This thesis focus on the quality assurance in the surgical treatment of gastric cancer. This has been investigated using data of the CRITICS trial. In this randomized clinical patients underwent... Show moreThis thesis focus on the quality assurance in the surgical treatment of gastric cancer. This has been investigated using data of the CRITICS trial. In this randomized clinical patients underwent preoperative chemotherapy, followed by surgery, followed by adjuvant chemotherapy or chemoradiotherapy. Surgical quality in the CRITICS trial was investigated and was excellent (PART I). Furthermore, the influence of hospital volume on surgical quality and survival was analyzed using data of the CRITICS trial (PART II). Surgery performed in hospitals with high hospital volume was associated with better surgical quality and better survival. In part III of this thesis analyses were performed to analyze treatment strategy and survival in patients with resectable gastric cancer and in patients with metastatic gastric cancer. Show less
This thesis addresses various aspects regarding the treatment of patients with early, active rheumatoid arthritis. The main conclusion of this thesis is that patients with RA benefit from... Show moreThis thesis addresses various aspects regarding the treatment of patients with early, active rheumatoid arthritis. The main conclusion of this thesis is that patients with RA benefit from combination therapy on the short-term, and the treat-to-target approach determines the success of the long-term outcomes. Following this strategy, high percentages of low disease activity and remission are achieved, and even drug-free remission has shown to be realistic outcome. As a result, functional ability remains stable over time (after improvement during the first year after initiating treatment), radiographic progression is limited in most patients and excess mortality was not observed. Show less