Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 15 de 15
Filter
1.
Cancers (Basel) ; 14(4)2022 Feb 16.
Article in English | MEDLINE | ID: mdl-35205748

ABSTRACT

Regular physical activity (PA) is associated with improved overall survival (OS) in stage I-III colorectal cancer (CRC) patients. This association is less defined in patients with metastatic CRC (mCRC). We therefore conducted a study in mCRC patients participating in the Prospective Dutch Colorectal Cancer cohort. PA was assessed with the validated SQUASH questionnaire, filled-in within a maximum of 60 days after diagnosis of mCRC. PA was quantified by calculating Metabolic Equivalent Task (MET) hours per week. American College of Sports and Medicine (ACSM) PA guideline adherence, tertiles of moderate to vigorous PA (MVPA), and sport and leisure time MVPA (MVPA-SL) were assessed as well. Vital status was obtained from the municipal population registry. Cox proportional-hazards models were used to study the association between PA determinants and all-cause mortality adjusted for prognostic patient and treatment-related factors. In total, 293 mCRC patients (mean age 62.9 ± 10.6 years, 67% male) were included in the analysis. Compared to low levels, moderate and high levels of MET-hours were significantly associated with longer OS (fully adjusted hazard ratios: 0.491, (95% CI 0.299-0.807, p value = 0.005) and 0.485 (95% CI 0.303-0.778, p value = 0.003), respectively), as were high levels of MVPA (0.476 (95% CI 0.278-0.816, p value = 0.007)) and MVPA-SL (0.389 (95% CI 0.224-0.677, p value < 0.001)), and adherence to ACSM PA guidelines compared to non-adherence (0.629 (95% CI 0.412-0.961, p value = 0.032)). The present study provides evidence that higher PA levels at diagnosis of mCRC are associated with longer OS.

2.
J Altern Complement Med ; 24(9-10): 942-953, 2018.
Article in English | MEDLINE | ID: mdl-30247961

ABSTRACT

OBJECTIVES: To compare the effectiveness of yoga added to standard care (SC) versus SC only, in women with breast cancer during chemotherapy. DESIGN: A multicenter pragmatic, randomized controlled study. SETTINGS/LOCATION: Three hospitals in the Netherlands. SUBJECTS: Women with stage I-III breast cancer undergoing chemotherapy. INTERVENTIONS: Women were randomized either to a program based on Dru Yoga, once a week yoga sessions for 12 weeks (N = 47), or SC only (N = 36). OUTCOME MEASURES: Primary outcome fatigue (Multidimensional Fatigue Inventory [MFI]; general fatigue) and secondary outcomes fatigue (MFI, Fatigue Quality List [FQL]), quality of life (30-item Quality of Life Questionnaire-C of the European Organization for Research and Treatment of Cancer [EORTC-QLQ-C-30]) and psychological distress (Hospital Anxiety Depression Scale [HADS], Impact of Events Scale [IES]) were measured at baseline (T0), 3 months (T1), and 6 months (T2) and analyzed on observed cases. Other outcomes were adequate relief, reintegration to work, and adverse events. RESULTS: No significant differences were found in general fatigue at T1 (MFI: yoga; 14.6 ± 4.5 vs. SC; 14.2 ± 4.2, p = 0.987). Similar findings were observed for other fatigue (sub)scales of MFI and FQL and functional domains of EORTC. With respect to EORTCs symptom scales, women in the yoga group reported significantly less nausea and vomiting compared with SC at T2 (p = 0.004), but not at T1 (p = 0.807). Depressive symptoms were significantly lower with yoga at T1 (HADS: yoga; 4.7 ± 4.1 vs. SC; 5.1 ± 4.2, p = 0.031). More women in the yoga group experienced adequate relief compared with SC at T1 (yoga; 51% vs. SC; 19%) and had returned to work at T2 (yoga; 53% vs. SC; 23%). No adverse events were reported with yoga. CONCLUSIONS: A Dru-based yoga program failed to demonstrate a significant beneficial effect on fatigue. Possible favorable effects of the yoga program on nausea and vomiting and early return to work in breast cancer survivors warrant further research.


Subject(s)
Breast Neoplasms/therapy , Fatigue/therapy , Neoadjuvant Therapy , Quality of Life , Yoga , Adult , Depression/therapy , Female , Humans , Middle Aged , Netherlands , Stress, Psychological/therapy
4.
Clin Imaging ; 35(3): 232-5, 2011.
Article in English | MEDLINE | ID: mdl-21513864

ABSTRACT

Retroperitoneal cystic tumours are rarely found, and of these, the most common lesion is a cystic lymphangioma. We present two postpartum patients with a cystic retroperitoneal tumour which showed spontaneous regression and a review of the literature.


Subject(s)
Cysts/complications , Cysts/diagnosis , Diagnostic Imaging/methods , Retroperitoneal Neoplasms/complications , Retroperitoneal Neoplasms/diagnosis , Adult , Female , Humans , Neoplasm Regression, Spontaneous , Postpartum Period
5.
J Emerg Med ; 39(5): 592-5, 2010 Nov.
Article in English | MEDLINE | ID: mdl-19157748

ABSTRACT

BACKGROUND: Bleeding within the biliary tree, called hemobilia, is a rare complication after blunt hepatic trauma. OBJECTIVES: To report on a patient who developed hemobilia 1 month after a blunt abdominal injury and to discuss the diagnosis and treatment of hemobilia. CASE REPORT: A 17-year-old boy presented with upper gastrointestinal bleeding caused by hemobilia 1 month after a blunt liver injury. Angiography revealed a pseudoaneurysm of the right hepatic artery, which was successfully treated with embolization. CONCLUSIONS: The diagnosis of hemobilia first requires consideration of the diagnosis, particularly in patients with previous abdominal trauma. Hemobilia should be included in the differential diagnosis of upper gastrointestinal bleeding. Investigations of choice include computed tomography scan followed by angiography. During angiography, treatment can be done by endovascular embolization.


Subject(s)
Hemobilia/etiology , Wounds, Nonpenetrating/complications , Adolescent , Aneurysm, False/diagnosis , Aneurysm, False/diagnostic imaging , Aneurysm, False/etiology , Embolization, Therapeutic , Enbucrilate/administration & dosage , Ethiodized Oil/administration & dosage , Gastrointestinal Hemorrhage/complications , Hemobilia/diagnosis , Hemobilia/therapy , Hepatic Artery , Humans , Liver/injuries , Male , Tomography, X-Ray Computed
6.
J Gastrointest Surg ; 13(11): 2064-7, 2009 Nov.
Article in English | MEDLINE | ID: mdl-19557482

ABSTRACT

INTRODUCTION: Within this report, we present a patient with difficulty of swallowing caused by an aberrant right subclavian artery. DISCUSSION: This is a congenital anomaly with the right subclavian artery originating from the dorsal part of the aortic arch and coursing through the mediastinum between the esophagus and the vertebral column. The diagnosis and treatment of this disorder is discussed based on the findings from the literature.


Subject(s)
Deglutition Disorders/etiology , Subclavian Artery/abnormalities , Aged , Anastomosis, Surgical , Aorta, Thoracic/abnormalities , Humans , Male , Subclavian Artery/diagnostic imaging , Subclavian Artery/surgery , Tomography, X-Ray Computed , Vascular Surgical Procedures
7.
BMC Med Imaging ; 9: 5, 2009 Apr 07.
Article in English | MEDLINE | ID: mdl-19351404

ABSTRACT

BACKGROUND: Breast-conserving treatment of invasive breast carcinoma with an extensive intraductal component (EIC) is associated with DCIS-involved surgical margins and therefore it has an increased recurrence rate. EIC is a non-palpable lesion of which the size is frequently underestimated on mammography. This study was undertaken to evaluate the accuracy of MRI in size assessment of breast cancer with EIC. METHODS: 23 patients were identified and the mammographic (n = 21) and MR (n = 23) images were re-reviewed by a senior radiologist. Size on MR images was compared with histopathological tumour extent. RESULTS: The correlation of radiological size with histopathological size was r = 0.20 in mammography (p = 0.39) compared to r = 0.65 in MRI (p < 0.01). Mammography underestimated histopathological tumour size in 62%. MR images over- or underestimated tumour size in 22% and 30% of the cases, respectively. In poorly differentiated EIC, MRI adequately estimated the extent more often compared to moderately differentiated EIC (60% versus 25%, respectively). CONCLUSION: Size assessment of MRI imaging was more accurate compared to mammography. This was predominantly true for poorly differentiated EIC.


Subject(s)
Algorithms , Breast Neoplasms/diagnosis , Carcinoma, Ductal, Breast/diagnosis , Image Enhancement/methods , Image Interpretation, Computer-Assisted/methods , Adult , Aged , Female , Humans , Middle Aged , Reproducibility of Results , Sensitivity and Specificity
8.
Am J Surg ; 198(2): 262-9, 2009 Aug.
Article in English | MEDLINE | ID: mdl-19375068

ABSTRACT

BACKGROUND: After breast-conserving surgery of ductal carcinoma in situ (DCIS) of the breast or invasive breast carcinoma with an extensive intraductal component, tumor-positive surgical margins are frequently found. Therefore, the extent of the intraductal disease needs to be accurately determined preoperatively. METHODS: Data for this review were identified by search of PubMed. Reference lists of selected articles were cross-searched for additional literature. RESULTS: DCIS is accurately detected with magnetic resonance imaging (MRI), but the typical malignant features are inconsistently seen and most often in high-grade DCIS or in DCIS with a small invasive component. The histopathologic extent of DCIS is more accurately demonstrated with MRI. However, overestimation due to benign proliferative lesions does frequently occur. An improved depiction of DCIS could lead to improved preoperative staging. Conversely, the identification of more extensive disease on MRI could give rise to unnecessary interventions. Therefore, MRI should be used carefully and preferable in specialized and experienced centers. CONCLUSION: [corrected] To date, there is no evidence that the use of MRI improves outcomes (ie, decreases recurrence rates) in patients with DCIS.


Subject(s)
Breast Neoplasms/pathology , Carcinoma in Situ/pathology , Carcinoma, Ductal, Breast/pathology , Magnetic Resonance Imaging , Breast Neoplasms/surgery , Carcinoma in Situ/surgery , Carcinoma, Ductal, Breast/surgery , Female , Humans , Mastectomy , Mastectomy, Segmental , Preoperative Care
10.
Int J Radiat Oncol Biol Phys ; 69(3): 703-10, 2007 Nov 01.
Article in English | MEDLINE | ID: mdl-17544591

ABSTRACT

PURPOSE: Outcomes after different treatment strategies for ductal carcinoma in situ (DCIS) of the breast were analyzed for a geographically defined population in the East Netherlands. METHODS AND MATERIALS: A total of 798 patients with a first diagnosis of DCIS between January 1989 and December 2003 were included and their medical records were reviewed. Survival rates for ipsilateral recurrences were calculated by the Kaplan-Meier method and a multivariate Cox proportional hazards regression model was used to evaluate the prognostic significance of different variables. RESULTS: The 5-year recurrence-free survival was 75% for breast conserving surgery (BCS) alone (237 patients) compared with 91% for BCS followed by radiation therapy (RT; 153 patients) and 99% for mastectomy (408 patients, p < 0.01). Independent risk factors for local recurrences were treatment strategy, symptomatically detected DCIS, and presence of comedo necrosis. Margin status reached statistical significance only for patients treated by BCS (hazard ratio, 2.0; 95% confidence interval, 1.1-4.0) whereas significance of other prognostic variables did not change. CONCLUSIONS: In a defined population outside a trial setting, RT after BCS for DCIS lowered recurrence rates. Besides the use of RT, a microscopically complete excision of DCIS is essential. This is especially true for patients with symptomatically detected DCIS and with tumors that contain comedo necrosis, as these groups are at particular high risk for recurrent disease.


Subject(s)
Breast Neoplasms/therapy , Carcinoma, Intraductal, Noninfiltrating/therapy , Neoplasm Recurrence, Local , Adult , Aged , Aged, 80 and over , Breast Neoplasms/mortality , Carcinoma, Intraductal, Noninfiltrating/mortality , Combined Modality Therapy/statistics & numerical data , Female , Humans , Mastectomy/statistics & numerical data , Mastectomy, Segmental/statistics & numerical data , Middle Aged , Neoplasm Recurrence, Local/mortality , Neoplasm Recurrence, Local/prevention & control , Netherlands/epidemiology , Proportional Hazards Models , Radiation Injuries/complications , Radiotherapy/statistics & numerical data , Survival Rate , Treatment Outcome
11.
Pediatr Surg Int ; 22(10): 857-60, 2006 Oct.
Article in English | MEDLINE | ID: mdl-16924507

ABSTRACT

A 20-year-old patient with a chronic fistula located at the left scapular region caused by a deep located subscapular bronchogenic cyst is described.


Subject(s)
Bronchogenic Cyst/complications , Cutaneous Fistula/etiology , Adult , Bronchogenic Cyst/diagnosis , Bronchogenic Cyst/surgery , Cutaneous Fistula/diagnosis , Cutaneous Fistula/surgery , Diagnosis, Differential , Humans , Magnetic Resonance Imaging , Male , Scapula
12.
Acta Oncol ; 45(5): 544-9, 2006.
Article in English | MEDLINE | ID: mdl-16864167

ABSTRACT

To assess quality of surgical treatment of ductal carcinoma in situ (DCIS) and to compare teaching and non-teaching hospitals that constitute the Comprehensive Cancer Centres of the Middle Netherlands (IKMN), we retrospectively reviewed 499 patients with 502 DCIS lesions treated in the period 1989-2002. In teaching hospitals fewer patients presented with clinical symptoms compared to non-teaching hospitals (15% versus 24.0%, p = 0.01). Finally, 65% of patients underwent breast-conserving surgery and 35% of patients a mastectomy (no significant differences between the two types of hospitals). In teaching hospitals 19% of the patients had a disease-involved or unknown surgical margins versus 13% in non-teaching hospitals (p = 0.04). Twenty patients (4%) received radiation therapy postoperatively with no differences between teaching and non-teaching hospitals (p = 0.98). Quality of surgical treatment is the most important prognostic factor in treatment of DCIS. The quality of excisions should be improved and the exact status of margins should be recorded in pathology reports.


Subject(s)
Breast Neoplasms/surgery , Carcinoma in Situ/surgery , Outcome and Process Assessment, Health Care , Quality Assurance, Health Care/methods , Adult , Aged , Aged, 80 and over , Breast Neoplasms/diagnosis , Carcinoma in Situ/diagnosis , Female , Hospitals, District/statistics & numerical data , Hospitals, University/statistics & numerical data , Humans , Middle Aged , Netherlands , Outcome and Process Assessment, Health Care/statistics & numerical data , Predictive Value of Tests , Retrospective Studies , Treatment Outcome
13.
Am J Surg ; 192(2): 172-8, 2006 Aug.
Article in English | MEDLINE | ID: mdl-16860625

ABSTRACT

BACKGROUND: The value of magnetic resonance imaging (MRI) in diagnosis and size assessment of ductal carcinoma-in-situ (DCIS) and DCIS with small (<10 mm) invasive carcinoma was evaluated. METHODS: Fifty-four patients with DCIS and 12 patients with DCIS and small invasive carcinoma were included. Mammographic (N = 64) and MRI (N = 22) images were retrospectively reviewed. Correlation coefficients were calculated to assess differences in size between imaging and histopathologic examination. RESULTS: Mammographic rate of detection for DCIS was 48/52 (92%) and for DCIS with small invasive carcinoma, 10/12 (83%). MRI revealed 1 false negative case and the rate of detection for DCIS was 16/17 (94%). Correlation of mammographic size with histopathologic size was r = .44 (P < .01) and r = 0.49 (P = .03) for MRI. Mammography underestimated lesion size by 5 mm or more in 47%, whereas with MRI size was adequately assessed in 43% and overestimated in 38%. CONCLUSIONS: DCIS can be visualised on MRI with high sensitivity, although tumor size can be overestimated.


Subject(s)
Breast Neoplasms/diagnosis , Carcinoma in Situ/diagnosis , Carcinoma, Ductal, Breast/diagnosis , Magnetic Resonance Imaging , Adult , Biopsy, Needle , Diagnosis, Differential , Female , Follow-Up Studies , Humans , Mammography , Middle Aged , Neoplasm Staging , Reproducibility of Results , Retrospective Studies
14.
Ann Surg Oncol ; 13(7): 990-8, 2006 Jul.
Article in English | MEDLINE | ID: mdl-16788762

ABSTRACT

BACKGROUND: The main goal in treatment of ductal carcinoma-in-situ (DCIS) of the breast is to prevent local recurrences. Radiotherapy after breast-conserving surgery has been shown to decrease the recurrence rate, although whether all patients should be treated with radiotherapy remains a topic of debate. The aim of this study was to assess the local recurrence rate after conservative surgical treatment of DCIS without radiotherapy and to identify risk factors for local recurrence. METHODS: A total of 499 female patients with 502 DCIS lesions treated in the period 1989 to 2002 were retrospectively reviewed. Survival rates were calculated by the Kaplan-Meier method, and differences were tested by using the log-rank test. The association of variables with local recurrence was analyzed by using the chi2 test. RESULTS: Treatment constituted of lumpectomy in 329 patients (65%). Thirty-eight patients (8%) had disease-positive margins, and for 41 patients (8%) the margin status was not known. Eighty tumors recurred, for a local recurrence rate of 13% after 4 years compared with 17% for patients treated with breast-conserving surgery only. Risk factors for ipsilateral recurrences were younger age (< 50 years), treatment with breast-conserving surgery only, and presence of disease-involved surgical margins. CONCLUSIONS: Conservative treatment of DCIS results in high recurrences rates, and outcomes can be improved by performing more radical surgery. Because radiotherapy has been shown to be effective in preventing recurrent disease, and, to date, no subgroups have been identified in which radiation can be omitted, its use is recommended, especially in younger patients.


Subject(s)
Breast Neoplasms/pathology , Carcinoma, Ductal, Breast/pathology , Carcinoma, Intraductal, Noninfiltrating/pathology , Neoplasm Recurrence, Local/diagnosis , Adult , Age Factors , Aged , Aged, 80 and over , Breast Neoplasms/surgery , Carcinoma, Ductal, Breast/surgery , Carcinoma, Intraductal, Noninfiltrating/surgery , Female , Humans , Mammography , Mastectomy, Segmental , Middle Aged , Neoplasm Recurrence, Local/etiology , Prognosis , Retrospective Studies , Survival Rate , Treatment Outcome
15.
Gynecol Oncol ; 97(1): 279-81, 2005 Apr.
Article in English | MEDLINE | ID: mdl-15790477

ABSTRACT

BACKGROUND: Carcinoma arising in a neovagina is rare. CASE: A patient with an adenocarcinoma arising from a neovagina constructed with use of a sigmoid segment. CONCLUSION: Transplanted intestinal tissue should not be overlooked, especially in patients with an increased risk for developing metachronous malignancies.


Subject(s)
Adenocarcinoma/pathology , Colon, Sigmoid/surgery , Neoplasms, Second Primary/pathology , Plastic Surgery Procedures , Vagina/surgery , Vaginal Neoplasms/pathology , Colon, Sigmoid/pathology , Female , Humans , Middle Aged
SELECTION OF CITATIONS
SEARCH DETAIL
...