Therapeutic Surgical Management of Palpable Melanoma Groin Metastases: Superficial or Combined Superficial and Deep Groin Lymph Node Dissection
Identifieur interne : 002C67 ( Pmc/Checkpoint ); précédent : 002C66; suivant : 002C68Therapeutic Surgical Management of Palpable Melanoma Groin Metastases: Superficial or Combined Superficial and Deep Groin Lymph Node Dissection
Auteurs : A. P. T. Van Der Ploeg [Pays-Bas] ; A. C. J. Van Akkooi [Pays-Bas] ; P. I. M. Schmitz [Pays-Bas] ; A. N. Van Geel [Pays-Bas] ; J. H. De Wilt [Pays-Bas] ; A. M. M. Eggermont [Pays-Bas, France] ; C. Verhoef [Pays-Bas]Source :
- Annals of Surgical Oncology [ 1068-9265 ] ; 2011.
Abstract
Management of patients with clinically detectable lymph node metastasis to the groin is by ilioinguinal or combined superficial and deep groin dissection (CGD) according to most literature, but in practice superficial groin dissection (SGD) only is still performed in some centers. The aim of this study is to evaluate the experience in CGD versus SGD patients in our center.
Between 1991 and 2009, 121 therapeutic CGD and 48 SGD were performed in 169 melanoma patients with palpable groin metastases at our institute. Median follow-up was 20 and, for survivors, 45 months.
In this heterogeneous group of patients, overall (OS) and disease-free survival, local control rates, and morbidity rates were not significantly different between CGD and SGD patients. However, CGD patients had a trend towards more chronic lymphedema. Superficial lymph node ratio, the number of positive superficial lymph nodes, and the presence of deep nodes were prognostic factors for survival. CGD patients with involved deep lymph nodes (24.8%) had estimated 5-year OS of 12% compared with 40% with no involved deep lymph nodes (
This study demonstrated that survival and local control do not differ for patients with palpable groin metastases treated by CGD or SGD. Patients without pathological iliac nodes on CT might safely undergo SGD, while CGD might be reserved for patients with multiple positive nodes on SGD and/or positive deep nodes on CT scan.
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DOI: 10.1245/s10434-011-1741-0
PubMed: 21537867
PubMed Central: 3192282
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Van Der Ploeg</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Department of Surgical Oncology, Erasmus University Medical Center – Daniel den Hoed Cancer Center, Rotterdam, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Surgical Oncology, Erasmus University Medical Center – Daniel den Hoed Cancer Center, Rotterdam</wicri:regionArea><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="Van Akkooi, A C J" sort="Van Akkooi, A C J" uniqKey="Van Akkooi A" first="A. C. J." last="Van Akkooi">A. C. J. Van Akkooi</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Department of Surgical Oncology, Erasmus University Medical Center – Daniel den Hoed Cancer Center, Rotterdam, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Surgical Oncology, Erasmus University Medical Center – Daniel den Hoed Cancer Center, Rotterdam</wicri:regionArea><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="Schmitz, P I M" sort="Schmitz, P I M" uniqKey="Schmitz P" first="P. I. M." last="Schmitz">P. I. M. Schmitz</name><affiliation wicri:level="3"><nlm:aff id="Aff2">Trials and Statistics, Erasmus University Medical Center – Daniel den Hoed Cancer Center, Rotterdam, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Trials and Statistics, Erasmus University Medical Center – Daniel den Hoed Cancer Center, Rotterdam</wicri:regionArea><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="Van Geel, A N" sort="Van Geel, A N" uniqKey="Van Geel A" first="A. N." last="Van Geel">A. N. Van Geel</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Department of Surgical Oncology, Erasmus University Medical Center – Daniel den Hoed Cancer Center, Rotterdam, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Surgical Oncology, Erasmus University Medical Center – Daniel den Hoed Cancer Center, Rotterdam</wicri:regionArea><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="De Wilt, J H" sort="De Wilt, J H" uniqKey="De Wilt J" first="J. H." last="De Wilt">J. H. De Wilt</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Department of Surgical Oncology, Erasmus University Medical Center – Daniel den Hoed Cancer Center, Rotterdam, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Surgical Oncology, Erasmus University Medical Center – Daniel den Hoed Cancer Center, Rotterdam</wicri:regionArea><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="Aff3">Department of Surgery, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Surgery, Radboud University Nijmegen Medical Center, Nijmegen</wicri:regionArea><placeName><settlement type="city">Nimègue</settlement><region type="province" nuts="2">Gueldre</region></placeName></affiliation></author><author><name sortKey="Eggermont, A M M" sort="Eggermont, A M M" uniqKey="Eggermont A" first="A. M. M." last="Eggermont">A. M. M. Eggermont</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Department of Surgical Oncology, Erasmus University Medical Center – Daniel den Hoed Cancer Center, Rotterdam, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Surgical Oncology, Erasmus University Medical Center – Daniel den Hoed Cancer Center, Rotterdam</wicri:regionArea><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff4">Institut de Cancérologie Gustave Roussy, Villejuif, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Institut de Cancérologie Gustave Roussy, Villejuif</wicri:regionArea><wicri:noRegion>Villejuif</wicri:noRegion><wicri:noRegion>Villejuif</wicri:noRegion></affiliation></author><author><name sortKey="Verhoef, C" sort="Verhoef, C" uniqKey="Verhoef C" first="C." last="Verhoef">C. Verhoef</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Department of Surgical Oncology, Erasmus University Medical Center – Daniel den Hoed Cancer Center, Rotterdam, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Surgical Oncology, Erasmus University Medical Center – Daniel den Hoed Cancer Center, Rotterdam</wicri:regionArea><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">21537867</idno><idno type="pmc">3192282</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3192282</idno><idno type="RBID">PMC:3192282</idno><idno type="doi">10.1245/s10434-011-1741-0</idno><date when="2011">2011</date><idno type="wicri:Area/Pmc/Corpus">000C13</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000C13</idno><idno type="wicri:Area/Pmc/Curation">000C12</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000C12</idno><idno type="wicri:Area/Pmc/Checkpoint">002C67</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">002C67</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Therapeutic Surgical Management of Palpable Melanoma Groin Metastases: Superficial or Combined Superficial and Deep Groin Lymph Node Dissection</title><author><name sortKey="Van Der Ploeg, A P T" sort="Van Der Ploeg, A P T" uniqKey="Van Der Ploeg A" first="A. P. T." last="Van Der Ploeg">A. P. T. Van Der Ploeg</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Department of Surgical Oncology, Erasmus University Medical Center – Daniel den Hoed Cancer Center, Rotterdam, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Surgical Oncology, Erasmus University Medical Center – Daniel den Hoed Cancer Center, Rotterdam</wicri:regionArea><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="Van Akkooi, A C J" sort="Van Akkooi, A C J" uniqKey="Van Akkooi A" first="A. C. J." last="Van Akkooi">A. C. J. Van Akkooi</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Department of Surgical Oncology, Erasmus University Medical Center – Daniel den Hoed Cancer Center, Rotterdam, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Surgical Oncology, Erasmus University Medical Center – Daniel den Hoed Cancer Center, Rotterdam</wicri:regionArea><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="Schmitz, P I M" sort="Schmitz, P I M" uniqKey="Schmitz P" first="P. I. M." last="Schmitz">P. I. M. Schmitz</name><affiliation wicri:level="3"><nlm:aff id="Aff2">Trials and Statistics, Erasmus University Medical Center – Daniel den Hoed Cancer Center, Rotterdam, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Trials and Statistics, Erasmus University Medical Center – Daniel den Hoed Cancer Center, Rotterdam</wicri:regionArea><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="Van Geel, A N" sort="Van Geel, A N" uniqKey="Van Geel A" first="A. N." last="Van Geel">A. N. Van Geel</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Department of Surgical Oncology, Erasmus University Medical Center – Daniel den Hoed Cancer Center, Rotterdam, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Surgical Oncology, Erasmus University Medical Center – Daniel den Hoed Cancer Center, Rotterdam</wicri:regionArea><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="De Wilt, J H" sort="De Wilt, J H" uniqKey="De Wilt J" first="J. H." last="De Wilt">J. H. De Wilt</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Department of Surgical Oncology, Erasmus University Medical Center – Daniel den Hoed Cancer Center, Rotterdam, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Surgical Oncology, Erasmus University Medical Center – Daniel den Hoed Cancer Center, Rotterdam</wicri:regionArea><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="Aff3">Department of Surgery, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Surgery, Radboud University Nijmegen Medical Center, Nijmegen</wicri:regionArea><placeName><settlement type="city">Nimègue</settlement><region type="province" nuts="2">Gueldre</region></placeName></affiliation></author><author><name sortKey="Eggermont, A M M" sort="Eggermont, A M M" uniqKey="Eggermont A" first="A. M. M." last="Eggermont">A. M. M. Eggermont</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Department of Surgical Oncology, Erasmus University Medical Center – Daniel den Hoed Cancer Center, Rotterdam, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Surgical Oncology, Erasmus University Medical Center – Daniel den Hoed Cancer Center, Rotterdam</wicri:regionArea><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff4">Institut de Cancérologie Gustave Roussy, Villejuif, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Institut de Cancérologie Gustave Roussy, Villejuif</wicri:regionArea><wicri:noRegion>Villejuif</wicri:noRegion><wicri:noRegion>Villejuif</wicri:noRegion></affiliation></author><author><name sortKey="Verhoef, C" sort="Verhoef, C" uniqKey="Verhoef C" first="C." last="Verhoef">C. Verhoef</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Department of Surgical Oncology, Erasmus University Medical Center – Daniel den Hoed Cancer Center, Rotterdam, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Surgical Oncology, Erasmus University Medical Center – Daniel den Hoed Cancer Center, Rotterdam</wicri:regionArea><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author></analytic><series><title level="j">Annals of Surgical Oncology</title><idno type="ISSN">1068-9265</idno><idno type="eISSN">1534-4681</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Management of patients with clinically detectable lymph node metastasis to the groin is by ilioinguinal or combined superficial and deep groin dissection (CGD) according to most literature, but in practice superficial groin dissection (SGD) only is still performed in some centers. The aim of this study is to evaluate the experience in CGD versus SGD patients in our center.</p></sec><sec><title>Methods</title><p>Between 1991 and 2009, 121 therapeutic CGD and 48 SGD were performed in 169 melanoma patients with palpable groin metastases at our institute. Median follow-up was 20 and, for survivors, 45 months.</p></sec><sec><title>Results</title><p>In this heterogeneous group of patients, overall (OS) and disease-free survival, local control rates, and morbidity rates were not significantly different between CGD and SGD patients. However, CGD patients had a trend towards more chronic lymphedema. Superficial lymph node ratio, the number of positive superficial lymph nodes, and the presence of deep nodes were prognostic factors for survival. CGD patients with involved deep lymph nodes (24.8%) had estimated 5-year OS of 12% compared with 40% with no involved deep lymph nodes (<italic>p</italic> = 0.001). Preoperative computed tomography (CT) scan had high negative predictive value of 91% for detection of pelvic nodal involvement.</p></sec><sec><title>Conclusions</title><p>This study demonstrated that survival and local control do not differ for patients with palpable groin metastases treated by CGD or SGD. Patients without pathological iliac nodes on CT might safely undergo SGD, while CGD might be reserved for patients with multiple positive nodes on SGD and/or positive deep nodes on CT scan.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Balch, Cm" uniqKey="Balch C">CM Balch</name></author><author><name sortKey="Ross, Mi" uniqKey="Ross M">MI Ross</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Karakousis, Cp" uniqKey="Karakousis C">CP Karakousis</name></author><author><name sortKey="Driscoll, Dl" uniqKey="Driscoll D">DL Driscoll</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Karakousis, Cp" uniqKey="Karakousis C">CP Karakousis</name></author><author><name sortKey="Emrich, Lj" uniqKey="Emrich L">LJ Emrich</name></author><author><name sortKey="Rao, U" uniqKey="Rao U">U Rao</name></author></analytic></biblStruct><biblStruct><analytic><author><name 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Rumke</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Karakousis, Cp" uniqKey="Karakousis C">CP Karakousis</name></author><author><name sortKey="Driscoll, Dl" uniqKey="Driscoll D">DL Driscoll</name></author><author><name sortKey="Rose, B" uniqKey="Rose B">B Rose</name></author><author><name sortKey="Walsh, Dl" uniqKey="Walsh D">DL Walsh</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Badgwell, B" uniqKey="Badgwell B">B Badgwell</name></author><author><name sortKey="Xing, Y" uniqKey="Xing Y">Y Xing</name></author><author><name sortKey="Gershenwald, Je" uniqKey="Gershenwald J">JE Gershenwald</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Ann Surg Oncol</journal-id><journal-title-group><journal-title>Annals of Surgical Oncology</journal-title></journal-title-group><issn pub-type="ppub">1068-9265</issn><issn pub-type="epub">1534-4681</issn><publisher><publisher-name>Springer-Verlag</publisher-name><publisher-loc>New York</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">21537867</article-id><article-id pub-id-type="pmc">3192282</article-id><article-id pub-id-type="publisher-id">1741</article-id><article-id pub-id-type="doi">10.1245/s10434-011-1741-0</article-id><article-categories><subj-group subj-group-type="heading"><subject>Melanomas</subject></subj-group></article-categories><title-group><article-title>Therapeutic Surgical Management of Palpable Melanoma Groin Metastases: Superficial or Combined Superficial and Deep Groin Lymph Node Dissection</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>van der Ploeg</surname><given-names>A. P. T.</given-names></name><degrees>MSc</degrees><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>van Akkooi</surname><given-names>A. C. J.</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Schmitz</surname><given-names>P. I. M.</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="Aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>van Geel</surname><given-names>A. N.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>de Wilt</surname><given-names>J. H.</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="Aff1">1</xref><xref ref-type="aff" rid="Aff3">3</xref></contrib><contrib contrib-type="author"><name><surname>Eggermont</surname><given-names>A. M. M.</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="Aff1">1</xref><xref ref-type="aff" rid="Aff4">4</xref></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Verhoef</surname><given-names>C.</given-names></name><degrees>PhD</degrees><address><phone>+31 10-7041506</phone><fax>+31 10-7041011</fax><email>c.verhoef@erasmusmc.nl</email></address><xref ref-type="aff" rid="Aff1">1</xref></contrib><aff id="Aff1"><label>1</label>Department of Surgical Oncology, Erasmus University Medical Center – Daniel den Hoed Cancer Center, Rotterdam, The Netherlands</aff><aff id="Aff2"><label>2</label>Trials and Statistics, Erasmus University Medical Center – Daniel den Hoed Cancer Center, Rotterdam, The Netherlands</aff><aff id="Aff3"><label>3</label>Department of Surgery, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands</aff><aff id="Aff4"><label>4</label>Institut de Cancérologie Gustave Roussy, Villejuif, France</aff></contrib-group><pub-date pub-type="epub"><day>3</day><month>5</month><year>2011</year></pub-date><pub-date pub-type="pmc-release"><day>3</day><month>5</month><year>2011</year></pub-date><pub-date pub-type="ppub"><month>11</month><year>2011</year></pub-date><volume>18</volume><issue>12</issue><fpage>3300</fpage><lpage>3308</lpage><history><date date-type="received"><day>9</day><month>11</month><year>2010</year></date></history><permissions><copyright-statement>© The Author(s) 2011</copyright-statement></permissions><abstract id="Abs1"><sec><title>Background</title><p>Management of patients with clinically detectable lymph node metastasis to the groin is by ilioinguinal or combined superficial and deep groin dissection (CGD) according to most literature, but in practice superficial groin dissection (SGD) only is still performed in some centers. The aim of this study is to evaluate the experience in CGD versus SGD patients in our center.</p></sec><sec><title>Methods</title><p>Between 1991 and 2009, 121 therapeutic CGD and 48 SGD were performed in 169 melanoma patients with palpable groin metastases at our institute. Median follow-up was 20 and, for survivors, 45 months.</p></sec><sec><title>Results</title><p>In this heterogeneous group of patients, overall (OS) and disease-free survival, local control rates, and morbidity rates were not significantly different between CGD and SGD patients. However, CGD patients had a trend towards more chronic lymphedema. Superficial lymph node ratio, the number of positive superficial lymph nodes, and the presence of deep nodes were prognostic factors for survival. CGD patients with involved deep lymph nodes (24.8%) had estimated 5-year OS of 12% compared with 40% with no involved deep lymph nodes (<italic>p</italic> = 0.001). Preoperative computed tomography (CT) scan had high negative predictive value of 91% for detection of pelvic nodal involvement.</p></sec><sec><title>Conclusions</title><p>This study demonstrated that survival and local control do not differ for patients with palpable groin metastases treated by CGD or SGD. Patients without pathological iliac nodes on CT might safely undergo SGD, while CGD might be reserved for patients with multiple positive nodes on SGD and/or positive deep nodes on CT scan.</p></sec></abstract><custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name><meta-value>© Society of Surgical Oncology 2011</meta-value></custom-meta></custom-meta-group></article-meta></front></pmc><affiliations><list><country><li>France</li><li>Pays-Bas</li></country><region><li>Gueldre</li><li>Hollande-Méridionale</li></region><settlement><li>Nimègue</li><li>Rotterdam</li></settlement></list><tree><country name="Pays-Bas"><region name="Hollande-Méridionale"><name sortKey="Van Der Ploeg, A P T" sort="Van Der Ploeg, A P T" uniqKey="Van Der Ploeg A" first="A. P. T." last="Van Der Ploeg">A. P. T. Van Der Ploeg</name></region><name sortKey="De Wilt, J H" sort="De Wilt, J H" uniqKey="De Wilt J" first="J. H." last="De Wilt">J. H. De Wilt</name><name sortKey="De Wilt, J H" sort="De Wilt, J H" uniqKey="De Wilt J" first="J. H." last="De Wilt">J. H. De Wilt</name><name sortKey="Eggermont, A M M" sort="Eggermont, A M M" uniqKey="Eggermont A" first="A. M. M." last="Eggermont">A. M. M. Eggermont</name><name sortKey="Schmitz, P I M" sort="Schmitz, P I M" uniqKey="Schmitz P" first="P. I. M." last="Schmitz">P. I. M. Schmitz</name><name sortKey="Van Akkooi, A C J" sort="Van Akkooi, A C J" uniqKey="Van Akkooi A" first="A. C. J." last="Van Akkooi">A. C. J. Van Akkooi</name><name sortKey="Van Geel, A N" sort="Van Geel, A N" uniqKey="Van Geel A" first="A. N." last="Van Geel">A. N. Van Geel</name><name sortKey="Verhoef, C" sort="Verhoef, C" uniqKey="Verhoef C" first="C." last="Verhoef">C. Verhoef</name></country><country name="France"><noRegion><name sortKey="Eggermont, A M M" sort="Eggermont, A M M" uniqKey="Eggermont A" first="A. M. M." last="Eggermont">A. M. M. 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