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Nieuwkamer B, Vrouwe J, Willemse P, Nicolai M, Bevers R, Pelger R, Hamdy N, Osanto S. Quantitative ultrasound of the calcaneus (QUS): A valuable tool in the identification of patients with non-metastatic prostate cancer requiring screening for osteoporosis. Bone Rep 2023; 18:101679. [PMID: 37425192 PMCID: PMC10323220 DOI: 10.1016/j.bonr.2023.101679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 04/14/2023] [Accepted: 04/16/2023] [Indexed: 07/11/2023] Open
Abstract
Non-metastatic prostate cancer (PCa) patients are at increased risk for osteoporosis and fractures mainly due to androgen deprivation therapy (ADT)-associated hypogonadism, but this remains largely underdiagnosed and untreated. In this study, we examine the value of pre-screening calcaneal QUS in identifying patients who should be referred for screening for osteoporosis using dual-energy X-Ray absorptiometry (DXA). In a single-center retrospective cross-sectional cohort study, we analysed data on DXA and calcaneal QUS measurements systematically collected between 2011 and 2013 in all non-metastatic PCa patients attending our Uro-Oncological Clinic at the Leiden University Medical Center. Receiver operating characteristic curves were used to assess the positive (PPV) and negative (NPV) predictive values of QUS T-scores of 0, -1.0, and - 1.8 in identifying DXA-diagnosed osteoporosis (T-scores ≤ - 2.5 and ≤ -2) at lumbar spine and/or femoral neck. Complete sets of data were available in 256 patients, median age 70.9 (53.6-89.5) years; 93.0 % had received local treatment, 84.4 % with additional ADT. Prevalence of osteoporosis and osteopenia was respectively 10.5 % and 53 %. Mean QUS T-score was -0.54 ± 1.58. Whereas PPV at any QUS T-score was <25 %, precluding the use of QUS as surrogate for DXA in screening for osteoporosis, QUS T-scores of -1.0 to 0.0 had a NPV of ≥94.5 % for DXA T-scores ≤ 2.5 and ≤ -2 at any site, confidently identifying patients least likely to have osteoporosis, thereby significantly reducing the number of patients requiring DXA screening for diagnosing osteoporosis by up to two-third. Osteoporosis screening is a significant unmet need in non-metastatic prostate cancer patients treated with ADT, and QUS may represent a valuable alternative pre-screening strategy to overcome logistics, time demands, and economic barriers encountered with current strategies for osteoporosis screening in these patients. Summary Osteoporosis and associated increased fracture risk are common in non-metastatic prostate carcinoma, mainly due to androgen deprivation therapy, but these often remain underdiagnosed and untreated. We demonstrate that QUS is a safe, less costly pre-screen tool that reduces by up to two-third the number of patients requiring referral for DXA for osteoporosis screening.
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Affiliation(s)
- B.B. Nieuwkamer
- Department of Medical Oncology, Leiden University Medical Center (LUMC), Albinusdreef 2, 2333 ZA Leiden, the Netherlands
- Department of Urology, Reinier de Graaf Hospital (RdGG), Reinier de Graafweg 5, 2625 AD Delft, the Netherlands
| | - J.P.M. Vrouwe
- Department of Medical Oncology, Leiden University Medical Center (LUMC), Albinusdreef 2, 2333 ZA Leiden, the Netherlands
- Centre for Human Drug Research (CHDR), Zernikedreef 8, 2333 CL Leiden, the Netherlands
| | - P.M. Willemse
- Department of Urology, University Medical Center Utrecht (UMCU), Heidelberglaan 100, 3584 CX Utrecht, the Netherlands
| | - M.P.J. Nicolai
- Department of Urology, Leiden University Medical Center (LUMC), Albinusdreef 2, 2333 ZA Leiden, the Netherlands
- Department of Urology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, the Netherlands
| | - R.F.M. Bevers
- Department of Urology, Leiden University Medical Center (LUMC), Albinusdreef 2, 2333 ZA Leiden, the Netherlands
| | - R.C.M. Pelger
- Department of Urology, Leiden University Medical Center (LUMC), Albinusdreef 2, 2333 ZA Leiden, the Netherlands
| | - N.A.T. Hamdy
- Department of Medicine, Division of Endocrinology and Center for Bone Quality, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands
| | - S. Osanto
- Department of Medical Oncology, Leiden University Medical Center (LUMC), Albinusdreef 2, 2333 ZA Leiden, the Netherlands
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Krouwel EM, Birkhoff EML, Nicolai MPJ, Osanto S, Putter H, Pelger RCM, Elzevier HW. An Educational Need Regarding Treatment-Related Infertility and Fertility Preservation: a National Survey Among Members of the Dutch Society for Medical Oncologists. J Cancer Educ 2023; 38:106-114. [PMID: 34623602 PMCID: PMC9852179 DOI: 10.1007/s13187-021-02084-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/29/2021] [Indexed: 06/13/2023]
Abstract
Cancer diagnosis and treatment may influence reproductive planning and impact fertility in patients of reproductive age. Although guidelines have been established in the past decade, education, practice, and attitudes of medical oncologists regarding fertility preservation remain undecided. A nationwide survey was performed among members of the Dutch Society for Medical Oncology. Demographics, practice, knowledge, and barriers were measured regarding information provision of fertility preservation towards cancer patients of childbearing age. From 392 members, 120 oncologists completed the questionnaire (30.6%). Majority of oncologists was convinced it is their responsibility to discuss impact of cancer treatment to fertility (93.2%), yet 68.3% discussed the subject often or always (n = 82). Oncologists employed in district general hospitals were less likely to discuss fertility (p = 0.033). On average, 44.6% of reproductive men and 28.9% of reproductive women is referred to fertility specialists. Half of the respondents declared to possess sufficient knowledge regarding fertility preservation (n = 57, 47.5%). Poor prognosis (53%), unlikely survival (43.1%), and high chances on fertility recovery (28.7%) were identified as barriers to discussing fertility preservation. Among oncologists, impact of cancer treatment on fertility is a well-accepted responsibility to counsel. Despite, self-reported knowledge regarding fertility preservation is strongly varying. In practice, fertility is discussed to some extent, influenced by several barriers and depending on prognosis and type of hospital. Patients benefit from knowledge improvement among oncology care providers concerning fertility effects of cancer treatment. Education during medical school, residency, and among practicing oncologists may raise awareness, together with enhancement of referral possibilities.
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Affiliation(s)
- E. M. Krouwel
- Department of Urology, Leiden University Medical Centre, Leiden, the Netherlands
- Department of Medical Decision Making, Leiden University Medical Centre, Leiden, the Netherlands
| | - E. M. L. Birkhoff
- Department of Urology, Leiden University Medical Centre, Leiden, the Netherlands
- Department of Medical Decision Making, Leiden University Medical Centre, Leiden, the Netherlands
| | - M. P. J. Nicolai
- Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, The Netherlands
| | - S. Osanto
- Department of Oncology, Leiden University Medical Centre, Leiden, the Netherlands
| | - H. Putter
- Department of Medical Statistics, Leiden University Medical Centre, Leiden, the Netherlands
| | - R. C. M. Pelger
- Department of Urology, Leiden University Medical Centre, Leiden, the Netherlands
- Department of Medical Decision Making, Leiden University Medical Centre, Leiden, the Netherlands
| | - H. W. Elzevier
- Department of Urology, Leiden University Medical Centre, Leiden, the Netherlands
- Department of Medical Decision Making, Leiden University Medical Centre, Leiden, the Netherlands
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Krouwel EM, Albers LF, Nicolai MPJ, Putter H, Osanto S, Pelger RCM, Elzevier HW. Discussing Sexual Health in the Medical Oncologist's Practice: Exploring Current Practice and Challenges. J Cancer Educ 2020; 35:1072-1088. [PMID: 31209770 PMCID: PMC7679345 DOI: 10.1007/s13187-019-01559-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Sexuality is a significant quality-of-life concern for many cancer patients. Patients may be disadvantaged if they are not informed and not offered sexual health care. We sought to reveal oncologists' current practice and opinions concerning sexual counselling. The aim of this study was to explore the knowledge, attitude and practice patterns of Dutch medical oncologists regarding treatment-related sexual dysfunction. Questionnaires were sent to 433 members of the Dutch Society of Medical Oncology. The majority (81.5%) of the 120 responding medical oncologists (response rate 30.6%) stated they discussed sexual function with fewer than half of their patients. At the same time, 75.8% of the participating oncologists agreed that addressing sexual function is their responsibility. Sexual function was discussed more often with younger patients and patients with a curative treatment intent. Barriers for avoiding discussing sexual function were lack of time (56.1%), training (49.5%) and advanced age of the patient (50.4%). More than half (64.6%) stated they had little knowledge about the subject and the majority (72.9%) wanted to acquire additional training in sexual function counselling. Medical oncologists accept that sexual function counselling falls within their profession, yet they admit to not counselling patients routinely concerning sexual function. Only in a minority of cases do medical oncologists inform their patients about sexual side effects of treatment. Whether they counsel patients is related to how they view patient's prognosis, patient's age, and self-reported knowledge. Findings indicate there is a role for developing education and practical training.
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Affiliation(s)
- E M Krouwel
- Department of Urology, J3P, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands
- Department of Medical Decision Making, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands
| | - L F Albers
- Department of Urology, J3P, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands.
- Department of Medical Decision Making, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands.
| | - M P J Nicolai
- Department of Urology, J3P, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands
- Department of Medical Decision Making, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands
| | - H Putter
- Department of Medical Statistics, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands
| | - S Osanto
- Department of Oncology, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands
| | - R C M Pelger
- Department of Urology, J3P, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands
- Department of Medical Decision Making, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands
| | - H W Elzevier
- Department of Urology, J3P, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands
- Department of Medical Decision Making, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands
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Horwich A, Babjuk M, Bellmunt J, Bruins HM, De Reijke TM, De Santis M, Gillessen S, James N, Maclennan S, Palou J, Powles T, Ribal MJ, Shariat SF, Van Der Kwast T, Xylinas E, Agarwal N, Arends T, Bamias A, Birtle A, Black PC, Bochner BH, Bolla M, Boormans JL, Bossi A, Briganti A, Brummelhuis I, Burger M, Castellano D, Cathomas R, Chiti A, Choudhury A, Compérat E, Crabb S, Culine S, De Bari B, DeBlok W, De Visschere PJL, Decaestecker K, Dimitropoulos K, Dominguez-Escrig JL, Fanti S, Fonteyne V, Frydenberg M, Futterer JJ, Gakis G, Geavlete B, Gontero P, Grubmüller B, Hafeez S, Hansel DE, Hartmann A, Hayne D, Henry AM, Hernandez V, Herr H, Herrmann K, Hoskin P, Huguet J, Jereczek-Fossa BA, Jones R, Kamat AM, Khoo V, Kiltie AE, Krege S, Ladoire S, Lara PC, Leliveld A, Linares-Espinós E, Løgager V, Lorch A, Loriot Y, Meijer R, Carmen Mir M, Moschini M, Mostafid H, Müller AC, Müller CR, N'Dow J, Necchi A, Neuzillet Y, Oddens JR, Oldenburg J, Osanto S, Oyen WJG, Pacheco-Figueiredo L, Pappot H, Patel MI, Pieters BR, Plass K, Remzi M, Retz M, Richenberg J, Rink M, Roghmann F, Rosenberg JE, Rouprêt M, Rouvière O, Salembier C, Salminen A, Sargos P, Sengupta S, Sherif A, Smeenk RJ, Smits A, Stenzl A, Thalmann GN, Tombal B, Turkbey B, Vahr Lauridsen S, Valdagni R, Van Der Heijden AG, Van Poppel H, Vartolomei MD, Veskimäe E, Vilaseca A, Vives Rivera FA, Wiegel T, Wiklund P, Williams A, Zigeuner R, Witjes JA. EAU-ESMO consensus statements on the management of advanced and variant bladder cancer-an international collaborative multi-stakeholder effort: under the auspices of the EAU and ESMO Guidelines Committees†. Ann Oncol 2019; 30:1697-1727. [PMID: 31740927 PMCID: PMC7360152 DOI: 10.1093/annonc/mdz296] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Although guidelines exist for advanced and variant bladder cancer management, evidence is limited/conflicting in some areas and the optimal approach remains controversial. OBJECTIVE To bring together a large multidisciplinary group of experts to develop consensus statements on controversial topics in bladder cancer management. DESIGN A steering committee compiled proposed statements regarding advanced and variant bladder cancer management which were assessed by 113 experts in a Delphi survey. Statements not reaching consensus were reviewed; those prioritised were revised by a panel of 45 experts before voting during a consensus conference. SETTING Online Delphi survey and consensus conference. PARTICIPANTS The European Association of Urology (EAU), the European Society for Medical Oncology (ESMO), experts in bladder cancer management. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Statements were ranked by experts according to their level of agreement: 1-3 (disagree), 4-6 (equivocal), 7-9 (agree). A priori (level 1) consensus was defined as ≥70% agreement and ≤15% disagreement, or vice versa. In the Delphi survey, a second analysis was restricted to stakeholder group(s) considered to have adequate expertise relating to each statement (to achieve level 2 consensus). RESULTS AND LIMITATIONS Overall, 116 statements were included in the Delphi survey. Of these, 33 (28%) statements achieved level 1 consensus and 49 (42%) statements achieved level 1 or 2 consensus. At the consensus conference, 22 of 27 (81%) statements achieved consensus. These consensus statements provide further guidance across a broad range of topics, including the management of variant histologies, the role/limitations of prognostic biomarkers in clinical decision making, bladder preservation strategies, modern radiotherapy techniques, the management of oligometastatic disease and the evolving role of checkpoint inhibitor therapy in metastatic disease. CONCLUSIONS These consensus statements provide further guidance on controversial topics in advanced and variant bladder cancer management until a time where further evidence is available to guide our approach.
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Affiliation(s)
- A Horwich
- Emeritus Professor, The Institute of Cancer Research, London, UK; Emeritus Professor, The Institute of Cancer Research, London, UK.
| | - M Babjuk
- Depatment of Urology, 2nd Faculty of Medicine, Hospital Motol, Charles University, Prague, Czech Republic; Department of Urology, Medical University of Vienna, Vienna, Austria
| | - J Bellmunt
- IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain; Harvard Medical School, Boston, USA
| | - H M Bruins
- Department of Urology, Radboud University Medical Center, Nijmegen
| | - T M De Reijke
- Department of Urology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - M De Santis
- Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, Charité University Hospital, Berlin, Germany
| | - S Gillessen
- Division of Cancer Sciences, University of Manchester, Manchester; The Christie NHS Foundation Trust, Manchester, UK; Division of Oncology and Haematology, Kantonsspital St Gallen, St Gallen; University of Bern, Bern, Switzerland
| | - N James
- University Hospitals Birmingham NHS Foundation Trust, Birmingham; Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham
| | - S Maclennan
- Academic Urology Unit, University of Aberdeen, Aberdeen, UK
| | - J Palou
- Department of Urology, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - T Powles
- The Royal Free NHS Trust, London; Barts Cancer Institute, Queen Mary University of London, London, UK
| | - M J Ribal
- Uro-Oncology Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - S F Shariat
- Depatment of Urology, 2nd Faculty of Medicine, Hospital Motol, Charles University, Prague, Czech Republic; Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, Weill Cornell Medical College, New York; Department of Urology, University of Texas Southwestern Medical Center, Dallas, USA; Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - T Van Der Kwast
- Department of Pathology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - E Xylinas
- Department of Urology, Bichat-Claude Bernard Hospital, Assistance Publique Hôpitaux de Paris, Paris; Paris Descartes University, Paris, France
| | - N Agarwal
- Huntsman Cancer Institute, University of Utah (NCI-CCC), Salt Lake City, USA
| | - T Arends
- Urology Department, Canisius-Wilhelmina Ziekenhuis Nijmegen, Nijmegen, The Netherlands
| | - A Bamias
- 2nd Propaedeutic Dept of Internal Medicine, Medical School, National & Kapodistrian University of Athens, Athens, Greece
| | - A Birtle
- Division of Cancer Sciences, University of Manchester, Manchester; Rosemere Cancer Centre, Lancashire Teaching Hospitals, Preston, UK
| | - P C Black
- Department of Urologic Sciences, Vancouver Prostate Centre, University of British Columbia, Vancouver, Canada
| | - B H Bochner
- Department of Urology, Weill Cornell Medical College, New York; Urology Service, Department of Urology, Memorial Sloan Kettering Cancer Center, New York, USA
| | - M Bolla
- Emeritus Professor of Radiation Oncology, Grenoble - Alpes University, Grenoble, France
| | - J L Boormans
- Department of Urology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - A Bossi
- Department of Radiation Oncology, Gustave Roussy Institute, Villejuif, France
| | - A Briganti
- Department of Urology, Urological Research Institute, Milan; Vita-Salute University, San Raffaele Scientific Institute, Milan, Italy
| | - I Brummelhuis
- Department of Urology, Radboud University Medical Center, Nijmegen
| | - M Burger
- Department of Urology, Caritas-St. Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - D Castellano
- Medical Oncology Department, 12 de Octubre University Hospital (CIBERONC), Madrid, Spain
| | - R Cathomas
- Department Innere Medizin, Abteilung Onkologie und Hämatologie, Kantonsspital Graubünden, Chur, Switzerland
| | - A Chiti
- Department of Biomedical Sciences, Humanitas University, Milan; Humanitas Research Hospital, Milan, Italy
| | - A Choudhury
- Division of Cancer Sciences, University of Manchester, Manchester; The Christie NHS Foundation Trust, Manchester, UK
| | - E Compérat
- Department of Pathology, Tenon Hospital, HUEP, Paris; Sorbonne University, Paris, France
| | - S Crabb
- Cancer Sciences Unit, University of Southampton, Southampton, UK
| | - S Culine
- Department of Cancer Medicine, Hôpital Saint Louis, Paris
| | - B De Bari
- Radiation Oncology Department, Centre Hospitalier Régional Universitaire "Jean Minjoz" of Besançon, INSERM UMR 1098, Besançon, France; Radiation Oncology Department, Centre Hospitalier Universitaire Vaudois, Université de Lausanne, Lausanne, Switzerland
| | - W DeBlok
- Department of Urology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - P J L De Visschere
- Department of Radiology and Nuclear Medicine, Division of Genitourinary Radiology and Mammography, Ghent University Hospital, Ghent
| | - K Decaestecker
- Department of Urology, Ghent University Hospital, Ghent, Belgium
| | - K Dimitropoulos
- Department of Urology, Aberdeen Royal Infirmary, Aberdeen, UK
| | - J L Dominguez-Escrig
- Servicio de Urología, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | - S Fanti
- Department of Nuclear Medicine, Policlinico S Orsola, University of Bologna, Bologna, Italy
| | - V Fonteyne
- Department of Radiotherapy Oncology, Ghent University Hospital, Ghent, Belgium
| | - M Frydenberg
- Department of Surgery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Australia
| | - J J Futterer
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - G Gakis
- Department of Urology and Paediatric Urology, University Hospital of Würzburg, Julius-Maximillians University, Würzburg, Germany
| | - B Geavlete
- Department of Urology, Saint John Emergency Clinical Hospital, Bucharest, Romania
| | - P Gontero
- Division of Urology, Molinette Hospital, University of Studies of Torino, Torino, Italy
| | - B Grubmüller
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - S Hafeez
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London; Department of Clinical Oncology, The Royal Marsden NHS Foundation Trust, London, UK
| | - D E Hansel
- Department of Urology, University of California, San Diego Pathology, La Jolla, USA
| | - A Hartmann
- Institute of Pathology, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - D Hayne
- Department of Urology, UWA Medical School, University of Western Australia, Perth, Australia
| | - A M Henry
- Leeds Institute of Medical Research, University of Leeds, Leeds, UK
| | - V Hernandez
- Department of Urology, Hospital Universitario Fundación de Alcorcón, Madrid, Spain
| | - H Herr
- Urology Service, Department of Urology, Memorial Sloan Kettering Cancer Center, New York, USA
| | - K Herrmann
- Department of Nuclear Medicine, Universitätsklinikum Essen, Essen, Germany
| | - P Hoskin
- Division of Cancer Sciences, University of Manchester, Manchester; The Christie NHS Foundation Trust, Manchester, UK; Mount Vernon Centre for Cancer Treatment, London, UK
| | - J Huguet
- Department of Urology, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - B A Jereczek-Fossa
- Department of Oncology and Hemato-oncology, University of Milan, Milan; Division of Radiotherapy, IEO European Institute of Oncology, IRCCS, Milan, Italy
| | - R Jones
- Institute of Cancer Sciences, College of Medicine, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - A M Kamat
- Department of Urology - Division of Surgery, The University of Texas, MD Anderson Cancer Center, Houston, USA
| | - V Khoo
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London; Department of Clinical Oncology, The Royal Marsden NHS Foundation Trust, London, UK; Department of Medicine, University of Melbourne, Melbourne; Monash University, Melbourne, Australia
| | - A E Kiltie
- CRUK/MRC Oxford Institute for Radiation Oncology, University of Oxford, Oxford, UK
| | - S Krege
- Department of Urology, Pediatric Urology and Urologic Oncology, Kliniken Essen-Mitte, Essen, Germany
| | - S Ladoire
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - P C Lara
- Department of Oncology, Hospital Universitario San Roque, Canarias; Universidad Fernando Pessoa, Canarias, Spain
| | - A Leliveld
- Department of Urology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | - V Løgager
- Department of Radiology, Copenhagen University Hospital Herlev and Gentofte, Herlev, Denmark
| | - A Lorch
- Department of Medical Oncology and Hematology, University Hospital Zürich, Zürich, Switzerland
| | - Y Loriot
- Département de Médecine Oncologique, Gustave Roussy, INSERM U981, Université Paris-Sud, Université Paris-Saclay, Villejuif, France
| | - R Meijer
- UMC Utrecht Cancer Center, MS Oncologic Urology, Utrecht, The Netherlands
| | - M Carmen Mir
- Servicio de Urología, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | - M Moschini
- Department of Urology, Luzerner Kantonsspital, Luzern, Switzerland
| | - H Mostafid
- Department of Urology, Royal Surrey County Hospital, Guildford, UK
| | - A-C Müller
- Department of Radiation Oncology, Eberhard Karls University, Tübingen, Germany
| | - C R Müller
- Cancer Treatment Centre, Sorlandet Hospital, Kristiansand, Norway
| | - J N'Dow
- Academic Urology Unit, University of Aberdeen, Aberdeen, UK; Department of Urology, Aberdeen Royal Infirmary, Aberdeen, UK
| | - A Necchi
- Department of Medical Oncology, Istituto Nazionale Tumori of Milan, Milan, Italy
| | - Y Neuzillet
- Department of Urology, Hospital Foch, University of Versailles-Saint-Quentin-en-Yvelines, Suresnes, France
| | - J R Oddens
- Department of Urology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - J Oldenburg
- Department of Oncology, Akershus University Hospital, Lørenskog; Faculty of Medicine, University of Oslo, Oslo, Norway
| | - S Osanto
- Department of Clinical Oncology, Leiden University Medical Center, Leiden
| | - W J G Oyen
- Department of Biomedical Sciences, Humanitas University, Milan; Humanitas Research Hospital, Milan, Italy; Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Radiology and Nuclear Medicine, Rijnstate Hospital, Arnhem, The Netherlands
| | - L Pacheco-Figueiredo
- Department of Urology, Centro Hospitalar São João, Porto; Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
| | - H Pappot
- Department of Oncology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark
| | - M I Patel
- Department of Urology, Westmead Hospital, University of Sydney, Sydney, Australia
| | - B R Pieters
- Department of Radiation Oncology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam
| | - K Plass
- EAU Guidelines Office, Arnhem, The Netherlands
| | - M Remzi
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - M Retz
- Department of Urology, Rechts der Isar Medical Center, Technical University of Munich, Munich, Germany
| | - J Richenberg
- Department of Imaging and Nuclear Medicine, Royal Sussex County Hospital, Brighton; Brighton and Sussex Medical School, Brighton, UK
| | - M Rink
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg
| | - F Roghmann
- Department of Urology, Ruhr-University Bochum, Marien Hospital, Herne, Germany
| | - J E Rosenberg
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York; Weill Cornell Medical College, New York, USA
| | - M Rouprêt
- Department of Urology, Sorbonne Université, GRC n°5, ONCOTYPE-URO, AP-HP, Hôpital Pitié-Salpêtrière, Paris
| | - O Rouvière
- Hospices Civils de Lyon, Service d'Imagerie Urinaire et Vasculaire, Hôpital Edouard Herriot, Lyon; Université de Lyon, Université Lyon 1, Faculté de Médecine Lyon Est, Lyon, France
| | - C Salembier
- Department of Radiation Oncology, Europe Hospitals Brussels, Brussels, Belgium
| | - A Salminen
- Department of Urology, University Hospital of Turku, Turku, Finland
| | - P Sargos
- Department of Radiotherapy, Institut Bergonié, Bordeaux, France
| | - S Sengupta
- Department of Surgery, Austin Health, University of Melbourne, Melbourne; Eastern Health Clinical School, Monash University, Melbourne, Australia
| | - A Sherif
- Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden
| | - R J Smeenk
- Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - A Smits
- Department of Urology, Radboud University Medical Center, Nijmegen
| | - A Stenzl
- Department of Urology, Eberhard Karls University Tübingen, Tübingen, Germany
| | - G N Thalmann
- Department of Urology, Inselspital, Bern University Hospital, Berne, Switzerland
| | - B Tombal
- Division of Urology, IREC, Cliniques Universitaires Saint Luc, UCL, Brussels, Belgium
| | - B Turkbey
- Molecular Imaging Program, National Cancer Institute, Bethesda, USA
| | - S Vahr Lauridsen
- Department of Urology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - R Valdagni
- Department of Oncology and Hemato-oncology, Università degli Studi di Milano, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - H Van Poppel
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - M D Vartolomei
- Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Cell and Molecular Biology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Targu Mures, Romania
| | - E Veskimäe
- Department of Urology, Tampere University Hospital, Tampere, Finland
| | - A Vilaseca
- Uro-Oncology Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - F A Vives Rivera
- Clinica HematoOncologica Bonadona Prevenir, Universidad Metropolitana, Clinica Club de Leones, Barranquilla, Colombia
| | - T Wiegel
- Department of Radiation Oncology, University Hospital Ulm, Ulm, Germany
| | - P Wiklund
- Icahn School of Medicine, Mount Sinai Health System, New York City, USA; Department of Urology, Karolinska Institutet, Stockholm, Sweden
| | - A Williams
- Department of Urology, Auckland City Hospital, Auckland, New Zealand
| | - R Zigeuner
- Department of Urology, Medizinische Universität Graz, Graz, Austria
| | - J A Witjes
- Department of Urology, Radboud University Medical Center, Nijmegen
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Osanto S, Alvarez C, Bloem H, van der Hulle T, Jonker M, Ozdemir M, Goossens K, Wijffelman M, Pelger R, Van Poppel H, Burggraaf K. Efficacy of enzalutamide in hormone-sensitive metastatic prostate cancer: Clinical utility of 18F-choline PET and whole body MRI. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz248.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Krouwel EM, Nicolai MPJ, van Steijn-van Tol AQMJ, Putter H, Osanto S, Pelger RCM, Elzevier HW. Fertility preservation counselling in Dutch Oncology Practice: Are nurses ready to assist physicians? Eur J Cancer Care (Engl) 2016; 26. [PMID: 28026055 DOI: 10.1111/ecc.12614] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2016] [Indexed: 12/30/2022]
Abstract
Cancer and its treatments may result in impaired fertility, which could cause long-term distress to cancer survivors. For eligible patients, fertility preservation (FP) is available to secure future reproductive potential. Many physicians, however, feel inhibited about discussing FP. Oncology nurses may serve as an initiator for discussing the subject and provide additional support. Our aim was to investigate their knowledge about FP, the way they apply this, and possible barriers to discussing FP with patients of reproductive age. A questionnaire was administered via mail, Internet and the Dutch Oncology Nursing Congress. Four hundred and twenty-one oncology nurses participated, a third of whom (31.1%) had "sufficient" knowledge of FP. Twenty-eight per cent of participants reported that they "never/hardly ever" discussed FP; 32.2% "almost always/always." FP discussions were more frequently performed by graduate nurses, academic nurses, experienced nurses and nurses with sufficient knowledge. Reasons for not discussing FP were a "lack of knowledge" (25.2%), "poor prognosis" (16.4%) and "lack of time" (10.5%). In conclusion, several obstacles may result in FP not being routinely discussed, specifically a lack of knowledge. Yet nurses feel responsible for addressing the issue, indicating that assistance with FP discussions should be encouraged. Educational training about FP is recommended.
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Affiliation(s)
- E M Krouwel
- Department of Urology, Leiden University Medical Centre, Leiden, The Netherlands
| | - M P J Nicolai
- Department of Urology, Leiden University Medical Centre, Leiden, The Netherlands
| | | | - H Putter
- Department of Medical Statistics, Leiden University Medical Centre, Leiden, The Netherlands
| | - S Osanto
- Department of Oncology, Leiden University Medical Centre, Leiden, The Netherlands
| | - R C M Pelger
- Department of Urology, Leiden University Medical Centre, Leiden, The Netherlands
| | - H W Elzevier
- Department of Urology, Leiden University Medical Centre, Leiden, The Netherlands
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Krouwel E, Nicolai M, van Steijn-van Tol A, Putter H, Osanto S, Pelger R, Elzevier H. Addressing changed sexual functioning in cancer patients: A cross-sectional survey among Dutch oncology nurses. Eur J Oncol Nurs 2015; 19:707-15. [DOI: 10.1016/j.ejon.2015.05.005] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Revised: 04/28/2015] [Accepted: 05/05/2015] [Indexed: 10/23/2022]
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8
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Willemse PM, Hamdy NAT, de Kam ML, Burggraaf J, Osanto S. Changes in bone mineral density in newly diagnosed testicular cancer patients after anticancer treatment. J Clin Endocrinol Metab 2014; 99:4101-8. [PMID: 25119312 DOI: 10.1210/jc.2014-1722] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Patients with germ cell tumors (GCTs) have an excellent prognosis but are at risk for silent fractures. Data on bone mineral density (BMD) after anticancer treatment are scarce. OBJECTIVE The objective of the study was BMD monitoring in GCT patients treated with or without chemotherapy. DESIGN We prospectively studied 63 newly diagnosed GCT patients with a median age of 33 years (range 16-70 y) within 3 months of unilateral orchidectomy. Twenty-seven patients (42.9%) had no metastases. Thirty-six patients (57.1%) with metastatic disease received combination chemotherapy. SETTING This study was conducted at the outpatient clinic of a single academic institution. INTERVENTIONS We performed dual-energy X-ray absorptiometry scans and collected blood samples on a yearly basis, before and up to 5 years after anticancer treatment. MAIN OUTCOME MEASURES Changes in total hip and lumbar spine BMD, serum concentrations of gonadal hormones, and bone turnover markers were measured. RESULTS BMD remained normal in stage I patients. In patients with metastatic disease, a significant decrease in lumbar spine BMD (-1.52%; P = .004) and total hip BMD (-2.05%; P < .0001) was observed 1 year after chemotherapy and remained stable thereafter for up to 5 years. There was no significant relationship between the observed decrease in BMD and gonadal status, vitamin D status, or cumulative dose of cisplatin or (antiemetic) corticosteroids. CONCLUSIONS Metastatic GCT survivors demonstrate significant bone loss within the first year after curative combination chemotherapy, with no recovery up to 5 years after anticancer treatment. Whether this bone loss is associated with increased fracture risk and whether this could be prevented by bone modifying treatment remains to be established.
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Affiliation(s)
- P M Willemse
- Departments of Clinical Oncology (P.M.W., S.O.) and Endocrinology and Metabolic Diseases (N.A.T.H.), Leiden University Medical Center, 2333 ZA Leiden, The Netherlands, and Centre for Human Drug Research (M.L.d.K., J.B.), 2333 CL Leiden, The Netherlands
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van Schinkel LD, Willemse PM, van der Meer RW, Burggraaf J, van Elderen SGC, Smit JWA, de Roos A, Osanto S, Lamb HJ. Reply: Comment on ‘Chemotherapy for testicular cancer induces acute alterations in diastolic heart function’. Br J Cancer 2014; 110:265. [PMID: 24201753 PMCID: PMC3887301 DOI: 10.1038/bjc.2013.704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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10
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Willemse PM, Burggraaf J, Hamdy NAT, Osanto S. Reply: 'Comment on Prevalence of the metabolic syndrome and cardiovascular disease risk in chemotherapy-treated testicular germ cell tumour survivors'. Br J Cancer 2013; 109:2503-4. [PMID: 24045664 PMCID: PMC3817323 DOI: 10.1038/bjc.2013.567] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- P M Willemse
- Department of Clinical Oncology, Leiden University Medical Center, Albinusdreef 2, 2333 Leiden, ZA, The Netherlands
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Van Poppel H, Watkin N, Osanto S, Moonen L, Horwich A, Kataja V. Penile cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2013; 24 Suppl 6:vi115-24. [DOI: 10.1093/annonc/mdt286] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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12
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van Schinkel LD, Willemse PM, van der Meer RW, Burggraaf J, van Elderen SGC, Smit JWA, de Roos A, Osanto S, Lamb HJ. Chemotherapy for testicular cancer induces acute alterations in diastolic heart function. Br J Cancer 2013; 109:891-6. [PMID: 23922115 PMCID: PMC3749589 DOI: 10.1038/bjc.2013.445] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Revised: 07/04/2013] [Accepted: 07/10/2013] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND After treatment with cisplatin-based chemotherapy for testicular cancer (TC), patients have higher prevalence of cardiovascular complications after long-term follow up. Little is known about acute cardiovascular effects of cisplatin-based chemotherapy. The aim of this study was to explore acute effects of chemotherapy on cardiac function in patients treated for TC. METHODS Fourteen TC patients (age 34.6 ± 12.3 years) were studied before and 3 months after start with cisplatin-based chemotherapy. Cardiac function was assessed with magnetic resonance imaging. Fasting glucose and insulin levels were measured and insulin sensitivity, reflected by the quantitative insulin sensitivity index (Quicki index), was calculated. RESULTS Left ventricular (LV) end-diastolic volume and LV stroke volume (SV) significantly decreased from 192 ± 27 to 175 ± 26 ml (P<0.05) and 109 ± 18 to 95 ± 16 ml (P<0.05), respectively. The ratio of early and atrial filling velocities across the mitral valve, a parameter of diastolic heart function, decreased after chemotherapy from 1.87 ± 0.43 to 1.64 ± 0.45 (P<0.01). Metabolic parameters were unfavourably changed, reflected by a decreased Quicki index, which reduced from 0.39 ± 0.05 to 0.36 ± 0.05 (P<0.05). CONCLUSION Chemotherapy for TC induces acute alterations in diastolic heart function, paralleled by unfavourable metabolic changes. Therefore, early after chemotherapy, metabolic treatment may be indicated to possibly reduce long-term cardiovascular complications.
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Affiliation(s)
- L D van Schinkel
- Department of Endocrinology, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.
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Stemkens D, Aben K, Osanto S, Groot JD, Verhoof E. P038 Completing the PDCA circle for guidelines within one organisation. BMJ Qual Saf 2013. [DOI: 10.1136/bmjqs-2013-002293.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Willemse PM, Burggraaf J, Hamdy NAT, Weijl NI, Vossen CY, van Wulften L, van Steijn-van Tol AQMJ, Rosendaal FR, Osanto S. Erratum: Prevalence of the metabolic syndrome and cardiovascular disease risk in chemotherapy-treated testicular germ cell tumour survivors. Br J Cancer 2013. [PMCID: PMC3708557 DOI: 10.1038/bjc.2013.358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Willemse PM, Burggraaf J, Hamdy NAT, Weijl NI, Vossen CY, van Wulften L, van Steijn-van Tol AQMJ, Rosendaal FR, Osanto S. Prevalence of the metabolic syndrome and cardiovascular disease risk in chemotherapy-treated testicular germ cell tumour survivors. Br J Cancer 2013; 109:60-7. [PMID: 23660945 PMCID: PMC3708554 DOI: 10.1038/bjc.2013.226] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2013] [Revised: 04/14/2013] [Accepted: 04/17/2013] [Indexed: 11/09/2022] Open
Abstract
Background: Testicular cancer patients have an increased risk for cardiovascular disease (CVD), which might be related to the increased prevalence of the metabolic syndrome (MetS) in this group of patients. Methods: We assessed the prevalence of MetS and calculated the 10-year CVD risk in a cohort of 255 testicular germ cell tumour survivors (median age, 38.7 years; interquartile range, 31–48) at a mean of 7.8 years after anti-cancer treatment, and compared these with data obtained from 360 healthy men. Results: Survivors had an age-adjusted increased risk for MetS of 1.9 compared with that of healthy controls. The risk for MetS was highest in survivors treated with combination chemotherapy (CT) 2.3 (Adult Treatment Panel of the National Cholesterol Education Program classification) and 2.2 (International Diabetes Federation classification). The risk of MetS was especially increased in survivors with testosterone levels in the lowest quartile (OR, 2.5). Ten-year cardiovascular risk as assessed by the Framingham Risk Score (3.0%) and Systemic Coronary Risk Evaluation (1.7%) algorithms was low, independent of treatment, and was comparable to controls. Conclusion: Testicular germ cell tumour survivors have an increased prevalence of MetS, with hypogonadism and CT treatment being clear risk factors for the development of the syndrome. The increased prevalence of MetS was not associated with an increased 10-year cardiovascular risk.
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Affiliation(s)
- P M Willemse
- Department of Clinical Oncology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
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Ashcroft BA, de Sonneville J, Yuana Y, Osanto S, Bertina R, Kuil ME, Oosterkamp TH. Determination of the size distribution of blood microparticles directly in plasma using atomic force microscopy and microfluidics. Biomed Microdevices 2012; 14:641-9. [PMID: 22391880 PMCID: PMC3388260 DOI: 10.1007/s10544-012-9642-y] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Microparticles, also known as microvesicles, found in blood plasma, urine, and most other body fluids, may serve as valuable biomarkers of diseases such as cardiovascular diseases, systemic inflammatory disease, thrombosis, and cancer. Unfortunately, the detection and quantification of microparticles are hampered by the microscopic size of these particles and their relatively low abundance in blood plasma. The use of a combination of microfluidics and atomic force microscopy to detect microparticles in blood plasma circumvents both problems. In this study, capture of a specific subset of microparticles directly from blood plasma on antibody-coated mica surface is demonstrated. The described method excludes isolation and washing steps to prepare microparticles, improves the detection sensitivity, and yields the size distribution of the captured particles. The majority of the captured particles have a size ranging from 30 to 90 nm, which is in good agreement with prior results obtained with microparticles immediately isolated from fresh plasma. Furthermore, the qualitative shape of the size distribution of microparticles is shown not to be affected by high-speed centrifugation or the use of the microfluidic circuit, demonstrating the relative stable nature of microparticles ex vivo.
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Affiliation(s)
- B A Ashcroft
- Leiden Institute of Physics, Leiden, The Netherlands
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Luelmo S, Osanto S, Weijl N. Phase II Study of Everolimus and Capecitabine in Patients with Locally advanced or Metastatic Hepatocellular Carcinoma (HCC). Results of the first 10 Patients Included. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33251-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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18
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Woei-A-Jin FJSH, De Kruif MD, Garcia Rodriguez P, Osanto S, Bertina RM. Microparticles expressing tissue factor are concurrently released with markers of inflammation and coagulation during human endotoxemia. J Thromb Haemost 2012; 10:1185-8. [PMID: 22489893 DOI: 10.1111/j.1538-7836.2012.04733.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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De Wit R, Skoneczna IA, Gedske Daugaard K, de Santis M, Garin A, Aass N, Witjes JA, Albers P, White J, Germa-Lluch JR, Osanto S, Marreaud S, Collette L. A randomized phase III study comparing paclitaxel-BEP (T-BEP) to standard BEP in patients with in intermediate prognosis germ cell cancer (GCC): An intergroup study of EORTC, German TCSG/AUO, MRC, and Spanish GCC group (EORTC 30983). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.4509] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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20
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Porta C, Escudier B, Hutson TE, Figlin RA, Calvo E, Grünwald V, Osanto S, Ravaud A, Panneerselvam A, Knox JJ, Motzer RJ. Analysis of the relationship between Karnofsky performance status (KPS) and tumor response in the RECORD-1 phase III trial of everolimus in patients with advanced renal cell carcinoma (RCC). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.4610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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21
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Osanto S, Kruit WHJ. Immuuntherapie van kanker. ONCOLOGIE 2011. [DOI: 10.1007/978-90-313-8476-1_10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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22
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Willemse PM, Hamdy NAT, van Wulften L, van Steijn-van Tol AQMJ, Putter H, Osanto S. Prevalence of vertebral fractures independent of BMD and anticancer treatment in patients with testicular germ cell tumors. J Clin Endocrinol Metab 2010; 95:4933-42. [PMID: 20702527 DOI: 10.1210/jc.2010-0093] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT The prognosis of testicular germ cell tumors (GCT) is excellent, and survival of GCT patients has significantly increased. However, skeletal morbidity may potentially be increased in these patients due to chemotherapy-associated hypogonadism. OBJECTIVE Our objective was assessment of skeletal fragility in testicular GCT patients. DESIGN AND SETTING We conducted a cross-sectional study in long-term survivors and newly diagnosed patients at a single center with recruitment over a 2-yr period. PATIENTS AND METHODS We studied 199 cured long-term survivors of GCT, a mean of 7.4 yr after unilateral orchidectomy, and 45 newly diagnosed patients within 3 months of unilateral orchidectomy but before anticancer treatment. Bone mineral density (BMD) measurements were performed, and the presence of vertebral fractures (VF) was assessed in lateral thoracolumbar x-rays of the spine using the Genant's semiquantitative method. RESULTS Sixty-three patients (25.8%) had Z-scores between -1 and -2 sd, and 12 patients (5.7%) had Z-scores below -2 sd. Moderate and severe VF (grade 2 or higher) were observed in 13.6% of cured long-term survivors and in 15.6% of newly diagnosed patients. Including mild (grade 1) VF, the prevalence was 40.2 and 31.1%, respectively. There was no relationship between severity or number of VF and age, tumor type, staging, previous chemotherapy, gonadal status, vitamin D levels, or BMD values. CONCLUSION We identify a relatively high prevalence of mild to moderate VF independently of BMD or previous chemotherapy in long-term survivors and in newly diagnosed patients with GCT. Although the pathogenesis of these fractures remains unclear, their presence represents a potential cause of skeletal morbidity in otherwise healthy survivors of testicular GCT.
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Affiliation(s)
- P M Willemse
- Department of Clinical Oncology, Leiden University Medical Center, Leiden, The Netherlands
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Qin Y, Verdegaal EME, Siderius M, Bebelman JP, Smit MJ, Leurs R, Willemze R, Tensen CP, Osanto S. Quantitative expression profiling of G-protein-coupled receptors (GPCRs) in metastatic melanoma: the constitutively active orphan GPCR GPR18 as novel drug target. Pigment Cell Melanoma Res 2010; 24:207-18. [PMID: 20880198 DOI: 10.1111/j.1755-148x.2010.00781.x] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
G-protein-coupled receptors (GPCRs) have been implicated in the tumorigenesis and metastasis of human cancers and are considered amongst the most desirable targets for drug development. Utilizing a robust quantitative PCR array, we quantified expression of 94 human GPCRs, including 75 orphan GPCRs and 19 chemokine receptors, and 36 chemokine ligands, in 40 melanoma metastases from different individuals and benign nevi. Inter-metastatic site comparison revealed that orphan GPR174 and CCL28 are statistically significantly overexpressed in subcutaneous metastases, while P2RY5 is overexpressed in brain metastases. Comparison between metastases (all three metastatic sites) and benign nevi revealed that 16 genes, including six orphan receptors (GPR18, GPR34, GPR119, GPR160, GPR183 and P2RY10) and chemokine receptors CCR5, CXCR4, and CXCR6, were statistically significantly differentially expressed. Subsequent functional experiments in yeast and melanoma cells indicate that GPR18, the most abundantly overexpressed orphan GPCR in all melanoma metastases, is constitutively active and inhibits apoptosis, indicating an important role for GPR18 in tumor cell survival. GPR18 and five other orphan GPCRs with yet unknown biological function may be considered potential novel anticancer targets in metastatic melanoma.
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Affiliation(s)
- Y Qin
- Department of Dermatology, Leiden University Medical Center, Leiden, The Netherlands
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Garcia Rodriguez P, Eikenboom H, Tesselaar M, Huisman M, Nijkeuter M, Osanto S, Bertina R. Plasma levels of microparticle-associated tissue factor activity in patients with clinically suspected pulmonary embolism. Thromb Res 2010; 126:345-9. [DOI: 10.1016/j.thromres.2010.07.006] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2010] [Revised: 07/01/2010] [Accepted: 07/12/2010] [Indexed: 12/21/2022]
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Weijl NI, Willemse P, Van Steijn-Van Tol J, Kolb R, Burggraaf K, Osanto S. Serum nonprotein-bound iron in testicular cancer patients treated with BEP chemotherapy. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e13148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Osanto S, Hutson TE, Calvo E, Escudier BJ, Oudard S, Porta C, Bracarda S, Grunwald V, Ravaud A, Motzer RJ. Efficacy and safety of everolimus in elderly patients (pts) with metastatic renal cell carcinoma (mRCC). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.4608] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Yuana Y, Oosterkamp TH, Bahatyrova S, Ashcroft B, Garcia Rodriguez P, Bertina RM, Osanto S. Atomic force microscopy: a novel approach to the detection of nanosized blood microparticles. J Thromb Haemost 2010; 8:315-23. [PMID: 19840362 DOI: 10.1111/j.1538-7836.2009.03654.x] [Citation(s) in RCA: 180] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
BACKGROUND Microparticles (MPs) are small vesicles released from cells of different origin, bearing surface antigens from parental cells. Elevated numbers of blood MPs have been reported in (cardio)vascular disorders and cancer. Most of these MPs are derived from platelets. OBJECTIVES To investigate whether atomic force microscopy (AFM) can be used to detect platelet-derived MPs and to define their size distribution. METHODS Blood MPs isolated from seven blood donors and three cancer patients were immobilized on a modified mica surface coated with an antibody against CD41 prior to AFM imaging. AFM was performed in liquid-tapping mode to detect CD41-positive MPs. In parallel, numbers of CD41-positive MPs were measured using flow cytometry. Mouse IgG1 isotype control was used as a negative control. RESULTS AFM topography measurements of the number of CD41-positive MPs were reproducible (coefficient of variation=16%). Assuming a spherical shape of unbound MPs, the calculated diameter of CD41-positive MPs (dsph) ranged from 10 to 475 nm (mean: 67.5+/-26.5 nm) and from 5 to 204 nm (mean: 51.4+/-14.9 nm) in blood donors and cancer patients, respectively. Numbers of CD41-positive MPs were 1000-fold higher than those measured by flow cytometry (3-702x10(9) L(-1) plasma vs. 11-626x10(6) L(-1) plasma). After filtration of isolated MPs through a 0.22-microm filter, CD41-positive MPs were still detectable in the filtrate by AFM (mean dsph: 37.2+/-11.6 nm), but not by flow cytometry. CONCLUSIONS AFM provides a novel method for the sensitive detection of defined subsets of MPs in the nanosize range, far below the lower limit of what can be measured by conventional flow cytometry.
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Affiliation(s)
- Y Yuana
- Department of Clinical Oncology, Leiden University Medical Centre, Leiden, the Netherlands
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de Kruijf E, van Nes J, Sajet A, Putter H, Osanto S, Speetjens F, Smit V, Liefers G, van de Velde C, Kuppen P. PP17 The predictive value of HLA Class I tumor cell expression and tumor infiltration by regulatory T cells for chemotherapy in patients with early breast cancer. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)72154-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Mulders P, Hawkins R, Nathan P, de Jong I, Osanto S, Porfiri E, Protheroe A, Mookerjee B, Pike L, Gore M. 49LBA Final results of a Phase II randomised study of cediranib (RECENTIN™) in patients with advanced renal cell carcinoma (RCC). EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)72084-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Tesselaar MET, Romijn FPHTM, van der Linden IK, Bertina RM, Osanto S. Microparticle-associated tissue factor activity in cancer patients with and without thrombosis. J Thromb Haemost 2009; 7:1421-3. [PMID: 19500241 DOI: 10.1111/j.1538-7836.2009.03504.x] [Citation(s) in RCA: 123] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Woei-A-Jin FJSH, Kapiteijn E, Nortier JWR, Osanto S. Abdominal pain, low grade fever and persistent shock. Neth J Med 2009; 67:288-292. [PMID: 19687524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Affiliation(s)
- F J S H Woei-A-Jin
- Department of General Internal Medicine, Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, the Netherlands.
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Kolb A, Smit N, Lentz-Ljuboje R, Osanto S, van Pelt J. Non-transferrin bound iron measurement is influenced by chelator concentration. Anal Biochem 2009; 385:13-9. [DOI: 10.1016/j.ab.2008.11.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2008] [Revised: 11/04/2008] [Accepted: 11/04/2008] [Indexed: 10/21/2022]
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Broeyer FJF, Osanto S, Ritsema van Eck HJ, van Steijn AQMJ, Ballieux BEPB, Schoemaker RC, Cohen AF, Burggraaf J. Evaluation of biomarkers for cardiotoxicity of anthracyclin-based chemotherapy. J Cancer Res Clin Oncol 2008; 134:961-8. [PMID: 18343950 PMCID: PMC2515587 DOI: 10.1007/s00432-008-0372-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2007] [Accepted: 02/28/2008] [Indexed: 11/25/2022]
Abstract
Introduction The clinical assessment of the myocardial damage caused by anthracyclin (ANT)-therapy is difficult. Therefore a study was performed to evaluate non-invasive markers of anthracyclin-induced cardiac effects, with emphasis on course-to-course variation. Methods Eligible for study participation were patients, without known cardiologic abnormalities who did not use cardiotoxic medication (except for ANT-therapy), who had previously completed at least three cycles of anthracyclin-containing chemotherapy (n = 14) and patients who were ANT-naïve and who were scheduled to receive doxorubicin-containing chemotherapy (n = 12). Seven patients in this last group also completed at least three cycles and were available for follow-up assessments; thus a total population of 21 patients (12F/9M) completed at least three courses ANT-chemotherapy. In these patients blood samples and ECG-recordings were taken within 6 months after completion of ANT-therapy. In 12 patients (10F/2M) assessments were also done before, immediately afterwards and at 24 h after each course of ANT. Results and Conclusions In the patients who completed chemotherapy, NT-proBNP was 277% (n = 21; 95% CI: 86–661%, P < 0.001) higher compared to healthy volunteers. During the first course NT-proBNP rose 269% (n = 12; 167–409%, P < 0.0001) at 24 h post-administration. The linear corrected QT (QTcL) directly after the first administration of ANT increased by 9.56 ms (n = 12; 3.85–15.27, P < 0.001) and this prolongation was still present at 24 h, 11.48 ms (n = 12; 5.61–17.34, P < 0.0001). Both NT-proBNP and QTcL returned to baseline before the start of the next course and a similar pattern was observed during each course. NT-proBNP and QTcL may be useful markers for course-to-course evaluation of anthracyclin-induced cardiotoxicity.
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Affiliation(s)
- F J F Broeyer
- Centre for Human Drug Research, Leiden, The Netherlands.
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de Mulder PHM, Haanen JBAG, Sleijfer S, Kruit WHJ, Gietema JA, Richel DJ, Groenewegen G, Voest EE, van den Eertwegh AJM, Osanto S, Jansen RLH, Mulders PFA. [Angiogenesis inhibitors for the systemic treatment of metastatic renal cell carcinoma: sunitinib, sorafenib, bevacizumab and temsirolimus]. Ned Tijdschr Geneeskd 2008; 152:371-375. [PMID: 18380383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Treatment of patients with metastatic renal cell carcinoma is evolving rapidly due to the advent of novel targeted therapies. Improved knowledge of the underlying pathogenesis has led to the development of drugs that modulate the dominant signal transduction pathways for this disease, which results in inhibition of angiogenesis. Recent evidence indicates that the receptor tyrosine kinase inhibitor sunitinib prolongs progression-free survival compared with interferon-alpha, especially in patients with intermediate risk. Immunotherapy with interferon-alpha or high-dose interleukin-2 should still be considered for low-risk patients, particularly those with clear-cell tumours and metastases of the lung only. In patients who fail treatment with interferon-alpha, sorafenib has been shown to improve progression-free survival. High-risk patients may benefit from treatment with temsirolimus, which inhibits mammalian target of rapamycin (mTOR) kinase activity and has shown to improve overall survival. These angiogenesis inhibitors did not receive mention in the recently published guideline 'Renal cell carcinoma'.
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Mulders PFA, Brouwers AH, Hulsbergen-van der Kaa CA, van Lin ENJT, Osanto S, de Mulder PHM. [Guideline 'Renal cell carcinoma']. Ned Tijdschr Geneeskd 2008; 152:376-380. [PMID: 18380384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Each year, more than 1500 new cases of renal cell carcinoma are diagnosed in the Netherlands, and approximately 850 patients die due to this disease. The guideline 'Renal cell carcinoma' contains clinical practice recommendations on the diagnosis (imaging, pathological assessment, histopathological classification) and treatment (surgery, chemo-, immuno-, and radiotherapy) of renal cell carcinoma. For diagnostic imaging, chest and abdominal CT is recommended. Scintigraphy is not recommended. The term 'Grawitz tumour' is obsolete and should be replaced by 'renal cell carcinoma' with histological subtype specification according to the 2004 WHO classification. Laparoscopic radical nephrectomy is as effective as open surgery for localised tumours (T1 and T2) and possibly also for T3 tumours. The laparoscopic approach is associated with less morbidity due to the less invasive nature of this technique. This operation requires experience. In partial nephrectomy, a small margin of healthy tissue is sufficient. Frozen section examination of the resection edges does not appear to be required. In patients with metastatic renal cell carcinoma who are eligible for immunotherapy, removal of the tumour prolongs survival. Metastasectomy prolongs survival in patients with a solitary metastasis. Most currently available cytotoxic agents are ineffective against renal cell carcinoma. Interferon-alpha may have a role in the treatment of patients with renal cell carcinoma and favourable prognostic factors, given the survival advantage demonstrated with this agent in clinical trials. The guideline is available in English at www.oncoline.nl.
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Affiliation(s)
- P F A Mulders
- Universitair Medisch Centrum St Radboud, Postbus 9101, 6500 HB Nijmegen.
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van Bronswijk H, Dubois EA, Osanto S, Cohen AF. [New drugs; sunitinib and sorafenib]. Ned Tijdschr Geneeskd 2007; 151:2888-2890. [PMID: 18257434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Sunitinib and sorafenib are both indicated for the treatment of advanced kidney carcinoma of the 'clear cell' type after failure of, or resistance to, other treatments. Both drugs inhibit the tyrosine-kinase activity of a number of growth factor receptors; sorafenib has an additional inhibitory effect on serine/threonine-kinase activity. This mechanism decreases signal transduction and results in an inhibition of tumour cell growth and angiogenesis. The adverse effects of the two drugs are different: sunitinib causes mainly fatigue and gastrointestinal discomfort, whereas sorafenib's most frequent adverse effects are diarrhoea, rash, the palmar-plantar erythrodysaesthesia syndrome, and hypertension.
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Affiliation(s)
- H van Bronswijk
- Leids Universitair Medisch Centrum, Albinusdreef 2, 2333 ZA, Leiden
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Abstract
5053 Background: Survival of men with testicular cancer is long due to successful therapeutic intervention, which usually includes orchidectomy. Therefore, we studied the prevalence of osteoporosis in a single center cohort of long term survivors of germ cell cancer. Methods: In a cross-sectional study design, we studied 186 male patients with a mean age of 39.6 years (range 18.1–66.8), who were treated between 1977 and 2006 for germ cell cancer. 181 (97.3%) patients underwent an unilateral, 3 (1.6%) a bilateral orchidectomy and in 2 (1.1%) patients no orchidectomy but retroperitoneal or mediastinal tumor biopsy was performed to confirm the diagnosis. 141 (75.8%) patients received cisplatin-based combination chemotherapy for metastases or primary extra-gonadal tumor at a mean age of 29.4 years (range 14.2- 62.6). Between 2003 and 2006, bone mineral density (BMD) was measured at the lumbar spine and femoral neck by DXA and Z-scores calculated. Vertebral deformities were evaluated by a semi-quantitative measurement on lateral x-rays of the spine. Non-vertebral fractures were evaluated by questionnaire and confirmed by x-ray. All patients had normal total testosterone, estradiol, parathyroid hormone, 25(OH)- vitamin D and 1,25(OH)2-vitamin D concentrations, evaluated by fasting blood samples. Results: BMD was low in 59 (31.7%) patients; 46 (24.7%) patients had Z-scores between -1 and -2 SD, while thirteen (7.0%) had Z-scores below -2 SD. Vertebral deformities were present in 57 of 151 (37.7 %) evaluated patients, sixteen of whom also had low BMD. There was no relationship between vertebral deformities and either age, chemotherapy or testosterone/estradiol levels. No correlation was found between vertebral deformities and low BMD. Eight of 114 (7.0%) patients who responded to the questionnaire had non-vertebral fractures at a mean age of 44.9 years (range 33.1–54.2); 1–17 years after the initial diagnosis of testicular cancer. Conclusions: More than one third of the eugonadal male survivors of germ cell cancer survivors have vertebral abnormalities which are not related to age, chemotherapy or genital hormone concentrations. The underlying mechanism remains unknown. This high prevalence of bone abnormalities indicates that screening should be advocated in all germ cell cancer survivors. No significant financial relationships to disclose.
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Tesselaar MET, Romijn FPHTM, Van Der Linden IK, Prins FA, Bertina RM, Osanto S. Microparticle-associated tissue factor activity: a link between cancer and thrombosis? J Thromb Haemost 2007; 5:520-7. [PMID: 17166244 DOI: 10.1111/j.1538-7836.2007.02369.x] [Citation(s) in RCA: 407] [Impact Index Per Article: 23.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Cancer, in particular mucinous adenocarcinoma, is associated with venous thromboembolism (VTE). Tissue factor (TF), initiator of coagulation, plays a central role in the paradigm that clotting and tumor growth form a vicious circle, in which hypercoagulability facilitates the aggressive biology of cancer and vice versa. Expression of TF in tumors is associated with poor differentiation and poor prognosis. PATIENT/METHODS We investigated the association between clinically manifest VTE and procoagulant properties of circulating microparticles (MP) isolated from blood of unselected pancreatic and breast adenocarcinoma patients' consecutive subjects, who presented with ultrasound or CT-scan confirmed VTE, and healthy subjects. RESULTS Patients with disseminated breast and pancreatic cancer had significantly increased levels of MP-associated TF activity compared with healthy controls, subjects with idiopathic acute VTE and non-metastatic cancer patients. Patients with both high MP-associated TF-activity and MP-associated epithelial mucin (MUC1) had a lower survival rate at 3-9 months follow-up than those with low TF-activity and no MUC1 expression: the likelihood of survival was 0.42 (95% CI: 0.19- 0.94) for an individual with these two predictor variables present, after adjustment for other factors (age cohort, type of cancer, VTE) in the Cox proportional hazards model. CONCLUSIONS Our results suggest an important role for MP-associated TF and MUC1 in the pathogenesis of thrombosis in disseminated mucinous adenocarcinoma patients. Future studies should reveal the mechanism underlying the observed associations.
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Affiliation(s)
- M E T Tesselaar
- Department of Clinical Oncology, Leiden University Medical Center, Leiden, the Netherlands
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Blom J, Doggen C, Osanto S. Malignancies, prothrombotic mutations, and the risk of venous thrombosis. J Vasc Surg 2006. [DOI: 10.1016/j.jvs.2006.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Blom JW, Osanto S, Rosendaal FR. High risk of venous thrombosis in patients with pancreatic cancer: a cohort study of 202 patients. Eur J Cancer 2006; 42:410-4. [PMID: 16321518 DOI: 10.1016/j.ejca.2005.09.013] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2005] [Revised: 09/12/2005] [Accepted: 09/28/2005] [Indexed: 02/07/2023]
Abstract
To estimate the risk of venous thrombosis associated with pancreatic malignancies we followed a cohort of patients with pancreatic cancer (n = 202). We calculated incidence rates of venous thrombosis and compared this with population rates using a Standardised Morbidity Ratio (SMR). The effects of location, histology and treatment were assessed by Cox-modelling. The incidence of venous thrombosis was 108.3/1000 patient-years (95% confidence interval (CI) 64.4-163.8), 58.6-fold increased (SMR 58.6, 95% CI 36.9-92.9). Patients with a tumour of the corpus/cauda had a 2-fold increased risk compared with those with a tumour of the caput. Patients treated with chemotherapy had a 4.8-fold increased risk (HR(adj) 4.8, 95% CI 1.1-20.8), whereas radiotherapy did not increase the risk. In a postoperative period of 30 d, patients had a 4.5-fold increased risk of venous thrombosis (HR(adj) 4.5, 95% CI 0.5-40.9). The risk was 1.9-fold increased in the presence of distant metastases (HR(adj) 1.9, 95% CI 0.7-5.1). Anti-thrombotic prophylaxis seems warranted in the first month after surgery, during and after treatment with chemotherapy, and when distant metastases have been diagnosed.
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Affiliation(s)
- J W Blom
- Department of Clinical Epidemiology, Leiden University Medical Centre, P.O. Box 9600, 2300 RC Leiden, The Netherlands
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Blom JW, Vanderschoot JPM, Oostindiër MJ, Osanto S, van der Meer FJM, Rosendaal FR. Incidence of venous thrombosis in a large cohort of 66,329 cancer patients: results of a record linkage study. J Thromb Haemost 2006; 4:529-35. [PMID: 16460435 DOI: 10.1111/j.1538-7836.2006.01804.x] [Citation(s) in RCA: 448] [Impact Index Per Article: 24.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND The incidence of venous thrombosis (VT) for cancer patients is increased compared with patients without cancer, but estimations of the incidence for different types of cancer have rarely been made because of the low incidence of various types of cancer. Large registries offer an opportunity to study the risk of VT in large cohorts of cancer patients, which is essential in decisions on prophylactic anti-coagulant treatment. METHODS This cohort study estimates the incidence of VT in cancer patients by using record linkage of a Cancer Registry and an Anticoagulation Clinic database in the Netherlands. Cumulative incidences in patients with different types of malignancies were estimated. We calculated relative risks (RRs) in relation to the presence of distant metastases and treatment. RESULTS Tumors of the bone, ovary, brain, and pancreas are associated with the highest incidence of VT (37.7, 32.6, 32.1, and 22.7/1000/0.5 year). Patients with distant metastases had a 1.9-fold increased risk [RRadj: 1.9; 95% confidence interval (CI): 1.6-2.3]. Chemotherapy leads to a 2.2-fold increased risk (RR(adj): 2.2; 95% CI: 1.8-2.7) and hormonal therapy leads to a 1.6-fold increased risk (RRadj: 1.6; 95% CI: 1.3-2.1) compared with patients not using these treatment modalities. Patients with radiotherapy or surgery did not have an increased risk. CONCLUSIONS We compared the overall incidences of VT in the first half year in our study to the risk of major bleeding as described in the literature. For patients with distant metastases, for several types of cancer, prophylactic anti-thrombotic treatment could be beneficial.
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Affiliation(s)
- J W Blom
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
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Abstract
BACKGROUND Well known risk factors for upper extremity deep venous thrombosis are the presence of a central venous catheter (CVC) and malignancy, but other potential risk factors, such as surgery, injury and hormone replacement therapy (HRT), have not yet been explored. METHODS We performed a population-based case-control study including 179 consecutive patients, aged 18-70 years with upper extremity deep venous thrombosis and 2399 control subjects. Participants reported on acquired risk factors in a questionnaire and factor V Leiden and prothrombin 20210A mutation were ascertained. Information on CVC was obtained from discharge letters. RESULTS Forty-two patients (23%) and one control subject (0.04%) had a CVC (ORadj: 1136, 95% CI: 153-8448, adjusted for age and sex). Cancer patients without a CVC had an eightfold increased risk of venous thrombosis of the arm (ORcrude: 7.7, 95% CI: 4.6-13.0). Other evident risk factors were prothrombotic mutations, surgery, immobilization of the arm (plaster cast), oral contraceptive use and family history, with odds ratios varying from 2.0 up to 13.1. The risk in the presence of injury and during puerperium was twofold or more increased, although not significantly. In contrast HRT, unusual exercise, travel and obesity did not increase the risk. Hormone users had an increased risk in the presence of prothrombotic mutations or surgery. Obese persons (BMI > 30 kg m(-2)) undergoing surgery had a 23-fold increased risk of arm thrombosis compared with non-obese persons not undergoing surgery. CONCLUSION A CVC is a very strong risk factor for arm thrombosis. Most risk factors for thrombosis in the leg are also risk factors for arm thrombosis.
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Affiliation(s)
- J W Blom
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
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Affiliation(s)
- C J Rooden
- Department of General Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands
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Blom J, Doggen C, Osanto S. Malignancies, prothrombotic mutations, and the risk of venous thrombosis. J Vasc Surg 2005. [DOI: 10.1016/j.jvs.2005.04.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Tesselaar MET, Ouwerkerk J, Nooy MA, Rosendaal FR, Osanto S. Risk factors for catheter-related thrombosis in cancer patients. Eur J Cancer 2004; 40:2253-9. [PMID: 15454250 DOI: 10.1016/j.ejca.2004.06.023] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2004] [Revised: 06/15/2004] [Accepted: 06/28/2004] [Indexed: 11/24/2022]
Abstract
We investigated the risk factors for venous thrombosis in cancer patients with implantable ports undergoing chemotherapy. One hundred and seventy one ports were placed in a central ("chest ports") and 84 in a peripheral vein ("arm ports"), 181 received prophylactic nadroparin and 10 coumarin. Clinically overt thrombosis was confirmed by ultrasound or angiography. Catheter-related thrombosis incidence without anticoagulants was 28% in arm and 33% in chest ports, but with anticoagulants this was 32% in arm and only 1% in chest ports (odds ratio (OR) 34.8 95% confidence interval (CI) 7.3-165). Left-sided placement compared with right-sided and catheter tip position in the superior vena cava compared with right atrium were associated with a 3.5 respectively 2.6-fold increased risk. Thrombosis was associated with elevated homocysteine levels (OR=3.8, 95% CI 1.3-11.3), but not with factor V Leiden or prothrombin 20210A gene mutations, or high concentration of factor VIII, IX or XI. Prophylaxis with anticoagulants is recommended for chest, but not for arm ports. Determination of plasma homocysteine levels may identify patients at an increased risk for thrombosis.
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Affiliation(s)
- M E T Tesselaar
- Department of Clinical Oncology, Leiden University Medical Center, P.O. Box, Albinusdreef 2, Leiden ZA 2333, The Netherlands
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Blom JW, Osanto S, Rosendaal FR. The risk of a venous thrombotic event in lung cancer patients: higher risk for adenocarcinoma than squamous cell carcinoma. J Thromb Haemost 2004; 2:1760-5. [PMID: 15456487 DOI: 10.1111/j.1538-7836.2004.00928.x] [Citation(s) in RCA: 162] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Only limited data on the incidence of venous thrombosis in different types of malignancy are available. Patients with adenocarcinoma are believed to have the highest risk of developing venous thrombosis. OBJECTIVES To study the incidence of thrombosis in patients with lung cancer, with an emphasis on the comparison between adenocarcinoma and squamous cell carcinoma, we have performed a cohort study of patients with non-small-cell lung cancer. In addition the risk associated with treatment and extent of disease was assessed. PATIENTS/METHODS A total of 537 patients with a first diagnosis of lung carcinoma were included. Patient and tumor characteristics as well as venous thrombotic events were recorded from the medical records and from the Anticoagulation Clinic. RESULTS Thrombotic risk in lung cancer patients was 20-fold higher than in the general population (standardized morbidity ratio (SMR): 20.0 (14.6-27.4). In the group of patients with squamous cell cancer we found 10 (10/258) cases (incidence: 21.2 per 1000 years) of venous thrombosis whereas in the group of patients with adenocarcinoma 14 (14/133) cases (incidence: 66.7 per 1000 years) occurred. The crude adjusted hazard ratio was 3.1 (95% CI: 1.4-6.9). The risk increased during chemotherapy and radiotherapy and in the presence of metastases. CONCLUSIONS The risk of venous thrombosis in lung cancer patients is increased 20-fold compared to the general population. Patients with adenocarcinoma have a higher risk than patients squamous cell carcinoma. During chemotherapy or radiotherapy and in the presence of metastases the risk is even higher.
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Affiliation(s)
- J W Blom
- Department of Clinical Epidemiology, Leiden University Medical Center, The Netherlands
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Weijl NI, Elsendoorn TJ, Lentjes EGWM, Hopman GD, Wipkink-Bakker A, Zwinderman AH, Cleton FJ, Osanto S. Supplementation with antioxidant micronutrients and chemotherapy-induced toxicity in cancer patients treated with cisplatin-based chemotherapy: a randomised, double-blind, placebo-controlled study. Eur J Cancer 2004; 40:1713-23. [PMID: 15251161 DOI: 10.1016/j.ejca.2004.02.029] [Citation(s) in RCA: 178] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2004] [Revised: 02/04/2004] [Accepted: 02/05/2004] [Indexed: 01/01/2023]
Abstract
Cisplatin-induced toxicities are mainly caused by the formation of free radicals, leading to oxidative organ damage. Plasma concentrations of antioxidants decrease significantly during cisplatin chemotherapy for cancer. Forty-eight cancer patients treated with cisplatin-based chemotherapy were randomised in a double-blind manner to receive either supplementation with vitamin C, vitamin E and selenium dissolved in a beverage or to receive a placebo beverage. Primary outcome measures were the amount of nephrotoxicity and ototoxicity induced by cisplatin. No significant differences were found between the two study groups with respect to these primary outcome measures. However, patients who achieved the highest plasma concentrations of the three antioxidant micronutrients had significantly less loss of high-tone hearing. In addition, significant correlations were found between the reduced/oxidised vitamin C ratio and malondialdehyde (MDA), markers of oxidative stress, and cisplatin-induced ototoxicity and nephrotoxicity. The lack of protection against cisplatin-induced toxicities in patients in the intervention arm may be related to poor compliance and/or inadequate supplementation. Supplementation with a higher dose (intensity) and in combination with other antioxidants should be investigated further.
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Affiliation(s)
- N I Weijl
- Department of Clinical Oncology, Leiden University Medical Center, Leiden, The Netherlands
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Weijl NI, Elsendoorn TJ, Moison RMW, Lentjes EGWM, Brand R, Berger HM, Osanto S. Non-protein bound iron release during chemotherapy in cancer patients. Clin Sci (Lond) 2004; 106:475-84. [PMID: 14670072 DOI: 10.1042/cs20030271] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2003] [Revised: 12/10/2003] [Accepted: 12/11/2003] [Indexed: 11/17/2022]
Abstract
Non-protein bound iron (NPBI) is able to catalyse oxidative reactions, causing damage to vital structures. Adverse effects induced by cisplatin seem, in part, to be mediated by free radicals. In the present study, we have measured plasma NPBI, various other iron parameters and antioxidants in 28 cancer patients undergoing cisplatin-based chemotherapy at various time points before and during chemotherapy. No NPBI was present prior to therapy, but within 1-4 days following the first administration of chemotherapy, mean NPBI rose significantly to 10.6+/-6.6 micromol/l (range, 0.6-21.3 micromol/l) in 18 (64.3%) of the 28 patients measured. The rise in NPBI was accompanied by a significant rise in total plasma iron and ferritin and a marked decrease in the latent iron-binding capacity. Concomitantly, plasma vitamins C and E decreased significantly, indicating consumption of antioxidants. Similar observations were also made during the fourth chemotherapy cycle. The increase in NPBI preceded and correlated significantly with chemotherapy toxicity, such as a decrease in leucocyte count and haemoglobin, with a transient rise in various liver enzymes and with known cisplatin-related toxicity, i.e. the loss of renal and hearing function. In conclusion, cisplatin chemotherapy induces oxidative damage which rapidly leads to release of iron from intracellular proteins and the appearance of NPBI. Bone marrow, red blood cells, liver and kidney seem to be a likely source of NPBI. The observed high levels of NPBI may be a major causative determinant in chemotherapy-induced toxicity.
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Affiliation(s)
- N I Weijl
- Department of Clinical Oncology, Leiden University Medical Center, Leiden, The Netherlands
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