadenectomy (IFL) is generally recommended. In this study we assessed the feasibility of repeat SLN procedure in patients with recurrent vulvar SCC who were not able or willing to undergo IFL., Methods: A retrospective study was performed in consecutive patients with recurrent vulvar SCC who underwent a repeat SLN procedure between 2006 and 2014. We present the clinical and pathological outcomes. The study conforms to the STROBE guidelines., Results: A total number of 27 patients aged 35-87years at first diagnosis of SCC of the vulva were identified. Median follow-up after 2nd surgery was 27.4 (range 2-96) months. In 78% of patients and in 84% of the groins the repeat SLN procedure was successful. No structured questionnaires were used to describe details on the repeat SLN procedures but in general the gynecologic oncologists experienced repeat SLN procedures more challenging compared to primary procedures. There were no groin recurrences documented., Conclusions: Our findings suggest that it is feasible to perform a repeat SLN procedure in recurrent vulvar SCC, but the procedure appears technically more challenging compared to primary setting, resulting in a lower SLN identification rate., (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Published
- 2016
- Full Text
- View/download PDF
30. Treatment Regimen, Surgical Outcome, and T-cell Differentiation Influence Prognostic Benefit of Tumor-Infiltrating Lymphocytes in High-Grade Serous Ovarian Cancer.
- Author
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Wouters MC, Komdeur FL, Workel HH, Klip HG, Plat A, Kooi NM, Wisman GB, Mourits MJ, Arts HJ, Oonk MH, Yigit R, de Jong S, Melief CJ, Hollema H, Duiker EW, Daemen T, de Bruyn M, and Nijman HW
- Subjects
- Aged, Antigens, CD metabolism, Biomarkers, Combined Modality Therapy, Cystadenocarcinoma, Serous pathology, Cystadenocarcinoma, Serous therapy, Female, Humans, Immunophenotyping, Kaplan-Meier Estimate, Lymphocytes, Tumor-Infiltrating metabolism, Lymphocytes, Tumor-Infiltrating pathology, Middle Aged, Neoplasm Grading, Neoplasm Staging, Ovarian Neoplasms pathology, Ovarian Neoplasms therapy, Phenotype, Prognosis, Proportional Hazards Models, T-Lymphocyte Subsets immunology, T-Lymphocyte Subsets metabolism, T-Lymphocyte Subsets pathology, Treatment Outcome, Cell Differentiation, Cystadenocarcinoma, Serous immunology, Cystadenocarcinoma, Serous mortality, Lymphocytes, Tumor-Infiltrating immunology, Ovarian Neoplasms immunology, Ovarian Neoplasms mortality
- Abstract
Purpose: Tumor-infiltrating lymphocytes (TIL) are associated with a better prognosis in high-grade serous ovarian cancer (HGSC). However, it is largely unknown how this prognostic benefit of TIL relates to current standard treatment of surgical resection and (neo-)adjuvant chemotherapy. To address this outstanding issue, we compared TIL infiltration in a unique cohort of patients with advanced-stage HGSC primarily treated with either surgery or neoadjuvant chemotherapy., Experimental Design: Tissue microarray slides containing samples of 171 patients were analyzed for CD8(+) TIL by IHC. Freshly isolated CD8(+) TIL subsets were characterized by flow cytometry based on differentiation, activation, and exhaustion markers. Relevant T-cell subsets (CD27(+)) were validated using IHC and immunofluorescence., Results: A prognostic benefit for patients with high intratumoral CD8(+) TIL was observed if primary surgery had resulted in a complete cytoreduction (no residual tissue). By contrast, optimal (<1 cm of residual tumor) or incomplete cytoreduction fully abrogated the prognostic effect of CD8(+) TIL. Subsequent analysis of primary TIL by flow cytometry and immunofluorescence identified CD27 as a key marker for a less-differentiated, yet antigen-experienced and potentially tumor-reactive CD8(+) TIL subset. In line with this, CD27(+) TIL were associated with an improved prognosis even in incompletely cytoreduced patients. Neither CD8(+) nor CD27(+) cell infiltration was of prognostic benefit in patients treated with neoadjuvant chemotherapy., Conclusions: Our findings indicate that treatment regimen, surgical result, and the differentiation of TIL should all be taken into account when studying immune factors in HGSC or, by extension, selecting patients for immunotherapy trials., (©2015 American Association for Cancer Research.)
- Published
- 2016
- Full Text
- View/download PDF
31. Update on sentinel lymph node biopsy for early-stage vulvar cancer.
- Author
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Slomovitz BM, Coleman RL, Oonk MH, van der Zee A, and Levenback C
- Subjects
- Female, Humans, Lymphatic Metastasis, Neoplasm Staging, Lymph Nodes pathology, Sentinel Lymph Node Biopsy methods, Vulvar Neoplasms pathology
- Abstract
Two prospective, multicenter clinical trials have demonstrated the feasibility and reproducibility of sentinel lymph node (SLN) biopsy as part of the standard management of early-stage vulvar carcinoma. On the basis of the results of these trials, many gynecologic oncologists have incorporated SLN biopsy for vulvar cancer into their practice. Studies have further shown that SLN biopsy is associated with better quality of life than full lymphadenectomy, is more cost-effective than full lymphadenectomy, and improved pathologic evaluation. A large observational study is currently evaluating the outcomes of patients with early-stage vulvar cancer according to the results of their SLN biopsy and the approach to their care; this study may confirm that full inguinofemoral lymphadenectomy is no longer necessary in most patients with this disease. Here, we review the published data supporting SLN biopsy as part of the standard of care for women with early-stage vulvar cancer and discuss future considerations for the management of this disease., (Copyright © 2015 Elsevier Inc. All rights reserved.)
- Published
- 2015
- Full Text
- View/download PDF
32. Letter to the editor on "The importance of performing a sentinel node biopsy in case of recurrent vulvar cancer".
- Author
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Oonk MH, de Hullu JA, and van der Zee AJ
- Subjects
- Female, Humans, Lymph Nodes pathology, Neoplasm Recurrence, Local pathology, Sentinel Lymph Node Biopsy statistics & numerical data, Vulvar Neoplasms pathology
- Published
- 2014
- Full Text
- View/download PDF
33. Current controversies in the management of patients with early-stage vulvar cancer.
- Author
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Oonk MH, de Hullu JA, and van der Zee AG
- Subjects
- Female, Humans, Lymph Node Excision, Lymphatic Metastasis, Neoplasm Staging, Prognosis, Sentinel Lymph Node Biopsy, Vulvar Neoplasms pathology, Vulvar Neoplasms therapy
- Abstract
Purpose of Review: The purpose of this review is to outline current controversies in management of early-stage vulvar cancer. The main focus will be on the procedures for assessing the sentinel node and the treatment of those with evidence of metastatic involvement., Recent Findings: Assessment of the sentinel node has recently been introduced into the standard treatment of early-stage squamous cell vulvar cancer. The combination of a radioactive tracer and blue dye is the most accurate technique for sentinel node detection. Preoperative imaging is recommended to rule out gross nodal involvement and ultrasound with fine needle aspiration cytology by an experienced radiologist appears to have the highest sensitivity/specificity for detecting metastases, although large comparative studies are not available. All patients with sentinel node metastases require additional treatment to the groin, independent of the size of metastasis in the sentinel node and currently this involves inguinofemoral lymphadenectomy. Further research is ongoing to investigate the role of radiotherapy instead of lymphadenectomy. The little experience there is of sentinel node biopsy in vulvar melanoma suggests that the procedure is feasible and inclusion criteria should follow those of cutaneous melanoma., Summary: Sentinel node biopsy is safe in treatment of early-stage vulvar cancer. Ongoing studies are investigating the optimal additional treatment for patients with a positive sentinel node in terms of efficacy and morbidity.
- Published
- 2010
- Full Text
- View/download PDF
34. Update on the sentinel lymph node procedure in vulvar cancer.
- Author
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Oonk MH, van de Nieuwenhof HP, van der Zee AG, and de Hullu JA
- Subjects
- Carcinoma, Squamous Cell epidemiology, Carcinoma, Squamous Cell pathology, Carcinoma, Squamous Cell surgery, Clinical Trials as Topic, Female, Humans, Lymph Node Excision adverse effects, Lymphatic Metastasis, Vulvar Neoplasms epidemiology, Vulvar Neoplasms pathology, Lymph Node Excision methods, Sentinel Lymph Node Biopsy methods, Vulvar Neoplasms surgery
- Abstract
Currently, standard treatment for early-stage vulvar cancer typically includes wide local excision of the primary tumor and inguinofemoral lymphadenectomy. The morbidity of this treatment is high. The sentinel lymph node (SLN) procedure provides us with a technique for determining the status of the regional lymph nodes with less treatment-related morbidity. Recently, a large multicenter observational study provided level 3 evidence indicating that it appears safe to omit inguinofemoral lymphadenectomy in case of a negative SLN. This review focuses on the different aspects of the SLN procedure in vulvar cancer.
- Published
- 2010
- Full Text
- View/download PDF
35. The role of sentinel node biopsy in gynecological cancer: a review.
- Author
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Oonk MH, van de Nieuwenhof HP, de Hullu JA, and van der Zee AG
- Subjects
- Endometrial Neoplasms pathology, Female, Humans, Neoplasm Staging, Sensitivity and Specificity, Uterine Cervical Neoplasms pathology, Vulvar Neoplasms pathology, Genital Neoplasms, Female pathology, Lymphatic Metastasis diagnosis, Sentinel Lymph Node Biopsy
- Abstract
Purpose of Review: In early-stage vulvar, cervical and endometrial cancer, lymph node status is the most important prognostic factor. Surgical treatment is aimed at removing the primary tumor and adequately staging the regional lymph nodes. As morbidity of regional lymphadenectomy is high, sentinel node biopsy is a technique with potential for adequate staging with less treatment-related morbidity. This manuscript reviews its current role in vulvar, cervical and endometrial cancer., Recent Findings: In early-stage vulvar cancer, level 3 evidence indicates that it appears to be safe to omit inguinofemoral lymphadenectomy in case of a negative sentinel node. However, false-negative results with fatal consequences do occur and are often attributable to procedural failures. For early-stage cervical cancer, level 3 evidence points to an acceptable false-negative rate of a negative sentinel node; clinical utility and safety remain to be established. The optimal technique of the sentinel node biopsy in endometrial cancer is currently unclear., Summary: In early-stage vulvar cancer, data suggest that sentinel node biopsy could be offered as a treatment option instead of routine inguinofemoral lymphadenectomy. However, more (long-term follow-up) data are needed to further appreciate real clinical benefits. It is emphasized that the procedure should be performed by a skilled multidisciplinary team, centralized in oncology centers and preferably within the protection of clinical trials. For cervical cancer, data are promising, but routine application cannot be recommended due to lack of data on clinical utility and safety. For endometrial cancer, studies on the sentinel node biopsy are still in feasibility stage.
- Published
- 2009
- Full Text
- View/download PDF
36. Postpartum peril.
- Author
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van Lonkhuijzen LR, Westerlaan HE, and Oonk MH
- Subjects
- Adult, Female, Humans, Infant, Newborn, Infarction diagnostic imaging, Liver blood supply, Male, Pregnancy, HELLP Syndrome diagnostic imaging, Tomography, X-Ray Computed
- Published
- 2007
- Full Text
- View/download PDF
37. Vulvar ulceration with an unexpected underlying cause.
- Author
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Oonk MH, van der Ploeg JM, and van Lonkhuijzen LR
- Subjects
- Adult, Crohn Disease diagnosis, Crohn Disease drug therapy, Female, Glucocorticoids therapeutic use, Humans, Prednisolone therapeutic use, Crohn Disease complications, Ulcer etiology, Vulvar Diseases etiology
- Published
- 2006
- Full Text
- View/download PDF
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