A

Surgical Complications in a Multicenter Randomized Trial Comparing Preoperative Chemoradiotherapy and Immediate Surgery in Patients With Resectable and Borderline Resectable Pancreatic Cancer (PREOPANC Trial)

Annals of Surgery, vol. 275, pp. 979–984

Abstract

OBJECTIVES: To investigate the effect of preoperative chemoradiotherapy on surgical complications in patients after pancreatic resection for (borderline-)resectable pancreatic cancer. SUMMARY OF BACKGROUND DATA: Preoperative chemoradiotherapy is increasingly used in patients with (borderline-)resectable pancreatic cancer. concerns have been raised about the potential harmful effect of any preoperative therapy on the surgical complication rate after pancreatic resection. METHODS: An observational analysis was performed within the multicenter randomized controlled PREOPANC trial (April 2013-July 2017). The trial randomly assigned (1:1) patients to preoperative chemoradiotherapy followed by surgery and the remaining adjuvant chemotherapy or to immediate surgery, followed by adjuvant chemotherapy. The main analysis consisted of a per-protocol approach. The endpoints of the present analyses were the rate of postoperative complications. RESULTS: This study included 246 patients from 16 centers, of whom 66 patients underwent resection after preoperative therapy and 98 patients after immediate surgery. No differences were found regarding major complications (37.9% vs 30.6%, P=0.400), postpancreatectomy hemorrhage (9.1% vs 5.1%, P=0.352), delayed gastric emptying (21.2% vs 22.4%, P=0.930), bile leakage (4.5% vs 3.1%, P=0.686), intra-abdominal infections (12.1% vs 10.2%, P=0.800), and mortality (3.0% vs 4.1%, P=1.000). There was a significant lower incidence of postoperative pancreatic fistula in patients who received preoperative chemoradiotherapy (0% vs 9.2%, P=0.011). CONCLUSIONS: Preoperative chemoradiotherapy did not increase the incidence of surgical complications or mortality and reduced the rate of postoperative pancreatic fistula after resection in patients with (borderline-)resectable pancreatic cancer.

Authors 16

  1. Jelle C. van Dongen corresponding

    Erasmus MC Cancer Institute

    Affiliation as printed

    Department of Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands

    Albert J. Ten Tije made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Author contribution statement: Jelle C. van Dongen made a substantial contribution to the conception and design of the study, acquisition, analysis and interpretation of data, drafting and critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Bas Groot Koerkamp made a substantial contribution to the conception and design of the study, analysis and interpretation of data, the drafting and critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Bert A. Bonsing made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Casper H.J. van Eijck made a substantial contribution to the conception and design of the study, analysis and interpretation of data, the drafting and critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Erwin van der Hars made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Eva Versteijne made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Geertjan van Tienhoven made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Gijs A. Patijn made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Ignace H. de Hingh made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    J. Sven D. Mieog made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Judith de Vos-Geelen made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Marc G. Besselink made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Mustafa Suker made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Olivier R. Busch made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Sebastiaan Festen made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

  2. Mustafa Suker corresponding

    Erasmus MC Cancer Institute

    Affiliation as printed

    Department of Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands

    Albert J. Ten Tije made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Author contribution statement: Jelle C. van Dongen made a substantial contribution to the conception and design of the study, acquisition, analysis and interpretation of data, drafting and critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Bas Groot Koerkamp made a substantial contribution to the conception and design of the study, analysis and interpretation of data, the drafting and critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Bert A. Bonsing made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Casper H.J. van Eijck made a substantial contribution to the conception and design of the study, analysis and interpretation of data, the drafting and critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Erwin van der Hars made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Eva Versteijne made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Geertjan van Tienhoven made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Gijs A. Patijn made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Ignace H. de Hingh made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    J. Sven D. Mieog made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Judith de Vos-Geelen made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Marc G. Besselink made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Mustafa Suker made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Olivier R. Busch made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Sebastiaan Festen made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

  3. Amsterdam University Medical Centers · Cancer Center Amsterdam

    Affiliation as printed

    Department of Radiation Oncology, Cancer Center Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands

    Albert J. Ten Tije made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Author contribution statement: Jelle C. van Dongen made a substantial contribution to the conception and design of the study, acquisition, analysis and interpretation of data, drafting and critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Bas Groot Koerkamp made a substantial contribution to the conception and design of the study, analysis and interpretation of data, the drafting and critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Bert A. Bonsing made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Casper H.J. van Eijck made a substantial contribution to the conception and design of the study, analysis and interpretation of data, the drafting and critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Erwin van der Hars made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Eva Versteijne made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Geertjan van Tienhoven made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Gijs A. Patijn made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Ignace H. de Hingh made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    J. Sven D. Mieog made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Judith de Vos-Geelen made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Marc G. Besselink made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Mustafa Suker made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Olivier R. Busch made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Sebastiaan Festen made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

  4. Leiden University Medical Center

    Affiliation as printed

    Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands

    Albert J. Ten Tije made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Author contribution statement: Jelle C. van Dongen made a substantial contribution to the conception and design of the study, acquisition, analysis and interpretation of data, drafting and critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Bas Groot Koerkamp made a substantial contribution to the conception and design of the study, analysis and interpretation of data, the drafting and critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Bert A. Bonsing made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Casper H.J. van Eijck made a substantial contribution to the conception and design of the study, analysis and interpretation of data, the drafting and critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Erwin van der Hars made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Eva Versteijne made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Geertjan van Tienhoven made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Gijs A. Patijn made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Ignace H. de Hingh made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    J. Sven D. Mieog made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Judith de Vos-Geelen made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Marc G. Besselink made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Mustafa Suker made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Olivier R. Busch made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Sebastiaan Festen made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

  5. Leiden University Medical Center

    Affiliation as printed

    Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands

    Albert J. Ten Tije made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Author contribution statement: Jelle C. van Dongen made a substantial contribution to the conception and design of the study, acquisition, analysis and interpretation of data, drafting and critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Bas Groot Koerkamp made a substantial contribution to the conception and design of the study, analysis and interpretation of data, the drafting and critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Bert A. Bonsing made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Casper H.J. van Eijck made a substantial contribution to the conception and design of the study, analysis and interpretation of data, the drafting and critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Erwin van der Hars made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Eva Versteijne made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Geertjan van Tienhoven made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Gijs A. Patijn made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Ignace H. de Hingh made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    J. Sven D. Mieog made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Judith de Vos-Geelen made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Marc G. Besselink made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Mustafa Suker made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Olivier R. Busch made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Sebastiaan Festen made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

  6. Maastricht University Medical Centre · Maastricht University

    Affiliation as printed

    Department of Internal Medicine, Division of Medical Oncology, GROW School for Oncology and Developmental Biology, Maastricht UMC+, Maastricht, the Netherlands

    Albert J. Ten Tije made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Author contribution statement: Jelle C. van Dongen made a substantial contribution to the conception and design of the study, acquisition, analysis and interpretation of data, drafting and critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Bas Groot Koerkamp made a substantial contribution to the conception and design of the study, analysis and interpretation of data, the drafting and critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Bert A. Bonsing made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Casper H.J. van Eijck made a substantial contribution to the conception and design of the study, analysis and interpretation of data, the drafting and critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Erwin van der Hars made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Eva Versteijne made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Geertjan van Tienhoven made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Gijs A. Patijn made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Ignace H. de Hingh made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    J. Sven D. Mieog made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Judith de Vos-Geelen made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Marc G. Besselink made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Mustafa Suker made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Olivier R. Busch made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Sebastiaan Festen made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

  7. Maasstad Ziekenhuis

    Affiliation as printed

    Department of Surgery, Maasstad Hospital, Rotterdam, the Netherlands

  8. Isala

    Affiliation as printed

    Department of Surgery, Isala Oncology Center, Zwolle, the Netherlands

    Albert J. Ten Tije made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Author contribution statement: Jelle C. van Dongen made a substantial contribution to the conception and design of the study, acquisition, analysis and interpretation of data, drafting and critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Bas Groot Koerkamp made a substantial contribution to the conception and design of the study, analysis and interpretation of data, the drafting and critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Bert A. Bonsing made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Casper H.J. van Eijck made a substantial contribution to the conception and design of the study, analysis and interpretation of data, the drafting and critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Erwin van der Hars made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Eva Versteijne made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Geertjan van Tienhoven made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Gijs A. Patijn made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Ignace H. de Hingh made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    J. Sven D. Mieog made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Judith de Vos-Geelen made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Marc G. Besselink made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Mustafa Suker made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Olivier R. Busch made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Sebastiaan Festen made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

  9. Ignace H. J. T. de Hingh corresponding

    Catharina Ziekenhuis · Erasmus MC Cancer Institute

    Affiliation as printed

    Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands

    Albert J. Ten Tije made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Author contribution statement: Jelle C. van Dongen made a substantial contribution to the conception and design of the study, acquisition, analysis and interpretation of data, drafting and critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Bas Groot Koerkamp made a substantial contribution to the conception and design of the study, analysis and interpretation of data, the drafting and critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Bert A. Bonsing made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Casper H.J. van Eijck made a substantial contribution to the conception and design of the study, analysis and interpretation of data, the drafting and critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Department of Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands

    Erwin van der Hars made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Eva Versteijne made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Geertjan van Tienhoven made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Gijs A. Patijn made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Ignace H. de Hingh made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    J. Sven D. Mieog made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Judith de Vos-Geelen made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Marc G. Besselink made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Mustafa Suker made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Olivier R. Busch made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Sebastiaan Festen made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

  10. OLVG · Amsterdam University Medical Centers · Cancer Center Amsterdam

    Affiliation as printed

    Department of Surgery, OLVG, Amsterdam, the Netherlands

    Albert J. Ten Tije made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Author contribution statement: Jelle C. van Dongen made a substantial contribution to the conception and design of the study, acquisition, analysis and interpretation of data, drafting and critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Bas Groot Koerkamp made a substantial contribution to the conception and design of the study, analysis and interpretation of data, the drafting and critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Bert A. Bonsing made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Casper H.J. van Eijck made a substantial contribution to the conception and design of the study, analysis and interpretation of data, the drafting and critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Department of Radiation Oncology, Cancer Center Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands

    Erwin van der Hars made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Eva Versteijne made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Geertjan van Tienhoven made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Gijs A. Patijn made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Ignace H. de Hingh made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    J. Sven D. Mieog made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Judith de Vos-Geelen made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Marc G. Besselink made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Mustafa Suker made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Olivier R. Busch made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Sebastiaan Festen made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

  11. Leiden University Medical Center · Amphia Ziekenhuis

    Affiliation as printed

    Department of Medical Oncology, Amphia Hospital, Breda, the Netherlands

    Albert J. Ten Tije made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Author contribution statement: Jelle C. van Dongen made a substantial contribution to the conception and design of the study, acquisition, analysis and interpretation of data, drafting and critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Bas Groot Koerkamp made a substantial contribution to the conception and design of the study, analysis and interpretation of data, the drafting and critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Bert A. Bonsing made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Casper H.J. van Eijck made a substantial contribution to the conception and design of the study, analysis and interpretation of data, the drafting and critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands

    Erwin van der Hars made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Eva Versteijne made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Geertjan van Tienhoven made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Gijs A. Patijn made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Ignace H. de Hingh made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    J. Sven D. Mieog made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Judith de Vos-Geelen made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Marc G. Besselink made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Mustafa Suker made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Olivier R. Busch made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Sebastiaan Festen made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

  12. Maastricht University Medical Centre · Maastricht University · Amsterdam University Medical Centers · Cancer Center Amsterdam · University of Amsterdam

    Affiliation as printed

    Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, the Netherlands

    Albert J. Ten Tije made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Author contribution statement: Jelle C. van Dongen made a substantial contribution to the conception and design of the study, acquisition, analysis and interpretation of data, drafting and critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Bas Groot Koerkamp made a substantial contribution to the conception and design of the study, analysis and interpretation of data, the drafting and critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Bert A. Bonsing made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Casper H.J. van Eijck made a substantial contribution to the conception and design of the study, analysis and interpretation of data, the drafting and critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Department of Internal Medicine, Division of Medical Oncology, GROW School for Oncology and Developmental Biology, Maastricht UMC+, Maastricht, the Netherlands

    Erwin van der Hars made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Eva Versteijne made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Geertjan van Tienhoven made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Gijs A. Patijn made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Ignace H. de Hingh made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    J. Sven D. Mieog made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Judith de Vos-Geelen made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Marc G. Besselink made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Mustafa Suker made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Olivier R. Busch made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Sebastiaan Festen made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

  13. Maastricht University Medical Centre · Maastricht University · Amsterdam University Medical Centers · Cancer Center Amsterdam · University of Amsterdam

    Affiliation as printed

    Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, the Netherlands

    Albert J. Ten Tije made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Author contribution statement: Jelle C. van Dongen made a substantial contribution to the conception and design of the study, acquisition, analysis and interpretation of data, drafting and critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Bas Groot Koerkamp made a substantial contribution to the conception and design of the study, analysis and interpretation of data, the drafting and critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Bert A. Bonsing made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Casper H.J. van Eijck made a substantial contribution to the conception and design of the study, analysis and interpretation of data, the drafting and critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Department of Internal Medicine, Division of Medical Oncology, GROW School for Oncology and Developmental Biology, Maastricht UMC+, Maastricht, the Netherlands

    Erwin van der Hars made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Eva Versteijne made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Geertjan van Tienhoven made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Gijs A. Patijn made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Ignace H. de Hingh made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    J. Sven D. Mieog made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Judith de Vos-Geelen made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Marc G. Besselink made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Mustafa Suker made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Olivier R. Busch made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Sebastiaan Festen made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

  14. Amsterdam University Medical Centers · Cancer Center Amsterdam

    Affiliation as printed

    Department of Radiation Oncology, Cancer Center Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands

    Albert J. Ten Tije made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Author contribution statement: Jelle C. van Dongen made a substantial contribution to the conception and design of the study, acquisition, analysis and interpretation of data, drafting and critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Bas Groot Koerkamp made a substantial contribution to the conception and design of the study, analysis and interpretation of data, the drafting and critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Bert A. Bonsing made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Casper H.J. van Eijck made a substantial contribution to the conception and design of the study, analysis and interpretation of data, the drafting and critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Erwin van der Hars made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Eva Versteijne made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Geertjan van Tienhoven made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Gijs A. Patijn made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Ignace H. de Hingh made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    J. Sven D. Mieog made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Judith de Vos-Geelen made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Marc G. Besselink made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Mustafa Suker made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Olivier R. Busch made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Sebastiaan Festen made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

  15. Bas Groot Koerkamp corresponding

    Erasmus MC Cancer Institute

    Affiliation as printed

    Department of Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands

    Albert J. Ten Tije made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Author contribution statement: Jelle C. van Dongen made a substantial contribution to the conception and design of the study, acquisition, analysis and interpretation of data, drafting and critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Bas Groot Koerkamp made a substantial contribution to the conception and design of the study, analysis and interpretation of data, the drafting and critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Bert A. Bonsing made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Casper H.J. van Eijck made a substantial contribution to the conception and design of the study, analysis and interpretation of data, the drafting and critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Erwin van der Hars made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Eva Versteijne made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Geertjan van Tienhoven made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Gijs A. Patijn made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Ignace H. de Hingh made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    J. Sven D. Mieog made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Judith de Vos-Geelen made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Marc G. Besselink made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Mustafa Suker made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Olivier R. Busch made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Sebastiaan Festen made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

  16. Casper H.J. van Eijck corresponding

    Erasmus MC Cancer Institute

    Affiliation as printed

    Department of Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands

    Albert J. Ten Tije made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Author contribution statement: Jelle C. van Dongen made a substantial contribution to the conception and design of the study, acquisition, analysis and interpretation of data, drafting and critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Bas Groot Koerkamp made a substantial contribution to the conception and design of the study, analysis and interpretation of data, the drafting and critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Bert A. Bonsing made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Casper H.J. van Eijck made a substantial contribution to the conception and design of the study, analysis and interpretation of data, the drafting and critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Erwin van der Hars made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Eva Versteijne made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Geertjan van Tienhoven made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Gijs A. Patijn made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Ignace H. de Hingh made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    J. Sven D. Mieog made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Judith de Vos-Geelen made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Marc G. Besselink made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Mustafa Suker made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Olivier R. Busch made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

    Sebastiaan Festen made a substantial contribution to the conception and design of the study, critical revisal of the article and gave final approval of the current version of the manuscript to be published

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References 34