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Pancreatic Neoplasms: HELP
Articles by Ate van der Gaast
Based on 4 articles published since 2010
(Why 4 articles?)
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Between 2010 and 2020, Ate van der Gaast wrote the following 4 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Clinical Trial Nurse-led follow-up at home vs. conventional medical outpatient clinic follow-up in patients with incurable upper gastrointestinal cancer: a randomized study. 2014

Uitdehaag, Madeleen J / van Putten, Paul G / van Eijck, Casper H J / Verschuur, Els M L / van der Gaast, Ate / Pek, Chulja J / van der Rijt, Carin C D / de Man, Rob A / Steyerberg, Ewout W / Laheij, Robert J F / Siersema, Peter D / Spaander, Manon C W / Kuipers, Ernst J. ·Erasmus MC University Medical Center Rotterdam, The Netherlands. Electronic address: uitdehaag@go-spirit.nl. · Erasmus MC University Medical Center Rotterdam, The Netherlands. ·J Pain Symptom Manage · Pubmed #23880585.

ABSTRACT: CONTEXT: Upper gastrointestinal cancer is associated with a poor prognosis. The multidimensional problems of incurable patients require close monitoring and frequent support, which cannot sufficiently be provided during conventional one to two month follow-up visits to the outpatient clinic. OBJECTIVES: To compare nurse-led follow-up at home with conventional medical follow-up in the outpatient clinic for patients with incurable primary or recurrent esophageal, pancreatic, or hepatobiliary cancer. METHODS: Patients were randomized to nurse-led follow-up at home or conventional medical follow-up in the outpatient clinic. Outcome parameters were quality of life (QoL), patient satisfaction, and health care consumption, measured by different questionnaires at one and a half and four months after randomization. As well, cost analyses were done for both follow-up strategies in the first four months. RESULTS: In total, 138 patients were randomized, of which 66 (48%) were evaluable. At baseline, both groups were similar with respect to clinical and sociodemographic characteristics and health-related QoL. Patients in the nurse-led follow-up group were significantly more satisfied with the visits, whereas QoL and health care consumption within the first four months were comparable between the two groups. Nurse-led follow-up was less expensive than conventional medical follow-up. However, the total costs for the first four months of follow-up in this study were higher in the nurse-led follow-up group because of a higher frequency of visits. CONCLUSION: The results suggest that conventional medical follow-up is interchangeable with nurse-led follow-up. A cost utility study is necessary to determine the preferred frequency and duration of the home visits.

2 Clinical Trial Phase II trial of Uracil/Tegafur plus leucovorin and celecoxib combined with radiotherapy in locally advanced pancreatic cancer. 2011

Morak, Marjolein J M / Richel, Dick J / van Eijck, Casper H J / Nuyttens, Joost J M E / van der Gaast, Ate / Vervenne, Walter L / Padmos, Esther E / Schaake, Eva E / Busch, Olivier R C / van Tienhoven, Geertjan. ·Department of Surgery, Erasmus Medical Centre, Rotterdam, The Netherlands. ·Radiother Oncol · Pubmed #21075468.

ABSTRACT: BACKGROUND AND PURPOSE: To investigate the efficacy and toxicity of a short intensive Uracil/Tegafur (UFT) based chemoradiotherapy scheme combined with celecoxib in locally advanced pancreatic cancer. MATERIAL AND METHODS: The Academic Medical Centre, Amsterdam and the Erasmus Medical Centre, Rotterdam enrolled 83 eligible patients with unresectable pancreatic cancer in a prospective multicentre phase II study. Median age was 62 years, median tumour size 40 mm and the majority of the patients (85%) had pancreatic head cancers. Treatment consisted of 20×2.5 Gy radiotherapy combined with UFT 300 mg/m(2) per day, leucovorin (folinic acid) 30 mg and celecoxib 80 0mg for 28 days concomitant with radiotherapy. Four patients were lost to follow-up. RESULTS: Full treatment compliance was achieved in 55% of patients, 80% received at least 3 weeks of treatment. No partial or complete response was observed. Median survival was 10.6 months and median time to progression 6.9 months. Toxicity was substantial with 28% grades III and IV gastro-intestinal toxicity and two early toxic deaths. CONCLUSIONS: Based on the lack of response, the substantial toxicity of mainly gastro-intestinal origin and the reported mediocre overall and progression free survival, we cannot advise our short intensive chemoradiotherapy schedule combined with celecoxib as the standard treatment.

3 Article National compliance to an evidence-based multidisciplinary guideline on pancreatic and periampullary carcinoma. 2016

van Rijssen, Lennart B / van der Geest, Lydia G M / Bollen, Thomas L / Bruno, Marco J / van der Gaast, Ate / Veerbeek, Laetitia / Ten Kate, Fibo J W / Busch, Olivier R C. ·Dutch Pancreatic Cancer Group (DPCG), The Netherlands; Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands. · Dutch Pancreatic Cancer Group (DPCG), The Netherlands; Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands. · Dutch Pancreatic Cancer Group (DPCG), The Netherlands; Department of Radiology, St. Antonius Hospital, Nieuwegein/Utrecht, The Netherlands. · Dutch Pancreatic Cancer Group (DPCG), The Netherlands; Department of Gastroenterology, Erasmus Medical Center, Rotterdam, The Netherlands. · Department of Medical Oncology, Erasmus Medical Center, Rotterdam, The Netherlands. · Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands. · Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands. · Dutch Pancreatic Cancer Group (DPCG), The Netherlands; Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands. Electronic address: o.r.busch@amc.nl. ·Pancreatology · Pubmed #26560441.

ABSTRACT: BACKGROUND: We evaluated national compliance to selected quality indicators from the Dutch multidisciplinary evidence-based guideline on pancreatic and periampullary carcinoma and identified areas for improvement. METHODS: Compliance to 3 selected quality indicators from the guideline was evaluated before and after implementation of the guideline in 2011: 1) adjuvant chemotherapy after tumor resection for pancreatic carcinoma, 2) discussion of the patient within a multidisciplinary team (MDT) meeting and 3) a maximum 3-week interval between final MDT meeting and start of treatment. RESULTS: In total 5086 patients with pancreatic or periampullary carcinoma were included. In 2010, 2522 patients were included and in 2012, 2564 patients. 1) Use of adjuvant chemotherapy following resection for pancreatic carcinoma increased significantly from 45% (120 out of 268) in 2010 to 54% (182 out of 336) in 2012 which was mainly caused by an increase in patients aged <75 years. 2) In 2012, 64% (896 of 1396) of patients suspected of a pancreatic or periampullary carcinoma was discussed within a MDT meeting which was higher in patients aged <75 years and patients starting treatment with curative intent. 3) In 2012, the recommended 3 weeks between final MDT meeting and start of treatment was met in 39% (141 of 363) of patients which was not influenced by patient and tumor characteristics. CONCLUSION: Compliance to three selected quality indicators in pancreatic cancer care was low in 2012. Areas for improvement were identified. Future compliance will be investigated through structured audit and feedback from the Dutch Pancreatic Cancer Audit.

4 Article Problems and needs in patients with incurable esophageal and pancreaticobiliary cancer: a descriptive study. 2015

Uitdehaag, Madeleen J / Verschuur, Els M L / van Eijck, Casper H J / van der Gaast, Ate / van der Rijt, Carin C D / de Man, Rob A / Steyerberg, Ewout W / Kuipers, Ernst J / Siersema, Peter D. ·Madeleen J. Uitdehaag, PhD, RN, is with Departments of Gastroenterology and Hepatology, Erasmus MC, University Medical Center Rotterdam, the Netherlands, and Department Nursing, Saxion University of Applied Science, Deventer/Enschede, the Netherlands. Els M. L. Verschuur, PhD, RN, is with Departments of Gastroenterology and Hepatology, Erasmus MC, University Medical Center Rotterdam; the Netherlands. Casper H. J. van Eijck, PhD, MD, is with Department of Surgery, Erasmus MC, University Medical Center Rotterdam; the Netherlands. Ate van der Gaast, PhD, MD, is with Department of Medical Oncology, Erasmus MC, University Medical Center Rotterdam; the Netherlands. Carin C. D. van der Rijt, PhD, MD, is with Department of Medical Oncology, Erasmus MC, University Medical Center Rotterdam; the Netherlands. Rob A. de Man, PhD, MD, is with Departments of Gastroenterology and Hepatology, Erasmus MC, University Medical Center Rotterdam, the Netherlands. Ewout W. Steyerberg, PhD, is with Department of Public Health, Erasmus MC, University Medical Center Rotterdam; the Netherlands. Ernst J. Kuipers, PhD, MD, is with Departments of Gastroenterology and Hepatology, Erasmus MC, University Medical Center Rotterdam, the Netherlands. Peter D. Siersema, PhD, MD, is with Departments of Gastroenterology and Hepatology, Erasmus MC, University Medical Center Rotterdam, the Netherlands, and Department of Gastroenterology and Hepatology, University Medical Center Utrecht, the Netherlands. ·Gastroenterol Nurs · Pubmed #25636012.

ABSTRACT: Patients with incurable esophageal cancer (EC) or pancreaticobiliary cancer (PBC) often have multiple symptoms and their quality of life is poor. We investigated which problems these patients experience and how often care is expected for these problems to provide optimal professional care. Fifty-seven patients with incurable EC (N = 24) or PBC (N = 33) from our outpatient clinic completed the validated "Problems and Needs for Palliative Care" (PNPC) questionnaire and two disease-specific quality of life questionnaires, European Organization for Research and Treatment in Cancer (EORTC). Although patients in general had several problems, physical, emotional, and loss of autonomy (LOA) problems were most common. For these physical and emotional problems, patients also expected professional care, although to a lesser extent for LOA problems. Inadequate care was received for fatigue, fear, frustration, and uncertainty. We conclude that an individualized approach based on problems related to physical, emotional, and LOA issues and anticipated problems with healthcare providers has priority in the follow-up policy of patients with incurable upper gastrointestinal cancer. Caregivers should be alert to discuss needs for fatigue, feelings of fear, frustration, and uncertainty.