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3. The Role of Exenterative Surgery and Urinary Diversion in Persistent or Locally Recurrent Gynecological Malignancy: Complications and Survival.

Author

Spahn, M., Weiss, C., Bader, P., Studer, U. E., Burkhard, F. C., and Frohneberg, D.

Subjects
*CERVICAL cancer, *CANCER treatment complications, *CANCER patients, *URINARY organ surgery, *URINARY diversion
Abstract

Objective: Treatment options in patients with persistent or locally recurrent cervical cancer are limited. The aim of this study was to determine the chance of cure and associated morbidity following pelvic exenteration. Patients and Methods: Consecutive patients who underwent pelvic exenteration between January 1992 and December 2006 at the University Hospital of Bern or the Karlsruhe Medical Center were evaluated. Time to recurrence, type of exenteration and urinary diversion, pathological stage, postoperative complications and survival were assessed. Results: Initial therapy prior to diagnosis of persistent or locally recurrent disease included radiation therapy in 51%. Anterior exenteration was performed in 37 (86%) and total exenteration in 6 (14%). Half of the women underwent additional procedures. A continent urinary diversion was constructed in 16 and an ileal conduit in 27 patients. Early postoperative complications were generally minor and only 2 patients required surgical intervention. Four intestinal fistulas were successfully treated conservatively. Late complications were mainly tumor-related. Complication rates associated with the urinary diversion were low and there was no difference in complications between continent and incontinent diversions. The overall disease-specific 5-year survival rate after exenteration was 36.5%. Survival correlated significantly with surgical margin status. Conclusion: In patients with persistent or locally recurrent gynecological malignancy of the pelvis, exenteration is a viable option with long-term survival in over one third of patients. Continent urinary diversion did not show higher complication rates than an ileal conduit and should be considered even in irradiated patients. This may be of greater significance in younger patients in whom an intact body image can play an important role in quality of life. Copyright © 2010 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Published
2010
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6. Bladder Carcinoma during Pregnancy.

Author

Spahn, M., Bader, P., Westermann, D., Echtle, D., and Frohneberg, D.

Subjects
*PREGNANCY, *BLADDER cancer, *CANCER, *TUMORS, *CYSTOSCOPY
Abstract

Introduction: We report 3 cases of bladder cancer during pregnancy and give a review of the literature in an attempt to evaluate tumor at presentation, characteristics, maternal and fetal outcome. Materials and Methods: The case history of 3 pregnant women treated for bladder cancer in 2001 together with the results of a MEDLINE search from 1966 to 2003. Results: Out of 27 cases of nonbilharzial bladder carcinoma, 74% presented with transitional cell carcinoma. Five patients had muscle-invasive tumors. Major symptom was hematuria in 81%, which was initially mistaken as vaginal bleeding in 22%. Only half of the tumors were identified by ultrasonography. Although superficial bladder carcinoma was transurethrally resected alone, outcome and prognosis are good. But the prognosis of locally advanced bladder carcinoma is poor. None of the fetuses delivered before 30 weeks of gestation survived. Two of the 5 patients died from the disease and follow-up is only short in the rest. Conclusion: Any doubtful genital bleeding during pregnancy without definite proof of vaginal/cervical origin should be investigated by both ultrasonography of the upper urinary tract and urethrocystoscopy. Superficial bladder tumors can be most effectively treated by transurethral resection followed by cystoscopy, whereas the prognosis of muscle-invasive bladder carcinoma is poor and demands more radical treatment, depending on the stage of pregnancy. Copyright © 2005 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Published
2005
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13. 163 Historical trends in high-risk prostate cancer patients characteristics: A 27 years old observational study from the European multicenter prostate cancer clinical and translational research group (EMPaCT) data base.

Author

Bianchi, M., Briganti, A., Karnes, J., Gandaglia, G., Fossati, N., Spahn, M., Gontero, P., Tosco, L., Kneitz, B., Chun, F., Zaffuto, E., De Ridder, D., Sun, M., Graefen, M., Marchioro, G., Frohneberg, D., Guilloneau, B., Giona, S., Sanchez-Salas, R., and Cathelineau, X.

Subjects
*PROSTATE cancer risk factors, *PROSTATE cancer patients, *DATABASES, *SURVIVAL analysis (Biometry), *SCIENTIFIC observation, *HEALTH outcome assessment
Published
2016
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29. 526 OUTCOME OF MULTIMODALITY TREATMENT OF HIGH-RISK LOCALIZED PROSTATE CANCER (CT3-4 OR PSA ≥20 NG/ML OR BIOPSY GLEASON SCORE ≥8) WITH RADICAL PROSTATECTOMY AS INITIAL STEP: A MULTI-INSTITUTIONAL OUTCOME STUDY OF 1413 PATIENTS

Author

Joniau, S.G., Spahn, M., Gontero, P., Tombal, B., Bangma, C., Walz, J., Hsu, C.Y., Van Der Eeckt, K., Marchioro, G., Bader, P., Frohneberg, D., Graefen, M., Huland, H., Schröder, F., Tizzani, A., Van Cangh, P., and Van Poppel, H.

Published
2009
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