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Book
Gynaecologische oncologie
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Year: 1996 Publisher: Leuven Medica

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Atlas of gynaecological cancer survey.
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ISBN: 9788184484809 Year: 2009 Publisher: New Delhi Jaypee brothers medical publ.

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Dissertation
Epithelial ovarian cancer : molecular and clinical predictors for platinum resistance.
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Year: 2012 Publisher: Leuven KU Leuven. Faculteit Geneeskunde. Departement Oncologie

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Clinical management of ovarian cancer
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ISBN: 1853177040 Year: 2001 Publisher: London Dunitz

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Book
Handboek gynaecologie
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ISBN: 9789463442565 Year: 2017 Publisher: Leuven/Den Haag Acco

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Het Handboek Gynaecologie is een initiatief van de hoogleraren gynaecologie en verloskunde van de Universiteit Gent, KU Leuven, Universiteit Antwerpen en Vrije Universiteit Brussel, in samenwerking met een aantal experten ter zake.De vier redacteurs zetten dit initiatief om in een overzichtelijk en compleet handboek.Het boek bestaat uit drie grote hoofdstukken: algemene gynaecologie, gynaecologische oncologie inclusief de senologie en de reproductieve geneeskunde. Dit handboek is in eerste instantie bedoeld als een universele leidraad voor de studenten geneeskunde, vroedkunde en verpleegkunde, maar het is ongetwijfeld ook een nuttig naslagwerk voor alle gynaecologen en assistenten in opleiding die hun theoretische achtergrond willen opfrissen.


Film
Robotchirurgie
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Year: 2011 Publisher: Leuven Dienst Media en Leren K.U.Leuven

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Opnames 3derde jaarlijkse SERGS bijeenkomst over robotchirurgie in de gyneacologie

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Dissertation
Anti-NMDA-receptor-encefalitis
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Year: 2017 Publisher: Leuven KU Leuven. Faculteit Geneeskunde

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We beschrijven de casus van een jonge gezonde vrouw, die plotseling neuropsychiatrische symptomen ontwikkelt met deterioratie waarvoor opname op intensieve zorgen met intubatie en algemene ondersteuning vereist is. Investigatie brengt als oorzakelijke factor een ovarieel matuur teratoma aan het licht. De diagnose van een anti-NMDA-receptor encefalitis wordt bevestigd door de aanwezigheid van de betreffende antistoffen in serum en liquor van de patiënte. Behandeling vereist een ovariëctomie en het opstarten van immunosuppressiva. Ondanks de ernst en het langdurige verloop van deze aandoening kennen de meeste patiënten - bij tijdige diagnose en behandeling - een goed herstel.

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Dissertation
Low Grade Serous Ovarian Cancer: Clinical outcome and molecular characteristics in a tertiary center
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Year: 2016 Publisher: Leuven KU Leuven. Faculteit Geneeskunde

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Dissertation
Evaluation of sentinel node mapping with fluorescence green in cervical and endometrial cancer
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Year: 2016 Publisher: Leuven KU Leuven. Faculteit Geneeskunde

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Objectives. This retrospective study demonstrates our experience with sentinel lymph node (SLN) mapping with fluorescence indocyanine green (ICG) in early stage cervical and endometrial cancer using a minimally invasive robotic approach (da Vinci®). Methods. We evaluated all cases (n=48) who underwent SLN mapping using fluorescence imaging from December 2014 to April 2016. In all cases we used ICG as a tracer. Four milliliters of diluted ICG (2 mg) of ICG was injected in the cervical stroma into four quadrants before initiating the SLN mapping. After the mapping, 27 (56.3%) cases underwent pelvic lymphadenectomy with or without para-aortic lymphadenectomy. Results. Forty-eight cases with early stage cervical (n=23) and endometrial cancer (n=25) were performed. Median age was 57 years (range, 28-80 years). The median number of SLNs harvested per patient was 3 (range, 0-7). At least one SLN was identified in 37 (77.1%) cases. Bilaterally mapping was seen in 31 (64.6%) cases, unilaterally in 6 (12.5%) cases, and none in 11 (22.9%). A para-aortic SLN was identified in 7 (18.9%) of the 37 mapped cases. Five women were found to have positive SLNs. We report one false negative case, so the false negative rate is 3.7%. In 6 (16.2%) cases, we found SLNs which contained no lymph nodes on final pathology (false positive mapping). The sensitivity and spe¬cificity for SLN mapping with ICG is 80% and 100%. The negative predictive value (NPV) is 94.7%. Conclusions. In our experience, fluorescence imaging with intracervical ICG injection using the ro¬botic approach shows good results in terms of overall detection rate, bilateral detection rate and false negative rate. Our results justifies performing studies with larger patient numbers.

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Dissertation
Dendritic cell immunotherapy in ovarian cancer : a murine model
Authors: --- --- ---
Year: 2018 Publisher: Leuven KU Leuven. Faculty of Medicine

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Ovarian cancer is the second most lethal type of gynecological tumor in women with an incidence rate of 12.5 per 100 000 women. Most patients are diagnosed at an advanced stage, which leads to a poor prognosis. High-grade serous ovarian cancer (HGSOC) is the most frequent histological subtype. Standard therapy consists of debulking surgery in combination with platin-based chemotherapy. As chemo-resistance remains an important issue in relapsed ovarian cancer, research is focusing on novel targeted therapies. Immune escape is an important mechanism for tumor resistance as described in the hallmarks of cancer, which remains poorly explored in ovarian cancer. The presence of immunosuppressive cells is an important contributing factor in immune escape. These cells are present in the tumor microenvironment (TME) due to the secretion of chemokines, cytokines and other mediators produced by the tumor and immune cells present in and around the tumor. These immunosuppressive cells will start producing cytokines that will strengthen the immunosuppressive effects, leading to a downward spiral of effects, all contributing to the escape of tumor cells from the immune surveillance. Currently the most relevant immunosuppressive cells appear to be the regulatory T cells (Treg), the myeloid- derived suppressor cells (MDSC) and the tumor-associated macrophages (TAM). In ovarian cancer, the presence of Treg and TAM in the TME is correlated with poor survival. The goal of immunotherapy is to increase the influx of cytotoxic T cells in this immunosuppressive TME. Although immunotherapy successfully induces an immune response, which leads to T cell infiltration, the effects on tumor control (and therefore survival) are disappointing in ovarian cancer. Therefore, we believe that combinatorialstrategies are needed to overcome immunosuppression, to allow more ovarian cancer patients to benefit from the long-term responses of immunotherapy. For this purpose, it is important to gain insight into the immunological context of ovarian cancer patients, to be able to manipulate the immunosuppressive microenvironment.We optimized the ID8 ovarian cancer mouse model for immunotherapy research. We adapted the existing protocol for the generation of murine DC loaded with immunogenic hyp-PDT tumor lysate. Unfortunately, DC immunotherapy alone did not result in survival benefit.We were able to demonstrate by a retrospective serum study that immunosuppression washighly present in ovarian cancer, which makes it challenging to develop an effective immunotherapeutic strategy.. In addition we were able to correlate immunosuppressive cytokines to CA125, neutrophil-to-lymphocyte ratio and platelet count in blood. In a prospective study, we defined an immune signature (containing ratio's of immune cells in peripheral blood) that could discriminate between benign and malignant ovarian tumors. Furthermore, we also investigated the changes in immune cells during first-line treatment of ovarian cancer.In the mouse model, we observed that the adaptive immune system was unable to control tumor growth, most likely because it is overwhelmed by innate immunosuppression. We identified a key role for mMDSC in tumor progression and immunosuppression in the mouse model. Both our human and murine data point towards an important role for the mMDSC, whereas until now the knowledge of ovarian cancer immunobiology was limited to the behavior of the adaptive immune system in the primary tumor.In summary, we believe that the answer for ovarian cancer immunotherapy lies in a fine-tuned approach combining immunotherapy with a compound to reduce the immunosuppressive function of MDSC. Our results have given a first insight in this complex landscape and will be the basis for future experiments.

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