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This trial will randomize 3150 patients to early rhythm control therapy either by atrial catheter ablation or antiarrhythmic drugs (preferably dronedarone, and in case of a recurrence both modalities), or usual care as described in the 2010 AF guidelines.
Five-year local control is estimated to be similar for VBT and a watchful waiting policy (WWP), in which patients receive VBT combined with external radiation in case of a recurrence.
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Forty eightpercentt of patients report having another health care provider to turn to in case of an emergency or recurrence; 100% of missions report having a system in place to refer patients to another health care provider if needed.
In case of a 2nd recurrence, patients only receive conservative care until the end of the model's time horizon (or death).
In case of a second recurrence within 12 months after the last successful injection, participants will be randomized to either an arthroscopic subacromial decompression performed within four weeks or continuation of treatment by the general practitioner according to the National Guidelines for Shoulder Problems.
In case of a metachronous oligometastatic recurrence in arm A, a retreatment with radiotherapy or surgery is allowed.
Androgen deprivation therapy: ADT will be started as in arm A. In case of a metachronous oligometastatic recurrence, a retreatment with SBRT or surgery is allowed.
An argument often used against additional whole-brain irradiation is the option of salvage radiosurgery in case of an intra-cerebral recurrence distant from the treated lesions.
To corroborate the diagnosis of aHUS and to evaluate the risk of recurrence in case of a kidney transplantation, genetic tests were performed to investigate abnormalities in regulators of the alternative complement pathway and components of the C3bBb convertase.
The mean time-lapse before occurrence of the ipsilateral breast tumour recurrence was not significantly different in the case of a recurrence at the index quadrant or not (respectively 55 vs 53 months; P=0.8).
To ensure wide margins in case of local recurrence, a hemipelvectomy may be necessary.
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