12 results on '"Papathemelis T"'
Search Results
2. Entzündliche Erkrankungen der Adnexe
- Author
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Serno, J., Papathemelis, T., and Maass, N.
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- 2013
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3. Gutartige Uterustumoren
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Papathemelis, T.
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- 2012
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4. Treatment of endometrial cancer from 2000 to 2020 in Germany: a retrospective population based cohort study.
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Papathemelis T, Ortmann O, Kohl C, Neuser P, Tol KK, Klinkhammer-Schalke M, Ugocsai P, Walter CB, Rottmann M, Real C, Justenhoven C, Robers G, Schneider C, Gerken M, Sackmann A, and Kim-Wanner SZ
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- Humans, Female, Retrospective Studies, Germany epidemiology, Aged, Middle Aged, Registries, Aged, 80 and over, Combined Modality Therapy, Adult, Prognosis, Survival Rate, Endometrial Neoplasms therapy, Endometrial Neoplasms epidemiology, Endometrial Neoplasms pathology, Endometrial Neoplasms mortality
- Abstract
Purpose: Endometrial cancer (EC) is one of the most common malignancies among women in western countries. This study aimed to assess data on patient treatment in Germany throughout two decades to evaluate the development and effect of surgery, radiation, and chemotherapy., Methods: This retrospective registry study included 34,349 EC patients diagnosed between 2000 and 2020. Patients were classified into five risk groups. Overall survival was analyzed by Kaplan-Meier method as well as univariable and multivariable Cox regression to evaluate risk factors and treatment options., Results: Over the study period, minimal invasive surgery was used more often compared to open surgery and was associated with better overall survival. Patients with advanced EC were more likely to receive multimodal therapy. Patients with intermediate risk EC had a good prognosis upon surgery, which further improved when radiotherapy was added. High-risk patients showed poorer prognosis but clearly benefited from additional radiotherapy. Survival of elderly high-risk patients with a non-endometrioid histology was improved when chemotherapy was added to surgery and radiotherapy., Conclusion: Our study includes a large analysis of data from German clinical cancer registries on the care of endometrial cancer during two decades. We observed an increase of minimal invasive surgery. There is evidence that minimal invasive surgery is not inferior to open surgery. Adjuvant radio- and chemotherapy further improves survival depending on risk group and age., (© 2024. The Author(s).)
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- 2024
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5. Guideline concordant therapy improves survival in high-grade endometrial cancer patients.
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Scharl S, Sprötge T, Gerken M, Scharl A, Ortmann O, Kölbl O, Klinkhammer-Schalke M, and Papathemelis T
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- Humans, Female, Retrospective Studies, Radiotherapy, Adjuvant, Neoplasm Staging, Endometrial Neoplasms drug therapy
- Abstract
Purpose: Data from randomized controlled trials in high-grade endometrial cancer are scarce due to its low prevalence. Therefore, guideline recommendations in this cancer subtype rely on relatively few randomized trials and data from retrospective studies. The aim of this study was to evaluate the benefits from guideline-concordant therapy in high-grade endometrial cancer in a real-world patient group., Methods: The effect of treatment according to German S3 guidelines and the former S2k guideline on overall survival (OS) and recurrence-free survival (RFS) was evaluated in a cohort of 293 high-grade endometrial cancer patients., Results: Treatment concordant with the S3 guideline significantly improved OS (HR 0.623, CI 0.420-0.923, p = 0.018) and RFS (HR 0.578, CI 0.387-0.863, p = 0.007). Treatment concordant with the S2k guideline did not result in a significantly higher OS (HR 0.783, CI 0.465-1.316, p = 0.335) or RFS (HR 0.741, CI 0.347-1.740, p = 0.242)., Conclusion: Therapy according to the German S3 guideline improved OS and RFS in univariate as well as multivariate analysis in this cohort of high-grade endometrial cancer patients., (© 2022. The Author(s).)
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- 2023
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6. Risk factors and temporal patterns of recurrences in patients with vulvar cancer: implications for follow-up intervals and duration.
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Röhrmoser K, Ignatov A, Gerken M, Ortmann O, Klinkhammer-Schalke M, and Papathemelis T
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- Female, Humans, Aged, Aged, 80 and over, Retrospective Studies, Follow-Up Studies, Neoplasm Recurrence, Local epidemiology, Risk Factors, Vulvar Neoplasms therapy
- Abstract
Background: To date, information on risk factors and temporal patterns of recurrences in patients with vulvar cancer is sparse. Conclusive data for an optimal surveillance strategy are lacking., Methods: This multicenter, retrospective population-based register study included 1412 patients who have been treated from 2000 to 2017 for vulvar cancer in the German districts of Upper Palatinate, Lower Bavaria, and Saxony-Anhalt. Kaplan-Meier method, and univariate and multivariate Cox regression were employed to evaluate prognostic factors and temporal course of overall survival, cumulative recurrence, and recurrence-free survival rates., Results: After exclusion, the final study cohort comprised 829 patients. Most recurrences occurred within the first 3 years after diagnosis. Notably, a significant subset of patients were recurrent even after 5 years. The cumulative recurrence rate from all relapses was 18.6% 1 year after primary diagnosis. The recurrence rate increased to 34.7% after 3, to 41.8% after 5, and to 56.6% after 10 years post-diagnosis. The risk of relapse was significantly increased in patients over 70 years of age (hazard ratio (HR) = 2.7; p < 0.001; 95% CI 1.6-4.4), and in patients with positive nodal status N1 (HR = 2.0; p = 0.019; 95% CI 1.1-3.5) and N2/3 (HR = 2.2; p = 0.033; 95% CI 1.1-4.4)., Conclusion: Our study provides compelling evidence that follow-up care should be carried out for longer than 5 years, especially for high-risk patients., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
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- 2023
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7. The 3D in vivo chorioallantoic membrane model and its role in breast cancer research.
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Kohl C, Aung T, Haerteis S, Ignatov A, Ortmann O, and Papathemelis T
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- Animals, Cell Line, Tumor, Chorioallantoic Membrane metabolism, Chorioallantoic Membrane pathology, Female, Humans, Neovascularization, Pathologic pathology, Antineoplastic Agents therapeutic use, Breast Neoplasms pathology
- Abstract
Purpose: We aimed to evaluate the role of the chorioallantoic membrane model (CAM) in breast cancer research., Methods: The following is an overview of the use of the CAM in the field of breast cancer research based on a PubMed literature query., Results: The CAM is a 3D in vivo model that can be used for the analysis of tumor growth, biology and angiogenesis of primary tumor tissue or tumor cell lines. The CAM model has been used in breast cancer research for drug testing, migration assays and the evaluation of vascularization, amongst others. The CAM model is a valuable method that offers a better imitation of the physiological phenomena compared to 2D or 3D in vitro models., Conclusion: The CAM model has primarily and successfully been utilized for the assessment of the tumor biology of established breast cancer cell lines. Further, the CAM model is a promising method to analyze patient derived primary tumor material and could be used as a "patient-specific 3D-tumor-therapy-model" for the cost-efficient evaluation of anti-cancer drugs to find the optimal treatment for breast cancer patients., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
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- 2022
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8. Sentinel lymph node detection by means of indocyanine green using the Karl Storz VITOM ® fluorescence camera: a comparison between primary sentinel lymph node biopsy versus sentinel lymph node biopsy after neoadjuvant chemotherapy.
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Staubach P, Scharl A, Ignatov A, Ortmann O, Inwald EC, Hildebrandt T, Gerken M, Klinkhammer-Schalke M, Scharl S, and Papathemelis T
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- Adult, Aged, Aged, 80 and over, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Breast Neoplasms drug therapy, Coloring Agents analysis, Coloring Agents pharmacokinetics, Diagnostic Imaging instrumentation, Diagnostic Imaging methods, Female, Fluorescence, Humans, Indocyanine Green analysis, Indocyanine Green pharmacokinetics, Lymphatic Metastasis, Middle Aged, Neoadjuvant Therapy, Optical Imaging instrumentation, Optical Imaging methods, Predictive Value of Tests, Retrospective Studies, Sentinel Lymph Node metabolism, Sentinel Lymph Node pathology, Technetium analysis, Technetium pharmacokinetics, Antineoplastic Combined Chemotherapy Protocols pharmacology, Breast Neoplasms pathology, Sentinel Lymph Node diagnostic imaging, Sentinel Lymph Node drug effects, Sentinel Lymph Node Biopsy instrumentation, Sentinel Lymph Node Biopsy methods
- Abstract
Purpose: The usage of radioactive Technetium
99m (Tc99m ) colloid for the purpose of sentinel lymph node biopsy (SLNB) in early breast cancer is considered the gold standard in Germany. However, new tracers, such as near-infrared (NIR) imaging agents like indocyanine green (ICG) could offer an alternative in future, as they overcome drawbacks associated with radioactive Technetium99m (Tc99m ) like limited availability, high costs and radioactivity exposure for both patients and surgeons., Methods: In this double-arm retrospective study, we sought to establish the usefulness of indocyanine green as an alternative or an addition to the conventional Technetium99m (Tc99m ) in the identification of the SLN in early breast cancer., Results: Among the 161 patients who underwent primary SLNB, 34 patients had at least 1 SLN with metastasis. Among these patients with SLN metastasis, 33 had the SLN detected by ICG; while 31 had the SLN detected by Tc99m . The conventional Technetium99m radiotracer failed to detect 2 patients with metastasis in this Arm of the study. Among the 87 patients who underwent SLNB after NACT, 13 patients had at least 1 SLN with metastasis. Among these 13 patients with SLN metastasis, ICG and Tc99m had detected the SLN among 12 patients, while 1 patient had been detected by ICG alone., Conclusions: Our results show that ICG is as effective as the radioisotope for SLNB even among patients who have undergone NACT. This trial is registered with the German Clinical Trial Register, ID: DRKS00013606.- Published
- 2021
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9. Long-term outcome of patients with intermediate- and high-risk endometrial cancer after pelvic and paraaortic lymph node dissection: a comparison of laparoscopic vs. open procedure.
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Papathemelis T, Oppermann H, Grafl S, Gerken M, Pauer A, Scharl S, Scharl A, Inwald E, Ignatov A, Ortmann O, Klinkhammer-Schalke M, Hein A, Beckmann MW, and Lux MP
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- Aged, Cohort Studies, Disease-Free Survival, Endometrial Neoplasms pathology, Female, Humans, Kaplan-Meier Estimate, Laparoscopy methods, Laparoscopy statistics & numerical data, Lymph Node Excision statistics & numerical data, Lymph Nodes pathology, Middle Aged, Neoplasm Staging, Propensity Score, Proportional Hazards Models, Retrospective Studies, Treatment Outcome, Endometrial Neoplasms surgery, Lymph Node Excision methods, Lymph Nodes surgery
- Abstract
Objective: The primary therapy for intermediate- and high-risk endometrial cancer includes pelvic and paraaortic lymph node evaluation. Laparoscopic surgery is an increasingly popular intervention due to decreased risk and better short-term morbidity; however, a recent study casts doubt on the benefit of this approach in terms of oncological safety. In this cancer registry study, we sought to evaluate the benefit of laparoscopy versus laparotomy and retrospectively compared overall survival, recurrence rates, and recurrence-free survival among patients with intermediate- and high-risk endometrial cancer who underwent either laparoscopic or open surgery., Methods: This observational study included 419 patients who have been treated from 2011 to 2017. We employed Kaplan-Meier method, and univariable and multivariable Cox-regression to compare overall survival, recurrence rates, and recurrence-free survival in 110 patients, who underwent laparoscopic, with 309 patients, who underwent open surgery. To address the confounding bias in this retrospective study, we also performed a propensity score matching (PSM) analysis including 357 patients (laparoscopy: n = 107; open surgery: n = 250)., Results: We found a benefit for laparoscopic over open surgery in patients with intermediate- and high-risk endometrial cancer for overall survival in both univariable (p = 0.002; PSM: p = 0.016) and multivariable analyses (p = 0.019; PSM: p = 0.007). In contrast, there was no statistically significant difference between both patient groups regarding the cumulative recurrence rates. A univariable analysis identified a significant benefit for laparoscopy regarding recurrence-free survival (p = 0.003; PSM: p = 0.029) but a multivariable analysis failed to confirm this finding (p = 0.108; PSM: p = 0.118)., Conclusions: Our study provides evidence that laparoscopic systematic lymphadenectomy does not present a lower oncological efficacy than open surgery in the treatment of patients with endometrial cancer.
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- 2020
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10. Impact of nodal status and treatment strategy on overall survival in advanced stage cervical cancer.
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Papathemelis T, Knobloch S, Gerken M, Scharl A, Anapolski M, Ignatov A, Inwald EC, Ortmann O, Scharl S, and Klinkhammer-Schalke M
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- Adult, Aged, Aged, 80 and over, Combined Modality Therapy methods, Comorbidity, Female, Humans, Kaplan-Meier Estimate, Lymph Node Excision, Lymphatic Metastasis, Middle Aged, Neoplasm Staging, Retrospective Studies, Uterine Cervical Neoplasms therapy, Young Adult, Lymph Nodes pathology, Uterine Cervical Neoplasms mortality, Uterine Cervical Neoplasms pathology
- Abstract
Purpose: The lack of prognostic data impedes implementation of optimal therapy for cervical cancer. For instance, recommended therapy for FIGO IIB cervical cancer is radical hysterectomy or radiochemotherapy. To enlighten different therapeutic approaches, we investigated the benefit of individual therapies or combination thereof in patients with or without infested lymph nodes., Methods: The German Tumor Centre Regensburg registered 389 patients with FIGO IIB, IIIA, IIIB, and IVA cervical cancer between 2002 and 2015. We estimated hazard ratios (HR) for overall survival against different therapies using univariable and multivariable cox regression. After risk adjustment with respect to clinicopathological parameters, we performed model selection using conditional stepwise reverse selection., Results: We demonstrated the need for thorough assessment of the nodal status to obtain reliable data for treatment strategy. Our analysis showed significant differences for overall survival in FIGO IIB depending on therapy and nodal status. Outcome was inferior with radiochemotherapy without surgery for patients with N0 compared to surgery and radiochemotherapy combined (HR 3.012; 95% CI 1.075-8.441; p = 0.036); however, for N1, radiochemotherapy without surgery resulted in comparable outcome (HR 0.808; 95% CI 0.189-3.403; p = 0.765), whereas surgery alone yielded in poor outcome (HR 2.889; 95% CI 1.356-6.156; p = 0.006). Regardless of the nodal status, chemotherapy was superior in advanced stage cervical cancer FIGO III to IVA., Conclusions: Our study suggests that in terms of oncological outcome FIGO IIB cervical cancer patients benefit from a combination of surgery and radiochemotherapy. However, in the presence of lymph node infestation, surgery does not add substantial benefit to the patient.
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- 2019
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11. Is there a benefit of lymphadenectomy for overall and recurrence-free survival in type I FIGO IB G1-2 endometrial carcinoma? A retrospective population-based cohort analysis.
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Papathemelis T, Hassas D, Gerken M, Klinkhammer-Schalke M, Scharl A, Lux MP, Beckmann MW, and Scharl S
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- Aged, Aged, 80 and over, Endometrial Neoplasms surgery, Female, Follow-Up Studies, Humans, Middle Aged, Neoplasm Invasiveness, Neoplasm Recurrence, Local surgery, Neoplasm Staging, Retrospective Studies, Survival Rate, Endometrial Neoplasms mortality, Endometrial Neoplasms pathology, Lymph Node Excision mortality, Neoplasm Recurrence, Local mortality, Neoplasm Recurrence, Local pathology
- Abstract
Purpose: The recommended therapy for type I FIGO IB endometrial cancer (EC) is hysterectomy and adnexectomy, but the therapeutic benefits of additional pelvic and paraaortic lymph node dissection (LND) are still under discussion. In this study, we retrospectively evaluated overall survival (OAS) and recurrence-free survival (RFS) among patients with type I FIGO IB EC who did undergo systematic or elective lymphadenectomy or none at all., Methods: We selected 299 individuals from the database of the German Tumor Centre Regensburg who were diagnosed between 1998 and 2015 with endometrial adenocarcinoma of the uterus type I FIGO IB. We applied multivariable Cox regression to the selected patient data and estimated hazard ratios for OAS and RFS against the performed intervention. Further, we carried out risk adjustments with respect to clinicopathological parameters, and performed model selection using conditional stepwise forward selection., Results: We observed significant benefits of LND in the unadjusted survival analysis; however, we did not confirm this effect in multivariable regression analysis upon risk adjustment. In this case, hazard ratio (HR) for OAS in patients without LND versus patients with LND is reduced to 1.214 (95% CI 0.771-1.911; p = 0.402), HR for RFS is 1.059 (95% CI 0.689-1.626; p = 0.795). Similarly, we were also able to eliminate the statistical benefit of systematic versus elective LND by risk adjustment., Conclusions: In contrast to previous observations in high-grade EC, our study provides compelling evidence that LND, in particular systematic lymphadenectomy, is not beneficial for patients with type I FIGO IB EC in terms of long-term OAS and RFS.
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- 2018
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12. Survival benefit of pelvic and paraaortic lymphadenectomy in high-grade endometrial carcinoma: a retrospective population-based cohort analysis.
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Papathemelis T, Scharl S, Kronberger K, Gerken M, Scharl A, Pauer A, and Klinkhammer-Schalke M
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- Adult, Aged, Aged, 80 and over, Cohort Studies, Endometrial Neoplasms mortality, Endometrial Neoplasms pathology, Female, Humans, Hysterectomy, Lymph Node Excision methods, Lymph Node Excision statistics & numerical data, Middle Aged, Neoplasm Grading, Retrospective Studies, Endometrial Neoplasms surgery, Lymph Nodes surgery
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Objective: The standard therapy for high-grade endometrial cancer is surgery but the therapeutic effects of pelvic and paraaortic lymph node dissection (LND) are poorly investigated. In this study, we retrospectively evaluated overall survival, recurrence rates and recurrence-free survival among patients with high-grade type I and II endometrial carcinoma who underwent LND., Methods: This study included 284 patients who are recorded in the German Tumor Centre Regensburg form 1998 to 2015 and were selected by cancer grading, the absence of secondary tumors, primary surgery including hysterectomy and available follow-up. 244 of the 284 patients in this cohort were unequivocally classified as R0 after resection., Results: A significantly increased overall survival was observed for systematic LND of 25 or more paraaortic and pelvic lymph nodes versus patients who did not undergo such intervention (p < 0.001) or had elective LND of 1-24 lymph nodes both in univariable (p = 0.016) and multivariable (p = 0.014) analysis. A similar observation was made for recurrence-free survival of patients in the cohort who underwent complete tumor resection (R0). In addition, a reduced cumulative recurrence rate was observed for patients with systematic LND., Conclusions: Our study provides evidence that the systematic removal of 25 or more pelvic and paraaortic lymph nodes reduces the recurrence rate and that it is beneficial for the long-term overall and recurrence-free survival of patients with high-grade endometrial cancer.
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- 2017
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