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Zusammenfassung Hintergrund Das vom Innovationsfonds geförderte Projekt „Wirksamkeit der Versorgung in onkologischen Zentren“ (WiZen) ist ein breit angelegtes Projekt zur Erforschung der Wirksamkeit von Zertifizierungen in der Onkologie. Im Rahmen des Projektes werden bundesweite Daten der AOKen und Daten Klinischer Krebsregister aus verschiedenen Bundesländern für die Jahre 2006–2017 verwendet. Zur Kombination der Stärken beider Datenquellen werden diese für acht verschiedene Krebsentitäten datenschutzkonform miteinander verknüpft. Methoden Das Datenlinkage erfolgte dabei anhand indirekter Identifikatoren und wurde mittels der Krankenversichertennummer als direktem Identifikator und Goldstandard validiert. Dies ermöglicht die Quantifizierung von Potenzial und Qualität verschiedener Linkage-Varianten. Als Kriterien zur Bewertung der Zuordnungen wurden Sensitivität und Spezifität sowie Treffergenauigkeit und Treffergüte genutzt. Die durch das Linkage resultierenden Verteilungen relevanter Variablen wurden anhand der ursprünglichen Verteilungen in den Einzeldatensätzen validiert. Ergebnisse Je nach Kombination indirekter Identifikatoren ergab sich eine Bandbreite von 22.125 bis 3.092.401 Linkage-Treffern. Eine nahezu perfekte Verknüpfung der betrachteten Daten konnte durch die Kombination von Informationen zu Entitätsart, Geburtsdatum, Geschlecht und Postleitzahl der Personen erreicht werden. Insgesamt wurden mit den genannten Merkmalen 74.586 eineindeutige Verknüpfungen und für die verschiedenen Entitäten eine mediane Treffergüte von mehr als 98% erreicht. Die Alters- und Geschlechtsverteilungen der verschiedenen Datenquellen sowie die verknüpften Sterbedaten wiesen zudem eine hohe Übereinstimmung auf. Diskussion und Schlussfolgerung GKV- und Krebsregisterdaten lassen sich mit hoher interner und externer Validität auf Individualdatenebene verknüpfen. Die stabile Verknüpfung ermöglicht durch den simultanen Zugang zu Variablen beider Datensätze („das Beste aus beiden Welten“) gänzlich neue Analysemöglichkeiten: Für einzelne Personen stehen nun sowohl Informationen zum UICC-Stadium der Erkrankung aus den Registern als auch Komorbiditäten aus den GKV-Daten zur Verfügung. Durch die Verwendung gut verfügbarer Linkagevariablen und den hohen Verknüpfungserfolg ist das Verfahren vielversprechend für künftige Linkages in der Versorgungsforschung.

This single-center study evaluated cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) for diffuse malignant peritoneal mesothelioma (DMPM).Prospectively collected data from a single institution data registry was retrospectively investigated. Eighty-four patients with primary malignant peritoneal mesothelioma underwent CRS and HIPEC with cisplatin and doxorubicin either for 60 min or 90 min of duration from 2011 to 2021. The primary endpoint was overall survival. The secondary endpoint was the evaluation of prognostic factors for overall survival. The tertiary endpoint was to assess the effect of neoadjuvant chemotherapy on survival.The median follow-up was 5.0 years (95%-CI 4.6-5.5). The median age was 59.2 years (IQR: 47-66). Eighty-two patients (97.6%) had epithelioid tumors. The median peritoneal cancer index was 18.0 (IQR: 13-27). Sixty-six patients (78.6%) had complete or near-complete cytoreduction (CCR 0 or CCR 1). Seventy patients (83.3%) received HIPEC for 60 min and 14 patients (16.7%) received it for 90 min. Twenty-two patients (26.2%) had grade 3 to 4 complications. Acute kidney injury (AKI) stage I-III occurred in 30 (35.7%) patients. Three patients (3.6%) died perioperatively. The overall median survival was 38.4 months (95%-CI 23.6-54.3), and the 5-year survival rate was 42%. Survival was independently associated with age, female gender, and thrombocytosis. Preoperative chemotherapy did not emerge as an adverse prognostic factor.In well-selected patients with DMPM, prolonged survival is achievable with CRS and HIPEC in specialized centers.

The aim of this study was to examine the prevalence of synchronous upper aerodigestive tract (UAT) tumors within oral squamous cell carcinoma (OSCC) patients, and to specify distinct risk groups who benefit from panendoscopy. Definite clinical and pathohistological characteristics, as well as overall and recurrence-free survival (OAS and RFS, respectively) of OSCC patients with and without synchronous second UAT tumors, carcinomas in situ, or higher-grade dysplasia/metaplasia, were evaluated based on a retrospective population-based cohort study, including alignment with cancer registry data. Out of 727 included OSCC patients, 465 cases (64.0%) received panendoscopy. Among these, 18 UAT tumors were detected, all of which were linked to patients with a positive history of nicotine abuse. Every synchronous UAT tumor was revealed by panendoscopy, which, analyzed as an independent staging procedure, was accompanied by a low complication rate (1.7%). When illuminating the impact of a second UAT tumor in OSCC patients, survival analysis revealed reduced 5-year OAS (63.9% vs 43.5%, p = 0.010) and RFS (57.1% vs 32.4%, p = 0.016) for patients with a second oncology diagnosis of the UAT. Within the limitations of the study, it seems that panendoscopy should be performed in the majority of patients suffering from OSCC, because most of them have a history of smoking and drinking, which correlates with an increased risk of developing synchronous UAT tumors.

s Background Malignant isocitrate dehydrogenase wild-type (IDHwt) gliomas impose a high symptomatic and psychological burden. Wide distances from patients’ homes to cancer centers may affect the delivery of psycho-oncological care. Here, we investigated, in a large brain tumor center with a rural outreach, the initiation of psycho-oncological care depending on spatial distance and impact of psycho-oncological care on emergency visits. Methods Electronic patient charts, the regional tumor registry, and interviews with the primary care physicians were used to investigate clinical data, psycho-oncological care, and emergency unit visits. Interrelations with socio-demographic, clinical, and treatment aspects were investigated using univariable and multivariable binary logistic regression analysis and the Pearson’s Chi-square test. Results Of 491, 229 adult patients of this retrospective cohort fulfilled the inclusion criteria for analysis. During the last three months of their lives, 48.9% received at least one psycho-oncological consultation, and 37.1% visited the emergency unit at least once. The distance from the cancer center did neither affect the initiation of psycho-oncological care nor the rate of emergency unit visits. Receiving psycho-oncological care did not correlate with the frequency of emergency unit visits in the last three months of life. Conclusion We conclude that the distance of IDHwt glioma patients’ homes from their cancer center, even in a rural area, does not significantly influence the rate of psycho-oncological care.

Purpose The aim of our study was to explore the impact of the COVID-19 pandemic on reported cancer cases in Bavaria, Germany, by comparing pre-pandemic (March 2019 to February 2020) and pandemic period (March 2020 to February 2021). Methods Data on incident cases were retrieved from the Bavarian Cancer Registry (until 22nd April 2022). We included patients with malignant and in situ neoplasms reported by pathology departments with consistent reporting. We calculated the number of incident cases during the COVID-19 pandemic and the pre-pandemic period with 95% confidence intervals (CI) with Bonferroni correction (α = 0.0018) based on a Poisson approach. We stratified for malignancy (malignant, in situ), tumor site, and month of year. Results Data was available for 30 out of 58 pathology departments (51.7%) from Bavaria. Incident malignant neoplasms dropped from 42,857 cases in the pre-pandemic period to 39,980 cases in the pandemic period (− 6.7%; 95% CI − 8.7%, − 4.7%). Reductions were higher for colon, rectum, skin/melanoma as well as liver (> 10.0% reduction) and less for breast cancer (4.9% reduction). No case reductions were observed for pancreas, esophagus, ovary, and cervix. Percent changes were largest for April 2020 (− 20.9%; 95% CI − 24.7%, − 16.8%) and January 2021 (− 25.2%; 95% CI − 28.8%, − 21.5%) compared to the previous year. Declines tended to be larger for in situ compared to malignant neoplasms. Conclusion Detection and diagnosis of cancer were substantially reduced during the COVID-19 pandemic. Potential effects, e.g. a stage shift of tumors or an increase of cancer mortality, need to be monitored.

Helge Willner, a former professor at the Bergische Universität Wuppertal (Germany), sadly passed away on September 4th, 2022. He published pioneering studies in the areas of transition-metal carbonyl cations, weakly coordinating borate anions, and highly reactive small molecules. He will be remembered as an outstanding researcher as well as a good teacher, colleague, and friend.

The Lewis acid-base adducts MoF5(NC5H5)n and MoOF4(NC5H5)n (n = 1, 2) were synthesized from the reactions of MoF5 and MoOF4 with C5H5N and structurally characterized by X-ray crystallography. Whereas the crystal structures of MoF5(NC5H5)2 and MoOF4(NC5H5)2 are isomorphous containing pentagonal-bipyramidal molecules, the fluorido-bridged, heptacoordinate [MoF5(NC5H5)]2 dimer differs starkly from monomeric, hexacoordinate MoOF4(NC5H5). For the weaker Lewis base CH3CN, only the 1:1 adduct, MoF5(NCCH3), could be isolated. All adducts were characterized by Raman spectroscopy in conjunction with vibrational frequency calculations. Multinuclear NMR spectroscopy revealed an unprecedented isomerism of MoOF4(NC5H5)2 in solution, with the pyridyl ligands occupying adjacent or nonadjacent positions in the equatorial plane of the pentagonal bipyramid. Paramagnetic MoF5(NC5H5)2 was characterized by electron paramagnetic resonance (EPR) spectroscopy as a dispersion in solid adamantane as well as in a diamagnetic host lattice of MoOF4(NC5H5)2; EPR parameters were computed using ZORA with the BPW91 functional using relativistic all-electron wave functions for Mo and simulated using EasySpin. Density functional theory calculations (B3LYP) and natural bond orbital analyses were conducted to elucidate the distinctive bonding and structural properties of all adducts reported herein and explore fundamental differences observed in the Lewis acid behavior of MoF5 and MoOF4.

Background Small bowel adenocarcinoma (SBA) remains a rare malignancy accounting for less than 5% of all the gastrointestinal tract cancers. However, only limited data and expert guidelines are available for this entity. As a result, treatment concepts are predominantly derived from colorectal cancer. Methods To substantiate data on the course of disease, diagnosis and treatment of SBA, we performed a population-based analysis from a Bavarian population of 2.2 million people. Results We identified 223 patients with SBA. Mean age at diagnosis was 67.8 years and patients were diagnosed rather late (34.5% UICC stage IV). Largest proportion of these patients were diagnosed with adenocarcinoma of the duodenum (132 patients, 59.2%) and most patients were diagnosed with late stage cancer, stage IV (70 patients, 31.4%). With respect to treatment, most patients underwent primary surgery (187 patients, 84.6%). Systemic therapy seemed to have an impact in UICC stage IV patients but not in UICC stage IIB or III. The 5-year survival rate was 29.0%. This was significantly less compared to colon cancer in the same cohort, which was 50.0%. Furthermore, median survival of patients with small bowel cancer was only 2.0 years (95% CI 1.4–2.5) compared to 4.9 years (95% CI 4.8–5.1) of patients with colon cancer. Conclusion SBA showed a distinct epidemiology compared to colon cancer. Thus, data acquisition particularly on systemic treatment are paramount, with the objective to complement the available guidelines.

Zusammenfassung Hintergrund Trotz steigender Inzidenz ist die optimale chirurgische Versorgung des Adenokarzinoms des ösophagogastralen Übergangs (AEG) Typ II weiterhin Gegenstand aktueller Forschung. Ziel dieser Untersuchung ist es, Überlebens- und Rezidivraten von Patienten zu vergleichen, die sich entweder einer transhiatal erweiterten Gastrektomie (TEG) oder einer thorakoabdominellen Ösophagektomie (TAE) unterzogen. Material und Methoden Es handelt es sich um eine retrospektive populationsbasierte Kohortenstudie (n = 272) auf der Basis von Krebsregisterdaten. Berücksichtigt wurden alle Patienten, die zwischen 2002 und 2020 an einem AEG Typ II erkrankten. Während 63 Patienten mittels TAE operiert wurden, gehören der Gruppe der TEG 209 Patienten an. Um das Gesamtüberleben, Rezidivraten und rezidivfreies Überleben zu untersuchen, wurden die Kaplan-Meier-Methode sowie uni- und multivariable Cox-Regressionen angewendet. Ergebnisse Zwischen beiden Operationsgruppen gab es bezüglich des Gesamtüberlebens keinen signifikanten Unterschied (p = 0,333). Allerdings ließ die Richtung der HR im Zeitraum von 2016 bis 2020 eine mögliche Tendenz in Richtung der TAE erkennen (p = 0,058). Im Gegensatz dazu ergab der Kaplan-Meier-Schätzer ein signifikant höheres Risiko, nach einer TAE an einem Rezidiv zu erkranken (p = 0,049). Dies konnte nicht im Zeitraum 2016 bis 2020, der mehr als die Hälfte der TAE-Patienten umfasst, beobachtet werden (p = 0,993). Hinsichtlich des rezidivfreien Überlebens wurden keine signifikanten Unterschiede detektiert (p = 0,772). Diskussion Die Ergebnisse dieser verhältnismäßig kleinen Kohorte decken sich mit den meisten Studien, die hinsichtlich des Gesamtüberlebens entweder keine Unterschiede oder eine Tendenz in Richtung der TAE fanden. Weitere Arbeiten kamen ebenfalls zu dem Ergebnis, dass es keine signifikanten Unterschiede zwischen den beiden Operationsgruppen bezüglich des rezidivfreien Überlebens gibt. Zusammenfassend lässt sich festhalten, dass es keine signifikanten Unterschiede zwischen TEG und TAE in der Therapie des AEG Typ II gibt.

The first isolated examples of cationic fluoridotungsten(V) complexes are reported as octacoordinate [WF4 (L)4 ]+ (L=C5 H5 N, P(CH3 )3 ). The [WF4 (NC5 H5 )4 ]+ cation is synthesised as its [O3 SCF3 ]- salt upon reaction of WF5 (NC5 H5 )2 with [(CH3 )3 Si(NC5 H5 )][O3 SCF3 ] in excess C5 H5 N, whereas [WF4 {P(CH3 )3 }4 ]+ is accessed directly from WF6 upon reaction with (CH3 )3 SiO3 SCF3 and excess P(CH3 )3 . These salts were characterised by X-ray crystallography and Raman spectroscopy in the solid state. New geometry indices for octacoordinate complexes (τ8 and τ8 ') are introduced, allowing for the facile differentiation of trigonal-dodecahedral (TD) and square-antiprismatic (SA) geometries. This has disambiguated the SA geometries of [WF4 (L)4 ]+ and the geometries of a series of previously reported d0 and d1 MA4 B4 complexes. Computational (DFT-B3LYP) studies of [WF4 (PH3 )4 ]2+/+ and related model systems demonstrate the occurrence of a second-order Jahn-Teller (SOJT) distortion from TD in d0 complexes to SA in d1 complexes, with the degree of SOJT stabilisation being most significant in 5d complexes containing fluorido ligands and monodentate neutral donors.

The Lewis-acid behavior of [SF3][MF6] (M = Sb, As) salts toward mono- and bidentate nitrogen bases was explored. Reactions of [SF3][MF6] with excesses of CH3CN and C5H5N yielded [SF3(L)2]+ (L = CH3...

Due to insufficient and conflicting prospective evidence, the recommendations on when to apply adjuvant radiochemotherapy in early-stage cervical cancer vary between international guidelines. In this population-based study, we evaluated the outcome of patients with early-stage cervical cancer based on risk factors and the adjuvant therapy they received. The effect of primary therapy (surgery and radiochemotherapy RCT, surgery and radiotherapy RT, and surgery alone) on overall survival (OS) and recurrence-free survival (RFS) was evaluated in the complete cohort of 442 patients and in subgroups according to risk profile and nodal status. In low-risk patients, there was no difference in OS (p = 0.276) depending on whether patients received adjuvant therapy or not. Concerning RFS, patients with RT (including one patient with RCT) exhibited a significantly worse outcome compared to the group with surgery alone (p = 0.015). In intermediate-risk patients, the administration of adjuvant RT significantly benefited RFS when compared to surgery only in multivariate analysis (p = 0.031). Concerning OS, no significant influence for adjuvant treatment could be seen (p = 0.354). Though trends towards better OS and RFS could be observed in patients of the high-risk group—both in RCT and RT groups compared to surgery alone—the effects did not prove to be significant. Our study reaffirms the evidence against the use of adjuvant radio(chemo)therapy in low-risk early-stage cervical cancer. In intermediate-, and less pronounced in high-risk patients, however, it seems to be beneficial. The role of adjuvant radio(chemo)therapy in early cervical cancer should be further investigated in prospective randomized trials.

Diabetes mellitus type II (DM) and immune cell infiltration determine patient outcome in many tumor entities. Here we studied a possible link between the metabolic and immune cell status of OSCC patients. Glucose transporter (GLUT) 1 mRNA expression was elevated in all tumor samples, whereas other glycolytic markers such as lactate dehydrogenase (LDH) A or monocarboxylate transporter (MCT) 1 were increased in tumor samples from patients with diabetes and these patients had a significantly worse prognosis compared to non-diabetic patients. Analyses of immune cell infiltration in tumors from diabetic and non-diabetic patients revealed an increased leukocyte (CD45+) infiltration compared to normal mucosa only in non-diabetic patients. In line, the amount of CD3+ T cells per mm2 tumor tissue, was elevated in patients without diabetes and crucial for patient outcome in OSCC patients without diabetes, as compared to healthy mucosa using fluorescence immunohistochemistry in tissue microarrays of 229 patients. Our results demonstrate that diabetes is a prognostic factor for OSCC patients and associates with decreased leukocyte and CD3+ infiltration indicating that metabolic differences between diabetic and non-diabetic patients may alter tumor-infiltrating T cells and thereby determine patient outcome.

The incidence of adenocarcinoma of the esophagogastric junction (AEG) has significantly increased. However, the best surgical treatment for AEG type II is still the subject of current research. The goal of this retrospective cohort study is to compare survival and recurrence rates in patients, who underwent either thoracoabdominal esophagectomy (TAE) or transhiatal extended gastrectomy (TEG).The study is based on a cohort of 272 patients diagnosed with AEG type II between 2002 and 2020, recorded by a population-based clinical cancer registry. Of the included patients 63 underwent TAE and 209 TEG. In order to compare overall survival, recurrence rates, and recurrence free survival, we applied the Kaplan-Meier method, univariable and multivariable Cox regression.Our analysis showed no statistically significant difference concerning overall survival (p = 0.333). However a tendency towards higher survival rates after TAE for the period from 2016-2020 (p = 0,058) is possible. In contrast a significant difference concerning higher cumulative recurrence rates after TAE was found after Kaplan-Meier analysis (p = 0.049). This trend was not observed for the time after 2016 (p = 0.993), in which over 50% of TAE were performed. No differences were found regarding recurrence-free survival (p = 0.772).Our findings in a rather small cohort are concordant with most studies showing no differences or a trend towards better survival after TAE. Other studies found no significant difference regarding recurrence-free survival as well. In conclusion, no significant differences were found between TEG and TAE in surgical treatment of AEG type II.HINTERGRUND: Trotz steigender Inzidenz ist die optimale chirurgische Versorgung des Adenokarzinoms des ösophagogastralen Übergangs (AEG) Typ II weiterhin Gegenstand aktueller Forschung. Ziel dieser Untersuchung ist es, Überlebens- und Rezidivraten von Patienten zu vergleichen, die sich entweder einer transhiatal erweiterten Gastrektomie (TEG) oder einer thorakoabdominellen Ösophagektomie (TAE) unterzogen.Es handelt es sich um eine retrospektive populationsbasierte Kohortenstudie (n = 272) auf der Basis von Krebsregisterdaten. Berücksichtigt wurden alle Patienten, die zwischen 2002 und 2020 an einem AEG Typ II erkrankten. Während 63 Patienten mittels TAE operiert wurden, gehören der Gruppe der TEG 209 Patienten an. Um das Gesamtüberleben, Rezidivraten und rezidivfreies Überleben zu untersuchen, wurden die Kaplan-Meier-Methode sowie uni- und multivariable Cox-Regressionen angewendet.Zwischen beiden Operationsgruppen gab es bezüglich des Gesamtüberlebens keinen signifikanten Unterschied (p = 0,333). Allerdings ließ die Richtung der HR im Zeitraum von 2016 bis 2020 eine mögliche Tendenz in Richtung der TAE erkennen (p = 0,058). Im Gegensatz dazu ergab der Kaplan-Meier-Schätzer ein signifikant höheres Risiko, nach einer TAE an einem Rezidiv zu erkranken (p = 0,049). Dies konnte nicht im Zeitraum 2016 bis 2020, der mehr als die Hälfte der TAE-Patienten umfasst, beobachtet werden (p = 0,993). Hinsichtlich des rezidivfreien Überlebens wurden keine signifikanten Unterschiede detektiert (p = 0,772).Die Ergebnisse dieser verhältnismäßig kleinen Kohorte decken sich mit den meisten Studien, die hinsichtlich des Gesamtüberlebens entweder keine Unterschiede oder eine Tendenz in Richtung der TAE fanden. Weitere Arbeiten kamen ebenfalls zu dem Ergebnis, dass es keine signifikanten Unterschiede zwischen den beiden Operationsgruppen bezüglich des rezidivfreien Überlebens gibt. Zusammenfassend lässt sich festhalten, dass es keine signifikanten Unterschiede zwischen TEG und TAE in der Therapie des AEG Typ II gibt.

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.

The usage of radioactive Technetium99m (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. 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. 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. 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.

The structure of [WOF4]4 has been reinvestigated by low-temperature X-ray crystallography and DFT (MN15/def2-SVPD) studies. Whereas the W4F4 ring of the tetramer is planar and disordered in the solid state, the optimized gas-phase geometry prefers a disphenoidally puckered W4F4 ring and demonstrates asymmetric fluorine bridging. Dissolution of MOF4 (M = Mo, W) in SO2 and SF4 results in the formation of MOF4(OSO) and [SF3][M2O2F9], respectively. Both SO2 adducts and [SF3][Mo2O2F9] have been characterized by X-ray crystallography. The crystal structure of [SF3][Mo2O2F9] reveals dimerization of the ion pair that results in a rare heptacoordinate sulfur center. Optimization of the {[SF3][M2O2F9]}2 dimers in the gas phase, however, results in the elongation of one contact such that the sulfur centers are effectively hexacoordinate. Meanwhile, the crystal structure of [SF3][W2O2F9]·HF instead demonstrates hexacoordinate sulfur centers and a highly unusual coordination to [SF3]+ from [W2O2F9]- through an oxido ligand. While [SF3][W2O2F9] does not decompose at ambient temperature, MOF4(OSO) and [SF3][Mo2O2F9] are unstable toward evolution of SO2 or SF4. Computational studies reveal that the monomerization of [WOF4]4 in the gas phase at 25 °C is thermodynamically unfavorable using SO2, but favorable using SF4, consistent with the relative thermal stabilities of WOF4(OSO) and [SF3][W2O2F9].

Background To evaluate a new procedure in daily clinical practice, it might not be sufficient to rely exclusively on the findings of randomized clinical trials (RCTs). This is the first systematic review providing a synthesis of the most important RCTs and relevant retrospective cohort studies on short- and long-term outcomes of laparoscopic surgery in colon cancer patients. Materials and methods In a literature search, more than 1800 relevant publications on the topic were identified. Relevant RCTs and representative high-quality retrospective studies were selected based on the widely accepted Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) criteria. Finally, 9 RCTs and 14 retrospective cohort studies were included. Results Laparoscopic surgery for colon cancer is associated with a slightly longer duration of surgery, but a variety of studies show an association with a lower rate of postoperative complications and a shorter duration of hospital stay. Particularly in older patients with more frequent comorbidities, laparoscopy seems to contribute to decreasing postoperative mortality. Concerning long-term oncologic outcomes, the laparoscopic and open techniques were shown to be at least equivalent. Conclusion The findings of the existing relevant RCTs on laparoscopic surgery for colon cancer are mostly confirmed by representative retrospective cohort studies based on real-world data; therefore, its further implementation into clinical practice can be recommended.

Crystals of 1,10-phenanthrolinium pentafluoridooxidotungstate(VI), (1,10-phen-H)[WOF5] (1,10-phen = 1,10-phenanthroline, C12H8N2), were obtained upon hydrolysis of WF6(1,10-phen) in CH3CN at 193 K. The (1,10-phen-H)[WOF5] salt contains a rare example of a [WOF5]− anion in which the oxygen and fluorine atoms are ordered. This ordering was verified by bond-valence determinations and structural comparisons with [Xe2F11][WOF5] and Lewis acid-base adducts of WOF4 with main-group donor ligands. The crystal packing is controlled by N—H...F hydrogen bonding that is directed exclusively to the axial F atom as a result of its increased basicity caused by the trans influence of the oxido ligand.

Chalcogen-bonding interactions of SF4 with the polycyclic amines DABCO (C6H12N2) and HMTA (C6H12N4) were studied by low-temperature Raman spectroscopy and X-ray crystallography, revealing the 2:1 adducts C6H12N2·2SF4 and C6H12N4·2SF4 obtained from SF4 solvent. In C6H12N2·2SF4, the sulfur in each SF4 molecule is pentacoordinate with each SF4 coordinated by a single amine group, whereas C6H12N4·2SF4 forms a one-dimensional coordination polymer with three of the four nitrogen atoms in HMTA exhibiting N---S chalcogen bonds: one terminal N---SF4 and one experimentally unprecedented bridging N---(SF4)---N moiety. Solvolysis of C6H12N2·2SF4 by HF yielded crystals of [C6H12N2H]+2F-[SF5]-·6SF4, in which SF4 acts as a chalcogen-bond donor toward N as well as F. Solvolysis of C6H12N4·2SF4 resulted in the formation of the monoprotonated HMTA salt [C6H12N4H]+[HF2]-·SF4. Excess HF also led to isolation of monoprotonated HTMA, as seen in the crystal structure of the [C6H12N4H]+[H2F3]-·HF salt. The reaction of bicyclic, monobasic quinuclidine with SF4 and HF gave [C7H13NH]+F-·3.5SF4, which contains N-H---F----SF4 interactions, as well as an interstitial, disordered SF4 molecule.

The enhanced reactivity of [WF5 ]+ over WF6 has been exploited to access a neutral derivative of elusive WF5 . The reaction of WF6 (NC5 H5 )2 with [(CH3 )3 Si(NC5 H5 )][O3 SCF3 ] in CH2 Cl2 results in quantitative formation of trigonal-dodecahedral [WF5 (NC5 H5 )3 ]+ , which has been characterised as its [O3 SCF3 ]- salt by Raman spectroscopy in the solid state and variable-temperature NMR spectroscopy in solution. The salt is susceptible to slow decomposition in solution at ambient temperature via dissociation of a pyridyl ligand, and the resultant [WF5 (NC5 H5 )2 ]+ is reduced to WF5 (NC5 H5 )2 in the presence of excess C5 H5 N, as determined by 19 F NMR spectroscopy. Pentagonal-bipyramidal WF5 (NC5 H5 )2 was isolated and characterised by X-ray crystallography and Raman spectroscopy in the solid state, representing the first unambiguously characterised WF5 adduct, as well as the first heptacoordinate adduct of a transition-metal pentafluoride. DFT-B3LYP methods have been used to investigate the reduction of [WF5 (NC5 H5 )2 ]+ to WF5 (NC5 H5 )2 , supporting a two-electron reduction of WVI to WIV by nucleophilic attack and diprotonation of a pyridyl ligand in the presence of free C5 H5 N, followed by comproportionation to WV .

Objectives Studies from several countries reported socioeconomic inequalities in lung cancer survival. Hypothesized reasons are differences in cancer care or tumor characteristics. We investigated associations of small-area deprivation and lung cancer survival in Germany and the possible impact of differences in patient, tumor or treatment factors. Materials and Methods Patients registered with a primary tumor of the lung between 2000–2015 in three German population-based clinical cancer registries were included. Area-based socioeconomic deprivation on municipality level was measured with the categorized German Index of Multiple Deprivation. Association of deprivation with overall survival was investigated with Cox regression models. Results Overall, 22,905 patients were included. Five-year overall survival from the least to the most deprived quintile were 17.2%, 15.9%, 16.7%, 15.7%, and 14.4%. After adjustment for patient and tumor factors, the most deprived group had a lower survival compared to the least deprived group (Hazard Ratio (HR) 1.06, 95% confidence interval (CI) 1.01–1.11). Subgroup analyses revealed lower survival in the most deprived compared to the least deprived quintile in patients with stage I-III [HR: 1.14, 95% CI: 1.06–1.22]. The association persisted when restricting to patients receiving surgery but was attenuated for subgroups receiving either chemotherapy or radiotherapy. Conclusion Our results indicate differences in lung cancer survival according to area deprivation in Germany, which were more pronounced in patients with I-III stage cancer. Future research should address in more detail the underlying reasons for the observed inequalities and possible approaches to overcome them.

The aim of this study was to investigate the impact of pre-operative conization on disease-free survival (DFS) in early-stage cervical cancer.In this population-based cohort study we analysed from clinical cancer registries to determine DFS of women with International Federation of Gynecology and Obstetrics (FIGO) stage IA1-IB1 cervical cancer with respect to conization preceding radical hysterectomy performed between January 2010 and December 2015.Out of 993 datasets available for the analysis, 235 patients met the inclusion criteria of the current study. The median follow-up was 5.4 years. During the study period, 28 (11.9%) recurrences were observed. All of these occurred in patients with FIGO stage IB1. For further evaluation, patients with FIGO IB1 tumors2 cm were further analysed and divided into two groups, based on pre-operative conization. Pre-operative conization was associated with a reduced rate of recurrence (p = 0.007), with only three (5.2%) recurrences in this group (CO) compared to 25 recurrences (21.0%) in the group without conization (NCO) preceding radical hysterectomy. DFS was estimated at 79.0% and 94.8% in NCO and CO, respectively (p = 0.008). After adjustment for other prognostic covariates, conization remained a favourable prognostic factor for DFS (HR 0.27; 95% CI 0.08-0.93, p = 0.037). Lymph node involvement was the only unfavourable factor (HR 4.38; 95% CI 1.36-14.14, p = 0.014) in the multivariable analysis.Pre-operative conization is associated with improved DFS in early-stage cervical cancer independently of the surgical approach.

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.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.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).Our study provides compelling evidence that follow-up care should be carried out for longer than 5 years, especially for high-risk patients.

This study compared the perioperative outcomes after the same combination of hyperthermic intraperitoneal chemotherapy (HIPEC) compounds when administered for 90 min vs. 60 min, while all other therapy variables remained constant.A total of 120 patients were included with peritoneal surface malignancy who underwent cisplatin (75 mg/mSixty-five patients (54.2%) in the 60 min and 55 patients (45.8%) in the 90 min HIPEC group were compared. Patients, tumor characteristics, and postoperative complications were comparable. The only significant difference was the rate of chest drain/pleural puncture with an incidence of 18.5% and 34.5% in the 60 min and 90 min group, respectively (p=0.045). After adjustment in a multi-variable regression analysis, the odds for patients with HIPEC 90 min of having chest drain or pleural puncture in comparison to patients with HIPEC 60 min was still higher, but not significant with an OR of 2.238 (95%CI=0.932-5.373; p=0.071).HIPEC administered for 90 min is safe and does not increase perioperative morbidity and mortality compared to the 60-min administration.

Background Treatment of cancer patients in certified cancer centers, that meet specific quality standards in term of structures and procedures of medical care, is a national treatment goal in Germany. However, convincing evidence that treatment in certified cancer centers is associated with better outcomes in patients with pancreatic cancer is still missing. Methods We used patient-specific information (demographic characteristics, diagnoses, treatments) from German statutory health insurance data covering the period 2009–2017 and hospital characteristics from the German Standardized Quality Reports. We investigated differences in survival between patients treated in hospitals with and without pancreatic cancer center certification by the German Cancer Society (GCS) using the Kaplan–Meier estimator and Cox regression with shared frailty. Results The final sample included 45,318 patients with pancreatic cancer treated in 1,051 hospitals (96 GCS-certified, 955 not GCS-certified). 5,426 (12.0%) of the patients were treated in GCS-certified pancreatic cancer centers. Patients treated in certified and non-certified hospitals had similar distributions of age, sex, and comorbidities. Median survival was 8.0 months in GCS-certified pancreatic cancer centers and 4.4 months in non-certified hospitals. Cox regression adjusting for multiple patient and hospital characteristics yielded a significantly lower hazard of long-term, all-cause mortality in patients treated in GCS-certified pancreatic centers (Hazard ratio = 0.89; 95%-CI = 0.85–0.93). This result remained robust in multiple sensitivity analyses, including stratified estimations for subgroups of patients and hospitals. Conclusion This robust observational evidence suggests that patients with pancreatic cancer benefit from treatment in a certified cancer center in terms of survival. Therefore, the certification of hospitals appears to be a powerful strategy to improve patient outcomes in pancreatic cancer care. Trial registration ClinicalTrials.gov (NCT04334239).

Background: This bicentric study evaluated cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) for platinum-sensitive recurrent ovarian cancer patients. Methods: The data of 88 patients with the first peritoneal recurrence of platinum-sensitive epithelial ovarian cancer who underwent CRS and HIPEC from a prospective HIPEC registry were retrospectively investigated. Endpoints were feasibility, chemotherapeutic compound, time of exposure, complications, and overall survival. Results: The median follow-up was 4.7 years (95%-CI 4.6–5.5). The median age was 55.8 years (IQR: 50.3–66.2). Eighty-four patients (95.5%) had high-grade serous histology. The median peritoneal cancer index was 12.0 (IQR: 7.0–20.5). Sixty-five patients (73.9%) had complete cytoreduction (CCR 0). Thirty-eight patients (43.2%) received HIPEC for 60 min, and fifty patients (56.8%) for 90 min. Eighteen patients (20.5%) had grade III to IV complications. One patient (1.1%) died perioperatively. The overall median survival was 43.1 months (95%-CI 34.1–52.2), and the 5-year survival rate was 39.7%. Only 90 min HIPEC and cisplatin were associated with survival. Conclusion: In well-selected patients with platinum-sensitive recurrent ovarian cancer, survival may correlate with complete CRS and 90 min cisplatin-based HIPEC. We confirmed the results of primary OC studies; therefore, this combination should be used for further analysis in the recurrent situation.

Background To evaluate predictive clinico-pathological characteristics on outcome in head and neck melanoma (HNM) in a population-based study with particular emphasis on the prognostic effect of sentinel lymph node biopsy (SLNB), Charlson comorbidity index (CCI) and distinct tumor localisations. Methods Here we primarily describe a retrospective multicenter population-based cohort study with 402 patients having undergone resection with curative intent of HNM between 2010 and 2017. SLNB was used in the diagnosis of 79 HNM patients. Outcome was analyzed, focusing on SLNB, CCI as well as tumor localisation. Overall survival (OAS) und recurrence free survival (RFS) was examined by uni- and multivariate analysis. Results Histopathologically verified lymph node metastasis according to SLNB was associated with impaired RFS in HNM patients (p = 0.004). Especially in higher tumor stages, the sole implementation of SLNB improved survival significantly in the present cohort (p = 0.042). With most of the HNM being located in the face, melanoma of the scalp and neck could be linked to deteriorated patient’s outcome in uni- as well as multivariate analysis (p = 0.021, p = 0.004). Conclusions SLNB is a useful tool in predicting development of distant metastasis after HNM resection with curative intent. Especially in higher tumor stages, performing a SLNB ameliorated survival of HNM patients. Additionally, CCI as well as a distinct tumor localisations in HNM were identified as important risk factors in our population-based cohort study.

The Lewis acid-base adducts MoF

Antimony pentafluoride is a strong Lewis acid and fluoride-ion acceptor that has not previously demonstrated any discreet fluoride-ion donor properties. The first donor-stabilised [SbF