Tissue is the issue

BJMO - volume 15, issue 1, january 2021

M. Kukhalashvili MD, JB. Vermorken MD, PhD, T. van den Wyngaert MD, PhD, A. Snoeckx MD, PhD, M. Lammens MD, PhD, M. Peeters MD, PhD, P. Specenier MD, PhD


Multimodal therapy, including preoperative chemoradiotherapy followed by total mesorectal excision, has become the standard treatment for patients with locoregionally advanced rectal cancer.1 We report on a 54- year old female patient with rectal adenocarcinoma cT3N0M0, who was treated with neoadjuvant chemo-radiotherapy (capecitabine 825 mg/m² BID 5 days/week + 45 Gy in 25 fractions) followed by total mesorectal excision and adjuvant capecitabine for six months. Eleven weeks after the start of adjuvant capecitabine, she presented with dyspnoea, non-productive cough, shortness of breath, chest wall pain, and decrease of physical activity, for which she was admitted to the Antwerp University Hospital (UZA) in Edegem. Computed tomography (CT) revealed pulmonary emboli, enlarged mediastinal and hilar lymph nodes, and multiple micronodules in both lungs. Radiologic findings were suggestive of metastatic lymph nodules and numerous pulmonary metastases. However, pathological diagnosis showed nude granulomas without necrosis without evidence of tumour. Our case illustrates that sarcoid-like lesions may mimic lung metastases in cancer patients being treated with chemotherapy and that tissue still remains the issue.

(BELG J MED ONCOL 2021;15(1):40-3)

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Algorithms for molecular testing in solid tumours

BJMO - volume 13, issue 7, november 2019

Ir A. Hébrant PhD, M. Lammens MD, PhD, C. Van den Broecke MD, N. D’Haene MD, PhD, J. Van den Oord MD, PhD, A. Vanderstichele MD, PhD, A. Dendooven MD, PhD, P. Neven MD, PhD, K. Punie MD, G. Floris MD, PhD, J. Van der Meulen MD, HA. Poirel MD, PhD, C. Dooms MD, PhD, S. Rottey MD, PhD, T. Boterberg MD, PhD, L. Brochez MD, PhD, M.C. Burlacu MD, G. Costante MD, D. Creytens MD, PhD, P. De Paepe MD, PhD, R. De Pauwn MD, B. Decallonne MD, PhD, F. Dedeurwaerdere MD, H. Denys MD, PhD, L. Ferdinande MD, PhD, R. Forsyth MD, PhD, M. Garmyn MD, PhD, T. Gevaert MD, PhD, J. De Grève MD, PhD, E. Govaerts MD, E. Hauben MD, PhD, J. Kerger MD, O. Kholmanskikh Van Criekingen MD, PhD, V. Kruse MD, PhD, Y. Lalami MD, L. Lapeire MD, PhD, P. Lefesvre MD, PhD, J.P. Machiels MD, PhD, B. Maes MD, PhD, G. Martens MD, PhD, M. Remmelink MD, PhD, I. Salmon MD, PhD, R. Sciot MD, PhD, S. Tejpar MD, PhD, K. Van de Vijver MD, PhD, L. Van de Voorde MD, I. Van den Berghe MD, A. Van den Bruel MD, K. Vandecasteele MD, PhD, L. Vanwalleghem MD, K. Vermaelen MD, PhD, R. Salgado MD, PhD, E. Wauters MD, PhD, B. Weynand MD, PhD, E. Van Valckenborgh PhD, G. Raicevic PhD, M. Van den Bulcke PhD, P. Pauwels MD, PhD


In order to advise the Federal Government on the reimbursement of molecular tests related to Personalised Medicine in Oncology, the Commission of Personalised Medicine (ComPerMed), represented by Belgian experts, has developed a methodology to classify molecular testing in oncology. The different molecular tests per cancer type are represented in algorithms and are annotated with a test level reflecting their relevance based on current guidelines, drug approvals and clinical data. The molecular tests are documented with recent literature, guidelines and a brief technical description. This methodology was applied on different solid tumours for which molecular testing is a clear clinical need.

(BELG J MED ONCOL 2019;13(7):286–95)

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Belgian consensus guidelines for prostate core needle biopsy reporting

BJMO - volume 12, issue 6, october 2018

T. Gevaert MD, PhD, L. Libbrecht MD, PhD, E. Lerut MD, PhD, B. Weynand MD, PhD, M. Lammens MD, PhD, S. Verschuere MD, PhD, C. Mattelaer MD, B. Lelie MD, J. Eben MD, L. Martinez , M-A. van Caillie MD, S. Rorive MD, PhD, S. Verbeke MD, PhD, M. Baldewijns MD, PhD

The Belgian Working Group on Uropathology has agreed upon a dataset for prostate core needle biopsy reporting, based on existing international guidelines, recent scientific insights, national survey analysis and panel discussion, with the focus on a user- and receptor-friendly format. This dataset should encourage standardised structured reporting of prostate biopsies in the Belgian healthcare system, aiming to improve the quality of individual pathology reports and to provide real benefit for the clinical management of patients and secondary users. Therefore the Belgian Working Group on Uropathology recommends implementing this dataset in each Belgian pathology lab, in close consultation with the entire clinical team involved in the treatment of the prostate cancer patient.

(BELG J MED ONCOL 2018;12(6):279–286)

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TPFE (docetaxel, cisplatin, 5-FU and cetuximab) for recurrent mucoepidermoid carcinoma of the parotid gland: an aggressive strategy for an aggressive disease

BJMO - volume 11, issue 8, december 2017

A.R. Garcia MD, C. van Laer MD, D. van den Weyngaert MD, T. van den Wyngaert MD, PhD, M. Lammens MD, PhD, P. Specenier MD, PhD, J.B. Vermorken MD, PhD


The prognosis of patients with advanced malignant salivary gland cancer is usually poor. Systemic therapy combined with best supportive care is recommended for patients with metastatic or recurrent advanced salivary gland cancer ineligible for surgery or radiotherapy. Sensitivity to chemotherapy is thought to be histotype specific. However, to date, none of the systemic therapies, whether cytotoxic or non cytotoxic, can be considered standard for these tumours.

We report the case of a 43 year-old male patient with a third (loco)regional recurrence and metastases in lymph nodes below the clavicles of a mucoepidermoid carcinoma of the right parotid gland. He participated in a feasibility study and was treated with 3-weekly cycles of docetaxel, cisplatin, 5-fluorouracil plus weekly cetuximab (TPFE). After four TPFE cycles, additional radiation was given to the left neck. A complete response was reached which is ongoing for ten years. TPFE induced acute toxicities: skin rash grade 3, hypotension grade 3, neutropenia grade 3, anaemia grade 2 and alopecia grade 2. This observation underlines the importance of offering patients the possibility to participate in clinical trials. International collaboration for rare head and neck cancers, such as mucoepidermoid carcinoma, is urgently needed.

(BELG J MED ONCOL 2017;11(8):386-392)

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