12 results on '"G. Emons"'
Search Results
2. Einfluss der Diagnose des Erstrezidivs auf die gesundheitsbezogene Lebensqualität von Patientinnen mit fortgeschrittenem Ovarialkarzinom (AGO-OVAR 19/II)
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B Czogalla, B Ataseven, S Kommoss, A Reuß, J Sehouli, B Lampe, B Schmalfeldt, P Wimberger, R Witteler, P Buderath, U Herwig, H Bronger, G Emons, M Klar, A Hasenburg, N de Gregorio, F Hilpert, A du Bois, S Mahner, and P Harter
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- 2022
3. The influence of anastomotic techniques on postoperative anastomotic complications: Results of the Oesophago-Gastric Anastomosis Audit
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S.K. Kamarajah, R.P.T. Evans, D. Nepogodiev, J. Hodson, J.R. Bundred, I. Gockel, J.A. Gossage, A. Isik, B. Kidane, H.A. Mahendran, I. Negoi, K.E. Okonta, R. Sayyed, R. van Hillegersberg, R.S. Vohra, B.P.L. Wijnhoven, P. Singh, E.A. Griffiths, D. Alderson, J. Bundred, J. Gossage, B. Jefferies, S. McKay, I. Mohamed, K. Siaw-Acheampong, R. Vohra, K. Wanigasooriya, T. Whitehouse, A. Gjata, J.I. Moreno, F.R. Takeda, R. Guevara Castro, T. Harustiak, A. Bekele, A. Kechagias, A. Kennedy, A. Da Roit, A. Bagajevas, J.S. Azagra, L. Mejía-Fernández, J. El Kafsi, R.H. Sayyed, M. Sousa, A.S. Sampaio, R. Blanco, B. Wallner, P.M. Schneider, P.K. Hsu, S. Gananadha, V. Wills, M. Devadas, C. Duong, M. Talbot, M.W. Hii, R. Jacobs, N.A. Andreollo, B. Johnston, G. Darling, A. Isaza-Restrepo, G. Rosero, F. Arias-Amézquita, D. Raptis, J. Gaedcke, D. Reim, J. Izbicki, J.H. Egberts, S. Dikinis, D.W. Kjaer, M.H. Larsen, M.P. Achiam, J. Saarnio, D. Theodorou, T. Liakakos, D.P. Korkolis, W.B. Robb, C. Collins, T. Murphy, J. Reynolds, V. Tonini, M. Migliore, L. Bonavina, M. Valmasoni, R. Bardini, J. Weindelmayer, M. Terashima, R.E. White, E. Alghunaim, M. Elhadi, A.M. Leon-Takahashi, H. Medina-Franco, P.C. Lau, J. Heisterkamp, C. Rosman, G. Beban, R. Babor, A. Gordon, J.I. Rossaak, K.M.I. Pal, A.U. Qureshi, S.A. Naqi, A.A. Syed, J. Barbosa, C.S. Vicente, J. Leite, J. Freire, R. Casaca, R.C.T. Costa, R.R. Scurtu, S.S. Mogoanta, C. Bolca, S. Constantinoiu, D. Sekhniaidze, M. Bjelović, J.B.Y. So, G. Gačevski, C. Loureiro, M. Pera, A. Bianchi, M. Moreno Gijón, J. Martín Fernández, M.S. Trugeda Carrera, M. Vallve-Bernal, M.A. Cítores Pascual, S. Elmahi, I. Halldestam, J. Hedberg, S. Mönig, S. Gutknecht, M. Tez, A. Guner, M.B. Tirnaksiz, E. Colak, B. Sevinç, A. Hindmarsh, I. Khan, D. Khoo, R. Byrom, J. Gokhale, P. Wilkerson, P. Jain, D. Chan, K. Robertson, S. Iftikhar, R. Skipworth, M. Forshaw, S. Higgs, R. Nijjar, Y.K.S. Viswanath, P. Turner, S. Dexter, A. Boddy, W.H. Allum, S. Oglesby, E. Cheong, D. Beardsmore, N. Maynard, R. Berrisford, S. Mercer, S. Puig, R. Melhado, C. Kelty, T. Underwood, K. Dawas, W. Lewis, A. Al-Bahrani, G. Bryce, M. Thomas, A.T. Arndt, F. Palazzo, R.A. Meguid, J. Fergusson, E. Beenen, C. Mosse, J. Salim, S. Cheah, T. Wright, M.P. Cerdeira, P. McQuillan, M. Richardson, H. Liem, J. Spillane, M. Yacob, F. Albadawi, T. Thorpe, A. Dingle, C. Cabalag, K. Loi, O.M. Fisher, S. Ward, M. Read, M. Johnson, R. Bassari, H. Bui, I. Cecconello, R.A.A. Sallum, J.R.M. da Rocha, L.R. Lopes, V. Tercioti, J.D.S. Coelho, J.A.P. Ferrer, G. Buduhan, L. Tan, S. Srinathan, P. Shea, J. Yeung, F. Allison, P. Carroll, F. Vargas-Barato, F. Gonzalez, J. Ortega, L. Nino-Torres, T.C. Beltrán-García, L. Castilla, M. Pineda, A. Bastidas, J. Gómez-Mayorga, N. Cortés, C. Cetares, S. Caceres, S. Duarte, A. Pazdro, M. Snajdauf, H. Faltova, M. Sevcikova, P.B. Mortensen, N. Katballe, T. Ingemann, B. Morten, I. Kruhlikava, A.P. Ainswort, N.M. Stilling, J. Eckardt, J. Holm, M. Thorsteinsson, M. Siemsen, B. Brandt, B. Nega, E. Teferra, A. Tizazu, J.H. Kauppila, V. Koivukangas, S. Meriläinen, R. Gruetzmann, C. Krautz, G. Weber, H. Golcher, G. Emons, A. Azizian, M. Ebeling, S. Niebisch, N. Kreuser, G. Albanese, J. Hesse, L. Volovnik, U. Boecher, M. Reeh, S. Triantafyllou, D. Schizas, A. Michalinos, E. Balli, M. Mpoura, A. Charalabopoulos, D.K. Manatakis, D. Balalis, J. Bolger, C. Baban, A. Mastrosimone, O. McAnena, A. Quinn, C.B. Ó Súilleabháin, M.M. Hennessy, I. Ivanovski, H. Khizer, N. Ravi, N. Donlon, M. Cervellera, S. Vaccari, S. Bianchini, l. Sartarelli, E. Asti, D. Bernardi, S. Merigliano, L. Provenzano, M. Scarpa, L. Saadeh, B. Salmaso, G. De Manzoni, S. Giacopuzzi, R. La Mendola, C.A. De Pasqual, Y. Tsubosa, M. Niihara, T. Irino, R. Makuuchi, K. Ishii, M. Mwachiro, A. Fekadu, A. Odera, E. Mwachiro, D. AlShehab, H.A. Ahmed, A.O. Shebani, A. Elhadi, F.A. Elnagar, H.F. Elnagar, S.T. Makkai-Popa, L.F. Wong, Y.R. Tan, S. Thannimalai, C.A. Ho, W.S. Pang, J.H. Tan, H.N.L. Basave, R. Cortés-González, S.M. Lagarde, J.J.B. van Lanschot, C. Cords, W.A. Jansen, I. Martijnse, R. Matthijsen, S. Bouwense, B. Klarenbeek, M. Verstegen, F. van Workum, J.P. Ruurda, P.C. van der Sluis, M. de Maat, N. Evenett, P. Johnston, R. Patel, A. MacCormick, M. Young, B. Smith, C. Ekwunife, A.H. Memon, K. Shaikh, A. Wajid, N. Khalil, M. Haris, Z.U. Mirza, S.B.A. Qudus, M.Z. Sarwar, A. Shehzadi, A. Raza, M.H. Jhanzaib, J. Farmanali, Z. Zakir, O. Shakeel, I. Nasir, S. Khattak, M. Baig, Noor MA, H.H. Ahmed, A. Naeem, A.C. Pinho, R. da Silva, A. Bernardes, J.C. Campos, H. Matos, T. Braga, C. Monteiro, P. Ramos, F. Cabral, M.P. Gomes, P.C. Martins, A.M. Correia, J.F. Videira, C. Ciuce, R. Drasovean, R. Apostu, S. Paitici, A.E. Racu, C.V. Obleaga, M. Beuran, B. Stoica, C. Ciubotaru, V. Negoita, I. Cordos, R.D. Birla, D. Predescu, P.A. Hoara, R. Tomsa, V. Shneider, M. Agasiev, I. Ganjara, D. Gunjić, M. Veselinović, T. Babič, T.S. Chin, A. Shabbir, G. Kim, A. Crnjac, H. Samo, I. Díez del Val, S. Leturio, J.M. Ramón, M. Dal Cero, S. Rifá, M. Rico, A. Pagan Pomar, J.A. Martinez Corcoles, J.L. Rodicio Miravalles, S.A. Pais, S.A. Turienzo, L.S. Alvarez, P.V. Campos, A.G. Rendo, S.S. García, E.P.G. Santos, E.T. Martínez, M.J. Fernández Díaz, C. Magadán Álvarez, V. Concepción Martín, C. Díaz López, A. Rosat Rodrigo, L.E. Pérez Sánchez, M. Bailón Cuadrado, C. Tinoco Carrasco, E. Choolani Bhojwani, D.P. Sánchez, M.E. Ahmed, T. Dzhendov, F. Lindberg, M. Rutegård, M. Sundbom, C. Mickael, N. Colucci, A. Schnider, S. Er, E. Kurnaz, S. Turkyilmaz, A. Turkyilmaz, R. Yildirim, B.E. Baki, N. Akkapulu, O. Karahan, N. Damburaci, R. Hardwick, P. Safranek, V. Sujendran, J. Bennett, Z. Afzal, M. Shrotri, B. Chan, K. Exarchou, T. Gilbert, T. Amalesh, D. Mukherjee, S. Mukherjee, T.H. Wiggins, R. Kennedy, S. McCain, A. Harris, G. Dobson, N. Davies, I. Wilson, D. Mayo, D. Bennett, R. Young, P. Manby, N. Blencowe, M. Schiller, B. Byrne, D. Mitton, V. Wong, A. Elshaer, M. Cowen, V. Menon, L.C. Tan, E. McLaughlin, R. Koshy, C. Sharp, H. Brewer, N. Das, M. Cox, W. Al Khyatt, D. Worku, R. Iqbal, L. Walls, R. McGregor, G. Fullarton, A. Macdonald, C. MacKay, C. Craig, S. Dwerryhouse, S. Hornby, S. Jaunoo, M. Wadley, C. Baker, M. Saad, M. Kelly, A. Davies, F. Di Maggio, P. Mistry, R. Singhal, O. Tucker, S. Kapoulas, S. Powell-Brett, P. Davis, G. Bromley, L. Watson, R. Verma, J. Ward, V. Shetty, C. Ball, K. Pursnani, A. Sarela, H. Sue Ling, S. Mehta, J. Hayden, N. To, T. Palser, D. Hunter, K. Supramaniam, Z. Butt, A. Ahmed, S. Kumar, A. Chaudry, O. Moussa, A. Kordzadeh, B. Lorenzi, M. Wilson, P. Patil, I. Noaman, J. Willem, G. Bouras, R. Evans, M. Singh, H. Warrilow, A. Ahmad, N. Tewari, F. Yanni, J. Couch, E. Theophilidou, J.J. Reilly, null van Boxel Gijs, K. Akbari, D. Zanotti, B. Sgromo, G. Sanders, T. Wheatley, A. Ariyarathenam, A. Reece-Smith, L. Humphreys, C. Choh, N. Carter, B. Knight, P. Pucher, A. Athanasiou, B. Tan, M. Abdulrahman, J. Vickers, K. Akhtar, R. Chaparala, R. Brown, M.M.A. Alasmar, R. Ackroyd, K. Patel, A. Tamhankar, A. Wyman, R. Walker, B. Grace, N. Abbassi, N. Slim, L. Ioannidi, G. Blackshaw, T. Havard, X. Escofet, A. Powell, A. Owera, F. Rashid, P. Jambulingam, J. Padickakudi, H. Ben-Younes, K. Mccormack, I.A. Makey, M.K. Karush, C.W. Seder, M.J. Liptay, G. Chmielewski, E.L. Rosato, A.C. Berger, R. Zheng, E. Okolo, A. Singh, C.D. Scott, M.J. Weyant, J.D. Mitchell, Surgery, Intensive Care, Radiotherapy, Oral and Maxillofacial Surgery, Rheumatology, Medical Microbiology & Infectious Diseases, Erasmus MC other, Hematology, Gastroenterology & Hepatology, Public Health, Medical Informatics, Internal Medicine, Public Administration, Epidemiology, Erasmus School of Economics, Cell biology, Pathology, Health Services Management & Organisation (HSMO), and Molecular Genetics
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Pulmonary and Respiratory Medicine ,Esophageal Neoplasms ,Anastomosis ,Anastomotic Leak ,outcomes ,Esophageal Neoplasms/surgery ,surgical techniques ,Cohort Studies ,Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14] ,Necrosis ,Postoperative Complications ,Esophagectomy/adverse effects ,SDG 3 - Good Health and Well-being ,Surgical ,Surgical Stapling ,anastomotic leak ,esophageal cancer ,esophagectomy ,Anastomosis, Surgical ,Esophagectomy ,Humans ,Suture Techniques ,Anastomosis, Surgical/adverse effects ,Suture Techniques/adverse effects ,Surgical Stapling/adverse effects ,Surgery ,Postoperative Complications/etiology ,Necrosis/surgery ,Cardiology and Cardiovascular Medicine ,Anastomotic Leak/etiology - Abstract
BACKGROUND: The optimal anastomotic techniques in esophagectomy to minimize rates of anastomotic leakage and conduit necrosis are not known. The aim of this study was to assess whether the anastomotic technique was associated with anastomotic failure after esophagectomy in the international Oesophago-Gastric Anastomosis Audit cohort.METHODS: This prospective observational multicenter cohort study included patients undergoing esophagectomy for esophageal cancer over 9 months during 2018. The primary exposure was the anastomotic technique, classified as handsewn, linear stapled, or circular stapled. The primary outcome was anastomotic failure, namely a composite of anastomotic leakage and conduit necrosis, as defined by the Esophageal Complications Consensus Group. Multivariable logistic regression modeling was used to identify the association between anastomotic techniques and anastomotic failure, after adjustment for confounders.RESULTS: Of the 2238 esophagectomies, the anastomosis was handsewn in 27.1%, linear stapled in 21.0%, and circular stapled in 51.9%. Anastomotic techniques differed significantly by the anastomosis sites (P < .001), with the majority of neck anastomoses being handsewn (69.9%), whereas most chest anastomoses were stapled (66.3% circular stapled and 19.3% linear stapled). Rates of anastomotic failure differed significantly among the anastomotic techniques (P < .001), from 19.3% in handsewn anastomoses, to 14.0% in linear stapled anastomoses, and 12.1% in circular stapled anastomoses. This effect remained significant after adjustment for confounding factors on multivariable analysis, with an odds ratio of 0.63 (95% CI, 0.46-0.86; P = .004) for circular stapled versus handsewn anastomosis. However, subgroup analysis by anastomosis site suggested that this effect was predominantly present in neck anastomoses, with anastomotic failure rates of 23.2% versus 14.6% versus 5.9% for handsewn versus linear stapled anastomoses versus circular stapled neck anastomoses, compared with 13.7% versus 13.8% versus 12.2% for chest anastomoses.CONCLUSIONS: Handsewn anastomoses appear to be independently associated with higher rates of anastomotic failure compared with stapled anastomoses. However, this effect seems to be largely confined to neck anastomoses, with minimal differences between techniques observed for chest anastomoses. Further research into standardization of anastomotic approach and techniques may further improve outcomes.
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- 2022
4. Randomized Trial of Cytoreductive Surgery for Relapsed Ovarian Cancer
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Harter, Philipp, Sehouli, Jalid, Vergote, Ignace, Ferron, Gwenael, Reuss, Alexander, Meier, Werner, Greggi, Stefano, Mosgard, Berit J, Selle, Frederic, Guyon, Frédéric, Pomel, Christophe, Lécuru, Fabrice, Zang, Rongyu, Avall-Lundqvist, Elisabeth, Kim, Jae-Weon, Ponce, Jordi, Raspagliesi, Francesco, Kristensen, Gunnar, Classe, Jean-Marc, Hillemanns, Peter, Jensen, Pernille, Hasenburg, Annette, Ghaem-Maghami, Sadaf, Mirza, Mansoor R, Lund, Bente, Reinthaller, Alexander, Santaballa, Ana, Olaitan, Adeola, Hilpert, Felix, du Bois, Andreas, S Buchholz, A Burges, U Canzler, D Denschlag, A El-Balat, G Emons, R Felberbaum, N de Gregorio, M Gropp-Meier, V Hanf, L Hanker, R Hils, C Kurzeder, B Lampe, A Mustea, M Schmidt, R Schutz, M Weigel, S Weiser, A Zorr, C Marth, E Petru, T Scholl, M Beltran, I Bover, A Gomez di Laino, N Lainez, S Martinez, A Poveda Velasco, M Romeo, H Crouet, E de Gournay, G Deplanque, P Follana, A Floquet, D Lanvin, J Leveque, E Pujade-Lauraine, N Raban, B Resch, A M Savoye, G Aletti, G Giorda, F Landoni, C Scaffa, J Abu, F Alexander-Sefre, D Barton, S Butler-Manuel, R Clayton, R Crawford, T Duncan, A El-Ghobashy, C Fotopoulou, M Hall, C Intrivici, A Lawrence, D Luesley, R Naik, A Nordin, J Tidy, L Fokdahl, A Hofsjö, P Kjolhede, B Eyjolfsdottir, Z Y Dai, P Zhang, B Aminossadati, M Hahmann, C Nasemann, S Yahiaoui, M Wittenberg, C Schade-Brittinger, G Elser, D Reddig, M Kuncke, S Polleis, Y Mattukat, A Riha, R Berger, J de Roover, B Kaur, J Crook, F Nepote, B Votan, M Andriamamonjy, J Bryce, S Ristinge, Philipp, H, Jalid, S, Ignace, V, Gwenael, F, Alexander, R, Werner, M, Stefano, G, Berit J, M, Frederic, S, Frédéric, G, Christophe, P, Fabrice, L, Rongyu, Z, Elisabeth, A, Jae-Weon, K, Jordi, P, Francesco, R, Gunnar, K, Jean-Marc, C, Peter, H, Pernille, J, Annette, H, Sadaf, G, Mansoor R, M, Bente, L, Ana, S, Adeola, O, Felix, H, Andreas, D, Buchholz, S, Burges, A, Canzler, U, Denschlag, D, El-Balat, A, Emons, G, Felberbaum, R, de Gregorio, N, Gropp-Meier, M, Hanf, V, Hanker, L, Hils, R, Kurzeder, C, Lampe, B, Mustea, A, Schmidt, M, Schutz, R, Weigel, M, Weiser, S, Zorr, A, Marth, C, Petru, E, Scholl, T, Beltran, M, Bover, I, Gomez di Laino, A, Lainez, N, Martinez, S, Poveda Velasco, A, Romeo, M, Crouet, H, de Gournay, E, Deplanque, G, Follana, P, Floquet, A, Lanvin, D, Leveque, J, Pujade-Lauraine, E, Raban, N, Resch, B, M Savoye, A, Aletti, G, Giorda, G, Landoni, F, Scaffa, C, Abu, J, Alexander-Sefre, F, Barton, D, Butler-Manuel, S, Clayton, R, Crawford, R, Duncan, T, El-Ghobashy, A, Fotopoulou, C, Hall, M, Intrivici, C, Lawrence, A, Luesley, D, Naik, R, Nordin, A, Tidy, J, Fokdahl, L, Hofsjö, A, Kjolhede, P, Eyjolfsdottir, B, Y Dai, Z, Zhang, P, Aminossadati, B, Hahmann, M, Nasemann, C, Yahiaoui, S, Wittenberg, M, Schade-Brittinger, C, Elser, G, Reddig, D, Kuncke, M, Polleis, S, Mattukat, Y, Riha, A, Berger, R, de Roover, J, Kaur, B, Crook, J, Nepote, F, Votan, B, Andriamamonjy, M, Bryce, J, and Ristinge, S
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EPITHELIAL OVARIAN ,Oncology ,medicine.medical_specialty ,BEVACIZUMAB ,MULTICENTER ,Antineoplastic Agents ,PACLITAXEL ,Systemic therapy ,law.invention ,Antineoplastic Agent ,Randomized controlled trial ,law ,Internal medicine ,Humans ,Medicine ,RECURRENT ,Proportional Hazards Models ,Aged ,Ovarian Neoplasms ,SECONDARY CYTOREDUCTION ,business.industry ,Ovarian Neoplasm ,Antineoplastic Agents/therapeutic use ,Obstetrics and Gynecology ,Ovarian Neoplasms/drug therapy ,Cytoreduction Surgical Procedures ,General Medicine ,CHEMOTHERAPY ,Middle Aged ,OPEN-LABEL ,medicine.disease ,Survival Analysis ,Combined Modality Therapy ,Neoplasm Recurrence, Local/drug therapy ,Recurrent Ovarian Cancer ,Proportional Hazards Model ,Quality of Life ,Female ,Survival Analysi ,Neoplasm Recurrence, Local ,business ,Cytoreductive surgery ,Ovarian cancer ,Human - Abstract
BACKGROUND: Treatment for patients with recurrent ovarian cancer has been mainly based on systemic therapy. The role of secondary cytoreductive surgery is unclear. METHODS: We randomly assigned patients with recurrent ovarian cancer who had a first relapse after a platinum-free interval (an interval during which no platinum-based chemotherapy was used) of 6 months or more to undergo secondary cytoreductive surgery and then receive platinum-based chemotherapy or to receive platinum-based chemotherapy alone. Patients were eligible if they presented with a positive Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) score, defined as an Eastern Cooperative Oncology Group performance-status score of 0 (on a 5-point scale, with higher scores indicating greater disability), ascites of less than 500 ml, and complete resection at initial surgery. A positive AGO score is used to identify patients in whom a complete resection might be achieved. The primary end point was overall survival. We also assessed quality of life and prognostic factors for survival. RESULTS: A total of 407 patients underwent randomization: 206 were assigned to cytoreductive surgery and chemotherapy, and 201 to chemotherapy alone. A complete resection was achieved in 75.5% of the patients in the surgery group who underwent the procedure. The median overall survival was 53.7 months in the surgery group and 46.0 months in the no-surgery group (hazard ratio for death, 0.75; 95% confidence interval, 0.59 to 0.96; P = 0.02). Patients with a complete resection had the most favorable outcome, with a median overall survival of 61.9 months. A benefit from surgery was seen in all analyses in subgroups according to prognostic factors. Quality-of-life measures through 1 year of follow-up did not differ between the two groups, and we observed no perioperative mortality within 30 days after surgery. CONCLUSIONS: In women with recurrent ovarian cancer, cytoreductive surgery followed by chemotherapy resulted in longer overall survival than chemotherapy alone. (Funded by the AGO Study Group and others; DESKTOP III ClinicalTrials.gov number, NCT01166737.).
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- 2021
5. Endometrial Cancer. Guideline of the DGGG, DKG and DKH (S3-Level, AWMF Registry Number 032/034-OL, September 2022) - Part 2 with Recommendations on the Therapy of Precancerous Lesions and Early-stage Endometrial Cancer, Surgical Therapy, Radiotherapy and Drug-based Therapy, Follow-up Care, Recurrence and Metastases, Psycho-oncological Care, Palliative Care, Patient Education, and Rehabilitative and Physiotherapeutic Care.
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Emons G, Steiner E, Vordermark D, Uleer C, Paradies K, Tempfer C, Aretz S, Cremer W, Hanf V, Mallmann P, Ortmann O, Römer T, Schmutzler RK, Horn LC, Kommoss S, Lax S, Schmoeckel E, Mokry T, Grab D, Reinhardt M, Steinke-Lange V, Brucker SY, Kiesel L, Witteler R, Fleisch MC, Friedrich M, Höcht S, Lichtenegger W, Mueller M, Runnebaum I, Feyer P, Hagen V, Juhasz-Böss I, Letsch A, Niehoff P, Zeimet AG, Battista MJ, Petru E, Widhalm S, van Oorschot B, Panke JE, Weis J, Dauelsberg T, Haase H, Beckmann MW, Jud S, Wight E, Prott FJ, Micke O, Bader W, Reents N, Henscher U, Schallenberg M, Rahner N, Mayr D, Kreißl M, Lindel K, Mustea A, Strnad V, Goerling U, Bauerschmitz GJ, Langrehr J, Neulen J, Ulrich UA, Nothacker MJ, Blödt S, Follmann M, Langer T, Wenzel G, Weber S, and Erdogan S
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Summary The S3-guideline on endometrial cancer, first published in April 2018, was reviewed in its entirety between April 2020 and January 2022 and updated. The review was carried out at the request of German Cancer Aid as part of the Oncology Guidelines Program and the lead coordinators were the German Society for Gynecology and Obstetrics (DGGG), the Gynecology Oncology Working Group (AGO) of the German Cancer Society (DKG) and the German Cancer Aid (DKH). The guideline update was based on a systematic search and assessment of the literature published between 2016 and 2020. All statements, recommendations and background texts were reviewed and either confirmed or amended. New statements and recommendations were included where necessary. Aim The use of evidence-based risk-adapted therapies to treat low-risk women with endometrial cancer prevents unnecessarily radical surgery and avoids non-beneficial adjuvant radiation therapy and/or chemotherapy. For women with endometrial cancer and a high risk of recurrence, the guideline defines the optimum level of radical surgery and indicates whether chemotherapy and/or adjuvant radiation therapy is necessary. This should improve the survival rates and quality of life of these patients. The S3-guideline on endometrial cancer and the quality indicators based on the guideline aim to provide the basis for the work of certified gynecological cancer centers. Methods The guideline was first compiled in 2018 in accordance with the requirements for S3-level guidelines and was updated in 2022. The update included an adaptation of the source guidelines identified using the German Instrument for Methodological Guideline Appraisal (DELBI). The update also used evidence reviews which were created based on selected literature obtained from systematic searches in selected literature databases using the PICO process. The Clinical Guidelines Service Group was tasked with carrying out a systematic search and assessment of the literature. Their results were used by interdisciplinary working groups as a basis for developing suggestions for recommendations and statements which were then modified during structured online consensus conferences and/or additionally amended online using the DELPHI process to achieve a consensus. Recommendations Part 2 of this short version of the guideline provides recommendations on the treatment of precancerous lesions and early-stage endometrial cancer, surgical treatment, radiotherapy and drug-based therapy, follow-up, recurrence, and metastasis of endometrial cancer as well as the state of psycho-oncological care, palliative care, patient education, rehabilitative and physiotherapeutic care., Competing Interests: Conflict of Interest/Interessenkonflikt The conflicts of interest of the authors are listed in the long German-language version of the guideline. Die Interessenkonflikte der Autoren sind in der Langfassung der Leitlinie aufgelistet., (Thieme. All rights reserved.)
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- 2023
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6. Endometrial Cancer. Guideline of the DGGG, DKG and DKH (S3-Level, AWMF Registry Number 032/034-OL, September 2022). Part 1 with Recommendations on the Epidemiology, Screening, Diagnosis and Hereditary Factors of Endometrial Cancer, Geriatric Assessment and Supply Structures.
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Emons G, Steiner E, Vordermark D, Uleer C, Paradies K, Tempfer C, Aretz S, Cremer W, Hanf V, Mallmann P, Ortmann O, Römer T, Schmutzler RK, Horn LC, Kommoss S, Lax S, Schmoeckel E, Mokry T, Grab D, Reinhardt M, Steinke-Lange V, Brucker SY, Kiesel L, Witteler R, Fleisch MC, Friedrich M, Höcht S, Lichtenegger W, Mueller M, Runnebaum I, Feyer P, Hagen V, Juhasz-Böss I, Letsch A, Niehoff P, Zeimet AG, Battista MJ, Petru E, Widhalm S, van Oorschot B, Panke JE, Weis J, Dauelsberg T, Haase H, Beckmann MW, Jud S, Wight E, Prott FJ, Micke O, Bader W, Reents N, Henscher U, Schallenberg M, Rahner N, Mayr D, Kreißl M, Lindel K, Mustea A, Strnad V, Goerling U, Bauerschmitz GJ, Langrehr J, Neulen J, Ulrich UA, Nothacker MJ, Blödt S, Follmann M, Langer T, Wenzel G, Weber S, and Erdogan S
- Abstract
Summary The S3-guideline on endometrial cancer, first published in April 2018, was reviewed in its entirety between April 2020 and January 2022 and updated. The review was carried out at the request of German Cancer Aid as part of the Oncology Guidelines Program and the lead coordinators were the German Society for Gynecology and Obstetrics (DGGG), the Gynecology Oncology Working Group (AGO) of the German Cancer Society (DKG) and the German Cancer Aid (DKH). The guideline update was based on a systematic search and assessment of the literature published between 2016 and 2020. All statements, recommendations and background texts were reviewed and either confirmed or amended. New statements and recommendations were included where necessary. Aim The use of evidence-based risk-adapted therapies to treat women with endometrial cancer of low risk prevents unnecessarily radical surgery and avoids non-beneficial adjuvant radiation therapy and/or chemotherapy. For women with endometrial cancer and a high risk of recurrence, the guideline defines the optimum level of radical surgery and indicates whether chemotherapy and/or adjuvant radiation therapy is necessary. This should improve the survival rates and quality of life of these patients. The S3-guideline on endometrial cancer and the quality indicators based on the guideline aim to provide the basis for the work of certified gynecological cancer centers. Methods The guideline was first compiled in 2018 in accordance with the requirements for S3-level guidelines and was updated in 2022. The update included an adaptation of the source guidelines identified using the German Instrument for Methodological Guideline Appraisal (DELBI). The update also used evidence reviews which were created based on selected literature obtained from systematic searches in selected literature databases using the PICO process. The Clinical Guidelines Service Group was tasked with carrying out a systematic search and assessment of the literature. Their results were used by interdisciplinary working groups as a basis for developing suggestions for recommendations and statements which were then modified during structured online consensus conferences and/or additionally amended online using the DELPHI process to achieve a consensus. Recommendations Part 1 of this short version of the guideline provides recommendations on epidemiology, screening, diagnosis, and hereditary factors. The epidemiology of endometrial cancer and the risk factors for developing endometrial cancer are presented. The options for screening and the methods used to diagnose endometrial cancer are outlined. Recommendations are given for the prevention, diagnosis, and therapy of hereditary forms of endometrial cancer. The use of geriatric assessment is considered and existing structures of care are presented., Competing Interests: Conflict of Interest/Interessenkonflikt The conflicts of interest of the authors are listed in the long German-language version of the guideline./Die Interessenkonflikte der Autoren sind in der Langfassung der Leitlinie aufgelistet., (© Thieme Medical Publishers.)
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- 2023
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7. Treatment strategies in patients with gynecological sarcoma: Results of the prospective intergroup real-world registry for gynecological sarcoma in Germany (REGSA-NOGGO RU1).
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Roser E, Harter P, Zocholl D, Denschlag D, Chekerov R, Wimberger P, Kurzeder C, Hasenburg A, Muallem MZ, Mustea A, Emons G, Zeimet AG, Beck F, Arndt T, Brucker SY, Kommoss S, Heitz F, Welz J, Egger EK, Kalder M, Buderath P, Klar M, Marth C, Ulrich UA, Weigel M, Traub L, Anthuber C, Strauss H, Hanker L, Link T, Kubiak K, Melekian B, Hornung D, Pölcher M, Lampe B, Krauß T, Keilholz U, Flörcken A, Pietzner K, and Sehouli J
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- Humans, Female, Hysterectomy, Germany epidemiology, Retrospective Studies, Sarcoma epidemiology, Sarcoma therapy, Sarcoma pathology, Gynecology, Endometrial Neoplasms pathology, Uterine Neoplasms pathology
- Abstract
Objective: Gynecological sarcomas account for 3% of all gynecological malignancies and are associated with a poor prognosis. Due to the rarity and heterogeneity of gynecological sarcomas there is still no consensus on optimal therapeutic strategies. This study's objective was to describe the treatment strategies used in patients with gynecological sarcomas in the primary course of disease., Methods: The German prospective registry for gynecological sarcoma (REGSA) is the largest registry for gynecological sarcomas in Germany, Austria and Switzerland. Primary inclusion criteria for REGSA are histological diagnosis of sarcoma of the female genital tract, sarcoma of the breast or uterine smooth muscle tumors of uncertain malignant potential (STUMP). We evaluated data of the REGSA registry on therapeutic strategies used for primary treatment from August 2015 to February 2021., Results: A total of 723 patients from 120 centers were included. Data on therapeutic strategies for primary treatment were available in 605 cases. Overall, 580 (95.9%) patients underwent primary surgery, 472 (81.4%) of whom underwent only hysterectomy. Morcellation was reported in 11.4% (n=54) of all hysterectomies. A total of 42.8% (n=202) had no further surgical interventions, whereas an additional salpingo-ophorectomy was performed in 54% (n=255) of patients. An additional lymphadenectomy was performed in 12.7% (n=60), an omentectomy in 9.5% (n=45) and intestinal resection in 6.1% (n=29) of all patients. Among 448 patients with available information, 21.4% (n=96) received chemo- or targeted therapies, more commonly as single-agent treatment than as drug combinations. Information about anti-hormonal treatment was available for 423 patients, among which 42 (9.9%) received anti-hormonal treatment, 23 (54.8%) of whom with low-grade endometrial stroma sarcomas. For radiotherapy, data of 437 patients were available, among which 29 (6.6%) patients underwent radiotherapy., Conclusion: Our study showed that treatment of patients with gynecologic sarcomas is heterogeneous. Further trials are needed along with more information on treatment modalities, therapy response and patient-reported outcomes to implement new treatment strategies., Competing Interests: Competing interests: None declared., (© IGCS and ESGO 2023. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2023
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8. Optimal Treatment Duration of Bevacizumab as Front-Line Therapy for Advanced Ovarian Cancer: AGO-OVAR 17 BOOST/GINECO OV118/ENGOT Ov-15 Open-Label Randomized Phase III Trial.
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Pfisterer J, Joly F, Kristensen G, Rau J, Mahner S, Pautier P, El-Balat A, Kurtz JE, Canzler U, Sehouli J, Heubner ML, Hartkopf AD, Baumann K, Hasenburg A, Hanker LC, Belau A, Schmalfeldt B, Denschlag D, Park-Simon TW, Selle F, Jackisch C, Burges A, Lück HJ, Emons G, Meier W, Gropp-Meier M, Schröder W, de Gregorio N, Hilpert F, and Harter P
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- Humans, Female, Bevacizumab, Duration of Therapy, Carcinoma, Ovarian Epithelial drug therapy, Carcinoma, Ovarian Epithelial pathology, Carboplatin, Paclitaxel, Antineoplastic Combined Chemotherapy Protocols adverse effects, Ovarian Neoplasms pathology, Peritoneal Neoplasms drug therapy, Peritoneal Neoplasms pathology
- Abstract
Purpose: To compare standard versus extended duration of bevacizumab treatment in combination with front-line chemotherapy in women with newly diagnosed stage IIB-IV ovarian cancer., Methods: In this multicenter, open-label, randomized phase III trial (ClinicalTrials.gov identifier: NCT01462890), patients with newly diagnosed International Federation of Gynecology and Obstetrics stage IIB-IV epithelial ovarian, fallopian tube, or peritoneal cancer underwent primary cytoreductive surgery followed by six cycles of chemotherapy (paclitaxel 175 mg/m
2 plus carboplatin area under the curve 5 once every 3 weeks) and bevacizumab (15 mg/kg once every 3 weeks). Patients were randomly assigned 1:1 to receive bevacizumab for either 15 or 30 months, stratified by International Federation of Gynecology and Obstetrics stage/residual tumor. The primary end point was investigator-assessed progression-free survival (PFS) according to RECIST version 1.1. Secondary end points included overall survival (OS), safety, and tolerability., Results: Between November 11, 2011, and August 6, 2013, 927 women were randomly assigned. There was no difference in PFS between treatment arms (hazard ratio, 0.99; 95% CI, 0.85 to 1.15; unstratified log-rank P = .90). Median PFS was 24.2 versus 26.0 months with standard versus extended duration of bevacizumab, respectively; restricted mean PFS was 39.5 versus 39.3 months, respectively. There was no OS difference between treatment arms (hazard ratio, 1.04; 95% CI, 0.87 to 1.23; P = .68). Serious/nonserious adverse events of special interest occurred in 29% versus 34% of patients in the standard versus experimental arms, respectively, and were consistent with the known safety profile of standard bevacizumab., Conclusion: Longer treatment duration with bevacizumab for up to 30 months did not improve PFS or OS in patients with primary epithelial ovarian, fallopian tube, or peritoneal cancer. A bevacizumab treatment duration of 15 months remains the standard of care.- Published
- 2023
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9. Hormone-Dependent Cancers: Molecular Mechanisms and Therapeutical Implications.
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Emons G
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- Male, Humans, Hormones, Breast, Prostatic Neoplasms
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Hormone-dependent cancers of the breast and prostate are the most common cancers in women and men, respectively [...].
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- 2022
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10. Gene-expression profiles of pretreatment biopsies predict complete response of rectal cancer patients to preoperative chemoradiotherapy.
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Emons G, Auslander N, Jo P, Kitz J, Azizian A, Hu Y, Hess CF, Roedel C, Sax U, Salinas G, Stroebel P, Kramer F, Beissbarth T, Grade M, Ghadimi M, Ruppin E, Ried T, and Gaedcke J
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- Biopsy, Clinical Trials as Topic, Humans, Neoadjuvant Therapy, Treatment Outcome, Chemoradiotherapy, Rectal Neoplasms genetics, Rectal Neoplasms pathology, Rectal Neoplasms therapy
- Abstract
Purpose: Preoperative (neoadjuvant) chemoradiotherapy (CRT) and total mesorectal excision is the standard treatment for rectal cancer patients (UICC stage II/III). Up to one-third of patients treated with CRT achieve a pathological complete response (pCR). These patients could be spared from surgery and its associated morbidity and mortality, and assigned to a "watch and wait" strategy. However, reliably identifying pCR based on clinical or imaging parameters remains challenging., Experimental Design: We generated gene-expression profiles of 175 patients with locally advanced rectal cancer enrolled in the CAO/ARO/AIO-94 and -04 trials. One hundred and sixty-one samples were used for building, training and validating a predictor of pCR using a machine learning algorithm. The performance of the classifier was validated in three independent cohorts, comprising 76 patients from (i) the CAO/ARO/AIO-94 and -04 trials (n = 14), (ii) a publicly available dataset (n = 38) and (iii) in 24 prospectively collected samples from the TransValid A trial., Results: A 21-transcript signature yielded the best classification of pCR in 161 patients (Sensitivity: 0.31; AUC: 0.81), when not allowing misclassification of non-complete-responders (False-positive rate = 0). The classifier remained robust when applied to three independent datasets (n = 76)., Conclusion: The classifier can identify >1/3 of rectal cancer patients with a pCR while never classifying patients with an incomplete response as having pCR. Importantly, we could validate this finding in three independent datasets, including a prospectively collected cohort. Therefore, this classifier could help select rectal cancer patients for a "watch and wait" strategy., Translational Relevance: Forgoing surgery with its associated side effects could be an option for rectal cancer patients if the prediction of a pathological complete response (pCR) after preoperative chemoradiotherapy would be possible. Based on gene-expression profiles of 161 patients a classifier was developed and validated in three independent datasets (n = 76), identifying over 1/3 of patients with pCR, while never misclassifying a non-complete-responder. Therefore, the classifier can identify patients suited for "watch and wait"., (© 2022. The Author(s).)
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- 2022
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11. Correction to: Use of oral contraceptives in BRCA mutation carriers and risk for ovarian and breast cancer: a systematic review.
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Huber D, Seitz S, Kast K, Emons G, and Ortmann O
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- 2022
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12. Risk-Adjusted Cancer Screening and Prevention (RiskAP): Complementing Screening for Early Disease Detection by a Learning Screening Based on Risk Factors.
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Schmutzler RK, Schmitz-Luhn B, Borisch B, Devilee P, Eccles D, Hall P, Balmaña J, Boccia S, Dabrock P, Emons G, Gaissmaier W, Gronwald J, Houwaart S, Huster S, Kast K, Katalinic A, Linn SC, Moorthie S, Pharoah P, Rhiem K, Spranger T, Stoppa-Lyonnet D, van Delden JJM, van den Bulcke M, and Woopen C
- Abstract
Background: Risk-adjusted cancer screening and prevention is a promising and continuously emerging option for improving cancer prevention. It is driven by increasing knowledge of risk factors and the ability to determine them for individual risk prediction. However, there is a knowledge gap between evidence of increased risk and evidence of the effectiveness and efficiency of clinical preventive interventions based on increased risk. This gap is, in particular, aggravated by the extensive availability of genetic risk factor diagnostics, since the question of appropriate preventive measures immediately arises when an increased risk is identified. However, collecting proof of effective preventive measures, ideally by prospective randomized preventive studies, typically requires very long periods of time, while the knowledge about an increased risk immediately creates a high demand for action., Summary: Therefore, we propose a risk-adjusted prevention concept that is based on the best current evidence making needed and appropriate preventive measures available, and which is constantly evaluated through outcome evaluation, and continuously improved based on these results. We further discuss the structural and procedural requirements as well as legal and socioeconomical aspects relevant for the implementation of this concept., Competing Interests: The authors have no conflicts of interest to declare., (Copyright © 2021 by S. Karger AG, Basel.)
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- 2022
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