This thesis consists of two sections. In Section I, (pre)clinical research investigating novel targets for pre- and intraoperative molecular imaging of pancreatic cancer are discussed. In Section... Show moreThis thesis consists of two sections. In Section I, (pre)clinical research investigating novel targets for pre- and intraoperative molecular imaging of pancreatic cancer are discussed. In Section II, various studies are described which lay the groundwork for further investigation into response monitoring and prediction in rectal cancer using various imaging modalities. Show less
There is a lack of knowledge regarding the definition, classification and appropriate treatment of malignant lateral lymph nodes in patients with (locally advanced) rectal cancer. This thesis aimed... Show moreThere is a lack of knowledge regarding the definition, classification and appropriate treatment of malignant lateral lymph nodes in patients with (locally advanced) rectal cancer. This thesis aimed to increase this knowledge and improve treatment practices for this population. Show less
The pelvis is often considered to be complex due to the intricate relationship between the pelvic organs and vital structures such as blood vessels, lymphatics, autonomic and somatic nerves. In... Show moreThe pelvis is often considered to be complex due to the intricate relationship between the pelvic organs and vital structures such as blood vessels, lymphatics, autonomic and somatic nerves. In case of rectal or cervical cancer, an excellent knowledge of the pelvic anatomy is essential to achieve optimal oncological and functional outcomes. This thesis describes specific parts of the pelvic anatomy that have remained controversial or have not been described from the perspective of a surgical oncological approach. In addition, a novel 3D virtual anatomical atlas was developed to create a bridge between 2D generic anatomy to in vivo surgical anatomy and to enhance patient-specific surgical planning and guidance. Show less
In the Netherlands around 10.000 patients are diagnosed with colorectal carcinoma every year, of who about 2500 have rectal carcinoma (www.oncoline.nl). It is the third most common cancer in men ... Show moreIn the Netherlands around 10.000 patients are diagnosed with colorectal carcinoma every year, of who about 2500 have rectal carcinoma (www.oncoline.nl). It is the third most common cancer in men (after prostate and lung cancer) and the second most common in women (after breast cancer). In the treatment of rectal cancer a multi-disciplinary approach is the best way to achieve optimal outcomes. Imaging, (neo)adjuvant therapy, surgery and pathology will be discussed separately to define their role in the treatment of rectal cancer. The principle investigation method of this thesis is the analysis of the patterns of local recurrence of rectal cancer. By determination of the location of locally recurrent rectal cancer on imaging and relating these to patient, treatment and tumor variables, the mechanism of local relapse genesis is reconstructed. By doing this the effect of neoadjuvant treatment, surgery, intra-operative radiotherapy and adjuvant treatment on local control can be quantified. First patterns of local recurrence are described for rectal cancer in general (Chapters 3-5) and then only for locally advanced rectal cancer (Chapters 6-7). Subsequently, the effect of preoperative evaluation of local recurrent rectal cancer on results of the multimodality treatment of local relapse is analyzed (Chapters 8-9). Show less
