Specialization
Focus of research
My two main research lines currently are:
1) endoscopic management of Barrett esophagus-related neoplasia and esophageal adenocarcinoma,
2) endoscopic vacuum therapy for defects in the upper gastrointestinal tract and anastomotic leakage.
My research goals are to develop minimally invasive treatments that are safe and effective, particularly with regards to oncological treatment. Additionally, I aim to customize treatments to individual patients and promote a multidisciplinary approach to patient care.
In the field of Barrett’s esophagus-related neoplasia and low-risk cancer, my research has yielded clinically relevant results. We established a partly retrospective, but currently prospectively maintained database with all patients (> 1500) treated with endoscopic eradication therapy in the Barrett Expert Centers in the Netherlands, from 2018. Based on data from this worldwide unique cohort, my research team found that endoscopic resection and ablation techniques offer safe and effective treatment, with very low risk of recurrence after long-term follow-up. The same patient cohort was used to develop a prediction model to identify patients with an increased risk of recurrence during follow-up, who may benefit from more stringent surveillance. This model was validated in two external datasets from Leuven and Zurich, demonstrating excellent predictive value (C-statistic 0.91). The unique patient cohort established for these studies has proven to be an excellent source for multiple spin-off studies.
Moreover, in patients with high-risk esophageal adenocarcinoma, my research has explored the concept of a watchful waiting strategy. Traditionally, surgery has been the recommended course of action for this indication according to guidelines. However, based on a retrospective study including all patients treated endoscopically for these high-risk cancers within the Netherlands, the risk of metastasis seems lower than was historically assumed, suggesting that a watchful waiting approach can be a safe and viable alternative. This approach is also being assessed in a retrospective cohort in multiple European hospitals, also to expand my available database of patients treated for these high-risk esophageal cancers. But, since this approach needs to be validated prospectively, I am currently running a study in 19 international centers, to prospectively assess the safety of a watchful waiting approach. This study is financially supported by a grant from the Dutch Cancer Society (KWF) and is worldwide the first prospective study in this field, and already referred to as a landmark study during international conferences.
More recently I started my research in the field of endoscopic vacuum therapy, to better understand its indications, safety and efficacy. This innovative technique involves the use of a vacuum-assisted system to treat defects in the esophagus and anastomotic leakage. For this research I collaborate closely with our surgical colleagues, and our multidisciplinary collaboration has already resulted in three peer-reviewed publications in two years, multiple presentations at international conferences, and significant improvements in how we currently treat these patients at our center.
Overall, my research has made significant clinically meaningful contributions to the field of gastroenterology. My dedication to multidisciplinary and multicenter collaboration and patient-tailored treatments has the potential to revolutionize the field, improving patient outcomes and quality of life.