Time-varying impact of established prognostic factors in resected pancreatic ductal adenocarcinoma.

Background: Prognostic factors in resected pancreatic ductal adenocarcinoma (PDAC) have been determined under the assumption that hazard ratios (HRs) remain static. However, PDAC is a dynamic disease with evolving conditional survival. The aim of this study was to determine if the impact of prognostic factors in PDAC is time-varying.

Phase I study of intraperitoneal irinotecan with systemic capecitabine and oxaliplatin for patients with gastric peritoneal metastases.

Background: Peritoneal metastases of gastric cancer are associated with a poor prognosis (median overall survival (OS) ∼9 months). Catheter-based intraperitoneal (CBIP) chemotherapy is a locoregional approach to deliver chemotherapy leading to higher intraperitoneal (IP) concentrations of cytotoxic drugs compared to intravenous administration.

Method: This multicenter, open-label 3 + 3 + 3 dose-escalation phase I trial evaluated 3-weekly IP irinotecan with oral capecitabine and intravenous oxaliplatin (CAPOX).

Emerging treatment modalities for gastric cancer with peritoneal metastases: A systematic review.

Introduction: Gastric cancer remains associated with a high mortality, since patients often present with advanced-stage disease such as peritoneal metastases. Treatment options in this setting are limited and mainly consist of palliative systemic therapy.

Objectives: This systematic review aims to summarize emerging therapeutic strategies for patients with peritoneally metastasized gastric cancer in relation to response, toxicity and survival.

Surgical Complications in Patients with (borderline) Resectable Pancreatic Cancer after Neoadjuvant Therapy in the PREOPANC-2 Randomized Controlled Trial.

Objective: To compare the incidence of major surgical complications between patients with (borderline) resectable pancreatic cancer treated with neoadjuvant FOLFIRINOX versus neoadjuvant gemcitabine-based chemoradiotherapy.

Summary Of Background Data: There are ongoing concerns regarding the possible adverse impact of neoadjuvant treatment on postoperative complication rates following pancreatectomy.

Methods: This study was a predefined analysis within the investigator-initiated nationwide randomized controlled PREOPANC-2 trial.

Treatment of colorectal peritoneal metastases with oxaliplatin induces biomarkers predicting response to immune checkpoint blockade.

Background: Colorectal cancer (CRC) patients with inoperable peritoneal metastases (PM) have a dismal prognosis with limited treatment options. Local treatment of CRC-PM with oxaliplatin is commonly applied, but biomarkers steering patient selection, or informing potentially effective combination therapies are lacking. A novel potentially effective treatment strategy is Pressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC) in which CRC-PM are exposed to cyclic treatment with high concentrations of locally applied oxaliplatin.

Defining region boundaries to assess the peritoneal cancer index on imaging: a Delphi study.

Background: The gold standard for evaluating the presence and extent of peritoneal lesions is determining the surgical peritoneal cancer index (PCI). However, there is a growing need for non-invasive methods to assess peritoneal lesions. While the standardised and quantified PCI scoring system can be applied to imaging, the region definitions used for surgical PCI assessment are not directly applicable to radiological assessment.

Going in circles? - Identifying the dissemination process of healthcare networks within their member organizations.

Purpose-oriented networks are the dominant organizational model for collaboratively addressing complex healthcare challenges. However, their impact on health outcomes remains limited, because organizations rarely adapt their practices based on network-level decisions. Using an in-depth multiple case study of three multi-hospital networks, we therefore developed a process model to understand the dissemination process from the network level to the operational level.

Impact of feeding strategy after pancreatoduodenectomy on delayed gastric emptying and hospital stay: nationwide study.

Background: Delayed gastric emptying is a major contributor to prolonged hospital stay following pancreatoduodenectomy. Although enhanced recovery after surgery guidelines recommend unrestricted feeding after pancreatoduodenectomy, nationwide studies evaluating the impact of different feeding strategies after surgery on delayed gastric emptying and length of hospital stay are limited. This study aimed to identify the use and impact of different feeding strategies after pancreatoduodenectomy on delayed gastric emptying and length of hospital stay.

Routine Imaging After Resection of Pancreatic Ductal Adenocarcinoma: Nationwide Utilization and Survival Analysis.

Objective: To evaluate the utilization of routine imaging and the impact on survival after resection of pancreatic ductal adenocarcinoma (PDAC).

Background: Evidence on the benefit of routine imaging after resection of PDAC on early detection and treatment of disease recurrence is currently lacking. The availability of more effective treatment options for PDAC recurrence may have increased the utilization of routine imaging in daily clinical practice.

Leveraging real-world data for continuous evaluation of computational clinical practice guidelines.

Objectives: There is a bidirectional interaction between clinical practice guidelines and clinical care, with each informing the other. Structural signalling of trends in guideline adherence in clinical practice is essential for advanced updates. Recent advances in computable care guidelines allow automated evaluation using real-world registry data.

Nationwide trends and the impact of an oncology hospital network on reducing the burden of thyroid cytology procedures.

The diagnostic care pathway of thyroid nodules spans multiple institutions. Collaborative networks are important to deal with such pathways that result from centralization and differentiation of care. Despite the high prevalence of thyroid nodules and the increase in cancer diagnoses, most nodules are benign and attributable to overdiagnosis, leading to an increase in fine-needle aspirations (FNAs).

Trends in resection rates and postoperative mortality for gastrointestinal cancers between 2005 and 2020 in the Netherlands.

Aim: This study assesses trends in resection rates and postoperative mortality for oesophageal, gastric, colon, rectal, periampullary and pancreatic cancer in the Netherlands.

Methods: This retrospective cohort study included all patients with gastrointestinal cancer diagnosed in the period 2005-2020 as registered in the Netherlands Cancer Registry. Cochran-Armitage trend tests were used to assess trends in resection rates.

[Rise in incidence of early-onset colorectal cancer in the Netherlands: cause for concern?].

Objective: To describe trends in incidence of early-onset colorectal cancer in the Netherlands.

Design: Observational research.

Method: We selected colorectal cancer patients aged 15 to 49 years, diagnosed between 1989-2023, from the Netherlands Cancer Registry (NCR).

The pharmacokinetic profile of mitomycin C released from an injectable supramolecular hydrogel in a rodent model.

Objective: This study evaluates the pharmacokinetics of an ureido-pyrimidinone poly(ethylene) glycol (UPy-PEG) hydrogel loaded with mitomycin C (MMC) in rats. The hydrogel aims to enhance the intraperitoneal residence time of MMC, potentially improving therapeutic outcomes for peritoneal metastases (PM) patients.

Methods: Rats were divided into two groups: h-MMC (n = 8), receiving MMC encapsulated in hydrogel, and pbs-MMC (n = 6), receiving MMC in PBS.

Combined peritoneal and liver metastases in colorectal cancer: A Dutch nationwide population-based analysis of incidence, treatment and survival.

Introduction: The aim of this study was to determine the incidence, treatment patterns, survival and factors associated with curative treatment in colorectal cancer patients with combined liver and peritoneal metastases using Dutch population-based data.

Materials And Methods: Data from the Netherlands Cancer Registry were used. All patients diagnosed with synchronous isolated peritoneal and liver metastasized colorectal adenocarcinoma between January 1, 2015 and December 31, 2021 were included.

Patterns of disease dissemination and survival in patients with synchronous and metachronous metastatic pancreatic adenocarcinoma: Nationwide population-based study.

Aim: Despite advances in understanding pancreatic adenocarcinoma, evidence on its metastatic patterns and impact on patient survival remains limited. This study aims to identify patterns of disease dissemination in synchronous versus metachronous metastatic pancreatic adenocarcinoma (mPAC) and their association with overall survival (OS).

Methods: Patients diagnosed with synchronous- or metachronous-mPAC were selected from the Netherlands Cancer Registry (2015-2021).

Computer-Aided Decision Support and 3D Models in Pancreatic Cancer Surgery: A Pilot Study.

Preoperative planning of patients diagnosed with pancreatic head cancer is difficult and requires specific expertise. This pilot study assesses the added value of three-dimensional (3D) patient models and computer-aided detection (CAD) algorithms in determining the resectability of pancreatic head tumors. This study included 14 hepatopancreatobiliary experts from eight hospitals.

Video-assessment of Surgical Performance in Robotic Gastro-enterostomy During Pancreatoduodenectomy: Evaluating the Learning Curve and Risk of Delayed Gastric Emptying.

Objective: The aim of this study is to identify learning curves for robotic gastro-enterostomy (RGE) during RPD and the predictive value of the objective structured assessment of technical skills (OSATS) score for DGE according to the Birkmeyer et al and UPMC method.

Summary Of Background Data: In some series, robotic pancreatoduodenectomy (RPD) has been associated with increased risk of delayed gastric emptying (DGE). It is unclear whether this is attributable to learning curve.

The prognostic value of peritoneal metastases in patients with gastric cancer: a nationwide population-based study.

Background: The peritoneum is a common metastatic site in gastric cancer. The prognosis of synchronous peritoneal metastases compared to other metastatic sites in gastric cancer remains understudied. This study aims to evaluate the impact of peritoneal metastases on survival in patients with metastatic gastric cancer.

Quality of Life Among Patients With Locally Advanced Pancreatic Cancer: A Prospective Nationwide Multicenter Study.

Background: Health care providers of patients with cancer should discuss the impact of treatment, such as multiagent chemotherapy and surgery, on quality of life (QoL). However, in the era of shared decision-making, data on QoL in locally advanced pancreatic cancer (LAPC) remain scarce.

Methods: We performed a prospective multicenter study involving patients with LAPC across 13 Dutch centers.

Influence of a nationwide colorectal cancer screening program on the incidence of synchronous colorectal peritoneal metastases.

This study aims to assess the influence of colorectal cancer screening on the incidence of synchronous colorectal peritoneal metastases (CPM). Patients diagnosed with CPM between 2009 and 2022 were selected from the Netherlands Cancer Registry. Crude rates of the observed and expected CPM incidence were calculated per 100,000 individuals and compared.

Video Grading of Bile Duct Anastomoses During Robotic Pancreatoduodenectomy Predicts Bile Leak and Identifies the Learning Curve: A Multicenter Study.

Objective: To determine if video grading using Objective Structured Assessment of Technical Skills (OSATS) could estimate the risk of postoperative bile leak (BL) after robotic pancreatoduodenectomy (RPD) and to identify a learning curve effect.

Summary Background Data: The hepaticojejunostomy (HJ) bile leak rate after RPD is rather high with 10% and may be improved by structured training and skills. Robotic HJ therefore requires confirmation of adequate performance.

Predisposing conditions in patients with small intestinal adenocarcinomas in the Netherlands: A 20-year nationwide cohort study.

Small intestinal adenocarcinomas (SIAs) are associated with predisposing conditions, including inflammatory bowel disease (IBD) and celiac disease, but also genetic syndromes such as Lynch syndrome (LS) and familial adenomatous polyposis (FAP). This nationwide cohort study investigated the incidence of genetic and non-genetic predisposing conditions in SIA and their influence on tumor characteristics and clinical features. Data were obtained from the Netherlands Cancer Registry.

Preoperative stereotactic radiotherapy to prevent pancreatic fistula in high-risk patients undergoing pancreatoduodenectomy (FIBROPANC): prospective multicentre phase II single-arm trial.

Background: Postoperative pancreatic fistula is the main driver of morbidity and mortality after pancreatoduodenectomy. In high-risk patients, the rate of postoperative pancreatic fistula approaches 50%, whereas it is below 5% in patients with pancreatic cancer who receive neoadjuvant chemoradiotherapy. The aim of this study was to evaluate the safety, feasibility, and efficacy of preoperative stereotactic body radiotherapy on the pancreatic neck transection margin in high-risk patients undergoing pancreatoduodenectomy to prevent postoperative pancreatic fistula.

Root-cause analysis of mortality after pancreatic resection in a nationwide cohort.

Background: This study evaluates leading causes of in-hospital mortality after pancreatic resection nationwide to determine areas for improvement.

Methods: This observational cohort study included all in-hospital mortality after pancreatic resection in the Netherlands (2014-2019). Each fatality was considered to be caused by local complications (i.